Carbohydrate supplementation and the immune system

This is the first of three short blogs taken from the latest Exercise and Immunology Review. We will be looking at the effect of the macronutrients on exercise and the immune system. Up first, we have carbohydrate and endurance exercise. 

From the point of view of performance, the benefit of carbohydrate during endurance exercise is well established. During long training sessions and competitions, the recommended amount of carbohydrate is between 30-60g/hr and up to 90g/hr for very long events such as Iron Man. The primary aim of ingesting this amount of carbohydrate is to maintain blood glucose levels but it appears that it also has an indirect effect on the immune system. As we exercise, we increase the level of stress hormones within our body (adrenaline, noradrenaline and cortisol) and these hormones impair immune function. Illness and infections are common among athletes and I am sure we have all experienced the inconvenience of having to cut our training short due to illness. While following an habitually high carbohydrate diet does not seem to have much of an effect on immune function compared to a low carb diet, in other words, they both show similar levels of post-exercise immune depression, supplementing with carbohydrate during exercise does have an effect.

As plasma glucose falls during exercise, plasma cortisol rises. Cortisol stimulates protein catabolism and gluconeogenesis (formation of glucose from non-carbohydrate sources), it also has a potent anti-inflammatory and immune depressive effect. While there is sufficient evidence to show that supplementing with carbohydrate during endurance exercise attenuates the body’s cortisol response through maintaining plasma glucose levels, there are also reports of carbohydrate having a beneficial effect on immune function regardless of plasma cortisol levels. Simply put, carbohydrate supplementation during exercise appears to diminish the post exercise reduction in immune function. However, the catch is that the benefit of carbohydrate supplementation on immune function doesn’t appear to have an effect on the incidence of URTIs otherwise known as a cold.

The practical application

Whilst it appears that supplementing with carbohydrate may not lessen your chances of catching a cold, it does help to keep your immune system functioning when faced with the stress of exercise. This is obviously useful in terms of recovery from URTIs and fighting off other infections. I would also consider the link between carbohydrate and immune function when planning training sessions and would avoid any high intensity work during periods of low-carb or fasted training. I would probably also avoid placing a period of such training immediately after a block of high intensity training.  

Reference

Berman S et al. (2017) Immunonutrition and Exercise Consensus Statement. Exercise and Immunology Review: Vol 23