Carbohydrate supplementation and prolonged intermittent, high-intensity exercise in adolescents: research findings, ethical issues, and suggestions for the future
Shaun M. Phillips
Sports Medicine (In Press)
In the last decade, research has begun to investigate the efficacy of carbohydrate supplementation for improving... more
In the last decade, research has begun to investigate the efficacy of carbohydrate supplementation for improving aspects of physical capacity and skill performance during sport-specific exercise in adolescent team games players. This research remains in its infancy, and further study would be beneficial considering the large youth population actively involved in team games.
Literature on the influence of carbohydrate supplementation on skill performance is scarce, limited to shooting accuracy in adolescent basketball players, and conflicting in its findings. Between-studies differences in the exercise protocol, volume of fluid and carbohydrate consumed, use of prior fatiguing exercise, and timing of skill tests may contribute to the different findings. Conversely, initial data supports carbohydrate supplementation in solution and gel form for improving intermittent endurance running capacity following soccer-specific shuttle-running. These studies produced reliable data, but were subject to limitations including lack of quantification of the metabolic response of participants, limited generalization of data due to narrow participant age and maturation ranges, use of males and females within the same sample, and non-standardized pre-exercise nutritional status between participants.
There is a lack of consensus regarding the influence of frequently consuming carbohydrate-containing products on tooth enamel erosion and development of overweight / obesity in adolescent athletes and non-athletes. These discrepancies mean that the initiation, or exacerbation, of health issues due to frequent consumption of carbohydrate-containing products by adolescents cannot be conclusively refuted. Coupled with the knowledge that consuming a natural, high-carbohydrate diet ~3-8 h before exercise can significantly alter substrate use and improve exercise performance in adults, a moral and ethical concern is raised regarding the direction of future research in order to further knowledge while safeguarding the health and wellbeing of young participants.
It could be deemed unethical to continue study into carbohydrate supplementation while ignoring the potential health concerns and the possibility of generating similar performance enhancements using natural dietary interventions. Therefore, future work should investigate the influence of pre-exercise dietary intake on the prolonged intermittent, high-intensity exercise performance of adolescents. This would enable quantification of whether pre-exercise nutrition can modulate exercise performance, and if so, the optimum dietary composition to achieve this. Research could then combine this knowledge with ingestion of carbohydrate-containing products during exercise to facilitate ethical and healthy nutritional guidelines for enhancing the exercise performance of adolescents.
This article addresses the available evidence regarding carbohydrate supplementation and prolonged intermittent, high-intensity exercise in adolescent team games players. It discusses the potential health concerns associated with frequent use of carbohydrate-containing products by adolescents and how this affects the research ethics of the field, and considers directions for future work.
Ingesting a 6% carbohydrate-electrolyte solution improves endurance capacity, but not sprint performance, during intermittent, high-intensity shuttle running in adolescent team games players aged 12 – 14 years
Shaun M. Phillips, Anthony P. Turner, Shirley Gray, Mark F. Sanderson & John Sproule
European Journal of Applied Physiology (2010) 108: 811-821.
The main aim of this study was to investigate the influence of consuming a 6% carbohydrate-electrolyte (CHO-E)... more The main aim of this study was to investigate the influence of consuming a 6% carbohydrate-electrolyte (CHO-E) solution on the intermittent, high-intensity endurance performance and capacity of adolescent team games players. Fifteen participants (mean age 12.7 ± 0.8 years) performed two trials separated by 3-7 days. In each trial, they completed 60 min of exercise composed of four 15 min periods of part A of the Loughborough Intermittent Shuttle Test, followed by an intermittent run to exhaustion (part B). In a double-blind, randomised, counterbalanced fashion participants consumed either the 6% CHO-E solution or a non-carbohydrate (CHO) placebo (5 ml.kg-1 BM) during the 5 min pre-trial and after each 15 min period of part A (2 ml.kg-1 BM). Time to fatigue was increased by 24.4% during part B when CHO was ingested (5.1 ± 1.8 vs. 4.1 ± 1.6 min, P < 0.05), with distance covered in part B also significantly greater in the CHO trial (851 ± 365 vs. 694 ± 278 m, P < 0.05). No significant between-trials differences were observed for mean 15 m sprint time (P = 0.35), peak sprint time (P = 0.77), or heart rate (P = 0.08) during part A. These results demonstrate, for the first time, that ingestion of a CHO-E solution significantly improves the intermittent, high-intensity endurance running capacity of adolescent team games players during an exercise protocol designed to simulate the physiological demands of team games.
Carbohydrate Ingestion During Team Games Exercise: Current Knowledge and Areas for Future Investigation
Shaun M. Phillips, John Sproule & Anthony P. Turner
Sports Medicine (2011) 41 (7): 559-585.
There is a growing body of research on the influence of ingesting carbohydrate-electrolyte (CHO-E) solutions... more There is a growing body of research on the influence of ingesting carbohydrate-electrolyte (CHO-E) solutions immediately prior to and during prolonged intermittent, high-intensity exercise (team games exercise) designed to replicate field-based team games. This review presents the current body of knowledge in this area, and identifies avenues of further research. Almost all early work supported the ingestion of CHO-E solutions during prolonged intermittent exercise, but was subject to methodological limitations. A key concern was the use of exercise protocols characterised by prolonged periods at the same exercise intensity, the lack of maximal or high-intensity work components, and long periods of seated recovery, that failed to replicate the activity pattern or physiological demand of team games exercise. The advent of protocols specifically designed to replicate the demands of field-based team games enabled a more externally valid assessment of the influence of carbohydrate (CHO) ingestion during this form of exercise. Once again, the research overwhelmingly supports CHO ingestion immediately prior to and during team games exercise for improving time to exhaustion during intermittent running. While the external validity of exhaustive exercise at fixed prescribed intensities as an assessment of exercise capacity during team games may appear questionable, these assessments should perhaps not be viewed as exhaustive exercise tests per se but as indicators of the ability to maintain high-intensity exercise, which is a recognised marker of performance and fatigue during field-based team games. Possible mechanisms of enhancement include sparing of muscle glycogen, glycogen resynthesis during low-intensity exercise periods, and attenuated effort perception during exercise. Most research fails to show improvements in sprint performance during team games exercise with CHO ingestion, perhaps due to the lack of influence of CHO on sprint performance when endogenous muscle glycogen concentration remains above a critical threshold of ~200 mmol/kg dry weight. Despite the increasing number of publications in this area, few studies have attempted to drive the research base forwards by investigating potential modulators of CHO efficacy during team games exercise, preventing the formulation of optimal CHO intake guidelines. Potential modulators may be different to those during prolonged steady-state exercise due to the constantly changing exercise intensity and frequency, duration and intensity of rest intervals, the potential for team games exercise to slow the rate of gastric emptying, and restricted access to CHO-E solutions during many team games. This review has highlighted fluid volume, CHO concentration, CHO composition and solution osmolality; glycaemic index of pre-exercise meals; fluid and CHO ingestion patterns; fluid temperature; CHO mouthwashes; CHO supplementation in different ambient temperatures; and investigation of all of these areas in different subject populations as important avenues for future research to enable a more comprehensive understanding of CHO ingestion during team games exercise.
Beverage carbohydrate concentration influences the intermittent endurance capacity of adolescent team games players during prolonged intermittent running
Shaun M. Phillips, Anthony P. Turner, Mark F. Sanderson & John Sproule
European Journal of Applied Physiology (2012) 112 (3): 1107-1116
This study investigated the influence of consuming a 2, 6, and 10% carbohydrate-electrolyte (CHO-E) solution on the... more This study investigated the influence of consuming a 2, 6, and 10% carbohydrate-electrolyte (CHO-E) solution on the intermittent endurance capacity and sprint performance of adolescent team games players. Seven participants (five males and two females; mean age 13.3 ± 0.5 years, height 1.71 ± 0.05 m, body mass (BM) 62.0 ± 6.3 kg) performed three trials separated by 3 to 7 days. In each trial, they completed four 15 min periods of part A of the Loughborough Intermittent Shuttle Test (LIST) followed by an intermittent run to exhaustion (part B). Participants consumed 5 ml.kg-1 BM of the solution during the 5 min pre-exercise period, and a further 2 ml.kg-1 BM every 15 min during part A of the LIST. Intermittent endurance capacity increased by 34% with ingestion of the 6% CHO-E solution compared with the 10% solution (5.5 ± 0.8 vs. 4.1 ± 1.5 min, P < 0.05), equating to a distance of 931 ± 172 vs. 706 ± 272 m (P < 0.05). There was no significant difference between the 2% (4.8 ± 1.2 min) and 6% (P = 0.10) or the 2% and 10% solutions (P = 0.09). Carbohydrate concentration did not significantly influence mean 15 m sprint time (P = 0.38). These results suggest that the carbohydrate concentration of an ingested solution influences the intermittent endurance capacity of adolescent team games players with a 6% solution significantly more effective than a 10% solution.
Carbohydrate gel ingestion significantly improves the intermittent endurance capacity, but not sprint performance, of adolescent team games players during a simulated team games protocol
Shaun M. Phillips, Anthony P. Turner, Mark F. Sanderson & John Sproule
European Journal of Applied Physiology (2012) 112 (3): 1133-1141
The aim of this study was to investigate the influence of ingesting a carbohydrate (CHO) gel on the intermittent... more The aim of this study was to investigate the influence of ingesting a carbohydrate (CHO) gel on the intermittent endurance capacity and sprint performance of adolescent team games players. Eleven participants (mean age 13.5 ± 0.7 years, height 1.72 ± 0.08 m, body mass (BM) 62.1 ± 9.4 kg) performed two trials separated by 3-7 days. In each trial, they completed four 15 min periods of part A of the Loughborough Intermittent Shuttle Test, followed by an intermittent run to exhaustion (part B). In the 5 min pre-exercise, participants consumed 0.818 ml.kg-1 BM of a CHO or a non-CHO placebo gel, and a further 0.327 ml.kg-1 BM every 15 min during part A of the LIST (38.0 ± 5.5 g CHO.h-1 in the CHO trial). Intermittent endurance capacity was increased by 21.1% during part B when the CHO gel was ingested (4.6 ± 2.0 vs. 3.8 ± 2.4 min, P < 0.05, r = 0.67), with distance covered in part B significantly greater in the CHO trial (787 ± 319 vs. 669 ± 424 m, P < 0.05, r = 0.57). Gel ingestion did not significantly influence mean 15 m sprint time (P = 0.34), peak sprint time (P = 0.81), or heart rate (P = 0.66). Ingestion of a CHO gel significantly increases the intermittent endurance capacity of adolescent team games players during a simulated team games protocol.
Natural Medicine for Common Ailments
This is a collection of non-synthetic health tips for common illnesses. This is a collection of non-synthetic health tips for common illnesses.
Oily fish consumption in young adults: current intakes, knowledge, barriers and motivations
Background: Long chain omega-3 polyunsaturated fatty acids (n-3 PUFA) play an important role in the prevention of... more
Background: Long chain omega-3 polyunsaturated fatty acids (n-3 PUFA) play an important role in the prevention of many health problems, including cardiovascular disease, mental health issues such as depression and neurological malformations during foetal growth. The Scientific Advisory Committee on Nutrition recommends that adults should consume at least two portions of fish per week, one of which (approximately 140 g) should be oily, although there be safe upper levels for intake (SACN, 2004). Despite dietary recommendations, recent surveys suggest only one in four adults eat oily fish regularly and that the average intake in consumers is only 45g week-1, approximately one-third of a portion (Bates et al., 2010). This study aimed to improve understanding of the knowledge, motivations, barriers and information access regarding oily fish in young adults in whom dietary habits may still be developing to inform methods for increasing consumption.
Methods: A self-administered cross-sectional survey was used to collect data from students at the University of Bristol [n = 112, mean (SD) age 20.9 (2.6) years, 75% female]. The survey was developed from two previously validated questionnaires to assess current fish intake, knowledge, motivations, barriers and information access in relation to oily fish consumption . The survey was delivered via the University of Bristol Online Survey system. A chi-squared test was used to test for differences between groups and Spearman's rank correlation coefficient was used to identify associations. Alpha was set at <0.05.
Results: Only 36.6% of participants met the dietary recommendation of eating ≥1 portion of oily fish per week. Where oily fish was eaten, the average portion size was below recommended levels at 106 g. A large proportion of participants lacked specific awareness of the intake recommendations (48.8%) and safe upper levels for women (68.8%) and men (70.5%). Neither the frequency of consumption of oily fish, nor the meeting the dietary recommendation significantly differed by overall knowledge level (χ2 = 18.166, d.f. = 15, P = 0.254; χ2 = 1.913, d.f. = 3, P = 0.591, respectively). The main motivational drivers for fish consumption were liking the taste (77.3%) and knowing the associated health benefits (69.1%). The perceived high price (36.8%), unpleasant smell (38.9%) and dislike of taste (30.5%) were the main reported barriers to consuming oily fish. Other key barriers included a dislike of bones (21.5%) and difficulty with preparation and cooking (19.6%). A dislike of the taste was strongly negatively associated with consumption behaviour (r = -0.372, P = 0.004). Wholly or partially following a vegetarian diet was negatively associated with fish consumption and in turn n-3 PUFA intake (r = -0.286, P = 0.31). The types of information participants said they would most like to receive on fish were recipes (38.4%), details of health benefits (30.4%) and tips on cooking and preparation methods (29.5%). Online routes such as e-mail prompts were the preferred channel of communication for this information.
Discussion: Lack of awareness of the dietary recommendations and health benefits of fish has also been noted in previous studies (Burger, 2008). Previous studies have also reported similar barriers to oily fish consumption (Jones & Cornu, 1994). Together, these findings indicate a need to increase understanding of specific key issues around oily fish intake in young people. They suggest a value of health promotion strategies including electronic routes, that address cost, taste, smell, convenience and preparation and cooking issues including recipes and vegetarian sources of n-3 PUFA alternatives.
Conclusions: Oily fish consumption in young people may be facilitated by using electronic methods to target barriers to consumption, gaps in knowledge and awareness around fish consumption.
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Seen by: and 3 moreHazelnut economy of early Holocene hunter-gatherers: a case study from Mesolithic Duvensee, northern Germany
published in Journal of Archaeological Science 37, 2010, 2871-2880
Throughout the greater part of human evolution in Europe, use of plant foods is invisible and thus might have played a... more
Throughout the greater part of human evolution in Europe, use of plant foods is invisible and thus might have played a secondary role in nutrition. Ecological changes at the beginning of the early Holocene provoked innovations in early Mesolithic subsistence, focusing on the rich plant resources of the increasingly forested environment. High-resolution analyses of the excellently preserved and well-dated special task camps documented in detail at Duvensee, Northern Germany, offer an outstanding opportunity for case studies on Mesolithic subsistence and land use strategies. Quantification of the nut utilisation demonstrates the great importance of hazelnuts. These studies revealed very high return rates and allow for absolute assessments of the development of early Holocene economy. Stockpiling of the
energy rich resource and an increased logistical capacity are innovations characterising an intensified early Mesolithic land use, which is reflected in the stable tradition of uniform seasonal settlement patterns at early Mesolithic Duvensee. The case study reveals characteristics in early Mesolithic subsistence and land use that anticipate attributes of the Neolithic economy.
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Seen by: and 41 moreUse of GC/C-IRMS in Nutrition and Metabolic Research
Review for Current Opinion in Clinical Nutrition and Metabolic Care
Linking gas-chromatography via an on-line combustion interface to isotope ratio mass spectrometry has opened the door... more
Linking gas-chromatography via an on-line combustion interface to isotope ratio mass spectrometry has opened the door to high precision compound specific isotope analysis. For this reason, GC/C-IRMS is now increasingly employed in metabolic and nutritional research because it offers a reliable and risk-free alternative to radioactive tracers.
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Seen by: and 7 moreDifferential Valine Metabolism In Adipose Tissue of Low and High Fat‐oxidizing Obese Subjects
by Chris Evelo
Mandy Claessens, Wim H Saris, Freek G Bouwman, Chris T Evelo, Gabby B J Hul, Ellen E Blaak, Edwin C Mariman (2007). Proteomics Clin. Appl. 1: 1306-1315
Differences in fat metabolism are of importance in relation to energy balance. Low fat-oxidizers (LFO) are thought to... more Differences in fat metabolism are of importance in relation to energy balance. Low fat-oxidizers (LFO) are thought to be more prone for developing obesity. We studied whether LFO have different fasting adipose tissue (AT) protein profiles than high fat-oxidizers (HFO). Six LFO and six HFO subjects were selected from an obese group (n = 99, body mass index>30 kg/m2) taking part in a multi-center study (Nutrient-Gene interaction in human obesity) based on the postprandial fat oxidation capacity after a high fat load. AT protein profiles were studied by 2-DE. Differential proteins were clustered with MAPPfinder according to their function. Protein profiles of purified blood cells and adipocytes served to confine the comparison to adipocyte-specific proteins in AT profiles of LFO and HFO subjects. LFO had increased mitochondrial ROS scavengers possibly related to long-chain unsaturated fatty acid-induced increases in mitochondrial ROS-production. Carbohydrate oxidation seemed to be reduced since expression of several proteins from the glycolysis pathway was lower in LFO. Up-regulation of the valine catabolism at the level of methylmalonate-semialdehyde dehydrogenase appeared to be (part of) the compensatory mechanism. In conclusion, the fasting AT protein profile of LFO and HFO differ at the level of ROS scavenging, the glycolysis pathway and valine metabolism.
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Seen by:Gene Expression In Human Small Intestinal Mucosa In Vivo is Mediated by Iron-Induced Oxidative Stress
by Chris Evelo
Freddy J Troost, Robert-Jan M Brummer, Guido R M M Haenen, Aalt Bast, Rachel I van Haaften, Chris T Evelo, Wim H M Saris (2006). Physiol Genomics 25: 2. 242-249 Apr
Iron-induced oxidative stress in the small intestine may alter gene expression in the intestinal mucosa. The present... more Iron-induced oxidative stress in the small intestine may alter gene expression in the intestinal mucosa. The present study aimed to determine which genes are mediated by an iron-induced oxidative challenge in the human small intestine. Eight healthy volunteers [22 yr(SD2)] were tested on two separate occasions in a randomized crossover design. After duodenal tissue sampling by gastroduodenoscopy, a perfusion catheter was inserted orogastrically to perfuse a 40-cm segment of the proximal small intestine with saline and, subsequently, with either 80 or 400 mg of iron as ferrous gluconate. After the intestinal perfusion, a second duodenal tissue sample was obtained. Thiobarbituric acid-reactive substances, an indicator of lipid peroxidation, in intestinal fluid samples increased significantly and dose dependently at 30 min after the start of perfusion with 80 or 400 mg of iron, respectively (P < 0.001). During the perfusion with 400 mg of iron, the increase in thiobarbituric acid-reactive substances was accompanied by a significant, momentary rise in trolox equivalent antioxidant capacity, an indicator of total antioxidant capacity (P < 0.05). The expression of 89 gene reporters was significantly altered by both iron interventions. Functional mapping showed that both iron dosages mediated six distinct processes. Three of those processes involved G-protein receptor coupled pathways. The other processes were associated with cell cycle, complement activation, and calcium channels. Iron administration in the small intestine induced dose-dependent lipid peroxidation and a momentary antioxidant response in the lumen, mediated the expression of at least 89 individual gene reporters, and affected at least six biological processes.
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Seen by:Reduction of Colonic Inflammation In HLA-B27 Transgenic Rats by Feeding Marie Ménard Apples, Rich In Polyphenols
by Chris Evelo
C Castagnini, C Luceri, S Toti, E Bigagli, G Caderni, A P Femia, L Giovannelli, M Lodovici, V Pitozzi, M Salvadori, L Messerini, R Martin, E G Zoetendal, S Gaj, L Eijssen, C T Evelo, C M Renard, A Baron, P Dolara (2009). Br J Nutr 1-9 Jul
Inflammatory bowel diseases (IBD) are immunomediated ailments affecting millions of individuals. Although diet is... more Inflammatory bowel diseases (IBD) are immunomediated ailments affecting millions of individuals. Although diet is regarded as an important factor influencing IBD, there are no accepted dietary recommendations presently available. We administered 7·6 % lyophilised apples obtained from two cultivars (Golden Delicious and Marie Ménard, low and high in polyphenols, respectively) to HLA-B27 transgenic rats which develop spontaneous IBD. After 3 months feeding, rats fed Marie Ménard apples had reduced myeloperoxidase activity (3·6 (sem 0·3) v. 2·2 (sem 0·2) U/g tissue; P < 0·05) and reduced cyclo-oxygenase-2 (P < 0·05) and inducible NO synthase gene expression (P < 0·01) in the colon mucosa and significantly less diarrhoea (P < 0·05), compared with control rats. Cell proliferation in the colon mucosa was reduced significantly by feeding Golden Delicious apples, with a borderline effect of Marie Ménard apples. Gene expression profiling of the colon mucosa, analysed using the Whole Rat Genome 4 × 44 K Agilent Arrays, revealed a down-regulation of the pathways of PG synthesis, mitogen-activated protein kinase (MAPK) signalling and TNFα–NF-κB in Marie Ménard-fed rats. In the stools of the animals of this group we also measured a significant reduction of bacteria of the Bacteriodes fragilis group. In conclusion, the administration of Marie Ménard apples, rich in polyphenols and used at present only in the manufacturing of cider, ameliorates colon inflammation in transgenic rats developing spontaneous intestinal inflammation, suggesting the possible use of these and other apple varieties to control inflammation in IBD patients.
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Challenges of Molecular Nutrition Research 6: the Nutritional Phenotype Database to Store, Share and Evaluate Nutritional Systems Biology Studies
by Chris Evelo
Ben van Ommen, Jildau Bouwman, Lars Dragsted, Christian A Drevon, Ruan Elliott, Philip de Groot, Jim Kaput, John C Mathers, Michael Müller, Fre Pepping, Jahn Saito, Augustin Scalbert, Marijana Radonjic, Philippe Rocca-Serra, Tony Travis, Suzan Wopereis, Chris T Evelo (2010) Genes Nutr 5: 189–203
The challenge of modern nutrition and health research is to identify food-based strategies promoting lifelong optimal... more The challenge of modern nutrition and health research is to identify food-based strategies promoting lifelong optimal health and well-being. This research is complex because it exploits a multitude of bioactive compounds acting on an extensive network of interacting processes. Whereas nutrition research can profit enormously from the revolution in ‘omics’ technologies, it has discipline-specific requirements for analytical and bioinformatic procedures. In addition to measurements of the parameters of interest (measures of health), extensive description of the subjects of study and foods or diets consumed is central for describing the nutritional phenotype. We propose and pursue an infrastructural activity of constructing the ‘‘Nutritional Phenotype database’’ (dbNP). When fully developed, dbNP will be a research and collaboration tool and a publicly available data and knowledge repository. Creation and implementation of the dbNP will maximize benefits to the research community by enabling integration and interrogation of data from multiple studies, from different research groups, different countries and different—omics levels. The dbNP is designed to facilitate storage of biologically relevant, preprocessed—omics data, as well as study descriptive and study participant phenotype data. It is also important to enable the combination of this information at different levels (e.g. to facilitate linkage of data describing participant phenotype, genotype and food intake with information on study design and—omics measurements, and to combine all of this with existing knowledge). The biological information stored in the database (i.e. genetics, transcriptomics, proteomics, biomarkers, metabolomics, functional assays, food intake and food composition) is tailored to nutrition research and embedded in an environment of standard procedures and protocols, annotations, modular data-basing, networking and integrated bioinformatics. The dbNP is an evolving enterprise, which is only sustainable if it is accepted and adopted by the wider nutrition and health research community as an open source, pre-competitive and publicly available resource where many partners both can contribute and profit from its developments. We introduce the Nutrigenomics Organisation (NuGO, http://www.nugo.org) as a membership association responsible for establishing and curating the dbNP. Within NuGO, all efforts related to dbNP (i.e. usage, coordination, integration, facilitation and maintenance) will be directed towards a sustainable and federated infrastructure.
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Seen by:The Effects of Snacking on Energy Intake and Body Weight
by Sue Green
Green SM and Burley VJ (1995) The effects of snacking on energy intake and body weight. British Nutrition Foundation Nutrition Bulletin 78(21), 103-108.
Carbohydrates and Human Appetite
by Sue Green
Blundell JE, Green SM & Burley VJ (1994) Carbohydrates & human appetite. American Journal of Clinical Nutrition 59(Suppl), 728S-734S.


