Carbohydrates and exercise performance in non-fasted athletes: A systematic review of studies mimicking real-life

There is a consensus claiming an ergogenic effect of carbohydrates ingested in the proximity of or during a performance bout. However, in performance studies, the protocols that are used are often highly standardized (e.g. fasted subjects, constant exercise intensity with time-to-exhaustion tests), and do not necessarily reflect competitive real-life situations. Therefore, we aimed at systematically summarizing all studies with a setting mimicking the situation of a real-life competition (e.g., subjects exercising in the postprandial state and with time-trial-like performance tests such as fixed distance or fixed time tests). We performed a PubMed search by using a selection of search terms covering inclusion criteria for sport, athletes, carbohydrates, and fluids, and exclusion criteria for diseases and animals. This search yielded 16,658 articles and the abstract of 16,508 articles contained sufficient information to identify the study as non-eligible for this review. The screening of the full text of the remaining 150 articles yielded 17 articles that were included in this review. These articles described 22 carbohydrate interventions covering test durations from 26 to 241 min (mostly cycling). We observed no performance improvement with half of the carbohydrate interventions, while the other half of the interventions had significant improvement between 1% and 13% (improvement with one of five interventions lasting up to 68 min and with 10 of 17 interventions lasting between 70 and 241 min). Thus, when considering only studies with a setting mimicking real-life competition, there is a mixed general picture about the ergogenic effect of carbohydrates ingested in the proximity of or during a performance bout with an unlikely effect with bouts up to perhaps 70 min and a possible but not compelling ergogenic effect with performance durations longer than about 70 min.