What is a Carbohydrate Mouth Rinse?

A Carbohydrate Mouth Rinse is a strategy that will improve the performance of certain physical activities.

Carbohydrates as a Basic Tool for the Performance

The utility of carbohydrates during long term aerobic exercise (around 2 hours) has been proven in many occasions. In fact, it significantly increases the performance in different sport disciplines, duration and intensity.

In 1997, Jeukendrup, who is one of the most important researchers about carbohydrates, proved that taking a carbohydrate and electrolyte drink improved the performance in a 2.3%. Particularly in shorter and more intense exercises (around an hour). Above all, it shortened the time it took to reach the objective and increased the expressed maximum potency.

The reason why taking carbohydrate-rich drinks is an effective strategy for the performance is simple: energy availability.

There is a limit of 1.26g/hour in a 2:1 ratio (glucose:fructose), without colonic fermentation, so that the nutrients will be available in the blood to be used as energy.

However, Jeukendrup postulated the possibility of not drinking carbohydrate drinks. That is how the carbohydrate mouth rinse came to be.

Carbohydrate Mouth Rinse

Basically, you just have to take a carbohydrate drink but instead of swallowing it, you use it as a mouth rinse and spit it out.

Well, even though this may look pointless it has actually proven that it can increase the performance during short term high intensity efforts. In fact, its benefits are the same as drinking carbohydrates, but with the advantages of not taking nutrients during the workout.

This has evolved to the point that it is the referent proposed by Jeukendrup (2014) for sports that last 30-75 minutes.

Figure I. Postulated model about the use of carbohydrates in efforts that last 30-75 minutes (Jeukendrup, 2014).

The mechanisms through which this method can improve the performance are complex and mostly hypothetical. Even though we do not know the core of this mechanism, we actually do not know most of the details.

What is the evidence?

“FOR HIGH-INTENSITY PERFORMANCE, CARBOHYDRATES ARE STILL KING” (Kanter, 2018).

The International Society of Sports Nutrition (2018) placed carbohydrates in the “1” evidence category. Therefore, it means that it has a strong efficacy and it is apparently safe when it comes to improving the performance.

Using carbohydrates drinks for a mouth rinse significantly improves the performance in high intensity sport trials. In fact, it improves a 2.8% on average in the studies carried out by (de Ataide et al., 2019).

Figure II. Forest Plot of the analysis of the use of a mouth rinse efforts close to an hour. (The green dots on the right mean that the mouth rinse is more effective than the placebo), the black diamond is the mean difference (De Ataide et al., 2019).

Strategy to improve the sport performance

Above all, a mouth rinse is an effective strategy to improve the performance in sport disciplines that involve a high intensity between 30 and 75 minutes.

The action mechanism of a carbohydrate mouth rinse is complex and we do not know the details.

However, we do know that activating the “sweet receptors” (T1R2 and T1R3) from the mouth stimulates certain brain areas. Consequently, this increases the oxygen-rich blood and preserves the neurotransmitter balance in the neurons.

Figure III. Graphic representation of taste receptor cells and the taste buds from the mouth. (Chandrashekar et al., 2006).

The proposed mechanism postulated by Hill, relies on the mouth rinse to block the brain activity that inhibits the recruitment of motor units.

In other words, we will activate certain regions of the brain in order to “fool” it. Consequently, it will prevent it from perceiving the situation as exhausting so that it will not limit our performance.

Figure IV. Effects of a mouth rinse with a 6.4% of maltodextrin (CHO) or placebo (PLA) in three different circumstances: after eating (FED), on an empty stomach (FAST), or fasting + glycogen depletion (DEP). (Ataide-Silva, 2016).

How is it used

1. Take a recipient (a bottle or a shaker) and fill it with water.
2. Add the necessary amount of a carbohydrates to have a 6.4-10% concentration. For example: you can add 64-100g of dextrose to a liter of water.
3. Rinse your mouth for 5-10 seconds every 5-10 minutes.

Don’t forget

Bibliography

Study 1-5

1. Ataide-Silva, T., Ghiarone, T., Bertuzzi, R., Stathis, C. G., Leandro, C. G., & Lima-Silva, A. E. (2016). CHO Mouth Rinse Ameliorates Neuromuscular Response with Lower Endogenous CHO Stores. Medicine and Science in Sports and Exercise, 48(9), 1810–1820.
2. Chandrashekar, J., Hoon, M. A., Ryba, N. J. P., & Zuker, C. S. (2006). The receptors and cells for mammalian taste. Nature, 444(7117), 288–294.
   de Ataide e Silva, T., Di Cavalcanti Alves de Souza, M. E., de Amorim, J. F., Stathis, C. G., Leandro, C. G., & Lima-Silva, A. E. (2013). Can carbohydrate mouth rinse improve performance during exercise? A systematic review. Nutrients, 6(1), 1–10.
3. Jeukendrup, A. (2014). A step towards personalized sports nutrition: carbohydrate intake during exercise. Sports Medicine (Auckland, N.Z.), 44 Suppl 1(Suppl 1), S25-33.
4. Jeukendrup, A., Brouns, F., Wagenmakers, A. J., & Saris, W. H. (1997). Carbohydrate-electrolyte feedings improve 1 h time trial cycling performance. International Journal of Sports Medicine, 18(2), 125–129.
5. Kanter, M. (2018). High-Quality Carbohydrates and Physical Performance: Expert Panel Report. Nutrition Today, 53(1), 35–39.

Study 6-10

6. Kerksick, C. M., Wilborn, C. D., Roberts, M. D., Smith-Ryan, A., Kleiner, S. M., Jäger, R., … Kreider, R. B. (2018). ISSN exercise & sports nutrition review update: research & recommendations. Journal of the International Society of Sports Nutrition, 15(1), 38.
7. Noakes, T. D. (2000). Physiological models to understand exercise fatigue and the adaptations that predict or enhance athletic performance. Scandinavian Journal of Medicine & Science in Sports, 10(3), 123–145.
8. Ren, X., Zhou, L., Terwilliger, R., Newton, S. S., & de Araujo, I. E. (2009). Sweet taste signaling functions as a hypothalamic glucose sensor. Frontiers in Integrative Neuroscience, 3, 12.
9. Thomas, D. T., Erdman, K. A., & Burke, L. M. (2016). American College of Sports Medicine Joint Position Statement. Nutrition and Athletic Performance. Medicine and Science in Sports and Exercise, 48(3), 543–568.
10. Vitale, K., & Getzin, A. (2019). Nutrition and Supplement Update for the Endurance Athlete: Review and Recommendations. Nutrients, 11(6).

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