Influence of the bicarbonate pool and on the occurrence of 13CO2 in exhaled air

Pioglitazone does not enhance exogenous glucose oxidation or metabolic clearance rate during aerobic exercise in men under acute high-altitude exposure

Insulin insensitivity decreases exogenous glucose oxidation and metabolic clearance rate (MCR) during aerobic exercise in unacclimatized lowlanders at high altitude (HA). Whether use of an oral insulin sensitizer before acute HA exposure enhances exogenous glucose oxidation is unclear. This study investigated the impact of pioglitazone (PIO) on exogenous glucose oxidation and glucose turnover compared with placebo (PLA) during aerobic exercise at HA. With the use of a randomized crossover design, native lowlanders (n = 7 males, means ± SD, age: 23 ± 6 yr, body mass: 84 ± 11 kg) consumed 145 g (1.8 g/min) of glucose while performing 80 min of steady-state (1.43 ± 0.16 V̇o2 L/min) treadmill exercise at HA (460 mmHg; [Formula: see text] 96.6 mmHg) following short-term (5 days) use of PIO (15 mg oral dose per day) or PLA (microcrystalline cellulose pill). Substrate oxidation and glucose turnover were determined using indirect calorimetry and stable isotopes ([13C]glucose and 6,6-[2H2]glucose). Exogenous glucose oxidation was not different between PIO (0.31 ± 0.03 g/min) and PLA (0.32 ± 0.09 g/min). Total carbohydrate oxidation (PIO: 1.65 ± 0.22 g/min, PLA: 1.68 ± 0.32 g/min) or fat oxidation (PIO: 0.10 ± 0.0.08 g/min, PLA: 0.09 ± 0.07 g/min) was not different between treatments. There was no treatment effect on glucose rate of appearance (PIO: 2.46 ± 0.27, PLA: 2.43 ± 0.27 mg/kg/min), disappearance (PIO: 2.19 ± 0.17, PLA: 2.20 ± 0.22 mg/kg/min), or MCR (PIO: 1.63 ± 0.37, PLA: 1.73 ± 0.40 mL/kg/min). Results from this study indicate that PIO is not an effective intervention to enhance exogenous glucose oxidation or MCR during acute HA exposure. Lack of effect with PIO suggests that the etiology of glucose metabolism dysregulation during acute HA exposure may not result from insulin resistance in peripheral tissues.NEW & NOTEWORTHY Short-term (5 days) use of the oral insulin sensitizer pioglitazone does not alter circulating glucose or insulin responses to enhance exogenous glucose oxidation during steady-state aerobic exercise in young healthy men under simulated acute (8 h) high-altitude (460 mmHg) conditions. These results indicate that dysregulations in glucose metabolism in native lowlanders sojourning at high altitude may not be due to insulin resistance at peripheral tissue.

Ketone Monoester Plus Carbohydrate Supplementation Does Not Alter Exogenous and Plasma Glucose Oxidation or Metabolic Clearance Rate During Exercise in Men Compared with Carbohydrate Alone

BACKGROUND

Increasing β-hydroxybutyrate (βHB) availability through ketone monoester plus carbohydrate (KE+CHO) supplementation is suggested to enhance physical performance by sparing glucose use during exercise. However, no studies have examined the effect of ketone supplementation on glucose kinetics during exercise.

OBJECTIVES

This exploratory study primarily aimed to determine the effect of KE+CHO supplementation on glucose oxidation and physical performance during steady-state exercise compared with carbohydrate.

METHODS

Using a randomly assigned, crossover design (clinicaltrials.gov, NCT04737694), 12 men consumed KE+CHO (573 mg ketone monoester/kg body mass, 110 g glucose) or carbohydrate (110 g glucose) before and during 90 min of steady-state treadmill exercise [54 ± 3% peak oxygen uptake (V̇˙O_2peak)] wearing a weighted vest (30% body mass; 25 ± 3 kg). Glucose oxidation and turnover were determined using indirect calorimetry and stable isotopes. Participants performed an unweighted time to exhaustion (TTE; 85% V̇˙O_2peak) after steady-state exercise and a weighted (25 ± 3 kg) 6.4 km time trial (TT) the next day after consuming a bolus of KE+CHO or carbohydrate. Data were analyzed by paired t-tests and mixed model ANOVA.

RESULTS

βHB concentrations were higher (P < 0.05) after exercise [2.1 mM (95% CI: 1.6, .6)] and the TT [2.6 mM (2.1, 3.1)] in KE+CHO compared with carbohydrate. TTE was lower [-104 s (-201, -8)], and TT performance was slower [141 s (19,262)] in KE+CHO than in carbohydrate (P < 0.05). Exogenous [-0.01 g/min (-0.07, 0.04)] and plasma [-0.02 g/min (-0.08, 0.04)] glucose oxidation and metabolic clearance rate {MCR [0.38 mg·kg^-1·min^-1 (-0.79, 1.54)]} were not different, and glucose rate of appearance [-0.51 mg·kg^-1·min^-1 (-0.97, -0.04)], and disappearance [-0.50 mg·kg^-1·min^-1 (-0.96, -0.04)] were lower (P < 0.05) in KE+CHO compared with carbohydrate during steady-state exercise.

CONCLUSIONS

In the current study, the rates of exogenous and plasma glucose oxidation and MCR were not different between treatments during steady-state exercise, suggesting blood glucose utilization is similar between KE+CHO and carbohydrate. KE+CHO supplementation also results in lower physical performance compared with carbohydrate. This trial was registered at www.

CLINICALTRIALS

gov as NCT04737694.

Dose-Response Oxidation of Ingested Phytoglycogen during Exercise in Endurance-Trained Men

BACKGROUND

Phytoglycogen (PHY; PhytoSpherix; Mirexus Biotechnologies), a highly branched polysaccharide extracted from sweet corn, has considerable potential for exercise oxidation due to its low viscosity in water, high water retention, and exceptional stability.

OBJECTIVES

Using gas chromatography-isotope ratio mass spectrometry, we investigated dose-response oxidation of ingested PHY during prolonged, moderate-intensity exercise.

METHODS

Thirteen men (≥1 y endurance-training experience, ≥6 d·wk-1, ∼1-1.5 h·d-1; age, 25.7 ± 5.5 y; mass, 79.3 ± 10.0 kg;  V̇O2max, 59.9 ± 5.5 mL·kg-1·min-1; means ± SDs) cycled for 150 min (50% maximal watt output) while ingesting PHY concentrations of 0.0% (0.0 g·min-1), 3.6% (0.5 g·min-1), 7.2% (1.0 g·min-1), 10.8% (1.5 g·min-1), or 14.4% (2 g·min-1) in water (2100 mL) (n = 7-10/dose). Substrate oxidation was determined using stable-isotope methods and indirect calorimetry.

RESULTS

PHY oxidation plateaued between 60 and 150 min of exercise and increased (P < 0.001) from 0.49 to 0.72 g·min-1 with 0.5- and 1.0-g·min-1 doses without further increases (0.76 and 0.73 g·min-1; P > 0.05) with 1.5 or 2 g·min-1. Peak PHY oxidation (0.84 ± 0.04 g·min-1) occurred in the final 30 min of exercise with 2 g·min-1. Exercise blood glucose was greater (5.1 mmol·L-1) with 1.0-, 1.5-, and 2-g·min-1 doses compared with that of 0.5 (4.7 mmol·L-1) or 0.0 g·min-1 (4.2 mmol·L-1) (P < 0.0001). Gastrointestinal distress was minimal except with 2 g·min-1 (P < 0.001).

CONCLUSIONS

In male endurance athletes, PHY oxidation plateaued at 0.72-0.76 g·min-1 during 150 min of cycling at 50% Wmax (peak oxidation of 0.84 g·min-1 occurred during the final 30 min). This trial was registered at clinicaltrials.gov as NCT02909881.

Neither Beetroot Juice Supplementation nor Increased Carbohydrate Oxidation Enhance Economy of Prolonged Exercise in Elite Race Walkers

Given the importance of exercise economy to endurance performance, we implemented two strategies purported to reduce the oxygen cost of exercise within a 4 week training camp in 21 elite male race walkers. Fourteen athletes undertook a crossover investigation with beetroot juice (BRJ) or placebo (PLA) [2 d preload, 2 h pre-exercise + 35 min during exercise] during a 26 km race walking at speeds simulating competitive events. Separately, 19 athletes undertook a parallel group investigation of a multi-pronged strategy (MAX; n = 9) involving chronic (2 w high carbohydrate [CHO] diet + gut training) and acute (CHO loading + 90 g/h CHO during exercise) strategies to promote endogenous and exogenous CHO availability, compared with strategies reflecting lower ranges of current guidelines (CON; n = 10). There were no differences between BRJ and PLA trials for rates of CHO (p = 0.203) or fat (p = 0.818) oxidation or oxygen consumption (p = 0.090). Compared with CON, MAX was associated with higher rates of CHO oxidation during exercise, with increased exogenous CHO use (CON; peak = ~0.45 g/min; MAX: peak = ~1.45 g/min, p < 0.001). High rates of exogenous CHO use were achieved prior to gut training, without further improvement, suggesting that elite athletes already optimise intestinal CHO absorption via habitual practices. No differences in exercise economy were detected despite small differences in substrate use. Future studies should investigate the impact of these strategies on sub-elite athletes’ economy as well as the performance effects in elite groups.

Comparable Exogenous Carbohydrate Oxidation from Lactose or Sucrose during Exercise

PURPOSE

Ingesting readily oxidized carbohydrates (CHO) such as sucrose during exercise can improve endurance performance. Whether lactose can be utilized as a fuel source during exercise is unknown. The purpose of this study was to investigate the metabolic response to lactose ingestion during exercise, compared with sucrose or water.

METHODS

Eleven participants (age, 22 ± 4 yr; V[Combining Dot Above]O2peak, 50.9 ± 4.7 mL·min·kg) cycled at 50% Wmax for 150 min on five occasions. Participants ingested CHO beverages (lactose or sucrose; 48 g·h, 0.8 g·min) or water throughout exercise. Total substrate and exogenous CHO oxidation was estimated using indirect calorimetry and stable isotope techniques (naturally high C-abundance CHO ingestion). Naturally low C-abundance CHO trials were conducted to correct background shifts in breath CO2 production. Venous blood samples were taken to determine plasma glucose, lactate, and nonesterified fatty acid concentrations.

RESULTS

Mean exogenous CHO oxidation rates were comparable with lactose (0.56 ± 0.19 g·min) and sucrose (0.61 ± 0.10 g·min; P = 0.49) ingestion. Endogenous CHO oxidation contributed less to energy expenditure in lactose (38% ± 14%) versus water (50% ± 11%, P = 0.01) and sucrose (50% ± 7%, P ≤ 0.05). Fat oxidation was higher in lactose (42% ± 8%) than in sucrose (28% ± 6%; P ≤ 0.01); CHO conditions were lower than water (50% ± 11%; P ≤ 0.05). Plasma glucose was higher in lactose and sucrose than in water (P ≤ 0.01); plasma lactate was higher in sucrose than in water (P ≤ 0.01); plasma nonesterified fatty acids were higher in water than in sucrose (P ≤ 0.01).

CONCLUSIONS

Lactose and sucrose exhibited similar exogenous CHO oxidation rates during exercise at moderate ingestion rates. Compared with sucrose ingestion, lactose resulted in higher fat and lower endogenous CHO oxidation.

Sports Drink Intake Pattern Affects Exogenous Carbohydrate Oxidation during Running

PURPOSE

This study aimed to determine whether the pattern of carbohydrate sports drink ingestion during prolonged submaximal running affects exogenous carbohydrate oxidation rates and gastrointestinal (GI) comfort.

METHODS

Twelve well-trained male runners (27 ± 7 yr; 67.9 ± 6.7 kg; V˙O2peak, 68 ± 7 mL·kg·min) completed two exercise trials of 100 min steady-state running at 70%V˙O2peak. In each of the trials, 1 L of a 10% dextrose solution, enriched with [U-C] glucose, was consumed as either 200 mL every 20 min (CHO-20) or 50 mL every 5 min (CHO-5). Expired breath and venous blood samples were collected at rest and every 20 min during exercise. Subjective scales of GI comfort were recorded at regular intervals.

RESULTS

Average exogenous carbohydrate oxidation rates were 23% higher during exercise in CHO-20 (0.38 ± 0.11 vs 0.31 ± 0.11 g·min; P = 0.017). Peak exogenous carbohydrate oxidation was also higher in CHO-20 (0.68 ± 0.14 g·min vs 0.61 ± 0.14 g·min; P = 0.004). During exercise, total carbohydrate oxidation (CHO-20, 2.15 ± 0.47; CHO-5, 2.23 ± 0.45 g·min, P = 0.412) and endogenous carbohydrate oxidation (CHO-20, 1.78 ± 0.45; CHO-5, 1.92 ± 0.40 g·min; P = 0.148) were not different between trials. Average serum glucose (P = 0.952) and insulin (P = 0.373) concentrations were not different between trials. There were no differences in reported symptoms of GI comfort and stomach bloatedness (P > 0.05), with only 3% of reported scores classed as severe (≥5 out of 10).

CONCLUSION

Ingestion of a larger volume of carbohydrate solution at less frequent intervals during prolonged submaximal running increased exogenous carbohydrate oxidation rates. Neither drinking pattern resulted in increased markers of GI discomfort to a severe level.

Acute hypoxia reduces exogenous glucose oxidation, glucose turnover, and metabolic clearance rate during steady-state aerobic exercise

BACKGROUND

Exogenous carbohydrate oxidation is lower during steady-state aerobic exercise in native lowlanders sojourning at high altitude (HA) compared to sea level (SL). However, the underlying mechanism contributing to reduction in exogenous carbohydrate oxidation during steady-state aerobic exercise performed at HA has not been explored.

OBJECTIVE

To determine if alterations in glucose rate of appearance (R_a), disappearance (R_d) and metabolic clearance rate (MCR) at HA provide a mechanism for explaining the observation of lower exogenous carbohydrate oxidation compared to during metabolically-matched, steady-state exercise at SL.

METHODS

Using a randomized, crossover design, native lowlanders (n = 8 males, mean ± SD, age: 23 ± 2 yr, body mass: 87 ± 10 kg, and VO_2peak: SL 4.3 ± 0.2 L/min and HA 2.9 ± 0.2 L/min) consumed 145 g (1.8 g/min) of glucose while performing 80-min of metabolically-matched (SL: 1.66 ± 0.14 V̇O₂ L/min 329 ± 28 kcal, HA: 1.59 ± 0.10 V̇O₂ L/min, 320 ± 19 kcal) treadmill exercise in SL (757 mmHg) and HA (460 mmHg) conditions after a 5-h exposure. Substrate oxidation rates (g/min) and glucose turnover (mg/kg/min) during exercise were determined using indirect calorimetry and dual tracer technique (¹³C-glucose oral ingestion and [6,6-²H₂]-glucose primed, continuous infusion).

RESULTS

Total carbohydrate oxidation was higher (P < 0.05) at HA (2.15 ± 0.32) compared to SL (1.39 ± 0.14). Exogenous glucose oxidation rate was lower (P < 0.05) at HA (0.35 ± 0.07) than SL (0.44 ± 0.05). Muscle glycogen oxidation was higher at HA (1.67 ± 0.26) compared to SL (0.83 ± 0.13). Total glucose R_a was lower (P < 0.05) at HA (12.3 ± 1.5) compared to SL (13.8 ± 2.0). Exogenous glucose R_a was lower (P < 0.05) at HA (8.9 ± 1.3) compared to SL (10.9 ± 2.2). Glucose R_d was lower (P < 0.05) at HA (12.7 ± 1.7) compared to SL (14.3 ± 2.0). MCR was lower (P < 0.05) at HA (9.0 ± 1.8) compared to SL (12.1 ± 2.3). Circulating glucose and insulin concentrations were higher in response carbohydrate intake during exercise at HA compared to SL.

CONCLUSION

Novel results from this investigation suggest that reductions in exogenous carbohydrate oxidation at HA may be multifactorial; however, the apparent insensitivity of peripheral tissue to glucose uptake may be a primary determinate.

Exercising with low muscle glycogen content increases fat oxidation and decreases endogenous, but not exogenous carbohydrate oxidation

BACKGROUND

Initiating aerobic exercise with low muscle glycogen content promotes greater fat and less endogenous carbohydrate oxidation during exercise. However, the extent exogenous carbohydrate oxidation increases when exercise is initiated with low muscle glycogen is unclear.

PURPOSE

Determine the effects of muscle glycogen content at the onset of exercise on whole-body and muscle substrate metabolism.

METHODS

Using a randomized, crossover design, 12 men (mean ± SD, age: 21 ± 4 y; body mass: 83 ± 11 kg; VO_2peak: 44 ± 3 mL/kg/min) completed 2 cycle ergometry glycogen depletion trials separated by 7-d, followed by a 24-h refeeding to elicit low (LOW; 1.5 g/kg carbohydrate, 3.0 g/kg fat) or adequate (AD; 6.0 g/kg carbohydrate, 1.0 g/kg fat) glycogen stores. Participants then performed 80 min of steady-state cycle ergometry (64 ± 3% VO_2peak) while consuming a carbohydrate drink (95 g glucose +51 g fructose; 1.8 g/min). Substrate oxidation (g/min) was determined by indirect calorimetry and ¹³C. Muscle glycogen (mmol/kg dry weight), pyruvate dehydrogenase (PDH) activity, and gene expression were assessed in muscle.

RESULTS

Initiating steady-state exercise with LOW (217 ± 103) or AD (396 ± 70; P < 0.05) muscle glycogen did not alter exogenous carbohydrate oxidation (LOW: 0.84 ± 0.14, AD: 0.87 ± 0.16; P > 0.05) during exercise. Endogenous carbohydrate oxidation was lower and fat oxidation was higher in LOW (0.75 ± 0.29 and 0.55 ± 0.10) than AD (1.17 ± 0.29 and 0.38 ± 0.13; all P < 0.05). Before and after exercise PDH activity was lower (P < 0.05) and transcriptional regulation of fat metabolism (FAT, FABP, CPT1a, HADHA) was higher (P < 0.05) in LOW than AD.

CONCLUSION

Initiating exercise with low muscle glycogen does not impair exogenous carbohydrate oxidative capacity, rather, to compensate for lower endogenous carbohydrate oxidation acute adaptations lead to increased whole-body and skeletal muscle fat oxidation.

Concordance between 13 C:12 C ratio technique respect to indirect calorimetry to estimate carbohydrate and Fat oxidation rates by means stoichiometric equations during exercise. A reliability and agreement study

Indirect calorimetry is a tool used routinely by sport/exercise physiologist to assess the metabolic response to training and to nutritional interventions. There are different stoichiometric equations to estimate fat (FatOxR ) and carbohydrates (CHOOxR ) oxidation rates, however there are not enough information in literature about what are the most accurate equations. The purpose of this study was to determine the concordance between indirect calorimetry and a method of reference for stoichiometric equations used to estimate FatOxR and CHOOxR . Concordance between indirect calorimetry and the method of reference (13 C to 12 C ratio (13 C:12 C ratio) technique) for key stoichiometric equations was assessed in well-trained triathletes. Subjects carried out a carbohydrate depletion-repletion protocol, labeling the glycogen stores with 13 C, and a laboratory test to assess the 13 C metabolic response during a wide range of aerobic intensities during exercise. All the equations showed a narrow agreement interval (Δ) (CHOOxR nPC (protein component negligible): -0.308, 0.308, CHOOxR PC (protein component): -0.268, 0.268, FatOxR nPC and PC: -0.032, 0.032 (g·min-1 )). FatOxR showed a similar concordance (28-32%) with CHOOxR nPC ranging from 55% to 75%, and for CHOOxR PC between 51% to 71%. None of the stoichiometric equations met a perfect agreement with the method of reference. The Jeukendrup and Wallis equation showed the best concordance for CHOOxR nPC whilst the Frayn and Ferrannini (Glu) equations had the best agreement for CHOOxR PC. All FatOxR equations showed similar concordances and they are able to be used indistinctly.

Liver and muscle glycogen oxidation and performance with dose variation of glucose-fructose ingestion during prolonged (3 h) exercise

PURPOSE

This study investigated the effect of small manipulations in carbohydrate (CHO) dose on exogenous and endogenous (liver and muscle) fuel selection during exercise.

METHOD

Eleven trained males cycled in a double-blind randomised order on 4 occasions at 60% [Formula: see text] for 3 h, followed by a 30-min time-trial whilst ingesting either 80 g h^-1 or 90 g h^-1 or 100 g h^{-1 13}C-glucose-¹³C-fructose [2:1] or placebo. CHO doses met, were marginally lower, or above previously reported intestinal saturation for glucose-fructose (90 g h^-1). Indirect calorimetry and stable mass isotope [¹³C] techniques were utilised to determine fuel use.

RESULT

Time-trial performance was 86.5 to 93%, 'likely, probable' improved with 90 g h^-1 compared 80 and 100 g h^-1. Exogenous CHO oxidation in the final hour was 9.8-10.0% higher with 100 g h^-1 compared with 80 and 90 g h^-1 (ES = 0.64-0.70, 95% CI 9.6, 1.4 to 17.7 and 8.2, 2.1 to 18.6). However, increasing CHO dose (100 g h^-1) increased muscle glycogen use (101.6 ± 16.6 g, ES = 0.60, 16.1, 0.9 to 31.4) and its relative contribution to energy expenditure (5.6 ± 8.4%, ES = 0.72, 5.6, 1.5 to 9.8 g) compared with 90 g h^-1. Absolute and relative muscle glycogen oxidation between 80 and 90 g h^-1 were similar (ES = 0.23 and 0.38) though a small absolute (85.4 ± 29.3 g, 6.2, - 23.5 to 11.1) and relative (34.9 ± 9.1 g, - 3.5, - 9.6 to 2.6) reduction was seen in 90 g h^-1 compared with 100 g h^-1. Liver glycogen oxidation was not significantly different between conditions (ES < 0.42). Total fat oxidation during the 3-h ride was similar in CHO conditions (ES < 0.28) but suppressed compared with placebo (ES = 1.05-1.51).

CONCLUSION

'Overdosing' intestinal transport for glucose-fructose appears to increase muscle glycogen reliance and negatively impact subsequent TT performance.

Carbohydrate dose influences liver and muscle glycogen oxidation and performance during prolonged exercise

This study investigated the effect of carbohydrate (CHO) dose and composition on fuel selection during exercise, specifically exogenous and endogenous (liver and muscle) CHO oxidation. Ten trained males cycled in a double‐blind randomized order on 5 occasions at 77% V˙O2max for 2 h, followed by a 30‐min time‐trial (TT) while ingesting either 60 g·h⁻¹ (LG) or 75 g·h⁻¹¹³C‐glucose (HG), 90 g·h⁻¹ (LGF) or 112.5 g·h⁻¹¹³C‐glucose‐¹³C‐fructose ([2:1] HGF) or placebo. CHO doses met or exceed reported intestinal transporter saturation for glucose and fructose. Indirect calorimetry and stable mass isotope [¹³C] tracer techniques were utilized to determine fuel use. TT performance was 93% “likely/probable” to be improved with LGF compared with the other CHO doses. Exogenous CHO oxidation was higher for LGF and HGF compared with LG and HG (ES > 1.34, P < 0.01), with the relative contribution of LGF (24.5 ± 5.3%) moderately higher than HGF (20.6 ± 6.2%, ES = 0.68). Increasing CHO dose beyond intestinal saturation increased absolute (29.2 ± 28.6 g·h⁻¹, ES = 1.28, P = 0.06) and relative muscle glycogen utilization (9.2 ± 6.9%, ES = 1.68, P = 0.014) for glucose‐fructose ingestion. Absolute muscle glycogen oxidation between LG and HG was not significantly different, but was moderately higher for HG (ES = 0.60). Liver glycogen oxidation was not significantly different between conditions, but absolute and relative contributions were moderately attenuated for LGF (19.3 ± 9.4 g·h⁻¹, 6.8 ± 3.1%) compared with HGF (30.5 ± 17.7 g·h⁻¹, 10.1 ± 4.0%, ES = 0.79 & 0.98). Total fat oxidation was suppressed in HGF compared with all other CHO conditions (ES > 0.90, P = 0.024–0.17). In conclusion, there was no linear dose response for CHO ingestion, with 90 g·h⁻¹ of glucose‐fructose being optimal in terms of TT performance and fuel selection.

Altitude Acclimatization Alleviates the Hypoxia-Induced Suppression of Exogenous Glucose Oxidation During Steady-State Aerobic Exercise

This study investigated how high-altitude (HA, 4300 m) acclimatization affected exogenous glucose oxidation during aerobic exercise. Sea-level (SL) residents (n = 14 men) performed 80-min, metabolically matched exercise (V˙O₂ ∼ 1.7 L/min) at SL and at HA < 5 h after arrival (acute HA, AHA) and following 22-d of HA acclimatization (chronic HA, CHA). During HA acclimatization, participants sustained a controlled negative energy balance (-40%) to simulate the “real world” conditions that lowlanders typically experience during HA sojourns. During exercise, participants consumed carbohydrate (CHO, n = 8, 65.25 g fructose + 79.75 g glucose, 1.8 g carbohydrate/min) or placebo (PLA, n = 6). Total carbohydrate oxidation was determined by indirect calorimetry and exogenous glucose oxidation by tracer technique with ¹³C. Participants lost (P ≤ 0.05, mean ± SD) 7.9 ± 1.9 kg body mass during the HA acclimatization and energy deficit period. In CHO, total exogenous glucose oxidized during the final 40 min of exercise was lower (P < 0.01) at AHA (7.4 ± 3.7 g) than SL (15.3 ± 2.2 g) and CHA (12.4 ± 2.3 g), but there were no differences between SL and CHA. Blood glucose and insulin increased (P ≤ 0.05) during the first 20 min of exercise in CHO, but not PLA. In CHO, glucose declined to pre-exercise concentrations as exercise continued at SL, but remained elevated (P ≤ 0.05) throughout exercise at AHA and CHA. Insulin increased during exercise in CHO, but the increase was greater (P ≤ 0.05) at AHA than at SL and CHA, which did not differ. Thus, while acute hypoxia suppressed exogenous glucose oxidation during steady-state aerobic exercise, that hypoxic suppression is alleviated following altitude acclimatization and concomitant negative energy balance.

A comparison of substrate oxidation during prolonged exercise in men at terrestrial altitude and normobaric normoxia following the coingestion of 13C glucose and 13C fructose

This study compared the effects of coingesting glucose and fructose on exogenous and endogenous substrate oxidation during prolonged exercise at altitude and sea level, in men. Seven male British military personnel completed two bouts of cycling at the same relative workload (55% W_max) for 120 min on acute exposure to altitude (3375 m) and at sea level (~113 m). In each trial, participants ingested 1.2 g·min⁻¹ of glucose (enriched with ¹³C glucose) and 0.6 g·min⁻¹ of fructose (enriched with ¹³C fructose) directly before and every 15 min during exercise. Indirect calorimetry and isotope ratio mass spectrometry were used to calculate fat oxidation, total and exogenous carbohydrate oxidation, plasma glucose oxidation, and endogenous glucose oxidation derived from liver and muscle glycogen. Total carbohydrate oxidation during the exercise period was lower at altitude (157.7 ± 56.3 g) than sea level (286.5 ± 56.2 g, P = 0.006, ES = 2.28), whereas fat oxidation was higher at altitude (75.5 ± 26.8 g) than sea level (42.5 ± 21.3 g, P = 0.024, ES = 1.23). Peak exogenous carbohydrate oxidation was lower at altitude (1.13 ± 0.2 g·min⁻¹) than sea level (1.42 ± 0.16 g·min⁻¹, P = 0.034, ES = 1.33). There were no differences in rates, or absolute and relative contributions of plasma or liver glucose oxidation between conditions during the second hour of exercise. However, absolute and relative contributions of muscle glycogen during the second hour were lower at altitude (29.3 ± 28.9 g, 16.6 ± 15.2%) than sea level (78.7 ± 5.2 g (P = 0.008, ES = 1.71), 37.7 ± 13.0% (P = 0.016, ES = 1.45). Acute exposure to altitude reduces the reliance on muscle glycogen and increases fat oxidation during prolonged cycling in men compared with sea level.

Fructose and Sucrose Intake Increase Exogenous Carbohydrate Oxidation during Exercise

Peak exogenous carbohydrate oxidation rates typically reach ~1 g∙min-1 during exercise when ample glucose or glucose polymers are ingested. Fructose co-ingestion has been shown to further increase exogenous carbohydrate oxidation rates. The purpose of this study was to assess the impact of fructose co-ingestion provided either as a monosaccharide or as part of the disaccharide sucrose on exogenous carbohydrate oxidation rates during prolonged exercise in trained cyclists. Ten trained male cyclists (VO2peak: 65 ± 2 mL∙kg-1∙min-1) cycled on four different occasions for 180 min at 50% Wmax during which they consumed a carbohydrate solution providing 1.8 g∙min-1 of glucose (GLU), 1.2 g∙min-1 glucose + 0.6 g∙min-1 fructose (GLU + FRU), 0.6 g∙min-1 glucose + 1.2 g∙min-1 sucrose (GLU + SUC), or water (WAT). Peak exogenous carbohydrate oxidation rates did not differ between GLU + FRU and GLU + SUC (1.40 ± 0.06 vs. 1.29 ± 0.07 g∙min-1, respectively, p = 0.999), but were 46% ± 8% higher when compared to GLU (0.96 ± 0.06 g∙min-1: p < 0.05). In line, exogenous carbohydrate oxidation rates during the latter 120 min of exercise were 46% ± 8% higher in GLU + FRU or GLU + SUC compared with GLU (1.19 ± 0.12, 1.13 ± 0.21, and 0.82 ± 0.16 g∙min-1, respectively, p < 0.05). We conclude that fructose co-ingestion (0.6 g∙min-1) with glucose (1.2 g∙min-1) provided either as a monosaccharide or as sucrose strongly increases exogenous carbohydrate oxidation rates during prolonged exercise in trained cyclists.

Energy substrate utilization with and without exogenous carbohydrate intake in boys and men exercising in the heat

Little is known about energy yield during exercise in the heat in boys compared with men. To investigate substrate utilization with and without exogenous carbohydrate (CHOexo) intake, seven boys [11.2 ± 0.2 (SE) yr] and nine men (24.0 ± 1.1 yr) cycled (4 × 20-min bouts) at a fixed metabolic heat production ( Ḣ p) per unit body mass (6 W/kg) in a climate chamber (38°C and 50% relative humidity), on two occasions. Participants consumed a 13C-enriched 8% CHO beverage (CARB) or placebo beverage (CONT) in a double-blinded, counterbalanced manner. Substrate utilization was calculated for the last 60 min of exercise. CHOexo oxidation rate (2.0 ± 0.3 vs. 2.5 ± 0.2 mg·kg fat-free mass−1·min−1, P = 0.02) and CHOexo oxidation efficiency (12.8 ± 0.6 vs. 16.0 ± 0.9%, P = 0.01) were lower in boys compared with men exercising in the heat. Total carbohydrate (CHOtotal), endogenous CHO (CHOendo), and total fat (Fattotal) remained stable in boys and men ( P > 0.05) during CARB, whereas CHOtotal oxidation rate decreased ( P < 0.001) and Fattotal oxidation rate increased over time similarly in boys and men during CONT ( P < 0.001). The relative contribution of CHOexo to total energy yield increased over time in both groups ( P < 0.001). In conclusion, endogenous substrate metabolism and the relative contribution of fuels to total energy yield were not different between groups. The ingestion of a CHO beverage during exercise in the heat may be as beneficial for boys as men to spare endogenous substrate.

Oxidative fuel selection and shivering thermogenesis during a 12- and 24-h cold-survival simulation

Because the majority of cold exposure studies are constrained to short-term durations of several hours, the long-term metabolic demands of cold exposure, such as during survival situations, remain largely unknown. The present study provides the first estimates of thermogenic rate, oxidative fuel selection, and muscle recruitment during a 24-h cold-survival simulation. Using combined indirect calorimetry and electrophysiological and isotopic methods, changes in muscle glycogen, total carbohydrate, lipid, protein oxidation, muscle recruitment, and whole body thermogenic rate were determined in underfed and noncold-acclimatized men during a simulated accidental exposure to 7.5 °C for 12 to 24 h. In noncold-acclimatized healthy men, cold exposure induced a decrease of ∼0.8 °C in core temperature and a decrease of ∼6.1 °C in mean skin temperature (range, 5.4-6.9 °C). Results showed that total heat production increased by approximately 1.3- to 1.5-fold in the cold and remained constant throughout cold exposure. Interestingly, this constant rise in Ḣprod and shivering intensity was accompanied by a large modification in fuel selection that occurred between 6 and 12 h; total carbohydrate oxidation decreased by 2.4-fold, and lipid oxidation doubled progressively from baseline to 24 h. Clearly, such changes in fuel selection dramatically reduces the utilization of limited muscle glycogen reserves, thus extending the predicted time to muscle glycogen depletion to as much as 15 days rather than the previous estimates of approximately 30-40 h. Further research is needed to determine whether this would also be the case under different nutritional and/or colder conditions.

Assessing a commercially available sports drink on exogenous carbohydrate oxidation, fluid delivery and sustained exercise performance

Background

Whilst exogenous carbohydrate oxidation (CHO_EXO) is influenced by mono- and disaccharide combinations, debate exists whether such beverages enhance fluid delivery and exercise performance. Therefore, this study aimed to ascertain CHO_EXO, fluid delivery and performance times of a commercially available maltodextrin/ fructose beverage in comparison to an isocaloric maltodextrin beverage and placebo.

Methods

Fourteen club level cyclists (age: 31.79 ± 10.02 years; height: 1.79 ± 0.06 m; weight: 73.69 ± 9.24 kg; VO_2max: 60.38 ± 9.36 mL · kg^·-1 min^-1) performed three trials involving 2.5 hours continuous exercise at 50% maximum power output (W_max: 176.71 ± 25.92 W) followed by a 60 km cycling performance test. Throughout each trial, athletes were randomly assigned, in a double-blind manner, either: (1) 1.1 g · min^-1 maltodextrin + 0.6 g · min^-1 fructose (MD + F), (2) 1.7 g · min^-1 of maltodextrin (MD) or (3) flavoured water (P). In addition, the test beverage at 60 minutes contained 5.0 g of deuterium oxide (²H₂O) to assess quantification of fluid delivery. Expired air samples were analysed for CHO_EXO according to the ¹³C/¹²C ratio method using gas chromatography continuous flow isotope ratio mass spectrometry.

Results

Peak CHO_EXO was significantly greater in the final 30 minutes of submaximal exercise with MD + F and MD compared to P (1.45 ± 0.09 g · min^-1, 1.07 ± 0.03 g · min^-1and 0.00 ± 0.01 g · min^-1 respectively, P < 0.0001), and significantly greater for MD + F compared to MD (P = 0.005). The overall appearance of ²H₂O in plasma was significantly greater in both P and MD + F compared to MD (100.27 ± 3.57 ppm, 92.57 ± 2.94 ppm and 78.18 ± 4.07 ppm respectively, P < 0.003). There was no significant difference in fluid delivery between P and MD + F (P = 0.078). Performance times significantly improved with MD + F compared with both MD (by 7 min 22 s ± 1 min 56 s, or 7.2%) and P (by 6 min 35 s ± 2 min 33 s, or 6.5%, P < 0.05) over 60 km.

Conclusions

A commercially available maltodextrin-fructose beverage improves CHO_EXO and fluid delivery, which may benefit individuals during sustained moderate intensity exercise. The greater CHO_EXO observed when consuming a maltodextrin-fructose beverage may support improved performance times.

The ingestion of protein with a maltodextrin and fructose beverage on substrate utilisation and exercise performance

The study investigated the ingestion of maltodextrin, fructose, and protein on exogenous carbohydrate oxidation (CHOEXO) and exercise performance. Seven trained cyclists and (or) triathletes (maximal oxygen consumption, 59.20 ± 9.00 mL·kg−1·min−1) performed 3 exercise trials that consisted of 150 min of cycling at 50% maximal power output (160 ± 11 W), followed by a 60-km time trial. One of 3 beverages were randomly assigned during each trial and consumed at 15-min intervals: (i) 0.84 g·min−1 maltodextrin + 0.52 g·min−1 fructose + 0.34 g·min−1 protein (MD+F+P); (ii) 1.10 g·min−1 maltodextrin + 0.60 g·min−1 fructose (MD+F); or (iii) 1.70 g·min−1 maltodextrin (MD). CHOEXO and fuel utilisation were assessed via measurement of expired air 13C content and indirect calorimetry, respectively. Mean total CHO oxidation (CHOTOT) rates were 2.35 ± 0.18, 2.76 ± 0.08, and 2.61 ± 0.17 g·min−1 with MD, MD+F, and MD+F+P, respectively, although not significantly different. Peak CHOEXO rates with MD+F were significantly greater by 41.4% (p = 0.001) and 45.4% (p = 0.0001) compared with MD+F+P and MD, respectively (1.57 ± 0.22 g·min−1, 1.11 ± 0.08 g·min−1, and 1.08 ± 0.11 g·min−1, respectively). Performance times were 2.2% and 5.0% faster with MD+F compared with MD+F+P and MD, respectively; however, they were not statistically significant. Ingestion of an MD−fructose−protein commercial sports beverage significantly reduced peak and mean CHOEXO rates compared with MD+F, but did not significantly influence CHOTOT. The addition of protein to an MD+F beverage did not enhance performance times.

Preexercise galactose and glucose ingestion on fuel use during exercise

PURPOSE

This study determined the effect of ingesting galactose and glucose 30 min before exercise on exogenous and endogenous fuel use during exercise.

METHODS

Nine trained male cyclists completed three bouts of cycling at 60% W(max) for 120 min after an overnight fast. Thirty minutes before exercise, the cyclists ingested a fluid formulation containing placebo, 75 g of galactose (Gal), or 75 g of glucose (Glu) to which (13)C tracers had been added, in a double-blind randomized manner. Indirect calorimetry and isotope ratio mass spectrometry were used to calculate fat oxidation, total carbohydrate (CHO) oxidation, exogenous CHO oxidation, plasma glucose oxidation, and endogenous liver and muscle CHO oxidation rates.

RESULTS

Peak exogenous CHO oxidation was significantly higher after Glu (0.68 ± 0.08 g.min(-1), P < 0.05) compared with Gal (0.44 ± 0.02 g.min(-1)); however, mean rates were not significantly different (0.40 ± 0.03 vs. 0.36 ± 0.02 g.min(-1), respectively). Glu produced significantly higher exogenous CHO oxidation rates during the initial hour of exercise (P < 0.01), whereas glucose rates derived from Gal were significantly higher during the last hour (P < 0.01). Plasma glucose and liver glucose oxidation at 60 min of exercise were significantly higher for Glu (1.07 ± 0.1 g.min(-1), P < 0.05, and 0.57 ± 0.08 g.min(-1), P < 0.01) compared with Gal (0.64 ± 0.05 and 0.29 ± 0.03 g.min(-1), respectively). There were no significant differences in total CHO, whole body endogenous CHO, muscle glycogen, or fat oxidation between conditions.

CONCLUSION

The preexercise consumption of Glu provides a higher exogenous source of CHO during the initial stages of exercise, but Gal provides the predominant exogenous source of fuel during the latter stages of exercise and reduces the reliance on liver glucose.

Stable isotope breath tests for assessing gastric emptying: A comprehensive review

A stable isotope ([(13)C]) breath test is a promising method for assessing gastric emptying, but it has not been pervasive yet in Japan. We think that there are some barriers to its popularization, including the uncertainty concerning its theoretical backgrounds, the ambiguity of analyzing and interpreting the data, and the lack of standard protocols for breath sampling. The aim of the present review is to break through these barriers. We hope this article could make the [(13)C]-gastric breath test more maneuverable for and more accessible to researchers and clinicians.

Carbohydrate intake reduces fat oxidation during exercise in obese boys

The recent surge in childhood obesity has renewed interest in studying exercise as a therapeutic means of metabolizing fat. However, carbohydrate (CHO) intake attenuates whole body fat oxidation during exercise in healthy children and may suppress fat metabolism in obese youth. To determine the impact of CHO intake on substrate utilization during submaximal exercise in obese boys, seven obese boys (mean age: 11.4 ± 1.0 year; % body fat: 35.8 ± 3.9%) performed 60 min of exercise at an intensity that approximated maximal fat oxidation. A CHO drink (CARB) or a placebo drink (CONT) was consumed in a double-blinded, counterbalanced manner. Rates of total fat, total CHO, and exogenous CHO (CHO(exo)) oxidation were calculated for the last 20 min of exercise. During CONT, fat oxidation rate was 3.9 ± 2.4 mg × kg fat-free mass (FFM)(-1 )× min(-1), representing 43.1 ± 22.9% of total energy expenditure (EE). During CARB, fat oxidation was lowered (p = 0.02) to 1.7 ± 0.6 mg × kg FFM(-1 )× min(-1), contributing to 19.8 ± 4.9% EE. Total CHO oxidation rate was 17.2 ± 3.1 mg × kg FFM(-1 )× min(-1) and 13.2 ± 6.1 mg × kg FFM(-1) × min(-1) during CARB and CONT, respectively (p = 0.06). In CARB, CHO(exo) oxidation contributed to 23.3 ± 4.2% of total EE. CHO intake markedly suppresses fat oxidation during exercise in obese boys.

Stochastic simulations of the exponential-beta function as an assessment of the validity of the choice of the Wagner-Nelson method for the analysis of ¹³C-octanoic acid breath tests

A compartmental model that generates the exponential-beta function μkβ(1 - e(-kt))(β - 1) e(-kt) in order to run stochastic simulations has been constructed. The mathematical considerations that lead to the development of the model and the comparison of its performance with real data sets obtained from the studies of gastric emptying in healthy volunteers using ¹³C-octanoic acid breath tests are demonstrated. Stochastic simulations have been used to introduce randomness. These confirmed the choice of an exponential-beta function to model the physiological system, as agreement was obtained between experimental and theoretical data. The comparisons were made by visual inspection only, as the intention was to demonstrate that the stochastic exponential-β model would generate the full range of observed curve shapes.

Fruit bats (Pteropodidae) fuel their metabolism rapidly and directly with exogenous sugars

Previous studies reported that fed bats and birds mostly use recently acquired exogenous nutrients as fuel for flight, rather than endogenous fuels, such as lipids or glycogen. However, this pattern of fuel use may be a simple size-related phenomenon because, to date, only small birds and bats have been studied with respect to the origin of metabolized fuel, and because small animals carry relatively small energy reserves, considering their high mass-specific metabolic rate. We hypothesized that approximately 150 g Egyptian fruit bats (Rousettus aegyptiacus Pteropodidae), which are more than an order of magnitude heavier than previously studied bats, also catabolize dietary sugars directly and exclusively to fuel both rest and flight metabolism. We based our expectation on the observation that these animals rapidly transport ingested dietary sugars, which are absorbed via passive paracellular pathways in the intestine, to organs of high energy demand. We used the stable carbon isotope ratio in exhaled CO(2) (delta(13)C(breath)) to assess the origin of metabolized substrates in 16 Egyptian fruit bats that were maintained on a diet of C3 plants before experiments. First, we predicted that in resting bats delta(13)C(breath) remains constant when bats ingest C3 sucrose, but increases and converges on the dietary isotopic signature when C4 sucrose and C4 glucose are ingested. Second, if flying fruit bats use exogenous nutrients exclusively to fuel flight, we predicted that delta(13)C(breath) of flying bats would converge on the isotopic signature of the C4 sucrose they were fed. Both resting and flying Egyptian fruit bats, indeed, directly fuelled their metabolism with freshly ingested exogenous substrates. The rate at which the fruit bats oxidized dietary sugars was as fast as in 10 g nectar-feeding bats and 5 g hummingbirds. Our results support the notion that flying bats, irrespective of their size, catabolize dietary sugars directly, and possibly exclusively, to fuel flight.

Carbohydrate supplementation and sex differences in fuel selection during exercise

PURPOSE

To compare the effects of a high-CHO diet (80% CHO) and glucose ingestion (2 g x kg(-1)) during exercise (120 min, 57% VO2max) on fuel selection in women taking (W+OC) or not (W-OC) oral contraceptives and in men (six in each group).

METHODS

Substrate oxidation was measured using indirect respiratory calorimetry in combination with a tracer technique to compute the oxidation of exogenous (13C-glucose) and endogenous CHO.

RESULTS

In the control situation (mixed diet with water ingestion during exercise), the percent contribution to the energy yield (%En) of CHO oxidation was higher in men than in women (62 vs 53 %En). The high-CHO diet and glucose ingestion during exercise separately increased the %En from CHO oxidation in both men (+12%) and women (+24%), and the sex difference observed in the control situation disappeared. However, the increase in the %En from total CHO oxidation observed when glucose was ingested during exercise and when combined with a high-CHO diet was larger in women than in men (+47 vs +17 %En). This was not attributable to a higher %En from exogenous glucose oxidation in women, for which no sex difference was observed (25 and 27 %En in men and women), but was attributable to a smaller decrease in endogenous glucose oxidation. No significant difference in fuel selection was observed between W+OC and W-OC.

CONCLUSIONS

The increase in total CHO oxidation after the high-CHO diet was not different between sexes. Glucose ingestion during exercise, separately and combined to the high-CHO diet, had a greater effect in women than in men; this was mostly attributable to the smaller reduction in endogenous CHO oxidation.

Effects of ingesting [13C]glucose early or late into cold exposure on substrate utilization

One of the factors limiting the oxidation of exogenous glucose during cold exposure may be the delay in establishing a shivering steady state (approximately 60 min), reducing glucose uptake into skeletal muscle. Therefore, using indirect calorimetry and isotopic methodologies in non-cold-acclimatized men, the main purpose of this study was to determine whether ingesting glucose at a moment coinciding with the maximal shivering intensity could increase the utilization rate of the ingested glucose. (13)C-enriched glucose was ingested (800 mg/min) from the onset (G0) or after 60 min (G60) of cold exposure when the thermogenic rate was stabilized to low-intensity shivering (approximately 2.5 times resting metabolic rate). For the same quantity of glucose ingested, the oxidation rate of exogenous glucose was 35% higher in G60 (159+/-17 vs. 118+/-17 mg/min in G0) between minutes 60 and 90. By the end of cold exposure, exogenous glucose oxidation was significantly greater in G0, reaching 231+/-14 mg/min, approximately 15% higher than the only rates previously reported. This considerably reduced the utilization of endogenous reserves over time and compared with the G60 condition. This study also demonstrates a fall in muscle glycogen utilization, when glucose was ingested from the onset of cold exposure (from approximately 150 to approximately 75 mg/min). Together, these findings indicate the importance of ingesting glucose immediately on exposure to a cold condition, relying on shivering thermogenesis and sustaining that consumption for as long as possible. This substrate not only provides an auxiliary fuel source for shivering thermogenesis, but, more importantly, preserves the limited endogenous glucose reserves.

Fuel selection and cycling endurance performance with ingestion of [13C]glucose: evidence for a carbohydrate dose response

Endurance performance and fuel selection while ingesting glucose (15, 30, and 60 g/h) was studied in 12 cyclists during a 2-h constant-load ride [∼77% peak O2 uptake] followed by a 20-km time trial. Total fat and carbohydrate (CHO) oxidation and oxidation of exogenous glucose, plasma glucose, glucose released from the liver, and muscle glycogen were computed using indirect respiratory calorimetry and tracer techniques. Relative to placebo (210 ± 36 W), glucose ingestion increased the time trial mean power output (%improvement, 90% confidence limits: 7.4, 1.4 to 13.4 for 15 g/h; 8.3, 1.4 to 15.2 for 30 g/h; and 10.7, 1.8 to 19.6 for 60 g/h glucose ingested; effect size = 0.46). With 60 g/h glucose, mean power was 2.3, 0.4 to 4.2% higher, and 3.1, 0.5 to 5.7% higher than with 30 and 15 g/h, respectively, suggesting a relationship between the dose of glucose ingested and improvements in endurance performance. Exogenous glucose oxidation increased with ingestion rate (0.17 ± 0.04, 0.33 ± 0.04, and 0.52 ± 0.09 g/min for 15, 30, and 60 g/h glucose), but endogenous CHO oxidation was reduced only with 30 and 60 g/h due to the progressive inhibition of glucose released from the liver (probably related to higher plasma insulin concentration) with increasing ingestion rate without evidence for muscle glycogen sparing. Thus ingestion of glucose at low rates improved cycling time trial performance in a dose-dependent manner. This was associated with a small increase in CHO oxidation without any reduction in muscle glycogen utilization.

Measuring energy expenditure in birds using bolus injections of 13C-labelled Na-bicarbonate

The (13)C-labelled Na-bicarbonate technique uses stable isotopes to measure energy expenditure in birds. After administration, the isotopes reach equilibrium within the body's bicarbonate pools at a fast rate due to the small size of the bicarbonate pool in relation to CO(2) flux. This technique is therefore ideal for measuring energy expenditure over short-term activities. The major advantage of this technique is that it can be applied without the animal having to wear a respirometry mask or being enclosed in a respirometry chamber. Despite the technique's suitability for use in birds and other animals, there have been few studies that have used it to date and so its potential is not fully understood. Here we discuss the methodology and review previous applications.

Fuel selection during prolonged arm and leg exercise with 13C-glucose ingestion

PURPOSE

To compare fuel selection during prolonged arm (AE) and leg exercise (LE) with water or glucose ingestion.

METHODS

Ten subjects (VO2max: 4.77 +/- 0.20 and 3.36 +/- 0.15 L x min(-1) for LE and AE, respectively) completed 120 min of LE and AE at 50% of the mode-specific maximal power output (353 +/- 18 and 160 +/- 9 W, respectively) with ingestion of water (20 mL x kg(-1)) or 13C-glucose (2 g x kg(-1)). Substrate oxidation was measured using indirect respiratory calorimetry corrected for urea excretion and 13CO2 production at the mouth.

RESULTS

The contribution of protein oxidation to the energy yield (%En) was higher during AE than LE (approximately 8% vs approximately 4%) because of the lower energy expenditure and was not significantly modified with glucose ingestion. With water ingestion, the %En from CHO oxidation was not significantly different during LE and AE (64 +/- 2% and 66 +/- 2%, respectively). Glucose ingestion significantly increased the %En from total CHO oxidation during AE (78 +/- 3%) but not during LE (71 +/- 2%). Exogenous glucose oxidation was not significantly different in AE and LE (56 +/- 4 and 65 +/- 3 g, respectively), but the %En from exogenous glucose was higher during AE than LE (30 +/- 1% and 24 +/- 1%) because of the lower energy expenditure. When glucose was ingested, the %En from endogenous CHO oxidation was significantly reduced during both AE (66 +/- 2% to 48 +/- 3%) and LE (64 +/- 2% to 47 +/- 3%) and was not significantly different in the two modes of exercise.

CONCLUSIONS

The difference in fuel selection between AE and LE when water was ingested was modest with a slightly higher reliance on CHO oxidation during AE. The amount of exogenous glucose oxidized was lower but its %En was higher during AE because of the lower energy expenditure.

Effects of two glucose ingestion rates on substrate utilization during moderate-intensity shivering

Although the importance of food consumption to survive in the cold is well established, most shivering studies have focused on fuel selection in fasting subjects. Therefore, the aim of the present study was to provide the first estimates of exogenous glucose as well as liver and muscle glycogen oxidation rates of non-cold acclimatized men (n = 6) ingesting glucose in trace amounts (Control; C), and at rates of 400 mg min(-1) (Low Glucose; LG), and 800 mg min(-1) (High Glucose; HG) during moderate-intensity shivering (~3 times resting metabolic rate or ~20% VO(2max)) using indirect calorimetry and stable isotope methodologies. Exogenous glucose oxidation peaked at ~200 mg min(-1) at the lowest glucose ingestion rate (~400 mg min(-1)). In addition, glucose ingestion increased the contribution of plasma glucose to total heat production by ~50% but did not change the role played by muscle glycogen (~27% of heat production for control condition and ~23-28% for LG and HG). Instead, the contribution of liver-derived glucose to total heat production was reduced by 40-60% in LG and HG, respectively. In conclusion, glucose ingestion even at low rates contributes a significant proportion of total heat production during moderate intensity shivering and reduces the utilization of liver-derived glucose but not muscle glycogen.

Exogenous glucose oxidation is reduced with carbohydrate feeding during exercise after starvation

Lean healthy individuals are characterized by the ability to rapidly adapt metabolism to acute changes in substrate availability and metabolic rate. However, in glucose-intolerance/insulin-resistant conditions, such as that induced by starvation, the flexibility of tissues to rapidly respond to change in substrate availability is diminished. We asked whether the conundrum of increased glucose demand by the contracting skeletal muscle during prolonged exercise and the glucose intolerance of starvation would result in the obstruction of oxidative disposal of ingested (13)C-labeled glucose during exercise. Seven lean, healthy, physically active individuals (2 women, 5 men) completed a randomized crossover study comparing the effects of the normal-fed condition vs a 67-hour water-only fast on the metabolic response to carbohydrate ingestion during 80 minutes of exercise at 56% of maximum oxygen uptake. Compared with the normal condition, fasting resulted in a large overall increase in the rate of fat oxidation (mean effect, 71%; 95% confidence limit, +/-22%) and moderate reductions in both exogenous (-54%, +/-10%) and endogenous (-40%, +/-19%) glucose oxidation rates during exercise. Over the course of exercise, fat oxidation was impermeable to change in the fasting condition, but increased moderately (33%, +/-19%) in the normal condition. These changes were associated with a large increase in plasma free fatty-acid concentration (120%, +/-64%) and a moderate increase in blood lactate concentration (58%, +/-50%). In contrast, large reductions in resting blood glucose (-21%, +/-14%) and moderate reductions in plasma insulin concentrations (-47%, +/-26%) were observed in the fast condition; but this effect was reversed for glucose (30%, +/- 24%) and negated for insulin by the end of exercise. To conclude, a 67-hour fast leads to an impermeable increase in fat oxidation, suppression of both exogenous and endogenous carbohydrate oxidation, and a metabolic response consistent with resistance to contraction-induced exogenous glucose uptake and oxidation.

Oxidation of maltose and trehalose during prolonged moderate-intensity exercise

PURPOSE

The aim of the present study was to compare the effects of trehalose (TRE) and maltose (MAL) ingestion on exogenous carbohydrate oxidation rates and blood metabolite responses during prolonged moderate-intensity cycling exercise.

METHODS

Nine trained subjects performed three randomly assigned bouts of exercise separated by at least 1 wk. Each trial consisted of 150 min of cycling at 55% of maximal power output (Wmax) while ingesting a solution providing either 1.1 g x min(-1) TRE, 1.1 g x min(-1) MAL, or water (WAT).

RESULTS

Total carbohydrate oxidation rates were significantly higher (P < 0.05) in both the MAL (2.09 +/- 0.18 g x min(-1)) and TRE (1.92 +/- 0.32 g x min(-1)) trials compared with the WAT trial (1.62 +/- 0.28 g x min(-1)). Peak exogenous carbohydrate oxidation was significantly higher in the MAL trial compared with the TRE trial (1.01 +/- 0.24 and 0.73 +/- 0.22 g x min(-1), respectively, P < 0.05). The MAL trial resulted in significantly reduced endogenous carbohydrate oxidation rates compared with the WAT trial (1.20 +/- 0.25 and 1.62 +/- 0.28 g x min(-1), respectively, P < 0.05). When compared with the WAT trial, total fat oxidation for the same period was significantly reduced in both carbohydrate trials (0.91 +/- 0.19, 0.68 +/- 0.19, and 0.79 +/- 0.19 g x min(-1) for WAT, MAL, and TRE, respectively, P < 0.05) and tended to be lower in MAL compared with TRE (P < 0.06).

DISCUSSION

Both solutions maintained high plasma glucose concentrations. MAL had a "sparing" effect on endogenous carbohydrate stores. The reduced exogenous carbohydrate oxidation rate of TRE compared to MAL is probably due to a reduced enzymatic hydrolysis rate within the small intestine, causing a slower availability.

Reliability of the time to maximal [13CO2] excretion and the half-[13CO2] excretion time as a gastric emptying parameter: assessments using the Wagner-Nelson method

In the [(13)C]-octanoate breath test, two popular parameters have been used to quantify gastric emptying rates, namely the time to the maximal [(13)CO(2)] excretion (T(max)) and the time to the half-[(13)CO(2)] recovery (T(1/2b)). Although each of T(max) and T(1/2b) is closely correlated with the scintigraphic half-emptying time, the two parameters occasionally indicate different judgments on a gastric emptying rate. In this study, to clarify which of the two parameters is more reliable, T(max) and T(1/2b) were compared to the "reference" parameters calculated using the Wagner-Nelson method, which allows accurate estimation of a time-course of gastric emptying from breath data. Ten healthy male volunteers underwent the breath test after ingestion of a muffin meal (320 kcal) containing 100 mg [(13)C]-octanoate. Breath samples were collected at 15-min intervals for 6 h. According to the conventional analytical algorithm, T(max) and T(1/2b) were mathematically calculated. By applying Wagner-Nelson analysis to the breath test, the time-percent gastric retention curve was generated and the half-emptying time (T(1/2WN)) was determined. T(1/2WN) was more closely correlated with T(max) (r=0.954, P<0.0001) than with T(1/2b) (r=0.782, P=0.008). T(max) was significantly correlated with the percent gastric retention value in the early (t=0.25 and 0.5 h), the middle (t=1.0 and 1.5 h), and the late (t=2.0 h) postprandial phase. T(1/2b) was significantly correlated with the gastric retention value in the middle and the late phase, but not with the gastric retention value in the early phase. The present results show that T(1/2b) has limited capability to reflect gastric emptying in the early postprandial period, suggesting that T(max) is more reliable than T(1/2b) as a gastric emptying parameter.

Substrate source utilization during moderate intensity exercise with glucose ingestion in Type 1 diabetic patients

Substrate oxidation and the respective contributions of exogenous glucose, glucose released from the liver, and muscle glycogen oxidation were measured by indirect respiratory calorimetry combined with tracer technique in eight control subjects and eight diabetic patients (5 men and 3 women in both groups) of similar age, height, body mass, and maximal oxygen uptake, over a 60-min exercise period on cycle ergometer at 50.8% (SD 4.0) maximal oxygen uptake [131.0 W (SD 38.2)]. The subjects and patients ingested a breakfast (containing ∼80 g of carbohydrates) 3 h before and 30 g of glucose (labeled with 13C) 15 min before the beginning of exercise. The diabetic patients also received their usual insulin dose [Humalog = 9.1 U (SD 0.9); Humulin N = 13.9 U (SD 4.4)] immediately before the breakfast. Over the last 30 min of exercise, the oxidation of carbohydrate [1.32 g/min (SD 0.48) and 1.42 g/min (SD 0.63)] and fat [0.33 g/min (SD 0.10) and 0.30 g/min (SD 0.10)] and their contribution to the energy yield were not significantly different in the control subjects and diabetic patients. Exogenous glucose oxidation was also not significantly different in the control subjects and diabetic patients [6.3 g/30 min (SD 1.3) and 5.2 g/30 min (SD 1.6), respectively]. In contrast, the oxidation of plasma glucose and oxidation of glucose released from the liver were significantly lower in the diabetic patients than in control subjects [14.5 g/30 min (SD 4.3) and 9.3 g/30 min (SD 2.8) vs. 27.9 g/30 min (SD 13.3) and 21.6 g/30 min (SD 12.8), respectively], whereas that of muscle glycogen was significantly higher [28.1 g/30 min (SD 15.5) vs. 11.6 g/30 min (SD 8.1)]. These data indicate that, compared with control subjects, in diabetic patients fed glucose before exercise, substrate oxidation and exogenous glucose oxidation overall are similar but plasma glucose oxidation is lower; this is associated with a compensatory higher utilization of muscle glycogen.

Exogenous oxidation of isomaltulose is lower than that of sucrose during exercise in men

Isomaltulose (ISO) is a disaccharide that is slowly digested, resulting in a slow availability for absorption. The aim of this study was to compare the blood substrate responses and exogenous carbohydrate (CHO) oxidation rates from orally ingested sucrose (SUC) and ISO during moderate intensity exercise. We hypothesized that the oxidation of ISO is lower compared with SUC, resulting in lower plasma glucose and insulin concentrations and subsequent lower CHO and higher fat oxidation rates. Ten trained men [maximal oxygen uptake (VO(2)max), 64 +/- 1 mL/(kg body mass.min)] cycled on 3 occasions for 150 min at 59 +/- 2% VO(2)max and consumed either water (WAT) or 1 of 2 CHO solutions providing 1.1 g/min of CHO in the form of either SUC or ISO. Peak exogenous CHO oxidation rates were higher (P < 0.05) during the SUC trial (0.92 +/- 0.03 g/min) than during the ISO trial (0.54 +/- 0.05 g/min). Total endogenous CHO oxidation over the final 90 min of exercise was lower (P < 0.05) in the SUC trial (107 +/- 10 g) than in the WAT (137 +/- 7 g) and ISO (127 +/- 9 g) trials. Fat oxidation was higher during the WAT trial than during the SUC and ISO trials. ISO resulted in a lower plasma insulin response at 30 min compared with SUC, whereas the glucose response did not differ between the 2 CHO. Oxidation of ingested ISO was significantly less than that of SUC, most likely due to the lower rate of digestion of ISO. A lower CHO delivery and a small difference in plasma insulin may have resulted in higher endogenous CHO use and higher fat oxidation during the ISO trial than during the SUC trial.

Muscle glycogen oxidation during prolonged exercise measured with oral [13C]glucose: comparison with changes in muscle glycogen content

Plasma glucose and muscle glycogen oxidation during prolonged exercise [75-min at 48 and 76% maximal O2 uptake (V̇o2 max)] were measured in eight well-trained male subjects [V̇o2 max = 4.50 l/min (SD 0.63)] using a simplified tracer technique in which a small amount of glucose highly enriched in 13C was ingested: plasma glucose oxidation was computed from 13C/12C in plasma glucose (which was stable beginning at minute 30 and minute 15 during exercise at 48 and 76% V̇o2 max, respectively) and 13CO2 production, and muscle glycogen oxidation was estimated by subtracting plasma glucose oxidation from total carbohydrate oxidation. Consistent data from the literature suggest that this small dose of exogenous glucose does not modify muscle glycogen oxidation and has little effect, if any, on plasma glucose oxidation. The percent contributions of plasma glucose and muscle glycogen oxidation to the energy yield at 48% V̇o2 max [15.1% (SD 3.8) and 45.9% (SD 5.8)] and at 76% V̇o2 max [15.4% (SD 3.6) and 59.8% (SD 9.2)] were well in line with data previously reported for similar work loads and exercise durations using conventional tracer techniques. The significant reduction in glycogen concentration measured from pre- and postexercise vastus lateralis muscle biopsies paralleled muscle glycogen oxidation calculated using the tracer technique and was larger at 76% than at 48% V̇o2 max. However, the correlation coefficients between these two estimates of muscle glycogen utilization were not different from zero at each of the two work loads. The simplified tracer technique used in the present experiment appears to be a valid alternative approach to the traditional tracer techniques for computing plasma glucose and muscle glycogen oxidation during prolonged exercise.

Comparison of exogenous glucose, fructose and galactose oxidation during exercise using C-labelling

Six subjects exercised for 120 min on a cycle ergometer (65 (se 3) % VO2max) when ingesting a placebo or glucose, fructose or galactose (100 g in 1000 ml water) labelled with 13C. The oxidation of energy substrates including exogenous hexoses was compared using indirect respiratory calorimetry and 13CO2 production at the mouth. Total carbohydrate progressively decreased and total fat oxidation increased over the 120 min exercise period in the four experimental situations. During the 120 min of exercise, the amount of fructose oxidized (38.8 (se 2.6) g; 9.0 (se 0.6) % energy yield) was not significantly (approximately 4 %) lower than that of exogenous glucose (40.5 (se 3.4) g; 9.2 (se 0.8) % energy yield), while that of galactose (23.7 (se 3.5) g; 5.5 (se 0.9) % energy yield) was only 59 % and 61 % that of glucose and fructose, respectively. When compared with the placebo, the ingestion and oxidation of the three hexoses did not significantly modify fat oxidation or total carbohydrate oxidation, but it significantly reduced (9-13 %) endogenous carbohydrate oxidation. The present data indicate that fructose and exogenous glucose ingested during exercise could be oxidized at a similar rate, but that the oxidation rate of galactose was only approximately 60 % that of the exogenous glucose and fructose, presumably because of a preferential incorporation of galactose into liver glycogen (Leloir pathway). The reduction in endogenous carbohydrate oxidation was, however, similar with the three hexoses.

High rates of exogenous carbohydrate oxidation from a mixture of glucose and fructose ingested during prolonged cycling exercise

A recent study from our laboratory has shown that a mixture of glucose and fructose ingested at a rate of 1·8 g/min leads to peak oxidation rates of approximately 1·3 g/min and results in approximately 55 % higher exogenous carbohydrate (CHO) oxidation rates compared with the ingestion of an isocaloric amount of glucose. The aim of the present study was to investigate whether a mixture of glucose and fructose when ingested at a high rate (2·4 g/min) would lead to even higher exogenous CHO oxidation rates (>1·3 g/min).Eight trained male cyclists (VO2max: 68±1 ml/kg per min) cycled on three different occasions for 150 min at 50 % of maximal power output (60±1 % VO2max) and consumed either water (WAT) or a CHO solution providing 1·2 g/min glucose (GLU) or 1.2 g/min glucose+1·2 g/min fructose (GLU+FRUC). Peak exogenous CHO oxidation rates were higher (P<0·01) in the GLU+FRUC trial compared with the GLU trial (1·75 (se 0·11) and 1·06 (se 0·05) g/min, respectively). Furthermore, exogenous CHO oxidation rates during the last 90 min of exercise were approximately 50 % higher (P<0·05) in GLU+FRUC compared with GLU (1·49 (se 0·08) and 0·99 (se 0·06) g/min, respectively). The results demonstrate that when a mixture of glucose and fructose is ingested at high rates (2·4 g/min) during 150 min of cycling exercise, exogenous CHO oxidation rates reach peak values of approximately 1·75 g/min.

Dose-Response Effects of Ingested Carbohydrate on Exercise Metabolism in Women

PURPOSE

The effect of different quantities of carbohydrate (CHO) intake on CHO metabolism during prolonged exercise was examined in endurance-trained females.

METHOD

On four occasions, eight females performed 2 h of cycling at approximately 60% .VO2max with ingestion of beverages containing low (LOW, 0.5 g.min(-1)), moderate (MOD, 1.0 g.min(-1)), or high (HIGH, 1.5 g.min(-1)) amounts of CHO, or water only (WAT). Test solutions contained trace amounts of [U-13C] glucose. Indirect calorimetry combined with measurement of expired 13CO2 and plasma 13C enrichment enabled calculation of exogenous CHO, liver-derived glucose, and muscle glycogen oxidation during the last 30 min of exercise.

RESULTS

The highest rates of exogenous CHO oxidation were observed in MOD, with no further increases in HIGH (peak rates of 0.33 +/- 0.02, 0.50 +/- 0.03, and 0.48 +/- 0.05 g.min(-1) for LOW, MOD, and HIGH, respectively; P < 0.05 for LOW vs MOD and HIGH). Endogenous CHO oxidation was lowest in MOD (0.99 +/- 0.06, 0.82 +/- 0.08, 0.70 +/- 0.07, and 0.89 +/- 0.09 g.min(-1); P < 0.05 for MOD vs all other trials). Compared with WAT, CHO ingestion reduced liver glucose oxidation during exercise by approximately 30% (P < 0.05 for WAT vs all CHO). Differential rates of muscle glycogen oxidation were observed with different CHO doses (0.57 +/- 0.07, 0.53 +/- 0.08, 0.41 +/- 0.07, and 0.60 +/- 0.09 g.min(-1) for WAT, LOW, MOD, and HIGH respectively; P < 0.05 for MOD vs HIGH).

CONCLUSION

In endurance-trained women, the highest rates of exogenous CHO oxidation and greatest endogenous CHO sparing was observed when CHO was ingested at moderate rates (1.0 g.min(-1), 60 g.h(-1)) during exercise.

Hummingbirds Fuel Hovering Flight with Newly Ingested Sugar

We sought to characterize the ability of hummingbirds to fuel their energetically expensive hovering flight using dietary sugar by a combination of respirometry and stable carbon isotope techniques. Broadtailed hummingbirds (Selasphorus platycercus) were maintained on a diet containing beet sugar with an isotopic composition characteristic of C3 plants. Hummingbirds were fasted and then offered a solution containing cane sugar with an isotopic composition characteristic of C4 plants. By monitoring the rates of CO2 production and O2 consumption, as well as the stable carbon isotope composition of expired CO2, we were able to estimate the relative contributions of carbohydrate and fat, as well as the absolute rate at which dietary sucrose was oxidized during hovering. The combination of respirometry and carbon isotope analysis revealed that hummingbirds initially oxidized endogenous fat following a fast and then progressively oxidized proportionately more carbohydrates. The contribution from dietary sources increased with each feeding bout, and by 20 min after the first meal, dietary sugar supported approximately 74% of hovering metabolism. The ability of hummingbirds to satisfy the energetic requirements of hovering flight mainly with recently ingested sugar is unique among vertebrates. Our finding provides an example of evolutionary convergence in physiological and biochemical traits among unrelated nectar-feeding animals.

Substrate utilization during prolonged exercise with ingestion of 13C-glucose in acute hypobaric hypoxia (4,300 m)

Energy substrate oxidation was measured using indirect respiratory calorimetry combined with tracer technique in five healthy young male subjects, during a 80-min exercise period on ergocycle with ingestion of 140 g of (13)C-labelled glucose, in normoxia and acute hypobaric hypoxia (445 mmHg or 4,300 m), at the same relative [77% V(.-)((O)(2)(max))] and absolute workload (161+/-8 W, corresponding to 77 and 54% V(.-)((O)(2)(max)) in hypoxia and normoxia). The oxidation rate of exogenous glucose was not significantly different in the three experimental situations: 21.4+/-2.9, 20.2+/-1.2 and 17.2+/-0.6 g over the last 40 min of exercise at approximately 77 and approximately 54% V(.-)((O)(2)(max)) in normoxia and in hypoxia, respectively, providing 12.5+/-1.5, 16.8+/-1.1 and 14.9+/-1.1% of the energy yield, although ingestion of glucose during exercise resulted in a higher plasma glucose concentration in hypoxia than normoxia. The contribution of carbohydrate (CHO) oxidation to the energy yield was significantly higher in hypoxia (92.0+/-2.1%) than in normoxia for both a given absolute (75.3+/-5.2%) and relative workload (78.1+/-1.8%). This greater reliance on CHO oxidation in hypoxia was entirely due to the significantly larger contribution of endogenous glucose oxidation to the energy yield: 75.9+/-1.7% versus 66.6+/-3.3 and 55.2+/-3.7% in normoxia at the same relative and absolute workload.