FUELING FOR OPTIMAL

ULTRA-PERFORMANCE: FROM HIGH CHO TO KETO-ADAPTATION

Trent Stellingwerff, PhD

Canadian Sport Institute PacificMay 30th, 2017 – 10:00 to 10:30am

Explosion of news…but what does the

current evidence say?

http://www.diabetes.co.uk/blog/2016/07/low-carb-diet-propelled-chris-froome-three-tour-de-france-titles/

via Dr. James Morton

Presentation overview

1) Fueling with high CHO intakes

2) Keto-adapting for ultra performance?

4) What do Champion Endurance Athletes Eat?

5) Summary

3) The Gut – an important organ!

FUELING WITH HIGH

CHO INTAKES

Historical – Boston Marathon

Gordon B, Kohn LA, Levine SA, Matton M, Scriver WM, Whiting WB. Sugar content of the blood in runners following a marathon race. JAMA. 1925;85:508-9.

Historical – 1970’s / Coyle & 1980’s

Coyle EF, Coggan AR, Hemmert MK, Ivy JL. Muscle glycogen utilization during prolonged strenuous exercise when fed

carbohydrate. J Appl Physiol. 1986;61(1):165-72.

Seven endurance-trained

cyclists exercised at 71%

VO2max to fatigue, while

ingesting a flavored water

solution (i.e., placebo) during

one trial and while ingesting a

glucose polymer solution

(~60g/h)

Of the 61 included published performance

studies (n = 679 subjects), 82% showed

statistically significant performance benefits (n =

50 studies), with 18% showing no change

compared with placebo. There was a significant

(p = 0.0036) correlative relationship between

increasing total exercise time and the subsequent

percent increase in performance with CHO intake

versus placebo.

-5.00

0.00

5.00

10.00

15.00

20.00

25.00

0.00 50.00 100.00 150.00 200.00 250.00 300.00

Single SourceCHO

Multi-SourceCHO

Total Exercise Time (minutes)

% incre

ase in p

erf

orm

ance v

s. pla

cebo

r=0.3563

p=0.0036

n=38 studies of CHO vs. water using a TT with multiple CHO intake rates

Stellingwerff T, Cox GR. Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations.

Appl Physiol Nutr Metab. 2014;39(9):998-1011.

CHO intake and performance…

KETO-ADAPTING SO ONE

DOESN’T NEED TO

CONSUME CHO DURING

RACING?

The Continuum of CHO Availability

is Context Specific

3 4 5 6 7 8 9 10

g carbohydrate / kg BM / day

Ketogenic Low Moderate High(<50g CHO/day

for ~3 weeks???)

** NO consistent and established definitions and/or

physiological cut-offs for this continuum!

AND

This is not exercise context specific…

4g/kg/day for a sedentary

person is not low, but it is for an elite marathon runner

But, fat-adaptation can occur in as little as 3 to 5 days and

ketogensis in ~3 weeks, w/ some athletes saying a few years

are needed for optimal adaptation. In most instances, LCHF

approach requires <50g CHO / day

Published Data –Short to Moderate Term Fat Adaptation or Ketogenic Dietary

Impact on Exercise Performance (each individual perf. test per study shown)

Performance Decrease (12) No Effect (7) Improved Performance (2)Phinney, S.D., et al.,

Metabolism, 1983. 32(8): p.

769-76.

Havemann, L., et al., 100km

performance. J Appl Physiol

(1985), 2006. 100(1): p. 194-

202.

Burke LM, et al. J Appl

Physiol 89: 2413–2421, 2000.

Burke LM, et al.. Med Sci

Sports Exerc 34: 83–91, 2002.

Carey AL,et al. . J Appl

Physiol 91: 115–122, 2001.

Lambert, E.V., et al., No

Change High Intensity Test.

Eur J Appl Physiol Occup

Physiol, 1994. 69(4): p. 287-

93.

Goedecke, J.H., et al.,

Metabolism, 1999. 48(12): p.

1509-17.

Bergstrom, J., et al., Acta Physiologica Scandinavica, 1967. 71(2):

p. 140-50.

CHRISTENSEN, E. H.,et al. . Scand. Arch. Physiol. 81:160–171,

1939.

GALBO, H. et al. Acta Physiol. Scand. 107:19–32, 1979.

Pitsiladis, Y.P. Et al. The Journal of physiology, 1999. 517 ( Pt 3):

p. 919-30.

Starling, R.D., et al., Journal of Applied Physiology, 1997. 82(4): p.

1185-9.

Maughan, R.J. and D.C. Poole, Eur J Appl Physiol Occup Physiol,

1981. 46(3): p. 211-9.

Greenhaff, P.L., et al. European journal of applied physiology

and occupational physiology, 1987. 56(3): p. 331-7.

Greenhaff, P.L., et al., European journal of applied physiology and

occupational physiology, 1987. 56(4): p. 444-50.

Greenhaff, P.L., et al. European journal of applied physiology and

occupational physiology, 1988. 57(5): p. 583-90.

Havemann, L., et al., 1k sprint performance. J Appl Physiol

(1985), 2006. 100(1): p. 194-202.

Havemann, L., et al., 4k sprint performance. J Appl Physiol

(1985), 2006. 100(1): p. 194-202.

O’KEEFFE, et al. Nutr. Res. 9:819–830, 1989.

Lambert, E.V., et al.,.

International journal of sport

nutrition and exercise

metabolism, 2001. 11(2): p. 209-

25.

Lambert, E.V., et al., Inc. Perf.

Prolonged Test. Eur J Appl

Physiol Occup Physiol, 1994.

69(4): p. 287-93.

Ketogenic Data – Phinney 1983

Phinney SD, Bistrian BR, Evans WJ, Gervino E, Blackburn GL. The human metabolic response to chronic ketosis without

caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation. Metabolism.

1983;32(8):769-76..

Is there a time that fat oxidation potentially

contributes to performance???

Ultramarathoning? - Case calculations:

Rob Krar won Leadville 100miler at

9:46/mile or 6 min/km

from Athletics Canada physiological

testing data base 6min/km in elite male

distance runners projects to ~45 to 50%

VO2max. (still ~60 to 70% CHO oxidation

when fed and fueling!)

BUT, 70g/hr of CHO intake =

~280kcals/hr, which can completely

satisfy the CHO requirement of

elite ultra-marathoning! (note: Rob Krar fuels ~75g CHO/hr while racing…)

And this calculates to: 283 +/- 114 kcals per hour of carbohydrate oxidation (or

about 719 +/- 94 kcals per hour of total required energy need).

Conversely, keto-adaptation can

double fat oxidation at these lower

intensities (Phinney, 1983; Volek, 2015, Burke,

2016): 1.5g FAT/min = 90 g FAT/hr =

810 calories of fuel per hour, which

also satisfies caloric requirement

PROS vs CONS to either approach?

No published data whatsoever…

Individual trial and error…(background fiber type,

metabolism, insulin sensitivity, GI symptoms, individual efficiency/economy etc.

CHO Energy production during

exercise is more efficient!

5.5% more kcals of energy produced per liter of oxygen consumed when

utilizing 100% CHO vs. 100% fat (= lower VO2 per given power = 5.5% more

efficient!)

OR

~ 1% more energy liberated per L of O2 consumed for a 0.05 increase in RQ

Prof. Andy Jones estimates a 0.05 increase in RQ (more CHO dependent) could

be worth a 60-90 sec faster marathon performance!

Ultra-ultra endurance?

Trekking to Antarctica

Stroud, M. A., et al. Energy expenditure using isotope-labelled water (2H218O), exercise performance, skeletal muscle enzyme activities and

plasma biochemical parameters in humans during 95 days of endurance exercise with inadequate energy intake. EJAP. 76(3), 243-252., 1997

In November 1992, two men set of from the Atlantic coast of the Antarctic pulling

sledges weighing 222 kg each which contained 100 days of food and fuel and other

essential survival equipment. The expedition was the first to successfully complete

a crossing of Antarctica without the use of aircraft to ferry food and equipment,

and was the longest unsupported walk ever made. (95 days they aborted as lost

~30% of BW )

From days 20 to 30 = ~45 to 48 MJ/day EE = ~11,000 kcals per day! (~7x BMR!)

Average caloric intake = ~5,000 kcals per day of ~56% fat, 35% CHO, 8% PRO

(so daily CHO intake = ~1,750 kcals = ~400g CHO per day)

Would the have been successful or faster if keto-adapted?

Effect of body weight on marathon

performance

2017

Leger, L., & Mercier, D. (1984). Gross energy cost of horizontal treadmill and track running. Sports Med, 1(4), 270-277

VO2 (ml/kg/min) = 2.209 + 3.163 speed

(km/h) for 130 subjects (trained and untrained males and females) and 10

treadmill studies.

e.g. 100kg w/ VO2 of 25ml/kg/min

= 5h 51min marathon

A 10% drop in body weight (to 90kg)

would give a 5h 13min marathon

A 38min improvement!

(without any extra training)

(go to 75kg and marathon = 4h 17min

Almost 1 hr quicker)

GUT – AN IMPORTANT

ORGAN!

Prevalence of GI symptoms

30-50% of all

endurance athletes suffer

from significant upper and

lower GI symptoms

de Oliveira EP, Burini RC. The impact of physical exercise on the gastrointestinal tract. Curr Opin Clin Nutr Metab Care. 2009;12(5):533-8.

Horner KM, Schubert MM, Desbrow B, Byrne NM, King NA. Acute exercise and gastric emptying: a meta-analysis and implications for appetite

control. Sports Med. 2015;45(5):659-78.

de Oliveira EP, Burini RC, Jeukendrup A. Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations.

Sports Med. 2014;44 Suppl 1:S79-85.

GI Problems & History of GI Problems

Pfeiffer B, Stellingwerff T, Hodgson AB, et al. Nutritional intake and gastrointestinal problems

during competitive endurance events. Med Sci Sports Exerc. Feb 2012;44(2):344-351.

Practice fueling & hydration sweat rate

tracking during long runs

• On every run longer than ~75min track sweat rate in different weather conditions,

especially in targeted race weather conditions – track information into worksheet.

• Practice fueling and hydration in every long run. Practice with different amounts of

fluids and fuels, mimicking the timing of intake in your race (~15 to 20min) -- track

information into worksheet. Ideally practice under race pace intensities and durations!

• Aim for at least 40g of carbs/hr and >500ml/hr water to start. But try and really “test”

your GI and see what you can handle. The more you can adapt and handle taking in

carbohydrate, the more fuel you will have at the end of the race. Ideally, you can

adapt to hit >60g CHO/hr or more when running and >90g CHO/hr cycling!

Track information into spreadsheet / work tool to find out what your

Individual sweat rate and fueling intake abilities are…

WHAT DO CHAMPION

ENDURANCE ATHLETES

CONSUME?

Kenyan: Chronic Diet?

Marathon All-Time Rankings

77% CHO!

~10.5 g CHO/kg/day!

(607 g CHO/day)

67% CHO!

~9.9 g CHO/kg/day!

(552g CHO/day)

Elite Ultra-marathoner nutrition intakes

Stellingwerff, T. (2016). Competition Nutrition Practices of Elite Ultramarathon Runners. International journal of sport nutrition and

exercise metabolism, 26(1), 93-99.

Rontoyannis GP, Skoulis T, Pavlou KN. Energy balance in ultramarathon running. Am J Clin Nutr. 1989;49(5 Suppl):976-9.

Three world-class veteran male ultra-

runners (mean±SD; age 35±2y; mass

59.5±1.7kg; 16.7±2.5h 100-mile best-

times) agreed to complete a

competition-specific nutrition intake

questionnaire after a 100-mile race.

Truly ELITE: In 2014 competed in 16

ultramarathons with a total of eight

wins!

Wins at:

Western States 100-miler

Leadville 100-miler

Run Rabbit Run 100-miler

World 100km Championships - Doha

Yannis Kouros – 96g/h over 5 days of racing!

(every WR from 100 to 1000miles of running)

95%

SUMMARY

Lean Body Mass as percentage of BM

Energy requirements

CHO considerations for athletes – it’s NOT

black & white but a continuum…Daily training volume

Muscle glycogen less limiting for completion of

session

Less need for carbohydrate intake over total

day or around sessions

Some sessions may be deliberately done with

low carbohydrate availability

High muscle glycogen requirement for

completion of training

Promote opportunities for carbohydrate

intake in total day and around session

Light, Skill, A1

Lower, including energy

deficit for weight loss

Low High

Training IntensityVO2max, Tolerance,

Speed

Development

Prolonged metabolic

stress to induce

aerobic adaptation

High quality,

speed/technique

3 4 5 6 7 8 9 10

g carbohydrate / kg BM / day

Goal of session

High, including

needs for growth

Low High

Feedback from experimentationSeems

over-fuelled

Often runs out of

fuel in sessions

Exercise

Time (hrs)0 1 2 3 4 5 6 7 8+

Endogenous

Energy Stores Required

Exogenous

Caloric Intake

CHO Intake

Rate

Mouth-

wash

to 30g/h

30 to

60 g/h40 to 110g/h

CHO Type

Glucose

Only

Glucose + Fructose Blends

CHO FormSports Drinks /

Gels

Solid Sports

Food (low fiber

and fat)

Solid Food

Exercise

Intensity Stellingwerff, T., & Cox, G. R. (2014). Systematic review: Carbohydrate supplementation on exercise

performance or capacity of varying durations. Appl Physiol Nutr Metab, 39(9), 998-1011

Questions?

Thank-you…