ArticlePDF Available

Abstract and Figures

ENDURANCE ATHLETES EXPEND REMARKABLE AMOUNTS OF ENERGY AND CHALLENGE THE RECOVERY PROCESSES OF THEIR BODIES. SCORES OF NUTRITIONAL SUPPLEMENTS ARE MARKETED FOR THEIR ABILITY TO IMPROVE ONE OR BOTH OF THESE PROCESSES. A LIMITED NUMBER OF THESE SUPPLEMENTS HAVE AN APPRECIABLE AMOUNT OF RESEARCH TO SUPPORT THEIR USE BY ENDURANCE ATHLETES. CARBOHYDRATE-ELECTROLYTE SOLUTIONS, CAFFEINE, AND ADDING PROTEIN TO CARBOHYDRATE SUPPLEMENTATION OR MEALS ARE 3 STRATEGIES THAT ARE SCIENTIFICALLY BACKED AND SHOULD BE CONSIDERED AS A TRAINING AID FOR THOSE ENDURANCE ATHLETES WHO COMPETE AND TRAIN ON A REGULAR BASIS.
Content may be subject to copyright.
Supplements for
Endurance Athletes
Chad Kerksick, PhD, ATC, CSCS*D, NSCA-CPT*D
1,2,3
and Mike Roberts, MS, CSCS
1
1
Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma;
2
Section of Endocrinology
and Diabetes, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma;
and
3
Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
SUMMARY
ENDURANCE ATHLETES EXPEND
REMARKABLE AMOUNTS OF EN-
ERGY AND CHALLENGE THE RE-
COVERY PROCESSES OF THEIR
BODIES. SCORES OF NUTRI-
TIONAL SUPPLEMENTS ARE MAR-
KETED FOR THEIR ABILITY TO
IMPROVE ONE OR BOTH OF THESE
PROCESSES. A LIMITED NUMBER
OF THESE SUPPLEMENTS HAVE AN
APPRECIABLE AMOUNT OF RE-
SEARCH TO SUPPORT THEIR USE
BY ENDURANCE ATHLETES. CAR-
BOHYDRATE-ELECTROLYTE SOL-
UTIONS, CAFFEINE, AND ADDING
PROTEIN TO CARBOHYDRATE
SUPPLEMENTATION OR MEALS
ARE 3 STRATEGIES THAT ARE
SCIENTIFICALLY BACKED AND
SHOULD BE CONSIDERED AS A
TRAINING AID FOR THOSE EN-
DURANCE ATHLETES WHO COM-
PETE AND TRAIN ON A REGULAR
BASIS.
INTRODUCTION
Reports of athletes consuming
specific foods, nutrients, or in-
gredients to optimize perfor-
mance can be traced back for
centuries. Endurance athletes, by virtue
of training for their sporting compet-
itions, can expect to burn tens of
thousands of calories. It is estimated
that a typical male endurance athlete
will expend approximately 1,000 kcal
and a female 600–700 kcal when
completing an hour of activity at
approximately 70% of their maximal
oxygen uptake (i.e.,
_
VO
2
max) (59).
With this remarkable demand for
energy and a desire to adopt various
training or nutritional strategies to
maximize performance, the interest in
nutritional supplements to aid in this
process continues to be popular.
In a 2004 survey addressed to 207
collegiate athletes, many of who par-
ticipated in endurance-oriented sports,
only 11% of the respondents claimed
to have never consumed a nutritional
supplement (25). Their reasons for
supplementing included a desire to
increase health and energy levels and
decrease the chance for injury. Al-
though supplements that fulfill the
aforementioned claims do exist, there
are several supplements (albeit, indi-
vidual ingredients or proprietary
blends) which, to date, have not
proven to be beneficial for endurance
performance and/or recovery in labo-
ratory settings (Table 1). Therefore,
this review will attempt to discuss
those nutritional supplements that
have adequate scientific support for
their ability to impact endurance
training and performance. Although
other notable supplements have stud-
ies to support their consideration such
as medium-chain triglycerides, phos-
phates, carnitine, or glycerol supple-
mentation, the conclusions are
equivocal. Currently, the literature
surrounding carbohydrate-electrolyte
solutions (sports drinks), caffeine, and
ingestion of carbohydrate + protein
during exercise and after exercise to
facilitate performance and promote
recovery is widespread and continues
to grow in support.
CARBOHYDRATE-ELECTROLYTE
BEVERAGES
BACKGROUND
In a historical sense, reports surround-
ing the ingestion of sugary candy and
sweets before endurance events go
back the early 1900s. From there,
Swedish scientists in the 1960s re-
ported that high carbohydrate feedings
before and during exercise increased
endurance performance parameters
(43), and a few years later, the first
commercial carbohydrate-electrolyte
drink became available. Although much
of the attention for carbohydrate-
electrolyte beverages has centered on
increasing performance, carbohydrate-
electrolyte beverages can also atten-
uate fatigue, replace lost fluid and
carbohydrate, prevent extraneous los-
ses of important electrolytes, and
assist in thermoregulation during pro-
longed athletic events (15,59). It is
these combinations of effects that make
carbohydrate-electrolyte solutions one
of the most effective nutritional supple-
ments for an endurance athlete (56).
FLUID AND ELECTROLYTE
REPLACEMENT
Endurance athletes can have sweat
rates ranging from 1.2 to 1.7 liters of
bodily fluid (i.e., approximately 2%
bodyweight in a 70 kg athlete) per
hour (63), with the highest docu-
mented sweat rate being 4.2 liters per
KEY WORDS:
carbohydrate; caffeine; electrolyte;
glycogen; performance; sport; exercise;
recovery
Copyright ÓNational Strength and Conditioning Association Strength and Conditioning Journal | www.nsca-lift.org 55
hour (59). Considering that a serious
decrement in performance can occur
after only a 2% reduction in body mass
from fluid and this can occur after only
1 hour (Table 2), endurance athletes
need to take strides to ensure that
optimal fluid rehydration occurs (63).
In this respect, simply taking strides
to adequately replace fluids when
exercising during hot/humid environ-
ments can be ergogenic (performance
enhancing) for an endurance athlete
(56). In addition to fluid loss, losing
electrolytes from the blood as a person
sweats increases as a concern when
prolonged bouts of exercise are un-
dertaken, and only water is used to
replace lost fluids. This situation can
result in the development of hypona-
tremia (low blood sodium levels) and is
a situation that can result in deleterious
health effects including fainting, seiz-
ures, and death (13,52).
Currently, most commercial carbohy-
drate-electrolyte solutions contain any-
where from 50 to 110 mg of sodium
per 8 fluid ounces. The most practical
advice seems to be for athletes to
weigh themselves before and after an
exercise bout and attempt to keep body
mass losses to no more than 1% when
exercising for greater than 90 minutes
(13,53). Considering the wide varia-
tions in the ambient temperature,
humidity, racecourse topography,
placement of fluid stations, distance
to be covered, and so on makes
additional specific recommendations
challenging to meet all situations.
Minimally, athletes could strive to
consume approximately 100 mL of
fluid every 10 minutes resulting in an
hourly ingestion of 600 mL, an amount
that has been shown to help offset
the magnitude of fluid loss seen when
exercising for prolonged periods in hot
and humid conditions (18) but may not
necessarily be enough to offset de-
velopment of dehydration. Table 2
is provided to illustrate the potential
changes in body weight that can occur,
how quickly it can happen, and how
much fluid is needed to offset this
fluid loss.
CARBOHYDRATE REPLACEMENT
During moderate intensity (e.g., ap-
proximately 65–70%
_
VO
2
max) exercise,
carbohydrate is oxidized at a rate of
1 gram of carbohydrate per minute or
60 grams of carbohydrate per hour
(36,38). When considering that endog-
enous carbohydrate stores can become
severely depleted after 60–90 minutes
of prolonged exercise, replacing lost
carbohydrate is a primary concern for
the endurance athlete. Studies have
illustrated that carbohydrate ingestion
during exercise alters hepatic glucose
Table 1
List of popular supplements that have alleged physiological effects in endurance athletes
Performance-enhancing
ingredients
pH and fluid
modulators
Fuel provision
ingredients Recovery-enhancing ingredients
Acetylcholine b-Alanine a-Lipoic acid 5-HT
Carbohydrate-electrolyte
drinks or gels
Carnosine Branched-chain amino acids Adaptogens (i.e., extracts from Rhodiola rosea,
Cordyceps sinensis,Panax ginseng, and so on)
Citrulline Creatine Caffeine Antioxidants (i.e., vitamins C and E, catechins,
polyphenols)
Creatine Polylactate Carbohydrate/electrolyte
drinks or gels
HMB
Dimethylglycine Sodium tablets Creatine Carbohydrate-protein beverages
Ginseng (i.e., extracts
from Panax ginseng)
Sodium bicarbonate L-Carnitine Colostrum
Coenzyme Q10 Echinacea
Iron Sodium citrate Glycerol GABA
Inosine Medium-chain triglycerides Glucosamine and chondroitin sulfate
Phosphatidylserine Modified corn starch L-Glutamine
Smilax (Sarsaparilla root) Phosphate Ketoisocaproate
Taurine Pyruvate
Ribose 5-HT
Synephrine
5-HT = 5-hydroxytryptophan; HMB = b-hydroxy-b-methybutyrate; GABA = g-aminobutyric acid.
VOLUME 32 | NUMBER 1 | FEBRUARY 2010
56
Supplements for Endurance Athletes
output (8,16), but its impact on muscle
glycogen utilization is equivocal.
Nonetheless, ingesting 30–60 grams
of carbohydrate (in any form except
fructose) per hour during exercise
increases time to exhaustion at
predetermined intensity levels and
time-trial performance of varying dis-
tances (2,5,10,11,23,24,37,45, 48,57,65).
Fructose alone is attributed to gastro-
intestinal distress, decreased perfor-
mance, and lower rates of glycogen
resynthesis, likely because of different
digestive kinetics and absorption
mechanisms when compared with
other forms of carbohydrate (12,22).
For this reason, it is not recommended
to ingest fructose unless it is combined
Table 2
Rate of fluid loss and required fluid replacement
Percent of body mass lost (in lbs)
1% 2% 3% 4%
Body mass (lbs) Pounds of body mass lost
140 1.4 2.8 4.2 5.6
160 1.6 3.2 4.8 6.4
180 1.8 3.6 5.4 7.2
200 2 4 6 8
220 2.2 4.4 6.6 8.8
240 2.4 4.8 7.2 9.6
260 2.6 5.2 7.8 10.4
280 2.8 5.6 8.4 11.2
300 3 6 9 12
320 3.2 6.4 9.6 12.8
340 3.4 6.8 10.2 13.6
Sweat rate
Time (min) 0.5 L/h 1 L/h 1.5 L/h 2 L/h 2.5 L/h 3 L/h 3.5 L/h
Amount of fluid lost (in lbs) according to sweat rate
30 0.6 1.1 1.7 2.2 2.8 3.3 3.9
60 1.1 2.2 3.3 4.4 5.5 6.6 7.7
90 1.7 3.3 5.0 6.6 8.3 9.9 11.6
120 2.2 4.4 6.6 8.8 11.0 13.2 15.4
150 2.8 5.5 8.3 11.0 13.8 16.5 19.3
180 3.3 6.6 9.9 13.2 16.5 19.8 23.1
Cups of fluid needed to replace body mass loss
30 1 234567
60 2 4 6 8 11 13 15
90 3 6 10 13 16 19 22
120 4 8 13 17 21 25 30
150 5 111621263237
180 6 131925323844
Strength and Conditioning Journal | www.nsca-lift.org 57
with other carbohydrate sources
(34,64).
Widrick et al. (65) determined that
preexercise muscle glycogen status and
carbohydrate ingestion improved the
time it took for cyclists to complete
a 70 km self-paced time trial. Through-
out exercise, carbohydrate was in-
gested using a 9% carbohydrate
solution at a rate of 116 66 grams of
carbohydrate per trial. When carbohy-
drate was provided, blood glucose
values were sustained and performance
over the last 14% of the 70 km distance
(or 10 km) was greater (65). Similarly,
when cyclists ingested an 8% carbohy-
drate solution before and every 15
minutes throughout a prolonged exer-
cise bout, cycling time to exhaustion
was extended by 47 minutes or a 30%
increase in endurance (45). Trained
runners also experienced increased
time to exhaustion during an intermit-
tent run to fatigue when ingesting
a 6.9% carbohydrate solution before
and every 15 minutes throughout a 90
minute bout of running at intensities
ranging from ;60% to 90% peak heart
rate (48). Lastly, 2 additional studies
further highlighted the importance of
carbohydrate delivery during endur-
ance exercise.
In the first study, Febbraio et al. (23)
had trained cyclists ride at 63% of peak
power for 120 minutes, followed by
completion of a 7 kilojoules per kilo-
gram of body mass time trial while
ingesting various combinations of car-
bohydrate or placebo before and
during exercise. Only during the 2
conditions where carbohydrate was
ingested during exercise (placebo be-
fore exercise + carbohydrate during
exercise and carbohydrate before ex-
ercise + carbohydrate during exercise)
did performance significantly improve
during the exercise trial (Figure 1) (23).
Fielding et al. (24) reported that a more
frequent intake of a 5% carbohydrate
solution (equal amounts of carbohy-
drate in identical concentrations every
30 minutes or every 60 minutes) was
responsible for an improved mainte-
nance of blood glucose over a 4-hour
bike ride, which resulted in a signifi-
cantly longer ride to exhaustion.
Also, recent studies have suggested
that delivering carbohydrate in the
form of a gel effectively supports
glucose levels in the blood and can
improve performance during a field
soccer test of intermittent running to
exhaustion (50) or prolonged cycling at
75%
_
VO
2
peak (55). Although much of
the published literature using carbohy-
drate involves exercise periods of .60
minutes, recent studies have suggested
that carbohydrate ingestion may also
be beneficial for activities less than
60 minutes in duration (2,57); however,
the number of investigations support-
ing this conclusion is limited at the
current time.
Practically, many commercially avail-
able carbohydrate-electrolyte solutions
(Table 3) deliver carbohydrate solu-
tions at a concentration of 6–8%
carbohydrate (e.g., 6–8 grams of car-
bohydrate for every 100 mL of fluid).
At this concentration, consuming
0.5–1.5 cups (4–12 fluid ounces) of
fluid every 10–15 minutes will replace
the amount of carbohydrate that is
oxidized (11,36) and will also help to
replace lost fluids and electrolytes.
In summary, regular consumption of
a carbohydrate-electrolyte solution can
Figure 1. Performance enhancing effect of carbohydrate ingestion before and during prolonged cycling exercise. Data shown
illustrates the amount of time to complete a standardized amount of work after a 120-minute bout of cycling at 65%
_
VO
2
max under 4 conditions: (a) ingestion of a 25.7% carbohydrate solution before and during the exercise bout (white),
(b) ingestion of a sweet placebo before and a 25.7% carbohydrate solution during the exercise bout (light gray), (c)
ingestion of a 25.7% carbohydrate before exercise and a sweet placebo during the exercise bout (dark gray), and (d)
ingesting a sweet placebo before and during the exercise bout (black). Time to complete a standardized amount of work
(7 kJ/kg body mass) was significantly lower (p,0.05) and indicated by when the 25.7% carbohydrate solution was
ingested during the exercise bout. Modified with permission from Febbraio et al. (23).
VOLUME 32 | NUMBER 1 | FEBRUARY 2010
58
Supplements for Endurance Athletes
be an effective strategy for the endur-
ance athlete to replace lost fluid and
electrolytes, sustain blood glucose,
spare glycogen (66), and promote
greater levels of performance. The
interested reader is encouraged to
consult the following reviews
(18,37,38,59).
CAFFEINE
BACKGROUND
Caffeine is a drug that has been used as
a dietary supplement for its ability to
increase endurance performance, spare
glycogen, promote greater fat oxidation,
prevent fatigue, and reduce perceived
effort (3,9,17,19,21,32,42,44,49,60,62).
Caffeine is an alkaloid present in more
than 60 plant species and reports of its
use as a stimulant goes back several
centuries. It is estimated that the mean
caffeine intake in U.S. adults ranges
from 106 to 170 mg/d (40). Upon
ingestion, caffeine enters the blood-
stream quickly (within 15–45 minutes)
and has a half-life of 2.5–7.5 hours. A
number of studies are available report-
ing ergogenic benefits for caffeine at
doses ranging from 3 to 9 mg/kg
(4,9,19,44,60,62). In addition, caffeine
increases serum levels of catechol-
amines and free fatty acids in the blood
(9), leading to an increase in fat
utilization and a sparing of muscle
glycogen while reducing an individu-
al’s perception of effort (3,19,20,49).
PERFORMANCE
Costill et al. (14) in the late 1970s
demonstrated that subjects drinking
caffeinated coffee before exercise were
able to cycle longer and oxidize more
fat for fuel when compared with
placebo-treated subjects (14). A study
by Graham (26) reported that a caffeine
dose of 3–6 mg/kg increased time to
exhaustion, whereas a 9 mg/kg dose
provided no effect when participants
ran on a treadmill at 85%
_
VO
2
max
until volitional fatigue (26). Doherty
and Smith (19) used a meta-analytic
approach and concluded that exercise
test outcomes were improved by
9.1–15.4% when caffeine supplementa-
tion was provided, and this positive
effect appears to be greater in pro-
longed exercise bouts versus graded
or short-term exercise bouts. In this
regard, when running athletes were
provided a caffeine dose of 3 or 6
mg/kg 1 hour before an exhaustive
running exercise bout, running time
increased from 49.4 to 60 minutes (27)
and when combined with a carbohy-
drate-electrolyte beverage, caffeine, at
a dosage of 195 milligrams of caffeine
for every 1 liter of carbohydrate-
electrolyte solution, has been shown
to improve work capacity by 15% dur-
ing a 15-minute cycling trial after a
135-minute exhaustive ride when com-
pared with a decaffeinated carbohydrate-
electrolyte control beverage (17).
Other studies have reported improved
outcomes relative to rowing perfor-
mance (9), high-intensity cycling (21),
and repeated endurance performance
(4). At lower doses (2–3 mg/kg), the
ergogenic response appears to be more
variable (32), which could be attributed
to the athletes’ normal dietary intake
of caffeine. Finally, after following an
exercise and diet protocol to deplete
muscle glycogen stores, trained cyclists
consumed either a high-carbohydrate
meal (4 grams of carbohydrate for
every kilogram of body mass) or an
identical carbohydrate meal with
caffeine added to the meal at a dosage
of 8 milligrams of caffeine for every
kilogram of body mass. After 1 hour of
recovery, muscle glycogen in both
groups increased similarly, but after
4 hours, muscle glycogen was signifi-
cantly greater when caffeine was added
to the carbohydrate meal, resulting in
a 66% increase in the rate of glycogen
resynthesis (Figure 2; 51). These latest
findings are interesting because they
may suggest an ability of caffeine to aid
in the recovery process in addition to
enhancing performance. However, it is
important that the reader understands
that these findings are the first of such
studies to illustrate an ability of caffeine
when combined with carbohydrate to
promote greater glycogen restoration
and more research needs to be con-
ducted before this recommendation
can be more conclusive.
Caffeine is a banned stimulant at urinary
levels of 12 mg/mL, and for this reason,
it should be used with caution if
Table 3
Nutritional content of commercially available carbohydrate-electrolyte
beverages
Beverage
(per 8 oz) Calories
Carbohydrate
(g)
Carbohydrate
(%)
Sodium
(mg)
Gatorade 50 14 6 110
Powerade 70 19 8 55
All Sport 70 19 8 55
HydraFuel 66 16 7 25
Cytomax 66 13 5 53
Exceed 70 17 7 50
10-K 60 15 6 55
Quickick 67 16 7 100
1st Ade 60 16 7 55
Pedialyte 25 6 2.5 253
Coca-Cola 103 27 11 6
Orange juice 104 25 10 6
Water 0 0 0 Low
Strength and Conditioning Journal | www.nsca-lift.org 59
participating in any National Collegiate
Athletic Association or International
Olympic Committee sanctioned events.
Studies have, however, illustrated that
ergogenic benefits are present with
urinary caffeine levels below the banned
threshold (20,44), but athletes are en-
couraged to use caution when involved
in competition. Reports have contended
that while ergogenic, the diuretic effect
of caffeine should be a primary consid-
eration because of the already rapid fluid
and electrolyte loss that typically occurs
during prolonged exercise in a hot/
humid environment (see above). How-
ever, a review of 10 clinical trials by
Armstrong (1) in 2000 refutes this
suggestion and concluded that at com-
mon caffeine doses (100–680 mg), the
diuretic effect of caffeine was similar to
the diuretic effect from water. Similarly,
this contention was later supported
in a study by Millard-Stafford et al. (46)
that also concluded a caffeine +
carbohydrate solution had no negative
impact relative to hydration, sweat rate,
electrolytes, and other related markers.
ADDITION OF PROTEIN TO
CARBOHYDRATE
BACKGROUND
Making some form of carbohydrate
available, irrespective of type, is an
important consideration for the endur-
ance athlete to restore muscle glyco-
gen. Equally as important are timing
considerations because studies have
illustrated that much of the recovery
ability of the muscle is lost after 2 hours
(29). If rapid recovery is not important,
maximal glycogen restoration may
occur either by regularly (every 15–30
minutes) ingesting carbohydrate at
a dose of 1.2 grams of carbohydrate
per kilogram per hour (84–120 grams
of carbohydrate per hour for individ-
uals weighing 70 to 100 kg, respec-
tively) for several hours (33,61) or to
just simply ingest high dietary levels of
carbohydrate (8–10 grams of carbohy-
drate per kilogram per day or 560–
1,000 grams of carbohydrate per day
for individuals weighing 70–100 kg,
respectively), especially if performing
on consecutive days (39). Adding small
amounts of protein to carbohydrate to
maintain a 3:1 or 4:1 carbohydrate to
protein ratio may help to facilitate
greater performance (31,55) and min-
imize muscle damage (41,54,55) while
also promoting maximal recovery of
muscle glycogen (7,28,30,47,58).
PERFORMANCE
When 3 hours of cycling at 45–75%
_
VO
2
max were followed by a time to
exhaustion trial at 85%
_
VO
2
max, par-
ticipants who consumed a 7.75% car-
bohydrate + 1.94% protein solution (a
4:1 carbohydrate to protein ratio) in
200 mL amounts increased time to
exhaustion (26.9 64.5 minutes) when
Table 4
Practical applications for the use of supplements for endurance athletes
Glycogen stores inside the body are limited and may only last for 60–90 minutes of moderate intensity exercise and depend
largely on body mass, recovery efforts, and training volume/intensity of the athlete. Any athlete who exercises
for this duration will need to replace lost carbohydrate.
The number of available dietary supplements to increase endurance performance continues to grow. Those products,
however, which have been supported by science to increase performance, recovery, or health of an endurance athlete,
are limited.
The premise of dietary supplementation is based on the thought that all athletes and coaches follow sound dietary practices
and is currently getting adequate nutrients from their current dietary regimen. In this respect, all strategies discussed
throughout this article have their limitations because variations in dietary intake and other recovery steps can impact
the efficacy of the discussed strategies.
Athletes and coaches should monitor fluid losses during prolonged exercise bouts in hot/humid environments to determine
the rate at which fluid is lost as sweat from the body because many factors can influence an individual’s sweat rate.
Minimally, consuming 100 mL (;0.5 cups) of fluid every 10 minutes has been shown to help offset fluid losses and is
recommended as a baseline recommendation.
Ingesting 4–12 fluid ounces (;0.5–1.5 cups) of a 6–8% carbohydrate-electrolyte solution every 10–15 minutes during
exercise can serve as an effective means to replace lost carbohydrate, fluid, and electrolytes. Athletes and coaches
need to experiment with what timing and dosing strategies work best and understand that every athlete’s response
is different.
Supplementing with caffeine at a dose of 3–6 mg/kg body mass 30–60 minutes before exercise has been shown to
effectively increase different types of endurance performance. Increased caffeine intake can also increase oxidation of fat,
spare glycogen, and reduce the athlete’s perception of effort.
Adding a small amount of protein to a carbohydrate source has been shown to help restore greater levels of muscle
glycogen, increase performance, and prevent the amount of muscle damage that occurs during a prolonged bout
of endurance exercise.
VOLUME 32 | NUMBER 1 | FEBRUARY 2010
60
Supplements for Endurance Athletes
compared with that of a 7.75% carbo-
hydrate (19.7 64.6 minutes) or a
placebo treatment (12.7 63.1 minutes)
(Figure 3; 31). Interestingly, these
findings were replicated when a carbo-
hydrate + protein gel (0.15 grams of
carbohydrate/kg +0.038 grams of pro-
tein/kg) was ingested versus an iden-
tical carbohydrate gel every 15 minutes
during prolonged endurance exercise
bouts to exhaustion (55). Further,
when a carbohydrate (0.8 grams of
carbohydrate/kg body mass) + protein
(0.4 grams of protein/kg body mass)
solution was ingested immediately
after exercise as part of recovery from
an exhaustive cycling trial, subsequent
performance and power production
Figure 2. Skeletal muscle glycogen content immediately, 1 hour, and 4 hours after a prolonged cycling bout to fatigue at 70%
_
VO
2
peak. Open bars signify 1 gram per kilogram of body mass of carbohydrate consumption, whereas closed bars
indicate carbohydrate + 8 milligram per kilogram of body mass of caffeine consumption. During the carbohydrate-only
trial, boluses were ingested within 5 minutes after exercise and 60, 120, and 180 minutes after exercise. During the
carbohydrate + caffeine trial, subjects followed the same carbohydrate ingestion pattern and a total of 8 milligram per
kilogram of body mass caffeine was given in 2 doses immediately and 2 hours after exercise. * = significant difference
from immediate postexercise (p,0.05); # = significant difference from 1-hour postexercise (p,0.05); = significant
difference between trials at 4-hour postexercise (p,0.05). Modified with permission from Pedersen et al. (51).
Figure 3. Time to fatigue during a cycling bout at 85%
_
VO
2
max. Before the time trial, subjects exercised for 30 minutes at 45%
_
VO
2
max and performed 15 33 to 8-minute intervals at 75%
_
VO
2
max interjected with 15 33 to 8-minute active
recovery periods at 45%
_
VO
2
max. Following this 180-minute sequence, subjects cycled to fatigue at 85%
_
VO
2
max. Equal
boluses of each supplement were provided at 10-minute intervals over the 180-minute period before the fatigue test.
* = greater than the placebo (p,0.05); = greater than 7.75% carbohydrate solution. Modified with permission from Ivy
et al. (31).
Strength and Conditioning Journal | www.nsca-lift.org 61
were increased when an additional
exhaustive exercise bout was under-
taken 6 hours later when compared
with carbohydrate ingestion (6).
GLYCOGEN RESYNTHESIS
Adding protein to carbohydrate may
help to promote recovery of lost
muscle glycogen, although these find-
ings are mixed (7,28,30,35,58). For
example, after cycling for 2.5 hours to
deplete muscle glycogen, recovery of
muscle glycogen was measured after
ingesting either carbohydrate or a com-
bination of carbohydrate and protein
(30). After starting with similar levels of
glycogen, cyclists ingested 80 grams of
carbohydrate + 28 grams of protein
+ 6 grams of fat, a lower carbohydrate
(80 grams of carbohydrate) + fat
combination, or a higher carbohydrate
(108 grams of carbohydrate) + fat
combination and the authors found
that muscle glycogen was significantly
higher in the carbohydrate + protein +
fat treatment 4 hours after ingestion
(30). Subsequent studies, however,
have suggested that while high carbo-
hydrate intake (1.2 grams of carbohy-
drate/kg/h or 84–120 grams of
carbohydrate per hour for individuals
weighing 70–100 kg, respectively) may
be all that is needed to promote
maximal glycogen recovery (35,58),
added protein may support muscle
protein synthesis and net protein
balance after exercise (28).
MUSCLE DAMAGE
Additional studies report that a carbo-
hydrate + protein combination, either
in a solution or in a gel, can prevent the
muscle damage associated with pro-
longed endurance exercise when in-
gested during and after prolonged
endurance exercise (54,55). In these
studies, male and female cyclists had
blood levels of creatine kinase, a marker
of muscle damage, determined after
prolonged cycling bouts. The results
indicated that both the carbohydrate +
protein solution and gel significantly
reduced blood levels of creatine kinase
(54,55). Moreover, when 8 endurance
athletes completed approximately 6
hours of exercise at 50%
_
VO
2
max
while ingesting either carbohydrate
(0.7 grams of carbohydrate/kg/h) or
carbohydrate + protein (0.7 grams of
carbohydrate/kg/h + 0.25 grams of
protein/kg/h) every 30 minutes during
exercise, the net protein oxidation rates
(muscle breakdown) were not different
when compared with baseline for
carbohydrate. Carbohydrate + protein
ingestion, however, improved the over-
all net protein balance. Although net
protein balance was still negative,
meaning that more protein breakdown
was occurring than protein synthesis,
these findings suggest that a combina-
tion of carbohydrate + protein may aid
in preventing muscle breakdown and
improve recovery (41).
CONCLUSIONS
Endurance activity places great de-
mands on the metabolic systems of
the human body. Optimal training and
dietary habits are essential for an
athlete to perform at their highest
levels and adequately recovery. Several
dietary supplements are available in
the marketplace targeted to increasing
the performance of endurance athletes.
Many of these, however, lack the
necessary scientific inquiry to be rec-
ommended for their ability to enhance
performance. Practical applications for
the use of supplements for endurance
athletes are presented in Table 4. Much
research is available that supports the
use of carbohydrate-electrolyte solu-
tions before and during a prolonged
exercise bout. These drinks are now
widely available as many commercial
products and are also effective at
maintaining fluid and electrolyte bal-
ance in addition to providing carbo-
hydrate to the body as an energy
source. For more than 40 years,
supplementation with caffeine has
been investigated as an ergogenic aid
and a recent flurry of interest has
reinforced its place as an effective
ergogenic aid for the endurance ath-
lete. Most recently, scientists have
begun to add a small amount of protein
to existing carbohydrate-electrolyte
solutions and have found this addition
can further increase performance,
prevent muscle damage, and assist in
the recovery of muscle glycogen.
Chad Kerksick
is an assistant
professor of exercise
physiology and
director of the
Applied Biochemistry and Molecular
Physiology Laboratory in the Department
of Health and Exercise Science at the
University of Oklahoma in Norman,
Oklahoma.
Mike Roberts is
a doctoral research
and teaching
assistant and
a laboratory
coordinator in the Department of Health
and Exercise Science at the University of
Oklahoma in Norman, Oklahoma.
REFERENCES
1. Armstrong LE. Caffeine, body fluid-
electrolyte balance, and exercise
performance. Int J Sport Nutr Exerc Metab
12: 189–206, 2002.
2. Ball TC, Headley SA, Vanderburgh PM, and
Smith JC. Periodic carbohydrate
replacement during 50 min of high-intensity
cycling improves subsequent sprint
performance. Int J Sport Nutr 5: 151–158,
1995.
3. Bell DG, Jacobs I, and Ellerington K. Effect
of caffeine and ephedrine ingestion on
anaerobic exercise performance. Med Sci
Sports Exerc 33: 1399–1403, 2001.
4. Bell DG and McLellan TM. Effect of
repeated caffeine ingestion on repeated
exhaustive exercise endurance. Med Sci
Sports Exerc 35: 1348–1354, 2003.
5. Below PR, Mora-Rodriguez R, Gonzalez-
Alonso J, and Coyle EF. Fluid and
carbohydrate ingestion independently
improve performance during 1 h of intense
exercise. Med Sci Sports Exerc
27: 200–210, 1995.
6. Berardi JM, Noreen EE, and Lemon PW.
Recovery from a cycling time trial is
enhanced with carbohydrate-protein
supplementation vs. isoenergetic
carbohydrate supplementation. J Int Soc
Sports Nutr 5: 24, 2008.
7. Berardi JM, Price TB, Noreen EE, and
Lemon PW. Postexercise muscle glycogen
VOLUME 32 | NUMBER 1 | FEBRUARY 2010
62
Supplements for Endurance Athletes
recovery enhanced with a carbohydrate-
protein supplement. Med Sci Sports Exerc
38: 1106–1113, 2006.
8. Bosch AN, Dennis SC, and Noakes TD.
Influence of carbohydrate ingestion on fuel
substrate turnover and oxidation during
prolonged exercise. J Appl Physiol
76: 2364–2372, 1994.
9. Bruce CR, Anderson ME, Fraser SF,
Stepto NK, Klein R, Hopkins WG, and
Hawley JA. Enhancement of 2000-m
rowing performance after caffeine
ingestion. Med Sci Sports Exerc 32:
1958–1963, 2000.
10. Coggan AR and Coyle EF. Metabolism
and performance following carbohydrate
ingestion late in exercise. Med Sci Sports
Exerc 21: 59–65, 1989.
11. Coggan AR and Coyle EF. Carbohydrate
ingestion during prolonged exercise:
Effects on metabolism and performance.
Exerc Sport Sci Rev 19: 1–40, 1991.
12. Conlee RK, Lawler RM, and Ross PE.
Effects of glucose or fructose feeding on
glycogen repletion in muscle and liver after
exercise or fasting. Ann Nutr Metab
31: 126–132, 1987.
13. Convertino VA, Armstrong LE, Coyle EF,
Mack GW, Sawka MN, Senay LC Jr, and
Sherman WM. American college of sports
medicine position stand. Exercise and fluid
replacement. Med Sci Sports Exerc
28: 1–7, 1996.
14. Costill DL, Dalsky GP, and Fink WJ. Effects
of caffeine ingestion on metabolism and
exercise performance. Med Sci Sports
10: 155–158, 1978.
15. Coyle EF and Coggan AR. Effectiveness of
carbohydrate feeding in delaying fatigue
during prolonged exercise. Sports Med
1: 446–458, 1984.
16. Coyle EF, Coggan AR, Hemmert MK, and
Ivy JL. Muscle glycogen utilization during
prolonged strenuous exercise when fed
carbohydrate. JApplPhysiol61: 165–172,
1986.
17. Cureton KJ, Warren GL, Millard-Stafford ML,
Wingo JE, Trilk J, and Buyckx M. Caffeinated
sports drink: Ergogenic effects and possible
mechanisms. Int J Sport Nutr Exerc Metab
17: 35–55, 2007.
18. Dennis SC, Noakes TD, and Hawley JA.
Nutritional strategies to minimize fatigue
during prolonged exercise: Fluid,
electrolyte and energy replacement.
J Sports Sci 15: 305–313, 1997.
19. Doherty M and Smith PM. Effects of
caffeine ingestion on exercise testing: A
meta-analysis. Int J Sport Nutr Exerc Metab
14: 626–646, 2004.
20. Doherty M and Smith PM. Effects of
caffeine ingestion on rating of perceived
exertion during and after exercise: A meta-
analysis. Scand J Med Sci Sports 15: 69–78,
2005.
21. Doherty M, Smith P, Hughes M, and
Davison R. Caffeine lowers perceptual
response and increases power output
during high-intensity cycling. J Sports Sci
22: 637–643, 2004.
22. Erickson MA, Schwarzkopf RJ, and
McKenzie RD. Effects of caffeine, fructose,
and glucose ingestion on muscle glycogen
utilization during exercise. Med Sci Sports
Exerc 19: 579–583, 1987.
23. Febbraio MA, Chiu A, Angus DJ, Arkinstall MJ,
and Hawley JA. Effects of carbohydrate
ingestion before and during exercise on
glucose kinetics and performance. JAppl
Physiol 89: 2220–2226, 2000.
24. Fielding RA, Costill DL, Fink WJ, King DS,
Hargreaves M, and Kovaleski JE. Effect of
carbohydrate feeding frequencies and
dosage on muscle glycogen use during
exercise. Med Sci Sports Exerc 17: 472–
476, 1985.
25. Froiland K, Koszewski W, Hingst J, and
Kopecky L. Nutritional supplement use
among college athletes and their sources
of information. Int J Sport Nutr Exerc Metab
14: 104–120, 2004.
26. Graham TE. Caffeine and exercise:
Metabolism, endurance and performance.
Sports Med 31: 785–807, 2001.
27. Graham TE and Spriet LL. Metabolic,
catecholamine, and exercise performance
responses to various doses of caffeine.
J Appl Physiol 78: 867–874, 1995.
28. Howarth KR, Moreau NA, Phillips SM, and
Gibala MJ. Co-ingestion of protein with
carbohydrate during recovery from
endurance exercise stimulates skeletal
muscle protein synthesis in humans. J Appl
Physiol 106: 1394–1402, 2008.
29. Ivy JL. Glycogen resynthesis after exercise:
Effect of carbohydrate intake. Int J Sports
Med 19(Suppl 2): S142–S145, 1998.
30. Ivy JL, Goforth HW Jr, Damon BM,
McCauley TR, Parsons EC, and Price TB.
Early postexercise muscle glycogen
recovery is enhanced with a carbohydrate-
protein supplement. J Appl Physiol
93: 1337–1344, 2002.
31. Ivy JL, Res PT, Sprague RC, and Widzer MO.
Effect of a carbohydrate-protein supplement
on endurance performance during exercise
of varying intensity. Int J Sport Nutr Exerc
Metab 13: 382–395, 2003.
32. Jenkins NT, Trilk JL, Singhal A, O’Connor PJ,
and Cureton KJ. Ergogenic effects of
low doses of caffeine on cycling
performance. Int J Sport Nutr Exerc Metab
18: 328–342, 2008.
33. Jentjens R and Jeukendrup A.
Determinants of post-exercise glycogen
synthesis during short-term recovery.
Sports Med 33: 117–144, 2003.
34. Jentjens RL, Moseley L, Waring RH,
Harding LK, and Jeukendrup AE. Oxidation
of combined ingestion of glucose and
fructose during exercise. J Appl Physiol
96: 1277–1284, 2004.
35. Jentjens RL, van Loon LJ, Mann CH,
Wagenmakers AJ, and Jeukendrup AE.
Addition of protein and amino acids to
carbohydrates does not enhance
postexercise muscle glycogen synthesis.
J Appl Physiol 91: 839–846, 2001.
36. Jeukendrup AE. Carbohydrate intake
during exercise and performance. Nutrition
20: 669–677, 2004.
37. Jeukendrup A, Brouns F, Wagenmakers AJ,
and Saris WH. Carbohydrate-electrolyte
feedings improve 1 h time trial cycling
performance. Int J Sports Med 18: 125–129,
1997.
38. Jeukendrup AE and Jentjens R. Oxidation
of carbohydrate feedings during prolonged
exercise: Current thoughts, guidelines and
directions for future research. Sports Med
29: 407–424, 2000.
39. Keizer HA, Kuipers H, van Kranenburg G,
and Geurten P. Influence of liquid and solid
meals on muscle glycogen resynthesis,
plasma fuel hormone response, and
maximal physical working capacity. Int J
Sports Med 8: 99–104, 1987.
40. Knight CA, Knight I, Mitchell DC, and
Zepp JE. Beverage caffeine intake in US
consumers and subpopulations of interest:
Estimates from the share of intake panel
survey. Food Chem Toxicol 42: 1923–
1930, 2004.
41. Koopman R, Pannemans DL, Jeukendrup AE,
Gijsen AP, Senden JM, Halliday D, Saris WH,
vanLoonLJ,andWagenmakersAJ.
Combined ingestion of protein and
carbohydrate improves protein balance
during ultra-endurance exercise. Am J
Physiol Endocrinol Metab 287: E712–E720,
2004.
42. Kovacs EM, Stegen J, and Brouns F. Effect
of caffeinated drinks on substrate
metabolism, caffeine excretion, and
performance. J Appl Physiol 85: 709–715,
1998.
43. Krogh A and Lindhard J. The relative value
of fat and carbohydrate as sources of
muscular energy: With appendices on the
correlation between standard metabolism
Strength and Conditioning Journal | www.nsca-lift.org 63
and the respiratory quotient during rest and
work. Biochem J 14: 290–363, 1920.
44. Magkos F and Kavouras SA. Caffeine and
ephedrine: Physiological, metabolic and
performance-enhancing effects. Sports
Med 34: 871–889, 2004.
45. McConell G, Snow RJ, Proietto J, and
Hargreaves M. Muscle metabolism during
prolonged exercise in humans: Influence of
carbohydrate availability. J Appl Physiol
87: 1083–1086, 1999.
46. Millard-Stafford ML, Cureton KJ, Wingo JE,
Trilk J, Warren GL, and Buyckx M.
Hydration during exercise in warm, humid
conditions: Effect of a caffeinated sports
drink. Int J Sport Nutr Exerc Metab
17: 163–177, 2007.
47. Nicholas CW, Green PA, Hawkins RD, and
Williams C. Carbohydrate intake and
recovery of intermittent running capacity.
Int J Sport Nutr 7: 251–260, 1997.
48. Nicholas CW, Williams C, Lakomy HK,
Phillips G, and Nowitz A. Influence of
ingesting a carbohydrate-electrolyte
solution on endurance capacity during
intermittent, high-intensity shuttle running.
J Sports Sci 13: 283–290, 1995.
49. Paluska SA. Caffeine and exercise. Curr
Sports Med Rep 2: 213–219, 2003.
50. Patterson SD and Gray SC. Carbohydrate-
gel supplementation and endurance
performance during intermittent high-
intensity shuttle running. Int J Sport Nutr
Exerc Metab 17: 445–255, 2007.
51. Pedersen DJ, Lessard SJ, Coffey VG,
Churchley EG, Wootton AM, Ng T, Watt MJ,
and Hawley JA. High rates of muscle glycogen
resynthesis after exhaustive exercise when
carbohydrate is coingested with caffeine.
J Appl Physiol 105: 7–13, 2008.
52. Rehrer NJ. Fluid and electrolyte balance
in ultra-endurance sport. Sports Med
31: 701–715, 2001.
53. Rehrer NJ, Brouns F, Beckers EJ, and
Saris WH. The influence of beverage
composition and gastrointestinal function
on fluid and nutrient availability during
exercise. Scand J Med Sci Sports
4: 159–172, 1994.
54. Saunders MJ, Kane MD, and Todd MK.
Effects of a carbohydrate-protein beverage
on cycling endurance and muscle damage.
Med Sci Sports Exerc 36: 1233–1238,
2004.
55. Saunders MJ, Luden ND, and Herrick JE.
Consumption of an oral carbohydrate-
protein gel improves cycling endurance
and prevents postexercise muscle damage.
J Strength Cond Res 21: 678–684, 2007.
56. Sawka MN, Burke LM, Eichner ER,
Maughan RJ, Montain SJ, and
Stachenfeld NS. American college of
sports medicine position stand. Exercise
and fluid replacement. Med Sci Sports
Exerc 39: 377–390, 2007.
57. Sugiura K and Kobayashi K. Effect of
carbohydrate ingestion on sprint
performance following continuous and
intermittent exercise. Med Sci Sports Exerc
30: 1624–1630, 1998.
58. Tarnopolsky MA, Bosman M, Macdonald JR,
Vandeputte D, Martin J, and Roy BD.
Postexercise protein-carbohydrate and
carbohydrate supplements increase
muscle glycogen in men and women.
J Appl Physiol 83: 1877–1883,
1997.
59. Tarnopolsky MA, Gibala M, Jeukendrup AE,
and Phillips SM. Nutritional needs of elite
endurance athletes. Part I: Carbohydrate
and fluid requirements. Eur J Sport Sci
5: 3–14, 2005.
60. Van Baak MA and Saris WH. The effect of
caffeine on endurance performance after
nonselective beta-adrenergic blockade.
Med Sci Sports Exerc 32: 499–503,
2000.
61. Van Loon LJV, Saris WH, Kruijshoop M,
and Wagenmakers AJ. Maximizing
postexercise muscle glycogen synthesis:
Carbohydrate supplementation and the
application of amino acid or protein
hydrolysate mixtures. Am J Clin Nutr
72: 106–111, 2000.
62. Van Soeren MH and Graham TE. Effect of
caffeine on metabolism, exercise
endurance, and catecholamine responses
after withdrawal. J Appl Physiol
85: 1493–1501, 1998.
63. Von Duvillard SP, Braun WA, Markofski M,
Beneke R, and Leithauser R. Fluids and
hydration in prolonged endurance
performance. Nutrition 20: 651–656,
2004.
64. Wallis GA, Rowlands DS, Shaw C,
Jentjens R, and Jeukendrup AE. Oxidation
of combined ingestion of maltodextrins and
fructose during exercise. Med Sci Sports
Exerc 37: 426–432, 2005.
65. Widrick JJ, Costill DL, Fink WJ, Hickey MS,
McConell GK, and Tanaka H.
Carbohydrate feedings and exercise
performance: Effect of initial muscle
glycogen concentration. J Appl Physiol
74: 2998–3005, 1993.
66. Yaspelkis BB, Patterson JG, Anderla PA,
Ding Z, and Ivy JL. Carbohydrate
supplementation spares muscle glycogen
during variable-intensity exercise. J Appl
Physiol 75: 1477–1485, 1993.
VOLUME 32 | NUMBER 1 | FEBRUARY 2010
64
Supplements for Endurance Athletes
... This would trigger a further decrease in insulin secretion, which would stimulate lipolysis and ß-hydroxybutyrate formation from fatty acids. Further studies should also investigate whether post-race nutritional strategies [57,58] could influence recovery hyperglycaemia. ...
Article
Full-text available
Background Ultra-trail running races pose appreciable physiological challenges, particularly for glucose metabolism. Previous studies that yielded divergent results only measured glycaemia at isolated times. Objectives We aimed to explore the impact of an ultra-endurance race on continuously measured glycaemia and to understand potential physiological mechanisms, as well as the consequences for performance and behavioural alertness. Methods Fifty-five athletes (78% men, 43.7 ± 9.6 years) ran a 156-km ultra-trail race (six 26-km laps, total elevation 6000 m). Participants wore a masked continuous glucose monitoring sensor from the day before the race until 10 days post-race. Blood was taken at rest, during refuelling stops after each lap, and after 24-h recovery. Running intensity (% heart rate reserve), performance (lap times), psychological stress, and behavioural alertness were explored. Linear mixed models and logistic regressions were carried out. Results No higher risk of hypo- or hyperglycaemia was observed during the exercise phases of the race (i.e. excluding stops for scientific measurements and refuelling) compared with resting values. Laps comprising a greater proportion of time spent at maximal aerobic intensity were nevertheless associated with more time > 180 mg/dL (P = 0.021). A major risk of hyperglycaemia appeared during the 48-h post-race period compared with pre-race (P < 0.05), with 31.9% of the participants spending time with values > 180 mg/dL during recovery versus 5.5% during resting. Changes in circulating insulin, cortisol, and free fatty acids followed profiles comparable with those usually observed during traditional aerobic exercise. However, creatine phosphokinase, and to a lesser extent lactate dehydrogenase, increased exponentially during the race (P < 0.001) and remained high at 24-h post-race (P < 0.001; respectively 43.6 and 1.8 times higher vs. resting). Glycaemic metrics did not influence physical performance or behavioural alertness. Conclusion Ultra-endurance athletes were exposed to hyperglycaemia during the 48-h post-race period, possibly linked to muscle damage and inflammation. Strategies to mitigate muscle damage or subsequent inflammation before or after ultra-trail races could limit recovery hyperglycaemia and hence its related adverse health consequences. Trial Registration Number NCT05538442 2022–09-21 retrospectively registered. Graphical abstract
... The better muscular endurance, the longer it takes to achieve muscle fatigue so that it will affect a person's physical performance, both athletes and non-athletes [1]. Various factors both internal and external can affect muscular endurance, genetic factors such as polymorphism in the α-actinin-3 (ACTN3) gene and the angiotensin-1 gene converting enzyme insertion / deletion (ACE I / D) are one of the internal factors that can affect muscular endurance [2,3]. This genetic factor is a hereditary factor that is specific to certain individuals. ...
Conference Paper
Excessive workload, lack of regular physical activity and unhealthy diet are commonly experienced by most of the people in modern society. These conditions lead to fatigue and decreased productivity. Previous studies showed that consumption of watermelon juice showed ergogenic effect due to the high content of amino acid citrulline. Despite rich of citrulline and another nutrients, watermelon rind is usually discarded and considered unedible. Therefore we are interested in studying the ergogenic effect of watermelon rind juice (WRJ) in particular to increase muscular endurance in healthy non-athlete volunteers. Methods. Twelve healthy male subjects with aged between 18-20 years old were volunteered to involve in this quasi-experimental study with cross-over design. Body weight and height were measured to obtain Body Mass Index (BMI) value. Blood pressure (BP), heart rate (HR), respiratory rate, blood lactate and muscle endurance in push up test were measured after consumption of mineral water. Three days later, the same parameters were measured from the same subjects 60 minutes after consumption of 500 ml WRJ. Result. We observed no significant difference in BMI among subjects. Despite not statistically significant, the mean of BP after push up challenge was slightly lower following WRJ consumption than mineral water (117/80 mmHg vs. 115/75 mmHg, respectively). The decrease of blood pressure was coincided with the increase of mean HR indicating vasodilatation effect of WRJ. As expected, we found the increase of muscle endurance in 45% subjects following WRJ consumption. However, blood lactate level was increased. Conclution. We concluded that WMJ supported muscle endurance in push up test with slight vasodilation effect in healthy, young non athlete-volunteers.
... However, current scientific evidence on the performance enhancing effects of energy drinks is equivocal. For instance, empirical studies on pre-exercise ingestion of energy drinks suggest they may improve aerobic performance (18,19,21,29,32). On the other hand, several other studies have indicated that energy drinks do not appear to improve aerobic capacity (5,29,30). ...
... Endurance athletes expend a remarkable amount of energy and challenge the recovery processes of their bodies. [19] They rely on various nutritional supplements or ergogenic aids to meet these excess bodily demands. Lin et al. [8] in 1999 elaborated that nutritional supplements have been long and widely used in the sports arena to increase performance; hence, athletes and coaches search for new options and alternatives to increase their endurance capacity in a healthier way. ...
Article
Full-text available
Cycling is an endurance sport relying mainly on aerobic capacity to provide fuel during long-duration cycling events. Athletes are constantly searching for new methods to improve this capacity through various nutritional and ergogenic aids.s The aim of the study was to find out the effect of Ashwagandha on the cardiorespiratory endurance capacity, that is, aerobic capacity of elite Indian cyclists. Forty elite (elite here refers to the participation of the athlete in at least state-level events) Indian cyclists were chosen randomly and were equally divided into experimental and placebo groups. The experimental group received 500 mg capsules of aqueous roots of Ashwagandha twice daily for eight weeks, whereas the placebo group received starch capsules. The baseline treadmill test for the cyclists were performed to measure their aerobic capacity in terms of maximal aerobic capacity (VO(2) max), metabolic equivalent, respiratory exchange ratio (RER), and total time for the athlete to reach his exhaustion stage. After eight weeks of supplementation, the treadmill test was again performed and results were obtained. There was significant improvement in the experimental group in all parameters, whereas the placebo group did not show any change with respect to their baseline parameters. There was significant improvement in the experimental group in all parameters, namely, VO(2) max (t = 5.356; P < 0.001), METS (t = 4.483; P < 0.001), and time for exhaustion on treadmill (t = 4.813; P < 0.001) in comparison to the placebo group which did not show any change with respect to their baseline parameters. Ashwagandha improved the cardiorespiratory endurance of the elite athletes.
Article
Marathon runners are a group of endurance athletes who spend a remarkable amount of energy during which they may manifest fatigue and restlessness. However, these athletes are prone to musculoskeletal and cardiovascular disorders when not under ideal dietary recommendations or medical supervision. The existing medical remedies seem to be self-administered “commercial supplements” for the improvement of cardiopulmonary endurance (CPE), which may affect the functioning of the kidney. We present a case of a marathon runner who presented with generalized weakness/fatigue during running, lack of sleep, and appetite, seeking improvement in overall health condition for his run. We considered the case to be of an endurance athlete in need of improved CPE and initiated an ayurvedic treatment and dietary plan. Ashwagandha , Triphala , and Gokshura churnas significantly improved the CPE while simultaneously improving his generalized weakness after treatment.
Article
Full-text available
Caffeine is a common substance in the diets of most athletes and it is now appearing in many new products, including energy drinks, sport gels, alcoholic beverages and diet aids. It can be a powerful ergogenic aid at levels that are considerably lower than the acceptable limit of the International Olympic Committee and could be beneficial in training and in competition. Caffeine does not improve maximal oxygen capacity directly, but could permit the athlete to train at a greater power output and/or to train longer. It has also ben shown to increase speed and/or power output in simulated race conditions. These effects have been found in activities that last as little as 60 seconds or as long as 2 hours. There is less information about the effects of caffeine on strength; however, recent work suggests no effect on maximal ability, but enhanced endurance or resistance to fatigue. There is no evidence that caffeine ingestion before exercise leads to dehydration, ion imbalance, or any other adverse effects. The ingestion of caffeine as coffee appears to be ineffective compared to doping with pure caffeine. Related compounds such as theophylline are also potent ergogenic aids. Caffeine may act synergistically with other drugs including ephedrine and anti-inflammatory agents. It appears that male and female athletes have similar caffeine pharmacokinetics, i.e., for a given dose of caffeine, the time course and absolute plasma concentrations of caffeine and its metabolites are the same. In addition, exercise or dehydration does not affect caffeine pharmacokinetics. The limited information available suggests that caffeine non-users and users respond similarly and that withdrawal from caffeine may not be important. The mechanism(s) by which caffeine elicits its ergogenic effects are unknown, but the popular theory that it enhances fat oxidation and spares muscle glycogen has very little support and is an incomplete explanation at best. Caffeine may work, in part, by creating a more favourable intracellular ionic environment in active muscle. This could facilitate force production by each motor unit.
Article
Full-text available
In this study we assessed whether a liquid carbohydrate-protein (C+P) supplement (0.8 g/kg C; 0.4 g/kg P) ingested early during recovery from a cycling time trial could enhance a subsequent 60 min effort on the same day vs. an isoenergetic liquid carbohydrate (CHO) supplement (1.2 g/kg). Two hours after a standardized breakfast, 15 trained male cyclists completed a time trial in which they cycled as far as they could in 60 min (AM(ex)) using a Computrainer indoor trainer. Following AM(ex), subjects ingested either C+P, or CHO at 10, 60 and 120 min, followed by a standardized meal at 4 h post exercise. At 6 h post AM(ex) subjects repeated the time trial (PM(ex)). There was a significant reduction in performance for both groups in PM(ex) versus AM(ex). However, performance and power decreases between PM(ex) and AM(ex) were significantly greater (p </= 0.05) with CHO (-1.05 +/- 0.44 km and -16.50 +/- 6.74 W) vs C+P (-0.30 +/- 0.50 km and -3.86 +/- 6.47 W). Fat oxidation estimated from RER values was significantly greater (p </= 0.05) in the C+P vs CHO during the PM(ex), despite a higher average workload in the C+P group. Under these experimental conditions, liquid C+P ingestion immediately after exercise increases fat oxidation, increases recovery, and improves subsequent same day, 60 min efforts relative to isoenergetic CHO ingestion.
Article
Recreational enthusiasts and athletes often are advised to abstain from consuming caffeinated beverages (CB). The dual purposes of this review are to (a) critique controlled investigations regarding the effects of caffeine on dehydration and exercise performance, and (b) ascertain whether abstaining from CB is scientifically and physiologically justifiable. The literature indicates that caffeine consumption stimulates a mild diuresis similar to water, but there is no evidence of a fluid-electrolyte imbalance that is detrimental to exercise performance or health. Investigations comparing caffeine (100-680 mg) to water or placebo seldom found a statistical difference in urine volume. In the 10 studies reviewed, consumption of a CB resulted in 0-84% retention of the initial volume ingested, whereas consumption of water resulted in 0-81% retention. Further, tolerance to caffeine reduces the likelihood that a detrimental fluid-electrolyte imbalance will occur. The scientific literature suggests that athletes a...
Article
Increasing the plasma glucose and insulin concentrations during prolonged variable intensity exercise by supplementing with carbohydrate has been found to spare muscle glycogen and increase aerobic endurance. Furthermore, the addition of protein to a carbohydrate supplement will enhance the insulin response of a carbohydrate supplement. The purpose of the present study was to compare the effects of a carbohydrate and a carbohydrate-protein supplement on aerobic endurance performance. Nine trained cyclists exercised on 3 separate occasions at intensities that varied between 45% and 75% VO2max for 3 h and then at 85% VO2max until fatigued. Supplements (200 ml) were provided every 20 min and consisted of placebo, a 7.75% carbohydrate solution, and a 7.75% carbohydrate / 1.94% protein solution. Treatments were administered using a double-blind randomized design. Carbohydrate supplementation significantly increased time to exhaustion (carbohydrate 19.7 +/- 4.6 min vs. placebo 12.7 +/- 3.1 min), while the addition of protein enhanced the effect of the carbohydrate supplement (carbohydrate-protein 26.9 +/- 4.5 min, p < .05). Blood glucose and plasma insulin levels were elevated above placebo during carbohydrate and carbohydrate-protein supplementation, but no differences were found between the carbohydrate and carbohydrate-protein treatments. In summary, we found that the addition of protein to a carbohydrate supplement enhanced aerobic endurance performance above that which occurred with carbohydrate alone, but the reason for this improvement in performance was not evident.
Article
Preparations containing caffeine and ephedrine have become increasingly popular among sportspersons in recent years as a means to enhance athletic performance. This is due to a slowly accumulating body of evidence suggesting that combination of the two drugs may be more efficacious than each one alone. Caffeine is a compound with documented ergogenicity in various exercise modalities, while ephedrine and related alkaloids have not been shown, as yet, to result in any significant performance improvements. Caffeine-ephedrine mixtures, however, have been reported in several instances to confer a greater ergogenic benefit than either drug by itself. Although data are limited and heterogeneous in nature to allow for reaching consensus, the increase in performance is a rather uniform finding as it has been observed during submaximal steady-state aerobic exercise, short- and long-distance running, maximal and supramaximal anaerobic cycling, as well as weight lifting. From the metabolic point of view, combined ingestion of caffeine and ephedrine has been observed to increase blood glucose and lactate concentrations during exercise, wheareas qualitatively similar effects on lipid fuels (free fatty acids and glycerol) are less pronounced. In parallel, epinephrine and dopamine concentrations are significantly increased, wheareas the effects on norepinephrine are less clear. With respect to pulmonary gas exchange during short-term intense exercise, no physiologically significant effects have been reported following ingestion of caffeine, ephedrine or their combination. Yet, during longer and/or more demanding efforts, some sporadic enhancements have indeed been shown. On the other hand, a relatively consistent cardiovascular manifestation of the latter preparation is an increase in heart rate, in addition to that caused by exercise alone. Finally, evidence to date strongly suggests that caffeine and ephedrine combined are quite effective in decreasing the rating of perceived exertion and this seems to be independent of the type of activity being performed. In general, our knowledge and understanding of the physiological, metabolic and performance-enhancing effects of caffeine-ephedrine mixtures are still in their infancy. Research in this field is probably hampered by sound ethical concerns that preclude administration of potentially hazardous substances to human volunteers. In contrast, while it is certainly true that caffeine and especially ephedrine have been associated with several acute adverse effects on health, athletes do not seem to be concerned with these, as long as they perceive that their performance will improve. In light of the fact that caffeine and ephedra alkaloids, but not ephedrine itself, have been removed from the list of banned substances, their use in sports can be expected to rise considerably in the foreseeable future. Caffeine-ephedra mixtures may thus become one of most popular ergogenic aids in the years to come and while they may indeed prove to be one of the most effective ones, and probably one of the few legal ones, whether they also turn out to be one of the most dangerous ones awaits to be witnessed.
Article
Although it is known that carbohydrate (CHO) feedings during exercise improve endurance performance, the effects of different feeding strategies are less clear. Studies using (stable) isotope methodology have shown that not all carbohydrates are oxidised at similar rates and hence they may not be equally effective. Glucose, sucrose, maltose, maltodextrins and amylopectin are oxidised at high rates. Fructose, galactose and amylose have been shown to be oxidised at 25 to 50% lower rates. Combinations of multiple transportable CHO may increase the total CHO absorption and total exogenous CHO oxidation. Increasing the CHO intake up to 1.0 to 1.5 g/min will increase the oxidation up to about 1.0 to 1.1 g/min. However, a further increase of the intake will not further increase the oxidation rates. Training status does not affect exogenous CHO oxidation. The effects of fasting and muscle glycogen depletion are less clear. The most remarkable conclusion is probably that exogenous CHO oxidation rates do not exceed 1.0 to 1.1 g/min. There is convincing evidence that this limitation is not at the muscular level but most likely located in the intestine or the liver. Intestinal perfusion studies seem to suggest that the capacity to absorb glucose is only slightly in excess of the observed entrance of glucose into the blood and the rate of absorption may thus be a factor contributing to the limitation. However, the liver may play an additional important role, in that it provides glucose to the bloodstream at a rate of about 1 g/min by balancing the glucose from the gut and from glycogenolysis/gluconeogenesis. It is possible that when large amounts of glucose are ingested absorption is a limiting factor, and the liver will retain some glucose and thus act as a second limiting factor to exogenous CHO oxidation.
Article
Both carbohydrate depletion and dehydration have been shown to decrease performance whilst severe dehydration can also cause adverse health effects. Therefore carbohydrate and fluid requirements are increased with exercise. Ingestion of 200–300 g of CHO 3–4 h prior to exercise is an effective strategy in order to meet daily CHO demands and increase CHO availability during the subsequent exercise period. There is little evidence that CHO during the hour immediately prior to exercise has adverse effects such as rebound hypoglycaemia. CHO ingestion during exercise has been shown to improve performance as measured by enhanced work output or decreased exercise time to complete a fixed amount of work. Recent studies have demonstrated that exogenous CHO oxidation rates can be increased by ingesting combinations of CHO that use different intestinal CHO transporters. After exercise maximal muscle glycogen re‐synthesis rates can be achieved by ingesting CHO at a rate of ∼1.2 g/kg/h, in relatively frequent (e.g., 15–30 min) intervals for up to 5 h following exercise. Protein amino acid mixtures may increase glycogen synthesis further but only if relatively small amounts of CHO are ingested. Hypohydration and hyperthermia alone have negative effects on performance but their combination is particularly serious, both in terms of performance and health. Dehydration can be prevented by fluid ingestion pre exercise and during exercise. Because of large individual differences it is difficult to individualise the advice. Perhaps the best guidance for athletes is to weigh themselves to assess fluid losses during training and racing and limit weight losses to 1% during exercise lasting longer than 1.5 h. Excessive fluid intake has been associated with hyponatremia. Post exercise the volume of fluid ingested and sodium intake are important determinants of rehydration.
Article
VAN BAAK, M. A. and W. H. M. SARIS. The effect of caffeine on endurance performance after nonselectiveb-adrenergic blockade. Med. Sci. Sports Exerc., Vol. 32, No. 2, pp. 499 -503, 2000. Purpose: This study was designed to test the hypothesis that combined administration of propranolol and caffeine (Pr1C) would increase endurance performance compared with the administration of propranolol alone (Pr) if caffeine would be able to increase plasma free fatty acid (FFA) availability and/or lower plasma potassium concentration compared with propranolol administration alone. Methods: Fifteen volunteers participated in the double-blind placebo- controlled randomized cross-over study. An endurance exercise test until exhaustion was performed after ingestion of placebo (Pl), 80-mg propranolol (Pr), and 80-mg propranolol plus 5 mgzkg21 caffeine (Pr1C). Results: Endurance time (6SD) was 79.3 6 20.4 min in the Pl trial, 22.6 6 10.8 min in the Pr trial and 31.2 6 17.2 min in the Pr1C trial (P , 0.001). The difference between the Pr and Pr1C trials just failed to reach statistical significance ( P 5 0.056). Plasma FFA concentration and plasma potassium concentrations were similar in the Pr and Pr1C trials, but differed significantly from the Pl trial ( P , 0.05). Conclusion: Although there was a clear tendency for an improved performance in the Pr1C trial compared to the Pr trial, this improvement was not associated with increased plasma FFA concentration and/or reduced plasma potassium concentration in the Pr1C compared to the Pr trial. These results do not support the hypothesis that caffeine improves endurance performance by stimulating lipolysis or lowering plasma
Article
In order to maximize fluid and/or carbohydrate availability during exercise, in which performance may be limited by one or the other, the composition and ingestion pattern of a beverage can be adjusted accordingly. As carbohydrate concentration increases, the rate of gastric emptying decreases. With more highly concentrated carbohydrate solutions, the net fluid absorption of water in the intestine is also reduced, although lower concentrations of glucose containing carbohydrates (∼3-7%) actually can stimulate net intestinal absorption. Increasing the osmolality of a beverage can reduce the gastric emptying rate, but it has a more profound effect on gastric and intestinal secretions. Hyperosmolality increases secretions and as such decreases the rate of net absorption. Sodium inclusion in a beverage is warranted not only to offset losses (primarily from sweat) but, moreover, to promote fluid absorption in the intestine and to increase fluid retention. Recommendations include maintenance of fluid balance by ingestion of sufficient fluids, immediately prior to and during exercise, to restrict body weight losses to ≤1%. Somewhat more concentrated carbohydrate solutions may be ingested when the risk of hypohydration is low and performance is limited by carbohydrate availability. With increasing carbohydrate concentrations, at least up to 18%, there is a greater rate of carbohydrate passage through the gastrointestinal tract. When carbohydrate concentrations exceed 5%, the type of carbohydrate (mono- or disaccharides, long chain polymers, etc.) is important as the osmolality increases with increasing concentration and decreasing chain length. Thus, when concentrations of >8% are warranted, based on energy demands, there is an advantage to using glucose polymer solutions, owing to a decrease in gastrointestinal secretions and, hence, an increase in rate of net fluid absorption.