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Previous Volume 349:2503-2509 December 25, 2003 Number 26 Next

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ABSTRACT

Background Energy metabolism in muscles relies predominantly on the breakdown of glycogen early in exercise. In patients with McArdle's disease, blocked glycogenolysis in muscles results in low exercise tolerance and can lead to muscle injury, particularly in the first minutes of exercise. We hypothesized that ingesting sucrose before exercise would increase the availability of glucose and would therefore improve exercise tolerance in patients with McArdle's disease.

Methods In a single-blind, randomized, placebo-controlled crossover study, 12 patients with McArdle's disease drank 660 ml of a beverage that had been sweetened with artificial sweeteners (placebo) or with 75 g of sucrose after an overnight fast. Thirty to 40 minutes later, the patients rode a stationary bicycle at a constant workload for 15 minutes while the heart rate, level of perceived exertion, and venous blood glucose levels were monitored.

Results Supplemental sucrose increased the mean plasma glucose level by more than 36 mg per deciliter (2.0 mmol per liter) and resulted in a marked improvement in exercise tolerance in all patients. The mean (±SE) heart rate dropped by a maximum of 34±3 beats per minute (P<0.001), and the level of perceived exertion fell dramatically when the patients ingested glucose as compared with when they received the placebo.

Conclusions This study suggests that the ingestion of sucrose before exercise can markedly improve exercise tolerance in patients with McArdle's disease. The treatment takes effect during the time when muscle injury commonly develops in these patients. In addition to increasing the patients' exercise capacity and sense of well-being, the treatment may protect against exercise-induced rhabdomyolysis.

Source Information

From the Department of Neurology and the Copenhagen Muscle Research Center, National University Hospital, Rigshospitalet, Copenhagen, Denmark (J.V.); and the Departments of Neurology at Veterans Affairs Medical Center and University of Texas Southwestern Medical Center, and the Neuromuscular Center, Institute for Exercise and Environmental Medicine, Presbyterian Hospital (R.G.H.) — all in Dallas.

Address reprint requests to Dr. Vissing at the Neuromuscular Clinic, Department of Neurology 2082, National University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark, or at vissing{at}rh.dk.

Full Text of this Article

Related Letters:

Oral Sucrose and Exercise Tolerance in McArdle's Disease
Gaglia J. L., Wolfsdorf J. I., Vissing J., Haller R. G.
Extract | Full Text | PDF  
N Engl J Med 2004; 350:1575-1576, Apr 8, 2004. Correspondence

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