Is It Possible to Train Low-Carb and Compete High-Carb?
In the past, most elite athletes attempted to improve performance through strategies to achieve “high CHO availability,” meaning building up adequate pre-exercise glycogen levels and carbohydrate intake during competition to meet fuel needs (think pasta parties the night before and high carb intake during events and competitions). More recently, many have aimed instead for a strategy called “low CHO availability” to potentially enhance the adaptive responses to training or recovery with low carbohydrate intake and storage in muscles, often achieved with periodization of carbohydrate intake (1). Periodically doing endurance training with reduced carbohydrate availability but competing without carbohydrate intake restrictions (i.e., training low-carb and competing high-carb) may promote superior metabolic training adaptations compared with a high carbohydrate intake all the time, at least in athletes without diabetes (2). How well these strategies work for athletes with diabetes is unknown, although limiting carbohydrate intake after training has the potential to increase the incidence of nocturnal blood glucose lows in insulin users (3).
Supplementing with carbohydrate on as “as needed basis” during endurance activities may assist active individuals following a low-carb diet while training (2). Individuals with type 1 diabetes have been shown to effectively balance their blood glucose levels while supplementing with 75 grams of carbohydrate per hour of multi-day and prolonged activities, even though higher levels of insulin may be required to maintain normal blood glucose levels (4, 5). For intermittent sports like soccer, consuming 30 to 60 grams of carbohydrate per hour may prevent the fatigue or hypoglycemia that can occur toward the end of a game, at least in athletes without diabetes. Adapting to chronically low intake of carbohydrate results in higher rates of fat oxidation and use in elite ultraendurance athletes, even though their use of muscle glycogen during training is not lower and muscle glycogen repletion during and after a 3-hour run is similar to athletes with a higher carbohydrate diet (6). However, an enhanced ability to use fat as a fuel after adapting to a low-carb diet may or may not improve performance, even if performance during competitions and events is maintained. Research is lacking on such long-term adaptations and performance in athletes with diabetes, but the assumption is that if blood glucose levels are well managed, responses should be similar.
Adapted from Colberg SR, Nutrition and exercise performance in adults with type 1 diabetes. Canadian Journal of Diabetes, 44(8):750-758, 2020 (https://doi.org/10.1016/j.jcjd.2020.05.014)
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3. Scott SN, Anderson L, Morton JP, Wagenmakers AJM, Riddell MC. Carbohydrate Restriction in Type 1 Diabetes: A Realistic Therapy for Improved Glycaemic Control and Athletic Performance? Nutrients. 2019;11(5):1022. doi: 10.3390/nu11051022. PubMed PMID: 31067747.
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