Carbohydrate and fat are the two primary fuel sources oxidized by skeletal muscle tissue during prolonged (endurance-type) exercise. The relative contribution of these fuel sources largely depends on the exercise intensity and duration, with a greater contribution from carbohydrate as exercise intensity is increased. Consequently, endurance performance and endurance capacity are largely dictated by endogenous carbohydrate availability. As such, improving carbohydrate availability during prolonged exercise through carbohydrate ingestion has dominated the field of sports nutrition research. As a result, it has been well-established that carbohydrate ingestion during prolonged (>2 h) moderate-to-high intensity exercise can significantly improve endurance performance. Although the precise mechanism(s) responsible for the ergogenic effects are still unclear, they are likely related to the sparing of skeletal muscle glycogen, prevention of liver glycogen depletion and subsequent development of hypoglycemia, and/or allowing high rates of carbohydrate oxidation. Currently, for prolonged exercise lasting 2-3 h, athletes are advised to ingest carbohydrates at a rate of 60 g·h⁻¹ (~1.0-1.1 g·min⁻¹) to allow for maximal exogenous glucose oxidation rates. However, well-trained endurance athletes competing longer than 2.5 h can metabolize carbohydrate up to 90 g·h⁻¹ (~1.5-1.8 g·min⁻¹) provided that multiple transportable carbohydrates are ingested (e.g. 1.2 g·min⁻¹ glucose plus 0.6 g·min⁻¹ of fructose). Surprisingly, small amounts of carbohydrate ingestion during exercise may also enhance the performance of shorter (45-60 min), more intense (>75 % peak oxygen uptake; VO(₂peak)) exercise bouts, despite the fact that endogenous carbohydrate stores are unlikely to be limiting. The mechanism(s) responsible for such ergogenic properties of carbohydrate ingestion during short, more intense exercise bouts has been suggested to reside in the central nervous system. Carbohydrate ingestion during exercise also benefits athletes involved in intermittent/team sports. These athletes are advised to follow similar carbohydrate feeding strategies as the endurance athletes, but need to modify exogenous carbohydrate intake based upon the intensity and duration of the game and the available endogenous carbohydrate stores. Ample carbohydrate intake is also important for those athletes who need to compete twice within 24 h, when rapid repletion of endogenous glycogen stores is required to prevent a decline in performance. To support rapid post-exercise glycogen repletion, large amounts of exogenous carbohydrate (1.2 g·kg⁻¹·h⁻¹) should be provided during the acute recovery phase from exhaustive exercise. For those athletes with a lower gastrointestinal threshold for carbohydrate ingestion immediately post-exercise, and/or to support muscle re-conditioning, co-ingesting a small amount of protein (0.2-0.4 g·kg⁻¹·h⁻¹) with less carbohydrate (0.8 g·kg⁻¹·h⁻¹) may provide a feasible option to achieve similar muscle glycogen repletion rates.
