Over recent years, there has been a massive initiative to promote chocolate milk as “the best” drink for post-training recovery. Milk advertisers use very high level athletes as spokespersons to sell a product to people who are indeed active, but often very far from the training level of an Olympic athlete.

Nautilus Plus is participating to this initiative: “Whether you are a professional athlete or a weekend sports enthusiast, recover from your next training faster with the Ultimate Chocolate Milk®.”(1) Do we really need to fill ourselves with all this added sugar after our training?

One litre of chocolate milk contains up to 100 to 110 g of sugar!!! The quantity of sugar that the body can absorb is limited. In fact, the sugar will be stored in the liver and muscles in the form of glycogen, which only represents 5 % of the body’s total energy reserves (2). If your objective is, as for the majority of people, to lose fat, you need to remember this: to allow yourself to consume a supplement rich in carbohydrates after your training, you will have to have emptied or seriously depleted your glycogen stores in order for the extra sugar absorbed to be used to renew your glycogen stores. And if you absorb more sugar than you need to renew your reserves, it will be transformed into fat (3).

Scientific studies

Many scientific studies have been done on sports nutrition supplements and some included chocolate milk. The purpose of these studies was to determine which mixture of molecules, and in what proportion, best promotes post-training recovery as well as athletic performance. Almost all these studies followed this particular protocol:

1.  Study participants were subjected to intense exercise at 70 to 85% of their VO2 max during 1 to 3 hours. The purpose of this step was to considerably reduce the muscle and hepatic glycogen stores since 70 to 80% of the energy spent at 85% VO2 max is derived from glycogen. Under 65% of VO2 max, mostly fatty acids are used (4, 5).
2. A recovery period between 4 and 8 hours followed to allow the participants to replenish their glycogen stores with the various sports nutrition supplements covered in the study.
3. Participants were then subjected to a second high intensity exercise (VO2 max between 70 and 85%) until exhaustion (loss of 85 to 95% of their hepatic glycogen and 65 to 85 % of their muscle glycogen) (6). The difference in time or distance between the performances will determine which sports nutrition supplements helped the athlete the most to recuperate between the two sessions.
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The role of these sports nutrition supplements is therefore to replenish as quickly and efficiently as possible the glycogen stores which were SIGNIFICANTLY depleted during the first training, in order to allow a second intense performance within 4 to 8 hours.

This situation is certainly frequent among Olympic athletes or athletes from the Tour de France who train several times per day or several days in a row at extreme intensities, but what about other people? Is chocolate milk a good supplement for “weekend athletes” or people who train leisurely, three of four times per week?

After your leisure strength training?

For a person who does resistance strength training, the glycogen stores will fall by 25 to 40 % after an intense strength training (7 to 12), which is relatively little. The glycogen stores lost during the training will be rebuilt through normal nutrition, WITHOUT ANY SUPPLEMENTS, within 24 hours of the training. However, some people consider it very important to MAXIMIZE the production of lean muscle mass. So the rapid intake of PROTEIN supplements after the training (within 1 hour if possible, up to 3 hours later) is important since it promotes maximum muscle synthesis(13 to 33). Recently, a research team questioned this principle claiming that it would be the total quantity of proteins ingested each day that would prevail over the moment at which they are ingested (34, 35). The same team also mentioned that if a “window” for taking a protein supplement and maximizing the production of lean muscle mass does exist, it would rather span over a 4 to 6 hour period following the strength training.

According to various recent studies, 20 to 25g of proteins would be the recommended amount to take after a resistance training (25, 33, 36). Witard et al., 2014 consider that 20 g of whey protein containing approximately 2 g of leucine optimally stimulates muscle synthesis (33). A litre of chocolate milk contains approximately 30g of proteins, including 80% of micellar casein and 20% of whey (37). Studies on post-training muscle synthesis clearly show the very poor efficiency of micellar casein for this purpose (26, 28, 38, 39, 40) because it precipitates in the stomach and the absorption of amino acids responsible for muscle synthesis is therefore very slow (26, 41, 42, 43). One argument that is often used by chocolate milk advocates is that milk (skim) is more efficient than soy protein or casein to promote muscle synthesis (23, 24). That’s true! It is actually the 20% of whey proteins contained in the milk that makes it efficient for muscle regeneration (26, 28, 40). What they don’t say is that purified whey protein (concentrate or isolate) is the best all around for lean muscle mass gain (26, 28, 40, 44, 45, 37) and, consequently, is better than milk. Whey protein is very rich in BCAA and is quickly absorbed by the intestine, as opposed to casein which is absorbed slowly. Therefore, why take a milk supplement if a whey protein shake is more efficient? Not only does chocolate milk contain large quantities of casein, but it can also contain saturated fat (if it’s full fat) as well as a large quantity of added simple sugars, on top of the lactose. So, is it useful to add all this sugar to the proteins (which are already not optimal) to maximize muscle synthesis after my resistance training?

Some studies show that carbohydrates (CHO) could inhibit muscle breakdown caused by training (10, 46, 47, 48, 49). A few groups claim that a carbohydrate/protein (CHO:PRO) supplement would facilitate a better muscle synthesis since it would inhibit muscle breakdown (15, 32, 46, 48, 50, 51). Nevertheless, some of these studies did not include a control group for the proteins (PRO) only. So it is difficult to evaluate whether adding CHO to PRO provides an advantage or not over PRO taken separately. As for the few studies that included a control group for the PRO, the quantity used was sub-optimal and was given in the form of amino acids (46, 48, 50). However, when a control group taking PRO optimally is included in the study, adding CHO to PRO did not show any advantage in terms of lean muscle mass gain (49, 52 to 57). CHO: PRO ratios used in the studies on resistance training varied between 1:1 and 3:1 whereas chocolate milk offers a ratio between 3:1 and 4:1. That is a lot of unnecessary sugar!

In turn, adding CHO to protein supplements can be necessary when several INTENSIVE resistance trainings are planned during the same day. In such a case, the athlete must quickly renew its glycogen stores (58, 59). To this end, 1g/kg of weight of CHO should be added to the proteins and consumed immediately after the training; moreover, a meal should follow 2 hours after the training (59, 60). So you must weigh at least 220 lbs and must train intensely more than once a day to allow yourself a litre of chocolate milk. Even then, you won’t achieve optimal results because of the casein, which constitutes 80% of the total proteins, and because of the 2:1:0.46 (glucose:fructose:galactose) ratio of the various sugars present in the chocolate milk (61).

The fructose contained in chocolate milk comes from high fructose corn syrup (which has a very bad reputation) and from sucrose (1 glucose +1 fructose). In 2004, Bray GA et al. suggested that the obesity epidemic in the United-States was related to the HFCS found everywhere and in large quantities in our nutrition (62). However, the new report published by The International Journal of Obesity, 2015 (63) suggests that this epidemic cannot be linked to HFCS due to the lack of evidence demonstrating that HFCS would be worse than table sugar (sucrose) (63, 64, 65). Yet, chocolate milk contains both of these additives. The fructose contained in almost equal quantities in both these additives could be linked to obesity (66, 67). Some scientists are reluctant to establish such a link (63, 64). A small quantity of fructose consumed every day, such as normal consumption of fruits, is harmless. Unfortunately, fructose is now added in almost all processed food. So it’s easy to exceed the healthy daily quantities of “natural” fructose. The body metabolises fructose differently from glucose. The liver metabolises 70% of the blood fructose (compared to 15 to 30% for the glucose) (38) and will leave the remaining 30% to the other tissues, namely the kidneys, the testicles, the fatty tissues, the brain and the skeletal muscle (69). So the muscles will absorb a negligible amount of fructose (68). A large consumption of fructose can contribute to the development of the metabolic syndrome, consisting in weight gain, increased resistance to insulin, hypertension, and elevated triglyceride in the blood stream (67, 69). High quantities of fructose are also associated to increased cholesterol, LDL particles and visceral obesity (69).

After an intense cardiovascular training, such as a marathon, when the glycogen stores in the liver are low, the fructose present in a sports nutrition supplement will be used to replenish the hepatic stores. Furthermore, for marathon runners performing at high intensities for a long period of time, the intake of fructose in the form of supplements DURING performance at a ratio of 2:1 (glucose/maltodextrin:fructose), offers a definite advantage because it allows faster absorption of sugars through the intestines since different transporters are used for these two sugars. The supplement would also improve gastro-intestinal comfort and would increase these athletes’ performance (70 to 76). If, however, the quantity of fructose consumed is higher than what is needed to replenish the hepatic stores, the surplus could potentially be converted into fat (66). So for people who do resistance training, consuming fructose is of no value. Conclusion? If you need CHO to perform well during your second strength training, you should add glucose/maltodextrin to your whey proteins, in order to avoid consuming fructose unnecessarily.

Finally, at the beginning of 2015, Stuart M. Phillips’ team established that drinking 500ml of chocolate milk every day (18g of proteins) as a supplement, while following a resistance program three times per week over a period of twelve weeks, has no effect on muscle hypertrophy or on strength gain compared to a control group taking no supplements (77).

What about after leisure endurance training?

Many active people do endurance training several times per week such as jogging, spinning, swimming, etc. for one hour. The extent of the muscle and hepatic glycogen loss will vary according to the effort expended. To consume glycogen as a primary source of energy, the level of effort intensity must reach 70% and must be maintained for an extended period of time (4, 5, 78). Laboratory experiments have shown that glycogen stores decline by 50 to 75% after 3 hours of cycling at 70% of VO2max (79, 80). By increasing the effort to 80% of VO2max, you can continue your activity for 2 hours before running out of glycogen. Another example is that the glycogen stores depletion of marathon runners occurs, for 40% of them, around the 34th kilometre, commonly called “the wall”, when they sustain an effort of approximately 80% of VO2max(81, 82, 83) during more than 2h30. Do you think you will be burning as much glycogen during your hour of spinning?

The glycogen stores lost during the training, even if this loss is significant, will be rebuilt through normal nutrition, WITHOUT ANY SUPPLEMENTS, within 24 hours of the training  (84,85). Moreover, the meal frequency will have no incidence if the post-exercise recovery happens over more than 24 hours (85, 86, 87). It is unnecessary for someone coming out of an hour of spinning or jogging to ingest all the added sugars contained in chocolate milk since the subsequent meals will contain sufficient carbohydrates (CHO) to replenish the poorly depleted glycogen stores. Therefore, the person will be ready for the next training a few days later.

Without being Olympic athletes, some people will train intensely and frequently during a week. In such case, the quantity of CHO these people consume every day must be adjusted, spread throughout their meals according to the frequency and intensity of their training. Burke et al. 2011 recommend to take a quantity of CHO every day, depending on the type of training performed (intensity and duration) to allow for a good glycogen resynthesis during the 24 hours following the training (88).

If the objectives of the person doing endurance training don’t include maximum muscular development, the muscle regeneration following an effort, namely the replenishment of glycogen stores, will occur normally with the proteins contained in the subsequent meal, when taken in sufficient quantity.

Supplements are necessary when training sessions are very intense and close together (a few hours) and require to quickly replenish the glycogen stores (in less than 24 hours).

What about high level athletes? (1.3% of the American population are athletes and of which 0.006% are professional athletes) (89).

Although chocolate milk is not intended for Olympic athletes, choosing such athletes as spokesperson to promote chocolate milk as a post-training supplement is almost an obligation; indeed, practically only these athletes could ultimately use chocolate milk as a sports nutrition supplement. Moreover, most studies carried out on the subject are done in a top level training context. But is chocolate milk, as alleged by the television commercials, a good choice for this 1% of the population ?

The purpose of a supplement is to promote fast recovery between two trainings done very close together, mainly by QUICKLY regenerating the glycogen stores. So the muscle glycogen resynthesis speed is important. It was established that this synthesis is faster when CHO are taken right after the training (90, 91, 92) and can be maintained during 6 hours with frequent intake of this supplement (69, 90, 93). Delaying the intake of CHO by 2 hours decreases the resynthesis speed by 50% (16,90). This is particularly important for a fast recovery but is unnecessary for recovery over 24 hours or more (87). OPTIMALLY, the quantity of CHO should be 1.0 to 1.2g/kg of weight/h (94, 95, 96), consumed at 15 to 30 min intervals (97). At this volume and frequency, CHO alone are sufficient to ensure an optimal glycogen synthesis. Sure! But chocolate milk doesn’t only contain CHO!

Is it useful to add proteins to CHO? (98)

To determine which supplement is the best one, we need to compare the different supplements. It is difficult to compare the studies that analyze the effect of adding proteins to a CHO supplement because several variables differ: 1) intensity (% of VO2max) and duration of the first exercise that aims at reducing the glycogen stores 2) choice of exercise (jogging or cycling) 3) various types of supplements consumed (isocaloric or not, as well as the chosen sugars and proteins) 4) control groups used (lack of placebo or other control groups) 5) carbohydrates:protein ratios (CHO:PRO) will vary between 2:1 (Berardi et al. 2006/2008) (99, 100) and 6.2:1 (Betts et al. 2005) (101) 6) duration and intensity of the second performance (% of VO2max).

Nonetheless, it’s possible to draw certain conclusions.

1: Importantly, the drinks studied must be isocaloric (must contain the same amount of calories) :

Some studies show a performance improvement post-recovery when proteins (PRO) are added to CHO versus a control group taking only CHO (102 to 105). However, the quantity of calories between the two drinks was not adjusted, so it wasn’t possible to determine if the performance improvement could be attributed to the addition of proteins or to the aaddition of energy.

2: It is important to compare the CHO+PRO supplement to a control group taking CHO optimally (1.0 to 1.2g/kg of weight/h) AND which is isocaloric:

Some studies show that the addition of proteins to the CHO supplement improves the second performance when compared to a control group taking a CHO only supplement. But this supplement was given sub-optimally during recovery (96, 102, 104, 106, 107). When the control group took the CHO supplement OPTIMALLY, the studies did not show any improvement in the second performance when proteins were added to the mix, even with variable ratios. (95, 96, 101 to 115, 116). A study showed, however, an advantage (100) (see the “Ratio” section).

So the athlete can chose between taking a mix of CHO + PRO, when it is impossible to optimally take a CHO supplement during recovery (1.2g/kg/h every 30 min during 3 to 4 hours) (94, 95, 96, 117). This indeed makes for a lot of CHO to ingest. But at which ratio must the athlete take its proteins?

3: Ratio

Advocates of chocolate milk allege that a ratio of 4:1 is best to support athletic recovery. This belief comes from one of the early studies done on the subject and which showed that a sports nutrition supplement, Endurox R4, containing 4:1 CHO: PRO offered a performance advantage when compared to a control group taking CHO, namely Gatorade (102). However, Endurox R4 contained two and a half times more CHO than Gatorade, in addition to the whey proteins, which gave it almost four times more calories than the Gatorade supplement consumed SUB-OPTIMALLY by the participants. It is obvious that in these conditions, Endurox R4 improved performance compared to Gatorade given the significant difference in CHO and energy consumed between the two drinks. Since the ratio used in this study was 4:1, which is the same as the chocolate milk ratio, the dairy industry took the opportunity to pretend it was the best ratio. Nonetheless, research continued and more recent studies show that ratios containing less sugar are as efficient, if not more, than a 4:1 ratio. Berardi et al. 2008 show an advantage on the second performance with the CHO: PRO mix at a ratio of 2:1 (CHO: 0.8kg/kg/hand PRO: 0.4kg/kg/h), over the control group taking the CHO supplement optimally (100, 117). So why add more sugar than necessary with a ratio of 4:1 if it offers no advantage?

 

Studies done on chocolate milk (McLellan TM et al. 2014 (98)) :

There are 5 major studies comparing chocolate milk to a few other sports drinks during a short term recovery between two performances. (118, 119, 120, 121, 122)

• None of these 5 studies explained how the chocolate milk taste was reproduced for the control groups. If the athletes know which type of supplement they are given, it can certainly influence the results; in such a case, the study is no longer “blind”.
• Some studies did not include a placebo or a sub-optimal CHO supplement for the control group (118, 122).
• 4 studies on 5 did not administer the supplement optimally (118, 119, 120, 121). The fifth study did so for the first recovery hour only (122).
• Pritchett et al. 2009 show that chocolate milk (3.8:1) offers no advantage for the second performance over Endurox R4 (3.8:1, isocaloric and same quantity of CHO) (118).
• The other four studies indicated that chocolate milk presented an advantage for the second performance compared to the other drinks studied (119, 120, 121, 122). On the other hand, the studies also present other shortfalls:

For Karp et al. 2006 and Thomas et al. 2009, the glycogen stores reduction protocol was not standardized during the first training(119, 120). That means that the energy expenditure varies a lot from one person to another, even for each individual, from one training session to another. So some groups used more glycogen than others before starting the recovery phase. For Karp et al. 2006 for example, (similar to Thomas et al. 2009), the chocolate milk group (60.8 min) had trained 16% less than the CHO + PRO control group taking Endurox R4 (72.6 min), but equally to the Gatorade group (sub-optimal). These differences can explain the superior performance of the chocolate milk group during the second training. Furthermore, we must report that the study by Karp et al. 2006 was partly financed by the Dairy and Nutrition Council Inc (119).

In the study by Lunn et al. 2012, chocolate milk is compared to a control group taking CHO optimally during the first hour of recovery (122). Despite the fact that the regeneration of the glycogen stores was equal between the two groups, the performance of the chocolate milk group was superior to that of the CHO control group during the second performance (difference of a few seconds). However, the intensity of the second performance was at 100% VO2max and lasted a very short time (203 vs 250 sec). In these very high intensity and very short duration conditions, the more or less important level of muscle glycogen stores before the effort don’t seem to influence performance (123, 124, 125, 126), as opposed to a lower intensity and longer duration performance. So optimally replenishing the glycogen stores is probably not that important in this case. Even the authors admit that the type of test used and the inability to mask the taste of the chocolate milk may have influenced the results. The authors challenge this by emphasizing that the purpose of their study was to show that chocolate milk promotes a better muscle synthesis compared to CHO alone (122). Milk contains proteins whereas the CHO of the control group contained none. So it is not surprising that the results show that chocolate milk increases muscle synthesis. A control group also taking proteins would have certainly given results similar to the chocolate milk, and possibly even better results if whey protein would have been used.

 The study by Furguson-Stegall et al. 2011 compared a chocolate milk ratio smaller than 3:1 to an isocaloric CHO drink and to a placebo (water) (121). The drinks were given sub-optimally. The performance of the chocolate milk group was superior by a few minutes during the second training (40km of cycling) compared to the CHO control group. Nonetheless, the glycogen resynthesis was better with the CHO control group, a result that is slightly contradictory. This study was financed by a Chair established by The National Dairy Council, as well as The National Fluid Milk Processor Promotion Board.

Therefore, the contradictory results, the lack of control groups, the questionable protocols and the inability to obtain blinded studies, do not allow to claim without any doubt that chocolate milk is the best supplement compared to the other supplements studied. The number of serious studies on chocolate milk will have to be considerably larger. Furthermore, these studies will have to be done more independently (not financed by the dairy industry, for example) to achieve more conclusive results.

It should be noted that chocolate milk has not been compared to a supplement offering a ratio of 2:1 previously shown to offer better performances than a CHO supplement taken optimally by Berardi et al. 2008 (100). For comparison purposes, a 200lbs (90kg) man who ingests a supplement offering a ratio of 2:1 will consume 72g of CHO/h instead of 85g/h for a chocolate milk supplement taken optimally. So this represents approximately 40g less of added sugar consumed, during a 3 hour recovery, to achieve the same result, if not better.

The composition of the supplement used by Berardi et al. 2008 is also very different from that of chocolate milk; it contained 33% of maltodextrin, 33% of glucose and 33% of whey (100). So in addition to the ratio, the choice of nutrients is important.

4: CHO

Maltodextrin (MD) seems to be the ideal sugar for muscle glycogen resynthesis after an intense effort. Piehl-Aulin et al. 2000 have shown that a supplement containing very high molecular weight polyglucosides such as maltodextrin would be 25% more efficient for muscle glycogen synthesis than a low molecular weight glucose, maltose or oligomer supplement (127). This would be due to the faster absorption rate of sugars by the intestines, as well as an increased rate of gastric emptying. As seen previously, while the addition of fructose to MD (ratio 2:1, MD: FRU) represents a major advantage DURING a long performance (more than 2h30) such as a marathon(128), it seems that for the rapid muscle glycogen resynthesis between two performances, the addition of fructose or galactose to MD offers no advantage (129). Regarding sucrose (glucose: fructose), no advantage was observed concerning glycogen resynthesis when compared to glucose alone (69, 129, 130, 131, 132), nor during the second performance (129 to 131). Again, we notice that the fructose and galactose portion found in chocolate milk is not useful for the post-training recovery.

5: Proteins

As for strength training, the type of proteins added to the CHO as a post-training supplement is important. However, few studies compare the different types of proteins and their effects on the glycogen resynthesis speed during a short term recovery. Morifuji et al. 2010 have shown, in rats, that adding whey hydrolysate to CHO is more efficient for glycogen synthesis than the CHO control group, followed by non-hydrolysed whey and BCAA. Casein ranked dead last, having no significant effect on glycogen synthesis compared to the intake of glucose alone (133). A large proportion of studies on athletic recovery used hydrolysed or non-hydrolysed whey protein isolate as a source of proteins in their mixes. The advantage over the chocolate milk proteins (mainly consisting of casein) is that in addition to being absorbed faster, the whey protein allows a higher protein concentration mix while restricting the volume to be consumed. It is a non-negligible advantage for the athletes as well as for achieving ratios of 2:1, for example.

Lactose

Milk contains 25g of lactose per 500ml. The capacity to break down lactose into glucose and galactose molecules depends on the presence of the lactase enzyme in the small intestine. “Normally” in humans, the presence or activity of lactase is very strong at the beginning of childhood and starts declining after the child is weaned until it almost disappears in adulthood. The person is then unable to digest lactose for the rest of his or her life (134, 135, 136). Between 65 and 70% of the world population is unable to digest lactose once they reach adulthood (137, 138). So only 30 to 35% of the population can actually digest lactose. Why? During the human evolution, four different mutations occurred, namely a major one that occurred in Europe, which kept the lactase gene active and thus allowing some Caucasians to digest lactose during all their life(137 to 139). These European Caucasians travelled, reached America and gave their descendants the possibility to also carry this mutation. Despite this, approximately 21% of North Americans who have problems digesting lactose are Caucasians (140). The ability to digest lactose is directly linked to the quantity of lactase produced by the intestine (134 to 136) and this quantity varies from one person to another. So some people have more difficulty than others to digest this sugar even though it may not be a true intolerance, rather an incomplete digestion that can sometimes be asymptomatic (140 to 143).

Making up 50% of the sugar contained in chocolate milk, we must seriously question the lactose digestion capacity to quickly regenerate the glycogen stores post-training, if we take into account the differences in the quantities of lactase present in the intestines of each individuals. It was shown that adding sugar (144, 145, 146, 147), fat (147) or chocolate (144, 145) in milk slows down the digestion process. This slowing down certainly promotes a better digestion of the lactose by the lactase present in various amounts, but does make digestion more efficient ? Since it can be very difficult for some people, around the world, to digest lactose, chocolate milk could only be used by a very small portion of athletes, which already represent a tiny portion of the population.

Who promotes chocolate milk?

Besides dairy producers in Quebec and Canada, many nutritionists promote chocolate milk as an ideal post-training supplement. The most relevant comment made to this effect by a nutritionist is the comment from Isabelle Charêt, coach and triple medallist in speed skating at the 1994, 1998 and 2002 winter Olympics (148). She says that chocolate milk would be a lot more useful to people who train intensively: “Someone who goes to the gym three times a week has plenty of time to recover. But I still recommend to drink chocolate milk because people in general don’t drink enough milk.” Ah! But that’s the issue! We have to drink milk!

I will not go into further detail on this subject, but very recently (2013), a team from Harvard University acknowledged publicly the need to decrease to less than two portions per day, or to stop all together, our milk consumption (149, 150). The powerful dairy industry lobby, which represents a third of Quebec’s agriculture and 5 billion dollars of Canadian GDP, imposed itself to maintain the dominant position dairy products hold in the Canadian food guide (151). Nonetheless, the following question remains: is it necessary to include chocolate milk in our diet? Many scientists seem to think that it’s not (149, 150, 151, 152).

Conscious of the extent of the damages caused by the overconsumption of added sugars to human health, how can we encourage the consumption of such sugars just to impose a supplement that is increasingly considered as unnecessary to our health?

Conclusion? If you enjoy a glass of chocolate milk once in a while, as a treat, it’s no big deal! But if milk commercials encourage you to drink one after each of your trainings, and you are not an Olympic athlete (and even then…), I hope you’ll think twice about it.

You know the saying: When it seems too good to be true…

 

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