Metabolic availability of oral glucose during exercise: a reassessment

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.

Orange juice limits postprandial fat oxidation after breakfast in normal-weight adolescents and adults

Caloric beverages may promote weight gain by simultaneously increasing total energy intake and limiting fat oxidation. During moderate intensity exercise, caloric beverage intake depresses fat oxidation by 25% or more. This randomized crossover study describes the impact of having a caloric beverage with a typical meal on fat oxidation under resting conditions. On 2 separate days, healthy normal-weight adolescents (n = 7) and adults (n = 10) consumed the same breakfast with either orange juice or drinking water and sat at rest for 3 h after breakfast. The meal paired with orange juice was 882 kJ (210 kcal) higher than the meal paired with drinking water. Both meals contained the same amount of fat (12 g). For both age groups, both meals resulted in a net positive energy balance 150 min after breakfast. Resting fat oxidation 150 min after breakfast was significantly lower after breakfast with orange juice, however. The results suggest that, independent of a state of energy excess, when individuals have a caloric beverage instead of drinking water with a meal, they are less likely to oxidize the amount of fat consumed in the meal before their next meal.

Oxidation rate of exogenous carbohydrate during exercise is higher in boys than in men

To determine whether the relative utilization of exogenous carbohydrate (CHO(exo)) differs between children and adults, substrate utilization during 60 min of cycling at 70% peak O(2) uptake was studied in 12 pre- and early pubertal boys (9.8 +/- 0.1 yr) and 10 men (22.1 +/- 0.5 yr) on two occasions. Subjects consumed either a placebo or a (13)C-enriched 6% CHO(exo) beverage (total volume per trial: 24 ml/kg). Substrate utilization was calculated for the final 30 min of exercise. During both trials, total fat oxidation was higher (5.4 +/- 0.5 vs. 3.0 +/- 0.4 mg x kg(-1) x min(-1), P < 0.001) and total CHO oxidation lower (27.4 +/- 1.5 vs. 34.8 +/- 1.2 mg x kg(-1) x min(-1), P < 0.001) in boys than in men, respectively. During the CHO(exo) trial, CHO(exo) oxidation was higher (P < 0.001) in boys (8.8 +/- 0.5 mg x kg(-1) x min(-1)) than in men (6.2 +/- 0.5 mg x kg(-1) x min(-1)) and provided a greater (P < 0.001) relative proportion of total energy in boys (21.8 +/- 1.4%) than in men (14.6 +/- 0.9%). These results suggest that, although endogenous CHO utilization during exercise is lower, the relative oxidation of ingested CHO is considerably higher in boys than in men. The greater reliance on CHO(exo) in boys may be important in preserving endogenous fuels and may be related to pubertal status.

Substrate utilization during exercise with glucose and glucose plus fructose ingestion in boys ages 10--14 yr

We measured substrate utilization during exercise performed with water (W), exogenous glucose (G), and exogenous fructose plus glucose (FG) ingestion in boys age 10-14 yr. Subjects (n = 12) cycled for 90 min at 55% maximal O(2) uptake while ingesting either W (25 ml/kg), 6% G (1.5 g/kg), or 3% F plus 3% G (1.5 g/kg). Fat oxidation increased during exercise in all trials but was higher in the W (0.28 +/- 0.023 g/min) than in the G (0.24 +/- 0.023 g/min) and FG (0.25 +/- 0.029 g/min) trials (P = 0.04). Conversely, total carbohydrate (CHO) oxidation decreased in all trials and was lower in the W (0.63 +/- 0.05 g/min) than in the G (0.78 +/- 0.051 g/min) and FG (0.74 +/- 0.056 g/min) trials (P = 0.009). Exogenous CHO oxidation, as determined by expired (13)CO(2), reached a maximum of 0.36 +/- 0.032 and 0.31 +/- 0.030 g/min at 90 min in G and FG, respectively (P = 0.04). Plasma insulin levels decrease during exercise in all trials but were twofold higher in G than in W and FG (P < 0.001). Plasma glucose levels decreased transiently after the onset of exercise in all trials and then returned to preexercise values in the W and FG (approximately 4.5 mmol/l) trials but were elevated by approximately 1.0 mmol/l in the G trial (P < 0.001). Plasma lactate concentrations decreased after the onset of exercise in all trials but were lower by approximately 0.5 mmol/l in W than in G and FG (P = 0.02). Thus, in boys exercising at a moderate intensity, the oxidation rate of G plus F is slightly less than G alone, but both spare endogenous CHO and fat to a similar extent. In addition, compared with flavored W, the ingestion of G alone and of G plus F delays exhaustion at 90% peak power by approximately 25 and 40%, respectively, after 90 min of moderate-intensity exercise.

Glucose ingestion and substrate utilization during exercise in boys with IDDM

This study was intended to compare exogenous [(13)C]glucose (Glu(exo)) oxidation in boys with insulin-dependent diabetes mellitus (IDDM) and healthy boys of similar age, weight, and maximal O(2) uptake. In a control trial with water intake (CT) and in a (13)C-enriched glucose trial (GT), subjects cycled for 60 min (58.8 +/- 0.9% maximal O(2) uptake) while the utilization of total glucose, total fat, and Glu(exo) was assessed. In CT, total glucose was 84.7 +/- 9.2 vs. 91.3 +/- 6.6 g/60 min (not significantly different) and total fat was 13.3 +/- 2.2 vs. 11.1 +/- 1.7 g/60 min (not significantly different) in IDDM vs. healthy boys, respectively. In GT, Glu(exo) was 10.4 +/- 1.7 vs. 14.8 +/- 1.1 g/60 min, corresponding to 9.0 +/- 1.0 vs. 12.4 +/- 0.5% of the total energy supply in IDDM and healthy boys, respectively (P < 0.05). Endogenous glucose was spared in both groups by 12.6 +/- 3.5% (P < 0.05). Blood glucose and plasma insulin concentrations were two- to threefold higher in IDDM vs. healthy boys in both trials. In conclusion, Glu(exo) is impaired in exercising boys with IDDM, even when plasma insulin levels are elevated.

Effect of training status on fuel selection during submaximal exercise with glucose ingestion

In this study, an oral glucose load was enriched with a [U-(13)C]glucose tracer to determine differences in substrate utilization between endurance-trained (T) and untrained (UT) subjects during submaximal exercise at the same relative and absolute workload when glucose is ingested. Six highly trained cyclists/triathletes [maximal workload (Wmax), 400 +/- 9 W] and seven UT subjects (Wmax, 296 +/- 8 W) were studied during 120 min of cycling exercise at 50% Wmax ( approximately 55% maximal O(2) consumption). The T subjects performed a second trial at the mean workload of the UT group (148 +/- 4 W). Before exercise, 8.0 ml/kg of a (13)C-enriched glucose solution (80 g/l) was ingested. During exercise, boluses of 2.0 ml/kg of the same solution were administered every 15 min. Measurements were made in the 90- to 120-min period when a steady state was present in breath (13)CO(2) and plasma glucose (13)C enrichment. Energy expenditure was higher in T than in UT subjects (58 vs. 47 kJ/min, respectively; P < 0.001) at the same relative intensity. This was completely accounted for by an increased fat oxidation (0.57 vs. 0.40 g/min; P < 0.01). At the same absolute intensity, fat oxidation contributed more to energy expenditure in the T compared with the UT group (44 vs. 33%, respectively; P < 0.01). The reduction in carbohydrate oxidation in the T group was explained by a diminished oxidation rate of muscle glycogen (indirectly assessed by using tracer methodology at 0.72 +/- 0.1 and 1.03 +/- 0.1 g/min, respectively; P < 0.01) and liver-derived glucose (0.15 +/- 0.03 and 0.22 +/- 0.02 g/min, respectively; P < 0.05). Exogenous glucose oxidation rates were similar during all trials (+/-0.70 g/min).

Carbon isotope fractionation between blood and expired CO2 at rest and exercise

Carbon isotope fractionation occurs between bicarbonates and gaseous CO2. Accordingly, expired CO2 could be impoverished in 13C vs. blood CO2 (approximately 90% bicarbonates). The ratio 13C/12C in expired and blood CO2 was measured in six healthy subjects at rest and at the end of exercise (90 min; 65+/-5% VO2max), with ingestion of water (300 ml) without or with glucose (30 g) naturally or artificially enriched in 13C, in order to study a range of 13C/12C in blood (-17.5+/-0.3 to 3.4+/-0.6% delta 13C PDB-1). At rest, 13C/12C in expired CO2 was 4.7+/-0.2% delta 13C PDB-1 lower than in blood CO2. This difference was not modified in response to exercise with ingestion of water or 13C-glucose (average difference 4.6+/-0.4 % delta 13C PDB-1). Carbon isotope fractionation across the lung was approximately 30% lower than predicted from the fractionation factor between bicarbonates and gaseous CO2 (1.00674 at 37 degrees C, or a approximately 6.6% delta 13C PDB-1 difference). This is consistent with the fact that approximately 40% of expired CO2 is released from carbamates and dissolved CO2. From a methodological point of view, these results indicate that 13C/12C in expired CO2 adequately tracks 13C/12C in blood CO2 with a constant approximately 4.6 % delta 13C PDB-1 difference.

Glucose infusion partially attenuates glucose production and increases uptake during intense exercise

Glucose infusion can prevent the increase in glucose production (Ra) and increase glucose uptake (Rd) during exercise of moderate intensity. We postulated that 1) because in postabsorptive intense exercise (>80% maximal O2 uptake) the eightfold increase in Ra may be mediated by catecholamines rather than by glucagon and insulin, exogenous glucose infusion would not prevent the Ra increment, and 2) such infusion would cause greater Rd. Fit young men were exercised at >85% maximal O2 uptake for 14 min in the postabsorptive state [controls (Con), n = 12] or at minute 210 of a 285-min glucose infusion. In seven subjects, the infusion was constant (CI; 4 mg . kg-1 . min-1), and in seven subjects it was varied (VI) to mimic the exercise Ra response in Con. Although glucose suppressed Ra to zero (with glycemia approximately 6 mM and insulin approximately 150 pM), an endogenous Ra response to exercise occurred, to peak increments two-thirds those in Con, in both CI and VI. Glucagon was unchanged, and very small increases in the glucagon-to-insulin ratio occurred in all three groups. Catecholamine responses were similar in all three groups, and correlation coefficients of Ra with plasma norepinephrine and epinephrine were significant in all. In all CI and VI, Rd at rest was 2x Con, increased earlier in exercise, and was higher for the 1 h of recovery with glucose infusion. Thus the Ra response was only partly attenuated, and the catecholamines are likely to be the regulators. This suggests that an acute endogenous Ra rise is possible even in the postprandial state. Furthermore, the fact that more circulating glucose is used by muscle during exercise and early recovery suggests that muscle glycogen is spared.

Effect of carbohydrate ingestion on adipose tissue lipolysis during long-lasting exercise in trained men

To study whether sucrose administration acts on lipid mobilization during prolonged exercise, we used subcutaneous abdominal adipose tissue microdialysis in eight well-trained subjects submitted at random to two 100-min exercises (50% maximal aerobic power) on separate days. After 50 min of exercise, the subjects ingested either a sucrose solution (0.75 g/kg body wt) or water. By using a microdialysis probe, dialysate was obtained every 10 min from the subjects at rest, during exercise, and during a 30-min recovery period. During exercise without sucrose, plasma and dialysate glycerol increased significantly. With sucrose, the response was significantly lower for dialysate glycerol (P < 0.05). Plasma free fatty acid level was lower after sucrose than after water ingestion (P < 0.05). With water ingestion, plasma catecholamines increased significantly, whereas insulin fell (P < 0.05). With sucrose ingestion, the epinephrine response was blunted, whereas the insulin level was significantly increased. In conclusion, the use of adipose tissue microdialysis directly supports a lower lipid mobilization during exercise when sucrose is supplied, which confirms that the availability of carbohydrate influences lipid mobilization.

Exogenous 13C glucose oxidation during exercise: North American vs Western European studies

The purpose of this study was to test the hypothesis that the well-documented changes in background 13C enrichment of expired CO2 observed in response to exercise and carbohydrate ingestion, in subjects living on a North American diet, are not present in subjects living on a Western European diet. The experimental protocol used by Pirnay et al. in 1977 and by Krzentowski et al. in 1984 in subjects living on a Western European diet (4 h of exercise on a treadmill at approximately 50% VO2max with ingestion of 100 g of glucose in 400 ml of water) was duplicated as closely as possible in six subjects living on a North American diet. The actual amounts of exogenous glucose oxidized, computed with a high artificial 13C enrichment of glucose (+189.7/1000 delta 13C PDB-1) which allows one to neglect the 1-2/1000 delta changes in 13C background, were [mean (SEM)] 54.7 (5.4) and 84.2 (3.4) g over 2 h and 4 h of exercise, respectively. These values compare well with data computed by Pirnay et al. [56.6 (13.1) and 94.9 (4.2) g] and by Krzentowski et al. [55.0 (6.2) and 88.0 (4.5) g] using a natural enrichment of glucose (-11.21 and -10.63/1000 delta 13C PDB-1, respectively) assuming no change in 13C background in their Western European subjects. Under the same assumption and using a natural enrichment of glucose (-11.30/1000 delta 13C PDB-1) the oxidation of exogenous glucose was overestimated by 30-40% in our North American subjects.(ABSTRACT TRUNCATED AT 250 WORDS)