READERS SUMMARY
1. Quick overview of carbohydrate metabolism
2. Quick overview of fat metabolism
3. Quick over view of protein metabolism
4. Are all exercises created equal?
5. What exercises optimize us for health and longevity?
The process of how food is turned into ATP is called cellular respiration. Foods are made from carbohydrates, proteins, and fats. This a quick overview of dietary biochemistry to show how our foods and mitochondria have to interact. Carbs have four stages of metabolism that allow them to be transformed into CO2, H2O, and ATP. Stage one is called glycolysis. It has either 10 or 11 steps. 10 if they occur in the cytoplasm, or 11 if they occur in the mitochondria. It begins with glucose of glycogen and ends with pyruvate under anaerobic conditions. It only allows for 2 ATP to be made form glucose and three if glycogen was the source. It also liberated 2 hydrogens in the form of NADH. Stage two carb metabolism has no name but it allows formation of Acetyl CoA from pyruvate. This occurs in the mitochondrial matrix without oxygen, but is an aerobic process. No ATP is made but two Hydrogen atoms (H) are released to make 2 NADH. Stage three of carbohydrate metabolism is the Krebs cycle. This has eight steps and occurs in the mitochondrial matrix. Again no oxygen is required but it is an aerobic process. The pass through allows 2 ATP to be made at four steps and 2 H atoms are removed at 4 steps. 3 of those H atoms are picked up by NAD and the fourth by FAD. Stage four of carbohydrate metabolism is known as electron chain transport that we spoke about in detail in the recent mitochondrial series added to the QUILT. This path occurs on the inner membrane of the mitochondria and consists of relaying electrons from the H atoms from one protein carrier to another and transporting the remaining hydrogen ions into the inner membrane space to create a voltage change across the membrane. This creates an electrical current. The electrical current is then used to fuel ATP production. For each H atom carried to the chain system by NAD, 3 ATP are formed. For each H carried by FAD, 2 ATP are formed. A total of 36 ATP are made if the fuel substrate is glucose and the muscle is skeletal. A total of 37 ATP is made if the fuel is glycogen and the muscle is skeletal. A total of 38 ATP are made if the fuel is glucose and it is cardiac muscle, and 39 ATP are made if the fuel is glycogen and the muscle is cardiac.
Now for the fats’ discussion. Triglycerides (TG’s) is stored in adipocytes or in muscle and are the major storage depot of all humans. TG’s contain fatty acids and a glycerol backbone. Muscles can only use fatty acids (FFA) as a fuel. FFA’s can only be used as a fuel source aerobically in the mitochondria. FFA must undergo beta oxidation, which involves the removal of hydrogen atoms and the removal of a pair of carbon atoms to form Acetyl CoA. Those Acetyl CoA then can enter the Krebs Cycle and electrons chains. The ATP produced from FFA depends wholly on the number of carbon pairs. For human fat the yield is 138 molecules of ATP per molecule of FFA. When Glucose supplies are inadequate (low carb) , Oxalo-acetate must be converted to glucose, Acetyl CoA is derived from FFA is turned into acetoacetic acid, beta-hydroxybutyric acid, and acetone. Acetone is the bad breath maker!
Amino Acids are primarily used in anabolic cellular processes in human cells. They build proteins. BCAA (branched Chain AA) can be used a primary fuel source if required by environment, but constitute 5-15{a7b724a0454d92c70890dedf5ec22a026af4df067c7b55aa6009b4d34d5da3c6} of the energy supply in the long term especially in those engaging in dynamic intense activity. All amino acids have amino groups (NH2) that must be removed before it can be used for fuel. It gets removed either by oxidative deamination or transamination (most common). Then the AA enters the Krebs cycle and electron transport at several locations. Ultimately all of the intermediates except Acetyl CoA are converted to pyruvate before being used for energy. 15 ATP are derived from each of the amino acid derivatives utilized as pyruvate and 12 ATP are produced from each derivative utilized as acetyl CoA.
Now that basics of dietary human biochemistry are covered, you might ask, why should I care? Fuel sources are prioritized based upon uses and needs. Humans have fat as primary fuel sources. Then we go to muscle glycogen, then liver glycogen stores and finally circulating glucose. We use energy based upon the current cellular environment (levee 1). This choice is complex but based upon the interaction the type, duration and intensity of exercise, and the muscle fiber types the patient currently has. The long term and short term nutritional status and fitness levels are also critical factors that need to be assessed in terms of dietary recommendations. I tend to assess these using my quantified self platform of testing.
In general, short duration, high intensity dynamic exercise is a special situation (HIIT). This exercise relies predominately on the ATP-PC and glycogen stored in the muscle fibers. This is the kind of exercise we want to strive for to be optimized. In aerobic activity there is higher sustained intensity. This requires the use of carbohydrates (glucose and glycogen) as fuel substrates. They key point here for humans is that the lower the intensity of the aerobics, the more important fats are as a fuel source. So severe aerobic exercises like marathons cause severe metabolic stress to the system. It uses all fuel sources and increases the flow of electrons through our electron chains to create more leakiness. Remember the more leakiness we see across the first complex the more aging and degenerative diseases we see. This point is made crystal clear in this February 2011 study that has got many endurance athletes rethinking the training methods they hold dogmatic. I know of at least 12 professional teams who have totally revamped their approaches after seeing this data evolve over the last few years.
For optimization, we should shoot for exercises that are hormetic and do not constantly cause leakiness at the mitochondria. What does that mean? It means that exercise should be a mild stressor to the cell that helps it improve function and doesn’t degrade our function. We should use mostly HIIT exercising to save our mitochondria and our stem cells. Carbs provide a rapid and large amount of electrons to the respiratory chains. This in turn allows more ROS generation in the mitochondria. This leads to more aging and degenerative diseases as we saw in the last few posts about mitochondria. This information is counter intuitive but the data is already mounting that our biochemistry is not suited for endurance work. We are better suited to HIIT work using fats to provide electrons to replenish our ATP. That way we can save our somatic stem cells and, more importantly, not have to replenish our mitochondria, or take them out by apoptosis every 5 days instead of every 3 weeks. The choice should be yours to make based upon our biochemistry and not what a trainer tells you based upon the opinion of their associations.
11
Mark Sisson loves sprints.
What are your favorite HIIT exercises? And how does straight anaerobic strength training fit in with it all? You know, Primal Blueprint's Lift Heavy Things.
Thanks for this post – I've been waiting for the workout piece. Do you have recommendations for HIIT frequency.
Meredith I do for patients who I have data on. I can give you some broad guidelines that wont hurt you but may not optimize you. For women I like heavy weights 4 times a week alternating body areas. And 15 minutes of sprinting 40 yd dashes. Time does not matter, twice a week. A good source is Bill Phillips book Body for Life. If you want optimazation I add a Tabata protocol to the rotations and then go after the core harder than all other areas. You also must watch cortisol and sex steroid hormones when you go to Tabata's and you may have to increase carbs then. Obviously this is something that has to be done while your quantifying yourself with data. Loved your answer to the newbie lady on PH. I put some more hormone info after yours. I upvoted you!
Thank you. I'll read that. I have the lifting down and the Tabatas, but not the 40 yd sprints. I'll have to measure that out and get outside to do that. I'm doing metabolic conditioning bodyweight routines on my non lifting days as well. Those may have to be taken down a notch. I'm tracking and measuring a la n=1 for the next few weeks or so just to see what's working and what's not.
Thanks again for your responsiveness. How are you managing to accomplish all of this?
Hi Dr.K,
My problem seems similar to the poster 'Sage', although she seems a bit thinner. We both have stubborn apron fat that won't budge. I have been paleo since August 2009. I went from 143 to 128 in 3 months. i'm about 129 now, but i am stronger from lifting weights. my issues are zero or close to zero ferritin most probably from heavy periods (you advised me to get my hormone levels checked out and perhaps go the bioidentical hormone root, but I'm scared of that), which I am dealing with by cutting flow with Aleve and supplementing with iron (need to up the supplementation, but also concerned about excess ROS production). August of 2010 I was supplementing a lot with iron and got my ferritin up to 28. At that time I also had Reverse T3 tested. It was 252 pg/mL. My free T4 was 1.17 ng/dL, Triiodothyronine, Free, Serum: 2.2 pg/mL All were within range.
During that summer of supplementing with lots of iron, I also started supplementing with half an iodine/iodide tablet (6mg). Then I started to have lots of noticeable hairloss. I don't know if it was from the supplementing or if I had stopped the iodine, and then it happened. I don't remember. I do know that I upped my vitamin D a lot that summer through natural sun exposure.
The hairloss made me loathe to supplement with iron, which is why I haven't done it aggressively.
I'm not vain, so I can take the apron belly fat and the comments from little kids about having a baby inside if i am basically healthy the way i am now. any thoughts? thx!!!!
PS i'm 46 years old and 5'3".
@V sounds like a hormone issue and some terminal fat issues. HSL and LPL are very sex steroid hormone dependent. And the last twenty pounds of fat are always tougher to loose because they concentrate many toxins that the liver has collected over your life. In cases like this I go for BHRT treatment and supplements to help your liver and fat get rid of the baggage its carrying. Organic acid testing help a bunch because you need to assess how you liver is handling detox pathways.
hi Dr K
would a naturopathic doctor be well suited to facilitating BHRT? or should i see a specialist?
Well I do them for some of my patients and I am sure other MDs do in your town. Im sure there are many health practioners doing it locally. Sage check experience levels and talk with other patients about their experiences! If I can help further let me know
Thx doc. I searched the term bioidentical over at paleohacks.com and saw your very indepth answers . I also like the site cemcor.com which had Info matching yours. That site also recommends Prometrium as a way to add progesterone to deal with estrogen dominance. I feel that aside from looking 3 months pregnant, I have good quality of life with temp changes at night almost non existent. My memory is pretty good, even with low ferritin. If I pass a threshhold where say I can't get a good night's sleep because of hot flashes, I feel that prometrium looks most promising based on my research so far. I believe it is the only bioidentical hormone that is FDA approved. Again,thank you for taking the time to educate us- it is much appreciated.
http://www.ncbi.nlm.nih.gov/pubmed/19766332 Study showing the effect of carbs and fat on electron flow.
I came across this quote from you (not sure if here or PH) and would like your thoughts:
"They solve it by eating bacon, and pastured meats from US Wellness meats in am. Others just eat leftover meats for breakfast and one eats boars head genoa salami (great source of vitamin k2) and liverwurst."
I got some and wife says salami has nitrites that give her headaches. Bummer. Nitrites a bad additive in your opinion?
@Martin Nitrates do not matter.
Hi Dr.K! Is chia and hempseed a good omega-3 source or is it something like flaxseed?
I also found a product that is maybe better than whey protein? It is called Jay Robb Egg white protein.
On 10 December you told Martin "Nitrates do not matter". Did you mean that they are irrelevant so far as the protocol you are outlining goes? Or did you mean that they are not a colon cancer health risk – which is what I suspect Martin was alluding to?
BTW, thank you very much for the work you are putting into education, information and reforming the way we look at health and treat illness. I'm among the many who truly appreciate it.
@Keith Thomas. At this point of time based upon the literature and science we know about I do not fear nitrates at all for any risk of disease if one is eating correctly. If one is not then you might have some issues but even that is pretty murky.
Dr. Jack,
My 26 yo daughter has been allergic and had asthma since early childhood. In the last 3-4 years she has found she is allergic to wheat. Any little bit causes her gastric pain. I think gluten is also in her irritants. She has been eating the Dukan diet for 2 years and done well with it for weight control.
Recently she has been going to be shivering cold and blows her own breath under the covers to get warm. Later she wakes with sweat and is hot needing to remove the covers. This is disturbing her sleep and causing distress. She has been on allergy shots that had to be stopped due to the bad reaction that lasted for 5 days after and she is now allergic to many common foods. Most fruits, nuts, some vegetables to name a few. Her 3 yo son also has gastric issues.
Is there a connection to our temperature control with the gut? Or can you suggest how we might proceed? I have been doing the Leptin Rx for a month myself and am wondering if there might be a connection for my daughter.
Thank you for all you do here.
@eric. http://en.m.wikipedia.org/wiki/Gluten-sensitive_e…. Huge connection!
15years ago I went on a high protein diet, low card diet and lost weight. But I stopped the diet because I was told that the “ketosis” would burn out my kidneys. Years later I was told that the reason I had adrenal overload was that I had burned out my kidneys with the diet I had done.
Is this a fallacy?
What is it about the epi-paleo diet you espouse that the individual does not have that issue, if it really is an issue? What is different about the epi-paleo diet or the missing piece that prevents ketosis from burning out kidneys if there is such a thing?
Bests…Trey
DHA is the key……….read the Ubi series and you will see why.