My contention with sports drinks isn’t that they don’t have a purpose, it’s that they’re generally overconsumed and overhyped.  I can’t help but think that sales figures are sports drink manufacturers’ biggest concern, but Kevin Garnett’s bellow seems to scream otherwise.  What’s the reasoning behind the typical sugar, water, and electrolyte composition of these drinks?  When, if at all, does it become important to rehydrate with something other than water?  What, beyond the commercial viability of selling sugar water, are the real benefits to professional athletes and amateurs alike?

The Formula

Sports drinks are generally made of water, various simple sugars like glucose and fructose, and electrolyte-containing ingredients like salt, citric acid, sodium citrate, and potassium sulfate.  The theories behind the inclusion of these ingredients are seemingly straightforward.  Water is necessary for hydration and proper temperature regulation.  Sugar is a carbohydrate and is a quick source of energy.  Electrolytes are lost when you sweat and are integral for many bodily processes including maintaining proper fluid balance and nerve and muscle functioning.

Every Athlete is an Individual

Sweating is an important process for body temperature regulation.  Unfortunately, my body sucks at temperature regulation.  Post-run you’ll find me with a bright red face and just a little dew about my temples and in the middle of my back.  My husband, however, sweats so much it drips off of his bandanna.  We both just ran the same trail, the same distance, and at the same pace, but our bodies’ reactions are not the same.  Evidence shows that we all lose fluids (and with them electrolytes) at different rates during exercise and beyond that, even the composition of sweat differs from person to person.^{1, 10} These differences are determined due to environmental conditions, clothing choices, fitness level, diet, age, gender, and use of certain medications, among many other factors.² It seems logical to replace these lost electrolytes, but evidence shows that the body is generally able to cope with and adjust to these losses by relying on dietary stores.⁸

Fluid and Electrolyte Balance

Dehydration stresses your body and decreases athletic performance, so before beginning exercise of any intensity level, make sure you are hydrated.  Those who are faster, heavier, and in warmer environments generally need additional fluids over their smaller, slower counterparts who are in cooler climates.  Preceding your athletic endeavor, it is typically sufficient to eat regularly and drink water throughout the day.⁸ While exercising, it is ideal to drink fluids at a rate to keep weight loss under 2% of total body weight (weigh yourself pre- and post-exercise to determine your water loss). ^3,8 The amount of liquid necessary to stay within this range will vary depending on your personal rate of sweating.

While the effects of dehydration are clear-cut, the effects of exercise-induced electrolyte loss are a bit more convoluted. If you pay close attention to the claims sports drink manufacturers make as a means to sell their products, they avoid specifically mentioning the idea that replacing electrolytes will improve performance or even rehydrate you more quickly.  They simply point out the following facts: you lose electrolytes when you sweat, electrolytes are important for various bodily functions, and electrolytes (sodium in particular) stimulate thirst.¹¹

These are accurate statements, but the marketing implication seems to be that because of these things, replacing electrolytes has an actual impact on athletic performance.  The Institute of Medicine states that, “Because substantial quantities of sodium, chloride, and to a lesser extent, potassium are lost in the sweat during prolonged exertion, especially in the heat, many are concerned that this electrolyte loss should be replenished during exercise to maintain the appropriate distribution of electrolytes in the various fluid compartments of the body.  However, there is little direct evidence of a beneficial effect of electrolyte replacement for any but a small proportion of endurance athletes.³“  In other words, replacing electrolytes during a four-mile run probably isn’t going to make me any faster, better, or stronger.⁹ Also, you don’t need to rely on specially-formulated drinks to replace electrolytes. Electrolytes like sodium, potassium, magnesium, and calcium, are naturally found in many foods, such as fruits, vegetables, and sea salt.  In short-duration activities your body is able to draw on its own stores to balance itself.

Regardless of athletic impact, electrolyte inclusion has a definite positive aspect.  Research shows that small amounts of sodium chloride (salt), an electrolyte, increase the palatability of beverages.^{2, 3, 10} If enjoying drinking a beverage increases the amount a person drinks, then the inclusion of electrolytes might be an important factor for making sure you drink enough water to stay sufficiently hydrated during and after exercise.

While it’s highly important drink adequate fluids before and after exercise, you can actually drink too much water.  Normally the body adapts to increased water intake by increasing urine output.  This stabilizing effect is less efficient during exercise, however, so if you are sweating heavily for extended periods of time (such as marathons or ultra events) and drinking only water, it’s possible that you’ll end up with too much water in relationship to electrolytes, sodium in particular.  This is known as water intoxication or hyponatremia, and the result can be irregular heartbeat, swelling of tissues, and even coma or death.

Carbohydrate Content

It turns out that the part of sports drink I scoff at the most, the carbohydrate (sugar) content, has actually been shown to improve athletic performance and increase endurance when used after an extended duration of activity.^3,4 Specifically, research shows that using a carbohydrate-containing sports drink at least 30 minutes before you expect to be fatigued can delay the onset of fatigue.^3,8 It is important to note, however, that the body has adequate blood glucose and stored glucose (glycogen) to maintain energy for several hours of sustained athletic activity (generally believed to be about three hours).⁷ Ask yourself how often you exercise for several hours or more and what you’re trying to accomplish with exercise.  If you are of the camp that’s using physical activity to lose weight, you might want to reconsider adding calories that your body doesn’t really need.

Water vs. Electrolyte Drinks

Consider the following questions:  Are you hydrated before you start exercising?  How much do you sweat?  How long and at what intensity are you exercising?  Will you drink plain water or do you need to be enticed by something a little sweet and salty?

Short duration (less than 3 hours) and well hydrated?  Choose water.

Not much of a water drinker, exercising at high intensity (where you would benefit from an easily-digestible carbohydrate boost) or for three hours or more?  Try our sports drink recipes; they use antioxidant and nutrient-rich whole fruit, unprocessed sea salt (rich in electrolytes and trace minerals), and taste far less syrupy-sweet than commercially-available sports drinks.

Mango-Citrus Electrolyte Drink

• 32 oz water
• 1 Tbsp lemon juice
• 1 Tbsp raw apple cider vinegar (try Bragg’s)
• 1/4 tsp baking soda
• 1/8 tsp sea salt
• 1 cup mango, fresh or frozen

Mix all ingredients in blender.  Strain.  Chill until cool.

Nutrition breakdown:

calories: 110
carbohydrates: 29.4 g
sugar: 24.8 g
sodium: 608 mg
potassium: 286 mg
magnesium: 14 mg
calcium: 17 mg

Berry-Citrus Electrolyte Drink

• 32 oz water
• 1 Tbsp lemon juice
• 1 Tbsp raw apple cider vinegar (try Bragg’s)
• 1/4 tsp baking soda
• 1/8 tsp sea salt
• 1 cup mixed berries (any combination of strawberries, blueberries, blackberries, and/or raspberries), fresh or frozen
• 1 Tbsp honey

Mix all ingredients in blender.  Strain.  Chill until cool.

Nutrition breakdown:

calories: 151
carbohydrates: 40.2 g
sugar: 32.5 g
sodium: 606 mg
potassium: 153 mg
magnesium: 8 mg
calcium: 10 mg

^{1 Kilding, AE, et al. (2009). Sweat rate and sweat electrolyte composition in international female soccer players during game specific training. Int J Sports Med 30(6) 443-7.
2 Sawka, MN, et al. (2010). Exercise and fluid replacement, from Medscape http://www.medscape.com/viewarticle/717055_5
3 Marriott, BM (1994). Fluid replacement and heat stress. Institute of Medicine, Food and Nutrition Board, Committee on Military Nutrition Research.
4 Gisolfi, CV (1993). Use of electrolytes in fluid replacement solutions: What have we learned from intestinal absorption studies? University of Iowa, Iowa City.
5 Irving, RA (1991). Evaluation of renal function and fluid homeostasis during recovery from exercise-induced hyponatremia. Journal of Applied Physiology 70(1) 342-348.
6 Greenleaf, JE, et al. (1996). Mechanisms controlling fluid ingestion: thirst and drinking from Body fluid balance: exercise and sport.
7 Armstrong, LE, et al. (1999). Fluid-electrolyte balance during labor and exercise: concepts and misconceptions. Int J Sports Nutrition 9(1) 1-12.
8 Latzka, WA, et al. (1999). Water and electrolyte requirements for exercise. Clinical Sports Med 18(3) 513-24.
9 Coombes, JS, et al. (2000). The effectiveness of commercially available sports drinks. Sports Med 29(3) 181-209.
10 Maughan, RJ, et al. (1997). Recovery from prolonged exercise: restoration of water and electrolyte balance. J Sports Science 15(3) 297-303.
11 (26 Aug 2010). Gatorade website, frequently asked questions, science and nutrition http://www.gatorade.com/frequently_asked_questions/default.aspx}

You can probably guess that I’m going to disagree.  That’s my gut reaction anyway.  If I’m fair, though, high-fructose corn syrup is an outstanding example of the confusion at the heart of much of the nutrition world.  Depending on whom you ask, high-fructose corn syrup can be shown to be the root of all evil or just another delightful way to sweeten our foods.  So which is it?

It’s Made From Corn

It’s true what our lady told her man- high-fructose corn syrup (HFCS) is made from corn, but that’s a definite oversimplification.  Making HFCS isn’t in the realm of making, say, maple syrup, which involves little more than drilling a hole into a tree and waiting.  In fact, it’s exponentially more complicated, to the point of being industrial.

The short version of this process is still fairly long, so bear with me.  In order to minimize your boredom, I’m going to skip the processing of corn into cornstarch and use cornstarch as the starting material.  First, cornstarch is treated with an enzyme called alpha-amylase.  This enzyme breaks cornstarch down into shorter chemical chains, which happens to a further degree when the cornstarch is treated with yet another enzyme, glucoamylase.  These enzymes come from bacteria and fungus, respectively, making them making them relatively inexpensive.  The third enzyme, glucose-isomerase, is very expensive, and is used to convert the glucose in the cornstarch into a mixture of glucose and fructose (mixture A).

Next, the mixture is refined with carbon filters and ion exchange, and liquid chromatography is used to increase the percentage of fructose in the mixture.  Finally, this high-fructose mixture is blended with the aforementioned glucose/fructose mixture (mixture A) and viola, high-fructose corn syrup is born!

Simplifying HFCS to the point where “it’s made from corn” is akin to calling it “natural”, a word not used in the commercial, but frequently thrown around the rest of the pro-HFCS website (which is coincidentally sponsored by the Corn Refiners Association).  Technically, you could call this process and resulting mixture “natural”, especially considering that the Food and Drug Administration (FDA) has no formal definition for the word “natural”, but do you even know what liquid chromatography is?  Do you know what a tree and bucket are?  Which of those scenarios seems more “natural” to you?

As for the moderation part, I’ll give them some credit.  Part of me immediately thinks this is an excuse, as the same argument could be made for any number of dietary and lifestyle practices.  But yes, sure, high-fructose corn syrup is fine in moderation.  The issue is that we don’t consume it at that level.

American Consumption Doesn’t Qualify as Moderation

As of 2005, soda, made with high-fructose corn syrup, was the number one source of calories in America.¹ According to the USDA, the availability per capita (how much was available to be consumed per person) of high-fructose corn syrup increased 10,673 percent from 1970-2005.⁹ Today, a majority of the sweeteners used by food and beverage manufacturers (55 percent) are made from corn.¹ That reliance means that HFCS is found in a vast number of products, including salad dressings, cookies, breads, juices, cereals, granola bars, candies, condiments, crackers, pastries and cakes, chocolate, yogurt, ice cream, jams and jellies, sauces, and chips.  Of the money Americans spend on food, 90 percent is spent on processed foods.¹ If we eat this many processed foods made by manufacturers that rely so heavily on high-fructose corn syrup, can we really call that moderation?

The Calories are the Same

Okay, so maybe the idea that high-fructose corn syrup and sugar have the same number of calories means something, but it’s only a fraction of the story.  If calories were all nutrition was about, you certainly wouldn’t need my help.  Let’s look beyond this distracting oversimplification and talk about how this compound differs from sugar and how those differences affect your body.

Here’s where I have to get technical again for a moment.  The differences between HFCS and regular table sugar are twofold.  There is a small percentage difference in fructose concentration, with table sugar being fifty percent each glucose and fructose, and high-fructose corn syrup at either forty-two percent fructose or fifty-five percent fructose (the remainder in either case being glucose).   There is also a difference in whether the glucose and fructose are bound together.  In table sugar, they are bound to one another, and in high-fructose corn syrup, they aren’t.   Again, depending on whom you ask, either of these differences can be made into a major issue or dismissed as a minor detail.  It appears that the answer lies somewhere in between.

To illustrate what I mean let’s look at soda, since Americans drink a ridiculous amount of it.  Most sodas have HFCS in them, and studies show that it is the free (unbound) fructose within HFCS that causes the metabolic differences between HFCS and sugar.^{5, 6, 7} Sugar stimulates a hormone called insulin to be released, which goes into your blood, picks up the sugar from the things you eat and drink, and stores it tidily away in your cells (after fulfilling the body’s energy needs).  Free, unbound fructose in HFCS doesn’t stimulate insulin to be released.  Thus, rather than being digested into blood sugar, HFCS seems to end up being converted to trigylcerides (a form of fat in your blood) and fat tissue.

Aside from direct conversion to fat, this bypassing of insulin stimulation causes other problems.  Because insulin isn’t released, it can’t enhance the production of another hormone, leptin.  Leptin regulates appetite control and metabolism.  Because fructose fails to stimulate leptin, your brain doesn’t receive the signal that you’re full.  If you are not receiving the signal that you are full, you are more likely to overeat.  Therefore, despite the fact that sugar and high-fructose corn syrup match calorically, they certainly are not the same thing.

In the United States, soda is predominantly sweetened with HFCS, whereas many other countries are still using sugar.  Does that mean you should start importing your soda?  It’s not that easy, as unfortunately there also are downfalls to consuming excess table sugar.  Regardless of the intricacies in their chemical structures, too much of any sweetener means too many calories consumed.  But remember that it’s not just about calories.  Too much sugar leads to weight gain (especially around your middle, as the belly is the first place excess sugars are stored), increases in total cholesterol and LDL or “bad” cholesterol, and a condition called insulin resistance.  Long-term insulin resistance may lead to diabetes, heart disease, cancer, insomnia, carbohydrate craving, depression and mood swings, migraine headaches, heartburn, and irritable bowel syndrome.

What’s a Person to Do?

The easy answer is to limit your intake of all sweeteners, including high-fructose corn syrup.  Many of those against HFCS point to the mirrored increased consumption of HFCS alongside increased rates of obesity and diabetes as proof that HFCS is detrimental to your health.  It would be nice if it were that simple, but it seems that HFCS is only a part of the overall picture of the changes that have taken place in the Standard American Diet (SAD), including increased portion sizes and increased intake of processed foods.

Ideally, your diet would consist of whole foods and your sweet tooth would be satisfied by small amounts of fruit and natural, unrefined sweeteners like honey, stevia, maple syrup, agave nectar, brown rice syrup, date sugar, Sucanat, vegetable glycerin, and xylitol.

The big question: Was our lady correct to brush aside the unarticulated concerns of her man?  I ultimately return to the principle that guides me whenever science doesn’t offer a simple and easy answer; the less a food is processed, the better.  Given that you can’t drill into a kernel of corn and wait for high-fructose corn syrup to come spilling out, I’d say she say she shouldn’t be so quick to bite into that popsicle.

¹ Mercola, Dr. J. (2009) Don’t Believe the Hype — Fructose Truly is Much Worse Than Glucose, from Natural Health Information Articles and Health Newsletter by Dr. Joseph Mercola Web Site: http://articles.mercola.com/sites/articles/archive/2009/05/16/Dont-Believe-the-Hype-Fructose-Truly-is-Much-Worse-Than-Glucose.aspx
² Forristal, LJ. (2003) The Murky World of High-Fructose Corn Syrup from The Weston A. Price Foundation Web Site: http://www.westonaprice.org/motherlinda/cornsyrup.html
³ High-Fructose Corn Syrup from Wikipedia: http://en.wikipedia.org/wiki/High_fructose_corn_syrup
⁴ U.S. Consumption of Caloric Sweeteners. (2008), from USDA Economic Research Service Web Site: http://www.ers.usda.gov/Briefing/Sugar/data.htm
⁵ Bray, GA, et al. (2004). Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. American Society for Clinical Nutrition, 79(4), 537-543.
⁶ Elliott, SS, et al. (2002). Fructose, weight gain, and the insulin resistance syndrome. American Society for Clinical Nutrition, 76(5), 911-922.
⁷ Schwarz, J-M, et al. (1989). Thermogenesis in men and women induced by fructose vs glucose added to a meal. American Journal of Clinical Nutrition, 49(4), 667-674.
⁸ Two Bites TV Spot. (2008), from SweetSurprise.com Web Site: http://sweetsurprise.com/videos/two-bites
⁹ Wells, HF & Buzby, JC. Dietary Assessment of Major Trends in U.S. Food Consumption, 1970-2005 (2008), from USDA Economic Research Web Site: http://www.ers.usda.gov/Publications/EIB33/

Carbohydrates All Turn Into Sugar

First, let’s talk about what carbohydrates are.  Vegetables, fruits, grains, breads, pasta, sweets, juices, sodas, beer, wine, potato chips and most other snack foods are all classified as carbohydrates.  They all break down into simple sugars in the body once we consume them.  But all carbohydrates are not created equally. Carbohydrate foods such as soda and candy are devoid of fiber and nutrients, and they contain a lot more sugar than vegetables or whole grains, causing our blood sugar to rise rapidly once eaten.  High blood sugar puts the body into red alert and our body sends a team to deal with it immediately.

The Power of Insulin

The most powerful member of that team is the hormone insulin.  Insulin has the very important job of regulating and transporting sugar in our blood.  We need a constant supply of sugar in our blood, but it is also dangerous to have too much.  Insulin protects our blood sugar levels by delivering sugar to areas of the body where it is needed for energy, or in excess, stores the sugar as fat.

It is very important for our brain to have a constant supply of sugar in order to function properly, so the body satisfies the brain’s need for sugar first.  Next, insulin takes sugar to our muscles to be burned for our physical needs of movement.  Our muscles also have the ability to store carbohydrates as glycogen for energy needs in the immediate future, so next, sugar goes into these glycogen stores.  If there is still sugar leftover, insulin puts it into fat storage, which typically goes to our waistline, or stores it as triglycerides (a “bad” type of cholesterol).

If we continually eat too many carbohydrates and the wrong kind of carbohydrates, our blood sugar is always spiking too high and then dropping too low instead of staying in a balanced state.  High blood sugar means high insulin levels.  High insulin levels mean intense sugar cravings.  Intense sugar cravings lead to an addiction to sugar and poor quality carbohydrate foods. That addiction leads to hypoglycemia, diabetes, adrenal exhaustion, mental instability and weight gain, to name a few.  High insulin levels also mean that another powerful hormone, glucagon, cannot do its work in burning fat.

Protein Creates Glucagon and Burns Fat

Glucagon’s job is to release stored carbohydrates from fat to be used as energy.  Eating protein rich foods triggers glucagon into action, but if insulin is too high, glucagon is blocked and cannot work.  If we choose high sugar carbohydrate meals and snacks without properly balancing protein, glucagon can’t work to break down fat stores because insulin levels are always high.  High insulin levels block glucagon.  Balanced insulin levels, hence balanced blood sugar, allow glucagon to work at burning fat.

Some Symptoms of Low Blood Sugar

• Craving for sweets
• Hunger
• Nervousness and irritability
• Exhaustion and drowsiness
• Depression
• Headaches
• Insomnia
• Forgetfulness, confusion, and indecisiveness
• Anxiety
• Heart palpitations and rapid pulse

Some Symptoms of High Blood Sugar

• Frequent urination
• Thirst
• Feeling weak or tired
• Blurred vision
• Dry mouth
• High blood pressure
• High cholesterol
• Weight gain
• Inflammation
• Fluid retention

Balancing Our Blood Sugar

Keeping your blood sugar balanced will keep insulin in check, glucagon working to burn fat, and will eliminate your sugar cravings once and for all.  In order to balance your blood sugar, you will need to eat healthy carbohydrates along with protein and fat with every meal and snack.  Healthy carbohydrate choices are vegetables, low sugar fruits and whole grains that are not refined.  Pair your choice of a healthy carbohydrate with a high quality protein such as chicken, turkey, or an egg, and a fat such as butter or avocado, every time you eat.  By doing this, you will avoid the blood sugar rollercoaster and avoid your body’s willpower being overrun by powerful hormones such as insulin.  You will lose weight because the hormone glucagon is able to do its work, and your sugar cravings will go away.  Freeing yourself from the addiction of sugar frees your mind so that you are relaxed, happy, confident and content; and frees your body to become energetic, strong, and on the road to optimal health.