endurance athletes may benefit from consuming additional

Chorley J., Cianca J., Divine J. This Pedersen D.J., Lessard S.J., Coffey V.G., Churchley E.G., Wootton A.M., Ng T., Watt M.J., Hawley J.A. Wilmore J.H., Costill D.L., Kenney W.L. 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. Grain Brain: The Surprising Truth about Wheat, Carbs, and SugarYour Brains Silent Killers. Protein. Conjugated linoleic acids are isomers of the essential n-6 linoleic acid, synthesized in the gut by bacteria and supplied in dairy products and ruminant meats (cow, sheep, goat, deer) [32]. Therefore, following the instinctive thirst mechanism and monitoring bodily parameters such as body weight, urine color, race pace, body temperature, and environmental temperature with each workout can help the athlete fine tune their individual hydration needs and avoid complications of EAH [19]. Recent data show that beetroot juice consumption should ideally commence within 90 min of exercise rather than 23 h prior as in earlier studies, since NO levels peak at 23 h and then sharply fall leaving the athlete in a potentially suboptimal time interval for exercise [51,55,56]. In recent years, there has been a shift in running from standard marathon races to other distance races such as mud runs, color runs, and obstacle course races [3]. Since then several publications have surfaced: a PubMed search on nitrate supplementation exercise yielded only 52 publications in the previous 10 years (20042013), but over 180 publications in the last 5 years (20142018). Diet, Muscle Glycogen and Physical Performance. Results however are currently mixed and sometimes contradictory; many positive studies are on subjects of 10 or fewer, and effects may be less pronounced or not even benefit already trained/elite athletes due to their nutrition plan (already containing adequate nitrate) and/or improved metabolic efficiency from maximizing training adaptations [12,53]. Conjugated linoleic acids, fish oil, and MCTs may have promise, but further studies are needed to specifically define their role in endurance athletes. Physiol. Endurance athletes are susceptible to upper respiratory infection (URI), and elite athletes have a higher rate of URI than recreational athletes [84]. Exercise-associated hyponatremia is serious and one of the potential causes of exercise-associated collapse [45] which can be fatal [42]. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. The https:// ensures that you are connecting to the Thomas D.T., Erdman K.A., Burke L.M. 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. Probiotics are considered live food ingredients that provide a beneficial effect to the host organism [83] and occur naturally in fermented foods such as yogurt, kimchee, sauerkraut, miso and natto, or can be taken in supplement form. Accessibility This may not only be for health concerns but as part of a periodization training plan, to enhance the training stimulus, or even improve mental toughness and grit [91] by exercising in low carbohydrate states. Therefore, many suggest it could be a tool in the tool belt as part of an athletes overall training and nutrition plan but should not be employed in high-intensity training or race situations due to performance concerns [12,19]. BCAAs compete with tryptophan for transport across the blood brain barrier, and increased tryptophan may increase serotonin and contribute to feelings of fatigue [13]. Temporary ingestion of higher quantities during intense training may provide additional benefit [9,27]. Periodically training in low glycogen/low glucose availability states may stimulate upregulation of fat oxidation pathways, spare glycogen stores, and may prolong time to exhaustion [12,19,20]. Post-exercise refueling of CHO is also a complex topic and separately discussed below in Recovery Nutrition and also outlined in Table 1. 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. Asian populations have higher concentrations of high-activity COMT polymorphism than Caucasians, and so there may be a population-specific effect in Asian populations [67]. Global Variation in the Frequencies of Functionally Different Catechol-O-Methyltransferase Alleles. Metabolic, Catecholamine, and Exercise Performance Responses to Various Doses of Caffeine. Muscle protein synthesis (MPS) is upregulated for 24 h following exercise and is due to the increased sensitivity to oral protein intake during this time [8,29]. Carbohydrate Needs Endurance athletes need somewhere in the range of ____-____ grams of carbs per kg of body weight and depends on energy expenditure, level/vol of training goals etc. The field of probiotic research in athletes is still in its early stages, and few studies exist regarding performance outcomes [86]. [(accessed on 3 April 2019)]; Wyndham C.H., Strydom N.B. Manner of ingestion must also be considered when interpreting study results. In a review, green tea extract was shown to enhance fat oxidation and improve performance during endurance exercise [65]. Taking the two together improves cycling work production compared to caffeine or carbohydrate alone, while perception of work remains unchanged [74]. We also recommend athletes should practice their fueling plan at race/game intensity, as GI tolerability can be decreased on race day due to the increased stress response and sympathetic/parasympathetic imbalance on game day. Another important clinical consideration is in hot conditions; clinicians should counsel athletes to reduce CHO intake by 10% due to lowered CHO oxidation rates in hot environments [11]. Probiotic supplementation can improve mucosal T-cell interferon concentration to normal levels and attenuate the reduction in natural killer cell activity [83]. A later study by Carter supports this showing that even an intravenous infusion of glucose during a 1 h time trial, despite increases in plasma glucose for oxidation and evidence of increased glucose uptake into the tissues, had no effect on 1-h cycling time trial performance [25]. The authors declare no conflict of interest. and transmitted securely. Integr. Spriet L.L. Sports nutrition involves the fields of sports medicine, sports science, dietetics, cultural influences, and even popular media. An important point to the clinician however, is that even after 4.5 h of cycling at 70% of maximum O2 consumption (VO2max) when CHO stores should be entirely depleted, elite athletes can still run at 16 km/h for an additional 2.5 h at 66% VO2max [13]. However, the authors caution this strategy in hypertensives or those needing to restrict total sodium intake. WebEndurance athletes may benefit from consuming additional A.minerals. Burke L.M., Hawley J.A., Wong S.H.S., Jeukendrup A.E. Inclusion in an NLM database does not imply endorsement of, or agreement with, 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. ISSN Exercise & Sports Nutrition Review Update: Research & Recommendations. Manufacturers and sellers promote these products, sometimes referred to as ergogenic aids, by claiming that they improve strength or endurance, increase exercise Therefore, it remains to be seen if green tea catechins exert a significant performance effect on trained and non-overweight athletes. Aggressive carbohydrate refeeding at 1.2 g/kg/h for the first few hours post-exercise should be implemented if glycogen repletion is needed quickly for another event with <4 h recovery time [11,30]. A systematic review demonstrated that rinsing every 510 min (of at least 510 s of oral contact) with a 6.410% carbohydrate solution may improve performance by ~23% [21] in high intensity (>70% VO2max) exercises bouts of up to 1 h. We therefore suggest that for athletes with GI distress during high-intensity exercise that precludes actual oral carbohydrate intake, this strategy may be of value if the event is 1 h or less. Phillips S.M., Van Loon L.J.C. Similarly, eccentric and highly stressful exercise bouts that raise free radical and ROS levels can delay recovery to peak form due to the excessive oxidant load surpassing the innate antioxidant system [58,59,60,61]; ingestion of high antioxidant foods such as tart cherry juice may improve recovery [62]. Palmatier M.A., Kang A.M., Kidd K.K. WebNevertheless, given the additional benefits of consuming protein immediately after exercise to support the repair and remodeling of skeletal muscle (see below), endurance Caffeine is a trimethylxanthine, similar to adenosine in chemical structure [71]. Exercise Associated Hyponatraemia: Quantitative Analysis to Understand the Aetiology. In the Boston marathon [42], an alarming 13% of finishers had hyponatremia which was even considered an underestimation, and 0.6% (90 finishers) were critical (120 mmol/L). Hyponatremia among Runners in the Boston Marathon. Separate "Supps" and "Fuel". Endurance athletes may benefit from consuming additional. Overtraining syndrome: How much exercise is too In the absence of high-quality evidence, we also provide practical recommendations on select supplements and offer our clinical advice on specific topics based on years of treating endurance athletes. Studies have shown that high carbohydrate (810 g/kg/day) refeeding can restore pre-exercise glycogen values within 24 h [11]. the contents by NLM or the National Institutes of Health. Larsen F.J., Ekblom B., Sahlin K., Lundberg J.O., Weitzberg E. Effects of Dietary Nitrate on Blood Pressure in Healthy Volunteers. Key recommendations for macronutrients, hydration, and supplements (exercise duration is listed in italics within parentheses). To cover every vitamin, mineral, and supplement available in the arena of nutrition for athletes however is beyond the scope of this paper, so this review shall focus on the major macronutrient requirements including carbohydrate (CHO), protein and fat needs, hydration requirements, and select specific topics including caffeine, nitrates, probiotics, and antioxidants as they relate to endurance athletes. Strength and power athletes are typically recommended to consume in the higher range and endurance athletes the lower range, based on individual needs. Total fat and fatty acids. High Rates of Muscle Glycogen Resynthesis after Exhaustive Exercise When Carbohydrate Is Coingested with Caffeine. The pro-oxidant environment including the buildup of reactive oxygen species (ROS) from exercise triggers adaptations in the form of increased superoxide dismutase and glutathione peroxidase enzymes, muscle repair, and mitochondrial biogenesis pathways [58,59,60,61,62]. Regul. WebResearch has demonstrated that endurance athletes on a high-carbohydrate diet can exercise longer than athletes eating a low-carbohydrate, high-fat diet. Krabak B.J., Parker K.M., DiGirolamo A. Exercise-Associated Collapse: Is Hyponatremia in Our Head? However, doses above 9 mg/kg may result in urinary caffeine detection and considered above the doping threshold in many professional sports organizations [36]. The proposed health benefits of green tea are typically attributed to its antioxidant properties that can scavenge ROS and free radicals associated with many chronic diseases [63,64]. and A.G.; writingoriginal draft preparation, K.V. Of note, few human studies exist regarding green tea extract on athletic performance. During the epic bike ride of a triathlon, Kris has two types of bottles. An outdated model is simply following nitrogen balance, which was originally designed to prevent nutrient deficiency, not optimize performance. Pre-competition (Loading) recommendations also vary according to duration of exercise, from 6 g/kg/day (<90 min of exercise) to 1012 g/kg/day (>90 min of exercise) with a 14 g/kg final top-off 14 h prior to event. Additionally, as with any supplement, since the US Food and Drug Administration (FDA) is not authorized to review dietary supplement products for safety and effectiveness before they are marketed, there is the risk of contaminants and illicit substances in commercial supplements. Gomez-Cabrera M.-C., Domenech E., Via J. An interesting study by Cox et al. Montain S.J., Cheuvront S.N., Sawka M.N. HHS Vulnerability Disclosure, Help Institute of Medicine, Food and Nutrition Board . Branched-chain amino acid supplementation still may help endurance athletes via central governor theory modulation [13]. Methods: A PubMed/Medline search on the topics of endurance, athletes, nutrition, and performance was undertaken and a review performed summarizing the current evidence concerning macronutrients, hydration, and supplements as it pertains to endurance athletes. Probiotics have many proposed health benefits including antimicrobial activity to improve diarrheal illness and reduce urogenital infection, assisting with lactose intolerance, preventing constipation, improving immune function, and possibly even having anticarcinogenic effects to the colon [83]. the Dietary Reference Intakes regular soda The Effect of Glucose Infusion on Glucose Kinetics during a 1-h Time Trial. Further advice for the overdrinking athlete could include presenting the dichotomy illustrated in the 2007 ACSM position stand: while dehydration can impair exercise performance and contribute to heat illness or exacerbate exertional rhabdomyolysis, exercise-associated hyponatremia can produce grave illness or even death [40]. Low and Moderate Doses of Caffeine Late in Exercise Improve Performance in Trained Cyclists. Several supplements are commercially available to athletes, of which, few may be of benefit for endurance activities, including nitrates, antioxidants, caffeine, and probiotics, and are reviewed here. Beaumont R., Cordery P., Funnell M., Mears S., James L., Watson P. Chronic Ingestion of a Low Dose of Caffeine Induces Tolerance to the Performance Benefits of Caffeine. )The New York Times. Therefore, the AND, DC, and ACSM recommend spreading protein dosing at ~0.3 g/kg every 35 h throughout the day [8]. Of note in one study, the anhydrous form of supplemental caffeine may have a greater ergogenic effect than drinking coffee [75], although in this study the caffeine capsule was actually taken with water. Long endurance bouts can challenge hydration status; fluid and therefore bodyweight loss is expected with exercise and 0.13.0% bodyweight loss after exercise is still defined as euhydration [44,45]. In retrospect this should have prompted further thought as not being as serious a health risk as believed. Medium-chain triglycerides (MCTs) have also gained attention in recent years, as MCTs can directly enter mitochondria and be used for energy via beta-oxidation [36]. [(accessed on 3 April 2019)]; Goldstein E.R., Ziegenfuss T., Kalman D., Kreider R., Campbell B., Wilborn C., Taylor L., Willoughby D., Stout J., Graves B.S., et al. Interestingly, addition of potassium does not show any additional rehydration benefit [11]. Knowledge of CLAs effects on endurance exercise is currently limited and often conflicting, and most research has been on overweight subjects. D.vitamins. maximum heart rate. If taken up to 23 h prior to endurance exercise it can reduce oxygen cost during exercise, may improve time to exhaustion, cardiorespiratory performance at anaerobic threshold, and VO2max [45]. Antioxidants and Exercise Performance: With a Focus on Vitamin Endurance athletes looking to maximize fat oxidation and spare glycogen during longer, lower intensity events may find this valuable. This renewed interest is based on the higher oxidation of fat vs. glucose in lower intensity (<70% VO2max) exercise states typically seen in ultra-endurance events [19]. 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]. Murase T., Haramizu S., Shimotoyodome A., Nagasawa A., Tokimitsu I. These benefits may help the athlete in terms of comfort and recovery from exercise, and therefore indirectly may play a role in performance. Ultra-endurance activities are typically defined as events lasting at least 4 [4] to 6 h [5] duration. One is full of water, electrolytes (in the form of Kaged Muscle Hydra Endurance athletes may experience this when exercising in difficult conditions, such as bad weather and low fuel availability. McMahon N.F., Leveritt M.D., Pavey T.G. The International Society of Sports Nutrition (ISSN) recommends in order to maximize glycogen stores athletes should employ an 812 g/kg/day high CHO diet [9]. Consequently, glycogen depletion must not be the sole determiner of fatigue. The AND, DC, and ACSM all recommend protein ingestion for athletes in the range of 1.22.0 g/kg/day [8], with the ISSN recommending 1.42.0 g/kg/day [9]. 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). [(accessed on 2 April 2019)]; Costa R.J.S., Hoffman M.D., Stellingwerff T. Considerations for Ultra-Endurance Activities: Part 1Nutrition. It benefits athletes because the greater the PWR is, the less physical effort the athlete has to do to achieve a goal. If tolerable, the athlete may therefore consider a pre-exercise dose of 0.3 g/kg protein according to GI tolerance. [(accessed on 25 May 2019)]; Shilton A. Lets Try a TriathlonThe New York Times. Dementia has even been colloquially referred to as type 3 diabetes. Athletes may worry what potential effects consuming high glycemic meals or foods have on training-related metabolic responses and exercise performance. 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. If an athlete cannot tolerate this carbohydrate volume, the addition of caffeine (3 mg/kg, even up to 8 mg/kg if no side effects) can boost glycogen repletion up to 66% more [30,87]. International Society of Sports Nutrition Position Stand: Nutrient Timing. Oral Administration of Vitamin C Decreases Muscle Mitochondrial Biogenesis and Hampers Training-Induced Adaptations in Endurance Performance. In one study, upon a 2 h cycling at 60% VO2max interspersed with bouts of high-intensity (82% VO2max) exercise followed by a cycling time-trial, athletes were given either low dose (1.5 mg/kg) or moderate dose (2.9 mg/kg) caffeine at 80 min in to the cycling challenge. It has numerous proposed mechanisms of action. In: Lamprecht M., editor. Careers, Unable to load your collection due to an error. 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. The authors recommend that athletes begin at lower doses if they are not caffeine tolerant and adjust accordingly. In the final 14 h prior to the event, a single dose of 14 g/kg CHO is recommended for a final top-off of liver glycogen stores, as typically endurance events occur in the early morning directly after the overnight fast which depletes liver glycogen [8]. Carter J.M., Jeukendrup A.E., Jones D.A. Prior studies have illustrated the challenges that ultra-endurance exercise exerts on the body in terms of fatigue, sub-optimal nutrition, and energy deficit [4,5], and brings awareness to the potential medical complications of ultra-endurance exercise [5] underscoring the importance of an individualized nutritional approach [4]. Athletes may think more is better and increase protein beyond recommendations. Bentley D.J., Ackerman J., Clifford T., Slattery K.S., Lamprecht M. Green Tea Catechins and Sport Performance. The Running Bubble Has Popped. Exercise and Fluid Replacement. Although there have been significant advances in the understanding of nutritional requirements for endurance athletes, many gaps still exist in the literature. Nutrition for sports and exercise - British Nutrition Foundation 124). The world of endurance nutrition is continually evolving, and clinicians need to keep up-to-date as research emerges on sports nutrition topics. Grit: The Power of Passion and Perseverance (Vol. If the athlete can only tolerate 0.8 g/kg/h of carbohydrate, adding protein at 0.20.4 g/kg/h can also boost glycogen repletion [30,87]. This translates roughly to >1380 mg of sodium/L, amounts significantly higher than in typical sports drinks. Effects of Dietary Nitrate on Oxygen Cost during Exercise. Moderate Exercise Is an Antioxidant: Upregulation of Antioxidant Genes by Training. The Advisory Statement by Noakes and the International Marathon Medical Directors Association suggest the athlete start with a hydration plan in the range of 400800 mL/h [47], which was also adopted in the ACSM Position Stand in 2007 [40] recommending athletes drink ad libidum, in the suggested range of 400800 mL/h. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Nikolaidis P.T., Veniamakis E., Rosemann T., Knechtle B. However, adequate protein intake and timing of intake are critical to any athlete, whether endurance or resistance trained. In a review of the literature, only six studies were found, and while two did show an ergogenic effect on performance, one study was in mice [86]. Glaister M., Gissane C. Caffeine and Physiological Responses to Submaximal Exercise: A Meta-Analysis. Relevant to endurance athletes, green tea extracts have been shown to stimulate fat oxidation and weight loss at ranges of 2701200 mg/day [63]. Systemically, caffeine assists in mobilization of fatty acids for energy (decreasing dependence on glycogen) and increases thermogenesis [72]. Exogenous Carbohydrate Oxidation during Ultraendurance Exercise. Spence L., Brown W.J., Pyne D.B., Nissen M.D., Sloots T.P., McCormack J.G., Locke A.S., Fricker P.A. Timing and dose are also shown to be important; 0.250.3 g/kg of a quality protein source (see below) in the immediate 02 h post exercise provides approximately 10 g of essential amino acids (EAA) (which maximally stimulate MPS and the MPS associated signaling proteins mTOR, p70s6k, Akt needed for protein synthesis) [8,9,28,30]. Jonvik K.L., Nyakayiru J., van Loon L.J.C., Verdijk L.B. Probiotics may play a role in reducing these symptoms [85]. 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]. Federal government websites often end in .gov or .mil. Nitrates may help reduce oxygen cost and improve time to exhaustion, possibly cardiorespiratory performance at anaerobic threshold, and even VO2max. The Effects of Catechin Rich Teas and Caffeine on Energy Expenditure and Fat Oxidation: A Meta-Analysis. In a review, tart cherry juice at 812 oz twice a day (or 1 oz if concentrate), taken 45 days prior and 23 days after an event may promote recovery [62]. Green Tea Extract Improves Endurance Capacity and Increases Muscle Lipid Oxidation in Mice. Due to the popularity of endurance and ultra-endurance events, there is a need to define nutritional needs of the athletes. In these situations, high glycemic index foods (>70) are preferred [30]. The role of antioxidant supplements in sport was notably questioned by Gomez-Cabrera [58,59,60,61] who highlighted the potential blunting of the training adaptation response to exercise. The stimuli for SIADH include nausea/vomiting, hypoglycemia, hypotension, interleukin-6 (IL-6) release, and hyperthermia, all of which can occur with prolonged exercise [44,45]. 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]. However, dilution of serum sodium causing EAH commonly occurs at much lower water intake rates, placing the athlete at risk [39,45]. It is defined by a serum, plasma, or blood sodium concentration below the reference laboratory range, which for most laboratories is <135 mmol/L [44]. 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]. This increased absorption provides an ideal time to optimize protein intake in order to maintain muscle mass after endurance exercise, as prolonged endurance exercise may induce a catabolic state and resultant muscle breakdown [8,9,30]. Physiological Models to Understand Exercise Fatigue and the Adaptations That Predict or Enhance Athletic Performance. Fats recently have been gaining popularity again, especially with ultra-endurance athletes, although training low with a high-fat diet may not necessarily improve performance. Protein also plays an essential role in sports nutrition, as it provides the body with the necessary amount of amino acidsto help build and repair muscles and tissues. B.carbohydrates. Sections are divided into Carbohydrate (with subsections on pre-competition loading vs. during competition fueling requirements), Protein (subsections on daily vs. pre-, during, and post-exercise requirements), Fat, Hydration, and finally Supplements and Hot Topics. When available, new and controversial or opposing views to traditional sports nutrition recommendations are presented. Graham T.E., Spriet L.L. J. Physiol. Probiotics and Athletic Performance: A Systematic Review. WebEndurance athletes may benefit from consuming additional are designed to prevent nutritional deficiencies and chronic diseases. Additionally, a final word of warning bears consideration: since the methods of growing, harvesting, and preparing green tea vary widely (and any supplement may contain contaminants or banned substances), athletes should exercise caution. How To Supplement For Endurance Sports - Bodybuilding.com Fortunately, lower doses <3 mg/kg can be similarly ergogenic in endurance cycling and running research, improving vigilance, mood, and cognitive function, without any major side effects [77]. Armstrong L.E., Casa D.J., Maresh C.M., Ganio M.S. The AND, DC, and ACSM all recommend sodium ingestion during exercise in athletes with high sweat rates (>1.2 L/h), subjective salty sweaters, and prolonged exercise >2 h [9]. Traditionally, proteins containing branched-chain amino acids (BCAAs leucine, isoleucine, and valine) have garnered much attention in both popular media and research due to their role in protein metabolism, nerve function, and glucose/insulin regulation. American College of Sports Medicine Position Stand Exercise and Fluid Replacement. U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality Clinical Guidelines and Recommendations. Before In the authors clinical experience treating endurance athletes, these topics were included to provide clinicians with information regarding the more commonly asked questions by endurance athletes. There has been considerable discussion in both the medical literature and popular media [88,89] regarding the recent trend of low carbohydrate diets. Sports nutrition recommendations for endurance exercise however remains a complex issue with often opposing views and advice by various health care professionals. This can reduce creatine kinase elevations, improve subjective feelings of muscle soreness, and may increase MPS and net protein balance [9,11]. This higher intake recommendation stems from research demonstrating that exogenous CHO oxidation peaks at a CHO ingestion rate of 1.01.1 g/min, due to the maximal GI absorption at this rate [11,17]. Bussau V.A., Fairchild T.J., Rao A., Steele P., Fournier P.A. When taken every 35 h spread throughout the day (including a dose immediately before or 02 h post-exercise) to a total of ~1.22.0 g/kg/day, this strategy may promote positive nitrogen balance and optimally benefit endurance athletes. Received 2019 Apr 9; Accepted 2019 Jun 6. ; Analysis, investigation, resources, data curation, K.V. Certain vegetables such as beets, and beetroot juice, contain high levels of inorganic nitrate (NO3). B.carbohydrates. Athletes may also be concerned about severe or systemic side effects with this level of dosing.
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