The 4 mM blood lactate level as an index of exercise performance in 11-13 year old children

Sex-specific differences in the metabolic enzyme activity and transporter levels in mouse skeletal muscle during postnatal development

Although sex-associated differences in energy metabolism in adults are well-characterized, developmental sex-specific changes in skeletal muscle metabolism are largely unknown. This study investigated sex differences in high-energy phosphate, glycolytic, and mitochondrial enzyme activities and metabolite transporter protein levels in mouse skeletal muscles during the early postnatal period (day 10), post-weaning (day 28), sexual maturity (day 56), and adult life (day 140). No significant sex-specific differences were observed on days 10 and 28, except for glucose transporter (GLUT) 4 level. The hexokinase, phosphofructokinase, and lactate dehydrogenase activities of skeletal muscle were higher and the citrate synthase, cytochrome c oxidase, and β-hydroxyacyl-CoA dehydrogenase activities were lower in female mice than those in male mice on days 56 and 140. The GLUT4 and FAT/CD36 protein levels were higher and the monocarboxylate transporter 4 level was lower in the skeletal muscles of female mice than those of male mice, particularly on days 56 and 140. At 140 days of age, the respiratory exchange ratio during treadmill running (15 m/min, 60 min) was lower in females than that in males, despite no sex differences at rest. In summary, sex differences were not evident in the early postnatal and post-weaning periods but became apparent after the mice reached sexual maturity. These findings indicate that sexually mature animals are a better model for investigating sex differences, particularly in the context of studying energy metabolism in mice.

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.

The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy.http://bit.ly/31SXeB5

Influência da maturação sexual, idade cronológica e índices de crescimento no limiar de lactato e no desempenho da corrida de 20 minutos

Crianças e adolescentes apresentam, em uma determinada carga, menores concentrações de lactato [la] do que os adultos; especula-se que essas diferenças são ligadas a aspectos maturacionais. O objetivo deste estudo foi verificar a influência da maturação sexual, idade cronológica (I) e índices de crescimento (IC - massa corporal, estatura e somatório de dobras cutâneas subescapular e tricipital) na velocidade do limiar de lactato na concentração fixa de lactato ([la]) de 2,5mmol.l-1 (V2,5) e na corrida de 20 minutos (V20). Trinta e três meninos participantes de escolas de esportes foram submetidos a: 1) avaliação antropométrica e avaliação da maturação sexual através dos índices de Tanner (maturação sexual de órgãos genitais e maturação sexual de pêlos púbicos); 2) teste progressivo descontínuo de 3 x 800m (pista de atletismo) para determinar V2,5; e 3) corrida de 20 minutos para determinar a V20 e a [la] final. Não foi encontrada associação entre maturação sexual, idade cronológica e indicadores de crescimento com V2,5. Somente a estatura se mostrou associada com V20. Assim, outras variáveis de desempenho, fisiológicas ou biomecânicas, podem influenciar mais no limiar de lactato e na corrida de 20 minutos, do que as variáveis de crescimento durante a adolescência.

Anaerobic and aerobic enzyme activities in human skeletal muscle from children and adults

Literature has shown that children have lower anaerobic capacity and oxidize more lipids during aerobic activity compared with adults. The purpose of the present study was to examine the effects of age on the activity of marker enzymes for anaerobic and aerobic metabolism in human skeletal muscle from relatively sedentary children and adults. The m. obliquus internus abdominis was analyzed for anaerobic [creatine kinase, adenylate kinase, and lactate dehydrogenase (LDH)] and aerobic (carnitine palmitoyltransferase and 2-oxoglutarate dehydrogenase) enzyme activities in 32 male individuals. The subjects were divided into two groups: children (3-11 y; n=20) and adults (29-54 y; n=12). LDH activity was higher in adults (118.2 +/- 20.1) compared with children (27.8 +/- 10.1) micromol.min(-1).g(-1) wet weight (p <0.0002). Creatine kinase activity was 28% (p <0.0003) lower in children than in adults, and adenylate kinase activity was 20% (p <0.006) lower in children than in adults. In addition, we found higher 2-oxoglutarate dehydrogenase activity in adults compared with children (p <0.04), with no effect of age on carnitine palmitoyltransferase activity (NS). When samples were expressed relative to protein content, only LDH activity remained significantly lower in children compared with adults (p <0.0001). In conclusion, the lower LDH activity observed in children compared with adults may partially explain decreased anaerobic and lactate generation capacity of the children studied. However, the mechanisms for the relatively deficient anaerobic enzyme activities of children are not clear.

A new test to improve the training quality of wheelchair racing athletes

STUDY DESIGN

Validation of a new wheelchair racing test.

OBJECTIVE

To assess the reproducibility of test parameters at different, subjectively chosen, intensity levels in wheelchair racing athletes.

SETTING

Swiss Paraplegic Centre, Nottwil, Switzerland.

SUBJECTS

We tested 11 (eight male, three female) young competitive wheelchair racing athletes. Their age was 20.5+/-6.4 years, height 164.7+/-16.3 cm and weight 54.1+/-9.2 kg. Average weekly training time was 6.8+/-2.7 h. All had been engaged in regular training for over 3.9+/-2.8 years.

METHODS

Within a period of 3+/-1 days, every athlete completed two identical tests in their own racing chair on a training roller. The tests consisted of five 1500 m bouts at routine training intensities of 1 (warm-up) up to 5 (race speed), with a rest of 2 min between each bout. The athletes were blinded to all the collected data during the whole of the test, except for indications of the 500, 1000 and 1500 m markers. We measured the overall time (for 1500 m), average speed, stroke frequency, heart rate, rate of perceived exertion (RPE) and the concentration of lactic acid for all five intensity bouts. In order to get a measure on how reproducible these intensity levels were, we compared the two tests of each athlete with each other, and calculated the root-mean-squared coefficients of variation (CV) for all measured parameters during every bout.

RESULTS

CVs of the measured data show that the most reproducible values were found for bout 5 (2.6-7.9%); except for the lactic acid parameter. The heart rate (CV: 3.1-6.4%) and stroke frequency (CV: 6.5-7.9%) parameters reached rather constant values throughout all five bouts. Lactic acid concentrations showed very high CVs (16.8-29.7%).

CONCLUSION

We conclude that this test is, with the exception of the lactic acid measurements, well reproducible, and particularly suitable for young wheelchair athletes. We find it to be a helpful tool for improving awareness for the individual training intensities, and for pursuing the development of the training process, as particularly the high-intensity bouts are well reproducible.

Maximal lactate steady state in trained adolescent runners

The aims of this study were: (1) to identify the exercise intensity that corresponds to the maximal lactate steady state in adolescent endurance-trained runners; (2) to identify any differences between the sexes; and (3) to compare the maximal lactate steady state with commonly cited fixed blood lactate reference parameters. Sixteen boys and nine girls volunteered to participate in the study. They were first tested using a stepwise incremental treadmill protocol to establish the blood lactate profile and peak oxygen uptake (VO2). Running speeds corresponding to fixed whole blood lactate concentrations of 2.0, 2.5 and 4.0 mmol x l(-1) were calculated using linear interpolation. The maximal lactate steady state was determined from four separate 20-min constant-speed treadmill runs. The maximal lactate steady state was defined as the fastest running speed, to the nearest 0.5 km x h(-1), where the change in blood lactate concentration between 10 and 20 min was < 0.5 mmol x l(-1). Although the boys had to run faster than the girls to elicit the maximal lactate steady state (15.7 vs 14.3 km x h(-1), P < 0.01), once the data were expressed relative to percent peak VO2 (85 and 85%, respectively) and percent peak heart rate (92 and 94%, respectively), there were no differences between the sexes (P > 0.05). The running speed and percent peak VO2 at the maximal lactate steady state were not different to those corresponding to the fixed blood lactate concentrations of 2.0 and 2.5 mmol x l(-1) (P > 0.05), but were both lower than those at the 4.0 mmol x l(-1) concentration (P < 0.05). In conclusion, the maximal lactate steady state corresponded to a similar relative exercise intensity as that reported in adult athletes. The running speed, percent peak VO2 and percent peak heart rate at the maximal lactate steady state are approximated by the fixed blood lactate concentration of 2.5 mmol x l(-1) measured during an incremental treadmill test in boys and girls.

Níveis de lactecidemia durante jogo de pólo aquático: estudo preliminar

O jogo de pólo aquático é uma modalidade de característica intermitente, disputada em quatro períodos de 7min com 2min de intervalo entre estes. Em caso de prorrogação, há um período de repouso de 5min e, a seguir, serão jogados dois períodos de 3min cada, com um intervalo de 1min para as equipes trocarem de lado. Para modalidades com estas características, tem sido sugerida a utilização da mensuração de lactato sanguíneo como indicador da solicitação metabólica. Em função disso, o presente estudo tem como objetivo analisar a concentração de lactato sanguíneo [La] imediatamente após cada um dos períodos de um jogo do Campeonato Paulista Infanto-Juvenil de 1999 (disputa de 3º lugar) e verificar se ocorre diferença na [La] entre os períodos e a prorrogação. Foram sujeitos deste estudo cinco atletas da equipe de nível estadual do Clube Internacional de Regatas (idade = 15,8 ± 0,4 anos; massa corporal = 71,5 ± 11,0kg e estatura = 180 ± 4cm). O sangue foi coletado no lóbulo da orelha e analisado pelo lactímetro Yellow Springs modelo 1500 Sport. Para a comparação da [La] entre os períodos foi utilizada a estatística não paramétrica de Kruskal-Wallis Anova. Os resultados da [La] não diferiram (qui-quadrado = 0,9615; gl = 4; p = 0,9156) entre os períodos (período 1 = 4,64 ± 1,21mM; período 2 = 5,08 ± 1,95mM; período 3 = 4,72 ± 1,33mM; período 4 = 4,32 ± 1,12mM; prorrogação = 4,11 ± 1,03mM). Os resultados indicam que a contribuição da glicólise anaeróbia não foi predominante, sugerindo haver solicitação do sistema anaeróbio aláctico (ATP-CP) nos momentos decisivos do jogo e do metabolismo aeróbio no intervalo entre as ações. Devido a carência de estudos dessa natureza relacionados a essa modalidade esportiva, é oportuna a elaboração de trabalhos subseqüentes que possam trazer informações mais conclusivas.

Metabolic and hormonal responses to exercise in children and adolescents

Ethical and methodological factors limit the availability of data on metabolic and hormonal responses to exercise in children and adolescents. Despite this, it has been reported that young individuals show age-dependent responses to short and long term exercise when compared with adults. Adenosine triphosphate (ATP) and phosphocreatine stores are not age-dependent in children and adolescents. However, phosphorus-31 nuclear magnetic resonance spectroscopy (31PNMR) studies showed smaller reductions in intramuscular pH in children and adolescents during high intensity exercise than adults. Muscle glycogen levels at rest are less important in children, but during adolescence these reach levels observed in adults. Immaturity of anaerobic metabolism in children is a major consideration, and there are several possible reasons for this reduced glycolytic activity. There appear to be higher proportions of slow twitch (type I) fibres in the vastus lateralis part of the quadriceps in children than in untrained adults, and anaerobic glycolytic ATP rephosphorylation may be reduced in young individuals during high intensity exercise. Reduced activity of phosphofructokinase-1 and lactate dehydrogenase enzymes in prepubertal children could also explain the lower glycolytic capacity and the limited production of muscle lactate relative to adults. These observations may be related to reduced sympathetic responses to exhaustive resistance exercise in young people. In contrast, children and adolescents are well adapted to prolonged exercise of moderate intensity. Growth and maturation induce increases in muscle mass, with proliferation of mitochondria and contractile proteins. However, substrate utilisation during exercise differs between children and adults, with metabolic and hormonal adaptations being suggested. Lower respiratory exchange ratio values are often observed in young individuals during prolonged moderate exercise. Data indicate that children rely more on fat oxidation than do adults, and increased free fatty acid mobilisation. glycerol release and growth hormone increases in preadolescent children support this hypothesis. Plasma glucose responses during prolonged exercise are generally comparable in children and adults. When glucose is ingested at the beginning of moderate exercise, plasma glucose levels are higher in children than in adults, but this may be caused by decreased insulin sensitivity during the peripubertal period (as shown by glucose: insulin ratios).

CONCLUSIONS

Children are better adapted to aerobic exercise because their energy expenditure appears to rely more on oxidative metabolism than is the case in adults. Glycolytic activity is age-dependent, and the relative proportion of fat utilisation during prolonged exercise appears higher in children than in adults.

Maximising the clinical use of exercise gaseous exchange testing in children with repaired cyanotic congenital heart defects: the development of an appropriate test strategy

Implicit in deciding upon an exercise test strategy to elucidate cardiopulmonary function in children with congenital heart disease are appropriate application of gas exchange techniques and the significance of the data collected to the specific congenital heart disorder. Post-operative cardiopulmonary responses to exercise in cyanotic disorders are complex and, despite a large body of extant literature in paediatric patients, there has been much difficulty in achieving quality and consistency of data. Maximal oxygen uptake is widely recognised as the best single indicator of cardiopulmonary function and has therefore been the focus of most clinical exercise tests in children. Many children with various heart anomalies are able to exercise to maximum without adverse symptoms, and it is essential that test termination is based on the same criteria for these children. Choosing appropriate, valid indicators of maximum in children with congenital heart disease is beset by difficulties. Such maximal intensity exercise testing procedures have been challenged on the grounds that they do not give a good indication of cardiopulmonary function that is relevant to real life situations. Furthermore, they are prone to much interindividual variability and error in the definition of maximal exertion. Alternative strategies have been proposed which focus upon dynamic submaximal and kinetic cardiopulmonary responses, which are thought to be less dependent on maximal voluntary effort and more suited to the daily activity patterns of children. These methods are also not without problems. Variability in anaerobic threshold measurements and controversy regarding its physiological meaning have been debated. It is recommended that an appropriate cardiopulmonary exercise gas exchange test strategy, which provides clinically useful information for children with cyanotic congenital heart disease, should include both maximal and submaximal data. The inclusion of oxygen uptake kinetics and ventilatory data are encouraged, since they may allow the distinction between a pulmonary, cardiovascular or inactivity related exercise limitation.

Aerobic fitness of prepubescent children

This study was designed to enhance understanding of the assessment and interpretation of the aerobic fitness of prepubertal children. Written informed consent to participate was obtained from 70% of the children in year six of the 15 state schools in the city of Exeter. Twenty-five per cent of the eligible children in each school were randomly selected from those who volunteered. The data reported here are those obtained from the 111 boys (11.1 SD 0.4 years) and 53 girls (10.9 SD 0.3 years) classified as Tanner stage 1 in both pubic hair rating and either genitalia rating (boys) or breast rating (girls). Peak oxygen uptake (peak VO2) was determined using a discontinuous, incremental protocol on a treadmill. Only a minority of children demonstrated a levelling-off or plateau in VO2 despite an increase in exercise intensity. There was no evidence to suggest that the children who demonstrated a VO2 plateau had significantly (p < 0.05) higher peak VO2, peak heart rate, peak respiratory exchange ratio or peak blood lactate than those children who did not demonstrate a plateau in VO2. These findings indicate that a VO2 plateau should not be used as a requirement for defining a maximal exercise test with prepubertal children. Boys had a significantly (p < 0.01) higher peak VO2 than girls, whether expressed in 1.min-1 (1.78 vs 1.46) or in relation to body mass (51 vs 45 ml.kg-1.min-1). The results compare favourably with those of similarly aged children from other countries, but why prepubescent boys have significantly higher (13.3%) mass-related peak VO2 than prepubescent girls is not readily apparent. Although conventional, the expression of peak VO2 as per body mass ratio may not adequately partition out body-size differences. The influence of body mass was therefore removed using a linear adjustment scaling model and a log-linear model, but the boys' peak VO2 remained significantly (p < 0.01) higher than the girls' peak VO2 with the difference now being 16.0% and 16.2%, respectively.

Daily physical activity and blood lactate indices of aerobic fitness in children

This study examined the relationship between daily physical activity and aerobic fitness in 11-16-year-olds. Habitual physical activity was assessed in 28 boys (mean(s.d.) age 13.6(1.3) years) and 45 girls (mean(s.d) age 13.7(1.3) years) from minute-by-minute heart rate monitoring during 3 school days. Aerobic fitness was assessed by determining the percentage peak VO2 at blood lactate reference values of 2.5 and 4.0 mmol l-1 during incremental treadmill running. The 4.0 mmol l-1 level occurred at a mean(s.d.) value of 89(7)% peak VO2 in both boys and girls and mean(s.d.) values at the 2.5 mmol l-1 level were 82(9)% peak VO2 in girls. Mean(s.d.) percentage time with heart rates at or above 140 beats min-1 was 6(3)% in boys and 5(3)% in girls. Corresponding values for percentage time at or above 160 beats min-1 were 3(2) for boys and 2(1) for girls. The number of 10- and 20-min periods of activity with the heart rate sustained above the 140 and 160 beats min-1 thresholds were also totalled over the 3 days. No significant relationships were identified between percentage peak VO2 at the 2.5 or 4.0 mmol l-1 blood lactate reference levels and either percentage time or number of 10- or 20-min periods above 140 or 160 beats min-1 (P > 0.05). These results support the hypothesis that daily physical activity levels in 11-16-year-old children do not stress aerobic metabolism sufficiently to influence aerobic fitness.