Brain Fuel: Carbohydrates, Exercise, and CNS Function

J. Mark Davis, Ph.D. University of South Carolina at Columbia

This presentation will explore the role of the brain and its primary fuel source, glucose, on performance during exercise. There is little debate that carbohydrate feedings can delay fatigue during prolonged exercise of a continuous nature (i.e., endurance running, cycling, etc). And recent research suggests a similar benefit for "stop and go" exercise similar to team sports like soccer, basketball, tennis and hockey.

However, an important question remains regarding the biological mechanisms of such a benefit, an understanding that has important implications for optimal nutrition strategies. Good evidence suggests that carbohydrate feedings delay fatigue by maintaining blood glucose as an important energy source for muscles, especially at times of depleted muscle glycogen. However, what is often left out of any discussion of fatigue is the important role of the brain and the fact that plasma glucose is essentially the only fuel source for the brain. Central nervous system components of fatigue (CNS fatigue) can include lack of motivation, poor mood state, cognitive impairments, abnormally high perceived exertion and force sensation, and impaired neuromuscular coordination and even a direct inhibition of central drive to muscles. Until very recently, an understanding of possible biological mechanisms of CNS fatigue were so limited that it was not possible to develop reasonable hypotheses to test in scientific studies.

Within the last five years or so, it has become evident that an important interaction between low fuel (glucose) availability and neurotransmitter imbalances may help to explain many of the impairments associated with CNS fatigue. It is now known, contrary to popular belief, that glucose availability can be limited in isolated brain regions undergoing high metabolic demand even though blood glucose is within normal levels (e.g., the hippocampus during cognitively demanding tasks or the striatum during neuromuscular exercise.) Under those circumstances, performance associated with that region can be sub-optimal. Increasing glucose availability via glucose infusion either systemically or in specific brain regions of primary importance to the task can increase performance of that task.

Brain Fuel: Carbohydrates, Exercise, and CNS Function

J. Mark Davis, Ph.D. University of South Carolina at Columbia

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The serotonin/dopamine hypothesis has also been developed to help explain CNS fatigue. It suggests that an imbalance in these neurotransmitters characterized by increases in serotonin and decreases in dopamine in important brain regions is associated with CNS fatigue. There is also a good association during exercise between reduced brain glucose availability and altered neurotransmitter release that matches the imbalances hypothesized to be involved in CNS fatigue (i.e., increased 5-HT and decreased dopamine). When glucose availability is increased via glucose administration, the neurotransmitters are normalized. However, these changes have not yet been directly linked to CNS fatigue during exercise.

Research is now beginning to focus on possible CNS factors that contribute to fatigue and poor performance during prolonged exercise in humans. However, unlike animal studies where investigation of brain mechanisms is relatively simple, human studies are exceedingly difficult for ethical reasons. As a result, researchers generally rely on indirect markers of CNS function (e.g., plasma concentrations of amino acid precursors of neurotransmitter synthesis) and measurement of human behavior, cognitive function, and mood. Nonetheless, available evidence suggests that carbohydrate feedings designed to increase blood glucose can improve both CNS (mental) and physical function during exercise designed to mimic the demands of team sports, where it could be argued that a combination of mental and physical function is even more important than in individual endurance events like a marathon run.

Coaches, athletic trainers, and athletes themselves have long known the importance of the mental edge in athletic competition. Likewise, the ancient Romans and Greeks lived by the notion that optimal health and performance requires proper nutrition and physical activity for both mind and body. However, scientists have only begun to understand the neurobiology of brain function in this regard. A complete understanding of the interaction of nutrition and physical activity on brain function represents an exciting new frontier in exercise physiology and sports nutrition.