POINT-COUNTERPOINT COMMENTSComment on Point:Counterpoint: The lactate paradox does/does not occur during exercise at high altitude”George A. BrooksGeorge A. BrooksPublished Online:01 Jun 2007https://doi.org/10.1152/japplphysiol.00287.2007This is the final version - click for previous versionMoreSectionsPDF (29 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInEmailWeChat The following letter is in response to the Point:Counterpoint “The lactate paradox does/does not occur during exercise at high altitude” that appears in this issue.To the Editor: The exchange between Drs. West and van Hall (8, 9) is unsatisfying. West's (9) paper is classic, but incomplete. And while anachronism may explain Dr. van Hall's (8) dire response, his behavior should not be supported by the Journal of Applied Physiology. So far as I know, there has been only one attempt to determine the effects of acute and chronic altitude exposure on lactate kinetics that imposed appropriate dietary controls to distinguish between hypoxia and cachexia (2). West did not reference any of the papers, whereas van Hall cited some of the body of work, but chose to ignore the results. Seemingly, van Hall ignored the results because he has no understanding of the Lactate Shuttle (1), a concept that has received cross-disciplinary support (7). Hence, he cannot understand our findings that working muscle beds can simultaneously produce and consume lactate (3), diverse tissues can produce lactate for consumption by working muscle (4), and the sympathetic nervous system greatly influences carbohydrate metabolism at altitude (5). As summarized previously by Reeves (6), our results are (and should be) different from those of van Hall et al. because they gave no consideration to the necessity of controlling diet and body mass, which is essential (2), rendering their data uninterpretable. We showed by means of tracers and (a-v) measurements that lactate flux is increased on acute altitude because sympathetic nervous system (SNS) activity is increased and that with time at altitude lactate flux and SNS activity decrease.REFERENCES1 Brooks GA. Lactate shuttles in nature. Biochem Soc Trans 30: 258–264, 2002.Crossref | PubMed | ISI | Google Scholar2 Brooks GA, Butterfield GE. Metabolic response of lowlanders to high altitude exposure: malnutrition vs. the effect of hypoxia. In: Lung Biology in Health and Disease, High Altitude, edited Hornbein T and Schoene B. New York: Dekker, 2001, p. 569–600.Google Scholar3 Brooks GA, Butterfield GE, Wolfe RR, Groves BM, Mazzeo RS, Sutton JR, Wolfel EE, Reeves JT. Decreased reliance on lactate during exercise after acclimatization to 4,300 m. J Appl Physiol 71: 333–341, 1991.Link | ISI | Google Scholar4 Brooks GA, Wolfel EE, Butterfield GE, Cymerman A, Roberts AC, Mazzeo RS, Reeves JT. Poor relationship between arterial [lactate] and leg net release during steady-rate exercise at 4,300 m altitude. Am J Physiol Regul Integr Comp Physiol 275: R1192–R1201, 1998.Link | ISI | Google Scholar5 Mazzeo RS, Bender PR, Brooks GA, Butterfield GE, Groves BM, Sutton JR, Wolfel EE, Reeves JT. Arterial catecholamine responses during exercise with acute and chronic high-altitude exposure. Am J Physiol Endocrinol Metab 261: E419–E424, 1991.Link | ISI | Google Scholar6 Reeves JT, Wolfel EE, Green HJ, Mazzeo RS, Young AJ, Sutton JR, Brooks GA. Oxygen transport during exercise at high altitude and the lactate paradox: lessons from Operation Everest II and Pikes Peak. In: Exercise and Sport Sciences Reviews, vol. 20. New York: Williams and Wilkins, 1992, p. 275–296.Google Scholar7 Schurr A. Lactate: the ultimate cerebral oxidative energy substrate. J Cereb Blood Flow Metab 26: 142–152, 2006.Crossref | PubMed | ISI | Google Scholar8 Van Hall G. Counterpoint: The lactate paradox does not occur during exercise at high altitude. J Appl Physiol. In press.Google Scholar9 West J. Point: The lactate paradox does occur during exercise at high altitude. J Appl Physiol. In press.Google Scholar Download PDF Previous Back to Top Next FiguresReferencesRelatedInformationCited ByRegulation of human metabolism by hypoxia-inducible factor28 June 2010 | Proceedings of the National Academy of Sciences, Vol. 107, No. 28The lactate paradox revisited in lowlanders during acclimatization to 4100 m and in high-altitude natives27 February 2009 | The Journal of Physiology, Vol. 587, No. 5 More from this issue > Volume 102Issue 6June 2007Pages 2408-2408 Copyright & PermissionsCopyright © 2007 the American Physiological Societyhttps://doi.org/10.1152/japplphysiol.00287.2007PubMed17379751History Published online 1 June 2007 Published in print 1 June 2007 Metrics
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