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Cited by 50Muscle metabolism and nutritionDiet, Metabolism, and DiseaseExercise and Physiological Responses

Dietary sugars, exercise and hepatic carbohydrate metabolism

Open access
Gonzalez, Javier T., Betts, James A.·2019·Proceedings of the Nutrition Society
DOI 10.1017/s0029665118002604
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Abstract

The present paper reviews the physiological responses of human liver carbohydrate metabolism to physical activity and ingestion of dietary sugars. The liver represents a central link in human carbohydrate metabolism and a mechanistic crux point for the effects of dietary sugars on athletic performance and metabolic health. As a corollary, knowledge regarding physiological responses to sugar ingestion has potential application to either improve endurance performance in athletes, or target metabolic diseases in people who are overweight, obese and/or sedentary. For example, exercise increases whole-body glycogen utilisation, and the breakdown of liver glycogen to maintain blood glucose concentrations becomes increasingly important as exercise intensity increases. Accordingly, prolonged exercise at moderate-to-high exercise intensity results in depletion of liver glycogen stores unless carbohydrate is ingested during exercise. The exercise-induced glycogen deficit can increase insulin sensitivity and blood glucose control, and may result in less hepatic lipid synthesis. Therefore, the induction and maintenance of a glycogen deficit with exercise could be a specific target to improve metabolic health and could be achieved by carbohydrate (sugar) restriction before, during and/or after exercise. Conversely, for athletes, maintaining and restoring these glycogen stores is a priority when competing in events requiring repeated exertion with limited recovery. With this in mind, evidence consistently demonstrates that fructose-containing sugars accelerate post-exercise liver glycogen repletion and could reduce recovery time by as much as half that seen with ingestion of glucose (polymers)-only. Therefore, athletes aiming for rapid recovery in multi-stage events should consider ingesting fructose-containing sugars to accelerate recovery.

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  • Complete replenishment of muscle glycogen stores typically unfolds over a 24-36 h period post-exercise, provided that 7-12 g·kg−1 carbohydrate are consumed per day.

    “Complete replenishment of muscle glycogen stores typically unfolds over a 24–36 h period post-exercise, provided that 7–12 g·kg−1 carbohydrate are consumed per day [15–18].”

    From Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review (2025) · cites this paper as [16]

    The Exercise performance section says muscle glycogen may take 20–24 h to fully recover after exhaustive exercise with high carbohydrate intake, or up to 46 h on a moderate-carbohydrate diet (page unavailable in our copy). It does not give the claimed 24–36 h range or specify 7–12 g/kg of carbohydrate per day; its intake recommendation is 1–1.2 g/kg per hour during the first 4 h of recovery. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Liver glycogen resynthesis proceeds at a slower pace during the initial post-exercise hours, achieving saturation only after 11-25 h, contingent upon adherence to a high-carbohydrate diet.

    “Liver glycogen resynthesis proceeds at a slower pace during the initial post-exercise hours, achieving saturation only after 11–25 h, contingent upon adherence to a high-carbohydrate diet [16].”

    From Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review (2025) · cites this paper as [16]

    The Exercise performance section reports that liver glycogen resynthesis is about 30–50% slower in the first 2 hours than at 3–5 hours post-exercise. It estimates 11 hours with glucose–fructose mixtures and about 25 hours with glucose alone, but those times are extrapolations under high carbohydrate ingestion, not observed saturation times or a general requirement for a high-carbohydrate diet. (LLM, conf=0.86)

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Research works printed but not linked: 1

  1. Hultman E & Harris RC (1988) Carbohydrate metabolism, Principles of Exercise Biochemistry. Basel, Switzerland: S. Karger.

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Authors
Gonzalez, J. T., & Betts, J. A.
Affiliations
University of Bath (GB)
Corresponding author
Gonzalez, Javier T.
ORCID
Venue
Proceedings of the Nutrition Society
Publisher
Cambridge University Press (CUP)
Published
2018-10-23
Volume
78
Issue
02
Pages
246-256
ISSN
  • 0029-6651 (ISSN-L)
  • 1475-2719
DOI
10.1017/s0029665118002604
OpenAlex
W2896290000
Cited by
50
References
100
Citations by year
2026: 4 · 2025: 10 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 2 · 2020: 5 · 2019: 8
FWCI
0.42
Type
journal article
Language
en
Update notices
correction (2019-02-11)
Open access
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Proceedings of The Nutrition Society (publishedVersion)
  • PubMed (publishedVersion)
  • Pure (University of Bath) (submittedVersion, other-oa)
Funders
  • GlaxoSmithKline
  • PepsiCo
  • International Life Sciences Institute Europe
  • Directorate for Biological Sciences
  • Medical Research Council
  • Biotechnology and Biological Sciences Research Council
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords
dietary sugar, fructose, glucose, hepatic carbohydrate metabolism, liver glycogen, physical activity, endurance performance, glycogen repletion, post-exercise recovery, insulin sensitivity, glycemic control, hepatic lipid synthesis, metabolic health, obesity, sedentary lifestyle
MeSH terms
Dietary Sugars, Blood Glucose, Fructose, Glycogen, Humans, Insulin Resistance, Liver, Exercise, Muscle, Skeletal, Carbohydrate Metabolism, Athletic Performance

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