Benefits
Pairs with sodium to aid water absorption in oral rehydration solutions
Glucose is absorbed through SGLT1, a sodium-dependent transporter, which is why oral rehydration solutions combine glucose with sodium. In healthy volunteers, glucose-electrolyte solutions were well absorbed in the small intestine, and in 72 healthy men an oral rehydration solution kept more fluid in the body than water over 4 hours, while a sports drink did not. Ongoing vomiting or diarrhoea needs medical care.
Endurance exercise fuel and delayed fatigue
A meta-analysis of 136 studies found that carbohydrate taken during endurance exercise improved performance versus placebo, most in longer events and time-to-exhaustion tests, and the type of carbohydrate did not change the effect. In one cycling study a glucose polymer drink let riders go about an hour longer. A single sugar such as glucose can be burned at up to about 60 g an hour.
Mechanism of action
SGLT1 sodium-glucose transport
Glucose is thought to be absorbed mainly through SGLT1, a sodium-dependent transporter in the small intestine, so glucose and sodium are taken up together and water absorption follows. This is the basis for pairing glucose with sodium in oral rehydration solutions.
Solution makeup and water absorption
In healthy human small intestine, a lower-osmolality glucose-electrolyte solution (60 mmol/L sodium, 90 mmol/L glucose) gave more water absorption than other solutions tested, including the WHO solution, and solutions with two sugars gave more water absorption at a given osmolality than single-sugar solutions.
Carbohydrate oxidation during exercise
SGLT1 is believed to become saturated at about 60 g of glucose an hour. Adding fructose, which uses a different transporter, raised carbohydrate oxidation above 1 g a minute (1.26 g/min) in one study, which is why ultra-endurance fuelling plans use mixed sugars.
Clinical trials
Systematic review and meta-analysis of studies on the efficacy and effectiveness of oral rehydration solution and recommended home fluids, with evidence graded using CHERG rules. (Munos et al. 2010, Int J Epidemiol)
Children under 5 with diarrhoea; 157 papers were included in the oral rehydration solution meta-analyses.
Oral rehydration solution was estimated to prevent 93% of diarrhoea deaths and was effective in home, community and facility settings. Evidence was insufficient for recommended home fluids. This is medical treatment of an illness, not a sports or supplement use.
Randomized trial: euhydrated, fasted men drank 1 L of still water or one of 13 common drinks over 30 minutes, and urine was collected for 4 hours. (Maughan et al. 2016, Am J Clin Nutr)
72 healthy men.
Four-hour urine output was lower than with water after an oral rehydration solution (1038 vs 1337 g), full-fat milk and skimmed milk; the hydration index at 2 hours was 1.54 for the oral rehydration solution. Cola, tea, coffee, lager, orange juice, sparkling water and a sports drink did not differ from water.
Crossover trial: cyclists rode at 71% of VO2max to fatigue while drinking flavored water or a glucose polymer solution (2.0 g/kg at 20 minutes, then 0.4 g/kg every 20 minutes). (Coyle et al. 1986, J Appl Physiol (1985))
7 endurance-trained cyclists.
Fatigue came at 3.02 hours with placebo and 4.02 hours with carbohydrate (P < 0.01). Carbohydrate kept blood glucose and carbohydrate oxidation up late in exercise; muscle glycogen use did not differ in the first 3 hours. A small study using a glucose polymer rather than pure glucose.
Systematic review, meta-analysis and meta-regression of studies comparing carbohydrate intake during endurance exercise with placebo or control, testing moderators such as dose, carbohydrate type and event duration. (Ramos-Campo et al. 2024, Crit Rev Food Sci Nutr)
136 studies of carbohydrate ingestion during endurance exercise.
Carbohydrate significantly improved endurance performance versus placebo or control. Effects were larger in time-to-exhaustion tests than time trials, in longer events and in less trained people. Dose, ergometer, form of intake and type of carbohydrate did not change the size of the effect. Perceived exertion was lower with carbohydrate.