First, let us be clear on one thing. Performance is all about desire, the desire to push your body to the extreme. However, do not expect great things from your body unless you treat it well. That means getting plenty of sleep, eating a healthy diet, and using a sports drink that delivers what you need when you need it.

Every sports drink out there claims to have the "right stuff" in order to improve your performance, but most of them really do not back up their claims with any real scientific data. First, let us understand the difference between improving your performance and peak performance. I can take a bag of Skittles dissolve them in my water bottle and all of a sudden I have a drink that will improve my performance. In activities over an hour, any source of carbohydrate will help improve your performance compared to water. Therefore, those "scientific" papers that show "Product X" increased their athletes' performance when they are using water as the control groups are just stating the obvious.

Peak performance is something completely different that unfortunately the majority of us never get to experience. It is when you are good (I mean really good) and is usually reserved to the pros, semi-pros and a few seriously talented amateur athletes. These people are at the top of their sport and when they compete, in order to win, they need every bit of energy their bodies can absorb.

Now you know basically anything is better than water and most of us never achieve peak performance. Let us look at the data on single versus multiple carbohydrate sources, but first a quick chemistry lesson. Carbohydrates are one of the three major sources of calories (the others being protein and fat) in our diets. They are commonly classified as simple sugars (monosaccharides and disaccharides) or complex carbohydrates (oligosaccharides and polysaccharides).

Monosaccharides or "one sugar" are the simplest form of carbohydrates and cannot be broken down into any other sugars. When they are metabolized, they release energy, which is used to fuel the body. Examples of monosaccharides are glucose and fructose. Disaccharides or "two sugars" are (you guessed it) when two monosaccharides are combined together. Examples are sucrose (your common table sugar), which is fructose and glucose joined together and lactose (or milk sugar), which is glucose and galactose (another monosaccharide) joined together.

Complex carbohydrates are oligosaccharides ("few sugars") and polysaccharides ("many sugars"). There are many different types of complex carbohydrates. The two that are probably most familiar to athletes are glycogen and maltodextrin.

Glycogen is how your body stores glucose and is just thousands of glucose molecules linked together. Glycogen is mainly stored in the liver and muscles. Your body can only store a limited amount of glycogen (about 2000 kcal) so after long periods of exertion without any energy consumption, glycogen stores become depleted (called glycogen debt) and performance significantly decreases. So next time you are on a group run or ride and you see your buddy starting to bonk, hand over one of your gels, and say "it's time to repay your glycogen debt". Then just smile at the confused look on his or her face.

Maltodextrin is produced from starch which is polysaccharide consisting of a large number of glucose molecules joined together. It is a very common additive in sports nutrition products, because although technically a complex carbohydrate, it is easily digestible and absorbed as rapidly as glucose. However, unlike glucose, maltodextrin is not very sweet.

So when you look at a nutrition label and it says, for example, carbohydrates 30 grams (g) and sugars 10g, what it means is that out of the total 30g of carbohydrates, 10g are monosaccharides or disaccharides (simple sugars) and the rest (20g) are oligosaccharides and polysaccharides (complex carbohydrates).

Now that your chemistry lesson is over, back to the question, which is better, a sports drink that contains just simple sugars, a sports drink that contains just complex carbohydrates, or a sports drink that contains both. It turns out there is a fair amount of good scientific data on this topic.

Your gut has a limited number of receptors to transport carbohydrates into your bloodstream. By using a drink that contains only one source of carbohydrates (whether simple or complex), you run the risk of overwhelming those receptors, transport will slow down, and this leads to less available energy. In addition, all those extra carbohydrates sitting around will cause water to leave your bloodstream to enter your gut. This situation can lead to abdominal pain, dehydration and decreased performance during exercise. Studies have shown that by using two different sources of carbohydrates (for example, maltodextrin and fructose) that are transported by different receptors you get increased absorption. This will allow you to supply more energy, faster, to metabolizing tissues which translates into better performance.

So although for the most of us Skittles in water is about as much performance enhancement we need, if you push yourself to the extreme and are not sure if your sports drink may be slowing you down check out some of the following articles and learn for yourself.

Wallis GA, Rowlands DS, Shaw C, Jentjens RL, Jeukendrup AE. "Oxidation of combined ingestion of maltodextrins and fructose during exercise." Medicine & Science in Sports & Exercise, 2005; 37(3):426-32. Currell K, Jeukendrup AE. "Superior endurance performance with ingestion of multiple transportable carbohydrates." Med Sci Sports Exerc. 2008 Feb;40(2):275-81.

Jentjens RL, Achten J, Jeukendrup AE. "High oxidation rates from combined carbohydrates ingested during exercise." Med Sci Sports Exerc. 2004 Sep;36(9):1551-8.

Salvatore J. Tirrito M.D., F.A.C.C.

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