What is a Carbohydrate Mouth Rinse?

What is a Carbohydrate Mouth Rinse?

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

Carbohydrate Mouth Rinse

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.

This is possible thanks to the creation of new and highly branched carbohydrates with weak glycosidic bonds and a high molecular weight. Moreover, there is also the use of glucose monomers (such as amylopectin, maltodextrin, HBCD or dextrose), the monosaccharide absorption in the intestine… Even during physical exercise when the splanchnic blood flow drops drastically.

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.

We tell you everything you need to know about Post-Workout Carbohydrates in this post.

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.

Spitting mouth rinse

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

Use of carbohydrates

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.

So, in order to make and easy reading, this article will be mostly practical: “what is it used for” and “how is it used”.

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).CHO mouth rinse Placebo

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).

The American College of Sport Medicine (ACSM) places carbohydrates where they belong in their position stand from 2016. Moreover, it recognizes the role of mouth rinse in improving the performance during 45-75 minutes of physical exercise.

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.

After passing this threshold, taking carbohydrates becomes a relevant factor and a mouth rinse would not be enough (Jeukendrup, 2014).

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.

Mouth receptors

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.

Effects of a mouth rinse

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).

With the information we have now, those who will benefit the most from this system are: those who exercise on an empty stomach, those who have a low glycogen availability.

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.
Thanks to this protocol, your performance will improve around a 2-3% (Vitale and Getzin, 2019).

Don’t forget

  • If your workout lasts more than 90 minutes, you will have to drink a carbohydrate drink. The mouth rinse will not be enough anymore.
  • It is better to use the most studied carbohydrate sources for this protocol, that is, dextrose and maltodextrin.
  • If you have a high blood glucose availability (due to a carbohydrate-rich diet) you will not obtain any benefit from this protocol.
  • Moreover, it is pointless to use this protocol if you use an intra-workout drink with carbohydrates.
  • Using a mouth rinse protocol will not increase the 1RM or the number of repetitions in strength training (Dunkin, 2017; Clarke, 2015; Painelli, 2011)

Cyclists

The athletes who are going to make the most of this protocol are cyclists and runners who follow “train low, compete high” protocols of around an hour.

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

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. Vitale, K., & Getzin, A. (2019). Nutrition and Supplement Update for the Endurance Athlete: Review and Recommendations. Nutrients, 11(6).

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About Alfredo Valdés
Alfredo Valdés
A specialist in Pathophysiology and biomolecular effects on nutrition and sportive activity who will show you the elaborate world of sports nutrition in his articles, employing a simple and critical writing.
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