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POINT-COUNTERPOINT COMMENTS
Integrative Biology
University of California
gbrooks{at}berkeley.edu
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.
REFERENCES
This article has been cited by other articles:
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G. van Hall, C. Lundby, M. Araoz, J. A. L. Calbet, M. Sander, and B. Saltin The lactate paradox revisited in lowlanders during acclimatization to 4100 m and in high-altitude natives J. Physiol., March 1, 2009; 587(5): 1117 - 1129. [Abstract] [Full Text] [PDF] |
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