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Cited by 77Muscle metabolism and nutritionSports Performance and TrainingExercise and Physiological Responses

Glucose Plus Fructose Ingestion for Post-Exercise Recovery—Greater than the Sum of Its Parts?

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Gonzalez, Javier, Fuchs, Cas, Betts, James, Van Loon, Luc·2017·Nutrients
DOI 10.3390/nu9040344PMC PMC5409683
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Abstract

Carbohydrate availability in the form of muscle and liver glycogen is an important determinant of performance during prolonged bouts of moderate- to high-intensity exercise. Therefore, when effective endurance performance is an objective on multiple occasions within a 24-h period, the restoration of endogenous glycogen stores is the principal factor determining recovery. This review considers the role of glucose–fructose co-ingestion on liver and muscle glycogen repletion following prolonged exercise. Glucose and fructose are primarily absorbed by different intestinal transport proteins; by combining the ingestion of glucose with fructose, both transport pathways are utilised, which increases the total capacity for carbohydrate absorption. Moreover, the addition of glucose to fructose ingestion facilitates intestinal fructose absorption via a currently unidentified mechanism. The co-ingestion of glucose and fructose therefore provides faster rates of carbohydrate absorption than the sum of glucose and fructose absorption rates alone. Similar metabolic effects can be achieved via the ingestion of sucrose (a disaccharide of glucose and fructose) because intestinal absorption is unlikely to be limited by sucrose hydrolysis. Carbohydrate ingestion at a rate of ≥1.2 g carbohydrate per kg body mass per hour appears to maximise post-exercise muscle glycogen repletion rates. Providing these carbohydrates in the form of glucose–fructose (sucrose) mixtures does not further enhance muscle glycogen repletion rates over glucose (polymer) ingestion alone. In contrast, liver glycogen repletion rates are approximately doubled with ingestion of glucose–fructose (sucrose) mixtures over isocaloric ingestion of glucose (polymers) alone. Furthermore, glucose plus fructose (sucrose) ingestion alleviates gastrointestinal distress when the ingestion rate approaches or exceeds the capacity for intestinal glucose absorption (~1.2 g/min). Accordingly, when rapid recovery of endogenous glycogen stores is a priority, ingesting glucose–fructose mixtures (or sucrose) at a rate of ≥1.2 g·kg body mass−1·h−1 can enhance glycogen repletion rates whilst also minimising gastrointestinal distress.

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  • The maximal exogenous carbohydrate oxidation rate increases in a curvilinear fashion with carbohydrate ingestion rate, reaching peak exogenous oxidation rates of approximately 1.1 g/min when ingesting glucose (polymers) only during exercise.

    “It has been well established that the maximal exogenous carbohydrate oxidation rate increases in a curvilinear fashion with carbohydrate ingestion rate, reaching peak exogenous oxidation rates of ∼1.1 g/min when ingesting glucose (polymers) only during exercise (Jeukendrup & Jentjens, 2000; Gonzalez et al. 2017).”

    From Fructose co‐ingestion to increase carbohydrate availability in athletes (2019) · cites this paper as Gonzalez et al. 2017

    Section 4 states that exogenous carbohydrate oxidation increases curvilinearly with ingestion rate when glucose polymers are consumed during exercise. It gives the peak as approximately 1.2 g/min, rather than the claimed 1.1 g/min. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • After intestinal absorption, fructose appears to be actively metabolized in the splanchnic area, whereas glucose appears to be largely transmitted passively from the splanchnic area into the systemic circulation.

    “After intestinal absorption, fructose appears to be actively metabolized in the splanchnic area (i.e. intestine, liver and kidneys), whereas glucose appears to be largely transmitted passively from the splanchnic area into the systemic circulation (Gonzalez et al. 2017; Tappy & Rosset, 2017; Jang et al. 2018; Tappy, 2018; Fig. 1).”

    From Fructose co‐ingestion to increase carbohydrate availability in athletes (2019) · cites this paper as Gonzalez et al. 2017

    Section 2, “Dietary Carbohydrates for Sport Nutrition” (page unavailable), says fructose is almost completely metabolized on its first pass through the liver, whereas glucose can bypass the liver and enter systemic circulation. Section 4 also describes fructose conversion in the intestine and liver. The copy does not establish that glucose is largely transmitted passively, or identify the kidneys as a site of fructose metabolism in this account. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Liver glycogen resynthesis is inherently slower than that of muscle, possibly owing to its higher rate of glycogen turnover and/or distinct glycogen synthesis pathways that are contingent on hormonal fluctuations.

    “Moreover, liver glycogen resynthesis is inherently slower than that of muscle, possibly owing to its higher rate of glycogen turnover and/or distinct glycogen synthesis pathways that are contingent on hormonal fluctuations (notably insulin, glucagon, and epinephrine) [45, 47].”

    From Nutritional Strategies to Improve Post-exercise Recovery and Subsequent Exercise Performance: A Narrative Review (2025) · cites this paper as [47]

    Section 3.2 suggests that liver glycogen stores may take longer than muscle stores to recover after exercise, but it does not say liver resynthesis is inherently slower. It attributes the possible difference to post-exercise handling of glucose, not higher glycogen turnover. Sections 5.2 and 2 describe distinct liver synthesis pathways and insulin regulation, but do not establish the claimed explanation involving fluctuations in insulin, glucagon, and epinephrine. Page numbers are unavailable in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Combining the intake of glucose plus fructose can further increase total exogenous carbohydrate availability and allow higher exogenous carbohydrate oxidation rates.

    “Combining the intake of glucose plus fructose can further increase total exogenous carbohydrate availability and, as such, allow higher exogenous carbohydrate oxidation rates.”

    From Fructose co‐ingestion to increase carbohydrate availability in athletes (2019) · cites this paper as Gonzalez et al. 2017

  • Oxidation of fructose-derived glucose and lactate by skeletal muscle can fully account for the higher exogenous carbohydrate oxidation rates observed following ingestion of glucose and fructose mixtures compared to glucose only.

    “The oxidation of fructose‐derived glucose and lactate by skeletal muscle can thus fully account for the higher exogenous carbohydrate oxidation rates observed following ingestion of glucose and fructose mixtures compared to glucose only (Gonzalez et al. 2017).”

    From Fructose co‐ingestion to increase carbohydrate availability in athletes (2019) · cites this paper as Gonzalez et al. 2017

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Authors
Gonzalez, J., Fuchs, C., Betts, J., & Van Loon, L.
Affiliations
  • University of Bath (GB)
  • Maastricht University Medical Centre (NL)
  • Department of Human Biology and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+ (MUMC+), P.O. Box 616, 6200 MD Maastricht, The Netherlands
Corresponding author
Gonzalez, Javier
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2017-03-30
Volume
9
Issue
4
Pages
344
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu9040344
PMC
PMC5409683
OpenAlex
W2603914339
Cited by
77
References
99
Citations by year
2026: 2 · 2025: 8 · 2024: 3 · 2023: 6 · 2022: 11 · 2021: 13 · 2020: 14 · 2019: 10 · 2018: 8 · 2017: 2
FWCI
1.09
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • The University of Bath Online Publications Store (The University of Bath) (submittedVersion, cc-by)
  • Pure (University of Bath) (submittedVersion, cc-by)
  • Research Bank (Australian Catholic University) (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, cc-by)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords
sucrose, post-exercise recovery, glycogen repletion, muscle glycogen, liver glycogen, carbohydrate absorption, gastrointestinal distress, endurance performance
MeSH terms
Blood Glucose, Dietary Carbohydrates, Fructose, Glucose, Glycogen, Humans, Liver, Exercise, Muscle, Skeletal, Athletic Performance, Sports Nutritional Physiological Phenomena

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