Senior year in college I was sitting in a literature class, when my teacher went off on a slight tangent about nutrition in the school system. The story behind her current agitation was simple: her child could not eat her chocolate covered protein bar in the cafeteria because it was chocolate covered and ‘unhealthy’, yet, plenty of children could drink Gatorade at lunch. Pointing at a girl’s Gatorade in class, she said “you know that’s just crap right?” The girl nodded and she moved on. But I couldn’t. I had a Gatorade. I had a Gatorade almost every other day. Unbeknownst to her, she just disrespected my beloved sports drink. From my point of view, I ran 15 miles per week, worked out for hours, and had regrettably over active sweat glands. So, I thought I earned the Gatorade. After all, Gatorade was made with athletes in mind, and I was an athlete of my own decree. Hurt feelings aside, she did have a point. Just because something is deemed ‘healthy’ or meant to ‘improve’ someone’s performance doesn’t mean it’s for everyone. But then again, what if that child in the cafeteria worked his tail off six days a week. Would it ever get to the point that an adolescent would ever need something like Gatorade? Gatorade was formulated for collegiate athletes not preteen recess stars.
Gatorade is considered an ergogenic aid, or items designed to help athletes preform their very best. Ergogenic aids are nothing new. We have been trying to find ergogenic aids since the beginning of sports. Athletes and warriors in ancient times use to eat lion hearts and deer livers in attempt to gain the abilities of those animals and become stronger and faster.1 Since 1920, researchers have been looking into exercise results due to one of these aids, carbohydrates. They found that high carbohydrate diets were more beneficial for increasing muscular work than high fat diets were. In 1924 Harvard Medical School sought to prove this theory by testing the Boston Marathon runners.1 They collected blood from the first 20 finishers and found that low blood glucose levels correlated with unfavorable post-race symptoms, such as fatigue and stupor. With the help of some of these same runners, the researchers prepared for next year’s race. They gave the runners a high carbohydrate diet the day before the race and equipped the runners with hard candies and told them when to eat them during the run. The results showed that by normalizing blood glucose levels the runners were able to prevent those ill symptoms.1
Research on carbohydrates continued and in 1965 it reached the University of Florida.1 . The University wanted to develop something to aid their Gator football team’s poor performance, and Gatorade was born. By the 1970s the word spread that carbohydrates could improve performance and ‘carbohydrate loading’ began.1 This was done because increasing the muscle glycogen stores lead to increased endurance and performance. And with a developing demand for carbohydrate rich items, came a developing commercialized market. Although, this was before gyms became mainstream like they are today, marketing was kept to running magazine and athletes. But as sports performance has spread from just the professional athlete to the casual weekend warrior, Gatorade has spread into a multimillion dollar sports beverage industry.
Today, it is highly accepted that muscle glycogen is a very important factor during exercise. Glycogen is used as fuel to provide energy, or ATP, to keep muscles contracting so we can do the things we want. Since we use up these stores as we exercise it is important to replenish them. It has been proven that actually consuming carbohydrates during the actual exercise, and not just before, can increase exercise performance and decrease fatigue by replenishing these glycogen stores.2 Tests done on triathletes and marathon runners have been able to show a correlation between carbohydrates consumed and finish times. It has also been shown to help in team sports where performance is more intermittent. If the participants are able to ingest carbohydrates they can delay fatigue and time to exhaustion. Even other skill sets, such as dribbling, accuracy, and agility, were improved with carbohydrates. This effect is essential towards the end of the game when others might be hitting exhaustion. With this, researchers have found that there is a dose response between the amount of carbohydrate ingested and exercise performance.2 This means that as the dose increase, the performance increases. Researchers have found that the greatest performance enhancement occurred when the ingestion rate was between 60 and 80 grams per hour.
Carbohydrates don’t just help because they offer more glycogen to the body. Glucose injections offer the same products, but not the same results. However, just a carbohydrate mouth rinses can show results. This demonstrates that it may not be just the carbohydrates in the traditional metabolic sense, but also a sensory neuron response. Parts of the higher brain are activated by these carbohydrate mouth rinses, although to true path from brain to increased exercise performance is unknown.
The American College of Sports Medicine recommends an intake of 30-60 grams of carbohydrate per hour during exercise.2 The upper limit was created because it originally believed that carbohydrates ingested during exercise would only be oxidized at a rate of 60 grams per hour. There’s no need to eat more than you can oxidize. When you first look at the intestinal absorption of carbohydrates this would make sense. Glucose is absorbed via the sodium-dependent transporter that becomes saturated when carbohydrate ingestion is at 60 grams per hour.2 However, fructose uses a different transporter when ingested at the same time as glucose. This means that oxidation of carbohydrates can actually exceed 60 grams per hour, if multiple types of carbohydrate is used. In studies it has been shown that participants rated a lower perceived exertion when they ingested a mixture of glucose and fructose versus plan glucose.2 Benefits for multiple sugars were shown when exercise was longer than 2.5 hours. At shorter durations it was shown that multiple transportable carbohydrates had the same effect as single transportable carbohydrates. Gatorade and other sports drinks use a mixture of glucose and fructose to obtain this benefit.3
When looking at carbohydrate oxidation rates it is more important to look at intensity versus training status.2 A well trained athlete versus an untrained one will oxidize carbohydrates at the same rate, if the intensity is the same. If intensity is low than carbohydrate oxidation is low. This means that the ingested carbohydrate that isn’t used could be sent to the liver to be stored. Therefore, if the participant is exercising at a low intensity, they should adjust the amount of carbohydrates downward. Simarly, if intensities are high enough, benefits of the carbohydrates can been seen after just an hour of exercise.2 This is compared to the previous notion that all exercises had to exceed a certain time limit of two hours.
Unfortunately, there can be downsides to consuming carbohydrates while exercising. Ingesting a lot of carbohydrates during a workout can cause gastrointestinal discomfort.2,3 During training it is important to practice this nutrition strategy so that during an event or competition the participant does not have unexpected gastrointestinal discomfort. By increasing carbohydrates in the diet the body upregulates the intestinal transporters available, increasing absorption. It is also important to keep in mind that ingestion of carbohydrates at highly concentrated doses have been related to reduce fluid absorption, so balancing this out with fluid intake is important, as to not cause a large fluid deficit.2,3 Gatorade combats this by providing it’s carbohydrates in a liquid form versus bar, and by including sodium to increase fluid reabsorption.
When you exercise you burn glycogen stores and sweat out electrolytes, mostly sodium, and fluid stores. All of which need to be replenished. This is especially important if someone has multiple training sessions in a day because if you lose too much water you could become dehydrated. And in extreme cases this hypohydration could lead to death.4 It is advised you should drink as much as you sweat out, if not more. However, drinking plain water lowers your plasma osmolality and sodium concentration, meaning the blood has a higher percentage of water and a lower percentage of sodium. This change triggers the body to produce more urine to excrete the excess water and return the plasma osmolality back to normal.4 The concentration drop also reduces the urge to drink; combined with an increase in urine, the rehydration rate is reduced with pure water. Some rehydration drinks use potassium to decrease plasma osmolality, increasing hydration. While potassium is lost in sweat, sodium is the main cation lost, and therefore when formulating rehydration beverages, that is generally what is used, such as in Gatorade. For fluid restoration, the participant must consume a greater amount than what was lost from sweat. This is because the body still has obligatory urine loss, even if you are in a state of deficit.4 For participants that cannot find a cool place, and cannot limit the amount they continue to sweat post workout, they could face a sweat loss twice as high as their urinary loss. Both of these could lead to a greater and dangerous water deficit.
There are many factors that play into how much a participant will drink after a workout, a large one being palatability. If a participant finds the beverage pleasant to drink they are more likely to drink more if it, which can be very beneficial when it comes to large fluid deficits.4 Things that commonly effect palatability include the temperature of the drink, the flavor, and if it has been carbonated or not. Although carbonation does not affect the effectiveness of the drink to rehydrate the body, participants have rated it a lower palatability. Salt when added to a drink can increase the amount participants willingly drink. And since sodium helps increase fluid restoration, it is a helpful additive. However, if you add too much the drink can become too salty and unappealing. So sports drink not only have an advantage over plain water in their rehydration abilities, but because of the increased palatability this effect is magnified by the amount the participant is willing to drink.4
One study tested the effectiveness of Gatorade, the carbohydrate-electrolyte solution, against two other popular rehydrating drinks and water.4 They selected Apfelschorle, a carbonated water/ apple juice mixture popular in Germany, and bottled mineral water, popular in Italy. After being dehydrated by the same percentage of body mass the participants drank a volume of liquid equal to 150% of the body mass lost during exercise. An hour after hydration it was found that urine volume was greatest with plain water. This means that although participants are drinking the same amount of fluid as those drinking sports drinks, they end up excreting out a higher percentage from the urinary system. After the full four hours, all urinary amounts were about equal. They also found that after that four hours, Gatorade had the highest Net fluid and sodium balance. One side effect of dehydration is a decreased amount of blood plasma. This can lead to various side effects generally associated with dehydration, such as decreased blood pressure and light headedness, so it is important to raise plasma volume back to normal as a soon as possible. The fastest beverage to increase plasma volume above the amount from before exercise was Gatorade.4 Although participants found Gatorade to be a bit saltier and sweeter than other options, it clearly has some benefits. Gatorade was the only beverage that fully rehydrated the participants back to their pretrial hydration levels. No one was able to fully replenish all of their lost sodium, but Gatorade got the closet and did have the required significant amount of sodium to rehydrate the body. Some products such as the Apfelschorle, try and use another electrolyte, potassium, to achieve the same benefit. However, the potassium actually decreased the rate of plasma-volume recovery.
Most of the studies done regarding exercise performance and ergogenic aids, such as Gatorade have been done on elite athletes, such as marathon runners.2,4 Not much has been looked into for sedentary people, let alone children. But what has been looked into extensively is childhood obesity and what causes it.3,5 And up on the chopping block in Gatorade.
Sugar-sweetened beverages are beverages with added sugar, such as soft drinks, fruit flavored drinks, energy drinks, and sports drinks such as Gatorade. Sugar-sweetened beverages (SSB) account for the largest amount of added sugar in US youth’s diet.5 Adolescents consume the greatest amount of SSB of any age group. About 70% of boys and 60% of girls, ages 12-19, will drink a SSB today. A recent study indicated that almost one in four students in high school will have at least three SSB.5 Because of this high sugar consumption, that can increase caloric intake by 100 to almost 700 calories, SSB have been linked to obesity, cavities, type 2 diabetes, disruptive behavior, and poor mental health. Although soda is the mostly commonly consumed SSB, sports drinks were also popular.5 An increase in SSB consumption was linked to eating fast-food frequently and watching a lot of television. However, an increase in sports activities is what lead to sports drinks, specifically, being consumed. Increased television time was related to a decrease in sports drinks being consumed.5 A lot has to do with availability and if students can buy SSB in school. Schools are now switching out soda machines for sports drinks. Although, it might be more beneficial to get rid of all SSB options.
Sports and Energy drinks have grown into a large industry that has started marketing to children and adolescents.5 Since they can easily be sucked into the misguidance of ‘drink our product and become a famous athlete.’ As children being to engage in sports and exercise it is important to teach them about proper rehydration. When they being to exercise their water needs can increase dramatically, especially if they are out in the heat, high humidity, and direct sun exposure.5 It is important to have them drink water frequently while they are exercising to prevent dehydration and heat illnesses. As long as their nutritional needs are being met, water will be sufficient for most children. It is important with children to choose a beverage for rehydration that does not contain an excessive amount of carbohydrates and calories. If they ingest too many carbohydrates they can off balance the other important parts of their nutrition. This could lead to a lack in protein needed for growth and development or fill them up with carbohydrates of low nutritional value. As well as increase their calorie intake and lead to obesity.
With regular day to day activities most children have little need for beverages to contain carbohydrates.5 They get enough from their food. However, some children are involved in tournaments or long practices where recovery time may be short or the point of exhaustion maybe reached. In these cases the amount of available glycogen in the body is decreasing and a supply of carbohydrate will need to be administered to prevent the child from becoming fatigued. And therefore, it would be appropriate to supply the child with commercial sports drinks, like Gatorade.5 As long as over excessive amounts of these carbohydrate containing beverage is not consumed. Similarly to carbohydrates, most children will not need a supplemented amount of electrolytes for their body.5 With adequate electrolytes balances, the enhanced sports drinks will offer little benefit over regular water. Though, just as with carbohydrates, there are those exceptions. Children that participate in extended vigorous exercise, or sweat a lot due to excessive heat or humidity, could benefit from the rehydration properties of sports drinks.
Unfortunately, most children do not know the difference between sports drinks and energy drinks.5 This can be a problem because they are not interchangeable. Energy drinks contain higher amounts of sugar, and stimulants that can cause problems in children. Especially if a child starts drinking them before having to sit still in class all day. Most children also do not know to change the amount of use of these products based on the degree of athletic participation.5 For pediatricians it is becoming important to question the child and parent on sports and energy drink use, and educate them if need be. Let them know that sports drinks have a specific function and that they are not made for everyone. And they should try and promote water as the go to rehydration beverage for adolescence. There is also a need for dentists to look into the matter and parents to be concerned about the relationship between sports drinks and dental caries.5 As with any sugary drink the bacteria can build up because of carbohydrate sitting on the teeth, causing decay. Most sports drinks contain citric acid, which can lower pH.5 The lowered pH and citric acid by itself cause a demineralization of the enamel of the teeth, leading to dental caries.
Adolescence are still learning about nutrition, and just with anything else, they need a little bit of help figuring it out. And sometimes that comes in the form of regulation. If schools continue to allow these products in the cafeteria, students may follow their desire without thinking about the outcome of that soda or even sports drink. Luckily for students, changes are happening. On the one hand, in the 2009-2010 school year, US school systems began phasing out soda from their system.5 Sadly, on the other hand, beverage manufactures are using this as an opportunity to promote their drinks as a ‘healthy alternative’ and schools are putting sports drinks in the place of sodas. Fortunately, some school districts have started creating policies to ban all of these sugary drinks in schools. The Institute of Medicine’s Nutrition Standards for Foods in Schools recommended that schools ‘restrict sports drinks to use by athletes only during prolonged, vigorous sports activities.’5 They also recommend limiting the total amount of sugar in the foods and drinks in general, and allowing free access to water during the day.
In 1965 things were different. Gyms were not popular like they are today, people didn’t run as a leisurely activity, like they do today. The fitness world was different, it was saved for the Olympians and professionals. But now things have changed, everyone wants to workout, lose weight, bulk up, or various other fitness goals. And although people try to eat healthy and make good decisions I think they are missing something. Gatorade and other sports drinks manufactures have used famous athletes to promote their product. They made it seem like drinking their product will make you more like them. They wouldn’t drink something unhealthy, so it must be good for you, right? I think Gatorade has caught on to this misnomer that has spread the sedentary population. Gatorade released a series of commercials I was quite fond of, where people buying the product had to “Sweat it to get it”. Meaning if you weren’t sweating, you didn’t need Gatorade. And on their website it says:
“Sweat. It says, “I was here. I put in the work.” Every drop of sweat is a reminder that what you get out is a result of what you put in. From teen athletes to the pros, Gatorade Thirst Quencher is created to help replace what you sweat out.”
I love Gatorade and always will. But I know its place. Gatorade was excellently developed for the University of Florida Gators, and therefore, hard working athletes. Refueling the body’s depleted glycogen stores, it improves endurance and performance. Utilizing multiple transportable carbohydrates, it increases carbohydrate oxidation. It’s diluted carbohydrate form is easier on the stomach. With enough electrolytes, it rehydrates the body and raises blood plasma levels. Lastly, it taste delicious, enough that athletes are going to drink more of it and rehydrate faster. However, what it doesn’t do is help those who don’t need to replenish glycogen, electrolytes, or fluid. Adolescents, like the child in my teacher’s story, might very well need those traits and it may be appropriate for them to consume Gatorade. Though, at that age, children still need guidance. Even parents don’t always understand what’s best for their bodies. The first step, as always, is education. Teach parents and children the outcome of drinking Gatorade or other sweetened sports drinks when it isn’t necessary. With education, hopefully regulation changes follow, leading to sugar-sweetened beverages only being offered by an adult in times of practical need. Children also need to learn what it takes to actually be that athlete in the commercial and what Gatorade means for an athlete. Hopefully, Gatorade and start helping with that themselves.