Carbohydrate and Lactate Metabolism

Van Hall, G., J. A. L. Calbet, H. Søndergaard, and B. Saltin. Similar carbohydrate but enhanced lactate utilization during exercise after 9 wk of acclimatization to 5,620 m. Am J Physiol Endocrinol Metab 283: E1203–E1213, 2002. First published July 30, 2002; 10.1152/ajpendo. 00134.2001.—We hypothesized that reliance on lactate as a means of energy distribution is higher after a prolonged period of acclimatization (9 wk) than it is at sea level due to a higher lactate Ra and disposal from active skeletal muscle. To evaluate this hypothesis, six Danish lowlanders (25 2 yr) were studied at rest and during 20 min of bicycle exercise at 146 W at sea level (SL) and after 9 wk of acclimatization to 5,260 m (Alt). Whole body glucose Ra was similar at SL and Alt at rest and during exercise. Lactate Ra was also similar for the two conditions at rest; however, during exercise, lactate Ra was substantially lower at SL (65 mol min 1 kg body wt 1) than it was at Alt (150 mol min 1 kg body wt 1) at the same exercise intensity. During exercise, net lactate release was 6-fold at Alt compared with SL, and related to this, tracer-calculated leg lactate uptake and release were both 3or 4-fold higher at Alt compared with SL. The contribution of the two legs to glucose disposal was similar at SL and Alt; however, the contribution of the two legs to lactate Ra was significantly lower at rest and during exercise at SL (27 and 81%) than it was at Alt (45 and 123%). In conclusion, at rest and during exercise at the same absolute workload, CHO and blood glucose utilization were similar at SL and at Alt. Leg net lactate release was severalfold higher, and the contribution of leg lactate release to whole body lactate Ra was higher at Alt compared with SL. During exercise, the relative contribution of lactate oxidation to whole body CHO oxidation was substantially higher at Alt compared with SL as a result of increased uptake and subsequent oxidation of lactate by the active skeletal muscles.