Muscle carnitine level in endurance training and running a marathon

Clinical Effects of L-Carnitine Supplementation on Physical Performance in Healthy Subjects, the Key to Success in Rehabilitation: A Systematic Review and Meta-Analysis from the Rehabilitation Point of View

L-carnitine supplementation improves body strength, sports endurance and exercise capacity, as well as delaying the onset of fatigue. The aim of this study was to identify the correct dosage of supplementation to obtain improvements in physical performance and evaluate the changes related to L-carnitine supplementation in specific metabolic parameters, such as serum lactate, VO₂, serum total and free carnitine at rest and after physical activities, in healthy subjects. The search was conducted on PubMed, EMBASE, Cochrane Library, Scopus and Web of Science and identified 6404 articles with the keywords: "carnitine" AND "exercises" OR "rehabilitation" OR "physical functional performance" OR "physical activity" OR "sports" OR "health" OR "healthy". A total of 30 publications met the inclusion criteria and were included in the systematic review. The meta-analysis did not show any significant differences in serum lactate values at rest and after exercise in healthy subjects who took L-carnitine supplementation (p > 0.05). On the contrary, L-carnitine administration significantly changed maximal oxygen consumption (VO₂) at rest (p < 0.005), serum free and total carnitine at rest and after exercise (p < 0.001). The dosage of supplementation that obtained a significant change in serum total carnitine was 2 g/dL for 4 weeks at rest, 1 g/dL for 3 weeks after exercise, and in serum free carnitine was 2 g/dL for 3 weeks and 2 g/dL for 4 weeks at rest. Based on our study, serum total and free carnitine at rest and after exercise, and VO₂ at rest could be used to clinically follow individuals during physical activity and rehabilitation programs. Moreover, the supplementation should have a correct dosage to have maximum effect. Other robust trials are needed to find the best dosage to obtain positive results in metabolic parameters and in physical performance.

Effects of amino acid derivatives on physical, mental, and physiological activities

Nutritional ergogenic aids have been in use for a long time to enhance exercise and sports performance. Dietary components that exhibit ergogenic activity are numerous and their consumption is common and popular among athletes. They often come under scrutiny by legal authorities for their claimed benefits and safety concerns. Amino acid derivatives are propagated as being effective aids to enhance physical and mental performance in many ways, even though studies have pointed out that individuals who are deficient are more likely to benefit from dietary supplementation of amino acid derivatives than normal humans. In this review, some of the most common and widely used amino acids derivatives in sports and athletics namely creatine, tyrosine, carnitine, HMB, and taurine have been discussed for their effects on exercise performance, mental activity as well as body strength and composition. Creatine, carnitine, HMB, and taurine are reported to delay the onset of fatigue, improve exercise performance, and body strength. HMB helps in increasing fat-free mass and reduce exercise induced muscle injury. Taurine has been found to reduce oxidative stress during exercise and also act as an antihypertensive agent. Although, studies have not been able to find any favorable effect of tyrosine administration on exercise performance, it has been proved to be very effective in fighting stress, improving mood and cognitive performance particularly in sleep-deprived subjects. While available data from published studies and findings are equivocal about the efficacy of creatine, tyrosine, and HMB, more comprehensive researches on carnitine and taurine are necessary to provide evidence for the theoretical basis of their ergogenic role in nutritional modification and supplementation.

Physiological and nutritional aspects of post-exercise recovery: specific recommendations for female athletes

Gender-based differences in the physiological response to exercise have been studied extensively for the last four decades, and yet the study of post-exercise, gender-specific recovery has only been developing in more recent years. This review of the literature aims to present the current state of knowledge in this field, focusing on some of the most pertinent aspects of physiological recovery in female athletes and how metabolic, thermoregulatory, or inflammation and repair processes may differ from those observed in male athletes. Scientific investigations on the effect of gender on substrate utilization during exercise have yielded conflicting results. Factors contributing to the lack of agreement between studies include differences in subject dietary or training status, exercise intensity or duration, as well as the variations in ovarian hormone concentrations between different menstrual cycle phases in female subjects, as all are known to affect substrate metabolism during sub-maximal exercise. If greater fatty acid mobilization occurs in females during prolonged exercise compared with males, the inverse is observed during the recovery phase. This could explain why, despite mobilizing lipids to a greater extent than males during exercise, females lose less fat mass than their male counterparts over the course of a physical training programme. Where nutritional strategies are concerned, no difference appears between males and females in their capacity to replenish glycogen stores; optimal timing for carbohydrate intake does not differ between genders, and athletes must consume carbohydrates as soon as possible after exercise in order to maximize glycogen store repletion. While lipid intake should be limited in the immediate post-exercise period in order to favour carbohydrate and protein intake, in the scope of the athlete's general diet, lipid intake should be maintained at an adequate level (30%). This is particularly important for females specializing in long-duration events. With protein balance, it has been shown that a negative nitrogen balance is more often observed in female athletes than in male athletes. It is therefore especially important to ensure that this remains the case during periods of caloric restriction, especially when working with female athletes showing a tendency to limit their caloric intake on a daily basis. In the post-exercise period, females display lower thermolytic capacities than males. Therefore, the use of cooling recovery methods following exercise, such as cold water immersion or the use of a cooling vest, appear particularly beneficial for female athletes. In addition, a greater decrease in arterial blood pressure is observed after exercise in females than in males. Given that the return to homeostasis after a brief intense exercise appears linked to maintaining good venous return, it is conceivable that female athletes would find a greater advantage to active recovery modes than males. This article reviews some of the major gender differences in the metabolic, inflammatory and thermoregulatory response to exercise and its subsequent recovery. Particular attention is given to the identification of which recovery strategies may be the most pertinent to the design of training programmes for athletic females, in order to optimize the physiological adaptations sought for improving performance and maintaining health.

Metabolic functions of L-carnitine and its effects as feed additive in horses. A review

L-carnitine, a betaine derivative of beta-hydroxybutyrate, is found in virtually all cells of higher animals and also in some microorganisms and plants. In animals it is synthesized almost exclusively in the liver. Two essential amino acids, i.e., lysine and methionine serve as primary substrates for its biosynthesis. Also required for its synthesis are sufficient amounts of vitamin B6, nicotinic acids, vitamin C and folate. The first discovered ergogenic function of L-carnitine is the transfer of activated long-chain fatty acids across the inner mitochondrial membrane into the mitochondrial matrix. For this transfer acyl-CoA esters are transesterified to form acylcarnitine esters. Thus, in carnitine deficiency fat oxidation and energy production from fatty acids are markedly impaired. Skeletal muscles constitute the main reservoir of carnitine in the body and have a carnitine concentration at least 200 times higher than blood plasma. Uptake of carnitine by skeletal muscles takes place by an active transport mechanism which transports L-carnitine into muscles probably in the form of an exchange process with gamma-butyrobetain. In young animals including foals, the capacity for biosynthesis of carnitine is not yet fully developed and apparently cannot meet the requirements of sucking animals. Sucking animals depend therefore on an extra supply of carnitine which is usually provided with milk. Additionally, young animals including foals possess a lower concentration of carnitine in blood plasma than adult animals. Besides its role as carrier of activated acyl groups, L-carnitine functions as a buffer for acetyl groups which may be present in excess in different tissues during ketosis and hypoxic muscular activity. Other functions of L-carnitine are protection of membrane structures, stabilizing of a physiologic CoA-SH/acetyl-CoA ratio and reduction of lactate production. Animal's derived feeds are rich in L-carnitine whereas plants contain usually very little or no carnitine. Carnitine is absorbed from the small intestine by active and passive transport mechanisms. From the increase in renal excretion of L-carnitine after oral supplementations of 10 g/d to horses it has been concluded that the efficiency of absorption of L-carnitine is rather low (about 5 to 10% of the supplied dose). A further decrease in fractional carnitine absorption was observed when the oral dose of carnitine was increased. L-carnitine is virtually not degraded in the body and renal excretion of carnitine is comparatively small under normal conditions. The concentration of L-carnitine in blood plasma of horses varies markedly between animals and between different days. In addition, circadian changes in carnitine concentration in plasma have been reported. Peak concentrations were found during late afternoon, being up to 30% higher than those in the morning. In breeding mares the carnitine concentration in blood plasma declines with onset of lactation. In resting skeletal muscles about 90% of the total carnitine content is present as free carnitine with the remaining part being available as carnitine esters. With increasing exercise intensity a continuing greater proportion of free carnitine (up to 80%) is converted into carnitine esters, mainly into acetylcarnitine. This shift from free to acetylcarnitine is readily reversed within about 30 min after termination of exercise. It appears that acute exercise does not have a marked effect on the content of total carnitine in skeletal muscle whereas training seems to elevate its total concentration in the middle gluteal muscle of 3 to 6 year old horses and to reduce variation of its concentration compared to age-matched untrained horses. Oral supplementations of 5 to 50 g of L-carnitine per day to horses elevated the carnitine concentration in blood plasma to about twice its basal concentration. No clear relationship existed, however, between the orally administered dose of carnitine and the increase of L-carni

Utilization of lipids during exercise in human subjects: metabolic and dietary constraints

During endurance exercise, skeletal muscle relies mainly on both carbohydrate (CHO) and fat oxidation to cover energy needs. Numerous scientific studies have shown that increasing the exercise intensity leads to a progressive utilization of CHO. The latter will induce a state of glycogen depletion which is generally recognized as being a limiting factor for the continuation of strenuous exercise. Different dietary interventions have been proposed to overcome this limitation. A high-CHO diet during periods of intense training and competition, as well as CHO intake during exercise, are known to maintain a high rate of CHO oxidation and to delay fatigue. However, it has been recognized also that enhancing fatty acid (FA) oxidation during exercise induces a reduced rate of glycogen degradation, resulting in an improved endurance capacity. This is most strikingly observed as a result of frequent endurance exercise which improves a number of factors known to govern the FA flux and the oxidative capacity of skeletal muscle. Such factors are: (1) blood flow and capillarization; (2) lipolysis of triacylglycerol (TAG) in adipose tissue and circulating TAG and transport of FA from blood plasma to the sarcoplasm; (3) availability and rate of hydrolysis of intramuscular TAG; (4) activation of the FA and transport across the mitochondrial membrane; (5) the activity of enzymes in the oxidative pathway; (6) hormonal adaptations, i.e. sensitivity to catecholamines and insulin. The observation that the plasma FA concentration is an important factor in determining the rate of FA oxidation, and that some dietary factors may influence the rate of FA supply to muscle as well as to the mitochondria, has led to a number of dietary interventions with the ultimate goal to enhance FA oxidation and endurance performance. It appears that experimental data are not equivocal that dietary interventions, such as a high-fat diet, medium-chain TAG-fat emulsions and caffeine intake during exercise, as well as L-carnitine supplementation, do significantly enhance FA oxidation during exercise. So far, only regular endurance exercise can be classified as successful in achieving adaptations which enhance FA mobilization and oxidation.

Relationships between muscle carnitine, age and oxidative status

Muscle carnitine levels were examined in 31 younger [mean (SD), 27 (5) years] and 27 older [49 (8) years] men. Needle biopsies were obtained from the lateral gastrocnemius or vastus lateralis muscles and assayed for free and total carnitine concentrations via a 5,5'-Dithiobis-(2-nitrobenzoic acid) DTNB-linked spectrophotometric procedure. A subgroup of subjects (n = 28) were assessed for citrate synthase (CS) and succinate dehydrogenase (SDH) activity, and type I muscle fiber composition (% type I fibers). An additional sub-group of nine subjects was assessed for free and total serum carnitine levels. No mean (SEM) differences in free [21.6 (0.7) vs 20.3 (0.9) mumol.g dry weight-1] and total [26.4 (0.6) vs 26.1 (0.9) mumol.g dry weight-1) muscle carnitine levels were found between the younger and older subjects, respectively. Correlational data revealed no significant relationships between total muscle carnitine and CS (r = -0.36), SDH (r = -0.26), or % type I fibers (r = -0.16). In addition, there was a low non-significant relationship between serum and muscle total carnitine concentrations (r = -0.44). These findings suggest that muscle carnitine levels are similar between younger and older males, and there does not appear to be any relationship between muscle carnitine and markers of muscle oxidative potential (i.e., oxidative enzymes, % type I fiber). Since serum carnitine is often used as an indicator of body carnitine status, it is noteworthy that we found a low negative relationship between blood and muscle carnitine concentrations.