New insights in paediatric exercise metabolism

Research in paediatric exercise metabolism has been constrained by being unable to interrogate muscle in vivo. Conventionally, research has been limited to the estimation of muscle metabolism from observations of blood and respiratory gases during maximal or steady state exercise and the analysis of a few muscle biopsies taken at rest or post-exercise. The purpose of this paper is to review how the introduction of 31P-magnetic resonance spectroscopy and breath-by-breath oxygen uptake kinetics studies has contributed to current understanding of exercise metabolism during growth and maturation. Methodologically robust studies using 31P-magnetic resonance spectroscopy and oxygen uptake kinetics with children are sparse and some data are in conflict. However, it can be concluded that children respond to exercise with enhanced oxygen utilization within the myocyte compared with adults and that their responses are consistent with a greater recruitment of type I muscle fibres. Changes in muscle metabolism are age, maturation- and sex-related and dependent on the intensity of the exercise challenge. The introduction of experimental models such as “priming exercise” and “work-to-work” transitions provide intriguing avenues of research into the mechanisms underpinning exercise metabolism during growth and maturation.