Metabolic flexibility is unimpaired during exercise in the cold following acute glucose ingestion in young healthy adults

Purpose: Metabolic flexibility is compromised in individuals suffering from metabolic diseases, lipo- and glucotoxicity, and mitochondrial dysfunctions. Exercise studies performed in cold environments have demonstrated an increase in lipid utilization, which could lead to a compromised substrate competition, glycotoxic-lipotoxic state, or metabolic inflexibility. Whether metabolic flexibility is altered during incremental maximal exercise to volitional fatigue in a cold environment remains unclear. Methods: Ten young healthy participants performed four maximal incremental treadmill tests to volitional fatigue, in a fasted state, in a cold (0 degrees C) or a thermoneutral (22.0 degrees C) environment, with and without a pre-exercise ingestion of a 75-g glucose solution. Metabolic flexibility was assessed via indirect calorimetry using the change in respiratory exchange ratio (Delta RER), maximal fat oxidation (Delta MFO), and where MFO occurred along the exercise intensity spectrum (Delta Fat(max)), while circulating lactate and glucose levels were measured pre and post exercise. Results: Multiple linear mixed-effects regressions revealed an increase in glucose oxidation from glucose ingestion and an increase in lipid oxidation from the cold during exercise (p < 0.001). No differences were observed in metabolic flexibility as assessed via.RER (0.05 +/- 0.03 vs. 0.05 +/- 0.03; p = 0.734), Delta MFO (0.21 +/- 0.18 vs. 0.16 +/- 0.13 g min (-1); p = 0.133) and Delta Fat(max) (13.3 +/- 19.0 vs. 0.6 +/- 21.3 %VO2peak; p = 0.266) in cold and thermoneutral, respectively. Conclusions: Following glucose loading, metabolic flexibility was unaffected during exercise to volitional fatigue in a cold environment, inducing an increase in lipid oxidation. These results suggest that competing pathways responsible for the regulation of fuel selection during exercise and cold exposure may potentially be mechanistically independent. Whether long-term metabolic influences of high-fat diets and acute lipid overload in cold and warm environments would impact metabolic flexibility remain unclear.

Automated summary

During incremental maximal exercise to volitional fatigue in a cold environment, glucose ingestion led to increased glucose oxidation, while cold exposure increased lipid oxidation. However, metabolic flexibility was not altered in this context.