FITNESS: THE COMPLETE GUIDE

OFFICIAL TEXT FOR ISSA’S CERTIFIED FITNESS TRAINER PROGRAM

issaonline.edu Frederick C. Hatfield, PhD

Contributors
Frederick C. Hatfield, PhD
Sal Arria, DC, MSS
Patrick S. Gamboa, MBA, MSS
Josh Bryant, MS, MFS
Paul O. Davis, PhD, FASCM
Michael Yessis, PhD
James A. Peterson, PhD
Charles Staley, BS, MSS
John Berardi, PhD
Brian St. Pierre, MS, RD
Ryan Andrews, MS, MA, RD
Karl Knopf, EdD
Thomas D. Fahey, EdD
Darin Rell, BS, CFT, AHA, BLS Instructor 

Reviewers
Cameron Baker, BS, MFS
Josh Bryant, MS, MFS

Editors
Peter A. Balaskas
Joanna Hatzopoulos

Graphics and Illustration

Sarah McDonough, Art Director 
Karen Williams, Senior Artist, Illustrator 
 Alex Gundersen, Illustrator 
Samantha Hird, Photography (Flexibility)

Fitness: The Complete Guide (Edition 9.0)

Official course text for:  International Sports Sciences Association’s Certified Fitness Trainer Course

10 9 8 7 6 5 4 3 2 1

Copyright © 2015 TXu1-157-866 International

International Sports Sciences Association.

Published by the International Sports Sciences Association, Carpinteria, CA 93013.

 All rights reserved. No part of this work may be reproduced

reproduced or transmitted in any form or by any electronic,
electronic, mechanical, or other means,
means, now
known or hereafter invented, including xerography, photocopying, and recording, or in any information storage and retrieval system without
the written permission of the publisher.

Direct copyright, permissions, reproduction, and publishing inquiries to:

International Sports Sciences Association, 1015 Mark Avenue, Carpinteria, CA 93013

1.800.892.4772 • 1.805.745.8111 (local) • 1.805.745.8119 (fax)

DISCLAIMER OF WARRANTY
This text is informational only. The data and information contained herein are based upon information from various published and
unpublished sources that represents training, health, and nutrition literature and practice summarized by the author and publisher.
The publisher of this text makes no warranties, expressed or implied, regarding the currency, completeness, or scientific accuracy of
this information, nor does it warrant the fitness of the information for any particular purpose. The information is not intended for use
in connection with the sale of any product. Any claims or presentations regarding any specific products or brand names are strictly the
responsibility of the product owners or manufacturers. This summary of information from unpublished sources, books, research journals,
and articles is not intended to replace the advice or attention of health care professionals. It is not intended to direct their behavior or
replace their independent professional judgment. If you have a problem or concern with your health, or before you embark on any health,
fitness, or sports training programs, seek clearance and guidance from a qualified health care professional.
Contributors
Frederick C. Hatfield, PhD
Sal Arria, DC, MSS
Patrick S. Gamboa, MBA, MSS
Josh Bryant, MS, MFS
Paul O. Davis, PhD, FASCM
Michael Yessis, PhD
James A. Peterson, PhD
Charles Staley, BS, MSS
John Berardi, PhD
Brian St. Pierre, MS, RD
Ryan Andrews, MS, MA, RD
Karl Knopf, EdD
Thomas D. Fahey, EdD
Darin Rell, BS, CFT, AHA, BLS Instructor 

Reviewers
Cameron Baker, BS, MFS
Josh Bryant, MS, MFS

Editors
Peter A. Balaskas
Joanna Hatzopoulos

Graphics and Illustration

Sarah McDonough, Art Director 
Karen Williams, Senior Artist, Illustrator 
 Alex Gundersen, Illustrator 
Samantha Hird, Photography (Flexibility)

Fitness: The Complete Guide (Edition 9.0)

Official course text for:  International Sports Sciences Association’s Certified Fitness Trainer Course

10 9 8 7 6 5 4 3 2 1

Copyright © 2015 TXu1-157-866 International

International Sports Sciences Association.

Published by the International Sports Sciences Association, Carpinteria, CA 93013.

 All rights reserved. No part of this work may be reproduced

reproduced or transmitted in any form or by any electronic,
electronic, mechanical, or other means,
means, now
known or hereafter invented, including xerography, photocopying, and recording, or in any information storage and retrieval system without
the written permission of the publisher.

Direct copyright, permissions, reproduction, and publishing inquiries to:

International Sports Sciences Association, 1015 Mark Avenue, Carpinteria, CA 93013

1.800.892.4772 • 1.805.745.8111 (local) • 1.805.745.8119 (fax)

DISCLAIMER OF WARRANTY
This text is informational only. The data and information contained herein are based upon information from various published and
unpublished sources that represents training, health, and nutrition literature and practice summarized by the author and publisher.
The publisher of this text makes no warranties, expressed or implied, regarding the currency, completeness, or scientific accuracy of
this information, nor does it warrant the fitness of the information for any particular purpose. The information is not intended for use
in connection with the sale of any product. Any claims or presentations regarding any specific products or brand names are strictly the
responsibility of the product owners or manufacturers. This summary of information from unpublished sources, books, research journals,
and articles is not intended to replace the advice or attention of health care professionals. It is not intended to direct their behavior or
replace their independent professional judgment. If you have a problem or concern with your health, or before you embark on any health,
fitness, or sports training programs, seek clearance and guidance from a qualified health care professional.
 About the Author | iii

ABOUT THE AUTHOR

Frederick C. Hatfield, MSS, PhD, is co-ounder and
president o the ISSA. Dr. Hatfield, (aka “Dr. Squat”)
won the World Championship three times in the
sport o powerlifing and perormed a competitive
squat with 1014 pounds at a body weight o 255
pounds (more weight than anyone in history had
ever lifed in competition). Dr. Hatfield’s ormer
positions include an assistant proessorship at the
University o Wisconsin (Madison) and senior vice
president and director o research and development
or Weider Health and Fitness, Incorporated. Dr.
Hatfield was honored by Southern Connecticut State University when they presented
him with the 1991 Alumni Citation Award. He has written over 60 books (including
several best-sellers)
best-sellers) and hundreds o articles in t he general areas o sports train ing,
fitness, bodybuilding, and perormance nutrition. He has been coach a nd training
consultant or several worl
world-ranked
d-ranked and pro
proessional
essional athletes, sports governing
bodies, and proessional teams worldwide. Dr. Hatfield qualified or the 1998 World
Championships
Champio nships in Olympic Lifing and competed in t he Masters Division.

International Sports Sciences Association

TABLE OF CONTENTS
Introduction, p. 1
SECTION ONE
ANATOMY AND PHYSIOLOGY, p. 9
1 Metabolism, p. 11
2 Basic Anatomy and Physiology, p. 29
3 Musculoskeletal Anatomy
and Physiology, p. 71

SECTION TWO
KINESIOLOGY AND BIOMECHANICS, p. 113
4 Kinesiology of Exercise, p. 115
5 Biomechanics of Exercise, p. 131
6 Musculoskeletal Deviations, p. 149
7 Muscle Mechanics, p. 161
SECTION THREE SECTION SIX
HEALTH AND PHYSICAL FITNESS, p. 181 FITNESS FOR ALL
Topics in Fitness for Special Populations , p. 615
8 Strength, p. 183
21 Exercise and Older Adults, p. 617 
9 Cardiovascular Training, p. 301
22 Exercise and Adaptive Fitness, p. 627 
10 Flexibility Training, p. 333
23 Exercise and Our Youth, p. 635
11 Body Composition, p. 359
24 Exercise and Hypertension, p. 641
SECTION FOUR
25 Exercise and Diabetes, p. 647 
PROGRAM DEVELOPMENT, p. 381
26 Exercise and Arthritis, p. 653
12 Drawing-In Phase, p. 383
27 Exercise and Coronary
13 Basic Assessment of
Heart Disease, p. 659
Fitness Participants, p. 393
28 Exercise and Pregnancy, p. 665
14 Training Principles, p. 415
29 Exercise and Asthma, p. 671
15 Periodization, p. 459
30 Sports Medicine
16 Determining Training Loads, p. 477 
in the Trenches, p. 677 
SECTION FIVE 31 Basic First Aid, p. 715
NUTRITION, p. 495
References, p. 725
17 The Big Picture of Nutrition, p. 497 
Glossary, p. 737 
18 Nutritional Physiology, p. 517 
Index, p. 759
19 Nutritional Science, p. 545
20 Nutritional Coaching, p. 575
 TOPICS COVERED IN THIS UNIT

Personal Training
Who Wants Personal Training?
What is a Personal Trainer?
Why is Personal Training Necessary?
What Should a Personal Trainer Know?
ISSA Code of Ethics and Standards
Principles and Purpose
Academic Standards
Professional Standards

INTRODUCTION

THE WHO, WHAT, WHY, AND HOW

OF PERSONAL TRAINING
2 | Introduction
U.S. President Theodore Roosevelt
PERSONAL TRAINING
oday’s fitness industry is a multibillion-dollar business.
Personal training is its ever-growing offspring. Te roots
o personal training are difficult to pinpoint. Some credit
its origin to be in the 1950s (when personal trainers were
first actively certified), although one could contend that
personal training dates back to the beginning o recorded
history. While the proession and terminology associated
with personal training were not yet in existence, the
concept o optimal health (which is the motivation behind
the proession) was already being touted by ancient
philosophers. Around 400 BC, Hippocrates wrote this:
“Eating alone will not keep a man well; he must also
take exercise. For food and exercise, while possessing
opposite qualities, yet work together to produce health …
and it is necessary, as it appears, to discern the power of
various exercises, both natural exercises and artificial,
to know which of them tends to increase flesh and which
to lessen it; and not only this, but also to proportion
exercise to bulk of food, to the constitution of the patient,
to the age of the individual.”  creative intellectual activity.”
Fitness: The Complete Guide
O all o the leaders o the United States, Teodore
Roosevelt was one o the strongest presidents, both
physically and mentally. However, he did not start that
way. As a child, Roosevelt was small or his age and quite
sickly. He had debilitating asthma, had poor eyesight, and
was extremely thin. When he was 12 years old, his ather
told him,
“You have the mind, but you have not the body, and
without the help of the body, the mind cannot go as far
as it should. You must make the body.” (Morris, 1979).
Roosevelt began spending every day building his body
as well as his mind. He worked out with weights, hiked,
hunted, rowed, and boxed. History can attest: Teodore
Roosevelt’s strength in mind and body contributed to his
strength as the leader o his nation.
Another great leader was U.S. President John Kennedy.
Like Roosevelt, Kennedy acknowledged the benefits o
physical activity or optimal health. He once said,
“Physical fitness is not only one of the most important
keys to a healthy body, it is the basis of dynamic and
 
 The Who, What, Why, and How of Personal Training | 3

WHO WANTS WHAT IS A

PERSONAL TRAINING? PERSONAL TRAINER?
According to the International Health, Racquet & Sports Te proession o personal training is a relatively new
Club Association and American Sports Data (IHRSA/ field that continues to expand its boundaries and redefine
ASD) Health Club rend Report, since 1998, the number itsel. Prior to the early 1980s, no minimal requirements
o Americans belonging to health clubs has grown existed to qualiy or identiy a person as a personal
45 percent (about 14 million members). Health club trainer. Tose engaged in training were still an esoteric
memberships among children under 18 years o age have group. Many learned about training solely through
 jumped by 187 percent since 1987. Te number o clients personal experiences in the gym. Recognizing the need
considering personal training services continues to grow. or standardization and credibility, Dr. Sal Arria and Dr.
According to IHR SA’s Annual Health Club C onsumer Fred Hatfield pioneered a program o personal fitness
Study (2014), 52.9 mill ion Americans aged 6 years and training that merged gym experience with practical and
older are members o health clubs. Over 12 percent o applied sciences.
these members pay or the services o a personal trainer
oday, a personal fitness trainer can be defined as a person
and over 6 million health club members alone paid or
who educates and trains clients in the perormance o sae
a personal trainer this past year. In-home sessions, park
and appropriate exercises in order to effect ively lead them
boot camp sessions, and other non traditional training
to optimal health. Personal trainers can be sel-employed
sessions were not included in gym data.
or work in health clubs, physicians’ offices, physical
Here are some statistics from the report: therapy clinics, wellness centers, hospitals, rehabilitation
• Three out of five clients are women. acilities, and private studios.
• Clients report an average of 18 sessions
with a trainer. WHY IS PERSONAL
• Trainers charge between $15 and $100 per
hour—an average of $50 per hour. TRAINING NECESSARY?
• Average sessions used in 12 months are Te U.S. Surgeon General’s Report on Physical Activity
as follows: and Health supports the role o physical activity or
Sessions Percentage good health and disease prevention. Te National
1–6 47% Institutes o Health released a consensus statement on the
7–11 12% importance o physical activity or cardiovascular health
(US Department o Health and Human Services,). In
12–24 11%
addition, the Centers or Disea se Control and Prevention
25–49 8%
(CDC) launched the Healthy People Initiative, which
50 + 11% lists physical activity, fitness, and nutrition at the top o
Not Reported 11% twenty-two priority areas. Finally, the American Heart
• Number of sessions clients used by age are Association included physical inactivity and low fitness
as follows: levels as primary risk actors, along with smoking,
 Age Range Sessions hypertension, and high cholesterol.
6–11 22 Unortunately, although t he resounding benefits o
12–17 26 physical activity and fitness are touted and reported, the
18–34 15 United States is currently undergoing an obesity epidemic.
35–54 14 In the United States, 25 to 35 percent o people remain
sedentary. o make matters worse, ederal resources
55 + 24
and unds or physical activity have lagged ar behind
Tese statistics support the growing trend and need or other aspects o health. Health and physical education in
personal training services. While those 4 million people schools are low priorities, and when districts are looking
who purchased personal training services are sold on the to trim their budgets, health and physical education
need or personal training, let’s explore what exactly is a programs are ofen the first to be cut.
personal trainer?

International Sports Sciences Association

4 | Introduction
Consider the ollowing: Each year in the United States,
people spend $2.5 trillion on health care. Tis meteoric
figure translates into an expenditure o almost $7,000 or
each member o the U.S. population. Regret tably, this
financial commitment has neither shown signs o abating
nor has it produced satisactory results with regard to
treating a wide variety o chronic health problems.
Attempts to identiy the actors that have been major
contributions to this virtual epidemic o medical
problems have produced a litany o probable reasons
why such a large number o individuals are so apparently
unhealthy, including poor eating habits, sedentary
liestyle, stress, and poor health habits (e.g., smoking). At
the same time, a number o studies have been undertaken
to identiy what, i anything, can be done to diminish
either the number or the severity o medical problems
affecting the public. Tese studies have provided
considerable evidence that exercise has substantial
medicinal benefits or people o all ages.
wo o the most widely publicized efforts to investigate
the possible relationship between exercise and disease
were longitudinal studies, each o which involved more
than 10,000 subjects. In a renowned study o 17,000
Harvard graduates, Ralph Paffenbarger, MD, ound that
men who expended approximately 300 calories a day (the
equivalent o walking briskly or 45 minutes) reduced
their death rates rom all causes by an extraordinary 28
percent and lived an average o more tha n 2 years longer
than their sedentary classmates. Another study conducted
by Steven Blair, PED, o the Institute o Aerobics
Research in Dallas documented the act that a relatively
modest amount o exercise has a significant effect on
the mortality rate o both men and women. Te higher
the fitness level, the lower the death rate (afer the data
were adjusted or age differences between subjects in this
8-year investigation o 13,344 individuals). An analysis
o the extensive data yielded by both studies suggests one
inescapable conclusion: Exercise is medicine!
Accepting the premise that regular exercise can play
a key role in reducing your risk o medical problems
and in decreasing your ultimate costs or health care is
critical. Despite the vast number o individuals who lead a
sedentary liestyle, the need or and the value o exercising
on a regular basis is an irreutable act o lie (and death).
For example, afer a detailed review o the results o his
long-term investigation, Dr. Paffenbarger concluded that
not exercising had the equiva lent impact on a person’s
health as smoking one and a hal packs o cigarettes a
Fitness: The Complete Guide
day. Fortunately, with ew exceptions, most people are too
sensible to ever consider ravaging their health by smoking
excessively. Unortunately, many o these same people ail
to recognize the extraordinary benefits o exercise in the
prevention o medical problems.
Any listing o the medical problems and health-related
conditions that can be at least partially treated and
controlled by exercise would be ex tensive. Among
the most significant o these health concerns and the
manner in which exercise is thought to help alleviate each
condition are the ollowing:
• Allergies. Exercise is one of the body’s most
efficient ways to control nasal congestion (and
the accompanying discomfort of restricted nasal
blood flow).
• Angina. Regular aerobic exercise dilates
vessels, increasing blood flow — thereby
improving the body’s ability to extract
oxygen from the bloodstream.
• Anxiety. Exercise triggers the release of
mood-altering chemicals in the brain.
• Arthritis. By forcing a skeletal joint to move,
exercise induces the manufacture of synovial fluid,
helps to distribute it over the cartilage, and forces
it to circulate throughout the joint space.
• Back pain. Exercise helps to strengthen the
abdominal muscles,the lower back extensor
muscles, and the hamstring muscles.
• Bursitis and tendinitis. Exercise can strengthen
the tendons — enabling them to handle greater
loads without being injured.
• Cancer. Exercise helps maintain ideal bodyweight
and helps keep body fat to a minimum.
• Carpal tunnel syndrome. Exercise helps build
up the muscles in the wrists and forearms, thereby
reducing the stress on arms, elbows, and hands.
• Cholesterol. Exercise helps to raise HDL (high-
density lipoprotein—the “good” cholesterol)
levels in the blood and lower LDL (low-density
lipoprotein—the undesirable cholesterol) levels.
• Constipation. Exercise helps strengthen the
abdominal muscles, thereby making it easier to
pass a stool.
• Depression. Exercise helps speed metabolism
and deliver more oxygen to the brain; the
improved level of circulation in the brain tends to
enhance mood.
 The Who, What, Why, and How of Personal Training | 5
• Diabetes. Exercise helps lower blood sugar
levels, strengthen the skeletal muscles and heart,
improve circulation, and reduce stress.
• Fatigue. Exercise can help alleviate the fatigue-
causing effects of stress, poor circulation and
blood oxygenation, bad posture, and poor
breathing habits.
• Glaucoma. Exercise helps relieve intraocular
hypertension (the pressure buildup on the eyeball
that heralds the onset of glaucoma).
• Headaches. Exercise helps force the brain to
secrete more of the body’s opiate-like, pain-
dampening chemicals (e.g., endorphins and
enkephalins).
• Heart disease. Exercise helps promote many
changes that collectively lower the risk of heart
disease—a decrease in body fat, a decrease in LDL
cholesterol, an increase in the efficiency of the
heart and lungs, a decrease in blood pressure, and
a lowered heart rate.
• High blood pressure. Exercise reduces the level
of stress-related chemicals in the bloodstream that
constrict arteries and veins, increases the release
of endorphins, raises the level of HDL in the
bloodstream, lowers resting heart rate (over time),
improves the responsiveness of blood vessels (over
time), and helps reduce blood pressure through
maintenance of body weight.
• Insomnia. Exercise helps reduce muscular
tension and stress.
• Intermittent claudication. Claudication is pain
caused by too little blood flow to the extremities.
Exercise helps improve peripheral circulation and
increases pain tolerance.
• Knee problems. Exercise helps strengthen
the structures attendant to the knee (muscles,
tendons, and ligaments) thereby facilitating the
ability of the knee to withstand stress.
• Lung disease. Exercise helps strengthen the
muscles associated with breathing and helps
boost the oxygen level in the blood.
• Memory problems. Exercise helps to improve
cognitive ability by increasing the blood and
oxygen flow to the brain.
• Menstrual problems and PMS. Exercise
helps to control the hormonal imbalances often
associated with PMS by increasing the release of
beta-endorphins.
• Osteoporosis. Exercise promotes bone
density, thereby lowering an individual’s risk of
experiencing a bone fracture.
• Overweight problems. Exercise is an
appetite suppressant. It also increases metabolic
rate, burns fat, increases lean muscle mass, and
improves self-esteem—all factors that contribute
to healthy weight.
• Varicose veins. Exercise can help control the
level of discomfort caused by existing varicose
veins and help prevent additional varicose veins.
International Sports Sciences Association
6 | Introduction
Are the positive effects that result rom exercising
regularly worth the required effort? Absolutely. Should
you make exercise an integral part o your daily regimen?
O course, you should. In countless ways, your lie may
depend on it. Te meteoric rise o health care and
health problems makes your success as a personal
trainer predictable.
Implications for Certified Fitness
Trainer Professionals
Te need or personal training services continues to grow.
As uture ISSA fitness proessionals, it is imperative that
we keep up with the evolving recommendations or health
and physical fitness that have a direct application or
fitness programs and exercise recommendations. With
the emergence o the latest technologies, inormation
regarding health and fitness is easily accessible. However,
because o the nature o the media’s use o vague and
brie headlines in conjunction with radio and television
sound bites that provide only limited, conusing, and
ofen conflicting recommendations, it is important that
we can help our clients, riends, and amily members put
each new study or report in proper perspective. Personal
trainers today are committed to a long-term career in
health and fitness and are increasing their knowledge
through additional courses in post-rehabilitation,
corporate wellness, youth fitness, senior fitness, and pre-
and postnatal specializations to better serve their clients
in achieving and living the fitness liestyle. As you can see,
Fitness: The Complete Guide
we as personal trainers have an inherent responsibility
to positively influence the health and fitness attitudes
o those around us. Individually and collectively, we
can bring health and fitness to the masses and make the
dream o optimal health a reality or all.
WHAT SHOULD A PERSONAL
TRAINER KNOW?
As the industry continues to expand its boundaries and
the realm o scientific knowledge concerning the human
response and adaptation to exercise continues to g row, it
is essential that personal fitness trainers be competent in
the ollowing:
• Exercise programming
• Exercise physiology
• Functional anatomy and biomechanics
• Assessments and fitness testing
• Nutrition and weight management
• Basic emergency procedures and safety
• Program administration
• Human behavior and motivation
Our ability as fitness proessionals to educate and
effectively draw our clients into the fitness liestyle
and optimal health comes rom a plan that is based in
the aorementioned areas as well as the knowledge o
 The Who, What, Why, and How of Personal Training | 7

muscular, cardiopulmonary, and metabolic adaptations.
Tese adaptations are known as the training effect . Te
training effect is the body’s adaptation to the learned
and expected stress imposed by physical activity. When
the body experiences the training effect, it begins to
change at the cellular level, allowing more energy to
be released with less oxygen. Te heart and capillaries
become stronger and more dispersed in order to allow a
more efficient flow o oxygen and nutrients. Te muscles,
tendons, and bones involved with this activity also
strengthen to become more proficient. In time, the body
releases unnecessary at rom its rame, and stride and
gait become more efficient. Additionally, resting heat
rate and blood pressure drop. Tese adaptations can be
achieved through an educated trainer who can develop an
appropriate fitness and health plan.
Te fitness and health plan must account or the basic
principles o fitness training: overload, specificity,
individual differences, reversibility, periodization, rest,
overtraining, and stimulus variability. Te plan requires
a thorough understanding o the major muscles o the
body and how they work, as well as an understanding
o metabolism—how the body converts ood energy
into other orms o energy it can use at rest and during
exercise. In addition, trainers must learn about the
unction and regulation o the lungs, heart, blood vessels,
hormones, brain, and nerves, as well as the weight control
and temperature regulation systems at rest and during
exercise. Once you have the knowledge and support to
develop comprehensive, individualized, and periodized
plans that effectively produce the training effect, then
you will be able to effectively draw your riends, amily
members, and uture clients into the fitness liestyle and
optimal health.

Over a quarter century ago, Dr. Sal Arria and Dr. Fred Hatfield had a vision to pioneer a personal fitness
trainer program that would merge in-gym experience with practical and applied sciences in order to share
the benefits of the fitness lifestyle with the masses. As the profession continues to grow and expand its
boundaries, for the ISSA trainer of today and the ISSA trainer of tomorrow, education and support are vital.
It is the hope and vision of the ISSA that through this course text and the support provided by the entire ISSA
staff, ISSA-certified trainers will continue to be more educated than in the past; they will be well-rounded and
knowledgeable about exercise and how it relates to optimal health and fitness.

International Sports Sciences Association

8 | Introduction
ISSA CODE OF ETHICS AND STANDARDS
Principles and Purposes
Upon receipt o the ISSA Certificate, members become, in effect, de acto representatives o the leader in the fitness
certification industry, and as such are expected to conduct themselves according to the highest standards o honor, ethics,
and proessional behavior at all times. Tese principles are intended to aid ISSA members in their goal to provide the
highest quality o service possible to their clients and the community.
 Academic Standards
Requirements for Graduation
1. Certification will not be issued to any student/
member who does not successfully complete
or meet all pertinent qualifications or has not
achieved passing scores on the relevant ISSA
examinations.
2. Certification will not be issued to any student/
member unless they have successfully completed
CPR/AED training as evidenced by a current and
valid CPR/AED card.
3. Certification will not be issued until all fees are
paid in full.
Professional Standards
ISSA members will do the following:
1. Serve clients with integrity, competence,
objectivity, and impartiality, always putting the
clients’ needs, interests, and requests ahead of his
or her own. Members must always strive for client
satisfaction.
2. Recognize the value of continuing education
by upgrading and improving their knowledge
and skills on an annual or semi-annual basis.
Members must keep abreast of relevant changes
in all aspects of exercise programming theory and
techniques.
3. Not knowingly endanger his or her clients or
put his or her clients at risk. Unless they have
allied health care licenses, members must stay
within the realm of exercise training and lifestyle
counseling with clients. Clients with special
medical conditions must be referred to proper
medical professionals.
4. Never attempt to diagnose an injury or any other
medical or health-related condition.
5. Never prescribe or dispense any kind of
medication whatsoever (including over-the-
counter medications) to anyone.
Fitness: The Complete Guide
6. Never attempt to treat any health condition or
injury under any circumstance whatsoever (except
as standard first aid or CPR procedure may
require).
7. Never recommend exercise for anyone with a
known medical problem without first obtaining
clearance to do so and/or instructions from the
attending qualified medical professional.
8. Ensure that CPR certification and knowledge of
 first aid procedures is current.
9. Work toward the ultimate goal of helping clients
become more self-sufficient over time, reducing
the number of supervised training sessions.
10. Respect client confidentiality. All client information
and records of client cases may not be released
without written release from the client.
11. Charge fees that are reasonable, legitimate, and
commensurate with services delivered and the
responsibility accepted. All additional fees and
services must be disclosed to clients in advance.
12. Adhere to the highest standards of accuracy and
truth in all dealings with clients, and will not
advertise their services in a deceptive manner.
13. Not get intimately involved with their clients.
Minimize problems by always maintaining a
professional demeanor, not becoming overly
 friendly with clients, and documenting training
sessions, evaluations, and training programs. We
cannot overemphasize this point: Be a professional;
do not get personally involved with clients! 
14. Price cutting (also called low balling) is a sales
technique that reduces the retail prices of a service
so as to attempt to eliminate competition. It can
also potentially eliminate your ability to make a
living. Corporate gyms hire trainers with little to
no experience and charge members minimally
$50 per hour to train with inexperienced trainers.
This is a very shortsighted business model that
will generally attract the wrong kind of clients.
The most effective long-term strategy is to simply
charge what you are worth and strive to be the
best at what you do.
SECTION ONE
 Anatomy and Physiology

Metabolism
Basic Anatomy and Physiology
Musculoskeletal Anatomy and Physiology
TOPICS COVERED IN THIS UNIT

Introduction
Homeostasis
Understanding Metabolism
Metabolic Set Point
Food and Metabolism
Environment and Metabolism
Exercise and Metabolic Responses
Energy Metabolism
ATP Production
Monitoring Metabolism
Conclusion

UNIT 1

METABOLISM
12 | Unit 1

Unit Outline
I. Introduction IV. Energy Metabolism
II. Homeostasis A. ATP Production
III. Understanding Metabolism 1. ATP/CP Energy Pathway 
A. Metabolic Set Point 2. Glycolytic Pathway 
B. Food and Metabolism 3. Oxidative Pathway 
C. Environment and Metabolism 4. How the Systems Interact
D. Exercise and Metabolic Responses 5. Glycogen Depletion and Metabolism
of Fatigue
1. Aerobic System Changes
B. Monitoring Metabolism
2. Anaerobic System Changes
V. Conclusion

Learning Objectives
 After completing this unit, you will be able to do the following:
• Define key terms.
• Understand the role of metabolism in the body and how it relates to exercise.
• Determine the metabolic needs of each of the three energy pathways described,
and apply them in the coming units.

training effect: An increase in
 functional capacity of muscles
and other bodily tissues as
a result of increased stress
(overload) placed upon them.
homeostasis: The automatic
tendency to maintain a relatively
constant internal environment.
INTRODUCTION
As revealed in the book’s introduction, personal fitness trainers have a tremendous
influence on shaping the health and fitness attitudes and practices o those around
them. Te sphere o influence includes riends, amily members, coworkers, and, o
course, clients. As a fitness proessional, your ability to effectively draw your clients
into the fitness liestyle—including the ability to maintain optimal health—largely
depends on your knowledge o the muscular, cardiopulmonary, and metabolic
adaptations to exercise. Tese adaptations are known as the training effect.
Te training effect impacts the body in several ways. Te body begins to change
at the cellular level, allowing more energy to be released with less oxygen. Heart
unction improves and the capillaries prolierate in order to allow a more efficient
flow o oxygen and nutrients. Te muscles, connective tissues, and bones involved
with a particular physical activity strengthen to accommodate improved proficiency
at perorming the activity. Over time, the body’s composition changes (e.g., at mass
may increase while muscle mass decreases) and movements become more efficient. In
addition, resting heart rate and blood pressure drop. You can help your clients achieve
these adaptations by educating yoursel and learning how to develop appropriate
fitness and health plans or them.

Fitness: The Complete Guide

 Metabolism | 13

Te training effect would not be possible without

sufficient energy to bring about the positive muscular,
cardiopulmonary, and metabolic adaptations. But where
Thermostat
exactly does this energy come rom? activated

Where Does Energy Come From?

All energy on ear th originates rom the sun. Plants use
the light energy rom the sun to orm carbohydrates, ats,
and proteins. Carbohydrates are sugars and starches used Room condition Room condition
by the body as uel. Fats are compounds that store energy. warms up returns to normal
Proteins are important components o cells and tissues;
they are large, complex molecules comprised o amino
acids. (Carbohydrates, ats, and proteins are discussed
in more detail in Section 5 o this text.) Humans and
other animals eat plants and other animals to obtain
energy required to maintain cellular activities. Te body
uses carbohydrates, ats, and proteins to provide the
necessary energy to maintain cellular activity both at
Room condition Room condition
rest and during activity. Because all cells require energy, returns to normal cools down
the body must have a way to convert carbohydrates, ats,
and proteins into a biologically usable orm o energy
to both uel physical activity a nd provide the structura l
components o the body. Te ability to run, jump, and
lif weights is contingent upon, and limited by, the body’s
ability to transorm ood into biological energy. Tese
physical abilities are urther contingent upon thousands
o chemical reactions that occur throughout the body Thermostat
all day long. Collectively, these reactions are known as activated
metabolism. Tese many chemical reactions occurring
in the body must be regulated in order to maintain a
balance. Te body consists o trillions o cells, which are
Figure 1.1 Homeostasis example
organized into tissues, organs, and systems. Tis intricate
organized system is covered in more detail in Unit 2. Te
body’s components work together in a highly organized the temperature increases above the set point determined
manner to maintain th is balance. Metabolic activities are by the system, then the thermostat shuts off the urnace.
continually occurring i n the tril lions o cells in your body In this way, the temperature is kept at the desired steady
and must be careully regulated to maintain a constant state. I the temperature decreases below the set point
internal environment, or steady state. Tis steady state determined by the system, then the thermostat turns
must be maintained regardless o your ever-changing on the urnace to maintain the desired steady state (see
external environment. Figure 1.1). Tis eedback system revolves around a
cycle o events. Inormation about a change is ed back
to the system so that the regulator (in this exa mple, the
HOMEOSTASIS thermostat) can control the process (in the example o
temperature regulation).
Homeostasis reers to the body’s automatic tendency
to maintain a constant internal body environment A good example o homeostasis in the body is the method
through various processes. Walter Bradord Cannon is by which the body maintains a constant temperature o
credited with coining the term in his book Te Wisdom 98.6 degrees Fahrenheit. For example, i either physical
of the Body  (1932). For homeostasis to work, eedback exertion or external heat causes your body temperature
systems must exist that various physiological u nctions to rise, your brain sends a signal to increase the rate o
turn off and on. Imagine a eedback system such as the sweating. Heat is carried away in sweat, which evaporates.
thermostat in your urnace or air conditioning system. I I body temperature begins to drop due to a cold external

International Sports Sciences Association

14 | Unit 1
metabolism: The total of
all the chemical and physical
processes by which the body
builds and maintains itself
(anabolism) and by which it
breaks down its substances
 for the production of energy
(catabolism).
glucose: Principal circulating
sugar in the blood and the
major energy source of the
body.
ketone bodies: Bodies
produced as intermediate
products of fat metabolism.
lactic acid: A by-product
of glucose and glycogen
metabolism in anaerobic muscle
energetics.
amino acid: The building
blocks of protein. There are
24 amino acids, which form
countless number of different
proteins.
fatty acids: Any of a large
group of monobasic acids,
especially those found in animal
and vegetable fats and oils.
anabolism: The building up in
the body of complex chemical
compounds from simpler
compounds (e.g., proteins from
amino acids).
catabolism: The breaking
down in the body of complex
chemical compounds into
simpler ones (e.g., proteins to
amino acids).
Fitness: The Complete Guide
environment, shivering begins to generate heat and keep the body temperature at that
critical 98.6 degrees F. Other metabolic unctions under homeostatic control include
the ollowing:
• Hormone production and concentration level maintenance
• Maintenance of serum oxygen levels and carbon dioxide levels
• pH balance in the blood and cells
• Water content of cells and blood
• Blood glucose levels and other nutrient levels in the cell
• Metabolic rate
Te concept o homeostasis is o special interest to fitness enthusiasts. You are in
equilibrium even with environmental stimuli acting upon you. For example, think
about how your muscles change in response to different training programs. I you
spend most o your time lifing heavy weights, your muscles will grow larger; a shif
in your homeostasis takes place. Te simple action o weight training causes more
protein synthesis in the target muscles. Hormone levels change to accommodate this
growth. On the other hand, i you choose to run several miles per day, your muscles
will adapt differently. Tey develop a higher endurance capacity, they stimulate the
ormation o more at-burning, slow-twitch muscle fibers, and they develop a higher
capacity to use oxygen in energy production. Nutrient intake can also affect your
homeostatic balance. Eating too much o the wrong oods or too little o the right
oods can cause homeostasis to shif out o balance. Consume too many calories, and
your body stores at; too little protein, and your muscles break down. I you don’t
consume enough energy-supplying calories, you will eel tired sooner. For optimum
homeostasis and metabolism, eating the right nutrients in the right amounts at the
right times is vital.
UNDERSTANDING METABOLISM
Te body sustains itsel and adapts to its environment through metabolism . In order
or metabolism to occur, the body needs both energy and building blocks or growth
and repair. It gets its energy rom the breakdown o nutrients such as glucose, ketone
bodies, lactic acid, amino acids , and fatty acids. o construct molecules or growth
and repair, a delicate interplay must exist between anabolism and catabolism.
Te many biochemical processes that make up the body’s metabolism are categorized
into two general phases: anabolism and catabolism. Anabolism and catabolism occur
simultaneously—and constantly. However, they differ in magnitude depending on the
level o activity or rest and on when the last meal was eaten. When anabolism exceeds
catabolism, net growth occurs. When catabolism exceeds anabolism, the body has a
net loss o substances and body tissues and may lose weight.
Anabolism includes the chemical reactions that combine different biomolecules to
create larger, more complex ones. Te net result o anabolism is the creation o new
cellular material, such as enzy mes, proteins, cell membranes, new cells, and growth/
repair o the many tissues. Tat energy is stored as glycogen and/or at and in muscle
tissue. Anabolism is necessary or growth, maintenance, and repair o tissues.
Catabolism includes the chemical reactions that break down complex biomolecules
into simpler ones or energy production, or recycling o molecular components, or
or their excretion. Catabolism provides the energy needed or transmitting nerve
impulses and muscle contraction.
 Metabolism | 15

Metabolism includes only the chemical changes that occur within tissue cells in the
body. It does not include those changes to substances that take place in the digestion
o oods in the gastrointestinal system. For optimal unction, a healthy metabolism
needs many nutrients. A slight deficiency o even one vitamin can slow down
metabolism and cause chaos throughout the body. Te body builds thousands o
enzymes to drive its metabolism in the direction influenced by activity and nutrition.
So, when you are training or engaged in vigorous physical activity several hours a day,
you must ensure that your diet contains the nutrients your body needs in order to
optimize the many metabolic unctions taking place.

METABOLIC SET POINT

Based on the discussion o homeostasis and metabolism, it is evident that the body
is a highly regulated collection o many biochemical reactions. Much research
over the years has revealed that the body seeks to maintain a cer tain base rate o
metabolism, called the metabolic set point, which results in basal metabolic metabolic set point: The
rate (BMR). Tis set point is regulated by both genetic and environmental actors. base rate of metabolism that
Researchers have demonstrated that you can change your metabolic set point through the body seeks to maintain;
resulting in basal metabolic rate.
diet and physical act ivity.
basal metabolic rate
Te metabolic set point is the average rate at which the metabolism runs, and it (BMR): The minimum energy
will result in a body composition set point. People with a slow metabolism seem to required to maintain the body’s
store at easily, while people with a ast metabolism seem to be able to eat and never life function at rest; usually
gain at. Your metabolic set point can be influenced by the external environment expressed in calories per hour
(climate), nutrition, exercise, and other actors. Studies have demonstrated that when per square meter of the body
surface.
individuals go on a low-calorie diet, the body’s metabolic set point becomes lower
in order to conserve energy. It actually resets itsel to burn ewer calories, thereby
conserving energy. Exercise tends to increase metabolic rate, causing the body to burn
more at or energy.
thermic effect: The heat
liberated from a particular food;
Calculating Caloric Expenditure it is a measure of its energy
content and its tendency to be
You can estimate your total daily caloric expenditure by multiplying the Harris- burned as heat. This process of
Benedict equations or basal metabolic rate by an activity level actor that accounts or heat liberation is also commonly
your daily physical activity levels and t he thermic effect o ood. referred to as “thermogenesis.”

Calculating Caloric Expenditure

MALE metric: DCE = ALF × ((13.75 × WKG) + (5 × HC) – (6.76 × age) + 66)
imperial: DCE = ALF × ((6.25 × WP) + (12.7 × HI) – (6.76 × age) + 66)
FEMALE metric: DCE = ALF × ((9.56 × WKG) + (1.85 × HC) – (4.68 × age) + 655)
imperial: DCE = ALF × ((4.35 × WP) + (4.7 × HI) – (4.68 × age) + 655)
WHERE

ALF = Activity level factor  AND ALF HAS THE FOLLOWING VALUES:

DCE = Daily caloric expenditure Sedentary:  ALF = 1.2

HC = Height in centimeters Lightly active:  ALF = 1.375
HI = Height in inches Moderately active:  ALF = 1.55
WKG = Weight in kilograms Very active:  ALF = 1.725
WP = Weight in pounds Extremely active:  ALF = 1.9

Eq. 1.1
16 | Unit 1
calorie: A unit of heat;
specifically, it is the amount of
energy required to raise the
temperature of 1 kilogram
of water 1 degree Celsius at
1 atmosphere. As a unit of
metabolism (as in diet and
energy expenditure), it is spelled
with a capital C; 1 Calorie =
1,000 calories, or 1kilocalorie
(kcal).
kilocalorie (kcal): A unit of
measurement that equals 1,000
calories, or 1 Calorie. Used
in metabolic studies, it is the
amount of heat required to raise
the temperature of 1 kilogram
of water 1 degree Celsius at
a pressure of 1 atmosphere.
The term is used in nutrition to
express the fuel (energy) value
of food.
respiratory quotient (RQ):
 A method of determining
the “fuel mix” being used,
giving us a way to measure
the relative amounts of fats,
carbohydrates, and proteins
being burned for energy.
oxidation: The chemical act
of combining with oxygen or of
removing hydrogen.
Fitness: The Complete Guide
FOOD AND METABOLISM
In addition to exercise, the type o ood you eat can also influence your metabolism.
Te ood you eat can be burned to liberate energy, it can be converted into body
weight, or it can be excreted. All oods release heat when they are burned. Tis
release o heat is measured in kilocalories. A calorie is a unit o heat. Practically
speaking, this unit is too small to be useul, thereore, the kilocalorie (1,000 calories)
is the preerred unit in metabolism studies. Te term Calorie (with a capital “C”) is
synonymous w ith ki localorie.
Te heat liberated rom ood is known as the thermic effect. Increased thermogenesis
(heat production) correlates with increased oxygen consumption and an increased
metabolic rate. Te more heat your body produces, the more oxygen it needs, because
heat cannot be liberated in the absence o oxygen. Food efficiency is simply a measure
o how efficiently a particular ood is converted to body weight. Foods with high
ood efficiency are prone to be converted to body weight, while oods with low ood
efficiency are prone to be burned as energy.
Understanding how the body will use the consumed calories can help you in setting
up your nutritional program. Simply counting calories will not lead to loss o body at.
Te heat liberated rom a particular ood, whether it is at, protein, or carbohydrate,
is determined by its particular molecular structure, and this structure determines
its thermic effect. Te higher the thermic effect o any par ticular ood, the higher the
metabolic rate will be. Know what the body is consuming; and, more importantly,
know how the body will use the consumed calories. A method o determining the mix
o uels being utilized in the body is ca lled the respiratory quotient (RQ), which
provides a way to measure the relative amounts o ats, carbohydrates, and proteins
being burned or energy.
Te respiratory quotient (RQ) is the ratio o the volume o carbon dioxide expired
to the volume o oxygen consumed. Because the amounts o oxygen used up or the
combustion o at, carbohydrate, and protein differ, differences in the RQ indicate
which nutrient source is being predominantly used or energy purposes. Te ormula
or calculating RQ is as ollows:
RQ = volume of CO2 expired ÷ volume of O2 utilized
Eq. 1.2
Te RQ or carbohydrate is 1.0, whereas the RQ or at is 0.7. Fat has a lower RQ value
because atty acids require more oxygen or oxidation than the amount o carbon
dioxide produced. Te RQ or energy production rom protein is about 0.8. Te
average person at rest will have an RQ o about 0.8; however, this result is rom using a
mixture o atty acids and carbohydrates, not the protein itsel, or energy production.
Remember, proteins (broken down into amino acids) are not usually used or energy.
In a normal diet containing carbohydrate, at, and protein, about 40to 45 percent o
the energy is derived rom atty acids, 40 to 45 percent rom carbohydrates, and 10 to
15 percent rom protein. However, this rate o energy production varies based on diet,
physical activity, and level o physical training.
 Metabolism | 17

Research indicates that when the diet is high in carbohydrates, the RQ is higher,
thereore more energy is being produced rom carbohydrates. When the diet is low in
carbohydrates and high in at, more energy is produced rom at. Interestingly, recent
studies published in academic journals suggest that more efficient body at reduction
occurs with a high-at diet than with a high-carbohydrate diet (on a calorie-per-
calorie basis).
In addition, training intensity affects the energy source during exercise. For example,
•
a training intensity below 60 percent o maximal oxygen uptake (VO2 max) results maximal oxygen uptake
•
in a RQ o about 0.8, indicating an equal portion o energy derived rom atty acids (VO2 max): The highest rate of
•
and carbohydrate. As training intensity increases above 60 percent o VO2 max, more oxygen consumption which a
•
carbohydrate is used or energy. Exercise intensity at 100 percent VO2 max (which can person is capable.
only be sustained or minutes) yields a RQ o 1. Keep in mind that amino acids, in branched-chain amino
particular the branched-chain amino acids (BCAAs, which aid in recovery), are also acids (BCAAs): The amino
being used or energy during exercise and at rest, perhaps as much as 10 percent or acids L-leucine, L-isoleucine and
L-valine, which have a particular
more during exercise.
molecular structure that gives
In general, physical conditioning lowers the RQ, which means more energy is being them their name and comprises
obtained rom atty acids in the trained individual. However, more energy is also 35 percent of muscle tissue. The
BCAAs, particularly L-leucine,
being obtained rom protein in the trained individual. Carbohydrate is always being help increase work capacity
used or energy. For example, in a study comparing the RQ o untrained versus by stimulating production of
trained individuals during exercise, the RQ o the untrained individuals was 0.95 and insulin, the hormone that opens
the RQ o the trained individuals was 0.9. Tis means that while both groups were muscle cells to glucose. BCAAs
using mostly carbohydrate or uel during exercise, the trained individuals were using are burned as fuel during highly
a higher amount o atty acids or energy. At rest, atty acids are the predominant intense training and at the end
of long-distance events when
energy source in most people; as exercise begins, carbohydrate utilization increases. the body recruits protein for
High-intensity exercise uses more carbohydrate, while low- to moderate-intensity as much as 20 percent of its
exercise uses atty acids and carbohydrate or energy. O course, these ratios change energy needs.
when one consumes only ats and proteins and no carbohydrates as uel.
While this discussion o RQ is very brie, you can see that the energy substrate
utilization o the body is quite varied, and both composition o the diet and intensity
o physical activity determine which energy substrates are used. Tereore, it is easy to
see why different sports require different dietary considerations.

International Sports Sciences Association

18 | Unit 1

ENVIRONMENT
AND METABOLISM
Te body’s environment also influences its metabolic
rate. When you are exposed to a progressively colder
climate, your body will increase its metabolic rate to keep
the body temperature constant and to prevent shivering.
Shivering is invoked when the core temperature o the
body begins to drop rom being in the cold. Shivering is
actually a series o involuntary muscle contractions that
are triggered to create heat in the body, like turning on
a urnace. When exposed to higher-than-average cold
conditions or a ew days, the body actually increases its
basal metabolic rate; its goal is to run hotter than average
in order to compensate or being in a colder climate.
When conditions begin to warm up, even a 60-degree-
Fahrenheit (F) day can seem extremely hot, because the
body’s metabolic rate is already run ning ast. Afer several
days o acclimating to the hot climate, the metabolic rate Te magnitude o these changes is driven primarily by
decreases and 80 degrees F eels as hot as the 60 degrees F whether the exercise is anaerobic or aerobic. Te type and
did a ew months earlier. duration o exercise dictates the primar y energy mix used.
High-intensity exercise simulates development o ast-
twitch muscle fibers, while low-intensity exercise results
EXERCISE AND in development o slow-twitch muscle fibers.
METABOLIC RESPONSES In addition, a series o hormonal changes occur during
exercise and non-exercise periods. Tese changes also
Exercise stimulates a series o metabolic responses
are benefited and acilitated with a nutrient profile that
that affect the body’s anatomy, physiology, and
matches the type o metabolic fluctuation.
biochemical makeup.
Endurance exercise stimulates the following changes:
• Increased muscle glycogen storage capacity
 Aerobic System Changes
• Increased muscle mitochondrial density Aerobic training greatly increases the body’s unctional
capacity to transport and use oxygen and to burn atty
• Increased resting adenosine triphosphate (ATP) acids during exercise. Recent research shows that long,
content in muscles
slow distance training is not as efficient as interval
• Increased resting creatine phosphate (CP) training in acilitating this unctional capacity. Some o
content in muscles the major changes measured as a result o aerobic exercise
• Increased resting creatine content in muscles (especially interval training) include the ollowing:

• Increased aerobic enzymes • Increased mitochondrial density in slow-twitch

muscle fiber, which results in higher energy
• Increased percentage of slow-twitch muscle fibers production from fatty acids. Maximum oxidative
• Decreased percentage of fast-twitch muscle fibers capacity develops in all fiber types

• Decreased muscle size, when compared to • Higher aerobic capacity

strength training • Increase in trained muscle capacity to utilize
• Increased cardiac output and mobilize fat, resulting from higher amounts
of fat-metabolizing enzymes, and increased
• Decreased resting heart rate blood flow
• Decreased body fat • Greater development of slow-twitch muscle fibers,
increased myoglobin content (an iron–protein
• Increased Krebs cycle enzymes
compound in muscle), which acts to store and
• Increased number of capillaries transport oxygen in the muscles

Fitness: The Complete Guide

 Metabolism | 19

adenosine triphosphate
 Anaerobic System Changes (ATP): An organic compound
Anaerobic training greatly increases the body’s unctional capacity or development o  found in muscle which,
upon being broken down
explosive strength and maximization o short-term energy systems. Some o the major
enzymatically, yields energy for
changes measured as a result o anaerobic exercise include the ollowing: muscle contraction.
• Increased size and number of fast-twitch muscle fibers creatine phosphate (CP):
 A high-energy phosphate
• Increased tolerance to higher levels of blood lactate
molecule that is stored in cells
• Increases in enzymes involved in the anaerobic phase of glucose and can be used to immediately
breakdown (glycolysis) resynthesize ATP.

• Increased muscle resting levels of ATP, CP, creatine, and glycogen content
• Increased levels of growth hormone and testosterone after short bouts (45 to
75 min) of high-intensity weight training

ENERGY METABOLISM
Energy metabolism is a series o chemical reactions that result in the breakdown o
oodstuffs (carbohydrate, at, protein) by which energy is produced, used, and given
off as heat. Roughly, the body is about 20 percent efficient at trapping energy released.
About 80 percent is released as heat, which explains why your body heats up quickly
when you exercise. A closer look at muscle anatomy reveals that the mode o energy
storage and energy systems used is related to physical activity.
Physical activities can be classified into these our basic groups, based on the energy
systems that are used to support these activities:
• Strength/power: Energy coming from immediate ATP stores. Examples
include shot put, powerlift, high jump, golf swing, tennis serve, and a throw.
 Activities last about 0 to 3 seconds of maximal effort.
• Sustained power: Energy coming from immediate ATP and CP stores. Exam-
ples include sprints, fast breaks, football lineman. Activities last about 0 to 10
seconds of near-maximal effort.
• Anaerobic power/endurance: Energy coming from ATP, CP, and lactic
acid. Examples include 200- to 400-meter dash and 100-yard swim. Activities
lasting about 1 to 2 minutes.
• Aerobic endurance: Energy coming from the oxidative pathway. Activities
last over 2 minutes.

In power events, which last a ew seconds or less at maximal effort, the muscles
depend on the immediate energy system, namely AP and CP reserves. In speed
events, the immediate and non-oxidative (glycolytic) energy sources are utilized. In
endurance events, the immediate and non-oxidative energy sources are used, and the
oxidative energy mechanisms become a more important source o energy. AP and
CP are replenished rom energy derived rom complete breakdown o glucose, atty
acids, and some proteins.

ATP PRODUCTION
Adenosine triphosphate (AP) is the molecule that stores energy in a orm that can
be used or muscle contractions. Energy production then revolves around rebuilding
AP molecules afer they are broken down or energy utilization. Muscle cells store a
limited amount o AP. During exercise the body requires a constant supply o AP in

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20 | Unit 1

order to provide the energy needed or muscular contraction. Tereore, to maintain
a constant supply o energy, metabolic pathways must exist in the cell with the ability
to produce AP rapidly. Muscle cells can produce AP by any one o or a combination
o three metabolic pathways: the AP/CP pathway, the glycolytic pathway, and the
oxidative pathway.

 ATP/CP Energy Pathway

ATP/CP pathway: ATP and
CP provide anaerobic sources
of phosphate-bond energy. The
energy liberated from hydrolysis
(splitting) of CP re-bonds ADP
and Pi to form ATP.
Creatine phosphate (CP) is high-energy phosphate molecule that is stored in cells and
can be used to immediately re-synthesize AP. Te ATP/CP pathway (see Figure 1.2)
is anaerobic, which means it requires no oxygen or energy use. Tis energy pathway is
demonstrated in sports that require ballistic, explosive strength or maximal effort or
short periods o time, such as shot putting, pitching, weight lifing, and powerlifing.
AP is the energy source or all human movement. Te release o one o its three
phosphate molecules provides the energy or human movement. Unortunately,
muscle cells store only a limited supply o AP that is readily available or use (5
mmol/kg o muscle). In maximal efforts, it is totally gone within 1.26 seconds!
However, regardless o their intensity or length, all activities begin with this pathway.
With the help o an enzyme called myosin APase, AP loses one phosphate molecule
in order to release energy (see Equation 1.3).

myosin ATPase 
ATP ADP + Pi + Energy

Eq. 1.3 Pi: inorganic phosphate

 ADP + Pi is
resynthesized into

Pi
 ATP

CP from muscle
lends a phosphate
(Pi) to ADP
 ADP
 ATP losses
phosphate to
release energy

Energy for
muscle contraction

Figure 1.2 The ATP/CP energy pathway

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 Metabolism | 21

For short-term, high-intensity activities such as shot putting or throwing, this

pathway is enough. However, urther use in this pathway requires that the adenosine adenosine diphosphate
diphosphate (ADP; di = the two phosphate molecules lef afer one is lost) be re- (ADP): an organic compound
synthesized back to AP with the help o creatine phosphate (CP) and an enzyme in metabolism that functions in
the transfer of energy during the
called creatine kinase (see Equation 1.4). catabolism of glucose, formed
by the removal of a phosphate
molecule from adenosine
Creatine Kinase  triphosphate (ATP) and
ADP + CP ATP + Creatine composed of adenine, ribose,
and two phosphate groups.
Eq. 1.4

Like AP, CP is stored in small amounts (16 mmols/kg o muscle). As seen in Figure
1.3, CP stores all rapidly afer 10 seconds o maximal activity and are usually
completely depleted in under 60 seconds.
Whether or not you can increase your resting levels o AP through training has not
widely been studied or understood. Research has suggested that it is possible through
both weight training and aerobic training. However, this possibility is mainly because
o fiber hypertrophy (increase in size), thus more AP can be stored in type II than in type II muscle fibers
type I muscle fibers (considering the size and growth potential o type II fibers). (fast twitch): Muscle fiber
type that contracts quickly and
Perhaps an even bigger question than “how much?” or “can you increase?” is “how is used mostly in intensive,
quickly can AP and CP stores be replenished?” Although individual differences exist, short-duration exercises.
research has shown that AP stores can be ully restored within 3.5 minutes and CP type I muscle fibers
stores can be ully replenished within 8 minutes. (slow twitch): A muscle
 fiber characterized by its slow
speed of contraction and a high
capacity for aerobic glycolysis.
CP-Splitting

Glycolysis
Oxidation
  y
   l
  p
  p
  u
   S
  y
  g
  r
  e
  n
   E
   f
  o
   t
  n
  e
  c
  r
  e
   P

Time in Seconds

Figure 1.3 Pathways of muscular energetics

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22 | Unit 1
glycolytic pathway: A
metabolic process in which
glucose is broken down to
produce energy anaerobically.
gluconeogenesis: Chemical
process that converts lactate
and pyruvate back into glucose.
 When glycogen (sugar stored
in muscles) stores are low,
glucose for emergency energy
is synthesized from protein
and the glycerol portion of fat
molecules. This is one important
reason that ATP/CP athletes and
glycolytic athletes are warned to
stay away from undue aerobic
exercise: It’s muscle-wasting.
anaerobic threshold: The
point where increasing energy
demands of exercise cannot be
met by the use of oxygen, and
an oxygen debt begins to be
incurred.
oxidative pathway: A
metabolic process in which
oxygen combines with lactic
acid, resynthesizing glycogen to
produce energy aerobically.
Krebs cycle: Citric acid cycle;
a set of 8 reactions, arranged in
a cycle, in which free energy is
recovered in the form of ATP.
electron transport chain:
The passing of electrons over a
membrane, aiding in a reaction
to recover free energy for the
synthesis of ATP.
pyruvate: A byproduct of
glycolysis.
beta oxidation: A series of
reactions in which fatty acids are
broken down.
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Glycolytic Pathway
Like the AP/CP pathway, the glycolytic pathway is anaerobic. Once it has depleted
the readily available AP/CP stores, the body must break down carbohydrates to
produce more AP. Tis process uses either glycogen (which is stored in the muscle
cells) or glucose (which is ound in the blood) to convert ADP back into AP; the
waste product is lactic acid (see Equation 1.5).
Glucose + 2Pi + 2ADP + 2NAD+ 2 lactic acid + 2ATP + 2NAD
Eq. 1.5
Tis lactic acid eventually builds more quickly than it can be flushed out o the muscle
to the point o the anaerobic threshold, otherwise known as muscular atigue. At this
point, the body must either stop or slow down until the lactic acid is removed. Lactic
acid is converted to a less toxic orm, called lactate, which is used either as an energy
substrate or to produce more glucose (a process called gluconeogenesis). Getting
rid o lactic acid is not as important as it is how efficiently the body can use it. I you
produce lactic acid aster than you can use it, therein lies the problem. Stored sugars
are rarely ever depleted (and are never depleted in the glycolytic pathway). However,
this is not the limiting actor; the limiting actor is the accumulation o lactic acid.
Generally, the glycolytic pathway ends under maximal conditions at around 80
seconds beore the oxidative pathway (and lower levels o activity) takes over.
How well muscles function in the glycolytic pathway is determined by three
related factors:
• How quickly the body can utilize the lactic acid
• How well the body can tolerate the pain caused by the accumulation
of lactic acid
• How far the body can go before it becomes vital to clear the lactic acid in
order for work to continue. This is called the anaerobic threshold.
Blood lactate levels usually return to normal within a n hour afer activity. Research
shows that training can increase the rate in which lactic acid is utilized or removed as
well as push back the anaerobic threshold. As or the ability to tolerate the pain, it
comes with personal experience.
Oxidative Pathway
Te oxidative pathway is a system that is aerobic, which means it uses oxygen to
produce AP by way o the Krebs cycle and electron transport chain. Ultimately,
more AP is produced through this pathway than through the other two; however,
it takes much longer. Pyruvate, which is produced through glycolysis, undergoes
a long trip through the Krebs cycle to convert several coenzymes that have lost an
electron back into their original state. It is in the electron transport chain where these
coenzymes undergo oxidation to convert ADP back into AP. In the end, up to 38
molecules o AP can be produced through the oxidative pathway.
It is only in this pathway that at can be used or energy. Breaking down at or energy
is also a long process (called beta oxidation), which does not direct ly produce AP.
 Metabolism | 23

Rather, it provides the coenzymes needed or the Krebs

cycle. Scientists have estimated that while at rest (and in
the oxidative pathway), 70 percent o energy comes rom
at, not  carbohydrates or protein. However, as exercise
intensity increases, more and more carbohydrates are
used instead o at (beta oxidation can’t keep up). In act,
at the upper limits o the aerobic pathway, 100 percent o
the energy is coming rom carbohydrates—not  at! I at
these levels carbohydrates aren’t available, the body will
indeed catabolize the very muscle it’s using or energy.
How the Systems Interact
o better understand how each o these energy systems
relate to each other, you need to take a look at what
happens when muscles contract. First, consider the
immediate energy systems. Te brain sends a signal
along the nerves, triggering a release o calcium ions in
the muscles, which stimulates the muscles to contract
and, in the process, the high-energy molecule AP
releases energy and is reduced to ADP plus one phosphate

Contraction

Blood

 ADP + Pi Myosin ATPase

Creatine phosphate

Creatine  ATP Ca-ATPase

Relaxation

 Amino acids

Glycogen
Glucose Glycolysis Oxidative Proteins
phosphorylation

Lactic acid Fatty acids

Oxygen

Fatty
acids

MUSCLE FIBER

Figure 1.4 Pathway interactions

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24 | Unit 1
atom. In this way, the immediately available AP stores
are depleted very rapidly, in the first ew seconds o a
maximal muscle contraction.
Te second immediate source o cellular energy is creatine
phosphate (CP). Te cell contains several more times
CP molecules than AP molecules. Creatine phosphate
serves to instantaneously regenerate AP molecules.
Tereore, the AP that is broken down to ADP during
muscle contraction is restored to the high-energy AP by
CP. Te third immediate energy system enables the cell to
regenerate AP rom two ADP molecules, resulting in one
AP and one adenosine monophosphate (AMP) molecule.
Tis immediate energy source is depleted in a matter
o seconds under conditions o all-out effort (maximal
muscle contractions).
Te storage capacity o AP and CP in a cell is quickly
reached or a particular muscle size. In order to increase
the amount o AP and CP on hand, the muscle fibers
must increase in size. Tis is why power athletes get big
muscles. Te workload demands that more AP and CP be
available. o meet this demand, the muscle fibers increase
in size, causing the entire muscle to get big. When you
train, different energy systems are conditioned to work
best at the particular workload imposed on the muscles.
As the immediate energy supply is quickly depleted
through high-intensity physical activity, the non-oxidative
energy source kicks in. Te non-oxidative system is a
major contributor o energy during 4 to 50 seconds o
effort. Non-oxidative metabolism (glycolysis) involves the
breakdown o glucose to regenerate A DP into AP. Muscle
tissue is densely packed with non-oxidative enzyme
systems. What happens chemically is that the glucose
molecule is split in hal and energy is released. Tis energy
is enough to regenerate 2 AP molecules and leave two
Fitness: The Complete Guide
pyruvate molecules. In general, these pyruvate molecules
are immediately converted to lactic acid molecules. Te
amount o ree glucose is generally low in the cells, so
glucose is derived rom the breakdown o glycogen.
Fast-twitch muscle fibers (those associated with strength
and size) are also reerred to as ast glycolytic muscle
fibers, because they house the metabolic machinery to get
quick energy through ast glycolysis pathways. Te ast-
twitch fibers have a low capacity or oxidative metabolism
and are instead set up to ru n glucose through their ast
glycolysis pathways. Lactic acid then builds up because it
is being produced too rapidly to enter into the oxidative
pathways. Lactic acid is then cleared rom the muscle, ed
into the bloodstream, taken to the liver, and there made
into glucose and glycogen. Glycolysis takes place in the
cytoplasm o the cell.
For physical activities lasting more than 2 minutes, the
oxidative metabolic pathways produce the majority
o energy to maintain muscle contractions. Potential
oxidative energy sources include glucose, glycogen, ats,
and amino acids. Oxidative energy production takes
place in the mitochondria o the cells. Far more energy
is produced when glucose is completely broken down
in the mitochondria. Glucose is still first split in hal
by glycolysis. Te pyruvate molecules then enter into
the mitochondria, where they are completely broken
down. Te oxidative pathways are the Krebs cycle and
electron transport. Fatty acids, which come rom at,
are a major energy source during endurance events. Te
processes o at utilization are activated more slowly than
carbohydrate metabolism and proceed at a lower rate.
Fatty acids are activated and combined with the molecule
carnitine, which enables them to then be transported into
the mitochondria.

Glycogen Depletion
and Metabolism of Fatigue
Glycogen is essential to perormance or both anaerobic
and aerobic activities. Muscles being strenuously exercised
will rely on glycogen to power these strength-generating
muscle contractions. In endurance exercise, while the
primary uel is atty acids, glycogen is also utilized. In
act, at catabolism works better when carbohydrates
are being metabolized. Studies on long-term exercise
and work perormance all indicate the onset o atigue
when glycogen is depleted. Tis again underscores the
importance o adequate carbohydrate intake and glycogen
replenishment. Glycogen depletion is just one actor that
contributes to the onset o atigue. Several other atigue-
causing actors acing athletes include the ollowing:
• ATP and CP depletion
• Lactic acid accumulation
• Calcium ion buildup in muscles
• Oxygen depletion
• Blood pH decrease
Metabolism | 25
MONITORING METABOLISM
Until recently, there were no affordable and easy-to-use
home testing methods that were designed or athletes
to measure key metabolic parameters. Measuring the
state o nitrogen metabolism allows you to determine
whether protein intake is sufficient and also whether
certain supplements are being ingested in a mounts that
are sufficient or improving nitrogen balance. Currently
on the horizon is a newly developed testing device that
combines nitrogen balance testing with at metabolism
status. Tese tests measure the output o metabolic waste
products in uri ne. Tey are easy to use a nd offer a means
to finely tune your train ing and nutrition programs.
A product developed by B. Fritz and Dr. Fahey is a
testing method that was probably the best-kept secret o
Russian athletes. Tis test provides an economical way to
determine testosterone and cortisol levels in the body by
analysis o saliva. When t he body is over trained, cortisol
levels increase. Cortisol is a catabolic hormone that
stimulates the breakdown o muscle tissue. High amounts
in the blood ultimately lead to tissue wasting and negative
nitrogen balance. So, when the testosterone/cortisol
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26 | Unit 1
resting metabolic rate
(RMR): The amount of energy
(calories) required to efficiently
perform vital bodily functions
such as respiration, organ
 function and heart rate while the
body is awake, but at rest.
Fitness: The Complete Guide
ratio is high, anabolism is prevailing. However, when cortisol levels are high and the
ratio is lowered, it is an indication o overtraining. esting testosterone/cortisol ratio
helps you determine whether the body is in a state o overtraining or not. In this way,
you can determine how hard to train, whether to take a ew days off, or i tra ining
intensity should increase.
In addition, in the medical field and in many fitness centers, handheld portable
•
indirect calorimeters are used that measure oxygen consumption ( VO2) and
determine resting metabolic rate (RMR). As discussed earlier in this unit, the
rate o oxidation or the burning o the calories is different or at, carbohydrate, and
protein. Te ood you eat can either be burned to liberate energy, converted into body
weight, or be excreted. I you light a candle and then place a dome over the candle,
cutting off the fire’s source o oxygen, the fire will go out. In the same way the body’s
ability to undergo oxidation is contingent on oxygen. I the body is getting more
oxygen, it should be burning more calories.
Nutrition monitoring plays a vital role in the care o patients with diabetes, heart
disease, high blood pressure, and obesity, as well as conditions that place patients
at risk or malnutrition, such as cancer, burns, trauma, inection, obstructive lung
disease, and HIV. Indirect calorimeters can be used in acute care, long-term care,
home care, and clinic-based care settings such as physician offices, rehabilitation
centers, ambulatory surgery centers, and fitness-based acilities.
CONCLUSION
In order to maintain its many chemical and physical activities, the body needs energy.
Earth’s energy originates rom the sun. Plants use solar energy to perorm chemical
reactions to orm carbohydrates, at, and protein. Humans, like other animals,
consume plants and other animals to obtain the energy required to maintain cellular
activities. Tese cellular activities, k nown as metabolism, are maintained under
homeostatic controls. Te many chemical reactions occurring in the body must be
regulated in order to maintain a balance between the trillions o cells in the body.
Tese cells maintain balance through an intricate organization system. We will now
discuss this intricate organized system known as the body.
 Metabolism | 27

Key Terms
adenosine diphosphate (ADP) electron transport chain metabolism
adenosine triphosphate (ATP)  fatty acids oxidation
amino acid gluconeogenesis oxidative pathway
anabolism glucose pyruvate
anaerobic threshold glycolytic pathway respiratory quotient (RQ)
 ATP/CP pathway homeostasis resting metabolic rate (RMR)
basal metabolic rate (BMR) ketone bodies thermic effect
beta oxidation kilocalorie (kcal) training effect
branched-chain amino acids Krebs cycle type I muscle fibers
(BCAAs) (slow twitch)
lactic acid
calorie • type II muscle fibers
maximal oxygen uptake ( VO2 max)
(fast twitch)
catabolism
metabolic set point
creatine phosphate (CP)

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