Carbohydrate and Electrolyte Supplementation Strategies to Enhance Sports Performance: A Systematic Review and Meta-Analysis

Abstract

Fatigue and reduced energy availability significantly affect athletic performance, and nutritional strategies to maintain carbohydrate and electrolyte levels are critical for delaying fatigue and preserving endurance. This study aimed to evaluate the effects of carbohydrate and electrolyte (CHO-E) supplementation on sports performance in physically active individuals. A systematic review and meta-analysis of 26 studies, including randomised and observational designs, was conducted. Four separate analyses examined the impact of CHO-E supplementation on performance outcomes, metabolic biomarkers, blood mineral concentrations, and additional performance descriptors. The meta-analysis showed that CHO-E supplementation significantly increased time to exhaustion (Standard Mean Difference (SMD) 0.60; 95% confidence interval (CI): 0.17, 1.02; p = 0.006), blood glucose levels (SMD 0.82; 95% CI: 0.45, 1.19; p < 0.001), and blood sodium levels (SMD 0.22; 95% CI: 0.07, 0.36; p = 0.004) compared to placebo, while no significant effect was observed for time to finish (SMD −0.07; 95% CI: −0.28, 0.13; p = 0.49). These findings indicate that CHO-E supplementation during moderate-to-high intensity exercise can enhance performance by extending endurance and supporting metabolic and electrolyte balance. Overall, the results support the targeted use of CHO-E supplementation to maintain energy availability and physiological stability during prolonged physical activity, providing evidence-based guidance for athletes and practitioners.