Post-exercise ingestion of a unique, high molecular weight glucose
polymer solution improves performance during a subsequent bout
of cycling exercise
FRANCIS B. STEPHENS, MARC ROIG, GERALD ARMSTRONG, &
PAUL L. GREENHAFF
The aim of the present study was to determine the effect of post-exercise ingestion of a unique, high molecular weight
glucose polymer solution, known to augment gastric emptying and post-exercise muscle glycogen re-synthesis, on
performance during a subsequent bout of intense exercise. On three randomized visits, eight healthy men cycled to
exhaustion at 73.0% (s¼1.3) maximal oxygen uptake (90 min, s¼15). Immediately after this, participants consumed a onelitre
solution containing sugar-free flavoured water (control),
100 g of a low molecular weight glucose polymer or 100 g of a
very high molecular weight glucose polymer, and rested on a bed for 2 h. After recovery, a 15-min time-trial was performed
on a cycle ergometer, during which work output was determined. Post-exercise ingestion of the very high molecular weight
glucose polymer solution resulted in faster and greater increases in blood glucose (P50.001) and serum insulin (P50.01)
concentrations than the low molecular weight glucose polymer solution, and greater work output during the 15-min timetrial
(164.1 kJ, s¼21.1) than both the sugar-free flavoured water (137.5 kJ, s¼24.2; P50.05) and the low molecular weight
glucose polymer (149.4 kJ, s¼21.8; P50.05) solutions. These findings could be of practical importance for athletes wishing
to optimize performance by facilitating rapid re-synthesis of the muscle glycogen store during recovery following prolonged
sub-maximal exercise.
Keywords: Gastric emptying, skeletal muscle glycogen, sub-maximal exercise
Introduction
Muscle glycogen is recognized as the major fuel
supporting adenosine triphosphate (ATP) homeostasis
during sustained moderate-to-intense exercise,
with the rate of glycogen utilization increasing
with the intensity of exercise performed (Bergstrom,
Hermansen, Hultman, & Saltin, 1967; Bergstrom &
Hultman, 1966, 1967a; Hultman, Bergstrom, &
Anderson, 1967). The depletion of muscle glycogen
during exercise is associated with an accelerated rate
of muscle phosphocreatine degradation, adenine
nucleotide loss (Broberg & Sahlin, 1989), and
muscle fatigue (Bergstrom & Hultman, 1966;
Hultman et al., 1967), most probably due to the
inability of muscle to maintain ATP production at
the required rate. Thus, high pre-exercise muscle
(and liver) glycogen concentrations are believed
to be essential for optimal endurance exercise
performance (Bergstrom et al., 1967), and the rapid
re-synthesis of the muscle glycogen store is, therefore,
of crucial importance during recovery for
individuals who take part in training sessions or
competitions where prolonged sub-maximal exercise
or several periods of sub-maximal or intense exercise
are performed in a single day.
Limiting factors to post-exercise muscle glycogen
re-synthesis following carbohydrate feeding include
the amount, timing, and form of carbohydrate
administered, the rate of gastric emptying and
intestinal absorption of the ingested carbohydrate,
glucose storage and output by the liver, and muscle
glucose transport and oxidation (for a review, see
Jentjens&Jeukendrup, 2003). Studies in which glucose
has been intravenously infused immediately following
glycogen-depleting exercise have reported two- tothreefold
greater rates of glycogen re-synthesis compared
with post-exercise carbohydrate feeding [30 – 40 vs.
Correspondence: F. B. Stephens, E Floor, School of Biomedical Sciences, University of Nottingham Medical School, Queen’s Medical Centre, Nottingham
NG7 2UH, UK. E-mail:
francis.stephens@nottingham.ac.uk
Journal of Sports Sciences, January 15th 2008; 26(2): 149 – 154
ISSN 0264-0414 print/ISSN 1466-447X online 2008 Taylor & Francis
DOI: 10.1080/02640410701361548
85 – 130 mmol kg dry muscle71 h71 (Bergstrom &
Hultman, 1967b; Hansen, Asp, Kiens, Richter, 1999;
Jentjens & Jeukendrup, 2003; Piehl-Aulin, Soderlund,
& Hultman, 2000; Roch-Norlund, Bergstrom, &
Hultman, 1972). This suggests that the rate of gastric
emptying and intestinal absorption of the ingested
carbohydrate, and glucose storage and output into
the circulation by the liver, rather than muscle
glucose uptake, is limiting to post-exercise muscle
glycogen re-synthesis following carbohydrate feeding.
Indeed, by using a unique, high molecular
weight, low osmolality glucose polymer solution [the
lower the osmolality of a carbohydrate polymer
solution, the faster its rate of gastric emptying
(Hunt, Smith, & Jiang, 1985; Vist & Maughan,
1995)], Piehl-Aulin and colleagues (2000) achieved
muscle glycogen synthesis rates following glycogendepleting
exercise that were 70% greater over 2 h
(50 vs. 30 mmol kg dry muscle71 h71) compared
with a commercially available solution of monomeric
and short-chain oligomeric glucose with a
lower molecular weight (500,000 – 700,000 vs.
*500 g mol71) and higher osmolality (60 – 84 vs.
*300 mOsmol kg71). Using the same carbohydrate
solutions, Leiper and colleagues (Leiper,
Aulin, & Soderlund, 2000) confirmed that this
observation was likely to be due to a two-fold greater
rate of gastric emptying in the first 10 min after
carbohydrate administration.
Taking these observations together, we predicted
that achieving a greater re-synthesis of muscle
glycogen following glycogen-depleting exercise
would result in the enhancement of performance
during a subsequent bout of exercise. Therefore, the
aim of the present study was to determine the effect
of a unique, high molecular weight glucose polymer
solution, ingested immediately after exhaustive exercise,
on performance during a subsequent cycling
time-trial, compared with an isoenergetic, commercially
available, low molecular weight glucose
polymer solution, in healthy, recreationally active
young males.
Materials and methods
Participants
Eight healthy, recreationally active young men (mean
age 23.0 years, s¼4.5; body mass 78.7 kg, s¼7.6;
body mass index 24.3 kg m72, s¼2.4), recruited
from the student population at the University of
Nottingham, participated in the present study, which
was approved by the University of Nottingham
Medical School Ethics Committee in accordance
with the Declaration of Helsinki. Before taking part
in the study, all participants underwent routine
medical screening and completed a general health
questionnaire. All participants provided their informed
consent to take part in the study and were
aware that they were free to withdraw from the
experiment at any point. Upon entry to the study
each participant performed a continuous, incremental
exercise test to exhaustion on an electrically
braked cycle ergometer (Lode Excalibur, Lode,
Groningen, The Netherlands) to determine their
maximal oxygen uptake ( _V O2max), which was confirmed
no less than 3 days later. The mean _V O2max
for the group was 47.8 ml min71 kg71 (s¼4.4).
Each participant was then familiarized with prolonged
cycling exercise at least 1 week before the
start of the experiment.
Experimental protocol
Each participant reported to the laboratory at
09.00 h on three randomized occasions, separated
by at least 1 week, and voided their bladder. The
visits were randomized to eliminate any training
effect of the prolonged exercise protocol. All
participants were instructed to maintain the same
dietary intake in the previous 24 h, and to abstain
from alcohol and strenuous exercise in the previous
48 h. On arrival at the laboratory, participants were
asked to rest in a supine position on a bed for 20 min
while a cannula was inserted retrogradely into a
superficial vein on the dorsal surface of the nondominant
hand for subsequent venous blood sampling.
A 0.9% saline drip (Baxter Healthcare,
Northampton, UK) was attached to keep the cannula
patent. Participants then performed two-legged
cycling exercise on an electrically braked cycle
ergometer (Lode Excalibur, Lode, Groningen, The
Netherlands) to the point of exhaustion at a
predetermined workload equivalent to 75% _V O2max
(217 W, s¼13), while maintaining a pedalling
frequency of 70 rev min71. Participants were allowed
to stop exercising at any time, but after a short
rest of up to 5 min were required to resume exercise.
In an attempt to maximize depletion of muscle
glycogen stores, this work – rest protocol was repeated
until participants were no longer able to
maintain a pedal frequency of 70 rev min71 for
more than 2 min. We have previously demonstrated
that this protocol results in almost complete muscle
glycogen depletion in the exercised leg (Casey et al.,
1995). To eliminate the effect of volume on gastric
emptying, consumption of water was allowed ad
libitum throughout exercise on the first visit, with the
pattern of consumption then repeated for the
following visits.
Immediately after exercise, participants rested in a
semi-supine position on a bed for 2 h with their hand
in a hand-warming unit (air temperature 50 – 558C)
to arterialize the venous drainage of the hand
150 F. B. Stephens et al.
(Gallen & MacDonald, 1990). Thereafter, participants
ingested a one-litre solution containing sugarfree
flavoured water (control), 100 g of a low
molecular weight (approximately 900 g mol71) glucose
polymer derived from hydrolysed corn starch
(Maxijul, SHS International, Liverpool, UK), or
100 g of a very high molecular weight (approximately
500,000 – 700,000 g mol71) glucose polymer, also
derived from corn starch (*****, Swecarb AB,
Kalmar, Sweden). The carbohydrate solutions were
isoenergetic (*1600 kJ), with osmolalties of 124 and
34 mOsmol kg71 for the low and very high molecular
weight drinks, respectively. The low molecular
weight drink was chosen as we believe it is
representative of the standard ‘‘recovery’’ carbohydrate
(maltodextrin) drink on the market (e.g.
Science in Sport PSP22, High5 EnergySource).
Two hours after the consumption of the drink,
participants were asked to perform as much work as
possible in 15 min of cycling exercise on an
electrically braked cycle ergometer (Lode Excalibur,
Lode, Groningen, The Netherlands). This endurance
performance time-trial, which has been shown
to be reproducible in trained athletes [coefficient of
variation of 3.5% (Jeukendrup, Saris, Brouns, &
Kester, 1996)] and recreationally active participants
similar to the present cohort (coefficient of variation
of 1.6%), consisted of pedalling at the highest
intensity sustainable on the cycle ergometer for
15 min. The ergometer was programmed to a
pedalling-dependent mode such that with an increase
in pedalling rate, the work rate was also
increased. During the test, participants were only
made aware of the time remaining so that they could
pace themselves to maximize work output. The total
amount of work performed in 15 min, recorded
every second on a computer attached to the
ergometer, was taken as a measure of endurance
performance.
Sample collection and analysis
During the recovery period of each experimental
visit, 3 ml of arterialized venous blood were obtained
every 10 min and used immediately for measurement
of blood glucose concentration (YSI 2300
STATplus, Yellow Springs Instruments, OH, USA).
The remaining blood was allowed to clot and, after
centrifugation, the serum was stored frozen at
7808C. Insulin was measured in these samples at a
later date with a radioimmunoassy kit (Coat-a-Count
Insulin, DPC, CA, USA).
Statistical analysis
A two-way repeated-measures analysis of variance
(time and treatment effects; GraphPad Prism 4.02,
GraphPad Software Inc, CA) was performed to
locate differences in blood glucose and serum insulin
concentration during the recovery period. When a
significant main effect was detected, the data were
analysed further with a Student’s paired t-test using
the Bonferroni correction. A one-way analysis of
variance with Tukey’s post-hoc test was used to locate
any differences in exercise performance. Statistical
significance was set at P50.05, and all the values
presented in the text and figures are reported as
means and standard deviations (s).
Results
Glycogen-depleting exercise
Mean time to exhaustion for the sugar-free flavoured
water (control), low molecular weight solution, and
high molecular weight solution was 91 min (s¼12),
90 min (s¼15), and 88 min (s¼9), respectively,
while cycling at an exercise intensity of 73.4%
(s¼0.
, 72.5% (s¼1.9), and 73.1% (s¼1.3) of
_V
O2max, respectively.
Blood glucose
Blood glucose concentration was the same following
the bout of exhaustive exercise during the sugar-free
flavoured water (3.9 mmol l71, s¼0.3), low molecular
weight solution (3.7 mmol l71, s¼0.2), and
high molecular weight solution (3.9 mmol l71,
s¼0.4) trials (Figure 1). After consumption of the
sugar-free flavoured water, blood glucose concentration
remained at 3.9 mmol l71 for 2 h. Following
consumption of the low and high molecular weight
solutions, blood glucose concentration increased to a
peak of 7.3 mmol l71 (s¼0.
and 8.1 mmol l71
Figure 1. Blood glucose concentration during a 2-h period of
recovery from glycogen-depleting exercise and following the
ingestion of a one-litre solution containing sugar-free flavoured
water (idiot), 100 g of a low molecular weight glucose polymer
(LMW) or 100 g of a very high molecular weight glucose polymer
(HMW). *P50.05, **P50.01, ***P50.01, HMW significantly
greater than LMW. Values are means+standard deviations.
Carbohydrate ingestion and exercise performance 151
(s¼0.5) after 50 and 30 min, respectively, and then
declined to similar values of 6.1 mmol l71 (s¼0.5)
and 6.1 mmol l71 (s¼0.7), respectively, after 2 h.
This increase in blood glucose concentration occurred
at a faster rate following consumption of the
high than the low molecular solution (0.14 vs.
0.07 mmol l71 min71), such that blood glucose
concentration was higher at 10 (P50.05), 20
(P50.01), 30 (P50.001), and 40 (P50.01) min
following ingestion.
Serum insulin
Serum insulin concentration was the same following
the bout of exhaustive exercise during the sugar-free
flavoured water (5.4 mU l71, s¼2.9), low molecular
weight solution (5.2 mU l71, s¼3.0), and high
molecular weight solution trials (6.1 mU l71,
s¼2.7), respectively (Figure 2). Following consumption
of the sugar-free flavoured water, serum insulin
concentration remained around 6.0 mU l71 for 2 h.
Following consumption of the low and high molecular
weight solutions, serum insulin concentration
increased to a peak of 68.7 mU l71 (s¼33.2)
and 80.6 mU l71 (s¼52.
after 40 and 70 min,
respectively, and then declined to similar values
of 45.7 mU l71 (s¼18.7) and 48.0 mU l71
(s¼20.4), respectively, after 2 h. Serum insulin
concentration was greater following consumption of
the high than the low molecular weight solution at 20
(P50.05), 30 (P50.01), and 40 (P50.01) min
following ingestion.
Work output
Work output during the 15-min endurance performance
time-trial test, performed 2 h after the
ingestion of the sugar-free flavoured water, low
molecular weight solution, and high molecular
weight solution, was 137.5 kJ (s¼24.2), 149.4 kJ
(s¼21.
, and 164.1 kJ (s¼21.1), respectively.
Work output following the consumption of the low
and high molecular weight solutions was greater than
that following the consumption of the sugar-free
flavoured water (P50.01 and P50.001, respectively).
Furthermore, work output was 10% greater
(P50.01) following ingestion of the high than the
low molecular weight solution. Importantly, this
increase in work output was observed in all
participants studied (range 3.4 – 23.3%; Figure 3).
Discussion
The main aim of the present study was to determine
the effect of a unique, high molecular weight glucose
polymer solution (known to increase the rate of
gastric emptying and post-exercise muscle glycogen
re-synthesis, compared with a low molecular weight
glucose polymer solution) on performance during a
subsequent cycling time-trial. In this respect, work
output 2 h after glycogen-depleting exercise and the
ingestion of the high molecular weight solution was
20% greater (P50.001) than with the sugar-free
flavoured water and, more importantly, 10% greater
(P50.01) than with the low molecular weight
solution. Furthermore, this positive performance
effect of the high molecular weight solution was
observed in all eight participants (Figure 3).
Previous studies have shown that the high molecular
weight solution used in the present study
emptied from the stomach twice as fast, and resulted
in a 70% greater increase in muscle glycogen content
Figure 2. Serum insulin concentration during a 2-h period of
recovery from glycogen-depleting exercise and following the
ingestion of a one-litre solution containing sugar-free flavoured
water (idiot), 100 g of a low molecular weight glucose polymer
(LMW) or 100 g of a very high molecular weight glucose polymer
(HMW). *P50.05, **P50.01, HMW significantly greater than
LMW. Values are means+standard deviations.
Figure 3. Work output for each individual participant during a 15-
min ‘‘all-out’’ cycling time-trial that was performed 2 h after
glycogen-depleting exercise and the ingestion of a one-litre
solution containing sugar-free flavoured water (idiot), 100 g of
a low molecular weight glucose polymer (LMW) or 100 g of a very
high molecular weight glucose polymer (HMW). **P50.01,
***P50.001, LMW and HMW significantly greater than idiot,
respectively. {{P50.01, HMW significantly greater than LMW.
152 F. B. Stephens et al.
2 h after glycogen-depleting exercise, compared with
a low molecular weight solution (Leiper et al., 2000;
Piehl-Aulin et al., 2000). In accordance with this,
peak blood glucose concentration following ingestion
of the high molecular weight solution in the
present study was 10% greater, and occurred 20 min
earlier, than with the low molecular weight solution
(Figure 1). Furthermore, the rate of increase in
blood glucose concentration was two-fold greater
over the first 30 min following ingestion, which is in
line with the two-fold greater rate of gastric emptying
observed during the initial 10 min following ingestion
of the high molecular weight solution by Leiper
and colleagues (2000). The rapid increase in blood
glucose concentration following ingestion of the high
molecular weight solution also resulted in a significantly
higher serum insulin concentration during
the first hour of recovery (Figure 2). In the present
study, there were no differences between visits in
exercise time to exhaustion in the ‘‘glycogen-depleting’’
phase of the study, suggesting that post-exercise
muscle glycogen content was similar across treatments
at exhaustion. Furthermore, blood glucose
values before the cycling time-trial were the same for
the high and low molecular weight trials. It is
reasonable to speculate, therefore, that the improvement
in exercise performance observed after ingestion
of the high molecular weight solution in the
present study was the result of greater re-synthesis of
the skeletal muscle glycogen store during the 2 h of
recovery following exhaustive exercise compared
with after ingestion of the low molecular weight
solution, particularly as the ingestion of carbohydrate
per se resulted in an increase in performance compared
with ingestion of the sugar-free flavoured
water.
It should be noted, however, that in the study of
Piehl-Aulin and colleagues (2000), there were no
differences in blood glucose or serum insulin
concentration between the high molecular weight
and control drink. The reasons for the discrepancy
between the findings of the present study and those
of Piehl-Aulin et al. (2000) are unclear, but could
be because a mixture of monomeric and short-chain
oligomeric glucose, with a lower molecular weight
than the low molecular weight drink used in the
present study (*500 vs. *900 g mol71), was used
in the control drink by Piehl-Aulin and colleagues.
Additionally, any potential differences in blood
glucose or serum insulin concentration during
recovery in Piehl-Aulin and colleagues’ study could
have been missed because of the use of venous
blood sampling (as opposed to arterialized-venous
sampling in the present study), the relatively large
time interval in blood sampling (30 min), the large
inter-individual variation in blood glucose
and serum insulin, or the repeated ingestion of
carbohydrate every 30 min of recovery. Also, Piehl-
Aulin et al. (2000) speculated that if a faster delivery
of glucose to the intestine is combined with a faster
glucose uptake by the muscle cell immediately after
exercise, this may mask an increase in delivery
of glucose to the blood from the intestine and
result only in minor changes in blood glucose
concentration.
Since the pioneering work of Bergstrom and
Hultman in the 1960s (Bergstrom & Hultman,
1966, 1967a, 1967b; Bergstrom et al., 1967), it has
been recognized that a clear relationship exists
between pre-exercise muscle glycogen concentration
and prolonged exercise performance. In the present
study, a 15-min high-intensity sub-maximal timetrial
was used to measure exercise performance
and it is unquestionable that, assuming a normal
pre-exercise muscle glycogen content of 350 –
450 mmol kg dry muscle71, muscle glycogen availability
will not limit performance in this test.
However, given that the participants performed
prolonged exhaustive exercise before the time-trial,
it is clear that muscle glycogen content would have
been markedly reduced. Indeed, we have previously
shown that this exercise model reduces muscle
glycogen content to *25 mmol kg dry muscle71
(Casey, Short, Hultman, & Greenhaff, 1995). Thus,
we propose that muscle glycogen content would not
have been restored during the 2 h of recovery that
preceded the 15-min time-trial, particularly in the
control condition where only water was ingested,
such that its availability would have limited exercise
performance during the 15-min time-trial (particularly
in the control trial). By way of example, in the
study by Piehl-Aulin et al. (2000), muscle glycogen
content increased from 60 to 118 and 153 mmol kg
dry muscle71 during the 2 h of recovery following
glycogen-depleting exercise in the low and high
molecular weight trials, respectively. Furthermore,
300 g of carbohydrate was administered in Piehl-
Aulin and colleagues’ study compared with only
100 g in the present study. It is plausible, therefore,
that post-exercise re-synthesis of muscle glycogen
following the ingestion of the high molecular weight
solution in the present study could well account for
the increase in performance observed in all participants
compared with the low molecular weight
solution and certainly the sugar-free flavoured water.
This is particularly the case when one considers that
untrained individuals (normal pre-exercise muscle
glycogen content of *300 mmol kg dry muscle71)
will utilize around 150 mmol kg dry muscle71 of
glycogen during 15 min of cycling exercise at 85%
_V
O2max (Dyck et al., 1993), which, based on heart
rate responses, approximates the workload achieved
in the present time-trial (170 – 180 beats min71;
data not shown).
Carbohydrate ingestion and exercise performance 153
The degree of glycogen re-synthesis in the liver
may have also contributed to the difference in 15-
min time-trial performance following post-exercise
ingestion of the high molecular weight solution in the
present study, particularly as liver-biopsy studies in
healthy human volunteers have clearly demonstrated
that the liver is extremely sensitive to changes in
dietary carbohydrate intake (Nilsson & Hultman,
1973). Indeed, magnetic resonance spectroscopy
studies have demonstrated that following exhaustive
exercise liver glycogen is depleted to a considerable
extent and, if the post-exercise carbohydrate load is
inadequate, glycogen re-synthesis can impair glucose
release from the liver and subsequent exercise
capacity (Casey et al., 2000).
Conclusion
The ingestion of a unique, hign molecular weight
glucose polymer solution (known to increase postexercise
muscle glucose delivery and glycogen resynthesis
compared with a standard, low molecular
weight glucose polymer solution) increased work
output during a subsequent highly reproducible,
high-intensity sub-maximal time-trial cycling test.
Furthermore, this effect was observed in all
participants studied. These findings could be of
practical importance for athletes who partake in
training sessions, or indeed competitions, where
rapid re-synthesis of the muscle glycogen store is
required and performance must be maintained
during a second period of exercise. It is noteworthy,
however, that ingestion of this high molecular
weight glucose polymer solution immediately before
exercise does not appear to increase carbohydrate
oxidation during exercise compared with a low
molecular weight solution (Rowlands et al., 2005),
most likely because carbohydrate oxidation during
exercise is not limited by gastric emptying or
muscle carbohydrate delivery following pre-exercise
carbohydrate feeding. Thus, it would appear that
the high molecular weight solution should be
ingested immediately following exhaustive exercise
when a significant period of recovery is anticipated
before a subsequent bout of exercise.
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par Nutrimuscle-Conseils » 6 Fév 2009 11:25 
mais je devrais en prendre plus !!
