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The effect of multi-ingredient intra- versus extra-cellular buffering supplementation combined with branched-chain amino acids and creatine on exercise-induced ammonia blood concentration and aerobic capacity in taekwondo athletes.
Durkalec-Michalski, K, Kusy, K, Główka, N, Zieliński, J
Journal of the International Society of Sports Nutrition. 2021;(1):48
Abstract
BACKGROUND This study aimed to investigate the effect of multi-ingredient intra- (BA) versus extra- (ALK) cellular buffering factor supplementation, combined with the customary intake of branched-chain amino acids (BCAA) and creatine malate (TCM), on body composition, exercise variables, and biochemical and hematological parameters in 9 elite taekwondo athletes. METHODS Eight-week randomized double-blind crossover BA (5.0 g·day-1 of β-alanine) versus ALK (0.07 g·kgFFM-1·day-1 of sodium bicarbonate) supplementation combined with BCAA (0.2 g·kgFFM-1·day-1) and TCM (0.05 g·kgFFM-1·day-1) during a standard 8-week taekwondo training period was implemented. In the course of the experiment, body composition (dual X-ray absorptiometry), aerobic capacity (ergospirometric measurements during an incremental treadmill test until exhaustion), and exercise blood biomarkers concentrations were measured. Data were analyzed using repeated measures within-between interaction analysis of variance with the inclusion of experimental supplementation order. RESULTS The maximum post-exercise blood ammonia concentration decreased in both groups after supplementation (from 80.3 ± 10.6 to 72.4 ± 10.2 µmol∙L-1, p = 0.013 in BA; from 81.4 ± 8.7 to 74.2 ± 8.9 µmol∙L-1, p = 0.027 in ALK), indicating reduced exercise-related adenosine triphosphate degradation. However, no differences were found in body composition, aerobic capacity, blood lactate concentration, and hematological parameters after neither BA (combined with BCAA and TCM) nor ALK (combined with BCAA and TCM) supplementation. CONCLUSIONS In highly trained taekwondo athletes, neither extra- nor intracellular buffering enhancement resulting from BA and ALK supplementation, combined with BCAA and TCM treatment, affects body mass and composition, maximum oxygen uptake, and hematological indices, even though certain advantageous metabolic adaptations can be observed.
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Ammonia Inhalation Does Not Increase Deadlift 1-Repetition Maximum in College-Aged Male and Female Weight Lifters.
Vigil, JN, Sabatini, PL, Hill, LC, Swain, DP, Branch, JD
Journal of strength and conditioning research. 2018;(12):3383-3388
Abstract
Vigil, JN, Sabatini, PL, Hill, LC, Swain, DP, and Branch, JD. Ammonia inhalation does not increase deadlift 1-repetition maximum in college-aged male and female weight lifters. J Strength Cond Res 32(12): 3392-3397, 2018-Ammonia inhalant use by powerlifters and weight lifters is a prevalent practice with little research support for improved performance. The purpose of this study was to investigate the effects of ammonia as a stimulant on athletic performance during a deadlift 1-repetition maximum (1RM) absolute strength test. Subjects (men: n = 10, mean ± SD age = 21 ± 1 year, mass = 72.5 ± 6.8 kg; and women: n = 10, age = 22 ± 5 years, mass = 66.2 ± 8.1 kg) were required to have at least 2 years of resistance training experience while lacking a history of asthma, lightheadedness, fainting, anaphylaxis, sickle cell traits, and other respiratory disorders. After a baseline 1RM test, subjects were paired by 1RM performance and gender, then randomly assigned in a counterbalanced treatment order to control (water) or ammonia trials after a minimum 72-hour recovery period for another 1RM test involving attempts at 100.0, 102.5, 105.0, and 107.5% of the established 1RM value. Testing was then repeated after the minimum rest period for the remaining trial. Results revealed the expected gender main effect for absolute deadlift 1RM (93.0 ± 29.5 [women]; 152.0 ± 29.5 kg [men]; p < 0.001), but no trial main effect (p = 0.874) or gender by trial interaction effect (baseline = 93.0 ± 15.3, 151.8 ± 42.3 kg; water = 92.0 ± 12.5, 150.9 ± 37.8 kg; ammonia = 92.5 ± 16.4, 153.4 ± 37.9 kg) for women and men, respectively (p = 0.559). Within the limitations of this study, there is no support for the practice of ammonia inhalation to improve deadlift 1RM in training or competition.
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[Effect of Acupuncture at Thirteen Evil Acupoints on Liver Function, and the Contents of Blood Ammonia and β-endorphin in Patients with Hepatic Encephalopathy].
Su, HH, Cui, HS, Su, HL
Zhen ci yan jiu = Acupuncture research. 2017;(4):342-5
Abstract
OBJECTIVE To observe the therapeutic effect of acupuncture at thirteen evil acupoints in patients with hepatic encephalopathy, and to explore its possible mechanism. METHODS Patients with hepatic encephalopathy were randomly divided into acupuncture group (n=38) and western medicine group (n=36). Patients in the western medicine group were treated by intravenous injection of aspartate ornithine and branched chain amino acids, and those in the acupuncture group were treated with acupuncture at thirteen evil acupoints on the basis of the western medicine. All the patients were treated for 1 week. The liver function and blood ammonia were measured by automatic biochemical analyzer. The changes of plasma β-endorphin were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS Following the treatment, of the 36 and 38 hepatic encep-halopathy patients in the western medicine and acupuncture groups, 12 and 18 experienced a marked improvement in their symptoms, 13 and 16 were effective, and 11 and 4 invalid, with the effective rates being 69.4% and 89.5%, respectively. Compared with pre-treatment, the levels of serum aspartate aminotransferase, alanine aminotransferase, total bilirubin, and plasma β-endo-rphin and blood ammonia were significantly lower in both western medicine and acupuncture groups(P<0.01), and the therapeutic effects of the acupuncture group were obviously superior to those of the western medicine group in the above mentioned indexes (P<0.05, P<0.01). CONCLUSIONS Treatment of acupuncture at thirteen evil acupoints combined with western medicine can enhance the curative effect of hepatic encephalopathy, improve patients' liver function and decrease the levels of plasma ammonia and β-endorphin.
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Effects of supplementation with branched chain amino acids and ornithine aspartate on plasma ammonia and central fatigue during exercise in healthy men.
Mikulski, T, Dabrowski, J, Hilgier, W, Ziemba, A, Krzeminski, K
Folia neuropathologica. 2015;(4):377-86
Abstract
INTRODUCTION Our previous studies showed only slight improvement in central fatigue, measured indirectly by psychomotor performance, after branched chain amino acids (BCAA) supplementation during various efforts in healthy men. It is hypothesised that hyperammonaemia resulting from amino acids metabolism may attenuate their beneficial effect on psychomotor performance; therefore, the L-ornithine L-aspartate (OA) as an ammonia decreasing agent was used. The aim of this study was to investigate the effectiveness of oral BCAA + OA supplementation to reduce plasma ammonia concentration and enhance psychomotor performance during exhaustive exercise in healthy men. MATERIAL AND METHODS Eleven endurance-trained men (mean age 32.6 ± 1.9 years) performed two sessions (separated by one week) of submaximal cycloergometer exercise for 90 minutes at 60% of maximal oxygen uptake followed by graded exercise until exhaustion with randomised, double-blind supplementation with a total of 16 g BCAA and 12 g OA (BCAA + OA trial) or flavoured water (placebo trial). Before exercise, during both efforts and after 20 minutes of recovery multiple choice reaction time (MCRT), perceived exertion, heart rate and oxygen uptake were measured and venous blood samples were taken for plasma leucine, valine, isoleucine, ornithine, aspartate, free tryptophan (fTRP), ammonia, lactate and glucose determination. RESULTS After ingestion, during both efforts and after 20 minutes of recovery the plasma concentrations of all supplemented amino acids were significantly increased, while the fTRP/BCAA ratio decreased in the BCAA + OA trial more than in the placebo trial. At the end of graded exercise plasma fTRP was lower and MCRT shorter in BCAA + OA than in the placebo trial (p < 0.05). At the end of prolonged exercise the plasma ammonia concentration was higher in BCAA + OA than in placebo trial (p < 0.05). Decreases in plasma ammonia during recovery were significantly higher in BCAA + OA than in the placebo trial. Plasma ammonia positively correlated with the total plasma BCAA and MCRT only in the BCAA + OA trial. The fTRP/BCAA ratio positively correlated with MCRT only in the placebo trial. CONCLUSIONS Supplementation with BCAA and OA is a useful way to improve MCRT during high-intensity exercise and accelerate the elimination of ammonia at the recovery stage after exercise in healthy young men.
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The dysfunction of ammonia in heart failure increases with an increase in the intensity of resistance exercise, even with the use of appropriate drug therapy.
Medeiros, WM, Carvalho, AC, Peres, P, De Luca, FA, Gun, C
European journal of preventive cardiology. 2014;(2):135-44
Abstract
BACKGROUND Hyperammonemia during rest periods is a dysfunction in heart failure (HF). The low formation of ammonia during exercise reflects an inefficiency of purine metabolism. Hyperkalemia in response to physical exercise is common in HF and may contribute to a contractile inefficiency in type II fibers, leading to early fatigue. We tested the hypothesis that during resistance exercise of high intensity and low volume, this disorder of ammonia metabolism would be more intense, due to the hyperkalemia present in HF. METHODS Alternating resistance exercise (RE) of low intensity and high volume, and high intensity and low volume, were applied to 18 patients with an interval of 7 days between them (functional class II-III New York Heart Association, FE = 33.5 ± 4%) and compared with 22 healthy controls matched for age and gender. Ammonia, potassium and lactate levels were assessed before and immediately after the RE. RESULTS Significant differences: Deltas (control vs. HF) in 40% RE: lactate (mg/dl) 26.3 ± 10 vs. 37.7 ± 7; p < 0,001, ammonia (ug/dl) 92.5 ± 18 vs. 48.9 ± 9; p < 0.001. Deltas (control vs. HF) in 80%RE: lactate(mg/dl) 45.0 ± 12 vs. 54.1 ± 11; p < 0.05, ammonia(ug/dl) 133.5 ± 22 vs. 32.2 ± 7; p < 0.001, potassium (mEq/L) 1.6 ± 0.4 vs. 2.0 ± 0.8; p < 0.05. A negative correlation was found between the deltas of ammonia and potassium (r = -0.74, p < 0.001) in the HF group. CONCLUSIONS We conclude that in HF, there is an inefficiency of purine metabolism that increases with increasing exercise intensity, but not with an increase of total volume. These findings suggest that hyperkalemia may play an important role in the disorders of purine metabolism.
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Effect of zinc on liver cirrhosis with hyperammonemia: a preliminary randomized, placebo-controlled double-blind trial.
Katayama, K, Saito, M, Kawaguchi, T, Endo, R, Sawara, K, Nishiguchi, S, Kato, A, Kohgo, H, Suzuki, K, Sakaida, I, et al
Nutrition (Burbank, Los Angeles County, Calif.). 2014;(11-12):1409-14
Abstract
OBJECTIVE To our knowledge, no randomized study has shown whether zinc replacement therapy is effective for hyperammonemia in liver cirrhosis; therefore, we performed a double-blind, placebo-controlled trial to examine efficacy and safety of the zinc replacement therapy. METHODS Patients with liver cirrhosis and hyperammonemia (at or above the institutional reference value) and hypozincemia (≤65 μg/dL) were enrolled in the outpatient units of the participating institutions and were randomly divided to receive placebo (P group) or zinc acetate preparation at a dose of 3 capsules/d for a total zinc content of 150 mg/d (Z group) by the envelope method. Of the 18 enrolled patients, 6 dropped out; thus, the analyses included 12 patients (5 in the P group and 7 in the Z group). Variations in blood concentrations of zinc and ammonia as well as liver function test results were compared. RESULTS Blood zinc levels significantly increased in the Z group (P = 0.0037; Friedman test) but not the P group. Blood ammonia levels significantly decreased in the Z group (P = 0.0114; Friedman test) but not the P group. The percent change in blood ammonia level also revealed significant reduction at the eighth week in the Z group (P = 0.0188: Mann-Whitney test). No serious adverse events attributable to the zinc preparation were noted. CONCLUSION Although this study is preliminary and includes a small sample, it is, to our knowledge, the first randomized controlled trial to show that zinc supplementation for 3 mo seems effective and safe for treating hyperammonemia in liver cirrhosis. Studies with a larger sample size are needed to confirm our findings.
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The metabolic effect of resistant starch and yoghurt on the renal and faecal nitrogen and ammonia excretion in humans as measured by lactose-[(15)N2]ureide.
Wutzke, KD, Scholübbers, D
Isotopes in environmental and health studies. 2013;(4):464-70
Abstract
Resistant starch (RS) and Lactobacillus acidophilus yoghurt (LC1) were supplemented simultaneously in healthy adults to evaluate the effect on the urinary and faecal nitrogen and ammonia excretion by means of lactose-[(15)N2]ureide ((15)N-LU) degradation. Nineteen subjects received a regular daily diet either without or with supplementation of an RS-LC1-mixture composed of fibre of potatoes (RS type 1), wrinkle pea starch (RS type 2), and LC1 over a 20-day period in randomised order. Thereafter, (15)N-LU was administered together with breakfast. Urine and faeces were collected over a period of 48 and 72 h, respectively. The (15)N abundances were measured by isotope ratio mass spectrometry. The intake of the pre- and probiotic mixture composed of RS of type 1, type 2 and of LC1 significantly lowered the colonic generation and the renal excretion of toxic (15)NH3 and functioned as an ammonia shift from urinary to faecal (15)N excretion when using (15)N-LU as a xenobiotic marker.
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Ammonia control and neurocognitive outcome among urea cycle disorder patients treated with glycerol phenylbutyrate.
Diaz, GA, Krivitzky, LS, Mokhtarani, M, Rhead, W, Bartley, J, Feigenbaum, A, Longo, N, Berquist, W, Berry, SA, Gallagher, R, et al
Hepatology (Baltimore, Md.). 2013;(6):2171-9
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Abstract
UNLABELLED Glycerol phenylbutyrate is under development for treatment of urea cycle disorders (UCDs), rare inherited metabolic disorders manifested by hyperammonemia and neurological impairment. We report the results of a pivotal Phase 3, randomized, double-blind, crossover trial comparing ammonia control, assessed as 24-hour area under the curve (NH3 -AUC0-24hr ), and pharmacokinetics during treatment with glycerol phenylbutyrate versus sodium phenylbutyrate (NaPBA) in adult UCD patients and the combined results of four studies involving short- and long-term glycerol phenylbutyrate treatment of UCD patients ages 6 and above. Glycerol phenylbutyrate was noninferior to NaPBA with respect to ammonia control in the pivotal study, with mean (standard deviation, SD) NH3 -AUC0-24hr of 866 (661) versus 977 (865) μmol·h/L for glycerol phenylbutyrate and NaPBA, respectively. Among 65 adult and pediatric patients completing three similarly designed short-term comparisons of glycerol phenylbutyrate versus NaPBA, NH3 -AUC0-24hr was directionally lower on glycerol phenylbutyrate in each study, similar among all subgroups, and significantly lower (P < 0.05) in the pooled analysis, as was plasma glutamine. The 24-hour ammonia profiles were consistent with the slow-release behavior of glycerol phenylbutyrate and better overnight ammonia control. During 12 months of open-label glycerol phenylbutyrate treatment, average ammonia was normal in adult and pediatric patients and executive function among pediatric patients, including behavioral regulation, goal setting, planning, and self-monitoring, was significantly improved. CONCLUSION Glycerol phenylbutyrate exhibits favorable pharmacokinetics and ammonia control relative to NaPBA in UCD patients, and long-term glycerol phenylbutyrate treatment in pediatric UCD patients was associated with improved executive function (ClinicalTrials.gov NCT00551200, NCT00947544, NCT00992459, NCT00947297). (HEPATOLOGY 2012).
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Overnight glucose infusion suppresses renal ammoniagenesis and reduces hyperammonaemia induced by a simulated bleed in cirrhotic patients.
Mpabanzi, L, Deutz, N, Hayes, PC, Dejong, CH, Olde Damink, SW, Jalan, R
Alimentary pharmacology & therapeutics. 2012;(8):921-8
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BACKGROUND A simulated upper gastrointestinal (UGI) bleed in cirrhotic patients has been shown to induce hyperammonaemia. The kidney was the site of this exaggerated ammoniagenesis with alanine as substrate. Administration of alanine to decompensated cirrhotic patients did not change hepatic gluconeogenesis, but resulted in increased ammoniagenesis. We hypothesise that reduced hepatic glycogen stores result in hyperglucagonaemia which may drive increased renal gluconeogenesis and therefore alanine uptake and renal ammoniagenesis. AIM: To determine whether an overnight glucose infusion lowers renal ammoniagenesis by reducing hyperglucagonaemia and renal ammoniagenesis. METHODS Patients with decompensated cirrhosis were studied in a cross-over design. An UGI bleed was simulated via intragastric administration of an amino acids mixture mimicking the haemoglobin molecule after a 12-h overnight fast (F-group) or after a 12-h treatment with 20% glucose solution (G-group). RESULTS Before the simulated bleed the glucagon levels were 21 (15-31) pmol/L in the F-group and 15 (9-21) pmol/L in the G-group (P < 0.01). After the simulated bleed, arterial ammonia levels increased in both groups [F-group: 73-118 μmol/L (P = 0.01); G-group 64-87 μmol/L (P = 0.01)]. The enhancement of hyperammonaemia was significantly higher in the F-group (45 [19-71] μmol/L) compared with the G-group (23 [13-39] μmol/L) (P = 0.01). The difference in renal ammoniagenesis during the simulated bleed in the F-group was 399 (260-655) nmol/kg/bwt/min and was significantly higher than in the G-group 313 (1-498) nmol/kg/bwt/min (P = 0.05). CONCLUSIONS Overnight glucose infusion results in reduced renal ammoniagenesis and attenuates ammonia levels. These observations have implications for the development of nutritional strategies in hyperammonaemic patients.
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The effect of pre- and probiotics on the colonic ammonia metabolism in humans as measured by lactose-[¹⁵N₂]ureide.
Wutzke, KD, Lotz, M, Zipprich, C
European journal of clinical nutrition. 2010;(10):1215-21
Abstract
BACKGROUND The evaluation of ammonia detoxification by pre- and probiotics by means of colonic lactose-[(15)N(2)]ureide ((15)N-LU) degradation is of great interest both scientifically and in terms of nutrition physiology. OBJECTIVE Pre- and probiotics were supplemented in healthy adults to evaluate the effect of the ammonia metabolism in the human colon by means of (15)N-LU. METHODS A total of 14 participants aged 20-28 years daily received a regular diet either without (no treatment) or with supplementation of 30 g fibre of potatoes (FPs), 30 g wrinkle pea starch (WPS, resistant starch content: 12 and 70%, respectively) and 375 g Lactobacillus acidophilus (LC1) yoghurt, over a 10-day period in a randomised order. After 1 week, 5.7 mg/kg body weight (15)N-LU was administered together with breakfast. A venous blood sample was taken after 6 h. Urine and faeces were collected over a period of 48 and 72 h, respectively. The (15)N abundances were measured by isotope ratio mass spectrometry. RESULTS The mean renal (15)N-excretion differed significantly between the supplementation of FP and no treatment (32.5 versus 46.3%, P=0.034), FP and LC1 (32.5 versus 51.6%, P=0.001), and WPS and LC1 (38.5 versus 51.6%, P=0.048). The mean faecal (15)N-excretion amounted to 42.7% (no treatment), 59.7% (FP), 41.8% (WPS) and 44.0% (LC1). In comparison with no treatment, the urinary (15)NH(3)-enrichment was significantly decreased at 16 h after FP supplementation. CONCLUSION The prebiotic intake of FP and WPS lowered the colonic generation and the renal excretion of toxic (15)NH(3), respectively, when using (15)N-LU as a xenobiotic marker.