Carbohydrate Supplementation Research Articles

The Effect of Pre-Exercise Caffeine and Glucose Ingestion on Endurance Capacity in Hypoxia: A Double-Blind Crossover Trial

The impact of caffeine and glucose supplementation in a hypoxic environment on endurance exercise performance remains inconclusive. The current study examined the effect of pre-exercise carbohydrate and caffeine supplementation on endurance exercise performance in an acute hypoxic environment. Eight healthy active young males participated in this double-blind, within-subjects crossover study. Participants ingested the test drink 60 min before exercising at 50% Wmax for 90 min on a cycle ergometer (fatiguing preload); there followed an endurance performance test at 85% Wmax until exhaustion in a hypoxic chamber (~15%O2). Participants completed four experimental trials in a randomized order: caffeine (6 mg·kg−1; Caff), glucose (1 g·kg−1; CHO), caffeine (6 mg·kg−1) + glucose (1 g·kg−1; Caff−CHO), and taste- and color-matched placebo with no caffeine or CHO (PLA). Blood samples were collected during fasting, pre-exercise, every 30 min throughout the exercise, and immediately after exhaustion. The caffeine and glucose trials significantly enhanced endurance capacity in hypoxic conditions by Caff, 44% (68.8–31.5%, 95% confidence interval), CHO, 31% (44.7–15.6%), and Caff−CHO, 46% (79.1–13.2%). Plasma-free fatty-acid and glycerol concentrations were higher in Caff and PLA than in CHO and Caff−CHO (p < 0.05). The estimated rate of fat oxidation was higher in Caff and PLA than in CHO and Caff−CHO (p < 0.05). There were no significant differences in ratings of perceived exertion between trials. In conclusion, the ingestion of caffeine, glucose, or caffeine + glucose one hour before exercising in hypoxic conditions significantly improved 85% Wmax endurance performance after prolonged exercise.

Effects of Maltodextrin-Fructose Supplementation on Inflammatory Biomarkers and Lipidomic Profile Following Endurance Running: A Randomized Placebo-Controlled Cross-Over Trial.

Managing metabolism for optimal training, performance, and recovery in medium-to-high-level endurance runners involves enhancing energy systems through strategic nutrient intake. Optimal carbohydrate intake before, during, and after endurance running can enhance glycogen stores and maintain optimal blood glucose levels, influencing various physiological responses and adaptations, including transitory post-endurance inflammation. This randomized trial investigates the impact of a high-dose 2:1 maltodextrin-fructose supplementation to medium-to-high-level endurance runners immediately before, during, and after a 15 km run at 90% VO2max intensity on post-exercise inflammatory stress. We evaluated inflammatory biomarkers and lipidomic profiles before the endurance tests and up to 24 h after. We focused on the effects of high-dose 2:1 maltodextrin-fructose supplementation on white blood cell count, neutrophil number, IL-6, cortisol, and CRP levels, as well as polyunsaturated fatty acids, ω-3 index, and AA/EPA ratio. This supplementation significantly reduced inflammatory markers and metabolic stress. Additionally, it may enhance the post-activity increase in blood ω-3 fatty acid levels and reduce the increase in ω-6 levels, resulting in a lower trend of AA/EPA ratio at 24 h in the treated arm. Adequate carbohydrate supplementation may acutely mitigate inflammation during a one-hour endurance activity of moderate-to-high intensity. These effects could be beneficial for athletes engaging in frequent, high-intensity activities.

The Influence of Nutrition Intervention on the P1NP and CTX-1 Response to an Acute Exercise Bout: A Systematic Review with Meta-Analysis.

Although nutrition and exercise both influence bone metabolism, little is currently known abouttheir interaction, or whether nutritional intervention can modulate the bone biomarker response to acute exercise. Improved understanding of the relationships between nutrition, exercise and bone metabolism may have substantial potential to inform nutritional interventions to protect the bone health of exercising individuals, and to elucidate mechanisms by which exercise and nutrition influence bone. The aim was to synthesise available evidence related to the influence of nutrition on the response of the bone biomarkers procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide of type 1 collagen (CTX-1) to acute exercise, using a systematic review and meta-analytic approach. Studies evaluating the influence of nutritional status or intervention on the bone biomarker response to an acute exercise bout were included and separated into four categories: (1) feeding status and energy availability, (2) macronutrients, (3) micronutrients and (4) other. Studies conducted on healthy human populations of any age or training status were included. Meta-analysis was conducted when data from at least five studies with independent datasets were available. In the case of insufficient data to warrant meta-analysis, results from individual studies were narratively synthesised and standardised mean effect sizes visually represented. Twenty-two articles were included. Of these, three investigated feeding status or energy availability, eight macronutrients, eight micronutrients (all calcium) and six other interventions including dairy products or collagen supplementation. Three studies had more than one intervention and were included in all relevant outcomes. The largest and most commonly reported effects were for the bone resorption marker CTX-1. Meta-analysis indicated that calcium intake, whether provided via supplements, diet or infusion, reduced exercise-induced increases in CTX-1 (effect size - 1.1; 95% credible interval [CrI] - 2.2 to - 0.05), with substantially larger effects observed in studies that delivered calcium via direct infusion versus in supplements or foods. Narrative synthesis suggests that carbohydrate supplementation may support bone during acute exercise, via reducing exercise-induced increases in CTX-1. Conversely, a low-carbohydrate/high-fat diet appears to induce the opposite effect, as evidenced by an increased exercise associated CTX-1 response, and reduced P1NP response. Low energy availability may amplify the CTX-1 response to exercise, but it is unclear whether this is directly attributable to energy availability or to the lack of specific nutrients, such as carbohydrate. Nutritional intervention can modulate the acute bone biomarker response to exercise, which primarily manifests as an increase in bone resorption. Ensuring adequate attention to nutritional factors may be important to protect bone health of exercising individuals, with energy, carbohydrate and calcium availability particularly important to consider. Although a wide breadth of data were availablefor this evidence synthesis, there was substantial heterogeneity in relation to design and intervention characteristics. Direct and indirect replication is required to confirm key findings and to generate better estimates of true effect sizes.

The Impact of Carbohydrate, Protein, and Combined Carbohydrate-Protein Supplementation on Muscle Damage and Oxidative Stress Markers During Prolonged Cycling Performance in the Heat

Background: The impact of oxidative stress (OS) on exercise performance and recovery depends on the mode, intensity, and duration of physical activity, which can lead to inflammation, fatigue, and muscle dysfunction. The effects of carbohydrate (CHO) and protein (PRO) supplementation, as well as their combination (CHO-PRO), on exercise performance remain controversial, particularly under normal and hot environmental conditions. Objectives: The present study examined the influence of locally based isocaloric carbohydrate (CHO) and protein (PRO) supplements on muscle damage and oxidative stress (OS) biomarkers during cycling in the heat (31°C, 70% relative humidity), compared to a placebo (PL). Methods: Sago (Sa), Soy (So), and Sago+Soy (SS) were used as the carbohydrate (CHO), protein (PRO), and CHO-PRO supplements, respectively. The Sa, So, and SS supplements contained 7.5% Sa, 7.5% So, and 6.0% Sa+1.5% So, respectively. Twelve well-trained male cyclists (age: 19.0 ± 5.6 years, height: 170.8 ± 7.6 cm, body weight: 60.1 ± 11.2 kg, and VO2max: 56.5 ± 6.5 mL·kg⁻¹·min⁻¹) participated in four experimental trials. Each trial involved 90 minutes of steady-state cycling on an ergometer at 60% VO2max, followed by a 20-km exhaustive cycling time-trial performance. During the steady-state cycling, participants received supplements five times at 0, 20, 40, 60, and 80 minutes. Results: Plasma concentrations of creatine kinase and F2-isoprostanes, which are biomarkers of muscle damage and oxidative stress (OS), significantly decreased after the trials (P < 0.05). The reduction in these biomarkers in the placebo group indicated that Sa, So, and SS supplementation did not provide additional benefits, as the placebo exhibited similar effects. Conclusions: In conclusion, despite the unexpected results, endurance athletes exercising in hot and humid conditions may potentially reduce symptoms of muscle damage and oxidative stress by consuming greater amounts of carbohydrate and protein supplements.

Trehalose Improved 20-min Cycling Time-Trial Performance After 100-min Cycling in Amateur Cyclists.

Carbohydrate (CHO) supplementation during endurance exercise can improve performance. However, it is unclear whether low glycemic index (GI) CHO leads to differential ergogenic and metabolic effects compared with a standard high GI CHO. This study investigated the ergogenic and metabolic effects of CHO supplementation with distinct GIs, namely, (a)trehalose (30g/hr), (b)isomaltulose (30g/hr), (c)maltodextrin (60g/hr), and (d)placebo (water). In this double-blind, crossover, counterbalanced, placebo-controlled study, 13 male cyclists cycled a total of 100min at varied exercise intensity (i.e.,10-min stages at 1.5, 2.0, and 2.5W/kg; repeated three times plus two 5-min stages at 1.0W/kg before and after the protocol), followed by a 20-min time trial on four separated occasions. Blood glucose and lactate (every 20min), heart rate, and ratings of perceived exertion were collected throughout, and muscle biopsies were taken before and immediately after exercise. The results showed that trehalose improved time-trial performance compared with placebo (total work done 302 ± 39 vs. 287 ± 48kJ; p = .01), with no other differences between sessions (all p ≥ .07). Throughout the 100-min protocol, blood glucose was higher with maltodextrin compared with the other supplements at all time points (all p < .05). Heart rate, ratings of perceived exertion, muscle glycogen content, blood glucose, and lactate were not different between conditions when considering the 20-min time trial (all p > .05). Trehalose supplementation throughout endurance exercise improved cycling performance and appears to be an appropriate CHO source for exercise tasks up to 2hr. No ergogenic superiority between the different types of CHO was established.

Narrowing inequity gap: ERAS home delivery kit

ObjectiveTo enhance adherence to Enhanced Recovery After Surgery (ERAS) protocols and address pre-operative preparation equity gaps, a system was developed to automatically mail chlorhexidine (CHG) and nutritional carbohydrate supplements (ERAS Kits) to surgical patients. BackgroundThis retrospective observational study focused on adult patients undergoing abdominal surgeries at a large academic hospital, using a pre-post design. MethodsThe study compared adherence to pre-operative ERAS pathways, involving nutritional supplements and chlorhexidine soap usage, before (September 2021-March 2022) and after (September 2022-March 2023) implementing automatic ERAS Kits mailing. A Chi square test analyzed adherence rates. ResultsPost-implementation, adherence to preoperative nutrition rose from 49.6 % to 57.7 % (P = 0.006), and surgical site preparation from 73.8 % to 78.7 % (P = 0.06). Notable improvements were seen among Black patients, Medicaid recipients, and those from lower-income neighborhoods in nutrition adherence, and among younger patients and Medicaid recipients in site preparation. ConclusionMailing ERAS Kits directly to patients significantly enhanced compliance with preoperative protocols, demonstrating an effective strategy to improve care accessibility and reduce disparities for vulnerable groups.

Effects of In-Exercise Carbohydrate Supplementation on Prolonged High-Intensity Exercise Performance in Oral Contraceptive Users.

To examine the impact of oral contraceptive (OC) phases on performance, physiological, and subjective responses to prolonged, intensive exercise when carbohydrate (CHO) stores are reduced. Ten well-trained female cyclists using monophasic OC completed 4 identical trials (>150min) under conditions of in-trial 60-g·h-1 CHO supplementation (CHO+) or placebo (CHO-) during the sugar- (SUG) and active-pill (ACT) phases of their OC cycle. Each trial comprised two 400-kcal time trials (TT) separated by 1hour of submaximal cycling at first ventilatory threshold. Change in completion time from TT1 to TT2 was minimized in CHO+ compared with CHO- (4.06 [2.55] vs 6.08 [5.33]min; P = .019, effect size = -0.36). An interaction effect of OC and CHO was observed for time to complete TT (P = .006), mean TT power (P = .002), mean TT heart rate (P = .002), and posttrial emotional balance (P = .020) and negative emotional state (P = .033). In ACT, mean TT power and heart rate were higher in CHO+ when compared with CHO-, resulting in faster TTs in CHO+ and improved posttrial emotional well-being. When CHO was not supplemented, TT power and heart rate were higher in SUG when compared with ACT, resulting in faster TTs in SUG and improved posttrial emotional balance. CHO depletion during ACT negatively influenced TT performance and emotional well-being when compared with SUG. Irrespective of OC pill phase, CHO supplementation should be prioritized to sustain performance and improve postexercise recovery-stress balance.

Abstract MP59: Associations of Plasma Inosine With Lipid Profiles in the Bogalusa Heart Study

Introduction: Inosine, a naturally occurring purine nucleotide, has been used as a dietary supplement to enhance overall health. An emerging study in a rat model has indicated that inosine holds promise as a potential treatment for atherosclerosis by reducing cholesterol-driven inflammation and improving vascular function, providing a foundational concept for further investigation in humans. Hypothesis: We hypothesize that inosine can improve lipid profiles among humans. Methods: We profiled inosine and 886 known metabolites using plasma samples from 1,261 participants of the Bogalusa Heart Study (BHS) 2013-2016 survey. Linear regression models were used to evaluate the relationship between inosine and four lipid phenotypes, including total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides, while controlling for age, sex, race, education, smoking, drinking, BMI, lipid medication, and total physical activity. Statistically significant findings in the BHS were validated in the Protein and Blood Pressure (ProBP) study, where 80 adults with available stored samples underwent 8-week dietary supplementation of carbohydrate, milk protein, and soy protein in a random order with 2-week washouts. Inosine and lipids were measured at baseline and post-intervention. We tested associations of longitudinal changes of inosine with changes in lipids profile. We also performed formal mediation analyses in the BHS to identify metabolites and metabolic pathways that might mediate inosine’s association with lipids. Results: In the BHS, inosine was significantly associated with HDL cholesterol (β=1.85, 95% CI: 0.72- 2.98) but not with LDL cholesterol, triglycerides, or TC. In the ProBP trial, inosine change was positively associated with HDL cholesterol change during the soy protein intervention (β=2.13, 95% CI: 0.59-3.66). Our mediation analysis identified 74 metabolites that nominally mediated (p&lt;0.05) the inosine-HDL association. After Bonferroni correction for 228 independent metabolite clusters, three metabolites, including PC(18:2(9Z,12Z)/20:4(5Z,8Z,11Z,14Z)), arachidonic acid, and LysoPC(18:2/0:0) were significant mediators (p&lt;0.05/228). The 74 nominally significant metabolites were enriched in the sphingolipid metabolic pathway (False Discovery Rate= 0.00312). Conclusion: Inosine appears to enhance HDL cholesterol, possibly through the sphingolipid metabolic pathway.

Abstract MP78: A Comprehensive Investigation of the Effect of Dietary Intervention on Perfluorooctanoic Acid and Perfluorooctane Sulfonate

Introduction: The US Environment Protection Agency has proposed National Primary Drinking Water Regulation for six per- and polyfluoroalkyl substances including perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS). The health effects of the two chemicals need to be thoroughly evaluated. In addition, few studies have investigated interventions that can help clear the two chemicals from the human body. Hypothesis: We hypothesize that the plasma metabolome reflects reactions of the human body to PFOA/PFOS exposures and dietary supplements can reduce PFOA/PFOS. Methods: In the Protein and Blood Pressure (ProBP) trial, 80 participants were randomly assigned to take 40 grams/day of soy protein, milk protein, or carbohydrate supplementation each for 8 weeks in a cross-over design. Plasma PFOA and PFOS levels were tracked from baseline to each of the three intervention phases. We analyzed the associations of serum PFOS and PFOA with a total of 964 known metabolites at baseline and each dietary intervention, respectively. Age, sex, and race were adjusted in all analyses. ProBP findings were evaluated for replication among 1261 participants of the Bogalusa Heart Study (BHS). Results: PFOA and PFOS were significantly reduced after phase I and were decreased further with intervention phases. Soy protein showed the strongest reduction on both PFOA (net change: -0.13, p=1.13х10 -5 ) and PFOS (net change: -0.18, p=4.32х10 -5 ) compared with carbohydrate and milk protein. After Bonferroni correction for 77 independent metabolite clusters (p&lt;6.49х10 -4 ), PFOS was positively associated with 54 metabolites (47 at baseline, 9 at soy protein, 8 at milk protein, and 6 at carbohydrate, respectively). Of which, 20 associations were replicated in BHS ( Table ). PFOA was positively associated with 3-methyladipate at soy protein and bilirubin (E,E) at milk protein. Conclusions: Dietary intervention reduced serum PFOA and PFOS. Several metabolites may play important roles in PFOA/PFOS related health effects.

Effects of dietary carbohydrate levels on growth performance, feed utilization, liver histology and intestinal microflora of juvenile tiger puffer, Takifugu rubripes

An 8-week feeding trial was conducted to investigate the effects of dietary carbohydrate levels on growth performance, body composition, and plasma biochemical parameters, liver and gut histology, and intestinal microbiota of Takifugu rubripes. Five isonitrogenous and isolipidic experimental diets were formulated with graded levels of cassava starch: 0% (C0), 8% (C8), 16% (C16), 24% (C24), and 32% (C32). The results showed that weight gain rate, specific growth rate (SGR) and protein efficiency ratio significantly increased in C16 and C24 groups (P < 0.05), while the feed conversion ratio expressed an opposite trend. Feeding rate is decreased with the increasing of carbohydrate levels (P < 0.05). Liver lipid content was dramatically increased in C24 treatment (P < 0.05). The intestinal amylase activity and muscle glycogen content were higher than other groups (P < 0.05). Plasma glucose levels were increased in C24 and C32 groups (P < 0.05). In addition, the abundance of intestinal potentially pathogenic bacteria (Staphylococcus) decreased, and the intestinal probiotics (Lactobacillus) increased with the increasing of dietary carbohydrate level (P < 0.05). The intestinal bacteria, indicated by Sobs, Chao and Shannon indexes, were more diverse with the increasing of the carbohydrate level (P < 0.05), meanwhile the abundance of transport and metabolism of carbohydrate, lipid and amino acid were enhanced with the increasing of carbohydrate levels (P < 0.05). In conclusion, appropriate supplementation of carbohydrate in diet promoted growth performance and feed utilization of juvenile Takifugu rubripes, and increased the liver lipid and muscle glycogen content, as well as intestinal microbial diversity. Based on the quadratic regression between SGR and carbohydrate levels, the optimal dietary carbohydrate level of juvenile Takifugu rubripes is 21.6%.

Impact of preoperative carbohydrate loading on postoperative course and morbidity in debulking surgery for epithelial ovarian cancer.

Despite the theoretical benefits, the favorable effect of preoperative carbohydrate loading on postoperative morbidity remains controversial. Most of the outcomes reported in the literature are derived from non-gynecologic surgery data, with only one study involving a limited number of patients specifically in gynecological oncology. The present study aimed to investigate the impact of carbohydrate loading, as a single element of enhanced recovery after surgery protocols, on postoperative course and morbidity in patients undergoing debulking surgery for epithelial ovarian cancer (EOC). The present study was a non-randomized, prospective cohort trial enrolling patients with EOC who underwent surgery between June 2018 and December 2021. An oral carbohydrate supplement with a dose of 50 g was given to patients 2-3 h before anesthesia. Data on postoperative course and morbidity were collected and compared with data of a historical cohort including consecutive patients who underwent surgery without a carbohydrate loading between January 2015 and June 2018. Analyses were performed on a total of 162 patients, including 72 patients in the carbohydrate loading group and 90 patients in the control group. Median length of hospital stay (11 days vs. 11 days; P=0.555), postoperative days 1-7 serum c-reactive protein levels (P=0.213), 30-day readmission (11.6% vs. 11.5%, P=0.985), 30-day relaparotomy (2.8% vs. 3.4%, P=0.809) and 30-day morbidity (48.6% vs. 46.7%; P=0.805) were comparable between the cohorts. No significant differences in grades of morbidities were identified between the cohorts (P=0.511). Multivariate analysis revealed that the sole independent risk factor for any postoperative morbidity was operative time. In conclusion, based on the results of the present study, postoperative course and morbidity seemed to be unaffected by carbohydrate loading in patients undergoing debulking surgery for EOC.

Exercising Safely with the MiniMed™ 780G Automated Insulin Delivery System.

The physical and psychological benefits of exercise are particularly pertinent to people with type 1 diabetes (T1D). The variability in subcutaneous insulin absorption and the delay in offset and onset in glucose lowering action impose limitations, given the rapidly varying insulin requirements with exercise. Simultaneously, there are challenges to glucose monitoring. Consequently, those with T1D are less likely to exercise because of concerns regarding glucose instability. While glucose control with exercise can be enhanced using automated insulin delivery (AID), all commercially available AID systems remain limited by the pharmacokinetics of subcutaneous insulin delivery. Although glycemic responses may vary with exercises of differing intensities and durations, the principles providing the foundation for guidelines include minimization of insulin on board before exercise commencement, judicious and timely carbohydrate supplementation, and when possible, a reduction in insulin delivered in anticipation of planned exercise. There is an increasing body of evidence in support of superior glucose control with AID over manual insulin dosing in people in T1D who wish to exercise. The MiniMed™ 780G AID system varies basal insulin delivery with superimposed automated correction boluses. It incorporates a temporary (elevated glucose) target of 8.3 mmol/L (150 mg/dL) and when it is functioning, the autocorrection boluses are stopped. As the device has recently become commercially available, there are limited data assessing glucose control with the MiniMed™ 780G under exercise conditions. Importantly, when exercise was planned and implemented within consensus guidelines, %time in range and %time below range targets were met. A practical approach to exercising with the device is provided with illustrative case studies. While there are limitations to spontaneity imposed on any AID device due to the pharmacokinetics associated with the subcutaneous delivery of current insulin formulations, the MiniMed™ 780G system provides people with T1D an excellent option for exercising safely if the appropriate strategies are implemented.

Recovery during Successive 120-min Football Games: Results from the 120-min Placebo/Carbohydrate Randomized Controlled Trial.

This study aimed to examine the recovery kinetics (i.e., time-dependent changes) of performance-related variables between two 120-min male football games performed 3 d apart with and without carbohydrate supplementation. Twenty male players (20 ± 1 yr; body fat, 14.9% ± 5.1%; maximal oxygen consumption, 59.4 ± 3.7 mL·kg -1 ·min -1 ) participated in two 120-min football games (G1, G2) according to a randomized, two-trial, repeated-measures, crossover, double-blind design. Participants received carbohydrate/placebo supplements during recovery between games. Field activity was monitored during the games. Performance testing and blood sampling were performed before and at 90 and 120 min of each game. Muscle biopsies were collected at baseline and at 90 and 120 min of G1 and pre-G2. Compared with G1, G2 was associated with reduced total distance (10,870 vs 10,685 m during 90 min and 3327 vs 3089 m during extra 30 min; P = 0.007-0.038), average (6.7 vs 6.2 km/h during extra 30-min game-play; P = 0.007) and maximal speed (32.2 vs 30.2 km/h during 90 min and 29.0 vs 27.9 km/h during extra 30 min; P < 0.05), accelerations/decelerations ( P < 0.05), and mean heart rate ( P < 0.05). Repeated sprint ability ( P < 0.001), jumping ( P < 0.05), and strength ( P < 0.001) performance were compromised before and during G2. Muscle glycogen was not restored at G2 baseline ( P = 0.005). Extended game-play reduced lymphocyte, erythrocyte counts, hematocrit, hemoglobin, reduced glutathione ( P < 0.05) and increased delayed onset of muscle soreness, creatine kinase activity, blood glycerol, ammonia, and protein carbonyls ( P < 0.05) before and during G2. Pax7 + ( P = 0.004) and MyoD + cells ( P = 0.019) increased at baseline G2. Carbohydrate supplementation restored performance and glycogen, reduced glycerol and delayed onset of muscle soreness responses, and increased leukocyte counts and Pax7 + and MyoD + cells. Results suggest that extended football games induce a prolonged recovery of performance, which may be facilitated by carbohydrate supplementation during a congested game fixture.

Adaptation of Glucose Metabolism to Limb Autotomy and Regeneration in the Chinese Mitten Crab.

Limb autotomy and regeneration represent distinctive responses of crustaceans to environmental stress. Glucose metabolism plays a pivotal role in energy generation for tissue development and regeneration across various species. However, the relationship between glucose metabolism and tissue regeneration in crustaceans remains elusive. Therefore, this study is aimed at analyzing the alterations of glucose metabolic profile during limb autotomy and regeneration in Eriocheir sinensis, while also evaluating the effects of carbohydrate supplementation on limb regeneration. The results demonstrated that limb autotomy triggered a metabolic profile adaption at the early stage of regeneration. Hemolymph glucose levels were elevated, and multiple glucose catabolic pathways were enhanced in the hepatopancreas. Additionally, glucose and ATP levels in the regenerative limb were upregulated, along with increased expression of glucose transporters. Furthermore, the gene expression and activity of enzymes involved in gluconeogenesis were repressed in the hepatopancreas. These findings indicate that limb regeneration triggers metabolic profile adaptations to meet the elevated energy requirements. Moreover, the study observed that supplementation with corn starch enhanced limb regeneration capacity by promoting wound healing and blastema growth. Interestingly, dietary carbohydrate addition influenced limb regeneration by stimulating gluconeogenesis rather than glycolysis in the regenerative limb. Thus, these results underscore the adaptation of glucose metabolism during limb autotomy and regeneration, highlighting its essential role in the limb regeneration process of E. sinensis.

EFFECT OF SAQ TRAINING WITH &amp; WITHOUT CARBOHYDRATE SUPPLEMENTATION AMONG ELITE FOOTBALLER'S SPEED

The main objective of the current study was to evaluate the changes in performance (speed) through SAQ training and carbohydrate supplementation of 08 weeks intervention. The study was conducted in the vicinity of Punjab University, Lahore. Participants (n=16) were selected through the inclusion criteria which included elite footballers and the participants were divided into two groups which were groups (A) and (B). Hypotheses of this study were: H0 1 There is no significant difference between the pre-test of group A (speed) and the pre-test of group B (speed). Ha 2 There is a significant difference between the pre-test of group A (speed) and the post-test of group A (speed). Ha 3 There is a significant difference between the pre-test of group B (speed) and the post-test of group B (speed). Ha 4 It is hypothesized that there is a significant difference between training with the Supplementation group (A) and Training without the Supplementation group (B). Group (A) was allowed to follow the 08-week exercise plan (intervention) and carbohydrate supplementation. Only group (B) was allowed to follow the 08-week exercise plan (intervention). Descriptive statistics, means and standard deviations were calculated. The inferential statistics and different tests including paired sample t-test and independent samples t-test were applied to calculate the differences in performance of all studied groups. The data was analyzed and evaluated statistically using Version 22 of IBM SPSS (Statistical Product and Service Solutions) software. The means (with standard deviation) of the speed tests of training with carbohydrate supplementation group (A) and the means (with standard deviation) of the speed tests of training without carbohydrate supplementation group (B) were compared. This study confirms that there was not a significant difference between groups (A) and (B) before training and carbohydrate supplementation. There was a significant difference in speed in, the pre-test of the group (A) compared with the post-test, followed by SAQ Training with carbohydrate supplementation. On the other hand, there was also a significant difference in speed, in the pre-test of group B compared with the post-test, followed by SAQ Training only. The study confirmed that there was a significant change in the speed of footballers' training with carbohydrate supplementation group (A) compared to training without carbohydrate supplementation group (B), after 08 weeks of intervention.

Effect of carbohydrate level in the diets of Kholmogor cows on milk productivity and milk quality

The effect of the diets with different ratio of easily digestible carbohydrates on milk productivity and milk quality of high-yielding Kholmogor cows during the milking period was studied. The research and production experiment on the cows was conducted in the Arkhangelsk region in 2022. Selection of animals in the control and experimental groups was carried out by the method of pair-analogues under the stall barn system. Two groups of cows participated in the research: experimental and control groups of 10 cows each. The experiment lasted for 100 days. Carbohydrate-protein mixture was used as a carbohydrate supplement to the diets of experimental animals in the amount of 1.5 kg per head per day. Selective milk quality control for mass fraction of fat, protein, lactose, dry matter, milk solids non-fat (MSNF), freezing point, urea and somatic cells were determined on a Bentley Combi 150 high-speed infrared milk analyzer at the Selective Milk Quality Control Laboratory. It was found that the sugar-protein ratio in the experimental group was twice higher (0.58) than in the control group (0.29), due to the presence of carbohydrate supplementation in the diet. The increase in milk productivity of the animals by 4.6 and 0.14% of the protein level in milk at inclusion of carbohydrate-protein mixture in the amount of 1.5 kg per one head per day in the diet was established. A 3.2% decrease in the level of urea in milk was recorded, indicating a more efficient use of amino acids by the animals in the process of metabolism at the same level of absorption of ammonium forms while increasing the level of simple carbohydrates in the diet. The positive effect of this additive on the content of dry skim milk residue, which increased in the milk of the cows of the experimental group by 0.128 absolute % (abs.%), was revealed. Application of the carbohydrate-protein mixture in the amount of 1.5 kg per one head per day and control over the quality of produced products will increase the milk productivity of cows, improve the quality of products, increase the productive longevity of dairy cattle.

Recovery Phase Nutrition and Insulin Strategies for a Collegiate Distance Runner with Type 1 Diabetes Mellitus: A Case Study.

There is scant published research regarding nutrition and insulin strategies for athletic performance in collegiate distance runners with type 1 diabetes mellitus (CDRT1). Acute carbohydrate supplementation (CHOsup) and insulin reduction used to minimize hypoglycemia during exercise may result in deteriorated glycemic control post exercise in CDRT1. The present case study of a CDRT1 investigated outcomes associated with a moderate-carbohydrate (ModCHO) diet and 24 h insulin adjustment during recovery phases for improved glycemic control and reduced use of acute strategies. During an 8-day period, a female CDRT1 followed a ModCHO (~4 g/kg/day) nutrition program. Recovery phase adjustments to insulin doses were made using an equation developed to estimate reduced insulin needs post exercise, as a function of exercise intensity and duration. Daily training was performed in the fasted state at 6:00 a.m. and included additional exercise strategies to reduce glycemic variability when needed. Daily blood glucose time-in-range (TIR) and use of CHOsup were assessed. Athlete well-being was determined using the Student-Athlete Well-Being Scale (SAWS)TM at baseline, and days 1, 3, and 7. Throughout the 8-day period, mean TIR increased (77% versus < 50%) and the magnitude of glycemic excursions decreased (~3.8-15 versus ~3.0-26 mmol/L) relative to a prior comparison period. Minimal pre-exercise CHOsup was employed and CHOsup during exercise was not required. Additionally, the athlete achieved a new lifetime best in the 5000 m run and maintained positive well-being. The present case study provides examples of recovery phase strategies (i.e., ModCHO diet and 24 h insulin adjustments) that may support glycemic control and athletic performance in CDRT1 and provides potential considerations for nutrition and insulin strategies for use by athletes and coaches.

SAT175 Noninsulinoma Pancreatogenous Hypoglycemia Syndrome As A Complication Of Nissen Fundoplication

Abstract Disclosure: R. Rinn: None. S. Lacount: None. J. Muuse: None. Hypoglycemia is a common condition that is typically diagnosed with Whipple’s Triad (hypoglycemic symptoms, low blood glucose, resolution of symptoms with treatment). It is important to recognize and treat early as it has the potential for lethal outcomes. Dumping syndrome is a rare presentation after Nissen’s fundoplication and predominantly reported in children. Here we present a case of an adult with persistent postprandial hypoglycemia after Nissen Fundoplication. A 79-year-old male with a recent Nissen’s fundoplication presented with repeated episodes of extreme fatigue and diaphoresis after eating. Other complaints included weakness and significant weight loss. Finger stick glucose on multiple checks were found to be in 40s. He was hospitalized and underwent extensive workup with Endocrinology and Gastroenterology. Important labs revealed elevated insulin 10.2, C-peptide level at 7.3 and pro-insulin at 27.7, negative insulin antibodies, a normal Insulin like growth factor (IGF-1) at 74, Beta-hydroxybutyrate level 0.1, and a negative screen for sulfonylureas. He was discharged home on a low carbohydrate diet but continued having repeated Whipple’s triad positive hypoglycemic episodes. In terms of imaging, CT of the abdomen did not reveal a mass, other localization studies were deferred since the episodes were mostly post-prandial concerning for NIPHS than insulinoma. For management, he had minimal response to octreotide and verapamil. His symptoms are currently being managed on acarbose and diazoxide with dietary modifications consisting of high protein and limited complex carbohydrates. Postprandial hypoglycemia as a complication of Nissen’s fundoplication is thought to be secondary to dumping syndrome (DS). DS is divided into two stages- early/osmotic stage and late/ hypoglycemic stage. Both types are caused by a large amount of gastric contents emptying into the duodenum, resulting in vasomotor symptoms from changes in blood pressure, pulse and glucose levels, as well as gastrointestinal symptoms. Glucagon like peptide-1 is responsible for the second phase and the levels are directly related to gastric emptying and inversely related to plasma glucose concentration. Accelerated gastric emptying causes increased GLP-1 levels leading to exaggerated insulin response resulting in rebound severe hypoglycemia. It is important to realize that diet plays an important role in symptom management. After Nissen’s fundoplication, a decrease occurs in the storage capacity of the fundus and gastric distensibility, which causes increased gastric motility with rapid emptying. Dietary modifications include reduction of carbohydrate intake and supplementation of dietary fibers with meals greatly help relieve symptoms associated with dumping syndrome in addition to drug therapy. Presentation: Saturday, June 17, 2023

Examination of Serum Metabolome Altered by Dietary Carbohydrate, Milk Protein, and Soy Protein Interventions Identified Novel Metabolites Associated with Blood Pressure: The ProBP Trial.

This study aims to discover metabolites of dietary carbohydrate, soy and milk protein supplements and evaluate their roles in blood pressure (BP) regulation in the protein and blood pressure (ProBP), a cross-over trial. Plasma metabolites are profiled at pre-trial baseline and after 8 weeks of supplementation with carbohydrate, soy protein, and milk protein, respectively, among 80 ProBP participants. After Bonferroni correction (α = 6.49 × 10-4 ), dietary interventions significantly changed 40 metabolites. Changes of erucate (22:1n9), an omega-9 fatty acid, are positively associated with systolic BP changes (Beta = 1.90, p = 6·27 × 10-4 ). This metabolite is also associated with higher odds of hypertension among 1261 participants of an independent cohort (odds ratio per unit increase = 1.34; 95% confidence interval: 1.07-1.68). High levels of acylcholines dihomo-linolenoyl-choline (p = 4.71E-04) and oleoylcholine (p = 3.48E-04) at baseline predicted larger BP lowering effects of soy protein. Increasing cheese intake during the trial, as reflected by isobutyrylglycine and isovalerylglycine, reduces the BP lowering effect of soy protein. The study identifies molecular signatures of dietary interventions. Erucate (22:1n9) increases systolic BP. Acylcholine enhances and cheese intake reduces the BP lowering effect of soy protein supplement.

Efficacy, safety and tolerability of high caloric diet in amyotrophic lateral sclerosis patients: A systematic review and meta-analysis

BackgroundSeveral randomized clinical trials were done to determine whether supplementation with a high caloric diet, either through carbohydrate or lipid supplementation, is safe, tolerable and improves survival. However, most of these trials are small and the results are conflicting. MethodsRandomized prospective trials utilizing high caloric supplementation among patients with amyotrophic lateral sclerosis (ALS) were searched using the terms [(“amyotrophic lateral sclerosis” or “motor neuron disease” or “ALS” or “MND”) and (“high calorie” or “high fat” or “high protein” or “high carbohydrate” or “supplementation”)] in Medline, Cochrane, Embase, Scopus, Prospero and Herdin by two independent neurologists. Journal articles deemed relevant were assessed for eligibility. Main resultsThere were 57 articles obtained from databases, 49 of which were excluded. Four articles were further excluded since all of them had different interventions. Overall, there were 311 ALS patients included in the study, 176 of them were from the intervention group while 135 were used as controls. Overall, high caloric supplementation in ALS was deemed safe and tolerable, and also when adverse events, tolerability and mortality are combined using meta-analysis. Although in most publications the efficacy of giving high caloric supplementation has been generally beneficial, some of the outcome parameters are not statistically different from controls when studies are combined using meta-analysis. ConclusionsCurrent evidence suggests that high calorie supplementation is generally safe and tolerable for patients with ALS. However, it has not been shown to be efficacious in improving weight and functional disability.