Journal
PROCEEDINGS OF THE NUTRITION SOCIETY
Volume 78, Issue 2, Pages 246-256Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0029665118002604
Keywords
Glucose; Galactose; Fructose; Glycogen; Physical activity
Categories
Funding
- European Society of Clinical Nutrition and Metabolism
- Rank Prize Funds
- The Physiological Society (UK)
- Biotechnology and Biological Sciences Research Council (UK)
- Medical Research Council (UK)
- Arla Foods Ingredients
- Lucozade Ribena Suntory
- Kenniscentrum Suiker and Voeding
- GlaxoSmithKline Nutritional Healthcare RD
- Kelloggs
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The present paper reviews the physiological responses of human liver carbohydrate metabolism to physical activity and ingestion of dietary sugars. The liver represents a central link in human carbohydrate metabolism and a mechanistic crux point for the effects of dietary sugars on athletic performance and metabolic health. As a corollary, knowledge regarding physiological responses to sugar ingestion has potential application to either improve endurance performance in athletes, or target metabolic diseases in people who are overweight, obese and/or sedentary. For example, exercise increases whole-body glycogen utilisation, and the breakdown of liver glycogen to maintain blood glucose concentrations becomes increasingly important as exercise intensity increases. Accordingly, prolonged exercise at moderate-to-high exercise intensity results in depletion of liver glycogen stores unless carbohydrate is ingested during exercise. The exercise-induced glycogen deficit can increase insulin sensitivity and blood glucose control, and may result in less hepatic lipid synthesis. Therefore, the induction and maintenance of a glycogen deficit with exercise could be a specific target to improve metabolic health and could be achieved by carbohydrate (sugar) restriction before, during and/or after exercise. Conversely, for athletes, maintaining and restoring these glycogen stores is a priority when competing in events requiring repeated exertion with limited recovery. With this in mind, evidence consistently demonstrates that fructose-containing sugars accelerate post-exercise liver glycogen repletion and could reduce recovery time by as much as half that seen with ingestion of glucose (polymers)-only. Therefore, athletes aiming for rapid recovery in multi-stage events should consider ingesting fructose-containing sugars to accelerate recovery.
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