Effects of carbohydrate quality and amount on plasma lactate: results from the OmniCarb trial

Abstract

IntroductionPlasma lactate is a marker of non-oxidative glucose metabolism associated with progression to diabetes. We examined the effect of carbohydrate quality (glycemic index (GI)) and amount (%kcal) on plasma lactate. We hypothesized that low GI (≤45 (g)) versus high (≥65 (G)) and low %kcal from carbohydrate (40% kcal (c)) versus high (58% kcal (C)) each would reduce lactate levels.Research design and methodsWe measured lactate in OmniCarb, a randomized, cross-over trial of four diets in overweight/obese adults without diabetes or cardiovascular disease (N=163). The four diets were high carbohydrate+high GI (CG, reference), high carbohydrate+low GI (Cg), low carbohydrate+high GI (cG), and low carbohydrate+low GI (cg). Participants (N=163) consumed each of the four diets over a 5-week period, separated by 2-week washout periods. Plasma lactate levels were measured at baseline, during which the participants consumed their own diets, and after each 5-week period.ResultsBaseline plasma lactate was 1.2 mmol/L. In the setting of high carbohydrate amount, reducing GI lowered plasma lactate non-significantly by 0.08 mmol/L (Cg vs CG: 95% CI −0.16 to 0.00; p=0.06). In the setting of high GI, reducing carbohydrate amount lowered plasma lactate by 0.10 mmol/L (cG vs CG: 95% CI −0.19 to −0.02; p=0.02). The combined effect of reducing GI and carbohydrate proportion in the diet (cg vs CG) was similar (cg vs CG: −0.08; 95% CI −0.16 to 0.00; p=0.04). All four diets reduced plasma lactate compared with baseline.ConclusionsCompared with a diet with high GI and high carbohydrate amount, diets with low GI and/or low carbohydrate amount reduced plasma lactate. Whether this change in lactate leads to long-term change in glucose metabolism needs to be examined.Trial registration numberNCT00608049.

The Impact of a High-Carbohydrate/Low Fat vs. Low-Carbohydrate Diet on Performance and Body Composition in Physically Active Adults: A Cross-Over Controlled Trial

“…Based on this, it is also of particular interest to investigate the blood lactate kinetics measured during the CPX testing. Blood lactate values were not significantly different in our study in comparison to both diets at baseline—yet after 10 min of testing the blood lactate response of the LC group showed an altered kinetic, which is in line with previous findings from Hu et al [ 26 ]. In their study, it was shown that LC diets reduce resting plasma lactate levels; however, if this finding impacts functional capacity and physiological markers need to be investigated during a longer period of carbohydrate-restricted feeding, larger cohorts and during varying types of exercise accompanied by different intensities.…”

Reduced glucose tolerance and insulin sensitivity after prolonged exercise in endurance athletes

“…In obese subjects, high levels of fasting plasma lactate are used as a marker of non-oxidative glucose metabolism and is associated with impaired glucose handling. 66 In contrast, we observed that CON had increased lactate during OGTT after PE but that glucose tolerance was not affected, whereas END showed a decrease in lactate but had reduced glucose tolerance. We do not know if the alterations in circulating lactate reflected a change in metabolism or an increase in gluconeogenesis.…”

“…The suppressed lactate response during a glucose load can therefore assist in preserving fat oxidation to spare glucose for glycogen resynthesis, providing that the observed differences in lactate are sufficient to alter lipolysis. In obese subjects, high levels of fasting plasma lactate are used as a marker of non‐oxidative glucose metabolism and is associated with impaired glucose handling 66 . In contrast, we observed that CON had increased lactate during OGTT after PE but that glucose tolerance was not affected, whereas END showed a decrease in lactate but had reduced glucose tolerance.…”

Comparison of the Effect of Different Conditioning Media on the Angiogenic Potential of Hypoxia Preconditioned Blood-Derived Secretomes: Towards Engineering Next-Generation Autologous Growth Factor Cocktails

“…Indeed, chronic and acute hyperglycemia can trigger platelet activation [ 26 , 27 ], while in diabetic patients, the production of several growth factors involved in initiating and sustaining the healing process is compromised [ 25 ]; for example, vascular endothelial growth factor (VEGF) and transforming growth factor-beta (TGF-beta) protein expression is reduced in diabetic dermal wounds [ 28 , 29 ]. Recently, plasma lactate has emerged as an early indicator of aberrant metabolism, specifically, development of insulin resistance and diabetes mellitus [ 30 ]. In the context of wound healing, lactate accumulates as a consequence of both aerobic and anaerobic glycolysis following microcirculation disruption, immune activation, and increased cell proliferation [ 31 ].…”