Supplements for
Endurance Athletes
Chad Kerksick, PhD, ATC, CSCS*D, NSCA-CPT*D1,2,3 and Mike Roberts, MS, CSCS1
1
Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma; 2Section of Endocrinology
and Diabetes, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma;
and 3Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
SUMMARY
ENDURANCE ATHLETES EXPEND
REMARKABLE AMOUNTS OF EN-
ERGY AND CHALLENGE THE RE-
COVERY PROCESSES OF THEIR
BODIES. SCORES OF NUTRI-
TIONAL SUPPLEMENTS ARE MAR-
KETED FOR THEIR ABILITY TO
IMPROVE ONE OR BOTH OF THESE
PROCESSES. A LIMITED NUMBER
OF THESE SUPPLEMENTS HAVE AN
APPRECIABLE AMOUNT OF RE-
SEARCH TO SUPPORT THEIR USE
BY ENDURANCE ATHLETES. CAR-
BOHYDRATE-ELECTROLYTE SOL-
UTIONS, CAFFEINE, AND ADDING
PROTEIN TO CARBOHYDRATE
SUPPLEMENTATION OR MEALS
ARE 3 STRATEGIES THAT ARE
SCIENTIFICALLY BACKED AND
SHOULD BE CONSIDERED AS A
TRAINING AID FOR THOSE EN-
DURANCE ATHLETES WHO COM-
PETE AND TRAIN ON A REGULAR
BASIS.
INTRODUCTION
eports of athletes consuming
R specific foods, nutrients, or in-
gredients to optimize perfor-
mance can be traced back for
centuries. Endurance athletes, by virtue
of training for their sporting compet-
itions, can expect to burn tens of
thousands of calories. It is estimated
that a typical male endurance athlete
will expend approximately 1,000 kcal
and a female 600700 kcal when
completing an hour of activity at
approximately 70% of their maximal
Copyright National Strength and Conditioning Association
oxygen uptake (i.e., V_ O2max) (59).
With this remarkable demand for
energy and a desire to adopt various
training or nutritional strategies to
maximize performance, the interest in
nutritional supplements to aid in this
process continues to be popular.
In a 2004 survey addressed to 207
collegiate athletes, many of who par-
ticipated in endurance-oriented sports,
only 11% of the respondents claimed
to have never consumed a nutritional
supplement (25). Their reasons for
supplementing included a desire to
increase health and energy levels and
decrease the chance for injury. Al-
though supplements that fulfill the
aforementioned claims do exist, there
are several supplements (albeit, indi-
vidual ingredients or proprietary
blends) which, to date, have not
proven to be beneficial for endurance
performance and/or recovery in labo-
ratory settings (Table 1). Therefore,
this review will attempt to discuss
those nutritional supplements that
have adequate scientific support for
their ability to impact endurance
training and performance. Although
other notable supplements have stud-
ies to support their consideration such
as medium-chain triglycerides, phos-
phates, carnitine, or glycerol supple-
mentation, the conclusions are
equivocal. Currently, the literature
surrounding carbohydrate-electrolyte
solutions (sports drinks), caffeine, and
ingestion of carbohydrate + protein
during exercise and after exercise to
facilitate performance and promote
recovery is widespread and continues
to grow in support.
Strength and Conditioning Journal | www.nsca-lift.org
CARBOHYDRATE-ELECTROLYTE
BEVERAGES
BACKGROUND
In a historical sense, reports surround-
ing the ingestion of sugary candy and
sweets before endurance events go
back the early 1900s. From there,
Swedish scientists in the 1960s re-
ported that high carbohydrate feedings
before and during exercise increased
endurance performance parameters
(43), and a few years later, the first
commercial carbohydrate-electrolyte
drink became available. Although much
of the attention for carbohydrate-
electrolyte beverages has centered on
increasing performance, carbohydrate-
electrolyte beverages can also atten-
uate fatigue, replace lost fluid and
carbohydrate, prevent extraneous los-
ses of important electrolytes, and
assist in thermoregulation during pro-
longed athletic events (15,59). It is
these combinations of effects that make
carbohydrate-electrolyte solutions one
of the most effective nutritional supple-
ments for an endurance athlete (56).
FLUID AND ELECTROLYTE
REPLACEMENT
Endurance athletes can have sweat
rates ranging from 1.2 to 1.7 liters of
bodily fluid (i.e., approximately 2%
bodyweight in a 70 kg athlete) per
hour (63), with the highest docu-
mented sweat rate being 4.2 liters per
KEY WORDS:
carbohydrate; caffeine; electrolyte;
glycogen; performance; sport; exercise;
recovery
55
Supplements for Endurance Athletes

Table 1
List of popular supplements that have alleged physiological effects in endurance athletes

Performance-enhancing pH and fluid Fuel provision

ingredients modulators ingredients Recovery-enhancing ingredients

Acetylcholine b-Alanine a-Lipoic acid 5-HT

Carbohydrate-electrolyte Carnosine Branched-chain amino acids Adaptogens (i.e., extracts from Rhodiola rosea,
drinks or gels Cordyceps sinensis, Panax ginseng, and so on)
Citrulline Creatine Caffeine Antioxidants (i.e., vitamins C and E, catechins,
polyphenols)
Creatine Polylactate Carbohydrate/electrolyte HMB
drinks or gels
Dimethylglycine Sodium tablets Creatine Carbohydrate-protein beverages
Ginseng (i.e., extracts Sodium bicarbonate L-Carnitine Colostrum
from Panax ginseng)
Coenzyme Q10 Echinacea
Iron Sodium citrate Glycerol GABA
Inosine Medium-chain triglycerides Glucosamine and chondroitin sulfate
Phosphatidylserine Modified corn starch L-Glutamine

Smilax (Sarsaparilla root) Phosphate Ketoisocaproate

Taurine Pyruvate
Ribose 5-HT
Synephrine
5-HT = 5-hydroxytryptophan; HMB = b-hydroxy-b-methybutyrate; GABA = g-aminobutyric acid.

hour (59). Considering that a serious
decrement in performance can occur
after only a 2% reduction in body mass
from fluid and this can occur after only
1 hour (Table 2), endurance athletes
need to take strides to ensure that
optimal fluid rehydration occurs (63).
In this respect, simply taking strides
to adequately replace fluids when
exercising during hot/humid environ-
ments can be ergogenic (performance
enhancing) for an endurance athlete
(56). In addition to fluid loss, losing
electrolytes from the blood as a person
sweats increases as a concern when
prolonged bouts of exercise are un-
dertaken, and only water is used to
replace lost fluids. This situation can
result in the development of hypona-
tremia (low blood sodium levels) and is
a situation that can result in deleterious
health effects including fainting, seiz-
ures, and death (13,52).
Currently, most commercial carbohy-
drate-electrolyte solutions contain any-
where from 50 to 110 mg of sodium
per 8 fluid ounces. The most practical
advice seems to be for athletes to
weigh themselves before and after an
exercise bout and attempt to keep body
mass losses to no more than 1% when
exercising for greater than 90 minutes
(13,53). Considering the wide varia-
tions in the ambient temperature,
humidity, racecourse topography,
placement of fluid stations, distance
to be covered, and so on makes
additional specific recommendations
challenging to meet all situations.
Minimally, athletes could strive to
consume approximately 100 mL of
fluid every 10 minutes resulting in an
hourly ingestion of 600 mL, an amount
that has been shown to help offset
the magnitude of fluid loss seen when
exercising for prolonged periods in hot
and humid conditions (18) but may not
necessarily be enough to offset de-
velopment of dehydration. Table 2
is provided to illustrate the potential
changes in body weight that can occur,
how quickly it can happen, and how
much fluid is needed to offset this
fluid loss.
CARBOHYDRATE REPLACEMENT
During moderate intensity (e.g., ap-
proximately 6570% V_ O2max) exercise,
carbohydrate is oxidized at a rate of
1 gram of carbohydrate per minute or
60 grams of carbohydrate per hour
(36,38). When considering that endog-
enous carbohydrate stores can become
severely depleted after 6090 minutes
of prolonged exercise, replacing lost
carbohydrate is a primary concern for
the endurance athlete. Studies have
illustrated that carbohydrate ingestion
during exercise alters hepatic glucose

56 VOLUME 32 | NUMBER 1 | FEBRUARY 2010

 Table 2
Rate of fluid loss and required fluid replacement

Percent of body mass lost (in lbs)

1% 2% 3% 4%
Body mass (lbs) Pounds of body mass lost

140 1.4 2.8 4.2 5.6

160 1.6 3.2 4.8 6.4
180 1.8 3.6 5.4 7.2
200 2 4 6 8
220 2.2 4.4 6.6 8.8
240 2.4 4.8 7.2 9.6
260 2.6 5.2 7.8 10.4
280 2.8 5.6 8.4 11.2
300 3 6 9 12
320 3.2 6.4 9.6 12.8
340 3.4 6.8 10.2 13.6
Sweat rate
Time (min) 0.5 L/h 1 L/h 1.5 L/h 2 L/h 2.5 L/h 3 L/h 3.5 L/h
Amount of fluid lost (in lbs) according to sweat rate
30 0.6 1.1 1.7 2.2 2.8 3.3 3.9
60 1.1 2.2 3.3 4.4 5.5 6.6 7.7
90 1.7 3.3 5.0 6.6 8.3 9.9 11.6
120 2.2 4.4 6.6 8.8 11.0 13.2 15.4
150 2.8 5.5 8.3 11.0 13.8 16.5 19.3
180 3.3 6.6 9.9 13.2 16.5 19.8 23.1
Cups of fluid needed to replace body mass loss
30 1 2 3 4 5 6 7
60 2 4 6 8 11 13 15
90 3 6 10 13 16 19 22
120 4 8 13 17 21 25 30
150 5 11 16 21 26 32 37
180 6 13 19 25 32 38 44

output (8,16), but its impact on muscle
glycogen utilization is equivocal.
Nonetheless, ingesting 3060 grams
of carbohydrate (in any form except
fructose) per hour during exercise
increases time to exhaustion at
predetermined intensity levels and
time-trial performance of varying dis-
tances (2,5,10,11,23,24,37,45, 48,57,65).
Fructose alone is attributed to gastro-
intestinal distress, decreased perfor-
mance, and lower rates of glycogen
resynthesis, likely because of different
digestive kinetics and absorption
mechanisms when compared with
other forms of carbohydrate (12,22).
For this reason, it is not recommended
to ingest fructose unless it is combined

Strength and Conditioning Journal | www.nsca-lift.org 57

Supplements for Endurance Athletes

with other carbohydrate sources
(34,64).
Widrick et al. (65) determined that
preexercise muscle glycogen status and
carbohydrate ingestion improved the
time it took for cyclists to complete
a 70 km self-paced time trial. Through-
out exercise, carbohydrate was in-
gested using a 9% carbohydrate
solution at a rate of 116 6 6 grams of
carbohydrate per trial. When carbohy-
drate was provided, blood glucose
values were sustained and performance
over the last 14% of the 70 km distance
(or 10 km) was greater (65). Similarly,
when cyclists ingested an 8% carbohy-
drate solution before and every 15
minutes throughout a prolonged exer-
cise bout, cycling time to exhaustion
was extended by 47 minutes or a 30%
increase in endurance (45). Trained
runners also experienced increased
time to exhaustion during an intermit-
tent run to fatigue when ingesting
a 6.9% carbohydrate solution before
and every 15 minutes throughout a 90
minute bout of running at intensities
ranging from ;60% to 90% peak heart
rate (48). Lastly, 2 additional studies
further highlighted the importance of
carbohydrate delivery during endur-
ance exercise.
In the first study, Febbraio et al. (23)
had trained cyclists ride at 63% of peak
power for 120 minutes, followed by
completion of a 7 kilojoules per kilo-
gram of body mass time trial while
ingesting various combinations of car-
bohydrate or placebo before and
during exercise. Only during the 2
conditions where carbohydrate was
ingested during exercise (placebo be-
fore exercise + carbohydrate during
exercise and carbohydrate before ex-
ercise + carbohydrate during exercise)
did performance significantly improve
during the exercise trial (Figure 1) (23).
Fielding et al. (24) reported that a more
frequent intake of a 5% carbohydrate
solution (equal amounts of carbohy-
drate in identical concentrations every
30 minutes or every 60 minutes) was
responsible for an improved mainte-
nance of blood glucose over a 4-hour
bike ride, which resulted in a signifi-
cantly longer ride to exhaustion.
Also, recent studies have suggested
that delivering carbohydrate in the
form of a gel effectively supports
glucose levels in the blood and can
improve performance during a field
soccer test of intermittent running to
exhaustion (50) or prolonged cycling at
75% V_ O2peak (55). Although much of
the published literature using carbohy-
drate involves exercise periods of .60
minutes, recent studies have suggested
that carbohydrate ingestion may also
be beneficial for activities less than
60 minutes in duration (2,57); however,
the number of investigations support-
ing this conclusion is limited at the
current time.
Practically, many commercially avail-
able carbohydrate-electrolyte solutions
(Table 3) deliver carbohydrate solu-
tions at a concentration of 68%
carbohydrate (e.g., 68 grams of car-
bohydrate for every 100 mL of fluid).
At this concentration, consuming
0.51.5 cups (412 fluid ounces) of
fluid every 1015 minutes will replace
the amount of carbohydrate that is
oxidized (11,36) and will also help to
replace lost fluids and electrolytes.
In summary, regular consumption of
a carbohydrate-electrolyte solution can

Figure 1. Performance enhancing effect of carbohydrate ingestion before and during prolonged cycling exercise. Data shown
illustrates the amount of time to complete a standardized amount of work after a 120-minute bout of cycling at 65%
V_ O2max under 4 conditions: (a) ingestion of a 25.7% carbohydrate solution before and during the exercise bout (white),
(b) ingestion of a sweet placebo before and a 25.7% carbohydrate solution during the exercise bout (light gray), (c)
ingestion of a 25.7% carbohydrate before exercise and a sweet placebo during the exercise bout (dark gray), and (d)
ingesting a sweet placebo before and during the exercise bout (black). Time to complete a standardized amount of work
(7 kJ/kg body mass) was significantly lower (p , 0.05) and indicated by when the 25.7% carbohydrate solution was
ingested during the exercise bout. Modified with permission from Febbraio et al. (23).

58 VOLUME 32 | NUMBER 1 | FEBRUARY 2010

 Table 3 regard, when running athletes were
Nutritional content of commercially available carbohydrate-electrolyte provided a caffeine dose of 3 or 6
beverages mg/kg 1 hour before an exhaustive
running exercise bout, running time
Beverage Carbohydrate Carbohydrate Sodium increased from 49.4 to 60 minutes (27)
(per 8 oz) Calories (g) (%) (mg)
and when combined with a carbohy-
Gatorade 50 14 6 110 drate-electrolyte beverage, caffeine, at
a dosage of 195 milligrams of caffeine
Powerade 70 19 8 55
for every 1 liter of carbohydrate-
All Sport 70 19 8 55 electrolyte solution, has been shown
to improve work capacity by 15% dur-
HydraFuel 66 16 7 25
ing a 15-minute cycling trial after a
Cytomax 66 13 5 53 135-minute exhaustive ride when com-
pared with a decaffeinated carbohydrate-
Exceed 70 17 7 50
electrolyte control beverage (17).
10-K 60 15 6 55
Other studies have reported improved
Quickick 67 16 7 100 outcomes relative to rowing perfor-
mance (9), high-intensity cycling (21),
1st Ade 60 16 7 55
and repeated endurance performance
Pedialyte 25 6 2.5 253 (4). At lower doses (23 mg/kg), the
ergogenic response appears to be more
Coca-Cola 103 27 11 6
variable (32), which could be attributed
Orange juice 104 25 10 6 to the athletes normal dietary intake
Water 0 0 0 Low of caffeine. Finally, after following an
exercise and diet protocol to deplete
muscle glycogen stores, trained cyclists
consumed either a high-carbohydrate
be an effective strategy for the endur- (4,9,19,44,60,62). In addition, caffeine
meal (4 grams of carbohydrate for
ance athlete to replace lost fluid and increases serum levels of catechol-
every kilogram of body mass) or an
electrolytes, sustain blood glucose, amines and free fatty acids in the blood
identical carbohydrate meal with
spare glycogen (66), and promote (9), leading to an increase in fat
caffeine added to the meal at a dosage
greater levels of performance. The utilization and a sparing of muscle
of 8 milligrams of caffeine for every
interested reader is encouraged to glycogen while reducing an individu-
kilogram of body mass. After 1 hour of
consult the following reviews als perception of effort (3,19,20,49).
recovery, muscle glycogen in both
(18,37,38,59).
groups increased similarly, but after
PERFORMANCE
CAFFEINE 4 hours, muscle glycogen was signifi-
Costill et al. (14) in the late 1970s
cantly greater when caffeine was added
BACKGROUND demonstrated that subjects drinking
to the carbohydrate meal, resulting in
Caffeine is a drug that has been used as caffeinated coffee before exercise were
a 66% increase in the rate of glycogen
a dietary supplement for its ability to able to cycle longer and oxidize more
resynthesis (Figure 2; 51). These latest
increase endurance performance, spare fat for fuel when compared with
findings are interesting because they
glycogen, promote greater fat oxidation, placebo-treated subjects (14). A study
may suggest an ability of caffeine to aid
prevent fatigue, and reduce perceived by Graham (26) reported that a caffeine
in the recovery process in addition to
effort (3,9,17,19,21,32,42,44,49,60,62). dose of 36 mg/kg increased time to
Caffeine is an alkaloid present in more exhaustion, whereas a 9 mg/kg dose enhancing performance. However, it is
than 60 plant species and reports of its provided no effect when participants important that the reader understands
use as a stimulant goes back several ran on a treadmill at 85% V_ O2max that these findings are the first of such
centuries. It is estimated that the mean until volitional fatigue (26). Doherty studies to illustrate an ability of caffeine
caffeine intake in U.S. adults ranges and Smith (19) used a meta-analytic when combined with carbohydrate to
from 106 to 170 mg/d (40). Upon approach and concluded that exercise promote greater glycogen restoration
ingestion, caffeine enters the blood- test outcomes were improved by and more research needs to be con-
stream quickly (within 1545 minutes) 9.115.4% when caffeine supplementa- ducted before this recommendation
and has a half-life of 2.57.5 hours. A tion was provided, and this positive can be more conclusive.
number of studies are available report- effect appears to be greater in pro- Caffeine is a banned stimulant at urinary
ing ergogenic benefits for caffeine at longed exercise bouts versus graded levels of 12 mg/mL, and for this reason,
doses ranging from 3 to 9 mg/kg or short-term exercise bouts. In this it should be used with caution if

Strength and Conditioning Journal | www.nsca-lift.org 59

Supplements for Endurance Athletes

Table 4
Practical applications for the use of supplements for endurance athletes

Glycogen stores inside the body are limited and may only last for 6090 minutes of moderate intensity exercise and depend
largely on body mass, recovery efforts, and training volume/intensity of the athlete. Any athlete who exercises
for this duration will need to replace lost carbohydrate.
The number of available dietary supplements to increase endurance performance continues to grow. Those products,
however, which have been supported by science to increase performance, recovery, or health of an endurance athlete,
are limited.
The premise of dietary supplementation is based on the thought that all athletes and coaches follow sound dietary practices
and is currently getting adequate nutrients from their current dietary regimen. In this respect, all strategies discussed
throughout this article have their limitations because variations in dietary intake and other recovery steps can impact
the efficacy of the discussed strategies.
Athletes and coaches should monitor fluid losses during prolonged exercise bouts in hot/humid environments to determine
the rate at which fluid is lost as sweat from the body because many factors can influence an individuals sweat rate.
Minimally, consuming 100 mL (;0.5 cups) of fluid every 10 minutes has been shown to help offset fluid losses and is
recommended as a baseline recommendation.
Ingesting 412 fluid ounces (;0.51.5 cups) of a 68% carbohydrate-electrolyte solution every 1015 minutes during
exercise can serve as an effective means to replace lost carbohydrate, fluid, and electrolytes. Athletes and coaches
need to experiment with what timing and dosing strategies work best and understand that every athletes response
is different.
Supplementing with caffeine at a dose of 36 mg/kg body mass 3060 minutes before exercise has been shown to
effectively increase different types of endurance performance. Increased caffeine intake can also increase oxidation of fat,
spare glycogen, and reduce the athletes perception of effort.
Adding a small amount of protein to a carbohydrate source has been shown to help restore greater levels of muscle
glycogen, increase performance, and prevent the amount of muscle damage that occurs during a prolonged bout
of endurance exercise.

participating in any National Collegiate
Athletic Association or International
Olympic Committee sanctioned events.
Studies have, however, illustrated that
ergogenic benefits are present with
urinary caffeine levels below the banned
threshold (20,44), but athletes are en-
couraged to use caution when involved
in competition. Reports have contended
that while ergogenic, the diuretic effect
of caffeine should be a primary consid-
eration because of the already rapid fluid
and electrolyte loss that typically occurs
during prolonged exercise in a hot/
humid environment (see above). How-
ever, a review of 10 clinical trials by
Armstrong (1) in 2000 refutes this
suggestion and concluded that at com-
mon caffeine doses (100680 mg), the
diuretic effect of caffeine was similar to
the diuretic effect from water. Similarly,
this contention was later supported
in a study by Millard-Stafford et al. (46)
that also concluded a caffeine +
carbohydrate solution had no negative
impact relative to hydration, sweat rate,
electrolytes, and other related markers.
ADDITION OF PROTEIN TO
CARBOHYDRATE
BACKGROUND
Making some form of carbohydrate
available, irrespective of type, is an
important consideration for the endur-
ance athlete to restore muscle glyco-
gen. Equally as important are timing
considerations because studies have
illustrated that much of the recovery
ability of the muscle is lost after 2 hours
(29). If rapid recovery is not important,
maximal glycogen restoration may
occur either by regularly (every 1530
minutes) ingesting carbohydrate at
a dose of 1.2 grams of carbohydrate
per kilogram per hour (84120 grams
of carbohydrate per hour for individ-
uals weighing 70 to 100 kg, respec-
tively) for several hours (33,61) or to
just simply ingest high dietary levels of
carbohydrate (810 grams of carbohy-
drate per kilogram per day or 560
1,000 grams of carbohydrate per day
for individuals weighing 70100 kg,
respectively), especially if performing
on consecutive days (39). Adding small
amounts of protein to carbohydrate to
maintain a 3:1 or 4:1 carbohydrate to
protein ratio may help to facilitate
greater performance (31,55) and min-
imize muscle damage (41,54,55) while
also promoting maximal recovery of
muscle glycogen (7,28,30,47,58).
PERFORMANCE
When 3 hours of cycling at 4575%
V_ O2max were followed by a time to
exhaustion trial at 85% V_ O2max, par-
ticipants who consumed a 7.75% car-
bohydrate + 1.94% protein solution (a
4:1 carbohydrate to protein ratio) in
200 mL amounts increased time to
exhaustion (26.9 6 4.5 minutes) when

60 VOLUME 32 | NUMBER 1 | FEBRUARY 2010

Figure 2. Skeletal muscle glycogen content immediately, 1 hour, and 4 hours after a prolonged cycling bout to fatigue at 70%
V_ O2peak. Open bars signify 1 gram per kilogram of body mass of carbohydrate consumption, whereas closed bars
indicate carbohydrate + 8 milligram per kilogram of body mass of caffeine consumption. During the carbohydrate-only
trial, boluses were ingested within 5 minutes after exercise and 60, 120, and 180 minutes after exercise. During the
carbohydrate + caffeine trial, subjects followed the same carbohydrate ingestion pattern and a total of 8 milligram per
kilogram of body mass caffeine was given in 2 doses immediately and 2 hours after exercise. * = significant difference
from immediate postexercise (p , 0.05); # = significant difference from 1-hour postexercise (p , 0.05); = significant
difference between trials at 4-hour postexercise (p , 0.05). Modified with permission from Pedersen et al. (51).

compared with that of a 7.75% carbo-
hydrate (19.7 6 4.6 minutes) or a
placebo treatment (12.7 6 3.1 minutes)
(Figure 3; 31). Interestingly, these
findings were replicated when a carbo-
hydrate + protein gel (0.15 grams of
carbohydrate/kg +0.038 grams of pro-
tein/kg) was ingested versus an iden-
tical carbohydrate gel every 15 minutes
during prolonged endurance exercise
bouts to exhaustion (55). Further,
when a carbohydrate (0.8 grams of
carbohydrate/kg body mass) + protein
(0.4 grams of protein/kg body mass)
solution was ingested immediately
after exercise as part of recovery from
an exhaustive cycling trial, subsequent
performance and power production

Figure 3. Time to fatigue during a cycling bout at 85% V_ O2max. Before the time trial, subjects exercised for 30 minutes at 45%
V_ O2max and performed 15 3 3 to 8-minute intervals at 75% V_ O2max interjected with 15 3 3 to 8-minute active
recovery periods at 45% V_ O2max. Following this 180-minute sequence, subjects cycled to fatigue at 85% V_ O2max. Equal
boluses of each supplement were provided at 10-minute intervals over the 180-minute period before the fatigue test.
* = greater than the placebo (p , 0.05); = greater than 7.75% carbohydrate solution. Modified with permission from Ivy
et al. (31).

Strength and Conditioning Journal | www.nsca-lift.org 61

Supplements for Endurance Athletes
were increased when an additional
exhaustive exercise bout was under-
taken 6 hours later when compared
with carbohydrate ingestion (6).
GLYCOGEN RESYNTHESIS
Adding protein to carbohydrate may
help to promote recovery of lost
muscle glycogen, although these find-
ings are mixed (7,28,30,35,58). For
example, after cycling for 2.5 hours to
deplete muscle glycogen, recovery of
muscle glycogen was measured after
ingesting either carbohydrate or a com-
bination of carbohydrate and protein
(30). After starting with similar levels of
glycogen, cyclists ingested 80 grams of
carbohydrate + 28 grams of protein
+ 6 grams of fat, a lower carbohydrate
(80 grams of carbohydrate) + fat
combination, or a higher carbohydrate
(108 grams of carbohydrate) + fat
combination and the authors found
that muscle glycogen was significantly
higher in the carbohydrate + protein +
fat treatment 4 hours after ingestion
(30). Subsequent studies, however,
have suggested that while high carbo-
hydrate intake (1.2 grams of carbohy-
drate/kg/h or 84120 grams of
carbohydrate per hour for individuals
weighing 70100 kg, respectively) may
be all that is needed to promote
maximal glycogen recovery (35,58),
added protein may support muscle
protein synthesis and net protein
balance after exercise (28).
MUSCLE DAMAGE
Additional studies report that a carbo-
hydrate + protein combination, either
in a solution or in a gel, can prevent the
muscle damage associated with pro-
longed endurance exercise when in-
gested during and after prolonged
endurance exercise (54,55). In these
studies, male and female cyclists had
blood levels of creatine kinase, a marker
of muscle damage, determined after
prolonged cycling bouts. The results
indicated that both the carbohydrate +
protein solution and gel significantly
reduced blood levels of creatine kinase
(54,55). Moreover, when 8 endurance
athletes completed approximately 6
hours of exercise at 50% V_ O2max
62 VOLUME 32 | NUMBER 1 | FEBRUARY 2010
while ingesting either carbohydrate
(0.7 grams of carbohydrate/kg/h) or
carbohydrate + protein (0.7 grams of
carbohydrate/kg/h + 0.25 grams of
protein/kg/h) every 30 minutes during
exercise, the net protein oxidation rates
(muscle breakdown) were not different
when compared with baseline for
carbohydrate. Carbohydrate + protein
ingestion, however, improved the over-
all net protein balance. Although net
protein balance was still negative,
meaning that more protein breakdown
was occurring than protein synthesis,
these findings suggest that a combina-
tion of carbohydrate + protein may aid
in preventing muscle breakdown and
improve recovery (41).
CONCLUSIONS
Endurance activity places great de-
mands on the metabolic systems of
the human body. Optimal training and
dietary habits are essential for an
athlete to perform at their highest
levels and adequately recovery. Several
dietary supplements are available in
the marketplace targeted to increasing
the performance of endurance athletes.
Many of these, however, lack the
necessary scientific inquiry to be rec-
ommended for their ability to enhance
performance. Practical applications for
the use of supplements for endurance
athletes are presented in Table 4. Much
research is available that supports the
use of carbohydrate-electrolyte solu-
tions before and during a prolonged
exercise bout. These drinks are now
widely available as many commercial
products and are also effective at
maintaining fluid and electrolyte bal-
ance in addition to providing carbo-
hydrate to the body as an energy
source. For more than 40 years,
supplementation with caffeine has
been investigated as an ergogenic aid
and a recent flurry of interest has
reinforced its place as an effective
ergogenic aid for the endurance ath-
lete. Most recently, scientists have
begun to add a small amount of protein
to existing carbohydrate-electrolyte
solutions and have found this addition
can further increase performance,
prevent muscle damage, and assist in
the recovery of muscle glycogen.
Chad Kerksick
is an assistant
professor of exercise
physiology and
director of the
Applied Biochemistry and Molecular
Physiology Laboratory in the Department
of Health and Exercise Science at the
University of Oklahoma in Norman,
Oklahoma.
Mike Roberts is
a doctoral research
and teaching
assistant and
a laboratory
coordinator in the Department of Health
and Exercise Science at the University of
Oklahoma in Norman, Oklahoma.
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