Impact of carbohydrate timing on glucose metabolism and substrate oxidation following high-intensity evening aerobic exercise in athletes: a randomized controlled study.

Abstract

Objective: The study aimed to investigate the impact of nutrient timing in relation to evening exercise. Specifically, it examined the effects of pre- or post-exercise carbohydrate (CHO) ingestion on glucose metabolism, glucose regulation, and overall substrate oxidation in well-trained athletes during and after physical exercise (PE), spanning the nocturnal period and the subsequent morning.

Methods: Ten male endurance cyclists participated in the study. The initial assessments included body composition measurements and an incremental cycle test to determine maximal oxygen uptake ($\dot{V}$O2 max) and maximum power output (Wmax). Following this, participants underwent a control (rest previous day) oral glucose tolerance test (OGTT) and a familiarization exercise trial that had two objectives: (1) to establish the appropriate amount of CHO to use in the pre- or post-exercise drink during the experimental trials, and (2) to familiarize participants with the equipment and study protocol. In the three days prior to both the control and experimental trials, participants followed a standardized, individualized diet designed to meet their energy needs. During the experimental trials, participants completed two separate evening exercise sessions (50 min@70%Wmax +  ~24 min time-trial (TT)) with either pre- or post-exercise CHO ingestion (253 ± 52 g), matching the CHO oxidized during exercise. The CHO drink and a volume-matched placebo (PLA) drink (containing no energy) were randomly assigned to be consumed two hours before and directly after the experimental exercise sessions. Post-exercise nocturnal interstitial glucose levels (24:00-06:00) were continuously monitored, and a 120-min OGTT was conducted the following morning to assess substrate oxidation rates and glucose control.

Results: Pre-exercise CHO intake significantly lowered capillary glucose levels during steady-state exercise (mean difference 0.41 ± 0.27 mmol/L, p = 0.001) without affecting perceived exertion and TT-performance. No difference was observed in nocturnal glucose regulation (00:00-06:00) regardless of whether CHO was consumed before or after exercise. Post-exercise CHO ingestion reduced glucose tolerance during the OGTT compared to the iso-caloric pre-exercise CHO intake (mean difference 0.76 ± 0.21 mmol/L, p = 0.017). However, a post-exercise CHO intake improved respiratory exchange ratio/metabolic flexibility (MetF) significantly. Enhanced MetF during the first OGTT hour after post-exercise CHO ingestion resulted in 70% and 91% higher CHO oxidation compared to pre-exercise CHO and control, respectively (p ≤ 0.029). Average 120-min OGTT fat oxidation rates were higher with both pre- and post-exercise CHO ingestion compared to control (p ≤ 0.008), with no difference between pre- and post-exercise CHO intake.

Conclusion: Morning glucose tolerance was markedly reduced in healthy athletes when CHO was ingested after evening exercise. However, the observed improvements in MetF during the OGTT compared to placebo post-exercise suggest a potential for enhanced athletic performance in subsequent exercise sessions. This opens exciting possibilities for future research to explore whether enhanced MetF induced by CHO-timing can translate to improved athletic performance, offering new avenues for optimizing training and performance.