Combined ingestion of protein and carbohydrate improves protein balance during ultra-endurance exercise

Department of Human Biology, Nutrition Research Institute Maastricht, Maastricht University, 6200 MD Maastricht, The Netherlands Submitted 1 December 2003 ; accepted in final form 25 May 2004 The aims of this study were to compare different tracer methods to assess whole body protein turnover during 6 h of prolonged endurance exercise when carbohydrate was ingested throughout the exercise period and to investigate whether addition of protein can improve protein balance. Eight endurance-trained athletes were studied on two different occasions at rest (4 h), during 6 h of exercise at 50% of maximal O 2 uptake (in sequential order: 2.5 h of cycling, 1 h of running, and 2.5 h of cycling), and during subsequent recovery (4 h). Subjects ingested carbohydrate (CHO trial; 0.7 g CHO·kg –1· h –1 ) or carbohydrate/protein beverages (CHO + PRO trial; 0.7 g CHO·kg –1 ·h –1 and 0.25 g PRO·kg –1 ·h –1 ) at 30-min intervals during the entire study. Whole body protein metabolism was determined by infusion of L -[1- 13 C]leucine, L -[ 2 H 5 ]phenylalanine, and [ 15 N 2 ]urea tracers with sampling of blood and expired breath. Leucine oxidation increased from rest to exercise [27 ± 2.5 vs. 74 ± 8.8 (CHO) and 85 ± 9.5 vs. 200 ± 16.3 mg protein·kg –1 ·h –1 (CHO + PRO), P < 0.05], whereas phenylalanine oxidation and urea production did not increase with exercise. Whole body protein balance during exercise with carbohydrate ingestion was negative (–74 ± 8.8, –17 ± 1.1, and –72 ± 5.7 mg protein·kg –1 ·h –1 ) when L -[1- 13 C]leucine, L -[ 2 H 5 ]phenylalanine, and [ 15 N 2 ]urea, respectively, were used as tracers. Addition of protein to the carbohydrate drinks resulted in a positive or less-negative protein balance (–32 ± 16.3, 165 ± 4.6, and 151 ± 13.4 mg protein·kg –1 ·h –1 ) when L -[1- 13 C]leucine, L -[ 2 H 5 ]phenylalanine, and [ 15 N 2 ]urea, respectively, were used as tracers. We conclude that, even during 6 h of exhaustive exercise in trained athletes using carbohydrate supplements, net protein oxidation does not increase compared with the resting state and/or postexercise recovery. Combined ingestion of protein and carbohydrate improves net protein balance at rest as well as during exercise and postexercise recovery. protein metabolism; dietary supplements; protein intake Address for reprint requests and other correspondence: R. Koopman, Dept. of Human Biology, Maastricht Univ., PO Box 616, 6200 MD Maastricht, The Netherlands (E-mail: R.Koopman{at}HB.unimaas.nl )