NUTRITION & ERGOGENIC AIDS

Effects of Oral Lactate Consumption on

Metabolism and Exercise Performance
Dave Morris, PhD

lactate could enhance energy substrate

Abstract
status during exercise by sparing muscle
Study of lactate metabolism has revealed that orally consumed lactate is
glycogen or by fortifying blood glucose
used as an energy substrate either directly by oxidation or by conversion to
stores. More recent studies of lactate
glucose. Disposal of lactate by oxidation or gluconeogenesis consumes
have called into question its role in pro-
protons and can fortify blood bicarbonate levels temporarily and increase
moting muscle fatigue either directly
pH. These characteristics have led to investigations of lactate consumption
(5,9) or through contributing to meta-
as an energy substrate and as a buffering agent. Evidence has revealed no
bolic acidosis (14). Close examination of
effects of lactate consumption on time to exhaustion during low- to
glycolysis reveals that complete metab-
moderate-intensity exercise, suggesting that it is ineffective as an energy
olism of glucose to lactate results in no
supplement. Lactate ingestion has been shown to increase blood pH and
net release of protons and, thus, does not
bicarbonate levels and increase time to exhaustion in short, high-intensity
contribute to acidosis. In fact, during the
work bouts. Future work should focus on determining optimal doses of
production of lactate from pyruvate,
lactate, temporal relationships between doses and exercise, and the
protons are consumed and acidosis is
efficacy of lactate as an ergogenic in different types of high-intensity
inhibited (14). Furthermore, lactate oxi-
exercise.
dation and lactate consumption via glu-
coneogenesis consume hydrogen ions
and are alkalinizing processes.
Introduction Lactate’s role as an energy substrate and mediator of pH
For many years, the production and metabolism of lactate balance has sparked interest into the metabolic and exercise
have been scrutinized by exercise physiologists. In the early performance effects of orally consumed lactate. This article
days of study, lactate was considered to be a waste product aimed to review published studies on the metabolic and
formed when glucose-6-phosphate was catabolized by gly- ergogenic effects of lactate consumption. The review will first
colysis under hypoxic conditions. Lactate production was address the studies that have focused on lactate consumption
also thought to release hydrogen ions, which promoted as an energy supplement and then will present works that
skeletal muscle fatigue by contributing to acidosis. Others have investigated its use as a buffering agent.
suggested that high levels of lactate in the muscle cell could
promote reductions in work capacity (7). Thus, no viable
reason could be seen for using orally consumed lactate as an Oral Lactate as an Energy Substrate
ergogenic aid. The initial investigations of lactate consumption as an
Viewpoints on lactate started to change in the 1980s, energy supplement evolved from previous works that studied
when researchers began providing evidence that it was not a the metabolic fates of intravenously infused lactate in exer-
harmful waste product but an energy intermediate that could cising subjects (8,11). These studies of lactate metabolism
be further metabolized to provide substrate for the tri- demonstrated that substantial amounts of infused lactate
carboxylic acid cycle or gluconeogenesis (11). In either case, were oxidized in exercising skeletal muscle and led some
investigators to ponder the effects of oral lactate con-
Department of Health, Leisure, and Exercise Science, Appalachian State sumption on endurance exercise performance. Early attempts
University, Boone, NC
of lactate ingestion were unsuccessful because oral con-
Address for correspondence: Dave Morris, PhD, Department of Health, sumption of large boluses was found to result in extreme
Leisure, and Exercise Science, Appalachian State University, 53 Holmes gastric distress. However, Fahey et al. (6) eventually identi-
Convocation Center, 111 Rivers St., Boone, NC 28608; fied tolerable oral doses of lactate and compared the effects
E-mail: morrisdm@appstate.edu of consuming beverages containing 7% lactate, 7% malto-
1537-890X/1104/185Y188
dextrin, or aspartame on various metabolic responses during
Current Sports Medicine Reports 3 h of cycle ergometry at 50% of V̇O2max. The beverages
Copyright * 2012 by the American College of Sports Medicine were provided in 250-mL doses 5 min before and every

www.acsm-csmr.org Current Sports Medicine Reports 185

Copyright © 2012 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
20 min during exercise. Treatments were applied in a
randomized, double-blind, crossover design. Blood was
drawn before and during exercise and analyzed for glucose,
lactate, pH, and bicarbonate. In each of the three treatments,
blood glucose remained at basal levels through 100 min of
exercise. During the final 60 min of exercise, blood glucose
dropped significantly from preexercise levels, when subjects
consumed the placebo, but was maintained at basal levels in
the lactate and maltodextrin trials. No difference in blood
glucose was observed between the lactate and maltodextrin
trials. Blood pH and bicarbonate increased significantly over
basal levels during the final 60 min of the lactate trial, while
no differences in these variables were observed in the placebo
and maltodextrin trials.
While these results demonstrated positive metabolic respon-
ses to lactate ingestion, the investigation lacked key evidence to
support the use of oral lactate consumption as an ergogenic aid.
The exercise intensity was low and not reflective of intensities
typically found in competitive endurance events. More impor-
tantly, a performance trial was not included in the assessment of
the supplements.
Swensen et al. (15) compared the effects of a combined
7% carbohydrate-lactate beverage to a 7% beverage con-
taining only carbohydrate on various metabolic variables
and time to exhaustion in trained cyclists during cycle ergo-
metry at 70% of V̇O2max. The original intent of this study
was to compare a 7% carbohydrate beverage to a 7% lactate
beverage identical to that used by Fahey et al. (6). However,
during pilot trials, the subjects of Swensen et al. (15) devel-
oped severe gastric distress after consuming the 7% lac-
tate beverage. Ultimately, these investigators used a 7%
carbohydrate-lactate beverage containing 6.25 g of glucose
polymer and 0.75 g of lactate per 100 mL of water. This
combined beverage was similar to a commercially available
carbohydrate-lactate beverage (CytoMaxA) but with a higher
concentration of lactate. Consumption of each beverage
commenced at the beginning of exercise and was repeated
every 20 min during exercise. At each feeding, the subjects
consumed enough of each drink to provide 0.3 g of carbo-
hydrate per kilogram of body mass. The treatments were
applied in a randomized, double-blind, crossover fashion,
and both solutions were flavored with an artificial sweetener
to help blind the subjects to the treatments. Blood glucose
levels were maintained at resting levels during the first 3 h of
exercise in both trials, and no significant differences were
observed between treatments. Carbohydrate oxidation rates
also were similar for both treatments. Finally, no significant
difference in time to exhaustion between the two treatments
was observed (214.7 T 17 min for the carbohydrate trial vs
214.4 T 22 min for the carbohydrate-lactate trial).
Bryner et al. (3) measured the effects of beverages contain-
ing only water, 2% lactate, 8% carbohydrate, and a combi-
nation of 8% carbohydrate and 2% lactate on exercise
performance and physiological responses in trained cyclists
during cycle ergometry. These investigators also used a ran-
domly assigned, double-blind, crossover design. The exercise
challenge combined a moderate-intensity exercise test to
exhaustion followed by a 30-s Wingate test in an attempt to
mimic a competitive situation in which athletes would have
to indulge in a long, exhaustive competition and sprint
against competitors at the end of the race. Work rates for
186 Volume 11 & Number 4 & July/August 2012
Copyright © 2012 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
the endurance portion of the exercise challenge were de-
signed to elicit approximately 86% of maximum heart rate
and were maintained at a cadence of 80 rpm. When the
subjects indicated that they could no longer maintain 80 rpm
they immediately performed a 30-s Wingate test against a
resistance of 0.09 kgIkgj1 body mass. The subjects con-
sumed the beverages at the start of exercise and every 20 min
thereafter until exhaustion. Identical volumes of each bever-
age were given at each consumption period for all treat-
ments, and these volumes were equal to the amount that
would provide 0.3 g of carbohydrate per kilogram of body
mass from the 8% carbohydrate beverage. The authors
measured time to exhaustion during the submaximal ride
and perceived exertion, RER, blood bicarbonate, blood pH,
and blood glucose levels before and at 30-min intervals dur-
ing exercise. Blood bicarbonate, pH, and glucose levels also
were measured following the Wingate test. During the 30-s
Wingate test, peak power, and fatigue rate were measured
and were expressed in absolute terms and in relation to the
same values obtained during an initial 30-s Wingate test
that was performed several days before the advent of the
experimental trials.
Bryner et al. (3) found no difference in time to exhaustion
between treatments. During the 30-s Wingate test, no sig-
nificant differences were observed between treatments with
respect to absolute peak power or peak power relative to the
initial peak power output obtained in the days before the
experimental trials. Inexplicably, the absolute fatigue rate
was lower in the placebo trial compared with the carbohy-
drate and carbohydrate-plus-lactate trials. Perceived exertion
did not differ between the treatments at any point during the
exercise test to exhaustion. RER was significantly lower
in the lactate trial when compared with placebo and the
carbohydrate-lactate trial during the second hour of the
exercise test to exhaustion. No significant drops in blood
glucose levels from baseline were observed in the carbohy-
drate or carbohydrate-lactate trials at any time point during
or following exercise. Blood glucose levels were significantly
lower than preexercise levels following the Wingate test in
both the lactate-only and placebo trials and at 30 and 60 min
of the exercise to exhaustion test during the lactate-only trial.
These blood glucose levels were not, however, significantly
different from those observed at the same time points in the
carbohydrate or carbohydrate-lactate trials.
In measurements of pH, Bryner et al. (3) found significant
elevations compared with baseline after 30 min of exercise in
the placebo and lactate-only trials. This elevation was exten-
ded to the 60-min measurement in the lactate-only trial. No
other differences due to time or treatment were observed.
Blood bicarbonate was significantly lower compared with
baseline after 30 min of exercise in the placebo treatment and
after 60 min of exercise in the lactate treatment. Following the
Wingate test, blood bicarbonate levels were significantly lower
compared with baseline in all but the carbohydrate trial.
The results of Bryner et al. (3) can be difficult to interpret
because of the variability in many of the measures and
the statistical approached used to analyze the data. While
means and standard deviations were not presented for all of
the dependent variables, those that were generally had high
standard deviations resulting in coefficients of variation
that ranged from approximately 0.30 to greater than 0.50.
Oral Lactate Use and Exercise Performance
Unfortunately, no tests of statistical power were performed.
The authors also used a series of paired t-tests to compare
baseline measurements to those recorded during exercise
and at fatigue. This practice is known to cause alpha infla-
tion and increase the likelihood of a type 1 error. Thus, the
statistical approach and low statistical power could have
contributed to the seemingly random observations of stat-
istical significance.
Azevedo et al. (1) also used a two-stage exercise test to
investigate the metabolic and performance effects of orally
consumed lactate. Trained cyclists performed 90 min of cycle
ergometry at a work rate that elicited 62% of V̇O2max fol-
lowed by an exercise test to exhaustion at a work rate that
elicited 86% of V̇O2max. Subjects consumed 6% w/v bev-
erages containing either carbohydrate (glucose + fructose) or
a combination of carbohydrate and lactate. Drinks were
provided in isocaloric 250-mL doses 2 min before the advent
of exercise and every 15 min during the 3-h exercise period.
Both drinks were enriched with 13C-labeled glucose, fruc-
tose, or lactate (carbohydrate + lactate beverage only). Blood
and expired air were collected during the initial exercise
period and analyzed for the carbon isotope to assess sub-
strate utilization. The subjects performed three trials of
the carbohydrate-lactate treatment and two trials of the car-
bohydrate-only treatment to assess substrate utilization of all
of the components of each drink. The treatments were
applied in a randomized crossover fashion, but only the
subjects were blinded to the composition of the drinks.
The metabolic results revealed a high rate of lactate oxida-
tion during the carbohydrate-lactate trials. Subjects increased
their time to exhaustion in the 86% V̇O2max portion of the
exercise trial by 25% from 5.2 T 1.0 min in the carbohydrate
trial to 6.5 T 0.8 min in the carbohydrate-lactate trial
(P G 0.05). Interclass correlation coefficients were high for
both treatments (r = 0.89, P G 0.03 for carbohydrate only;
r = 0.957, P G 0.04 for carbohydrate-lactate), indicating a high
degree of reliability for this type of performance test.
The mechanism for the increase in performance observed
during the carbohydrate-lactate trial is not clear entirely. The
subjects received isocaloric amounts of each beverage, so it is
doubtful that energy balance contributed to the difference in
performance. A possible explanation for the increase in per-
formance is an increase in the blood bicarbonate and pH
levels following the ingestion of lactate. Significant evidence
suggests that acidosis contributes to development of muscle
fatigue and high-intensity exercise performance has been
shown to be enhanced when the blood is alkalinized by
consumption of sodium bicarbonate (10). Lactate con-
sumption also has been shown to increase blood pH and
bicarbonate levels in previous investigations (2,6,15).
Although Azevedo et al. (1) did not measure bicarbonate or
pH levels, prolonged exercise at intensities similar to those
used in their performance test has been shown to elicit
acidosis (12). Thus, if acidosis was a major contributing
factor to fatigue in their protocol, the consumption of lactate
could have provided an ergogenic effect by acting as a buf-
fering agent.
Oral Lactate as a Buffering Agent
Numerous investigations have monitored the metabolic
fates of infused or ingested lactate (1,8,11). During rest,
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approximately half of exogenous lactate has is oxidized while
the remainder is used as substrate for numerous metabolic
processes, most notably gluconeogenesis (11). Disposal of
lactate by oxidation (C3H5O3 + 3O2 + H+ Y 3CO2 + 3H2O)
or gluconeogenesis (2C3H5O3 + 2H+ Y C6H12O6) consumes
protons and thus has the potential to affect blood bicarbonate
and pH levels.
Van Montfoort et al. (16) were the first to investigate the
use of oral lactate consumption as a buffering agent. In their
investigation, 15 trained distance runners completed a single,
high-intensity run to exhaustion following consumption of
400 mgIkgj1 body mass of sodium lactate, 525 mgIkgj1 body
mass of sodium citrate, 300 mgIkgj1 body mass of sodium
bicarbonate, or 209 mgIkgj1 body mass of sodium chlo-
ride given in a randomized, double-blind, crossover fashion.
Ninety minutes following the ingestion of the supplements, the
subjects began a 15-min warm-up and then proceeded to the
exercise test to exhaustion. Compared to placebo (NaCl),
lactate consumption resulted in a 4% improvement in per-
formance by increasing time to exhaustion from 77 to 80 s.
While these results are promising, there are several con-
cerns about this investigation. High-intensity exercise tests to
exhaustion typically have intrasubject variation in perform-
ance of approximately 5% to 10% (2,4), which is greater
than the performance improvement that was observed by
Van Montfoort et al. (16). The limitations of treadmill run-
ning as an exercise test also must be recognized. Work per-
formed on a treadmill is very difficult to measure and is
affected by the body mass of the subject. No mention was
made about monitoring the body mass of the subjects before
each exercise trial and, thus, some fluctuation in perform-
ance could have been due to changes in body mass. Yet
another possible shortcoming in this investigation is the time
span between ingestion of the lactate and the performance of
the exercise trial. The subjects were given 60 min to consume
their supplements followed by a 90-min rest period before
starting their warm-up. The performance trial began
approximately 15 min after the commencement of the warm-
up, or about 105 min following the consumption of the last
capsule of sodium lactate and 165 min after consumption
began. Subsequent data have suggested that the optimum
time for performance enhancement following lactate inges-
tion may be closer to 80 min after ingestion (13).
In a pilot work for the study of lactate ingestion, we
measured blood bicarbonate responses for 120 min follow-
ing the ingestion of 20, 120, and 220 mgIkgj1 body mass of
lactate. In contrast to Van Montfoort et al. (16), our subjects
consumed their supplements in a bolus within a 5-min
period. Blood samples were taken and analyzed for blood
bicarbonate levels before, and every 20 min for 120 min
following the ingestion of the supplements. These trials
revealed that blood bicarbonate levels peaked at 80 min
following the ingestion of the lactate supplements followed
by a steady decline through the 120-min measurement point.
This response pattern was seen in each of the three doses.
Furthermore, while the 120- and 220-mgIkgj1 body mass
doses resulted in substantially higher blood bicarbonate
levels compared with the 20-mgIkgj1 dose, no differences
were noted between the 120- and 220-mgIkgj1 doses with
respect to the magnitude of increase in blood bicarbonate
levels. Finally, while Van Montfoort et al. (16) reported
Current Sports Medicine Reports 187
that postingestion blood pH and bicarbonate were sig-
nificantly higher after lactate ingestion when compared
with NaCl consumption, they did not compare the post-
ingestion to preingestion levels of these variables in any
of the treatments. Thus, the effects of lactate ingestion on
blood pH and bicarbonate were not entirely clear.
In a subsequent investigation by Morris et al. (13), 11
trained cyclists consumed 120 mgIkgj1 body mass of lactate
in a single bolus 80 min before performing high-intensity cycle
ergometry to exhaustion. The exercise protocol consisted of
four 1-min work intervals at 100% of V̇O2max work rate
each followed by 1-min recovery periods performed at 25%
of V̇O2max work rate. Immediately following the final rest
period, the subjects performed a final work bout to exhaustion
at 100% of V̇O2max work rate. Each subject repeated the
protocol under three conditions: following consumption of
lactate, an equal volume of placebo, and no treatment. The
lactate and placebo were provided in a double-blinded manner
and a randomized crossover approach was used for the ap-
plication of the treatments. Time to exhaustion in the lactate
trial (168 T 31 s) was significantly greater than in the no-
treatment (143 T 29 s) and placebo (137 T 41 s) trials. This
represented an increase in performance of 18% compared
with the no-treatment trial and 17% compared with the pla-
cebo trial, which is much greater than the variability typically
seen in repeated applications of high-intensity exercise tests
to exhaustion. Furthermore, blood bicarbonate levels were
significantly elevated following consumption of lactate when
compared with preconsumption levels and when compared
with preconsumption and postconsumption levels of the pla-
cebo and no-treatment protocols. No changes due to any of
the treatments were observed in blood pH.
Summary
The study of exogenous lactate as an ergogenic has
focused on its use as an energy substrate and as an alkalin-
izing agent. Investigations have shown that orally consumed
lactate is oxidized readily by working muscle and can main-
tain blood glucose levels during extended exercise bouts.
However, lactate is not well tolerated by the gastrointestinal
track and can be consumed only in relatively dilute solu-
tions (È2% w/v solution vs 6% to 9% w/v solution in car-
bohydrate beverages). Thus, the total caloric load that can
be provided by oral lactate consumption is limited and rela-
tively low. Two studies have investigated the effects of lactate,
consumed alone or with carbohydrate, on time to exhaustion
during low- to moderate-intensity exercise and neither dem-
onstrated ergogenic effects. However, lactate consumption
may be effective as a buffering agent. Numerous investiga-
tions have demonstrated that oral consumption of lactate can
increase blood pH and/or bicarbonate levels. Three studies of
the effects of lactate consumption on performance of high-
intensity exercise revealed increases in exercise time to ex-
haustions ranging from 4% to 25%. Although each of these
188 Volume 11 & Number 4 & July/August 2012
Copyright © 2012 by the American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
three studies supported the use of lactate as a buffering agent,
continued research in this area is encouraged. Dozens of
similar studies using sodium bicarbonate as a buffer have
provided conflicting results and revealed the importance of
proper dosing and timing of the ingestion of buffering agents
in relation to the exercise task. The intensity, duration, and
type of exercise challenge, i.e., time to exhaustion versus time
trials, single exercise bouts versus repeated efforts, may in-
fluence the efficacy of buffering agents as ergogenics and
should be explored in relation to lactate consumption.
The author declares no conflict of interest and does not
have any financial disclosures.
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Oral Lactate Use and Exercise Performance