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Carbohydrates, Physical

Training, and Sport

Robert Wildman, PhD, RD,1 Chad Kerksick, PhD, ATC, CSCS*D, NSCA-CPT*D,2 and Bill Campbell, PhD, CSCS3
Department of Human Nutrition, Kansas State University, Manhattan, Kansas; 2Department of Health and Exercise
Science, University of Oklahoma, Norman, Oklahoma; and 3School of Physical Education and Exercise Science,
University of South Florida, Tampa, Florida


he need for carbohydrate is a foremost thought among athletes.

Pasta dinners the night before
games and other high-carbohydrate
meals help maximize muscle glycogen
stores while gels and sport drink during
training or competition help fuel

working muscle as well as maintain

blood glucose levels (11,14). After
training or competition, carbohydrate
is invaluable to recover glycogen stores
(39,47,60,72), maximize muscle net
protein balance (75), and help fuel
other repair mechanisms. Glucose is
the primary carbohydrate fuel for
working muscle, and its contribution
to total energy increases relative to
exercise intensity and decreases with
prolonged duration secondary to waning muscle glycogen (62,63).

muscle glycogen content is reduced

(4,27,36). Meanwhile, the difference between the level of glucose in the arteries
supplying skeletal muscles and in the
veins that drain them is greater when the
muscles are engaged in physical activity
(65,80). Therefore, glucose uptake complements glycogen breakdown during
exercise. Furthermore, both hypoglycemia and muscle glycogen depletion have
proved to be independently involved in
reducing athletic performance and promoting fatigue (10,12,64).

Many other factors will influence how

much carbohydrate is used during
exercise including an athletes general
diet (46), timing, and composition of
the most recent meal (13,25,28,68) and
the consumption of a sport beverage
during exercise (8,12,54,56). In addition
to pre- and post-exercise considerations, interest in the role of the timing
and type of carbohydrate in the postworkout recovery period is growing as
a means of refueling and supporting
recovery efforts and maximizing skeletal muscle protein synthesis potential
(39,47,58,60,71,72,75). This review will
provide an overview of carbohydrate
level, timing, and type as well as
discussing exercise metabolism and
performance with special attention to
making recommendations for athletes
to optimize performance.

Kavouras et al. (46) reported that

endurance athletes consuming a highcarbohydrate diet (.600 g/d) while
reducing training had mixed muscle
glycogen levels of 104.5 6 9.4 mmol/kg
wet wt. Muscle glycogen levels tend to be
10 to 25% higher in type II vs type I
muscle fibers (31,32,69), and muscle
glycogen levels can be increased with
moderate- to high-intensity training
(3,49,50). For instance, MacDougall
et al. (50) reported a 66% increase in
muscle glycogen content following 5
months of weight training and that
increases were demonstrated in both
type I and II by 39 and 31%, respectively
(51). The total amount of muscle
glycogen is approximately 300 to 500 g
depending on an athletes gender, size,
and training status, while liver glycogen
stores range between 60 and 120 g.



Muscle tissues (biopsies) taken before and

after exhaustive exercise show that

Copyright National Strength and Conditioning Association


carbohydrate; muscle; metabolism;

glycogen; sport; exercise; review

Strength and Conditioning Journal |


Carbohydrate, Training, and Performance

Meanwhile, a blood glucose concentration of 70 to 110 mg/100 mL would

approximate 4 to 6 g of glucose for a total
blood volume of 5.5 L or the equivalent
of 16 to 24 kcal.

The forms of carbohydrate commonly

found in natural foods including grains,
fruits, vegetables, and dairy are starches
and sugars such as glucose, fructose,
lactose, and sucrose. Manufactured
sport bars, shakes, gels, etc, use glucose,
fructose, maltodextrin, corn syrup,
high-fructose corn syrup, starches, fruit
pastes, and purees (Table) with the
choice based on sensory and functional
properties and cost. In addition, the
type of carbohydrate chosen can have
different properties in the digestive
tract as well as varied glycemic and
insulinemic effects. Furthermore, the
combination of other nutrients, particularly amino acids, peptides, and
protein, brings about additional considerations for recovery, net muscle
protein synthesis, and soreness.

It has long been known that during

exercise, the utilization of carbohydrate
by skeletal muscle increases (4,36).
However, because free glucose is found
in relatively low levels in the blood and
within muscle cells, increased glucose
demands during exercise must be met
by glycogen breakdown (glycogenolysis) (4,36) and by an increased uptake of

Examples of carbohydrates
used to formulate sport
nutrition products*





Waxy maize starch



CS = corn syrup; HFCS = high fructose

corn syrup.
*Energy sources.
Typically derived from milk protein


Figure 1. Carbohydrate utilization during exercise. (1) Muscle glycogen stores are the
principal carbohydrate during high-intensity exercise bouts. (2) Ingestion of
carbohydrate can enhance glucose availability during exercise. (3) Conversion
of pyruvate to lactate increase as intensity increases, especially in type II fibers.

circulating glucose via the translocation

of GluT4 transporters to the sarcolemma in an insulin-independent
manner (16,29,30,59,83). Glucose is
metabolized via glycolysis yielding pyruvate, which can be converted to lactic
acid (lactate) or enter mitochondria for
aerobic metabolism (Figure 1). Increased exercise intensity leads to the
recruitment of more type II muscle
fibers that have lower O2 availability
and less mitochondria than type I
fibers and thus are more carbohydrate
dependent and produce more lactic
The increased reliance on carbohydrate as an energy source when
exercise intensity increases is demonstrated by an elevation in the respiratory exchange ratio and the level of
lactic acid in the blood during highintensity exercise (37). At roughly 50 to
65% V_ O2peak, the percentage contribution made by fatty acids to energy
expenditure tends to peak and as


intensity increases further the reliance

on carbohydrate does as well, especially muscle glycogen (62). Romijn
et al. (62) reported that after 30
minutes of cycling at 25% V_ O2peak,
carbohydrate made minor contribution
to ATP provision; but at 85% V_ O2peak,
carbohydrate, primarily glycogen, accounted for roughly two-thirds of the
energy expended (Figure 2).
Elsewhere, Gaitanos et al. (23) reported that 6 seconds of all-out cycling
reduced the glycogen content of vastus
lateralis muscle by 14%. Meanwhile,
a 30-second cycling sprint was reported to reduce muscle glycogen
content by as much as 27% (17), and
a 75-second cycling sprint to fatigue
reduced muscle glycogen content by
approximately 20% (35). Spriet et al.
(70) reported that during three 30second maximal cycling sprints separated by 4 minutes of rest, glycogen
made a progressively lower contribution to energy expenditure during the

athlete closer to fatigue. Furthermore,

a strong relationship exists between the
depletion of muscle glycogen stores
and/or hypoglycemia and the onset of
fatigue during endurance exercise
bouts in the range of 60 to 85%
V_ O2peak (68). As blood glucose levels
approach 45 mg/100 mL, one may
experience lightheadedness, lethargy,
and nausea (neuroglycopenia) (68).
For highly trained individuals, exercise
at this intensity could be endured
for more than 2 to 3 hours (72). This
is a typical time frame for sports such as
endurance cycling (e.g., tour stages and
cycling centuries), marathons (42 km
or 26.2 miles), triathlons (sprint or
Olympic distance), and Nordic skiing.

Figure 2. Contribution of different fuel sources in cycling exercise (fasted state) at

3 submaximal intensities after 30 minutes. Note that at 65% V_ O2peak,
the contribution made by muscle fuel resources begins to exceed blood
resources while the absolute contribution made by blood resources is
consistent despite changes in intensity. Based on data from Romijn et al.
(62) (note: calorie = 1/1,000 of a kilocalorie).

later sprints, which led to a decreased

work output. Multi-exercise resistance
workouts to fatigue have been noted to
reduce muscle glycogen content by up
to 25 to 40% in the active muscle (61,73).

During prolonged exercise, as muscle

glycogen stores wane, there is an
increasing reliance on plasma glucose
as a carbohydrate resource (62,63).
This transition typically takes an

General daily recommendations for

athletes are 8 to 10 g of carbohydrate
per kilogram of body mass daily or
$60% energy (1). Many athletes engage in carbohydrate loading (or
glycogen supercompensation) to maximize glycogen stores, a practice that
involves very high-carbohydrate intake
(.70% daily caloric intake from carbohydrate), reduced training, and/
or cessation in the days leading to an
endurance event or game (6,46,66).
While the classic method of glycogen
loading involved glycogen depletion
with 1 or more strenuous exercise
bouts and a very low-carbohydrate
intake for a couple of days, more recent
studies suggest a similar degree of
glycogen optimization by simply tapering and ceasing exercise and consuming a high-carbohydrate diet
(6,26,46,66). For instance, Bussau
et al. (6) provided participants a highglycemic carbohydrate diet at 10
gkg21d21 and significantly increased
muscle glycogen levels from 95 6 5
mmol/kg wet wt (baseline) to 180 6
15 mmol/kg wet wt after 1 day.
In a classic study by Bergstrom and
Hultman (4), it was determined that
an initial muscle glycogen content of
3.31, 1.75, or 0.63 g/100 g of wet
muscle grams allowed their participants to tolerate a standard endurance
workload for 167, 114, and 57 minutes

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Carbohydrate, Training, and Performance

prior to fatiguing. Thus, one potential

benefit of ingesting carbohydrate in the
hours prior to exercise would be to
raise muscle glycogen levels prior to
the onset of exercise. Along this line of
thinking, Coyle et al. (13) reported
that eating a high-carbohydrate meal
4 hours before 105 minutes of exercise
at 70% V_ O2peak increased muscle glycogen levels by 42% at the onset of
exercise and led to greater reliance on
muscle glycogen and total carbohydrate during the exercise bout. Meanwhile, research efforts on the ingestion
of carbohydrate at or within 60
minutes of exercise have yielded equivocal results with regard to performance
For instance, Sherman et al. (67) fed
either 75 or 150 g of glucose polymer
60 minutes prior to 90-minute cycling
at 70% V_ O2peak followed by a time trial
and reported that the cyclists were 13%
faster. Other studies have also reported
a positive impact of carbohydrate ingestion within an hour of endurance
exercise (25,28,55,74). On the other
hand, Foster et al. (22) reported decreased performance in cycling to
exhaustion at 80% V_ O2peak when
participants were provided 70 g of
glucose 30 minutes prior. Meanwhile,
several related studies of ingesting
carbohydrate within an hour of exercise have resulted in neither a positive
nor negative effect on performance
(7,15,20,34). Furthermore, research on
the type of carbohydrate (high or low
glycemic index) within 1 hour prior to
training has also led to equivocal
findings (19,74). Regarding carbohydrate type, the ingestion of either a high
or low glycemic meal or water 45
minutes prior to cycling for 135
minutes did not alter glycogen utilization or performance (20). In a similar
study, performance was not different
during 2 hours of cycling at 70%
V_ O2peak after ingesting either a high or
low glycemic meal 30 minutes before
the onset of exercise (19).
Goodpaster et al. (28) had cyclists
ingest 1 g/kg of glucose, resistant
starch (70% amylase/30% amylopectin), 100% amylopectin (waxy maize),


or a placebo in a 18.7% solution 30

minutes before a 90-minute ride at 66%
V_ O2peak, which was followed by a 30minute isokinetic performance trial.
Serum glucose and insulin levels were
significantly higher 15 minutes after
the cyclists ingested glucose compared
with the other treatments. Likewise,
after 30 minutes and just prior to
exercise onset, serum insulin levels
were still higher for the glucose
treatment trial. When compared with
placebo, carbohydrate oxidation was
greater in the glucose, resistant starch,
and amylopectin trials, and performance was greater in the glucose and
amylopectin trials. Carbohydrate oxidation and performance did not differ
among the different carbohydrate
types (28).
Carbohydrate ingestion immediately
prior (#5 minutes) to exercise can
result in improvements, especially if an
individual has not eaten for extended
periods (e.g., overnight fast). For instance, Neufer et al. (52) reported that
when cyclists ingested 45 g of carbohydrate 5 minutes prior to cycling for
45 minutes at 80% of their V_ O2peak
followed by a time trial, they were able
to generate a 10% greater average of
work output. It is logical to think that
any improvements in performance related to ingesting carbohydrate immediately before exercise would basically
be the same as ingesting carbohydrate
early in the session or distributed
throughout the exercise bout (2). This
supports the notion that during higher
intensity exercise, which would last
a shorter time (,1 hour), performance
can be enhanced by ingesting carbohydrate just few minutes prior to the
onset of exercise. However, added
benefits are not likely to result from
consuming additional carbohydrate
during the exercise bout (24).

Carbohydrate consumption during exercise increases the availability of

carbohydrate to working muscle fibers,
which can have a positive influence on
endurance (8,12,51) performance as
well as intermittent high-intensity


performance (54,56), the latter of

which could be applicable to sports
such as football, ice hockey, and soccer.
Carbohydrate type is an important
consideration as glucose, maltose, sucrose, amylopectin, and maltodextrins
are oxidized at higher rates than
fructose, amylose, and galactose (44).
Whether or not carbohydrate ingestion can slow the rate of muscle
glycogen, breakdown remains debated.
Some research involving cyclists suggests no effect while studies involving
treadmill running have suggested that
carbohydrate ingestion may actually
slow the rate of glycogen breakdown,
especially in type I fibers (12,33,76,77).
Regardless, carbohydrate ingestion
during endurance exercise can extend
performance time prior to fatigue
(12,51). For instance, McConell et al.
(51) provided highly trained cyclists
with an 8% carbohydrate solution
before and every 15 minutes during
a time trial performed at 70% V_ O2peak
and reported an average increase in
time to reach volitional exhaustion of
approximately 30% (47 minutes) over
placebo. Elsewhere, in a study design
whereby cyclists completed 4 distinct
70-km self-paced time trials while
intermittently receiving 116 6 6 g of
a carbohydrate beverage or placebo
and starting with high or low preexercise, glycogen content led to higher measures of power output and pace
in the final 14% of the time trial (84).
Other studies have also observed that
carbohydrate ingestion during prolonged endurance or intermittent exercise followed by a time trial can
enhance measures of performance
The ergogenic effects of glucose administration during exercise result from
maintaining euglycemia and supplying
muscle with an energy source as
glycogen stores become depleted
(11,14). However, glucose uptake and
oxidation may peak around 1.0 to 1.2
g/min late in exercise (44,72). Even
when higher amounts of glucose are
consumed during exercise, glucose
oxidation still plateaus (79). However,
some studies involving a blend of

carbohydrate types have reported

higher oxidation rates. For instance,
Wallis et al. (82) reported that providing maltodextrin and fructose can
lead to oxidation rates of 1.5 g/min
throughout 150 minutes of cycling at
55% maximum power output (64.2 6
3.5% V_ O2peak). Jentjens et al. (42)
reported a 21% increase in carbohydrate oxidation to 1.2 g of carbohydrate per minute after ingesting
a mixture of glucose and sucrose at
2.4 g/min while cycling at 63 6 2%
V_ O2peak.

Ingesting carbohydrate, either in liquid

or solid form shortly after training
or competition, is crucial to maximizing muscle glycogen recovery
(39,47,60,72). Timing is critical. If
carbohydrate is ingested within 30
minutes or so after exercise, enhanced
glucose uptake occurs as a result of the
increased GluT4 translocation during
exercise. On the contrary, if carbohydrate delivery is delayed by 2 hours, the
rate of glycogen recovery is slowed by
50% (39). Irrespective of post-exercise
timing, maximal glycogen resynthesis
is realized if 1.2 g of carbohydrate per
kilogram per hour is consumed every
15 to 30 minutes (41,78) for up to 5
hours, while maximal glycogen levels
are restored within 24 hours if dietary
carbohydrate intake levels of 8 g of
carbohydrate per kilogram per day (47)
are achieved. A carbohydrate intake of
9 to 10 g of carbohydrate per kilogram
per day is suggested for athletes who
are completing intense exercise bouts
on consecutive days (53).
The glycemic and insulinemic effect of
different carbohydrates is an important
consideration. For instance, Conlee
et al. (9) reported that fructose is not
an effective promoter of muscle glycogen recovery after glycogen-reducing
exercise. This is attributable to its
relatively low insulinemic effect and
subsequent low glucose availability and
uptake in skeletal muscle. Meanwhile,
Wallis et al. (81) reported that when
fructose is mixed with glucose in a 1:2

ratio, the rate of glycogen recovery is

not significantly different during the 4
hours after glycogen-depleting exhaustion exercise compared with an equivalent amount of glucose.
Similarly, post-exercise ingestion of
varying forms of starch has been shown
to impact resynthesis of muscle glycogen but not resulting performance. In
this regard, Jozsi et al. (45) reported
decreased muscle glycogen resynthesis
when cyclists ingested a 3,000-kcal diet
over a 24-hour period consisting of
100% amylose when compared with
dietary ingestion of glucose, maltodextrin, or a waxy starch (100% amylopectin). Twenty-four hours after a
glycogen-depleting exercise bout and
ingesting each respective isocaloric and
isocarbohydrate diet, muscle glycogen
levels were increased by a statistically
similar level after glucose (+197.7 6 31.6
mmolkg21dry21 muscle weight), waxy
starch/amylopectin (+171.8 6 37.1
mmolkg21dry21 muscle weight),
and maltodextrin (+136.7 6 24.5
mmolkg21dry21 muscle weight), which
was greater compared with ingestion
of 100% amylose (+90.8 6 12.8
mmolkg21dry21 muscle weight). However, subsequent performance was not
dependent on which type of carbohydrate was ingested (45).
Highmolecular weight carbohydrates
have become popular in more recent
years based on purported faster absorption and more potent insulinemic effect
than simpler sugars such as glucose. For
instance, when well-trained men endured glycogen-depleting exercise and
then consumed 75 g of a commercial
processed highmolecular weight, low
osmolality carbohydrate with fast
digestive kinetics (Vitargo; SweCarb,
Skeppsbron, Sweden) or a glucose/maltodextrin solution (lowmolecular
weight, high osmolality) immediately
after and at 30, 60, and 90 minutes (58)
post exercise, it was reported that the
highmolecular weight, processed carbohydrate solution, led to a 68% faster
glycogen recovery within the first 2
hours of recovery. Meanwhile, Stephens
et al. (71) provided 100 g of the same
highmolecular weight carbohydrate

(58) or a glucose/maltodextrin solution

to 8 healthy men after cycling to
exhaustion at approximately 73%
V_ O2peak. Participants then rested for
2 hours before completing a 15-minute
time trial. During the resting period,
both blood glucose and insulin were
significantly higher in the highmolecular weight carbohydrate group as
compared with the glucose/maltodextrin trial. Additionally, work output for
the highmolecular weight carbohydrate group was significantly greater
(average 10% higher) during a 15minute time trial that began 2 hours
after completion of the initial exhaustive exercise bout.
Higher glycemic index foods may
allow for a more rapid glycogen recovery versus lower glycemic index
foods. Meanwhile, the coingestion of
carbohydrate (4 g/kg body mass) with
caffeine (8 mg/kg body mass) has been
reported to result in a greater accumulation of glycogen during recovery
from exhaustive exercise (57). The
addition of protein to carbohydrate
has also been reported to enhance
muscle glycogen recovery. For instance, researchers depleted leg muscle
glycogen stores of athletes by having
them a cycle for 2.5 hours, and after
4 hours, muscle glycogen recovery was
greater when a protein supplement was
added to carbohydrate (40). However,
when a relatively high amount of
carbohydrate was provided after glycogen depletion exercise, additional
protein did not further enhance glycogen recovery (43). Likewise, Howarth
et al. (38) provided cyclists 1.2 g of
carbohydrate per kilogram per hour,
1.2 g of carbohydrate + 0.4 g of protein
per kilogram per hour, or 1.6 g of
carbohydrate per kilogram per hour for
2 hours after completing 2 hours of
cycling. They reported no difference in
the rate of glycogen recovery between
the trials, but the combination of
carbohydrate and protein led to higher
mixed muscle fractional synthetic rate
and whole body net protein balance.
In relation to the latter, carbohydrate
has been reported to support protein
and more specifically essential amino

Strength and Conditioning Journal |


Carbohydrate, Training, and Performance

acids in net muscle protein synthesis

largely by reducing post-training muscle protein breakdown (75), while
carbohydrate by itself does very little
to promote muscle protein synthesis
but can offset changes in protein
breakdown (5). Koopman et al. (48)
reported that if, indeed, carbohydrate
plays a supporting role in muscle
protein synthesis after training, it can
be negated by ample protein intake.

 The general recommendation for

carbohydrate intake among athletes
is 6 to 10 g/kg body weight (1). For
endurance athletes training aggressively or competing daily, a carbohydrate intake at the high end is better
 Athletes need to experiment with
timing and type of carbohydrate to
identify what works best for them.

 General recommendation for carbohydrate intake 3 to 4 hours prior to

exercise for an adult is 1 to 2 g/kg or
roughly 200 to 350 g. This would be
appropriate to raise glycogen stores
at the onset of exercise and potentially enhance performance especially if there was an extended
fasting period prior (e.g., sleep).
 Many athletes choose foods that
they have tolerated well in the past
and that have minimal indigestible
material (e.g., fiber). This meal
should be lower in fat to allow for
an optimal rate of emptying from the
stomach and should provide fluids to
optimize hydration status.

 During endurance exercise bouts,

athletes should strive to ingest 30
to 60 g of carbohydrate per hour of
performance to maintain blood glucose levels and optimize glucose
uptake and oxidation. This can be
achieved by drinking 600 to 1,200
mL of a 6 to 8% carbohydrate sport
drink per hour.



 Immediately after training or competition, it is recommended that

athletes ingest at least 1.5 g of
carbohydrate per kilogram of body
 Ingesting 1.2 g of carbohydrate per
kilogram of body weight every 30
minutes over a 5-hour period can
 Maximal glycogen levels can be
restored within 24 hours at dietary
carbohydrate intake levels of 8 g of
carbohydrate per kilogram per day.
 Waiting to ingest carbohydrate for
a couple of hours after strenuous
exercise will dramatically reduce the
rate of glycogen recovery.


 Despite lower glycemic and insulinemic responses with fructose versus

glucose, at this time, it does not seem
that there is a performance benefit to
using either if fructose is well
 Glycemic index of a pre-exercise
food(s) can clearly impact metabolic
response; however, the impact on
exercise performance is unresolved.
 Waxy maize starch (amylopectin)
can offer lower insulinemic responses compared with glucose if
used prior to exercise but result in
similar carbohydrate oxidation rates
and performance during prolonged
endurance exercise. Also, waxy
maize starch can be used after
exercise to facilitate fast muscle
glycogen recovery in a manner
similar to glucose and maltodextrin
if ingested in the post-exercise
molecular weight carbohydrates
may enhance post-exercise insulin levels and the rate of glycogen
resynthesis, which could be beneficial for short-term recovery periods
 Amylose and resistant starches
are not recommended as an exclusive carbohydrate source viable


carbohydrate option before, during,

or after exercise.
Robert Wildman
is adjunct faculty
in the Department
of Human Nutrition at Kansas
State University.

Chad Kerksick
is an assistant
professor of Exercise Physiology and
directs the Applied
and Molecular
Physiology Laboratory in the Health
and Exercise Science Department at the
University of Oklahoma.
Bill Campbell
is an assistant
professor at the
University of
South Florida and
is also the director
of the Exercise
and Performance
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