eCite Digital Repository

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


Snipe, RMJ and Khoo, A and Kiktic, CM and Gibson, P and Costa, RJS, Carbohydrate and protein intake during exertional-heat stress ameliorates intestinal epithelial injury and small intestine permeability, Applied physiology, nutrition, and metabolism, 42, (12) pp. 1283-1292. ISSN 1715-5312 (2017) [Refereed Article]

PDF (Pre-print version)

Copyright Statement

Copyright 2017 the Authors

DOI: doi:10.1139/apnm-2017-0361


Background: 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.

Methods: Eleven (male n=6, female n=5) endurance runners completed 2h running at 60% V̇O2max in 35C ambient temperature on three occasions in randomised order, consuming water (WATER) or 15g glucose (GLUC) or energy-matched whey protein hydrolysate (WPH) before and every 20min during EHS. Rectal temperature and gastrointestinal symptoms were recorded every 10min 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 was used to measure small intestine permeability.

Results: Compared to WATER, GLUC and WPH ameliorated EHS-associated intestinal epithelial injury (I-FABP: 897478pgml-1 vs. 123197pgml-1 and 82156pgml-1, respectively, p<0.001) and small intestine permeability (lactulose:L-rhamnose ratio 0.0340.014 vs. 0.0170.005 and 0.0080.002, respectively, p=0.001). Endotoxaemia was observed post-EHS in all trials (10.2pgml-1, p=0.001). Post-EHS anti-endotoxin antibodies were higher (p<0.01) and cortisol and IL-6 lower (p<0.05) on GLUC than WATER only. Total and upper-gastrointestinal symptoms were greater on WPH, compared to GLUC and WATER (p<0.05), in response to EHS.

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 carbohydrate is a more appropriate option.

Item Details

Item Type:Refereed Article
Keywords:gastrointestinal, exercise, IFABP
Research Division:Health Sciences
Research Group:Sports science and exercise
Research Field:Sports science and exercise not elsewhere classified
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Specific population health (excl. Indigenous health) not elsewhere classified
UTAS Author:Kiktic, CM (Dr Cecilia Kitic)
ID Code:120048
Year Published:2017
Web of Science® Times Cited:51
Deposited By:Health Sciences
Deposited On:2017-08-09
Last Modified:2018-09-13
Downloads:50 View Download Statistics

Repository Staff Only: item control page