Acid – Base Homeostasis in the Exercise a Traditional Review

Yıl 2022, Cilt: 6 Sayı: 2, 74 - 94, 31.12.2022

Cebrail Gençoğlu , Mustafa Gül , Süleyman Ulupınar , Serhat Özbay , Ayhan Tanyeli , Saime Özbek Şebin , Emine Öncan

https://doi.org/10.30769/usbd.1180707

Öz

During high intensity exercise (i.e., working above the lactate threshold), the contracting skeletal muscles generate plenty of hydrogen (H+) ions. These H+ ions can lead to the exercise-induced metabolic acidosis and impairment of acid-base homeostasis. Therefore, the aim of this study is to explain (a) the physiological mechanism of changes in the body pH level due to exercise and its effect on sportive performance, (b) the physiological mechanism of changes in exercise-induced acid-base homeostasis and its effect on athletic performance, and (c) the methods to minimize the negative effects of the mentioned physiological events. The aim of this study is to examine the nutritional supplements that can be used in the light of current literature. In this review, scientific articles and books on exercise and acid-base balance, exercise-induced acid-base disorders were examined. Pub Med, Web of Science, Medline, Cochrane Library, Google Scholar and ULAKBİM electronic databases were searched using the keywords “exercise and pH balance”, “acidosis and exercise”, “exercise and acid-base balance”, “athletic performance and fluid balance”, “sport supplements for acid-base balance”, “sports beverage for athletes” and “nutritional strategies for acid-base balance”. A decrease in pH level with metabolic acidosis could decrease the exercise performance. Metabolic acidosis also negatively affects exercise performance due to factors such as the feeling of fatigue, and the decrease in mechanical performance in the muscles in athletes Therefore, showing the necessary sensitivity to the protection of acid-base balance and using supportive nutritional supplements (sodium bicarbonate, sodium citrate, beta alanine, etc.) for delaying fatigue by athletes are recommended alternatives to maintain optimal performance.

Anahtar Kelimeler

Acidosis, Alkalosis, Sport, Performance

Egzersizde Asit-Baz Homeostazi Bir Geleneksel Derleme

Öz

Yüksek yoğunluklu egzersiz sırasında (örneğin, laktat eşiğinin üzerinde çalışmak) kasılan iskelet kasları, önemli miktarda hidrojen (H+) iyonu birikimine sebep olur. Bu H+ iyonları, egzersize bağlı metabolik asidozun gelişmesine ve asit-baz homeostazının bozulmasına sebep olabilir. Dolayısıyla bu çalışmanın amacı (a) egzersize bağlı vücut pH seviyesinde meydana gelen değişimlerin fizyolojik mekanizmasını ve sportif performansa etkisini, (b) egzersize bağlı asit-baz homeostazında görülen değişimlerin fizyolojik mekanizmasını ve sportif performansa etkisini ve (c) bahsedilen fizyolojik olayların olumsuz etkilerinin minimize edilmesi için kullanılabilecek besin takviyelerini güncel literatür ışığında incelemeyi amaçlamıştır. Bu derleme çalışmasında egzersiz ve asit-baz dengesi, egzersize bağlı asit-baz bozuklukları ile ilgili konuları içeren bilimsel metinler ve kitaplar incelenmiştir. Pub Med, Web of Science, Medline, Cochrane Library, Google Scholar ve ULAKBİM elektronik veri tabanları “exercise and pH balance”, “acidosis and exercise”, “exercise and acid-base balance”, “athletic performance and fluid balance”, “sport supplements for asid-base balance”, “sports beverage for athletes’’ ve “nutritional strategies for acid-base balance” anahtar kelimeleri kullanılarak taranmıştır. Metabolik asidozla birlikte sporcularda yorgunluk hissi, kaslardaki mekanik performansın azalması gibi etmenler dolayısıyla egzersiz performansını da olumsuz etkiler. Bu nedenle sporcular tarafından yüksek şiddetli egzersizlerde bozulabilecek asit-baz homeostazı için destekleyici besinsel takviyelerin kullanılması (sodyum bikarbonat, sodyum sitrat, beta alanin vb.) sportif performansın optimal biçimde sürdürülebilmesi, oluşabilecek yorgunluğun geciktirilebilmesi ve performansın artırılması için tavsiye edilen alternatiflerdir.

Anahtar Kelimeler

pH, Asidoz, Alkaloz, Spor, Performans, Acidosis, Alkalosis, Sport, Performance

Kaynakça

• Abe, H. (2000). Role of histidine-related compounds as intracellular proton buffering constituents in vertebrate muscle. Biochemistry C/C Of Biokhimiia, 65(7), 757-765.
• Acarkan, T. (2013). Latent Asidoz. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi(17), 18-24.
• Allen, D. G., Lamb, G. D., & Westerblad, H. (2008). Skeletal muscle fatigue: Cellular mechanisms. Physiological Reviews, 88(1), 287-332. doi: 10.1152/physrev.00015.2007
• Aschenbach, W., Ocel, J., Craft, L., Ward, C., Spangenburg, E., ve Williams, J. (2000). Effect of oral sodium loading on high-intensity arm ergometry in college wrestlers. Medicine and Science in Sports and Exercise, 32(3), 669-675.
• Ashikawa, I., & Itoh, K. (1979). Raman spectra of polypeptides containing L‐histidine residues and tautomerism of imidazole side chain. Biopolymers: Original Research on Biomolecules, 18(8), 1859-1876. Bangsbo, J., Johansen, L., Graham, T., & Saltin, B. (1993). Lactate and H+ effluxes from human skeletal muscles during intense, dynamic exercise. The Journal of physiology, 462(1), 115-133.
• Boning, D., & Maassen, N. (2008). Point: Counterpoint: Lactic acid is/is not the only physicochemical contributor to the acidosis of exercise. Journal of Applied Physiology, 105(1), 358-359.
• Carr, A. J., Hopkins, W. G., & Gore, C. J. (2011). Effects of acute alkalosis and acidosis on performance. Sports Medicine, 41(10), 801-814.
• Cicioğlu, İ., Tamer, K., Çevik, C., & Düzgün, E. (2001). Farklı dozlarda sodyum bikarbonat alımının yoğun egzersiz performansına etkisi. Gazi Beden Eğitimi ve Spor Bilimleri Dergisi, 6(1), 41-52.
• Constable, P. D. (2014). Acid-base assessment: when and how to apply the Henderson-Hasselbalch equation and strong ion difference theory. Veterinary Clinics: Food Animal Practice, 30(2), 295-316.
• Coombes, J., & McNaughton, L. R. (1993). Effects of bicarbonate ingestion on leg strength and power during isokinetic knee flexion and extension. The Journal of Strength & Conditioning Research, 7(4), 241-249.
• Costill, D. L., Verstappen, F., Kuipers, H., Janssen, E., & Fink, W. (1984). Acid-base balance during repeated bouts of exercise: influence of HCO3. International journal of sports medicine, 5(05), 228-231.
• Cox, P. J., Kirk, T., Ashmore, T., Willerton, K., Evans, R., Smith, A., . . . McLure, S. W. (2016). Nutritional ketosis alters fuel preference and thereby endurance performance in athletes. Cell metabolism, 24(2), 256-268.
• Dearlove, D. J., Faull, O. K., Rolls, E., Clarke, K., & Cox, P. J. (2019). Nutritional ketoacidosis during incremental exercise in healthy athletes. Frontiers in physiology, 10, 290.
• Derave, W., Ozdemir, M. S., Harris, R. C., Pottier, A., Reyngoudt, H., Koppo, K., . . . Achten, E. (2007). β-Alanine supplementation augments muscle carnosine content and attenuates fatigue during repeated isokinetic contraction bouts in trained sprinters. Journal of applied physiology, 103(5), 1736-1743.
• Djarova, T., Ilkov, A., Varbanova, A., Nikiforova, A., & Mateev, G. (1986). Human growth hormone, cortisol, and acid-base balance changes after hyperventilation and breath-holding. International Journal of Sports Medicine, 7(06), 311-315.
• Ertuğrul, L. (2010). Fizyoloji (1. ed.). Akademi Basın ve Yayıncılık.
• Farrell, P. A., Joyner, M. J., & Caiozzo, V. (2011). ACSM's advanced exercise physiology: Wolters Kluwer Health Adis (ESP).
• Foster, G. T., Vaziri, N. D., & Sassoon, C. (2001). Respiratory alkalosis. Respiratory care, 46(4), 384-391.
• Fry, A. C., & Karet, F. E. (2007). Inherited renal acidoses. Physiology, 22(3), 202-211.
• Gattinoni, L., & Lissoni, A. (1998). Pathophysiology and diagnosis of respiratory acid-base disturbances in patients with critical illness. In Critical care nephrology (pp. 297-311): Springer.
• Gençoğlu, C., & Akkuş, E. (2020). Egzersize tiroid hormon yanıtları. Medical Sciences, 15(3), 71-80.
• Gough, L. A., Rimmer, S., Sparks, S. A., McNaughton, L. R., & Higgins, M. F. (2019). Post-exercise supplementation of sodium bicarbonate improves acid base balance recovery and subsequent high-intensity boxing specific performance. Frontiers in Nutrition, 6, 155.
• Gönlügür, U., & Gönlügür, T. (2020). The Role of the lungs in acid-base balance. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 11(1), 23-26.
• Gropper, S. S., & Smith, J. L. (2012). Advanced nutrition and human metabolism: Cengage Learning, Boston, Massachusetts, ABD.
• Guyton, A., & Hall, J. (2016). Textbook of medical physiology (13th Ed.) (11th ed.): Philadelphia: Elseiver.
• Günay, M., Baltacı, A. K., Şıktar, E., ve Şıktar, E. (2018). Egzersiz ve solunum. Gazi Kitabevi Tic. Ltd. Şti.
• Hargreaves, M., & Spriet, L. L. (2020). Skeletal muscle energy metabolism during exercise. Nature Metabolism, 2(9), 817-828.
• Harris, R. C., Tallon, M., Dunnett, M., Boobis, L., Coakley, J., Kim, H. J., . . . Wise, J. A. (2006). The absorption of orally supplied β-alanine and its effect on muscle carnosine synthesis in human vastus lateralis. Amino acids, 30(3), 279-289.
• Hazır, T., ve Gül, Ş. (2015). Yüksek şiddetli egzersiz sonrasında pasif, kor egzersizleri ile kombine pasif ve aktif toparlanmanın kandan laktik asit eliminasyonu üzerine etkisi. Spor Bilimleri Dergisi, 26(4), 165-176.
• Hill, C., Harris, R. C., Kim, H., Harris, B., Sale, C., Boobis, L., . . . Wise, J. A. (2007). Influence of β-alanine supplementation on skeletal muscle carnosine concentrations and high intensity cycling capacity. Amino acids, 32(2), 225-233.
• Hollidge-Horvat, M., Parolin, M., Wong, D., Jones, N., &Heigenhauser, G. (2000). Effect of induced metabolic alkalosis on human skeletal muscle metabolism during exercise. American Journal of Physiology-Endocrinology And Metabolism, 278(2), E316-E329.
• Jones, N. L. (2008). An obsession with CO2. Applied Physiology, Nutrition, and Metabolism, 33(4), 641-650.
• Junior, A. H. L., de Salles Painelli, V., Saunders, B., & Artioli, G. G. (2015). Nutritional strategies to modulate intracellular and extracellular buffering capacity during high-intensity exercise. Sports Medicine, 45(1), 71-81.
• Kellum, J. (2005). Making strong ion difference the" Euro" for bedside acid-base analysis. In Yearbook of Intensive Care and Emergency Medicine 2005 (pp. 675-685): Springer.
• Koca, F., Süer, C., & Erol, E. (2004). Sodyum bikarbonat alımının farklı yüksekliklerde yapılan yoğun anaerobik egzersizlere ergojenik etkisi. Sağlık Bilimleri Dergisi, 13(2), 39-45.
• Kowalchuk, J. M., Heigenhauser, G., Lindinger, M. I., Sutton, J. R., & Jones, N. L. (1988). Factors influencing hydrogen ion concentration in muscle after intense exercise. Journal of Applied Physiology, 65(5), 2080-2089.
• Laiken, N., &Fanestil, D. (1985). Acid-base balance and regulation of H+ excretion. In Best and Taylor's physiologic bases of medical practice (pp. 286): Williams and Wilkins Baltimore.
• Leblanc, M., & Kellum, J. A. (1998). Biochemical and biophysical principles of hydrogen ion regulation. In Critical care nephrology (pp. 261-277): Springer.
• Lieberman, M., & Marks, A. D. (2009). Marks' basic medical biochemistry: A clinical approach: Lippincott Williams & Wilkins.
• Linderman, J. K., & Fahey, T. D. (1991). Sodium bicarbonate ingestion and exercise performance: An update. Sports Medicine, 11(2), 71-77. https://doi.org/10.2165/00007256-199111020-00001
• Lindinger, M. I., & Heigenhauser, G. J. (2008). Counterpoint: Lactic acid is not the only physicochemical contributor to the acidosis of exercise. Journal of Applied Physiology, 105(1), 359-361.
• Lindinger, M. I., & Heigenhauser, G. J. (2012). Effects of Gas Exchange on Acid‐Base Balance. Comprehensive Physiology, 2(3), 2203-2254.
• Liu, Q., Sikand, P., Ma, C., Tang, Z., Han, L., Li, Z., . . . Dong, X. (2012). Mechanisms of itch evoked by β-alanine. Journal of Neuroscience, 32(42), 14532-14537.
• Lühker, O., Pohlmann, A., Hochreiter, M., & Berger, M. M. (2018). Acid–base balance during muscular exercise: Response to Dr. Böning and Dr. Maassen. European journal of applied physiology, 118(4), 865-866.
• Maas, A., Rispens, P., Siggaard-Andersen, O., & Zijlstra, W. (1984). On the reliability of the Henderson-Hasselbalch equation in routine clinical acid-base chemistry. Annals of clinical biochemistry,21(1),26-39.
• Marsh, G., Paterson, D., Thompson, R., & Driedger, A. (1991). Coincident thresholds in intracellular phosphorylation potential and pH during progressive exercise. Journal of Applied Physiology, 71(3), 1076-1081.
• Mc Naughton, L., & Cedaro, R. (1992). Sodium citrate ingestion and its effects on maximal anaerobic exercise of different durations. European Journal of Applied Physiology and Occupational Physiology, 64(1),36-41.
• Mc Naughton, L., & Thompson, D. (2001). Acute versus chronic sodium bicarbonate ingestion and anaerobic work and power output. Journal of sports medicine and physical fitness, 41(4), 456-462.
• McArdle, W. D., Katch, F. I., & Katch, V. L. (2006). Essentials of exercise physiology: Lippincott Williams & Wilkins.
• McArdle, W. D., Katch, F. I., & Katch, V. L. (2010). Exercise physiology: nutrition, energy, and human performance: Lippincott Williams & Wilkins.
• Nanang, M., Fuad, N., Didik, R., Topo, S., & Panuwun, J. (2018). Effect of alkaline fluids to blood pH and lactic acid changes on sub maximal physical exercise. Paper presented at the IOP conference series: earth and environmental science.
• Nelson, D., & Cox, M. (2005). Lehninger principles of Biochemistry. Macmillan worth Publishers.
• Öçmen, E., ve Gökmen, N. (1998). Asit baz dengesi ve bozuklukları. 178-189.
• Parry, H. A., Roberts, M. D., & Kavazis, A. N. (2020). Human skeletal muscle mitochondrial adaptations following resistance exercise training. International journal of sports medicine, 41(06), 349-359.
• Paşaoğlu, H., Günay, M., Paşaoğlu, Ö. T., ve Keskin, K. (2019). Egzersiz Biyokimyası (1. ed.): Gazi Kitabevi.
• Po, H. N., & Senozan, N. (2001). The Henderson-Hasselbalch equation: Iits history and limitations. Journal of Chemical Education, 78(11), 1499.
• Potteiger, J. A. (2011). ACSM's Introduction to Exercise Science: Wollters Kluwer/Lippincott Williams & Wilkins Health.
• Powers, S. (2014). Exercise physiology: Theory and application to fitness and performance: McGraw-Hill Higher Education.
• Ratamess, N. A. (2012). ACSM's foundations of strength training and conditioning (Vol. 407). Wolters Kluwer Health/Lippincott Williams & Wilkins.
• Robergs, R., Costill, D., Fink, W., Williams, C., Pascoe, D., Chwalbinska-Moneta, J., & Davis, J. (1990). Effects of warm-up on blood gases, lactate and acid-base status during sprint swimming. International Journal of Sports Medicine, 11(04), 273-278.
• Robergs, R. A., Ghiasvand, F., & Parker, D. (2004). Biochemistry of exercise-induced metabolic acidosis. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology.
• Robertson, R. J., Falkel, J. E., Drash, A. L., Swank, A. M., Metz, K. F., Spungen, S. A., & Leboeuf, J. R. (1987). Effect of induced alkalosis on physical work capacity during arm and leg exercise. Ergonomics, 30(1), 19-31.
• Rodwell, V. W., Bender, D. A., Botham, K. M., Kennelly, P. J., & Weil, P. A. (2018). Harper's illustrated biochemistry. McGraw-Hill Education New York (NY).
• Roth, D. A., & Brooks, G. A. (1990). Lactate transport is mediated by a membrane-bound carrier in rat skeletal muscle sarcolemmal vesicles. Archives of Biochemistry and Biophysics, 279(2), 377-385.
• Sahlin, E. H. K. (1980). Acid-base balance during exercise. Exercise and sport sciences reviews, 8(1), 41-128.
• Sahlin, K., & Ren, J. M. (1989). Relationship of contraction capacity to metabolic changes during recovery from a fatiguing contraction. Journal of Applied Physiology, 67(2), 648-654.
• Sale, C., Saunders, B., & Harris, R. C. (2010). Effect of beta-alanine supplementation on muscle carnosine concentrations and exercise performance. Amino Acids, 39(2), 321-333.
• Sinclair, M., Hart, R. A., Pope, H. M., & Campbell, E. (1968). The use of the Henderson-Hasselbalch equation in routine medical practice. Clinica Chimica Acta, 19(1), 63-69.
• Stickland, M. K., Lindinger, M. I., Olfert, I. M., Heigenhauser, G. J., & Hopkins, S. R. (2011). Pulmonary gas exchange and acid‐base balance during exercise. Comprehensive Physiology, 3(2), 693-739.
• Street, D., Bangsbo, J., & Juel, C. (2001). Interstitial pH in human skeletal muscle during and after dynamic graded exercise. The Journal of physiology, 537(3), 993-998.
• Tanokura, M., Tasumi, M., & Miyazawa, T. (1976). 1H Nuclear magnetic resonance studies of histidine‐containing di‐and tripeptides. Estimation of the effects of charged groups on the pKa value of the imidazole ring. Biopolymers: Original Research on Biomolecules, 15(2), 393-401.
• Telci, L. (2011). Asit Baz Dengesi (2. ed.). Nobel Tıp Kitabevleri Ltd. Şti.
• Ulupinar, S., Ozbay, S., Gencoglu, C., Altinkaynak, K., Sebin, E., & Oymak, B. (2021). Exercise in the cold causes greater irisin release but may not be enough for adropin. Chinese Journal of Physiology, 64(3), 129.
• Ulupınar, S., Özbay, S., Altınkaynak, K., Şebin, E., ve Gençoğlu, C. (2021). Farklı hava sıcaklıklarında yapılan aerobik egzersizlerin bağışıklık hücrelerine akut etkisi. Turkiye Klinikleri Spor Bilimleri, 13(1), 1-8.
• Ulupınar, S., Özbay, S., ve Gençoğlu, C. (2020). Siklet sporlarında dehidrasyon ve hiponatremi. Ulusal Spor Bilimleri Dergisi, 4(2), 103-115.
• Widmaier, E. P., Raff, H., & Strang, K. T. (2015). Vander’s Human Physiology. In The Mechanisms of Body Function, 14th Ed. New York: McGraw-Hill Education.
• Widmaier, E. P., Raff, H., Strang, K. T., & Vander, A. J. (2019). Vander's Human Physiology: The Mechanisms of Body Function (15th ed.). New York: McGraw-Hill Education.
• Wilkes, D., Gledhill, N., & Smyth, R. (1983). Effect of acute induced metabolic alkalosis on 800-m racing time. Medicine and Science in Sports and Exercise, 15(4), 277-280.