Abbreviations: HMB, β-hydroxy-β-mehtylbutyrate; hGH, human growth hormone; IGF-1, insulin growth factor 1; LBM, lean body mass; GHB, gamma hydroxybutyrate; PIF, proteolysis-inducing factor
IntroductionGlutamine, arginine and beta-hydroxy beta-methylbutyrate (HMB) are dietary supplements that may enhance athletic performance. Many sports competitions are won by a fraction of a second, so it is not surprising that athletes want to try the latest nutritional supplements to give them that competitive edge. Glutamine, arginine and HMB are just a few of many supplements that can aid performance. Glutamine is the most abundant amino acid in the body that our muscles make, store and release at a high rate. This building block for proteins has many functions in the body. Glutamine serves as a major fuel source for the cells that protect us from disease and aid our immune system. It supports protein synthesis, regulates nitrogen metabolism in catabolic states, preserves muscle glutamine and supports gut integrity. [1][2][3][4] During stress (clinical trauma, starvation, or prolonged, strenuous exercise) the concentration of glutamine in blood is decreased.Because of drops in glutamine levels during times of stress, surgery, injury, and serious illness, it is "conditionally essential" or needed in greater amounts during these conditions. Prolonged endurance exercise like a marathon or triathlon, may also decrease our body's glutamine levels in our muscles and blood. Over trained athletes have been found to have significantly decreased blood concentrations of glutamine when compared with non-over trained athletes.In theory, glutamine supplementation will enhance immune function, decrease the risk of infection, and help to prevent overtraining syndrome. The benefits of glutamine supplementation in sick patients who have had major trauma or surgery have been well established. However, the benefits of glutamine supplementation for athletes during heavy training have not been definitive. A study by Castell and Newsholme 5 looked at the effects of feeding glutamine both at rest in sedentary controls and after exhaustive exercise in middledistance, marathon and ultra-marathon runners as well as elite rowers during both training and competition. Questionnaires established the incidence of infection for 7d after exercise: infection levels were highest in marathon and ultra-marathon runners, and in elite male rowers after intensive training. They found that the glutamine group showed fewer infections compared to the placebo group.In another study by Castell 6 published in 2002, he concluded that: "Provision of glutamine or a glutamine precursor has been found to decrease the incidence of illness in endurance athletes. At present, it has not been established precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression (suppression that occurs after prolonged, strenuous exercise)". However, evidence indicates that neutrophils might be implicated instead of lymphocytes as previously...