title: Carbohydrate and glutamine supplementation modulates the Th1/Th2 balance after exercise performed at a simulated altitude of 4500 m.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effect of carbohydrate or glutamine supplementation, or a combination of the two, on the immune system and inflammatory parameters after exercise in simulated hypoxic conditions at 4500 m.
  
  
  METHODS
  Nine men underwent three sessions of exercise at 70% VO2peak until exhaustion as follows: 1) hypoxia with a placebo; 2) hypoxia with 8% maltodextrin (200 mL/20 min) during exercise and for 2 h after; and 3) hypoxia after 6 d of glutamine supplementation (20 g/d) and supplementation with 8% maltodextrin (200 mL/20 min) during exercise and for 2 h after. All procedures were randomized and double blind. Blood was collected at rest, immediately before exercise, after the completion of exercise, and 2 h after recovery. Glutamine, cortisol, cytokines, glucose, heat shock protein-70, and erythropoietin were measured in serum, and the cytokine production from lymphocytes was measured.
  
  
  RESULTS
  Erythropoietin and interleukin (IL)-6 increased after exercise in the hypoxia group compared with baseline. IL-6 was higher in the hypoxia group than pre-exercise after exercise and after 2 h recovery. Cortisol did not change, whereas glucose was elevated post-exercise in the three groups compared with baseline and pre-exercise. Glutamine increased in the hypoxia + carbohydrate + glutamine group after exercise compared with baseline. Heat shock protein-70 increased post-exercise compared with baseline and pre-exercise and after recovery compared with pre-exercise, in the hypoxia + carbohydrate group. No difference was observed in IL-2 and IL-6 production from lymphocytes. IL-4 was reduced in the supplemented groups.
  
  
  CONCLUSIONS
  Carbohydrate or glutamine supplementation shifts the T helper (Th)1/Th2 balance toward Th1 responses after exercise at a simulated altitude of 4500 m. The nutritional strategies increased in IL-6, suggesting an important anti-inflammatory effect.
authors.affiliation: Department of Physiology, Federal University of São Paulo, Brazil; Postgraduate Nutrition, Federal University of São Paulo, Brazil.
authors.forename: Aline V
authors.initials: AV
authors.lastname: Caris
authors.affiliation: Department of Physiology, Federal University of São Paulo, Brazil; Department of Psychobiology, Federal University of São Paulo, Brazil; Department of Physical Education, State University of São Paulo, Brazil.
authors.forename: Fábio S
authors.initials: FS
authors.lastname: Lira
authors.affiliation: Department of Physiology, Federal University of São Paulo, Brazil; Department of Psychobiology, Federal University of São Paulo, Brazil.
authors.forename: Marco T
authors.initials: MT
authors.lastname: de Mello
authors.affiliation: Department of Physiology, Federal University of São Paulo, Brazil; Postgraduate Nutrition, Federal University of São Paulo, Brazil.
authors.forename: Lila M
authors.initials: LM
authors.lastname: Oyama
authors.affiliation: Department of Psychobiology, Federal University of São Paulo, Brazil; Department of Bioscience, Federal University of São Paulo, Brazil. Electronic address: Ronaldo.thomatieli@unifesp.br.
authors.forename: Ronaldo V T
authors.initials: RV
authors.lastname: dos Santos
mesh_terms: D000328:Adult; D000531:Altitude; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D001786:Blood Glucose / Q000378:metabolism; D019587:Dietary Supplements; D004311:Double-Blind Method; D004921:Erythropoietin / Q000097:blood; D015444:Exercise / Q000502:physiology*; D005973:Glutamine / Q000494:pharmacology*; D018840:HSP70 Heat-Shock Proteins / Q000097:blood; D006801:Humans; D000860:Hypoxia / Q000150:complications; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D007378:Interleukins / Q000097:blood; D008297:Male; D011134:Polysaccharides / Q000494:pharmacology*; D018417:Th1 Cells / Q000378:metabolism; D058408:Th1-Th2 Balance; D018418:Th2 Cells / Q000378:metabolism; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D001786:Blood Glucose; D018840:HSP70 Heat-Shock Proteins; D007378:Interleukins; D011134:Polysaccharides; D005973:Glutamine; D004921:Erythropoietin; C008315:maltodextrin
keywords: High altitude; Immune function; Inflammation; Lymphocytes; Physical exercise