Journal of Science and Medicine in Sport 17 (2014) 239–243

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Journal of Science and Medicine in Sport

journal homepage: www.elsevier.com/locate/jsams

Original research

Effects of carbohydrate-hydration strategies on glucose metabolism,

sprint performance and hydration during a soccer match simulation
in recreational players
Michael Kingsley a,b,∗ , Carlos Penas-Ruiz c , Chris Terry b , Mark Russell d
a
Exercise Physiology, La Trobe Rural Health School, La Trobe University, Australia
b
Sport and Exercise Science, Engineering, Swansea University, UK
c
Nutrition and Bromatology, Pharmacy, Universidad Complutense de Madrid, Spain
d
Sport and Exercise Sciences, Northumbria University, UK

a r t i c l e i n f o a b s t r a c t

Article history: Objectives: This study compared the effects of three carbohydrate-hydration strategies on blood glucose
Received 24 September 2012 concentration, exercise performance and hydration status throughout simulated soccer match-play.
Received in revised form 16 April 2013 Design: A randomized, double-blind and cross-over study design was employed.
Accepted 18 April 2013
Methods: After familiarization, 14 recreational soccer players completed the soccer match
Available online 20 May 2013
simulation on three separate occasions. Participants consumed equal volumes of 9.6%
carbohydrate–caffeine–electrolyte (∼6 mg/kg BW caffeine) solution with carbohydrate–electrolyte
Keywords:
gels (H-CHO), 5.6% carbohydrate–electrolyte solution with electrolyte gels (CHO) or electrolyte solution
Supplementation
Football
and electrolyte gels (PL). Blood samples were taken at rest, immediately before exercise and every
Shooting 15 min during exercise (first half: 15, 30, 45 min; second half: 60, 75, 90 min).
Rebound hypoglycemia Results: Supplementation influenced blood glucose concentration (time × treatment interaction:
p < 0.001); however, none of the supplementation regimes were effective in preventing a drop in blood
glucose at 60 min. Mean sprint speed was 3 ± 1% faster in H-CHO when compared with PL (treatment:
p = 0.047). Supplementation caused a 2.3 ± 0.5% increase in plasma osmolality in H-CHO (p < 0.001) with-
out change in CHO or PL. Similarly, mean sodium concentrations were 2.1 ± 0.4% higher in H-CHO when
compared with PL (p = 0.006).
Conclusions: Combining high carbohydrate availability with caffeine resulted in improved sprint perfor-
mance and elevated blood glucose concentrations throughout the first half and at 90 min of exercise;
however, this supplementation strategy negatively influenced hydration status when compared with
5.6% carbohydrate–electrolyte and electrolyte solutions.
© 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

1. Introduction exercise capacity.3 For example, Nicholas et al.4 demonstrated

Recreational and competitive team sport players often consume
carbohydrate–electrolyte solutions during exercise with the aim
to enhance blood glucose concentrations while maintaining euhy-
dration. More recently, carbohydrate–electrolyte gels have also
become popular to provide additional exogenous carbohydrate
during exercise,1 partly because gels allow the disassociation of
fluid and carbohydrate provision.2
Providing fluids with carbohydrate concentrations between 5
and 8% before and during activity patterns designed to simulate
intermittent sports has been repeatedly demonstrated to improve
∗ Corresponding author.
E-mail addresses: m.kingsley@latrobe.edu.au, m.i.c.kingsley@swansea.ac.uk
(M. Kingsley).
that ingesting 5 ml kg−1 BM of 6.9% carbohydrate–electrolyte solu-
tion prior to and 2.5 ml kg−1 BM of 6.9% carbohydrate–electrolyte
solution every 15-min during exercise improved exercise capac-
ity in recreationally active adults when compared with placebo.
Subsequently, the consumption of a carbohydrate gel has been
demonstrated to improve exercise capacity when compared with
a placebo solution.5
Commercial sports drinks and gels generally contain carbo-
hydrates and electrolytes; however, carbohydrate composition
and concentration is variable between manufacturers. Previous
studies evaluating the influence of carbohydrate concentration
on gastric emptying and intestinal absorption during continu-
ous exercise, have led to recommendations that drinks containing
between 5 and 8% carbohydrates should be ingested during exer-
cise, including team sports.6 Consuming multiple transportable
carbohydrates, typically fructose and glucose in a ratio of 1:2, is

1440-2440/$ – see front matter © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.jsams.2013.04.010
240 M. Kingsley et al. / Journal of Science and Medicine in Sport 17 (2014) 239–243

effective in enhancing gastric emptying,7 intestinal carbohydrate Table 1

Composition of the treatment beverages and gels ingested during the main trials
and water absorption7,8 and exogenous carbohydrate oxidation
(mean ± SEM).
rates.8,9 Moreover, caffeine has become a popular additive because
as well as being a central nervous system stimulant, when Beverages (per 100 ml) Gels (per 100 g)
co-ingested with carbohydrate, caffeine enhances carbohydrate H-CHO CHO PL Active PL
oxidation.10 However, the influence of strategies aimed at increas-
Solution osmolality 292 ± 3 112 ± 16 78 ± 1 1250 ± 31 82 ± 9
ing carbohydrate provision while maintaining fluid delivery has not (mOsm kg−1 )
been evaluated during high-intensity intermittent running. Caffeine (mg) 29.4 0 0 0 0
In summary, based on early work demonstrating a pay-off Energy (kJ) 177 99 8 647 20
between carbohydrate concentration and fluid delivery, intermit- Carbohydrate (g) 9.6 5.6 0.5 37.3 0.4
Fructose (g) 3.20 0.12 0.04 0.30 0.10
tent sports players have been encouraged to consume a 5–8% Fat (g) 0 0 0 0.3 0.3
carbohydrate–electrolyte solution before and during match-play.6 Protein (g) 0 0 0 0.2 0.2
However, these data were obtained during continuous exercise and Potassium (mg) 20.9 19.3 25.2 21.5 19.2
with a simple carbohydrate composition. Therefore, it is unclear Sodium (mg) 88.3 82.9 83.2 47.3 50.1
whether a non-carbohydrate sports drink, standard carbohydrate
sports drinks or a strategy aimed to enhance carbohydrate deliv-
ery should be encouraged for recreational soccer players. We (CHO), and electrolyte beverage and placebo gels (PL). The partici-
hypothesized that an advanced carbohydrate strategy (H-CHO), pants consumed carbohydrate at rates of 142 ± 3 g h−1 , 54 ± 2 g h−1
consisting of a 9.6% carbohydrate–electrolyte–caffeine solution and 5 ± 1 g h−1 throughout exercise during H-CHO, CHO and PL,
with a concentrated carbohydrate–electrolyte gel, would elevate respectively. The beverages and gels were consumed from iden-
blood glucose concentrations throughout soccer specific exercise tical containers and participants reported that the drinks and gels
and enhance exercise performance without influencing hydration were indistinguishable by taste and texture.
status or abdominal discomfort when compared with a standard Participants reported to trials in pairs according to estimated
sports drink and electrolyte solution. aerobic capacity (within 0.5 decimal levels on MSFT) at 08:00, after
an overnight fast. After emptying their bowels, baseline hydration
status was measured from a mid-flow urine sample by freez-
2. Methods ing point depression (Gonotec Cryoscopic Osmometer Osmomat
030; YSI, UK). At 08:20, participants consumed a standardized
Fourteen recreational soccer players (age: 24 ± 1 years, breakfast, consisting of 3 slices of white bread, 20 g of margarine
height: 1.80 ± 0.02 m, mass: 79.1 ± 2.3 kg, estimated V̇O2max : and 20 g of fruit jam (Energy: 1830 kJ; 57% carbohydrates, 35%
48.7 ± 1.6 ml kg−1 min−1 ) completed the study requirements, fats, 8% proteins) with 500 ml of treatment beverage. Participants
which were approved by a Human Ethics Committee of Swansea rested for 100 min before pre-exercise blood samples (170 ␮L hep-
University and conducted in accordance with the 1975 Declaration arinized tubes; Instrumentation Laboratory, UK) were taken for
of Helsinki. Participants were informed about potential risks and determination of blood glucose, sodium and lactate concentrations
signed written informed consent. Participants were recruited on (GEM Premier3000; Instrumentation Laboratory, UK). Approxi-
the basis that they had no injuries, were non-diabetic and were not mately 300 ␮L of venous blood from an antecubital vein was
at elevated risk of cardiovascular disease.11 centrifuged at 4000 × g for 15 min and osmolality of 50 ␮L plasma
Participants attended an indoor athletics facility with a rubber- was measured by freezing point depression (Gonotec Cryoscopic
ized surface for at least two preliminary visits and three main trials. Osmometer Osmomat 030; YSI, UK). Changes in plasma volume
Preliminary visits were used to estimate maximum oxygen uptake were estimated from blood haemoglobin concentration (Hemocue
via the multistage fitness test (MSFT)12 and to familiarize partici- Ltd, UK) and hematocrit (Micro Hct MK IV, Hawsley, UK), as pre-
pants with the soccer match simulation (SMS).13 Briefly, the SMS viously described.15 A 20-min standardized warm-up (running,
includes 90 min of intermittent free-running activity and ball skills dynamic stretching and ball skills) was completed before the SMS.
(dribbling, passing and shooting), completed in two 45-min halves Body mass (model 770; Seca, UK) and stature (Portable Stadiome-
separated by 15-min recovery (half-time). The construct validity ter; Holtain, UK) were measured. Blood glucose, sodium and lactate
and reliability of the skill tests have been previously reported14 ; concentrations were determined every 15 min throughout exercise
however, outcomes from the ball skills were not determined for this (first half: 15, 30, 45 min; second half: 60, 75, 90 min). In addition,
study. During the familiarization sessions the participants ingested plasma osmolality and body mass were determined after comple-
water at 14 ml kg−1 h−1 BM to promote gastric tolerance to fluid ting the SMS. Sweat losses were calculated as the change in body
ingestion. mass, with corrections made for fluid intake and urine loss.
Three main trials (H-CHO, CHO and PL) were completed in a Environmental conditions were measured during exercise
randomized, double-blind and cross-over fashion, separated by (ETHG-912; Oregon Scientific, USA). Heart rate (HR) was contin-
7 ± 2 days. Participants refrained from strenuous physical activ- uously recorded (Polar S610; Polar, Finland), ratings of perceived
ity and caffeine consumption for two days before testing. Dietary exertion (RPE: 6–20)16 and abdominal discomfort (0–10 Likert
records were analyzed for two days before all main trials (Com- scale) using anchor statements ranging from no abdominal pain (0)
peat v5.8.0; CompEat, UK). An initial bolus of treatment beverage to very severe abdominal pain (10)17 were obtained every 15 min.
(500 ml) was consumed with a standardized breakfast. Addition- Sprint times were measured using timing gates (Brower, USA).
ally, treatment beverage (5.25 ml kg−1 BM) and 2× pre-packed gels Statistical analyses were performed using IBM SPSS (version
(60 g) were consumed 20 min before exercise and 10 min before 19.0, SPSS Inc., Chicago, USA). Shapiro–Wilk’s test was con-
the second half of exercise and equal volumes (2.63 ml kg−1 BM) ducted to assess normality of data. All results were reported
of treatment beverages were consumed at 15, 30, 60 and 75 min as mean ± standard error of mean (SEM) and statistical signifi-
of exercise. The beverages and gels were specifically manufac- cance was set at p ≤ 0.05. One-way repeated measures analysis of
tured for this study and independently analyzed (Table 1; Eclipse variance (ANOVA) were used to compare anthropometrics, envi-
Scientific Group, UK). Throughout the trials, participants received ronmental conditions, nutritional intake, mean HR and sweat losses
9.6% carbohydrate–caffeine–electrolyte beverage and active gels between trials. Two-way repeated measures analysis of variance
(H-CHO), 5.6% carbohydrate–electrolyte beverage and placebo gels (ANOVA; within-participant factors: treatment × time of sample)
 M. Kingsley et al. / Journal of Science and Medicine in Sport 17 (2014) 239–243
Fig. 1. Blood glucose concentrations (A) and lactate concentrations (B) during the
high carbohydrate (H-CHO), carbohydrate (CHO) and placebo (PL) trials. Data pre-
sented as mean ± SEM. *Represents significant difference from PL (p < 0.05).
were used where data contained multiple time points. Mauchly’s
test was consulted and Greenhouse–Geisser correction was applied
if sphericity was violated. Where significant p-values were iden-
tified for interaction effects (time × treatment), supplementation
was deemed to have influenced the response and simple main effect
analyses were performed. Significant main effects of time were
further investigated using pairwise comparisons with Bonferroni
confidence-interval adjustment. Non-parametric data (abdominal
discomfort) were analyzed using a two-way Friedman test. A signif-
icant effect was identified and repeated Friedman tests examined
treatment and time differences. Repeated Wilcoxon Signed Rank
tests were employed post hoc to identify the location of a significant
treatment effect, using Bonferroni-corrected alpha values.
3. Results
Calculated daily macronutrient intake prior to the main trials
was 3.3 ± 0.3, 1.0 ± 0.1 and 1.1 ± 0.1 g kg−1 d−1 from carbohy-
drates, fats and proteins, respectively. No between-trial differences
existed for macronutrient content and energy intake. Participants
reported to the main trials in a similar hydration status, where
urine osmolality was 842 ± 48, 722 ± 61 and 799 ± 48 mOsm l−1
for H-CHO, CHO and PL, respectively (treatment: F(2,26) = 1.573,
p = 0.226). Ambient temperature (H-CHO, CHO, PL: 19.0 ± 0.4,
19.0 ± 0.3, 19.0 ± 0.1 ◦ C), barometric pressure (H-CHO, CHO, PL:
761 ± 2, 759 ± 2, 761 ± 2 mmHg) and humidity (H-CHO, CHO, PL:
59 ± 2, 59 ± 2, 62 ± 2%) were similar between trials.
As anticipated, supplementation influenced the pattern of
response in blood glucose concentrations (time × treatment inter-
action: F(12,156) = 5.453, p < 0.001; Fig. 1). Ingestion of carbohydrates
caused 23.4 ± 4.1% and 7.7 ± 4.5% increases in blood glucose con-
centration above PL throughout exercise in H-CHO and CHO,
241
respectively. Blood glucose concentrations were elevated above PL
at 15, 30, 45, 75, and 90 min in H-CHO and at 45 and 90 min in
CHO. At 60 min (15 min after half-time), blood glucose concentra-
tions fell rapidly (Fig. 1A). Ten participants (∼71%) experienced
blood glucose concentrations below 4.00 mmol l−1 and 57% of
participants returned values of less than 3.80 mmol l−1 in at
least one trial. Although supplementation did not influence the
pattern of blood lactate response (time × treatment interaction:
F(12,156) = 1.469, p = 0.141; Fig. 1B), mean blood lactate concentra-
tions were higher in H-CHO (6.78 ± 0.61 mmol l−1 ) when compared
with CHO (5.74 ± 0.66 mmol l−1 ) and PL (5.66 ± 0.71 mmol l−1 ;
treatment: F(2,26) = 5.237, p = 0.012).
The pattern of response for sprint speed was not influenced
by supplementation (time × treatment interaction: F(10,130) = 0.402,
p = 0.944). However, mean sprint speed was influenced by supple-
mentation (H-CHO: 5.73 ± 0.08 m s−1 , CHO: 5.66 ± 0.08 m s−1 and
PL: 5.58 ± 0.10 m s−1 ; treatment: F(2,26) = 3.493, p = 0.047), where
mean sprint speed was 3 ± 1% faster in H-CHO when com-
pared with PL (Fig. 2). Mean HR during exercise was higher
in H-CHO (169 ± 3 beats min−1 ) when compared with CHO
(166 ± 3 beats min−1 ) and PL (164 ± 3 beats min−1 ; treatment:
F(2,26) = 33.461, p = 0.001).
Fluid ingestion during exercise was 1.66 ± 0.05 l and this vol-
ume maintained body mass during exercise (time of sample:
F(1,13) = 0.391, p = 0.543). Sweat losses were not different between
trials (H-CHO: 1.71 ± 0.10 l, CHO: 1.59 ± 0.07 l, PL: 1.79 ± 0.10 l;
p > 0.088). The pattern of response in plasma osmolality was
influenced by supplementation (time × treatment interaction:
F(2,26) = 7.356, p = 0.003), where exercise caused a 2.3 ± 0.5%
increase in plasma osmolality in H-CHO (p < 0.001) and no change
in CHO or PL.
The pattern of response in sodium concentration was simi-
lar between trials (time × treatment interaction: F(12,156) = 1.443,
p = 0.152); nevertheless, mean sodium concentrations were higher
in H-CHO when compared with PL (H-CHO: 143 ± 1 mmol l−1 , CHO:
141 ± 1 mmol l−1 , PL: 140 ± 1 mmol l−1 ; treatment: F(2,26) = 6.327,
p = 0.006). Although the pattern of change in plasma volume did
not differ with supplementation (time × treatment interaction:
F(12,156) = 1.805, p = 0.052), plasma volume changes occurred during
exercise (time of sample: F(6,78) = 4.509, p = 0.001) and mean values
at 90 min were −4.4 ± 3.2%, −3.0 ± 2.9% and 3.6 ± 3.1% in H-CHO,
CHO and PL, respectively.
Rate of perceived exertion increased over time from 13 ± 1
at 15 min to 16 ± 1 at 90 min (time of sample: F(5,65) = 49.767,
p < 0.001); however, supplementation did not influence RPE
(treatment: F(2,26) = 0.602, p = 0.555). Supplementation influenced
abdominal discomfort (p = 0.006), where mean values during H-
CHO (2.0 ± 0.7) were higher than CHO (0.2 ± 0.2) and PL (0.4 ± 0.4).
4. Discussion
In accordance with our hypotheses, the high
carbohydrate–electrolyte–caffeine and carbohydrate–electrolyte
treatments increased blood glucose concentrations and improved
sprint performance during simulated soccer match-play. Although
neither carbohydrate-hydration strategy attenuated the drop in
blood glucose observed after half-time, glucose concentrations
were elevated at the end of exercise in H-CHO. Blood lactate con-
centration and mean heart rate were also higher in the H-CHO trial
when compared with CHO and PL. Despite this, H-CHO resulted
in higher plasma osmolality and sodium concentration compared
with CHO and PL.
Both H-CHO and CHO effectively increased blood glucose
concentrations above PL (Fig. 1A), where the provision of
142 ± 3 g h−1 (H-CHO) and 54 ± 2 g h−1 (CHO) elevated blood
242 M. Kingsley et al. / Journal of Science and Medicine in Sport 17 (2014) 239–243
Fig. 2. Sprint speed during the high carbohydrate (H-CHO), carbohydrate (CHO) and placebo (PL) trials (treatment effect: F = 3.493, p = 0.047). Data presented as mean ± SEM.
glucose concentrations by 23 ± 4% and 8 ± 5%, respectively. Early
research demonstrated that carbohydrate oxidation was limited
to ∼72 g h−1 when carbohydrates are consumed in the form of
glucose or maltodextrin18 ; therefore, most commercially avail-
able sports drinks are formulated to provide 30–80 g h−1 of
carbohydrate19 at rates of fluid ingestion of 400–800 ml h−1 .20
However, carbohydrate oxidation rates can be increased by
20–50% if multiple transportable carbohydrates are ingested dur-
ing exercise.21 Absorption in the intestinal lumen is the main
rate-limiting factor for carbohydrate oxidation during exercise.22
Consequently, carbohydrate gels are becoming popular because
they have the potential to provide larger doses of carbohydrates,
reduce fluid ingestion rates and decrease the chances of abdominal
discomfort.2 Furthermore H-CHO supplementation included caf-
feine, which has been demonstrated to further enhance intestinal
carbohydrate absorption and oxidation rates.10
H-CHO improved sprint performance (3 ± 1%) compared with
the placebo condition (PL). This finding generally agrees with pre-
vious studies demonstrating that carbohydrates, ingested as drinks
or gels, can improve exercise capacity,3–5 sprint performance23 and
soccer skills performance24 ; nevertheless in this study, the dif-
ference was only measurable in the high carbohydrate–caffeine
supplementation strategy.
Blood glucose concentrations decreased after half-time in all
trials. The majority of participants experienced blood glucose con-
centrations of less than 4.00 mmol l−1 (71%) and 57% of participants
returned hypoglycaemic values (<3.80 mmol l−1 ). Our group has
previously reported a rapid fall in blood glucose concentrations
after half-time in professional players during the SMS when a
6% sucrose–electrolyte beverage was consumed before and dur-
ing exercise.24 Because pre-exercise carbohydrate feeding did not
elicit a hypoglycaemic response in participants during the first
half, we hypothesize that increased insulin secretion along with
enhanced muscle glucose uptake and reduced liver glucose secre-
tion might explain the rapid drop in blood glucose that occurred
when participants resumed exercise after half-time. Although
sprint performance was not statistically reduced after half-time
in this study, several studies have observed a decrease in exercise
performance immediately after the recovery period during actual
match performance.25,26 The acute drop in blood glucose observed
here might be partially responsible for declining performance as
acute reductions in blood glucose concentration are associated
with altered mood state and cognitive dysfunction.27 Furthermore,
carbohydrate solutions (6% and 12%) have been reported to improve
vigilance and self-reported mood during sustained aerobic activity
in a dose-related manner even when euglycaemia is maintained.28
Therefore, the investigation of strategies to attenuate the acute
drop in blood glucose provides opportunity for future research.
Sweat losses during the trials were similar across all supple-
mentations; however, plasma osmolality increased by 2.3 ± 0.5% in
H-CHO. It is likely that increasing the carbohydrate concentration
caused water secretion from the enteric blood flow towards the
intestinal lumen to balance the osmotic pressure between com-
partments, thereby increasing plasma osmolality. In support of
this theory, plasma sodium concentrations were higher at the end
of exercise in H-CHO. Several studies have shown that ingesting
hypertonic carbohydrate solutions (>8% glucose and maltodex-
trin) increases plasma osmolality during continuous exercise.29
However, these findings from the current study are novel in that
they support a similar increase in plasma osmolality when multi-
ple transportable carbohydrates and caffeine are consumed during
high-intensity intermittent exercise.
Higher ratings of abdominal discomfort were reported during
H-CHO. This finding supports previous studies30 and suggests that
high doses of carbohydrate slow gastric emptying during intermit-
tent as well as during continuous exercise.
5. Conclusions
High carbohydrate feeding with caffeine increased blood glu-
cose concentrations and improved sprint performance throughout
soccer-specific exercise. However, this supplementation strategy
(H-CHO) was unable to attenuate the acute drop in blood glu-
cose commonly observed after the half-time period. In addition,
H-CHO increased plasma osmolality, heart rate and blood lactate
concentrations when compared with 6% carbohydrate–electrolyte
and electrolyte solutions. Therefore, future research seems neces-
sary to determine a carbohydrate-hydration strategy that improves
soccer performance throughout match-play without compromis-
ing hydration.
Practical implications
• Supplementation with 9.6% carbohydrate–electrolyte–caffeine
beverage with carbohydrate–electrolyte gels can improve sprint
 M. Kingsley et al. / Journal of Science and Medicine in Sport 17 (2014) 239–243
performance during high-intensity intermittent exercise in
recreational team players.
• Supplementation with 9.6% carbohydrate–electrolyte–caffeine
beverage with carbohydrate–electrolyte gels increases plasma
osmolality after high-intensity intermittent exercise.
• Supplementation with carbohydrates in the last 10 min of half-
time does not prevent hypoglycemia at the onset of exercise after
half-time.
Acknowledgements
This study was supported by a research grant from High 5 Ltd,
United Kingdom. The authors are grateful to Mr Dan Turner and Mr
Robert Rees for their assistance during data collection and to Mr
Gary Freegard for his technical support.
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