A person’s health span is composed of many factors including genetics, epigenetics, and lifestyle factors that include, but not limited to, diet, exercise, stress, relationships, and other environmental influences. Those intertwined, complex factors are very much individual to each person and unlocking or digging deep into the factors that define a person’s health and disease status takes careful consideration. Intervention takes precision in terms of accurate determination of the diseased or altered metabolic state and the ensuing plan to reverse the individual back on the path to better health. At the core of this plan is the precise assessment of an individual’s metabolic flexibility.
Metabolic flexibility by definition refers to an individual’s ability to mobilize and oxidize fatty acids from adipose (fat) stores in the mitochondria under low energy demands such as at rest or under low-intense exercise while at the same time having the ability to quickly breakdown stored glycogen and utilize glucose in the muscle and liver at the other end of the spectrum, that being under high-energy demands.1 The mitochondria is the site in which energy substrates, fats and glucose are utilized to produce the most important molecule in the body, ATP, which is used to fuel nearly everything in the body. Age is the biggest risk factor for all-cause-mortality and as we age, our mitochondria become less abundant and less efficient in their ability to produce ATP.2 Different disease states, such as obesity, can further reduce the effectiveness of our mitochondria to function at an optimal level.2 Those who are obese due to caloric excess and sedentary lifestyle, flood the mitochondria with too much substrate (fatty acids and glucose) resulting in gridlock and thus very poor energy production.1
Overtime this will result in less utilization of fat from our body’s fat stores by the mitochondria under resting or low energy demanding conditions with a greater reliance on the breakdown of glucose for the generation of ATP.3 Because a sedentary lifestyle creates very little energy demand, the mitochondria are not challenged as they would be by exercise, especially at a high intensity, and as a result lose some of their function.3 This loss of function contributes to a whole host of very dangerous metabolic conditions such as insulin resistance, storage of fat around organs (ectopic or visceral fat), increased oxidative stress, and systemic inflammation, especially if excessive caloric consumption continues well above what the body needs.1 These conditions are the essential precursors for Type II Diabetes, cardiovascular disease, metabolic syndrome, some cancers, and neurodegenerative disease such as Alzheimer’s and dementia.1,4
Your metabolic inflexibility can be assessed in several ways and Precision Health Performance (PHP) can provide those assessment tools to unlock the key information needed to reverse these dangerous metabolic conditions. The goal of PHP is to reverse a person’s metabolic inflexibility to become more metabolically flexible in their ability to mobilize stored fat for oxidation (ATP production) in fasting and low-level exercise conditions while creating higher energy demanding conditions to mobilize and oxidize glucose. This is accomplished through personalized exercise prescription, obtained by specific tests, and targeted nutritional interventions based on a thorough assessment of nutritional status and intake. Other evaluations such as specific blood biomarkers that have been prescribed and assessed by a physician along with sleep and stress markers further give clues to a person’s specific interventions to improve metabolic flexibility and thus the mitochondria’s number and function, ultimately resulting in improved functional performance and thus health.
References:
- Smith, R. et al. Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease. Endocrine Reviews. 2018; 39: 489-517.
- Grevendonk, L. et al. Impact of aging and exercise on skeletal muscle mitochondrial capacity, energy metabolism, and physical function. Nature Communication, 2021; 12:4773 |https://doi.org/10.1038/s41467-021-24956-2
- San-Millan, I. & Brooks, G. Assessment of Metabolic Flexibility by Means of Measuring Blood Lactate, Fat, and Carbohydrate Oxidation Responses to Exercise in Professional Endurance Athletes and Less-Fit Individuals. Sports Med. 2017; DOI 10.1007/s40279-017-0751-x.
- Bishop, D. et al. High-Intensity Exercise and Mitochondrial Biogenesis: Current Controversies and Future Research Directions. Physiology. 2018; 34:56-70.