Carbohydrate needs and the menstrual cycle

Curious about how your menstrual cycle may affect your carbohydrate needs?

Estrogen has the effect of increasing glycogen uptake and storage in the muscle and glycogen sparing and increased fat utilization during exercise.

So, when estrogen is low, your body should be able to utilize relatively more endogenous carbohydrate (stored glycogen) to fuel exercise. Practically, this means you really need to pay attention to carbohydrate loading and post-exercise carbohydrate recovery to ensure you have adequate glycogen stores, particularly when you have back-to-back training days.

When estrogen is higher, your body should be able to oxidize relatively more fat compared to endogenous carbohydrate (glycogen) during exercise. Does this mean that you should be on a lower carbohydrate diet during these phases? NO! Not if you are still attempting to complete training sessions that include some intensity. This means you may need to increase the amount of exogenous carbohydrate you are taking in just before and during your training sessions to support higher intensity work. Remember, when carbohydrate intake rates are higher than 60 g/h, you are better off taking in mixed glucose-fructose carbohydrate sources to allow your GI tract to effectively absorb the carbohydrate for oxidation. Taking in high rates of carbohydrate also requires practice!

Final point, not all women are the same so MC and fueling needs can differ between individuals. It’s a great idea to start tracking your menstrual cycle and make notes on how you are feeling during training and recovery, and then start adjusting fuel as needed.

How do I use sports drinks?

We’ve talked about carbohydrate recommendations during training and racing, but sometimes it’s hard to EAT 60+ grams of carbs per hour, especially if you are out for a long/hard ride.

Did you know you can also meet (at least a portion) of your hourly carbohydrate goals with a carb-electrolyte drink (CHO-E)? But, before you go that route, you want to know the contents of what you are drinking, the mixing instructions, and scale the serving size information from the nutrition label to the amount of fluid in the bottle you are using.

If you are also using gels or chews, make sure you are factoring in the total grams of carbohydrate and milligrams of sodium the products are providing you together, with your CHO-E drink. Here are some of the more common drinks and their CHO and sodium content per 24 oz (710 ml).

Skratch Hydration: 31 g CHO, 570 mg sodium

Skratch Superfuel: 120 g CHO, 480 mg sodium

Tailwind Endurance Fuel: 50 g CHO, 600 mg sodium

Gu Roctane: 69 g CHO, 366 mg sodium

SWORD Performance: 45 g CHO, 600 mg sodium

As always, try it first during training, try it at race pace, and over time in multiple environmental conditions before you settle on a race day plan!

What are multi-transportable carbs and why do I need them?

Multiple transportable carbohydrates, aka different types of single carbohydrates (i.e. glucose, fructose, maltodextrin) can be beneficial during endurance activity lasting  >2.5 hours in duration. Currently recommended practices for carbohydrate intake during endurance exercise include: 

  • Optional CHO mouth rinsing during exercise 30-75 min 

  • 30–60 g/h during 1–2.5 h of endurance exercise 

  • Up to 90 g/h of multi-transportable CHO (e.g. glucose or maltodextrin:fructose blends) for exercise >2.5 h. 

Previously it was thought that the body could only utilize 1 g of CHO/min (60 g/h) during exercise. However, this was based on research examining a glucose-only solution. When researchers started adding different single CHOs (ie fructose) to the mix, carbohydrate delivery and oxidation rates increased. 

Intestinal absorption of carbohydrate is the limiting factor when it comes to how much exogenous carbohydrate your body can utilize during exercise. Glucose and fructose rely on different transport proteins (SGLT1 and GLUT5) for absorption in the gut. Because the glucose transporter is saturated when glucose ingestion exceeds  > ~60 g/h,  multiple transportable CHO (e.g. glucose-fructose) solutions are recommended when CHO intake rates are higher than ~60 g/h. The ideal solution is proposed to contain  a 2:1 glucose to fructose, or maltodextrin to fructose ratio (ie 60 g of glucose or maltodextrin, and 30 g of fructose). It should be noted that the fructose addition to glucose provides benefit after the glucose transporter is saturated at ~60 g/h. 

Finally, research has suggested that multiple transportable CHO vs. single CHO can result in performance improvements. One study in particular found an 8% performance improvement with a glucose:fructose solution (56.1 min) compared to a glucose only solution (60.7 min) during a 40 km bike time trial that followed  2 hours of cycling at 55% of max in trained male cyclists. Evidence also suggests reduced GI discomfort with multiple-transportable CHO mixtures compared to glucose alone. Athletes can choose CHO-based sports nutrition products in the form of liquids, gels, or solids based on personal preference, environmental conditions, and demands of the course and event. 

PMID: 26373645; 22468766; 20574242; 18202575

Do we need sex-specific carb intake recommendations during endurance exercise?

Ingestion of ~90 g CHO/h in the form of glucose or maltodextrin-fructose can increase exogenous CHO utilization and improve endurance performance. However, the majority of research in this area has been completed in males, but do women require different CHO intake recommendations during endurance exercise?

In general, women are able to oxidize a greater percentage of fat versus stored CHO (glycogen), compared to men completing endurance exercise at the same relative intensity. However, current research does not suggest a sex-difference in exogenous CHO oxidation during exercise after ingesting a glucose solution. What about the ingestion of multiple-transportable CHO (e.g. glucose-fructose solution) > 60 g/h? 

A recent study provided elite male and female cross-country ski athletes an 18% maltodextrin and fructose hydrogel beverage at a rate of 2.2 g/min (132 g/h) during a 2 h roller skiing protocol in cold ambient conditions at 70% max. Neither group experienced GI symptoms and there were no significant differences in glycogen utilization change, peak rate of exogenous CHO oxidation (though females tended to have lower peak oxidation rates than males, 1.2 vs 1.5 g/min), RPE, or performance between males and females in response to CHO ingestion. 

Results from other studies measuring exogenous CHO oxidation in females vs. males are mixed. Some indicate that exogenous CHO oxidation is ~2-4% higher in females compared to males while others found the opposite or no difference.  More research is needed to answer this question specifically, but at this point there is insufficient evidence to indicate CHO intake recommendations should be different for females and males engaging in endurance exercise. Further, it has been demonstrated that both male and female athletes can tolerate high rates (>90 g/h) of CHO (glucose-fructose) intake without experiencing GI symptoms in cool conditions. 

Finally, because hormonal changes throughout the menstrual cycle may iinduce changes in fuel utilization, eating a pre-exercise CHO meal in addition to ingesting ~90 g of multiple transportable CHO per hour during endurance exercise > 2.5 h may help minimize hormonal effects and help support performance. 

PMID: 10953068, 12070184, 14750011, 14967866, 16278245, 20019632, 31655603, 34015236



Recovery snack ideas

There doesn’t seem to be a strict time frame on the post-exercise recovery window, but we do know that the sooner you can take in your recovery nutrition, the better. While the training is the important stimulus to improve your performance on the bike, you actually make the gains during recovery. Here are a couple tips to ensure you’re getting in what you need to maximize your training and recovery. 

  1. If you didn’t take in any calories during the workout but the workout was shorter than 45 minutes and pretty easy, you don’t need a specific recovery drink or meal. Rehydrate with fluid and electrolytes, and eat your next healthy meal or snack as planned.

  2. If the workout was longer than 60 minutes or a hard one, try to take in a recovery snack or drink within 30-60 minutes. A good rule of thumb is to get about 1 gram of carb per kg of your bodyweight. The addition of 20-25 grams of protein is also beneficial, particularly for women and aging athletes. You can then eat your next regular healthy snack or meal another 60-90 minutes after your recovery snack or drink. 

Try some of these great examples of post-ride recovery snacks:

  • Sandwich with protein

  • Waffles with fruit and yogurt

  • Rice with eggs and veggies

  • Yogurt with fruit and granola

  • Steel-cut oats with fruit

  • Toast with eggs

  • Protein smoothie with whey protein, your favorite milk, a banana, some frozen fruit, and a handful of spinach

Practical tips for training the gut

Higher carbohydrate intake is associated with improved endurance performance but it’s not always comfortable to take in 60-90 grams (or more!) per hour when you haven’t practiced it. If you have a hard time taking in the recommended amount of hourly carbohydrate intake, you aren’t alone! The most common reasons for not reaching the recommendations seem to be:

- GI issues
- Too full
- Carrying that much fluid/food for several hours
- Low appetite and feeling like you’re “forcing” nutrition intake
- More carbs doesn’t seem necessary if you feel like you are performing well with less

In this post I want to address one of the most common complaints: GI issues. But, GI symptoms don’t have to be a regular occurrence if you work on TRAINING THE GUT...Yes! The gut is trainable just like the rest of your body. If you are barely able to reach the 60 g CHO/h intake recommendation then it’s not likely that you will be able to easily go out and throw back 90 g CHO/h without issues. That’s why we need to be deliberate in how we train our body’s ability to digest, absorb, and utilize that amount of hourly carb intake.

One of the best ways to adapt our GI system to a higher carbohydrate intake during exercise is to eat more carbohydrates in your regular diet. Repeated exposure to carbohydrates, including glucose and fructose, can speed up gastric emptying rates of these monosaccharides and increase the transporter activity to facilitate better absorption and oxidation of the carbohydrate. Benefits may include decreased feelings of “fullness”, less GI distress, and better overall performance. There are several other things you can implement when “training the gut”:

1) Start euhydrated (consume ~2-4 ml/lb fluid with sodium 2-4 h prior to establish euhydration)

2) Hydrate with ~ 400-800 ml/h using fluid with sodium (adjust as needed based on environmental conditions)

3) Gradually increase the hourly rate of carbohydrate intake

4) Practice ingesting carbs during different types of workouts (intermittent high intensity intervals and steady state, short and long duration)

5) Train shortly after a meal

6) Decrease fat/fiber/protein leading in the meal(s) prior to the training session

7) Practice your race nutrition strategy in different conditions well in advance of your goal event

PMID: 28332114, 26891166