ONLINE DRIVERS MEDIA

The advantage of HDL is its stability that reduces the risk of plaque build-up in the intestinal wall, which is clogged by the remnants of oxidized LDL and causes heart disease & co.

First things first: We are not talking about "hard experimental evidence" as you could generate it in a randomized controlled trial in a metabolic ward. The data I am reporting today is from a cohort with 1,566 participants with extensive lipid phenotype data completed the Harvard Standardized Food Frequency Questionnaire to determine their daily micronutrient intake over the past year - an epidemiological study that used stepwise linear regression was used to separately evaluate the effects of dietary covariates on adjusted levels of HDL-C, HDL-2, HDL-3, and apoA1.

Interestingly, this is the first study with a quality data-set that determined the association between specific dietary micronutrients with HDL-C, HDL-2, HDL-3, and apoA1, and how these dietary associations differ across the various measures of HDL - not just one.
To identify the HDL-promoters in the diet, the scientists use demographic and clinical variables in the base model. What they found was that numerous dietary intakes increased total HDL-C variance.
The results of their stepwise linear regression model in Table 1 indicate - probably for some people much surprisingly - that all alcohol intake levels were positively associated with HDL-C.

"In addition, magnesium, folate, and the saturated fat, myristic acid (14:0), were all positively and independently associated with HDL-C. Carbohydrate intake, iron, and % of fat derived from animal sources were each negatively additive for HDL-C." (Kim. 2014)

Similar effects from dietary intakes were observed for HDL-2, of which we know that it is decreased in women with rheumatoid arthritis (Arts. 2012) and individuals with other inflammatory diseases (including metabolic syndrom) and associated with a slightly higher reduction in acute myocardial infarction risk than "regular" HDL in several studies (Salonen. Salonen. 1991; Stampfer. 1991; Buring. 1992; Gaziano. 1993) for all alcohol intakes, magnesium, folate, and myristic acid (14:0), eicosapentaenoic acid (20:5, a ?-3 EPA), all of which were positively and independently associated with HDL-2 levels.

Table 1:  Best-fit model from stepwise linear regression predicting HDL-C levels using dietary intake data (Kim. 2014)

The opposite was the case for arachidonic acid (20:4, an ?-6 ARA), carbohydrate and iron intakes, which were both negatively associated with HDL-2 (see Table 1).

Dont forget to put things into perspective!

And just to make sure, I dont get angry emails from bulletproof coffee drinkers: Your coffee is fine, the content of the only "good" saturated fat, i.e. myristic acid, happens to be especially high coconut oil (41%; Sodamade. 2013) and relatively high in butter (12% independent of whether its grass-fed or not; Couvreur. 2006) - surprised? Not really, I guess. As a SuppVersity reader you are by now aware that the bad reputation coconut oil and butter have for being mostly saturated fats is no longer supported by contemporary scientific evidence (Dias. 2014).

And with respect to the total animal fat intake - for the average Westerner thats a good measure of how much processed meat he / she eats, so I would not overrate the small negative association (1/80 of the one of having a ton of carbohydrates in your diet!) the scientists found in the study at hand.
References:

• Arts, Elke, et al. "High-density lipoprotein cholesterol subfractions HDL2 and HDL3 are reduced in women with rheumatoid arthritis and may augment the cardiovascular risk of women with RA: a cross-sectional study." Arthritis Res Ther 14.3 (2012): R116.
• Buring, J. E., et al. "Decreased HDL2 and HDL3 cholesterol, Apo AI and Apo A-II, and increased risk of myocardial infarction." Circulation 85.1 (1992): 22-29.
• Couvreur, S., et al. "The linear relationship between the proportion of fresh grass in the cow diet, milk fatty acid composition, and butter properties." Journal of dairy science 89.6 (2006): 1956-1969.
• Dias, C. B., et al. "Saturated fat consumption may not be the main cause of increased blood lipid levels." Medical hypotheses 82.2 (2014): 187-195.
• Gaziano, J. Michael, et al. "Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction." New England Journal of Medicine 329.25 (1993): 1829-1834. 
• Kim et al. "Effects of dietary components on high-density lipoprotein measures in a cohort of 1,566 participants." Nutrition & Metabolism 2014, 11:44.
• Leon, ARTHUR S., and OTTO A. Sanchez. "Response of blood lipids to exercise training alone or combined with dietary intervention." Medicine and science in sports and exercise 33.6 Suppl (2001): S502-15.
• Salonen, Jukka T., et al. "HDL, HDL2, and HDL3 subfractions, and the risk of acute myocardial infarction. A prospective population study in eastern Finnish men." Circulation 84.1 (1991): 129-139. 
• Sodamade, A¹, and O. S. Bolaji. "Fatty acids composition of three different vegetable oils (soybean oil, groundnut oil and coconut oil) by high-performance liquid chromatography." Chemistry and Materials Research 3.7 (2013): 26-29.
• Stampfer, Meir J., et al. "A prospective study of cholesterol, apolipoproteins, and the risk of myocardial infarction." New England Journal of Medicine 325.6 (1991): 373-381.

Compared to liquid beverages, gels have the advantage of causing lower GI stress, when significant quantities of CHOs are consumed during exercise. Bars, can be held in the cheek pouch and chewed during critical phases of a race.

The headline gives it away. Todays SuppVersity article is a brief review of the (mostly sponsored) literature on Gatora.... ah, I mean carbohydrate supplementation during exercise. The headline also implies that the usefulness and efficacy of carbohydrate supplements depends on exercise duration and the type of exercise.

As a seasoned student of the SuppVersity you will know that certain paradox involved with regard to the duration / type of exercise. Short exercise durations, for example, shouldnt require large CHO boluses, long duration exercise, on the other hand, is fueled mostly by fat - so why should you supplement with carbohydrates, anyway?
I promise to answer this and other questions in the following paragraphs, but before I do so, I would like to point out that there is as of now no evidence that the much-praised "fat adaptation" increases the exercise performance to an "Olympia" level. Carbohydrate supplements, on the other hand, are still part of the regular supplementation regimen for the 99% of the top athletes.

That being said, the human physiology dictates that the use of carbohydrate supplements during aerobic workouts that last less than 60 minutes is useless, because muscle glycogen is generally not limiting to performance when exercise durations are less than ~60 minutes.

It should not work for short duration exercise, but it still does

Interestingly, 16 out of 23 studies, Trent Stellingwerff and Gregory R. Cox from the Canadian Sport Institute-Pacific and the Australian Institute of Sport reviewed for their recent paper in Applied Physiology have found that carbohydrate supplementation and/or oral (mouth) exposure to carbohydrate can improve performance of tasks less than 1 hour in duration:

You wont fully deplete your muscular glyocogen levels during short duration resistance training (Haff. 2003)

"In 2004 a seminal paper was published showing that a carbohydrate mouth-wash (swirling 25ml of a 6% CHO beverage (only ~1.5g of CHO in 25ml [6.4% maltodextrin solution (CHO)]) around in the mouth for ~10 sec, every 7.5min) significantly improved time trial (TT) performance [in seven male and two female endurance cyclists] by ~3% (Carter et al. 2004a)." (Stellingwerff & Cox. 2014)

This effect of CHO mouth-washing to improve performance in events from 30-60min has now been replicated in several other performance studies (10 of 13 studies) using both cycling and running interventions and with both sweet (sucrose) and non-sweet (maltodextrin) caloric CHO sources,as compared to 5 non-caloric artificial sweetener placebo trials showing no performance enhancing effects.

Figure 1: Hard to believe, but true - In 2010 Pottier et al. observed that CHO mouth-rinsing, but not CHO ingestion increases the 1h high intensity time-trial performance in trained subjects.

 "All these findings have been mechanistically supported with a functional magnetic resonance brain imaging study showing that CHO mouth-washing from both sweet tasting glucose and non-sweet maltodextrin can stimulate the brain areas of the insula/frontal operculum, orbitofrontal cortex and striatum, which are involved with brain centers responsible for reward and motor control (Chambers et al. 2009). Interestingly, if the mouth (oral receptors) and GI tract is by-passed by CHO infusion straight into the blood stream then 1h cycling TT performance was unaltered as compared to no CHO supplementation (Carter et al. 2004b)." (Stellingwerff & Cox. 2014)

Studies evaluating the effects on perceived exertion (Fares et al. 2011) found similar benefits all of which support the idea that the effect does not occur in the musculature, but rather in the head.
It should be obvious that the physiological, or rater intra-muscular benefits of carbohydrate supplements increases with the exercise duration.

CHO supplementation during exercise that lasts 60 minutes or longer

In view of the fact that it is 100% logical and well established by studies by Coyle et al. (Coyle 1992a; Coyle 1992b) that the intake of carbohydrate (glucose alone, and glucose + fructose blends) can significantly improve prolonged endurance capacity and performance (>60min of exercise (Jeukendrup 2010)).

Figure 2: Overview of the performance increases in the 50 studies Stellingwerff & Cox reviewed (2014)

Against that background I will not bother you with another overview of the results, but focus on the efficacy of different carbohydrate supplementation strategies and types of carbohydrate supplements for exercise durations beyond the "magical" hour.

Glucose + fructose - the combination advantage

As a SuppVersity reader youve previously heard about the benefits of combining glucose and fructose in your intra-workout beverage. It is thus only logical that most commercially available formulas are mixtures  glucose + fructose (GLU:FRU) or maltodextrin + fructose - so-called "multi-transportable CHOs". The advantage of using both glucose and fructose is that the carbohydrates will be absorbed via SGLT1 and GLUT5 intestinal transporters.

Specifically during long(er) duration exercise, when the carbohydrate consumption can exceed 60g/h there is a significant performance increase with multi- vs. single source carbohydrate supplements (Stellingwerff & Cox. 2014)

An advantage that has been scientifically established among others by Jeukendrup et al. (2010) who found that this pattern of CHO ingestion results in ~20 to 50% higher CHO oxidation rates compared to the ingestion of a drink that contains nothing but glucose or maltodextrin.


Now an increase in carbohydrate oxidation alone does not sound like something you would aim for as an endurance athlete. In practice, increases in carbohydrate oxidation have yet been shown to increase the performance during prolonged exercise bouts compared to isocaloric glucose-only beverages. (Currell et al. 2008; Triplett et al. 2010; OBrien et al. 2011; OBrien et al. 2013).
Needless to say that there is still research to be done with respect to individual influencing variables of carbohydrate requirements. The currently available evidence, for example, is largely based on results from runners and cyclists. Two other factors / issues that come to mind are...

• the dose-response relationship, which appears to be capped at 75g/h - at least according to a large-scale multi-center study by Smith et al. (Smith. 2013) who found that their subjects, endurance trained cyclists or triathletes experienced significant performance increases, with increasing amounts of carbohydrates (0, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 110 and 120g of CHO/h) during a 2h constant load ride.
  
  

  Figure 3: Mean log time to complete time trial (natural) as function of CHO treatment condition with fitted quadratic curve (with 95% CI of mean curves). Differences 100 represent percent change in performance. The quadratic function relating CHO ingestion rate to time complete time trial for 43% (95% CI = 11%–75%,P= 0.059) of the variation in mean performance score (Smith. 2013)

  The CHO given was a 1:1:1 glucose:maltodextrin:fructose blend. Results indicated incremental performance improvements of 1.0%, 2.0%, 3.0%, 4.0%, and 4.7% at 9, 19, 31, 48, and 78g CHO/h, respectively, with diminishing performance enhancement seen at CHO levels >78g/h.
  
  The optimal amount for performance (+4.7%) was 78g/h, with a range of 68 to 88g/h. However, even at 10g/h, a 1.0% increase in performance was observed, showing even a small amount of carbohydrate has the potential to positively impact performance. 
• the optimal mix of glucose, dextrose, fructose, maltodextrin or other "special" carbohydrates  - needless to say that waxy maize, hydroxypropyl distarches (learn more) or the expensive fast absorbing highly insulinogenic patented carbohydrate source Vitargo come to mind, when we are talking about finding the optimal mix of different carbohydrate sources - a mix, by the way, of which you can safely assume that it will differ according to the physiological demands of the workout and the exercise duration.
  
  One thing we shouldnt forget, though, is that next to optimal performance, optimal GI tolerance, i.e. the absence of bloating, diarrhea & co would be an important criteria the "optimal" carbohydrate blend would have to meet.

• Figure 4: CHO suppl. ameliorates  testosterone reductions in 800m runners (de Sousa. 2010)

  the impact of carbohydrate supplementation on hormonal changes during and in response exercise - several human studies suggest that CHO supplementation attenuates the suppression of the hypothalamic-pituitary-gonadal axis and the rise in stress hormones during periods of intense training; a recent rodent study shows that the provision of carbohydrate supple- ments can prevent / reverse exercise-associated menstrual dysfunction (de Sousa. 2010; Zhao. 2014)

I guess, I could come up with additional research gabs, but in the end, a list of "gaps" is not exactly useful for you. Much in contrast to a conclusion, which I am about to formulate in the bottom line, now.
References:

• Carter,  J.,  Jeukendrup,  A.E.,  Mundel,  T.,  and  Jones,  D.A.  (2003).  Carbohydrate  supplementation  improves moderate and high-intensity exercise in the heat. Pflügers Archiv : European journal of physiology446: 211-9.
• Carter, J.M., Jeukendrup, A.E., and Jones, D.A. (2004a). The effect of carbohydrate mouth rinse on 1-h cycle time trial performance. Medicine and science in sports and exercise36: 2107-11.
• Carter, J.M., Jeukendrup, A.E.,  Mann, C.H., and  Jones, D.A. (2004b). The effect of glucose infusion on glucose kinetics during a 1-h time trial. Medicine and science in sports and exercise36: 1543-50. 
• Chambers,  E.S.,  Bridge,  M.W.,  and  Jones,  D.A.  (2009). Carbohydrate  sensing  in  the  human  mouth:  effects  on exercise performance and brain activity. The Journal of physiology587: 1779-94. 
• de Sousa, Maysa Vieira, et al. (2010). Effects of carbohydrate supplementation on competitive runners undergoing overload training followed by a session of intermittent exercise." European journal of applied physiology 109.3: 507-516.
• Fares, E.J. and Kayser, B. (2011). Carbohydrate mouthrinse effects on exercise capacity in pre- and postprandial States. J Nutr Metab2011: 385962.   
• Pottier, Andries, et al. (2010). Mouth rinse but not ingestion of a carbohydrate solution improves 1?h cycle time trial performance" Scandinavian journal of medicine & science in sports 20.1: 105-111.
• Sawka,  M.N.,  Burke,  L.M.,  Eichner,  E.R.,  Maughan,  R.J.,  Montain,  S.J.,  and  Stachenfeld,  N.S. (2007).  American College of Sports Medicine position stand. Exerciseand fluid replacement. Medicine and science in sports and exercise39: 377-90.
• Smith, JohnEric W., et al. (2013). Curvilinear dose-response relationship of carbohydrate (0-120 g/h) and performance." Med Sci Sports Exerc 45.2: 336-341. 
• Stellingwerff, T., & Cox, G. R. (2014). Systematic Review: Carbohydrate Supplementation on Exercise Performance or Capacity of Varying Durations. Applied Physiology, Nutrition, and Metabolism (2014). Ahead of Print. 
• Zhao, Can, et al. (2014). Effects of carbohydrate supplements on exercise-induced menstrual dysfunction and ovarian subcellular structural changes in rats." Journal of Sport and Health Science 3.3: 189-195.