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

Peak Week Carbohydrate Manipulation Practices in Physique Athletes: A Narrative Review

BACKGROUND

Physique athletes are ranked by a panel of judges against the judging criteria of the corresponding division. To enhance on-stage presentation and performance, competitors in certain categories (i.e. bodybuilding and classic physique) achieve extreme muscle size and definition aided by implementing acute "peaking protocols" in the days before competition. Such practices can involve manipulating nutrition and training variables to increase intramuscular glycogen and water while minimising the thickness of the subcutaneous layer. Carbohydrate manipulation is a prevalent strategy utilised to plausibly induce muscle glycogen supercompensation and subsequently increase muscle size. The relationship between carbohydrate intake and muscle glycogen saturation was first examined in endurance event performance and similar strategies have been adopted by physique athletes despite the distinct physiological dissimilarities and aims between the sports.

OBJECTIVES

The aim of this narrative review is to (1) critically examine and appraise the existing scientific literature relating to carbohydrate manipulation practices in physique athletes prior to competition; (2) identify research gaps and provide direction for future studies; and (3) provide broad practical applications based on the findings and physiological reasoning for coaches and competitors.

FINDINGS

The findings of this review indicate that carbohydrate manipulation practices are prevalent amongst physique athletes despite a paucity of experimental evidence demonstrating the efficacy of such strategies on physique performance. Competitors have also been observed to manipulate water and electrolytes in conjunction with carbohydrate predicated on speculative physiological mechanisms which may be detrimental for performance.

CONCLUSIONS

Further experimental evidence which closely replicates the nutritional and training practices of physique athletes during peak week is required to make conclusions on the efficacy of carbohydrate manipulation strategies. Quasi-experimental designs may be a feasible alternative to randomised controlled trials to examine such strategies due to the difficulty in recruiting the population of interest. Finally, we recommend that coaches and competitors manipulate as few variables as possible, and experiment with different magnitudes of carbohydrate loads in advance of competition if implementing a peaking strategy.

Postexercise muscle glycogen synthesis with glucose, galactose, and combined galactose-glucose ingestion

Ingested galactose can enhance postexercise liver glycogen repletion when combined with glucose but effects on muscle glycogen synthesis are unknown. In this double-blind randomized study participants [7 men and 2 women; V̇o2max: 51.1 (8.7) mL·kg-1·min-1] completed three trials of exhaustive cycling exercise followed by a 4-h recovery period, during which carbohydrates were ingested at the rate of 1.2 g·kg-1·h-1 comprising glucose (GLU), galactose (GAL) or galactose + glucose (GAL + GLU; 1:2 ratio). The increase in vastus lateralis skeletal-muscle glycogen concentration during recovery was higher with GLU relative to GAL + GLU [contrast: +50 mmol·(kg DM)-1; 95%CL 10, 89; P = 0.021] and GAL [+46 mmol·(kg DM)-1; 95%CL 8, 84; P = 0.024] with no difference between GAL + GLU and GAL [-3 mmol·(kg DM)-1; 95%CL -44, 37; P = 0.843]. Plasma glucose concentration in GLU was not significantly different vs. GAL + GLU (+ 0.41 mmol·L-1; 95%CL 0.13, 0.94) but was significantly lower than GAL (-0.75 mmol·L-1; 95%CL -1.34, -0.17) and also lower in GAL vs. GAL + GLU (-1.16 mmol·-1; 95%CL -1.80, -0.53). Plasma insulin was higher in GLU + GAL and GLU compared with GAL but not different between GLU + GAL and GLU. Plasma galactose concentration was higher in GAL compared with GLU (3.35 mmol·L-1; 95%CL 3.07, 3.63) and GAL + GLU (3.22 mmol·L-1; 95%CL 3.54, 2.90) with no difference between GLU + GAL (0.13 mmol·L-1; 95%CL -0.11, 0.37) and GLU. Compared with galactose or a galactose + glucose blend, glucose feeding was more effective in postexercise muscle glycogen synthesis. Comparable muscle glycogen synthesis was observed with galactose-glucose coingestion and exclusive galactose-only ingestion.NEW & NOTEWORTHY Postexercise galactose-glucose coingestion or exclusive galactose-only ingestion resulted in a lower rate of skeletal-muscle glycogen replenishment compared with exclusive glucose-only ingestion. Comparable muscle glycogen synthesis was observed with galactose-glucose coingestion and exclusive galactose-only ingestion.

What Is the Evidence That Dietary Macronutrient Composition Influences Exercise Performance? A Narrative Review

The introduction of the needle muscle biopsy technique in the 1960s allowed muscle tissue to be sampled from exercising humans for the first time. The finding that muscle glycogen content reached low levels at exhaustion suggested that the metabolic cause of fatigue during prolonged exercise had been discovered. A special pre-exercise diet that maximized pre-exercise muscle glycogen storage also increased time to fatigue during prolonged exercise. The logical conclusion was that the athlete's pre-exercise muscle glycogen content is the single most important acutely modifiable determinant of endurance capacity. Muscle biochemists proposed that skeletal muscle has an obligatory dependence on high rates of muscle glycogen/carbohydrate oxidation, especially during high intensity or prolonged exercise. Without this obligatory carbohydrate oxidation from muscle glycogen, optimum muscle metabolism cannot be sustained; fatigue develops and exercise performance is impaired. As plausible as this explanation may appear, it has never been proven. Here, I propose an alternate explanation. All the original studies overlooked one crucial finding, specifically that not only were muscle glycogen concentrations low at exhaustion in all trials, but hypoglycemia was also always present. Here, I provide the historical and modern evidence showing that the blood glucose concentration-reflecting the liver glycogen rather than the muscle glycogen content-is the homeostatically-regulated (protected) variable that drives the metabolic response to prolonged exercise. If this is so, nutritional interventions that enhance exercise performance, especially during prolonged exercise, will be those that assist the body in its efforts to maintain the blood glucose concentration within the normal range.

Skeletal Muscle Glycogen Content at Rest and During Endurance Exercise in Humans: A Meta-Analysis

BACKGROUND

Skeletal muscle glycogen is an important energy source for muscle contraction and a key regulator of metabolic responses to exercise. Manipulation of muscle glycogen is therefore a strategy to improve performance in competitions and potentially adaptation to training. However, assessing muscle glycogen in the field is impractical, and there are no normative values for glycogen concentration at rest and during exercise.

OBJECTIVE

The objective of this study was to meta-analyse the effects of fitness, acute dietary carbohydrate (CHO) availability and other factors on muscle glycogen concentration at rest and during exercise of different durations and intensities.

DATA SOURCE AND STUDY SELECTION

PubMed was used to search for original articles in English published up until February 2018. Search terms included muscle glycogen and exercise, filtered for humans. The analysis incorporated 181 studies of continuous or intermittent cycling and running by healthy participants, with muscle glycogen at rest and during exercise determined by biochemical analysis of biopsies.

DATA ANALYSIS

Resting muscle glycogen was determined with a meta-regression mixed model that included fixed effects for fitness status [linear, as maximal oxygen uptake ([Formula: see text]O_2max) in mL·kg^-1·min^-1] and CHO availability (three levels: high, ≥ 6 g·kg^-1 of CHO per day for ≥ 3 days or ≥ 7 g·kg^-1 CHO per day for ≥ 2 days; low, glycogen depletion and low-CHO diet; and normal, neither high nor low, or not specified in study). Muscle glycogen during exercise was determined with a meta-regression mixed model that included fixed effects for fitness status, resting glycogen [linear, in mmol·kg^-1 of dry mass (DM)], exercise duration (five levels, with means of 5, 23, 53 and 116 min, and time to fatigue), and exercise intensity (linear, as percentage of [Formula: see text]O_2max); intensity, fitness and resting glycogen were interacted with duration, and there were also fixed effects for exercise modes, CHO ingestion, sex and muscle type. Random effects in both models accounted for between-study variance and within-study repeated measurement. Inferences about differences and changes in glycogen were based on acceptable uncertainty in standardised magnitudes, with thresholds for small, moderate, large and very large of 25, 75, 150 and 250 mmol·kg^-1 of DM, respectively.

RESULTS

The resting glycogen concentration in the vastus lateralis of males with normal CHO availability and [Formula: see text]O_2max (mean ± standard deviation, 53 ± 8 mL·kg^-1·min^-1) was 462 ± 132 mmol·kg^-1. High CHO availability was associated with a moderate increase in resting glycogen (102, ± 47 mmol·kg^-1; mean ± 90% confidence limits), whereas low availability was associated with a very large decrease (- 253, ± 30 mmol·kg^-1). An increase in [Formula: see text]O_2max of 10 mL·kg^-1·min^-1 had small effects with low and normal CHO availability (29, ± 44 and 67, ± 15 mmol·kg^-1, respectively) and a moderate effect with high CHO availability (80, ± 40 mmol·kg^-1). There were small clear increases in females and the gastrocnemius muscle. Clear modifying effects on glycogen utilisation during exercise were as follows: a 30% [Formula: see text]O_2max increase in intensity, small (41, ± 20 mmol·kg^-1) at 5 min and moderate (87-134 mmol·kg^-1) at all other timepoints; an increase in baseline glycogen of 200 mmol·kg^-1, small at 5-23 min (28-59 mmol·kg^-1), moderate at 116 min (104, ± 15 mmol·kg^-1) and moderate at fatigue (143, ± 33 mmol·kg^-1); an increase in [Formula: see text]O_2max of 10 mL·kg^-1·min^-1, mainly clear trivial effects; exercise mode (intermittent vs. continuous) and CHO ingestion, clear trivial effects. Small decreases in utilisation were observed in females (vs. males: - 30, ± 29 mmol·kg^-1), gastrocnemius muscle (vs. vastus lateralis: - 31, ± 46 mmol·kg^-1) and running (vs. cycling: - 70, ± 32 mmol·kg^-1).

CONCLUSION

Dietary CHO availability and fitness are important factors for resting muscle glycogen. Exercise intensity and baseline muscle glycogen are important factors determining glycogen use during exercise, especially with longer exercise duration. The meta-analysed effects may be useful normative values for prescription of endurance exercise.

Nutritional Peak Week and Competition Day Strategies of Competitive Natural Bodybuilders

Bodybuilders utilize peaking strategies in a bid to fine-tune their aesthetics for competition day. The most prevalent peaking strategies utilized by natural bodybuilders are unreported in the current literature. Eighty-one (M-59, F-22) natural bodybuilders were recruited from competitions during the 2016 and 2017 British Natural Bodybuilder Federation seasons. Competitors completed a 34-item questionnaire designed to investigate peaking and contest day strategies. The questionnaire listed commonly utilized peaking strategies and provided additional space for qualitative information. Analysis of the data indicated that carbohydrate (CHO), water, and sodium manipulation were the most commonly utilized peaking strategies. The consumption of high glycemic index CHO was the most common competition day strategy. Only 6.2% of competitors reported following their regular diet the week prior to competition. The CHO manipulation strategies followed were similar to classical CHO loading, whereby bodybuilders attempt to maximize muscle glycogen concentrations. Furthermore, bodybuilders attempted to remove superfluous water by exploiting the diuretic/polyuria effect associated with water loading/restriction. The potentially deleterious effects of peaking on bodybuilders' health is considered and the efficacy of these strategies to enhance appearance is discussed. The findings of the present investigation are likely to be of interest to bodybuilders and their coaches.

Toward a Common Understanding of Diet-Exercise Strategies to Manipulate Fuel Availability for Training and Competition Preparation in Endurance Sport

From the breakthrough studies of dietary carbohydrate and exercise capacity in the 1960s through to the more recent studies of cellular signaling and the adaptive response to exercise in muscle, it has become apparent that manipulations of dietary fat and carbohydrate within training phases, or in the immediate preparation for competition, can profoundly alter the availability and utilization of these major fuels and, subsequently, the performance of endurance sport (events >30 min up to ∼24 hr). A variety of terms have emerged to describe new or nuanced versions of such exercise-diet strategies (e.g., train low, train high, low-carbohydrate high-fat diet, periodized carbohydrate diet). However, the nonuniform meanings of these terms have caused confusion and miscommunication, both in the popular press and among the scientific community. Sports scientists will continue to hold different views on optimal protocols of fuel support for training and competition in different endurance events. However, to promote collaboration and shared discussions, a commonly accepted and consistent terminology will help to strengthen hypotheses and experimental/experiential data around various strategies. We propose a series of definitions and explanations as a starting point for a more unified dialogue around acute and chronic manipulations of fat and carbohydrate in the athlete's diet, noting philosophies of approaches rather than a single/definitive macronutrient prescription. We also summarize some of the key questions that need to be tackled to help produce greater insight into this exciting area of sports nutrition research and practice.

Effects of Creatine and Carbohydrate Loading on Cycling Time Trial Performance

INTRODUCTION

Creatine (Cr) and carbohydrate loadings are dietary strategies used to enhance exercise capacity. This study examined the metabolic and performance effects of a combined CR and CHO loading regiment on time trial (TT) cycling bouts.

METHODS

Eighteen well-trained (~65 mL·kg·min V˙O2peak) men completed three performance trials (PT) that comprised a 120-km cycling TT interspersed with alternating 1- and 4-km sprints (six sprints each) performed every 10 km followed by an inclined ride to fatigue (~90% V˙O2peak). Subjects were pair matched into either CR-loaded (20 g·d for 5 d + 3 g·d for 9 d) or placebo (PLA) groups (n = 9) after the completion of PT1. All subjects undertook a crossover application of the carbohydrate interventions, consuming either moderate (6 g·kg body mass (BM) per day; MOD) or CHO-loaded (12 g·kg BM·d; LOAD) diets before PT2 and PT3. Muscle biopsies were taken before PT1, 18 h after PT1, and before both PT2 and PT3.

RESULTS

No significant differences in overall TT or inclined ride times were observed between intervention groups. PLA + LOAD improved power above baseline (P < 0.05) during the final 1-km sprint, whereas CR + MOD and CR + LOAD improved power (P < 0.05) during the final 4-km sprint. Greater power was achieved with MOD and LOAD compared with baseline with PLA (P < 0.05). CR increased pre-PT BM compared with PLA (+1.54% vs +0.99% from baseline). CR + LOAD facilitated greater [total CR] (P < 0.05 vs baseline) and muscle [glycogen] (P < 0.01 vs baseline and MOD) compared with PLA + LOAD. Mechanistic target of rapamycin decreased from baseline after glycogen depletion (~30%; P < 0.05).

CONCLUSIONS

Power output in the closing sprints of exhaustive TT cycling increased with CR ingestion despite a CR-mediated increase in weight. CR cosupplemented with carbohydrates may therefore be beneficial strategy for late-stage breakaway moments in endurance events.

A systematic review and meta-analysis of carbohydrate benefits associated with randomized controlled competition-based performance trials

Background

Carbohydrate supplements are widely used by athletes as an ergogenic aid before and during sports events. The present systematic review and meta-analysis aimed at synthesizing all available data from randomized controlled trials performed under real-life conditions.

Methods

MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched systematically up to February 2015. Study groups were categorized according to test mode and type of performance measurement. Subgroup analyses were done with reference to exercise duration and range of carbohydrate concentration. Random effects and fixed effect meta-analyses were performed using the Software package by the Cochrane Collaboration Review Manager 5.3.

Results

Twenty-four randomized controlled trials met the objectives and were included in the present systematic review, 16 of which provided data for meta-analyses. Carbohydrate supplementations were associated with a significantly shorter exercise time in groups performing submaximal exercise followed by a time trial [mean difference −0.9 min (95 % confidence interval −1.7, −0.2), p = 0.02] as compared to controls. Subgroup analysis showed that improvements were specific for studies administering a concentration of carbohydrates between 6 and 8 % [mean difference −1.0 min (95 % confidence interval −1.9, −0.0), p = 0.04]. Concerning groups with submaximal exercise followed by a time trial measuring power accomplished within a fixed time or distance, mean power output was significantly higher following carbohydrate load (mean difference 20.2 W (95 % confidence interval 9.0, 31.5), p = 0.0004]. Likewise, mean power output was significantly increased following carbohydrate intervention in groups with time trial measuring power within a fixed time or distance (mean difference 8.1 W (95 % confidence interval 0.5, 15.7) p = 0.04].

Conclusion

Due to the limitations of this systematic review, results can only be applied to a subset of athletes (trained male cyclists). For those, we could observe a potential ergogenic benefit of carbohydrate supplementation especially in a concentration range between 6 and 8 % when exercising longer than 90 min.

Electronic supplementary material

The online version of this article (doi:10.1186/s12970-016-0139-6) contains supplementary material, which is available to authorized users.

Rethinking fat as a fuel for endurance exercise

A key element contributing to deteriorating exercise capacity during physically demanding sport appears to be reduced carbohydrate availability coupled with an inability to effectively utilize alternative lipid fuel sources. Paradoxically, cognitive and physical decline associated with glycogen depletion occurs in the presence of an over-abundance of fuel stored as body fat that the athlete is apparently unable to access effectively. Current fuelling tactics that emphasize high-carbohydrate intakes before and during exercise inhibit fat utilization. The most efficient approach to accelerate the body's ability to oxidize fat is to lower dietary carbohydrate intake to a level that results in nutritional ketosis (i.e., circulating ketone levels >0.5 mmol/L) while increasing fat intake for a period of several weeks. The coordinated set of metabolic adaptations that ensures proper interorgan fuel supply in the face of low-carbohydrate availability is referred to as keto-adaptation. Beyond simply providing a stable source of fuel for the brain, the major circulating ketone body, beta-hydroxybutyrate, has recently been shown to act as a signalling molecule capable of altering gene expression, eliciting complementary effects of keto-adaptation that could extend human physical and mental performance beyond current expectation. In this paper, we review these new findings and propose that the shift to fatty acids and ketones as primary fuels when dietary carbohydrate is restricted could be of benefit for some athletes.

The effect of double--blind carbohydrate ingestion during 60 km of self-paced exercise in warm ambient conditions

This study evaluated double blind ingestions of placebo (PLA) versus 6% carbohydrate (CHO) either as capsules (c) or beverage (b) during 60 km self-paced cycling in the heat (32°C and 50% relative humidity). Ten well-trained males (mean ± SD: 26±3 years; 64.5±7.7 kg and 70.7±8.8 ml.kg⁻¹.min⁻¹ maximal oxygen consumption) completed four separate 60 km time trials (TT) punctuated by 1 km sprints (14, 29, 44, 59 km) whilst ingesting either PLA_b or PLA_c or CHO_b or CHO_c. The TT was not different among treatments (PLA_b 130.2±11.2 min, CHO_b 140.5±18.1 min, PLA_c 143.1±29.2 min, CHO_c 137.3±20.1 min; P>0.05). Effect size (Cohen’s d) for time was only moderate when comparing CHO_b – PLA_b (d = 0.68) and PLA_b – PLA_c (d = 0.57) whereas all other ES were ‘trivial’ to ‘small’. Mean speed throughout the trial was significantly higher for PLA_b only (P<0.05). Power output was only different (P<0.05) between the sprints and low intensity efforts within and across conditions. Core and mean skin temperatures were similar among trials. We conclude that CHO ingestion is of little or no benefit as a beverage compared with placebo during 60 km TT in the heat.

Strategies of dietary carbohydrate manipulation and their effects on performance in cycling time trials

The relationship between carbohydrate (CHO) availability and exercise performance has been thoroughly discussed. CHO improves performance in both prolonged, low-intensity and short, high-intensity exercises. Most studies have focused on the effects of CHO supplementation on the performance of constant-load, time-to-exhaustion exercises. Nevertheless, in the last 20 years, there has been a consistent increase in research on the effects of different forms of CHO supplementation (e.g., diet manipulation, CHO supplementation before or during exercise) on performance during closed-loop exercises, such as cycling time trials (TTs). A TT is a highly reproducible exercise and reflects a more realistic scenario of competition compared with the time-to-exhaustion test. CHO manipulation has been performed in various time periods, such as days before, minutes before, during a TT or in a matched manner (e.g. before and during a TT). The purpose of this review is to address the possible effects of these different forms of CHO manipulation on the performance during a cycling TT. Previous data suggest that when a high-CHO diet (~70% of CHO) is consumed before a TT (24-72 h before), the mean power output increases and reduces the TT time. When participants are supplemented with CHO (from 45 to 400 g) prior to a TT (from 2 min to 6 h before the TT), mean power output and time seem to improve due to an increase in CHO oxidation. Similarly, this performance also seems to increase when participants ingest CHO during a TT because such consumption maintains plasma glucose levels. A CHO mouth rinse also improves performance by activating several brain areas related to reward and motor control through CHO receptors in the oral cavity. However, some studies reported controversial results concerning the benefits of CHO on TT performance. Methodological issues such as time of supplementation, quantity, concentration and type of CHO ingested, as well as the TT duration and intensity, should be considered in future studies because small variations in any of these factors may have beneficial or adverse effects on TT performance.

Carbohydrates and exercise performance in non-fasted athletes: a systematic review of studies mimicking real-life

There is a consensus claiming an ergogenic effect of carbohydrates ingested in the proximity of or during a performance bout. However, in performance studies, the protocols that are used are often highly standardized (e.g. fasted subjects, constant exercise intensity with time-to-exhaustion tests), and do not necessarily reflect competitive real-life situations. Therefore, we aimed at systematically summarizing all studies with a setting mimicking the situation of a real-life competition (e.g., subjects exercising in the postprandial state and with time-trial-like performance tests such as fixed distance or fixed time tests). We performed a PubMed search by using a selection of search terms covering inclusion criteria for sport, athletes, carbohydrates, and fluids, and exclusion criteria for diseases and animals. This search yielded 16,658 articles and the abstract of 16,508 articles contained sufficient information to identify the study as non-eligible for this review. The screening of the full text of the remaining 150 articles yielded 17 articles that were included in this review. These articles described 22 carbohydrate interventions covering test durations from 26 to 241 min (mostly cycling). We observed no performance improvement with half of the carbohydrate interventions, while the other half of the interventions had significant improvement between 1% and 13% (improvement with one of five interventions lasting up to 68 min and with 10 of 17 interventions lasting between 70 and 241 min). Thus, when considering only studies with a setting mimicking real-life competition, there is a mixed general picture about the ergogenic effect of carbohydrates ingested in the proximity of or during a performance bout with an unlikely effect with bouts up to perhaps 70 min and a possible but not compelling ergogenic effect with performance durations longer than about 70 min.

The limitations of the constant load and self-paced exercise models of exercise physiology

The fundamental tenets of exercise physiology are to describe energy transformations during physical work and make predictions about physical performance during different conditions. Historically, the most popular method to observe such responses during exercise has been the constant load or fixed intensity protocol based largely on the assumption that there is a threshold response of the organism under given conditions. However, constant load exercise does not fully allow for randomness or variability as the biological system is overridden by a predetermined externally imposed load which cannot be altered. Conversely, in self-regulated (paced) exercise there is almost an immediate reduction in power output and muscle recruitment upon commencing exercise. This observation suggests the existence of a neural inhibitory command processes. This difference in regulation demonstrates the inherent importance of variability in the biological system; for in tightly controlled energy expenditure, as is the case during constant load exercise, sensory cues cannot be fully integrated to provide a more appropriate response to the given task. The collective evidence from conventional constant load versus self-regulated exercise studies suggest that energy transformations are indeed different so that the inherent biological variability accounts for the different results achieved by the two experimental paradigms.

The effects of carbohydrate intake and muscle glycogen content on self-paced intermittent-sprint exercise despite no knowledge of carbohydrate manipulation

The aim of this study was to determine the effects of carbohydrate (CHO) ingestion and muscle glycogen content, without the influence of knowledge of CHO consumption, on intermittent-sprint performance. Ten males completed two conditions on two consecutive days. Day 1 involved 2 × 40 min of leg cycling separated by 15 min of arm cycling, followed by an overnight diet consuming either a high [HCHO; 7 g/kg body weight (bw)] or low (LCHO; 2 g/kg bw) CHO diet. Participants were blinded to the knowledge CHO was being examined or manipulated. Day 2 included a 60-min intermittent-sprint exercise (ISE) protocol that included 15-m maximal sprints every minute and self-paced efforts of varying intensities. Pre and post-ISE muscle biopsies were obtained on Day 2. Pre- and post-exercise maximal voluntary torque (MVT), voluntary activation (VA) and twitch contractile properties were assessed during 15 maximal isometric contractions. Blood glucose and lactate, heart rate (HR) and rating of perceived exertion (RPE) were also recorded. Pre-ISE muscle glycogen was greater in HCHO compared with LCHO (597 ± 115 vs. 318 ± 72 mmol kg dry weight; P = 0.001). Total distance and hard running distance were 4.9 and 8.1% greater in HCHO, respectively (P = 0.02-0.04). Peak MVT, VA, HR and RPE were not different between conditions (P > 0.05). Blood glucose was higher pre-ISE for LCHO but lower post-ISE compared with HCHO (P < 0.05). These results indicate HCHO improved self-paced exercise intensities during the ISE protocol despite no knowledge of dietary manipulation. Due to the blinded study design, exercise intensities seem manipulated due to peripheral perturbations associated with CHO content rather than a conscious manipulation of exercise intensities.

Effect of prolonged exercise and pre-exercise dietary manipulation on hepatic triglycerides in trained men

The purpose of this study was to examine the effect of exercise and pre-exercise dietary manipulation on hepatic triglyceride concentration (HTGC). HTGC was measured by proton magnetic resonance spectroscopy ((1)H-MRS) before and after 90 min of moderate intensity cycling in six endurance trained males following 67 h of mixed diet (M) and an isocaloric minimal carbohydrate (2%) high fat (83%) diet (HF). Diets were administered by balanced crossover design. Whole-body fat oxidation, plasma-free fatty acid (FFA), glycerol and triglyceride concentrations were significantly elevated during exercise in HF versus M (P < 0.05 for all). There was no significant treatment × time interaction for HTGC (P = 0.368). However, there was a significant net increase in HTGC (time effect) during the combined 6 h exercise and post-exercise period (P = 0.037). In conclusion, we observed no measurable net change in the hepatic triglyceride pool across a period involving a prolonged exercise bout. Furthermore, manipulation of pre-exercise dietary intake did not influence the interaction between the hepatic triglyceride concentration and exercise in lean trained men. This supports the contention that hepatic triglycerides do not meaningfully contribute to the high rate of fat oxidation observed during acute exercise, or the enhancement of this with regular exercise training and/or pre-exercise dietary manipulation.

The placebo effect in sports performance: a brief review

The placebo effect, with its central role in clinical trials, is acknowledged as a factor in sports medicine, although until recently little has been known about the likely magnitude and extent of the effect in any specific research setting. Even less is known about the prevalence of the effect in competitive sport. The present paper reviews 12 intervention studies in sports performance. All examine placebo effects associated with the administration of an inert substance believed by subjects to be an ergogenic aid. Placebo effects of varying magnitudes are reported in studies addressing sports from weightlifting to endurance cycling. Findings suggest that psychological variables such as motivation, expectancy and conditioning, and the interaction of these variables with physiological variables, might be significant factors in driving both positive and negative outcomes. Programmatic research involving the triangulation of data, and investigation of contextual and personality factors in the mediation of placebo responses may help to advance knowledge in this area.

Fatigue in Tennis

This article reviews research sourced through sport science and medical journal databases (SportDiscus and PubMed) that has attempted to quantify the effects of fatigue on tennis performance. Specific physiological perturbations and their effects on common performance measures, such as stroke velocity and accuracy, are discussed. Current literature does not convincingly support anecdotal assertions of overt performance decrements during prolonged matches or matches played during unfavourable (e.g. hot and humid) environmental conditions. The constraints of field-based research have presented, and continue to present, a methological challenge to investigators within this domain. Limitations of previous investigations have included the following: (i) a restricted measurement approach to the multifaceted skills that form the basis of match performance; (ii) a lack of sensitivity and large variability in skill or performance measures; (iii) usage of non tennis-specific methods to induce fatigue; and (iv) fatigue levels failing to reflect those recorded in match play. Hyperthermia, dehydration and hypoglycaemia have all been identified as common challenges to sustained performance proficiency in tennis, with emerging evidence suggesting central fatigue may also be a key stressor. Mixed results underpin attempts to mitigate physiological compromise and in situ performance deterioration through application of potential ergogenetic strategies (e.g. carbohydrate and caffeine supplementation, and hyperhydration). Methodological limitations are again a likely explanation, but positive findings from other skill-based sports should encourage further research in tennis. To date, tennis has largely relied on traditional methods to measure performance and has not yet realised the benefits of new sports science methods. Future research is encouraged to adopt methodological approaches that capture the multi-dimensional nature of tennis. This can be achieved through the incorporation of multifaceted performance assessment (i.e. perceptual-cognitive and biomechanical measurement approaches), the improvement of measurement sensitivity in the field setting and through the use of experimental settings that accurately simulate the energetic demands of match play.

Efeitos do consumo prévio de carboidratos sobre a resposta glicêmica e desempenho

INTRODUÇÃO E OBJETIVO: A nutrição é uma importante ferramenta dentro da prática desportiva. Dentre os nutrientes, os carboidratos destacam-se como uma fonte energética importante. Dessa forma, o objetivo deste trabalho foi verificar a influência da resposta glicêmica no desempenho de indivíduos saudáveis, após a ingestão de bebidas com diferentes tipos de carboidratos. MÉTODOS: Foram avaliados 10 voluntários, do sexo masculino, com idade de 23 ± 2,1 anos. Os voluntários preencheram recordatório alimentar de três dias e de atividade física. Foram realizadas avaliações antropométricas e teste de cargas progressivas em cicloergômetro para determinação do consumo máximo de oxigênio e limiares ventilatórios. Cada voluntário realizou três testes submáximos na intensidade do 2º limiar ventilatório. Trinta minutos antes de cada teste submáximo, foram ingeridos 250ml de uma das bebidas compostas por: maltodextrina (malto), glicose (glicose), ou suco dietético (placebo). Foram realizadas punções de sangue capilar para determinação dos níveis glicêmicos e lactato sanguíneo. RESULTADOS E CONCLUSÃO: Houve aumento significativo na glicemia após 30 minutos do consumo da bebida malto (87,4 ± 11,2 para 116,9 ± 19,6ml.dl¹). Aos 15 minutos do exercício, houve diminuição nos níveis glicêmicos após o consumo das bebidas malto (116,9 ± 19,6 para 77,6 ± 14,5ml.dl¹) e glicose (113,2 ± 23,5 para 81,8 ± 13,1ml.dl¹) em comparação com o placebo. A ingestão da bebida glicose provocou aumento significativo na freqüência cardíaca durante o exercício (167,7 ± 14,2 e 177,1 ± 10,4bpm). O consumo de bebidas com diferentes tipos de carboidratos e de alto índice glicêmico antes do exercício não foi capaz de alterar o desempenho dos voluntários; entretanto, ocasionou alterações na glicemia e na freqüência cardíaca durante o exercício. Embora se especule que oscilações na glicemia durante o exercício possam prejudicar o desempenho em exercícios de longa duração, esse fato não foi verificado em nosso estudo.

Effect of altered pre-exercise carbohydrate availability on selection and perception of effort during prolonged cycling

This study assessed the effect of altered carbohydrate (CHO) availability on self-selected work rate during prolonged time-trial cycling. Eight endurance-trained men undertook two experimental cycling time-trials after glycogen-depleting exercise and 2 days of: (a) high (9.3 +/- 0 g CHO kg(-1) day(-1)) (HC) and (b) low CHO intakes (0.6 +/- 0.1 g CHO kg(-1) day(-1)) (LC), via a double-blinded crossover design. All feedback regarding performance was removed during both exercise trials. Self-selected external power output was not different during the first 2 h of exercise between experimental conditions (P > 0.05), despite reported sensations of increased tiredness before and during exercise, significantly reduced whole body CHO oxidation (P < 0.05), plasma lactate concentrations (P < 0.05) and earlier onset of fatigue during exercise in LC versus HC. Perceived exertion was not different throughout exercise between conditions (P > 0.05). Mean power output declined significantly in LC versus HC (P < 0.05) after approximately 2 h of exercise, and was associated with significant reductions in cadence, heart rate and plasma glucose concentration (P < 0.05). These results demonstrate that when compared with time-trial cycling performed after a HC diet, reduced CHO availability does not initially alter self-selected work rate in endurance athletes who are deceived of their CHO status prior to exercise. This finding suggests that reduced work rate during exercise following lowered CHO intake may, in part, be a consequence of the subject's awareness of dietary CHO restriction rather than solely a physiologically mediated action. Further research is required to distinguish the influence of circulating glucose and peripheral glycogen availability on pacing strategy during prolonged exercise.

Gender differences in carbohydrate metabolism and carbohydrate loading

Prior to endurance competition, many endurance athletes participate in a carbohydrate loading regimen in order to help delay the onset of fatigue. The "classic" regimen generally includes an intense glycogen depleting training period of approximately two days followed by a glycogen loading period for 3–4 days, ingesting approximately 60–70% of total energy intake as carbohydrates, while the newer method does not consist of an intense glycogen depletion protocol. However, recent evidence has indicated that glycogen loading does not occur in the same manner for males and females, thus affecting performance. The scope of this literature review will include a brief description of the role of estradiol in relation to metabolism and gender differences seen in carbohydrate metabolism and loading.

Muscle triglyceride and glycogen in endurance exercise: implications for performance

The importance of muscle glycogen as a metabolic substrate in sustaining prolonged exercise is well acknowledged. Being stored in proximity to the site of contraction and able to sustain high rates of adenosine diphosphate (ADP) phosphorylation, glycogen is viewed as the primary fuel for the maintenance of exercise of a moderate to intense nature. As such, to ensure optimal exercise performance, endurance athletes are encouraged to maximise the availability of muscle glycogen through the ingestion of a high carbohydrate (CHO) diet prior to competition. The skeletal muscle cell also contains significant quantities of triglyceride. Recent improvements in the ability to measure these intramyocellular triglyceride (IMTG) stores have confirmed that IMTG acts as a significant fuel substrate during prolonged exercise. While early research of the role of muscle glycogen in endurance exercise provided clear prescriptive information for the endurance-trained athlete, no such direction for optimising exercise performance is yet apparent from research concerning IMTG. In this article, we review the processes of muscle glycogen and triglyceride storage and metabolism. Attention is given to the effects of short-term alterations in diet on muscle substrate, particularly IMTG storage, and the implications of this to endurance exercise performance and competition preparation. We demonstrate that like glycogen, IMTG formation may be relatively rapid, and its storage predominates under conditions that promote minimal glycogen formation. This observation suggests that the role of IMTG is to maintain a readily available substrate to ensure that physical activity of a moderate nature can be performed when glycogen availability is not optimal. Under these conditions, IMTG may offer a similar availability of energy as glycogen in the endurance-trained athlete. Given the potential value of this substrate, the possibility of maximising IMTG storage without compromising glycogen availability prior to competition is considered.

Pre-exercise carbohydrate and fat ingestion: effects on metabolism and performance

A key goal of pre-exercise nutritional strategies is to maximize carbohydrate stores, thereby minimizing the ergolytic effects of carbohydrate depletion. Increased dietary carbohydrate intake in the days before competition increases muscle glycogen levels and enhances exercise performance in endurance events lasting 90 min or more. Ingestion of carbohydrate 3-4 h before exercise increases liver and muscle glycogen and enhances subsequent endurance exercise performance. The effects of carbohydrate ingestion on blood glucose and free fatty acid concentrations and carbohydrate oxidation during exercise persist for at least 6 h. Although an increase in plasma insulin following carbohydrate ingestion in the hour before exercise inhibits lipolysis and liver glucose output, and can lead to transient hypoglycaemia during subsequent exercise in susceptible individuals, there is no convincing evidence that this is always associated with impaired exercise performance. However, individual experience should inform individual practice. Interventions to increase fat availability before exercise have been shown to reduce carbohydrate utilization during exercise, but do not appear to have ergogenic benefits.

Carbohydrate loading and supplementation in endurance-trained women runners

The purpose of this study was to examine the effect of carbohydrate (CHO) augmentation on endurance performance and substrate utilization in aerobically trained women. Eight endurance-trained women completed a 24.2-km (15 mile) self-paced treadmill performance run under three conditions: CHO supplementation (S), CHO loading and supplementation (L+S), and placebo (P). Dietary CHO was approximately 75% of energy intake for L+S and approximately 50% for both S and P. A 6% CHO-electrolyte solution (S and L+S) or placebo (P) was ingested preexercise (6 ml/kg) and every 20 min during exercise (3 ml/kg). Blood glucose was significantly higher at 40, 60, and 100 min during L+S, and at 60, 80, and 100 min during S compared with P (P < 0.05). Blood lactate was significantly higher (P < 0.05) during L+S than S and P. Blood glycerol was significantly lower (P < 0.05) at 20, 80, and 100 min during L+S, and at 80 and 100 min during S than P. The proportion of CHO (%) utilized during exercise was significantly higher (P < 0.05) during L+S (71.3 +/- 3.8%) and S (67.3 +/- 4.3%) than P (59.2 +/- 4.6%). Performance times (P > 0.05) were 132.5 +/- 6.3 min (S), 134.4 +/- 6.3 min (L+S), and 136.6 +/- 7.9 min (P). In conclusion, it appears that when CHO availability in women is increased through CHO loading and/or CHO supplementation, there is a concomitant increase in CHO utilization. However, this may not necessarily result in significantly improved performance.

Glycerol hyperhydration fails to improve endurance performance and thermoregulation in humans in a warm humid environment

It is equivocal whether glycerol hyperhydration improves exercise performance and thermoregulation in the heat. The purpose of this study was to compare the effectiveness of glycerol with water hyperhydration, using a reliable, self-paced variable-intensity cycling protocol under hot, humid conditions. Seven moderately-to-well trained subjects ingested either a solution consisting of 1.2 g kg(-1) body mass (BM) glycerol mixed with 21 ml kg(-1) BM flavoured water (GLY) or placebo (PL), which was flavoured water of equal volume to the GLY trial, 2.5 h before exercise. Following hyperhydration, subjects undertook a self-paced, variable-intensity cycling protocol designed to simulate racing, with the aim being to cycle as great a distance as possible over 60 min. There were no differences in total distance cycled between conditions (29.7+/-5.7 km for PL, 28.9+/-5.7 km for GLY). Power output was not different at any time between conditions. Terminal rectal temperatures were 39.0+/-0.5 degrees C for PL and 38.8+/-0.7 degrees C for GLY and were not significantly different. Heart rate was significantly higher for GLY only during the high-intensity efforts. The sweat rate for GLY was 1.72+/-0.28 l h(-1) (P<0.01) compared with 1.15+/-0.29 l h(-1) for PL. It is concluded that glycerol hyperhydration has no significant advantage over water hyperhydration on performance or thermoregulation during a 1-h, variable-intensity exercise performance.

Intramyocellular triacylglycerol in prolonged cycling with high- and low-carbohydrate availability

Vastus lateralis intramyocellular lipid (IMCL) content was assessed by (1)H-magnetic resonance spectroscopy before and after prolonged time trial cycling bouts of approximately 3-h duration. Six highly trained male cyclists completed a double-blind, randomized, crossover design of two experimental trials after a strenuous exercise bout and 48 h of high (HC) (9.32 +/- 0.08 g. kg(-1). day(-1)) and low (LC) (0.59 +/- 0.21 g. kg(-1). day(-1)) dietary carbohydrate. Resting IMCL content was significantly higher after LC vs. HC (P < 0.01) and was reduced during exercise by 64 and 57%, respectively. IMCL was not different between conditions after exercise (P > 0.05). The approximately twofold increase in IMCL degradation in LC compared with HC suggests that higher rates of whole body lipid metabolism in LC were in part attributable to a greater IMCL utilization. Four subjects experienced reductions of IMCL in excess of 70% during exercise. To our knowledge, this is the first study to report near depletion of IMCL during prolonged cycling, indicating that IMCL, presumably the triacylglycerol component, may be exhausted by prolonged strenuous exercise.

Rapid carbohydrate loading after a short bout of near maximal-intensity exercise

PURPOSE

One limitation shared by all published carbohydrate-loading regimens is that 2-6 d are required for the attainment of supranormal muscle glycogen levels. Because high rates of glycogen resynthesis are reported during recovery from exercise of near-maximal intensity and that these rates could in theory allow muscle to attain supranormal glycogen levels in less than 24 h, the purpose of this study was to examine whether a combination of a short bout of high-intensity exercise with 1 d of a high-carbohydrate intake offers the basis for an improved carbohydrate-loading regimen.

METHODS

Seven endurance-trained athletes cycled for 150 s at 130% VO2peak followed by 30 s of all-out cycling. During the following 24 h, each subject was asked to ingest 12 g.kg-1 of lean body mass (the equivalent of 10.3 g.kg-1 body mass) of high-carbohydrate foods with a high glycemic index.

RESULTS

Muscle glycogen increased from preloading levels (+/- SE) of 109.1 +/- 8.2 to 198.2 +/- 13.1 mmol.kg-1 wet weight within only 24 h, these levels being comparable to or higher than those reported by others over a 2- to 6-d regimen. Densitometric analysis of muscle sections stained with periodic acid-Schiff not only corroborated these findings but also indicated that after 24 h of high-carbohydrate intake, glycogen stores reached similar levels in Type I, IIa, and IIb muscle fibers.

CONCLUSION

This study shows that a combination of a short-term bout of high-intensity exercise followed by a high-carbohydrate intake enables athletes to attain supranormal muscle glycogen levels within only 24 h.

Neural control of force output during maximal and submaximal exercise

A common belief in exercise physiology is that fatigue during exercise is caused by changes in skeletal muscle metabolism. This 'peripheral' fatigue results either from substrate depletion during submaximal exercise or metabolite accumulation during maximal exercise in the exercising muscles. However, if substrate depletion alone caused fatigue, intracellular ATP levels would decrease and lead to rigor and cellular death. Alternatively, metabolite accumulation would prevent any increase in exercise intensity near the end of exercise. At present, neither of these effects has been shown to occur, which suggests that fatigue may be controlled by changes in efferent neural command, generally described as 'central' fatigue. In this review, we examine neural efferent command mechanisms involved in fatigue, including the concepts of muscle wisdom during short term maximal activity, and muscle unit rotation and teleoanticipation during submaximal endurance activity. We propose that neural strategies exist to maintain muscle reserve, and inhibit exercise activity before any irreparable damage to muscles and organs occurs. The finding that symptoms of fatigue occur in the nonexercising state in individuals with chronic fatigue syndrome indicates that fatigue is probably not a physiological entity, but rather a sensory manifestation of these neural regulatory mechanisms.

Reduced neuromuscular activity and force generation during prolonged cycling

We examined neuromuscular activity during stochastic (variable intensity) 100-km cycling time trials (TT) and the effect of dietary carbohydrate manipulation. Seven endurance-trained cyclists performed two 100-km TT that included five 1-km and four 4-km high-intensity epochs (HIE) during which power output, electromyogram (EMG), and muscle glycogen data were analyzed. The mean power output of the 4-km HIE decreased significantly throughout the trial from 319 +/- 48 W for the first 4-km HIE to 278 +/- 39 W for the last 4-km HIE (P < 0.01). The mean integrated EMG (IEMG) activity during the first 4-km HIE was 16.4 +/- 9.8% of the value attained during the pretrial maximal voluntary contraction (MVC). IEMG decreased significantly throughout the trial, reaching 11.1 +/- 5.6% during the last 4-km HIE (P < 0.01). The study establishes that neuromuscular activity in peripheral skeletal muscle falls parallel with reduction in power output during bouts of high-intensity exercise. These changes occurred when <20% of available muscle was recruited and suggest the presence of a central neural governor that reduces the active muscle recruited during prolonged exercise.