Effect of heliox on lung dynamic hyperinflation, dyspnea, and exercise endurance capacity in COPD patients.

We tested the hypothesis that heliox breathing, by reducing lung dynamic hyperinflation (DH) and dyspnea (Dys) sensation, may significantly improve exercise endurance capacity in patients with chronic obstructive pulmonary disease [n = 12, forced expiratory volume in 1 s = 1.15 (SD 0.32) liters]. Each subject underwent two cycle ergometer high-intensity constant work rate exercises to exhaustion, one on room air and one on heliox (79% He-21% O2). Minute ventilation (VE), carbon dioxide output, heart rate, inspiratory capacity (IC), Dys, and arterial partial pressure of CO2 were measured. Exercise endurance time increased significantly with heliox [9.0 (SD 4.5) vs. 4.2 (SD 2.0) min; P < 0.001]. This was associated with a significant reduction in lung DH at isotime (Iso), as reflected by the increase in IC [1.97 (SD 0.40) vs. 1.77 (SD 0.41) liters; P < 0.001] and a decrease in Dys [6 (SD 1) vs. 8 (SD 1) score; P < 0.001]. Heliox induced a state of relative hyperventilation, as reflected by the increase in VE [38.3 (SD 7.7) vs. 35.5 (SD 8.8) l/min; P < 0.01] and VE/carbon dioxide output [36.3 (SD 6.0) vs. 33.9 (SD 5.6); P < 0.01] at peak exercise and by the reduction in arterial partial pressure of CO2 at Iso [44 (SD 6) vs. 48 (SD 6) Torr; P < 0.05] and at peak exercise [46 (SD 6) vs. 48 (SD 6) Torr; P < 0.05]. The reduction in Dys at Iso correlated significantly (R = -0.75; P < 0.01) with the increase in IC induced by heliox. The increment induced by heliox in exercise endurance time correlated significantly with resting increment in resting forced expiratory in 1 s (R = 0.88; P < 0.01), increase in IC at Iso (R = 0.70; P < 0.02), and reduction in Dys at Iso (R = -0.71; P < 0.01). In chronic obstructive pulmonary disease, heliox breathing improves high-intensity exercise endurance capacity by increasing maximal ventilatory capacity and by reducing lung DH and Dys.     

Prior exercise delays the onset of acidosis during incremental exercise.

The effects of prior moderate- and prior heavy-intensity exercise on the subsequent metabolic response to incremental exercise were examined. Healthy, young adult subjects (n = 8) performed three randomized plantar-flexion exercise tests: 1) an incremental exercise test (approximately 0.6 W/min) to volitional fatigue (Ramp); 2) Ramp preceded by 6 min of moderate-intensity, constant-load exercise below the intracellular pH threshold (pHT; Mod-Ramp); and 3) Ramp preceded by 6 min of heavy-intensity, constant-load exercise above pHT (Hvy-Ramp); the constant-load and incremental exercise periods were separated by 6 min of rest. (31)P-magnetic resonance spectroscopy was used to continuously monitor intracellular pH, phosphocreatine concentration ([PCr]), and inorganic phosphate concentration ([P(i)]). No differences in exercise performance or the metabolic response to exercise were observed between Ramp and Mod-Ramp. However, compared with Ramp, a 14% (SD 10) increase (P < 0.01) in peak power output (PPO) was observed in Hvy-Ramp. The improved exercise performance in Hvy-Ramp was accompanied by a delayed (P = 0.01) onset of intracellular acidosis [Hvy-Ramp 60.4% PPO (SD 11.7) vs. Ramp 45.8% PPO (SD 9.4)] and a delayed (P < 0.01) onset of rapid increases in [P(i)]/[PCr] [Hvy-Ramp 61.5% PPO (SD 12.0) vs. Ramp 45.1% PPO (SD 9.1)]. In conclusion, prior heavy-intensity exercise delayed the onset of intracellular acidosis and enhanced exercise performance during a subsequent incremental exercise test.     

The maximally attainable VO2 during exercise in humans: the peak vs. maximum issue.

The quantification of maximum oxygen uptake (V(O2 max)), a parameter characterizing the effective integration of the neural, cardiopulmonary, and metabolic systems, requires oxygen uptake (VO2) to attain a plateau. We were interested in whether a VO2 plateau was consistently manifest during maximal incremental ramp cycle ergometry and also in ascertaining the relationship between this peak VO2 (V(O2 peak)) and that determined from one, or several, maximal constant-load tests. Ventilatory and pulmonary gas-exchange variables were measured breath by breath with a turbine and mass spectrometer. On average, V(O2 peak) [3.51 +/- 0.8 (SD) l/min] for the ramp test did not differ from that extrapolated from the linear phase of the response in 71 subjects. In 12 of these subjects, the V(O2 peak) was less than the extrapolated value by 0.1-0.4 l/min (i.e., a "plateau"), and in 19 subjects, V(O2 peak) was higher by 0.05-0.4 l/min. In the remaining 40 subjects, we could not discriminate a difference. The V(O2 peak) from the incremental test also did not differ from that of a single maximum constant-load test in 38 subjects or from the V(O2 max) in 6 subjects who undertook a range of progressively greater discontinuous constant-load tests. A plateau in the actual VO2 response is therefore not an obligatory consequence of incremental exercise. Because the peak value attained was not different from the plateau in the plot of VO2 vs. work rate (for the constant-load tests), the V(O2 peak) attained on a maximum-effort incremental test is likely to be a valid index of V(O2 max), despite no evidence of a plateau in the data themselves. However, without additional tests, one cannot be certain.     

Effect of carbohydrate ingestion on glucose kinetics during exercise in the heat.

Six endurance-trained men [peak oxygen uptake (V(O(2))) = 4.58 +/- 0.50 (SE) l/min] completed 60 min of exercise at a workload requiring 68 +/- 2% peak V(O(2)) in an environmental chamber maintained at 35 degrees C (<50% relative humidity) on two occasions, separated by at least 1 wk. Subjects ingested either a 6% glucose solution containing 1 microCi [3-(3)H]glucose/g glucose (CHO trial) or a sweet placebo (Con trial) during the trials. Rates of hepatic glucose production [HGP = glucose rate of appearance (R(a)) in Con trial] and glucose disappearance (R(d)), were measured using a primed, continuous infusion of [6,6-(2)H]glucose, corrected for gut-derived glucose (gut R(a)) in the CHO trial. No differences in heart rate, V(O(2)), respiratory exchange ratio, or rectal temperature were observed between trials. Plasma glucose concentrations were similar at rest but increased (P < 0.05) to a greater extent in the CHO trial compared with the Con trial. This was due to the absorption of ingested glucose in the CHO trial, because gut R(a) after 30 and 50 min (16 +/- 5 micromol. kg(-1). min(-1)) was higher (P < 0.05) compared with rest, whereas HGP during exercise was not different between trials. Glucose R(d) was higher (P < 0.05) in the CHO trial after 30 and 50 min (48.0 +/- 6.3 vs 34.6 +/- 3.8 micromol. kg(-1). min(-1), CHO vs. Con, respectively). These results indicate that ingestion of carbohydrate, at a rate of approximately 1.0 g/min, increases glucose R(d) but does not blunt the rise in HGP during exercise in the heat.     

Prior eccentric exercise reduces v[combining dot above]o2peak and ventilatory threshold but does not alter movement economy during cycling exercise

Exercise-induced muscle damage (EIMD) has been shown to reduce force production and result in delayed-onset soreness and pain in the damaged muscle(s). Cycling in the presence of EIMD reduces peak power output and time-trial performance. However, its effect on peak aerobic capacity has not been widely studied. The purpose of this study was to examine the impact of EIMD targeted specifically to the quadriceps muscle group on peak oxygen consumption (V[Combining Dot Above]O2peak) during cycling. Ten participants (4 men, 6 women) completed a V[Combining Dot Above]O2peak test on a cycle ergometer before and 48 hours after performing 24 eccentric contractions with their right and left quadriceps with a weight equal to 120% of 1-repetition maximal concentric strength (1RM). The EIMD was assessed using 1RM, and muscle soreness was assessed using a 100-mm visual analog scale. The presence of EIMD was confirmed by a 9% reduction in 1RM (p = 0.0001) and increased ratings of soreness from 2.4 ± 2.1 to 24.6 ± 10.8 mm (p = 0.001). The V[Combining Dot Above]O2peak was reduced from 46.2 ± 9.7 to 41.8 ± 10.7 ml·kg·min (10%; p = 0.01) with participants terminating exercise at lower heart rates 191 ± 9 vs. 186 ± 10 b·min (p = 0.02) and power output 248 ± 79 vs. 238 ± 81 W (p = 0.02) after EIMD. Additionally, ventilatory threshold decreased from 34.2 ± 7.8 to 30.5 ± 8.5 ml·kg·min (11%; p = 0.031). Despite the reduction in V[Combining Dot Above]O2peak, cycling economy (p = 0.17) did not differ pre-EIMD and post-EIMD. These findings indicate that EIMD reduced peak aerobic exercise capacity to an extent that could result in meaningful reductions in exercise performance. The reduction is likely attributable to a combination of reduced strength, earlier accumulation of lactic acid, and heightened muscle pain during exercise.     

Effect of temperature on skeletal muscle energy turnover during dynamic knee-extensor exercise in humans.

The present study examined the effect of elevated temperature on muscle energy turnover during dynamic exercise. Nine male subjects performed 10 min of dynamic knee-extensor exercise at an intensity of 43 W (SD 10) and a frequency of 60 contractions per minute. Exercise was performed under normal (C) and elevated muscle temperature (HT) through passive heating. Thigh oxygen uptake (V(O2)) was determined from measurements of thigh blood flow and femoral arterial-venous differences for oxygen content. Anaerobic energy turnover was estimated from measurements of lactate release as well as muscle lactate accumulation and phosphocreatine utilization based on analysis of muscle biopsies obtained before and after each exercise. At the start of exercise, muscle temperature was 34.5 degrees C (SD 1.7) in C compared with 37.2 degrees C (SD 0.5) during HT (P < 0.05). Thigh V(O2) after 3 min was 0.52 l/min (SD 0.11) in C and 0.63 l/min (SD 0.13) in HT, and at the end of exercise it was 0.60 l/min (SD 0.14) and 0.61 l/min (SD 0.10) in C and HT, respectively (not significant). Total lactate release was the same between the two temperature conditions, as was muscle lactate accumulation and PCr utilization. Total ATP production (aerobic + anaerobic) was the same between each temperature condition [505.0 mmol/kg (SD 107.2) vs. 527.1 mmol/kg (SD 117.6); C and HT, respectively]. In conclusion, within the range of temperatures studied, passively increasing muscle temperature before exercise has no effect on muscle energy turnover during dynamic exercise.     

The impact of electronic mail versus print delivery of an exercise program on muscular strength and aerobic capacity in people with type 2 diabetes

Previous research indicates that the Internet, electronic mail (e-mail), and printed materials can be used to deliver interventions to improve physical activity in people with type 2 diabetes. However, no studies have been conducted investigating the effect of e-mail or print delivery of an exercise program on muscular strength and aerobic capacity in people with type 2 diabetes. The purpose of this clinical trial was to investigate the impact of e-mail vs. print delivery of an exercise program on muscular strength and aerobic capacity in people with type 2 diabetes. Nineteen participants with type 2 diabetes were allocated to either a group that was delivered a prescribed exercise program using e-mail (e-mail group, n = 10) or a group that was delivered the same prescribed exercise program in print form (print group, n = 9). Chest press and leg press estimated one-repetition maximum (1-RM) scores as well as estimated peak oxygen uptake ([latin capital V with dot above]O2peak) were measured at baseline and follow-up. Intention-to-treat analysis indicated significant improvements in chest press (mean = 7.00 kg, p = 0.001, effect size = 2.22) and leg press (mean = 19.32 kg, p = 0.002, effect size = 1.98) 1-RM scores and [latin capital V with dot above]O2peak (mean = 9.38 mL of oxygen uptake per kilogram of body mass per minute, p = 0.01, effect size = 1.45) within the e-mail group. Within the print group, significant improvements in chest press (mean = 9.13 kg, p = 0.01, effect size = 1.49) and leg press (mean = 16.68 kg, p = 0.01, effect size = 1.31) 1-RM scores and [latin capital V with dot above]O2peak (mean = 5.14 ml of oxygen uptake per kilogram of body mass per minute, p = 0.03, effect size = 1.14) were found. No significant between-group differences in improvements were found. Clinicians can deliver a prescribed exercise program, either by e-mail or in print form, to significantly improve muscular strength and aerobic capacity in people with type 2 diabetes, and expect similar outcomes.     

Influence of acute plasma volume expansion on VO2 kinetics, VO2 peak, and performance during high-intensity cycle exercise.

The purpose of this study was to examine the influence of acute plasma volume expansion (APVE) on oxygen uptake (V(O2)) kinetics, V(O2peak), and time to exhaustion during severe-intensity exercise. Eight recreationally active men performed "step" cycle ergometer exercise tests at a work rate requiring 70% of the difference between the gas-exchange threshold and V(O2max) on three occasions: twice as a "control" (Con) and once after intravenous infusion of a plasma volume expander (Gelofusine; 7 ml/kg body mass). Pulmonary gas exchange was measured breath by breath. APVE resulted in a significant reduction in hemoglobin concentration (preinfusion: 16.0 +/- 1.0 vs. postinfusion: 14.7 +/- 0.8 g/dl; P < 0.001) and hematocrit (preinfusion: 44 +/- 2 vs. postinfusion: 41 +/- 3%; P < 0.01). Despite this reduction in arterial O(2) content, APVE had no effect on V(O2) kinetics (phase II time constant, Con: 33 +/- 15 vs. APVE: 34 +/- 12 s; P = 0.74), and actually resulted in an increased V(O2peak) (Con: 3.90 +/- 0.56 vs. APVE: 4.12 +/- 0.55 l/min; P = 0.006) and time to exhaustion (Con: 365 +/- 58 vs. APVE: 424 +/- 64 s; P = 0.04). The maximum O(2) pulse was also enhanced by the treatment (Con: 21.3 +/- 3.4 vs. APVE: 22.7 +/- 3.4 ml/beat; P = 0.04). In conclusion, APVE does not alter V(O2) kinetics but enhances V(O2peak) and exercise tolerance during high-intensity cycle exercise in young recreationally active subjects.     

Aerobic power and insulin action improve in response to endurance exercise training in healthy 77-87 yr olds.

Previous studies have demonstrated that frail octogenarians have an attenuated capacity for cardiovascular adaptations to endurance exercise training. In the present study, we determined the magnitude of cardiovascular and metabolic adaptations to high-intensity endurance exercise training in healthy, nonfrail elderly subjects. Ten subjects [8 men, 2 women, 80.3 yr (SD2.5)] completed 10-12 mo (108 exercise sessions) of a supervised endurance exercise training program consisting of 2.5 sessions/wk (SD 0.2), 58 min/session (SD 6), at an intensity of 83% (SD 5) of peak heart rate. Primary outcomes were maximal attainable aerobic power [peak aerobic capacity (Vo(2peak))]; serum lipids, oral glucose tolerance, and insulin action during a hyperglycemic clamp; body composition by dual-energy X-ray absorptiometry, and energy expenditure using doubly labeled water and indirect calorimetry. The training program resulted in an increase in Vo(2peak) of 15% (SD 7) [22.9 (SD 3.3) to 26.2 ml.kg(-1).min(-1) (SD 4.0); P < 0.0001]. Favorable lipid changes included reductions in total cholesterol (-8%; P = 0.002) and LDL cholesterol (-10%; P = 0.003), with no significant change in HDL cholesterol or triglycerides. Insulin action improved, as evidenced by a 29% increase in glucose disposal rate relative to insulin concentration during the hyperglycemic clamp. Fat mass decreased by 1.8 kg (SD 1.4) (P = 0.003); lean mass did not change. Total energy expenditure increased by 400 kcal/day because of an increase in physical activity. No change occurred in resting metabolism. In summary, healthy nonfrail octogenarians can adapt to high-intensity endurance exercise training with improvements in aerobic power, insulin action, and serum lipid and lipoprotein risk factors for coronary heart disease; however, the adaptations in aerobic power and insulin action are attenuated compared with middle-aged individuals.     

Achievement of v[combining dot above]o2max criteria during a continuous graded exercise test and a verification stage performed by college athletes

ABSTRACT: Mier, CM, Alexander, RP, and Mageean, AL. Achievement of V[Combining Dot Above]O2max criteria during a continuous graded exercise test and a verification stage performed by college athletes. J Strength Cond Res 26(10): 2648-2654, 2012-The purpose of this study was to determine the incidence of meeting specific V[Combining Dot Above]O2max criteria and to test the effectiveness of a V[Combining Dot Above]O2max verification stage in college athletes. Thirty-five subjects completed a continuous graded exercise test (GXT) to volitional exhaustion. The frequency of achieving various respiratory exchange ratio (RER) and age-predicted maximum heart rate (HRmax) criteria and a V[Combining Dot Above]O2 plateau within 2 and 2.2 ml·kg·min (<2SD of the expected increase in V[Combining Dot Above]O2) were measured and tested against expected frequencies. After 10 minutes of active recovery, 10 subjects who did not demonstrate a plateau completed a verification stage performed at supramaximal intensity. From the GXT, the number of subjects meeting V[Combining Dot Above]O2max plateau was 5 (≤2 ml·kg·min) and 7 (≤2.2 ml·kg·min), RER criteria 34 (≥1.05), 32 (≥1.10), and 24 (≥1.15), HRmax criteria, 35 (<85%), 29 (<10 b·min) and 9 (HRmax). The V[Combining Dot Above]O2max and HRmax did not differ between GXT and the verification stage (53.6 ± 5.6 vs. 55.5 ± 5.6 ml·kg·min and 187 ± 7 vs. 187 ± 6 b·min); however, the RER was lower during the verification stage (1.15 ± 0.06 vs. 1.07 ± 0.07, p = 0.004). Six subjects achieved a similar V[Combining Dot Above]O2 (within 2.2 ml·kg·min), whereas 4 achieved a higher V[Combining Dot Above]O2 compared with the GXT. These data demonstrate that a continuous GXT limits the college athlete's ability to achieve V[Combining Dot Above]O2max plateau and certain RER and HR criteria. The use of a verification stage increases the frequency of V[Combining Dot Above]O2max achievement and may be an effective method to improve the accuracy of V[Combining Dot Above]O2max measurements in college athletes.     

Enhancement of arm exercise endurance capacity with dihydroxyacetone and pyruvate

The effects of dietary supplementation of dihydroxyacetone and pyruvate (DHAP) on endurance capacity and metabolic responses during arm exercise were determined in 10 untrained males (20-26 yr). Subjects performed arm ergometer exercise (60% peak O2 consumption) to exhaustion after consumption of standard diets (55% carbohydrate, 15% protein, 30% fat; 35 kcal/kg) containing either 100 g of Polycose (placebo, P) or DHAP (3:1, treatment) substituted for a portion of carbohydrate. The two diets were administered in a random order, and each was consumed for a 7-day period. Biopsy of the triceps muscle was obtained immediately before and after exercise. Blood samples were drawn through radial artery and axillary vein catheters at rest, after 60 min of exercise, and at exercise termination. Arm endurance was 133 +/- 20 min after P and 160 +/- 22 min after DHAP (P less than 0.01). Triceps glycogen at rest was 88 +/- 8 (P) and 130 +/- 19 mmol/kg (DHAP) (P less than 0.05). Whole arm arteriovenous glucose difference (mmol/l) was greater (P less than 0.05) for DHAP than P at rest (0.60 +/- 0.12 vs. 0.05 +/- 0.09) and after 60 min of exercise (1.00 +/- 0.12 vs. 0.36 +/- 0.11), but it did not differ at exhaustion. Neither respiratory exchange ratio nor respiratory quotient differed between trials at rest, after 60 min of exercise, or at exhaustion. Plasma free fatty acid, glycerol, beta-hydroxybutyrate, catecholamines, and insulin were similar during rest and exercise for both diets. Feeding DHAP for 7 days increased arm muscle glucose extraction before and during exercise, thereby enhancing submaximal arm endurance capacity.     

Comparison of cardiopulmonary responses to two types of dry-land upper-body exercise testing modes in competitive swimmers

In this study we compared cardiopulmonary responses to upper-body exercise in 12 swimmers, using simulation of the front-crawl arm-pulling action on a computer-interfaced isokinetic swim bench and arm cranking on a modified cycle ergometer. Subjects adopted a prone posture; exercise was initially set at 20 W and subsequently increased by 10 W. min(-1). The tests were performed in a randomised order at the same time of day, within 72 h. The highest (peak) oxygen consumption (VO(2peak)), heart rate (HR(peak)), blood lactate ([la(-)](peak)) and exercise intensity (EI(peak)) were recorded at exhaustion. Mean (SEM) peak responses to simulated swimming were higher than those to arm cranking for VO(2peak) [2.9 (0.2) vs 2.4 (0.1) l x min(-1); P = 0.01], HR(peak) [174 (2) vs 161 (2) beats x min(-1); P = 0.03], and EI(peak) [122 (6) vs 102 (5) W; P = 0.02]. However, there were no significant differences in [la(-)](peak) [9.6 (0.6) vs 8.2 (0.6) mmol x l(-1); P = 0.08]. Thus simulated swimming is the preferred form of dry-land ergometry for the assessment of swimmers.     

Maximal exercise capacity and oxygen consumption of lambs with an aortopulmonary left-to-right shunt

We determined maximal exercise capacity and measured hemodynamics in 10 6-wk-old lambs with an aortopulmonary left-to-right shunt [S, 57 +/- 11%, (SD)] and in 9 control lambs (C) during a graded treadmill test 8 days after surgery. Maximal exercise capacity (3.7 +/- 0.2 km/h and 10 +/- 5% inclination vs. 4.0 +/- 0.9 km/h and 15 +/- 0% inclination, P less than 0.02) and peak oxygen consumption (25 +/- 7 vs. 34 +/- 8 ml O2.min-1.kg-1, P less than 0.02) were both lower in the shunt than in the control lambs. This was due to a lower maximal systemic blood flow in the shunt lambs (271 +/- 38 vs. 359 +/- 71 ml.min-1.kg-1, P less than 0.01). Despite their high maximal left ventricular output, which was higher than in the control lambs (448 +/- 87 vs. 359 +/- 71 ml.min-1.kg-1, P less than 0.05), the left-to-right shunt could not be compensated for during maximal exercise because of a decreased reserve in heart rate (S: 183 +/- 22 to 277 +/- 38 beats/min; C: 136 +/- 25 to 287 +/- 29 beats/min) and in left ventricular stroke volume (S: 1.8 +/- 0.3 to 1.6 +/- 0.4 ml/kg; C: 1.0 +/- 0.3 to 1.3 +/- 0.2 ml/kg). We conclude that exercise capacity of shunt lambs is lower than that of control lambs, despite a good left ventricular performance, because a part of the reserves for increasing the left ventricular output is already utilized at rest.     

Supramaximal exercise after training-induced hypervolemia. I. Gas exchange and acid-base balance

The effect of an exercise-induced reduction in blood O2-carrying capacity on ventilatory gas exchange and acid-base balance during supramaximal exercise was studied in six males [peak O2 consumption (VO2peak), 3.98 +/- 0.49 l/min]. Three consecutive days of supramaximal exercise resulted in a preexercise reduction of hemoglobin concentration from 15.8 to 14.0 g/dl (P less than 0.05). During exercise (120% VO2peak) performed intermittently (1 min work to 4 min rest); a small but significant (P less than 0.05) increase was found for both O2 consumption (VO2) (l X min) and heart rate (beats/min) on day 2 of the training. On day 3, VO2 (l/min) was reduced 3.2% (P less than 0.05) over day 1 values. No changes were found in CO2 output and minute ventilation during exercise between training days. Similarly, short-term training failed to significantly alter the changes in arterialized blood PCO2, pH, and [HCO-3] observed during exercise. It is concluded that hypervolemia-induced reductions in O2-carrying capacity in the order of 10-11% cause minimal impairment to gas exchange and acid-base balance during supramaximal non-steady-state exercise.     

Glucose clearance in aged trained skeletal muscle during maximal insulin with superimposed exercise.

Insulin and muscle contractions are major stimuli for glucose uptake in skeletal muscle and have in young healthy people been shown to be additive. We studied the effect of superimposed exercise during a maximal insulin stimulus on glucose uptake and clearance in trained (T) (1-legged bicycle training, 30 min/day, 6 days/wk for 10 wk at approximately 70% of maximal O(2) uptake) and untrained (UT) legs of healthy men (H) [n = 6, age 60 +/- 2 (SE) yr] and patients with Type 2 diabetes mellitus (DM) (n = 4, age 56 +/- 3 yr) during a hyperinsulinemic ( approximately 16,000 pmol/l), isoglycemic clamp with a final 30 min of superimposed two-legged exercise at 70% of individual maximal heart rate. With superimposed exercise, leg glucose extraction decreased (P < 0.05), and leg blood flow and leg glucose clearance increased (P < 0.05), compared with hyperinsulinemia alone. During exercise, leg blood flow was similar in both groups of subjects and between T and UT legs, whereas glucose extraction was always higher (P < 0.05) in T compared with UT legs (15.8 +/- 1.2 vs. 14.6 +/- 1.8 and 11.9 +/- 0.8 vs. 8.8 +/- 1.8% for H and DM, respectively) and leg glucose clearance was higher in T (H: 73 +/- 8, DM: 70 +/- 10 ml. min(-1). kg leg(-1)) compared with UT (H: 63 +/- 8, DM: 45 +/- 7 ml. min(-1). kg leg(-1)) but not different between groups (P > 0.05). From these results it can be concluded that, in both diabetic and healthy aged muscle, exercise adds to a maximally insulin-stimulated glucose clearance and that glucose extraction and clearance are both enhanced by training.     

Acute exercise and GLUT4 expression in human skeletal muscle: influence of exercise intensity.

To examine the influence of exercise intensity on the increases in vastus lateralis GLUT4 mRNA and protein after exercise, six untrained men exercised for 60 min at 39 +/- 3% peak oxygen consumption (V(O2 peak)) (Lo) or 27 +/- 2 min at 83 +/- 2% V(O2 peak) (Hi) in counterbalanced order. Preexercise muscle glycogen levels were not different between trials (Lo: 408 +/- 35 mmol/kg dry mass; Hi: 420 +/- 43 mmol/kg dry mass); however, postexercise levels were lower (P < 0.05) in Hi (169 +/- 18 mmol/kg dry mass) compared with Lo (262 +/- 35 mmol/kg dry mass). Thus calculated muscle glycogen utilization was greater (P < 0.05) in Hi (251 +/- 24 mmol/kg) than in Lo (146 +/- 34). Exercise resulted in similar increases in GLUT4 gene expression in both trials. GLUT4 mRNA was increased immediately at the end of exercise (approximately 2-fold; P < 0.05) and remained elevated after 3 h of postexercise recovery. When measured 3 h after exercise, total crude membrane GLUT4 protein levels were 106% higher in Lo (3.3 +/- 0.7 vs. 1.6 +/- 0.3 arbitrary units) and 61% higher in Hi (2.9 +/- 0.5 vs. 1.8 +/- 0.5 arbitrary units) relative to preexercise levels. A main effect for exercise was observed, with no significant differences between trials. In conclusion, exercise at approximately 40 and approximately 80% V(O2 peak), with total work equal, increased GLUT4 mRNA and GLUT4 protein in human skeletal muscle to a similar extent, despite differences in exercise intensity and duration.     

Autoregulation of glucose production in men with a glycerol load during rest and exercise

Related to hepatic autoregulation we evaluated hypotheses that 1) glucose production would be altered as a result of a glycerol load, 2) decreased glucose recycling rate (Rr) would result from increased glycerol uptake, and 3) the absolute rate of gluconeogenesis (GNG) from glycerol would be positively correlated to glycerol rate of disappearance (R(d)) during a glycerol load. For these purposes, glucose and glycerol kinetics were determined in eight men during rest and during 90 min of leg cycle ergometry at 45 and 65% of peak O2 consumption (.VO2 (peak)). Trials were conducted after an overnight fast, with exercise commencing 12 h after the last meal. Subjects received a continuous infusion of [6,6-(2)H(2)]glucose, [1-(13)C]glucose, and [1,1,2,3,3-(2)H(5)]glycerol without (CON) or with an additional 1,000 mg (rest: 20 mg/min; exercise: 40 mg/min) of [2-(13)C]- or unlabeled glycerol added to the infusate (GLY). Infusion of glycerol dampened glucose Rr, calculated as the difference between [6,6-(2)H(2)]- and [1-(13)C]glucose rates of appearance (R(a)), at rest [0.35 +/- 0.12 (CON) vs. 0.12 +/- 0.10 mg. kg(-1). min(-1) (GLY), P < 0.05] and during exercise at both intensities [45%: 0.63 +/- 0.14 (CON) vs. 0.04 +/- 0.12 (GLY); 65%: 0.73 +/- 0.14 (CON) vs. 0.04 +/- 0.17 mg. kg(-1). min(-1) (GLY), P < 0.05]. Glucose R(a) and oxidation were not affected by glycerol infusion at rest or during exercise. Throughout rest and both exercise intensities, glycerol R(d) was greater in GLY vs. CON conditions (rest: 0.30 +/- 0.04 vs. 0.58 +/- 0.04; 45%: 0.57 +/- 0.07 vs. 1.19 +/- 0.04; 65%: 0.73 +/- 0.06 vs. 1.27 +/- 0.05 mg. kg(-1). min(-1), CON vs. GLY, respectively). Differences in glycerol R(d) (DeltaR(d)) between protocols equaled the unlabeled glycerol infusion rate and correlated with plasma glycerol concentration (r = 0.97). We conclude that infusion of a glycerol load during rest and exercise at 45 and 65% of .VO2(peak) 1) does not affect glucose R(a) or R(d), 2) blocks glucose Rr, 3) increases whole body glycerol R(d) in a dose-dependent manner, and 4) results in gluconeogenic rates from glycerol equivalent to CON glucose recycling rates.     

The effects of hyperthermia and hypoxia on ventilation during low-intensity steady-state exercise

This study assessed whether the elevated sensitivity of ventilation to hypoxia during exercise is accounted for by an elevation of esophageal temperature (T(es)). Eleven males volunteered for two exercise sessions on an underwater, head-out cycle ergometer at a steady-state rate of oxygen consumption (V(.)(O(2))) of approximately 0.87 l/min (SD 0.07). In one exercise session, 31.5 degrees C (SD 1.4) water held T(es) at a normothermic level of approximately 37.1 degrees C, and in the other exercise session, water at 38.2 degrees C (SD 0.1) maintained a hyperthermic T(es) of approximately 38.5 degrees C. After a 30-min rest and 20-min warm-up, exercising participants inhaled air for 10 min [Euoxia 1 (E1)], an isocapnic hypoxic gas mixture with 12% O(2) in N(2) (H1) for the next 10 min and air again [Euoxia 2 (E2)] for the last 10 min. A significant increase in V(.)(E) during all hyperthermia conditions (0.01< P < 0.048) was evident; however, during hyperthermic hypoxia, there was a disproportionate and significant (P = 0.017) increase in V(.)(E) relative to normothermic hypoxia. This was the main explanation for a significant esophageal temperature and gas type interaction (P = 0.012) for V(.)(E). Significant effects of hyperthermia, isocapnic hypoxia, and their positive interaction remained evident after removing the influence of (V(.)(O(2))) on V(.)(E). Serum lactate and potassium concentrations, as well as hemoglobin oxygen saturation, were each not significantly different between normothermic and hyperthermic-hypoxic conditions. In conclusion, the elevated sensitivity of exercise ventilation to hypoxia during exertion appears to be modulated by elevations in esophageal temperature, potentially because of a temperature-mediated stimulation of the peripheral chemoreceptors.     

Glucose kinetics and substrate oxidation during exercise in the follicular and luteal phases.

The purpose of this investigation was to determine whether plasma glucose kinetics and substrate oxidation during exercise are dependent on the phase of the menstrual cycle. Once during the follicular (F) and luteal (L) phases, moderately trained subjects [peak O(2) uptake (V(O(2))) = 48.2 +/- 1.1 ml. min(-1). kg(-1); n = 6] cycled for 25 min at approximately 70% of the V(O(2)) at their respective lactate threshold (70%LT), followed immediately by 25 min at 90%LT. Rates of plasma glucose appearance (R(a)) and disappearance (R(d)) were determined with a primed constant infusion of [6,6-(2)H]glucose, and total carbohydrate (CHO) and fat oxidation were determined with indirect calorimetry. At rest and during exercise at 70%LT, there were no differences in glucose R(a) or R(d) between phases. CHO and fat oxidation were not different between phases at 70%LT. At 90%LT, glucose R(a) (28.8 +/- 4.8 vs. 33.7 +/- 4.5 micromol. min(-1). kg(-1); P < 0.05) and R(d) (28.4 +/- 4.8 vs. 34.0 +/- 4.1 micromol. min(-1). kg(-1); P < 0.05) were lower during the L phase. In addition, at 90%LT, CHO oxidation was lower during the L compared with the F phase (82.0 +/- 12.3 vs. 93.8 +/- 9.7 micromol. min(-1) .kg(-1); P < 0.05). Conversely, total fat oxidation was greater during the L phase at 90%LT (7.46 +/- 1.01 vs. 6.05 +/- 0.89 micromol. min(-1). kg(-1); P < 0.05). Plasma lactate concentration was also lower during the L phase at 90%LT concentrations (2.48 +/- 0.41 vs. 3.08 +/- 0.39 mmol/l; P < 0.05). The lower CHO utilization during the L phase was associated with an elevated resting estradiol (P < 0.05). These results indicate that plasma glucose kinetics and CHO oxidation during moderate-intensity exercise are lower during the L compared with the F phase in women. These differences may have been due to differences in circulating estradiol.     

VO(2) kinetics and the O(2) deficit in heavy exercise.

The purpose of this study was to examine a new method for calculating the O(2) deficit that considered the O(2) uptake (VO(2)) kinetics during exercise as two separate phases in light of previous research in which it was shown that the traditional O(2) deficit calculation overestimated the recovery O(2) consumption (ROC). Eight subjects completed exercise transitions between unloaded cycling and 25% (heavy, H) or 50% (very heavy, VH) of the difference between the lactic acid threshold (LAT) and peak VO(2) for 8 min. The O(2) deficit, calculated in the traditional manner, was significantly greater than the measured ROC for both above-LAT exercises: 4.03 +/- 1.01 vs. 2.63 +/- 0.80 (SD) liters for VH and 2.36 +/- 0.91 vs. 1.74 +/- 0.63 liters for H for the O(2) deficit vs. ROC (P < 0.05). When the kinetics were viewed as two separate components with independent onsets, the calculated O(2) deficit (2.89 +/- 0.79 and 1.71 +/- 0.70 liters for VH and H, respectively) was not different from the measured ROC (P < 0.05). Subjects also performed the same work rate for only 3 min. These data, from bouts terminated before the slow component could contribute appreciably to the overall VO(2) response, show that the O(2) requirement during the transition is less than the final steady state for the work rate, as evidenced by symmetry between the O(2) deficit and ROC. This new method of calculating the O(2) deficit more closely reflects the expected O(2) deficit-ROC relationship (i.e., ROC >/= O(2) deficit). Therefore, estimation of the O(2) deficit during heavy exercise transitions should consider the slow component of VO(2) as an additional deficit component with delayed onset.