Comparing the Effects of Glucose-Fructose versus Glucose on the Oxidation Rate: A Systematic Review and Meta-Analysis
-
Zahra Gohari Dezfuli
,
Minoo Hasan Rashedi
,
Fatemeh Naeini
,
Sakineh Shab-Bidar
,
Mohammadhossein Pourgharib-Shahi
,
Xueying Zhang
,
Elaheh Dehghani
,
Kurosh Djafarian
Abstract
Background: Numerous studies have aimed to compare the effects of glucose (Glu) consumption with those of glucose-fructose (Glu-Fru) consumption on oxidation rates during exercise. However, divergent outcomes have surfaced due to variations in exercise protocols and concurrent substance ingestion, leading to a lack of consensus. This systematic review and meta-analysis investigated the comparative effects of Glu and Glu-Fru on total carbohydrate oxidation, endogenous carbohydrate oxidation, exogenous carbohydrate oxidation, and total fat oxidation rates during exercise.
Methods: A systematic search of PubMed, Scopus, and Web of Science databases up to February 2023. The search yielded 14 randomized controlled trials involving 125 endurance athletes.
Results: The meta-analyses revealed that Glu supplementation significantly increased total carbohydrate oxidation (WMD: 0.21 g/min) compared to Glu-Fru. Endogenous carbohydrate oxidation significantly increased with Glu (WMD: -0.12), while Glu-Fru led to increased exogenous carbohydrate oxidation (WMD: 0.27 g/min). Total fat oxidation decr eased with Glu-Fru (WMD: -0.06 g/min).
Conclusion: By investigating athletic nutrition complexities, our findings shed light on metabolic responses to Glu-Fru versus Glu supplementation. Tailoring hydration strategies, athletes should select an optimal Glu-Fru to Glu ratio for maximal oxidation and enhanced performance. Future research could explore dose-response relationships for optimal metabolic benefits during exercise.
1. Jeukendrup AE (2010). Carbohydrate and exercise performance: the role of multiple transportable carbohydrates. Curr Opin Clin Nutr Metab Care, 13 (4):452-7.
2. Frayn KN (1983). Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol Respir Environ Exerc Physiol, 55 (2):628-34.
3. Hargreaves M, Spriet LL (2020). Author Correction: Skeletal muscle energy metabolism during exercise. Nat Metab, 2 (9):990.
4. Ramadoss R, Stanzione JR, Volpe SL (2022). A Comparison of Substrate Utilization Profiles During Maximal and Submaximal Exercise Tests in Athletes. Front Psychol, 13:854451.
5. Randell RK, Rollo I, Roberts TJ, et al (2017). Maximal Fat Oxidation Rates in an Athletic Population. Med Sci Sports Exerc, 49 (1):133-140.
6. Venables MC, Achten J, Jeukendrup AE (2005). Determinants of fat oxidation during exercise in healthy men and women: a cross-sectional study. J Appl Physiol (1985), 98 (1):160-7.
7. Alghannam AF, Ghaith MM, Alhussain MH (2021). Regulation of Energy Substrate Metabolism in Endurance Exercise. Int J Environ Res Public Health, 18 (9):4963.
8. Coyle EF, Coggan AR, Hemmert MK, Ivy JL (1986). Muscle glycogen utilization during prolonged strenuous exercise when fed carbohydrate. J Appl Physiol (1985), 61 (1):165-72.
9. Smith JW, Zachwieja JJ, Péronnet F, et al (2010). Fuel selection and cycling endurance performance with ingestion of [13C]glucose: evidence for a carbohydrate dose response. J Appl Physiol (1985), 108 (6):1520-9.
10. Stellingwerff T, Cox GR (2014). Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations. Appl Physiol Nutr Metab, 39 (9):998-1011.
11. Jeukendrup AE, Wagenmakers AJ, Stegen JH, et al (1999). Carbohydrate ingestion can completely suppress endogenous glucose production during exercise. Am J Physiol, 276 (4):E672-83.
12. Jeukendrup AE, Jentjens R (2000). Oxidation of carbohydrate feedings during prolonged exercise: current thoughts, guidelines and directions for future research. Sports Med, 29 (6):407-24.
13. Rowlands DS, Houltham S, Musa-Veloso K, Brown F, Paulionis L, Bailey D (2015). Fructose-Glucose Composite Carbohydrates and Endurance Performance: Critical Review and Future Perspectives. Sports Med, 45 (11):1561-76.
14. Shi X, Summers RW, Schedl HP, et al (1995). Effects of carbohydrate type and concentration and solution osmolality on water absorption. Med Sci Sports Exerc, 27 (12):1607-15.
15. Pugh JN, Fearn R, Morton JP, Close GL (2018). Gastrointestinal symptoms in elite athletes: time to recognise the problem? Br J Sports Med, 52 (8):487-488.
16. Papantoniou K, Michailides C, Bali M, et al (2023). Gastrointestinal bleeding in athletes. Ann Gastroenterol, 36 (3):267-274.
17. Leturque A, Brot-Laroche E, Le Gall M, et al (2005). The role of GLUT2 in dietary sugar handling. J Physiol Biochem, 61 (4):529-37.
18. Jones HF, Butler RN, Brooks DA (2011). Intestinal fructose transport and malabsorption in humans. Am J Physiol Gastrointest Liver Physiol, 300 (2):G202-6.
19. Merino B, Fernández-Díaz CM, Cózar-Castellano I, Perdomo G (2019). Intestinal Fructose and Glucose Metabolism in Health and Disease. Nutrients, 12 (1):94.
20. Wallis GA, Wittekind A (2013). Is there a specific role for sucrose in sports and exercise performance? Int J Sport Nutr Exerc Metab, 23 (6):571-83.
21. DeBosch BJ, Chi M, Moley KH (2012). Glucose transporter 8 (GLUT8) regulates enterocyte fructose transport and global mammalian fructose utilization. Endocrinology, 153 (9):4181-91.
22. McDermott BP, Anderson SA, Armstrong LE, et al (2017). National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active. J Athl Train, 52 (9):877-895.
23. . AA ((2022)). Flexible Dieting: A Science-Based, Reality-Tested Method for Achieving and Maintaining Your Optimal Physique, Performance & Health. ed. Victory Belt Publishing, Las Vegas (NV).
24. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372:n71.
25. Liberati A, Altman DG, Tetzlaff J, et al (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol, 62 (10):e1-34.
26. Rohatgi A (2019) WebPlotDigitizer. 4.2 edn., Austin, TX
27. Sterne JAC, Savović J, Page MJ, et al (2019). RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ, 366:l4898.
28. Puhan MA, Schünemann HJ, Murad MH, et al (2014). A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis. BMJ, 349:g5630.
29. Trommelen J, Fuchs CJ, Beelen M, et al (2017). Fructose and Sucrose Intake Increase Exogenous Carbohydrate Oxidation during Exercise. Nutrients, 9 (2): 167.
30. Wilson PB, Ingraham SJ (2016). Effects of glucose-fructose versus glucose ingestion on stride characteristics during prolonged treadmill running. Sports Biomech, 15 (3):270-82.
31. Baur DA, Schroer AB, Luden ND, et al (2014). Glucose-fructose enhances performance versus isocaloric, but not moderate, glucose. Med Sci Sports Exerc, 46 (9):1778-86.
32. Roberts JD, Tarpey MD, Kass LS, et al (2014). Assessing a commercially available sports drink on exogenous carbohydrate oxidation, fluid delivery and sustained exercise performance. J Int Soc Sports Nutr, 11 (1):8.
33. Tarpey MD, Roberts JD, Kass LS, et al (2013). The ingestion of protein with a maltodextrin and fructose beverage on substrate utilisation and exercise performance. Appl Physiol Nutr Metab, 38 (12):1245-53.
34. Lecoultre V, Benoit R, Carrel G, et al (2010). Fructose and glucose co-ingestion during prolonged exercise increases lactate and glucose fluxes and oxidation compared with an equimolar intake of glucose. Am J Clin Nutr, 92 (5):1071-9.
35. Rowlands DS, Thorburn MS, Thorp RM, et al (2008). Effect of graded fructose coingestion with maltodextrin on exogenous 14C-fructose and 13C-glucose oxidation efficiency and high-intensity cycling performance. J Appl Physiol (1985), 104 (6):1709-19.
36. Currell K, Jeukendrup AE (2008). Superior endurance performance with ingestion of multiple transportable carbohydrates. Med Sci Sports Exerc, 40 (2):275-81.
37. Jeukendrup AE, Moseley L, Mainwaring GI, et al (2006). Exogenous carbohydrate oxidation during ultraendurance exercise. J Appl Physiol (1985), 100 (4):1134-41.
38. Jentjens RL, Underwood K, Achten J, et al (2006). Exogenous carbohydrate oxidation rates are elevated after combined ingestion of glucose and fructose during exercise in the heat. J Appl Physiol (1985), 100 (3):807-16.
39. Jentjens RL, Jeukendrup AE (2005). High rates of exogenous carbohydrate oxidation from a mixture of glucose and fructose ingested during prolonged cycling exercise. Br J Nutr, 93 (4):485-92.
40. Wallis GA, Rowlands DS, Shaw C, et al (2005). Oxidation of combined ingestion of maltodextrins and fructose during exercise. Med Sci Sports Exerc, 37 (3):426-32.
41. Jentjens RL, Moseley L, Waring RH, et al (2004). Oxidation of combined ingestion of glucose and fructose during exercise. J Appl Physiol (1985), 96 (4):1277-84.
42. Hulston CJ, Wallis GA, Jeukendrup AE (2009). Exogenous CHO oxidation with glucose plus fructose intake during exercise. Med Sci Sports Exerc, 41 (2):357-63.
43. Higgins JP, Thompson SG (2002). Quantifying heterogeneity in a meta-analysis. Stat Med, 21 (11):1539-58.
44. Gonzalez JT, Rumbold PL, Stevenson EJ (2012). Effect of calcium intake on fat oxidation in adults: a meta-analysis of randomized, controlled trials. Obes Rev, 13 (10):848-57.
45. Collado-Mateo D, Lavín-Pérez AM, Merellano-Navarro E, Coso JD (2020). Effect of Acute Caffeine Intake on the Fat Oxidation Rate during Exercise: A Systematic Review and Meta-Analysis. Nutrients, 12 (12):3603.
46. Li X, Wang W, Guo R, et al (2020). The Effects of Sports Drinks During High-Intensity Exercise on the Carbohydrate Oxidation Rate Among Athletes: A Systematic Review and Meta-Analysis. Front Physiol, 11:574172.
47. Labayen I, Díez N, Parra D, et al (2004). Basal and postprandial substrate oxidation rates in obese women receiving two test meals with different protein content. Clin Nutr, 23 (4):571-8.
48. Labayen I, Forga L, Martínez JA (1999). Nutrient oxidation and metabolic rate as affected by meals containing different proportions of carbohydrate and fat, in healthy young women. Eur J Nutr, 38 (3):158-66.
49. Rowlands DS, Swift M, Ros M, Green JG (2012). Composite versus single transportable carbohydrate solution enhances race and laboratory cycling performance. Appl Physiol Nutr Metab, 37 (3):425-36.
50. Gonzalez JT, Fuchs CJ, Smith FE, et al (2015). Ingestion of glucose or sucrose prevents liver but not muscle glycogen depletion during prolonged endurance-type exercise in trained cyclists. Am J Physiol Endocrinol Metab, 309 (12):E1032-9.
51. Burant CF, Takeda J, Brot-Laroche E, et al (1992). Fructose transporter in human spermatozoa and small intestine is GLUT5. J Biol Chem, 267 (21):14523-6.
52. Onywera VO, Scott RA, Boit MK, Pitsiladis YP (2006). Demographic characteristics of elite Kenyan endurance runners. J Sports Sci, 24 (4):415-22.
53. Sharma S (2003). Athlete's heart--effect of age, sex, ethnicity and sporting discipline. Exp Physiol, 88 (5):665-9.
2. Frayn KN (1983). Calculation of substrate oxidation rates in vivo from gaseous exchange. J Appl Physiol Respir Environ Exerc Physiol, 55 (2):628-34.
3. Hargreaves M, Spriet LL (2020). Author Correction: Skeletal muscle energy metabolism during exercise. Nat Metab, 2 (9):990.
4. Ramadoss R, Stanzione JR, Volpe SL (2022). A Comparison of Substrate Utilization Profiles During Maximal and Submaximal Exercise Tests in Athletes. Front Psychol, 13:854451.
5. Randell RK, Rollo I, Roberts TJ, et al (2017). Maximal Fat Oxidation Rates in an Athletic Population. Med Sci Sports Exerc, 49 (1):133-140.
6. Venables MC, Achten J, Jeukendrup AE (2005). Determinants of fat oxidation during exercise in healthy men and women: a cross-sectional study. J Appl Physiol (1985), 98 (1):160-7.
7. Alghannam AF, Ghaith MM, Alhussain MH (2021). Regulation of Energy Substrate Metabolism in Endurance Exercise. Int J Environ Res Public Health, 18 (9):4963.
8. Coyle EF, Coggan AR, Hemmert MK, Ivy JL (1986). Muscle glycogen utilization during prolonged strenuous exercise when fed carbohydrate. J Appl Physiol (1985), 61 (1):165-72.
9. Smith JW, Zachwieja JJ, Péronnet F, et al (2010). Fuel selection and cycling endurance performance with ingestion of [13C]glucose: evidence for a carbohydrate dose response. J Appl Physiol (1985), 108 (6):1520-9.
10. Stellingwerff T, Cox GR (2014). Systematic review: Carbohydrate supplementation on exercise performance or capacity of varying durations. Appl Physiol Nutr Metab, 39 (9):998-1011.
11. Jeukendrup AE, Wagenmakers AJ, Stegen JH, et al (1999). Carbohydrate ingestion can completely suppress endogenous glucose production during exercise. Am J Physiol, 276 (4):E672-83.
12. Jeukendrup AE, Jentjens R (2000). Oxidation of carbohydrate feedings during prolonged exercise: current thoughts, guidelines and directions for future research. Sports Med, 29 (6):407-24.
13. Rowlands DS, Houltham S, Musa-Veloso K, Brown F, Paulionis L, Bailey D (2015). Fructose-Glucose Composite Carbohydrates and Endurance Performance: Critical Review and Future Perspectives. Sports Med, 45 (11):1561-76.
14. Shi X, Summers RW, Schedl HP, et al (1995). Effects of carbohydrate type and concentration and solution osmolality on water absorption. Med Sci Sports Exerc, 27 (12):1607-15.
15. Pugh JN, Fearn R, Morton JP, Close GL (2018). Gastrointestinal symptoms in elite athletes: time to recognise the problem? Br J Sports Med, 52 (8):487-488.
16. Papantoniou K, Michailides C, Bali M, et al (2023). Gastrointestinal bleeding in athletes. Ann Gastroenterol, 36 (3):267-274.
17. Leturque A, Brot-Laroche E, Le Gall M, et al (2005). The role of GLUT2 in dietary sugar handling. J Physiol Biochem, 61 (4):529-37.
18. Jones HF, Butler RN, Brooks DA (2011). Intestinal fructose transport and malabsorption in humans. Am J Physiol Gastrointest Liver Physiol, 300 (2):G202-6.
19. Merino B, Fernández-Díaz CM, Cózar-Castellano I, Perdomo G (2019). Intestinal Fructose and Glucose Metabolism in Health and Disease. Nutrients, 12 (1):94.
20. Wallis GA, Wittekind A (2013). Is there a specific role for sucrose in sports and exercise performance? Int J Sport Nutr Exerc Metab, 23 (6):571-83.
21. DeBosch BJ, Chi M, Moley KH (2012). Glucose transporter 8 (GLUT8) regulates enterocyte fructose transport and global mammalian fructose utilization. Endocrinology, 153 (9):4181-91.
22. McDermott BP, Anderson SA, Armstrong LE, et al (2017). National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active. J Athl Train, 52 (9):877-895.
23. . AA ((2022)). Flexible Dieting: A Science-Based, Reality-Tested Method for Achieving and Maintaining Your Optimal Physique, Performance & Health. ed. Victory Belt Publishing, Las Vegas (NV).
24. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372:n71.
25. Liberati A, Altman DG, Tetzlaff J, et al (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol, 62 (10):e1-34.
26. Rohatgi A (2019) WebPlotDigitizer. 4.2 edn., Austin, TX
27. Sterne JAC, Savović J, Page MJ, et al (2019). RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ, 366:l4898.
28. Puhan MA, Schünemann HJ, Murad MH, et al (2014). A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis. BMJ, 349:g5630.
29. Trommelen J, Fuchs CJ, Beelen M, et al (2017). Fructose and Sucrose Intake Increase Exogenous Carbohydrate Oxidation during Exercise. Nutrients, 9 (2): 167.
30. Wilson PB, Ingraham SJ (2016). Effects of glucose-fructose versus glucose ingestion on stride characteristics during prolonged treadmill running. Sports Biomech, 15 (3):270-82.
31. Baur DA, Schroer AB, Luden ND, et al (2014). Glucose-fructose enhances performance versus isocaloric, but not moderate, glucose. Med Sci Sports Exerc, 46 (9):1778-86.
32. Roberts JD, Tarpey MD, Kass LS, et al (2014). Assessing a commercially available sports drink on exogenous carbohydrate oxidation, fluid delivery and sustained exercise performance. J Int Soc Sports Nutr, 11 (1):8.
33. Tarpey MD, Roberts JD, Kass LS, et al (2013). The ingestion of protein with a maltodextrin and fructose beverage on substrate utilisation and exercise performance. Appl Physiol Nutr Metab, 38 (12):1245-53.
34. Lecoultre V, Benoit R, Carrel G, et al (2010). Fructose and glucose co-ingestion during prolonged exercise increases lactate and glucose fluxes and oxidation compared with an equimolar intake of glucose. Am J Clin Nutr, 92 (5):1071-9.
35. Rowlands DS, Thorburn MS, Thorp RM, et al (2008). Effect of graded fructose coingestion with maltodextrin on exogenous 14C-fructose and 13C-glucose oxidation efficiency and high-intensity cycling performance. J Appl Physiol (1985), 104 (6):1709-19.
36. Currell K, Jeukendrup AE (2008). Superior endurance performance with ingestion of multiple transportable carbohydrates. Med Sci Sports Exerc, 40 (2):275-81.
37. Jeukendrup AE, Moseley L, Mainwaring GI, et al (2006). Exogenous carbohydrate oxidation during ultraendurance exercise. J Appl Physiol (1985), 100 (4):1134-41.
38. Jentjens RL, Underwood K, Achten J, et al (2006). Exogenous carbohydrate oxidation rates are elevated after combined ingestion of glucose and fructose during exercise in the heat. J Appl Physiol (1985), 100 (3):807-16.
39. Jentjens RL, Jeukendrup AE (2005). High rates of exogenous carbohydrate oxidation from a mixture of glucose and fructose ingested during prolonged cycling exercise. Br J Nutr, 93 (4):485-92.
40. Wallis GA, Rowlands DS, Shaw C, et al (2005). Oxidation of combined ingestion of maltodextrins and fructose during exercise. Med Sci Sports Exerc, 37 (3):426-32.
41. Jentjens RL, Moseley L, Waring RH, et al (2004). Oxidation of combined ingestion of glucose and fructose during exercise. J Appl Physiol (1985), 96 (4):1277-84.
42. Hulston CJ, Wallis GA, Jeukendrup AE (2009). Exogenous CHO oxidation with glucose plus fructose intake during exercise. Med Sci Sports Exerc, 41 (2):357-63.
43. Higgins JP, Thompson SG (2002). Quantifying heterogeneity in a meta-analysis. Stat Med, 21 (11):1539-58.
44. Gonzalez JT, Rumbold PL, Stevenson EJ (2012). Effect of calcium intake on fat oxidation in adults: a meta-analysis of randomized, controlled trials. Obes Rev, 13 (10):848-57.
45. Collado-Mateo D, Lavín-Pérez AM, Merellano-Navarro E, Coso JD (2020). Effect of Acute Caffeine Intake on the Fat Oxidation Rate during Exercise: A Systematic Review and Meta-Analysis. Nutrients, 12 (12):3603.
46. Li X, Wang W, Guo R, et al (2020). The Effects of Sports Drinks During High-Intensity Exercise on the Carbohydrate Oxidation Rate Among Athletes: A Systematic Review and Meta-Analysis. Front Physiol, 11:574172.
47. Labayen I, Díez N, Parra D, et al (2004). Basal and postprandial substrate oxidation rates in obese women receiving two test meals with different protein content. Clin Nutr, 23 (4):571-8.
48. Labayen I, Forga L, Martínez JA (1999). Nutrient oxidation and metabolic rate as affected by meals containing different proportions of carbohydrate and fat, in healthy young women. Eur J Nutr, 38 (3):158-66.
49. Rowlands DS, Swift M, Ros M, Green JG (2012). Composite versus single transportable carbohydrate solution enhances race and laboratory cycling performance. Appl Physiol Nutr Metab, 37 (3):425-36.
50. Gonzalez JT, Fuchs CJ, Smith FE, et al (2015). Ingestion of glucose or sucrose prevents liver but not muscle glycogen depletion during prolonged endurance-type exercise in trained cyclists. Am J Physiol Endocrinol Metab, 309 (12):E1032-9.
51. Burant CF, Takeda J, Brot-Laroche E, et al (1992). Fructose transporter in human spermatozoa and small intestine is GLUT5. J Biol Chem, 267 (21):14523-6.
52. Onywera VO, Scott RA, Boit MK, Pitsiladis YP (2006). Demographic characteristics of elite Kenyan endurance runners. J Sports Sci, 24 (4):415-22.
53. Sharma S (2003). Athlete's heart--effect of age, sex, ethnicity and sporting discipline. Exp Physiol, 88 (5):665-9.
| Files | ||
| Issue | Vol 54 No 4 (2025) | |
| Section | Review Article(s) | |
| Keywords | ||
| Carbohydrate Endurance exercise Oxidation rate Performance | ||
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How to Cite
1.
Gohari Dezfuli Z, Rashedi MH, Naeini F, Shab-Bidar S, Pourgharib-Shahi M, Zhang X, Dehghani E, Djafarian K. Comparing the Effects of Glucose-Fructose versus Glucose on the Oxidation Rate: A Systematic Review and Meta-Analysis. Iran J Public Health. 2025;54(4):723-738.
