PMID- 33106121
OWN - NLM
STAT- MEDLINE
DCOM- 20211014
LR  - 20231111
IS  - 1536-7290 (Electronic)
IS  - 1746-1391 (Print)
IS  - 1536-7290 (Linking)
VI  - 21
IP  - 10
DP  - 2021 Oct
TI  - The influence of carbohydrate ingestion on peripheral and central fatigue during 
      exercise in hypoxia: A narrative review.
PG  - 1423-1435
LID - 10.1080/17461391.2020.1842512 [doi]
AB  - Hypoxia impairs aerobic performance by accelerating fatiguing processes. These 
      processes may originate from sites either distal (peripheral) or proximal 
      (central) to the neuromuscular junction, though these are not mutually exclusive. 
      Peripheral mechanisms include decrements in muscle glycogen or fluctuations in 
      intramuscular metabolites, whereas central responses commonly refer to reductions 
      in central motor drive elicited by alterations in blood glucose and 
      neurotransmitter concentrations as well as arterial hypoxemia. Hypoxia may 
      accelerate both peripheral and central pathways of fatigue, with the level of 
      hypoxia strongly dictating the degree and primary locus of impairment. As more 
      people journey to hypoxic settings for work and recreation, developing strategies 
      to improve work capacity in these environments becomes increasingly relevant. 
      Given that sea level performance improves with nutritional interventions such as 
      carbohydrate (CHO) ingestion, a similar strategy may prove effective in delaying 
      fatigue in hypoxia, particularly considering how the metabolic pathways enhanced 
      with CHO supplementation overlap the fatiguing pathways upregulated in hypoxia. 
      Many questions regarding the relationship between CHO, hypoxia, and fatigue 
      remain unanswered, including specifics on when to ingest, what to ingest, and how 
      varying altitudes influence supplementation effectiveness. Therefore, the purpose 
      of this narrative review is to examine the peripheral and central mechanisms 
      contributing to fatigue during aerobic exercise at varying degrees of hypoxia and 
      to assess the role of CHO ingestion in attenuating fatigue onset.
FAU - Paris, Hunter L
AU  - Paris HL
AD  - Department of Sports Medicine, Pepperdine University, Malibu, CA, USA.
FAU - Sinai, Erin C
AU  - Sinai EC
AD  - Department of Sports Medicine, Pepperdine University, Malibu, CA, USA.
FAU - Shei, Ren-Jay
AU  - Shei RJ
AD  - Division of Pulmonary, Allergy, and Critical Care Medicine, Department of 
      Medicine, and Gregory Fleming James Cystic Fibrosis Research Center, University 
      of Alabama at Birmingham, Birmingham, AL, USA.
FAU - Keller, Alexandra M
AU  - Keller AM
AD  - Department of Sports Medicine, Pepperdine University, Malibu, CA, USA.
FAU - Mickleborough, Timothy D
AU  - Mickleborough TD
AD  - Department of Kinesiology, School of Public Health-Bloomington, Indiana 
      University, Bloomington, IN, USA.
LA  - eng
GR  - T32 HL105346/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Review
DEP - 20201122
PL  - Germany
TA  - Eur J Sport Sci
JT  - European journal of sport science
JID - 101146739
RN  - 0 (Blood Glucose)
RN  - 0 (Dietary Carbohydrates)
SB  - IM
MH  - Altitude
MH  - Blood Glucose
MH  - Dietary Carbohydrates/*administration & dosage
MH  - *Exercise
MH  - Humans
MH  - Hypoxia/*metabolism
MH  - *Muscle Fatigue
MH  - *Sports Nutritional Physiological Phenomena
PMC - PMC8140067
MID - NIHMS1643582
OTO - NOTNLM
OT  - Aerobic fitness
OT  - environmental physiology
OT  - nutrition
OT  - performance
COIS- Disclosure Statement No potential conflict of interest.
EDAT- 2020/10/28 06:00
MHDA- 2021/10/15 06:00
PMCR- 2022/10/01
CRDT- 2020/10/27 05:34
PHST- 2020/10/28 06:00 [pubmed]
PHST- 2021/10/15 06:00 [medline]
PHST- 2020/10/27 05:34 [entrez]
PHST- 2022/10/01 00:00 [pmc-release]
AID - 10.1080/17461391.2020.1842512 [doi]
PST - ppublish
SO  - Eur J Sport Sci. 2021 Oct;21(10):1423-1435. doi: 10.1080/17461391.2020.1842512. 
      Epub 2020 Nov 22.