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Carbohydrate supplementation: a critical review of recent innovations

  • Invited Review
  • Published:
European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

To critically examine the research on novel supplements and strategies designed to enhance carbohydrate delivery and/or availability.

Methods

Narrative review.

Results

Available data would suggest that there are varying levels of effectiveness based on the supplement/supplementation strategy in question and mechanism of action. Novel carbohydrate supplements including multiple transportable carbohydrate (MTC), modified carbohydrate (MC), and hydrogels (HGEL) have been generally effective at modifying gastric emptying and/or intestinal absorption. Moreover, these effects often correlate with altered fuel utilization patterns and/or glycogen storage. Nevertheless, performance effects differ widely based on supplement and study design. MTC consistently enhances performance, but the magnitude of the effect is yet to be fully elucidated. MC and HGEL seem unlikely to be beneficial when compared to supplementation strategies that align with current sport nutrition recommendations. Combining carbohydrate with other ergogenic substances may, in some cases, result in additive or synergistic effects on metabolism and/or performance; however, data are often lacking and results vary based on the quantity, timing, and inter-individual responses to different treatments. Altering dietary carbohydrate intake likely influences absorption, oxidation, and and/or storage of acutely ingested carbohydrate, but how this affects the ergogenicity of carbohydrate is still mostly unknown.

Conclusions

In conclusion, novel carbohydrate supplements and strategies alter carbohydrate delivery through various mechanisms. However, more research is needed to determine if/when interventions are ergogenic based on different contexts, populations, and applications.

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Abbreviations

βHB:

Beta hydroxybutyrate

CHO:

Carbohydrate

CHO + PRO:

Combined carbohydrate and protein solutions

FFA:

Free fatty acid

FMC:

Fast-absorbing modified carbohydrate or starch

GLUT5:

Intestinal fructose transporter

HGEL:

Carbohydrate hydrogel solution

IFABP:

Intestinal fatty acid-binding protein

L:R:

Lactulose to rhamnose ratio

MC:

Modified carbohydrate or starch

MCT:

Medium-chain triglycerid

MTC:

Multiple transportable carbohydrate

RER:

Respiratory exchange ratio

RM:

Repetition maximum

SGLT1:

Sodium-dependent glucose transporter 1

SMC:

Slow-absorbing modified carbohydrate or starch

T1D:

Type 1 diabetes

TTE:

Time to exhaustion

TT:

Time trial

VO2max :

Maximal oxygen consumption

VO2peak :

Peak oxygen consumption

W max :

Peak power output

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Acknowledgements

The authors would like to thank Katie Baur for reviewing this manuscript and providing comments. The authors are also grateful to Dr. William Wightman, for creating the artwork used in Fig. 1.

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Authors and Affiliations

  1. Department of Physical Education, Virginia Military Institute, 208 Cormack Hall, Lexington, VA, 24450, USA

    Daniel A. Baur

  2. Department of Kinesiology, James Madison University, Harrisonburg, VA, 22801, USA

    Michael J. Saunders

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  1. Daniel A. Baur
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Contributions

All authors contributed to the conception and drafting of this review. Daniel Baur was primarily responsible for drafting the following sections: abstract, introduction, conclusions, and sections on modified carbohydrate, hydrogels, caffeine, lipids, nitrate, diets, specials populations, and tables. Michael Saunders drafted the section on multiple transportable carbohydrates, protein, and the figure. Both authors provided edits and comments. All authors read and approved the final manuscript.

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Correspondence to Daniel A. Baur.

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Communicated by Michael Lindinger.

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Baur, D.A., Saunders, M.J. Carbohydrate supplementation: a critical review of recent innovations. Eur J Appl Physiol 121, 23–66 (2021). https://doi.org/10.1007/s00421-020-04534-y

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