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The lactate paradox: a review

Published online by Cambridge University Press:  18 June 2010

Miles F Bartlett  and
Robert A Lehnhard
Miles F Bartlett*
Affiliation:
Department of Kinesiology and Physical Education, University of Maine, Orono, ME04469, USA
Robert A Lehnhard
Affiliation:
Department of Kinesiology and Physical Education, University of Maine, Orono, ME04469, USA
*
*Corresponding author: [email protected]; [email protected]
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Abstract

The phenomenon known as the lactate paradox has been a topic of heated debate since it gained worldwide attention following Operation Everest in the early 1980s. What began as the simple finding that blood lactate (blood [La]) for a given sub-maximal workload or VO2 following acclimatization to high altitude is reduced compared with sea-level values, morphed into a complex set of parameters that have been redefined several times in the nearly 30 years that the lactate paradox has been researched. Though several strong hypotheses have been proposed to, to date, no one hypothesis has been able fully to explain the lactate paradox. The goal of the current article was to bring together the most prominent studies done on the lactate paradox and illuminate the details brought forth by each. In doing so we hope to stimulate new hypotheses and research studies that will further our understanding of the lactate paradox.

Keywords

NADNADHlactatepyruvate dehydrogenasealtitudelactate paradoxexerciseglycolytic flux
Type
Review Article
Information
Comparative Exercise Physiology , Volume 7 , Issue 1 , February 2010 , pp. 1 - 13
Copyright
Copyright © Cambridge University Press 2010

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References

1Edwards, H (1936). Lactic acid in rest and work at high altitude. American Journal of Physiology 116: 367–375.CrossRefGoogle Scholar
2West, J, Boyer, S, Graber, DJ, Hackett, P, Maret, K, Milledge, J et al. (1983). Maximal exercise at extreme altitudes on Mount Everest. Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology 55: 688–698.CrossRefGoogle ScholarPubMed
3West, JB (1986). Lactate during exercise at extreme altitude. Federation Proceedings 45: 2953–2957.Google ScholarPubMed
4Beidleman, B, Muza, S, Rock, P, Fulco, C, Lyons, T, Hoyt, R et al. . (1997). Exercise responses after altitude acclimatization are retained during reintroduction to altitude. Medicine and Science in Sport and Exercise 29: 1588–1595.CrossRefGoogle ScholarPubMed
5Bender, P, Groves, B, McCullough, R, McCullough, R, Trad, L, Young, A et al. . (1989). Decreased exercise muscle lactate release after high altitude acclimatization. Journal of Applied Physiology 67: 1456–1462.CrossRefGoogle ScholarPubMed
6Brooks, G, Butterfield, G, Wolfe, R, Groves, B, Mazzeo, R, Sutton, J et al. . (1991). Decreased reliance on lactate during exercise after acclimatization to 4300 m. Journal of Applied Physiology 71: 333–341.CrossRefGoogle Scholar
7Cerretelli, P and Samaja, M (2003). Acid–base balance at exercise in normoxia and in chronic hypoxia. Revisiting the “lactate paradox”. Journal of Applied Physiology 90: 431–448.Google ScholarPubMed
8Ferretti, G (2003). Limiting factors to oxygen transport on Mount Everest 30 years after: a critique of Paolo Cerretelli's contribution to the study of altitude physiology. European Journal of Applied Physiology 90: 344–350.CrossRefGoogle Scholar
9Grassi, B, Ferretti, G, Kayser, B, Marzorati, M, Colombini, A, Marconi, C et al. . (1995). Maximal rate of blood lactate accumulation during exercise at altitude in humans. Journal of Applied Physiology 79: 331–339.CrossRefGoogle ScholarPubMed
10Grassi, B, Ferretti, G, Marzorati, M, Kayser, B, Bordini, M, Colombini, A et al. . (1996). Peak blood lactate and blood lactate vs. workload during acclimatization to 5,050 m and in deacclimatization. Journal of Applied Physiology 80: 685–692.CrossRefGoogle Scholar
11Grassi, B, Mognoni, P, Marzorati, M, Mattiotti, S, Marconi, C and Cerretelli, P (2001). Power and peak blood lactate at 5050 m with 10 and 30 s ‘all out’ cycling. Acta Physiologica Scandinavica 172: 189–194.CrossRefGoogle ScholarPubMed
12Hochachka, P, Beatty, C, Burelle, Y, Trump, M, McKenzie, D and Matheson, G (2002). The lactate paradox in human high altitude physiological performance. News in Physiological Sciences 17: 122–126.Google ScholarPubMed
13Kayser, B, Ferretti, G, Grassi, B, Binzoni, T and Cerretelli, P (1993). Maximal lactic acid capacity at altitude: effect of bicarbonate loading. Journal of Applied Physiology 75: 1070–1074.CrossRefGoogle ScholarPubMed
14Lundby, C, Saltin, B and Van Hall, G (2000). The ‘lactate paradox’, evidence for a transient change in the course of acclimatization to severe hypoxia in lowlanders. Acta Physiologica Scandinavica 170: 265–269.CrossRefGoogle ScholarPubMed
15Noakes, T (2009). Evidence that reduced skeletal muscle recruitment explains the lactate paradox during exercise at high altitude. Journal of Applied Physiology 106: 737–738.CrossRefGoogle ScholarPubMed
16Pronk, M, Tiemessen, I, Hupperets, M, Kennedy, B, Powell, F, Hopkins, S et al. . (2003). Persistence of the lactate paradox over 8 weeks at 3800 m. High Altitude Medicine and Biology 4: 431–443.CrossRefGoogle Scholar
17Van Hall, G, Calbet, J, Sondergaard, H and Saltin, B (2001). The re-establishment of the normal blood lactate response to exercise in humans after prolonged acclimatization to altitude. Journal of Physiology 536: 963–975.CrossRefGoogle ScholarPubMed
18Van Hall, G, Calbet, J, Sondergaard, H and Saltin, B (2002). Similar carbohydrate but enhanced lactate utilization during exercise after 9 wk of acclimatization to 5,620 m. American Journal of Physiology: Endocrinology and Metabolism 283: E1203–E1213.Google Scholar
19Van Hall, G, Lundby, C, Araoz, M, Calbet, J, Snader, M and Saltin, B (2009). The lactate paradox revisited in lowlanders during acclimatization to 4100 m and in high altitude natives. Journal of Physiology 587: 1117–1129.CrossRefGoogle ScholarPubMed
20Van Hall, G (2007). Counterpoint: the lactate paradox does not occur during exercise at high altitude. Journal of Applied Physiology 102: 2399–2401.CrossRefGoogle Scholar
21West, JB (2007). The lactate paradox does occur during exercise at high altitude. Journal of Applied Physiology 102: 2398–2399.CrossRefGoogle ScholarPubMed
22Mazzeo, R, Secher, N, Rasmussen, P, Kayser, B, Wagner, P, Samaja, M et al. . (2007). Comments on Point: Counterpoint “The Lactate Paradox does/does not occur during exercise at high altitude”. Journal of Applied Physiology 102: 2403–2405.CrossRefGoogle Scholar
23West, JB (2006). Human responses to extreme altitudes. Integrative and Comparative Biology. Advance access published on 6 January 2006, doi:10.1093/icb/icj005.CrossRefGoogle ScholarPubMed
24Hochachka, P (1988). The lactate paradox: analysis of underlying mechanisms. Annals of Sports Medicine 4: 184–188.Google Scholar
25Brooks, G, Wolfel, E, Groves, B, Bender, P, Butterfield, G, Cymerman, A et al. . (1992). Muscle accounts for glucose disposal but not blood lactate appearance during exercise after acclimatization to 4,300 m. Journal of Applied Physiology 72: 2435–2445.CrossRefGoogle ScholarPubMed
26Brooks, G, Butterfield, G, Wolfe, R, Groves, B, Mazzeo, R, Sutton, J et al. . (1991). Increased dependence on blood glucose after acclimatization to 4300 m. Journal of Applied Physiology 70: 919–927.CrossRefGoogle Scholar
27Roberts, A, Reeves, J, Butterfield, G, Mazzeo, R, Sutton, J, Wolfel, E et al. . (1996). Altitude and B-blockade augment glucose utilization during submaximal exercise. Journal of Applied Physiology 80: 605–615.CrossRefGoogle Scholar
28Roberts, A, Butterfield, G, Cymerman, A, Reeves, J, Wolfel, E and Brooks, G (1996). Acclimatization to 4,300-m altitude decreases reliance on fat as a substrate. Journal of Applied Physiology 81: 1762–1771.CrossRefGoogle ScholarPubMed
29Mazzeo, R (2008). Physiological response to exercise at altitude: an update. Sports Medicine 38(1): 1–8.CrossRefGoogle ScholarPubMed
30Nelson, D and Cox, M (2005). Principles of Biochemistry. 4th edn. New York: W.H. Freeman and Company.Google Scholar
31Springer, C, Barstow, T, Wasserman, K and Cooper, D (1994). Oxygen uptake and heart rate responses during hypoxic exercise in children and adults. Medicine and Science in Sport and Exercise 23: 71–79.Google Scholar
32Engelen, M, Porszasz, J, Riley, M, Wasserman, K, Maehara, K and Barstow, T (1996). Effects of hypoxic hypoxia on O2 uptake and heart rate kinetics during heavy exercise. Journal of Applied Physiology 81: 2500–2508.CrossRefGoogle ScholarPubMed
33Bender, P, Groves, P, McCullough, R, McCullough, R, Huang, S, Hamilton, A et al. . (1988). Oxygen transport to exercising leg in chronic hypoxia. Journal of Applied Physiology 65: 2592–2597.CrossRefGoogle ScholarPubMed
34Rowell, L, Saltin, B, Kiens, B and Christensen, N (1986). Is peak quadriceps blood flow in humans even higher during exercise with hypoxemia? American Journal of Physiology (Heart and Circulatory Physiology 20) 251: H1038–H1044.CrossRefGoogle ScholarPubMed
35Brooks, G and Gaesser, G (1980). End points of lactate and glucose metabolism after exhausting exercise. Journal of Applied Physiology 49: 1057–1069.CrossRefGoogle ScholarPubMed
36Lundby, C and Wagner, P (2007). The lactate paradox: does acclimatization to high altitude affect blood lactate during exercise? Medicine and Science in Sports and Exercise 39: 749–755.Google Scholar
37Smith, E, Skelton, M, Kremer, D, Pascoe, D and Gladden, B (1997). Lactate distribution in the blood during progressive exercise. Medicine and Science in Sports and Exercise 29: 654–660.CrossRefGoogle ScholarPubMed
38Gladden, B (2004). Lactate metabolism: a new paradigm for the third millennium. Journal of Physiology 558.1: 5–30.CrossRefGoogle Scholar
39Parolin, M, Spriet, L, Hultman, E, Hollidge-Horvat, M, Jones, N and Heigenhauser, G (2000). Regulation of glycogen phosphorylase and PDH during exercise in human skeletal muscle during hypoxia. American Journal of Physiology: Endocrinology and Metabolism 278: E522–E534.Google ScholarPubMed
40Parolin, M, Spriet, L, Hultman, E, Matsos, M, Hollidge-Horvat, M, Jones, N et al. . (2000). Effects of PDH activation by dichloroacetate in human skeletal muscle during exercise in hypoxia. American Journal of Physiology: Endocrinology and Metabolism 279: E752–E761.Google ScholarPubMed
41Williamson, D, Lund, P and Krebs, H (1967). The redox state of free nicotinamide–adenine dinucleotide in the cytoplasm and mitochondria of rat liver. Biochemical Journal 103: 514–527.CrossRefGoogle ScholarPubMed
42Sahlin, K, Katz, A and Henriksson, J (1987). Redox state and lactate accumulation in human skeletal muscle during dynamic exercise. Biochemical Journal 245: 551–556.CrossRefGoogle ScholarPubMed
43Böning, D, Beneke, R and Maassen, N (2005). Lactic acid still remains the real cause of exercise-induced metabolic acidosis. American Journal of Physiology Regulatory, Integrative and Comparative Physiology 289: R902–R903.CrossRefGoogle ScholarPubMed
44Robergs, R, Ghiasvand, F and Parker, D (2004). Biochemistry of exercise-induced metabolic acidosis. American Journal of Physiology Regulatory, Integrative and Comparative Physiology 287: R502–R516.CrossRefGoogle ScholarPubMed
45Robergs, R and Parker, D (2005). Lingering construct of lactic acidosis. American Journal of Physiology Regulatory, Integrative and Comparative Physiology 289: R904–R910.CrossRefGoogle Scholar
46Lindinger, M, Kowalchuk, J and Heigenhauser, G (2005). Applying physicochemical principles to skeletal muscle acids–base status. American Journal of Physiology Regulatory, Integrative and Comparative Physiology 289: R891–R894.CrossRefGoogle Scholar
47Pate, E, Bhimani, M, Franks-Skiba, K and Cooke, R (1995). Reduced effect of pH on skinned rabbit psoas muscle mechanics at high temperatures: implications for fatigue. Journal of Physiology 486: 689–694.CrossRefGoogle ScholarPubMed
48Westerblad, H, Bruton, J and Lannergren, J (1997). The effect of intracellular pH on contractile function of intact, single fibres of mouse muscle declines with increasing temperature. Journal of Physiology 500: 193–204.CrossRefGoogle ScholarPubMed
49Westerblad, H, Allen, D and Lannergren, J (2002). Muscle fatigue: lactic acid or inorganic phosphate the major cause? News in Physiological Sciences 17: 17–21.Google ScholarPubMed
50Cooke, R (2007). Modulation of the actomyosin interaction during fatigue of skeletal muscle. Muscle Nerve 36: 756–777.CrossRefGoogle ScholarPubMed
51Cairns, A and Lindinger, M (2008). Do multiple ionic interactions contribute to skeletal muscle fatigue? Journal of Physiology 586.17: 4039–4054.CrossRefGoogle ScholarPubMed
52Cady, E, Jones, D, Lynn, J and Newham, D (1989). Changes in force and intracellular metabolites during fatigue of human skeletal muscle. Journal of Physiology 418: 311–325.CrossRefGoogle ScholarPubMed
53Green, H, Sutton, J, Wolfel, E, Reeves, J, Butterfield, G and Brooks, G (1992). Altitude acclimatization and energy metabolic adaptations in skeletal muscle during exercise. Journal of Applied Physiology 73: 2701–2708.CrossRefGoogle ScholarPubMed
54Karlsson, J and Saltin, B (1970). Lactate, ATP, and CP in working muscles during exhaustive exercise in man. Journal of Applied Physiology 29: 598–602.CrossRefGoogle ScholarPubMed
55Meyer, R, Dudley, G and Terjung, R (1980). Ammonia and IMP in different skeletal muscle fibers after exercise in rats. Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology 49: 1037–1041.CrossRefGoogle ScholarPubMed
56Welsh, D and Lindinger, M (1997). Metabolite accumulation increases adenine nucleotide degradation and decreases glycogenolysis in ischaemic rat skeletal muscle. Acta Physiologica Scandinavica 161: 203–210.CrossRefGoogle ScholarPubMed
57Bogdanis, G, Nevill, M, Lakomy, H and Boobis, L (1998). Power output and muscle metabolism during and following recovery from 10 and 20 s of maximal sprint exercise in humans. Acta Physiologica Scandinavica 163: 261–272.CrossRefGoogle ScholarPubMed
58Fitts, R and Holloszy, J (1976). Lactate and contractile force in frog muscle during development of fatigue and recovery. American Journal of Physiology 231: 430–433.CrossRefGoogle ScholarPubMed
59Brooks, G, Fahey, T and Baldwin, K (2005). Exercise Physiology: Human Bioenergetics and Its Applications. 4th edn. New York: McGraw-Hill.Google Scholar