Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations

This systematic review examines the efficacy of carbohydrate (CHO) supplementation on exercise performance of varying durations. Included studies utilized an all-out or endurance-based exercise protocol (no team-based performance studies) and featured randomized interventions and placebo (water-only) trial for comparison against exclusively CHO trials (no other ingredients). Of the 61 included published performance studies (n = 679 subjects), 82% showed statistically significant performance benefits (n = 50 studies), with 18% showing no change compared with placebo. There was a significant (p = 0.0036) correlative relationship between increasing total exercise time and the subsequent percent increase in performance with CHO intake versus placebo. While not mutually exclusive, the primary mechanism(s) for performance enhancement likely differs depending on the duration of the exercise. In short duration exercise situations (∼1 h), oral receptor exposure to CHO, via either mouthwash or oral consumption (with enough oral contact time), which then stimulates the pleasure and reward centers of the brain, provide a central nervous system-based mechanism for enhanced performance. Thus, the type and (or) amount of CHO and its ability to be absorbed and oxidized appear completely irrelevant to enhancing performance in short duration exercise situations. For longer duration exercise (>2 h), where muscle glycogen stores are stressed, the primary mechanism by which carbohydrate supplementation enhances performance is via high rates of CHO delivery (>90 g/h), resulting in high rates of CHO oxidation. Use of multiple transportable carbohydrates (glucose:fructose) are beneficial in prolonged exercise, although individual recommendations for athletes should be tailored according to each athlete's individual tolerance.