Points-based physical activity: a novel approach to facilitate changes in body composition in inactive women with overweight and obesity.

BACKGROUND: Physical activity (PA) interventions for the promotion of weight-management may benefit from increased choice and flexibility to overcome commonly-perceived barriers to PA. The aim of this study was to investigate the effects of a novel "points-based" approach to PA on body composition in inactive women, who are overweight or obese. METHODS: Seventy-six overweight or obese, inactive women were randomly allocated to one of three conditions: 'Points-based' PA (PBPA; 30 "PA points"•week- 1), Structured exercise (StructEx; 150 min moderate-intensity exercise•week- 1) or control (CONT; continue habitual inactive lifestyle) for a 24-week intervention. PA points for activities were adapted from MET values, and 30 points was equivalent to 150 min of brisk walking. Measures of body composition (dual-energy x-ray absorptiometry) and anthropometry were obtained at weeks 0, 4, 12 and 24. Self-report activities were recorded weekly, with objective measures of PA (tri-axial accelerometry) and self-report measures of food intake obtained at weeks 0 and 24. RESULTS: Fifty-eight women completed the study and provided data for primary outcomes. Of these, n = 41 and n = 19 provided data for food intake and objectively assessed PA. Mixed-design ANOVAs demonstrated that those in PBPA achieved a significant weight-loss at 24 weeks of - 3.3 ± 5.9 kg (- 3.4 ± 7.1%, p = 0.004). Waist circumference was reduced in PBPA at 24 weeks (- 2.8 ± 4.6 cm), compared with CONT (+ 2.1 ± 6.6 cm, p = 0.024). There was a trend for greater reductions in fat mass for those in PBPA vs. CONT (- 2.3 ± 4.6 kg vs. + 0.1 ± 2.0 kg, p = 0.075). Android fat was reduced in PBPA at both 12 weeks (- 6.1 ± 12.6%, p = 0.005) and 24 weeks (- 10.1 ± 18.4%, p = 0.005), while there was a trend for greater reductions in visceral adipose tissue in PBPA (- 5.8 ± 26.0%) vs. CONT at 24 weeks (+ 7.8 ± 18.3%, p = 0.053). Body composition, body weight and waist circumference were unchanged in StructEx. There were trends for increases in light-activity and reductions in sedentary time in PBPA. There was a trend for a reduction in daily energy intake of - 445 ± 564 kcal (p = 0.074), and a significant reduction in daily fat intake (p = 0.042) in PBPA. CONCLUSION: A "points-based" approach to physical activity appears to be an effective strategy for inducing modest reductions in body weight and body fat in inactive women with overweight and obesity. TRIAL REGISTRATION: NCT02020239 . Registered 12th December 2013.

A novel tool to predict food intake: the Visual Meal Creator.

Subjective appetite is commonly measured using an abstract visual analogue scale (VAS) technique, that provides no direct information about desired portion size or food choice. The purpose of this investigation was to develop and validate a user-friendly tool - the Visual Meal Creator (VIMEC) - that would allow for independent, repeated measures of subjective appetite and provide a prediction of food intake. Twelve participants experienced dietary control over a 5-hour period to manipulate hunger state on three occasions (small breakfast (SB) vs. large breakfast (LB) vs. large breakfast + snacks (LB+S)). Appetite measures were obtained every 60 minutes using the VIMEC and VAS. At 4.5 hours, participants were presented with an ad libitum test meal, from which energy intake (EI) was measured. The efficacy of the VIMEC was assessed by its ability to detect expected patterns of appetite and its strength as a predictor of energy intake. Day-to-day reproducibility and test-retest repeatability were assessed. Between- and within-condition differences in VAS and VIMEC scores (represented as mm and kcal of the "created" meal, respectively) were significantly correlated with one another throughout. Between- and within-condition changes in appetite scores obtained with the VIMEC exhibited a stronger correlation with EI at the test meal than those obtained with VAS. Pearson correlation coefficients for within-condition comparisons were 0.951, 0.914 and 0.875 (all p < 0.001) for SB, LB and LB+S respectively. Correlation coefficients for between-condition differences in VIMEC and EI were 0.273, 0.940 (p < 0.001) and 0.525 (p < 0.05) for SB - LB+S, SB - LB and LB - LB+S respectively. The VIMEC exhibited a similar degree of reproducibility to VAS. These findings suggest that the VIMEC appears to be a stronger predictor of energy intake than VAS.

Acute appetite and eating behaviour responses to apparatus-free, high-intensity intermittent exercise in inactive women with excess weight.

High-intensity intermittent exercise (HIIE) has been shown to transiently suppress appetite, but such exercise has traditionally required the use of specialist apparatus (e.g., cycle ergometer). This study aimed to determine appetite and eating behaviour responses to acute apparatus-free HIIE in inactive women with excess weight. A preliminary study (n = 18 inactive women, 9 healthy weight, 18.0-24.9 kg∙m-2; 9 with excess weight, 25.0-34.9 kg∙m-2) revealed that intervals of 30 s of "all out" star jumping elicited physiological responses akin to intervals of 30 s of "all out" cycling. Twelve women (29.2 ± 2.9kg∙m-2, 38 ± 7years, 28 ± 39 min MVPA∙week-1) then completed three trials in a within-subject, randomised cross-over design: 4 × 30 s "all out" star jumping (4 × 30 s); 2 × 30 s "all out" star jumping (2 × 30 s); resting control (CONT). Upon completing each late-morning exercise trial, lunch was provided upon request from the participant. The time from the exercise bout to lunch request - termed eating latency - was recorded, and ad libitum food intake at lunch was measured. Subjective appetite was measured using a visual analogue scale before and after exercise, and at lunch request. Free-living energy intake (EI) and energy expenditure (EE) were recorded for the remainder of the trial day and the three days following. Change-from-baseline in subjective appetite was significantly lower immediately after 4 × 30 s (-9.6 ± 18.4 mm) and 2 × 30 s (-11.5 ± 21.2 mm) vs. CONT (+8.1 ± 9.6 mm), (both p < 0.05, d = 0.905 and 1.027, respectively). Eating latency (4 × 30 s: 32 ± 33 min, 2 × 30 s: 31 ± 26 min, CONT: 27 ± 23 min, p = 0.843; η2p = 0.017) and lunch EI (4 × 30 s: 662±178 kcal, 2 × 30 sec: 715 ± 237 kcal, CONT: 726 ± 268 kcal, p = 0.451; η2p = 0.077) did not differ significantly between conditions. No significant differences were observed in trial day EI and EE, or in EI and EE on the three days following exercise (all p > 0.05). Mean trial day relative EI (EI - EE) was 201 ± 370 kcal lower after 4 × 30 s than CONT, but this difference was not statistically significant (p = 0.303, d = 0.585). In conclusion, very low-volume star jumping elicited a transient suppression of appetite without altering eating behaviour. (313 words).

Is the beneficial effect of prior exercise on postprandial lipaemia partly due to redistribution of blood flow?

Preprandial aerobic exercise lowers postprandial lipaemia (a risk factor for coronary heart disease); however, the mechanisms responsible are still not clear. The present study investigated whether blood flow to skeletal muscle and/or the liver was increased in the postprandial period after exercise, relative to a control trial, and whether this resulted from increased cardiac output or redistribution of flow. Eight overweight inactive males, aged 49.4±10.5 years (mean±S.D.), acted as their own controls in a counterbalanced design, either walking briskly for 90 min at 60% V̇O2max (maximal oxygen uptake), or resting in the lab, on the evening of day 1. The following morning, a fasting blood sample was collected, participants consumed a high-fat breakfast, and further venous blood samples were drawn hourly for 6 h. Immediately after blood sampling, Doppler ultrasound was used to measure cardiac output and blood flow through both the femoral artery of one leg and the hepatic portal vein, with the ultrasonographer blinded to trial order. The total postprandial triacylglycerol response was 22% lower after exercise (P=0.001). Blood flow through the femoral artery and the hepatic portal vein was increased by 19% (P<0.001) and 16% (P=0.033), respectively, during the 6-h postprandial period following exercise; however, postprandial cardiac output did not differ between trials (P=0.065). Redistribution of blood flow, to both exercised skeletal muscle and the liver, may therefore play a role in reducing the plasma triacylglycerol response to a high-fat meal on the day after an exercise bout.

Is the effect of prior exercise on postprandial lipaemia the same for a moderate-fat meal as it is for a high-fat meal?

Moderate-intensity exercise can lower the TAG response to a high-fat meal; however, the British diet is moderate in fat, and no study to date has compared the effect of such exercise on responses to high-fat and moderate-fat meals. The present work investigated the effect of brisk walking performed 13 h before intake of both high-fat and moderate-fat meals on postprandial plasma TAG concentrations. Eight inactive, overweight men completed four separate 2 d trials, i.e. rest (Con) or a 90-min treadmill walk (Ex) on the evening of day 1, followed by the ingestion of a moderate-fat (Mod) or high-fat (High) meal on the morning of day 2. High-fat meals contained 66 % of total energy as fat, while the percentage was 35 % for moderate-fat meals; both the meals were, however, isoenergetic. On day 2, venous blood was sampled in the fasted state, 30 and 60 min after ingesting the test meal and then hourly until 6 h post-meal. Exercise reduced plasma TAG concentrations significantly (P < 0·001), with no exercise × meal interaction (P = 0·459). Walking reduced the total TAG response to a high-fat meal by 29 % (relative to High Con); the same bout of exercise performed before ingesting a moderate-fat meal lowered total TAG by 26 % (compared with Mod Con). The ability of a single moderate-intensity aerobic exercise bout to lower postprandial TAG concentrations is just as great, in percentage terms, when the test meal ingested is of a moderate rather than a high fat content.

Changes in glucose tolerance and insulin sensitivity following 2 weeks of daily cinnamon ingestion in healthy humans.

Cinnamon can improve fasting glucose in humans yet data on insulin sensitivity are limited and controversial. Eight male volunteers (aged 25 +/- 1 years, body mass 76.5 +/- 3.0 kg, BMI 24.0 +/- 0.7 kg m(-2); mean +/- SEM) underwent two 14-day interventions involving cinnamon or placebo supplementation (3 g day(-1)). Placebo supplementation was continued for 5 days following this 14 day period. Oral glucose tolerance tests (OGTT) were performed on days 0, 1, 14, 16, 18, and 20. Cinnamon ingestion reduced the glucose response to OGTT on day 1 (-13.1 +/- 6.3% vs. day 0; P < 0.05) and day 14 (-5.5 +/- 8.1% vs. day 0; P = 0.09). Cinnamon ingestion also reduced insulin responses to OGTT on day 14 (-27.1 +/- 6.2% vs. day 0; P < 0.05), as well as improving insulin sensitivity on day 14 (vs. day 0; P < 0.05). These effects were lost following cessation of cinnamon feeding. Cinnamon may improve glycaemic control and insulin sensitivity, but the effects are quickly reversed.

The effect of feeding frequency on insulin and ghrelin responses in human subjects.

Recent work shows that increased meal frequency reduces ghrelin responses in sheep. Human research suggests there is an interaction between insulin and ghrelin. The effect of meal frequency on this interaction is unknown. Therefore, we investigated the effect of feeding frequency on insulin and ghrelin responses in human subjects. Five healthy male volunteers were recruited from the general population: age 24 (SEM 2)years, body mass 75.7 (SEM 3.2) kg and BMI 23.8 (SEM 0.8) kg/m(2). Volunteers underwent three 8-h feeding regimens: fasting (FAST); low-frequency(two) meal ingestion (LOFREQ(MEAL)); high-frequency (twelve) meal ingestion (HIFREQ(MEAL)). Meals were equi-energetic within trials,consisting of 64% carbohydrate, 23% fat and 13% protein. Total energy intake was equal between feeding trials. Total area under the curve for serum insulin and plasma ghrelin responses did not differ between trials (P>0.05), although the hormonal response patterns to the two meal feeding regimens were different. An inverse relationship was found between serum insulin and plasma ghrelin during the FAST andLOFREQ(MEAL) trials (P<0.05); and, in the postprandial period, there was a time delay between insulin responses and successive ghrelin responses.This relationship was not observed during the HIFREQ(MEAL) trial (P>0.05). This study provides further evidence that the postprandial fall in ghrelin might be due, at least partially, to the rise in insulin and that high-frequency feeding may disrupt this relationship.

Dose-response effects of ingested carbohydrate on exercise metabolism in women.

PURPOSE: The effect of different quantities of carbohydrate (CHO) intake on CHO metabolism during prolonged exercise was examined in endurance-trained females. METHOD: On four occasions, eight females performed 2 h of cycling at approximately 60% .VO2max with ingestion of beverages containing low (LOW, 0.5 g.min(-1)), moderate (MOD, 1.0 g.min(-1)), or high (HIGH, 1.5 g.min(-1)) amounts of CHO, or water only (WAT). Test solutions contained trace amounts of [U-13C] glucose. Indirect calorimetry combined with measurement of expired 13CO2 and plasma 13C enrichment enabled calculation of exogenous CHO, liver-derived glucose, and muscle glycogen oxidation during the last 30 min of exercise. RESULTS: The highest rates of exogenous CHO oxidation were observed in MOD, with no further increases in HIGH (peak rates of 0.33 +/- 0.02, 0.50 +/- 0.03, and 0.48 +/- 0.05 g.min(-1) for LOW, MOD, and HIGH, respectively; P < 0.05 for LOW vs MOD and HIGH). Endogenous CHO oxidation was lowest in MOD (0.99 +/- 0.06, 0.82 +/- 0.08, 0.70 +/- 0.07, and 0.89 +/- 0.09 g.min(-1); P < 0.05 for MOD vs all other trials). Compared with WAT, CHO ingestion reduced liver glucose oxidation during exercise by approximately 30% (P < 0.05 for WAT vs all CHO). Differential rates of muscle glycogen oxidation were observed with different CHO doses (0.57 +/- 0.07, 0.53 +/- 0.08, 0.41 +/- 0.07, and 0.60 +/- 0.09 g.min(-1) for WAT, LOW, MOD, and HIGH respectively; P < 0.05 for MOD vs HIGH). CONCLUSION: In endurance-trained women, the highest rates of exogenous CHO oxidation and greatest endogenous CHO sparing was observed when CHO was ingested at moderate rates (1.0 g.min(-1), 60 g.h(-1)) during exercise.

Very Low Volume Sprint Interval Exercise Suppresses Subjective Appetite, Lowers Acylated Ghrelin, and Elevates GLP-1 in Overweight Individuals: A Pilot Study.

High-intensity exercise has been shown to elicit a transient suppression of appetite and create a more anorexigenic profile of appetite-associated hormones. It is yet to be fully elucidated whether such a response is observed following very low-volume, intermittent exercise at supramaximal intensity in those who are overweight. Eight overweight individuals (BMI 27.7 ± 1.7 kg·m²) completed resting (REST) and exercise (EX) trials in a counterbalanced order. EX consisted of 4 × 30 s "flat-out" cycling on an ergometer (adapted Wingate test). Two hours post-exercise (or REST), participants were presented with an ad libitum meal. Subjective appetite measures and blood samples were obtained throughout. Subjective appetite, measured using VAS, was significantly lower immediately after exercise compared with REST (38.0 ± 28.5 mm vs. 75.1 ± 26.2 mm, p = 0.018, d = 1.09). This difference remained significant 30 min post-exercise. Acylated ghrelin concentration was suppressed in EX compared with REST immediately post-exercise (113.4 ± 43.0 pg·mL-1 vs. 189.2 ± 91.8 pg·mL-1, p = 0.03, d = 1.07) and remained lower until the ad libitum test-meal. Area-under-the-curve for GLP-1 concentration was significantly greater for EX, versus REST. There was no difference in absolute adlibitum intake or relative energy intake. As little as 4 × 30 s of "flat-out" cycling was sufficient to elicit a transient suppression of appetite and an enduring suppression of plasma acylated ghrelin. Nonetheless, food intake 2-h post-exercise was unaffected.

Effects of exercise in the cold on Ghrelin, PYY, and food intake in overweight adults.

PURPOSE: Exercise in cold water has been shown to simulate postexercise energy intake (EI) in normal-weight individuals. However, the effect of cold exercise on EI in overweight individuals has yet to be examined. The present study investigated the effect of brisk walking in a cold (8°C) and neutral (20°C) environment on postexercise EI and appetite hormone responses. METHODS: Sixteen overweight participants (10 men and six women; age, 50.1 ± 11.6 yr; body mass index, 28.9 ± 4.2 kg·m) completed a 45-min treadmill walk at 8°C and 20°C in a randomized counterbalanced design. Participants were presented with an ad libitum buffet meal 45 min after exercise, and EI was covertly measured. Skin and rectal temperature were monitored throughout exercise and for 30 min after exercise, and concentrations of the appetite hormones total ghrelin, acylated ghrelin, and total peptide YY were assessed before and after exercise and before and after meal. RESULTS: EI was significantly greater after exercise in the cold (1299 ± 657 kcal (mean ± SD)) compared with that after exercise in the neutral environment (1172 ± 537 kcal (mean ± SD)) (P < 0.05). The change in the acylated ghrelin concentrations and the acylated ghrelin AUC values were significantly greater during walking in the cold versus those during walking in the neutral condition (P < 0.05). CONCLUSIONS: These findings show that in overweight individuals, exercise in the cold stimulates postexercise EI to a greater extent than exercise in a neutral environment.

Matching energy intake to expenditure of isocaloric exercise at high- and moderate-intensities.

BACKGROUND: Those seeking to manage their bodyweight use a variety of strategies, but the most common approaches involve attempting to exercise more and/or consume fewer calories. A poor comprehension of the energy cost of exercise and the energy content of food may contribute to weight-gain and the poor success rate of exercise weight-loss interventions. PURPOSE: The purpose of this study is to investigate individuals' ability to consciously match energy intake with energy expenditure after isocaloric exercise at moderate and high intensities. METHOD: In a counterbalanced cross-over study design, 14 low- to moderately-active, lean individuals (7 male, 7 female; mean age 23±3 years; mean BMI 22.0±3.2 kg·m(-2)) completed both a moderate-intensity (60% VO2max, MOD) and a high-intensity (90% VO2max, HIGH) exercise bout on a treadmill, matched for energy expenditure, EE (450 kcal). Participants were blinded to the intensity and duration of each bout. Thirty minutes post-exercise, participants were presented with a buffet, where they were asked to consume food in an attempt to match energy intake with the energy expended during the exercise bout. This was termed the "matching task," providing a matching task energy intake value (EI(MATCH)). Upon finishing the matching task, a verbal estimate of energy expenditure (EST) was obtained before the participant was allowed to return to the buffet to consume any more food, if desired. This intake was covertly measured and added to EI(MATCH) to obtain an ad libitum intake value (EI(AD LIB)). RESULTS: A significant condition × task interaction showed that, in MOD, EST was significantly lower than EE (298±156 kcal vs. 443±22 kcal, p=0.01). In the HIGH condition, EE, EI(MATCH) and EST were similar. In both conditions, participants tended to over-eat to a similar degree, relative to EST, with EI(MATCH) 20% and 22% greater than EST in MOD and HIGH respectively. Between-condition comparisons demonstrated that EI(MATCH) and EST were significantly lower in MOD, compared with HIGH (374±220 kcal vs. 530±248 kcal, p=0.002 and 298±156 kcal vs. 431±129 kcal, p=0.002 respectively). For both conditions, EI(AD LIB) was approximately 2-fold greater than EE. DISCUSSION: Participants exhibited a strong ability to estimate exercise energy expenditure after high-intensity exercise. Participants appeared to perceive moderate-intensity exercise to be less energetic than an isocaloric bout of high-intensity exercise. This may have implications for exercise recommendations for weight-loss strategies, especially when casual approaches to exercise and attempting to eat less are being implemented.

No evidence of dehydration with moderate daily coffee intake: a counterbalanced cross-over study in a free-living population.

It is often suggested that coffee causes dehydration and its consumption should be avoided or significantly reduced to maintain fluid balance. The aim of this study was to directly compare the effects of coffee consumption against water ingestion across a range of validated hydration assessment techniques. In a counterbalanced cross-over design, 50 male coffee drinkers (habitually consuming 3-6 cups per day) participated in two trials, each lasting three consecutive days. In addition to controlled physical activity, food and fluid intake, participants consumed either 4×200 mL of coffee containing 4 mg/kg caffeine (C) or water (W). Total body water (TBW) was calculated pre- and post-trial via ingestion of Deuterium Oxide. Urinary and haematological hydration markers were recorded daily in addition to nude body mass measurement (BM). Plasma was analysed for caffeine to confirm compliance. There were no significant changes in TBW from beginning to end of either trial and no differences between trials (51.5±1.4 vs. 51.4±1.3 kg, for C and W, respectively). No differences were observed between trials across any haematological markers or in 24 h urine volume (2409±660 vs. 2428±669 mL, for C and W, respectively), USG, osmolality or creatinine. Mean urinary Na(+) excretion was higher in C than W (p = 0.02). No significant differences in BM were found between conditions, although a small progressive daily fall was observed within both trials (0.4±0.5 kg; p<0.05). Our data show that there were no significant differences across a wide range of haematological and urinary markers of hydration status between trials. These data suggest that coffee, when consumed in moderation by caffeine habituated males provides similar hydrating qualities to water.

The effects of high-intensity exercise on neural responses to images of food.

BACKGROUND: Acute bouts of high-intensity exercise modulate peripheral appetite regulating hormones to transiently suppress hunger. However, the effects of physical activity on central appetite regulation have yet to be fully investigated. OBJECTIVE: We used functional magnetic resonance imaging (fMRI) to compare neural responses to visual food stimuli after intense exercise and rest. DESIGN: Fifteen lean healthy men [mean ± SD age: 22.5 ± 3.1 y; mean ± SD body mass index (in kg/m(2)): 24.2 ± 2.4] completed two 60-min trials-exercise (EX; running at ∼70% maximum aerobic capacity) and a resting control trial (REST)-in a counterbalanced order. After each trial, an fMRI assessment was completed in which images of high- and low-calorie foods were viewed. RESULTS: EX significantly suppressed subjective appetite responses while increasing thirst and core-body temperature. Furthermore, EX significantly suppressed ghrelin concentrations and significantly enhanced peptide YY release. Neural responses to images of high-calorie foods significantly increased dorsolateral prefrontal cortex activation and suppressed orbitofrontal cortex (OFC) and hippocampus activation after EX compared with REST. After EX, low-calorie food images increased insula and putamen activation and reduced OFC activation compared with REST. Furthermore, left pallidum activity was significantly elevated after EX when low-calorie images were viewed and was suppressed when high-calorie images were viewed, and these responses correlated significantly with thirst. CONCLUSIONS: Exercise increases neural responses in reward-related regions of the brain in response to images of low-calorie foods and suppresses activation during the viewing of high-calorie foods. These central responses are associated with exercise-induced changes in peripheral signals related to appetite-regulation and hydration status. This trial was registered at www.clinicaltrials.gov as NCT01926431.

The effect of steady state exercise on circulating human IgE and IgG in young healthy volunteers with known allergy.

Allergy prevalence in the general population has been increasing since the 1980s and there is increasing evidence of a higher incidence of allergy or asthma in elite athletes. For individuals suffering from allergy to airborne allergens, such as pollen, exercise may exacerbate their condition due to increased ventilation during exercise. The effect of an acute steady state moderate intensity exercise task on circulating immunoglobulin E was therefore assessed in volunteers with known allergy. Immunoglobulin concentrations were assessed in young healthy volunteers with allergy (n=14) and control non-allergic volunteers (n=7) pre- and post- an acute steady state moderate intensity exercise task (60% W(max) for 40 min). Airborne allergic volunteers (n=7) displayed increased IgE levels (31% increase) (p<0.01) but food allergic volunteers (n=7) showed decreased IgE levels, following exercise (53% decrease) (p<0.01). There was no significant change in IgG levels in volunteers with food or airborne allergy or in control volunteers in response to exercise. Acute steady state moderate exercise significantly altered circulating IgE concentrations in volunteers with known allergy, while IgE concentrations in non-allergy sufferers did not change.

Effect of beverage glucose and sodium content on fluid delivery.

BACKGROUND: Rapid fluid delivery from ingested beverages is the goal of oral rehydration solutions (ORS) and sports drinks. OBJECTIVE: The aim of the present study was to investigate the effects of increasing carbohydrate and sodium content upon fluid delivery using a deuterium oxide (D2O) tracer. DESIGN: Twenty healthy male subjects were divided into two groups of 10, the first group was a carbohydrate group (CHO) and the second a sodium group (Na). The CHO group ingested four different drinks with a stepped increase of 3% glucose from 0% to 9% while sodium concentration was 20 mmol/L. The Na group ingested four drinks with a stepped increase of 20 mmol/L from 0 mmol/L to 60 mmol/l while glucose concentration was 6%. All beverages contained 3 g of D2O. Subjects remained seated for two hours after ingestion of the experimental beverage, with blood taken every 5 min in the first hour and every 10 min in the second hour. RESULTS: Including 3% glucose in the beverage led to a significantly greater AUC 60 min (19640 ± 1252 δ per thousand vs. VSMOW.60 min) than all trials. No carbohydrate (18381 ± 1198 δ per thousand vs. VSMOW.60 min) had a greater AUC 60 min than a 6% (16088 ± 1359 δ per thousand vs. VSMOW.60 min) and 9% beverage (13134 ± 1115 δ per thousand vs. VSMOW.60 min); the 6% beverage had a significantly greater AUC 60 min than the 9% beverage. There was no difference in fluid delivery between the different sodium beverages. CONCLUSION: In conclusion the present study showed that when carbohydrate concentration in an ingested beverage was increased above 6% fluid delivery was compromised. However, increasing the amount of sodium (0-60 mmol/L) in a 6% glucose beverage did not lead to increases in fluid delivery.