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Carbohydrates in Exercise and Recovery. Rookie version. Outline. I. Carbohydrates: Definitions, digestion, absorption A. Carbohydrates in the diet B. Digestion and absorption of carbohydrates C. Carbohydrate metabolism

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I.Carbohydrates: Definitions, digestion, absorption

A. Carbohydrates in the diet

B. Digestion and absorption of carbohydrates

C. Carbohydrate metabolism

D. Glycogen—storage of carbohydrates in the body

II. Properties of carbohydrates: Considerations for sports performance

A. Glycemic index

B. Glycemic loadC. High-fructose corn syrup


A. Carbohydrates before exercise

B. Carbohydrates during exercise

C. Recovery

D. Meal planning

IV. Competition

A. Carbohydrate loading

B. Pre-competition meals

C. Carbohydrates during competition

i carbohydrates

I. Carbohydrates:

Definitions, Digestion, Absorption, and Storage

carbohydrates in sports nutrition
Carbohydrates in Sports Nutrition
  • Carbohydrates (CHOs) are a major fuel source for exercising muscle, especially in high-intensity or long-duration activities
  • Carbohydrates can influence fluid absorption from the intestine (hydration)
  • Some CHOs can cause gastrointestinal intolerance and thereby impair exercise performance
  • Types of CHOs
    • Exogenous: CHO intake from the diet
    • Endogenous: CHO stored in the body (ie, glycogen) that can be used for energy needs
  • Glycogen is stored glucose in the body
    • It is a network of glucose molecules connected together, similar to starch

United States Anti-doping Agency. Optimal dietary intake guide. Available at: Accessed January 31, 2011.

carbohydrates in diet
Carbohydrates in Diet

Carbohydrates are found in the diet as

1. Free monosaccharides (1 sugar unit)

  • Glucose (aka dextrose, from corn and other plants)
  • Fructose (from fruit)
  • Galactose (from milk)

2. Di-, tri-, oligo- (4 to 10 units), or polysaccharides (chain of 11+ monosaccharides)

  • Sucrose (disaccharide of glucose + fructose)
  • Lactose (disaccharide of glucose + galactose)
  • Maltose (disaccharide of 2 glucose molecules)
  • Trehalose (disaccharide of 2 glucose molecules, with a different linkage between the two)
  • Starch (polysaccharide of glucose)

Berg JM, et al. Biochemistry. 5th ed. New York, NY: WH Freeman and Co; 2002.

carbohydrate digestion
Carbohydrate Digestion
  • Carbohydrates are absorbed as monosaccharides
  • Enzymes must digest di-, tri-, oligo-, and polysaccharides into individual monosaccharides
    • Enzymes exist in the saliva, stomach, and small intestine to break the different linkages between the various sugars
  • There are special transporters in the cell membranes of intestinal cells that selectively absorb monosaccharides
    • Monosaccharides are then transported into the blood stream, where they are distributed throughout the body
  • Carbohydrates that escape digestion and absorption make their way to the colon (with variable degrees of bacterial fermentation)

Holmes R. J Clin Pathol. 1971;5(suppl):10-13.

why is carbohydrate absorption important in sports nutrition
Why Is Carbohydrate Absorption Importantin Sports Nutrition?
  • The ability of the intestine to absorb a carbohydrate can be the rate-limiting step for its delivery to muscle cells for fuel use
  • Enzyme systems in the intestine may be insufficient to digest some carbohydrates (eg, lactose intolerance)
  • Intestinal sugar transporters can become saturated, resulting in malabsorption of a carbohydrate
  • There are multiple transporters for carbohydrates
    • Ingest a blend of sugars that require different intestinal transporter systems (ie, glucose and fructose)
      • Avoids saturation of any one transporter
    • May increase carbohydrate absorption relative to using just a single sugar
carbohydrate metabolism
Carbohydrate Metabolism








Pyruvate oxidation


Krebs cycle (aka tricarboxylic acid or TCA cycle)

ATP energy

Electron transport


Berg JM, et al. Biochemistry .5th ed. New York, NY: WH Freeman and Co.; 2002.

storage of carbohydrate in the body
Storage of Carbohydrate in the Body
  • If glucose is absorbed, but not needed right away, the body stores a small amount as glycogen
    • Glycogen is a fluctuating storage pool for glucose
    • The structure of glycogen is similar to starch
    • Found in the liver and skeletal muscles
      • Glycogen in liver is a reserve glucose supply to the brain
      • Glycogen in muscles is an energy source for exercise

Berg JM, et al. Biochemistry .5th ed. New York, NY: WH Freeman and Co.; 2002.

glycogen during exercise
Glycogen During Exercise
  • During exercise, glycogen is broken down and glucose molecules enter glycolysis (ie, energy metabolism)
  • Vitamin B6 is a structural part of the enzyme that breaks down glycogen
    • Shows one of the many roles of B-vitamins in energy metabolism
  • Glycogen can supply the body with only a limited amount of energy
    • Exogenous carbohydrates are important for high-intensity and long-duration exercise
  • Eat carbohydrates immediately after exercise for most rapid glycogen replenishment (recovery)
    • Ingestion of 50 grams of carbohydrate every 2 hours can result in up to 5% glycogen replacement per hour
      • Therefore, total replacement would take 20 hours

Hui YH. Handbook of Food Science, Technology, and Engineering. Volume 1. Boca Raton, FL: CRC Press; 2006:10-12. United States Anti-doping Agency. Optimal dietary intake guide. Available at: Accessed January 31, 2011.Tardie G. The Sports Journal. Available at: Accessed February 17, 2011.

ii properties of carbohydrates

II. Properties of Carbohydrates:

Considerations for Sports Performance

glycemic response to carbohydrates in sports nutrition
Glycemic Response to Carbohydrates in Sports Nutrition
  • Ingestion of carbohydrates affects both blood glucose levels and insulin response (glycemic response)1
    • Can influence energy sources during exercise
  • One measure of glycemic response is the glycemic index (GI)2,3
  • Glycemic load is a relatively new measure for glycemic response4
    • Based on the concept that exercise performance may be determined by both carbohydrate ingestion and the glycemic response of the overall diet

1. Mondazzi L and Arcelli E. J Am Coll Nutr. 2009;28:455S-463S.2. Burke LM, et al. Int J Sport Nutr. 1998;8:401-415.3. Donaldson CM, et al. Int J Sport Nutr Exerc Metab. 2010;20:154-165.4. O’Reilly J, et al. Sports Med. 2010;40:27-39.

what is the glycemic index
What Is the Glycemic Index?
  • System of ranking foods according to how much they raise blood glucose relative to a reference food
    • Developed by Jenkins DJ, et al.Am J Clin Nutr. 1981;34(3):362-366.
  • Rapidly digested or absorbed carbohydrates = high GI
  • Slowly digested or absorbed carbohydrates = low GI
  • References on GI
    • Brand-Miller J, et al. The New Glucose Revolution. 3rd ed. New York, NY: Marlowe & Co.; 2006
      • Written by experts on GI
    • Atkinson, et al. Diabetes Care. 2008;31(12):2281-2283
      • Most comprehensive table of the glycemic index of foods that has been assembled to date

Abbreviations: GI, glycemic index.Figure from

what does the glycemic index value mean
What Does the Glycemic Index Value Mean?
  • The glycemic index (GI) is expressed as a ratio comparing the blood glucose increase caused by a test food to that of a reference food (usually glucose, historically white bread) for 2 hours following ingestion:
  • GI values:

Split peas = 25 ± 6

Golden delicious apples = 39 ± 3

Oatmeal = 51 ± 8

Raisin bran flake type of cereal = 61 ± 5

White bread = 75 ± 2

Long-grain white rice = 76 ± 7

Corn flake type of cereal = 81 ± 3

Area Under the Curve for Test Food

= GI

× 100

Area Under the Curve for Reference Food

Atkinson FS, et al. Diabetes Care. 2008;31(12):2281-2283.

slow and fully digested chos low gi
Slow and Fully Digested CHOs (Low GI)
  • Isomaltulose1
    • Glucose and fructose
    • More steady and sustained release of glucose into the blood compared with sucrose
    • Occurs naturally in honey, but can be synthesized from sucrose
  • Sucromalt2
    • Produced by enzymatic conversion of sucrose and maltose into a fructose and oligosaccharide syrup
      • ~40% fructose, ~50% oligosaccharides, and ~10% other mono- and disaccharides
    • Digestion profile similar to isomaltulose
  • Gamma-cyclodextrin (γ-CD)3
    • Ring of 8 glucose molecules


Abbreviations: CHO, carbohydrate; GI, glycemic index.1. Lina BA, et al. Food Chem Toxicol. 2002;40(10):1375-1381. 2. Xtend™ Sucromalt. Cargill, Inc. Available at: Accessed February 24, 2011.3. Munro IC, et al. Regul Toxicol Pharmacol. 2004;39:S3-13.

what is the glycemic load
What Is the Glycemic Load?
  • Takes into account the amount of carbohydrate in a common serving in addition to its glycemic index
  • Example
    • Carrots (peeled, boiled) have a GI of 47 and 5 g CHO per serving

GL = (GI of CHO × gram CHO per serving) ÷ 100

The GL of carrots is: (47 × 5) ÷ 100 = 2.4

Abbreviations: CHO, carbohydrate; GL, glycemic load; GI, glycemic index.

Atkinson FS, et al. Diabetes Care. 2008;31(12):2281-2283.

glycemic index and load standards for foods
Glycemic Index and Load Standards for Foods
  • GI (based on glucose reference)
    • Low GI 0-55
    • Intermediate GI 56-69
    • High GI ≥ 70
  • GL
    • Low GL 0-10
    • Intermediate GL 11-19
    • High GL ≥ 20

Abbreviations: GI, glycemic index; GL, glycemic load.

Brand-Miller J, et al. The New Glucose Revolution: The Authoritative Guide to the Glycemic Index-The Dietary Solution for Lifelong Health. 3rd ed. New York, NY: Marlowe and Co.; 2006.

Brand-Miller JC, et al. Am J Clin Nutr. 2003;77(4):993-995.

limitations of glycemic index approach before and during exercise
Limitations of glycemic index approach before and during exercise
  • Clinical data have been mixed regarding the effectiveness of the glycemic index (GI) in food choice before exercise
    • Some discrepancies associated with how researchers evaluate exercise performance
      • Benefits observed in some time to exhaustion studies
      • Mainly no benefits in studies of time trial performance
    • No adverse effects of low glycemic index foods on performance have been observed
  • Carbohydrate ingestion during exercise can help maintain blood glucose and eliminate the need for low glycemic index pre-exercise food
    • Low glycemic index pre-exercise foods, though, may help reduce insulin response (may positively affect fat utilization during exercise)
    • If an athlete has inadequate access to carbohydrate during an event, low glycemic index carbohydrates before event may be helpful
  • Some of the low glycemic index foods used in research studies (e.g., lentils) might not be palatable as pre-exercise foods for athletes

Burke LM, et al. Int J Sport Nutr. 1998;8:401-415.Donaldson CM, et al. Int J Sport Nutr Exerc Metab. 2010;20:154-165.

what is high fructose corn syrup
What Is High-Fructose Corn Syrup?
  • Cornstarch is converted to corn syrup that is essentially 100% glucose
  • Enzymes and processing techniques convert some of the glucose to fructose to achieve corn syrup that is 55% fructose (HFCS-55)
  • HFCS-55 is the type of corn syrup used mainly in the beverage industry
    • Syrup is 55% fructose, 45% glucose
    • Similar to sucrose (table sugar; 50% fructose, 50% glucose)
  • The term “high-fructose corn syrup” is a little misleading
    • Because corn syrup is 100% glucose, any presence of fructose typically results in it being labeled “high-fructose corn syrup”

Soenen S, et al. Am J Clin Nutr. 2007;86(6):1586-1594.Smith JS, et al. Food Processing: Principles and Applications. Ames, IA: Blackwell Publishing; 2004:212-214.

the truth about high fructose corn syrup
The Truth About High-Fructose Corn Syrup
  • Too much sugar, of any kind, in beverages is not recommended
    • It is easy to consume too much energy, leading to weight gain
    • Most sugar-sweetened beverages provide little to no vitamins, minerals, or other essential nutrients
  • However, there are no differences in metabolic responses to high-fructose corn syrup vs sucrose in humans
    • No differences in circulating hormones
    • No differences in appetite or satiety-related variables (fullness)

DiMeglio DP, et al. Int J Obesity. 2000;24:794-800.

Melanson KJ, et al. Nutrition. 2007;23(2):103-112.

Stanhope KL, et al. Am J Clin Nutr. 2008;87(5):1194-1203.

Soenen S, et al. Am J Clin Nutr. 2007;86(6):1586-1594.

carbohydrates and sports nutrition
Carbohydrates and Sports Nutrition
  • Important for maximizing muscle glycogen stores
    • Depleted muscle glycogen—“Hitting the wall”
    • Depleted liver glycogen—“Bonking”
    • Both phenomena are experienced as a precipitous loss of energy as a result of low blood sugar
  • Training and high carbohydrate diets maximize glycogen stores

United States Anti-doping Agency. Optimal dietary intake guide. Available at: Accessed January 31, 2011.

Ensminger A. Foods and Nutrition Encyclopedia 2nd Edition Volume 1. Boca Raton, FL: CRC Press LLC; 1994. Pages 1202-1203.

Burke L. Practical Sports Nutrition. Champaign, IL: Human Kinetics; 2007. Page 124.

Clark N. Sports Nutrition Guidebook 4th Edition. Champaign, IL: Human Kinetics; 2008. Page 119.

carbohydrate and fat use at different exercise intensities
Carbohydrate and Fat Use at Different Exercise Intensities
  • As the intensity of exercise increases, muscle glycogen constitutes a greater portion of the energy source

(Weightlifting, sprinting, etc)


(Soccer, dancing, etc)

Muscle glycogen


Muscle triglyceride

Energy Expended, cal/kg/min

Plasma FFA

(Leisurely walking, slow cycling)


Plasma glucose





Maximal Oxygen Consumption, %

Abbreviations FFA, free fatty acid.Romijn JA, et al. Am J Physiol. 1993;265(Part 1):E380-E391.

carbohydrates in the days before exercise
Carbohydrates in the Days Before Exercise
  • High glycogen stores are very important to prolong endurance
    • Related to diet and exercise in the days and hours before exercising/competing
    • Endogenous carbohydrate oxidation occurs at high intensity
    • Especially important for events longer than 90-120 minutes (eg, marathons and cycling events)

United States Anti-doping Agency. Optimal dietary intake guide. Available at: Accessed January 31, 2011.

Latta S. Marathon & Beyond. 2003;7(5).

carbohydrates 1 to 2 hours before exercise
Carbohydrates 1 to 2 Hours Before Exercise
  • Low glycemic index foods and beverages
    • Especially important for endurance exercise
  • Carbohydrates that are also low in fiber may be beneficial due to varied gastrointestinal sensitivity among individuals
    • Examples
      • Fruit juices
      • Bagels
      • Breakfast cereals with < 3 g fiber/serving
      • Potatoes
  • Carbohydrate amounts vary among individuals, sport type, and sport intensity

United States Anti-doping Agency. Optimal dietary intake guide. Available at: Accessed January 31, 2011.

Wu CL and Williams C. Int J Sport Nutr Exerc Metab. 2006;16(5):510-527.

carbohydrates during exercise are also important
Carbohydrates During Exercise Are Also Important
  • Jeukendrup (2004) reviewed multiple studies (n = 22) of walking, running, and cycling in which carbohydrates were given during exercise
    • 23 of 36 observations within these studies showed a positive effect of carbohydrate on endurance
    • Effective dose
      • Minimum, 16 to 22 g carbohydrate/hour
      • Maximum, 75 g carbohydrate/hour
    • No studies showed an adverse, or ergolytic, effect of carbohydrate on performance
    • Form of carbohydrate (solid or liquid) was of little significance, although the vast majority of the studies used a beverage
  • Sports beverages that include different types of sugars will be absorbed via different sugar transporters in the gut
    • Increase exogenous carbohydrate oxidation during exercise from 1.0 g/min to 1.2 to 1.5 g/min

Jeukendrup AE. Nutrition. 2004;20(7-8):669-677.

carbohydrates after exercise
Carbohydrates After Exercise
  • Carbohydrates that are quickly digested and absorbed are recommended postexercise to restore muscle glycogen levels as fast as possible
    • Glucose
    • Maltose
    • Maltodextrin
  • Protein + carbohydrates postexercise maximizes the rate of glycogen synthesis
  • When intervals between exercise sessions are < 8 hours, consume carbohydrates as soon as practical postexercise for fastest recovery

Ivy JL, et al. J Appl Physiol. 2002;93:1337-1344.

recommendations for carbohydrate intake during recovery
Recommendations for Carbohydrate Intake During Recovery
  • Carbohydrate intakes are expressed per kga not % of energy
    • For immediate recovery after exercise (0 to 4 hours)
      • 1.2 g/kg/hr consumed at frequent intervals
  • For daily recovery, range of 3-12 g/kg/day; adjust with consideration of:
    • Athlete’s total energy needs
    • Specific training needs and stage of training
    • Feedback from training performance
    • Training intensity
      • 3-5 g/kg/day: very light training programs (low-intensity or skill-based exercise)
      • 5-7 g/kg/day: moderate intensity training programs for 60 min/day
      • 6-10 g/kg/day: moderate- to high-intensity endurance exercise for 1-3 hours per day
      • 8-12 g/kg/day: moderate- to high-intensity exercise for 4-5 hours/day

aMultiply the numbers by 0.45 to get carbohydrate intake in grams per pound of body weight.

Burke LM, et al. J Sport Sci. 2004;22(1):15-30.

putting together a meal plan
Putting Together a Meal Plan
  • Example:
    • 70-kg athlete requiring 4000 kcal/day and exercising 120 min/day 4 to 6 times/week
  • Macronutrient Target Recommendations
    • Grams/kg (body weight)/day
      • Carbohydrate 7 to 10 g/kg/day (490 to 700 g/day)
      • Protein 1.5 to 2.0 g/kg/day (105 to 140 g/day)
      • Fat Typically use percentage of energy as method
    • Percentage of energy
      • Fat 20% to 35% of energy (88 to 156 g/day)
    • Target recommendations for this athlete
      • Carbohydrate 600 g (60% of energy)
      • Protein 130 g (13% of energy)
      • Fat 120 g (27% of energy)
foods containing approximately 25 to 30 g carbohydrate
Foods Containing Approximately 25 to 30 g Carbohydrate
  • 1 cup of juice or 1 large piece of fruit
  • 1 bagel or 2 slices of bread
  • 1 cup of most cereals
  • 1 large baked potato
  • 2 cups of milk
  • ⅔ cup of dried beans
  • 1 cup of rice or corn
  • 1 cup of squash (other non-starchy vegetables have less carbohydrate)
  • 2 cups of commercial sports/electrolyte replacement drink
  • ½ to 1 energy bar (1 bar  25 to 45 g carbohydrate)
  • 1 pack of energy gel ( 25 g carbohydrate)

Atkinson FS, et al. Diabetes Care. 2009;31(12):2281-2283.

examples of postexercise meals
Examples of Postexercise Meals
  • Option 1
    • 1 regular bagel
    • 2 Tablespoons peanut butter
    • 8 fl oz skim milk
    • 1 medium banana
    • Meal provides 562 kcal, 77 g carbohydrate, 23 g protein, and 18 g fat
  • Option 2
    • 17-oz commercial nutrition shake
    • Provides 300 to 420 kcal, 17 to 70 g carbohydrate, 32 to 42 g protein, and 2 to 16 g fat
  • Competitions sometime require different carbohydrate intakes than practice
    • Endurance may be required for a longer amount of time
    • Maximum glycogen levels are optimal for best performance and require time to build (on the order of days; not possible for practices)
  • Do not try any new foods in competition before you try it at least once at practice
carbohydrates as energy at different times
Carbohydrates as Energy at Different Times
  • Carbohydrate consumed in the days before event
    • Used to provide adequate glycogen stores in muscle
      • Prevent “hitting the wall”
  • Carbohydrate consumed in the hours before the event
    • Used to preserve liver glycogen stores, which can deplete after approximately 8 to 12 hours of fasting
  • Carbohydrate consumed during event
    • Used to maintain blood glucose, especially when liver glycogen is depleted
      • Carbohydrate in the hours before and during exercise helps to prevent “bonking”

United States Anti-doping Agency. Optimal dietary intake guide. Available at: Accessed January 31, 2011.

Ensminger A. Foods and Nutrition Encyclopedia 2nd Edition Volume 1. Boca Raton, FL: CRC Press LLC; 1994. Pages 1202-1203.

Burke L. Practical Sports Nutrition. Champaign, IL: Human Kinetics; 2007. Page 124.

Clark N. Sports Nutrition Guidebook 4th Edition. Champaign, IL: Human Kinetics; 2008. Page 119.

carbohydrate loading
Carbohydrate Loading
  • Traditional protocol
    • Depletion of glycogen stores (~ days 6 to 3 before event)
      • Low-carbohydrate diet and hard exercise
    • Supercompensation of muscle glycogen (during the 36 to 48 h prior to event)
      • Very high-carbohydrate diet (10 to 12 g/kg body weight/day) and tapering of exercise
  • Cons
    • Depletion phase is hard on the body and difficult to toleratein training
      • May lead to headaches, irritability, and increased risk of injury
pre competition meal
Pre-Competition Meal
  • One of the most variable aspects of the athlete’s diet
    • Depends on individual tolerance
    • Athletes often have certain beliefs about food’s effect on performance
    • Ranges from no food to the old “steak and eggs” breakfast
    • Depends on the sport to some degree
  • Functions of the pre-event meal
    • Prevent dehydration
    • Maintain adequate muscle and liver glycogen levels
    • Avoid excess hunger feelings
    • Confidence in preparation for the event
pre competition meal continued
Pre-Competition Meal (continued)
  • Medium amount of energy
    • 300 to 500 kilocalories, more if there is time to digest before the event
  • 2 to 3 hours before event (perhaps 1 hour with liquid meal)
    • Ingestion of carbohydrate 1 hour before exercise does not usually impair performance
    • Depends on individual tolerance
    • Liquid meals are popular for gastrointestinal comfort during the event
  • GI of pre-event carbohydrates
    • No solid evidence for this, experiment in practice
  • Include 1 to 2 cups of fluid
  • Avoid foods with a high fat content and/or excess fiber

Abbreviations: GI, glycemic index.

examples of pre competition meals
Examples of Pre-Competition Meals
  • Option 1, liquid meal (blend all ingredients)1
    • 1 cup of vanilla yogurt
    • 4 to 6 peach halves, canned or fresh
    • 4 graham cracker squares
    • Dash nutmeg, optional
    • Meal provides 450 kcal, 75% CHO, 15% protein, and 10% fat
  • Option 2

1. Clark N. Sports Nutrition Guidebook. Champaign, IL: Human Kinetics; 1989.

carbohydrates during competition
Carbohydrates During Competition
  • Consuming carbohydrate is neither practical nor necessary during exercise lasting less than 45 minutes
  • Small amounts of carbohydrate from sports drinks or foods may enhance performance during sustained high-intensity exercise lasting 45-75 minutes
  • Athletes should consume 30-60 g carbohydrate per hour from carbohydrate-rich fluids or foods during endurance and intermittent, high-intensity exercise lasting 1-2.5 hours
  • During endurance and ultra-endurance exercise lasting 2.5-3 hours and beyond, athetes should consume upt to 80-90 g carbohydrate per hour
    • Products providing multiple transportable carbohydrates are necessary to achieve these high rates of carbohydrate oxidation

Jeukendrup AE. Nutrition. 2004;20(7-8):669-677.Burke LM, et al. Carbohydrates for training and competition. J Sport Sci. 2011 (in press as of April 2011).

summary of key messages
Summary of Key Messages
  • A diet with high carbohydrate availability helps to maximize glycogen stores and generally increases exercise performance
  • Consuming carbohydrate during exercise also generally helps performance
    • Experiment in practice regarding tolerated levels
    • Liquid carbohydrates also help with hydration
  • Eating as soon as possible after exercise promotes the most rapid recovery of muscle glycogen
    • Combination of carbohydrate and protein may facilitate this process
  • Frequent, smaller meals can help athletes with high energy and carbohydrate requirements get in the required amounts of nutrients