Since the excretory capacity of the kidneys is ~8001000 mL/h and fluid loss from exercise is estimated at an additional ~500 mL/h, in theory an athlete could conceivably consume up to 1.5 L/h without theoretical water retention [39]. Exhaustive endurance exercise and significant eccentric activities e.g., marathons, downhill running, and obstacle course races can result in catabolism of muscle, especially in the setting of inadequate protein or reduced energy availability and does raise muscle creatine kinase levels (a marker of muscle damage) [8,9,11]. High Rates of Muscle Glycogen Resynthesis after Exhaustive Exercise When Carbohydrate Is Coingested with Caffeine. Global Variation in the Frequencies of Functionally Different Catechol-O-Methyltransferase Alleles. Since mental toughness can play a key role in performance [91], the nutritional variables above could be considered by endurance athletes and incorporated into an athletes mental training. ; Analysis, investigation, resources, data curation, K.V. [(accessed on 3 April 2019)]; Wyndham C.H., Strydom N.B. Relevant to endurance athletes, green tea extracts have been shown to stimulate fat oxidation and weight loss at ranges of 2701200 mg/day [63]. However, prolonged time spent in train low may reduce ability to generate maximal power in high-intensity situations [12,19]. The catechins work as a catechol-o-methyltransferase (COMT) inhibitor (potentiating effects of norepinephrine, thermogenesis and fat oxidation) and phosphodiesterase inhibitor (preventing breakdown of cyclic adenosine monophosphate (cAMP) which stimulates hormone-sensitive lipase) [63].

Twelve articles were excluded as they either contained clinical studies on non-athletes, or mainly non-endurance (strength and power) athletes or were animal-based studies.

124). However, if the athletes focus is on racing and improving performance times, a high fat, low carbohydrate diet restricts that athletes ability to train and race and higher intensities [8] and may negatively affect their race outcome [8,12,19]. The authors recommend that athletes begin at lower doses if they are not caffeine tolerant and adjust accordingly. Rourke S. Drinking Tea: Are the Health Benefits Real? showed that while train low induced changes in mitochondrial enzyme activity (e.g., citrate synthase), there was no performance difference in actual exercise situations with either trained cyclists or triathletes involving steady-state exercise and time trial cycling [23]. All athletes risk dehydration in warmer (28 C) environments, however 50 kg athletes still risk overhydration at higher (800 mL/h) intakes and lower (12.5 km/h) speeds [48], further supporting that lighter slower runners are at increased risk and a hydration plan should be individualized [43]. Noakes T.D., Goodwin N., Rayner B.L., Branken T., Taylor R.K. Water Intoxication: A Possible Complication during Endurance Exercise. At these higher ends of intake, the authors recommend athletes routinely practice their fueling plan to assess GI comfort (e.g., liquid CHO may be more tolerable than solid) and practicality of their fueling plan. Furthermore, the commercial supplement industry is ever-changing. A PubMed/Medline search was performed for articles between 1980 and December 2018 using search terms nutrition for athletes, sports nutrition, endurance athlete nutrition, supplementation endurance, and the above MeSH keywords, without restrictions on language, sex or age. Convertino V.A., Armstrong L.E., Coyle E.F., Mack G.W., Sawka M.N., Senay L.C., Sherman W.M. However as clinical observations of overhydration mounted, the dangers became clearer. Most endurance athletes are familiar with high carbohydrate diets, but the importance of protein (both total daily intake and immediate post-exercise consumption) may not be as well-known by athletes. Gonalves L.S., Painelli V.S., Yamaguchi G., Oliveira L.F., Saunders B., da Silva R.P., Maciel E., Artioli G.G., Roschel H., Gualano B. Dispelling the Myth That Habitual Caffeine Consumption Influences the Performance Response to Acute Caffeine Supplementation. Dietary Protein for Athletes: From Requirements to Optimum Adaptation. [(accessed on 2 April 2019)]; Miller J.A. Silva T.d.A.e., de Souza M.E.D.C.A., de Amorim J.F., Stathis C.G., Leandro C.G., Lima-Silva A.E. Athletes who chronically restrict fat to <20% of total energy are at risk of low intake of fat-soluble vitamins and carotenoids, essential fatty acids including n-3 (omega-3) fatty acids [8,33], and possibly conjugated linoleic acids (CLA). Traditionally, there has been a long-held paradigm that habitual caffeine intake may blunt the ergogenic effects of acute pre-exercise caffeine consumption. However dairy-based proteins may be superior to other sources due to the higher leucine content and improved digestion/absorption kinetics of the EAAs found in liquid-based dairy foods [8]. [(accessed on 3 April 2019)]; Kim J., Park J., Lim K. Nutrition Supplements to Stimulate Lipolysis: A Review in Relation to Endurance Exercise Capacity. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. The topic of train low, training in a low carbohydrate state is also discussed, and the post-exercise nutritional recovery window remains an important point to emphasize to endurance competitors. In retrospect this should have prompted further thought as not being as serious a health risk as believed. While the prototypical endurance athlete may prefer a carbohydrate-based diet due to the above explained benefits in the previous section, some ultra-endurance athletes have recently become interested in ketoadaptation (becoming fat-adapted, or training low) with a high fat, low carbohydrate diet [32]. Antioxidants may help an athlete who has already peaked in terms of training adaptation, where the main goal is facilitating recovery and earlier return to competition in multi-stage events. This research received no external funding. Elite athletes, after they maximize training adaptations, often look to gain marginal benefits that they believe may be pivotal in whether they make the podium or not. Temporary ingestion of higher quantities during intense training may provide additional benefit [9,27]. Therefore, the authors suggest educating athletes on EAA (which contain BCAA) protein sources rather than solely BCAA which still pervade lay texts and popular media. BCAAs compete with tryptophan for transport across the blood brain barrier, and increased tryptophan may increase serotonin and contribute to feelings of fatigue [13]. The scale levels are derived from the 2002 United States Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ) report that addresses three key research elements: quality, quantity, and consistency of evidence [7]. Daily Training with High Carbohydrate Availability Increases Exogenous Carbohydrate Oxidation during Endurance Cycling. The authors declare no conflict of interest. Athletes commonly take supplements, and a few supplements may have merit in the endurance world. In summary, daily CHO requirements vary according to level of exercise, from 57 g/kg/day (1 h/day of moderate exercise), 610 g/kg/day (13 h/day of exercise), to 812 g/kg/day (4 h/day of exercise). Studies are mixed however, and nitrate may preferentially benefit non-elite recreational athletes. An interesting study by Cox et al.

; writingreview and editing, K.V. Athletes may also be concerned about severe or systemic side effects with this level of dosing. A systematic review was not done due to extreme heterogeneity of studies and data; a clinical/descriptive review was thus performed. Cumulatively, these effects can improve muscle economy, efficiency and mitigate fatigue, positively impact cardiorespiratory performance by decreasing effort at submaximal workloads, and in some studies improve time trial performance (albeit mainly in non-elite athletes) [12,51,52,53]. A safe starting dose may be up to 3 mg/kg. A follow up study by the same group showed even a CHO mouth rinse (without ingestion) has a positive effect on 1 h time trial performance [26] and is likely mediated by CHO receptors in the mouth associated with CNS motivation pathways.

Kerksick C.M., Arent S., Schoenfeld B.J., Stout J.R., Campbell B., Wilborn C.D., Taylor L., Kalman D., Smith-Ryan A.E., Kreider R.B., et al. The Effect of Carbohydrate Mouth Rinse on 1-h Cycle Time Trial Performance. Terasawa N., Okamoto K., Nakada K., Masuda K. Effect of Conjugated Linoleic Acid Intake on Endurance Exercise Performance and Anti-Fatigue in Student Athletes. In one placebo-controlled study, CLA at 0.9 g/day for 14 days significantly increased exercise time to exhaustion and tended to decrease perceived exertion in athletes [34], while 0.8 g/day for 8 weeks in another study showed no effect on time to exhaustion, VO2max, or body composition in healthy young men [35]. Exogenous Carbohydrate Oxidation during Ultraendurance Exercise. Can Carbohydrate Mouth Rinse Improve Performance during Exercise? Accessibility Attention to adequate intake is emphasized to improve recovery, ameliorate muscle damage, and maintain muscle mass. Larsen F.J., Ekblom B., Sahlin K., Lundberg J.O., Weitzberg E. Effects of Dietary Nitrate on Blood Pressure in Healthy Volunteers. Dosing also varies, and in studies typically ranges from either 300600 mg of nitrate supplement and up to 10 mg/kg, 0.1 mmol/kg with minimum 68 mmol total, 500 mL of beetroot juice, or approximately 36 whole beets [12,36,51]. Post-exercise fluid and sodium repletion recommendations are discussed in Recovery Nutrition section below. Nevertheless, endurance athletes may find it useful to purposefully exercise in lower carbohydrate availability states. Exercise and Fluid Replacement. Oral Administration of Vitamin C Decreases Muscle Mitochondrial Biogenesis and Hampers Training-Induced Adaptations in Endurance Performance. New Insights into the Interaction of Carbohydrate and Fat Metabolism during Exercise. However, in recent years, protein with higher EAA and leucine content (7003000 mg) have emerged to be the ideal source to stimulate MPS [9]. Gomez-Cabrera M.-C., Domenech E., Via J. However, it may produce overhydration in a 50 kg athlete running 10 km/h, or dehydration in a 90 kg athlete running 12.5 km/h. Spriet L.L. Ebell M.H., Siwek J., Weiss B.D., Woolf S.H., Susman J., Ewigman B., Bowman M. Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature. This low glucose state may be of advantage in ultra-endurance events where exercise is typically under 70% VO2max and fuel sources are predominantly fats. Carbohydrates for Training and Competition. Mouth rinse, oral antiseptics, or limited nitrate supplement oral contact time can all limit NO3 to NO2 conversion [12,19,51]. Endurance athletes prone to URI or GI symptoms, those susceptible to infection, or who travel frequently for events and are exposed to travel-related illness, may especially find benefit. Results: Carbohydrate and hydration recommendations have not drastically changed in years, while protein and fat intake have been traditionally underemphasized in endurance athletes. Partnerships Informed Choice. However recent studies show that short-term high-intensity exercise (or even complete physical inactivity) followed by a 1-day high (1012 g/kg/day) intake of CHO similarly achieves glycogen supercompensation, and this is maintained for 3 days [11,16].

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