Cited by 117Thermoregulation and physiological responsesExercise and Physiological ResponsesMuscle metabolism and nutrition

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Carbohydrate and protein intake during exertional heat stress ameliorates intestinal epithelial injury and small intestine permeability

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Snipe, Rhiannon M.J., Khoo, Anthony, Kitic, Cecilia M., Gibson, Peter R., Costa, Ricardo J.S.·2017·Applied Physiology Nutrition and Metabolism

DOI 10.1139/apnm-2017-0361

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Abstract

Exertional heat stress (EHS) disturbs the integrity of the gastrointestinal tract leading to endotoxaemia and cytokinaemia, which have symptomatic and health implications. This study aimed to determine the effects of carbohydrate and protein intake during EHS on gastrointestinal integrity, symptoms, and systemic responses. Eleven (male, n = 6; female, n = 5) endurance runners completed 2 h of running at 60% maximal oxygen uptake in 35 °C ambient temperature on 3 occasions in randomised order, consuming water (WATER), 15 g glucose (GLUC), or energy-matched whey protein hydrolysate (WPH) before and every 20 min during EHS. Rectal temperature and gastrointestinal symptoms were recorded every 10 min during EHS. Blood was collected pre- and post-EHS, and during recovery to determine plasma concentrations of intestinal fatty-acid binding protein (I-FABP) as a marker of intestinal epithelial injury, cortisol, endotoxin, and inflammatory cytokines. Urinary lactulose/l-rhamnose ratio was used to measure small intestine permeability. Compared with WATER, GLUC, and WPH ameliorated EHS associated intestinal epithelial injury (I-FABP: 897 ± 478 pg·mL−1 vs. 123 ± 197 pg·mL−1 and 82 ± 156 pg·mL−1, respectively, p < 0.001) and small intestine permeability (lactulose/l-rhamnose ratio: 0.034 ± 0.014 vs. 0.017 ± 0.005 and 0.008 ± 0.002, respectively, p = 0.001). Endotoxaemia was observed post-EHS in all trials (10.2 pg·mL−1, p = 0.001). Post-EHS anti-endotoxin antibodies were higher (p < 0.01) and cortisol and interleukin-6 lower (p < 0.05) on GLUC than WATER only. Total and upper gastrointestinal symptoms were greater on WPH, compared with GLUC and WATER (p < 0.05), in response to EHS. In conclusion, carbohydrate and protein intake during EHS ameliorates intestinal injury and permeability. Carbohydrate also supports endotoxin clearance and reduces stress markers, while protein appears to increase gastrointestinal symptoms, suggesting that carbohydrate is a more appropriate option.

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Authors: Snipe, R. M. J., Khoo, A., Kitic, C. M., Gibson, P. R., & Costa, R. J. S.
Affiliations: Monash University (AU)
University of Tasmania (AU)
The Alfred Hospital (AU)
ORCID: Snipe, Rhiannon M.J.
Kitic, Cecilia M.
Costa, Ricardo J.S.
Venue: Applied Physiology Nutrition and Metabolism
Publisher: Canadian Science Publishing
Published: 2017-12
Volume: 42
Issue: 12
Pages: 1283-1292
ISSN: 1715-5312 (ISSN-L)
1715-5320
DOI: 10.1139/apnm-2017-0361
OpenAlex: W2743575529
Cited by: 117
References: 69
Citations by year: 2026: 14 · 2025: 15 · 2024: 8 · 2023: 11 · 2022: 15 · 2021: 18 · 2020: 12 · 2019: 12 · 2018: 11 · 2017: 1
FWCI: 7.28
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: www.nrcresearchpress.com/page/about/CorporateTextAndDataMining (tdm)
Locations: Applied Physiology, Nutrition, and Metabolism (publishedVersion)
PubMed (publishedVersion)
UTAS Research Repository (acceptedVersion)
TSpace (University of Toronto) (acceptedVersion)
eCite Digital Repository (University of Tasmania) (submittedVersion)
Figshare (submittedVersion, cc-by)
Funders: Monash University (SGS15-0128)
Topics: Health Sciences › Medicine › Physiology (medical) › Thermoregulation and physiological responses
Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
Keywords: exertional heat stress, carbohydrate intake, whey protein hydrolysate, intestinal epithelial damage, intestinal permeability, endotoxemia, intestinal fatty acid binding protein, gastrointestinal symptoms, endurance running, anti-endotoxin antibodies, interleukin-6, cortisol, heat acclimation, sports nutrition
MeSH terms: Organism Hydration Status, Adult, Blood Glucose, Body Temperature, Dietary Carbohydrates, Dietary Proteins, Female, Gene Expression Regulation, Humans, Hydrocortisone, Intestinal Mucosa, Intestine, Small, Male, Permeability, Running, Exercise, Cytokines

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Carbohydrate and protein intake during exertional heat stress ameliorates intestinal epithelial injury and small intestine permeability

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