Glycerol-induced hyperhydration (GIH) has been shown to improve fluid retention and endurance performance compared with water-induced hyperhydration. The goal of this article is to report on what is known and unknown about how glycerol-containing hyperhydration solutions (GCHSs) are processed at the stomach and intestine level, propose strategies to improve the efficacy of GIH, and provide research questions for future studies. Through statistical analyses, it is demonstrated that the effectiveness of GCHSs in increasing fluid retention is maximized when fluid ingestion is in the upper range of what is normally administered by studies (~26 ml/kg body weight) and the duration of the protocol is no longer than the time it takes for the glycerol-fluid load to be totally or nearly completely integrated inside the body. The rate of gastric emptying and intestinal absorption of GCHSs is unknown. However, based on an analysis of indirect evidence obtained from human studies, it is proposed that most glycerol (~80 g) and fluid (~1,700 ml) ingested during a typical GIH protocol can be integrated inside the body within 60–90 min. Whether the stress associated with competition could alter these figures is unknown. Research in rats indicates that combining glycerol with glucose at a 3:1 ratio accelerates intestinal absorption of both glycerol and water, thereby potentially improving the efficacy of GIH. Human studies must be conducted to determine how GCHSs are processed by the gastrointestinal system and whether adding glucose to GCHSs could improve the technique’s efficacy.
Ronald J. Maughan, Phillip Watson, Philip A.A. Cordery, Neil P. Walsh, Samuel J. Oliver, Alberto Dolci, Nidia Rodriguez-Sanchez and Stuart D.R. Galloway
of blood volume and plasma osmolality ( Heer et al., 2000 ). Energy content and osmolality of beverages are known to influence the rate of gastric emptying ( Hunt & Stubbs, 1975 ; Vist & Maughan, 1994 , 1995 ). In addition, glucose and electrolyte composition and osmolality affect intestinal water
Alan J. McCubbin, Anyi Zhu, Stephanie K. Gaskell and Ricardo J.S. Costa
-associated gastrointestinal symptoms (GIS; Jeukendrup, 2014 ). More recently, there has been a focus on additional ingredients in CES to further improve gastric emptying, minimize GIS, and enhance carbohydrate absorption and oxidation during exercise ( Sutehall et al., 2018 ). Through the addition of alginate and pectin
G. Patrick Lambert, Timothy L. Bleiler, Ray-Tai Chang, Alan K. Johnson and Carl V. Gisolfi
Eight male runners performed four 2-hr treadmill runs at 65% ~ 0 , m a x in the heat (35"C, 15-20% RH). A different beverage was offered each trial and subjects drank ad libitum for 2 min every 20 min. The beverages were, 6% carbohydrate (CHO) solution (NC 6), 6% carbonated-CHO solution (C 6), 10% CHO solution (NC 10), and 10% carbonated-CHO solution (C 10). NC 6 and C 6 contained 4% sucrose and 2% glucose. NC 10 and C 10 contained high fructose corn syrup. Subjects drank more NC 6 than C 6. Fluid consumption was not different among other trials. During all trials, volume consumed and %ΔPV declined while heart rate and rectal temperature increased (p<0.05). No significant differences occurred between beverages for these variables. Percent body weight lost was greater (p<0.05) for the C 10 trial compared to the NC 6 trial. Neither sweat rate, percent fluid replaced, plasma [Na+], [K+], osmolality, percent of drink volume emptied from the stomach, or glucose concentration differed among trials. Plasma [K+] and osmolality increased (p<0.05) over time. Ratings of fullness and thirst were not different among beverages, although both perceptions increased (p<0.05) with time. It is concluded that (a) carbonation decreased the consumption of the 6% CHO beverage; (b) fluid homeostasis and thermoregulation were unaffected by the solutions ingested; and (c) fluid consumption decreased with time, while ratings of fullness and thirst increased.
Alan J. Ryan, Amy E. Navarre and Carl V. Gisolfi
These studies were done to determine the effect of carbonation and carbohydrate content on either gastric emptying or ad libitum drinking during treadmill exercise in the heat. Four test drinks were used: a 6% carbohydrate, noncarbonated; a 6% carbohydrate, carbonated; a 10% carbohydrate, noncarbonated; and a 10% carbohydrate, carbonated drink. For gastric emptying studies, subjects completed four 1-hr treadmill runs in the heat. They were given 400 mL of test drink at 0 rnin and 200 mL at 15, 30, and 45 min of exercise. For ad libitum drinking studies, subjects completed four 2-hr treadmill runs in the heat. Gastric residual volumes were similar during the four 1-hr runs. During the 2-hr runs, ad libitum drinking of the four beverages was also similar. Mean values for sweat rate, percentage of body weight lost, and percentage of fluid replaced by ad libitum drinking were similar for the four trials. Similar changes in heart rate, rectal temperature, and ratings of perceived exertion were also observed during the four 2-hr treadmill runs. We conclude that the presence of carbonation in a carbohydrate drink did not have a significant effect on either gastric emptying or ad libitum drinking.
Yoram Epstein and Lawrence E. Armstrong
Body water and electrolyte balance are essential to optimal physiological function and health. During exercise, work, or high temperatures, a significant level of dehydration can develop, and the ratio of extracellular to intracellular fluid can change, despite an ample supply of water. Physical and cognitive performance are impaired at 1-2% dehydration, and the body can collapse when water loss approaches 7%. Because fluid needs and intakes vary, formulating one general guideline for fluid replacement is difficult. Knowing the amount of water lost in sweat may enable predicting fluid needs via mathematical models for industrial, athletic, and military scenarios. Sodium imbalance might result from excessive Na+ loss or from gross o verity dration. In most work or exercise lasting < 3-4 hr, the major concern is that fluid be available to prevent heat-related illnesses, which can be prevented if fluid and electrolyte losses are balanced with intake, using the recommendations presented.
Hedy C. Reynolds, Loren Cordain, Mary A. Harris and Sheri Linnell
Thirteen trained runners were studied to determine whether postexercise glucose ingestion contributes to electrocardiogram (ECG) alterations by enhancing decreases in serum potassium (K+) concentrations. For the two randomly ordered trials, subjects ingested a 100 g (25% w/v glucose polymer) drink, either alone or with the addition of 3 g of potassium chloride (KCI), within 15 min following a 90-min run. ECG parameters, serum
Jacqueline R. Berning
Studies investigating fat as a fuel for exercise have found that increasing free fatty acids during exercise tends to spare muscle glycogen due to increased utilization of free fatty acids for energy, which in turn can enhance the capacity for endurance exercise. Medium-chain triglycerides do not delay gastric emptying or absorption. They are broken down by lipase in the stomach and duodenum to glycerol and medium-chain fatty acids (MCFA). Since MCFAs are metabolized as quickly as glucose, it has been speculated that they might provide an alternative carbon source for the muscle during prolonged exercise. While the majority of studies investigating the role of medium-chain triglycerides and exercise have found no sparing effect of muscle glycogen after consumption of medium-chain triglycerides, two recent studies have presented conflicting results. This review will investigate the speculated role of medium-chain triglycerides as an alternative fuel source for exercising muscles and will discuss the possibility that medium-chain triglycerides preserve muscle glycogen during exercise,
Xuguang Zhang, Niamh O’Kennedy and James P. Morton
The provision of exogenous carbohydrate (CHO) in the form of energy gels is regularly practiced among endurance and team sport athletes. However, in those instances where athletes ingest suboptimal fluid intake, consuming gels during exercise may lead to gastrointestinal (GI) problems when the nutritional composition of the gel is not aligned with promoting gastric emptying. Accordingly, the aim of the current study was to quantify the degree of diversity in nutritional composition of commercially available CHO gels intended for use in the global sports nutrition market. We surveyed 31 product ranges (incorporating 51 flavor variants) from 23 brands (Accelerade, CNP, High5, GU, Hammer, Maxim, Clif, USN, Mule, Multipower, Nectar, Carb-Boom, Power Bar, Lucozade, Shotz, TORQ, Dextro, Kinetica, SiS, Zipvit, Maxifuel, Gatorade and Squeezy). Gels differed markedly in serving size (50 ± 22 g: 29–120), energy density (2.34 ± 0.7 kcal/g: 0.83–3.40), energy content (105 ± 24 kcal: 78–204), CHO content (26 ± 6 g: 18–51) and free sugar content (9.3 ± 7.0 g: 0.6–26.8). Most notably, gels displayed extreme variation in osmolality (4424 ± 2883 mmol/kg: 303–10,135) thereby having obvious implications for both GI discomfort and the total fluid intake likely required to optimize CHO delivery and oxidation. The large diversity of nutritional composition of commercially available CHO gels illustrate that not all gels should be considered the same. Sports nutrition practitioners should therefore consider the aforementioned variables to make better-informed decisions regarding which gel product best suits the athlete’s specific fueling and hydration requirements.
Liam Sayer, Nidia Rodriguez-Sanchez, Paola Rodriguez-Giustiniani, Christopher Irwin, Danielle McCartney, Gregory R. Cox, Stuart D.R. Galloway and Ben Desbrow
number of its constituents (i.e., sodium [ Merson et al., 2008 ; Shirreffs & Maughan, 1998 ], carbohydrate [ Evans, Shirreffs, & Maughan, 2009 ; Osterberg et al., 2009 ], and protein [ Hobson & James, 2015 ; James et al., 2012 , 2014 ]), which are believed to delay gastric emptying and/or attenuate