ReviewNutrients2022
What Is the Evidence That Dietary Macronutrient Composition Influences Exercise Performance? A Narrative Review.
Review in Nutrients, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 32 citations in OpenAlex.
- Caffeine enhances performance regardless of fueling strategy; however, high carbohydrate availability is associated with improved training speeds compared with ketogenic diet.The British journal of nutrition · 2025Trial
- Effect of Low-To-Moderate Exogenous Carbohydrate Supplementation on Time to Exhaustion During Constant Load Intense Cycling in Healthy Individuals. A Double-Blind, Randomised and Placebo-Controlled Crossover Trial.European journal of sport science · 2025Trial
- Effects of Dietary Sweet Potato Tuber Meal on Production Performance, Meat Quality and Intestine of Wenchang Chickens.Biology · 2026Article
- Does a low-carbohydrate diet impede endurance sports performance? Yes.The American journal of clinical nutrition · 2026Article
- Carbohydrate Ingestion on Exercise Metabolism and Physical Performance.Endocrine reviews · 2026Review
- A ketogenic diet enhances aerobic exercise adaptation and promotes muscle mitochondrial remodeling in hyperglycemic male mice.Nature communications · 2026Article
- Fatigue in Final Hour of an Ironman Triathlon with Absence of Carbohydrate Supplementation: A Retrospective Case Study.International journal of exercise science · 2026Article
- Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review.Sports medicine (Auckland, N.Z.) · 2025Review
- A Systematic Review of the Effects of Low-Carbohydrate Diet on Athletic Physical Performance Parameters.Cureus · 2025Review
- Effects of 3-(4-Hydroxy-3-methoxyphenyl)propionic Acid on Enhancing Grip Strength and Inhibiting Protein Catabolism Induced by Exhaustive Exercise.International journal of molecular sciences · 2024Article
- Long-term health outcomes associated with hydration status.Nature reviews. Nephrology · 2024Review
- Are very high rates of exogenous carbohydrate ingestion (>90 g/hr) sufficient or indeed necessary to run a sub-2hr marathon? An analysis of the model predictions of Lukasiewicz and colleagues.Frontiers in nutrition · 2024Article
- Review
- Insight into continuous glucose monitoring: from medical basics to commercialized devices.Mikrochimica acta · 2023Review
- High fat diet improves metabolic flexibility during progressive exercise to exhaustion (VOBiology of sport · 2023Article
- Milk Fat Globule Membrane Relieves Fatigue via Regulation of Oxidative Stress and Gut Microbiota in BALB/c Mice.Antioxidants (Basel, Switzerland) · 2023Article
- Low carbohydrate high fat ketogenic diets on the exercise crossover point and glucose homeostasis.Frontiers in physiology · 2023Review
- Low and high carbohydrate isocaloric diets on performance, fat oxidation, glucose and cardiometabolic health in middle age males.Frontiers in nutrition · 2023Article
- New Horizons in Carbohydrate Research and Application for Endurance Athletes.Sports medicine (Auckland, N.Z.) · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The introduction of the needle muscle biopsy technique in the 1960s allowed muscle tissue to be sampled from exercising humans for the first time. The finding that muscle glycogen content reached low levels at exhaustion suggested that the metabolic cause of fatigue during prolonged exercise had been discovered. A special pre-exercise diet that maximized pre-exercise muscle glycogen storage also increased time to fatigue during prolonged exercise. The logical conclusion was that the athlete's pre-exercise muscle glycogen content is the single most important acutely modifiable determinant of endurance capacity. Muscle biochemists proposed that skeletal muscle has an obligatory dependence on high rates of muscle glycogen/carbohydrate oxidation, especially during high intensity or prolonged exercise. Without this obligatory carbohydrate oxidation from muscle glycogen, optimum muscle metabolism cannot be sustained; fatigue develops and exercise performance is impaired. As plausible as this explanation may appear, it has never been proven. Here, I propose an alternate explanation. All the original studies overlooked one crucial finding, specifically that not only were muscle glycogen concentrations low at exhaustion in all trials, but hypoglycemia was also always present. Here, I provide the historical and modern evidence showing that the blood glucose concentration-reflecting the liver glycogen rather than the muscle glycogen content-is the homeostatically-regulated (protected) variable that drives the metabolic response to prolonged exercise. If this is so, nutritional interventions that enhance exercise performance, especially during prolonged exercise, will be those that assist the body in its efforts to maintain the blood glucose concentration within the normal range.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.