***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Investigators have reported improved endurance performance and attenuated post- exercise muscle damage with carbohydrate-protein beverages ( CHO+P ) versus carbohydrate-only beverages ( CHO ) . However , these benefits have been demonstrated only when CHO+P was administered in beverage-form , and exclusively in male subjects . Thus , the purpose s of this study were to determine if an oral CHO+P gel  improved endurance performance and post-exercise muscle damage compared to a CHO gel , and determine if responses were similar between genders . Thirteen cyclists ( 8 men , 5 women ; & OV0312;O2peak = 57.9 ± 7.0 ml·kg-1·min-1 ) completed two timed cycle-trials to volitional exhaustion at 75 % of & OV0312;O2peak . At 15-minute intervals throughout these rides , subjects received CHO or CHO+P gels , which were matched for carbohydrate content ( CHO = 0.15 g CHO·kg BW-1 ; CHO+P = 0.15 g CHO + 0.038 g protein·kg BW-1 ) . Trials were performed using a r and omly counterbalanced , double-blind design . Subjects rode 13 % longer ( p > 0.05 ) when utilizing the CHO+P gel ( 116.6 ± 28.5 minutes ) versus the CHO gel ( 102.8 ± 25.0 minutes ) . In addition , men ( 101.8 ± 24.6 ; 114.8 ± 26.2 ) and women ( 104.4 ± 28.6 ; 119.6 ± 34.9 ) responded similarly to the CHO and CHO+P trials , with no significant treatment-by-gender effect . Postexercise creatine kinease ( CK ) was not significantly different between treatments . However , CK increased significantly following exercise in the CHO trial ( 183 ± 116 ; 267 ± 214 U·L-1 ) , but not the CHO+P trial ( 180 ± 133 ; 222 ± 141 U·L-1 ) . Therefore , to prolong endurance performance and prevent increases in muscle damage , it is recommended that male and female cyclists  consume CHO+P gels rather than CHO gels during and immediately following exercise Background The efficacy of chocolate milk ( CM ) as a recovery beverage following a period of increased training duration ( ITD ) was studied in intercollegiate soccer players . Methods 13 subjects completed one week of normal ' baseline ' training followed by four days of ITD . After each day of ITD , subjects received either a high-carbohydrate ( 504 kcal ; CHO : 122 g ; 2 g Fat ) or isocaloric CM ( 504 kcal ; 84 g CHO ; 28 g Pro ; 7 g Fat ) recovery beverage .  Serum creatine kinase ( CK ) , myoglobin ( Mb ) , muscle soreness , fatigue ratings and isometric quadriceps force ( MVC ) were obtained prior to ITD , and following 2- and 4-days of ITD . Performance tests ( T-drill , vertical jump ) were performed within training sessions . Treatments were administered in a r and omly counterbalanced protocol , and subjects repeated the procedures with the alternate beverage following a two-week washout period . Results Mean daily training time and HR increased ( p < 0.05 ) between baseline training and ITD , with no differences between treatments . No treatment*time effects were observed for Mb , muscle soreness , fatigue ratings and MVC . However , serum CK was significantly lower ( p < 0.05 ) following four days of ITD with CM ( 316.9 ± 188.3 U·L-1 ) compared to CHO ( 431.6 ± 310.8 U·L-1 ) . No treatment differences were observed for the performance tests . Conclusions Post-exercise CM provided similar muscle recovery responses to an isocaloric CHO beverage during four-days of ITD . Future studies should investigate if the attenuated CK levels observed with CM have functional significance during more dem and ing periods of training The aim of this study was to examine the effect of ingesting a commercially available carbohydrate-electrolyte ( CHO-E ) solution on strenuous exercise performance . Ten apparently healthy male volunteers ( Mean ± SD ; age 20 ± 2 yrs ; height 178 ± 7 cm ; body mass 77 ± 10 kg ; estimated VO2max 56 ± 3 ml−kg−1−min−1 ) completed three experimental trials in r and om order separated by a minimum of 7 days . For each trial , subjects consumed ( 8 ml.kg−1 body mass ) either a CHO-E solution ( 6 % carbohydrate , 50 mg Na/500 ml ) , a non-CHO-E placebo , or no fluid , 15 minutes prior to exercise . The exercise involved intermittent shuttle ( 20 m apart ) running for 1 hr followed by an incremental shuttle running test to exhaustion . Subjects displayed longer exercise times when the CHO-E solution was ingested compared with placebo or no fluid groups  ( exercise time to  exhaustion – CHO-E 649 ± 95 s , vs. placebo 601 ± 83 s , vs. no fluid 593 ± 107 s , P < 0.05 ) . There was a main effect for time for specific gravity of urine ( P < 0.05 vs. postexercise , pooled data ) and body mass ( P < 0.05 vs. postexercise , pooled data ) . The main finding from this investigation indicates that drinking a CHO-E solution 15 minutes prior to exercise improves performance . This study has practical implication s for those sports where drinking during activity is restricted This study examined the effects of 3 recovery drinks on endurance performance following glycogen-depleting exercise . Nine trained male cyclists performed 3 experimental trials , in a r and omized counter-balanced order , consisting of a glycogen-depleting trial , a 4-h recovery period , and a cycle to exhaustion at 70 % power at maximal oxygen uptake . At 0 and 2 h into the recovery period , participants consumed chocolate milk ( CM ) , a carbohydrate replacement drink ( CR ) , or a fluid replacement drink ( FR ) . Participants cycled 51 % and 43 % longer after ingesting CM ( 32 + /- 11 min ) than after ingesting CR ( 21 + /- 8 min ) or FR ( 23 + /- 8 min ) . CM is an effective recovery aid after prolonged endurance exercise for subsequent exercise at low-moderate intensities Summary Brain serotonin ( 5-hydroxytryptamine , 5-HT ) has been suggested to be involved in central fatigue during prolonged exercise . Changes in the ratio of plasma free tryptophan ( free Trp ) to branched-chain amino acids ( BCAA ) are associated with altered brain 5-HT synthesis . The purpose s of this study were to describe systematic ally the effects of prolonged exercise on changes in plasma free Trp and BCAA and to examine the effects of carbohydrate ( CHO ) feedings on these same variables . Eight well-trained men [ $ $ \dot V{\text{O}}_{\text{2 } } $ $ max = 57.8 ( SE 4.1 ) ml kg−1 min−1 ] cycled for up to 255 min at a power output corresponding toVO2 at lactate threshold ( approximately 68%VO2max ) on three occasions separated by at least 1 week . Subjects drank 5 ml kg−1 body wt−1 of either a water placebo , or a liquid beverage containing a moderate ( 6 % CHO ) or high ( 12 % CHO ) concentration of carbohydrate beginning at min 14 of exercise and every 30 min thereafter . Exercise time to fatigue was shorter in subjects receiving placebo [ 190 ( SE 4 ) min ] as compared to 6 % CHO [ 235 ( SE 10 ) min ] and 12 % CHO [ 234 ( SE 9 ) min ] ( P<0.05 ) . Glucose and insulin decreased in the placebo group , and free Trp , free-Trp/BCAA , and free fatty acids increased approximately five- to sevenfold ( P < 0.05 ) . These changes were attenuated in a dose-related manner by the carbohydrate drinks . Plasma free Trp and plasma free fatty acids were highly correlated ( r=0.86,P<0.001 ) . Plasma BCAA did not change in the placebo group , but decreased slightly in those receiving 6 % CHO and 12 % CHO ( P<0.05 ) . No differences in heart rate , $ $ \dot V{\text{O}}_{\text{2 } } $ $ , plasma volume and respiratory exchange ratio were found . The results indicate that free Trp and free Trp/BCAA increase progressively during prolonged cycling to fatigue . This response was attenuated by CHO feedings . Changes in plasma free fatty acids probably play a prominent role in these responses The study examined the effect of carbohydrate ingestion on exercise performance capacity .  Nine male cyclists performed two separate trials at 70 % VO2max for 60 min followed by a maximal ride for 10 min . During trials subjects were fed either an 8 % glucose solution ( CHO ) or a placebo solution ( PL ) , which were administered at rest and during and immediately after submaximal exercise . Statistical analyses indicated that glucose levels at rest increased significantly 15 min after the ingestion of CHO compared to PL . At 30 and 60 min during submaximal exercise , plasma glucose levels decreased significantly in the CHO but not in the PL trial . Following the performance ride , glucose levels increased significantly only during the CHO test trial . Free fatty acids did not change significantly during testing trials . The maximal performance ride results showed that in the CHO trial , a significantly greater external work load was accomplished compared to the PL trial . It is concluded that CHO ingestion improves maximal exercise performance after prolonged exercise OBJECTIVE To determine the effects of the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern on cardiometabolic risks in type 2 diabetic patients . RESEARCH DESIGN AND METHODS A r and omized crossover clinical trial was undertaken in 31 type 2 diabetic patients . For 8 weeks , participants were r and omly assigned to a control diet or the DASH eating pattern . RESULTS After following the DASH eating pattern , body weight ( P = 0.007 ) and waist circumference ( P = 0.002 ) reduced significantly . Fasting blood glucose levels and A1C decreased after adoption of the DASH diet ( −29.4 ± 6.3 mg/dl ; P = 0.04 and −1.7 ± 0.1 % ; P = 0.04 , respectively ) . After the DASH diet , the mean change for HDL cholesterol levels was higher ( 4.3 ± 0.9 mg/dl ; P = 0.001 ) and LDL cholesterol was reduced ( −17.2 ± 3.5 mg/dl ; P = 0.02 ) . Additionally , DASH had beneficial effects on systolic ( −13.6 ± 3.5 vs. −3.1 ± 2.7 mmHg ; P = 0.02 ) and diastolic blood pressure ( −9.5 ± 2.6 vs. −0.7 ± 3.3 mmHg ; P = 0.04 ) . CONCLUSIONS Among diabetic patients , the DASH diet had beneficial effects on cardiometabolic risks Coingestion of protein with carbohydrate ( CHO ) during recovery from exercise can affect muscle glycogen synthesis , particularly if CHO intake is suboptimal . Another potential benefit of protein feeding is an increased synthesis rate of muscle proteins , as is well documented after resistance exercise . In contrast , the effect of nutrient manipulation on muscle protein kinetics after aerobic exercise remains largely unexplored . We tested the hypothesis that ingesting protein with CHO after a st and ardized 2-h bout of cycle exercise would increase mixed muscle fractional synthetic rate ( FSR ) and whole body net protein balance ( WBNB ) vs. trials matched for total CHO or total energy intake . We also examined whether postexercise glycogen synthesis could be enhanced by adding protein or additional CHO to a feeding protocol that provided 1.2 g CHO x kg(-1 ) x h(-1 ) , which is the rate generally recommended to maximize this process . Six active men ingested drinks during the first 3 h of recovery that provided either 1.2 g CHO.kg(-1).h(-1 ) ( L-CHO ) , 1.2 g CHO + 0.4 g protein x kg(-1 ) x h(-1 ) ( PRO-CHO ) , or 1.6 g CHO x kg(-1 ) x h(-1 ) ( H-CHO ) in r and om order . Based on a primed constant infusion of l-[ring-(2)H(5)]phenylalanine , analysis of biopsies ( vastus lateralis ) obtained at 0 and 4 h of recovery showed that muscle FSR was higher ( P < 0.05 ) in PRO-CHO ( 0.09 + /- 0.01%/h ) vs. both L-CHO ( 0.07 + /- 0.01%/h ) and H-CHO ( 0.06 + /- 0.01%/h ) . WBNB assessed using [1-(13)C]leucine was positive only during PRO 
    Output:
    
Conclusion CM provides either similar or superior results when compared to placebo or other recovery drinks .