makers. Combined ingestion of protein and carbohydrate improves protein balance during ultra-endurance exercise. Am J Physiol Endocrinol Metab 287: E712-E720, 2004. First published May 27, 2004 10.1152/ajpendo.00543.2003.-The aims of this study were to compare different tracer methods to assess whole body protein turnover during 6 h of prolonged endurance exercise when carbohydrate was ingested throughout the exercise period and to investigate whether addition of protein can improve protein balance. Eight endurancetrained athletes were studied on two different occasions at rest (4 h), during 6 h of exercise at 50% of maximal O2 uptake (in sequential order: 2.5 h of cycling, 1 h of running, and 2.5 h of cycling), and during subsequent recovery (4 h). ]phenylalanine, and [ 15 N2]urea, respectively, were used as tracers. Addition of protein to the carbohydrate drinks resulted in a positive or less-negative protein balance (Ϫ32 Ϯ 16.3, 165 Ϯ 4.6, and 151]phenylalanine, and [ 15 N2]urea, respectively, were used as tracers. We conclude that, even during 6 h of exhaustive exercise in trained athletes using carbohydrate supplements, net protein oxidation does not increase compared with the resting state and/or postexercise recovery. Combined ingestion of protein and carbohydrate improves net protein balance at rest as well as during exercise and postexercise recovery. protein metabolism; dietary supplements; protein intake IN THE NINETEENTH CENTURY, skeletal muscle protein was thought to be the main fuel used to generate energy for muscle contractions (33). However, controlled nitrogen balance studies invalidated the proposed hypothesis, inasmuch as they showed no substantial increase in nitrogen loss during and/or after prolonged exercise (9, 14). Since then, various methods have been applied to investigate the effects of exercise on protein metabolism. This has resulted in many discrepant findings in the literature, which are due in part to differences in the methodology employed and in part to the conditions under which different exercise interventions have been performed.Since the introduction of stable isotope tracers in metabolic research, various methods have been applied to study whole body protein metabolism. Most studies have used plasma L-[1-13 C]leucine kinetics as a model for whole body protein metabolism. Whereas several studies have reported increases in whole body protein degradation during exercise (23,25,39,40), others have failed to observe such changes (6,26). Wolfe et al. (39) measured the rate of appearance of 13 CO 2 in the expired breath from infused 13 C-labeled leucine and reported a threefold increase in leucine oxidation rates during exercise. The latter was shown to occur in the absence of a change in total leucine flux, which implies that the observed increase in protein breakdown was accompanied by a reduction in the rate of protein synthesis. Another tracer method that has been developed to determine whole body protein metabolism, without the necessity of analyzing breath gases, is the ...