References

Here you will find a selection of inspiring quotes, scientific articles and books on the role of metabolism in health

Glossary

Glycolysis: The conversion of glucose (sugar) to pyruvate. This provides a small amount of energy. Pyruvate can be further converted to energy using cellular respiration. If not, pyruvate is converted to lactate. 

Cellular respiration: if oxygen is present, pyruvate can be further broken down in the mitochondria (the cell's energy factories). Ultimately, this produces a lot of energy. Much more than just glycolysis. 

Lactate: lactate is the end product of glycolysis when - for whatever reason - energy metabolism stops there. 

CO2if glucose is completely burned in the mitochondria, carbon dioxide (CO2).

Inspiring masters

'A living cell requires energy not only for all its functions, but also for the maintenance of its structure. Without energy life would be extinguished instantaneously, and the cellular fabric would collapse.' - Albert Szent- Györgyi, Nobel Lecture 1937

'What could be more important to understand than biological energy? Thought, growth, movement, every philosophical and practical issue involves the nature of biological energy'- Ray Peat

Metabolism as the origin of health and disease

'The organizing power of energy flow is hypothesised to be the origin of biological complexity and its decline the basis of 'complex' diseases and aging.' 'However, in the past 20 years, we have observed many patients with organ-based symptoms who have been found to have systemic mitochondrial defects. Therefore, systemic energetic defects can also cause organ-specific symptoms.' - Wallace DC. Bioenergetic origins of complexity and disease. Cold Spring Harb Symp Quant Biol. 2011;76:1-16.

Mitochondrial dysfunction as common cause of chronic diseases

Diaz-Vegas A, Sanchez-Aguilera P, Krycer JR, et al. Is Mitochondrial Dysfunction a Common Root of Noncommunicable Chronic Diseases? Endocr Rev. 2020;41(3)

Centenarians 'metabolic young'

Arai Y, Martin-Ruiz CM, Takayama M, et al. Inflammation, But Not Telomere Length, Predicts Successful Ageing at Extreme Old Age: A Longitudinal Study of Semi-supercentenarians. EBioMedicine. 2015;2(10):1549-1558. 

Lactate elevated in various conditions

Horne AW, Ahmad SF, Carter R, et al. Repurposing dichloroacetate for the treatment of women with endometriosis. Proc Natl Acad Sci U S A. 2019;116(51):25389-25391. 
This is a study in mice. But it shows that inhibiting glycolysis (in this case with the not-so-safe drug dichloroacetic acid) leads to a reduction in endometriosis. Research in humans will follow.

Newton DA, Lottes RG, Ryan RM, Spyropoulos DD, Baatz JE. Dysfunctional lactate metabolism in human alveolar type II cells from idiopathic pulmonary fibrosis lung explant tissue. Respir Res. 2021;22(1):278. 
This study looked at metabolism in the lung cells of people with idiopathic pulmonary fibrosis. Diseased lung cells use glycolysis more than cellular respiration. As a result, there is excess lactate in the lungs.

Esmael A, Talaat M, Egila H, Eltoukhy K. Mitochondrial dysfunction and serum lactate as a biomarker for the progression and disability in MS and its correlation with the radiological findings. Neurol Res. 2021;43(7):582-590. 
This study compared people with Multiple Sclerosis (MS) with people without MS. People with multiple sclerosis had higher levels of lactate in their blood. There also seemed to be a relationship with the level of lactate and the progression of MS. Higher lactate means more glycolysis is taking place than normal.

Metabolism and hormones in rheumatoid arthritis

Bertoldo E, Adami G, Rossini M, et al. The Emerging Roles of Endocrine Hormones in Different Arthritic Disorders. Front Endocrinol (Lausanne). 2021;12:620920.
In this review article, you can read, among other things, that oestrogen, parathormone and prolactin play a role in the development of rheumatoid arthritis. For example, oestrogen is quite abundant in an inflamed joint in rheumatoid arthritis.

Hanlon MM, Canavan M, Barker BE, Fearon U. Metabolites as drivers and targets in rheumatoid arthritis. Clin Exp Immunol. 2022;208(2):167-180.
This article notes that a 'bioenergetic crisis' exists in an inflamed joint. In a joint, oxygen and glucose (to make energy from) penetrate only slowly. The crisis occurs when immune cells become active and consume the small amounts of nutrition and oxygen that are there too quickly. They thereby create an environment in the joint with lack of oxygen and harmful waste products. The immune cells adapt to this by consuming nutrition and oxygen even more inefficiently. They no longer manage to resolve the inflammation. This is because they do not have the energy to do so. This creates a vicious circle.

Gaber T, Strehl C, Buttgereit F. Metabolic regulation of inflammation. Nat Rev Rheumatol. 2017;13(5):267-279. 
When immune cells are activated, a shift takes place in their metabolism. From cellular respiration (which uses oxygen and provides the most energy) to glycolysis.

Interesting books

Gerald Pollack. Cells, Gels and the Engines of Life. A New Unifying Approach to Cell Function. Ebner and Sons Publishing, Seattle, Washington, USA: 2001. 

James Nestor. Breath. The New Science Of A Lost Art. Riverhead Books: 2020. 

Ray Peat. Generative Energy. Restoring the Wholeness of Life. Eugene, Oregon: 1994.

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