The Effect of Sodium Alginate and Pectin Added to a Carbohydrate Beverage on Endurance Performance, Substrate Oxidation and Blood Glucose Concentration: A Systematic Review and Meta-analysis

Introduction: Scientific and public interest in the potential ergogenic effects of sodium alginate added to a carbohydrate (CHO) beverage has increased in the last similar to 5 years. Despite an extensive use of this technology by elite athletes and recent research into the potential effects, there has been no meta-analysis to objectively elucidate the effects of adding sodium alginate to a CHO beverage on parameters relevant to exercise performance and to highlight gaps in the literature. Methods: Three literature databases were systematically searched for studies investigating the effects of sodium alginate added to CHO beverage during prolonged, endurance exercise in healthy athletes. For the systematic review, the PROSPERO guidelines were followed, and risk assessment was made using the Cochrane collaboration's tool for assessing the risk of bias. Additionally, a random-effects meta-analysis model was used to determine the standardised mean difference between a CHO beverage containing sodium alginate and an isocaloric control for performance, whole-body CHO oxidation and blood glucose concentration. Results: Ten studies were reviewed systematically, of which seven were included within the meta-analysis. For each variable, there was homogeneity between studies for performance (n = 5 studies; I-2= 0%), CHO oxidation (n = 7 studies; I-2= 0%) and blood glucose concentration (n = 7 studies; I-2= 0%). When compared with an isocaloric control, the meta-analysis demonstrated that there is no difference in performance (Z= 0.54, p = 0.59), CHO oxidation (Z=0.34, p = 0.71) and blood glucose concentration (Z=0.44, p = 0.66) when ingesting a CHO beverage containing sodium alginate. The systematic review revealed that several of the included studies did not use sufficient exercise intensity to elicit significant gastrointestinal disturbances or demonstrate any ergogenic benefit of CHO ingestion. Risk of bias was generally low across the included studies. Conclusions: This systematic review and meta-analysis demonstrate that the current literature indicates no benefit of adding sodium alginate to a CHO beverage during exercise. Further research is required, however, before firm conclusions are drawn considering the range of exercise intensities, feeding rates and the apparent lack of benefit of CHO reported in the current literature investigating sodium alginate.