FISIOLOGI

Metabolisme part 1:
Energy Balance
dr. Jauhar Firdaus, M.Biotek

FAKULTAS KEDOKTERAN UNIVERSITAS JEMBER - 2020

Energy Balance
 Appetite and Satiety
 Energy Balance
 Metabolism
 Fed-State Metabolism
 Fasted-State Metabolism
 Homeostatic Control of Metabolism
 Regulation of Body Temperature
Appetite and Satiety
 The control of food intake is a complex process.
 The digestive system does not regulate energy intake, so we must depend
on behavioral mechanisms, such as hunger and satiety { satis,enough}, to
tell us when and how much to eat.
 Psychological and social aspects of eating, such as parents who say “Clean
your plate,” complicate the physiological control of food intake.
 As a result, we still do not fully understand what governs when, what, and
how much we eat.
 Our current model for behavioral regulation of food intake is based on two hypothalamic
centers: a feeding center that is tonically active and a satiety center that stops food intake
by inhibiting the feeding center.
 Output signals from these centers cause changes in eating behavior and create sensations
of hunger and fullness.
 Animals whose feeding centers are destroyed cease to eat. If the satiety centers are
destroyed, animals overeat and become obese { obesus, plump or fat}.
 Many different chemical signals influence food intake and satiety, including
neuropeptides, “braingut” hormones secreted by the GI tract, and chemical signals called
adipocytokines , which are secreted by adipose tissue.
Two classic theories for regulation of food intake

 There are two classic theories for regulation of food intake: the glucostatic theory and
the lipostatic theory.
 Current evidence indicates that these two classic theories are too simple to be the only
models,
 The glucostatic theory states that glucose metabolism by hypothalamic centers regulates
food intake. When blood glucose concentrations decrease, the satiety center is
suppressed, and the feeding center is dominant. When glucose metabolism increases, the
satiety center inhibits the feeding center.
 The lipostatic theory of energy balance proposes that a signal from the body’s fat stores
to the brain modulates eating behavior so that the body maintains a particular weight.
If fat stores are increased, eating decreases. In times of starvation, eating increases.
Obesity results from disruption of this pathway
 Mass Balance ~ Energy Balance

 We can apply the concept of mass balance

to energy balance:
 changes to the body’s energy stores result
from the difference between the energy put
into the body and the energy used
 Energy intake for humans consists of
energy in the nutrients we eat, digest, and In the human body, at least half the energy
released in chemical reactions is lost to the
absorb.
environment as unregulated “waste” heat.
 Energy output is a combination of work
performed and energy returned to the
environment as heat
 The work in takes one of three forms :
1. Transport work moves molecules from one side of a membrane to the other. Transport processes
bring materials into and out of the body and transfer them between compartments.
2. Mechanical work uses intracellular fibers and filaments to create movement. This form of work
includes external work, such as movement created by skeletal muscle contraction, and internal
work, such as the movement of cytoplasmic vesicles and the pumping of the heart.
3. Chemical work is used for growth, maintenance, and storage of information and energy. Chemical
work in the body can be subdivided into synthesis and storage. Storage includes both short-term
energy storage in high-energy phosphate compounds such as ATP and long-term energy storage in
the chemical bonds of glycogen and fat.
Estimating Fat—The Body Mass Index
 One way to estimate the total amount of energy stored in the body is a person’s body
weight.
 when energy intake exceeds energy output, a person gains weight. If energy use exceeds
dietary energy input, the body taps into its energy stores and the person loses weight.
 One current assessment for healthy weight is a measurement known as the body mass
index , or BMI. To calculate your BMI:

 A BMI 18.5 - 24.9 is considered normal weight.

 <18.5 is underweight, and > 24.5 is overweight.
 A BMI > 30 indicates obesity
 The discrepancy of BMI calculations:
o BMI calculation does not distinguish between fat mass and muscle mass ex:
heavily muscled athletes, such as football players, may have a BMI that
seems unhealthy. Muscle tissue weighs more than fat
o BMI calculations also do not allow for diff erences due to age, gender, and
ethnicity
 Fat mass index (fat mass / height 2 ) is a better health indicator than BMI.
Oxygen Consumption Reflects Energy Use

 To compile an energy balance sheet for the human body, we must estimate both
the energy content of food (energy intake) and the energy expenditure from heat
loss and various types of work (energy output).
 Th e most direct way to measure the energycontent of food is by direct
calorimetry. In this procedure, food is burned in an instrument called a bomb
calorimeter, and the heat released is trapped and measured.
 Estimating an individual’s energy expenditure, or metabolic rate, is more
complex than figuring the caloric content of ingested food.
 Law of mass balance, a person’s caloric intake minus heat production is the
energy used for chemical, mechanical, and transport work
 the most common method for estimating metabolic rate is to measure a person’s
oxygen consumption, the rate at which the body consumes oxygen as it
metabolizes nutrients. The measurement of oxygen onsumption is one form of
indirect calorimetry
 Recall that metabolism of glucose to trap energy in the bonds of ATP is most effi
cient in the presence of adequate oxygen
 Metabolic rate is calculated by multiplying oxygen consumption by the number
of kilocalories metabolized per liter of oxygen consumed:

 A mixed diet with an RQ of 0.8 requires one liter of O 2 for each 4.80 kcal
metabolized. For a 70-kg male whose resting oxygen consumption is 430 L/day,
this means
Many Factors Influence Metabolic Rate
 Metabolic rate can be highly variable from one person to another or from day to day
in a single individual
 An individual’s lowest metabolic rate is considered the basal metabolic rate (BMR)
 In reality, metabolic rate would be lowest when an individual is asleep. However,
because measuring the BMR of a sleeping person is diffi cult, metabolic rate is oft
en measured after a 12-hour fast in a person who is awake but resting (a resting
metabolic rate, RMR ) .
Other factors that aff ect metabolic rate in humans include :

 Age and sex, Adult males have an average BMR of 1.0 kcal kcal/hr/kg.. Adult females
have a lower rate than males: 0.9 kcal/hr/kg. (adipose vs muscle)
 Amount of lean muscle mass, Muscle has higher oxygen consumption than adipose
tissue, even at rest
 activity level, Physical activity and muscle contraction increase metabolic rate over the
basal rate
 Diet . Resting metabolic rate increases after a meal, a phenomenon termed diet-induced
thermogenesis
 Hormones. Basal metabolic rate is increased by thyroid hormones and by catecholamines
(epinephrine and norepinephrine). Some of the peptides that regulate food intake also
appear to infl uence metabolism.
 Genetics
 Of the factors aff ecting metabolic rate, a person can voluntarily
control only two: energy intake (how much food is eaten) and level
of physical activity.
The more activities increase lean muscle mass, RMR goes up, the
more energy use and the less calories goes into storge
 Energy Is Stored in Fat and Glycogen
 Why does the body store most of its extra energy in fat and not in glycogen?
 Normally we keep about 100 g of glycogen in the liver and 200 g in skeletal muscles. But
even this 300 g of glycogen can provide only enough energy for 10 to 15 hours. The
brain alone requires 150 g of glucose per day.
 Consequently, the body keeps most of its energy reserves in compact, high-energy fat
molecules. One gram of fat has 9 kcal, more than twice the energy content of an equal
amount of carbohydrate or protein.
 Metabolically, however, the energy in fat is harder to access, and the metabolism of fats
is slower than that of carbohydrates.
Metabolism
 Metabolism is the sum of all chemical reactions in the body
 Metabolic pathways that synthesize large molecules from smaller ones are called anabolic
pathways { ana -, completion + metabole, change}.
 Those that break large molecules into smaller ones are called catabolic pathways { cata -,
down or back}.
 In the human body, we divide metabolism into two states.
1. The period of time following a meal, when the products of digestion are being
absorbed, used, and stored, is called the fed state or the absorptive state . This is an
anabolic state in which the energy of nutrient biomolecules is transferred to high-
energy compounds or stored in the chemical bonds of other molecules
2. Once nutrients from a recent meal are no longer in the bloodstream and available for
use by the tissues, the body enters what is called the fasted state or the
postabsorptive state. The fasted state is catabolic because cells break down large
molecules into smaller molecules. The energy released by breaking chemical bonds of large
molecules is used to do work.
Nutrient pools are nutrients that are available for immediate use. They are located primarily in the plasma.
Enzymes Control the Direction of Metabolism
 How does the body control the shift of
metabolism between the fed state and the
fasted state? One key feature of metabolic
regulation is the use of different
enzymes to catalyze forward and
reverse reactions. This dual control,
sometimes called push-pull control,
allows close regulation of a reaction’s
direction.
Fed-State Metabolism

 Carbohydrates Make ATP

 Amino Acids Make Proteins
 Fats Store Energy

If glucose intake is low, amino acids can be used for energy, However, if more
protein is ingested than is needed for synthesis and energy expenditures, excess
amino acids are converted to fat
Fasted-State Metabolism
 Lipids Store More Energy than
Glucose or Protein
 Lipids are the primary fuel-storage
molecule of the body because they
have higher energy content than
proteins or carbohydrates.
 When the fasted-state body needs to
use stored energy, lipases break
down triglycerides into glycerol
and fatty acids through a series of
reactions collectively known as
lipolysis
 Low Carbohydrate/ Ketogenic Diets
 Low-carbohydrate diets, such as the Atkins and South Beach diet plans, are ketogenic
because most of their calories come from fats. The diets are very low in carbohydrate and
high in fat and protein, which shifts metabolism to β-oxidation of fats and production of
ketone bodies. People who go on these diets are oft en pleased by initial rapid weight loss,
but it is due to glycogen breakdown and water loss, not body fat reduction.
 ketogenic diets can also be dangerous. Ketone bodies such as acetoacetic acid and β-
hydroxybutyric acid are strong metabolic acids that can seriously disrupt the body’s pH
balance and lead to a state of ketoacidosis a metabolic acidosis.
 Among the other risks associated with ketogenic diets are dehydration, electrolyte loss,
inadequate intake of calcium and vitamins, gout, and kidney problems
“
TERIMA KASIH
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