Carbohydrate and glutamine supplementation modulates the Th1/Th2 balance after exercise performed at a simulated altitude of 4500 m

Nutrition. Nov-Dec 2014;30(11-12):1331-6. doi: 10.1016/j.nut.2014.03.019. Epub 2014 Mar 31.


Objective: The aim of this study was to evaluate the effect of carbohydrate or glutamine supplementation, or a combination of the two, on the immune system and inflammatory parameters after exercise in simulated hypoxic conditions at 4500 m.

Methods: Nine men underwent three sessions of exercise at 70% VO2peak until exhaustion as follows: 1) hypoxia with a placebo; 2) hypoxia with 8% maltodextrin (200 mL/20 min) during exercise and for 2 h after; and 3) hypoxia after 6 d of glutamine supplementation (20 g/d) and supplementation with 8% maltodextrin (200 mL/20 min) during exercise and for 2 h after. All procedures were randomized and double blind. Blood was collected at rest, immediately before exercise, after the completion of exercise, and 2 h after recovery. Glutamine, cortisol, cytokines, glucose, heat shock protein-70, and erythropoietin were measured in serum, and the cytokine production from lymphocytes was measured.

Results: Erythropoietin and interleukin (IL)-6 increased after exercise in the hypoxia group compared with baseline. IL-6 was higher in the hypoxia group than pre-exercise after exercise and after 2 h recovery. Cortisol did not change, whereas glucose was elevated post-exercise in the three groups compared with baseline and pre-exercise. Glutamine increased in the hypoxia + carbohydrate + glutamine group after exercise compared with baseline. Heat shock protein-70 increased post-exercise compared with baseline and pre-exercise and after recovery compared with pre-exercise, in the hypoxia + carbohydrate group. No difference was observed in IL-2 and IL-6 production from lymphocytes. IL-4 was reduced in the supplemented groups.

Conclusion: Carbohydrate or glutamine supplementation shifts the T helper (Th)1/Th2 balance toward Th1 responses after exercise at a simulated altitude of 4500 m. The nutritional strategies increased in IL-6, suggesting an important anti-inflammatory effect.

Keywords: High altitude; Immune function; Inflammation; Lymphocytes; Physical exercise.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Altitude*
  • Anti-Inflammatory Agents / pharmacology*
  • Blood Glucose / metabolism
  • Dietary Supplements*
  • Double-Blind Method
  • Erythropoietin / blood
  • Exercise / physiology*
  • Glutamine / pharmacology*
  • HSP70 Heat-Shock Proteins / blood
  • Humans
  • Hypoxia / complications
  • Inflammation / etiology
  • Inflammation / prevention & control
  • Interleukins / blood
  • Male
  • Polysaccharides / pharmacology*
  • Th1 Cells / metabolism
  • Th1-Th2 Balance*
  • Th2 Cells / metabolism
  • Young Adult


  • Anti-Inflammatory Agents
  • Blood Glucose
  • HSP70 Heat-Shock Proteins
  • Interleukins
  • Polysaccharides
  • Glutamine
  • Erythropoietin
  • maltodextrin