LWBK710-FM_i-xii.

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Essentials of Exercise Physiology

FOURTH EDITION

Victor L. Katch (Ann Arbor, MI)

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Frank I. Katch (Santa Barbara, CA)

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DEDICATION

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LWBK710-FM_i-xii.qxd 18/09/2010 00:26 Page iv Aptara

Preface

/…iÊvœÕÀ̅Êi`ˆÌˆœ˜ÊœvÊ ÃÃi˜Ìˆ>ÃʜvÊ ÝiÀVˆÃiÊ*…ÞȜœ}Þ Ài«ÀiÃi˜ÌÃÊ>˜ÊÕ«`>Ìi`]

Vœ“«>VÌÊÛiÀȜ˜ÊœvÊ̅iÊÃiÛi˜Ì…Êi`ˆÌˆœ˜ÊœvÊ ÝiÀVˆÃiÊ*…ÞȜœ}Þ\Ê ÕÌÀˆÌˆœ˜]Ê ˜iÀ}Þ]
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VœÕÀÃiʈ˜ÊiÝiÀVˆÃiÊ«…ÞȜœ}ÞʜÀʅi>Ì…‡Ài>Ìi`ÊÃVˆi˜Vi°Ê ÃÃi˜Ìˆ>ÃʜvÊ ÝiÀVˆÃi
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ORGANIZATION
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LWBK710-FM_i-xii.qxd 18/09/2010 00:26 Page v Aptara

Preface • v

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WORKBOOK FORMAT
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Highlights of New and

Expanded Content
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● 7…iÀiÊ>««ˆV>Li]ÊÜiʈ˜VÕ`iÊÀiiÛ>˜ÌʘÌiÀ˜iÌÊÜiLÈÌiÃÊÀi>Ìi`Ê̜ÊiÝiÀ‡

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Special Features
●
œÃiÊ1«Ê œÝið /…ˆÃÊ«œ«Õ>ÀÊvi>ÌÕÀiÊvœVÕÃiÃʜ˜Ê̈“iÞÊ>˜`ʈ“«œÀÌ>˜Ì
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LWBK710-FM_i-xii.qxd 18/09/2010 00:26 Page vi Aptara

vi • Preface

● +ÕiÃ̈œ˜ÃÊEÊ œÌið /…ˆÃÊvi>ÌÕÀiÊv>VˆˆÌ>ÌiÃÊÃÌÕ`i˜Ìʏi>À˜ˆ˜}ÊLÞÊvœVÕȘ}

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LWBK710-FM_i-xii.qxd 18/09/2010 00:27 Page vii Aptara

User’s Guide

ÃÃi˜Ìˆ>ÃʜvÊ ÝiÀVˆÃiÊ*…ÞȜœ}Þ ]Ê{̅Êi`ˆÌˆœ˜]ÊÜ>ÃÊVÀi>Ìi`Ê>˜`Ê`iÛiœ«i`Ê>ÃÊ>

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viii • User’s Guide

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LWBK710-FM_i-xii.qxd 18/09/2010 00:27 Page ix Aptara

User’s Guide • ix

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STUDENT RESOURCES
˜Ãˆ`iÊ̅iÊvÀœ˜ÌÊVœÛiÀʜvÊޜÕÀÊÌiÝÌLœœŽÊޜÕÊ܈Êvˆ˜`ÊޜÕÀÊ«iÀܘ>Ê>VViÃÃÊVœ`i
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LWBK710-FM_i-xii.qxd 18/09/2010 00:27 Page x Aptara

Acknowledgments

/…iÊvœÕÀ̅Êi`ˆÌˆœ˜ÊœvÊ ÃÃi˜Ìˆ>ÃʜvÊ ÝiÀVˆÃiÊ*…ÞȜœ}Þ Ài«ÀiÃi˜ÌÃÊ>ÊÌi>“ÊivvœÀÌ°

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LWBK710-FM_i-xii.qxd 18/09/2010 00:27 Page xi Aptara

Contents

Dedication ˆˆˆ
Preface ˆÛ
User’s Guide ۈˆ
Acknowledgments Ý

SECTION I
INTRODUCTION TO EXERCISE PHYSIOLOGY £

1. Origins of Exercise Physiology: Foundations

for the Field of Study Î

SECTION II
NUTRITION AND ENERGY Σ

2. Macronutrients and Micronutrients ÎÎ

3. Food Energy and Optimum Nutrition
for Exercise n£
4. Nutritional and Pharmacologic
Aids to Performance £ä™

SECTION III
ENERGY TRANSFER £{™

5. Fundamentals of Human Energy Transfer £x£

6. Human Energy Transfer During Exercise £nx
7. Measuring and Evaluating Human Energy-
Generating Capacities During Exercise ÓäÎ
8. Energy Expenditure During Rest and
Physical Activity ÓÎÇ

xi
LWBK710-FM_i-xii.qxd 18/09/2010 00:27 Page xii Aptara

xii • Contents

SECTION IV
THE PHYSIOLOGIC SUPPORT SYSTEMS ÓÈÎ

9. The Pulmonary System and Exercise ÓÈx

10. The Cardiovascular System and Exercise 늣
11. The Neuromuscular System and Exercise ÎÎÇ
12. Hormones, Exercise, and Training ÎÇÇ

SECTION V
EXERCISE TRAINING AND ADAPTATIONS {äÇ

13. Training the Anaerobic and

Aerobic Energy Systems {ä™
14. Training Muscles to Become Stronger {{Î
15. Factors Affecting Physiologic Function:
The Environment and Special Aids
to Performance {™Î

SECTION VI
OPTIMIZING BODY COMPOSITION,
SUCCESSFUL AGING, AND
HEALTH-RELATED EXERCISE BENEFITS xΣ

16. Body Composition, Obesity, and

Weight Control xÎÎ
17. Physical Activity, Exercise, Successful
Aging, and Disease Prevention x™x
18. Clinical Aspects of Exercise Physiology ÈΣ

Appendix

A. The Metric System and Conversion

Constants in Exercise Physiology Èș
B. Metabolic Computations in Open-Circuit
Spirometry ÈÇÓ
C. Evaluation of Body Composition—
Girth Method ÈÇÈ
D. Evaluation of Body Composition—
Skinfold Method ÈnÎ

Index Ènx
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S E C T I O N
I
Introduction
to Exercise
Physiology
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2 • SECTION I Introduction to Exercise Physiology

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Origins of Exercise
C h a p t e r
1
Physiology:
Foundations for
the Field of Study
CHAPTER OBJECTIVES

• Briefly outline Galen’s contributions to health and
scientific hygiene.
• Discuss the beginnings of the development of
exercise physiology in the United States.
• Describe the creation of the Harvard Fatigue Labora-
tory, its major scientists, and its contributions to the
field of exercise physiology.
• Describe the different jobs of an exercise physiologist.

• Discuss the contributions of George Wells Fitz to the • Discuss the roles of social networking and how they
evolution of the academic field of exercise physiology. relate to exercise physiologists.

• List contributions of Nordic scientists to the field of • List two of the most prominent exercise physiology
exercise physiology. professional organizations.

• Outline the course of study for the first academic

4-year program in the United States from the Depart-
ment of Anatomy, Physiology, and Physical Training at
Harvard University.

3
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4 • SECTION I Introduction to Exercise Physiology

INTRODUCTION
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Chapter 1 Origins of Exercise Physiology: Foundations for the Field of Study • 7

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10 • SECTION I Introduction to Exercise Physiology

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12 • SECTION I Introduction to Exercise Physiology

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Chapter 1 Origins of Exercise Physiology: Foundations for the Field of Study • 13

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Prelude to Exercise Science: Harvard’s Department

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14 • SECTION I Introduction to Exercise Physiology

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Chapter 1 Origins of Exercise Physiology: Foundations for the Field of Study • 15

BOX 1.2 CLOSE UP

What’s in a Name?

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20 • SECTION I Introduction to Exercise Physiology

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(1743–1794) (1872–1947) (1855–1911) (1860–1936) (1884–1951)

Nathan Zuntz Carl von Voit Max Rubner Max von Pettenkofer Eduard F.W. Pflüger
(1847–1920) (1831–1908) (1854–1932) (1818–1901) (1829–1910)
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Chapter 1 Origins of Exercise Physiology: Foundations for the Field of Study • 21

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22 • SECTION I Introduction to Exercise Physiology

An Example from This Section

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,ÆÊÜÜÜ°>>…«iÀ`°œÀ}É®°
Snook GA. The father of sports medicine (Galen). 1˜ÌˆÊ̅iÊi>ÀÞÊ£™xäÃ]Ê̅iÊ

*
,ÊÀi«ÀiÃi˜Ìi`Ê̅iÊ«Ài‡
Am. J. Sports Med., 6(3):128–131, 1978. `œ“ˆ˜>˜ÌÊ«ÀœviÃȜ˜>ÊœÀ}>˜ˆâ>̈œ˜ÊvœÀÊiÝiÀVˆÃiÊ«…ÞȜœ‡
Although there were many physicians who treated }ˆÃÌðÊ
ÃÊ̅iÊvˆi`ÊiÝ«>˜`i`Ê>˜`Ê`ˆÛiÀÈvˆi`ʈÌÃÊvœVÕÃ]
athletes before Galen, I believe that he was the first Ãi«>À>ÌiÊ«ÀœviÃȜ˜>ÊœÀ}>˜ˆâ>̈œ˜ÊÜ>Ãʘii`i`Ê̜ʓœÀiÊvՏÞ
to devote a major portion of his time to this field of Ài뜘`Ê̜ʫÀœviÃȜ˜>Ê˜ii`ðʘʣ™x{]ÊœÃi«…Ê7œvvi]Ê]
endeavor. Furthermore, his systematic observations, >˜`Ê££ÊœÌ…iÀÊ«…ÞÈVˆ>˜Ã]Ê«…ÞȜœ}ˆÃÌÃ]Ê>˜`Ê«…ÞÈV>Êi`ÕV>‡
his aggressive pursuit of newer and better ways of ̜ÀÃÊvœÕ˜`i`Ê̅iÊ
“iÀˆV>˜Ê
œi}iʜvÊ-«œÀÌÃÊi`ˆVˆ˜i
treatment, his teaching, and his publishing of his obser- ­

-ÆÊÜÜÜ°>VÓ°œÀ}®°Ê*ÀiÃi˜ÌÞ]Ê̅iÊ

-ʅ>ÃʓœÀiÊ̅>˜
vations make him a kindred soul to the team physician Óä]äääʓi“LiÀÃʈ˜ÊÇxÊVœÕ˜ÌÀˆiÃ]ʈ˜VÕ`ˆ˜}Ê£x]äääÊ

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and practitioners of sports medicine of today. It is for
iÀ̈vˆi`Ê*ÀœviÃȜ˜>ÃÊ>˜`ÊÈxääÊVœ˜viÀi˜ViÊ>ÌÌi˜`iiÃÊ­>Ãʜ
these reasons that I believe that he can justly be called "V̜LiÀÊÓä䙮°Ê/…iÊ

-ʘœÜÊÀi«ÀiÃi˜ÌÃÊ̅iʏ>À}iÃÌÊ«Àœ‡
the “Father of Sports Medicine.” viÃȜ˜>ÊœÀ}>˜ˆâ>̈œ˜Êˆ˜Ê̅iÊܜÀ`ÊvœÀÊiÝiÀVˆÃiÊ«…ÞȜœ}Þ
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Chapter 1 Origins of Exercise Physiology: Foundations for the Field of Study
BOX 1.3 CLOSE UP
How to Discern Reliable Historical Research
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26 • SECTION I Introduction to Exercise Physiology

Table 1.1 Partial List of Employment Opportunities for Qualified Exercise Physiologists

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Chapter 1 Origins of Exercise Physiology: Foundations for the Field of Study • 27

Table 1.2 Organizations Offering Training or Certification Programs Related to Physical Activity
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28 • SECTION I Introduction to Exercise Physiology

Major Knowledge and Competency Health/Fitness Director /…iʓˆ˜ˆ“Õ“Êi`ÕV>̈œ˜>

Table 1.3 Areas Required for Individuals «ÀiÀiµÕˆÃˆÌiÊvœÀÊ i>Ì…Ɉ̘iÃÃÊˆÀiV̜À ViÀ̈vˆV>̈œ
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ˆ˜ÌiÀiÃÌ°Ê Table 1.3 «ÀiÃi˜ÌÃÊVœ˜Ìi˜ÌÊ>Ài>ÃÊvœÀÊ`ˆvviÀi˜Ì Exercise Test Technologist ÝiÀVˆÃiÊ/iÃÌÊ/iV…‡

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S E C T I O N
II
Nutrition
and Energy
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«ÀœÌiˆ˜Ã]ÊۈÌ>“ˆ˜Ã]ʓˆ˜iÀ>Ã]Ê>˜`ÊÜ>ÌiÀ°Ê1˜`iÀÃÌ>˜`ˆ˜}Êi>V…ʘÕÌÀˆi˜Ì½ÃÊÀœiʈ˜
i˜iÀ}ÞʓiÌ>LœˆÃ“Ê>˜`Ê̈ÃÃÕiÊÃޘ̅iÈÃÊV>ÀˆvˆiÃʜ˜i½Ãʎ˜œÜi`}iʜvÊ̅iʈ˜ÌiÀ>V What is a scientist after all? It is a
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«ÀœvœÕ˜`ÞÊ>vviVÌÊiÝiÀVˆÃiÊV>«>VˆÌÞ]ÊÌÀ>ˆ˜ˆ˜}ÊÀi뜘ÈÛi˜iÃÃ]Ê>˜`Ê̅iÊ«œÌi˜Ìˆ>Ê̜ keyhole, the keyhole of nature,
>V…ˆiÛiÊ«œÃˆÌˆÛiʅi>Ì…ÊœÕÌVœ“iðÊ
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31
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7 Ç£ä‡VäÓÚΣ‡nä°µÝ`ÊʙɣxÉ£äÊʙ\£™Ê
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C h a p t e r
2
Macronutrients
and Micronutrients
CHAPTER OBJECTIVES

• Distinguish differences among monosaccharides,
disaccharides, and polysaccharides.
• Discuss carbohydrates’ role as an energy source, pro-
tein sparer, metabolic primer, and central nervous
system fuel.
• Define and give an example of a triacylglycerol, satu-
rated fatty acid, polyunsaturated fatty acid, monounsat-
urated fatty acid, and trans-fatty acid.
• Outline three broad roles of minerals in the body.
• Define osteoporosis, exercise-induced anemia, and
sodium-induced hypertension.
• Describe how regular physical activity affects bone
mass and the body’s iron stores.
• Outline factors related to the female athlete triad.
• List the functions of water in the body.

• List major characteristics of high- and low-density
lipoprotein cholesterol and discuss the role of each in
coronary heart disease.
• List four important functions of fat in the body.
• Define essential and non-essential amino acids and
give food sources for each.
• Define heat cramps, heat exhaustion, and heat stroke.
• Explain factors that affect gastric emptying and fluid
replacement.
• List five predisposing factors to hyponatremia with
prolonged exercise.

• List one function for each fat- and water-soluble

vitamin and explain the potential risks of consuming
these micronutrients in excess.

33
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34 • SECTION II Nutrition and Energy
Part 1 Macronutrients:
Energy Fuel and Building
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Chapter 2 Macronutrients and Micronutrients • 35

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36 • SECTION II Nutrition and Energy

BOX 2.1 CLOSE UP

Health Implications of Dietary Fiber

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ÕÌÀˆÌˆœ˜Ê œ>À`ʜvÊ̅iÊ >̈œ˜>Ê
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vœÀÊܜ“i˜Êœ`iÀÊ̅>˜Ê>}iÊxäÊÞi>Àð >Ã°Ê/…iÊvˆ}ÕÀiÊLiœÜʅˆ}…ˆ}…ÌÃÊ̅iÊvˆLiÀÊVœ˜Ìi˜ÌÊ
ˆLiÀÃʅœ`ÊVœ˜Ãˆ`iÀ>LiÊÜ>ÌiÀÊ>˜`Ê}ˆÛiʺLՏŽ»Ê̜Ê̅i Vœ““œ˜Êvœœ`ÃʏˆÃÌi`ÊLÞʜÛiÀ>ÊvˆLiÀÊVœ˜Ìi˜Ì°Ê œÌiÊ̅>
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Food
܏ÕLiÊvˆLiÀà “>Þʓœ`‡ Fiber One Bran Cereal, 1 cup
iÃ̏ÞÊÀi`ÕViÊÃiÀՓÊV…œ‡ Avocado, whole
iÃÌiÀœ°Ê/…iÃiʈ˜VÕ`i Rice bran, 1 oz
«iV̈˜Ê>˜`Ê}Õ>ÀÊ}Փ Pinto beans, dry, cooked, 1 cup
«ÀiÃi˜Ìʈ˜Êœ>ÌÃÊ­Àœi` 100% Bran cereal, 1 cup
œ>ÌÃ]ʜ>ÌÊLÀ>˜]ʜ>ÌÊvœÕÀ® Lima beans, fresh, cooked, 1 cup
i}ՓiÃ]ÊL>ÀiÞ]ÊLÀœÜ˜ Longanberries, fresh, 1 cup
ÀˆVi]Ê«i>Ã]ÊV>ÀÀœÌÃ]Ê>˜` Pumpkin pie, 1 slice
`ˆÛiÀÃiÊvÀՈÌð Spaghetti, whole wheat, 1 cup
œÀ “i˜ ܈̅ ii‡ Pear, Bartlett, 1
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Apple, 1 small
̅iˆÀÊ`>ˆÞÊ`ˆiÌÃÊÀi`ÕVi`
Strawberries, fresh, 1 cup
ÃiÀՓÊV…œiÃÌiÀœÊiÛiÃ
Potato, 1 small
LÞʣίÊ>˜`ʏœÜiÀi`Ê̅i
Almonds, dried, 1 oz
œÜ‡`i˜ÃˆÌÞʏˆ«œ«ÀœÌiˆ˜
Broccoli, raw, 1 cup
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V…œiÃÌiÀœÊ«Àœvˆi°Ê
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Strawberries, 3/4 cup
Carrot, 1 medium
Whole wheat toast, 1 slice
Seven grain bread, 1 slice
Banana, 1 small
Spaghetti, 1/2 cup
Danish pastry, plain, 1
White bread, 1 slice
0 2.5 5.0 7.5 10.0 12.5 15.0 17.5 20.0 22.5 25.0
Dietary Fiber, g
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Chapter 2 Macronutrients and Micronutrients • 37

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ÞÈÃÊ>˜`Ê}ÕVœ˜iœ}i˜iÈð

Diet Affects Glycogen Stores /…iÊLœ`ÞÊÃ̜ÀiÃÊVœ“«>À>̈ÛiÞʏˆÌ̏i

}ÞVœ}i˜ÊÜÊ`ˆiÌ>ÀÞʈ˜Ì>ŽiÊV>˜ÊVœ˜Ãˆ`iÀ>LÞÊ>vviVÌʈÌÃʵÕ>˜ÌˆÌÞ°ÊœÀÊiÝ>“«i]Ê>
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vœÀÊ̅iÊ>ÛiÀ>}iÊÇ䇎}ʓ>˜ÊœÀÊn{äÊ}ÊvœÀÊ>ÊÌÞ«ˆV>ÊxȇŽ}Êܜ“>˜°Ê/œÊiÃ̈“>ÌiÊ
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Carbohydrates’ Role in the Body

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}ÕVœ˜iœ}i˜iÈÃÊÃޘ̅iÈâiÃÊ}ÕVœÃiÊvÀœ“Ê«ÀœÌiˆ˜Ê­>“ˆ˜œÊ>Vˆ`îÊ>˜`Ê̅i )-0/24!.4 #!2"/(9$2!4%
}ÞViÀœÊ«œÀ̈œ˜ÊœvÊ̅iÊv>ÌʓœiVՏiÊ­ÌÀˆ>Vޏ}ÞViÀœ®°Ê/…ˆÃʓiÌ>LœˆV #/.6%23)/.3
«ÀœViÃÃʈ˜VÀi>ÃiÃÊV>ÀLœ…Þ`À>ÌiÊ>Û>ˆ>LˆˆÌÞÊ>˜`ʓ>ˆ˜Ì>ˆ˜ÃÊ«>Ó> Glucogenesis—Glycogen synthesis
}ÕVœÃiʏiÛiÃÊ՘`iÀÊ̅ÀiiÊVœ˜`ˆÌˆœ˜Ã\Ê from glucose (glucose m glycogen)
>° ˆiÌ>ÀÞÊÀiÃÌÀˆV̈œ˜ Gluconeogenesis—Glucose synthesis
L° *Àœœ˜}i`ÊiÝiÀVˆÃi largely from structural components
V° ,i«i>Ìi`ÊLœÕÌÃʜvʈ˜Ìi˜ÃiÊÌÀ>ˆ˜ˆ˜} of noncarbohydrate nutrients (pro-
ΰ iÌ>LœˆVÊ«Àˆ“iÀ° Þ«Àœ`ÕVÌÃʜvÊV>ÀLœ…Þ`À>ÌiÊLÀi>Ž`œÜ˜ÊÃiÀÛiÊ>ÃÊ> tein m glucose)
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38 • SECTION II Nutrition and Energy
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Fuel for the Central Nervous System /…iÊVi˜‡
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Recommended Carbohydrate Intake
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All Carbohydrates are Not Physiologically

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Chapter 2 Macronutrients and Micronutrients • 39

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ˆ˜VÀi>Ãiʈ˜ÃՏˆ˜ÊÃi˜ÃˆÌˆÛˆÌÞ°

A Role in Obesity?
LœÕÌÊÓx¯ÊœvÊ̅iÊ>`ՏÌÊ«œ«Õ>̈œ˜Ê«Àœ`ÕViÃÊiÝViÇ

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40 • SECTION II Nutrition and Energy

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42 • SECTION II Nutrition and Energy

High- and Low-Density Lipoprotein Choles-

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Derived Lipids
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Chapter 2 Macronutrients and Micronutrients • 43

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Fish Oils (and Fish) Are Healthful

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44 • SECTION II Nutrition and Energy

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triacylglycerols
>ÀÌiÀˆ>ÊÜ>Ã°ÊÌʓ>ÞÊ>ÃœÊˆ˜…ˆLˆÌÊ̅iÊ}ÀœÜ̅ʜvÊ>̅iÀœÃVi‡
300 g (2700 kCal)
ÀœÌˆVÊ«>µÕiÃ]ÊÀi`ÕViʫՏÃiÊ«ÀiÃÃÕÀiÊ>˜`Ê̜Ì>ÊÛ>ÃVՏ>À
ÀiÈÃÌ>˜ViÊ­ˆ˜VÀi>ÃiÊ>ÀÌiÀˆ>ÊVœ“«ˆ>˜Vi®]Ê>˜`ÊÃ̈“Տ>Ìi Plasma Plasma FFA
i˜`œÌ…iˆ>‡`iÀˆÛi`ʘˆÌÀˆVʜ݈`iÊ­ÃiiÊ
…>«ÌiÀÊ£ä®Ê̜Êv>Vˆˆ‡ triacylglycerols 0.4 g (3.6 kCal)
Ì>ÌiʓޜV>À`ˆ>Ê«iÀvÕȜ˜°Ê/…iʜˆ½ÃʏœÜiÀˆ˜}ÊivviVÌʜ˜ÊÌÀˆ>‡ 4.0 g (36 kCal)
Vޏ}ÞViÀœÊ«ÀœÛˆ`iÃÊ>``ˆÌˆœ˜>Ê…i>ÀÌÊ`ˆÃi>ÃiÊ«ÀœÌiV̈œ˜°
Total 12,304 g (110,700 kCal)
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Lipid’s Role in the Body nä¯Ê̜ʙä¯ÊœvÊ̅iÊLœ`Þ½ÃÊi˜iÀ}ÞÊÀiµÕˆÀi“i˜ÌðÊ"˜iÊ}ʜv
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Chapter 2 Macronutrients and Micronutrients • 45

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46 • SECTION II Nutrition and Energy

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Chapter 2 Macronutrients and Micronutrients • 47

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Essential and Non-essential Amino Acids /…iÊLœ`ÞÊÀiµÕˆÀiÃÊÓä

`ˆvviÀi˜ÌÊ>“ˆ˜œÊ>Vˆ`Ã]Ê>Ì…œÕ}…ÊÌi˜ÃʜvÊ̅œÕÃ>˜`ÃʜvÊ̅iÊÃ>“iÊ>“ˆ˜œÊ>Vˆ`Ãʓ>Þ
Vœ“Lˆ˜iʈ˜Ê>ÊȘ}iÊ«ÀœÌiˆ˜ÊVœ“«œÕ˜`°Ê"vÊ̅iÊ`ˆvviÀi˜ÌÊ>“ˆ˜œÊ>Vˆ`Ã]Êiˆ}…Ì
­˜ˆ˜iʈ˜Êˆ˜v>˜ÌîÊV>˜˜œÌÊLiÊÃޘ̅iÈâi`ʈ˜Ê̅iÊLœ`ÞÊ>ÌÊ>ÊÃÕvvˆVˆi˜ÌÊÀ>ÌiÊ̜ʫÀi
&OR 9OUR )NFORMATION
Ûi˜Ìʈ“«>ˆÀ“i˜ÌʜvʘœÀ“>ÊViÕ>ÀÊv՘V̈œ˜°Ê/…iÃiʓ>ŽiÊÕ«Ê̅iʈ˜`ˆÃ«i˜Ã>Li 4(% .).% %33%.4)!, !-)./ !#)$3
œÀÊiÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`à LiV>ÕÃiÊ̅iÞʓÕÃÌÊLiʈ˜}iÃÌi`Ê«ÀivœÀ“i`ʈ˜Êvœœ`ð 1. Histidine (infants)
/…iÊLœ`Þʓ>˜Õv>VÌÕÀiÃÊ̅iÊÀi“>ˆ˜ˆ˜}Ê£ÓÊ ˜œ˜‡iÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`ð /…ˆÃ 2. Leucine
`œiÃʘœÌʓi>˜Ê̅iÞÊ>ÀiÊ՘ˆ“«œÀÌ>˜ÌÆÊÀ>̅iÀ]Ê̅iÞÊvœÀ“ÊvÀœ“ÊVœ“«œÕ˜`à 3. Lysine
>Ài>`ÞÊi݈Ã̈˜}ʈ˜Ê̅iÊLœ`ÞÊ>ÌÊ>ÊÀ>ÌiÊ̅>ÌʓiiÌÃÊ`i“>˜`ÃÊvœÀʘœÀ“>Ê}ÀœÜ̅ 4. Isoleucine
>˜`Ê̈ÃÃÕiÊÀi«>ˆÀ° 5. Methionine

˜ˆ“>ÃÊ>˜`Ê«>˜ÌÃʓ>˜Õv>VÌÕÀiÊ«ÀœÌiˆ˜ÃÊ̅>ÌÊVœ˜Ì>ˆ˜ÊiÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`ð 6. Phenylalanine
œÊ…i>Ì…ÊœÀÊ«…ÞȜœ}ˆV>Ê>`Û>˜Ì>}iÊVœ“iÃÊvÀœ“Ê>˜Ê>“ˆ˜œÊ>Vˆ`Ê`iÀˆÛi`ÊvÀœ“Ê>˜Ê>˜ˆ‡ 7. Threonine
“>ÊVœ“«>Ài`Ê܈̅Ê̅iÊÃ>“iÊ>“ˆ˜œÊ>Vˆ`Ê`iÀˆÛi`ÊvÀœ“ÊÛi}iÌ>LiʜÀˆ}ˆ˜° *>˜ÌÃÊÃޘ‡ 8. Tryptophan
̅iÈâiÊ«ÀœÌiˆ˜Ê­>˜`Ê̅ÕÃÊ>“ˆ˜œÊ>Vˆ`îÊLÞʈ˜VœÀ«œÀ>̈˜}ʘˆÌÀœ}i˜ÊvÀœ“Ê̅iÊ܈ 9. Valine
­>œ˜}Ê܈̅ÊV>ÀLœ˜]ʜÝÞ}i˜]Ê>˜`ʅÞ`Àœ}i˜ÊvÀœ“Ê>ˆÀÊ>˜`ÊÜ>ÌiÀ®°Ê˜ÊVœ˜ÌÀ>ÃÌ]
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48 • SECTION II Nutrition and Energy

Sources of Proteins
/…iÊÌܜʫÀœÌiˆ˜ÊÜÕÀViÃʈ˜VÕ`iÊ̅œÃiʈ˜Ê̅iÊ`ˆiÌÊ>˜`Ê̅œÃi
Ãޘ̅iÈâi`ʈ˜Ê̅iÊLœ`Þ°

Dietary Sources
œ“«iÌiÊ«ÀœÌiˆ˜ÃÊ>ÀiÊvœÕ˜`ʈ˜
i}}Ã]ʓˆŽ]ʓi>Ì]ÊvˆÃ…]Ê>˜`Ê«œÕÌÀÞ°Ê }}ÃÊ«ÀœÛˆ`iÊ̅iʜ«Ìˆ
“>Ê“ˆÝÌÕÀiʜvÊiÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`ÃÊ>“œ˜}Êvœœ`ÊÜÕÀViÃÆ
…i˜Vi]Êi}}ÃÊÀiViˆÛiÊ̅iʅˆ}…iÃÌʵÕ>ˆÌÞÊÀ>̈˜}ÊVœ“«>Ài`
4 R group or ܈̅ʜ̅iÀÊvœœ`ðÊ*ÀiÃi˜ÌÞ]Ê>“œÃÌÊÌܜ‡Ì…ˆÀ`ÃʜvÊ`ˆiÌ>ÀÞ
1 Central
hydrocarbon H H
R side chain «ÀœÌiˆ˜Êˆ˜Ê̅iÊ1˜ˆÌi`Ê-Ì>ÌiÃÊVœ“iÃÊvÀœ“Ê>˜ˆ“>ÊÜÕÀViÃ]
group C ܅iÀi>ÃʙäÊÞi>ÀÃÊ>}œ]Ê«ÀœÌiˆ˜ÊVœ˜ÃՓ«Ìˆœ˜ÊœVVÕÀÀi`
H iµÕ>ÞÊvÀœ“Ê«>˜ÌÃÊ>˜`Ê>˜ˆ“>Ã°Ê,iˆ>˜Viʜ˜Ê>˜ˆ“>
H

N C O
2 NH2 (amine) ÜÕÀViÃÊvœÀÊ`ˆiÌ>ÀÞÊ«ÀœÌiˆ˜Ê>VVœÕ˜ÌÃÊvœÀÊ>ÊÀi>̈ÛiÞʅˆ}…
group H
VÕÀÀi˜Ìʈ˜Ì>ŽiʜvÊV…œiÃÌiÀœÊ>˜`ÊÃ>ÌÕÀ>Ìi`Êv>ÌÌÞÊ>Vˆ`ð
O
H
/…iʺLˆœœ}ˆVÊÛ>Õi» œÀÊ«ÀœÌiˆ˜ÊÀ>̈˜}ʜvÊvœœ`ÊÀiviÀÃÊ̜
3 COOH (carboxyl) ˆÌÃÊVœ“«iÌi˜iÃÃÊvœÀÊÃÕ««Þˆ˜}ÊiÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`ðÊ
˜ˆ‡
group “>ÊÜÕÀViÃÊVœ˜ÌÀˆLÕÌiʅˆ}…‡µÕ>ˆÌÞÊ«ÀœÌiˆ˜]Ê܅iÀi>ÃÊÛi}‡
iÌ>LiÃÊ­i˜ÌˆÃ]Ê`Àˆi`ÊLi>˜ÃÊ>˜`Ê«i>Ã]ʘÕÌÃ]Ê>˜`ÊViÀi>Ã®
Ài“>ˆ˜Êˆ˜Vœ“«iÌiʈ˜Êœ˜iʜÀʓœÀiʜvÊ̅iÊiÃÃi˜Ìˆ>Ê>“ˆ˜œ
>Vˆ`ÃÆÊ̅ÕÃ]Ê̅iÃiÊÀ>ÌiʏœÜiÀʈ˜ÊLˆœœ}ˆVÊÛ>Õi°Ê >̈˜}Ê>
Û>ÀˆiÌÞʜvÊ«>˜ÌÊvœœ`ÃÊ­}À>ˆ˜Ã]ÊvÀՈÌÃ]Ê>˜`ÊÛi}iÌ>Liî]Êi>V…
«ÀœÛˆ`ˆ˜}Ê>Ê`ˆvviÀi˜ÌʵÕ>ˆÌÞÊ>˜`ʵÕ>˜ÌˆÌÞʜvÊ>“ˆ˜œÊ>Vˆ`Ã]
Vœ˜ÌÀˆLÕÌiÃÊ>ÊœvÊ̅iÊÀiµÕˆÀi`ÊiÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`ð
Table 2.2 ˆÃÌÃÊiÝ>“«iÃʜvÊVœ““œ˜Êvœœ`ÊÜÕÀViÃʜvÊ«Àœ‡
Ìiˆ˜Ê>˜`Ê̅iˆÀÊÀi>̈ÛiÊ«ÀœÌiˆ˜ÊÀ>̈˜}°Ê
Figure 2.10 œÕÀÊVœ““œ˜Êvi>ÌÕÀiÃʜvÊ>“ˆ˜œÊ>Vˆ`ð
Synthesis in the Body ˜âޓiÃʈ˜Ê“ÕÃViÊv>VˆˆÌ>Ìi
˜ˆÌÀœ}i˜ÊÀi“œÛ>ÊvÀœ“ÊViÀÌ>ˆ˜Ê>“ˆ˜œÊ>Vˆ`ÃÊ>˜`ÊÃÕLÃi‡
>˜ˆ“>ÃÊ`œÊ˜œÌÊ«œÃÃiÃÃÊ>ÊLÀœ>`ÊV>«>LˆˆÌÞÊvœÀÊ«ÀœÌiˆ˜ÊÃޘ̅i‡ µÕi˜ÌÞÊ«>ÃÃʘˆÌÀœ}i˜Ê̜ʜ̅iÀÊVœ“«œÕ˜`Ãʈ˜Ê̅iÊLˆœV…i“‡
ÈÃÆÊ̅iÞʜLÌ>ˆ˜Ê“ÕV…ÊœvÊ̅iˆÀÊ«ÀœÌiˆ˜ÊvÀœ“ʈ˜}iÃÌi`ÊÜÕÀVið ˆV>ÊÀi>V̈œ˜ÃʜvÊÌÀ>˜Ã>“ˆ˜>̈œ˜ ˆÕÃÌÀ>Ìi`ʈ˜ÊFigure 2.12.

œ˜ÃÌÀÕV̈˜}Ê>ÊLœ`ÞÊ«ÀœÌiˆ˜ÊÀiµÕˆÀiÃÊëiVˆvˆVÊ>“ˆ˜
˜Ê>“ˆ˜iÊ}ÀœÕ«ÊňvÌÃÊvÀœ“Ê>Ê`œ˜œÀÊ>“ˆ˜œÊ>Vˆ`Ê̜Ê>˜
>Vˆ`Ê>Û>ˆ>LˆˆÌÞÊ>ÌÊ̅iÊ̈“iʜvÊ«ÀœÌiˆ˜ÊÃޘ̅iÈðÊ
œ“«iÌi >VVi«ÌœÀÊ>Vˆ`]Ê>˜`Ê̅iÊ>VVi«ÌœÀÊ̅ÕÃÊLiVœ“iÃÊ>ʘiÜÊ>“ˆ˜œ
«ÀœÌiˆ˜Ã œÀʅˆ}…iÀʵÕ>ˆÌÞÊ«ÀœÌiˆ˜ÃÊVœ“iÊvÀœ“Êvœœ`ÃÊ܈̅ >Vˆ`°Ê /…ˆÃÊ>œÜÃÊ>“ˆ˜œÊ>Vˆ`ÃÊ̜ÊvœÀ“ÊvÀœ“ʘœ˜q˜ˆÌÀœ}i˜‡
>ÊœvÊ̅iÊiÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`Ãʈ˜Ê̅iˆÀÊVœÀÀiVÌÊÀ>̈œ°Ê/…ˆÃ V>ÀÀވ˜}ʜÀ}>˜ˆVÊVœ“«œÕ˜`ÃÊ}i˜iÀ>Ìi`ʈ˜Ê“iÌ>LœˆÃ“°
“>ˆ˜Ì>ˆ˜ÃÊ«ÀœÌiˆ˜ÊL>>˜ViÊ>˜`Ê>œÜÃÊ̈ÃÃÕiÊ}ÀœÜ̅Ê>˜` i>“ˆ˜>̈œ˜ Ài«ÀiÃi˜ÌÃÊ̅iʜ««œÃˆÌiÊ«ÀœViÃÃÊ̜ÊÌÀ>˜Ã‡
Ài«>ˆÀ°Ê
˜Ê ˆ˜Vœ“«iÌiÊ«ÀœÌiˆ˜ œÀʏœÜiÀʵÕ>ˆÌÞÊ«ÀœÌiˆ˜ >“ˆ˜>̈œ˜°ÊÌʈ˜ÛœÛiÃÊÀi“œÛ>ÊœvÊ>˜Ê>“ˆ˜iÊ}ÀœÕ«ÊvÀœ“Ê̅i
>VŽÃʜ˜iʜÀʓœÀiʜvÊ̅iÊiÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`ðÊˆiÌÃÊ̅>Ì >“ˆ˜œÊ>Vˆ`ʓœiVՏi]Ê܈̅Ê̅iÊÀi“>ˆ˜ˆ˜}ÊV>ÀLœ˜ÊÎii̜˜
Vœ˜Ì>ˆ˜Ê“œÃ̏Þʈ˜Vœ“«iÌiÊ«ÀœÌiˆ˜ÊiÛi˜ÌÕ>ÞÊ«Àœ`ÕViÊ«Àœ‡ Vœ˜ÛiÀ̈˜}Ê̜Ê>ÊV>ÀLœ…Þ`À>ÌiʜÀʏˆ«ˆ`ʜÀÊLiˆ˜}ÊÕÃi`ÊvœÀ
Ìiˆ˜Ê“>˜ÕÌÀˆÌˆœ˜Ê`iëˆÌiÊ̅iÊvœœ`ÊÜÕÀVi½ÃÊ>`iµÕ>VÞÊvœÀ i˜iÀ}Þ°Ê/…iÊVi>Ûi`Ê>“ˆ˜iÊ}ÀœÕ«ÊvœÀ“ÃÊÕÀi>ʈ˜Ê̅iʏˆÛiÀÊvœÀ
i˜iÀ}ÞÊ>˜`Ê«ÀœÌiˆ˜ÊµÕ>˜ÌˆÌÞ° iÝVÀÊLÞÊ̅iʎˆ`˜iÞðÊ1Ài>ʓÕÃÌÊ`ˆÃ܏Ûiʈ˜ÊÜ>ÌiÀ]ÊÜ

Rating of Common Sources of

Alanine Table 2.2
Dietary Protein
⒩ ⒩ ⒰
Amino acid side Organic acid "" *,"/  Ê,
/ 
⒩ ⒤ ⒤ ⒤ ⒰⒩
chain group
⒩ }}à £ää
⒯ ˆÃ… Çä
⒩ ⒩ i>˜ÊLiiv ș
Amine group
œÜ½ÃʓˆŽ Èä
ÀœÜ˜ÊÀˆVi xÇ
Figure 2.11
…i“ˆV>ÊÃÌÀÕVÌÕÀiʜvÊ̅iÊVœ““œ˜]ʘœ˜‡ 7…ˆÌiÊÀˆVi xÈ
iÃÃi˜Ìˆ>Ê>“ˆ˜œÊ>Vˆ`Ê>>˜ˆ˜i°Ê
˜ˆ“>ÊÜÕÀViÃʜvÊ̅ˆÃÊ>“ˆ˜œÊ>Vˆ` -œÞLi>˜Ã {Ç
ˆ˜VÕ`iʓi>Ì]ÊÃi>vœœ`]ÊV>Ãiˆ˜>Ìi]Ê`>ˆÀÞÊ«Àœ`ÕVÌÃ]Êi}}Ã]ÊvˆÃ…] ÀiÜiÀ½Ãʅ>Å {x
>˜`Ê}i>̈˜°Ê6i}iÌ>Àˆ>˜ÊÜÕÀViÃʈ˜VÕ`iÊLi>˜Ã]ʘÕÌÃ]ÊÃii`Ã]ÊÜÞ] 7…œi‡}À>ˆ˜Ê܅i>Ì {{
܅iÞ]ÊLÀiÜiÀ½ÃÊÞi>ÃÌ]ÊLÀœÜ˜ÊÀˆViÊLÀ>˜]ÊVœÀ˜]ʏi}ՓiÃ]Ê>˜`Ê *i>˜ÕÌà {Î
܅œiÊ}À>ˆ˜Ã° ÀÞÊLi>˜Ã Î{
7…ˆÌiÊ«œÌ>̜ Î{
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Chapter 2 Macronutrients and Micronutrients • 49

O H H H O
HO C C C C C OH O H H H O
+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
H H N HO C C C C C OH iÃVÀˆLiÊ>ÊVœ“«iÌiÊ«ÀœÌiˆ˜°
H H H H
Glutamate Alpha-ketoglutarate
Transamination
H O O H H O
H C C C OH H C C C OH iÃVÀˆLiÊÌÀ>˜Ã>“ˆ˜>̈œ˜°
H H N
Pyruvate H H
Alanine

iÃVÀˆLiÊ`i>“ˆ˜>̈œ˜°

Figure 2.12 /…iÊLˆœV…i“ˆV>Ê«ÀœViÃÃʜvÊÌÀ>˜Ã>“ˆ˜>̈œ˜Ê«ÀœÛˆ`iÃÊvœÀÊ̅iʈ˜ÌÀ>“ÕÃVՇ

>ÀÊÃޘ̅iÈÃʜvÊ>“ˆ˜œÊ>Vˆ`ÃÊvÀœ“ʘœ˜«ÀœÌiˆ˜ÊÜÕÀViðÊ
˜Ê>“ˆ˜iÊ}ÀœÕ«ÊvÀœ“Ê>Ê`œ˜œÀ
}ÀœÕ«ÊÌÀ>˜ÃviÀÃÊ̜Ê>˜Ê>VVi«ÌœÀ]ʘœ˜q˜ˆÌÀœ}i˜‡Vœ˜Ì>ˆ˜ˆ˜}Ê>Vˆ`Ê̜ÊvœÀ“Ê>ʘiÜÊ>“ˆ˜œÊ>Vˆ`°

iÝViÃÈÛiÊ«ÀœÌiˆ˜ÊV>Ì>LœˆÃ“Ê­ˆ˜ÛœÛˆ˜}ʈ˜VÀi>Ãi`Ê`i>“ˆ˜>̈œ˜®Ê«Àœ“œÌiÃÊvÕˆ
œÃð
œÀÊ`i>“ˆ˜>̈œ˜Ê>˜`ÊÌÀ>˜Ã>“ˆ˜>̈œ˜]Ê̅iÊÀi“>ˆ˜ˆ˜}ÊV>ÀLœ˜ÊÎii̜˜ÊœvÊ̅i
˜œ˜‡˜ˆÌÀœ}i˜œÕÃÊ>“ˆ˜œÊ>Vˆ`ÊÀiÈ`ÕiÊvÕÀ̅iÀÊ`i}À>`iÃÊ`ÕÀˆ˜}Êi˜iÀ}ÞʓiÌ>Lœ‡
ˆÃ“°Ê˜ÊÜi‡˜œÕÀˆÃ…i`ʈ˜`ˆÛˆ`Õ>ÃÊ>ÌÊÀiÃÌ]Ê«ÀœÌiˆ˜ÊLÀi>Ž`œÜ˜Ê­ V>Ì>LœˆÃ“®
Vœ˜ÌÀˆLÕÌiÃÊLiÌÜii˜ÊÓ¯Ê̜Êx¯ÊœvÊ̅iÊLœ`Þ½ÃÊ̜Ì>Êi˜iÀ}ÞÊÀiµÕˆÀi“i˜Ì°ÊÕÀˆ˜}ʈÌÃ
V>Ì>LœˆÃ“] «ÀœÌiˆ˜ÊvˆÀÃÌÊ`i}À>`iÃʈ˜ÌœÊˆÌÃÊ>“ˆ˜œÊ>Vˆ`ÊVœ“«œ˜i˜ÌðÊ/…iʏˆÛi
̅i˜ÊÃÌÀˆ«ÃÊ̅iʘˆÌÀœ}i˜ÊvÀœ“Ê̅iÊ>“ˆ˜œÊ>Vˆ`ʓœiVՏiʭۈ>Ê`i>“ˆ˜>̈œ˜®Ê̜
vœÀ“ÊÕÀi>Ê­Ó
" Ó®ÊvœÀÊiÝVÀ°

Protein’s Role in the Body

œÊLœ`ÞʺÀiÃiÀۜˆÀûʜvÊ«ÀœÌiˆ˜Êi݈ÃÌÆÊ>Ê«ÀœÌiˆ˜ÊVœ˜ÌÀˆLÕÌiÃÊ̜Ê̈ÃÃÕiÊÃÌÀÕV‡
ÌÕÀiÃʜÀÊi݈ÃÌÃÊ>ÃÊVœ˜Ã̈ÌÕi˜ÌÃʜvʓiÌ>LœˆV]ÊÌÀ>˜Ã«œÀÌ]Ê>˜`ʅœÀ“œ˜>ÊÃÞÃÌi“ð
*ÀœÌiˆ˜ÊVœ˜Ã̈ÌÕÌiÃÊLiÌÜii˜Ê£Ó¯Ê>˜`Ê£x¯ÊœvÊ̅iÊLœ`Þʓ>ÃÃ]ÊLÕÌʈÌÃÊVœ˜Ìi˜Ìʈ˜
`ˆvviÀi˜ÌÊViÃÊÛ>ÀˆiÃÊVœ˜Ãˆ`iÀ>LÞ°Ê
ÊLÀ>ˆ˜ÊVi]ÊvœÀÊiÝ>“«i]ÊVœ˜Ì>ˆ˜Ãʜ˜Þ
>LœÕÌÊ£ä¯Ê«ÀœÌiˆ˜]ÊLÕÌÊ«ÀœÌiˆ˜ÊÀi«ÀiÃi˜ÌÃÊÕ«Ê̜ÊÓä¯ÊœvÊ̅iʓ>ÃÃʜvÊÀi`ÊLœœ` &OR 9OUR )NFORMATION
ViÃÊ>˜`ʓÕÃViÊViÃ°Ê/…iÊÃÞÃÌi“>̈VÊ>««ˆV>̈œ˜ÊœvÊÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜} &!4% /& !-)./ !#)$3 !&4%2
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œvÊ̅iÊLœ`Þ½ÃÊ̜Ì>Ê«ÀœÌiˆ˜° After deamination, the remaining

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Ê>˜`Ê
]Ê̅i carbon skeletons of the !-keto acids
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˜iÕÀœÌÀ>˜Ã“ˆÌÌiÀÊÃiÀœÌœ˜ˆ˜°Ê
“ˆ˜œÊ>Vˆ`ÃÊ>V̈Û>ÌiÊۈÌ>“ˆ˜ÃÊ̅>ÌÊ«>ÞÊ>ʎiÞÊÀœi distinct biochemical routes:
ˆ˜Ê“iÌ>LœˆVÊ>˜`Ê«…ÞȜœ}ˆVÊÀi}Տ>̈œ˜° 1. ÕVœ˜iœ}i˜iÈ×18 of the 20
/ˆÃÃÕiÊÃޘ̅iÈÃÊ­>˜>LœˆÃ“® >VVœÕ˜ÌÃÊvœÀʓœÀiÊ̅>˜Êœ˜i‡Ì…ˆÀ`ʜvÊ̅iÊ«Àœ‡ amino acids serve as a source for
Ìiˆ˜Êˆ˜Ì>ŽiÊ`ÕÀˆ˜}ÊÀ>«ˆ`Ê}ÀœÜ̅ʈ˜Êˆ˜v>˜VÞÊ>˜`ÊV…ˆ`…œœ`°Ê
ÃÊ}ÀœÜ̅ÊÀ>Ìi glucose synthesis.
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œ˜‡ 2. ˜iÀ}ÞÊÜÕÀVi—The carbon skele-
̈˜Õ>ÊÌÕÀ˜œÛiÀʜvÊ̈ÃÃÕiÊ«ÀœÌiˆ˜ÊœVVÕÀÃÊ܅i˜Ê>Ê«iÀܘÊ>ÌÌ>ˆ˜Ãʜ«Ìˆ“>ÊLœ`ÞÊÈâi tons oxidize for energy because
>˜`Ê}ÀœÜ̅ÊÃÌ>LˆˆâiðÊ
`iµÕ>ÌiÊ«ÀœÌiˆ˜Êˆ˜Ì>ŽiÊÀi«>ViÃÊ̅iÊ>“ˆ˜œÊ>Vˆ`ÃÊVœ˜‡ they form intermediates in citric
̈˜Õ>ÞÊ`i}À>`i`ʈ˜Ê̅iÊÌÕÀ˜œÛiÀÊ«ÀœViÃð acid cycle metabolism or related
*ÀœÌiˆ˜ÃÊÃiÀÛiÊ>ÃÊ«Àˆ“>ÀÞÊVœ˜Ã̈ÌÕi˜ÌÃÊvœÀÊ«>Ó>ʓi“LÀ>˜iÃÊ>˜`ʈ˜ÌiÀ˜> molecules.
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“i˜ÌÃ]Ê>˜`Ê}œLՏ>ÀÊ«ÀœÌiˆ˜ÃÊVœ“«ÀˆÃiÊ̅iʘi>ÀÞÊÓäääÊ`ˆvviÀi˜ÌÊi˜âޓiÃÊ̅>Ì to synthesize fatty acids.
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50 • SECTION II Nutrition and Energy

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Ìiˆ˜ÃÊ>ÃœÊÀi}Տ>ÌiÊ̅iÊ>Vˆ`qL>ÃiʵÕ>ˆÌÞʜvÊ̅iÊLœ`ÞÊvÕˆ`Ã
܅ˆV…ÊVœ˜ÌÀˆLÕÌiÃÊ̜ʘiÕÌÀ>ˆâˆ˜}Ê­LÕvviÀˆ˜}®ÊiÝViÃÃÊ>Vˆ`
“iÌ>LœˆÌiÃÊvœÀ“i`Ê`ÕÀˆ˜}Êۈ}œÀœÕÃÊiÝiÀVˆÃi°

Vegetarian Approach to Sound Nutrition

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ÀiÃi˜ÌÊviÜiÀÊ̅>˜Ê£¯ÊœvÊ̅iÊ1°-°Ê«œ«Õ>̈œ˜]Ê>Ì…œÕ}…
˜i>ÀÞÊ£ä¯ÊœvÊ
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˜Êˆ˜VÀi>Ș}ʘՓLiÀʜvÊVœ“«ï̈ÛiÊ>˜`ÊV…>“«ˆœ˜
>̅iÌiÃÊVœ˜ÃՓiÊ`ˆiÌÃÊVœ˜ÃˆÃ̈˜}Ê«Ài`œ“ˆ˜>ÌiÞʜvʘÕÌÀˆ‡
i˜ÌÃÊvÀœ“ÊÛ>Àˆi`Ê«>˜ÌÊÜÕÀViÃ]ʈ˜VÕ`ˆ˜}ÊܓiÊ`>ˆÀÞÊ>˜`
“i>ÌÊ«Àœ`ÕVÌðÊ
œ˜Ãˆ`iÀˆ˜}Ê̅iÊ̈“iÊÀiµÕˆÀi`ÊvœÀÊÌÀ>ˆ˜ˆ˜}
44% Meat, fish, poultry, eggs 7% Fruits, vegetables
>˜`ÊVœ“«ï̈œ˜]Ê>̅iÌiÃʜvÌi˜Êi˜VœÕ˜ÌiÀÊ`ˆvvˆVՏÌÞʈ
24% Dairy 5% Beans, peas, nuts
«>˜˜ˆ˜}]ÊÃiiV̈˜}]Ê>˜`Ê«Ài«>Àˆ˜}ʘÕÌÀˆÌˆœÕÃʓi>ÃÊvÀœ“ 19% Cereal 1% Fats, oils
«Ài`œ“ˆ˜>˜ÌÞÊ«>˜ÌÊÜÕÀViÃÊ܈̅œÕÌÊÀiÞˆ˜}ʜ˜ÊÃÕ««i‡
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œ˜ÌÀˆLṎœ˜ÊvÀœ“Ê̅iʓ>œÀÊvœœ`ÊÜÕÀViÃÊ̜Ê̅i
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܅ˆV…ʈÃÊVÀÕVˆ>Ê܅i˜ÊÌÀ>ˆ˜ˆ˜}ʈ˜Ìi˜ÃiÞ°Ê 6i}iÌ>Àˆ>˜‡ÌÞ«i
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Recommended Protein Intake
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iÌ>Àˆ>˜½Ãʓ>ˆ˜Ê˜ÕÌÀˆÌˆœ˜>ÊVœ˜ViÀ˜°Ê
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Table 2.3 Recommended Protein Intake for Adolescent and Adult Men and Women
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Chapter 2 Macronutrients and Micronutrients • 51

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Chapter 2 Macronutrients and Micronutrients • 53

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“>VÀœ˜ÕÌÀˆi˜ÌÃʘiViÃÃ>ÀˆÞÊÀiµÕˆÀi`ÊvœÀÊ«…ÞÈV>ÞÊ>V̈Ûi «iÀܘÊ܅œÊÜ>˜ÌÃÊ̜ʈ˜VÀi>ÃiʓÕÃViʓ>ÃÃÊ̅ÀœÕ}…
ˆ˜`ˆÛˆ`Õ>Ã¶ ÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}°

Part 2 Micronutrients:
Facilitators of Energy Transfer
and Tissue Synthesis

VITAMINS
&OR 9OUR )NFORMATION
The Nature of Vitamins .!452!, 6%2353 ,!"/2!4/29
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/…iÊvœÀ“>Ê`ˆÃVœÛiÀÞʜvÊۈÌ>“ˆ˜ÃÊÀiÛi>i`Ê̅>ÌÊ̅iÊLœ`ÞÊÀiµÕˆÀiÃÊ̅iÃiÊiÃÃi˜Ìˆ>
œÀ}>˜ˆVÊÃÕLÃÌ>˜ViÃʈ˜Ê“ˆ˜ÕÌiÊ>“œÕ˜ÌÃÊ̜ʫiÀvœÀ“Ê…ˆ}…ÞÊëiVˆvˆVʓiÌ>Lœˆ No difference exists between a
v՘V̈œ˜Ã°Ê6ˆÌ>“ˆ˜Ã]ʜvÌi˜ÊVœ˜Ãˆ`iÀi`Ê>VViÃÜÀÞʘÕÌÀˆi˜ÌÃ]Ê`œÊ˜œÌ «iÀvœÀ“Ê̅iÃi vitamin obtained naturally from food
̅ÀiiÊVœ““œ˜ÞÊ>ÃÃՓi`Êv՘V̈œ˜Ã\Ê and a vitamin produced synthetically.
Manufacturers gain huge profits in
£° -Õ««ÞÊi˜iÀ}Þ°
advertising vitamins as “natural” or
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“organically isolated,” yet such
ΰ
œ˜ÌÀˆLÕÌiÊÃÕLÃÌ>˜Ìˆ>ÞÊ̜Ê̅iÊLœ`Þ½Ãʓ>Ãð
vitamins are chemically identical to

Ê«Àœœ˜}i`ʈ˜>`iµÕ>Ìiʈ˜Ì>ŽiʜvÊ>Ê«>À̈VՏ>ÀÊۈÌ>“ˆ˜ÊV>˜ÊÌÀˆ}}iÀÊÃޓ«Ìœ“à those synthesized in the laboratory.
œvÊۈÌ>“ˆ˜Ê`ivˆVˆi˜VÞÊ>˜`ʏi>`Ê̜ÊÃiÛiÀiʓi`ˆV>ÊVœ“«ˆV>̈œ˜Ã°ÊœÀÊiÝ>“«i
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54 • SECTION II Nutrition and Energy

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Table 2.4
Fat-Soluble Vitamins for Healthy Adults (Ages 19–50 Years)a
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Chapter 2 Macronutrients and Micronutrients • 55

Food Sources, Major Bodily Functions, and Symptoms of Deficiency or Excess

Table 2.5
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56 • SECTION II Nutrition and Energy
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Eye function: A
Teeth: A, D, C

Blood clotting: K

Blood Cells: E

Skin: A, C, B6,
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steroids, A, B6
pantothenic acid,
norepinephrine, thyroxine

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A, riboflavin Neuromuscular function:
A, B6, B12, thiamine,
Bones: A, D, C niacin, pantothenic acid

Blood formation: Cell membranes: E

B6, B12, C, folate

Energy release: thiamine,

riboflavin, niacin, biotin,
B6, pantothenic acid

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Chapter 2 Macronutrients and Micronutrients • 57

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iÝViÃÃÊ܈̅Ê̅iʅœ«iʜvÊi˜…>˜Vˆ˜}ÊiÝiÀVˆÃiÊ«iÀvœÀ“>˜ViÊ>˜`ÊÌÀ>ˆ˜ˆ˜}ÊÀi뜘ÈÛi‡
˜iÃðÊœÀiÊ̅>˜ÊxxÊÞi>ÀÃʜvÊÀiÃi>ÀV…Ê`>Ì>Ê`œÊ˜œÌÊ«ÀœÛˆ`iÊiۈ`i˜ViÊ̅>ÌÊVœ˜ÃՓˆ˜}ÊۈÌ>‡
“ˆ˜Ê­>˜`ʓˆ˜iÀ>®ÊÃÕ««i“i˜ÌÃʈ“«ÀœÛiÃÊiÝiÀVˆÃiÊ«iÀvœÀ“>˜Vi]Ê̅iʅœÀ“œ˜>Ê>˜`
“iÌ>LœˆVÊÀi뜘ÃiÃÊ̜ÊiÝiÀVˆÃi]ʜÀÊ̅iÊ>LˆˆÌÞÊ̜ÊÌÀ>ˆ˜Ê>À`՜ÕÏÞÊ>˜`ÊÀiVœÛiÀÊvÀœ“ÊÃÕV…
ÌÀ>ˆ˜ˆ˜}ʈ˜Ê…i>Ì…ÞÊ«iÀܘÃÊ܈̅ʘÕÌÀˆÌˆœ˜>Þ
>`iµÕ>ÌiÊ`ˆiÌð 7…i˜ÊۈÌ>“ˆ˜q“ˆ˜iÀ>Ê`ivˆ
Vˆi˜VˆiÃÊ>««i>Àʈ˜Ê«…ÞÈV>ÞÊ>V̈ÛiÊ«iœ«i] &OR 9OUR )NFORMATION
̅iÞʜvÌi˜ÊœVVÕÀÊ>“œ˜}Ê̅iÃiÊ̅ÀiiÊ}ÀœÕ«Ã\Ê 2)#( $)%4!29 3/52#%3 /& !.4)/8)$!.4 6)4!-).3
£° 6i}iÌ>Àˆ>˜ÃʜÀÊ}ÀœÕ«ÃÊ܈̅ʏœÜ • "-carotene (best known of the pigmented compounds or carotenoids give
i˜iÀ}Þʈ˜Ì>ŽiÊÃÕV…Ê>ÃÊ`>˜ViÀÃ]Ê}ޓ‡ color to yellow, orange, and green leafy vegetables and fruits): Carrots;
˜>ÃÌÃ]Ê>˜`ÊÜiˆ}…̇V>ÃÃÊëœÀÌ dark-green leafy vegetables such as spinach, broccoli, turnips, beet, and
>̅iÌiÃÊ܅œÊÃÌÀˆÛiÊ̜ʓ>ˆ˜Ì>ˆ˜ÊœÀ collard greens; sweet potatoes; winter squash; and apricots, cantaloupe,
Ài`ÕViÊLœ`ÞÊÜiˆ}…Ì° mangos, and papaya
Ó° ˜`ˆÛˆ`Õ>ÃÊ܅œÊiˆ“ˆ˜>Ìiʜ˜iʜÀ • Vitamin C: Citrus fruits and juices; cabbage, broccoli, and turnip greens;
“œÀiÊvœœ`Ê}ÀœÕ«ÃÊvÀœ“Ê̅iˆÀÊ`ˆiÌ° cantaloupe; green and red sweet peppers; and berries
ΰ ˜`ˆÛˆ`Õ>ÃÊ­i°}°]Êi˜`ÕÀ>˜ViÊ>̅iÌiî • Vitamin E: Poultry, seafood, vegetable oils, wheat germ, fish liver oils,
܅œÊVœ˜ÃՓiʏ>À}iÊ>“œÕ˜ÌÃʜv whole-grain breads and fortified cereals, nuts and seeds, dried beans, green
«ÀœViÃÃi`Êvœœ`ÃÊ>˜`Êȓ«iÊÃÕ}>Àà leafy vegetables, and eggs
܈̅ʏœÜʓˆVÀœ˜ÕÌÀˆi˜ÌÊ`i˜ÃˆÌÞ°Ê
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«Ì>À>

58 • SECTION II Nutrition and Energy

BOX 2.2 CLOSE UP

Increased Metabolism During Exercise and
Free Radical Production

ÝiÀVˆÃiÊ«Àœ`ÕViÃÊÀi>V̈ÛiʜÝÞ}i˜Êˆ˜Ê>Ìʏi>ÃÌÊÌܜÊÜ>Þ𠈓«œÀÌ>˜ÌÊ«ÀœÌiV̈ÛiÊv՘V̈œ˜Ã°Ê/…iÃiÊ>˜ÌˆœÝˆ`>˜ÌÊۈÌ>‡
/…iÊvˆÀÃÌʜVVÕÀÃÊۈ>Ê>˜ÊiiVÌÀœ˜Êi>ŽÊˆ˜Ê̅iʓˆÌœV…œ˜`Àˆ> “ˆ˜ÃÊ«ÀœÌiVÌÊ̅iÊ«>Ó>ʓi“LÀ>˜iÊLÞÊÀi>V̈˜}Ê܈̅Ê>˜`
«ÀœL>LÞÊ>ÌÊ̅iÊVÞ̜V…Àœ“iʏiÛi]Ê̜ʫÀœ`ÕViÊÃÕ«iÀœÝˆ`i Ài“œÛˆ˜}ÊvÀiiÊÀ>`ˆV>ÃÊ̜ÊõÕiV…Ê̅iÊV…>ˆ˜ÊÀi>V̈œ˜°
À>`ˆV>Ã°Ê/…iÊÃiVœ˜`ʜVVÕÀÃÊ`ÕÀˆ˜}Ê>ÌiÀ>̈œ˜Ãʈ˜ÊLœœ`
vœÜÊ>˜`ʜÝÞ}i˜ÊÃÕ««Þp՘`iÀ«iÀvÕȜ˜Ê`ÕÀˆ˜}ʈ˜Ìi˜Ã
iÝiÀVˆÃiÊvœœÜi`ÊLÞÊÃÕLÃÌ>˜Ìˆ>ÊÀi«iÀvÕȜ˜Êˆ˜ÊÀiVœÛiÀÞp
܅ˆV…ÊÌÀˆ}}iÀÊiÝViÃÈÛiÊvÀiiÊÀ>`ˆV>Ê}i˜iÀ>̈œ˜°Ê/…i
Àiˆ˜ÌÀœ`ÕV̈œ˜ÊœvʓœiVՏ>ÀʜÝÞ}i˜Êˆ˜ÊÀiVœÛiÀÞÊ>Ãœ
«Àœ`ÕViÃÊÀi>V̈ÛiʜÝÞ}i˜ÊëiVˆiÃÊ̅>ÌÊV>ÕÃiʜ݈`>̈Ûi
ÃÌÀiÃðÊ-œ“iÊ>À}ÕiÊ̅>ÌÊ̅iÊ«œÌi˜Ìˆ>ÊvœÀÊvÀiiÊÀ>`ˆV>
`>“>}iʈ˜VÀi>ÃiÃÊ`ÕÀˆ˜}ÊÌÀ>Փ>]ÊÃÌÀiÃÃ]Ê>˜`ʓÕÃVi
`>“>}iÊ>˜`ÊvÀœ“Êi˜ÛˆÀœ˜“i˜Ì>Ê«œÕÌ>˜ÌÃ]ʈ˜VÕ`ˆ˜}
Ӝ}°
/…iÊÀˆÃŽÊœvʜ݈`>̈ÛiÊÃÌÀiÃÃʈ˜VÀi>ÃiÃÊ܈̅ʈ˜Ìi˜Ãi
iÝiÀVˆÃi° ݅>ÕÃ̈ÛiÊi˜`ÕÀ>˜ViÊiÝiÀVˆÃiÊLÞÊ՘ÌÀ>ˆ˜i`
«iÀܘÃÊ«Àœ`ÕViÃʜ݈`>̈ÛiÊ`>“>}iʈ˜Ê̅iÊ>V̈ÛiʓÕÃVið
˜Ìi˜ÃiÊÀiÈÃÌ>˜ViÊiÝiÀVˆÃiÊ>ÃœÊˆ˜VÀi>ÃiÃÊvÀiiÊÀ>`ˆV>Ê«Àœ‡
`ÕV̈œ˜]ʈ˜`ˆÀiV̏Þʓi>ÃÕÀi`ÊLÞʓ>œ˜`ˆ>`i…Þ`i]Ê̅i
ˆ«ˆ`Ê«iÀœÝˆ`>̈œ˜ÊLÞ«Àœ`ÕVÌ°Ê6>Àˆ>̈œ˜Ãʈ˜ÊiÃÌÀœ}i˜Êiۇ
iÃÊ`ÕÀˆ˜}Ê̅iʓi˜ÃÌÀÕ>ÊVÞViÊ`œÊ˜œÌÊ>vviVÌÊ̅iʓˆ`
œÝˆ`>̈ÛiÊÃÌÀiÃÃÊ̅>ÌÊ>VVœ“«>˜ˆiÃʓœ`iÀ>Ìi‡ˆ˜Ìi˜ÃˆÌÞ
iÝiÀVˆÃi°Ê/…iÊ>VVœ“«>˜Þˆ˜}Êvˆ}ÕÀiʈÕÃÌÀ>ÌiÃʅœÜÊÀi}Տ>
>iÀœLˆVÊiÝiÀVˆÃiÊ>vviVÌÃʜ݈`>̈ÛiÊÀi뜘ÃiÊ>˜`Ê̅iÊ«œÌi˜‡
̈>ÊvœÀÊ̈ÃÃÕiÊ`>“>}iʈ˜VÕ`ˆ˜}Ê«ÀœÌiV̈ÛiÊ>`>«ÌˆÛi
Ài뜘Ãið
œÌ…ˆ˜}ÊV>˜ÊÃ̜«ÊœÝÞ}i˜ÊÀi`ÕV̈œ˜Ê>˜`ÊvÀiiÊÀ>`ˆV>Ê«Àœ‡
`ÕV̈œ˜]ÊLÕÌÊ>˜Êi>LœÀ>Ìiʘ>ÌÕÀ>Ê`ivi˜ÃiÊi݈ÃÌÃÊ܈̅ˆ˜Ê̅i
ViÊ>˜`ÊiÝÌÀ>ViÕ>ÀÊë>ViÊ>}>ˆ˜ÃÌʈÌÃÊ`>“>}ˆ˜}ÊivviVÌð
/…ˆÃÊ`ivi˜Ãiʈ˜VÕ`iÃÊi˜âޓ>̈VÊ>˜`ʘœ˜‡i˜âޓ>̈V
“iV…>˜ˆÃ“ÃÊ̅>ÌÊܜÀŽÊˆ˜ÊVœ˜ViÀÌÊ̜ʈ““i`ˆ>ÌiÞÊVœÕ˜ÌiÀ
«œÌi˜Ìˆ>ÊœÝˆ`>̈ÛiÊ`>“>}i°Ê/…Àiiʓ>œÀÊ>˜ÌˆœÝˆ`>˜Ì
i˜âޓiÃʈ˜VÕ`iÊÃÕ«iÀœÝˆ`iÊ`ˆÃ“ÕÌ>Ãi] V>Ì>>Ãi] >˜`Ê}Õ‡
Ì>̅ˆœ˜iÊ«iÀœÝˆ`>Ãi° /…iʘÕÌÀˆÌˆÛi‡Ài`ÕVˆ˜}ÊۈÌ>“ˆ˜ÃÊ
]

]Ê>˜`Ê Ê>˜`Ê̅iÊۈÌ>“ˆ˜Ê
Ê«ÀiVÕÀÜÀÊ!‡V>ÀœÌi˜iÊ>ÃœÊÃiÀÛi

˜ÞÊÈ}˜ˆvˆV>˜ÌÊiÝViÃÃʜvÊۈÌ>“ˆ˜ÃÊv՘V̈œ˜Ê>ÃÊV…i“ˆ Û>Ü`ˆ>̜ÀÊ>˜`ʈ˜…ˆLˆÌÃÊv>ÌÌÞÊ>Vˆ`ʓœLˆˆâ>̈œ˜Ê`ÕÀˆ˜}ÊiÝiÀ‡
V>ÃʜÀÊiÃÃi˜Ìˆ>ÞÊ`ÀÕ}Ãʈ˜Ê̅iÊLœ`Þ°ÊœÀÊiÝ>“«i]Ê> VˆÃi]ÊÀ>«ˆ`ÞÊ`i«ï˜}ʓÕÃViÊ}ÞVœ}i˜°ÊœˆVÊ>Vˆ`ÊVœ˜Vi˜‡
“i}>`œÃiʜvÊÜ>ÌiÀ‡ÃœÕLiÊۈÌ>“ˆ˜Ê
ʈ˜VÀi>ÃiÃÊÃiÀՓ ÌÀ>Ìi`ʈ˜ÊÃÕ««i“i˜ÌÊvœÀ“ÊV>˜ÊÌÀˆ}}iÀÊ>˜Ê>iÀ}ˆVÊÀi뜘Ãi]
ÕÀˆVÊ>Vˆ`ʏiÛiÃ]Ê܅ˆV…Ê«ÀiVˆ«ˆÌ>ÌiÃÊ}œÕÌʈ˜Ê«iœ«iÊ«Ài`ˆÃ‡ «Àœ`ÕVˆ˜}ʅˆÛiÃ]ʏˆ}…Ì…i>`i`˜iÃÃ]Ê>˜`ÊLÀi>̅ˆ˜}Ê`ˆvvˆVՏ̈iÃ
«œÃi`Ê̜Ê̅ˆÃÊ`ˆÃi>Ãi°Ê
Ìʈ˜Ì>ŽiÃÊ}Ài>ÌiÀÊ̅>˜Ê£äääʓ} i}>`œÃiÃʜvÊۈÌ>“ˆ˜Ê
ÊV>˜Êˆ˜`ÕViÊ̜݈VˆÌÞÊ̜Ê̅iʘiÀۜÕÃ
`>ˆÞ]ÊÕÀˆ˜>ÀÞÊiÝVÀʜvʜÝ>>ÌiÊ­>ÊLÀi>Ž`œÜ˜Ê«Àœ`ÕVÌ ÃÞÃÌi“]Ê>˜`ÊiÝViÃÃÊۈÌ>“ˆ˜Êʈ˜Ì>ŽiÊV>˜Ê`>“>}iʎˆ`˜iÞð
œvÊۈÌ>“ˆ˜Ê
®Êˆ˜VÀi>ÃiÃ]Ê>VViiÀ>̈˜}ʎˆ`˜iÞÊÃ̜˜iÊvœÀ“>‡
̈œ˜Êˆ˜ÊÃÕÃVi«ÌˆLiʈ˜`ˆÛˆ`Õ>Ã°Ê˜ÊˆÀœ˜‡`ivˆVˆi˜Ìʈ˜`ˆÛˆ`Õ
>Ã]ʓi}>`œÃiÃʜvÊۈÌ>“ˆ˜Ê
ʓ>ÞÊ`iÃÌÀœÞÊÈ}˜ˆvˆV>˜
Vitamins and Exercise Performance
>“œÕ˜ÌÃʜvÊۈÌ>“ˆ˜Ê £Ó°Ê˜Ê…i>Ì…ÞÊ«iœ«i]ÊۈÌ>“ˆ˜Ê
ÊÃÕ«‡ Figure 2.15 ˆÕÃÌÀ>ÌiÃÊ̅>ÌÊ̅iÊÜ>ÌiÀ‡ÃœÕ>LiÊ ‡Vœ“«iÝ
«i“i˜ÌÃÊvÀiµÕi˜ÌÞʈÀÀˆÌ>ÌiÊ̅iÊLœÜiÊ>˜`ÊV>ÕÃiÊ`ˆ>ÀÀ…i>° ۈÌ>“ˆ˜ÃÊ«>ÞʎiÞÊÀœiÃÊ>ÃÊVœi˜âޓiÃÊ̜ÊÀi}Տ>ÌiÊi˜iÀ}އ
ÝViÃÃÊۈÌ>“ˆ˜Ê È “>Þʈ˜`ÕViʏˆÛiÀÊ>˜`ʘiÀÛiÊ`>“>}i° ވi`ˆ˜}ÊÀi>V̈œ˜ÃÊ`ÕÀˆ˜}ÊV>ÀLœ…Þ`À>Ìi]Êv>Ì]Ê>˜`Ê«ÀœÌiˆ˜
ÝViÃÈÛiÊÀˆLœv>ۈ˜Ê­ Ӯʈ˜Ì>ŽiÊV>˜Êˆ“«>ˆÀÊۈȜ˜]Ê>˜`Ê> V>Ì>LœˆÃ“°Ê/…iÞÊ>ÃœÊVœ˜ÌÀˆLÕÌiÊ̜ʅi“œ}œLˆ˜ÊÃޘ̅iÈÃ
“i}>`œÃiʜvʘˆVœÌˆ˜ˆVÊ>Vˆ`Ê­˜ˆ>Vˆ˜®ÊÃiÀÛiÃÊ>ÃÊ>Ê«œÌi˜Ì >˜`ÊÀi`ÊLœœ`ÊViÊ«Àœ`ÕV̈œ˜°Ê/…iÊLiˆivÊ̅>ÌʺˆvÊ>ʏˆÌ̏iʈÃ
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«Ì>À>

Chapter 2 Macronutrients and Micronutrients • 59

}œœ`]ʓœÀiʓÕÃÌÊLiÊLiÌÌiÀ»Ê…>Ãʏi`ʓ>˜ÞÊVœ>V…iÃ]Ê>̅iÌiÃ]ÊvˆÌ˜iÃÃÊi˜Ì…ÕÈ>ÃÌÃ
>˜`ÊiÛi˜ÊܓiÊÃVˆi˜ÌˆÃÌÃÊ̜Ê>`ۜV>ÌiÊÕȘ}ÊۈÌ>“ˆ˜ÊÃÕ««i“i˜ÌÃÊ>LœÛiÊÀiVœ“‡
+
ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
“i˜`i`ʏiÛiÃ°Ê/…iÊv>VÌÃÊ`œÊ˜œÌÊÃÕ««œÀÌÊÃÕV…Ê>`ۈViÊvœÀʈ˜`ˆÛˆ`Õ>ÃÊ܅œÊVœ˜‡ ÀˆivÞÊ`iÃVÀˆLiÊ̅iÊv՘V̈œ˜Êœvʓˆ˜iÀ>Ãʈ
ÃՓiÊ>˜Ê>`iµÕ>ÌiÊ`ˆiÌ° ̅iÊLœ`Þ°Ê
-Õ««i“i˜Ìˆ˜}Ê܈̅ÊۈÌ>“ˆ˜Ê È]Ê>˜ÊiÃÃi˜Ìˆ>ÊVœv>V̜Àʈ˜Ê}ÞVœ}i˜Ê>˜`Ê>“ˆ˜œ
>Vˆ`ʓiÌ>LœˆÃ“]Ê`ˆ`ʘœÌÊLi˜ivˆÌÊ̅iʓiÌ>LœˆVʓˆÝÌÕÀiʓiÌ>Lœˆâi`ÊLÞÊܜ“i
`ÕÀˆ˜}ʈ˜Ìi˜ÃiÊ>iÀœLˆVÊiÝiÀVˆÃi°Ê˜Ê}i˜iÀ>]Ê>̅iÌiýÊÃÌ>ÌÕÃÊvœÀÊ̅ˆÃÊۈÌ>“ˆ˜
iµÕ>ÃÊÀiviÀi˜ViÊÃÌ>˜`>À`ÃÊvœÀÊ̅iÊ«œ«Õ>̈œ˜Ê>˜`Ê`œiÃʘœÌÊ`iVÀi>ÃiÊ܈̅ÊÃÌÀi˜‡
՜ÕÃÊiÝiÀVˆÃiÊ̜Ê>ʏiÛiÊÜ>ÀÀ>˜Ìˆ˜}ÊÃÕ««i“i˜Ì>̈œ˜°ÊœÀÊi˜`ÕÀ>˜Vi‡ÌÀ>ˆ˜i`
“i˜]ʙÊ`>ÞÃʜvÊۈÌ>“ˆ˜Ê È ÃÕ««i“i˜Ì>̈œ˜Ê­Óäʓ}Ê«iÀÊ`>ޮʫÀœÛˆ`i`ʘœ
iÀ}œ}i˜ˆVÊivviVÌʜ˜ÊVÞVˆ˜}Ê̜Êi݅>ÕÃ̈œ˜Ê«iÀvœÀ“i`Ê>ÌÊÇä¯ÊœvÊ>iÀœLˆVÊV>«>VˆÌÞ°

…Àœ˜ˆVʅˆ}…‡«œÌi˜VÞ]ʓՏ̈ۈÌ>‡
“ˆ˜q“ˆ˜iÀ>ÊÃÕ««i“i˜Ì>̈œ˜ÊvœÀ
Üi‡˜œÕÀˆÃ…i`]ʅi>Ì…Þʈ˜`ˆÛˆ`Õ>Ã &OR 9OUR )NFORMATION
`œiÃʘœÌÊ>Õ}“i˜ÌÊ>iÀœLˆVÊvˆÌ˜iÃÃ
“ÕÃVՏ>ÀÊÃÌÀi˜}̅]ʘiÕÀœ“ÕÃVՏ>À (/7 !.4)/8)$!.4 6)4!-).3 3%26% 4/ .%542!,):% &2%% 2!$)#!,3
«iÀvœÀ“>˜ViÊ>vÌiÀÊ«Àœœ˜}i`ÊÀ՘‡
˜ˆ˜}]Ê>˜`Ê}i˜iÀ>Ê>̅ïVÊ«iÀvœÀ“‡
Free radicals
>˜Vi°Ê˜Ê>``ˆÌˆœ˜Ê̜Ê̅iÊ ‡Vœ“«iÝ
Vitamin C neutralizes free radicals
}ÀœÕ«]ʘœÊiÝiÀVˆÃiÊLi˜ivˆÌÃÊi݈ÃÌÊvœ so that they can no longer damage
molecules like DNA
iÝViÃÃÊۈÌ>“ˆ˜ÃÊ
Ê>˜`Ê Êœ˜ÊÃÌ>“ˆ˜>]
VˆÀVՏ>̜ÀÞÊv՘V̈œ˜]ʜÀÊi˜iÀ}ÞʓiÌ>L‡ Vitamin C
œˆÃ“°Ê-…œÀ̇ÌiÀ“Ê`>ˆÞÊÃÕ««i“i˜Ì>‡ Neutralized
free radical
̈œ˜Ê܈̅Ê{ääÊ1ʜvÊۈÌ>“ˆ˜Ê Free radicals can
«Àœ`ÕVi`ʘœÊivviVÌʜ˜Ê˜œÀ“>Ê˜iՇ damage DNA and
other molecules
Àœi˜`œVÀˆ˜iÊ>˜`ʓiÌ>LœˆVÊÀi뜘ÃiÃ
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MINERALS Think again if you are counting on

your daily multivitamin pill to ward off
the killer chronic diseases cancer or
The Nature of Minerals heart disease. The largest study to

««ÀœÝˆ“>ÌiÞÊ{¯ÊœvÊ̅iÊLœ`Þ½Ãʓ>ÃÃÊ­ !Óʎ}ÊvœÀÊ>Êx䇎}Êܜ“>˜®ÊVœ˜ÃˆÃÌÃʜvÊÓÓ date of multivitamin use in 161,808
“œÃ̏ÞʓiÌ>ˆVÊii“i˜ÌÃÊVœiV̈ÛiÞÊV>i`Ê “ˆ˜iÀ>Ã° ˆ˜iÀ>ÃÊÃiÀÛiÊ>ÃÊVœ˜‡ postmenopausal women published in
Ã̈ÌÕi˜ÌÃʜvÊi˜âޓiÃ]ʅœÀ“œ˜iÃ]Ê>˜`ÊۈÌ>“ˆ˜ÃÆÊ̅iÞÊVœ“Lˆ˜iÊ܈̅ʜ̅iÀÊV…i“ˆV>Ã the February 2009 Archives of Internal
­i°}°]ÊV>VˆÕ“Ê«…œÃ«…>Ìiʈ˜ÊLœ˜iÊ>˜`ʈÀœ˜Êˆ˜Ê̅iʅi“iʜvʅi“œ}œLˆ˜®ÊœÀÊi݈ÃÌÊȘ‡ Medicine reported that vitamin supple-
}Տ>ÀÞÊ­i°}°]ÊvÀiiÊV>VˆÕ“ʈ˜ÊLœ`ÞÊvÕˆ`î°Ê˜Ê̅iÊLœ`Þ] ÌÀ>Viʓˆ˜iÀ>Ã >ÀiÊ̅œÃi mentation did not affect the risk of
ÀiµÕˆÀi`ʈ˜Ê>“œÕ˜ÌÃÊ£ääʓ}Ê>Ê`>ÞʜÀÊLiœÜ]Ê>˜`Ê “>œÀʓˆ˜iÀ>Ã >ÀiÊÀiµÕˆÀi`ʈ˜ cancer, heart disease, or overall
>“œÕ˜ÌÃÊ£ääʓ}Ê`>ˆÞʜÀÊ>LœÛi°Ê ÝViÃÃʓˆ˜iÀ>ÃÊÃiÀÛiʘœÊÕÃivՏʫ…ÞȜœ}ˆVÊ«ÕÀ‡ mortality—and it made no difference
«œÃiÊ>˜`ÊV>˜Ê«Àœ`ÕViÊ̜݈VÊivviVÌð how long the supplements were taken.
This is unfortunate because Americans
Kinds, Sources, and Functions of Minerals spend about $23 billion annually
on these supplements. The study’s
œÃÌʓ>œÀÊ>˜`ÊÌÀ>Viʓˆ˜iÀ>ÃʜVVÕÀÊvÀiiÞʈ˜Ê˜>ÌÕÀi]ʓ>ˆ˜Þʈ˜Ê̅iÊÜ>ÌiÀÃʜv lead author offers this advice: “Get
ÀˆÛiÀÃ]ʏ>ŽiÃ]Ê>˜`ʜVi>˜ÃÆʈ˜Ê̜«ÃœˆÆÊ>˜`ÊLi˜i>̅Ê̅iÊi>À̅½ÃÊÃÕÀv>Vi°Êˆ˜iÀ>Ã nutrients from food. Whole foods are
i݈ÃÌʈ˜Ê̅iÊÀœœÌÊÃÞÃÌi“ÃʜvÊ«>˜ÌÃÊ>˜`ʈ˜Ê̅iÊLœ`ÞÊÃÌÀÕVÌÕÀiʜvÊ>˜ˆ“>ÃÊ̅>ÌÊVœ˜‡ better than dietary supplements.”
ÃՓiÊ«>˜ÌÃÊ>˜`ÊÜ>ÌiÀÊVœ˜Ì>ˆ˜ˆ˜}ʓˆ˜iÀ>Ã°Ê Table 2.6 ˆÃÌÃÊ̅iʓ>œÀÊLœ`ˆÞ
LWBK710-c02_31-80.qxd 9/15/10 10:40 PM Page 60 Aptara

60 • SECTION II Nutrition and Energy

LIPIDS CARBOHYDRATES PROTEINS

Vitamin C, Folate,
Vitamin B6, Vitamin B12,
Niacin

fatty acids + glycerol glucose/glycogen amino acids

Vitamin C, Folate, Vitamin B6,

Vitamin B12, Niacin

Niacin, Biotin,
Pantothenic acid
deamination

Pantothenic acid
Biotin, Niacin pyruvate Vitamin B6 ammonia

Niacin lactate
urea
Thiamine, Niacin
Pantothenic acid

Niacin, Folate
acetyl-CoA Vitamin B6 urine
Vitamin B12

Riboflavin
Niacin Citric
ENERGY Acid
Cycle Vitamin
B6
Electron Niacin
transport chain Riboflavin

Figure 2.15 i˜iÀ>ˆâi`ÊÀœiʜvÊÜ>ÌiÀ‡ÃœÕLiÊۈÌ>“ˆ˜Ãʈ˜Ê“>VÀœ˜ÕÌÀˆi˜ÌʓiÌ>LœˆÃ“°

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Chapter 2 Macronutrients and Micronutrients • 61

Important Major and Trace Minerals for Healthy Adults (Ages 19–50 Years): Their Food
Table 2.6
Sources, Functions, and Effects of Deficiencies and Excessesa

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Minerals and Physical Activity

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62 • SECTION II Nutrition and Energy

VˆÕ“®]ÊV>VˆÕ“ʈÃʈ˜ÛœÛi`ʈ˜Ê̅iÃiÊÈÝʈ“«œÀÌ>˜ÌÊv՘V‡
CATABOLISM (breakdown) ̈œ˜Ã\Ê
Calcium
£° ÕÃViÊ>V̈œ˜
Glucose Cobalt Ó° œœ`ÊVœÌ̈˜}
Copper ΰ iÀÛiʈ“«ÕÃiÊÌÀ>˜Ã“ˆÃȜ˜
Fatty CO2 + H2O
Iron {°
V̈Û>̈œ˜ÊœvÊÃiÛiÀ>Êi˜âޓiÃ]Ê­i°}°]Ê̈ÃÃÕiÊÌÀ>˜Ã}Õ‡
acids
Energy Magnesium Ì>“ˆ˜>Ãi]ʓˆÌœV…œ˜`Àˆ>Ê}ÞViÀœÊ«…œÃ«…>ÌiÊ`i…Þ‡
Amino Manganese `Àœ}i˜>ÃiÊQ“*R®
acids Potassium x° -ޘ̅iÈÃʜvÊV>VˆviÀœÊ­>V̈ÛiÊvœÀ“ÊœvÊۈÌ>“ˆ˜Ê®
Sulfur È° Õˆ`ÊÌÀ>˜Ã«œÀÌÊ>VÀœÃÃÊViÊ“i“LÀ>˜iÃ
Zinc
"ÃÌiœ«œÀœÃˆÃ\Ê
>VˆÕ“ʘÌ>Ži]Ê>˜`Ê ÝiÀVˆÃi /…iÊÎii‡
̜˜ÊVœ˜Ì>ˆ˜ÃʓœÀiÊ̅>˜Ê™™¯ÊœvÊ̅iÊLœ`Þ½ÃÊ̜Ì>ÊV>VˆÕ“°Ê7ˆÌ…
ANABOLISM (buildup)
V>VˆÕ“Ê`ivˆVˆi˜VÞ]Ê̅iÊLœ`ÞÊ`À>ÜÃʜ˜ÊˆÌÃÊV>VˆÕ“ÊÀiÃiÀÛiÃʈ
Calcium
Lœ˜iÊ̜ÊÀi«>ViÊ̅iÊ`ivˆVˆÌ°Ê7ˆÌ…Ê«Àœœ˜}i`ʘi}>̈Ûiʈ“L>
Glucose Glycogen
Chlorine >˜Vi]ʜÃÌiœ«œÀœÃˆÃ ­ˆÌiÀ>Þʓi>˜ˆ˜}ʺ«œÀœÕÃÊLœ˜iû®ÊiÛi˜‡
Fatty acids Fats Magnesium ÌÕ>ÞÊ`iÛiœ«ÃÊ>ÃÊ̅iÊLœ˜iÃʏœÃiÊV>VˆÕ“Ê“>ÃÃÊ­“ˆ˜iÀ>
Manganese Vœ˜Ìi˜Ì®Ê>˜`ÊV>VˆÕ“ÊVœ˜Vi˜ÌÀ>̈œ˜Ê­“ˆ˜iÀ>Ê`i˜ÃˆÌÞ®Ê>˜`
Amino acids Proteins Potassium «Àœ}ÀiÃÈÛiÞÊLiVœ“iÊ«œÀœÕÃÊ>˜`ÊLÀˆÌ̏i°Ê Figure 2.17 ˆÕÇ
ÌÀ>ÌiÃÊÌܜʜ««œÃˆ˜}Ê«ÀœViÃÃiÃ\Ê­£®Ê̅iÊLՈ`իʜvÊV>VˆÕ“ÊLÞ
ˆÌÃÊivvˆVˆi˜ÌÊÌÀ>˜Ã«œÀÌÊvÀœ“Ê̅iÊÓ>Êˆ˜ÌiÃ̈˜iÊvœÀÊÃ̜À>}iʈ
Figure 2.16 ˆ˜iÀ>ÃÊVœ˜ÌÀˆLÕÌiÊ̜ʓ>VÀœ˜ÕÌÀˆi˜ÌÊV>Ì>LœˆÃ“
­LÀi>Ž`œÜ˜®Ê>˜`Ê>˜>LœˆÃ“Ê­LՈ`Õ«®° ̅iÊLœ˜iʓ>ÌÀˆÝÊ­˜œÌiÊ̅>ÌÊ̅iÊLÕiÊ>ÀÀœÜ…i>`Ê«œˆ˜ÌÃʈ˜ÌœÊ̅i
Lœ˜i®Ê>˜`ʭӮʈ˜>`iµÕ>ÌiÊV>VˆÕ“ʈ˜Ì>ŽiʜÀÊ̅iʈ˜ivviV̈Ûi
>LÜÀ«Ìˆœ˜ÊœvÊV>VˆÕ“ÊLÞÊ̅iʈ˜ÌiÃ̈˜>Ê“ÕVœÃ>]Ê܅iÀiÊV>‡
Calcium
>VˆÕ“]Ê̅iʓœÃÌÊ>L՘`>˜Ìʓˆ˜iÀ>Êˆ˜Ê̅i VˆÕ“ÊÌÀ>ÛiÃʈ˜Ê̅iʜ««œÃˆÌiÊ`ˆÀiV̈œ˜ÊvÀœ“Ê̅iÊLœ˜iʈ˜Ìœ
Lœ`Þ]ÊVœ“Lˆ˜iÃÊ܈̅ʫ…œÃ«…œÀÕÃÊ̜ÊvœÀ“ÊLœ˜iÃÊ>˜` Lœ`ˆÞÊvÕˆ`Ã]ÊV>i` V>VˆÕ“ ÀiÜÀ«Ìˆœ˜°Êi>V…ˆ˜}ʜvÊV>VˆÕ“
Ìii̅°Ê/…iÃiÊÌܜʓˆ˜iÀ>ÃÊÀi«ÀiÃi˜ÌÊ>LœÕÌÊÇx¯ÊœvÊ̅i vÀœ“Ê̅iÊLœ˜iÃÊÀi“>ˆ˜ÃÊ>Ê`iÃÌÀÕV̈ÛiÊ«ÀœViÃÃÊ̅>Ìʏi>ÛiÃ
Lœ`Þ½ÃÊ̜Ì>Ê“ˆ˜iÀ>ÊVœ˜Ìi˜ÌʜvÊ>LœÕÌÊÓ°x¯ÊœvÊLœ`Þʓ>Ãð Lœ˜iÃʅœœÜÊ>˜`Êvi˜iÃÌÀ>Ìi`°Ê/…iÊi˜`ÊÀiÃՏÌ]ʜÃÌiœ«œÀœÃˆÃ]
˜Êˆœ˜ˆâi`ÊvœÀ“Ê­ !£¯ÊœvÊ̅iÊLœ`Þ½ÃÊ£Óääʓ}ʜvÊV>‡ ˜i}>̈ÛiÞʈ“«>VÌÃʓ>iÃÊ>˜`Êvi“>iÃʜvÊ>Ê>}iðÊ

Calcium

Normal Ineffective
absorption absorption
of calcium by of calcium by
small intestine small intestine

Increased
calcium
Lining of resorption
intestine from bone

Osteoporotic
bone
Calcium stored
in bone

Normal
bone

Figure 2.17 ­£®Ê

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i>V…iÃÊvÀœ“Ê̅iÊLœ˜iÃÊ­>À}iÊLÕiÊ>ÀÀœÜ…i>` «œˆ˜ÌÃʈ˜ÌœÊLœœ`ÊÃÌÀi>“®]ʏi>ۈ˜}Ê̅i“ÊLÀˆÌ̏iÊ>˜`ʏˆŽiÞÊ̜ÊvÀ>VÌÕÀi°
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Chapter 2 Macronutrients and Micronutrients • 63

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“iÀˆV>˜Ã]ʜÀ
xx¯ÊœvÊ«iœ«iÊxäÊÞi>ÀÃʜvÊ>}iÊ>˜`ʜ`iÀ]Ê܈̅ÊÈn¯Êܜ“i˜° &OR 9OUR )NFORMATION
/œ`>Þʈ˜Ê̅iÊ1˜ˆÌi`Ê-Ì>ÌiÃ]Ê>««ÀœÝˆ“>ÌiÞÊ£äʓˆˆœ˜Êˆ˜`ˆ‡
&)&4%%. 2)3+ &!#4/23 &/2 /34%/0/2/3)3
ۈ`Õ>ÃÊ>Ài>`ÞʏˆÛiÊ܈̅Ê̅iÊ`ˆÃi>Ãi]Ê>˜`Ê>“œÃÌÊÎ{ʓˆˆœ˜
“œÀiÊ>ÀiÊiÃ̈“>Ìi`Ê̜ʅ>ÛiʏœÜÊLœ˜iʓ>ÃÃÊ­œÃÌiœ«i˜ˆ>®°ÊˆvÌÞ 1. Advancing age
«iÀVi˜ÌʜvÊ>Êܜ“i˜ÊiÛi˜ÌÕ>ÞÊ`iÛiœ«ÊœÃÌiœ«œÀœÃˆÃ]Ê«Àˆ‡ 2. History of fracture as an adult, independent of cause
“>ÀÞÊvÀœ“Ê̅iˆÀÊÀi>̈ÛiÞʏœÜÊV>VˆÕ“ʈ˜Ì>ŽiÊ>˜`Ê̅iʏœÃÃʜv 3. History of fracture in a parent or sibling
̅iÊV>VˆÕ“‡Vœ˜ÃiÀۈ˜}ʅœÀ“œ˜iÊiÃÌÀœ}i˜Ê>Ìʓi˜œ«>ÕÃi° 4. Cigarette smoking
i˜Ê>ÀiʘœÌʈ““Õ˜iÆʓi˜Ê܈̅ʜÃÌiœ«œÀœÃˆÃÊ̜Ì>i`ÊÓʓˆ‡ 5. Slight build or tendency toward being underweight
ˆœ˜Êˆ˜ÊÓä䙰Ê/…ˆÃʘՓLiÀʈÃÊiÝ«iVÌi`Ê̜ÊiÝVii`ÊÓäʓˆˆœ˜Ê 6. White or Asian female
ˆ˜ÊÓäÓäÊ­ ÜÜÜ°˜œv°œÀ}É®°Ê"ÃÌiœ«œÀœÃˆÃ]Ê>Êȏi˜ÌÊ`ˆÃi>ÃiÊ̅>Ì 7. Sedentary lifestyle
ܓï“iÃÊ}œiÃÊ՘`iÌiVÌi`ÊvœÀÊÞi>ÀÃÊ՘̈Ê>ÊLœ˜iÊvÀ>VÌÕÀi 8. Early menopause
œVVÕÀðÊÌÊ>VVœÕ˜ÌÃÊvœÀʓœÀiÊ̅>˜Ê£°Èʓˆˆœ˜ÊvÀ>VÌÕÀiÃÊÞi>ÀÞ] 9. Eating disorder
ˆ˜VÕ`ˆ˜}Ê>LœÕÌÊÇää]äääÊ눘>ÊvÀ>VÌÕÀiÃ]ÊÓxä]äääÊÜÀˆÃÌÊvÀ>V‡ 10. High protein intake (particularly animal protein)
ÌÕÀiÃ]ÊÎää]äääʅˆ«ÊvÀ>VÌÕÀiÃ]Ê>˜`ÊÎää]äääÊvÀ>VÌÕÀiÃÊ>Ìʜ̅iÀ 11. Excess sodium intake
ÈÌiðÊ
“œ˜}Êܜ“i˜Êœ`iÀÊ̅>˜Ê>}iÊÈäÊÞi>ÀÃ]ʜÃÌiœ«œÀœÃˆÃ 12. Alcohol abuse
…>ÃÊÀi>V…i`ʘi>À‡i«ˆ`i“ˆVÊ«Àœ«œÀ̈œ˜Ã°Ê"˜Ê>ÛiÀ>}i]ÊÓ{¯Êœv 13. Calcium-deficient diet before and after menopause
…ˆ«ÊvÀ>VÌÕÀiÊ«>̈i˜ÌÃʜ`iÀÊ̅>˜ÊxäÊÞi>ÀÃʜvÊ>}iÊ`ˆiʈ˜Ê̅iÊÞi>À 14. High caffeine intake (equivocal)
vœœÜˆ˜}Ê̅iˆÀÊvÀ>VÌÕÀi° 15. Vitamin D deficiency (prevalent in !40% of adults)

Dietary Calcium Crucial.
ÃÊ>Ê}i˜iÀ>Ê}Ո`iˆ˜i]Ê>`œiÃVi˜Ì

LœÞÃÊ>˜`Ê}ˆÀÃÊ­>}iÃʙq£ÎÊÞi>ÀÃʜvÊ>}i®Ê>˜`Êޜ՘}Ê>`ՏÌʓi˜ &OR 9OUR )NFORMATION
>˜`Êܜ“i˜Ê­£{q£nÊÞi>ÀÃʜvÊ>}i®ÊÀiµÕˆÀiÊ£Îääʓ}ʜvÊV>VˆÕ“
`>ˆÞʜÀÊ>LœÕÌÊ>ÃʓÕV…ÊV>VˆÕ“ʈ˜ÊÈÝÊn‡œâÊ}>ÃÃiÃʜvʓˆŽ°ÊœÀ "/.% (%!,4( $)!'./34)# #2)4%2)! "!3%$ /.
6!2)!4)/. 34!.$!2$ $%6)!4)/. ;3$= /& /"3%26%$
>`ՏÌÃÊLiÌÜii˜Ê̅iÊ>}iÃʜvÊ£™Ê>˜`ÊxäÊÞi>ÀÃ]Ê̅iÊ`>ˆÞÊÀiµÕˆÀi‡ "/.% $%.3)49 6!,5%3 #/-0!2%$ 7)4( 6!,5%3 &/2
“i˜ÌÊ`iVÀi>ÃiÃÊ̜ʣäääʓ}°Ê
Ì…œÕ}…Ê}ÀœÜˆ˜}ÊV…ˆ`Ài˜ÊÀiµÕˆÀi ! '%.$%2 -!4#(%$ 9/5.' !$5,4 0/05,!4)/.
“œÀiÊV>VˆÕ“Ê«iÀÊ՘ˆÌÊLœ`Þʓ>ÃÃʜ˜Ê>Ê`>ˆÞÊL>ÈÃÊ̅>˜Ê>`ՏÌÃ]
Normal 1.0 SD below mean
“>˜ÞÊ>`ՏÌÃÊÀi“>ˆ˜Ê`ivˆVˆi˜Ìʈ˜ÊV>VˆÕ“ʈ˜Ì>Ži°ÊœÀÊiÝ>“«i
Osteopenia 1.0 to 2.5 SD below mean
̅iÊÌÞ«ˆV>Ê>`Տ̽ÃÊ`>ˆÞÊV>VˆÕ“ʈ˜Ì>ŽiÊÀ>˜}iÃÊLiÌÜii˜ÊxääÊ>˜`
Osteoporosis !2.5 SD below mean
Çääʓ}°ÊœÀiÊ̅>˜ÊÇx¯ÊœvÊ>`ՏÌÃÊVœ˜ÃՓiʏiÃÃÊ̅>˜Ê̅iÊÀiVœ“‡
Severe ! 2.5 SD below mean plus one
“i˜`i`Ê>“œÕ˜Ì]Ê>˜`Ê>LœÕÌÊÓx¯ÊœvÊܜ“i˜Êˆ˜Ê̅iÊ1˜ˆÌi`Ê-Ì>ÌiÃ
osteoporosis or more fragility fractures
Vœ˜ÃՓiʏiÃÃÊ̅>˜ÊÎääʓ}ʜvÊV>VˆÕ“Ê`>ˆÞ°Ê
̅iÌiÃ]Êvi“>i
`>˜ViÀÃ]Ê}ޓ˜>ÃÌÃ]Ê>˜`Êi˜`ÕÀ>˜ViÊVœ“«ï̜ÀÃÊ>ÀiÊ̅iʓœÃÌ
«Àœ˜iÊ̜ÊV>VˆÕ“Ê`ˆiÌ>ÀÞʈ˜ÃÕvvˆVˆi˜VÞ

Exercise Helps. ,i}Տ>ÀÊiÝiÀVˆÃiÊϜÜÃÊ̅iÊÀ>ÌiʜvÊÎiiÌ>Ê>}ˆ˜}°,i}>À`iÃÃʜv

>}iʜÀÊ}i˜`iÀ]Êޜ՘}ÊV…ˆ`Ài˜Ê>˜`Ê>`ՏÌÃÊ܅œÊ“>ˆ˜Ì>ˆ˜Ê«…ÞÈV>ÞÊ>V̈Ûi
ˆviÃÌޏiÃÊ>V…ˆiÛiÊ}Ài>ÌiÀÊLœ˜iʓ>ÃÃÊVœ“«>Ài`Ê܈̅ÊÃi`i˜Ì>ÀÞÊVœÕ˜ÌiÀ«>ÀÌð
œÀʓi˜Ê>˜`Êܜ“i˜Ê܅œÊÀi“>ˆ˜Ê«…ÞÈV>ÞÊ>V̈Ûi]ÊiÛi˜Ê>ÌÊ>}iÃÊÇäÊ>˜`Ê
näÊÞi>ÀÃ]ÊLœ˜iʓ>ÃÃÊiÝVii`ÃÊ̅>ÌʜvÊÃi`i˜Ì>ÀÞʈ˜`ˆÛˆ`Õ>ÃʜvÊȓˆ>ÀÊ>}i°Ê/…i
`iVˆ˜iʈ˜Êۈ}œÀœÕÃÊiÝiÀVˆÃiÊ>Ãʜ˜iÊ>}iÃÊVœÃiÞÊ«>À>iÃÊ̅iÊ>}i‡Ài>Ìi`ʏœÃÃʜv
Lœ˜iʓ>Ãð
ÝiÀVˆÃiʜvʓœ`iÀ>Ìiʈ˜Ìi˜ÃˆÌÞÊ«ÀœÛˆ`iÃÊ>ÊÃ>viÊ>˜`Ê«œÌi˜ÌÊÃ̈“ՏÕÃÊ̜ʓ>ˆ˜‡
Ì>ˆ˜Ê>˜`ÊiÛi˜Êˆ˜VÀi>ÃiÊLœ˜iʓ>ÃðÊ7iˆ}…̇Li>Àˆ˜}ÊiÝiÀVˆÃi Ài«ÀiÃi˜ÌÃÊ>Ê«>À̈V‡
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܅ˆV…Ê}i˜iÀ>ÌiÃÊVœ˜Ãˆ`iÀ>LiʓÕÃVՏ>ÀÊvœÀViÊ>}>ˆ˜ÃÌÊ̅i
Lœ`Þ½Ãʏœ˜}ÊLœ˜iÃ]Ê>ÃœÊ«ÀœÛiÃÊLi˜ivˆVˆ>°Ê ÝiÀVˆÃiÊLi˜ivˆ &OR 9OUR )NFORMATION
`i«i˜`ʜ˜Ê>`iµÕ>ÌiÊV>VˆÕ“Ê>Û>ˆ>LˆˆÌÞÊvœÀÊ̅iÊLœ˜i‡ 2%'5,!2 %8%2#)3% !.$ ).#2%!3%$ -53#,%
vœÀ“ˆ˜}Ê«ÀœViÃð 342%.'4( 3,/7 3+%,%4!, !').'
Moderate- to high-intensity aerobic exercise (weight
Female Athlete Triad: An Unexpected Problem bearing) performed 3 days per week for 50 to 60 minutes
for Women Who Train Intensely
Ê«>À>`œÝÊi݈ÃÌà each builds bone and retards its rate of loss. Muscle-
LiÌÜii˜ÊiÝiÀVˆÃiÊ>˜`ÊLœ˜iÊ`ޘ>“ˆVÃÊvœÀÊ>̅ïVÊ«Ài‡ strengthening exercises also benefit bone mass. Individuals
“i˜œ«>ÕÃ>Êܜ“i˜°Ê7œ“i˜Ê܅œÊÌÀ>ˆ˜Êˆ˜Ìi˜ÃiÞÊ>˜`Êi“«…>‡ with greater back strength and those who train regularly
ÈâiÊÜiˆ}…ÌʏœÃÃʜvÌi˜Êi˜}>}iʈ˜Ê`ˆÃœÀ`iÀi`Êi>̈˜} Li…>ۈœÀÃ] with resistance exercise have a greater spinal bone mineral
܅ˆV…ʈ˜Ê̅iÊiÝÌÀi“i]ÊV>ÕÃiʏˆvi‡Ì…Ài>Ìi˜ˆ˜}ÊVœ“«ˆV>̈œ˜Ã content than weaker and untrained individuals.
­ÃiiÊœÜÊ̜Ê,iVœ}˜ˆâiÊ7>À˜ˆ˜}Ê-ˆ}˜ÃʜvÊˆÃœÀ`iÀi`Ê >̈˜} ˆ˜
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64 • SECTION II Nutrition and Energy

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vÕˆ`°Ê iVÌÀœÞÌiÃʓœ`Տ>ÌiÊvÕˆ`ʓœÛi“i˜ÌÊ܈̅ˆ˜Ê̅i
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LiÌÜii˜Ê̅iÊVi½Ãʈ˜ÌiÀˆœÀÊ>˜`ÊiÝÌiÀˆœÀÊ>œÜÃʘiÀÛi
Disordered eating ˆ“«ÕÃiÊÌÀ>˜Ã“ˆÃȜ˜]ʓÕÃViÊÃ̈“Տ>̈œ˜Ê>˜`ÊVœ˜ÌÀ>V̈œ˜]
Multiple or recurrent stress fractures >˜`Ê«Àœ«iÀÊ}>˜`Êv՘V̈œ˜ˆ˜}°Ê iVÌÀœÞÌiÃʓ>ˆ˜Ì>ˆ˜
Adolescent or young adult «>Ó>ʓi“LÀ>˜iÊ«iÀ“i>LˆˆÌÞÊ>˜`ÊÀi}Տ>ÌiÊ̅iÊ>Vˆ`Ê>˜`
O

Lean and low body mass ea L>ÃiʵÕ>ˆÌˆiÃʜvÊLœ`ÞÊvÕˆ`Ã]Ê«>À̈VՏ>ÀÞÊLœœ`

st

Compulsive behavior
h
eo

Highly competitive
rr

Low self-esteem
o
p

Perfectionist -œ`ˆÕ“\ÊœÜÊÕV…ÊÃÊ ˜œÕ}…¶ /…iÊ܈`iÊ`ˆÃÌÀˆLṎœ˜

en
o

Self-critical
ro

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m

Depression
si

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A
s

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Chapter 2 Macronutrients and Micronutrients • 65

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&OR 9OUR )NFORMATION
3)8 02).#)0,%3 4/ 02/-/4% "/.% (%!,4(
1. Specificity: Exercise provides a local osteogenic effect.
2. Overload: Progressively increasing exercise intensity promotes continued
improvement.
3. Initial values: Individuals with the smallest total bone mass have the greatest
potential for improvement.
4. Diminishing returns: As one approaches the biologic ceiling for bone density,
further gains require greater effort.
5. More not necessarily better: Bone cells become desensitized in response to
prolonged mechanical-loading sessions.
6. Reversibility: Discontinuing exercise overload reverses the positive osteogenic
effects of exercise.
&OR 9OUR )NFORMATION
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The Centers for Disease Control and Prevention ­ÜÜÜ°V`V°}œÛ® says that nearly
70% of adult Americans should follow a low-salt diet that cuts recommended daily
sodium intake of 2300 mg to 1500 mg, about that found in two-thirds of a teaspoon
of salt. The three groups at special risk for sodium sensitivity include (1) people
with existing hypertension (30.5% of the adult population), (2) those age 40 years
and older without hypertension (34.4%), and (3) African Americans ages 20 to 39
years without hypertension (4.2%). And reducing sodium intake may have health
benefits beyond lowering blood pressure; it may improve flow-mediated dilatation,
the measure of a blood vessel’s healthy ability to relax.
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66 • SECTION II Nutrition and Energy

BOX 2.3 CLOSE UP

Lowering High Blood Pressure with Dietary
Intervention: The DASH Diet

i>ÀÞÊxäʓˆˆœ˜Ê
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THE DASH APPROACH
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Ìi˜Ãˆœ˜ÆÊÜÜÜ°˜…Lˆ°˜ˆ…°}œÛɅi>Ì…É«ÕLˆVɅi>ÀÌɅL«É`>ÅÉ
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Sodium sources

Restaurant and processed foods 77%

Naturally occurring 12%

Home Cooking 5%

Added while eating 6%

Average daily sodium consumption per person (mg)

3500

3000

2500

2000

1500

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Chapter 2 Macronutrients and Micronutrients • 67

Table 1 ŜÜÃÊ̅iÊ}i˜iÀ>Ê}œ>ÃÊ>˜`ʘ>ÌÕÀiʜvÊ̅i vœœÜ‡Õ«ÊœvÊܜ“i˜Ê܅œÃiÊ`ˆiÌÃʓœÃÌÊVœÃiÞÊÀiÃi“‡


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Table 1 Daily Nutrient Goals Used in the DASH Studies for a 2100-Calorie Eating Plan
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68 • SECTION II Nutrition and Energy

BOX 2.3 CLOSE UP

Lowering High Blood Pressure with Dietary
Intervention: The DASH Diet ­
œ˜Ìˆ˜Õi`®

Table 2 Sample DASH Diet (Including Recommended Substitutions to Reduce Sodium

to 1500 mg Daily) Consisting of Approximately 2100 kCal
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ܜ“i˜ÊVœÕ`ÊÃÌÀ>ˆ˜Ê>˜Ê>Ài>`Þʏˆ“ˆÌi`ʈÀœ˜ÊÀiÃiÀÛi°Ê/…ˆÃÊ`œiÃʘœÌʓi>˜Ê̅>Ì A relatiely high prevalence of non-
ˆ˜`ˆÛˆ`Õ>Ãʈ˜ÛœÛi`ʈ˜ÊÃÌÀi˜ÕœÕÃÊÌÀ>ˆ˜ˆ˜}ÊŜՏ`ÊÌ>ŽiÊÃÕ««i“i˜Ì>ÀÞʈÀœ˜ÊœÀ anemic iron depletion exists among
̅>Ìʈ˜`ˆV>̜ÀÃʜvÊëœÀÌÃÊ>˜i“ˆ>ÊÀiÃՏÌÊvÀœ“Ê`ˆiÌ>ÀÞʈÀœ˜Ê`ivˆVˆi˜VÞʜÀÊiÝiÀVˆÃi athletes in diverse sports as well as in
ˆ˜`ÕVi`ʈÀœ˜ÊœÃðÊÀœ˜ÊœÛiÀVœ˜ÃՓ«Ìˆœ˜ÊœÀʜÛiÀ>LÜÀ«Ìˆœ˜ÊVœÕ`Ê«œÌi˜Ìˆ>Þ recreationally active women and men.
V>ÕÃiʅ>À“°Ê"ÛiÀ‡Ì…i‡VœÕ˜ÌiÀÊÃÕ««i“i˜ÌÃÊVœ˜Ì>ˆ˜ˆ˜}ʅˆ}…ʏiÛiÃʜvʈÀœ˜ÊŜՏ` Low values for hemoglobin within
˜œÌÊLiÊÕÃi`ʈ˜`ˆÃVÀˆ“ˆ˜>ÌiÞÆÊiÝViÃÈÛiʈÀœ˜ÊV>˜Ê>VVՓՏ>ÌiÊ̜Ê̜݈VʏiÛiÃÊ>˜` the “normal” range often reflect
Vœ˜ÌÀˆLÕÌiÊ̜Ê`ˆ>LiÌiÃ]ʏˆÛiÀÊ`ˆÃi>Ãi]Ê>˜`ʅi>ÀÌÊ>˜`ʍœˆ˜ÌÊ`>“>}i°ÊÀœ˜ÊiÝViÃÃʓ>Þ functional anemia or marginal iron
iÛi˜Êv>VˆˆÌ>ÌiÊ}ÀœÜ̅ʜvʏ>Ìi˜ÌÊV>˜ViÀÃÊ>˜`ʈ˜viV̈œÕÃʜÀ}>˜ˆÃ“ðÊ
̅iÌiýʈÀœ˜ deficiency. Depleted iron reserves
ÃÌ>ÌÕÃÊŜՏ`ÊLiʓœ˜ˆÌœÀi`ÊLÞÊ«iÀˆœ`ˆVÊiÛ>Õ>̈œ˜Êœvʅi“>̜œ}ˆVÊV…>À>VÌiÀˆÃ̈Và and reduced iron-dependent protein
>˜`ʈÀœ˜ÊÀiÃiÀÛið production (e.g., oxidative enzymes)
with a relatively normal hemoglobin
Minerals and Exercise Performance concentration (non-anemic) charac-
terize this condition. The ergogenic

œ˜ÃՓˆ˜}ʓˆ˜iÀ>ÊÃÕ««i“i˜ÌÃÊ>LœÛiÊÀiVœ““i˜`i`ʏiÛiÃʜ˜Ê>˜Ê>VÕÌiʜÀ effects of iron supplementation on
V…Àœ˜ˆVÊL>ÈÃÊ`œiÃʘœÌÊLi˜ivˆÌÊiÝiÀVˆÃiÊ«iÀvœÀ“>˜ViʜÀÊi˜…>˜ViÊÌÀ>ˆ˜ˆ˜ aerobic exercise performance and
Ài뜘ÈÛi˜iÃðÊœÜiÛiÀ]ʏœÃÃʜvÊÜ>ÌiÀÊ>˜`Ê̅iʓˆ˜iÀ>ÊÃ>ÌÃÊÜ`ˆÕ“ÊV…œÀˆ`i training responsiveness benefit these
>˜`Ê«œÌ>ÃÈՓÊV…œÀˆ`iʈ˜ÊÃÜi>ÌÊ`œiÃÊ«œÃiÊ>˜Êˆ“«œÀÌ>˜ÌÊV…>i˜}iʈ˜Ê«Àœ‡ iron-deficient athletes.
œ˜}i`]ʅœÌÊÜi>̅iÀÊiÝiÀVˆÃi°Ê ÝViÃÈÛiÊÜ>ÌiÀÊ>˜`ÊiiVÌÀœÞÌiʏœÃÃʈ“«>ˆÀÃʅi>Ì Current recommendations support
̜iÀ>˜ViÊ>˜`ÊiÝiÀVˆÃiÊ«iÀvœÀ“>˜ViÊ>˜`ÊV>˜ÊÌÀˆ}}iÀʅi>ÌÊVÀ>“«Ã]ʅi>ÌÊi݅>ÕÇ iron supplementation for non-anemic
̈œ˜]ʜÀʅi>ÌÊÃÌÀœŽi°Ê/…iÊÞi>ÀÞʘՓLiÀʜvʅi>̇Ài>Ìi`Ê`i>̅ÃÊ`ÕÀˆ˜}ÊëÀˆ˜}Ê>˜` physically active women with low
ÃՓ“iÀÊvœœÌL>Ê«À>V̈ViÊ«ÀœÛˆ`iÃÊ>ÊÌÀ>}ˆVʈÕÃÌÀ>̈œ˜ÊœvÊ̅iʈ“«œÀÌ>˜Viʜv serum ferritin (measure of iron
Ài«>Vˆ˜}ÊvÕˆ`ÃÊ>˜`ÊiiVÌÀœÞÌiðÊÕÀˆ˜}Ê«À>V̈ViʜÀÊVœ“«ï̈œ˜]Ê>˜Ê>̅iÌiʓ> reserves) levels. Supplementation in
ÃÜi>ÌÊÕ«Ê̜Êxʎ}ʜvÊÜ>ÌiÀ°Ê/…ˆÃÊVœÀÀi뜘`ÃÊ̜Ê>LœÕÌÊn°äÊ}ʜvÊÃ>ÌÊ`i«ïœ˜ this case exerts little effect on hemo-
LiV>ÕÃiÊi>V…ÊŽˆœ}À>“Ê­£Ê®ÊœvÊÃÜi>ÌÊVœ˜Ì>ˆ˜ÃÊ>LœÕÌÊ£°xÊ}ʜvÊÃ>ÌÊ­œvÊ܅ˆV…Ê{ä¯ globin concentration and red blood
Ài«ÀiÃi˜ÌÃÊÜ`ˆÕ“®°Ê““i`ˆ>ÌiÊÀi«>Vi“i˜ÌʜvÊÜ>ÌiÀʏœÃÌÊ̅ÀœÕ}…ÊÃÜi>̈˜} cell volume. Any improved exercise
ŜՏ`ÊLiVœ“iÊ̅iʜÛiÀÀˆ`ˆ˜}ÊVœ˜Ãˆ`iÀ>̈œ˜° capacity likely occurs from increased
muscle oxidative capacity, not the
Defense Against Mineral Loss in Exercise 6ˆ}œÀœÕÃÊiÝiÀVˆÃi blood’s increased oxygen transport
ÌÀˆ}}iÀÃÊ>ÊÀ>«ˆ`Ê>˜`ÊVœœÀ`ˆ˜>Ìi`ÊÀii>ÃiʜvÊ̅iʅœÀ“œ˜iÃÊ Û>Ü«ÀiÃȘ >˜` capacity.
>`œÃÌiÀœ˜i >˜`Ê̅iÊi˜âޓiÊ Ài˜ˆ˜ ̜ʓˆ˜ˆ“ˆâiÊÜ`ˆÕ“Ê>˜`ÊÜ>ÌiÀʏœÃÃ
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70 • SECTION II Nutrition and Energy

BOX 2.4 CLOSE UP

Exercise-Induced Anemia: Fact or Fiction?

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i˜`ÕÀ>˜ViÊëœÀÌÃÊ>˜`ʈ˜VÀi>Ãi`Ê«>À̈Vˆ«>̈œ˜ÊœvÊܜ“i˜Êˆ˜ ÃÕ««œÀ̈˜}Ê̅iÊ«œÃÈLˆˆÌÞʜvÊ>˜ÊiÝiÀVˆÃi‡ˆ˜`ÕVi`Ê>˜i“ˆ>°
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VˆÃiÊÌÀ>ˆ˜ˆ˜}ÊVÀi>ÌiÃÊ>˜Ê>``i` iÝ«>˜Ãˆœ˜Êˆ˜Ê«>Ó>ÊۜÕ“i
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Chapter 2 Macronutrients and Micronutrients • 71

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72 • SECTION II Nutrition and Energy

T H O U G H T Q U E S T I O N S
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Chapter 2 Macronutrients and Micronutrients • 73

Daily water input Daily water output +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

>“iÊ̅iÊÓÊvÕˆ`ÊVœ“«>À̓i˜ÌÃʜvÊ̅
Lœ`Þ°
Source mL Source mL
Food 1000 Urine 1250 £°
Fluids 1200 Feces 100
Metabolism 350 Skin 850
Total 2550 Lungs 350 Ó°
Total 2550

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Temperate weather
ΰ

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Daily water input
Daily water output

Source mL

&OR 9OUR )NFORMATION

Food 1000
Fluids 1200 Source mL
Metabolism 350 Urine 500
Total 2550 Feces 100 (9$2!4)/. 4%2-)./,/'9
Skin 5000
Lungs 700 • Euhydration: Normal daily water
Total 6300 variation
• Hyperhydration: New steady-state
condition of increased water
content
• Hypohydration: New steady-state
condition of decreased water con-
tent
• Rehydration: Process of gaining
water from hypohydrated state
toward euhydration

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average rectal temperature of 103.5!F
Water Output /…iÊLœ`ÞʏœÃiÃÊÜ>ÌiÀʈ˜ÊvœÕÀÊÜ>ÞÃ\Ê after a 14-mile race in a tropical
climate differed from a “normal” 98!F
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when temperature was assessed orally.
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This 5.5!F discrepancy partly results
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from evaporative cooling of the
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mouth and airways during relatively
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74 • SECTION II Nutrition and Energy

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Chapter 2 Macronutrients and Micronutrients • 75

BOX 2.5 CLOSE UP

How to Distinguish Among Heat Cramps, Heat
Exhaustion, and Heat Stroke

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Chapter 2 Macronutrients and Micronutrients • 77

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2. Drink 150 to 300 mL (5–10 oz) of fluid about 30 minutes before exercise.
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3. Drink no more than 1000 mL ! h"1 (33 oz) of plain water spread over
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5. Do not restrict salt in the diet.
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6. Adding 5 to 8% glucose to the rehydration drink facilitates intestinal
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Food Energy
C h a p t e r
3
and Optimum
Nutrition for
Exercise
CHAPTER OBJECTIVES

• Define heat of combustion, digestive efficiency, and
Atwater general factors.
• Compute the energy content of a meal from its
macronutrient composition.
• Discuss possible reasons why consuming high-
glycemic carbohydrates during intense
aerobic exercise enhances endurance
performance.

• Compare the nutrient and energy intakes of physically • Define glucose polymer and give the rationale for
adding these compounds to a sports drink.
active men and women with sedentary counterparts.

• Outline the MyPyramid recommendations. • Make a general recommendation concerning

carbohydrate intake for athletes in intense training.
• Describe the timing and composition of the pre-event
• Describe the most effective way to replenish glycogen
(precompetition) meal, including reasons for limiting
reserves after an intense bout of training or
lipid and protein intake.
competition.
• Summarize effects of low, normal, and high
• Compare classic carbohydrate loading with the
carbohydrate intake on glycogen reserves and
modified procedure.
subsequent endurance performance.

• For endurance athletes, describe the potential

negative effects of consuming a concentrated sugar
drink 30 minutes before competition and the ideal
composition of a “sports drink.”

81
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82 • SECTION II Nutrition and Energy

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i˜iÀ}Þʈ˜VÀi>ÃiÃÊ̅iÊÌi“«iÀ>ÌÕÀiʜvÊ£™ÎäÊʜvÊÜ>ÌiÀÊLÞÊ£ !
° LÕÀ˜ˆ˜}ʜÀʜ݈`>̈œ˜ÊœvÊvœœ`ʈ˜Ê>ÊLœ“LÊV>œÀˆ“iÌiÀÊÀi«Ài‡
Ãi˜ÌÃʈÌÃÊ …i>ÌʜvÊVœ“LÕÃ̈œ˜ ­ÌœÌ>Êi˜iÀ}ÞÊÛ>ÕiʜvÊ̅i
vœœ`®°Ê ÕÀ˜ˆ˜}Ê£Ê}ʜvÊ«ÕÀiÊV>ÀLœ…Þ`À>ÌiÊވi`ÃÊ>ʅi>ÌʜvÊVœ“‡
LÕÃ̈œ˜ÊœvÊ{°Óäʎ
>]Ê£Ê}ʜvÊ«ÕÀiÊ«ÀœÌiˆ˜ÊÀii>ÃiÃÊx°Èxʎ
>]
Gross Energy Value of Foods
>˜`Ê£Ê}ʜvÊ«ÕÀiʏˆ«ˆ`Êވi`Ãʙ°{xʎ
>° iV>ÕÃiʓœÃÌÊvœœ`Ãʈ˜
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ÌÀ>Ìi`ʈ˜Ê Figure 3.1]Ê̜ʓi>ÃÕÀiÊ̅iÊ̜Ì>ÊœÀÊ}ÀœÃÃÊi˜iÀ}Þ “>VÀœ˜ÕÌÀˆi˜ÌÃ]Ê̅iÊV>œÀˆVÊÛ>ÕiʜvÊ>Ê}ˆÛi˜Êvœœ`ÊÀiviVÌÃÊ̅
ÃՓʜvÊ̅iʅi>ÌÃʜvÊVœ“LÕÃ̈œ˜ÊvœÀÊ̅iÃiÊ̅Àiiʓ>VÀœ˜ÕÌÀˆ‡
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̈œ˜Êˆ˜Ê̅iÊLœ“LÊV>œÀˆ“iÌiÀʏˆLiÀ>ÌiÃÊ>LœÕÌÊÈx¯Ê“œÀi
i˜iÀ}ÞÊ«iÀÊ}À>“Ê̅>˜Ê«ÀœÌiˆ˜ÊœÝˆ`>̈œ˜Ê>˜`Ê£Óä¯Ê“œÀi
Electrical
ignition i˜iÀ}ÞÊ̅>˜ÊV>ÀLœ…Þ`À>Ìiʜ݈`>̈œ˜°

Thermometer
Oxygen inlet
Net Energy Value of Foods
ˆvviÀi˜ViÃÊi݈ÃÌʈ˜Ê̅iÊi˜iÀ}ÞÊÛ>ÕiʜvÊvœœ`ÃÊ܅i˜ÊVœ“‡
«>Àˆ˜}Ê̅iʅi>ÌʜvÊVœ“LÕÃ̈œ˜Ê­}ÀœÃÃÊi˜iÀ}ÞÊÛ>Õi®Ê`iÌiÀ‡
“ˆ˜i`ÊLÞÊ`ˆÀiVÌÊV>œÀˆ“iÌÀÞÊ܈̅Ê̅iʘiÌ i˜iÀ}ÞÊ>Û>ˆ>Li
Mixing Oxygen
motor source ̜Ê̅iÊLœ`Þ°Ê/…ˆÃÊ«iÀÌ>ˆ˜ÃÊ«>À̈VՏ>ÀÞÊ̜ʫÀœÌiˆ˜ÊLiV>ÕÃi
ˆÌÃʘˆÌÀœ}i˜ÊVœ“«œ˜i˜ÌÊ`œiÃʘœÌʜ݈`ˆâi°Ê˜Ê̅iÊLœ`Þ]
˜ˆÌÀœ}i˜Ê>̜“ÃÊVœ“Lˆ˜iÊ܈̅ʅÞ`Àœ}i˜Ê̜ÊvœÀ“ÊÕÀi>]
܅ˆV…ÊiÝVÀiÌiÃʈ˜ÊÕÀˆ˜i°Ê ˆ“ˆ˜>̈œ˜ÊœvʅÞ`Àœ}i˜Êˆ˜Ê̅ˆÃ
Air space “>˜˜iÀÊÀi«ÀiÃi˜ÌÃÊ>ʏœÃÃʜvÊ>««ÀœÝˆ“>ÌiÞÊ£™¯ÊœvÊ«Àœ‡
Ìiˆ˜½ÃÊ«œÌi˜Ìˆ>Êi˜iÀ}Þ°Ê/…iʅÞ`Àœ}i˜ÊœÃÃÊÀi`ÕViÃÊ«Àœ‡
Water bath Bomb
mixer
Ìiˆ˜½Ãʅi>ÌʜvÊVœ“LÕÃ̈œ˜Êˆ˜Ê̅iÊLœ`ÞÊ̜Ê>LœÕÌÊ{°Èʎ
>
Electric «iÀÊ}À>“ʈ˜ÃÌi>`ʜvÊx°Èxʎ
>Ê«iÀÊ}À>“ʈ˜Ê̅iÊLœ“L
Water fuse
bath
V>œÀˆ“iÌiÀ°Ê˜ÊVœ˜ÌÀ>ÃÌ]ʈ`i˜ÌˆV>Ê«…ÞȜœ}ˆVÊvÕiÊÛ>ÕiÃ
Pressurized i݈ÃÌÊvœÀÊV>ÀLœ…Þ`À>ÌiÃÊ>˜`ʏˆ«ˆ`ÃÊ­˜iˆÌ…iÀÊVœ˜Ì>ˆ˜ÃʘˆÌÀœ‡
Food oxygen
sample
}i˜®ÊVœ“«>Ài`Ê܈̅Ê̅iˆÀʅi>ÌÃʜvÊVœ“LÕÃ̈œ˜Êˆ˜Ê̅i
Lœ“LÊV>œÀˆ“iÌiÀ°
Insulating
container
Digestive Efficiency
Figure 3.1 œ“LÊV>œÀˆ“iÌÀÞÊ`ˆÀiV̏Þʓi>ÃÕÀiÃÊ̅iÊi˜iÀ}Þ /…iʈ˜}iÃÌi`ʓ>VÀœ˜ÕÌÀˆi˜ÌÊ>Û>ˆ>LˆˆÌÞÊ̜Ê̅iÊLœ`ÞÊ`iÌiÀ‡
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Chapter 3 Food Energy and Optimum Nutrition for Exercise • 83

Vœ“«iÌi˜iÃÃʜvÊ`ˆ}iÃ̈œ˜Ê>˜`Ê>LÜÀ«Ìˆœ˜°
œÀ“>Þ]Ê>LœÕÌʙǯʜvÊV>ÀLœ…Þ`À>ÌiÃ] &OR 9OUR )NFORMATION
™x¯Êœvʏˆ«ˆ`Ã]Ê>˜`ʙӯʜvÊ«ÀœÌiˆ˜ÃÊLiVœ“i
30/243 4(!4 02/-/4% -!2').!, .542)4)/.
`ˆ}iÃÌi`]Ê>LÜÀLi`]Ê>˜`Ê>Û>ˆ>LiÊvœÀ
i˜iÀ}ÞÊVœ˜ÛiÀȜ˜°Ê>À}iÊÛ>Àˆ>̈œ˜Êi݈ÃÌà Gymnasts; ballet dancers; ice dancers; and weight-class athletes in boxing,
ˆ˜Ê̅iÊ`ˆ}iÃ̈ÛiÊivvˆVˆi˜VÞʜvÊ«ÀœÌiˆ˜]ÊÀ>˜} wrestling, rowing, and judo engage in arduous training. Owing to the nature
ˆ˜}ÊvÀœ“Ê>ʅˆ}…ÊœvʙǯÊvœÀÊ>˜ˆ“>Ê«ÀœÌiˆ˜ of their sport, these athletes continually strive to maintain a lean, light body
̜Ê>ʏœÜʜvÊÇn¯ÊvœÀÊ`Àˆi`Ê«i>ÃÊ>˜`ÊLi>˜Ã° mass dictated by either esthetic or weight-class considerations. Energy intake
ÕÀ̅iÀ“œÀi]ʏiÃÃÊi˜iÀ}ÞÊLiVœ“iÃÊ>Û>ˆ‡ often intentionally falls short of energy expenditure, and a relative state of
>LiÊvÀœ“Ê>ʓi>Ê܈̅Ê>ʅˆ}…‡vˆLiÀÊVœ˜Ìi˜Ì malnutrition develops. Nutritional supplementation for these athletes may

œ˜Ãˆ`iÀˆ˜}Ê>ÛiÀ>}iÊ`ˆ}iÃ̈ÛiÊivvˆVˆi˜ prove beneficial.
VˆiÃ]Ê̅iʘiÌʎ
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Energy Value of a Meal

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ÌÜ>ÌiÀÊÛ>ÕiÃʈvʜ˜i *ÀœÌiˆ˜\
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ä°nʎ
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>Ê­ä°£ÓÊ! ™°ä®]Ê>˜`Êä°äÈÊ}
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>Ê­ä°näÊ " £°änÊ " ä°Ó{®°

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>° ˆÛiÊ̅iÊ
ÌÜ>ÌiÀÊv>V̜ÀÃÊvœÀ\Ê
Table 3.1 «ÀiÃi˜ÌÃÊ>˜œÌ…iÀÊiÝ>“«iʜvʎ
>ÊV>VՏ>̈œ˜ÃÊvœÀÊÎÉ{ÊVիʜÀÊ£ääÊ}
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1˜ˆÌi`Ê-Ì>ÌiÃÊi«>À̓i˜ÌʜvÊ
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vœÀÊ>“œÃÌÊ>Êvœœ`ÃÊ­ ÜÜÜ°˜>°ÕÃ`>°}œÛÉv˜ˆVÉvœœ`Vœ“«ÉÃi>ÀV…É®°Êœœ`‡V>œÀˆi *ÀœÌiˆ˜\
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ˆ«ˆ`\

Method of Calculating the Caloric Value of a Food

Table 3.1 "vÊ̅iÊÎʓ>VÀœ˜ÕÌÀˆi˜ÌÃ]Ê܅ˆV…Êœ˜iʅ>ÃÊ̅i
from Its Composition of Macronutrients
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84 • SECTION II Nutrition and Energy

BOX 3.1 CLOSE UP

How to Read a Food Label

7
2 Nutrition Facts
Descriptive terms if
the product meets Manufacturer Serving size 3/4 c (28 g)
Servings per container 14
specified criteria name and
Amount per serving
address
Calories 110 5
Calories from fat 9

% Daily Value*
Serving size, number
Total Fat 1 g 2%
of servings per
Saturated fat 0 g 0%
container, and calorie
information
1 Trans fat 0 g 0%
Cholesterol 0 mg 0%
Product Sodium 250 mg 10%
name Total Carbohydrate 23 g 8%
Dietary fiber 1.5 g 6%
Sugars 10 g
Protein 3 g 6
Vitamin A 25%
Vitamin C 25% Nutrition information
Calcium 2% panel provides
Iron 25% quantities of nutrients
*Percent Daily Values are based on a
per serving, in both
2000 calorie diet. Your daily values may
be higher or lower depending on your
actual amounts and
calorie needs. as "% Daily Values"
Calories 2000 2500 based on a
Total fat
Sat Fat
Less than
Less than
65 g
20 g
80 g
25 g
2000-calorie energy
Cholesterol
Sodium
Less than
Less than
300 mg
2400 mg
300 mg
2400 mg
intake
Total Carbohydrate 300 g 375 g
Fiber 25 g 30 g

Calories per gram:

Fat 9
Carbohydrates 4
Protein 4

INGREDIENTS: Corn, whole wheat, sugar,

rolled oats, brown sugar, rice, partially
hydrogenated vegetable oir (sunflower and/or
canola oil), wheat flour, salt, malted barley flour,

3 corn syrup, whey (from milk), malted corn and

barley syrup, honey, artificial flavor, annatto
etract (color), BHT added to packaging material
to preserve product freshness.
Weight or measure VITAMINS AND MINERALS: Reduced iron,
niacinamide, vitamin B6, Vitamin A palmitate 4
zinc oxide (source of zinc), riboflavin (vitamin
B2), thiamin mononitrate (vitamin B1), folic

ÝV…>˜}iʈÃÌÃÊvœÀÊi>Ê
8
acid, vitamin B12, vitamin D.
Ingredients in
EXCHANGE: 1-1/2 starch, exchange
calculations based on
descending order
*>˜˜ˆ˜} ©1995, American Diabetes
Approved health claims Association, Inc. and The American Dietetic of predominance
Association.
stated in terms of the by weight
total diet

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Chapter 3 Food Energy and Optimum Nutrition for Exercise • 85

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n°
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`ˆiÌ° ™xʓ}ʜvÊV…œiÃÌiÀœÊ«iÀÊÃiÀۈ˜}Ê>˜`Ê«iÀÊ£ääÊ}ʜvʓi>Ì]
«œÕÌÀÞ]ʜÀÊÃi>vœœ`°
TERMS ON FOOD LABELS iÃÃÊv>Ì\ /Üi˜ÌއvˆÛiÊ«iÀVi˜ÌʜÀʏiÃÃÊv>ÌÊ̅>˜Ê̅iÊVœ“«>Àˆ

œ““œ˜ÊÌiÀ“ÃÊ>˜`Ê܅>ÌÊ̅iÞʓi>˜\ ܘÊvœœ`°
œÜÊv>Ì\ /…ÀiiÊ}À>“ÃʜÀʏiÃÃʜvÊv>ÌÊ«iÀÊÃiÀۈ˜}°
Àii\ ÕÌÀˆÌˆœ˜>ÞÊÌÀˆÛˆ>Ê>˜`Ê՘ˆŽiÞÊ̜ʅ>ÛiÊ«…ÞȜ‡
ˆ}…Ì\ ˆvÌÞÊ«iÀVi˜ÌʜÀʏiÃÃÊv>ÌÊ̅>˜Ê̅iÊVœ“«>ÀˆÃœ˜Êvœœ`
œ}ˆVÊVœ˜ÃiµÕi˜ViÃÆÊÃޘœ˜Þ“Ãʈ˜VÕ`iʺ܈̅œÕÌ]»
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ˆ}…\ /Üi˜ÌÞÊ«iÀVi˜ÌʜÀʓœÀiʜvÊ̅iÊ>ˆÞÊ6>ÕiÊ­6®ÊvœÀ
̅>˜Ê̅iÊVœ“«>ÀˆÃœ˜Êvœœ`°
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ˆ˜»ÊœÀʺiÝVii˜Ìʈ˜»° Energy Terms
iÃÃ\
Ìʏi>ÃÌÊÓx¯ÊiÃÃʜvÊ>Ê}ˆÛi˜Ê˜ÕÌÀˆi˜ÌʜÀÊV>œÀˆiÃÊ̅>˜
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φ\
˜Ê>“œÕ˜ÌÊ̅>ÌÊ>œÜÃÊvÀiµÕi˜ÌÊVœ˜ÃՓ«Ìˆœ˜ÊœvÊ̅i œÜÊV>œÀˆi\ œÀÌÞÊV>œÀˆiÃʜÀʏiÃÃÊ«iÀÊÃiÀۈ˜}°
vœœ`Ê܈̅œÕÌÊiÝVii`ˆ˜}Ê̅iʘÕÌÀˆi˜Ì½ÃÊ6° ,i`ÕVi`ÊV>œÀˆi\
Ìʏi>ÃÌÊÓx¯ÊviÜiÀÊV>œÀˆiÃÊ«iÀÊÃiÀۈ˜}
œœ`ÊÜÕÀVi\ *Àœ`ÕVÌÊ«ÀœÛˆ`iÃÊLiÌÜii˜Ê£ä¯Ê>˜`Ê£™¯ÊœvÊ> ̅>˜Ê̅iÊVœ“«>ÀˆÃœ˜Êvœœ`°
}ˆÛi˜Ê˜ÕÌÀˆi˜Ì½ÃÊ6Ê«iÀÊÃiÀۈ˜}°
Fiber Term
Cholesterol Terms ˆ}…ÊvˆLiÀ ˆÛiÊ}ʜÀʓœÀiʜvÊvˆLiÀÊ«iÀÊÃiÀۈ˜}

…œiÃÌiÀœÊvÀii\ iÃÃÊ̅>˜ÊÓʓ}Ê«iÀÊÃiÀۈ˜}Ê>˜`ÊÓÊ}ʜÀʏiÃÃ
Sodium Terms
œvÊÃ>ÌÕÀ>Ìi`Êv>ÌÊ«iÀÊÃiÀۈ˜}°
-œ`ˆÕ“ÊvÀii >˜`ÊÃ>ÌÊvÀii\ iÃÃÊ̅>˜Êxʓ}ʜvÊÜ`ˆÕ“Ê«iÀ
œÜÊV…œiÃÌiÀœ\ /Üi˜ÌÞʓ}ʜÀʏiÃÃʜvÊV…œiÃÌiÀœÊ«iÀÊÃiÀۇ
ÃiÀۈ˜}°
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iÃÃÊV…œiÃÌiÀœ\ /Üi˜ÌއvˆÛiÊ«iÀVi˜ÌʜÀʏiÃÃʜvÊV…œiÃ
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ˆ}…Ì\ œÜ‡V>œÀˆiÊvœœ`Ê܈̅Êxä¯ÊÜ`ˆÕ“ÊÀi`ÕV̈œ˜°
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Fat Terms Vœ“«>ÀˆÃœ˜Êvœœ`°
ÝÌÀ>ʏi>˜\ iÃÃÊ̅>˜ÊxÊ}ʜvÊv>Ì]ÊÓÊ}ʜvÊÃ>ÌÕÀ>Ìi`Êv>Ì]Ê>˜` 6iÀÞʏœÜÊÜ`ˆÕ“ \Ê/…ˆÀÌއvˆÛiʓ}ʜÀʏiÃÃʜvÊÜ`ˆÕ“Ê«i
™x “}ʜvÊV…œiÃÌiÀœÊ«iÀÊÃiÀۈ˜}Ê>˜`Ê«iÀÊ£ääÊ}ʜvʓi>Ì] ÃiÀۈ˜}°
«œÕÌÀÞ]ʜÀÊÃi>vœœ`°

R E F E R E N C E S
ÕÌÀˆÌˆœ˜>Ê>Liˆ˜}Ê>˜`Ê `ÕV>̈œ˜Ê
VÌÊ­ 
®Ê,iµÕˆÀi“i˜ÌÃÊ­nə{‡Óəx®\ÊÜÜÜ°v`>°}œÛÉ

ɘëiV̈œ˜Ո`iÃÉÕV“äÇ{™{n°…Ì“
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œ˜ÃՓiÀˆ˜vœÀ“>̈œ˜ÉÕV“äÇnnn™°…Ì“
Ìܜ«>ÀÌà «>˜iÊ­/…ˆÃÊÜiLÈÌiÊ«ÀœÛˆ`iÃÊVœ“«iÌiÊ`iÃVÀˆ«Ìˆœ˜ÊœvÊ̅iʘiÜÊvœœ`ʏ>LiÊ>˜`ÊÀiiÛ>˜ÌÊÌiÀ“ÃÊ>˜`ʓ>ÌiÀˆ>ÃÊÀi>Ìi`Ê̜
̅iʏ>Li°®

Calories Equal Calories

œ˜Ãˆ`iÀÊ̅iÊvœœÜˆ˜}ÊvˆÛiÊVœ““œ˜Êvœœ`Ã\ÊÀ>ÜÊViiÀÞ]ÊVœœŽi`
V>LL>}i]ÊVœœŽi`Ê>ë>À>}ÕÃÊëi>ÀÃ]ʓ>ޜ˜˜>ˆÃi]Ê>˜`ÊÃ>>`ʜˆ°Ê/œ
Vœ˜ÃՓiÊ£ääʎ
>ÊœvÊi>V…ÊœvÊ̅iÃiÊvœœ`Ã]ʜ˜iʓÕÃÌÊi>ÌÊÓäÊÃÌ>ŽÃ -/2% ,)0)$ %15!,3 -/2% #!,/2)%3
œvÊViiÀÞ]Ê{ÊVÕ«ÃʜvÊV>LL>}i]ÊÎäÊ>ë>À>}ÕÃÊëi>ÀÃ]ÊLÕÌʜ˜ÞÊ£Ê/Lë
œvʓ>ޜ˜˜>ˆÃiʜÀÊ{ÉxÊÌëʜvÊÃ>>`ʜˆ°Ê/…ÕÃ]Ê>ÊÓ>ÊÃiÀۈ˜}ʜv
ܓiÊvœœ`ÃÊVœ˜Ì>ˆ˜ÃÊ̅iÊiµÕˆÛ>i˜ÌÊi˜iÀ}ÞÊÛ>ÕiÊ>ÃÊ>ʏ>À}iʵÕ>˜‡
̈ÌÞʜvʜ̅iÀÊvœœ`ðÊ6ˆiÜi`ÊvÀœ“Ê>Ê`ˆvviÀi˜ÌÊ«iÀëiV̈Ûi]Ê̜ʓiiÌ
`>ˆÞÊi˜iÀ}Þʘii`Ã]Ê>ÊÃi`i˜Ì>ÀÞÊޜ՘}Ê>`ՏÌÊܜ“>˜ÊܜՏ`ʅ>Ûi
̜ÊVœ˜ÃՓiʓœÀiÊ̅>˜Ê{ÓäÊÃÌ>ŽÃʜvÊViiÀÞ]Ên{ÊVÕ«ÃʜvÊV>LL>}i]
œÀÊÈÎäÊ>ë>À>}ÕÃÊëi>ÀÃÊÞiÌʜ˜ÞÊ£°xÊVÕ«Ãʜvʓ>ޜ˜˜>ˆÃiʜÀÊ>LœÕÌ
nʜâʜvÊÃ>>`ʜˆ°Ê7…>ÌʈÃÊ̅iʓ>œÀÊ`ˆvviÀi˜ViÊ>“œ˜}Ê̅iÃi
vœœ`öÊ,iV>Ê̅>Ìʅˆ}…‡v>ÌÊvœœ`ÃÊVœ˜Ì>ˆ˜Ê“œÀiÊi˜iÀ}ÞÊ܈̅ʏˆÌ̏i
Ü>ÌiÀ]Ê>˜`Êvœœ`ÃʏœÜʈ˜Êv>ÌʜÀʅˆ}…ʈ˜ÊÜ>ÌiÀÊÌi˜`Ê̜ÊVœ˜Ì>ˆ˜ÊˆÌ̏i
i˜iÀ}Þ°
&OR 9OUR )NFORMATION
Lipid-rich foods contain a higher energy content
than foods that are relatively fat free. One glass of
whole milk, for example, contains 160 kCal; the
same quantity of skim milk contains only 90 kCal.
If a person who normally consumes 1 qt of whole
milk each day switches to skim milk, the total calo-
ries ingested each year would be reduced by the
equivalent calories in 25 lb of body fat. Thus, fol-
lowing this switch for just 3 years theoretically rep-
resents the equivalent energy in 75 lb of body fat.
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86 • SECTION II Nutrition and Energy

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˜Êˆ˜`ˆÛˆ`Õ>½Ã
ÜÕÀVi° Àœ“Ê>˜Êi˜iÀ}ÞÊÃÌ>˜`«œˆ˜Ì]Ê£ääÊV>œÀˆiÃÊvÀœ“ V>œÀˆVʈ˜Ì>ŽiÊiµÕ>ÃÊ̅iÊÃՓʜvÊ > i˜iÀ}ÞÊVœ˜ÃՓi`
“>ޜ˜˜>ˆÃiÊiµÕ>ÃÊ̅iÊÃ>“iÊ£ääÊV>œÀˆiÃʈ˜ÊÓäÊViiÀÞ vÀœ“ÊiˆÌ…iÀÊÓ>ÊœÀʏ>À}iʵÕ>˜ÌˆÌˆiÃʜvÊvœœ`ðÊ
iiÀÞÊ>˜`
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T H O U G H T Q U E S T I O N S
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Part 2 Optimal Nutrition for
Exercise and Sports
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Chapter 3 Food Energy and Optimum Nutrition for Exercise • 87

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DIETARY REFERENCE INTAKES

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consume more calories per kg of
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body mass than their sedentary
`ˆiÌÃÊvœÀʅi>Ì…ÞÊ«iœ«i°
counterparts. The extra energy
/…iÊvˆ˜>Ê˜ÕÌÀˆi˜ÌÊÀiVœ““i˜`>̈œ˜Ãʈ˜VÕ`i`Ê«œ«Õ>̈œ˜Ê`>Ì>ÊvÀœ“Ê
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required for exercise accounts for the
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larger caloric intake. Paradoxically,
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the most physically active men and
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women, who eat more on a daily
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basis, weigh less than those who
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exercise at a lower total caloric
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expenditure. Regular exercise allows a
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person to “eat more yet weigh less”
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of body fat despite the age-related
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tendency toward weight gain that
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begins at about age 21 years and
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continues at about one pound of
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weight gained for the next 40 years!
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Physically active persons maintain a
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lighter and leaner body and a health-
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…>vʜvÊ̅iʅi>Ì…Þʈ˜`ˆÛˆ`Õ>Ãʈ˜Ê>Ê«>À̈VՏ>ÀʏˆviÊÃÌ>}iÊ>˜`Ê}i˜`iÀ their increased food intake.
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Table 3.2 Mean ("SD) Nutrient Intake Based on 3-Day Diet Records By Level of Cardiorespiratory Fitness in 7959 Men and 2453 Women

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GRAINS
Make half your
grains whole
Any food made from wheat,
rice, oats, cornmeal, barley,
or another cereal grain is a
grain product
Bread, pasta, oatmeal,
breakfast cereals, tortillas,
and grits are examples of
grain products
For a 2000-Calorie diet you need the amounts below from each food group. To find the amounts right for you, go to MyPyramid.gov.
Eat 3 oz. every day
B Mediterranean Diet Pyramid
Red meat
(a few times a month)
Sweets, eggs, poultry, and fish
(a few times a week)
Breads, pasta, rice,
couscous, polenta
bulgur, and other
grains and potatoes
(daily)
Daily
exercise
VEGETABLES
Vary your veggies
Eat more dark-green veggies
like broccoli, spinach, and
other dark leafy greens
Eat more orange vegetables
like carrots and sweet
potatoes
Eat more dry beans and
peas like pinto beans, kidney
beans, and lentils
Eat 21/2 cups every day
Wine
(in moderation)
Chapter 3 Food Energy and Optimum Nutrition for Exercise
MyPyramid
FRUITS MILK
Focus on fruits Get your
calcium-rich foods
Eat a variety of fruit Go low-fat or fat-free when
you choose milk, yogurt,
Choose fresh, frozen, and other milk products
canned, or dried fruit
If you don’t or can’t
Go easy on fruit juices consume milk, choose
lactose-free products or
other calcium sources such
as fortified foods and
beverages
Eat 2 cups every day Drink 3 cups every day;
for kids aged 2 to 8, it’s 2
C Near-Vegetarian Diet Pyramid
(optional, or occasionally, or
Wine, alcohol
(optional)
Eggs whites, soy milks, dairy
• 93
MEAT & BEANS
Go lean with protein
Choose low-fat or lean
meats and poultry
Bake it, broil it, or grill it
Vary your protein routine –
choose more fish, beans,
peas, nuts, and seeds
Eat 51/2 oz. every day
Eggs and sweets
in small quantities)
nuts, seeds, and plant oils
(daily)
Whole grains, fruits,
vegetables, and
legumes
(at every meal)
Daily
exercise

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94 • SECTION II Nutrition and Energy

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96 • SECTION II Nutrition and Energy

Daily Energy Expenditure (kCal) >Vˆ`ÊLÀi>Ž`œÜ˜ÊÀiµÕˆÀiÊÜ>ÌiÀÊvœÀÊÕÀˆ˜>ÀÞÊiÝVÀ°

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Tour de France
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Chapter 3 Food Energy and Optimum Nutrition for Exercise • 97

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98 • SECTION II Nutrition and Energy

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feeding

vœÀÊi˜iÀ}Þ°
2.5

Glycemic Index and Pre-exercise Food Intake

0 30 60 90 120 135 150 180 195 210
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Chapter 3 Food Energy and Optimum Nutrition for Exercise • 99

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Lœœ`Ê}ÕVœÃiʏiÛiÃÊÃÕÃÌ>ˆ˜Ê̅iʓÕÃViýÊi˜iÀ}Þʘii`ð ˆÛiÊ̅iʓ>œÀÊ«ÕÀ«œÃiʜvÊ̅iÊ
«ÀiVœ“«ï̈œ˜Ê“i>°
Post-exercise Carbohydrate Intake
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«iÀʅœÕÀ°Ê Ûi˜Ê՘`iÀÊ̅iÊLiÃÌʜvÊVˆÀVՓÃÌ>˜ViÃ]ʈÌÊܜՏ`ÊÃ̈ÊÀiµÕˆÀiÊ>Ìʏi>ÃÌÊ
ÓäʅœÕÀÃÊ̜ÊÀiiÃÌ>LˆÃ…Ê}ÞVœ}i˜ÊÃ̜ÀiÃÊ܈̅Ê}ÞVœ}i˜Ê`i«ïœ˜°

GLUCOSE INTAKE, ELECTROLYTES,

AND WATER UPTAKE

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i˜iÀ}ÞÊvœÀÊiÝiÀVˆÃiÊ܅i˜Ê̅iÊLœ`Þ½ÃÊ}ÞVœ}i˜ÊÀiÃiÀÛiÃÊ`i«iÌi°ÊiÌiÀ“ˆ˜ˆ˜}Ê̅i
œ«Ìˆ“>ÊvÕˆ`ÉV>ÀLœ…Þ`À>ÌiʓˆÝÌÕÀiÊ>˜`ÊۜÕ“iÊ̜ÊVœ˜ÃՓiÊ`ÕÀˆ˜}ÊiÝiÀVˆÃiÊÌ>Ži
œ˜Êˆ“«œÀÌ>˜ViÊ܅i˜Ê̅iʜLiV̈ÛiÃÊ>ÌÌi“«ÌÊ̜ÊÀi`ÕViÊv>̈}ÕiÊ>˜`Ê«ÀiÛi˜ÌÊ`i…Þ`À>‡
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6"ӓ>Ý ÃœÜÃÊ̅iÊi“«Ìވ˜}ÊÀ>Ìi°Ê>ÃÌÀˆV
ۜÕ“iÊ}Ài>̏Þʈ˜vÕi˜ViÃÊ}>ÃÌÀˆVÊi“«ÌÞ
ˆ˜}ÆʈÌÃÊÀ>ÌiÊ`iVÀi>ÃiÃÊ>ÃÊÃ̜“>V…ÊۜÕ“i &OR 9OUR )NFORMATION
`iVÀi>ÃiðÊÌʓ>ŽiÃÊÃi˜ÃiÊ̜ʓ>ˆ˜Ì>ˆ˜Ê>Ê
Ài>̈ÛiÞʏ>À}iÊÃ̜“>V…ÊvÕˆ`ÊۜÕ“iÊÌ &,5)$ ).4!+% 02!#4)#!, 2%#/--%.$!4)/.3
ëii`Ê}>ÃÌÀˆVÊi“«Ìވ˜}° 1. Monitor dehydration rate from changes in body weight (have athlete uri-
nate before postexercise body weight determination to account for water
Consider Fluid Concentration lost in urine). Each pound of weight loss corresponds to about 450 mL
(15 fluid oz) of dehydration.

ʎiÞʵÕiÃ̈œ˜ÊVœ˜ViÀ˜ÃÊ̅iÊ«œÃÈLi 2. Drink fluids at the same rate as their estimated rate of depletion. This means
˜i}>̈ÛiÊivviVÌÃʜvÊÃÕ}>ÀÊ`Àˆ˜ŽÃʜ˜ÊÜ>ÌiÀ drinking at a rate close to 80% of sweating rate during prolonged exercise
>LÜÀ«Ìˆœ˜ÊvÀœ“Ê̅iÊ`ˆ}iÃ̈ÛiÊÌÀ>VÌ°Ê>Ç that produces cardiovascular stress, excessive heat, and dehydration.
ÌÀˆVÊi“«Ìވ˜}ÊϜÜÃÊ܅i˜Êˆ˜}iÃÌi`ÊvÕˆ` 3. Drink between 625 and 1250 mL each hour (250 mL every 15 min) of a 4%
Vœ˜Ì>ˆ˜Ê>˜ÊiÝViÃÈÛiÊVœ˜Vi˜ÌÀ>̈œ˜Êœv to 8% carbohydrate beverage to meet carbohydrate (30 to 60 g$h%1) and
«>À̈ViÃʈ˜Ê܏Ṏœ˜Ê­ˆ˜VÀi>Ãi`ʜӜ>‡ fluid requirements.
ˆÌޮʜÀÊ«œÃÃiÃÃʅˆ}…ÊV>œÀˆVÊVœ˜Ìi˜Ì°Ê
˜Þ 4. Consuming 400 to 600 mL of fluid immediately before exercise optimizes
v>V̜ÀÊ̅>Ìʈ“«>ˆÀÃÊvÕˆ`ÊÕ«Ì>Žiʘi}> the beneficial effect of increased stomach volume on fluid and nutrient
̈ÛiÞʈ“«>VÌÃÊ«Àœœ˜}i`ÊiÝiÀVˆÃiʈ˜Ê…œÌ passage into the intestine.
Üi>̅iÀ]Ê܅i˜Ê>`iµÕ>ÌiÊÜ>ÌiÀʈ˜Ì>ŽiÊ>˜` 5. Fluid temperature per se probably does not play a major role in replenish-
>LÜÀ«Ìˆœ˜Ê«>ÞÊ«Àˆ“iÊÀœiÃʈ˜Ê̅iÊ«>À̈V‡ ing fluid during exercise.
ˆ«>˜Ì½Ãʅi>Ì…Ê>˜`ÊÃ>viÌްʘ}iÃ̈˜}ÊÕ«Ê̜ 6. Avoid beverages containing alcohol or caffeine because both compounds
>˜Ên¯Ê}ÕVœÃiqÜ`ˆÕ“ÊœÀ>ÊÀi…Þ`À>̈œ˜ induce a diuretic effect (alcohol most pronounced) that facilitates water loss.
LiÛiÀ>}iÊV>ÕÃiÃʏˆÌ̏iʘi}>̈ÛiÊivviVÌʜ˜
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100 • SECTION II Nutrition and Energy

BOX 3.2 CLOSE UP

Recommended Oral Rehydration Beverage

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>`ۈÃ>LiÊ՘`iÀÊÃÕV…ÊVœ˜`ˆÌˆœ˜Ã°Ê˜ÊVœœÊÜi>̅iÀ]Ê܈̅
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LiÌÜii˜ÊÎäÊ>˜`ÊÈäÊ}Ê­£qÓʜâ®Ê«iÀʅœÕÀ°
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vÕˆ`ÊۜÕ“iʈ˜Ê̅iÊÃ̜“>V…

Gastric emptying
Volume: increased gastric volume increases
emptying rate
Caloric content: increased energy content Stomach
decreases emptying rate
Osmolality: increased solute concentration
decreases emptying rate
Exercise: intensity exceeding 75% of maximum
decreases emptying rate
pH: marked deviations from 7.0 decrease
emptying rate
Large
Hydration level: dehydration decreases gastric intestine
emptying and increases risk of gastrointesinal
distress

Intestinal fluid absortion

Carbohydrate: low to moderate level of Small
glucose + sodium increases fluid absorption intestine
Sodium: low to moderate level of sodium
increases fluid absorption
Osmolality: hypotonic to isotonic fluids contain-
ing NaCl and glucose increase fluid absorption
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Chapter 3 Food Energy and Optimum Nutrition for Exercise • 101

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Sodium’s Potential Benefit

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ΰ -ÕÃÌ>ˆ˜ÃÊ̅iÊ`ÀˆÛiÊ̜Ê`Àˆ˜Ž°

CARBOHYDRATE NEEDS
DURING INTENSE TRAINING
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Diet, Glycogen Stores, and Endurance Capacity

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“>VÀœ˜ÕÌÀˆi˜ÌðÊ/…iÊ̅ˆÀ`Ê«ÀœÛˆ`i`Ênä¯ example, preceding a glycogen loading protocol with a creatine loading protocol
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/…iÊÀiÃՏÌÃÊvÀœ“Ê̅ˆÃʈ˜˜œÛ>̈ÛiÊÃÌÕ`Þ lateralis muscle compared with muscle glycogen levels achieved with only glyco-
ˆÕÃÌÀ>Ìi`ʈ˜Ê Figure 3.8 ŜÜÊ̅>ÌÊ̅i gen loading. It appears that increases in creatine and cellular volume with crea-
}ÞVœ}i˜ÊVœ˜Ìi˜Ìʜvʏi}ʓÕÃViÃ]ÊiÝ«ÀiÃÃi` tine supplementation facilitate subsequent storage of muscle glycogen.
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102 • SECTION II Nutrition and Energy

200
Time to exhaustion (min)

150

High CHO—low fat

Figure 3.8
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Carbohydrate Loading

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ÎÊ`>ÞÃʈvÊ̅iÊ`ˆiÌÊVœ˜Ì>ˆ˜ÃÊ>LœÕÌÊÈä¯ÊœvÊ̜Ì>ÊV>œÀˆiÃÊ>ÃÊV>À‡
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>À‡
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ÃÕ«iÀVœ“«i˜Ã>̈œ˜ÊivviVÌÊÀi“>ˆ˜ÃÊÀi>̈ÛiÞÊÓ>°ÊÕÀˆ˜}
ˆ˜Ìi˜ÃiÊÌÀ>ˆ˜ˆ˜}]ʈ˜`ˆÛˆ`Õ>ÃÊ܅œÊ`œÊ˜œÌÊÕ«}À>`iÊ`>ˆÞÊV>œÀˆV
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Vœ˜ÃÊ­ÃiiÊ«>}iÊ£äή]Ê̅iʘiÜÊvœœ`ÊÀi}ˆ“i˜ÊŜՏ`ÊLiÊÌÀˆi`ʈ˜
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«ï̈œ˜°ÊœÀÊiÝ>“«i]Ê>ÊÀ՘˜iÀÊŜՏ`ÊÃÌ>ÀÌÊ܈̅Ê>ʏœ˜}ÊÀ՘
vœœÜi`ÊLÞÊ>ʅˆ}…‡V>ÀLœ…Þ`À>ÌiÊ`ˆiÌ°Ê/…iÊ>̅iÌiÊŜՏ`
“>ˆ˜Ì>ˆ˜Ê>Ê`iÌ>ˆi`ʏœ}ʜvʅœÜÊ̅iÊ`ˆiÌ>ÀÞʓ>˜ˆ«Õ>̈œ˜
>vviVÌÃÊ«iÀvœÀ“>˜Vi°Ê-ÕLiV̈ÛiÊviiˆ˜}ÃÊŜՏ`ÊLiʘœÌi`
`ÕÀˆ˜}ÊiÝiÀVˆÃiÊ`i«ïœ˜Ê>˜`ÊÀi«i˜ˆÃ…“i˜ÌÊ«…>ÃiðÊ7ˆÌ…
«œÃˆÌˆÛiÊÀiÃՏÌÃ]Ê̅iÊ«iÀܘÊŜՏ`Ê̅i˜ÊÌÀÞÊ̅iÊVœ“«iÌi
ÃiÀˆiÃʜvÊ`i«ïœ˜]ʏœÜ‡V>ÀLœ…Þ`À>ÌiÊ`ˆiÌÊ>˜`Ê>ʅˆ}…‡V>ÀLœ‡
…Þ`À>ÌiÊ`ˆiÌÊLÕÌʓ>ˆ˜Ì>ˆ˜Ê̅iʏœÜ‡V>ÀLœ…Þ`À>ÌiÊ`ˆiÌÊvœÀʜ˜Þ
£Ê`>Þ°ÊvʘœÊ>`ÛiÀÃiÊivviVÌÃÊ>««i>À]Ê̅iʏœÜ‡V>ÀLœ…Þ`À>ÌiÊ`ˆiÌ
ŜՏ`ÊLiÊ}À>`Õ>ÞÊiÝÌi˜`i`Ê̜Ê>ʓ>݈“Õ“ÊœvÊ{Ê`>Þð
Modified Loading Procedure
œvÊ̅iʘi}>̈ÛiÊ>ëiVÌÃʜvÊ̅iÊV>ÃÈVÊ}ÞVœ}i˜‡œ>`ˆ˜}
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VˆÃiÊ̜Ê`i«iÌiÊ}ÞVœ}i˜°Ê/…iÊ>̅iÌiÊÌÀ>ˆ˜ÃÊ>ÌÊ>LœÕÌÊÇx¯Êœv
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Lœ…Þ`À>ÌiÃÊÀi«ÀiÃi˜ÌÊ>««ÀœÝˆ“>ÌiÞÊxä¯ÊœvÊ̜Ì>ÊV>œÀˆV
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Chapter 3 Food Energy and Optimum Nutrition for Exercise • 103

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`À>ÌiÊVœ˜Ìi˜ÌÊ̅i˜Êˆ˜VÀi>ÃiÃÊ̜ÊÇä¯ÊœvÊi˜iÀ}Þʈ˜Ì>Ži]ÊÀi«i˜ˆÃ…ˆ˜}Ê}ÞVœ}i˜
+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
ÀiÃiÀÛiÃÊ̜Ê>LœÕÌÊ̅iÊÃ>“iÊ«œˆ˜ÌÊ>V…ˆiÛi`Ê܈̅Ê̅iÊV>ÃÈVʏœ>`ˆ˜}Ê«ÀœÌœVœ° ˆÃVÕÃÃÊ«œÌi˜Ìˆ>ÊLi˜ivˆÌÃʜvÊV>ÀLœ…Þ`À>Ì
œ>`ˆ˜}°
Rapid Loading Procedure: A One-Day Requirement /…iÊÓÊ̜
ÈÊ`>ÞÃÊÀiµÕˆÀi`Ê̜Ê>V…ˆiÛiÊÃÕ«À>˜œÀ“>Ê“ÕÃViÊ}ÞVœ}i˜ÊiÛiÃÊÀi«ÀiÃi˜ÌÃÊ>
ˆ“ˆÌ>̈œ˜ÊœvÊÌÞ«ˆV>ÊV>ÀLœ…Þ`À>Ìiʏœ>`ˆ˜}Ê«ÀœVi`ÕÀiðÊ,iÃi>ÀV…Ê…>ÃÊiÛ>Õ>Ìi`
܅i̅iÀÊ>ÊŜÀÌi˜i`Ê̈“iÊ«iÀˆœ`Ê̅>ÌÊVœ“Lˆ˜iÃÊ>ÊÀi>̈ÛiÞÊLÀˆivÊLœÕÌʜv
ˆ˜Ìi˜ÃiÊiÝiÀVˆÃiÊ܈̅ʜ˜ÞÊ£Ê`>Þʜvʅˆ}…‡V>ÀLœ…Þ`À>Ìiʈ˜Ì>ŽiÊ>V…ˆiÛiÃÊ̅i
`iÈÀi`ʏœ>`ˆ˜}ÊivviVÌ°Ê ˜`ÕÀ>˜Vi‡ÌÀ>ˆ˜i`Ê>̅iÌiÃÊVÞVi`ÊvœÀÊ£xäÊÃiVœ˜`ÃÊ>Ì
°
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`À>ÌiÊvœœ`Ã°Ê ˆœ«ÃÞÊ`>Ì>Ê«ÀiÃi˜Ìi`ʈ˜Ê Figure 3.9 ˆ˜`ˆV>Ìi`Ê̅>ÌÊV>ÀLœ…Þ`À>Ìi
iÛiÃʈ˜VÀi>Ãi`Ênӯʈ˜Ê>ÊvˆLiÀÊÌÞ«iÃʜvÊ̅iÊÛ>ÃÌÕÃʏ>ÌiÀ>ˆÃʓÕÃViÊ>vÌiÀʜ˜
Ó{ʅœÕÀðÊ/…iʈ˜VÀi>Ãi`Ê}ÞVœ}i˜ÊÃ̜À>}iÊiµÕ>i`ʜÀÊiÝVii`i`ÊÛ>ÕiÃÊÀi«œÀÌi`
LÞʜ̅iÀÃÊÕȘ}Ê>ÊӇÊ̜Êȇ`>ÞÊÀi}ˆ“i˜°Ê/…iÊŜÀ̇`ÕÀ>̈œ˜Êœ>`ˆ˜}Ê«ÀœVi`ÕÀi
Li˜ivˆÌÃʈ˜`ˆÛˆ`Õ>ÃÊ܅œÊ`œÊ˜œÌÊ܈ÅÊ̜Ê`ˆÃÀÕ«ÌʘœÀ“>ÊÌÀ>ˆ˜ˆ˜}Ê܈̅Ê̅iÊ̈“
ÀiµÕˆÀi`Ê>˜`Ê«œÌi˜Ìˆ>Ê˜i}>̈ÛiÊ>ëiVÌÃʜvʜ̅iÀʘÕÌÀˆi˜Ìʏœ>`ˆ˜}Ê«ÀœÌœVœÃ°

Limited Applicability and Negative Aspects

/…iÊ«œÌi˜Ìˆ>ÊLi˜ivˆÌÃÊvÀœ“ÊV>ÀLœ…Þ`À>Ìiʏœ>`ˆ˜}Ê>««Þʜ˜ÞÊ̜ʈ˜Ìi˜ÃiÊ>˜ &OR 9OUR )NFORMATION
«Àœœ˜}i`Ê>iÀœLˆVÊ>V̈ۈ̈iÃ°Ê 1˜iÃÃÊ̅iÊ>̅iÌiÊLi}ˆ˜ÃÊVœ“«ï˜}ʈ˜Ê>ÊÃÌ>Ìiʜv !$*534 #!2"/(9$2!4% ).4!+% 4/
`i«ïœ˜]ÊiÝiÀVˆÃˆ˜}ÊvœÀʏiÃÃÊ̅>˜ÊÈäʓˆ˜ÕÌiÃÊÀiµÕˆÀiÃʜ˜ÞʘœÀ“>ÊV>ÀLœ…Þ`À>Ìi %.%2'9 %80%.$)452% !.$ "/$9
ˆ˜Ì>ŽiÊ>˜`Ê}ÞVœ}i˜ÊÀiÃiÀÛiðÊ
>ÀLœ…Þ`À>Ìiʏœ>`ˆ˜}Ê>˜`Ê>ÃÜVˆ>Ìi`ʅˆ}…ʏiÛiÃ 7%)'(4
œvʓÕÃViÊ>˜`ʏˆÛiÀÊ}ÞVœ}i˜Ê`ˆ`ʘœÌÊLi˜ivˆÌÊ>̅iÌiÃʈ˜Ê>ÊÓ䰙‡Ž“Ê­£Î‡“ˆi Athletes who train arduously should
À՘ÊVœ“«>Ài`Ê܈̅Ê>ÊÀ՘Ê>vÌiÀÊ>ʏœÜ‡V>ÀLœ…Þ`À>ÌiÊ`ˆiÌ°Ê
Ãœ]Ê>ÊȘ}i]ʓ>݈“> consume 10 g of carbohydrates per kg
>˜>iÀœLˆVÊiÝiÀVˆÃiÊvœÀÊÇxÊÃiVœ˜`ÃÊ`ˆ`ʘœÌʈ“«ÀœÛiÊLÞʈ˜VÀi>Ș}ʓÕÃViÊ}ÞVœ‡ of body mass daily. A 100-lb (45-kg)
}i˜Ê>Û>ˆ>LˆˆÌÞÊ>LœÛiʘœÀ“>Ê̅ÀœÕ}…Ê`ˆiÌ>ÀÞʓ>˜ˆ«Õ>̈œ˜ÊLivœÀiÊiÝiÀVˆÃi° athlete who expends 2800 kCal daily
˜Ê“œÃÌÊëœÀÌÊVœ“«ï̈œ˜Ê>˜`ÊiÝiÀVˆÃiÊÌÀ>ˆ˜ˆ˜}]Ê>Ê`>ˆÞÊ`ˆiÌʜvÊÈä¯Ê̜ÊÇä¯Êœv requires approximately 450 g of car-
̜Ì>ÊV>œÀˆiÃÊ>ÃÊV>ÀLœ…Þ`À>ÌiÃÊ«ÀœÛˆ`iÃÊvœÀÊ>`iµÕ>ÌiʓÕÃViÊ>˜`ʏˆÛiÀÊ}ÞVœ}i˜ bohydrate, or 1800 kCal. An athlete
ÀiÃiÀÛiðÊ/…ˆÃÊ`ˆiÌÊi˜ÃÕÀiÃÊ>LœÕÌÊÌ܈ViÊ̅iʏiÛiÊœvʓÕÃViÊ}ÞVœ}i˜ÊVœ“«>Ài` who weighs 150 pounds (68 kg) and
܈̅Ê̅iÊ{x¯Ê̜Êxä¯ÊV>ÀLœ…Þ`À>ÌiÊ>“œÕ˜ÌʜvÊ̅iÊÌÞ«ˆV>Ê
“iÀˆV>˜Ê`ˆiÌ° œÀ expends 4200 kCal per day
should consume about 680 g of
carbohydrates (2720 kCal). In both
examples, carbohydrate intake equals
Muscle glycogen level (mmol•kg-1 wet wt)

250
64% of total energy intake.

200

150
&OR 9OUR )NFORMATION
100
+%%0 4(%- 5.2%&).%$ #/-0,%8
!.$ ,/7 ',9#%-)#
Little health risk exists in subsisting
50 chiefly on a variety of fiber-rich com-
plex carbohydrates if intake also
supplies essential amino acids, fatty
0 acids, minerals, and vitamins. The
Pre-loading Post-loading most desirable complex carbohydrates
exhibit slow digestion and absorption
Figure 3.9 ÕÃViÊ}ÞVœ}i˜ÊVœ˜Vi˜ÌÀ>̈œ˜ÊœvÊ̅iÊÛ>ÃÌÕÃʏ>ÌiÀ>ˆÃÊLivœÀiÊ­«Ài‡ rates. Such moderate- to low-glycemic
œ>`ˆ˜}®Ê>˜`Ê>vÌiÀÊ£näÊÃiVœ˜`Ãʜvʘi>À‡“>݈“>Êˆ˜Ìi˜ÃˆÌÞÊVÞVˆ˜}ÊiÝiÀVˆÃiÊvœœÜi`ÊLÞ types include whole-grain breads,
£Ê`>Þʜvʅˆ}…‡V>ÀLœ…Þ`À>Ìiʈ˜Ì>ŽiÊ­«œÃ̇œ>`ˆ˜}®°Ê­Àœ“Ê>ˆÀV…ˆ`]Ê/°Ê°]ÊiÌÊ>°\Ê,>«ˆ` cereals, pastas, legumes, most fruits,
V>ÀLœ…Þ`À>Ìiʏœ>`ˆ˜}Ê>vÌiÀÊŜÀÌÊLœÕÌʜvʘi>Àʓ>݈“>‡ˆ˜Ìi˜ÃˆÌÞÊiÝiÀVˆÃi°Êi`°Ê-Vˆ° and milk and milk products.
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104 • SECTION II Nutrition and Energy

BOX 3.3 CLOSE UP

Strategies for Carbohydrate Loading

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>ÀLœ…Þ`À>ÌiÊœ>`ˆ˜}
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i݅>ÕÃ̈œ˜Ê`ÕÀˆ˜}ʈ˜Ìi˜ÃiÊ>iÀœLˆVÊiÝiÀVˆÃiÊ`ˆÀiV̏ÞÊÀi>Ìià ­˜œÀ“>Ê«iÀVi˜Ì>}iʜvÊ«ÀœÌiˆ˜Êˆ˜Ê̅iÊ`>ˆÞÊ`ˆiÌ®°
̜Ê̅iʈ˜ˆÌˆ>Ê}ÞVœ}i˜ÊVœ˜Ìi˜ÌʜvÊ̅iʏˆÛiÀÊ>˜`Ê>V̈ÛiʓÕÇ
œ“«ï̈œ˜Ê>Þ
VՏ>ÌÕÀi°Ê˜Êœ˜iÊÃiÀˆiÃʜvÊiÝ«iÀˆ“i˜ÌÃ]ʓÕÃViÊ}ÞVœ}i˜
Vœ˜Ìi˜Ìʈ˜VÀi>Ãi`ÊÈÝvœ`]Ê>˜`Êi˜`ÕÀ>˜ViÊV>«>VˆÌÞ
ÌÀˆ«i`ÊvœÀÊÃÕLiVÌÃÊvi`Ê>ʅˆ}…‡V>ÀLœ…Þ`À>ÌiÊ`ˆiÌÊVœ“‡
«>Ài`Ê܈̅Êvii`ˆ˜}Ê̅iÊÃ>“iÊÃÕLiVÌÃÊ>ʏœÜ‡V>ÀLœ…Þ`À>Ìi
­…ˆ}…‡v>Ì®Ê`ˆiÌʜvÊȓˆ>ÀÊi˜iÀ}ÞÊVœ˜Ìi˜Ì°Ê
>ÀLœ…Þ`À>Ìi DIET-EXERCISE PLAN TO ENHANCE
œ>`ˆ˜}Ê«ÀœÛˆ`iÃÊ>ÊÃÌÀ>Ìi}ÞÊ̜ʈ˜VÀi>Ãiʈ˜ˆÌˆ>Ê“ÕÃViÊ>˜`
ˆÛiÀÊ}ÞVœ}i˜ÊiÛiÃÊLivœÀiÊ«Àœœ˜}i`Êi˜`ÕÀ>˜ViÊ«iÀ‡
vœÀ“>˜Vi°
CLASSIC CARBOHYDRATE
LOADING PROCEDURE
>ÃÈVÊV>ÀLœ…Þ`À>Ìiʏœ>`ˆ˜}ʈ˜ÛœÛiÃÊ>ÊÌܜ‡ÃÌ>}iÊ«ÀœVi‡
`ÕÀi°
œœÜʅˆ}…‡V>ÀLœ…Þ`À>ÌiÊ«ÀiVœ“«ï̈œ˜Ê“i>ÊÀiV‡
œ““i˜`>̈œ˜°
SPECIFICS OF PRECOMPETITION
GLYCOGEN STORAGE
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>LœÕÌÊÈÊ`>ÞÃÊLivœÀiÊVœ“«ï̈œ˜Ê̜ÊÀi`ÕViʓÕÃVi
>˜`ʏˆÛiÀÊ}ÞVœ}i˜ÊÃ̜ÀiÃ°Ê iV>ÕÃiÊ}ÞVœ}i˜Êœ>`ˆ˜}
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VˆÃi]Ê>̅iÌiÃʓÕÃÌÊi˜}>}iÊ̅iʓ>œÀʓÕÃViÃʈ˜ÛœÛi`
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Sample Meal Plans for Carbohydrate Depletion (Stage 1) and Carbohydrate Loading (Stage 2)
Preceding an Endurance Event

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Chapter 3 Food Energy and Optimum Nutrition for Exercise • 105

BOX 3.4 CLOSE UP

International Society of Sports Nutrition
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106 • SECTION II Nutrition and Energy

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S E L E C T E D R E F E R E N C E S

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Nutritional and
C h a p t e r
4
Pharmacologic
Aids to
Performance
CHAPTER OBJECTIVES

• List four examples of substances alleged to provide • Give the rationale for medium-chain triacylglycerol
ergogenic benefits. supplementation as an ergogenic aid.

• Summarize research concerning caffeine’s potential
as an ergogenic aid.
• Discuss the physiologic and psychologic effects of
alcohol and how alcohol affects exercise
performance.
• Discuss the possible ergogenic benefits and risks of
clenbuterol, amphetamines, chromium picolinate,
!-hydroxy-!-methylbutyrate, and buffering solutions.
• Discuss the positive and negative effects of anabolic
steroids use as an ergogenic aid.

• Explain how glutamine and phosphatidylserine affect • Discuss the positive and negative effects of
exercise performance and the training response. androstenedione use as an ergogenic aid.

• Describe any positive and negative ergogenic effects
of creatine supplementation.
• Explain how postexercise carbohydrate–protein–
creatine supplementation augments responses to
resistance training.
• Describe the medical use of human growth hormone,
including its potential dangers when used by healthy
individuals.
• Describe the rationale for DHEA (dehydroepiandros-
terone) as an ergogenic aid.

109
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DOUBLE-BLIND, PLACEBO-
CONTROLLED EXPERIMENT: THE
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ÕVÌðÊœÀÊ>Ê«œÃˆÌˆÛiʈ“«>VÌ]Ê̅iÃiÊÃÕ««i“i˜ÌÃʓÕÃÌÊ«ÀœÛˆ`i
>ʘÕÌÀˆi˜ÌÊ̅>ÌʈÃÊ՘`iÀÃÕ««ˆi`ʈ˜Ê̅iÊ`ˆiÌʜÀÊiÝiÀÌÃÊ>Ê`ÀÕ}‡
ˆŽiʈ˜vÕi˜Viʜ˜ÊViÕ>ÀÊv՘V̈œ˜
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Chapter 4 Nutritional and Pharmacologic Aids to Performanci • 111

Honey
(1, 6, 11);
Cocoa/Chocolate (1)
Fats & Sweets
Beans (2, 4);
Beef (2);
Eggs (3);
Cheese Mackerel (4);
(2, 9, 10); Salmon (4);
Milk (6, 9, 10); Soy Nuts
Milk Products (2, 4, 5, 9, 10);
(2, 4, 5, 10 ); Soy Protein
Soy Milk Products (2, 4, 5, 9, 10);
(2, 4, 5, 9, 10); Sardines (4); Tuna (4);
Yogurt (6, 10) Walnuts (4)
Milk, Meat, Poultry, Fish,
Yogurt & Cheese Eggs, Dry Beans & Nuts

Apples (2, 4); Artichokes (6); Broccoli (1, 2);

Bananas (6, 9); Brussels Sprouts (1, 2); Cabbage (1, 2);
Blueberries (2, 3, 4, 8); Carrots (1, 3, 7); Cauliflower (1, 2);
Cranberries (2, 8); Celery (9); Horseradish (1, 2, 6);
Grapefruit (1, 2); Garlic (2, 4, 9, 11); Leeks (2, 4, 6, 7);
Grapes/Juice (1, 2, 4), Lemons (1, 2); Onions (2, 4, 6, 7); Scallions/Shallots
Limes (1, 2), Oranges (1, 2); (2, 4, 6, 7); Soybeans (2, 4, 5, 9, 10);
Raspberries (1, 2); Tomatoes (1, 2); Watercress (2)
Fruits Vegetables

Psyllium-containing Bread and Cereal (4); Corn Products (2, 3);

Flaxseed (1, 2, 4); Oat Products (4); Rye Products (2); Wheat Bran Products (2)
Bread, Cereal, Rice & Pasta

Green or Black Tea (1, 2, 7)

Fluid

Functional Food Guide Pyramid

The numbers next to the foods refer to one of the potential benefits listed below
Potential Benefits
1. Antioxidant Benefits 6. Improves Gastrointestinal Health
2. Reduces Cancer Risk 7. Maintains Immune System
3. Maintenance of Vision 8. Maintains Urinary Tract Health
4. Improves Heart Health 9. Reduces Blood Pressure
5. May Decrease Menopause Symptoms 10. Improves Bone Health
11. Antibacterial Benefits

Figure 4.1 ՘V̈œ˜>Êvœœ`Ê}Ո`iÊ«ÞÀ>“ˆ`°ÊˆvviÀi˜ÌÊvœœ`ÃÊ«ÀœÛˆ`iÊ`ˆvviÀi˜ÌÊLi˜ivˆÌðʭÀœ“Ê1˜ˆÛiÀÈÌÞʜvʏˆ˜œˆÃÊ>ÌÊ

…ˆV>}œÊ>˜
̅iÊ1˜ˆÛiÀÈÌÞʜvʏˆ˜œˆÃÊ>ÌÊ1ÀL>˜>‡
…>“«>ˆ}˜°Ê՘V̈œ˜>Êœœ`ÃÊvœÀÊi>Ì…°®ÊÜÜÜ° ÕÌÀˆÜ>ÌV…°œÀ}Éä{œœ`ÃÉvv°…Ì“

&OR 9OUR )NFORMATION

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The World Anti-Doping Agency (WADA; ÜÜÜ°Ü>`>‡>“>°œÀ}Éi˜É«Àœ…ˆLˆÌi`ˆÃÌ°V…Ó)
currently bans the following nine categories of substances:
1. Anabolic androgenic steroids 6. Stimulants
2. Hormones and related substances 7. Narcotics
3. !2 agonists 8. Cannabinoids
4. Hormone antagonists and modulators 9. Glucocorticosteroids
5. Diuretics and other masking agents
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BOX 4.1 CLOSE UP

Key Points on Nutrition and Athletic Performance From the
American Dietetic Association, Dietitians of Canada, and
American College of Sports Medicine

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Chapter 4 Nutritional and Pharmacologic Aids to Performanci • 113

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Select subjects -Ì>ÌiÊ̅iÊÀiVœ““i˜`i`Ê«ÀœÌiˆ˜Êˆ˜Ì>ŽiÊvœÀ
i˜`ÕÀ>˜ViÊ>˜`ÊÃÌÀi˜}̅‡ÌÀ>ˆ˜i`Ê>̅iÌið

Pre-Test
(all subjects)

Placebo Random assignment Treatment

condition condition

Post test Compare results Post test

Treatment Crossover Placebo

condition condition

Post test Compare results Post test

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Part 1 Nutritional Ergogenic Aids Testing of urine samples provides the
primary method for drug detection.
Chemicals are added to the urine
sample, which is then heated and
vaporized in testing. The vapor passes
through an absorbent column and
BUFFERING SOLUTIONS an electric or magnetic field (gas
chromatography and mass spectrom-
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114 • SECTION II Nutrition and Energy

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116 • SECTION II Nutrition and Energy

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Change in total body strength (kg)

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Chapter 4 Nutritional and Pharmacologic Aids to Performanci • 117

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118 • SECTION II Nutrition and Energy

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ˆ˜}iÃ̈œ˜° among athletes that consuming crea-
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õÕ>Åʫ>ÞiÀðÊÌÊ>ÃœÊ>Õ}“i˜Ìi`ÊÀi«i>Ìi`ÊëÀˆ˜ÌÊVÞViÊ«iÀvœÀ“>˜ViÊ>vÌiÀÊ place for the creatine plus sugar-sup-
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>ÃœÊœVVÕÀʈ˜Ê˜œÀ“>ÞÊ>V̈Ûiʜ`iÀʓi˜° creatine, and 33.0% increase in total
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either a glucose supplement (1.0 g per kg body mass) or a placebo of
NutraSweet. Glucose supplementation reduced myofibrillar protein
breakdown as reflected by decreased excretion of 3-methylhistidine
and urinary nitrogen. Although not statistically significant, glucose sup-
plementation also increased the rate of the amino acid leucine’s incorpo-
ration into the vastus lateralis over the 10-hour post-exercise period.
These alterations indicated that the supplemented condition produced a
more positive body protein balance after exercise. The beneficial effect of
a post-exercise high-glycemic glucose supplementation most likely
occurred from increased insulin release with glucose intake, which should
enhance muscle protein balance in recovery.
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126 • SECTION II Nutrition and Energy

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“>ÃðÊ
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Caffeine’s Ergogenic Effects
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Chapter 4 Nutritional and Pharmacologic Aids to Performanci • 131

448 &OR 9OUR )NFORMATION

444 34/0 #!&&%).% 7(%. 53).' #2%!4).%
Caffeine
440 Caffeine blunts the ergogenic effect of
Placebo creatine supplementation. To evaluate
436
Time, s " 500m-1

the effect of pre-exercise caffeine inges-

432 tion on intramuscular creatine stores and
428 high-intensity exercise performance,
subjects consumed a placebo, a daily
424
creatine supplement (0.5 g"kg#1 body
420 mass), or the same daily creatine supple-
416 ment plus caffeine (5 mg "kg#1 body
mass) for 6 days. Under each condition,
412
they performed maximal intermittent
408 knee extension exercise to fatigue on an
isokinetic dynamometer. Creatine sup-
plementation, with or without caffeine,
increased intramuscular PCr by
between 4% and 6%. Dynamic torque
500 1000 1500 production also increased 10% to 23%
with creatine only compared with the
Distance, m
placebo. Taking caffeine, however,
Figure 4.9 -«ˆÌÊ̈“iÃÊvœÀÊi>V…ÊxääʓʜvÊ>Ê£xä䇓Ê̈“iÊÌÀˆ>ÊvœÀÊV>vviˆ˜iÊ­ˆ}…Ì totally negated creatine’s ergogenic
«ÕÀ«i®Ê>˜`Ê«>ViLœÊ­`>ÀŽÊ«ÕÀ«i®ÊÌÀˆ>Ã°Ê
>vviˆ˜iÊ«Àœ`ÕVi`ÊÈ}˜ˆvˆV>˜ÌÞÊv>ÃÌiÀÊ돈 effect. Thus, athletes who creatine load
̈“iðʭÀœ“Ê>V˜ÌœÃ…]Ê °,°]Ê7Àˆ}…Ì]Ê °°\Ê
>vviˆ˜iʈ˜}iÃ̈œ˜Ê>˜`Ê«iÀvœÀ“>˜ViʜvÊ> should refrain from caffeine-containing
£]xä䇓iÌÀiÊÃ܈“°Ê
>˜°Ê°Ê
««°Ê*…ÞȜ°]ÊÓä\£Èn]Ê£™™x°® foods and beverages for several days
before competition.
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V>vviˆ˜i°Ê Ûi˜Ê̅œÕ}…Ê…i>ÀÌÊÀ>ÌiÊ>˜`ʜÝÞ}i˜ÊÕ«Ì>ŽiÊÜiÀiÊȓˆ>ÀÊ`ÕÀˆ˜}Ê̅iÊÌܜ
ÌÀˆ>Ã]Ê̅iÊV>vviˆ˜iʓ>`iÊ̅iÊܜÀŽÊÃii“Êi>ÈiÀ°

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vœÀ“>˜ViÃÊVœ“«iÌi`ʈ˜ÊiÃÃÊ̅>˜ÊÓxʓˆ˜ÕÌiðʘÊ>Ê`œÕLi‡Lˆ˜`]ÊVÀœÃǜÛiÀ
ÃÌÕ`Þ]ÊÃiÛi˜Ê“>iÊ>˜`ÊvœÕÀÊvi“>iÊ`ˆÃÌ>˜ViÊÃ܈““iÀÃÊ­ !Óxʓˆ˜ÊvœÀÊ£xääʓ®
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Figure 4.9 ˆÕÃÌÀ>ÌiÃÊ̅>ÌÊ̅iÊ돈ÌÊ̈“iÃʈ“«ÀœÛi`Ê܈̅ÊV>vviˆ˜iÊvœÀÊi>V…Êxääʓ
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­Óäʓˆ˜]Êxn°ÈÊÃÊÛðÊӣʓˆ˜]ÊÓ£°nÊî°ÊœÜiÀÊ«>Ó>Ê«œÌ>ÃÈՓÊVœ˜Vi˜ÌÀ>̈œ˜
LivœÀiÊiÝiÀVˆÃiÊ>˜`ʅˆ}…iÀÊLœœ`Ê}ÕVœÃiʏiÛiÃÊ>ÌÊ̅iÊi˜`ʜvÊ̅iÊÌÀˆ>Ê>VVœ“«>‡
˜ˆi`Êi˜…>˜Vi`Ê«iÀvœÀ“>˜ViÊ܈̅ÊV>vviˆ˜i°Ê/…ˆÃÊÃÕ}}iÃÌi`Ê̅>ÌÊiiVÌÀœÞÌiÊL>‡
>˜ViÊ>˜`Ê}ÕVœÃiÊ>Û>ˆ>LˆˆÌÞʓˆ}…ÌÊLiʎiÞÊv>V̜ÀÃʈ˜ÊV>vviˆ˜i½ÃÊiÀ}œ}i˜ˆVÊivviVÌ° &OR 9OUR )NFORMATION
!./4(%2 53% &/2 6)!'2!
Proposed Mechanism for Ergogenic Action Viagra (sildenafil citrate) represents the
latest entry of drugs with purported

Ê«ÀiVˆÃiÊiÝ«>˜>̈œ˜ÊvœÀÊ̅iÊiÝiÀVˆÃi‡i˜…>˜Vˆ˜}ÊLœœÃÌÊvÀœ“ÊV>vviˆ˜iÊÀi“>ˆ˜Ã
ergogenic effects that athletes use to
iÕÈÛi°Ê˜Ê>ÊˆŽiˆ…œœ`]Ê̅iÊiÀ}œ}i˜ˆVÊivviVÌʜvÊV>vviˆ˜iÊ­œÀʜ̅iÀÊÀi>Ìi`
enhance exercise performance. The
“i̅ޏÝ>˜Ì…ˆ˜iÊVœ“«œÕ˜`îʈ˜Êˆ˜Ìi˜ÃiÊi˜`ÕÀ>˜ViÊiÝiÀVˆÃiʜVVÕÀÃÊvÀœ“Ê̅i
mechanism for ergogenic effects lies in
v>VˆˆÌ>Ìi`ÊÕÃiʜvÊv>ÌÊ>ÃÊvÕi]Ê̅ÕÃÊë>Àˆ˜}Ê̅iÊLœ`Þ½Ãʏˆ“ˆÌi`Ê}ÞVœ}i˜ÊÀiÃiÀÛiðʘ
its dilating effect on blood vessels to
µÕ>˜ÌˆÌˆiÃÊÌÞ«ˆV>ÞÊ>`“ˆ˜ˆÃÌiÀi`Ê̜ʅՓ>˜Ã]ÊV>vviˆ˜iÊ«ÀœL>LÞÊ>VÌÃʈ˜Êœ˜iʜÀ
enhance oxygen delivery to muscles.
“œÀiʜvÊ̅iÊ̅ÀiiÊvœœÜˆ˜}ÊÜ>ÞÃ\Ê
Research on the climbers of Mt. Everest
£° ÌÊ>VÌÃÊ`ˆÀiV̏ÞÊLÞÊÃ̈“Տ>̈˜}Ê>`ˆ«œÃiÊ̈ÃÃÕiÃÊ̜ÊÀii>ÃiÊv>ÌÌÞÊ>Vˆ`ð during acute hypoxia tends to support
Ó° ˜`ˆÀiV̏ÞÊLÞÊÃ̈“Տ>̈˜}Êi«ˆ˜i«…Àˆ˜iÊÀii>ÃiÊvÀœ“Ê̅iÊ>`Ài˜>Ê“i`Տ>Æ its effectiveness. No action has been
i«ˆ˜i«…Àˆ˜iÊ̅i˜Êv>VˆˆÌ>ÌiÃÊv>ÌÌÞÊ>Vˆ`ÊÀii>ÃiÊvÀœ“Ê>`ˆ«œVÞÌiÃʈ˜Ìœ taken regarding its use or the alternative
«>Ó>°Ê˜VÀi>Ãi`Ê«>Ó>Ê
ʏiÛiÃ]ʈ˜ÊÌÕÀ˜]ʈ˜VÀi>ÃiÊv>Ìʜ݈`>̈œ˜] tadalafil (phosphodiesterase-5 inhibitor;
̅ÕÃÊVœ˜ÃiÀۈ˜}ʏˆÛiÀÊ>˜`ʓÕÃViÊ}ÞVœ}i˜° common name, Cialis) in athletic com-
ΰ *Àœ`ÕViÃÊ>˜>}iÈVÊivviVÌÃʜ˜Ê̅iÊVi˜ÌÀ>Ê˜iÀۜÕÃÊÃÞÃÌi“Ê>˜`Êi˜…>˜Vià petition.
“œÌœ˜iÕÀœ˜>ÊiÝVˆÌ>LˆˆÌÞ]Êv>VˆˆÌ>̈˜}ʓœÌœÀÊ՘ˆÌÊÀiVÀՈ̓i˜Ì°
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132 • SECTION II Nutrition and Energy

BOX 4.2 CLOSE UP

How to Recognize Warning Signs of Alcohol Abuse

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ˆœÀÊvœÀÊVi˜ÌÕÀˆiðÊ
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ViÀi“œ˜ˆiÃ]Ê`ˆ˜˜iÀÃ]Ê>˜`ÊëœÀÌÊVœ˜ÌiÃÌÃ]Ê>˜`ʅ>ÃÊLii˜ÊÕÃi`
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iÌiÃÊ«œÃÃiÃÃÊ>ʘi}>̈ÛiÊ>Ì̈ÌÕ`iÊ>LœÕÌÊ`Àˆ˜Žˆ˜}]ÊLÕÌÊ̅iÞ]
>ÃÊ>Ê}ÀœÕ«]Ê>ÀiʘœÌʈ““Õ˜iÊ̜Ê>Vœ…œÊ>LÕÃi°

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LiˆiÛiÊ̅iÞÊV>˜ÊVœ˜ÌÀœÊ̅iˆÀÊ`Àˆ˜Žˆ˜}ʅ>LˆÌÃÊ>˜`Ê`œÊ˜œÌ
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̅iÞÊ`iÛiœ«Ê>Ê«…ÞÈV>Ê>˜`Êi“œÌˆœ˜>Ê`i«i˜`i˜Viʜ˜Ê̅i
`ÀÕ}]ÊV…>À>VÌiÀˆâi`ÊLÞÊiÝViÃÈÛiÊÕÃiÊ>˜`ÊVœ˜ÃÌ>˜ÌÊ«ÀiœV‡
VÕ«>̈œ˜Ê܈̅Ê`Àˆ˜Žˆ˜}Ê̅>Ìʏi>`ÃÊ̜ʓi˜Ì>]Êi“œÌˆœ˜>]
«…ÞÈV>]Ê>˜`ÊÜVˆ>Ê«ÀœLi“ð
ALCOHOL ABUSE: ARE YOU DRINKING
TOO MUCH?
/…iÊvœœÜˆ˜}ÊV…iVŽˆÃÌÊV>˜Ê…i«Êˆ`i˜ÌˆvÞÊ«ÀœLi“ÊLi…>ۇ
ˆœÀÃÊ܈̅Ê>Vœ…œ°Ê/ܜʜÀʓœÀiʺ9iûÊ>˜ÃÜiÀÃʜ˜Ê̅ˆÃ
µÕiÃ̈œ˜˜>ˆÀiʈ˜`ˆV>ÌiÊ>Ê«œÌi˜Ìˆ>ÊvœÀʍiœ«>À`ˆâˆ˜}ʅi>Ì…
̅ÀœÕ}…ÊiÝViÃÈÛiÊ>Vœ…œÊVœ˜ÃՓ«Ìˆœ˜°

Identifying Alcohol Abusea

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Chapter 4 Nutritional and Pharmacologic Aids to Performanci • 133

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>!!° cyclists received a placebo or a capsule containing 5, 9, or 13 mg of caffeine
ALCOHOL
&OR 9OUR )NFORMATION
#!&&%).% 7!2.).'
Individuals who normally avoid caffeine may experience undesirable side effects when
they consume it. Caffeine stimulates the central nervous system and can produce restless-
ness, headaches, insomnia and nervous irritability, muscle twitching, tremulousness, and
psychomotor agitation and trigger premature left ventricular contractions. From the
standpoint of temperature regulation, caffeine acts as a potent diuretic. Excessive
consumption could cause an unnecessary pre-exercise fluid loss, negatively affecting thermal
balance and exercise performance in a hot environment.
&OR 9OUR )NFORMATION
-/2% #!&&%).% )3 ./4 .%#%33!2),9 "%44%2
To study the effects of pre-exercise caffeine intake on endurance time trained, male
. per kg of
body mass 1 hour before cycling at 80% of maximal power output on a VO2max test. All
caffeine trials showed a 24% improvement in performance with no additional benefit from
caffeine quantities above 5 mg "kg body mass#1.

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>ÊœvÊi˜iÀ}Þ More young people in the United States use alcohol than tobacco or illicit drugs, which
«iÀÊ}À>“Ê­“®ÊœvÊ«ÕÀiÊÃÕL‡ accounts for approximately 75,000 deaths yearly. Alcohol represents a major factor in
ÃÌ>˜ViÊ­£ää¯ÊœÀÊÓääÊ«Àœœv®° about 41% of all deaths from motor vehicle accidents. Long-term alcohol abuse is associ-

`œiÃVi˜ÌÃÊ>˜`Ê>`ՏÌÃ]ÊLœÌ… ated with liver disease; cancer; cardiovascular disease; and neurologic damage, including
>̅iÌiÃÊ>˜`ʘœ˜‡>̅iÌiÃ] psychiatric problems such as depression, anxiety, and antisocial personality disorder. All
>LÕÃiÊ>Vœ…œÊ“œÀiÊ̅>˜Ê>˜Þ states prohibit people younger than age 21 years from purchasing alcohol, yet in 2007,
œÌ…iÀÊ`ÀÕ}ʈ˜Ê̅iÊ1˜ˆÌi` 26% of high school students reported episodic heavy or binge drinking. Zero-tolerance
-Ì>ÌiðÊ
VVœÀ`ˆ˜}Ê̜Ê7œÀ` laws make it illegal for youth younger than age 21 years to drive with any measurable
i>Ì…Ê"À}>˜ˆâ>̈œ˜ÊÃÌ>̈Ã̈VÃ] amount of alcohol in their system (i.e., with a blood alcohol concentration $0.02 g/dL).
>LœÕÌÊ£{äʓˆˆœ˜Ê«iœ«iʅ>Ûi In 2007, 11% of high school students reported driving a car or other vehicle during the
>Vœ…œ‡Ài>Ìi`Ê`ˆÃœÀ`iÀðÊ
past 30 days after drinking alcohol, and 29% of students reported riding in a car or other
ÃÌ>˜`>À`Ê`Àˆ˜ŽÊÀiviÀÃÊ̜ʜ˜i vehicle during the past 30 days driven by someone who had been drinking alcohol.
£Ó‡œâÊLœÌ̏iʜvÊLiiÀʜÀÊ܈˜i From U.S. Department of Health and Human Services. (2007). The Surgeon General’s
VœœiÀ]ʜ˜iÊx‡œâÊ}>ÃÃʜvÊ܈˜i] Call to Action to Prevent and Reduce Underage Drinking. Washington, DC: U.S.
œÀÊ£°xʜâʜvÊn䇫ÀœœvÊ`ˆÃ̈i` Department of Health and Human Services, Office of the Surgeon General.
ëˆÀˆÌÃ°Ê iÌÜii˜ÊÓx¯Ê>˜`ÊÎä¯ http://ncadi.samhsa.gov.
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Use Among Athletes

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134 • SECTION II Nutrition and Energy
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Alcohol Drinks for Fluid Replacement: Not a
Good Idea
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Chapter 4 Nutritional and Pharmacologic Aids to Performanci • 135

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Steroid Structure and Action

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`iÌiV̈œ˜° translates into 12 oz of regular beer (!4% alcohol by volume) or 5 oz of wine (11% to
/…iÊ`ˆvviÀi˜ViÊLiÌÜii˜ 14% alcohol by volume). The stomach absorbs between 15% and 25% of the alcohol
`œÃ>}iÃÊÕÃi`ʈ˜ÊÀiÃi>ÀV…ÊÃÌÕ`‡ ingested; the small intestine rapidly takes up the remainder for distribution throughout
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>LÕÃi`ÊLÞÊ>̅iÌiÃʅ>ÃÊVœ˜‡ system). The absence of food in the digestive tract facilitates alcohol absorption. The
ÌÀˆLÕÌi`Ê̜Ê>ÊVÀi`ˆLˆˆÌÞÊ}>« liver, the major organ for alcohol metabolism, removes alcohol at a rate of about 10 g per
LiÌÜii˜ÊÃVˆi˜ÌˆvˆVÊvˆ˜`ˆ˜ hour, equivalent to the alcohol content of one drink. Consuming two drinks in 1 hour
­œvÌi˜]ʘœÊivviVÌʜvÊÃÌiÀœˆ`î produces a blood alcohol concentration of between 0.04 and 0.05 g!dL"£. Age, body
>˜`Ê܅>ÌʓœÃÌʈ˜Ê̅iÊ>̅ïV mass, body fat content, and gender influence blood alcohol levels. The legal state limit for
Vœ““Õ˜ˆÌÞÊLiˆiÛiÊ̜ÊLiÊÌÀÕi° alcohol intoxication ranges between a blood alcohol concentration of 0.11 and 0.16 g!dL"£.
A blood alcohol concentration of greater than 0.40 g!dL"£ (19 drinks or more in 2 hours)
can lead to coma, respiratory depression, and eventual death.
Estimates of Steroid
Use

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>˜`Ênä¯ÊœvÊvi“>iÊ«ÀœviÃȜ˜> &$! !,%24 &/2 "/$9"5),$%23
Lœ`ÞÊLՈ`iÀîÊVÕÀÀi˜ÌÞÊÕÃi In October 2009, the FDA issued an alert to consumers to refrain from using body-
>˜`Àœ}i˜Ã]ʜvÌi˜ÊVœ“Lˆ˜i` building products sold as nutritional supplements because they may contain steroids or
܈̅ÊÃ̈“Տ>˜ÌÃ]ʅœÀ“œ˜iÃ] steroid-like substances that can cause stroke, pulmonary embolism, acute liver injury,
>˜`Ê`ˆÕÀïVðÊ
Ûi˜Êˆ˜Ê̅iÊëœÀÌ and kidney failure. Particular emphasis was placed on products labeled with code words
œvÊ«ÀœviÃȜ˜>ÊL>ÃiL>]ʈ˜ÌiÀ‡ such as anabolic and tren or phrases such as blocks estrogen or minimizes gyno. The gyno
ۈiÜÃʜvÊÃÌÀi˜}̅ÊÌÀ>ˆ˜iÀÃÊ>˜` and estrogen references indicate that the products aim to minimize feminizing effects
VÕÀÀi˜ÌÊ«>ÞiÀÃÊiÃ̈“>ÌiÊ̅>ÌÊÕ« such as breast swelling or shrinking testicles.
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/i˜`œ˜Ê`i}i˜iÀ>̈œ˜]ÊÀÕ«ÌÕÀià œ can fail a urine test for the banned ana-
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i˜ÌÀ>Ê iÀۜÕà œœ`ÊÃ܈˜}à 9ià because the supplement often contains
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Analysis of nine different brands of
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“«>ˆÀi`ʍÕ`}“i˜Ì 9ià 100-mg doses indicate wide fluctuations
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138 • SECTION II Nutrition and Energy
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BOX 4.3 CLOSE UP
American College of Sports Medicine (ACSM; www.acsm.org)
Position Statement on Anabolic Steroids
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Chapter 4 Nutritional and Pharmacologic Aids to Performanci • 141

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V>À`ˆ>VʓÕÃViÊ«ÀœÌiˆ˜Ê`i«œÃˆÌˆœ˜Ê>˜`ÊϜÜÃÊv>ÌÊ}>ˆ˜ÊLÞÊi˜…>˜Vˆ˜}ʏˆ«œÞÈð
+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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VœÕ˜ÌiÀÊ̅iʓÕÃVi‡Ü>Ã̈˜}ÊivviVÌÃʜvÊ>}ˆ˜}]ʈ““œLˆˆâ>̈œ˜]ʓ>˜ÕÌÀˆÌˆœ˜]Ê>˜` …Õ“>˜Ê}ÀœÜ̅ʅœÀ“œ˜iÊÕÃi°
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ˆ˜}Ê>˜ˆ“>ÃÊ̅>ÌÊÜiÀiÊÌÀi>Ìi`Ê܈̅ÊVi˜LÕÌiÀœÊˆ˜VÕ`iʓÕÃViÊÌÀi“œÀ]Ê>}ˆÌ>̈œ˜]
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Ã>viÌÞʈ˜Êœ˜}‡ÌiÀ“ÊÕÃi°Ê
i>ÀÞ]ÊVi˜LÕÌiÀœÊÕÃiÊV>˜˜œÌÊLiʍÕÃ̈vˆi`ʜÀÊÀiVœ“
“i˜`i`Ê>ÃÊ>˜ÊiÀ}œ}i˜ˆVÊ>ˆ`°

HUMAN GROWTH HORMONE:

THE STEROID COMPETITOR
Փ>˜Ê}ÀœÜ̅ʅœÀ“œ˜iÊ­…®]>ÃœÊŽ˜œÜ˜Ê>ÃÊܓ>̜ÌÀœ«ˆVʅœÀ“œ˜i]ÊVœ“‡
«iÌiÃÊ܈̅Ê>˜>LœˆVÊÃÌiÀœˆ`Ãʈ˜Ê̅iʈˆVˆÌʓ>ÀŽiÌʜvÊ>i}i`Ê̈ÃÃÕi‡LՈ`ˆ˜}]
«iÀvœÀ“>˜Vi‡i˜…>˜Vˆ˜}Ê`ÀÕ}ðÊ/…ˆÃʅœÀ“œ˜i]Ê«Àœ`ÕVi`ÊLÞÊ̅iÊ>`i˜œ…Þ‡
«œ«…ÞÈÃʜvÊ̅iÊ«ˆÌՈÌ>ÀÞÊ}>˜`]Êv>VˆˆÌ>ÌiÃÊ̈ÃÃÕi‡LՈ`ˆ˜}Ê«ÀœViÃÃiÃÊ>˜`ʘœÀ‡
&OR 9OUR )NFORMATION
“>Ê…Õ“>˜Ê}ÀœÜ̅°Ê-«iVˆvˆV>Þ]ʅÊÃ̈“Տ>ÌiÃÊLœ˜iÊ>˜`ÊV>À̈>}iÊ}ÀœÜ̅ 35--!29 /& 2%3%!2#( &).$).'3
i˜…>˜ViÃÊv>ÌÌÞÊ>Vˆ`ʜ݈`>̈œ˜]Ê>˜`ÊϜÜÃÊ}ÕVœÃiÊ>˜`Ê>“ˆ˜œÊ>Vˆ`ÊLÀi>Ž`œÜ˜° #/.#%2.).' !.$2/34%.%$)/.%
,i`ÕVi`ʅÊÃiVÀʭ>LœÕÌÊxä¯ÊiÃÃÊ>ÌÊ>}iÊÈäÊÞi>ÀÃÊ̅>˜Ê>}iÊÎäÊÞi>Àî • Elevates plasma testosterone
>VVœÕ˜ÌÃÊvœÀÊܓiʜvÊ̅iÊ`iVÀi>Ãiʈ˜ÊÊ>˜`ʈ˜VÀi>Ãiʈ˜Êv>Ìʓ>ÃÃÊ̅>ÌÊ>VVœ“‡ concentrations
«>˜ÞÊ>}ˆ˜}ÆÊÀiÛiÀÃ>ÊœVVÕÀÃÊ܈̅Êiݜ}i˜œÕÃʅÊÃÕ««i“i˜ÌÃÊ«Àœ`ÕVi`ÊLÞ • No favorable effect on muscle mass
}i˜ïV>ÞÊi˜}ˆ˜iiÀi`ÊL>VÌiÀˆ>° • No favorable effect on muscular

…ˆ`Ài˜Ê܈̅ʎˆ`˜iÞÊv>ˆÕÀiʜÀʅ‡`ivˆVˆi˜ÌÊV…ˆ`Ài˜ÊÌ>ŽiÊ̅ˆÃʅœÀ“œ˜ performance
̜ʅi«ÊÃ̈“Տ>Ìiʏœ˜}ÊLœ˜iÊ}ÀœÜ̅°Ê…ÊÕÃiÊ>««i>ÃÊ̜ÊÃÌÀi˜}̅Ê>˜`Ê«œÜiÀ • No favorable alteration in body
>̅iÌiÃÊLiV>ÕÃiÊ>ÌÊ«…ÞȜœ}ˆVʏiÛiÃ]ʈÌÊÃ̈“Տ>ÌiÃÊ>“ˆ˜œÊ>Vˆ`ÊÕ«Ì>ŽiÊ>˜`Ê«Àœ‡ composition
Ìiˆ˜ÊÃޘ̅iÈÃÊLÞʓÕÃViÊ܅ˆiÊi˜…>˜Vˆ˜}Êv>ÌÊLÀi>Ž`œÜ˜Ê>˜`ÊVœ˜ÃiÀۈ˜}Ê}ÞVœ‡ • Elevates a variety of estrogen
}i˜ÊÀiÃiÀÛið subfractions
,iÃi>ÀV…Ê…>ÃÊ«Àœ`ÕVi`ÊiµÕˆÛœV>ÊÀiÃՏÌÃÊVœ˜ViÀ˜ˆ˜}Ê̅iÊÌÀÕiÊLi˜ivˆÌÃʜvʅ • No favorable effects on muscle pro-
ÃÕ««i“i˜Ì>̈œ˜Ê̜ÊVœÕ˜ÌiÀÊ̅iʏœÃÃʜvʓÕÃViʓ>ÃÃ]Ê̅ˆ˜˜ˆ˜}ÊLœ˜iÃ]ʈ˜VÀi>Ãi` tein synthesis or tissue anabolism
Lœ`ÞÊv>ÌÊ­«>À̈VՏ>ÀÞÊ>L`œ“ˆ˜>Êv>Ì®]Ê>˜`Ê`i«ÀiÃÃi`Êi˜iÀ}ÞʏiÛiÃ°ÊœÀÊiÝ>“«i] • Impairs the blood lipid profile in
£ÈÊ«ÀiۈœÕÏÞÊÃi`i˜Ì>ÀÞÊޜ՘}ʓi˜Ê܅œÊ«>À̈Vˆ«>Ìi`ʈ˜Ê>ʣӇÜiiŽÊÀiÈÃÌ>˜Vi apparently healthy men
ÌÀ>ˆ˜ˆ˜}Ê«Àœ}À>“ÊÀiViˆÛi`Ê`>ˆÞÊÀiVœ“Lˆ˜>˜ÌʅÊ­{äÊ} !Ž}"£®ÊœÀÊ>Ê«>ViLœ° • Increases the likelihood of testing
]Ê̜Ì>ÊLœ`ÞÊÜ>ÌiÀ]Ê>˜`Ê܅œi‡Lœ`ÞÊ«ÀœÌiˆ˜ÊÃޘ̅iÈÃÊ­>ÌÌÀˆLÕÌi`Ê̜ positive for steroid use
ˆ˜VÀi>Ãi`ʘˆÌÀœ}i˜ÊÀiÌi˜Ìˆœ˜Êˆ˜Êi>˜Ê̈ÃÃÕiʜ̅iÀÊ̅>˜ÊÎiiÌ>Ê“ÕÃVi®Êˆ˜VÀi>Ãi`
“œÀiʈ˜Ê̅iʅÊÀiVˆ«ˆi˜ÌÃ]Ê܈̅ʘœÊ`ˆvviÀi˜ViÃÊLiÌÜii˜Ê}ÀœÕ«Ãʈ˜ÊvÀ>V̈œ˜>
À>ÌiʜvÊ«ÀœÌiˆ˜ÊÃޘ̅iÈÃʈ˜ÊÎiiÌ>Ê“ÕÃVi]Ê̜ÀÜÊ>˜`ʏˆ“LÊVˆÀVՓviÀi˜ViÃ]ʜÀ
“ÕÃViÊv՘V̈œ˜Êˆ˜Ê`ޘ>“ˆVÊ>˜`ÊÃÌ>̈VÊÃÌÀi˜}̅ʓi>ÃÕÀið &OR 9OUR )NFORMATION
"˜iʜvÊ̅iʏ>À}iÃÌÊÃÌÕ`ˆiÃÊ̜Ê`>ÌiÊ`iÌiÀ“ˆ˜i`Ê̅iÊivviVÌÃʜvʅʜ˜ÊV…>˜}ià .!349 3)$% %&&%#43 /& '(
ˆ˜Ê̅iÊLœ`ÞÊVœ“«œÃˆÌˆœ˜Ê>˜`Êv՘V̈œ˜>ÊV>«>VˆÌÞʜvʅi>Ì…Þʓi˜Ê>˜`Êܜ“i˜
Excessive GH production (or use)
À>˜}ˆ˜}ʈ˜Ê>}iÊvÀœ“Ê̅iʓˆ`‡ÈäÃÊ̜Ê̅iʏ>ÌiÊnäðÊi˜Ê܅œÊ̜œŽÊ…Ê}>ˆ˜i`Ê
during skeletal growth produces
ÇÊ«œÕ˜`Ãʜvʏi>˜ÊLœ`Þʓ>ÃÃÊ>˜`Ê`iVÀi>Ãi`Ê>Êȓˆ>ÀÊ>“œÕ˜ÌʜvÊv>Ìʓ>Ãð
gigantism, an endocrine and
7œ“i˜Ê}>ˆ˜i`Ê>LœÕÌÊÎÊ«œÕ˜`Ãʜvʏi>˜ÊLœ`Þʓ>ÃÃÊ>˜`ʏœÃÌÊxÊ«œÕ˜`ÃʜvÊLœ`ÞÊv>Ì
metabolic disorder characterized by
Vœ“«>Ài`Ê܈̅Ê̅iˆÀÊVœÕ˜ÌiÀ«>ÀÌÃÊ܅œÊÀiViˆÛi`Ê>Ê«>ViLœ°Ê/…iÊÃÕLiVÌÃ
abnormal size or overgrowth of the
Ài“>ˆ˜i`ÊÃi`i˜Ì>ÀÞÊ>˜`Ê`ˆ`ʘœÌÊV…>˜}iÊ̅iˆÀÊ`ˆiÌʜÛiÀÊ̅iÊȇ“œ˜Ì…ÊÃÌÕ`Þ
entire body or any of its parts. Exces-
«iÀˆœ`°Ê1˜vœÀÌ՘>ÌiÞ]ÊÃiÀˆœÕÃÊÈ`iÊivviVÌÃÊ>vviVÌi`ÊLiÌÜii˜ÊÓ{¯Ê>˜`Ê{ȯʜv
sive hormone production (or use) after
̅iÊÃÕLiVÌðÊ/…iÃiʈ˜VÕ`i`ÊÃܜi˜ÊviiÌÊ>˜`Ê>˜ŽiÃ]ʍœˆ˜ÌÊ«>ˆ˜]ÊV>À«>ÊÌ՘˜i
growth cessation produces the
Ãޘ`Àœ“iÊ­ÃÜiˆ˜}ʜvÊÌi˜`œ˜ÊÅi>̅ʜÛiÀÊ>ʘiÀÛiʈ˜Ê̅iÊÜÀˆÃÌ®]Ê>˜`Ê̅iÊ`iÛi‡
irreversible disorder acromegaly that
œ«“i˜ÌʜvÊ>Ê`ˆ>LïVʜÀÊ«Ài`ˆ>LïVÊVœ˜`ˆÌˆœ˜°Ê
Ãʈ˜Ê«ÀiۈœÕÃÊÀiÃi>ÀV…]ʘœ
presents as enlarged hands, feet, and
ivviVÌÃʜVVÕÀÀi`ÊvœÀʅÊÌÀi>̓i˜Ìʜ˜Ê“i>ÃÕÀiÃʜvʓÕÃVՏ>ÀÊÃÌÀi˜}̅ʜÀ
facial features.
i˜`ÕÀ>˜ViÊV>«>VˆÌÞÊ`iëˆÌiʈ˜VÀi>ÃiÃʈ˜Êi>˜ÊLœ`Þʓ>Ãð
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142 • SECTION II Nutrition and Energy

*ÀiۈœÕÏÞ]ʅi>Ì…ÞÊ«iœ«iÊVœÕ`ʜ˜ÞʜLÌ>ˆ˜Ê…ʜ˜
Peak production
̅iÊL>VŽÊ“>ÀŽiÌ]ʜvÌi˜Êˆ˜Ê>`ՏÌiÀ>Ìi`ÊvœÀ“°Ê/…iÊÕÃiʜv (20 - 25 years old)
…Õ“>˜ÊV>`>ÛiÀ‡`iÀˆÛi`ʅÊ­`ˆÃVœ˜Ìˆ˜Õi`ÊLÞÊ1°-°Ê«…Þȇ
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LWBK710-c05_149-184.qxd 9/15/10 10:45 PM Page 149 Aptara

S E C T I O N
III
Energy Transfer
ˆœV…i“ˆV>ÊÀi>V̈œ˜ÃÊ̅>ÌÊ`œÊ˜œÌÊVœ˜ÃՓiʜÝÞ}i˜Ê}i˜iÀ>ÌiÊVœ˜Ãˆ`iÀ>Li
i˜iÀ}ÞÊvœÀÊŜÀÌÊ`ÕÀ>̈œ˜Ã° /…ˆÃÊÀ>«ˆ`Êi˜iÀ}ÞÊ}i˜iÀ>̈œ˜ÊLiVœ“iÃÊVÀÕVˆ>Êˆ˜
“>ˆ˜Ì>ˆ˜ˆ˜}Ê>ʅˆ}…ÊÃÌ>˜`>À`ʜvÊ«iÀvœÀ“>˜Viʈ˜ÊëÀˆ˜ÌÊ>V̈ۈ̈iÃÊ>˜`ʜ̅iÀÊLÕÀÃÌÃʜv
>‡œÕÌÊiÝiÀVˆÃi°Ê˜ÊVœ˜ÌÀ>ÃÌ]ʏœ˜}iÀÊ`ÕÀ>̈œ˜Ê­>iÀœLˆV®ÊiÝiÀVˆÃiÊiÝÌÀ>VÌÃÊi˜iÀ}Þ
“œÀiÊϜ܏ÞÊvÀœ“Êvœœ`ÊV>Ì>LœˆÃ“Ê̅ÀœÕ}…ÊV…i“ˆV>ÊÀi>V̈œ˜ÃÊ̅>ÌÊÀiµÕˆÀiÊ̅i
Vœ˜Ìˆ˜Õ>ÊÕÃiʜvʜÝÞ}i˜°Ê*>˜˜ˆ˜}ÊivviV̈ÛiÊÌÀ>ˆ˜ˆ˜}Ê̜Êi˜…>˜ViÊiÝiÀVˆÃiÊ«iÀvœÀ“‡
>˜ViÊÀiµÕˆÀiÃÊ̅iÊvœœÜˆ˜}\Ê

£° ˜Ãˆ}…ÌÊ>LœÕÌʅœÜʓÕÃViÊ̈ÃÃÕiÊ}i˜iÀ>ÌiÃÊi˜iÀ}ÞÊ̜ÊÃÕÃÌ>ˆ˜ÊiÝiÀVˆÃi°
Ó° /…iÊÜÕÀViÃÊ̅>ÌÊ«ÀœÛˆ`iÊ̅>ÌÊi˜iÀ}Þ°
ΰ /…iÊi˜iÀ}ÞÊÀiµÕˆÀi“i˜ÌÃʜvÊ`ˆÛiÀÃiÊ«…ÞÈV>Ê>V̈ۈ̈ið

/…ˆÃÊÃiV̈œ˜Ê«ÀiÃi˜ÌÃÊ>ÊLÀœ>`ʜÛiÀۈiÜʜvÊ̅iÊv՘`>“i˜Ì>ÃʜvʅՓ>˜Êi˜iÀ}ÞÊÌÀ>˜Ã‡
viÀÊ`ÕÀˆ˜}ÊÀiÃÌÊ>˜`ÊiÝiÀVˆÃi°Ê7iÊi“«…>ÈâiÊ̅iʓi>˜ÃÊLÞÊ܅ˆV…Ê̅iÊLœ`Þ½ÃÊViÃ I often say that when you can
iÝÌÀ>VÌÊV…i“ˆV>Êi˜iÀ}ÞÊLœÕ˜`Ê܈̅ˆ˜Êvœœ`ʓœiVՏiÃÊ>˜`ÊÌÀ>˜ÃviÀʈÌÊ̜Ê>ÊVœ““œ˜
Vœ“«œÕ˜`Ê̅>ÌÊ«œÜiÀÃÊ>ÊvœÀ“ÃʜvÊLˆœœ}ˆVÊܜÀŽ°Ê/…iÊvœœ`ʘÕÌÀˆi˜ÌÃÊ>˜`Ê«ÀœViÃÃià measure what you are speaking
œvÊi˜iÀ}ÞÊÌÀ>˜ÃviÀÊ̅>ÌÊ«>Þʈ“«œÀÌ>˜ÌÊÀœiÃʈ˜ÊÃÕÃÌ>ˆ˜ˆ˜}Ê«…ÞȜœ}ˆVÊv՘V̈œ˜Ê`ÕÀ‡ about, and express it in numbers,
ˆ˜}ʏˆ}…Ì]ʓœ`iÀ>Ìi]Ê>˜`ÊÃÌÀi˜ÕœÕÃÊiÝiÀVˆÃi]ʈÃÊ}ˆÛi˜ÊëiVˆ>Ê>ÌÌi˜Ìˆœ˜Ê>ÃÊ>ÀiÊÌiV…‡
˜ˆµÕiÃÊ̜ʓi>ÃÕÀiÊ>˜`ÊiÛ>Õ>ÌiÊ̅iÊ`ˆÛiÀÃiʅՓ>˜Êi˜iÀ}ÞÊÌÀ>˜ÃviÀÊV>«>VˆÌˆið you know something about it;

but when you cannot measure it,

when you cannot express it in

numbers, your knowledge is of a

meagre and unsatisfactory kind.

pÊœÀ`ÊiÛˆ˜Ê
­7ˆˆ>“Ê/…œ“Ãœ˜]Ê
£ÃÌÊ >Àœ˜®Ê­£nÓ{q£™äÇ®]
˜}ˆÃ…Ê«…ÞÈVˆÃÌÊ>˜`
“>̅i“>̈Vˆ>˜

149
LWBK710-c05_149-184.qxd 9/15/10 10:45 PM Page 150 Aptara
LWBK710-c05_149-184.qxd 9/15/10 10:45 PM Page 151 Aptara

C h a p t e r
5
Fundamentals of
Human Energy
Transfer
CHAPTER OBJECTIVES

• Describe the first law of thermodynamics related to • Outline the process of electron transport–oxidative
energy balance and biologic work. phosphorylation.

• Define the terms potential energy and kinetic energy • Explain oxygen’s role in energy metabolism.
and give examples of each.
• Describe how anaerobic energy release occurs in
• Give examples of exergonic and endergonic chemical cells.
processes within the body and indicate their
importance. • Describe lactate formation during progressively
increasing exercise intensity.
• State the second law of thermodynamics and give a
• Outline the general pathways of the citric cycle during
practical application.
macronutrient catabolism.
• Identify and give examples of three forms of biologic
• Contrast adenosine triphosphate yield from
work.
carbohydrate, fat, and protein catabolism.
• Discuss the role of enzymes and coenzymes in
• Explain the statement, “Fats burn in a carbohydrate
bioenergetics.
flame.”
• Identify the high-energy phosphates and discuss their
contributions in powering biologic work.

151
LWBK710-c05_149-184.qxd 9/15/10 10:45 PM Page 152 Aptara
152 • SECTION III Energy Transfer
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̈œ˜ÃÊvœÀÊëiVˆvˆVÊëœÀÌÊÀiµÕˆÀi“i˜ÌÃ
Part 1 Energy—The Capacity
for Work
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POTENTIAL AND KINETIC ENERGY
*œÌi˜Ìˆ> i˜iÀ}Þ >˜` Žˆ˜ïVÊi˜iÀ}Þ Vœ˜Ã̈ÌÕÌiÊ̅iÊ̜Ì>
À®ÊÃiÀÛiÊ̅iÊVi½Ã
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Potential energy
dissipates to kinetic
energy as the water
Potential energy flows down the hill
Kinetic energy Work
results from
harnessing
potential
energy
Heat energy
Lower potential
energy
Figure 5.1 ˆ}…‡}À>`iÊ«œÌi˜Ìˆ>Êi˜iÀ}ÞÊV>«>LiʜvÊ«iÀvœÀ“‡
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Chapter 5 Fundamentals of Human Energy Transfer
BOX 5.1 CLOSE UP
Adenosine Triphosphate—Nature’s Powerful Ingredient

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154 • SECTION III Energy Transfer

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Forms of Energy
Chemical
Mechanical
Heat
Light
Chemical energy Electric
(fossil fuel, oil Nuclear
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Chapter 5 Fundamentals of Human Energy Transfer • 155

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156 • SECTION III Energy Transfer

O2
CO2
CO2 Sun
(fusion)

O2
Nuclear
energy
Radiant
energy

energy

Chlorophyll
6CO2 6H2O 6O2 Stored energy
Glucose
Lipids
Protein

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BIOLOGIC WORK IN HUMANS
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LWBK710-c05_149-184.qxd 9/15/10 10:45 PM Page 157 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 157

Cellular respiration
(reverse of photosynthesis)

Glucose 6 O2 6 CO2 6 H2O ATP

Mechanical Chemical work Extracellular Transport work

work fluid
Na+ Na+
Glucose Glycogen K+

ATP
ATP
Glycerol +
fatty acids Triacylglycerol

ATP

Amino acids Protein K+ ATP

ADP Na+
ATP K+
Cytoplasm P

Figure 5.4 /…iÊiÝiÀ}œ˜ˆVÊ«ÀœViÃÃʜvÊViÕ>ÀÊÀiëˆÀ>̈œ˜°Ê ÝiÀ}œ˜ˆVÊÀi>V̈œ˜Ã]ÊÃÕV…Ê>ÃÊ̅iÊLÕÀ˜ˆ˜}ʜvÊ}>܏ˆ˜iʜÀÊ̅iʜ݈`>̈œ˜Êœv

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LWBK710-c05_149-184.qxd 9/15/10 10:45 PM Page 158 Aptara

158 • SECTION III Energy Transfer

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Chapter 5 Fundamentals of Human Energy Transfer • 159

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160 • SECTION III Energy Transfer

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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 161 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 161

Muscle contraction

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O O O
ADENOSINE O P O P O P OH
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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 162 Aptara

162 • SECTION III Energy Transfer

Biologic work
INTRAMUSCULAR
HIGH-ENERGY PHOSPHATES
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Chapter 5 Fundamentals of Human Energy Transfer • 163

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164 • SECTION III Energy Transfer
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Chapter 5 Fundamentals of Human Energy Transfer • 165

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positions regarding conservation of energy in the resynthe-
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metabolism. Although it is true that energy provided by
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oxidation of NADH and FADH2 resynthesizes ADP to
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NADH (and hence ATP exchanged for ADP and Pi) from
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the cell’s cytoplasm across the mitochondrial membrane to
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deliver H! to electron transport. This added energy
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exchange of NADH shuttling across the mitochondral
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membrane reduces the net ATP yield for glucose metabo-
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lism and changes the overall efficiency of ATP production.
̈ÛiÞÊ՘ˆ“«i`i`Ê>ÌÊ>Ê«>À̈VՏ>ÀÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ°
On average, only 2.5 ATP molecules form from oxidation

iÀœLˆVÊi˜iÀ}ÞʓiÌ>LœˆÃ“ÊÀiviÀÃÊ̜Ê̅iÊi˜iÀ}އ}i˜iÀ>̈˜}
of one NADH moloecule. This decimal value for ATP
V>Ì>LœˆVÊÀi>V̈œ˜ÃÊ`ÕÀˆ˜}Ê܅ˆV…ÊœÝÞ}i˜ÊÃiÀÛiÃÊ>ÃÊ̅iÊvˆ˜>
does not indicate formation of a one-half of an ATP mole-
iiVÌÀœ˜Ê>VVi«ÌœÀʈ˜Ê̅iÊÀiëˆÀ>̜ÀÞÊV…>ˆ˜Ê>˜`ÊVœ“Lˆ˜iÃÊ܈̅
cule but rather indicates the average number of ATP pro-
…Þ`Àœ}i˜Ê̜ÊvœÀ“ÊÜ>ÌiÀ°Ê -œ“iʓˆ}…ÌÊ>À}ÕiÊ̅>ÌÊ̅iÊÌiÀ“
duced per NADH oxidation with the energy for
>iÀœLˆVʓiÌ>LœˆÃ“ ˆÃʓˆÃi>`ˆ˜}ÊLiV>ÕÃiʜÝÞ}i˜Ê`œiÃʘœÌ
mitochondrial transport subtracted. When FADH2 donates
«>À̈Vˆ«>ÌiÊ`ˆÀiV̏Þʈ˜Ê
/*ÊÃޘ̅iÈðÊ"ÝÞ}i˜½ÃÊ«ÀiÃi˜Vi
hydrogen, then on average only 1.5 molecules of ATP form
>ÌÊ̅iʺi˜`ʜvÊ̅iʏˆ˜i]»Ê…œÜiÛiÀ]ʏ>À}iÞÊ`iÌiÀ“ˆ˜iÃʜ˜i½Ã
for each hydrogen pair oxidized.
V>«>LˆˆÌÞÊvœÀÊ
/*Ê«Àœ`ÕV̈œ˜Êۈ>ÊÀiëˆÀ>̈œ˜°
LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 166 Aptara

166 • SECTION III Energy Transfer

S U M M A R Y
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ΰ -«ˆÌ̈˜}ʜvÊ
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i˜iÀ}ÞÊ«…œÃ«…>Ìið»

T H O U G H T Q U E S T I O N S
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Lœ`Þ¶ iÝ«i˜`ˆÌÕÀi°

Part 3 Energy Release

from Food
Food Energy
carbohydrates • lipids • proteins

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/*Ê­ Fig. 5.11®°Ê>VÀœ˜ÕÌÀˆi˜Ì
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̅iʘÕÌÀˆi˜ÌÃʓiÌ>Lœˆâi`° ADP + Pi ATP
Figure 5.12 œÕ̏ˆ˜iÃÊ̅iÊvœœÜˆ˜}ÊÈÝʓ>VÀœ˜ÕÌÀˆi˜Ì
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µÕi˜ÌÊ
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ΰ ÀiiÊv>ÌÌÞÊ>Vˆ`ÃÊ­`iÀˆÛi`ÊvÀœ“ÊÌÀˆ>Vޏ}ÞViÀœÃʈ˜
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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 167 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 167

+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
Liver Muscle tissue Adipose tissue 7…>ÌʈÃÊV>ÀLœ…Þ`À>Ìi½Ãʓ>œÀÊv՘V̈œ˜Êˆ˜
̅iÊLœ`Þ¶Ê
Glycogen
Intramuscular
energy stores
•ATP
Glucose Deaminated
•PCr
amino acid
•Triacylglycerols
•Glycogen
•Carbon skeletons
œ“«iÌiÊ̅iÊiµÕ>̈œ˜\
from amino acids

È£Ó"È ! È"Ó S

Triacylglycerols

Bloodstream
Fatty acids

œÜʓ>˜Þʎ
>ÃÊ>ÀiÊÀiµÕˆÀi`Ê̜ÊÃޘ̅iÈâi
œ˜iʓœiʜvÊ
/*ÊvÀœ“Ê
*Ê>˜`Ê*ˆ¶Ê

Deaminated Glucose Free

amino acid fatty acid

ˆÃÌÊ{ʜvÊ̅iÊÈʓ>VÀœ˜ÕÌÀˆi˜ÌÊvÕiÊÜÕÀVið
£°

Citric
Acid
Cycle
Ó°

Electron
transport
Mitochondrion ΰ

ATP
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ViÊ>˜`ʏˆÛiÀÊ}ÞVœ}i˜Ê`i«ïœ˜°
&OR 9OUR )NFORMATION
',5#/3% )3 ./4 2%42)%6!",% &2/- &!449 !#)$3
Cells can synthesize glucose from pyruvate and other 3-carbon com-
pounds. However, glucose cannot form from the 2-carbon acetyl
fragments of the "-oxidation of fatty acids. Consequently, fatty acids
cannot readily provide energy for tissues (e.g., brain and nerve
tissues) that use glucose almost exclusively for fuel. All dietary lipid
occurs in triacylglycerol form. Triacylglycerol’s glycerol component
can yield glucose, but the glycerol molecule contains only 3 (6%) of
the 57 carbon atoms in the molecule. Thus, fat from dietary sources
or stored in adipocytes does not provide an adequate potential
glucose source; about 95% of the fat molecule cannot be converted
to glucose.
LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 168 Aptara

168 • SECTION III Energy Transfer

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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 169 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 169

Glucose
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2
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8

2(2-phosphoglyceric acid)

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10
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Lactate 2 (Pyruvate) Lactate

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 Ó >ÌÊ>Ê«œˆ˜ÌÊLiœÜÊ̅iÊvˆÀÃÌÊ
/*ÊvœÀ“>̈œ oxidizing agents (electron acceptors)
­ÃiiÊFig. 5.10A®°Ê/…ÕÃ]Ê£°xÊÀ>̅iÀÊ̅>˜ÊÓ°xÊ
/*ʓœiVՏiÃÊvœÀ“Ê܅i˜Ê̅iÊÀiÇ in energy metabolism. Oxidation
«ˆÀ>̜ÀÞÊV…>ˆ˜ÊœÝˆ`ˆâiÃÊVÞ̜«>ӈVÊ
°Ê iV>ÕÃiÊÌܜʓœiVՏiÃʜvÊ
 reactions couple to reduction
vœÀ“ʈ˜Ê}ÞVœÞÈÃ]ÊÃÕLÃiµÕi˜ÌÊVœÕ«i`ÊiiVÌÀœ˜ÊÌÀ>˜Ã«œÀÌqœÝˆ`>̈ÛiÊ«…œÃ«…œ‡ reactions, allowing electrons (hydro-
Àޏ>̈œ˜Ê>iÀœLˆV>ÞÊ}i˜iÀ>ÌiÃÊvœÕÀÊ
/*ʓœiVՏið gens) picked up by NAD! and FAD
to transfer to other compounds
Lactate Formation -ÕvvˆVˆi˜ÌʜÝÞ}i˜ÊL>̅iÃÊ̅iÊViÃÊ`ÕÀˆ˜}ʏˆ}…ÌÊÌ (reducing agents) during energy
“œ`iÀ>ÌiʏiÛiÃʜvÊi˜iÀ}ÞʓiÌ>LœˆÃ“°Ê/…iʅÞ`Àœ}i˜ÃÊ­iiVÌÀœ˜Ã®ÊÃÌÀˆ««i`ÊvÀœ“ metabolism.
̅iÊÃÕLÃÌÀ>ÌiÊ>˜`ÊV>ÀÀˆi`ÊLÞÊ
ʜ݈`ˆâiÊ܈̅ˆ˜Ê̅iʓˆÌœV…œ˜`Àˆ>Ê̜ÊvœÀ“
LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 170 Aptara

170 • SECTION III Energy Transfer

Ê`ˆÀiVÌÊV…i“ˆV>Ê«>̅Ü>ÞÊi݈ÃÌÃÊvœÀʏˆÛiÀÊ}ÞVœ}i˜ÊÃޘ‡
GLUCOSE
̅iÈÃÊvÀœ“Ê`ˆiÌ>ÀÞÊV>ÀLœ…Þ`À>Ìi°ÊˆÛiÀÊ}ÞVœ}i˜ÊÃޘ̅iÈÃ
C C C C C C >ÃœÊœVVÕÀÃʈ˜`ˆÀiV̏ÞÊvÀœ“Ê̅iÊVœ˜ÛiÀȜ˜ÊœvÊ̅iÊ·V>ÀLœ˜
«ÀiVÕÀÜÀʏ>VÌ>ÌiÊ̜Ê}ÕVœÃi°Ê
ÀÞ̅ÀœVÞÌiÃÊ>˜`Ê>`ˆ«œVÞÌiÃ
Vœ˜Ì>ˆ˜Ê}ÞVœÞ̈VÊi˜âޓiÃ]ÊÎiiÌ>Ê“ÕÃViÊ«œÃÃiÃÃiÃÊ̅i
C C C C C C >À}iÃÌʵÕ>˜ÌˆÌÞÆÊ̅ÕÃ]ʓÕV…ÊœvÊ̅iʏ>VÌ>Ìi‡Ìœ‡}ÕVœÃiÊVœ˜‡
ÛiÀȜ˜ÊˆŽiÞʜVVÕÀÃʈ˜Ê“ÕÃVi°
/…iÊÌi“«œÀ>ÀÞÊÃ̜À>}iʜvʅÞ`Àœ}i˜Ê܈̅ʫÞÀÕÛ>ÌiÊÀi«‡
Energy Energy ÀiÃi˜ÌÃÊ>Ê՘ˆµÕiÊ>ëiVÌʜvÊi˜iÀ}ÞʓiÌ>LœˆÃ“ÊLiV>ÕÃiʈÌ
«ÀœÛˆ`iÃÊ>ÊÀi>`ÞʺVœiV̜À»ÊvœÀÊÌi“«œÀ>ÀÞÊÃ̜À>}iʜvÊ̅i
C C C Pyruvate
i˜`Ê«Àœ`ÕVÌʜvÊÀ>«ˆ`Ê}ÞVœÞÈðÊ
vÌiÀʏ>VÌ>ÌiÊvœÀ“Ãʈ˜Ê“ÕÇ
Vi]ʈÌÊiˆÌ…iÀÊ­£®Ê`ˆvvÕÃiÃʈ˜ÌœÊ̅iʈ˜ÌiÀÃ̈̈>Êë>ViÊ>˜`
C C C Pyruvate Lœœ`ÊvœÀÊLÕvviÀˆ˜}Ê>˜`ÊÀi“œÛ>ÊvÀœ“Ê̅iÊÈÌiʜvÊi˜iÀ}Þ
“iÌ>LœˆÃ“ÊœÀʭӮʫÀœÛˆ`iÃÊ>Ê}ÕVœ˜iœ}i˜ˆVÊÃÕLÃÌÀ>ÌiÊvœÀ
Figure 5.14 ÞVœÞÈÃ\Ê̅iÊ}ÕVœÃi‡Ìœ‡«ÞÀÕÛ>ÌiÊ«>̅Ü>Þ°Ê
}ÞVœ}i˜ÊÃޘ̅iÈðʘÊ̅ˆÃÊÜ>Þ]Ê}ÞVœÞÈÃÊVœ˜Ìˆ˜ÕiÃÊ̜
ȇV>ÀLœ˜Ê}ÕVœÃiÊ돈ÌÃʈ˜ÌœÊÌܜÊ·V>ÀLœ˜ÊVœ“«œÕ˜`Ã]Ê܅ˆV… ÃÕ««ÞÊ>˜>iÀœLˆVÊi˜iÀ}ÞÊvœÀÊ
/*ÊÀiÃޘ̅iÈðÊ/…ˆÃÊ>Ûi˜Õi
vÕÀ̅iÀÊ`i}À>`iʈ˜ÌœÊÌܜÊ·V>ÀLœ˜Ê«ÞÀÕÛ>ÌiʓœiVՏiðʏÕVœÃi vœÀÊiÝÌÀ>Êi˜iÀ}ÞÊÀi“>ˆ˜ÃÊÌi“«œÀ>ÀÞʈvÊLœœ`Ê>˜`ʓÕÃVi
돈Ì̈˜}ʜVVÕÀÃÊ՘`iÀÊ>˜>iÀœLˆVÊVœ˜`ˆÌˆœ˜Ãʈ˜Ê̅iÊViÃ½ÊÜ>ÌiÀÞ >VÌ>ÌiʏiÛiÃʈ˜VÀi>ÃiÊ>˜`Ê
/*ÊvœÀ“>̈œ˜Êv>ˆÃÊ̜ʎii«Ê«>Vi
“i`ˆÕ“°
܈̅ʈÌÃÊÀ>ÌiʜvÊÕÃi°Ê>̈}ÕiÊܜ˜ÊÃiÌÃʈ˜]Ê>˜`ÊiÝiÀVˆÃiÊ«iÀ‡
vœÀ“>˜ViÊ`ˆ“ˆ˜ˆÃ…iðʘVÀi>Ãi`ʈ˜ÌÀ>ViÕ>ÀÊ>Vˆ`ˆÌÞÊ՘`iÀ
Ü>ÌiÀÊ܅i˜Ê̅iÞʍœˆ˜Ê܈̅ʜÝÞ}i˜°Ê˜Ê>ÊLˆœV…i“ˆV>ÊÃi˜Ãi] >˜>iÀœLˆVÊVœ˜`ˆÌˆœ˜ÃʏˆŽiÞʓi`ˆ>ÌiÃÊv>̈}ÕiÊLÞʈ˜>V̈Û>̇
>ʺÃÌi>`ÞÊÀ>Ìi»Êi݈ÃÌÃÊLiV>ÕÃiʅÞ`Àœ}i˜ÊœÝˆ`ˆâiÃÊ>ÌÊ>LœÕÌ ˆ˜}ÊÛ>ÀˆœÕÃÊi˜âޓiÃʈ˜Êi˜iÀ}ÞÊÌÀ>˜ÃviÀʈ“«>ˆÀÊ̅iʓÕÃVi½Ã
̅iÊÃ>“iÊÀ>ÌiʈÌÊLiVœ“iÃÊ>Û>ˆ>Li°Ê/…ˆÃÊVœ˜`ˆÌˆœ˜ÊœvÊ>iÀœLˆV Vœ˜ÌÀ>V̈iÊ«Àœ«iÀ̈ið
}ÞVœÞÈÃÊvœÀ“ÃÊ«ÞÀÕÛ>ÌiÊ>ÃÊ̅iÊi˜`Ê«Àœ`ÕVÌ°
˜ÊÃÌÀi˜ÕœÕÃÊiÝiÀVˆÃi]Ê܅i˜Êi˜iÀ}ÞÊ`i“>˜`ÃÊiÝVii`
iˆÌ…iÀÊ̅iʜÝÞ}i˜ÊÃÕ««ÞʜÀÊ̅iÊṎˆâ>̈œ˜ÊÀ>Ìi]Ê̅iÊÀi눇 A Valuable “Waste Product” >VÌ>ÌiÊŜՏ`ʘœÌ
À>̜ÀÞÊV…>ˆ˜ÊV>˜˜œÌÊ«ÀœViÃÃÊ>ÊœvÊ̅iʅÞ`Àœ}i˜Êœˆ˜i` LiÊۈiÜi`Ê>ÃÊ>ʓiÌ>LœˆVÊÜ>ÃÌiÊ«Àœ`ÕVÌ°Ê/œÊ̅iÊVœ˜ÌÀ>ÀÞ]ʈÌ
̜
°Ê
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VœÞÈÃÊ`i«i˜`Ãʜ˜Ê
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«…œÃ«…œ}ÞViÀ>`i…Þ`iÊ­ÃiiÊÀi>V̈œ˜ÊÈʈ˜Ê Fig. 5.13®Æ LiVœ“iÃÊ>Û>ˆ>LiÊ`ÕÀˆ˜}ÊÀiVœÛiÀÞʜÀÊ܅i˜ÊiÝiÀVˆÃiÊ«>Vi
œÌ…iÀ܈Ãi]Ê̅iÊÀ>«ˆ`ÊÀ>ÌiʜvÊ}ÞVœÞÈÃʺ}Àˆ˜`ÃÊ̜Ê>ʅ>Ì°»Ê ϜÜÃʜÀÊVi>ÃiÃÊ­ÀiVœÛiÀÞ®]Ê
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! ºvÀiiÃÊÕ«»Ê>Ã
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«œÀ>ÀˆÞÊ܈̅ʫÞÀÕÛ>ÌiÊ̜ÊvœÀ“ʏ>VÌ>Ìi]ÊV>Ì>Þâi`ÊLÞÊ̅i
i˜âޓiʏ>VÌ>ÌiÊ`i…Þ`Àœ}i˜>Ãiʈ˜Ê̅iÊÀiÛiÀÈLiÊÀi>V̈œ˜
Ŝܘʈ˜ÊFigure 5.15°
>ÌÌ>V…i`Ê̜ʏ>VÌ>Ìi]Ê܅ˆV…ÊÃÕLÃiµÕi˜ÌÞʜ݈`ˆâiÊ̜ÊvœÀ“

/*°Ê/…iÊV>ÀLœ˜ÊÎii̜˜ÃʜvÊ̅iÊ«ÞÀÕÛ>ÌiʓœiVՏiÃ
ÀivœÀ“i`ÊvÀœ“ʏ>VÌ>ÌiÊ`ÕÀˆ˜}ÊiÝiÀVˆÃiÊ­œ˜iÊ«ÞÀÕÛ>Ìiʓœi‡
VՏiÊ! ÓʅÞ`Àœ}i˜ÃÊvœÀ“Ãʜ˜iʏ>VÌ>ÌiʓœiVՏi®ÊLiVœ“i
iˆÌ…iÀʜ݈`ˆâi`ÊvœÀÊi˜iÀ}ÞʜÀÊÃޘ̅iÈâi`Ê̜Ê}ÕVœÃiÊ­}Õ‡
ÕÀˆ˜}ÊÀiÃÌÊ>˜`ʓœ`iÀ>ÌiÊiÝiÀVˆÃi]Êܓiʏ>VÌ>ÌiÊVœ˜‡
œÀˆ
̈˜Õ>ÞÊvœÀ“ÃÊ>˜`ÊÀi>`ˆÞʜ݈`ˆâiÃÊvœÀÊi˜iÀ}Þʈ˜Ê˜iˆ}…‡
LœÀˆ˜}ʓÕÃViÊvˆLiÀÃÊ܈̅ʅˆ}…ʜ݈`>̈ÛiÊV>«>VˆÌÞʜÀʈ
“œÀiÊ`ˆÃÌ>˜ÌÊ̈ÃÃÕiÃÊÃÕV…Ê>ÃÊ̅iʅi>ÀÌÊ>˜`ÊÛi˜Ìˆ>̜ÀÞʓÕÇ
ViðÊ>VÌ>ÌiÊV>˜Ê>ÃœÊ«ÀœÛˆ`iÊ>˜Êˆ˜`ÀiVÌÊ«ÀiVÕÀÜÀʜvʏˆÛiÀ
}ÞVœ}i˜Ê­ÃiiʘiÝÌÊÃiV̈œ˜®°Ê
œ˜ÃiµÕi˜ÌÞ]ʏ>VÌ>ÌiÊ`œià Source Ü̜«iÊÌÀ>ViÀÊÃÌÕ`ˆiÃÊŜÜÊ̅>Ìʏ>VÌ>ÌiÊ«Àœ‡
˜œÌÊ>VVՓՏ>ÌiÊLiV>ÕÃiʈÌÃÊÀi“œÛ>ÊÀ>ÌiÊiµÕ>ÃʈÌÃÊÀ>Ìiʜv
«Àœ`ÕV̈œ˜°Ê"˜iʜvÊ̅iÊLi˜ivˆÌÃʜvÊ>À`՜ÕÃ]Ê«Àœœ˜}i
ÌÀ>ˆ˜ˆ˜}ÊvœÀÊëœÀÌÃʈÃÊ̅>ÌÊi˜`ÕÀ>˜ViÊ>̅iÌiÃʅ>ÛiÊ>˜
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ÊvœÀ
i˜…>˜Vi`Ê>LˆˆÌÞÊvœÀʏ>VÌ>ÌiÊVi>À>˜ViʜÀÊÌÕÀ˜œÛiÀÊ`ÕÀˆ˜}
iÝiÀVˆÃi°
Vœ˜iœ}i˜iÈîʈ˜Ê“ÕÃViʈÌÃivʜÀʈ˜Ê̅iʏˆÛiÀÊۈ>Ê̅iÊ
VÞVi ­Fig. 5.16®°Ê/…ˆÃÊVÞViÊÀi“œÛiÃʏ>VÌ>ÌiÊ>˜`ÊÕÃiÃʈÌÊ̜
Ài«i˜ˆÃ…Ê}ÞVœ}i˜ÊÀiÃiÀÛiÃÊ`i«iÌi`ÊvÀœ“ʈ˜Ìi˜ÃiÊiÝiÀVˆÃi°
Lactate Shuttle: Blood Lactate as an Energy
`ÕVi`ʈ˜Êv>Ã̇Ì܈ÌV…Ê“ÕÃViÊvˆLiÀÃÊ­>˜`ʜ̅iÀÊ̈ÃÃÕiîÊVˆÀ
VՏ>ÌiÃÊ̜ʜ̅iÀÊv>Ã̇ʜÀÊϜ܇Ì܈ÌV…ÊvˆLiÀÃÊvœÀÊVœ˜ÛiÀȜ
̜ʫÞÀÕÛ>Ìi°Ê*ÞÀÕÛ>Ìi]ʈ˜ÊÌÕÀ˜]ÊVœ˜ÛiÀÌÃÊ̜Ê>ViÌޏ‡
i˜ÌÀÞʈ˜ÌœÊ̅iÊVˆÌÀˆVÊ>Vˆ`ÊVÞViÊvœÀÊ>iÀœLˆVÊi˜iÀ}ÞʓiÌ>Lœ‡
ˆÃ“°Ê/…ˆÃÊ«ÀœViÃÃʜvʏ>VÌ>ÌiÊÅÕÌ̏ˆ˜} >“œ˜}ÊViÃÊi˜>LiÃ

1 H O O H OH O 2
NADH2 H C C C OH H C C C OH NAD Figure 5.15 >VÌ>ÌiÊvœÀ“ÃÊ܅i˜
2 hydrogen
LDH iÝViÃÃʅÞ`Àœ}i˜ÃÊvÀœ“Ê
ÊVœ“Lˆ˜i
H H H Ìi“«œÀ>ÀˆÞÊ܈̅ʫÞÀÕÛ>Ìi°Ê/…ˆÃÊvÀiiÃÊÕ«
atoms
Pyruvate Lactate
! ̜Ê>VVi«ÌÊ>``ˆÌˆœ˜>Ê…Þ`Àœ}i˜Ã
C3H4O3 C3H6O3 }i˜iÀ>Ìi`ʈ˜Ê}ÞVœÞÈðÊÊ" >VÌ>Ìi
`i…Þ`Àœ}i˜>Ãi°
LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 171 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 171

Muscle Cell +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

Muscle Muscle
Gycogen Protein iÃVÀˆLiÊ̅iʓ>œÀÊv՘V̈œ˜ÊœvÊ̅iÊVˆÌÀˆV
Blood >Vˆ`ÊVÞVi°Ê
Pyruvate Glucogenic
Amino Acids

Lactate
Alanine

˜Ê܅>ÌʜÀ}>˜>iÊ`œiÃÊ̅iÊVˆÌÀˆVÊ>Vˆ`ÊVÞVi
Glucose œVVÕÀ¶
Pyruvate

Lactate

Glycogen

Liver

Figure 5.16 /…iÊ

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vÀœ“Ê>V̈ÛiʓÕÃVi°Ê/…ˆÃÊ}ÕVœ˜iœ}i˜ˆVÊ«ÀœViÃÃʓ>ˆ˜Ì>ˆ˜ÃÊV>ÀLœ…Þ`À>ÌiÊÀiÃiÀÛið

}ÞVœ}i˜œÞÈÃʈ˜Êœ˜iÊViÊ̜ÊÃÕ««Þʜ̅iÀÊViÃÊ܈̅ÊvÕiÊvœÀʜ݈`>̈œ˜°Ê /…ˆÃ
“>ŽiÃʓÕÃViʘœÌʜ˜ÞÊ>ʓ>œÀÊÈÌiʜvʏ>VÌ>ÌiÊ«Àœ`ÕV̈œ˜ÊLÕÌÊ>ÃœÊ>Ê«Àˆ“>ÀÞÊ̈ÃÃÕi
vœÀʏ>VÌ>ÌiÊÀi“œÛ>Êۈ>ʜ݈`>̈œ˜°
&OR 9OUR )NFORMATION
Aerobic (Slow) Glycolysis: The Citric Acid Cycle &2%% 2!$)#!,3 &/2-%$ $52).'
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/…iÊ>˜>iÀœLˆVÊÀi>V̈œ˜ÃʜvÊÀ>«ˆ`Ê}ÞVœÞÈÃÊÀii>Ãiʜ˜ÞÊ>LœÕÌÊx¯ÊœvÊ̅iʜÀˆ}ˆ˜>
«œÌi˜Ìˆ>Êi˜iÀ}ÞÊ܈̅ˆ˜Ê̅iʜÀˆ}ˆ˜>Ê}ÕVœÃiʓœiVՏi°Ê/…ˆÃʓi>˜ÃÊ̅>ÌÊiÝÌÀ>V̇ The passage of electrons along the
ˆ˜}Ê̅iÊÀi“>ˆ˜ˆ˜}Êi˜iÀ}ÞʓÕÃÌʜVVÕÀÊLÞÊ>˜œÌ…iÀʓiÌ>LœˆVÊ«>̅Ü>Þ°Ê/…ˆÃ electron transport chain sometimes
œVVÕÀÃÊ܅i˜Ê«ÞÀÕÛ>ÌiʈÀÀiÛiÀÈLÞÊVœ˜ÛiÀÌÃÊ̜Ê>ViÌޏ‡
œ
]Ê>ÊvœÀ“ÊœvÊ>VïVÊ>Vˆ`° forms free radicals, molecules with an

ViÌޏ‡
œ
Êi˜ÌiÀÃÊ̅iÊÃiVœ˜`ÊÃÌ>}iʜvÊV>ÀLœ…Þ`À>ÌiÊLÀi>Ž`œÜ˜ÊŽ˜œÜ˜Ê>ÃÊ>iÀœ‡ unpaired electron in their outer orbital,
LˆVʭϜܮÊ}ÞVœÞÈÃÊ­>ÃœÊÌiÀ“i`Ê̅iÊ VˆÌÀˆVÊ>Vˆ`ÊVÞVi] ÀiLÃÊVÞVi]ʜÀÊÌÀˆV>À‡ making them highly reactive. These
LœÝޏˆVÊ>Vˆ`ÊVÞVi®° reactive free radicals bind quickly to
Figure 5.17 ŜÜÃÊ̅iʓiÌ>LœˆVÊÀi>V̈œ˜ÃʜvÊ«ÞÀÕÛ>ÌiÊ̜Ê>ViÌޏ‡
œ
°Ê >V… other molecules that promote potential
·V>ÀLœ˜Ê«ÞÀÕÛ>ÌiʓœiVՏiʏœÃiÃÊ>ÊV>ÀLœ˜Ê܅i˜ÊˆÌʍœˆ˜ÃÊ܈̅Ê>Ê
œ
ʓœiVՏi damage to the combining molecule.
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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 172 Aptara

172 • SECTION III Energy Transfer

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oxidize
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Acetyl-CoA
H+ H
+ H+
H+
H+ + + H+ H+
H+ + H
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H
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H H+ e– e– ELECTRON
H+ + TRANSPORT
H e– e– CHAIN
H+ H+
Reduced coenzymes
CITRIC (carrier molecules) e– e–
ACID CO2 transport hydrogen ADP+Pi ATP
CYCLE to the electron transport
chain
H+ H+
2H + + O = H2O
CO2
H+ H+
ATP

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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 173 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 173

PYRUVATE

NAD+

CO2 NADH + H+
coenzyme A (CoA)
1

ACETYL-COENZYME A
CoA

NAD+
2

H2O
NADH + H+ 3
10

H2O
CITRIC ACID CYCLE
9 NAD+
5
NADH + H+
6
8
FADH2
CO2 H2O
7
FAD
NAD+

NADH + H+
ATP

CO2 and H Release per Hydrolysis of 2 Pyruvate Molecules

Figure 5.19 ,ii>ÃiʜvÊÊ>˜`Ê
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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 174 Aptara

174 • SECTION III Energy Transfer

Glycolysis in cytosol

CH2OH
O
H H H
H
Glycogen
OH
OH H
HO OH

H OH
Glucose
4 ATP
(2 net ATP) 2 ATP
2 NAD+

2 NADH H+

2 Pyruvate

2 NAD+

Citric acid cycle and

electron transport
2 NAD+
in mitochondrion
2 CO2 2 NADH H+
2 NAD+
2 Acetyl-CoA

Electron transport-cytochromes
6 NAD+

6 NADH H+
2 ATP
6 NAD+
Citric Acid
2 ADP Cycle
2 FAD

2 FADH2
2 FAD
6 O2
4 CO2 6 H2O

Source Reaction Net ATPs

12 H2O
Substrate phosphorylation Glycolysis 2
2 H2 (4 H) Glycolysis 4
ATP Figure 5.20
ʘiÌÊވi`ʜvÊÎÓ
2 H2 (4 H) Pyruvate Acetyl-CoA 5
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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 175 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 175

ENERGY RELEASE FROM FAT +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 176 Aptara

176 • SECTION III Energy Transfer

Glucose Triacylglycerol + 3 H2O Glycerol + 3 Fatty acids

3-phosphoglyceraldehyde
coenzyme A
2H
coenzyme A
pyruvate

2H
BETA
acetyl -CoA CoA + acetyl OXIDATION

2H

2H
CITRIC
ACID 2H
CYCLE

ATP
2 CO2

Figure 5.21 Ài>Ž`œÜ˜ÊœvÊ}ÞV‡

ATP yield per iÀœÊ>˜`Êv>ÌÌÞÊ>Vˆ`ÊvÀ>}“i˜ÌÃʜvÊ>Ê
Source Pathway molecule ÌÀˆ>Vޏ}ÞViÀœÊ“œiVՏi°ÊÞViÀœ
neutral fat i˜ÌiÀÃÊ̅iÊi˜iÀ}ÞÊ«>̅Ü>ÞÃʜvÊ}ÞVœÞ‡
1 molecule glycerol Glycolysis + ÈðÊ/…iÊv>ÌÌÞÊ>Vˆ`ÊvÀ>}“i˜ÌÃÊi˜ÌiÀÊ̅i
Citric acid cycle 19 VˆÌÀˆVÊ>Vˆ`ÊVÞViÊۈ>Ê!‡œÝˆ`>̈œ˜°Ê/…i
3 molecules of 18- Beta oxidation + iiVÌÀœ˜ÊÌÀ>˜Ã«œÀÌÊV…>ˆ˜Ê«ÀœViÃÃiÃÊ̅i
carbon fatty acid Citric acid cycle 441 Àii>Ãi`ʅÞ`Àœ}i˜ÃÊvÀœ“Ê}ÞVœÞÈÃ]Ê
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LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 177 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 177

Metabolism Under Low-Carbohydrate Conditions "Ý>œ>V‡

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vÀœ“Êv>Ã̈˜}]Ê«Àœœ˜}i`ÊiÝiÀVˆÃi]ʜÀÊ`ˆ>LiÌiÃÊ`ÕiÊ̜Ê̅iˆÀÊ՘>Û>ˆ>LˆˆÌÞÊ̜ÊVœ“‡ ˆ˜Ê>ÊV>ÀLœ…Þ`À>ÌiÊv>“i»Ê“i>˜Ã
Lˆ˜iÊ܈̅Ê>ViÌޏ‡
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œ
Ê`iÀˆÛi`
vÀœ“Ê̅iÊv>ÌÌÞÊ>Vˆ`Ãʈ˜ÌœÊÃÌÀœ˜}Ê>Vˆ`ʓiÌ>LœˆÌiÃÊV>i`ʎi̜˜iÃʜÀʎi̜˜iÊLœ`‡
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ˆ“ˆÌi`ÊiÝÌi˜ÌÊLÞʘiÀۜÕÃÊÃÞÃÌi“Ê̈ÃÃÕiðÊ7ˆÌ…œÕÌʎi̜˜iÊV>Ì>LœˆÃ“]Ê̅iÞ
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/…iʅˆ}…Ê>Vˆ`ˆÌÞʜvʎi̜ÈÃÊ`ˆÃÀÕ«ÌÃʘœÀ“>Ê«…ÞȜœ}ˆVÊv՘V̈œ˜]ÊiëiVˆ>Þ
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i̜ÈÃÊ}i˜iÀ>ÞʜVVÕÀÃʓœÀiÊvÀœ“Ê>˜Êˆ˜>`iµÕ>ÌiÊ`ˆiÌÊ>Ãʈ˜Ê>˜œÀi݈>ʘiÀۜÃ>
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vÕi°ÊÕÀˆ˜}ÊiÝiÀVˆÃi]Ê>iÀœLˆV>ÞÊÌÀ>ˆ˜i`ʈ˜`ˆÛˆ`Õ>ÃÊÕÃiʎi̜˜iÃʓœÀiÊivviV‡
̈ÛiÞÊ̅>˜Ê՘ÌÀ>ˆ˜i`ʈ˜`ˆÛˆ`Õ>Ã°
Slower Energy Release From Fat
“ÕÃViʓ>ŽiÃÊÕÃiʜvÊv>ÌÌÞÊ>Vˆ`°Ê
iÀœLˆVÊÌÀ>ˆ˜ˆ˜}Êi˜…>˜ViÃÊ̅ˆÃʏˆ“ˆÌ]ÊLÕÌÊ̅i
Figure 5.22 !‡œÝˆ`>̈œ˜ÊœvÊ
>ÊÌÞ«ˆV>Ê£È‡V>ÀLœ˜Êv>ÌÌÞÊ>Vˆ`°Ê
>ÌÌÞÊ>Vˆ`ÃÊ`i}À>`iÊ̜ÊӇV>ÀLœ˜
vÀ>}“i˜ÌÃÊ̅>ÌÊVœ“Lˆ˜iÊ܈̅Ê
œ

̜ÊvœÀ“Ê>ViÌޏ‡
œ
°

ÊÀ>Ìiʏˆ“ˆÌÊi݈ÃÌÃÊvœÀʅœÜÊ>V̈Ûi
O
H OH
H
H 16-Carbon fatty acid
CoA activates the fatty acid
CoA
H CoA
H
H
ATP formation occurs with the cleavage of carbon bonds
ATP
CoA
ATP
Another CoA joins the chain, and the bond at the second carbon (the beta carbon)
weakens. Acetyl-CoA splits off, leaving the fatty acid two carbons shorter.
Acetyl
H CoA + C C CoA
H
H 14-Carbon fatty acid
The new shorter fatty acid enters the pathway, 14-Carbon fatty acid acetyl-CoA
repeating the cycle. The molecules of acetyl-CoA enter 12-Carbon fatty acid acetyl-CoA
the citric acid for energy metabolism. The final yield 10-Carbon fatty acid acetyl-CoA
from a 16 carbon fatty acid is 8 acetyl-CoA. 8-Carbon fatty acid acetyl-CoA
6-Carbon fatty acid acetyl-CoA
4-Carbon fatty acid acetyl-CoA
2-Carbon fatty acid acetyl-CoA
LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 178 Aptara

178 • SECTION III Energy Transfer

À>ÌiʜvÊi˜iÀ}ÞÊ}i˜iÀ>Ìi`Ê܏iÞÊLÞÊv>ÌÊLÀi>Ž`œÜ˜ÊÃ̈ÊÀi«‡ Hormones That Affect Fat Metabolism

ÀiÃi˜ÌÃʜ˜ÞÊ>LœÕÌʜ˜i‡…>vʜvÊ̅iÊÛ>ÕiÊ>V…ˆiÛi`Ê܈̅
V>ÀLœ…Þ`À>ÌiÊ>ÃÊ̅iÊV…ˆivÊ>iÀœLˆVÊi˜iÀ}ÞÊÜÕÀVi°Ê/…ÕÃ] «ˆ˜i«…Àˆ˜i]ʘœÀi«ˆ˜i«…Àˆ˜i]Ê}ÕV>}œ˜]Ê>˜`Ê}ÀœÜ̅ʅœÀ‡
`i«ï˜}ʓÕÃViÊ}ÞVœ}i˜Ê`iVÀi>ÃiÃÊ̅iʈ˜Ìi˜ÃˆÌÞÊ̅>ÌÊ> “œ˜iÊ>Õ}“i˜Ìʏˆ«>ÃiÊ>V̈Û>̈œ˜Ê>˜`ÊÃÕLÃiµÕi˜Ìʏˆ«œÞÈÃÊ>˜`
“ÕÃViÊV>˜ÊÃÕÃÌ>ˆ˜Ê>iÀœLˆVÊ«œÜiÀʜÕÌ«ÕÌ°ÊÕÃÌÊ>ÃÊ̅i 
ʓœLˆˆâ>̈œ˜ÊvÀœ“Ê>`ˆ«œÃiÊ̈ÃÃÕi°Ê*>Ó>ÊVœ˜Vi˜ÌÀ>̈œ˜Ã
…Þ«œ}ÞVi“ˆVÊVœ˜`ˆÌˆœ˜ÊVœˆ˜Vˆ`iÃÊ܈̅Ê>ʺVi˜ÌÀ>»ÊœÀ œvÊ̅iÃiʏˆ«œ}i˜ˆVʅœÀ“œ˜iÃʈ˜VÀi>ÃiÊ`ÕÀˆ˜}ÊiÝiÀVˆÃiÊ̜ÊVœ˜‡
˜iÕÀ>Êv>̈}Õi]ÊiÝiÀVˆÃˆ˜}Ê܈̅Ê`i«iÌi`ʓÕÃViÊ}ÞVœ}i˜ ̈˜Õ>ÞÊÃÕ««ÞÊ>V̈ÛiʓÕÃViÃÊ܈̅Êi˜iÀ}އÀˆV…ÊÃÕLÃÌÀ>Ìi°Ê
˜
V>ÕÃiÃʺ«iÀˆ«…iÀ>»ÊœÀʏœV>Ê“ÕÃViÊv>̈}Õi° ˆ˜ÌÀ>ViÕ>Àʓi`ˆ>̜À]Ê >`i˜œÃˆ˜iÊÎ !]x!‡VÞVˆVʓœ˜œ«…œÃ‡
«…>Ìi ­VÞVˆVÊ
*®] >V̈Û>ÌiÃʅœÀ“œ˜i‡Ãi˜ÃˆÌˆÛiʏˆ«>ÃiÊ>˜`
Excess Macronutrients Regardless of Source ̅ÕÃÊÀi}Տ>ÌiÃÊv>ÌÊLÀi>Ž`œÜ˜°Ê6>ÀˆœÕÃʏˆ«ˆ`‡“œLˆˆâˆ˜}ʅœÀ‡
Convert to Fat ÝViÃÃÊi˜iÀ}Þʈ˜Ì>ŽiÊvÀœ“Ê>˜ÞÊvÕi “œ˜iÃÊ̅>ÌÊ̅i“ÃiÛiÃÊ`œÊ˜œÌÊi˜ÌiÀÊ̅iÊViÊ>V̈Û>ÌiÊVÞVˆV
ÜÕÀViÊV>˜ÊLiÊVœÕ˜ÌiÀ«Àœ`ÕV̈Ûi°ÊFigure 5.23 ŜÜÃʅœÜ
*°Ê
ˆÀVՏ>̈˜}ʏ>VÌ>Ìi]ʎi̜˜iÃ]Ê>˜`Ê«>À̈VՏ>ÀÞʈ˜ÃՏˆ˜
̜œÊ“ÕV…ÊœvÊ>˜Þʓ>VÀœ˜ÕÌÀˆi˜ÌÊVœ˜ÛiÀÌÃÊ̜Êv>ÌÌÞÊ>Vˆ`Ã] ˆ˜…ˆLˆÌÊVÞVˆVÊ
*Ê>V̈Û>̈œ˜°Ê ÝiÀVˆÃiÊÌÀ>ˆ˜ˆ˜}‡ˆ˜`ÕVi`
܅ˆV…Ê̅i˜Ê>VVՓՏ>ÌiÊ>ÃÊLœ`ÞÊv>Ì°Ê-ÕÀ«ÕÃÊ`ˆiÌ>ÀÞÊV>ÀLœ‡ ˆ˜VÀi>ÃiÃʈ˜Ê̅iÊ>V̈ۈÌÞʏiÛiÊœvÊÎiiÌ>Ê“ÕÃViÊ>˜`Ê>`ˆ«œÃi
…Þ`À>ÌiÊvˆÀÃÌÊvˆÃÊ̅iÊ}ÞVœ}i˜ÊÀiÃiÀÛiðÊ7…i˜Ê̅i ̈ÃÃÕiʏˆ«>ÃiÃ]ʈ˜VÕ`ˆ˜}ÊLˆœV…i“ˆV>Ê>˜`ÊÛ>ÃVՏ>ÀÊ>`>«Ì>‡
ÀiÃiÀÛiÃÊvˆ]ÊiÝViÃÃÊV>ÀLœ…Þ`À>ÌiÊVœ˜ÛiÀÌÃÊ̜ÊÌÀˆ>Vޏ}ÞV ̈œ˜Ãʈ˜Ê̅iʓÕÃViÃÊ̅i“ÃiÛiÃ]Êi˜…>˜ViÊv>ÌÊÕÃiÊvœÀÊi˜iÀ}Þ
iÀœÃÊvœÀÊÃ̜À>}iʈ˜Ê>`ˆ«œÃiÊ̈ÃÃÕi°Ê ÝViÃÃÊ`ˆiÌ>ÀÞÊv>ÌÊV>œ‡ `ÕÀˆ˜}ʓœ`iÀ>ÌiÊiÝiÀVˆÃi°Ê*>À>`œÝˆV>Þ]ÊiÝViÃÃÊLœ`ÞÊv>Ì
ÀˆiÃʓœÛiÊi>ȏÞʈ˜ÌœÊ̅iÊLœ`Þ½ÃÊv>ÌÊ`i«œÃˆÌðÊ
vÌiÀÊ̅iÞʅ>Ûi `iVÀi>ÃiÃÊ̅iÊ>Û>ˆ>LˆˆÌÞʜvÊv>ÌÌÞÊ>Vˆ`ÃÊ`ÕÀˆ˜}ÊiÝiÀVˆÃi°Ê
Lii˜Ê`i>“ˆ˜>Ìi`]Ê̅iÊV>ÀLœ˜ÊÀiÈ`ÕiÃʜvÊiÝViÃÃÊ>“ˆ˜œ
…>«ÌiÀÊ£ÓÊ«ÀiÃi˜ÌÃÊ>ʓœÀiÊ`iÌ>ˆi`ÊiÛ>Õ>̈œ˜ÊœvʅœÀ“œ˜i
>Vˆ`ÃÊvÀœ“Ê«ÀœÌiˆ˜ÊÀi>`ˆÞÊVœ˜ÛiÀÌÊ̜Êv>Ì° Ài}Տ>̈œ˜Ê`ÕÀˆ˜}ÊiÝiÀVˆÃiÊ>˜`ÊÌÀ>ˆ˜ˆ˜}°

Carbohydrate Lipid Protein

Glucose Glycerol Pyruvate Amino Acids

NH2
Pyruvate
Pyruvate
Acetyl-CoA

Acetyl-CoA
Acetyl-CoA Glycerol
Fatty Acids
Fatty Acids Fatty Acids

Figure 5.23 iÌ>LœˆVÊv>Ìiʜvʓ>VÀœ˜ÕÌÀˆi˜ÌÊi˜iÀ}ÞÊÃÕÀ«Õð

LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 179 Aptara

Chapter 5 Fundamentals of Human Energy Transfer • 179

/…iÊ>Û>ˆ>LˆˆÌÞʜvÊv>ÌÌÞÊ>Vˆ`ʓœiVՏiÃÊÀi}Տ>ÌiÃÊv>ÌÊLÀi>Ž`œÜ˜ÊœÀÊÃޘ‡
̅iÈðÊ
vÌiÀÊ>ʓi>]Ê܅i˜Êi˜iÀ}ÞʓiÌ>LœˆÃ“ÊÀi“>ˆ˜ÃÊÀi>̈ÛiÞʏœÜ]Ê`ˆ}iÇ
+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
̈ÛiÊ«ÀœViÃÃiÃʈ˜VÀi>ÃiÊ
Ê>˜`ÊÌÀˆ>Vޏ}ÞViÀœÊ`iˆÛiÀÞÊ̜ÊViÃÆÊ̅ˆÃʈ˜ÊÌÕÀ˜ ˆÃVÕÃÃÊ̅iÊv>ÌiʜvÊiÝViÃÃÊi˜iÀ}Þʈ˜Ì>Ži°
Ã̈“Տ>ÌiÃÊÌÀˆ>Vޏ}ÞViÀœÊÃޘ̅iÈðʘÊVœ˜ÌÀ>ÃÌ]ʓœ`iÀ>ÌiÊiÝiÀVˆÃiʈ˜VÀi>ÃiÃ
v>ÌÌÞÊ>Vˆ`ÊÕÃiÊvœÀÊi˜iÀ}Þ]Ê܅ˆV…ÊÀi`ÕViÃÊ̅iˆÀÊViÕ>ÀÊVœ˜Vi˜ÌÀ>̈œ˜°Ê/…i
`iVÀi>Ãiʈ˜Êˆ˜ÌÀ>ViÕ>ÀÊ
ÃÊÃ̈“Տ>ÌiÃÊÌÀˆ>Vޏ}ÞViÀœÊLÀi>Ž`œÜ˜Êˆ˜Ìœ
}ÞViÀœÊ>˜`Êv>ÌÌÞÊ>Vˆ`ÊVœ“«œ˜i˜ÌðÊ
œ˜VÕÀÀi˜ÌÞ]ʅœÀ“œ˜>ÊÀii>ÃiÊÌÀˆ}‡
}iÀi`ÊLÞÊiÝiÀVˆÃiÊÃ̈“Տ>ÌiÃÊ>`ˆ«œÃiÊ̈ÃÃÕiʏˆ«œÞÈÃÊ̜ÊvÕÀ̅iÀÊ>Õ}“i˜ÌÊ

ÀˆivÞÊ`iÃVÀˆLiÊ̅iÊÀœiʜvÊVÞVˆVÊ
*ʈ
`iˆÛiÀÞÊ̜Ê>V̈ÛiʓÕÃVi°
v>ÌʓiÌ>LœˆÃ“°

ENERGY RELEASE FROM PROTEIN

Figure 5.24 ˆÕÃÌÀ>ÌiÃʅœÜÊ«ÀœÌiˆ˜ÊÃÕ««ˆiÃʈ˜ÌiÀ“i`ˆ>ÌiÃÊ>ÌÊ̅ÀiiÊ`ˆvviÀi˜Ì
iÛiÃÊ̅>Ìʅ>ÛiÊi˜iÀ}އ«Àœ`ÕVˆ˜}ÊV>«>LˆˆÌˆiðÊ*ÀœÌiˆ˜Ê>VÌÃÊ>ÃÊ>˜Êi˜iÀ}ÞÊÃÕL‡ ÀˆivÞÊ`ˆÃVÕÃÃÊ̅iÊivviVÌÃʜvÊiÝiÀVˆÃ
ÃÌÀ>ÌiÊ`ÕÀˆ˜}ʏœ˜}‡`ÕÀ>̈œ˜]Êi˜`ÕÀ>˜Vi‡ÌÞ«iÊ>V̈ۈ̈iðÊ/…iÊ>“ˆ˜œÊ>Vˆ`ÃÊ­«Àˆ‡ ÌÀ>ˆ˜ˆ˜}ʜ˜Êv>ÌʓiÌ>LœˆÃ“°
“>ÀˆÞÊ̅iÊLÀ>˜V…i`‡V…>ˆ˜Ê>“ˆ˜œÊ>Vˆ`ÃʏiÕVˆ˜i]ʈ܏iÕVˆ˜i]ÊÛ>ˆ˜i]Ê}ÕÌ>“ˆ˜i]
>˜`Ê>ë>À̈VÊ>Vˆ`®ÊvˆÀÃÌÊVœ˜ÛiÀÌÊ̜Ê>ÊvœÀ“Ê̅>ÌÊÀi>`ˆÞÊi˜ÌiÀÃÊ«>̅Ü>ÞÃÊvœ
i˜iÀ}ÞÊÀii>Ãi°Ê/…ˆÃÊVœ˜ÛiÀȜ˜ÊÀiµÕˆÀiÃÊÀi“œÛˆ˜}ʘˆÌÀœ}i˜ÊvÀœ“Ê̅iÊ>“ˆ˜œ
>Vˆ`ʓœiVՏi]Ê>Ê«ÀœViÃÃʎ˜œÜ˜Ê>ÃÊ`i>“ˆ˜>̈œ˜Ê­ÀiviÀÊ̜Ê
…>«ÌiÀÊÓ®°Ê/…iʏˆÛiÀ

Amino Acids NH2 Glucose

N Energy

c c c Pyruvate
Glucogenic amino acids
synthesize glucose or
become catabolized CoA
CO2
NH2
N
Acetyl-CoA
c c c Lipid

Ketogenic amino acids CoA

convert to acetyl-CoA
for triacylglycerol formation
or become catabolized

NH2
N CITRIC
ACID
c c c CYCLE
CO2
Some amino acids directly
enter the citric acid cycle
for catabolism Energy

Electron Transport

Energy Energy Energy

Figure 5.24 *ÀœÌiˆ˜‡Ìœ‡i˜iÀ}ÞÊ«>̅Ü>Þð

LWBK710-c05_149-184.qxd 9/15/10 10:46 PM Page 180 Aptara

180 • SECTION III Energy Transfer

BOX 5.2 CLOSE UP

How to Estimate Individual Protein Requirements

/œÌ>ÊLœ`ÞÊ«ÀœÌiˆ˜ÊÀi“>ˆ˜ÃÊVœ˜ÃÌ>˜ÌÊ܅i˜Ê˜ˆÌÀœ}i˜Êˆ˜Ì>Ži `ˆ>ÀÞ®]ÊÈÎÊ}ÆÊ11 Ê­VœiV̈œ˜Ê>˜`Ê>˜>ÞÈÃʜvÊÕÀˆ˜iʜÕ̇

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182 • SECTION III Energy Transfer

FATS CARBOHYDRATES PROTEINS

Fatty Acids + Glycerol Glucose / Glycogen Amino Acids

Deamination
Glycolysis
alanine
BETA ammonia
OXIDATION pyruvate

lactate glycine
urea

acetyl-CoA urine
ketone bodies
glutamate
oxaloacetate citrate
CITRIC
ACID
CYCLE

Predominant Interconversions
Nutrient Can Form Can Form Can Form
Glucose? Amino Acids? Fat?
Carbohydrates Yes Yes; addition of nitrogen yields Yes
non-essential amino acids
Fats Fatty acids no; No Yes
only glycerol portion
Figure 5.25 /…iʺ“iÌ>LœˆVʓˆ°»
Proteins Yes; glucogenic amino acids Yes Yes; ketogenic “«œÀÌ>˜Ìʈ˜ÌiÀVœ˜ÛiÀȜ˜ÃÊLiÌÜii˜
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Chapter 5 Fundamentals of Human Energy Transfer • 183

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184 • SECTION III Energy Transfer

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C h a p t e r
6
Human Energy
Transfer During
Exercise
CHAPTER OBJECTIVES

• Identify the body’s three energy systems and explain
their relative contributions to exercise intensity and
duration.
• Describe differences in blood lactate threshold
between sedentary and aerobically trained individuals.
• Outline the time course for oxygen uptake during
10 minutes of moderate exercise.
• Differentiate between the body’s two types of muscle
fibers.
• Explain differences in the pattern of recovery oxygen
uptake from moderate and exhaustive exercise, and
include factors that account for the excess post-
exercise oxygen consumption or EPOC from each
exercise mode.

• Draw a figure showing the relationship between • Outline optimal recovery procedures from steady-rate
and non–steady-rate exercise.
oxygen uptake and exercise intensity during progres-
sively increasing increments of exercise to maximum.

185
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186 • SECTION III Energy Transfer
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Chapter 6 Human Energy Transfer During Exercise • 187

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>iÀœLˆVÊi˜âޓiÃÊ܈̅ Discomfort occurs and performance decreases as the blood becomes more acidic.
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188 • SECTION III Energy Transfer
Blood Lactate as an Energy Source
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LONG-TERM ENERGY:
THE AEROBIC SYSTEM
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Chapter 6 Human Energy Transfer During Exercise • 189

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ÀÊ>˜`ʏ>V̈VÊ>Vˆ`Êi˜iÀ}ÞÊÃÞÃÌi“ð
ÝiÀVˆÃiÊ̅>ÌÊ}i˜iÀ>ÌiÃÊ>LœÕÌÊ>Ê·Ê̜Ê{‡ʜÝÞ}i˜Ê`ivˆVˆÌÊÃÕLÃÌ>˜Ìˆ>ÞÊ`i«iÌi

25
Muscle lactate concentration
(mM . kg wet muscle-1)

20

15

10

0
15
(mM . kg wet muscle-1)

&OR 9OUR )NFORMATION

ATP-PCr depletion

10
,)-)4%$ $52!4)/. /& 34%!$9 2!4%
%8%2#)3%
Theoretically, exercise could continue
5
indefinitely when performed at
steady-rate aerobic metabolism. Fac-
tors other than motivation, however,
0 limit the duration of steady-rate work.
1 2 3 4 5 6 7
Oxygen deficit (L) These include loss of important body
fluids in sweat and depletion of essen-
tial nutrients, especially blood glucose
Figure 6.3 ÕÃViÊ>`i˜œÃˆ˜iÊÌÀˆ«…œÃ«…>ÌiÊ­
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190 • SECTION III Energy Transfer

BOX 6.1 CLOSE UP

Overtraining: Too Much of a Good Thing

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>ˆâi`]Ê܈̅Ê̅œÃiʜÕ̏ˆ˜i`ʈ˜Ê̅i
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ÜiiŽÃʜÀÊiÛi˜Ê“œ˜Ì…ð
CARBOHYDRATES’ POSSIBLE
ROLE IN OVERTRAINING

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TAPERING OFTEN HELPS
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ˆ˜`ÕVi`Ê`>“>}i°

OVERTRAINING SIGNS AND SYMPTOMS

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Chapter 6 Human Energy Transfer During Exercise • 191

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̈˜ÕiÃʜ˜Þʜ˜Ê>ʺ«>އ>ÇޜՇ}œ»ÊL>ÈÃÆÊ
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«…œÃ«…>ÌiðÊ
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To adjust for the effects of variations in body size on oxygen uptake (i.e.,
bigger people usually consume more oxygen), researchers frequently
express oxygen uptake in terms of body mass (termed relative oxygen
uptake) as milliliters of oxygen per kilogram of body mass per minute
(mL ! kg"1 ! min"1). At rest, this averages about 3.5 mL ! kg"1 ! min"1 or
of 1 metabolic equivalent (MET) or 245 mL ! min"1 (absolute oxygen
uptake) for a 70-kg person. Other means of relating oxygen uptake to
aspects of body size and body composition include milliliters of oxygen per
kilogram of fat-free body mass per minute (mL ! kg FFM"1 ! min"1) and
sometimes milliliters of oxygen per square centimeter of muscle cross-
sectional area per minute (mL ! cm MCSA"2 ! min"1).

Oxygen Deficit in Trained and Untrained Individuals

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­`ÕÀ>̈œ˜Ê>˜`ʈ˜Ìi˜ÃˆÌÞʜvÊivvœÀÌ®]Ê`œiÃÊ>
20.0 ÌÀ>ˆ˜i`ʜÀÊ>˜Ê՘ÌÀ>ˆ˜i`Ê«iÀܘÊÀiVœÀ`Ê>
}Ài>ÌiÀʜÝÞ}i˜Ê`ivˆVˆÌ¶Ê Ý«>ˆ˜
·
Steady-rate VO2
Oxygen uptake, mL · kg–1 · min–1

15.0

Trained
Untrained
Oxygen deficit

10.0

5.0

Rest

0
0 2 4 6 8 10
Exercise time, min

Figure 6.4 "ÝÞ}i˜ÊÕ«Ì>ŽiÊ>˜`ʜÝÞ}i˜Ê`ivˆVˆÌÊvœÀÊÌÀ>ˆ˜i`Ê>˜`Ê՘ÌÀ>ˆ˜i`ʈ˜`ˆÛˆ`Õ>

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192 • SECTION III Energy Transfer

60
Region of VO2max

50
Grade 6
Oxygen consumption
(mL . kg-1 . min-1)

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Grade 5
30
Grade 4
20
Grade 3 Figure
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100
Percentage of total energy yield

ÀˆivÞÊiÝ«>ˆ˜Ê̅iÊ«…i˜œ“i˜œ˜ÊŽ˜œÜ˜Ê>
80
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60

40

20

10 20 30 40 50
Maximal exercise time (min)

Duration of maximal exercise

&OR 9OUR )NFORMATION
Seconds Minutes
)43 $)&&)#5,4 4/ %8#%,
). !,, 30/243
10 30 60 2 4 10 30 60 120
An understanding of the energy
Percentage
anaerobic 90 80 70 50 35 15 5 2 1 requirements of various physical activ-
Percentage
10 20 30 50 65 85 95 98 99
ities partly explains why a world-
aerobic record holder in the 1-mile run does
not achieve similar success as a long-
Figure 6.6 ,i>̈ÛiÊVœ˜ÌÀˆLṎœ˜ÊœvÊ>iÀœLˆVÊ>˜`Ê>˜>iÀœLˆVÊi˜iÀ}ÞʓiÌ>LœˆÃ“Ê`ÕÀˆ˜} distance runner. Conversely, premier
“>݈“>Ê«…ÞÈV>ÊivvœÀÌʜvÊÛ>ÀˆœÕÃÊ`ÕÀ>̈œ˜ÃÆÊÓʓˆ˜ÕÌiÃʜvʓ>݈“>ÊivvœÀÌÊÀiµÕˆÀiÃ
marathoners usually cannot run 1 mile
>LœÕÌÊxä¯ÊœvÊ̅iÊi˜iÀ}ÞÊvÀœ“ÊLœÌ…Ê>iÀœLˆVÊ>˜`Ê>˜>iÀœLˆVÊ«ÀœViÃÃiðÊ
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̅iÊÀi“>ˆ˜`iÀÊ}i˜iÀ>Ìi`ÊvÀœ“Ê>˜>iÀœLˆVÊ«ÀœViÃÃiðʭ
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194 • SECTION III Energy Transfer

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Chapter 6 Human Energy Transfer During Exercise • 195

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196 • SECTION III Energy Transfer

Metabolic Dynamics of Recovery Testing Hill’s Oxygen Debt Theory
VVi«Ì>˜Vi

Oxygen Uptake œvʈ½ÃÊiÝ«>˜>̈œ˜ÊvœÀÊ̅iʏ>VÌ>Vˆ`Ê«…>ÃiʜvÊ̅iʜÝÞ}i˜
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Traditional View: A.V. Hill’s 1922 Oxygen œvʏ>VÌ>ÌiÊ«Àœ`ÕVi`ʈ˜ÊiÝiÀVˆÃiÊ>VÌÕ>ÞÊÀiÃޘ̅iÈâiÃÊ̜
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Chapter 6 Human Energy Transfer During Exercise • 197

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Optimal Recovery From Steady-Rate Exercise

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Optimal Recovery from Non–Steady-Rate Exercise

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perfusion of blood through the
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“lactate-using” liver and heart.
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muscles in active recovery also

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muscle tissue oxidizes this substrate
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during citric acid cycle metabolism.
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198 • SECTION III Energy Transfer

BOX 6.2 CLOSE UP

How to Measure Work on a Treadmill, Cycle
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Measuring and
Evaluating Human
C h a p t e r
7
Energy-Generating
Capacities During
Exercise
CHAPTER OBJECTIVES

• Compare and contrast the concepts of measurement, • Explain factors that influence RQ and respiratory
evaluation, and prediction. exchange ratio.
.
• Explain specificity and generality applied to exercise • Define maximal oxygen uptake (VO2max), including its
performance and physiologic function. physiological significance.

• Describe procedures to administer two practical “field
tests” to evaluate power output capacity of the
intramuscular high-energy phosphates (immediate
energy system).
• Define graded exercise stress test.
• List
. criteria that
. indicate when a person reaches “true”
VO2max and VO2peak during a graded exercise test.

• Describe a commonly used test to evaluate the power
output capacity of glycolysis (short-term energy
system).
• Explain the differences between direct and indirect
calorimetry.
• Outline .three commonly used treadmill protocols to
assess VO2max.
.
• Explain how each of the following affects VO2max:
(1) mode of exercise, (2) heredity, (3) state of training,
(4) gender, (5) body composition, and (6) age.

• Explain the differences between open- and closed- • Describe procedures to administer
. a submaximal
walking “field test” to predict VO2max.
circuit spirometry.

• Describe different measurement systems used in • Outline the

. procedure to administer a step test to
predict VO2max.
open-circuit spirometry. .
• Define the term respiratory quotient (RQ), including its • List three assumptions when predicting VO2max from
submaximal exercise heart rate.
use and importance.

203
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204 • SECTION III Energy Transfer

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ˆ˜`ˆÛˆ`Õ>Ê`ˆvviÀi˜Við
OVERVIEW OF ENERGY TRANSFER
CAPACITY DURING EXERCISE
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10 30 2 5
s s min min
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the Immediate and Short-
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THE IMMEDIATE ENERGY SYSTEM
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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 205

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PERFORMANCE TESTS OF FAST AND SLOW

ANAEROBIC POWER
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206 • SECTION III Energy Transfer

BOX 7.1 CLOSE UP

Predicting Power of the Immediate Energy System
Using a Vertical Jump Test

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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 207

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>VÌ>ÌiʏiÛiÊ̜ÊÀiÛi>Ê̅iÊ`i}ÀiiʜvÊ>V̈Û>̈œ˜ÊœvÊ̅iÊŜÀ̇ÌiÀ“Êi˜iÀ}ÞÊÃÞÃÌi“° i˜iÀ}ÞÊÃÞÃÌi“°Ê

Physiologic Indicators of the Short-Term

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Blood Lactate Levels
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Figure 7.3 «ÀiÃi˜ÌÃÊ`>Ì>ʜLÌ>ˆ˜i`ÊvÀœ“Ê£äÊVœi}iʓi˜Ê܅œÊ«iÀvœÀ“i`Ê£ä
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1 foot-pound (ft-lb) ! 0.13825
Glycogen Depletion iV>ÕÃiÊ̅iÊŜÀ̇ÌiÀ“Êi˜iÀ}ÞÊÃÞÃÌi“ʏ>À}iÞ kilogram-meters (kg-m)
`i«i˜`Ãʜ˜Ê}ÞVœ}i˜ÊÃ̜Ài`Ê܈̅ˆ˜ÊëiVˆvˆVʓÕÃViÃÊ>V̈Û>Ìi`ÊLÞÊiÝiÀVˆÃi]Ê̅ 1 kg-m ! 7.233 ft-lb ! 9.8066 joules
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Vœ˜ÌÀˆLṎœ˜ÊœvÊ}ÞVœÞÈÃÊ̜ÊiÝiÀVˆÃi° 426.85 kg-m ! 4.186 kilojoules (kJ)
Figure 7.4 ŜÜÃÊ̅>ÌÊ̅iÊÀ>ÌiʜvÊ}ÞVœ}i˜Ê`i«ïœ˜Êˆ˜Ê̅iʵÕ>`ÀˆVi«Ã 1 joule ( J) ! 1 Newton-meter (Nm)
vi“œÀˆÃʓÕÃViÊ`ÕÀˆ˜}ÊLˆVÞViÊiÝiÀVˆÃiÊVœÃiÞÊ«>À>iÃÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ°
° 1 kilojoule (kJ) ! 1000 J !
7ˆÌ…ÊÃÌi>`އÀ>ÌiÊiÝiÀVˆÃiÊ>ÌÊ>LœÕÌÊÎä¯ÊœvÊ6"ӓ>Ý]Ê>ÊÃÕLÃÌ>˜Ìˆ>ÊÀiÃiÀÛiʜvʓÕÇ 0.23889 kCal
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208 • SECTION III Energy Transfer

150
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ÀiÃi˜Ìi`Ê>˜>iÀœLˆVÊ«œÜiÀ œÀÊܜÀŽÊ«iÀÊ՘ˆÌʜvÊ̈“i°Ê/…ˆÃ
130
Ài«ÀiÃi˜Ìi`Ê̅iʈ““i`ˆ>ÌiÊi˜iÀ}ÞÊÃÞÃÌi“Ê«œÌi˜Ìˆ>]Ê܈̅
Blood lactate, mg · dL–1

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90
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50
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30
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Muscle glycogen (mM . kg–1)

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Performance Tests of Glycolytic Power 70

Cycle Ergometer Tests
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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 209

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Other Anaerobic Tests ,՘˜ˆ˜}Ê>˜>iÀœLˆVÊ«œÜiÀÊÌiÃÌÃʈ˜VÕ`iÊ>‡œÕÌ «œÜiÀÊ>˜`Ê>˜>iÀœLˆVÊV>«>VˆÌÞ°
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Aerobic
100
90
Percentage of total work

Aerobic
80 Aerobic
Glycolysis
70
60
50 Glycolysis
40
Glycolysis
30
ATP-PCr
20
10 ATP-PCr
ATP-PCr
A 0

40
35
30
Aerobic
Kilojoules

25
20
Aerobic
15
10 Glycolysis
Glycolysis
Glycolysis
5
ATP-PCr ATP-PCr ATP-PCr
B 0
10 s 30 s 90 s
Short-duration tests

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210 • SECTION III Energy Transfer
BOX 7.2 CLOSE UP
Predicting Anaerobic Power and Capacity Using
the Wingate Cycle Ergometer Test

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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 211

Percentile Rankings for Average and Peak Power for Active Young Adults

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212 • SECTION III Energy Transfer
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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 213

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Figure 7.7
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INDIRECT CALORIMETRY Open-Circuit Spirometry

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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 215

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216 • SECTION III Energy Transfer

BOX 7.3 CLOSE UP

How to Calibrate an Instrument

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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 217

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Variable Errors
14

Variable error, L•min"1

12
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INTERPRETATION 0
0 20 40 60 80 100 120

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Table 2 Constant and Variable Errors for Six Ventilation Ranges

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218 • SECTION III Energy Transfer

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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 219

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Respiratory Quotient for a Mixed Diet &OR 9OUR )NFORMATION

ÕÀˆ˜}Ê>V̈ۈ̈iÃÊ̅>ÌÊÀ>˜}iÊvÀœ“ÊVœ“«iÌiÊLi`ÊÀiÃÌÊ̜ʓˆ`Ê>iÀœLˆVÊÜ>Žˆ˜} /89'%. $2)&4
.
œÀÊϜÜʍœ}}ˆ˜}]Ê̅iÊ,+ÊÃi`œ“ÊÀiviVÌÃÊ̅iʜ݈`>̈œ˜ÊœvÊ«ÕÀiÊV>ÀLœ…Þ The VO2 increases under these exercise con-
`À>ÌiʜÀÊ«ÕÀiÊv>̰ʘÃÌi>`]ʓiÌ>Lœˆâˆ˜}Ê>ʓˆÝÌÕÀiʜvʘÕÌÀˆi˜ÌÃʜVVÕÀÃÊ܈̅ ditions: (1) while performing at. an intensity
>˜Ê,+ʈ˜ÌiÀ“i`ˆ>ÌiÊLiÌÜii˜Êä°ÇäÊ>˜`Ê£°ää°ÊœÀʓœÃÌÊ«ÕÀ«œÃiÃ]ÊÜiÊ>ÃÃՓi level greater than about 70% VO2max; (2)
.
>˜Ê,+ʜvÊä°nÓÊvÀœ“Ê̅iʓiÌ>LœˆÃ“ÊœvÊ>ʓˆÝÌÕÀiʜvÊ{ä¯ÊV>ÀLœ…Þ`À>ÌiÊ>˜`ÊÈä¯ at a lower percentage of VO2max but for
v>ÌÊLÞÊ>««Þˆ˜}Ê̅iÊV>œÀˆVÊiµÕˆÛ>i˜ÌʜvÊ{°nÓxʎ
>Ê«iÀʏˆÌiÀʜvʜÝÞ}i˜ÊvœÀÊ̅i prolonged durations ( 30 minutes); and
i˜iÀ}ÞÊÌÀ>˜ÃvœÀ“>̈œ˜ °Ê1Ș}Ê{°nÓxʎ
>]Ê̅iʓ>݈“Õ“ÊiÀÀœÀÊ«œÃÈLiÊ (3) when performed in hot, humid environ-
ˆ˜ÊiÃ̈“>̈˜}Êi˜iÀ}ÞʓiÌ>LœˆÃ“ÊvÀœ“ÊÃÌi>`އÀ>ÌiʜÝÞ}i˜ÊÕ«Ì>ŽiÊiµÕ>Ã ments for prolonged periods. These
>LœÕÌÊ${¯° increases occur, although the energy
Table 7.1 «ÀiÃi˜ÌÃÊ̅iÊi˜iÀ}ÞÊiÝ«i˜`ˆÌÕÀiÊ«iÀʏˆÌiÀʜvʜÝÞ}i˜ÊÕ«Ì>Ži requirement. does not change. This upward
vœÀÊ`ˆvviÀi˜Ìʘœ˜‡«ÀœÌiˆ˜Ê,+ Û>ÕiÃ]ʈ˜VÕ`ˆ˜}ÊVœÀÀi뜘`ˆ˜}Ê«iÀVi˜Ì>}ià drift in the VO2 results from increasing
>˜`Ê}À>“ÃʜvÊV>ÀLœ…Þ`À>ÌiÊ>˜`Êv>ÌÊÕÃi`ÊvœÀÊi˜iÀ}Þ°Ê /…iʘœ˜‡«ÀœÌiˆ˜Ê,+ blood levels of catecholamines, lactate accu-
Û>ÕiÊ>ÃÃՓiÃÊ̅>ÌÊ̅iʓiÌ>LœˆVʓˆÝÌÕÀiÊVœ“«ÀˆÃiÃʜ˜ÞÊV>ÀLœ…Þ`À>ÌiÊ>˜` mulation (if exercise is intense enough),
v>̰ʘÌiÀ«ÀiÌÊ̅iÊÌ>LiÊ>ÃÊvœœÜÃ\ shifting substrate utilization (to greater car-
bohydrate use), increased energy cost of
Suppose oxygen uptake during 30 minutes of aerobic exercise ventilation, and increased body temperature.
averages 3.22. L%min&1. with CO2 production of 2.78 L%min&1. The RQ,
computed as VCO2 # VO2 (2.78 # 3.22), equals 0.86. From Table 7.1,
this RQ value (left column) corresponds to an energy equivalent of
4.875 kCal per liter of oxygen uptake, or an exercise energy output of &OR 9OUR )NFORMATION
15.7 kCal%min&1 (3.22 L O2 %min&1 ' 4.875 kCal). Based on a non-pro- 2%30)2!4/29 15/4)%.4 21 6%2353
tein RQ, 54.1% of the calories come from the combustion of carbohy- 2%30)2!4/29 %8#(!.'% 2!4)/ 2%2
drate, and 45.9% come from fat. The total calories expended during The respiratory exchange ratio or RER,
the 30-minute exercise period equal 471 kCal (15.7 kCal%min&1 ' 30). (the ratio of the amount of CO2 produced
to the amount of O2 consumed) represents
occurrences on a total body level, while the
RESPIRATORY EXCHANGE RATIO RQ (ratio of CO2 produced to O2 consumed)
represents the gas exchange from substrate

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220 • SECTION III Energy Transfer

Thermal Equivalents of Oxygen for the Non-Protein Respiratory Quotient, Including

Table 7.1
Percentage kCal and Grams Derived From Carbohydrate and Fat
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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 221

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MAXIMAL OXYGEN UPTAKE (VO2max)
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BOX 7.4 CLOSE UP

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222 • SECTION III Energy Transfer

Cross-country skiers

Runners

Swimmers

Speed skaters

Fencers

Sedentary Female
0 10 20 30 40 50 60 70 80 90
Maximal oxygen uptake, mL • kg–1 • min–1

Cross-country skiers

Middle-distance runners

Speed skaters

Cyclists

Rowers

Weight lifters

Figure 7.11 >݈“>ÊœÝÞ}i˜ÊÕ«Ì>Ži

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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 223

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224 • SECTION III Energy Transfer

BOX 7.5 CLOSE UP

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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 225

Average Maximal Oxygen Uptakes for 15 College Students During Continuous (Cont.) and
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20 A Naughton Test
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0 5 10 15 20 25 30 35 40 45 50 55 60
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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 227

• SECTION
BOX
227
CLOSE
7.6III Energy Transfer
UP
.
Predicting VO2max Using Age for Sedentary, Physically Active,
and Endurance-Trained Individuals
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EQUATIONS Fitness Status (Equation 4)
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° table «ÀiÃi˜ÌÃÊ`ˆvviÀi˜ÌÊiµÕ>̈œ˜Ã *Ài`ˆVÌi`Ê6"ӓ>Ý # xΰÇÊ" ä°xÎÇÊ­>}i]ÊÞ®
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(Equation 3)
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Equations to Predict VO2max (mL!kg–1 !min–1) from Age
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228 • SECTION III Energy Transfer

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Cardiorespiratory Fitness (METs)

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Peak oxygen uptake (mL • kg-1

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31.5 9

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Age (y)

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Chapter 7 Measuring and Evaluating Human Energy-Generating Capacities During Exercise • 231

BOX 7.7 CLOSE UP

The Weir Method of Calculating Energy Expenditure

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232 • SECTION III Energy Transfer

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Energy
C h a p t e r
8
Expenditure
During Rest and
Physical Activity
CHAPTER OBJECTIVES

• Define basal metabolic rate and indicate factors that • Describe two ways to predict resting daily energy
affect it. expenditure.

• Explain the effect of body weight on the energy cost of • Explain the concepts of exercise efficiency and
different forms of physical activity. exercise economy.

• Identify factors that contribute to the total daily energy • List three factors that affect the energy cost of walking
expenditure. and running.

• Outline different classification systems for rating the • Identify factors that contribute to the lower exercise
intensity of physical activity. economy of swimming compared with running.

237
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238 • SECTION III Energy Transfer

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Total Daily Energy Expenditure

Thermic effect of feeding

(Food intake; cold stress;
60-75%
thermogenic drugs) ~10%
• Obligatory thermogensis
• Facultative thermogensis 15-30%

Thermic effect
of physical activity
(Duration and intensity)
• In occupation Resting metabolic rate
• In home (Fat-free body mass;
• In sport and recreation gender;
Gender; thyroid
thyroid hormones;
hormones;
protein turnover)
• Sleeping metabolism
• Basal metabolism
• Arousal metabolism

Figure 8.1
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Chapter 8 Energy Expenditure During Rest and Physical Activity • 239

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242 • SECTION III Energy Transfer

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Table 8.1 Gross Energy Cost for Selected Recreational and Sports Activities in Relation to Body Massa
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Chapter 8 Energy Expenditure During Rest and Physical Activity • 243

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Body mass (kg)

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AVERAGE DAILY RATES OF
ENERGY EXPENDITURE

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Vœ˜Ãˆ`iÀi`ÊLiÌÜii˜ÊÃi`i˜Ì>ÀÞÊ>˜`Ê>V̈ÛiÊ>˜`Ê܅œÊ«>À̈Vˆ«>Ìiʈ˜ÊܓiÊÀiVÀi‡
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CLASSIFICATION OF WORK
BY ENERGY EXPENDITURE

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244 • SECTION III Energy Transfer

Average Rates of Energy Expenditure for Men and

Table 8.2
Women Living in the United Statesa
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Chapter 8 Energy Expenditure During Rest and Physical Activity • 245

Table 8.3
Five-Level Classification of Physical Activity Based on
Exercise Intensity
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246 • SECTION III Energy Transfer

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248 • SECTION III Energy Transfer

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œ“ÞÊLÞÊۈÃÕ>ÞÊVœ“«>Àˆ˜}Ê̅iÊi>ÃiʜvʓœÛi“i˜ÌÊ>“œ˜}ʅˆ}…ÞÊÌÀ>ˆ˜i`Ê>̅‡
iÌiðÊÌÊ`œiÃʘœÌÊÀiµÕˆÀiÊ>ÊÌÀ>ˆ˜i`ÊiÞiÊ̜Ê`ˆÃVÀˆ“ˆ˜>ÌiÊ̅iÊi>ÃiʜvÊivvœÀÌʈ˜
Vœ“«>ÀˆÃœ˜ÃʜvÊiˆÌiÊÃ܈““iÀÃ]ÊΈiÀÃ]Ê`>˜ViÀÃ]Ê}ޓ˜>ÃÌÃ]Ê>˜`Ê`ˆÛiÀÃÊ܈̅
iÃÃÊ«ÀœvˆVˆi˜ÌÊVœÕ˜ÌiÀ«>ÀÌÃÊ܅œÊÃii“Ê̜ÊiÝ«i˜`ÊVœ˜Ãˆ`iÀ>LiʺÜ>ÃÌi
i˜iÀ}Þ»Ê̜ʫiÀvœÀ“Ê̅iÊÃ>“iÊÌ>ÎðÊ
˜Þœ˜iÊ܅œÊ…>Ãʏi>À˜i`Ê>ʘiÜÊëœÀÌ
ÀiV>ÃÊ̅iÊ`ˆvvˆVՏ̈iÃÊi˜VœÕ˜ÌiÀi`Ê«iÀvœÀ“ˆ˜}ÊL>ÈVʓœÛi“i˜ÌÃÊ̅>ÌÊ܈Ì
«À>V̈Vi]ÊLiV>“iÊ>Õ̜“>̈VÊ>˜`ÊÃii“ˆ˜}ÞʺivvœÀ̏iÃð»

Exercise Oxygen Uptake

Reflects Economy

ÊVœ““œ˜Ê“i̅œ`Ê̜Ê>ÃÃiÃÃÊ`ˆvviÀi˜ViÃÊLiÌÜii˜Êˆ˜`ˆÛˆ`Õ>Ãʈ˜ÊiVœ˜œ“Þʜv
“œÛi“i˜ÌÊiÛ>Õ>ÌiÃÊ̅iÊÃÌi>`އÀ>ÌiʜÝÞ}i˜ÊÕ«Ì>ŽiÊ`ÕÀˆ˜}Ê>ÊëiVˆvˆVÊiÝiÀVˆÃiÊ>
>ÊÃiÌÊ«œÜiÀʜÕÌ«ÕÌʜÀÊëii`°Ê/…ˆÃÊ>««Àœ>V…Êœ˜ÞÊ>««ˆiÃÊ̜ÊÃÌi>`އÀ>ÌiÊiÝiÀVˆÃi
ˆ˜Ê܅ˆV…ÊœÝÞ}i˜ÊÕ«Ì>ŽiÊVœÃiÞʓˆÀÀœÀÃÊi˜iÀ}ÞÊiÝ«i˜`ˆÌÕÀi°Ê
ÌÊ>Ê}ˆÛi˜ÊÃÕL“>݇
ˆ“Õ“Êëii`ʜvÊÀ՘˜ˆ˜}]ÊVÞVˆ˜}]ʜÀÊÃ܈““ˆ˜}]Ê>˜Êˆ˜`ˆÛˆ`Õ>Ê܈̅Ê}Ài>ÌiÀʓœÛi“i˜Ì
iVœ˜œ“ÞÊVœ˜ÃՓiÃʏiÃÃʜÝÞ}i˜ °Ê Vœ˜œ“ÞÊÌ>ŽiÃʜ˜Êˆ“«œÀÌ>˜ViÊ`ÕÀˆ˜}ʏœ˜}iÀ
`ÕÀ>̈œ˜ÊiÝiÀVˆÃiÊ`ÕÀˆ˜}Ê܅ˆV…Ê̅iÊ>̅iÌi½ÃÊ>iÀœLˆVÊV>«>VˆÌÞÊ>˜`Ê̅iʜÝÞ}i˜
ÀiµÕˆÀi“i˜ÌÃʜvÊ̅iÊÌ>Îʏ>À}iÞÊ`iÌiÀ“ˆ˜iÊÃÕVViÃðÊ
ÊiÃiÊLiˆ˜}ÊiµÕ>]Ê>ÊÌÀ>ˆ˜‡
ˆ˜}Ê>`ÕÃ̓i˜ÌÊ̅>Ìʈ“«ÀœÛiÃÊiVœ˜œ“ÞʜvÊivvœÀÌÊ`ˆÀiV̏ÞÊÌÀ>˜Ã>ÌiÃÊ̜ʈ“«ÀœÛi`Ê
iÝiÀVˆÃiÊ«iÀvœÀ“>˜Vi°Ê Figure 8.5 Ài>ÌiÃÊÀ՘˜ˆ˜}ÊiVœ˜œ“ÞÊ̜Êi˜`ÕÀ>˜ViÊ«iÀ‡ &OR 9OUR )NFORMATION
vœÀ“>˜Viʈ˜ÊiˆÌiÊ>̅iÌiÃʜvÊVœ“«>À>LiÊ>iÀœLˆVÊvˆÌ˜iÃðÊ
i>ÀÞ]Ê>̅iÌiÃÊÜˆÌ %,)4% 25..%23 25. -/2%
}Ài>ÌiÀÊÀ՘˜ˆ˜}ÊiVœ˜œ“ˆiÃÊ­œÜiÀʜÝÞ}i˜ÊÕ«Ì>ŽiÊ>ÌÊ̅iÊÃ>“iÊÀ՘˜ˆ˜}Ê«>Vi® %#/./-)#!,,9
>V…ˆiÛiÊLiÌÌiÀÊ«iÀvœÀ“>˜Vi° At a particular speed, elite endurance
œÊȘ}iÊLˆœ“iV…>˜ˆV>Êv>V̜ÀÊ>VVœÕ˜ÌÃÊvœÀʈ˜`ˆÛˆ`Õ>Ê`ˆvviÀi˜ViÃʈ˜ÊÀ՘‡ runners run at a lower oxygen uptake
˜ˆ˜}ÊiVœ˜œ“Þ°Ê-ˆ}˜ˆvˆV>˜ÌÊÛ>Àˆ>̈œ˜Êˆ˜ÊiVœ˜œ“ÞÊ>ÌÊ>Ê«>À̈VՏ>ÀÊÀ՘˜ˆ˜}Êëii than less trained or less successful
œVVÕÀÃÊiÛi˜Ê>“œ˜}ÊÌÀ>ˆ˜i`ÊÀ՘˜iÀðʘÊ}i˜iÀ>]ʈ“«ÀœÛi`ÊÀ՘˜ˆ˜}ÊiVœ˜œ“Þ counterparts of similar age. This holds
ÀiÃՏÌÃÊvÀœ“ÊÞi>ÀÃʜvÊ>À`՜ÕÃÊÀ՘ÊÌÀ>ˆ˜ˆ˜}°Ê-…œÀ̇ÌiÀ“ÊÌÀ>ˆ˜ˆ˜}Ê̅>ÌÊi“«…>‡ for 8- to 11-year-old cross-country
ÈâiÃʜ˜ÞÊ̅iʺ«Àœ«iÀÊÌiV…˜ˆµÕiûʜvÊÀ՘˜ˆ˜}Ê­i°}°]Ê>À“Ê“œÛi“i˜ÌÃÊ>˜` runners and adult marathoners. Elite
Lœ`ÞÊ>ˆ}˜“i˜Ì®Ê«ÀœL>LÞÊ`œiÃʘœÌʈ“«ÀœÛiÊÀ՘˜ˆ˜}ÊiVœ˜œ“Þ°ÊˆÃÌ>˜ViÊÀ՘‡ distance athletes, as a group, run with
˜iÀÃÊ܅œÊ>VŽÊ>˜ÊiVœ˜œ“ˆV>ÊÃÌÀˆ`i‡i˜}̅ʫ>ÌÌiÀ˜ÊLi˜ivˆÌÊvÀœ“Ê>ÊŜÀ̇ÌiÀ 5% to 10% greater economy than
«Àœ}À>“ÊœvÊ>Õ`ˆœÛˆÃÕ>Êvii`L>VŽÊ̅>ÌÊvœVÕÃiÃʜ˜Êœ«Ìˆ“ˆâˆ˜}Ê̅iˆÀÊÃÌÀˆ`i well-trained middle-distance runners.
i˜}̅°
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250 • SECTION III Energy Transfer

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ʏˆ˜i>ÀÊÀi>‡
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10-km race time (min)

ň«ÊVÕÀÛiÃÊÕ«Ü>À`Ê̜ʈ˜`ˆV>ÌiÊ>Ê`ˆÃ«Àœ«œÀ̈œ˜>Ìiʈ˜VÀi>Ãi
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32
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31
44 46
.
VO2 (mL . kg–1 . min–1)
Figure 8.5 ,i>̈œ˜Ã…ˆ«ÊLiÌÜii˜ÊÃÕL“>݈“Õ“Ê“>݈“>ÊœÝއ
°
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WALKING ECONOMY
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v>ÃʜÕÌÈ`iÊ̅iÊÀi>“ÊœvÊÃi`i˜Ì>ÀÞʏˆÛˆ˜}°Ê Figure 8.6 `ˆÃ‡
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r = 0.82
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11

10

9
Energy expenditure (kCal . min–1)

nngg
3 llkkii
waa
w
g
nin
run

1
km . hr–1
1 2 3 4 5 6 7 8 9 10

1 2 3 4 5 6 Figure 8.6 ˜iÀ}ÞÊiÝ«i˜`ˆÌÕÀiÃÊ܅ˆi

Ü>Žˆ˜}ʜ˜Ê>ʏiÛiÊÃÕÀv>ViÊ>ÌÊ`ˆvviÀi˜ÌÊëii`ð
Velocity (speed), mph
/…iʏˆ˜i Ài«ÀiÃi˜ÌÃÊ>ÊVœ“«ˆ>̈œ˜ÊœvÊÛ>ÕiÃ
Ài«œÀÌi`ʈ˜Ê̅iʏˆÌiÀ>ÌÕÀi°
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Chapter 8 Energy Expenditure During Rest and Physical Activity • 251

Table 8.4
Prediction of Energy Expenditure (kCal!min"1) from +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
Speed of Level Walking and Body Mass
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Effects of Terrain and Walking Surface

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Effect of Different Terrain on the Energy Expenditure ΰ

Table 8.5
of Walking Between 5.2 and 5.6 km!h"1
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252 • SECTION III Energy Transfer

BOX 8.1 CLOSE UP

Predicting Energy Expenditure During Treadmill
Walking and Running
°

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Chapter 8 Energy Expenditure During Rest and Physical Activity • 253

Footwear Effects +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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ENERGY EXPENDITURE DURING RUNNING

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254 • SECTION III Energy Transfer

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Chapter 8 Energy Expenditure During Rest and Physical Activity • 255

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expended in training for 4 years before an Olympic competition exceeds
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more than likely contributes to the low levels of body fat (3% to 5% of
body mass for men; 12% to 17% for women) typical for these athletes.
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Marathon Running
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LœÕÌÊ Figure 8.7 ŜÜÃÊ̅iÊܜÀ`Ê>˜`ʜÞ“«ˆVÊLiÃÌÊ̈“ià vœÀʓi˜
™ä¯ÊœvÊ̅iÊ«œÜiÀÊ}i˜iÀ>Ìi`Ê܅i˜ÊVÞVˆ˜}Ê>ÌÊ{äʎ“ !…"£ >˜`Êܜ“i˜°Ê/…iÊܜÀ`ʓ>À>̅œ˜ÊÀiVœÀ`ÊvœÀʓi˜ÊˆÃÊÓʅ]Ê

3:00

2:45
Time, h:min

2:30

female:
2:15 2h:15min:25s

2:00

male: 2h:03min:59s
1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010

Year
Figure 8.7 >iÊ>˜`Êvi“>iÊܜÀ`ÊÀiVœÀ`Ê>˜`
"Þ“«ˆVÊÀiVœÀ`ʓ>À>̅œ˜ÊÀ՘Ê̈“iðÊ/…iʓ>iÊÀiVœÀ`]
Men’s Marathon Record Times Men’s Olympic Marathon Times ÃiÌʈ˜ÊÓäänÊ>ÌÊ̅iÊ iÀˆ˜]ÊiÀ“>˜Þ]ʓ>À>̅œ˜ÊˆÃÊÓʅ]Ê
Women’s Marathon Record Times Women’s Olympic Marathon Times Îʓˆ˜]Êx™ÊÃ]Ê>˜`Ê̅iÊvi“>iÊÀiVœÀ`ÊÃiÌÊ>ÌÊ̅iÊœ˜`œ˜]
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Chapter 8 Energy Expenditure During Rest and Physical Activity • 257

Îʓˆ˜]Êx™ÊÃÊ­ÃiÌʜ˜Ê-i«Ìi“LiÀÊÓn]ÊÓään]Ê>ÌÊ̅iÊ iÀˆ˜]ÊiÀ‡
“>˜Þ]ʓ>À>̅œ˜°®Ê/…iÊÀiVœÀ`ʅœ`iÀ]Ê>ˆiÊiLÀÃi>ÃÈi] &OR 9OUR )NFORMATION
LiV>“iÊ̅iÊvˆÀÃÌʓ>˜Ê̜ÊLÀi>ŽÊ̅iÊÓ\ä{ÊL>ÀÀˆiÀÊ>ÌÊ>˜Ê>ÛiÀ>} -!2!4(/. $)34!.#%
«>ViʜvÊ{\{{Ê«iÀʓˆi°Ê/…iÊܜ“i˜½ÃÊܜÀ`ÊÀiVœÀ`ʜvÊÓʅ]Ê
The current marathon distance (26 mi, 385 yd) was set for
£xʓˆ˜]ÊÓxÊÃÊÃiÌʜ˜Ê
«ÀˆÊ£™]ÊÓääÎ]Ê>ÌÊ̅iÊœ˜`œ˜]Ê ˜}>˜`]
the 1908 London Olympics so that the course could start at
>À>̅œ˜ÊLÞÊ*>Տ>Ê,>`VˆvviÊvÀœ“ÊÀi>ÌÊ ÀˆÌ>ˆ˜Ê܅œÊ«œÃÌi`Ê
Windsor Castle and end in front of the Royal Box. Not until
xʓˆ˜]Ê£äÊÃÆÊxʓˆ˜]ÊänÊÃÆÊ>˜`Ê{ʓˆ˜]ÊxÇÊÃÊ돈ÌÃÊvœÀÊ̅iÊvˆÀÃÌÊ
1921 was this distance adopted as the “official” marathon
“ˆiðÊ,>`VˆvviÊ>ÃœÊÃiÌÊܜÀ`‡ÀiVœÀ`ʓ>ÀŽÃÊvœÀÊÓäʓˆiÃ
distance by the International Association of Athletics Feder-
­£\{Î\{{®Ê>˜`ÊÎäʎ“Ê­£\ÎÈ\ÎÈ®Ê`ÕÀˆ˜}Ê̅ˆÃÊÀ՘°Ê/…iÊ>“>â‡
ations (IAAF, www.iaaf.org).
ˆ˜}ÞÊv>ÃÌÊ«>ViÃÊvœÀÊLœÌ…Ê>̅iÌiÃʘœÌʜ˜ÞÊÀiµÕˆÀiÊ>ÊÃÌi>`އ
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V>«>VˆÌÞʜvÊ̅iÊ>ÛiÀ>}iʓ>iÊVœi}iÊÃÌÕ`i˜Ì]ʈÌÊ>ÃœÊÀi«Ài‡
°
Ãi˜ÌÃÊ>LœÕÌÊnx¯ÊœvÊ̅iʓ>À>̅œ˜iÀýÊ6"ӓ>Ý]ʓ>ˆ˜Ì>ˆ˜i`ÊvœÀ &OR 9OUR )NFORMATION
œÛiÀÊÓʅœÕÀðÊ
iÀœLˆVÊV>«>VˆÌÞʜvÊ̅iÃiÊ>̅iÌiÃÊÀ>˜}iÃ
LiÌÜii˜ÊÇäÊ>˜`Ên{ʓ !Ž}"£!“ˆ˜"£°Ê/…iÊi˜iÀ}ÞÊiÝ«i˜`ˆ‡ -!2!4(/. 2%#/2$3 !2% $)&&)#5,4 4/ 2%0%!4
ÌÕÀiÊÀiµÕˆÀi`Ê̜ÊÀ՘Ê̅iʓ>À>̅œ˜Ê>ÛiÀ>}iÃÊ>LœÕÌÊÓ{ääʎ
>] Only five men and eight women have been able to follow
iÝVÕ`ˆ˜}Ê>˜ÞÊiiÛ>Ìi`Êi˜iÀ}ÞÊiÝ«i˜`ˆÌÕÀiÊ`ÕÀˆ˜}ÊÀiVœÛiÀÞ] one marathon world record with another. James Peters set
܅ˆV…ÊV>˜Ê«iÀÈÃÌÊvœÀÊÕ«Ê̜ÊÓ{Ê̜Ê{nʅœÕÀð four marathon records between 1952 and 1954, and Abebe
Bikila, Derek Clayton, Khalid Khannouchi, and most
recently Haile Gebrselassie each set two world records back-
ENERGY EXPENDITURE to-back. On the women’s side, Greta Weitz set four consecu-
DURING SWIMMING tive world records from 1978 to 1983 (the last stood only for
1 day!), and Chantal Langlace, Jacqueline Hansen, Christa
-܈““ˆ˜}Ê`ˆvviÀÃʈ˜ÊÃiÛiÀ>Êˆ“«œÀÌ>˜ÌÊÀiëiVÌÃÊvÀœ“ÊÜ>Ž‡ Vahlensieck, Joyce Smith, Tegla Loroupe, and most
ˆ˜}Ê>˜`ÊÀ՘˜ˆ˜}°ÊœÀʜ˜iÊ̅ˆ˜}]ÊÃ܈““iÀÃʓÕÃÌÊiÝ«i˜` recently Paula Radcliffe each broke the marathon record
i˜iÀ}ÞÊ̜ʓ>ˆ˜Ì>ˆ˜ÊL՜Þ>˜VÞÊ܅ˆiÊ}i˜iÀ>̈˜}ʅœÀˆâœ˜Ì> twice. Perhaps the most famous of all of the world records
“œÛi“i˜ÌÊ>ÌÊ̅iÊÃ>“iÊ̈“iÊÕȘ}Ê̅iÊ>À“ÃÊ>˜`ʏi}Ã]ÊiˆÌ…iÀʈ˜ were the races of Abebe Bikila, the barefoot Ethiopian, who
Vœ“Lˆ˜>̈œ˜ÊœÀÊÃi«>À>ÌiÞ°Ê"̅iÀÊ`ˆvviÀi˜ViÃʈ˜VÕ`iÊ̅i set world records 4 years apart while winning Olympic
i˜iÀ}ÞÊÀiµÕˆÀi“i˜ÌÃÊvœÀʜÛiÀVœ“ˆ˜}Ê`À>}ÊvœÀViÃÊ̅>Ìʈ“«i`i Marathons in 1960 (barefoot) and 1964 (wearing shoes).
̅iʓœÛi“i˜ÌʜvÊ>˜ÊœLiVÌÊ̅ÀœÕ}…Ê>ÊÜ>ÌiÀʓi`ˆÕ“°Ê/…i
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258 • SECTION III Energy Transfer

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S E C T I O N
IV
The Physiologic
Support Systems
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/*Ê>iÀœLˆV>Þ All the problems of the world

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order not to think, because

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C h a p t e r
9
The Pulmonary
System and
Exercise
CHAPTER OBJECTIVES

• Diagram the ventilatory system and show the glottis, • Identify major factors that regulate pulmonary
larynx, trachea, bronchi, bronchioles, and alveoli. ventilation during rest and exercise.

• Describe the dynamics of inspiration and expiration • Describe how hyperventilation extends breath-holding
during rest and exercise. time but can have dangerous consequences in sport
diving.
• Describe the Valsalva maneuver and its physiologic
consequences. • Graph relationships among pulmonary ventilation,
blood lactate concentrations, and oxygen uptake
• Define minute ventilation, alveolar minute ventilation,
during incremental exercise. Indicate the demarcation
ventilation–perfusion ratio, and anatomic and
points for the lactate threshold and onset of blood
physiologic dead spaces.
lactate accumulation.
• Explain the Bohr effect and its benefit during physical
• Explain what triggers exercise-induced asthma and
activity.
identify factors that affect its severity.
• List and quantify three means for carbon dioxide
transport in blood.

265
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266 • SECTION IV The Physiologic Support Systems

Part 1 Pulmonary Structure
and Function
vʜÝÞ}i˜ÊÃÕ««ÞÊ`i«i˜`i`ʜ˜Þʜ˜Ê`ˆvvÕȜ˜Ê̅ÀœÕ}…ÊΈ˜]
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“i˜Ì]ʏiÌÊ>œ˜iÊ̅iÊ{‡Ê̜ÊȇʜÝÞ}i˜ÊÕ«Ì>ŽiÊi>V…Ê“ˆ˜ÕÌiÊ̜
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`i«ˆVÌi`ʈ˜Ê Figure 9.1]ÊÀi}Տ>ÌiÃÊ̅iÊ}>ÃiœÕÃÊÃÌ>ÌiʜvʜÕÀ
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ΰ ,i}Տ>ÌiʅÞ`Àœ}i˜Êˆœ˜ÊVœ˜Vi˜ÌÀ>̈œ˜ÊQ!RÊ̜ʓ>ˆ˜‡
Ì>ˆ˜Ê>Vˆ`qL>ÃiÊL>>˜Vi
ANATOMY OF VENTILATION
/…iÊÌiÀ“ʫՏ“œ˜>ÀÞÊÛi˜Ìˆ>̈œ˜ `iÃVÀˆLiÃʅœÜÊ>“Lˆi˜Ì
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Õ˜}ðÊ
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>ˆÀʍÕÃÌʜÕÌÈ`iÊ̅iʘœÃiÊ>˜`ʓœÕ̅ÊvÀœ“Ê̅iÊLœœ`ÊvœÜ
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>˜`Ê>“œÃÌÊVœ“«iÌiÞʅՓˆ`ˆvˆi`Ê>ÃʈÌÊ«>ÃÃiÃÊ̅ÀœÕ}
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̅iÀÊÃÕL`ˆÛˆ`iʈ˜ÌœÊ˜Õ“iÀœÕÃÊ LÀœ˜V…ˆœià ̅>ÌÊVœ˜`ÕVÌ
ˆ˜Ã«ˆÀi`Ê>ˆÀÊ̅ÀœÕ}…Ê>ʘ>ÀÀœÜÊÀœÕÌiÊ՘̈ÊiÛi˜ÌÕ>ÞʓˆÝ‡
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ÀiëˆÀ>̜ÀÞÊÌÀ>VÌ°
Lungs
/…iʏ՘}ÃÊ«ÀœÛˆ`iÊ̅iÊÃÕÀv>ViÊLiÌÜii˜ÊLœœ`Ê>˜`Ê̅i
ÈÊÊ­>“œÕ˜ÌʜvÊ>ˆÀʈ˜Ê>ÊL>ÎiÌL>®Ê>˜`Ê«ÀœÛˆ`iÃÊ>˜ÊiÝVi«‡
̈œ˜>Þʏ>À}iʓœˆÃÌÊÃÕÀv>Vi°Ê/…iʏ՘}ÃʜvÊ>˜Ê>ÛiÀ>}i‡Ãˆâi`
«iÀܘÊÜiˆ}…Ê>LœÕÌʣʎ}]ÊÞiÌʈvÊëÀi>`ʜÕÌ]Ê̅iÞÊܜՏ`
VœÛiÀÊ>ÊÃÕÀv>ViʜvÊÈäÊ̜ÊnäʓÓ]Ê>LœÕÌÊÎxÊ̈“iÃÊ̅iÊiÝÌiÀ˜>
ÃÕÀv>ViʜvÊ̅iÊ«iÀܘ]Ê>˜`Ê>“œÃÌʅ>vÊ̅iÊÈâiʜvÊ>ÊÌi˜˜ˆÃ
VœÕÀÌʜÀÊ>˜Êi˜ÌˆÀiÊL>`“ˆ˜Ìœ˜ÊVœÕÀÌ°Ê/…ˆÃÊÀi«ÀiÃi˜ÌÃÊ>ÊVœ˜‡
È`iÀ>Liʈ˜ÌiÀv>ViÊvœÀÊ>iÀ>̈œ˜ÊœvÊLœœ`ÊLiV>ÕÃiÊ`ÕÀˆ˜}Ê>˜Þ
£ÊÃiVœ˜`ʜvʓ>݈“>ÊiÝiÀVˆÃi]ʘœÊ“œÀiÊ̅>˜Ê£Ê«ˆ˜ÌʜvÊLœœ`

Alveoli

Pulmonary artery Pulmonary

Nasal (deoxygenated arteriole
passage blood from heart) Bronchus
Oral cavity

Pharynx

Larynx

Cartilage
Pulmonary vein Pulmonary
(oxygenated venule
blood to heart) Bronchiole

Capillaries
lung
Bronchi
Deoxygenated blood Capillary Oxygenated blood
Bronchioles
Ribs

Plural space

CO2

Diaphragm
Alveolar
O2 membane
Alveolus

A B
Figure 9.1
° >œÀʫՏ“œ˜>ÀÞÊÃÌÀÕVÌÕÀiÃÊ܈̅ˆ˜Ê̅iÊ̅œÀ>VˆVÊV>ۈÌÞ°Ê ° ,iëˆÀ>̜ÀÞÊ«>ÃÃ>}iÃ]Ê>Ûiœˆ]Ê>˜`Ê}>ÃÊiÝV…>˜}iÊv՘V̈œ˜Êˆ˜
>˜Ê>ÛiœÕð
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Chapter 9 The Pulmonary System and Exercise • 267

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>ÌÊÀiÃÌ°
œÕÌÊ̅iÊLœ`Þ°

Mechanics of Ventilation
Figure 9.3 ˆÕÃÌÀ>ÌiÃÊ̅iÊ«…ÞÈV>Ê«Àˆ˜Vˆ«iÊ՘`iÀÞˆ˜}ÊLÀi>̅ˆ˜}Ê`ޘ>“ˆVð ˆÃÌÊÓÊv>V̜ÀÃÊ̅>ÌÊ`iÌiÀ“ˆ˜iʏ՘}Êvˆˆ˜}
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BOX 9.1 CLOSE UP

Common Symbols Used by Pulmonary Physiologists

*1"
,9Ê6 /
/" 8/ ,
Ê, -*,
/"  / ,
Ê, -*,
/"

° ° "
6
! ˆ˜ÕÌiÊÛi˜Ìˆ>̈œ˜ 6
!
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6/ ! /ˆ`>ÊۜÕ“i
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̈`>ÊۜÕ“i
"Ó ! *>À̈>Ê«ÀiÃÃÕÀiʜvÊV>ÀLœ˜Ê -Û"Ó¯ ! *iÀVi˜ÌÊÃ>ÌÕÀ>̈œ˜ÊœvÊ
*
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Lœœ`Ê܈̅ʜÝÞ}i˜
*

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*>V"Ó ! *>À̈>Ê«ÀiÃÃÕÀiʜvÊV>ÀLœ˜
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*Û"Ó ! *>À̈>Ê«ÀiÃÃÕÀiʜvʜÝÞ}i˜Êˆ˜
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268 • SECTION IV The Physiologic Support Systems

˜Ã«ˆÀ>̈œ˜ÊVœ˜VÕ`iÃÊ܅i˜Ê̅œÀ>VˆVÊV>ۈÌÞÊiÝ«>˜Ãˆœ˜
Vi>ÃiÃÊ>˜`ʈ˜ÌÀ>«Õ“œ˜ˆVÊ«ÀiÃÃÕÀiʈ˜VÀi>ÃiÃÊ̜ÊiµÕ>
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blood
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Chapter 9 The Pulmonary System and Exercise • 269

Diaphragm action Rib action

Ribs rise
Inspiration

Diaphragm
Expiration

Ribs lower

Diaphragm

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270 • SECTION IV The Physiologic Support Systems

5
IRV
4
Liters, BTPS

FVC
3 TLC
TV

2
ERV
FRC
1
RV
0

Average Values (mL)

Lung Volume/Capacity Definition
Males Females

Tidal Volume (TV) Volume inspired or expired 600 500

per breath

Inspiratory Reserve Volume (IRV) Maximum inspiration at end 3000 1900

of tidal inspiration

Expiratory Reserve Volume (ERV) Maximum expiration at end 1200 800

of tidal expiration

Total Lung Capacity (TLC) Volume in lungs after 6000 4200

maximum inspiration

Residual Lung Volume (RLV) Volume in lungs after 1200 1000

maximum expiration

Forced Vital Capacity (FVC) Maximum volume expired 4800 3200

after maximum inspiration

Inspiratory Capacity (IC) Maximum volume inspired 3600 2400

following tidal expiration

Functional Residual Capacity (FRC) Volume in lungs after 2400 1800

tidal expiration

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Chapter 9 The Pulmonary System and Exercise • 271

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272 • SECTION IV The Physiologic Support Systems

BOX 9.2 CLOSE UP

Predicting Pulmonary Function Variables from Stature and Age

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Chapter 9 The Pulmonary System and Exercise • 273

Table 9.1 Relationships Among Tidal Volume, Breathing Rate, and Minute and Alveolar Minute Ventilation
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Depth Versus Rate

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4(% '!3 ,!73
The four laws governing gas behavior
include:
500 • Boyle’s law: If temperature
Tidal volume (mL)

400 remains constant, the pressure of a

gas varies inversely with its volume.
300
• Gay–Lussac’s law: If gas volume
200 remains constant, its pressure
100 increases in direct proportion to its
absolute temperature.
0
• Law of partial pressures: In a
mixture of gases, each gas exerts a
partial pressure proportional to its
Alveolar air Physiologic dead Anatomic dead concentration.
space space
• Henry’s law: If temperature re-
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274 • SECTION IV The Physiologic Support Systems

90
5
Inspiratory
80
reserve

Percent of vital capacity

volume 70

Total lung capacity

4
60
Volume, liters

50
3 40
Tidal volume
30

2 20

Expiratory reserve volume 10

Functional
1 residual
capacity
Residual
volume
0
10 20 30 40 50 60
Minute volume, liters

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Chapter 9 The Pulmonary System and Exercise • 275

BOX 9.3 CLOSE UP

The Valsalva Maneuver Impedes Blood Flow Return to the Heart

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Üi>̅iÀÊVœ˜`ˆÌˆœ˜ÃÊ>˜`Ê`iVÀi>ÃiÃÊ«Ài`ˆVÌ>LÞÊ>Ìʈ˜VÀi>Ãi`
>ÌˆÌÕ`i°
RESPIRED GASES: CONCENTRATIONS
AND PARTIAL PRESSURES
>ÃÊVœ˜Vi˜ÌÀ>̈œ˜ÊŜՏ`ʘœÌÊLiÊVœ˜vÕÃi`Ê܈̅Ê}>Ã
«ÀiÃÃÕÀi\
££° ˆÃÀի̈œ˜Ãʈ˜Ê˜œÀ“>ÊLÀi>̅ˆ˜}Ê«>ÌÌiÀ˜ÃÊ`ÕÀˆ˜}ÊiÝiÀVˆÃi
ˆ˜VÕ`iÊ`Þë˜i>ʭŜÀ̘iÃÃʜvÊLÀi>̅®]ʅޫiÀÛi˜Ìˆ>̈œ˜
­œÛiÀLÀi>̅ˆ˜}®]Ê>˜`Ê̅iÊ6>Ã>Û>ʓ>˜iÕÛiÀÊ­vœÀVivՏÞ
ÌÀވ˜}Ê̜Êi݅>iÊ>}>ˆ˜ÃÌÊ>ÊVœÃi`Ê}œÌ̈î°
ΰ
vÌiÀÊÃÌÀ>ˆ˜ˆ˜}Ê̜ʺõÕiiâiʜÕÌ»Ê>ʓ>݈“ՓʏˆvÌʈ˜Ê̅i
ÃÌ>˜`ˆ˜}Ê«ÀiÃÃ]Ê̅iÊ«iÀܘÊÃÌ>ÌiÃ\ʺÊviiÊψ}…̏ÞÊ`ˆââÞ
>˜`ÊÃiiÊëœÌÃÊLivœÀiʓÞÊiÞið»Ê*ÀœÛˆ`iÊ>Ê«>ÕÈLi
«…ÞȜœ}ˆVÊiÝ«>˜>̈œ˜°Ê7…>ÌÊV>˜ÊLiÊ`œ˜iÊ̜ʫÀiÛi˜Ì
̅ˆÃÊvÀœ“Ê…>««i˜ˆ˜}¶
U >ÃÊVœ˜Vi˜ÌÀ>̈œ˜ ÀiviVÌÃÊ̅iÊ>“œÕ˜ÌʜvÊ}>Ã
ˆ˜Ê>Ê}ˆÛi˜ÊۜÕ“i]Ê܅ˆV…ʈÃÊ`iÌiÀ“ˆ˜i`ÊLÞÊ̅iÊ
«Àœ`ÕVÌʜvÊ̅iÊ}>ýʫ>À̈>Ê«ÀiÃÃÕÀiÊ>˜`Ê
܏ÕLˆˆÌÞ°
U >ÃÊ«ÀiÃÃÕÀi Ài«ÀiÃi˜ÌÃÊ̅iÊvœÀViÊiÝiÀÌi`ÊLÞÊ̅iÊ}>Ã
“œiVՏiÃÊ>}>ˆ˜ÃÌÊ̅iÊÃÕÀv>ViÃÊ̅iÞÊi˜VœÕ˜ÌiÀ°

ʓˆÝÌÕÀi½ÃÊ̜Ì>Ê«ÀiÃÃÕÀiÊiµÕ>ÃÊ̅iÊÃՓʜvÊ̅iÊ«>À̈>
«ÀiÃÃÕÀiÃʜvÊ̅iʈ˜`ˆÛˆ`Õ>Ê}>ÃiÃ]Ê܅ˆV…ÊVœ“«ÕÌiÃÊ>Ã
vœœÜÃ\
Partial pressure ! Percentage concentration "
Total pressure of gas mixture
Ambient Air
Table 9.2 «ÀiÃi˜ÌÃÊ̅iÊ«iÀVi˜Ì>}iÃ]Ê«>À̈>Ê«ÀiÃÃÕÀiÃ]Ê>˜`
ۜÕ“iÃʜvÊ̅iÊëiVˆvˆVÊ}>ÃiÃʈ˜Ê£ÊʜvÊ`ÀÞ]Ê>“Lˆi˜ÌÊ>ˆÀÊ>
Ãi>ʏiÛi°Ê/…iÊ«>À̈>Ê«ÀiÃÃÕÀiʭ̅iʏiÌÌiÀÊ * LivœÀiÊ̅iÊ}>Ã
ÃޓLœÊ`i˜œÌiÃÊ«>À̈>Ê«ÀiÃÃÕÀi®ÊœvʜÝÞ}i˜ÊiµÕ>ÃÊÓ䰙ί
œvÊ̅iÊ̜Ì>ÊÇÈäʓ“Ê}Ê«ÀiÃÃÕÀiÊiÝiÀÌi`ÊLÞÊ̅iÊ>ˆÀʓˆÝ‡
ÌÕÀi]ʜÀÊ£x™Ê““Ê}Ê­ä°Óä™ÎÊ" ÇÈäʓ“Ê}®ÆÊ̅iÊÀ>˜`œ“
“œÛi“i˜ÌʜvÊ̅iʓˆ˜ÕÌiʵÕ>˜ÌˆÌÞʜvÊV>ÀLœ˜Ê`ˆœÝˆ`iÊiÝiÀÌÃ
>Ê«ÀiÃÃÕÀiʜvʜ˜ÞÊä°Óʓ“Ê}Ê­ä°äääÎÊ " ÇÈäʓ“Ê}®]Ê
>˜`ʘˆÌÀœ}i˜Ê“œiVՏiÃÊiÝiÀÌÊ>Ê«ÀiÃÃÕÀiÊ̅>ÌÊÀ>ˆÃiÃÊ̅i
7 Ç£ä‡Vä™ÚÓÈ·Îää°µÝ`ÊʙɣÈÉ£äÊÊÇ\££*ÊÊ*>}iÊÓÇÇÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

Chapter 9 The Pulmonary System and Exercise • 277

Table 9.2
Percentages, Partial Pressures, and Volumes of Gases
in 1 L of Dry Ambient Air at Sea Level
+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
ˆÃÌÊ̅iÊ>“Lˆi˜ÌÊ>ˆÀÊ«iÀVi˜Ì>}iÃÊvœÀ
*
,/
ÊÊ œÝÞ}i˜]ÊV>ÀLœ˜Ê`ˆœÝˆ`i]Ê>˜`ʘˆÌÀœ}i˜Ê>Ài\Ê
*, --1, 6"1 Ê"

- * ,
/
 ­>Ì ÇÈäʓ“ }® 
-Ê­“"#£®Ê "Ó\
"ÝÞ}i˜ Ó䰙Π£x™Ê““Ê} Ó䙰Î

>ÀLœ˜Ê`ˆœÝˆ`i ä°äÎ ä°Óʓ“Ê} ä°{
ˆÌÀœ}i˜ Ǚ°ä{> Èääʓ“Ê} Ǚä°Î

"Ó\
>
˜VÕ`iÃÊ䰙ίÊ>À}œ˜Ê>˜`ʜ̅iÀÊÌÀ>ViÊÀ>ÀiÊ}>Ãið

Ó\

“iÀVÕÀÞʈ˜Ê>ʓ>˜œ“iÌiÀÊ>LœÕÌÊÈääʓ“Ê}Ê­ä°Ç™ä{Ê ! ÇÈäʓ“Ê}®°ÊœÀÊÃi>
iÛiÊ>“Lˆi˜ÌÊ>ˆÀ\

PO2 $ 159 mm Hg; PCO2 $ 0.2 mm Hg; and PN2 $ 600 mm Hg

ˆÛiÊ̅iÊvœÀ“Տ>ÊvœÀÊVœ“«Ṏ˜}Ê«>À̈>
«ÀiÃÃÕÀi°Ê

Tracheal Air

ˆÀÊi˜ÌiÀˆ˜}Ê̅iʘœÃiÊ>˜`ʓœÕ̅ʫ>ÃÃiÃÊ`œÜ˜Ê̅iÊÀiëˆÀ>̜ÀÞÊÌÀ>VÌÆʈÌÊVœ“‡
«iÌiÞÊÃ>ÌÕÀ>ÌiÃÊ܈̅ÊÜ>ÌiÀÊÛ>«œÀ]Ê܅ˆV…Êψ}…̏ÞÊ`ˆÕÌiÃÊ̅iʈ˜Ã«ˆÀi`Ê>ˆÀʓˆÝ‡
ÌÕÀi°Ê
ÌÊLœ`ÞÊÌi“«iÀ>ÌÕÀi]Ê̅iÊ«ÀiÃÃÕÀiʜvÊÜ>ÌiÀʓœiVՏiÃʈ˜Ê…Õ“ˆ`ˆvˆi`Ê>ˆ 7…>ÌÊ`iÌiÀ“ˆ˜iÃÊ}>ÃÊVœ˜Vi˜ÌÀ>̈œ˜¶Ê
iµÕ>ÃÊ{Çʓ“Ê}ÆÊ̅ˆÃʏi>ÛiÃÊÇ£Îʓ“Ê}Ê­ÇÈäʓ“Ê}Ê # {Çʓ“Ê}®Ê>ÃÊ̅i
̜Ì>Ê«ÀiÃÃÕÀiÊiÝiÀÌi`ÊLÞÊ̅iʈ˜Ã«ˆÀi`Ê`ÀÞÊ>ˆÀʓœiVՏiÃÊ>ÌÊÃi>ʏiÛi°Ê/…ˆÃ
`iVÀi>ÃiÃÊ̅iÊivviV̈ÛiÊ*"Ó ˆ˜ÊÌÀ>V…i>Ê>ˆÀÊLÞÊ>LœÕÌÊ£äʓ“Ê}ÊvÀœ“ʈÌÃÊ`ÀÞÊ>“Lˆ‡
i˜ÌÊÛ>ÕiʜvÊ£x™Ê““Ê}Ê̜ʣ{™Ê““Ê}Ê­ä°Óä™ÎÊ! QÇÈäʓ“Ê}Ê# {Çʓ“Ê}R®°
Փˆ`ˆvˆV>̈œ˜Ê…>ÃʏˆÌ̏iÊivviVÌʜ˜Êˆ˜Ã«ˆÀi`Ê
"Ó LiV>ÕÃiʜvÊV>ÀLœ˜Ê`ˆœÝˆ`i½Ã
ˆÃÌÊ̅iÊ*"Ó ˆ˜Ê>“Lˆi˜ÌÊ>ˆÀÊ>ÌÊÃi>ʏiÛi°Ê
˜i>Àʘi}ˆ}ˆLiÊVœ˜Vi˜ÌÀ>̈œ˜Êˆ˜Êˆ˜Ã«ˆÀi`Ê>ˆÀ°

Alveolar Air

Ûiœ>ÀÊ>ˆÀÊVœ“«œÃˆÌˆœ˜Ê`ˆvviÀÃÊVœ˜Ãˆ`iÀ>LÞÊvÀœ“Ê̅iʈ˜Vœ“ˆ˜}ÊLÀi>̅ʜvÊ>“Lˆ‡
i˜ÌÊ>ˆÀÊLiV>ÕÃiÊV>ÀLœ˜Ê`ˆœÝˆ`iÊVœ˜Ìˆ˜Õ>ÞÊi˜ÌiÀÃÊ̅iÊ>ÛiœˆÊvÀœ“Ê̅iÊLœœ`Ê>˜` ˆÃÌÊ>Ûiœ>À½ÃÊ>ˆÀÊVœ˜Vi˜ÌÀ>̈œ˜ÊvœÀʜÝÞ}i˜
œÝÞ}i˜Êi>ÛiÃÊ̅iʏ՘}ÃÊvœÀÊÌÀ>˜Ã«œÀÌÊ̅ÀœÕ}…œÕÌÊ̅iÊLœ`Þ°ÊTable 9.3 ŜÜÃÊ̅>Ì >˜`ÊV>ÀLœ˜Ê`ˆœÝˆ`iÊ>ÌÊÀiÃÌ\ÊÊ
“œˆÃÌÊ>Ûiœ>ÀÊ>ˆÀÊVœ˜Ì>ˆ˜ÃÊ>««ÀœÝˆ“>ÌiÞÊ£{°x¯ÊœÝÞ}i˜]Êx°x¯ÊV>ÀLœ˜Ê`ˆœÝˆ`i] "Ó\
>˜`Ênä°ä¯Ê˜ˆÌÀœ}i˜°

vÌiÀÊÃÕLÌÀ>V̈˜}ÊÜ>ÌiÀÊÛ>«œÀÊ«ÀiÃÃÕÀiʈ˜Ê“œˆÃÌÊ>Ûiœ>ÀÊ}>Ã]Ê̅iÊ>ÛiÀ>}iÊ>Ûi‡
œ>ÀÊ* "Ó iµÕ>ÃÊ£äÎʓ“Ê}Ê­ä°£{xÊ ! QÇÈäʓ“Ê}Ê # {Çʓ“Ê}R®]Ê>˜`Ê*
"Ó
iµÕ>ÃÊΙʓ“Ê}Ê­ä°äxxÊ! QÇÈäʓ“Ê}Ê# {Çʓ“Ê}R®°Ê/…iÃiÊÛ>ÕiÃÊÀi«ÀiÃi˜Ì
"Ó\
̅iÊ>ÛiÀ>}iÊ«ÀiÃÃÕÀiÃÊiÝiÀÌi`ÊLÞʜÝÞ}i˜Ê>˜`ÊV>ÀLœ˜Ê`ˆœÝˆ`iʓœiVՏiÃÊ>}>ˆ˜ÃÌ
̅iÊ>Ûiœ>ÀÊÈ`iʜvÊ̅iÊÀiëˆÀ>̜ÀÞʓi“LÀ>˜i°Ê/…iÞÊ`œÊ˜œÌÊi݈ÃÌÊ>ÃÊ«…ÞȜœ}ˆV
Vœ˜ÃÌ>˜ÌÃÊLÕÌÊÛ>ÀÞÊψ}…̏ÞÊ܈̅Ê̅iÊ«…>ÃiʜvÊ̅iÊÛi˜Ìˆ>̜ÀÞÊVÞViÊ>˜`Ê>`iµÕ>VÞ
œvÊÛi˜Ìˆ>̈œ˜Êˆ˜Ê`ˆvviÀi˜Ìʏ՘}ÊÃi}“i˜Ìð

Percentages, Partial Pressures, and Volumes of Gases

Table 9.3
in 1 L of Moist Alveolar Air at Sea Level (37°C)
*
,/
ÊÊ
*, --1, Ê6"1 Ê "Ê

- * ,
/
 ­>Ì ÇÈäÊ# {Çʓ“ }® 
-Ê­“"#£®Ê
"ÝÞ}i˜ £{°x £äÎʓ“Ê} £{x

>ÀLœ˜Ê`ˆœÝˆ`i x°x Ιʓ“Ê} xx
ˆÌÀœ}i˜ nä°ää xǣʓ“Ê} nää
7>ÌiÀÊÛ>«œÀ {Çʓ“Ê}
7 Ç£ä‡Vä™ÚÓÈ·Îää°µÝ`ÊʙɣÈÉ£äÊÊÇ\££*ÊÊ*>}iÊÓÇnÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

278 • SECTION IV The Physiologic Support Systems

MOVEMENT OF GAS IN AIR

A B C
AND FLUIDS O2 O2 O2
P = 160 mm Hg P = 160 mm Hg P = 160 mm Hg

˜œÜi`}iʜvʅœÜÊ}>ÃiÃÊ>VÌʈ˜Ê>ˆÀÊ>˜`ÊvÕˆ`ÃÊ>œÜÃÊÕÃÊÌ
՘`iÀÃÌ>˜`Ê̅iʓiV…>˜ˆÃ“ÊvœÀÊ}>ÃʓœÛi“i˜ÌÊLiÌÜii˜Ê̅i
iÝÌiÀ˜>Êi˜ÛˆÀœ˜“i˜ÌÊ>˜`Ê̅iÊLœ`Þ½ÃÊ̈ÃÃÕiðʘÊ>VVœÀ`
O2 O2 O2
܈̅Êi˜ÀÞ½Ãʏ>Ü] ̅iÊ>“œÕ˜ÌʜvÊ>ÊëiVˆvˆVÊ}>ÃÊ`ˆÃ܏Ûi`ʈ P = 0 mm Hg P = 80 mm Hg P = 160 mm Hg
>ÊvÕˆ`Ê`i«i˜`Ãʜ˜ÊÌܜÊv>V̜ÀÃ
£° *ÀiÃÃÕÀiÊ`ˆvviÀi˜Ìˆ>ÊLiÌÜii˜Ê̅iÊ}>ÃÊ>LœÛiÊ̅iÊvÕˆ Figure 9.7 -œṎœ˜ÊœvʜÝÞ}i˜Êˆ˜ÊÜ>ÌiÀÊ܅i˜ÊœÝÞ}i˜ÊvˆÀÃ
>˜`Ê}>ÃÊ`ˆÃ܏Ûi`ʈ˜Ê̅iÊvÕˆ Vœ“iÃʈ˜ÊVœ˜Ì>VÌÊ܈̅ʫÕÀiÊÜ>ÌiÀÊ­
®ÆÊ`ˆÃ܏Ûi`ʜÝÞ}i˜Ê…>vÜ>ÞÊ̜
Ó° -œÕLˆˆÌÞʜvÊ̅iÊ}>Ãʈ˜Ê̅iÊvÕˆ iµÕˆˆLÀˆÕ“Ê܈̅Ê}>ÃiœÕÃʜÝÞ}i˜Ê­ ®ÆÊ>˜`ÊiµÕˆˆLÀˆÕ“ÊiÃÌ>LˆÃ…i`
LiÌÜii˜Ê̅iʜÝÞ}i˜Êˆ˜Ê>ˆÀÊ>˜`ʜÝÞ}i˜Ê`ˆÃ܏Ûi`ʈ˜ÊÜ>ÌiÀÊ­
®°

Pressure Differential
Figure 9.7 ŜÜÃÊ̅ÀiiÊiÝ>“«iÃʜvÊ}>ÃʓœÛi“i˜Ì ÀˆÕ“°Ê/…iÃiÊiÝ>“«iÃʈÕÃÌÀ>ÌiÊ̅>ÌÊ̅iʘiÌÊ`ˆvvÕȜ˜ÊœvÊ>
LiÌÜii˜Ê>ˆÀÊ>˜`ÊvÕˆ`°Ê"ÝÞ}i˜Ê“œiVՏiÃÊVœ˜Ìˆ˜Õ>ÞÊÃÌÀˆŽ }>ÃʜVVÕÀÃʜ˜ÞÊ܅i˜Ê>Ê `ˆvviÀi˜Vi i݈ÃÌÃʈ˜Ê}>ÃÊ«ÀiÃÃÕÀi°
̅iÊÜ>ÌiÀÊÃÕÀv>Viʈ˜Êi>V…ÊœvÊ̅iÊ̅ÀiiÊV…>“LiÀðÊ*ÕÀiÊÜ>ÌiÀ -«iVˆvˆVÊ}>ýʫ>À̈>Ê«ÀiÃÃÕÀiÊ}À>`ˆi˜ÌÊÀi«ÀiÃi˜ÌÃÊ̅iÊ`ÀˆÛˆ˜
ˆ˜ÊVœ˜Ì>ˆ˜iÀÊ
ÊVœ˜Ì>ˆ˜ÃʘœÊœÝÞ}i˜]ÊÜÊ>ʏ>À}iʘՓLiÀʜv vœÀViÊvœÀʈÌÃÊ`ˆvvÕȜ˜°Ê-ˆ“ˆ>ÀÞ]ÊVœ˜Vi˜ÌÀ>̈œ˜Ê}À>`ˆi˜ÌÃ
œÝÞ}i˜Ê“œiVՏiÃÊ`ˆÃ܏Ûiʈ˜ÊÜ>ÌiÀ°Ê-œ“iʜÝÞ}i˜Ê“œi‡ «ÀœÛˆ`iÊ̅iÊ`ÀˆÛˆ˜}ÊvœÀViÊvœÀÊ`ˆvvÕȜ˜Êœvʘœ˜}>ÃiœÕÃʓœ‡
VՏiÃÊ>ÃœÊi>ÛiÊ̅iÊÜ>ÌiÀÊLiV>ÕÃiÊ̅iÊ`ˆÃ܏Ûi`ʓœiVՏià iVՏiÃÊ­i°}°]Ê}ÕVœÃi]ÊÜ`ˆÕ“]Ê>˜`ÊV>VˆÕ“®°
“œÛiÊVœ˜Ìˆ˜ÕœÕÏÞʈ˜ÊÀ>˜`œ“Ê“œÌˆœ˜°Ê˜ÊV…>“LiÀÊ ]Ê̅i
«ÀiÃÃÕÀiÊ}À>`ˆi˜ÌÊLiÌÜii˜Ê>ˆÀÊ>˜`ÊÜ>ÌiÀÊÃ̈Êv>ۜÀÃʜÝއ
Solubility
}i˜½ÃʘiÌʓœÛi“i˜ÌÊ­`ˆvvÕȜ˜®Êˆ˜ÌœÊ̅iÊvÕˆ`ÊvÀœ“Ê̅
}>ÃiœÕÃÊÃÌ>Ìi]ÊLÕÌÊ̅iʵÕ>˜ÌˆÌÞʜvÊ>``ˆÌˆœ˜>ÊœÝÞ}i˜Ê`ˆÃ‡ >ÃÊ܏ÕLˆˆÌÞ]ʜÀʈÌÃÊ`ˆÃ܏ۈ˜}Ê«œÜiÀ]ÊÀiviVÌÃÊ̅iʵÕ>˜
܏ۈ˜}ʈ˜Ê̅iÊvÕˆ`ÊÀi“>ˆ˜ÃʏiÃÃÊ̅>˜Êˆ˜ÊV…>“LiÀÊ
°Ê Ûi˜ ̈ÌÞʜvÊ>Ê}>ÃÊ`ˆÃ܏Ûi`ʈ˜ÊvÕˆ`Ê>ÌÊ>Ê«>À̈VՏ>ÀÊ«ÀiÃÃÕÀi°Ê
ÌÕ>Þ]Ê̅iÊ«ÀiÃÃÕÀiÃÊvœÀÊ}>ÃʓœÛi“i˜ÌÊ>ÌÌ>ˆ˜ÊiµÕˆˆLÀˆÕ“] }>ÃÊ܈̅Ê}Ài>ÌiÀÊ܏ÕLˆˆÌÞʅ>ÃÊ>ʅˆ}…iÀÊVœ˜Vi˜ÌÀ>̈œ˜Ê>ÌÊ>
>˜`Ê̅iʘՓLiÀʜvʓœiVՏiÃÊi˜ÌiÀˆ˜}Ê>˜`ʏi>ۈ˜}Ê̅iÊvÕˆ ëiVˆvˆVÊ«ÀiÃÃÕÀi°ÊœÀÊÌܜÊ`ˆvviÀi˜ÌÊ}>ÃiÃÊ>Ìʈ`i˜ÌˆV>Ê«ÀiÃ
iµÕ>ˆâiÊ­V…>“LiÀÊ
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Po2 = 159 mm Hg
Pco2 = 0.3 mm Hg

Trachea Po2
149 mm Hg

Pco2
0.3 mm Hg

Venous blood Arterial blood

Po2 40 mm Hg Po2 100 mm Hg Po2 100 mm Hg
Pco2 46 mm Hg Pco2 40 mm Hg Pco2 40 mm Hg

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Chapter 9 The Pulmonary System and Exercise • 279

BOX 9.4 CLOSE UP

Exercise-Induced Asthma

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Champions are not immune from asthma. One of the most
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several races in 1991 that led to the discovery of her asthmatic
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York Marathon she finished with a time of 2 h:33 min:40 s!
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Chapter 9 The Pulmonary System and Exercise • 281

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Part 3 Oxygen and Carbon
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282 • SECTION IV The Physiologic Support Systems

A Oxyhemoglobin Dissociation Curve

100 20

90 18

Effect of temperature
100
10°C
80 16
20°C
80
38°C
70 43°C 14
60
Percent saturation of hemoglobin

Oxygen content of hemoglobin

40

(mL per 100 mL blood)

60 12

20

50 10
pH 7.40
Effect of acidity
PO2 Percent Arterial O2 100
40 saturation (mL . L-1) Low acidity (pH 7.45) 8
10 13.3 24.95
20 35.5 66.60 80
30 58.0 108.81
30 40 73.9 138.64 6
44 78.4 147.08 60
48 82.0 153.83
52 84.9 159.27 High acidity (pH 7.35)
20 56 87.3 163.77 40 4
60 89.3 167.53
64 90.9 170.53
Normal arterial acidity (pH 7.40)
68 92.2 172.97
76 94.1 176.53 20
10 80 94.9 178.03 2
90 96.3 180.66
100 97.2 182.35 20 40 60 80 100

10 20 30 40 50 60 70 80 90 100
Pressure of oxygen in solution (mm Hg)

B Oxygen Transport Cascade

Air
(159)
150
Oxygen partial pressure

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(mm Hg)

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Chapter 9 The Pulmonary System and Exercise • 283

Po2 and Hemoglobin Saturation /…iÊ`ˆÃVÕÃȜ˜ÊœvÊ̅iÊLœœ`½ÃʜÝÞ}i˜‡

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(Hematocrit: 45% of
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284 • SECTION IV The Physiologic Support Systems
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Chapter 9 The Pulmonary System and Exercise • 285

A CO2 dissolved in plasma +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

ÀˆivÞÊ`iÃVÀˆLiÊ̅iÊ œ…ÀÊivviVÌ

CO2
RBC
dissolved
7…>ÌʈÃÊ̅iʯÊÃ>ÌÕÀ>̈œ˜ÊœvÊLÊ>ÌÊ>Ê*"Óʜv
in plasma Óäʓ“Ê}Ê>ÌʘœÀ“>ÊLœ`ÞÊÌi“«iÀ>ÌÕÀi¶Ê
Plasma

Capillary wall CO2

Tissue 7…>ÌʈÃÊ̅iÊv՘V̈œ˜ÊœvÊÓ]·*¶Ê

B CO2 chemically bound to hemoglobin

RBC
Plasma
Hb + CO2 Hb CO2

Capillary wall Tissue

CO2

C CO2 combined with water as bicarbonate

Plasma &OR 9OUR )NFORMATION

RBC %8%2#)3% 42!).).' !.$
-9/',/").

carbonic As might be expected, slow-twitch

CO2 + H2O H CO3 H CO3–+ H+ muscle fibers with high capacity to
anhydrase 2
anhydrase
carbonic bicarbonate
H CO3– generate ATP aerobically contain rel-
acid Cl–
Chloride shift atively large quantities of myoglobin.
Among animals, a muscle’s
Cl–
myoglobin content relates to their
level of physical activity. The leg
Capillary wall Tissue muscles of hunting dogs, for example,
contain more myoglobin than the
CO2 muscles of sedentary house pets; simi-
Figure 9.10
>ÀLœ˜Ê`ˆœÝˆ`iÊÌÀ>˜Ã«œÀÌʈ˜ÊLœœ`°Ê
° *…ÞÈV>ÞÊ`ˆÃ܏Ûi`ʈ˜ÊLœœ` lar findings exist for grazing cattle
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286 • SECTION IV The Physiologic Support Systems

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Chemical Factors
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Chapter 9 The Pulmonary System and Exercise • 289

120
Alveolar Po2
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110
100
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290 • SECTION IV The Physiologic Support Systems

30
Total ventilation
Minute ventilation, L per m 2 surface area per min

∆ pH
25

∆ Temperature
20
Uncertain

15

Neural factors Figure 9.14 i˜iÀ>ˆâi`ʈÕÃÌÀ>̈œ˜ÊœvÊ̅i

10
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Chapter 9 The Pulmonary System and Exercise • 293

Inadequate O2 delivery and/or utilization +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

œ“«iÌiÊ̅iÊvœœÜˆ˜}\
>VÌ>ÌiÊ# >
"Î S
Anaerobic metabolism
( lactate)
Delayed steady-rate VO2
( O2 deficit)
Buffering
( HCO3 VCO2 R) ivˆ˜iÊ̅iÊÛi˜Ìˆ>̜ÀÞÊ̅ÀiŜ`

Minute ventilation (VE)

a. Nonlinear increases (VE/VO2)
(incremental work test) ivˆ˜iÊ" 

b. Delayed steady-rate
(constant work test)

Respiratory compensation for

metabolic acidosis
( VE PaCO2)

Figure 9.16 >V̜ÀÃÊ̅>ÌÊÀi>ÌiÊ̜ʫՏ“œ˜>ÀÞÊ}>ÃÊiÝV…>˜}iÊ`ޘ>“ˆVÃÊvœÀÊ`iÌiV̈˜}

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&OR 9OUR )NFORMATION
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V>ṎœÕÏÞʈ˜ÌiÀ«ÀiÌÊ̅iÊëiVˆvˆVʓiÌ>LœˆVÊÈ}˜ˆvˆV>˜ViʜvÊ̅iÊ" 
Ê>˜`ʈÌÃÊ«œ buffering of lactate to the weaker car-
ÈLiÊÀi>̈œ˜Ã…ˆ«Ê̜Ê̈ÃÃÕiʅޫœÝˆ>° bonic acid. In the lungs, carbonic acid
splits into its water and carbon dioxide
" 
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ʜvÌi˜Êˆ˜VÀi>ÃiÃ
° components; this “non-metabolic”
܈̅Ê>iÀœLˆVÊÌÀ>ˆ˜ˆ˜}Ê܈̅œÕÌÊ>˜Ê>VVœ“«>˜Þˆ˜}ʈ˜VÀi>Ãiʈ˜Ê6
° "ӓ>Ý°Ê/…ˆÃÊÃÕ}‡ carbon dioxide provides an added
}iÃÌÃÊ̅>ÌÊÃi«>À>ÌiÊv>V̜ÀÃʈ˜vÕi˜ViÊ" 
Ê>˜`Ê
° " ӓ>Ý °Ê/À>`ˆÌˆœ˜>Þ]ÊiÝiÀ‡ stimulus to pulmonary ventilation.
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294 • SECTION IV The Physiologic Support Systems

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Chapter 9 The Pulmonary System and Exercise • 295

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frequently experience a severe, sharp
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the chest wall. This pain, called a
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BUFFERING accepted explanation nor has it been
possible to duplicate its occurrence
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in the laboratory. It usually occurs
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during adjustment to new metabolic
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demands and occurs most frequently
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in untrained individuals, it seems
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reasonable to speculate insufficient
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blood flow (ischemia) to either the
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diaphragm or intercostal muscles as
ÛiÀÃ>ÊvœÀÊL>ÈVÊ܏Ṏœ˜ÃÊ܅œÃiÊ«ÊiÝVii`ÃÊÇ°ä°Ê
…i“ˆV>ÞÊ«ÕÀiÊ­`ˆÃ̈i`®
the cause.
Ü>ÌiÀ]ÊVœ˜Ãˆ`iÀi`ʘiÕÌÀ>]ʅ>ÃÊiµÕ>Ê! >˜`Ê"" >˜`Ê̅ÕÃÊ>Ê«ʜvÊÇ°ä°
/…iÊ«ʜvÊLœ`ˆÞÊvÕˆ`ÃÊÀ>˜}iÃÊvÀœ“Ê>ʏœÜʜvÊ£°äÊvœÀÊ̅iÊ`ˆ}iÃ̈ÛiÊ>Vˆ
…Þ`ÀœV…œÀˆVÊ>Vˆ`Ê̜Ê>Êψ}…̏ÞÊL>ÈVÊ«ÊLiÌÜii˜ÊÇ°ÎxÊ>˜`ÊÇ°{xÊvœÀÊ>ÀÌiÀˆ>Ê>˜`
Ûi˜œÕÃÊLœœ`Ê>˜`ʓœÃÌʜ̅iÀÊLœ`ˆÞÊvÕˆ`ðÊ/…iÊ>Vˆ`qL>ÃiÊV…>À>VÌiÀˆÃ̈VÃʜ
Lœ`ˆÞÊvÕˆ`ÃÊvÕVÌÕ>ÌiÊ܈̅ˆ˜Ê˜>ÀÀœÜʏˆ“ˆÌÃÊLiV>ÕÃiʓiÌ>LœˆÃ“ÊÀi“>ˆ˜Ãʅˆ}…
Ãi˜ÃˆÌˆÛiÊ̜Ê! Vœ˜Vi˜ÌÀ>̈œ˜Ãʈ˜Ê̅iÊÀi>V̈˜}ʓi`ˆÕ“°Ê/…ÀiiʓiV…>˜ˆÃ“ÃÊÀi}‡
Տ>ÌiÊ̅iÊ«ʜvÊ̅iʈ˜ÌiÀ˜>Êi˜ÛˆÀœ˜“i˜Ì\
&OR 9OUR )NFORMATION
£°
…i“ˆV>ÊLÕvviÀÃ
Ó° *Տ“œ˜>ÀÞÊÛi˜Ìˆ>̈œ˜ #)'!2%44% 3-/+% #/.342)#43
ΰ ,i˜>Êv՘V̈œ˜ !)27!93
The increase in peripheral airway
resistance and subsequent increased
Chemical Buffers oxygen cost of breathing with
/…iÊV…i“ˆV>ÊLÕvviÀˆ˜}ÊÃÞÃÌi“ÊVœ˜ÃˆÃÌÃʜvÊ>ÊÜi>ŽÊ>Vˆ`Ê>˜`ÊÃ>ÌʜvÊ̅>ÌÊ>Vˆ`° cigarette smoking results mainly from
ˆV>ÀLœ˜>ÌiÊLÕvviÀ]ÊvœÀÊiÝ>“«i]ÊVœ˜ÃˆÃÌÃʜvÊ̅iÊÜi>ŽÊ>Vˆ`ÊV>ÀLœ˜ˆVÊ>Vˆ` >˜`ʈÌà a vagal reflex possibly triggered from
Ã>Ì]ÊÜ`ˆÕ“ÊLˆV>ÀLœ˜>Ìi°
>ÀLœ˜ˆVÊ>Vˆ`ÊvœÀ“ÃÊ܅i˜ÊLˆV>ÀLœ˜>ÌiÊLˆ˜`ÃÊ !° sensory stimulation by minute parti-
7…i˜Ê! Vœ˜Vi˜ÌÀ>̈œ˜ÊÀi“>ˆ˜ÃÊiiÛ>Ìi`]Ê̅iÊÀi>V̈œ˜Ê«Àœ`ÕViÃÊ̅iÊÜi>ŽÊ>Vˆ` cles in smoke and partially from
LiV>ÕÃiÊiÝViÃÃÊ! ˆœ˜ÃÊLˆ˜`ʈ˜Ê>VVœÀ`Ê܈̅Ê̅iÊ}i˜iÀ>ÊÀi>V̈œ˜\ nicotine’s stimulation of parasympa-
thetic nerves.
! ! ÕvviÀÊS ‡ ÕvviÀ
7 Ç£ä‡Vä™ÚÓÈ·Îää°µÝ`ÊʙɣÈÉ£äÊÊÇ\££*ÊÊ*>}iÊәÈÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

296 • SECTION IV The Physiologic Support Systems

˜ÊVœ˜ÌÀ>ÃÌ]Ê܅i˜Ê! Vœ˜Vi˜ÌÀ>̈œ˜Ê`iVÀi>ÃiÃÊ̅iÊLÕvviÀ‡ Protein Buffer 6i˜œÕÃÊLœœ`ÊLÕvviÀÃÊ̅iÊ! Àii>Ãi`

ˆ˜} Ài>V̈œ˜Ê“œÛiÃʈ˜Ê̅iʜ««œÃˆÌiÊ`ˆÀiV̈œ˜Ê>˜`ÊÀii>Ãià vÀœ“Ê̅iÊ`ˆÃÜVˆ>̈œ˜ÊœvÊÀi>̈ÛiÞÊÜi>ŽÊV>ÀLœ˜ˆVÊ>Vˆ`Ê«Àœ‡
! >ÃÊvœœÜÃ\ `ÕVi`ÊvÀœ“ÊÓ"Ê!
"Ó°Ê ÞÊv>À]ÊLÊ«ÀœÛˆ`iÃÊ̅iʓœÃÌʈ“«œÀ‡
Ì>˜ÌÊ! >VVi«ÌœÀÊvœÀÊ̅ˆÃÊLÕvviÀˆ˜}Êv՘V̈œ˜° LʈÃÊ>“œÃÌÊÈÝ
! ! ÕvviÀÊd ‡ ÕvviÀ
̈“iÃʓœÀiÊ«œÌi˜Ìʈ˜ÊÀi}Տ>̈˜}Ê>Vˆ`ˆÌÞÊ̅>˜Ê̅iʜ̅iÀ
ÕÀˆ˜}ʅޫiÀÛi˜Ìˆ>̈œ˜]Ê«>Ó>ÊV>ÀLœ˜ˆVÊ>Vˆ`Ê`iVˆ˜iÃ
LiV>ÕÃiÊV>ÀLœ˜Ê`ˆœÝˆ`iʏi>ÛiÃÊ̅iÊLœœ`Ê>˜`Êi݈ÌÃÊ̅ÀœÕ}… LÊ>ÊÜi>ŽiÀÊ>Vˆ`]Ê̅iÀiLÞʈ˜VÀi>Ș}ʈÌÃÊ>vvˆ˜ˆÌÞÊ̜ÊLˆ˜
̅iʏ՘}ð
œÃÌʜvÊ̅iÊV>ÀLœ˜Ê`ˆœÝˆ`iÊ}i˜iÀ>Ìi`ʈ˜Êi˜iÀ}ÞʓiÌ>Lœ‡
ˆÃ“ÊÀi>VÌÃÊ܈̅ÊÜ>ÌiÀÊ̜ÊvœÀ“Ê̅iÊÀi>̈ÛiÞÊÜi>ŽÊV>ÀLœ˜ˆV
>Vˆ`Ê̅>ÌÊ`ˆÃÜVˆ>ÌiÃʈ˜ÌœÊ ! >˜`Ê
" Î"°ÊˆŽi܈Ãi]Ê̅i
ÃÌÀœ˜}iÀʏ>V̈VÊ>Vˆ`ÊÀi>VÌÃÊ܈̅ÊÜ`ˆÕ“ÊLˆV>ÀLœ˜>ÌiÊ̜ÊvœÀ“
Ü`ˆÕ“ʏ>VÌ>ÌiÊ>˜`ÊV>ÀLœ˜ˆVÊ>Vˆ`Æʈ˜ÊÌÕÀ˜]ÊV>ÀLœ˜ˆVÊ>Vˆ`
`ˆÃÜVˆ>ÌiÃÊ>˜`ʈ˜VÀi>ÃiÃÊ! Vœ˜Vi˜ÌÀ>̈œ˜ÊœvÊ̅iÊiÝÌÀ>Vi‡
Õ>ÀÊvÕˆ`ðÊ"̅iÀʜÀ}>˜ˆVÊ>Vˆ`ÃÊÃÕV…Ê>ÃÊv>ÌÌÞÊ>Vˆ`ÃÊ`ˆÃÜVˆ
>ÌiÊ>˜`ʏˆLiÀ>ÌiÊ !]Ê>ÃÊ`œÊÃՏvÕÀˆVÊ>˜`Ê«…œÃ«…œÀˆVÊ>Vˆ`Ã
}i˜iÀ>Ìi`Ê`ÕÀˆ˜}Ê«ÀœÌiˆ˜ÊV>Ì>LœˆÃ“°Ê ˆV>ÀLœ˜>Ìi]Ê«…œÃ‡
«…>Ìi]Ê>˜`Ê«ÀœÌiˆ˜ÊV…i“ˆV>ÊLÕvviÀÃÊ«ÀœÛˆ`iÊ̅iÊÀ>«ˆ`ÊvˆÀÃ
ˆ˜iʜvÊ`ivi˜ÃiÊ̜ʓ>ˆ˜Ì>ˆ˜ÊVœ˜ÃˆÃÌi˜VÞʈ˜Ê̅iÊ>Vˆ`qL>Ãi
V…>À>VÌiÀʜvÊ̅iʈ˜ÌiÀ˜>Êi˜ÛˆÀœ˜“i˜Ì°
Bicarbonate Buffer /…iÊLˆV>ÀLœ˜>ÌiÊLÕvviÀÊÃÞÃÌi“
Vœ˜ÃˆÃÌÃʜvÊV>ÀLœ˜ˆVÊ>Vˆ`Ê>˜`ÊÜ`ˆÕ“ÊLˆV>ÀLœ˜>Ìiʈ˜Ê܏Շ
«>Ó>Ê«ÀœÌiˆ˜Ã°ÊL½ÃÊÀii>ÃiʜvʜÝÞ}i˜Ê̜Ê̅iÊViÃʓ>ŽiÃ
!°Ê/…iÊ ! }i˜iÀ>Ìi`Ê܅i˜ÊV>ÀLœ˜ˆVÊ>Vˆ`ÊvœÀ“Ãʈ˜Ê̅i
iÀÞ̅ÀœVÞÌiÊVœ“Lˆ˜iÃÊÀi>`ˆÞÊ܈̅Ê`iœÝÞ}i˜>Ìi`ÊLÊ­L"®
ˆ˜Ê̅iÊÀi>V̈œ˜\
! ! L" ­*ÀœÌiˆ˜®ÊS L
˜ÌÀ>ViÕ>ÀÊ̈ÃÃÕiÊ«ÀœÌiˆ˜ÃÊ>ÃœÊÀi}Տ>ÌiÊ«>Ó>Ê«°
-œ“iÊ>“ˆ˜œÊ>Vˆ`ÃÊ«œÃÃiÃÃÊvÀiiÊ>Vˆ`ˆVÊÀ>`ˆV>Ã°Ê7…i˜Ê`ˆÃ‡
ÜVˆ>Ìi`]Ê̅iÞÊvœÀ“Ê""]Ê܅ˆV…ÊÀi>`ˆÞÊÀi>VÌÃÊ܈̅Ê ! ̜
vœÀ“ÊÜ>ÌiÀ°
Physiologic Buffers
/…iʫՏ“œ˜>ÀÞÊ>˜`ÊÀi˜>ÊÃÞÃÌi“ÃÊ«ÀiÃi˜ÌÊ̅iÊÃiVœ˜`ʏˆ˜iʜv
`ivi˜Ãiʈ˜Ê>Vˆ`qL>ÃiÊÀi}Տ>̈œ˜°Ê/…iˆÀÊLÕvviÀˆ˜}Êv՘V̈œ˜
œVVÕÀÃʜ˜ÞÊ܅i˜Ê>ÊV…>˜}iʈ˜Ê«ʅ>ÃÊ>Ài>`ÞʜVVÕÀÀi`°
̈œ˜°ÊÕÀˆ˜}ÊLÕvviÀˆ˜}]ʅÞ`ÀœV…œÀˆVÊ>Vˆ`Ê­>ÊÃÌÀœ˜}Ê>Vˆ`®
Vœ˜ÛiÀÌÃÊ̜Ê̅iʓÕV…ÊÜi>ŽiÀÊV>ÀLœ˜ˆVÊ>Vˆ`ÊLÞÊVœ“Lˆ˜ˆ˜}
Ventilatory Buffer
܈̅ÊÜ`ˆÕ“ÊLˆV>ÀLœ˜>Ìiʈ˜Ê̅iÊvœœÜˆ˜}ÊÀi>V̈œ˜\ 7…i˜Ê̅iʵÕ>˜ÌˆÌÞʜvÊvÀiiÊ ! ˆ˜ÊiÝÌÀ>ViÕ>ÀÊvÕˆ`Ê>˜
«>Ó>ʈ˜VÀi>ÃiÃ]ʈÌÊ`ˆÀiV̏ÞÊÃ̈“Տ>ÌiÃÊ̅iÊÀiëˆÀ>̜ÀÞÊVi˜‡

Ê! >
"Î S >
Ê! Ó
"Î 4 ! ! 
"Î"
ÌiÀÊ̜ʈ““i`ˆ>ÌiÞʈ˜VÀi>ÃiÊ>Ûiœ>ÀÊÛi˜Ìˆ>̈œ˜°Ê/…ˆÃÊÀ>«ˆ`
/…iÊLÕvviÀˆ˜}ʜvʅÞ`ÀœV…œÀˆVÊ>Vˆ`Ê«Àœ`ÕViÃʜ˜ÞÊ> >`ÕÃ̓i˜ÌÊÀi`ÕViÃÊ>Ûiœ>ÀÊ*
"Ó >˜`ÊV>ÕÃiÃÊV>ÀLœ˜Ê`ˆœÝ‡
ψ}…ÌÊÀi`ÕV̈œ˜Êˆ˜Ê«°Ê-œ`ˆÕ“ÊLˆV>ÀLœ˜>Ìiʈ˜Ê«>Ó> ˆ`iÊ̜ÊLiʺLœÜ˜Êœvv»ÊvÀœ“Ê̅iÊLœœ`°Ê,i`ÕVi`Ê«>Ó>ÊV>À‡
iÝiÀÌÃÊ>ÊÃÌÀœ˜}ÊLÕvviÀˆ˜}Ê>V̈œ˜Êœ˜Ê>V̈VÊ>Vˆ`Ê̜ÊvœÀ“ Lœ˜Ê`ˆœÝˆ`iʏiÛiÃÊ>VViiÀ>ÌiÊ̅iÊÀiVœ“Lˆ˜>̈œ˜ÊœvÊ! >˜`
Ü`ˆÕ“ʏ>VÌ>ÌiÊ>˜`ÊV>ÀLœ˜ˆVÊ>Vˆ`°Ê
˜ÞÊ>``ˆÌˆœ˜>Êˆ˜VÀi>Ãi 
"Î"]ʏœÜiÀˆ˜}ÊvÀiiÊ ! Vœ˜Vi˜ÌÀ>̈œ˜Êˆ˜Ê«>Ó>°ÊœÀ
ˆ˜Ê ! Vœ˜Vi˜ÌÀ>̈œ˜ÊvÀœ“ÊV>ÀLœ˜ˆVÊ>Vˆ`Ê`ˆÃÜVˆ>̈œ˜ iÝ>“«i]Ê`œÕLˆ˜}Ê>Ûiœ>ÀÊÛi˜Ìˆ>̈œ˜ÊLÞʅޫiÀÛi˜Ìˆ>̈œ˜
V>ÕÃiÃÊ̅iÊ`ˆÃÜVˆ>̈œ˜ÊÀi>V̈œ˜Ê̜ʓœÛiʈ˜Ê̅iʜ««œÃˆÌi >ÌÊÀiÃÌʈ˜VÀi>ÃiÃÊLœœ`Ê>Ž>ˆ˜ˆÌÞÊ>˜`Ê«ÊLÞÊä°ÓÎÊ՘ˆÌÃÊvÀœ“
`ˆÀiV̈œ˜Ê̜ÊÀii>ÃiÊV>ÀLœ˜Ê`ˆœÝˆ`iʈ˜ÌœÊ܏Ṏœ˜° Ç°{äÊ̜ÊÇ°ÈΰÊ
œ˜ÛiÀÃiÞ]ÊÀi`ÕVˆ˜}ʘœÀ“>Ê>Ûiœ>ÀÊÛi˜Ìˆ>‡
̈œ˜Ê­…Þ«œÛi˜Ìˆ>̈œ˜®ÊLÞʅ>vʈ˜VÀi>ÃiÃÊLœœ`Ê>Vˆ`ˆÌÞÊLÞ
,iÃՏÌʜvÊ
Vˆ`œÃˆÃ >««ÀœÝˆ“>ÌiÞÊä°ÓÎÊ«Ê՘ˆÌðÊ/…iÊ«œÌi˜Ìˆ>Ê“>}˜ˆÌÕ`iʜv
Ó"Ê!
"Ó ← Ó
"Î d ! ! 
"Î" Ûi˜Ìˆ>̜ÀÞÊLÕvviÀˆ˜}ÊiµÕ>ÃÊÌ܈ViÊ̅iÊVœ“Lˆ˜i`ÊivviVÌʜvÊ>
̅iÊLœ`Þ½ÃÊV…i“ˆV>ÊLÕvviÀð

˜Êˆ˜VÀi>Ãiʈ˜Ê«>Ó>ÊV>ÀLœ˜Ê`ˆœÝˆ`iʜÀÊ! Vœ˜Vi˜ÌÀ>‡
̈œ˜Êˆ““i`ˆ>ÌiÞÊÃ̈“Տ>ÌiÃÊÛi˜Ìˆ>̈œ˜Ê̜Êiˆ“ˆ˜>Ìi Renal Buffer
…i“ˆV>ÊLÕvviÀÃʜ˜ÞÊÌi“«œÀ>ÀˆÞ
ºiÝViÃûÊV>ÀLœ˜Ê`ˆœÝˆ`i° >vviVÌÊiÝViÃÃÊ>Vˆ`ÊLՈ`Õ«°Ê
ÝVÀʜvÊ! LÞÊ̅iʎˆ`˜iÞÃ]

œ˜ÛiÀÃiÞ]Ê>Ê`iVÀi>Ãiʈ˜Ê«>Ó>Ê ! Vœ˜Vi˜ÌÀ>̈œ˜ >Ì…œÕ}…ÊÀi>̈ÛiÞÊϜÜ]Ê«ÀœÛˆ`iÃÊ>˜Êˆ“«œÀÌ>˜Ìʏœ˜}iÀ
ˆ˜…ˆLˆÌÃÊ̅iÊÛi˜Ìˆ>̜ÀÞÊ`ÀˆÛiÊ>˜`ÊÀiÌ>ˆ˜ÃÊV>ÀLœ˜Ê`ˆœÝˆ`i ÌiÀ“Ê`ivi˜ÃiÊ̅>Ìʓ>ˆ˜Ì>ˆ˜ÃÊ̅iÊLœ`Þ½ÃÊLÕvviÀÊÀiÃiÀÛi
̅>ÌÊ̅i˜ÊVœ“Lˆ˜iÃÊ܈̅ÊÜ>ÌiÀÊ̜ʈ˜VÀi>ÃiÊ>Vˆ`ˆÌÞÊ­V>ÀLœ˜ˆV Ž˜œÜ˜Ê>ÃÊ>Ž>ˆ˜iÊÀiÃiÀÛi° /œÊ̅ˆÃÊi˜`]Ê̅iʎˆ`˜iÞÃÊÃÌ>˜`
>Vˆ`®Ê>˜`ʘœÀ“>ˆâiÊ«° >ÃÊvˆ˜>Ê}Õ>À`ˆ>˜ÃÊ̜ʫÀiÃiÀÛiʘœÀ“>Êv՘V̈œ˜°Ê/…iÊÀi˜>
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Ó"Ê!
"Ó S Ó
"Î S ! ! 
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Phosphate Buffer Effects of Intense Exercise

/…iÊ«…œÃ«…>ÌiÊLÕvviÀˆ˜}ÊÃÞÃÌi“ÊVœ˜ÃˆÃÌÃʜvÊ«…œÃ«…œÀˆV
>Vˆ`Ê>˜`ÊÜ`ˆÕ“Ê«…œÃ«…>Ìi°Ê/…iÃiÊV…i“ˆV>ÃÊ>VÌÊȓˆ>ÀÞ
̜Ê̅iÊLˆV>ÀLœ˜>ÌiÊLÕvviÀðÊ*…œÃ«…>ÌiÊLÕvviÀÊiÝiÀÌÃÊ>˜
ˆ“«œÀÌ>˜ÌÊivviVÌʜ˜Ê>Vˆ`qL>ÃiÊL>>˜Viʈ˜Ê̅iʎˆ`˜iÞ
ÌÕLՏiÃÊ>˜`ʈ˜ÌÀ>ViÕ>ÀÊvÕˆ`ÃÊ܅iÀiÊ«…œÃ«…>ÌiÊVœ˜Vi˜
ÌÀ>̈œ˜ÊÀi“>ˆ˜Ãʅˆ}…°
˜VÀi>Ãi`Ê ! Vœ˜Vi˜ÌÀ>̈œ˜ÊvÀœ“ÊV>ÀLœ˜Ê`ˆœÝˆ`iÊ«Àœ`ÕV‡
̈œ˜Ê>˜`ʏ>VÌ>ÌiÊvœÀ“>̈œ˜Ê`ÕÀˆ˜}ÊÃÌÀi˜ÕœÕÃÊiÝiÀVˆÃiʓ>ŽiÃ
«ÊÀi}Տ>̈œ˜Ê«Àœ}ÀiÃÈÛiÞʓœÀiÊ`ˆvvˆVՏ̰Ê
Vˆ`qL>ÃiÊÀi}Õ
>̈œ˜ÊLiVœ“iÃÊiÝVii`ˆ˜}ÞÊ`ˆvvˆVՏÌÊ`ÕÀˆ˜}ÊÀi«i>Ìi`]ÊLÀˆi
LœÕÌÃʜvÊ>‡œÕÌÊiÝiÀVˆÃiÊ̅>ÌÊiiÛ>ÌiÊLœœ`ʏ>VÌ>ÌiÊÛ>ÕiÃÊ̜
ÎäʓÊ­ÓÇäʓ}ʜvʏ>VÌ>ÌiÊ«iÀÊ`ʜvÊLœœ`®ÊœÀʅˆ}…iÀ°
7 Ç£ä‡Vä™ÚÓÈ·Îää°µÝ`ÊʙɣÈÉ£äÊÊÇ\££*ÊÊ*>}iÊәÇÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

Chapter 9 The Pulmonary System and Exercise • 297

+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
7.5

œ“«iÌiÊ̅iÊvœœÜˆ˜}\
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Blood pH 7.3

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298 • SECTION IV The Physiologic Support Systems

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Chapter 9 The Pulmonary System and Exercise • 299

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NOTES
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The
C h a p t e r
Cardiovascular
System and
Exercise
CHAPTER OBJECTIVES
• List important functions of the cardiovascular system.
• Describe how to use the auscultatory method to
measure blood pressure and give average values for
systolic and diastolic blood pressure during rest and
moderate aerobic exercise.
• Describe the blood pressure response during
resistance exercise, upper-body exercise, and
exercise in the inverted position.
• State the potential benefits of aerobic exercise for
treating moderate hypertension.
• Identify intrinsic and extrinsic factors that regulate
heart rate during rest and exercise.
10
• Identify neural and local metabolic factors that
regulate blood flow during rest and exercise.
• Compare average values of cardiac output during rest
and maximal exercise for an endurance-trained athlete
and a sedentary person.
• Explain three physiologic mechanisms that affect the
heart’s stroke volume.
• Describe the relationship between maximal cardiac
output and maximal oxygen uptake among individuals
with varied aerobic fitness levels.
• List the Mayo Clinic’s seven benefits of regular
physical activity.
301
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302 • SECTION IV The Physiologic Support Systems
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Part 1 The Cardiovascular System
COMPONENTS OF THE
CARDIOVASCULAR SYSTEM
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Chapter 10 The Cardiovascular System and Exercise • 303

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Veins from Arteries to

upper body upper body Ó°

Superior
vena cava
ΰ

Aorta
Lung Pulmonary
artery
Lung {°

Pulmonary
vein

Left
atrium /…iʓޜV>À`ˆÕ“ÊVœ˜ÃˆÃÌÃʜvÊ܅>ÌÊÌÞ«iʜv
Right “ÕÃVi¶
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ventricle ventricle
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Hepatic ivÌʅi>ÀÌ
veins Hepatic
artery £°
Inferior Liver
vena cava
Portal vein
Alimentary
Ó°
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Kidneys

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Legs Arteries to ,ˆ}…Ìʅi>ÀÌ
lower body lower body
£°

Ó°
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iˆÌ…iÀÊVœ˜ÃÌÀˆVÌʜÀÊÀi>ÝÊ̜ÊÀi}Տ>ÌiÊ«iÀˆ«…iÀ>ÊLœœ`ÊvœÜ /…iÊÀi`ˆÃÌÀˆLṎœ˜Êv՘V‡ /…iÊV>«ˆ>ÀˆiÃÊVœ˜Ì>ˆ˜Ê>««ÀœÝˆ“>ÌiÞ
̈œ˜ÊœvÊ>ÀÌiÀˆœiÃÊLiVœ“iÃʈ“«œÀÌ>˜ÌÊ`ÕÀˆ˜}ÊiÝiÀVˆÃiÊLiV>ÕÃiÊLœœ`Ê`ˆÛiÀÌÃÊ̜ ÚÚÚÚÚÚÊ«iÀVi˜ÌʜvÊ̅iÊ̜Ì>ÊLœœ`ÊۜÕ“i°
>V̈ÛiʓÕÃViÃÊvÀœ“Ê>Ài>ÃÊ̅>ÌÊV>˜ÊÌi“«œÀ>ÀˆÞÊVœ“«Àœ“ˆÃiÊ̅iˆÀÊLœœ`ÊÃÕ««Þ°

Capillaries
/…iÊ>ÀÌiÀˆœiÃÊVœ˜Ìˆ˜ÕiÊ̜ÊLÀ>˜V…Ê>˜`ÊvœÀ“ÊÓ>iÀÊ>˜`ʏiÃÃʓÕÃVՏ>ÀÊÛiÃÃiÃ
V>i`ʓiÌ>ÀÌiÀˆœiðÊ/…iÃiÊ̈˜ÞÊÛiÃÃiÃʓiÀ}iʈ˜ÌœÊ V>«ˆ>Àˆià ­ÃiiÊLœÌ̜“Êœv
Fig. 10.3®]Ê>ʘiÌܜÀŽÊœvʓˆVÀœÃVœ«ˆVÊLœœ`ÊÛiÃÃiÃÊÜÊ̅ˆ˜Ê̅iÞÊ«ÀœÛˆ`iʜ˜Þ
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304 • SECTION IV The Physiologic Support Systems

Head, neck and

upper body
Superior vena cava
Branches of right Aorta
pulmonary artery
Right Pulmonary artery Left
lung lung
Left
atrium

Branches of
left pulmonary
vein
Branches of
right pulmonary
vein Semilunar (aortic) valves
Right atrium Mitral (bicuspid)
valve

Tricuspid valve

Left ventricle

Right ventricle
Inferior vena cava

Aorta

Trunk and
lower extremity Figure 10.2 /…iʅi>À̽ÃÊÛ>ÛiÃÊ«ÀœÛˆ`i
vœÀÊ̅iʜ˜i‡Ü>ÞÊvœÜʜvÊLœœ`ʈ˜`ˆV>Ìi`ÊL
̅iÊÞiœÜ >ÀÀœÜð

Veins Arteries

One-way valves Arterial walls

prevent back- contain elastic
flow of blood fibers and
muscle fibers

Venule Arteriole

Smooth muscle
fibers in arterioles
control blood flow
Figure 10.3 /…iÊÃÌÀÕVÌÕÀiʜvÊ̅iÊÜ>ÃʜvÊ̅iÊÛ>ÀˆœÕÃÊLœœ`
to capillary beds ÛiÃÃiÃ°Ê
ÊȘ}iʏ>ÞiÀʜvÊi˜`œÌ…iˆ>ÊViÃʏˆ˜iÃÊi>V…ÊÛiÃÃi°
Capillary
Endothelial ˆLÀœÕÃÊ̈ÃÃÕi]ÊÜÀ>««i`ʈ˜ÊÃiÛiÀ>Ê>ÞiÀÃʜvÊӜœÌ…Ê“ÕÃVi]
cells ÃÕÀÀœÕ˜`ÃÊ̅iÊ>ÀÌiÀˆ>ÊÜ>Ã°Ê
ÊȘ}iʏ>ÞiÀʜvʓÕÃViÊViÃ
Åi>̅iÃÊ̅iÊ>ÀÌiÀˆœiÃÆÊV>«ˆ>ÀˆiÃÊVœ˜ÃˆÃÌʜvʜ˜Þʜ˜iʏ>ÞiÀʜv
i˜`œÌ…iˆ>ÊViÃ°Ê˜Ê̅iÊÛi˜Õi]ÊvˆLÀœÕÃÊ̈ÃÃÕiÊi˜V>ÃiÃÊ̅
i˜`œÌ…iˆ>ÊViÃÆÊÛiˆ˜ÃÊ>ÃœÊ«œÃÃiÃÃÊ>ʏ>ÞiÀʜvÊӜœÌ…Ê“ÕÃVi°
Osmotic pressure within Blood pressure forces
ÊÛiÃÃi½ÃÊÀiÈÃÌ>˜ViÊ̜ÊvœÜÊ`i«i˜`Ãʜ˜ÊˆÌÃÊ`ˆ>“iÌiÀ°ÊiVÀi>Ã
capillaries draws fluid back fluid from capillary
ˆ˜}ÊÛiÃÃiÊ`ˆ>“iÌiÀÊLÞʜ˜i‡…>vʈ˜VÀi>ÃiÃÊÀiÈÃÌ>˜Viʣȇvœ`°
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Chapter 10 The Cardiovascular System and Exercise • 305

i˜œÕ}…ÊÀœœ“ÊvœÀÊLœœ`ÊViÃÊ̜ÊõÕiiâiÊ̅ÀœÕ}…ʈ˜ÊȘ}iÊvˆi°Ê
>«ˆ>ÀˆiÃÊVœ˜
Ì>ˆ˜Ê>LœÕÌÊx¯ÊœvÊ̅iÊLœ`Þ½ÃÊ̜Ì>ÊLœœ`ÊۜÕ“iÊ>ÌÊ>˜ÞÊ̈“i°Ê>ÃiÃ]ʘÕÌÀˆi˜ÌÃ] +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
>˜`ÊÜ>ÃÌiÊ«Àœ`ÕVÌÃÊÀ>«ˆ`ÞÊÌÀ>˜ÃviÀÊ>VÀœÃÃÊ̅iÊ̅ˆ˜]Ê«œÀœÕÃÊV>«ˆ>ÀÞÊÜ>Ã°Ê
7…>ÌÊÃÌÀÕVÌÕÀiÃÊ>ÀiÊ«ÀiÃi˜Ìʈ˜ÊÛiˆ˜ÃÊLÕÌ
Àˆ˜}ʜvÊӜœÌ…Ê“ÕÃViÊV>i`Ê̅iÊ«ÀiV>«ˆ>ÀÞÊ녈˜VÌiÀ i˜VˆÀViÃÊ̅iÊV>«ˆ>ÀÞ ˜œÌÊ>ÀÌiÀˆiöÊ7…>ÌÊ«ÕÀ«œÃiÊ`œÊ̅iÃiÊ
>ÌʈÌÃʜÀˆ}ˆ˜Ê̜ÊVœ˜ÌÀœÊ̅iÊÛiÃÃi½Ãʈ˜ÌiÀ˜>Ê`ˆ>“iÌiÀ°Ê/…ˆÃÊ녈˜VÌiÀÊ«ÀœÛˆ`iÃÊ> ÃÌÀÕVÌÕÀiÃÊÃiÀÛi¶
œV>Ê“i>˜ÃÊvœÀÊÀi}Տ>̈˜}ÊV>«ˆ>ÀÞÊLœœ`ÊvœÜÊ܈̅ˆ˜Ê>ÊëiVˆvˆVÊ̈ÃÃÕiÊ̜ʓi
“iÌ>LœˆVÊÀiµÕˆÀi“i˜ÌÃÊ̅>ÌÊV…>˜}iÊÀ>«ˆ`ÞÊ>˜`Ê`À>“>̈V>Þʈ˜ÊiÝiÀVˆÃi°

>«ˆ>ÀÞÊLÀ>˜V…ˆ˜}ʈ˜VÀi>ÃiÃÊ̅iÊ̜Ì>ÊVÀœÃÇÃiV̈œ˜>Ê>Ài>ʜvÊ̅iʓˆVÀœVˆÀ‡
VՏ>̈œ˜ÊnääÊ̈“iÃʓœÀiÊ̅>˜Ê̅iÊ£‡ˆ˜V…Ê`ˆ>“iÌiÀÊ>œÀÌ>°Ê œœ`ÊvœÜÊÛiœVˆÌ
Ài>ÌiÃʈ˜ÛiÀÃiÞÊ̜Ê̅iÊÛ>ÃVՏ>ÌÕÀi½ÃÊ̜Ì>ÊVÀœÃÃÊÃiV̈œ˜]ʓ>Žˆ˜}ÊÛiœVˆÌÞÊ«Àœ‡
ÀˆivÞÊ`ˆÃVÕÃÃÊ̅iÊÀœiʜvÊÛiˆ˜ÃÊ>ÃÊLœœ
}ÀiÃÈÛiÞÊ`iVÀi>ÃiÊ>ÃÊLœœ`ʓœÛiÃÊ̜Ü>À`Ê>˜`ʈ˜ÌœÊ̅iÊV>«ˆ>Àˆið
ÀiÃiÀۜˆÀð

Veins
/…iÊÛ>ÃVՏ>ÀÊÃÞÃÌi“Ê“>ˆ˜Ì>ˆ˜ÃÊVœ˜Ìˆ˜ÕˆÌÞʜvÊLœœ`ÊvœÜÊ>ÃÊV>«ˆ>ÀˆiÃÊvii`Ê`iœÝÞ
Ûi˜Õià ­Fig. 10.3®°Ê œœ`
}i˜>Ìi`ÊLœœ`Ê>ÌÊ>“œÃÌÊ>ÊÌÀˆVŽiʈ˜ÌœÊ̅iÊÓ>ÊÛiˆ˜ÃʜÀÊ
vœÜÊ̅i˜Êˆ˜VÀi>ÃiÃÊψ}…̏ÞÊLiV>ÕÃiÊ̅iÊÛi˜œÕÃÊÃÞÃÌi“½ÃÊVÀœÃÇÃiV̈œ˜>Ê>Ài
LiVœ“iÃʏiÃÃÊ̅>˜ÊvœÀÊV>«ˆ>ÀˆiðÊ/…iʏœÜiÀÊLœ`Þ½ÃÊÓ>iÀÊÛiˆ˜ÃÊiÛi˜ÌÕ>ÞÊi“«ÌÞ 7…iÀiÊ`œÊÛ>ÀˆVœÃiÊÛiˆ˜ÃÊÕÃÕ>ÞÊ>««i>À¶
ˆ˜ÌœÊ̅iʏ>À}iÃÌÊÛiˆ˜]Ê̅iʈ˜viÀˆœÀÊÛi˜>ÊV>Û>] ܅ˆV…ÊÌÀ>ÛiÃÊ̅ÀœÕ}…Ê̅iÊ>L`œ“ˆ˜> 7…Þ¶
>˜`Ê̅œÀ>VˆVÊV>ۈ̈iÃÊ̜Ü>À`Ê̅iʅi>ÀÌ°Ê6i˜œÕÃÊLœœ`Ê`À>ˆ˜ˆ˜}Ê̅iʅi>`]ʘiVŽ]Ê>˜`
ŜՏ`iÀÊÀi}ˆœ˜ÃÊi“«ÌˆiÃʈ˜ÌœÊ̅iÊÃÕ«iÀˆœÀÊÛi˜>ÊV>Û>>˜`ʓœÛiÃÊ`œÜ˜Ü>À`Ê̜ʍœˆ˜
̅iʈ˜viÀˆœÀÊÛi˜>ÊV>Û>Ê>Ìʅi>ÀÌʏiÛi°Ê/…iʓˆÝÌÕÀiʜvÊLœœ`ÊvÀœ“Ê̅iÊÕ««iÀÊ>˜`
œÜiÀÊLœ`ÞÊ̅i˜Êi˜ÌiÀÃÊ̅iÊÀˆ}…ÌÊ>ÌÀˆÕ“ >˜`Ê`iÃVi˜`Ãʈ˜ÌœÊ̅iÊÀˆ}…ÌÊÛi˜ÌÀˆVi vœÀ
`iˆÛiÀÞÊ̅ÀœÕ}…Ê̅iʫՏ“œ˜>ÀÞÊ>ÀÌiÀÞÊ̜Ê̅iʏ՘}ðÊ>ÃÊiÝV…>˜}iÊÌ>ŽiÃÊ«>Viʈ˜ ˆÃVÕÃÃÊ̅iʓ>œÀÊ`ˆvviÀi˜ViÃÊLiÌÜii˜
̅iʏ՘}ýÊ>Ûiœ>ÀqV>«ˆ>ÀÞʘiÌܜÀŽ]Ê܅iÀiÊ̅iʫՏ“œ˜>ÀÞÊÛiˆ˜ÃÊÀiÌÕÀ˜ÊœÝއ >ÀÌiÀˆiÃÊ>˜`ÊÛiˆ˜Ã°
}i˜>Ìi`ÊLœœ`Ê̜Ê̅iʏivÌʅi>ÀÌʫՓ«]Ê>˜`Ê̅iʍœÕÀ˜iÞÊ̅ÀœÕ}…Ê̅iÊLœ`ÞÊÀiÃՓið

Venous Return
Ê՘ˆµÕiÊV…>À>VÌiÀˆÃ̈VʜvÊÛiˆ˜ÃÊ܏ÛiÃÊ>Ê«œÌi˜Ìˆ>Ê«ÀœL‡

i“ÊÀi>Ìi`Ê̜Ê̅iʏœÜÊ«ÀiÃÃÕÀiʜvÊÛi˜œÕÃÊLœœ`°Ê Figure 10.4 ŜÜÃÊ̅>ÌÊ̅ˆ˜]

7…>ÌÊ`iÌiÀ“ˆ˜iÃÊLœœ`ÊÛiÃÃi½ÃÊÀiÈÃÌ>˜Vi
̜ÊvœÜ

Figure 10.4 /…iÊÛ>ÛiÃʈ˜ÊÛiˆ˜ÃÊ­
®Ê«ÀiÛi˜ÌÊ̅iÊL>VŽÊvœÜʜvÊLœœ`ÊLÕÌÊ`œÊ˜œÌʅˆ˜

`iÀÊ̅iʘœÀ“>Êœ˜i‡Ü>ÞÊvœÜʜvÊLœœ`Ê ®°Ê œœ`ʓœÛiÃÊ̅ÀœÕ}…ÊÛiˆ˜ÃÊLÞÊ̅iÊ>V̈œ˜Êœv
˜i>ÀLÞÊ>V̈ÛiʓÕÃViÊ­“ÕÃViʫՓ«®Ê­
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܈̅ˆ˜Ê̅iÊÛiˆ˜ÃÊ­®°
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306 • SECTION IV The Physiologic Support Systems

“i“LÀ>˜œÕÃ]Êv>«ˆŽiÊÛ>ÛiÃÊë>Vi`Ê>ÌÊŜÀÌʈ˜ÌiÀÛ> ÀˆÃiÃÊ>˜`ÊÀi“>ˆ˜ÃÊiÀiVÌÊ܈̅œÕÌʓœÛi“i˜Ì]Ê>˜Ê՘ˆ˜ÌiÀ‡
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«ÀiÃÃÊvÀœ“Ê“ÕÃVՏ>ÀÊVœ˜ÌÀ>V̈œ˜ÃʜÀʓˆ˜œÀÊ«ÀiÃÃÕÀiÊV…>˜}ià ­i`i“>®ÊœVVÕÀÃÊvÀœ“Ê«œœˆ˜}ʜvÊLœœ`ʈ˜Ê̅iʏœÜiÀÊiÝÌÀi“‡
܈̅ˆ˜Ê̅iÊV…iÃÌÊV>ۈÌÞÊ`ÕÀˆ˜}ÊLÀi>̅ˆ˜}°Ê
ÌiÀ˜>ÌiÊÛi˜œÕà ˆÌˆiÃÊ>˜`ÊVÀi>ÌiÃʺL>VŽÊ«ÀiÃÃÕÀi»Ê̅>ÌÊvœÀViÃÊvÕˆ`ÊvÀœ“Ê̅
Vœ“«ÀiÃȜ˜Ê>˜`ÊÀi>Ý>̈œ˜]ÊVœ“Lˆ˜i`Ê܈̅Ê̅iʜ˜i‡Ü>Þ V>«ˆ>ÀÞÊLi`ʈ˜ÌœÊÃÕÀÀœÕ˜`ˆ˜}Ê̈ÃÃÕiðÊ
œ˜VÕÀÀi˜ÌÞ]
>V̈œ˜ÊœvÊÛ>ÛiÃ]Ê«ÀœÛˆ`iÃÊ> º“ˆŽˆ˜}»ÊivviVÌÊȓˆ>ÀÊ̜Ê̅i ˆ“«>ˆÀi`ÊÛi˜œÕÃÊÀiÌÕÀ˜Ê`iVÀi>ÃiÃÊLœœ`Ê«ÀiÃÃÕÀiÆÊ>ÌÊ̅i
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Vœ˜Ãˆ`iÀ>LiÊi˜iÀ}ÞÊvœÀÊLœœ`ÊvœÜ]ʺ`ˆ>Ã̜i»ÊœÀÊÀi>Ý>̈œ ˆ˜VÀi>ÃiÃÊ̜ÊVœÕ˜ÌiÀÊ̅iʅޫœÌi˜ÃˆÛiÊVœ˜`ˆÌˆœ˜°Ê>ˆ˜Ì>ˆ˜‡
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…i>ÀÌ°Ê7ˆÌ…œÕÌÊÛ>ÛiÃ]ÊLœœ`ÊܜՏ`ÊÃÌ>}˜>ÌiʜÀÊ«œœÊ­>ÃÊˆÌ ˜iÃÃÊ>˜`ÊiÛi˜ÌÕ>Êv>ˆ˜Ìˆ˜}ÊvÀœ“ʈ˜ÃÕvvˆVˆi˜ÌÊViÀiLÀ>ÊLœœ
ܓï“iÃÊ`œiîʈ˜ÊiÝÌÀi“ˆÌÞÊÛiˆ˜Ã]Ê>˜`Ê«iœ«iÊܜՏ` ÃÕ««Þ°Ê,iÃՓˆ˜}Ê>ʅœÀˆâœ˜Ì>ÊœÀʅi>`‡`œÜ˜Ê«œÃˆÌˆœ˜
v>ˆ˜ÌÊiÛiÀÞÊ̈“iÊ̅iÞÊÃ̜œ`ÊÕ«ÊLiV>ÕÃiʜvÊÀi`ÕVi`ÊLœœ` ÀiÃ̜ÀiÃÊVˆÀVՏ>̈œ˜Ê>˜`ÊVœ˜ÃVˆœÕØiÃð
vœÜÊ̜Ê̅iÊLÀ>ˆ˜

V̈ÛiÊ
œœ‡œÜ˜ /…iÊ«œÌi˜Ìˆ>ÊvœÀÊÛi˜œÕÃÊ«œœˆ˜}
A Significant Blood Reservoir /…iÊÛiˆ˜ÃÊ`œÊ˜œÌ
“iÀiÞÊv՘V̈œ˜Ê>ÃÊ«>ÃÈÛiÊVœ˜`ՈÌðÊ
ÌÊÀiÃÌ]Ê̅iÊÛi˜œÕÃ
œœˆ˜}Ê`œÜ˜»Ê܈̅ÊÀ…Þ̅‡
ÃÞÃÌi“ʘœÀ“>ÞÊVœ˜Ì>ˆ˜ÃÊ>LœÕÌÊÈx¯ÊœvÊ̜Ì>ÊLœœ`Êۜ‡
ՓiÆʅi˜Vi]ÊÛiˆ˜ÃÊÃiÀÛiÊ>ÃÊV>«>VˆÌ>˜ViÊÛiÃÃiÃʜÀÊLœœ`
ÀiÃiÀۜˆÀðÊ
Êψ}…Ìʈ˜VÀi>Ãiʈ˜ÊÌi˜Ãˆœ˜Ê­Ìœ˜i®ÊLÞÊ̅iÊÛiˆ˜Ã½
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Chapter 10 The Cardiovascular System and Exercise • 307

+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
200
ˆÛiÊ>ʘœÀ“>ÊLœœ`Ê«ÀiÃÃÕÀiÊ>ÌÊÀiÃÌ°Ê

Blood pressure (mm Hg)

180
-ÞÃ̜ˆV\
160
ˆ>Ã̜ˆV\
140

120

100 -ÞÃ̜ˆVÊLœœ`Ê«ÀiÃÃÕÀiÊiÃ̈“>ÌiÃÊ܅>Ì
«…ÞȜœ}ˆVÊv>V̜À¶
80

Rest 2 4 6 8 10 12 14
Treadmill elevation (% grade) iÃVÀˆLiÊ̅iÊÀi>̈œ˜Ã…ˆ«ÊLiÌÜii˜ÊÃÞÃ̜ˆV
Lœœ`Ê«ÀiÃÃÕÀiÊ>˜`ÊV>À`ˆ>VʜÕÌ«ÕÌÊ`ÕÀˆ˜}
iÝiÀVˆÃiʜvʈ˜VÀi>Ș}ʈ˜Ìi˜ÃˆÌÞ°
Systolic blood pressure Diastolic blood pressure

Figure 10.5 i˜iÀ>ˆâi`ÊÀi뜘ÃiÊvœÀÊÃÞÃ̜ˆVÊ>˜`Ê`ˆ>Ã̜ˆVÊLœœ`Ê«ÀiÃÃÕÀiÃÊ`ÕÀˆ˜}

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vœÀViÃÊLœœ`Ê̅ÀœÕ}…Ê̅iÊÛiÇ Arterial blood pressure relates to arterial blood flow per minute (cardiac output) and
ÃiÃÊ>˜`ÊÀiÌÕÀ˜ÃʈÌÊ̜Ê̅i peripheral vascular resistance to blood flow in the following relationships:
…i>À̰ʘVÀi>Ãi`ÊLœœ`ÊvœÜ
Blood pressure ! Cardiac output " Total peripheral resistance
`ÕÀˆ˜}ʓœ`iÀ>ÌiÊiÝiÀVˆÃi
ˆ˜VÀi>ÃiÃÊÃÞÃ̜ˆVÊ«ÀiÃÃÕÀiʈ˜ Rearranging terms:
̅iÊvˆÀÃÌÊviÜʓˆ˜ÕÌiÃÆʈÌÊ̅i˜
Total peripheral resistance ! Blood pressure # Cardiac output
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The prevalence of hypertension in black and white men and women differs significantly. The
total prevalence is only slightly higher in blacks than whites (28.1% vs. 23.2%), yet in young
adults, hypertension occurs much more frequently in blacks, particularly black women. In
the 35 to 44 age range, hypertension occurs in one-third as many white women (8.5%) as
black women (22.9%). The fact that African Americans have a much greater incidence than
blacks in Africa compounds the issue of race and hypertension and perhaps emphasizes non-
genetic, lifestyle contributory factors to hypertension. Ongoing research focuses on diet,
stress, cigarette smoking, and other lifestyle and environmental factors that trigger this
chronic blood pressure response in genetically susceptible blacks ­…ÌÌ«\ÉÉÜÜÜ°>ŇÕðœÀ}É®.
The American College of Sports Medicine’s “Position Stand on Physical Activity, Physical
Fitness, and Hypertension” can be accessed at ÜÜÜ°>VӇ“ÃÃi°œÀ}.
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308 • SECTION IV The Physiologic Support Systems

BOX 1 0 .1 CLOSE UP
How to Measure Blood Pressure

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Step 1 Step 2 Step 3

Brachial artery
260
250
240 Cuff pressure
230
220 Cuff pressure below 120, but Cuff pressure
210 exceeds systolic above 70 just below diastolic
200
190 (no sound) (tapping sound) pressure (no sound)
180
170
160
150 Brachial artery
140 Intermittent Blood flow
130 closed
120 No blood flow blood flow fully restored
110
100
90
80
70
60
50
40
30
20
10
0
mm Hg
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310 • SECTION IV The Physiologic Support Systems

Upper-Body
° Exercise ÝiÀVˆÃiÊ>ÌÊ>Ê}ˆÛi˜Ê«iÀVi˜Ì‡
Blood Pressure Response During Rhythmic >}iʜvÊ6 "ӓ>Ý ˆ˜VÀi>ÃiÃÊÃÞÃ̜ˆVÊ>˜`Ê`ˆ>Ã̜ˆVÊLœœ`Ê«ÀiÇ
Aerobic Exercise and Heavy Resistance ÃÕÀiÃÊÃÕLÃÌ>˜Ìˆ>ÞʓœÀiʈ˜ÊÀ…Þ̅“ˆVÊ­Õ««iÀÊ>À“®ÊVœ“«>Ài`
Training of Small and Large Muscle Mass ܈̅ÊÀ…Þ̅“ˆVʏi}Ê­œÜiÀÊLœ`Þ®ÊiÝiÀVˆÃi°Ê/…iÊÓ>iÀ
300 >À“Ê“ÕÃViʓ>ÃÃÊ>˜`ÊÛ>ÃVՏ>ÌÕÀiʜvviÀÊ}Ài>ÌiÀÊÀiÈÃ̇
SBP
>˜ViÊ̜ÊLœœ`ÊvœÜÊ̅>˜Ê̅iʏ>À}iÀÊ>˜`ʓœÀiÊÛ>ÃVՏ>À‡
Blood Pressure, mm Hg

250 SBP
ˆâi`ʏœÜiÀ‡Lœ`ÞÊÀi}ˆœ˜Ã°Ê/…ˆÃʓi>˜ÃÊ̅>ÌÊLœœ`ÊvœÜÊ̜
̅iÊ>À“ÃÊ`ÕÀˆ˜}ÊiÝiÀVˆÃiÊÀiµÕˆÀiÃÊ>ʓÕV…ʏ>À}iÀÊÃÞÃ̜ˆV
200
SBP
…i>`ʜvÊ«ÀiÃÃÕÀiÊ>˜`Ê>VVœ“«>˜Þˆ˜}ʈ˜VÀi>Ãiʈ˜Ê“ÞœV>À‡
DPB
150
`ˆ>ÊܜÀŽœ>`Ê>˜`ÊÛ>ÃVՏ>ÀÊÃÌÀ>ˆ˜°ÊœÀʈ˜`ˆÛˆ`Õ>ÃÊ܈̅
DPB
SBP V>À`ˆœÛ>ÃVՏ>ÀÊ`ÞÃv՘V̈œ˜]ʓœÀiÊ«ÀÕ`i˜ÌÊiÝiÀVˆÃi
100 ˆ˜ÛœÛiÃʏ>À}iÀÊ “ÕÃViÊ}ÀœÕ«Ã]Ê>Ãʈ˜ÊÜ>Žˆ˜}]ÊÀ՘˜ˆ˜}]
DPB DPB LˆVÞVˆ˜}]Ê>˜`ÊÃÌ>ˆÀÊVˆ“Lˆ˜}] À>̅iÀÊ̅>˜Ê՘Ài}Տ>Ìi`
50 iÝiÀVˆÃiÃʜvÊ>ʏˆ“ˆÌi`ʓÕÃViʓ>ÃÃ]Ê>Ãʈ˜ÊŜÛiˆ˜}]ʜÛiÀ‡
…i>`ʅ>““iÀˆ˜}]ʜÀÊiÛi˜Ê>À“‡VÀ>˜Ž iÀ}œ“iÌÀÞ°
Rest Aerobic 2-arm curl, 2-leg
exercise heavy load press,
heavy load In Recovery

vÌiÀÊ>ÊLœÕÌʜvÊÃÕÃÌ>ˆ˜i`ʏˆ}…̇Ê̜ʓœ`iÀ>Ìi‡ˆ˜Ìi˜ÃˆÌÞÊiÝiÀVˆÃi]
Figure 10.6 œœ`Ê«ÀiÃÃÕÀiÊÀi뜘ÃiÊ`ÕÀˆ˜}ÊÀ…Þ̅“ˆVÊ>iÀœ‡
LˆVÊiÝiÀVˆÃiÊ>˜`ʅi>ÛÞÊÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}ʜvÊ>ÊÓ>Ê­>À“îÊ>˜` ÃÞÃ̜ˆVÊLœœ`Ê«ÀiÃÃÕÀiÊÌi“«œÀ>ÀˆÞÊ`iVÀi>ÃiÃÊLiœÜÊ«Ài‡iÝiÀVˆÃi
>À}iÊ­i}îʓÕÃViʓ>ÃðÊ/…iÊ̜«ÊœvÊi>V…ÊL>À Ài«ÀiÃi˜ÌÃÊÃÞÃ̜ˆV iÛiÃÊvœÀÊÕ«Ê̜ʣÓʅœÕÀÃʈ˜Ê˜œÀ“>Ê>˜`ʅޫiÀÌi˜ÃˆÛiÊÃÕLiVÌð
Lœœ`Ê«ÀiÃÃÕÀiÆÊ̅iÊLœÌ̜“ Ài«ÀiÃi˜ÌÃÊ`ˆ>Ã̜ˆVÊLœœ`Ê«ÀiÃÃÕÀi° *œœˆ˜}ʜvÊLœœ`ʈ˜Ê̅iÊۈÃViÀ>ÊœÀ}>˜ÃÊ>˜`ʏœÜiÀʏˆ“LÃ

Anterior view

Superior Aorta
vena cava

Pulmonary
artery Left main
coronary artery
Anterior Great cardiac vein
cardiac
veins
Anterior descending
Right branch of left
coronary coronary artery
artery Obstructed artery

Posterior view

Pulmonary
veins

Myocardial
infarction
Inferior
Coronary vena cava
sinus
Circumflex
branch of left
coronary artery
Left coronary
Descending Figure 10.7
˜ÌiÀˆœÀÊ>˜`Ê«œÃÌiÀˆœÀ
artery ۈiÜÃʜvÊ̅iÊVœÀœ˜>ÀÞÊVˆÀVՏ>̈œ˜]Ê܈̅
posterior branch
of right coronary >ÀÌiÀˆiÃÊÅ>`i`Ê`>ÀŽÊÀi` >˜`ÊÛiˆ˜Ã
artery
՘Å>`i`°Ê/…iʈ˜ÃiÌÊvˆ}ÕÀ ˆÕÃÌÀ>ÌiÃÊ>
“ÞœV>À`ˆ>Êˆ˜v>ÀV̈œ˜ÊÀiÃՏ̈˜}ÊvÀœ“Ê̅i
LœVŽ>}iÊ­œVVÕȜ˜®ÊœvÊ>ÊVœÀœ˜>ÀÞÊÛiÃÃi°
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Chapter 10 The Cardiovascular System and Exercise • 311

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«ÀiÃÃÕÀi°Ê/…ˆÃÊ …Þ«œÌi˜ÃˆÛiÊÀiVœÛiÀÞÊÀi뜘Ãi vÕÀ̅iÀÊÃÕ««œÀÌÃÊiÝiÀVˆÃiÊ>ÃÊ +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
>˜Êˆ“«œÀÌ>˜Ìʘœ˜«…>À“>Vœœ}ˆVʅޫiÀÌi˜Ãˆœ˜Ê̅iÀ>«Þ°Ê
Ê«œÌi˜Ìˆ>ÞÊivviV̈Ûi ˆÛiʜ˜iÊ«œÃÈLiÊiÝ«>˜>̈œ˜ÊvœÀÊ̅iÊ«œÃ̇
>««Àœ>V…ÊëÀi>`ÃÊÃiÛiÀ>ÊLœÕÌÃʜvʓœ`iÀ>ÌiÊ«…ÞÈV>Ê>V̈ۈÌÞÊ̅ÀœÕ}…œÕÌÊ̅iÊ`>Þ° iÝiÀVˆÃiʅޫœÌi˜ÃˆÛiÊÀi뜘Ãi°

THE HEART’S BLOOD SUPPLY

i>ÀÞÊÓäääÊ}>œ˜ÃʜvÊLœœ`ÊvœÜÊvÀœ“Ê̅iʅi>ÀÌÊi>V…Ê`>Þ]ÊLÕÌʘœ˜iʜvʈÌÃʜÝÞ
ÌÊÀiÃÌ]ʅœÜʓÕV…ÊœÝÞ}i˜ÊˆÃÊiÝÌÀ>VÌi`ÊvÀœ“
}i˜ÊœÀʘÕÌÀˆi˜ÌÃÊ«>ÃÃÊ`ˆÀiV̏ÞÊ̜Ê̅iʓޜV>À`ˆÕ“ÊvÀœ“Ê̅iʅi>À̽ÃÊV…>“LiÀð ̅iÊVœÀœ˜>ÀÞÊLœœ`ÊvœÜ
/…iʓޜV>À`ˆÕ“Ê“>ˆ˜Ì>ˆ˜ÃʈÌÃʜܘÊi>LœÀ>ÌiÊVˆÀVՏ>̜ÀÞÊÃÞÃÌi“°Ê Figure 10.7
ˆÕÃÌÀ>ÌiÃÊ̅iÃiÊÛiÃÃiÃÊ>ÃÊ>ÊۈÈLi]ÊVÀœÜ˜ˆŽiʘiÌܜÀŽ]Ê̅iÊ VœÀœ˜>ÀÞÊVˆÀVՏ>‡
̈œ˜] ̅>ÌÊ>ÀˆÃiÃÊvÀœ“Ê̅iÊ̜«Ê«œÀ̈œ˜ÊœvÊ̅iʅi>ÀÌ°
/…iʜ«i˜ˆ˜}ÃÊvœÀÊ̅iʏivÌÊ>˜`ÊÀˆ}…ÌÊVœÀœ˜>ÀÞÊ>ÀÌiÀˆiÃÊi“iÀ}iÊvÀœ“Ê̅iÊ>œÀÌ>
ÕÃÌÊ>LœÛiÊ̅iÊÃi“ˆÕ˜>ÀÊÛ>ÛiÃÊ܅iÀiʜÝÞ}i˜>Ìi`ÊLœœ`ʏi>ÛiÃÊ̅iʏivÌÊÛi˜ÌÀˆ‡ ˆÃÌÊÓÊv>V̜ÀÃÊ̅>Ìʈ˜VÀi>ÃiÊVœÀœ˜>ÀÞÊLœœ`
Vi°Ê/…iÊ>ÀÌiÀˆiÃÊ̅i˜ÊVÕÀÊ>ÀœÕ˜`Ê̅iʅi>À̽ÃÊÃÕÀv>ViÆÊ̅iÊÀˆ}…ÌÊVœÀœ˜>ÀÞÊ>ÀÌiÀÞ vœÜÊ`ÕÀˆ˜}Êۈ}œÀœÕÃÊiÝiÀVˆÃi
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`i˜ÃiÊV>«ˆ>ÀÞʘiÌܜÀŽÊ܈̅ˆ˜Ê̅iʓޜV>À`ˆÕ“°Ê œœ`ʏi>ÛiÃÊ̅iÊ̈ÃÃÕiÃʜvÊ̅i Ó°
ivÌÊÛi˜ÌÀˆViÊ̅ÀœÕ}…Ê̅iÊVœÀœ˜>ÀÞÊȘÕÃÆÊLœœ`ÊvÀœ“Ê̅iÊÀˆ}…ÌÊÛi˜ÌÀˆViÊi݈ÌÃ
̅ÀœÕ}…Ê̅iÊ>˜ÌiÀˆœÀÊV>À`ˆ>VÊÛiˆ˜ÃÊ>˜`Êi“«ÌˆiÃÊ`ˆÀiV̏Þʈ˜ÌœÊ̅iÊÀˆ}…ÌÊ>ÌÀˆÕ“°

Myocardial Oxygen Utilization

7ÀˆÌiÊ̅iÊiµÕ>̈œ˜ÊvœÀÊ̅iÊÀ>Ìi‡«ÀiÃÃÕÀi
"ÝÞ}i˜ÊṎˆâ>̈œ˜ÊLÞÊ̅iʅi>ÀÌʓÕÃViÊÀi“>ˆ˜Ãʅˆ}…ʈ˜ÊÀi>̈œ˜Ê̜ʈÌÃÊLœœ`Ê «Àœ`ÕVÌÊ­,**®°
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Lœœ`ÊvœÜˆ˜}ʈ˜Ê̅iÊVœÀœ˜>ÀÞÊÛiÃÃiÃ°Ê˜ÊVœ˜ÌÀ>ÃÌ]ʓœÃÌʜ̅iÀÊ̈ÃÃÕiÃÊÕÃiʜ˜
>LœÕÌÊÓx¯ÊœvÊ̅iÊLœœ`½ÃÊ>Û>ˆ>LiʜÝÞ}i˜Ê>ÌÊÀiÃÌ°Ê iV>ÕÃiʘi>À‡“>݈“>ÊœÝÞ}i˜
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312 • SECTION IV The Physiologic Support Systems

7…i˜Êi>V…ÊœvÊ̅iÃiÊv>V̜ÀÃʈ˜VÀi>ÃiÃÊ`ÕÀˆ˜}ÊiÝiÀVˆÃi]
…>˜}iÃʈ˜Ê…i>ÀÌÊÀ>ÌiÊ>˜`ÊLœœ`Ê«ÀiÃÃÕÀiÊVœ˜ÌÀˆLÕÌi
“ÞœV>À`ˆ>ÊLœœ`ÊvœÜÊ>`ÕÃÌÃÊ̜ÊL>>˜ViʜÝÞ}i˜ÊÃÕ««
܈̅Ê`i“>˜`°Ê/…iÊ«Àœ`ÕVÌʜvÊÃÞÃ̜ˆVÊLœœ`Ê«ÀiÃÃÕÀiÊ­- *Æ
“i>ÃÕÀi`Ê>ÌÊ̅iÊLÀ>V…ˆ>Ê>ÀÌiÀÞ®Ê>˜`Ê,Ê«ÀœÛˆ`iÃÊ>ÊVœ˜‡
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Part 2 Cardiovascular Regulation
>“iÊ̅iʅi>À̽Ãʺ«>Vi“>ŽiÀ°»
and Integration

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HEART RATE REGULATION

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Intrinsic Regulation &OR 9OUR )NFORMATION

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4(% !-!:).' (%!24
Here’s a straightforward calculation with an amazing answer about the heart.
“How many cars with 20-gallon capacity gas tanks would 60 years of resting cardiac out-
put fill up?” (Hint: Use an average resting cardiac output of 5 L ! min"1.)
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314 • SECTION IV The Physiologic Support Systems

Aorta

Superior
vena cava
.07
.04
.06 .09
SA node AV bundle .03 .07
(pacemaker) (bundle of His) .00
.16 .19 .22
.05
AV node .04

.07 .21
Purkinje .18
.19
fibers .17
.17
Inferior
Left bundle .21
vena cava .18
branch

Purkinje fibers Right bundle

branch

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Chapter 10 The Cardiovascular System and Exercise • 315

Atrial Depolarization
(P-wave)
P-R Interval Ventricular Depolarization
(QRS)
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R
QRS
ÊÌÀ>Vˆ˜}°
P
P
The depolarization of both atria is
represented by the P-wave. The
P-wave is the first ECG deflection.
Ventricular Repolarization
(S-T Segment)
°
S-T Segment
S-T
Earlier phase repolarization of both
ventricles extends from the end of
the QRS to the beginning of the
T-wave. The point at which the S-T
segment joins the QRS is known as
the J (junction)-point.
P-R Interval
P-R Interval
Electrical transmission from the atria
to the venticles. Includes the P-wave
and P-R Segment.
Ventricular Repolarization
(T-wave)
T
T T
The repolarization of both ventricles
is represented by the T-wave. The
S-T segment and the T-wave are
sensitive indicators of the oxygen
demand-oxygen supply status of
the ventricular myocardium.
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Q
S
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by the QRS complex. The R-wave is
the initial positive deflection; the
negative deflection before the R-wave
is the Q; the negative deflection after
the R-wave is the S-wave.
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and Repolarization ˆÃÌÊÓÊÕÃiÃÊvœÀÊ̅iÊ
(Q-T Interval)
QRS
£°
R
Ó°
Q
S
Includes the QRS complex, S-T
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The Autonomic Nervous System and &OR 9OUR )NFORMATION

Table 10.1
Cardiovascular Function (%!243 2%34 0%2)/$
-9*
/ /
Ê 1
*
,
-9*
/ /
Ê 1
The heart’s relatively long depolar-
ization period requires about 0.30
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316 • SECTION IV The Physiologic Support Systems

BOX 10.2 CLOSE UP

How to Place Electrodes for Bipolar and
12-Lead ECG Recordings

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Chapter 10 The Cardiovascular System and Exercise • 317

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318 • SECTION IV The Physiologic Support Systems

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baroreceptors

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eal ner ve
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aryng
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h
s sop
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G
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Chapter 10 The Cardiovascular System and Exercise • 319

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ÌiÃ̈˜}Ê>˜`ÊViÀ̈vˆV>̈œ˜Ê«Àœ}À>“ÃÊvœÀÊ>Êˆ˜ÌiÀiÃÌi`Ê«iÀܘíÜÜÜ°Ài`VÀœÃðœÀ}ÉÆ %#' /2 %+'
`i«ÌðÜ>ň˜}̜˜°i`Õɏi>À˜V«ÀÉ®°
ECG sometimes appears abbreviated
as EKG. The “K” comes from the
German spelling of the word for
BLOOD DISTRIBUTION electrocardiograph. In 1895, Dutch
physiologist Wilhelm Einthoven
Exercise Effects (1860–1927), 1924 Noble Prize win-
ner in Physiology or Medicine for his
˜VÀi>Ãi`Êi˜iÀ}ÞÊiÝ«i˜`ˆÌÕÀiÊÀiµÕˆÀiÃÊÀ>«ˆ`ÊÀi>`ÕÃ̓i˜ÌÃʈ˜ÊLœœ`ÊvœÜÊ̅> pioneering work in myocardial elec-
>vviVÌÊ̅iÊi˜ÌˆÀiÊV>À`ˆœÛ>ÃVՏ>ÀÊÃÞÃÌi“°ÊœÀÊiÝ>“«i]ʘiÀÛiÃÊ>˜`ʏœV>Ê“iÌ>LœˆV trophysiology, made the first tracings
Vœ˜`ˆÌˆœ˜ÃÊ>VÌʜ˜Ê̅iÊӜœÌ…Ê“ÕÃViÊL>˜`ÃʜvÊ>ÀÌiÀˆœiÊÜ>Ã]ÊV>ÕȘ}Ê̅i“Ê̜ of the heart’s electrical activity. He
>ÌiÀÊ̅iˆÀʈ˜ÌiÀ˜>Ê`ˆ>“iÌiÀÊ>“œÃÌʈ˜ÃÌ>˜Ì>˜iœÕÏްÊ
œ˜VÕÀÀi˜ÌÞ]ʘiÕÀ>ÊÃ̈“‡ used his invention of a 500-lb string
Տ>̈œ˜ÊœvÊÛi˜œÕÃÊV>«>VˆÌ>˜ViÊÛiÃÃiÃÊV>ÕÃiÃÊ̅i“Ê̜ʺÃ̈vvi˜]»Ê“œÛˆ˜}ÊLœœ` galvanometer consisting of a thin
vÀœ“Ê«iÀˆ«…iÀ>ÊÛiˆ˜Ãʈ˜ÌœÊ̅iÊVi˜ÌÀ>ÊVˆÀVՏ>̈œ˜° quartz wire in a magnetic field to
ÕÀˆ˜}ÊiÝiÀVˆÃi]Ê̅iÊÛ>ÃVՏ>ÀÊ«œÀ̈œ˜ÊœvÊ>V̈ÛiʓÕÃViÃʈ˜VÀi>ÃiÃÊ̅ÀœÕ}… record the heart’s electrical activity.
`ˆ>Ì>̈œ˜ÊœvʏœV>Ê>ÀÌiÀˆœiÃÆÊ>ÌÊ̅iÊÃ>“iÊ̈“i]ʜ̅iÀÊÛiÃÃiÃÊVœ˜ÃÌÀˆVÌÊ̜ʺÅÕÌ
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320 • SECTION IV The Physiologic Support Systems
BOX 10.3 CLOSE UP
Assessing Heart Rate by Palpation and Ascultation Methods
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v՘`>“i˜Ì>Ê̜œÊ̜ÊÃiÌÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞÊ>˜`Ê>ÃÃiÃÃ
V…>˜}iÃÊvÀœ“ÊiÝiÀVˆÃiÊÌÀ>ˆ˜ˆ˜}°ÊœÕÀʓi̅œ`ÃÊV>˜Ê“i>Ç
ÕÀiʅi>ÀÌÊÀ>Ìi\Ê­£®ÊLÞÊi>ÀÊ­>ÕÃVՏÌ>̈œ˜®]Ê­Ó®ÊLÞÊ̜ÕV… œÀÊV>ÀœÌˆ`Ê>ÀÌiÀˆiÃÊ܈̅Ê>Êvˆ˜}iÀʜÀʅ>˜`°Ê1ÃiÊ̅iÊ̈«ÊœvÊÌ
­«>«>̈œ˜®]ʭήÊ܈̅Ê>ʅi>ÀÌÊÀ>Ìiʓœ˜ˆÌœÀ]ʜÀÊ­{®Ê>˜Ê
 “ˆ``iÊ>˜`ʈ˜`iÝÊvˆ˜}iÀÃÆÊ`œÊ˜œÌÊÕÃiÊ̅iÊ̅ՓLÊLiV>ÕÃiʈ
ÀiVœÀ`iÀ°Ê/…iÊ>ÕÃVՏÌ>̈œ˜Ê>˜`Ê«>«>̈œ˜Ê“i̅œ`ÃÊ>Ài
«À>V̈V>Ê>˜`ÊÕÃivՏ°
HEART RATE BY THE
ASCULTATION METHOD
/…iÊ>ÕÃVՏÌ>̈œ˜Ê“i̅œ`ÊÕÃiÃÊ>ÊÃÌi̅œÃVœ«iÊ̜Ê>“«ˆvÞ
>˜`Ê`ˆÀiVÌÊÜ՘`ÊÜ>ÛiÃ]Ê̅ÕÃÊLÀˆ˜}ˆ˜}Ê̅iÊi>ÀʜvÊ̅iʏˆÃ‡
Ìi˜iÀÊVœÃiÀÊ̜Ê̅iÊÜ՘`ÊÜÕÀViÊ­…i>ÀÌ®°
Using the Stethoscope
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ˆ˜ÃiÀÌÊ̅i“Ê`ˆÀiV̏ÞÊ`œÜ˜Êi>V…Êi>ÀÊV>˜>°
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>ÀœÌˆ`Ê>ÀÌiÀÞ\ÊÕÃÌʏ>ÌiÀ>Ê̜Ê̅iʏ>ÀޘÝÊ­`œÊ˜œÌÊ>««Þ
ÃÕÀiÊޜÕÊV>˜Ê…i>ÀÊ̅iÊÜ՘`Ê>`iµÕ>ÌiÞ°
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̅iÊ«iV̜À>ˆÃʓ>œÀʓÕÃViʜÛiÀÊ̅iÊ̅ˆÀ`ʈ˜ÌiÀVœÃÌ>
ë>ViÊ̜Ê̅iʏivÌʜvÊ̅iÊÃÌiÀ˜Õ“°
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Ո`iÊ̜Ê*…ÞÈV>Ê
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*…ˆ>`i«…ˆ>\ʈ««ˆ˜VœÌÌÊ7ˆˆ>“ÃÊEÊ7ˆŽˆ˜Ã°®
HEART RATE BY PALPATION
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…
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Lœœ`ÊvœÜ°Ê
˜ >«ˆV>ÊLi>Ì ­ÛˆLÀ>̈œ˜Ê«ÕÃi®Ê}i˜iÀ>Ìi`ÊLÞ
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LiVœ“iÃÊ«Àœ“ˆ˜i˜Ìʈ““i`ˆ>ÌiÞÊvœœÜˆ˜}ÊiÝiÀVˆÃiʈ˜
i>˜Êˆ˜`ˆÛˆ`Õ>Ã°Ê*œÃˆÌˆœ˜Ê̅iÊi˜ÌˆÀiʅ>˜`ʜÛiÀÊ̅iʏivÌÊÈ`i
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Location for the Palpation Method
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LiœÜÊ̅iÊLiÞʜvÊ̅iÊLˆVi«ÃÊLÀ>V…ˆˆ]ÊÓÊ̜ÊÎÊV“Ê­£Êˆ˜®
>LœÛiÊ̅iÊ>˜ÌiVÕLˆÌ>ÊvœÃÃ>°
COUNTING HEART RATE
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Timed Heart Rate Method
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“Տ̈«ÞÊ̅iʫՏÃiÊVœÕ˜ÌÊLÞÊ{°ÊTable 1 «ÀiÃi˜ÌÃÊ̅iʅi>ÀÌ
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«Àœ`ÕViÃÊ̅iʏi>ÃÌÊ>VVÕÀ>ÌiʫՏÃiÊVœÕ˜Ì°
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Chapter 10 The Cardiovascular System and Exercise • 321

Table 1 Heart Rate (in beats per minute; bpm) Conversion. Find the Number of Pulse Counts for
6, 10, or 15 Seconds; Read Across for the bpm
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322 • SECTION IV The Physiologic Support Systems

BOX 10.3 CLOSE UP

Assessing Heart Rate by Palpation and Ascultation Methods ­
œ˜Ìˆ˜Õi`®

Thirty-Beat Heart Rate Method ,Ê­L«“®Ê! ÎäÊLÊ" ̈“iʭîÊ# ÈäÊÃÊ" £Ê“ˆ˜

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Table 2 Conversion Chart for 30-Beat Heart Rate Method

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Chapter 10 The Cardiovascular System and Exercise • 323

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INTEGRATED RESPONSE IN EXERCISE

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324 • SECTION IV The Physiologic Support Systems

Summary of Integrated Chemical, Neural, and Hormonal Adjustments Before

Table 10.2
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Chapter 10 The Cardiovascular System and Exercise • 325

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Part 3 Cardiovascular Dynamics

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During Exercise
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CARDIAC OUTPUT œœ`ÊvœÜÊvÀœ“Ê̅iʅi>ÀÌʈ˜VÀi>ÃiÃʈ

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326 • SECTION IV The Physiologic Support Systems

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328 • SECTION IV The Physiologic Support Systems
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>ʏ>À}iÀÊÃÌÀœŽiÊۜÕ“i°
Cardiovascular Drift: Reduced Stroke Volume
and Increased Heart Rate During Prolonged
Exercise -ÕL“>݈“>ÊiÝiÀVˆÃiÊvœÀʓœÀiÊ̅>˜Ê£xʓˆ˜‡
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Ài`ÕVˆ˜}Ê̅iʅi>À̽ÃÊÃÌÀœŽiÊۜÕ“i°
EXERCISE HEART RATE
Graded Exercise
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ň«Ê`iVÀi>ÃiÃÊVœ˜Ãˆ`iÀ>LÞÊvÀœ“Ê̅iÊÃÌÀœŽiÊۜÕ“i
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ˆ˜VÀi>ÃiÃÊ܈̅Ê>iÀœLˆVÊÌÀ>ˆ˜ˆ˜}°
Submaximum Exercise
i>ÀÌÊÀ>Ìiʈ˜VÀi>ÃiÃÊÀ>«ˆ`ÞÊ>˜`ʏiÛiÃʜvvÊ܈̅ˆ˜ÊÃiÛiÀ>
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ÊÃÕL‡
ÃiµÕi˜Ìʈ˜VÀi>Ãiʈ˜ÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞʈ˜VÀi>ÃiÃʅi>ÀÌÊÀ>Ìi
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200
180
160
Heart rate, b . min-1
140
120
100
80
60
1.0 2.0 3.0 4.0 5.0
Oxygen uptake, L . min-1
Figure 10.12 i˜iÀ>ˆâi`ÊÀi뜘ÃiÊvœÀʅi>ÀÌÊÀ>Ìiʈ˜ÊÀi>̈œ˜
̜ʜÝÞ}i˜ÊÕ«Ì>ŽiÊ`ÕÀˆ˜}ÊiÝiÀVˆÃiÊvœÀÊi˜`ÕÀ>˜Vi‡ÌÀ>ˆ˜i`ʈ˜`ˆÛˆ`‡
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̜Ê>V…ˆiÛiʅi>ÀÌÊÀ>ÌiÊÃÌ>Lˆˆâ>̈œ˜°
CARDIAC OUTPUT DISTRIBUTION
œœ`ÊvœÜÊ̜ÊëiVˆvˆVÊ̈ÃÃÕiÃʈ˜VÀi>ÃiÃʈ˜Ê«Àœ«œÀ̈œ˜Ê
̅iˆÀʓiÌ>LœˆVÊ>V̈ۈ̈ið
At Rest
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LÀ>ˆ˜]Ê>˜`ʜ̅iÀÊ̈ÃÃÕið
During Exercise
Figure 10.13B ˆÕÃÌÀ>ÌiÃÊ̅iÊ`ˆÃÌÀˆLṎœ˜ÊœvÊV>À`ˆ>VʜÕ̇
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Chapter 10 The Cardiovascular System and Exercise • 329

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330 • SECTION IV The Physiologic Support Systems

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30
26
CARDIAC OUTPUT AND
22
OXYGEN TRANSPORT
18
At Rest 14 Sedentary

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Maximum Cardiac Output and VO2max
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Chapter 10 The Cardiovascular System and Exercise • 331

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332 • SECTION IV The Physiologic Support Systems

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Chapter 10 The Cardiovascular System and Exercise • 333

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cise improves a muscle’s metabolic
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capacity in exercise. Local vascular
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muscle ultimately enhance its capacity
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ity of the active muscles.
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334 • SECTION IV The Physiologic Support Systems

S E L E C T E D R E F E R E N C E S


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The
C h a p t e r
11
Neuromuscular
System and
Exercise
CHAPTER OBJECTIVES

• Identify the major structural components of the central • Draw and label a skeletal muscle fiber’s ultrastructural
nervous system that control human movement. components.

• Diagram the anterior motoneuron and discuss its role • Describe the sequence of chemical and mechanical
in human movement. events during skeletal muscle contraction and
relaxation.
• Draw and label the basic components of a reflex arc.

• Define motor unit, neuromuscular junction, autonomic
nervous system, excitatory postsynaptic potential, and
inhibitory postsynaptic potential.
• Explain factors associated with neuromuscular fatigue.
• Contrast slow- and fast-twitch muscle fiber
characteristics including subdivisions.
• Outline muscle fiber-type distribution patterns among
diverse groups of elite athletes.

• Describe the function of muscle spindles and Golgi • Explain how exercise training modifies muscle fibers
and fiber types.
tendon organs.

337
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338 • SECTION IV The Physiologic Support Systems
Part 1 Neural Control of
Human Movement
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Chapter 11 The Neuromuscular System and Exercise • 339

Peripheral Central
Nervous Nervous
Brain System System

So m
at
ic
s
Skin

en
sor
Spinal cord fib

y
er

Visceral se
nsor
y fiber

r
Cardio- r fibe
vascular m oto
tic ber
Sympathe to r fi
Vertebral c mo
ti
column he
pat
Parasym

ic
at
om

m s
te o f
Muscle er
Spinal nerve ib
rf s
Moto us sy
nervo

Nervous System

Central Nervous System (CNS) Peripheral Nervous System (PNS)

• Brain (including retinas) • Cranial nerves III—XII
• Spinal cord • Spinal nerves
• Integrative/control centers

Afferent Division (sensory) Efferent Division (motor)

• Somatic and visceral neurons • Motor neurons
• Conducts impulses from • Conducts impulses from the
receptors to CNS CNS to effectors

Autonomic Nervous System Somatic Nervous System

• Involuntary • Voluntary
• Conducts impulses from the CNS • Conducts impulses from the CNS
to cardiac muscle, smooth to skeletal muscles
muscles, and glands

Sympathetic Parasympathetic

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340 • SECTION IV The Physiologic Support Systems

A
Diencephalon

Telencephalon

Thalamus

Epithalamus

Midbrain Cerebellum

Pons Medulla oblongata

Spinal cord

B Longitudinal
fissure

Motor
cortex
Central sulcus

Sensory
cortex

Left Right
hemisphere hemisphere
C
Frontal lobe Parietal lobe
Motor cortex
Sensory cortex
Taste area
Occipital lobe

Vestibular area

Auditory area Visual area

Cerebellum
Temporal lobe

Figure 11.2 ­
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342 • SECTION IV The Physiologic Support Systems

A B Spinal Cord Ventral View

Cerebrum White Gray Dorsal
Dorsal root matter matter root
Cerebellum ganglion
Spinal
Lower brainstem nerve
(medulla)

Peripheral Motor
nerves unit 2

Impulse
Spinal cord Motor
Motoneuron unit 1
axon Ventral
root

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at neuromuscular
junctions
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C
Spinal cord
Spinous
Nerve root process

Spinal cord

Superior articular Vertebral

process foramen
Intervertebral
disc

Spinal
nerve

Vertebral
Lumbar vertebrae body
Cervical vertebra
Figure 11.3 ­
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Chapter 11 The Neuromuscular System and Exercise • 343

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Autonomic Reflex Arc

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ÃÌÀiÌV…°Ê/…iʺŽ˜ii‡iÀŽ»ÊÀi>V̈œ˜Êœ˜ÞÊÌ>ŽiÃÊ>ÊviÜʓˆˆÃiVœ˜`ÃÊLiV>ÕÃiÊ̅iÊÌÀˆ}‡ The finger contains 120 motor units
}iÀi`ʈ“«ÕÃiʅ>ÃÊ̜ʓ>ŽiÊ>ÊÀiÌÕÀ˜ÊÌÀˆ«Êۈ>Ê̅iÊ눘>ÊVœÀ`Ê܈̅œÕÌÊ}œˆ˜}Ê̜Ê̅i that control 41,000 muscle fibers. In
LÀ>ˆ˜°Ê
Ê`i>ÞʜÀÊ>LÃi˜ViʜvÊ̅iÊÃÌÀiÌV…ÊÀiviÝÊV>˜Êˆ˜`ˆV>ÌiÊ«œÃÈLiʘiÕÀœœ}ˆ contrast, the medial gastrocnemius
œÀʘiÕÀœ“ÕÃVՏ>ÀÊ`ÞÃv՘V̈œ˜Ê̜Ê눘>Ê˜iÀÛiÃÊ>˜`Ê̅iˆÀʈ˜˜iÀÛ>̈œ˜ÃʜÀ muscle (calf ) has 580 motor units that
ˆ˜ÕÀˆiÃÊ̜Ê̅iʎ˜iiÊ>˜`ʏi}°Ê˜Ê>Ê«œÞÃޘ>«ÌˆVÊÀiviÝÊ>ÀVÊ̅iʘiÀÛiÃÊÃޘ>«Ãiʈ innervate 1,030,000 fibers. The ratio
̅iÊVœÀ`Ê̅ÀœÕ}…ʈ˜ÌiÀ˜iÕÀœ˜ÃÊ̅>ÌÊ`ˆÃÌÀˆLÕÌiʈ˜vœÀ“>̈œ˜Ê̜ÊÛ>ÀˆœÕÃÊVœÀ`ʏiۇ of muscle fibers per motor unit aver-
iÃ°Ê/…iʈ“«ÕÃiÊ̅i˜Ê«>ÃÃiÃʜÛiÀÊ̅iʓœÌœÀÊÀœœÌÊ«>̅Ü>ÞÊ̅ÀœÕ}…Ê>˜ÌiÀˆœÀ ages 340 for finger muscles and 1800
“œÌœ˜iÕÀœ˜ÃÊ̜Ê̅iÊivviV̜ÀʜÀ}>˜° for the gastrocnemius muscle.
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Sympathetic division Parasympathetic division

Dilates Constricts
pupil pupil

Inhibits Stimulates
salvation salvation

Relaxes Constricts
Cranial Constricts airways airways Cranial
blood vessels

Cervical Cervical

Accelerates Slows
heartbeat heartbeat

Thoracic Stimulates Thoracic

Inhibits Stimulates
secretion by digestion digestion
sweat glands

Celiac
ganglion Stimulates gall
bladder to
release bile

Stimulates
glucose pro-
Lumbar duction and Lumbar
release

Sacral Sacral
Stimulates Dilates blood
secretion of vessels in gut
epinephrine and
norepinephrine

Noradrenergic neurons

Stimulates urinary Postganglionic

Relaxes urinary
Inferior bladder to contract
bladder Cholinergic neurons
mesenteric
ganglion Preganglionic
Postganglionic
Stimulates Stimulates penile
ejaculation erection

Comparison of effects of sympathetic and parasympathetic activation on end organs

End organ Sympathetic effects Parasympathetic effects

Skeletal muscle Increase blood flow Decrease blood flow
Ventilation Increase Decrease
Sweat glands Increase perspiration No effect
Heart Increase force and contraction rate Decrease force and contraction rate
GI tract motility Decrease Increase
Eyes Dilate pupils Constrict pupils
Secretion of digestive juices Decrease Increase
Blood pressure Increase mean pressure Decrease mean pressure
Airways Increase diameter Decrease diameter

Figure 11.4 /…iÊÃޓ«>̅ïVÊ>˜`Ê«>À>Ãޓ«>̅ïVÊ`ˆÛˆÃˆœ˜ÃʜvÊ̅iÊ>Õ̜˜œ“ˆVʘiÀۜÕÃÊÃÞÃÌi“\ÊVœ“«>ÀˆÃœ˜ÃʜvÊivviVÌÃʜvÊ>V̈Û>̈œ˜

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V>Ì>LœˆVÊivviVÌÃÊ̅>ÌÊ«Ài«>ÀiÊ̅iÊLœ`ÞÊ̜ʺvˆ}…̻ʜÀʺvii]»Ê>˜`Ê«>À>Ãޓ«>̅ïVÊÃ̈“Տ>̈œ˜Ê«Àœ`ÕViÃÊ>˜>LœˆVÊÀi뜘ÃiÃÊ̅>ÌÊ œ“œÌi
˜œÀ“>Êv՘V̈œ˜Ê>˜`ÊVœ˜ÃiÀÛiÊi˜iÀ}Þ°Ê­œ`ˆvˆi`ÊvÀœ“Ê i>À]Ê°°]ÊiÌÊ>°\ iÕÀœÃVˆi˜Vi\Ê Ý«œÀˆ˜}Ê̅iÊ À>ˆ˜]ÊÎÀ`Êi`°Ê >Ìˆ“œÀi\
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344
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Chapter 11 The Neuromuscular System and Exercise • 345

White
Dorsal horn
Ventral horn +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
matter
Sensory neuron Gray À>ÜÊ>˜`ʏ>LiÊ>ÊÌÞ«ˆV>Ê>Õ̜˜œ“ˆVÊÀivi
(afferent fiber) matter
>ÀVʈ˜Ê̅iÊ눘>ÊVœÀ`°Ê
Muscle
spindle
Extensor
muscles
Alpha
Synapse
motor neuron
(efferent fiber)
ÀˆivÞÊ`iÃVÀˆLiÊ̅iʓ>ˆ˜Ê`ˆvviÀi˜Vi
LiÌÜii˜Ê>Êȓ«iÊ>˜`ÊVœ“«iÝÊ눘>
Tendon ÀiviÝ

Leg
extension

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>˜`ʓœÌœÀʜÕÌ«ÕÌ]ʈ˜VÕ`ˆ˜}Ê̅iÊÀiviÝÊ>V̈œ˜ÊÕÃÌÊ`iÃVÀˆLi`]ÊiÝ«>ˆ˜Ê…œÜÊ̅
…>˜`Ê܈̅`À>ÜÃÊvÀœ“Ê̅iʅœÌʜLiVÌÊ LivœÀi ̅iÊ«iÀܘʫiÀViˆÛiÃÊ«>ˆ˜°Ê,ivi
>V̈œ˜Ãʈ˜Ê̅iÊ눘>ÊVœÀ`Ê>˜`ʜ̅iÀÊÃÕLVœ˜ÃVˆœÕÃÊ>Ài>ÃʜvÊ̅iÊ
-ÊVœ˜ÌÀœ
“>˜ÞʓÕÃViÊv՘V̈œ˜Ã°Ê/…iÃiÊÀiviÝÊ>V̈œ˜ÃÊiÛi˜Êœ«iÀ>ÌiÊvœÀÊ«iœ«iÊ܅œÊ…>Û
…>`Ê̅iˆÀÊ눘>ÊVœÀ`ÃÊÃiÛiÀi`Ê>LœÛiÊ̅iʏiÛiÊÀiµÕˆÀi`ÊvœÀÊ̅iÊÀiviÝ
&OR 9OUR )NFORMATION
Complex Reflexes 490%3 /& -/4/.%52/.3
The large diameters of anterior

œ“«iÝÊ눘>ÊÀiviÝiÃÊ̅>Ìʈ˜ÛœÛiʓՏ̈«iÊÃޘ>«ÃiÃÊ>˜`ʓÕÃViÊ}ÀœÕ«ÃÊ>Ã
motoneurons, termed type A ! fibers,
i݈ÃÌ°Ê
œ˜Ãˆ`iÀÊ̅iÊÈÌÕ>̈œ˜ÊœvÊÃÌi««ˆ˜}ʜ˜Ê>ÊÌ>VŽÊ܈̅Ê̅iʏivÌÊvœœÌ°Ê
“œÃÌ
range between 8 and 20 "m (1 "m #
ȓՏÌ>˜iœÕÏÞÊ>ÃÊ̅iÊÌ>VŽÊ«ˆiÀViÃÊ̅iÊΈ˜]Ê̅iÊÀˆ}…Ìʏi}ÊÃÌÀ>ˆ}…Ìi˜ÃÊ̜ÊÀi“œÛi
one-millionth [0.000001] of a meter).
Üiˆ}…ÌÊvÀœ“Ê̅iʈ˜ÕÀi`ÊvœœÌ]Ê܅ˆV…ʏˆvÌÃʜvvÊ̅iÊ}ÀœÕ˜`°ÊFigure 11.6 ˆÕÃÌÀ>ÌiÃ
Diameters of other smaller type A
̅iʘiÕÀ>Ê>˜`ʓœÌœÀÊ«>̅Ü>ÞÃÊ>V̈Û>Ìi`ʈ˜Ê̅ˆÃÊVœ“«iÝÊ>V̈œ˜]ÊÌiÀ“i`Ê̅i
fibers ($ efferent motoneurons) do not
VÀœÃÃi`‡iÝÌi˜ÃœÀÊÀiviÝ ˆ˜Ê̅iÊvœœÜˆ˜}ÊvˆÛi‡ÃÌi«ÊÃiµÕi˜Vi\
exceed 10 "m. Their conduction
-Ìi«Ê£°Ê/…iÊÌ>VŽÊÃ̈“Տ>ÌiÃÊ«>ˆ˜ÊÀiVi«ÌœÀÃʈ˜Ê̅iÊΈ˜°Ê/…iÊÀiVi«ÌœÀà velocities equal about half of ! fibers.
ÌÀ>˜Ã“ˆÌÊ̅iʓiÃÃ>}iÊ̜Ê̅iÊ눘>ÊVœÀ`Êۈ>Ê̅iÊÃi˜ÃœÀÞʘiÀÛi° $ Efferent fibers connect with propri-
-Ìi«ÊÓ°Ê-i˜ÃœÀÞʘiÕÀœ˜ÃÊLÀ>˜V…Ê̜Êi>V…ÊÈ`iʜvÊ̅iÊVœÀ`Ê̜Ê>V̈Û>Ìi oreceptors (special stretch sensors) in
ˆ˜ÌiÀ˜iÕÀœ˜Ãʈ˜Ê̅iÊ}À>Þʓ>ÌÌiÀ° skeletal muscle to detect minute
-Ìi«ÊΰʘÌiÀ˜iÕÀœ˜ÃÊÃޘ>«ÃiÊ܈̅ʓœÌœ˜iÕÀœ˜Ã]ʈ˜˜iÀÛ>̈˜}ÊLœÌ…Êviݜ changes in muscle fiber length.
>˜`ÊiÝÌi˜ÃœÀʓÕÃViÃʈ˜Êi>V…ʏi}°
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346 • SECTION IV The Physiologic Support Systems

Crossed-Extensor Reflex
Extensor Flexor Interneurons Flexor Extensor
(relaxation) (contraction) (contraction) (relaxation)
To brain

+ +

+
+

+ Stimulation
Inhibition

Tack pierces left foot, Right leg extended

left leg withdrawn
Figure 11.6
ÀœÃÃi`‡iÝÌi˜ÃœÀÊÀiviÝʈ˜ÊLœÌ…ʏi}ÃÊÀi«ÀiÃi˜ÌÃÊ>ʓœÀiÊVœ“«iÝÊÀiviÝÊ܈̅ʓՏ̈«iÊÃޘ>«ÃiÃÊ>˜`ʓÕÃViÊ}ÀœÕ«

-Ìi«Ê{°Ê˜…ˆLˆÌˆœ˜Ê>˜`ÊÃ̈“Տ>̈œ˜ÊœvÊ>««Àœ«Àˆ>Ìiʏi}
viݜÀÊ>˜`ÊiÝÌi˜ÃœÀʓÕÃViÃÊV>ÕÃiÊVœ˜VÕÀÀi˜ÌÊÀ>«ˆ
iÝÌi˜Ãˆœ˜ÊœvÊ̅iÊ՘ˆ˜ÕÀi`ʏˆ“LÊ>˜`Êvi݈œ˜ÊÌ
Ài“œÛiÊ̅iʈ˜ÕÀi`ʏˆ“L°
-Ìi«Êx°Ê˜ÌiÀ˜iÕÀœ˜ÊVœ˜˜iV̈œ˜ÃÊȓՏÌ>˜iœÕÏÞ
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>««Àœ«Àˆ>ÌiÊÃi˜ÃœÀÞÊ>Ài>ÃʜvÊ̅iÊLÀ>ˆ˜Ê܅iÀiÊ̅i
«>ˆ˜ÊˆÃʺviÌ°»
Learned Reflexes /…iʎ˜ii‡iÀŽÊ>˜`ÊVÀœÃÃi`‡iÝÌi˜‡
ÜÀÊÀiviÝiÃʜVVÕÀÊ>Õ̜“>̈V>ÞÊ>˜`ÊÀiµÕˆÀiʘœÊi>À˜ˆ˜}
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>ÃʓœÃÌÊëœÀÌÃÊ«iÀvœÀ“>˜ViÃÊ>˜`ʜVVÕ«>̈œ˜>ÊÌ>ÎðÊ
œ˜‡ vˆÀÃÌÊÈʈ˜V…iÃʜvÊ̅iÊÌ>Ži>Ü>Þʈ˜Ê̅iÊL>VŽÃ܈˜}°Ê-iÌ̈˜}ÊÕ
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ܜÀ`Ê̜ÊÌÞ«iʈ˜ˆÌˆ>ÌiÃÊ>ÊÃiÀˆiÃʜvÊÀ>«ˆ`ʅ>˜`Ê>˜`Êvˆ˜}i
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“ÕÃÌÊ«À>V̈ViÊVœÀÀiVÌÊÃ܈˜}ʓiV…>˜ˆVÃÊ՘`iÀÊ̅iÊÜ>ÌV…vՏ
iÞiʜvÊ>ÊÌÀ>ˆ˜i`Ê«ÀœviÃȜ˜>]ʈ`i>ÞÊ܈̅Êۈ`iœÊvii`L>VŽ°
/…iÊ>`>}iʺ«À>V̈Viʓ>ŽiÃÊ«iÀviVÌ»ÊŜՏ`ÊLiÊ>“i˜`i`Ê̜
º«iÀviVÌÊ«À>V̈Viʏi>`ÃÊ̜ʓœÀiÊ«iÀviVÌÊ«iÀvœÀ“>˜Vi°»
Nerve Supply to Muscle /…iÊÌiÀ“ˆ˜>ÊLÀ>˜V…iÃʜv
œ˜iʘiÕÀœ˜Êˆ˜˜iÀÛ>ÌiÊ>Ìʏi>ÃÌʜ˜iʜvÊ̅iÊLœ`Þ½ÃÊ>««ÀœÝˆ“>ÌiÞ
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Chapter 11 The Neuromuscular System and Exercise • 347

Óxäʓˆˆœ˜Ê“ÕÃViÊvˆLiÀðÊ
LœÕÌÊ{Óä]äääʓœÌœÀʘiÀÛiÃÊi݈ÃÌÊÞiÌÊ>ÊȘ}iʘiÀÛ
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+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
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}ÀœÕ«Ê“ÕÃViÃ]ÊvœÀÊiÝ>“«i]Ê̅iʵÕ>`ÀˆVi«ÃÊ܈̅ÊvœÕÀÊÃi«>À>ÌiʓÕÃViÃÊ>VÌʈ˜ÊVœ˜‡ Ài>ÌiÃÊ̜Ê>ʓÕÃVi½ÃÊ«>À̈VՏ>ÀÊ
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iÃVÀˆLiÊ>˜Ê>˜ÌiÀˆœÀʓœÌœ˜iÕÀœ˜°

THE MOTOR UNIT

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“œÛi“i˜Ì°Ê
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}iʓœÌœ˜iÕÀœ˜Ê>˜`ʈÌÃÊVœ“«œÃˆÌiʓÕÃViÊvˆLiÀà “Þiˆ˜ÊÅi>̅°
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Motor Unit Anatomy

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348 • SECTION IV The Physiologic Support Systems

Alpha motoneuron
(cell body)

Dendrites Nerve
trunk

Axon Bare
hillock axon
Motor unit

Direction of
propagation of
action potential.

Nerve
fibers

Node of
Ranvier
Vein
Terminal Motor Artery
branches endplate

Impulse

Neurilemma
Myelin
sheath

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Chapter 11 The Neuromuscular System and Exercise • 349

Action
potential
Axon

Sarcolplasm of Synaptic vesicles

muscle fiber containing acetylcholine

Mitochondrion
Synaptic knob
Sarcolemma

Presynaptic
membrane
T tubule Postsynaptic
Sarcoplasmic membrane Neuromuscular
reticulum Synaptic cleft junction

Myofibril
Ionic concentrations (mM • L–1)
across neuron membrane
Ion Extracellular Intracellular
Sodium (Na+) 150 15
Chloride (Cl–) 110 10
Potassium (K+) 5 150

Myofilament

Figure 11.8 ˆVÀœ>˜>̜“ÞʜvÊ̅iʘiÕÀœ“ÕÃVՏ>Àʍ՘V̈œ˜]ʈ˜VÕ`ˆ˜}Ê`iÌ>ˆÃʜvÊ̅iÊ«ÀiÃޘ>«ÌˆVÊ>˜`Ê«œÃÌÃޘ>«ÌˆVÊVœ˜Ì>VÌÊ>Ài>ÊLiÌÜii˜

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350 • SECTION IV The Physiologic Support Systems

Table 11.1 Characteristics and Correspondence Between Motor Units and Muscle Fiber Types
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Motor Unit Physiology
Identifying Muscle Fibers with Motor Units

Ê܅œiʓÕÃViÊVœ˜Ì>ˆ˜Ãʓ>˜ÞÊ«œÃÈLiʓœÌœÀÊ՘ˆÌÃÊ
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Chapter 11 The Neuromuscular System and Exercise • 351

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50 g 100% Skeletal muscle

0
100 msec 2 4 6 60 min
Twitch Rate of fatigue

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20 g
100% Fast glycolytic
fibers
0
100 msec 2 4 6 60 min
Twitch Rate of fatigue

Slow (S) Fast oxidative

glycolytic fibers
50 g 100%
0
200 msec 2 4 6 60 min
Twitch Rate of fatigue

Slow
oxidative
fibers
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vœÀViÊÀiµÕˆÀi“i˜ÌÃʈ˜VÀi>Ãi°Ê-ÕÃÌ>ˆ˜i`]ÊÃÕL“>݈“>Êœ}‡
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>VVœ“«>˜ˆi`ÊLÞÊ>˜ÊœLiV̈ÛiÞʓi>ÃÕÀi`Ê`iVˆ˜iʈ˜
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̅iÊv>Ã̇Ì܈ÌV…Êv>̈}>LiÊ՘ˆÌÃÊ>ÌÊ«i>ŽÊvœÀVi°
ˆ˜`ˆV>ÌiÃÊ̅>ÌÊv>ˆÕÀiʈ˜Ê˜iÕÀ>ÊœÀʓޜ˜iÕÀ>ÊÌÀ>˜Ã“ˆÃ‡
/…iÊ`ˆvviÀi˜Ìˆ>ÊVœ˜ÌÀœÊœvÊ̅iʓœÌœÀÊ՘ˆÌÊvˆÀˆ˜}Ê«>ÌÌiÀ
Ȝ˜Ê«Àœ`ÕViÃÊv>̈}Õiʈ˜Ê>V̈ۈ̈iÃÊ̅>Ìʈ˜ÛœÛiʓ>݈“>
`ˆÃ̈˜}ՈÅiÃÊëiVˆvˆVÊ>̅ïVÊ}ÀœÕ«ÃÊ>˜`ÊΈi`ÊvÀœ
ivvœÀÌʓÕÃViÊ>V̈œ˜Ã°
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>ÞÊ`i“œ˜ÃÌÀ>ÌiÊ>ÊÃޘV…Àœ˜œÕÃÊ«>ÌÌiÀ˜ÊœvʓœÌœÀ‡Õ˜ˆÌÊvˆÀ
ˆ˜}Ê­ˆ°i°]ʓ>˜ÞʓœÌœÀÊ՘ˆÌÃÊÀiVÀՈÌi`ÊȓՏÌ>˜iœÕÏÞ
`ÕÀˆ˜}Ê>ʏˆvÌ®°Ê
˜`ÕÀ>˜ViÊ>̅iÌiÃÊ}i˜iÀ>ÞÊi݅ˆLˆÌÊ>˜Ê>Ãޘ‡ PROPRIOCEPTORS IN MUSCLES,
V…Àœ˜œÕÃÊvˆÀˆ˜}Ê«>ÌÌiÀ˜Ê­ˆ°i°]ÊܓiʓœÌœÀÊ՘ˆÌÃÊvˆÀiÊ܅ˆ JOINTS, AND TENDONS
œÌ…iÀÃÊÀiVœÛiÀ®°Ê/…iÊÃޘV…Àœ˜œÕÃÊvˆÀˆ˜}ʜvÊv>Ã̇Ì܈ÌV
“œÌœÀÊ՘ˆÌÃÊ>œÜÃÊ̅iÊÜiˆ}…ÌʏˆvÌiÀÊ̜Ê}i˜iÀ>Ìiʅˆ}…ÊvœÀVi ÕÃViÃ]ʍœˆ˜ÌÃ]Ê>˜`ÊÌi˜`œ˜ÃÊVœ˜Ì>ˆ˜ÊëiVˆ>ˆâi`ÊÃi˜ÃœÀÞ
µÕˆVŽÞÊvœÀÊ̅iÊ`iÈÀi`ʏˆv̰ʘÊVœ˜ÌÀ>ÃÌ]ÊvœÀÊi˜`ÕÀ>˜ViÊ>̅‡ ÀiVi«ÌœÀÃÊÃi˜ÃˆÌˆÛiÊ̜ÊÃÌÀiÌV…]ÊÌi˜Ãˆœ˜]Ê>˜`Ê«ÀiÃÃÕÀi°Ê/…iÃi
iÌiÃ]Ê̅iÊ>ÃޘV…Àœ˜œÕÃÊvˆÀˆ˜}ʜvÊ«Ài`œ“ˆ˜>˜ÌÞÊÏœÜ «Àœ«ÀˆœVi«ÌœÀ i˜`ʜÀ}>˜ÃÊ>“œÃÌʈ˜ÃÌ>˜Ì>˜iœÕÏÞÊÀi>Þ
7 Ç£ä‡V££ÚÎÎLJÎÇÈ°µÝ`ÊʙɣÈÉ£äÊÊÈ\äÇ*ÊÊ*>}iÊÎxÎÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

Chapter 11 The Neuromuscular System and Exercise • 353

VÀˆÌˆV>Êˆ˜vœÀ“>̈œ˜Ê>LœÕÌʓÕÃVՏ>ÀÊ`ޘ>“ˆVÃ]ʏˆ“LÊ«œÃˆÌˆœ˜]Ê>˜`ʎˆ˜iÃ̅iÈ>
>˜`Ê«Àœ«ÀˆœVi«Ìˆœ˜Ê̜ÊVœ˜ÃVˆœÕÃÊ>˜`ÊÃÕLVœ˜ÃVˆœÕÃÊ«œÀ̈œ˜ÃʜvÊ̅iÊVi˜ÌÀ>Ê˜iÀۇ
+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
œÕÃÊÃÞÃÌi“°Ê*Àœ«ÀˆœVi«Ìˆœ˜Ê>œÜÃÊVœ˜Ìˆ˜Õ>Ê“œ˜ˆÌœÀˆ˜}ʜvÊ̅iÊ«Àœ}ÀiÃÃʜvÊ>˜Þ ÀˆivÞÊ`iÃVÀˆLiÊ̅iÊ>`Û>˜Ì>}iʜvÊÃiiV̈Û
“œÛi“i˜ÌʜÀÊÃiµÕi˜ViʜvʓœÛi“i˜ÌÃÊ>˜`ÊÃiÀÛiÃÊ>ÃÊ̅iÊL>ÈÃÊvœÀʓœ`ˆvވ˜}ÊÃÕL‡ “œÌœÀÊÀiVÀՈ̓i˜Ì°
ÃiµÕi˜ÌʓœÌœÀÊ>V̈œ˜Ã°Ê˜`ˆÛˆ`Õ>ÃÊ܈̅ÊV…Àœ˜ˆVʏœÜÊL>VŽÊ«>ˆ˜]ʜÀʈ˜`ˆÛˆ`Õ>Ã
܅œÊ…>ÛiÊ՘`iÀ}œ˜iÊÃÕVViÃÃvՏʏœÜÊL>VŽÊÃÕÀ}iÀÞ]ʜvÌi˜ÊÌi“«œÀ>ÀˆÞʏœÃiÊvՏ
«Àœ«ÀˆœVi«Ìˆœ˜Êˆ˜Ê̅iÊ>˜ŽiÃ]Ê«Ài`ˆÃ«œÃˆ˜}Ê̅i“Ê̜ʫœÃÈLiÊL>>˜ViʈÃÃÕiÃÊ­i°}°]
>˜Êˆ˜>LˆˆÌÞÊ̜Êi>ȏÞÊL>>˜ViÊ܈̅Ê̅iÊiÞiÃʜ«i˜ÊœÀÊVœÃi`ʜ˜Êœ˜iʏi}Ê܈̅œÕÌ
ÃÜ>ވ˜}ÊvœÀʓœÀiÊ̅>˜ÊÎÊ̜ÊxÊî°
iÃVÀˆLiÊ̅iʓ>œÀÊv>V̜À­Ã®Ê̅>Ì
Muscle Spindles `ˆÃ̈˜}ՈÅiÃÊ>ÊΈi`ÊvÀœ“Ê>˜Ê՘Έi`
ˆ˜`ˆÛˆ`Õ>°
ÕÃViÊ눘`ià «ÀœÛˆ`iʓiV…>˜œÃi˜ÃœÀÞʈ˜vœÀ“>̈œ˜Ê>LœÕÌÊV…>˜}iÃʈ˜Ê“ÕÃViÊvˆLi
i˜}̅Ê>˜`ÊÌi˜Ãˆœ˜ °Ê/…iÞÊ«Àˆ“>ÀˆÞÊÀi뜘`Ê̜ʓÕÃViÊÃÌÀiÌV…Ê̅ÀœÕ}…ÊÀivi
>V̈œ˜ÊLÞʈ˜ˆÌˆ>̈˜}Ê>ÊÃÌÀœ˜}iÀʓÕÃViÊ>V̈œ˜Ê̜ÊVœÕ˜ÌiÀ>VÌÊ̅iÊÃÌÀiÌV…°

Structural Organization Figure 11.10 A–C ˆÕÃÌÀ>ÌiÃÊ̅iÊ}i˜iÀ>ÊœV>‡

̈œ˜ÊœvÊ̅iÊvÕÈvœÀ“‡Ã…>«i`ʓÕÃViÊ눘`iÊ>ÌÌ>V…i`ʈ˜Ê«>À>iÊ̜ÊÀi}Տ>ÀʓÕÃVi
vˆLiÀÃÊ­V>i`ÊiÝÌÀ>vÕÃ>ÊvˆLiÀ ®Ê>˜`Êœ}ˆÊÌi˜`œ˜Êi˜`ʜÀ}>˜Ã°
˜ÞÊiœ˜}>̈œ˜Êœv
̅iʓÕÃViÊÃÌÀiÌV…iÃÊ̅iÊ눘`i°Ê/…iʘՓLiÀʜvÊ눘`iÃÊ«iÀÊ}À>“ÊœvʓÕÃVi
Û>ÀˆiÃÊ`i«i˜`ˆ˜}ʜ˜Ê̅iʓÕÃViÊ}ÀœÕ«°ÊœÀiÊ눘`iÃÊi݈ÃÌʈ˜Ê“ÕÃViÃÊ̅>ÌÊÀœÕ‡
̈˜iÞÊ«iÀvœÀ“ÊVœ“«iÝʓœÛi“i˜ÌðÊ/…iÊ눘`iÊVœ˜Ì>ˆ˜ÃÊÌܜÊÌÞ«iÃʜvÊëiVˆ>‡
ˆâi`ÊvˆLiÀÃÊ܈̅ÊVœ˜ÌÀ>V̈iÊV>«>LˆˆÌˆiÃÊV>i`ˆ˜ÌÀ>vÕÃ>ÊvˆLiÀÃ

Sensory neurons Gamma motoneuron

Peripheral nerve to contractile end of
to central, noncontractile
A (motor and sensory B muscle spindle
nerve fibers) portion of muscle spindle
Alpha motoneuron
to muscle fibers

Individual Muscle
skeletal spindle Skeletal
muscle muscle
fiber
Golgi tendon
organ

Bone

Tendon

Sensory
neuron

Tendon (collagen)
connects bone
to muscle Golgi tendon
organ

Figure 11.10 ­
®Êi˜iÀ>ÊœV>̈œ˜ÊœvʓÕÃViÊ눘`iÃÊ>˜`Êœ}ˆÊÌi˜`œ˜Êi˜`ʜÀ}>˜Ã°Ê­ ®ÊÕÃViÊ눘`iÊÃÕÀÀœÕ˜`i`ÊLÞÊÎiiÌ>

“ÕÃViÊvˆLiÀðÊ/ܜÊÌÞ«iÃʜvÊÃi˜ÃœÀÞʘiÕÀœ˜Ãʈ˜˜iÀÛ>ÌiÊ̅iÊ눘`i½ÃÊVi˜ÌÀ>Ê«œÀ̈œ˜\Ê­£®Êv>Ã̇>`>«Ìˆ˜}ʘiÕÀœ˜ÃÊ܈̅ÊëˆÀ>Êi˜`ˆ}ÃÊ
>˜`Ê­Ó®ÊϜ܇>`>«Ìˆ˜}ʘiÕÀœ˜ÃÊ܈̅ÊLÀ>˜V…i`Êi˜`ˆ˜}ðÊ! “œÌœ˜iÕÀœ˜Ãʈ˜˜iÀÛ>ÌiÊ̅iÊVœ˜ÌÀ>V̈iÊi˜`ÃʜvʓÕÃViÊ눘`iÊViÃ]Ê>˜`Ê
"‡“œÌœ˜iÕÀœ˜ÃÊ>V̈Û>ÌiÊÎiiÌ>Ê“ÕÃViÊViÃ°Ê­
®Ê-œÜ‡>`>«Ìˆ˜}ÊÃi˜ÃœÀÞʘiÕÀœ˜Ãʈ˜˜iÀÛ>ÌiÊœ}ˆÊÌi˜`œ˜ÊœÀ}>˜ÃÊ­ÃiiÊ>ÃœÊˆ}°Ê££°£Ó®°
7 Ç£ä‡V££ÚÎÎLJÎÇÈ°µÝ`ÊʙɣÈÉ£äÊÊÈ\äÇ*ÊÊ*>}iÊÎx{Ê7 ǣ䇘`ÚÈnx‡È™n°µÝ`

354 • SECTION IV The Physiologic Support Systems

BOX 11.1 CLOSE UP

Proprioceptive Neuromuscular Facilitation Stretching

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LÞÊ«>ÃÈÛiÊ>ÃÈÃÌ>˜ViÊvÀœ“Ê>˜œÌ…iÀÊ«iÀܘʜÀÊ`iۈViÊ`ÕÀ‡
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>ÃÈÃÌ>˜ViÊvÀœ“Ê>˜œÌ…iÀÊ«iÀܘÊ>ÃÊ̅iÊÃi}“i˜ÌʓœÛiÃ
̅ÀœÕ}…ʈÌÃʘœÀ“>ÊÀ>˜}iʜvʓœÌˆœ˜ÊQ,"R®]Ê >V̈Ûi ­>
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ˆ˜ÛiÀÃiÊÃÌÀiÌV…ÊÀiviÝʈ˜`ÕViÃÊÀi>Ý>̈œ˜Êˆ˜Ê>ʓÕÃV
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ÃÌÀiÌV…®°
PROPRIOCEPTIVE NEUROMUSCULAR
FACILITATION STRETCHING
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Chapter 11 The Neuromuscular System and Exercise • 355

GUIDELINES FOR PROPER STRETCHING USING PNF

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356 • SECTION IV The Physiologic Support Systems
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Inhibitory
interneuron
Capsule
Sensory
fiber
Collagen
fibrils
Golgi tendon organ
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Chapter 11 The Neuromuscular System and Exercise • 357

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Pacinian Corpuscles VœÀ«ÕÃViö

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iiVÌÀˆV>ÞÊȏi˜ÌʜÀ
&OR 9OUR )NFORMATION
`ˆÃV…>À}iÊ>˜œÌ…iÀÊۜ‡ #!-),,/ '/,')
iÞʜvʈ“«ÕÃiÃÊ܅i˜ In 1878, Camillo Golgi (1843–1926), an Italian neurohistochemist, discovered the minute tendon
̅iÊÃ̈“ՏÕÃÊVi>Ãið organs that now bear his name using a silver nitrate stain described in his masterful text, On the Fine
*>Vˆ˜ˆ>˜ÊVœÀ«ÕÃVià Anatomy of the Nervous System. Golgi received the Nobel Prize in Physiology or Medicine in 1906 with
`iÌiVÌÊ V…>˜}ià ˆ˜ Santiago Ramón y Cajal (1852–1934) for their insightful contributions about the structures of the
“œÛi“i˜ÌʜÀÊ«ÀiÃÃÕÀi nervous system. One of Golgi’s greatest contributions was his creative method of staining individual
À>̅iÀÊ̅>˜Ê̅iʓ>}˜ˆ‡ nerve and cell structures using a weak solution of silver nitrate. This invaluable method traced the tiny
ÌÕ`iʜvʓœÛi“i˜ÌʜÀ processes and intricate structures of cells (nobelprize.org/nobel_prizes/medicine/laureates/
̅iʵÕ>˜ÌˆÌÞʜvÊ«ÀiÇ 1906/golgi-bio.html).
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358 • SECTION IV The Physiologic Support Systems

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Part 2 Muscular System:
Organization and
Activation
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vœÀ“iÀÃʈ˜Ê`ˆvviÀi˜ÌÊëœÀÌð
COMPARISON OF SKELETAL,
CARDIAC, AND SMOOTH MUSCLE
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Chapter 11 The Neuromuscular System and Exercise • 359

Table 11.2 Characteristics of the Three Types of Human Muscle

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360 • SECTION IV The Physiologic Support Systems

Bone

Tendon

Muscle
belly

Epimysium
(deep fascia)

Perimysium

Endomysium
(between fibers)
Capillary Fasciculus

Endomysium

Sarcoplasm

Single Nuclei
muscle fiber

Sarcolemma
A

Myofibrils Mitochondrion A band I band Z line

Sarcolemma Terminal Transverse Sarcoplasmic Nucleus

cisternae tubule reticulum

Triad of
B the reticulum

Figure 11.12
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Chapter 11 The Neuromuscular System and Exercise • 367

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368 • SECTION IV The Physiologic Support Systems

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Chapter 11 The Neuromuscular System and Exercise • 369

2 ACh
Muscle action potential
depolarizes transverse
tubules at the A-I junction
of the sarcomere.
1
Sac-like vesicles within
the terminal axon release
ACh. ACh diffuses across
the synaptic cleft and
attaches to specialized
ACh receptors on the
sarcolemma.
ACh
receptor

Wave of Synaptic
depolarization vesicles

T tubule

3
Depolarization of T-tubule Synaptic
system causes Ca2+ release cleft
Sarcoplasmic from the sarcoplasmic
reticulum reticulum’s lateral sacs ACh

4 Troponin Myosin 9
Ca2+ binds to troponin- complex binding sites Ca2+ removal restores
tropomyosin in the actin Actin inhibitory action of
filaments. This releases filament troponin—tropomyosin. In
the inhibition that pre- the presence of ATP, actin
vented actin from combin- Myosin and myosin remain in the
ing with myosin. filament dissociated relaxed state.

5 8
During muscle action, When muscle stimulation
actin combines with ceases, Ca2+ moves back
myosin ATPase to split ATP into the sarcoplasmic
with energy release. Myosin reticulum’s lateral sacs
Tension created from the ATPase through active transport
energy release produces requiring ATP hydrolysis.
myosin crossbridge move- Crossbridge ADP ATP

ment. movement

6 7
ATP binds to the myosin Crossbridge activation
crossbridge, breaking the continues when the
actin—myosin bond concentration of Ca2+
allowing the crossbridge remains high (from
to dissociate from actin. Crossbridge membrane depolarization)
This leads to sliding of ATP ATP
dissociates to inhibit action of the
thick and thin filaments, troponin—tropomyosin
causing muscle shortening. complex.

Figure 11.21 -V…i“>̈VÊۈiÜʜvÊ̅iʘˆ˜iʓ>ˆ˜ÊiÛi˜ÌÃʈ˜Ê“ÕÃViÊVœ˜ÌÀ>V̈œ˜Ê>˜`ÊÀi>Ý>̈œ˜°Ê ՓLiÀÃÊVœÀÀi뜘`Ê̜Ê̅iÊÃiµÕi˜Vi

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370 • SECTION IV The Physiologic Support Systems

BOX 11.2 CLOSE UP

Histochemical Staining Assays to Assess Muscle Fiber Types

A B C
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Slow-Twitch Muscle Fibers

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Muscle Fiber Type Differences
The following 10 multimedia video animations present many aspects of
Among Athletic Groups
muscle action processes. These videos, produced by students for students,
-iÛiÀ>Êˆ˜ÌiÀiÃ̈˜}ʜLÃiÀÛ>̈œ˜ÃÊi“iÀ}i are complementary to our presentation of muscle action dynamics.
Vœ˜ViÀ˜ˆ˜}ʓÕÃViÊvˆLiÀÊÌÞ«iÊÛ>Àˆ>̈œ 1. www.youtube.com/watch?v!iMD7wNhWdc8&feature!related
>“œ˜}ʈ˜`ˆÛˆ`Õ>ÃÊ>˜`ÊëœÀÌÊV>Ìi}œÀˆià 2. www.youtube.com/watch?v!zC0cd45W0oI&feature!related
>˜`Ê̅iÊ«œÃÈLiʈ˜vÕi˜ViʜvÊëiVˆvˆVÊiÝi 3. www.youtube.com/watch?v!FdV4_PBSVy0&feature!related
VˆÃiÊÌÀ>ˆ˜ˆ˜}ʜ˜ÊvˆLiÀÊVœ“«œÃˆÌˆœ˜Ê>˜ 4. www.youtube.com/watch?v!ren_IQPOhJc&feature!related
“iÌ>LœˆVÊV>«>VˆÌÞ°Ê"˜Ê>ÛiÀ>}i]ÊÃi`i˜Ì>ÀÞ 5. www.youtube.com/watch?v!IZjZAutXzbw&feature!related
V…ˆ`Ài˜Ê>˜`Ê>`ՏÌÃÊ«œÃÃiÃÃÊ>LœÕÌÊxä¯ 6. www.youtube.com/watch?v!EdHzKYDxrKc&feature!related
Ϝ܇Ì܈ÌV…ÊvˆLiÀðÊ/…iÊ«iÀVi˜Ì>}iʜvÊv>ÃÌ 7. www.youtube.com/watch?v!WRxsOMenNQM&feature!related
Ì܈ÌV…ÊvˆLiÀÃÊ«ÀœL>LÞÊ`ˆÃÌÀˆLÕÌiÃÊiµÕ> 8. www.youtube.com/watch?v!InIha7bCTjM&feature!related
LiÌÜii˜ÊÃÕL`ˆÛˆÃˆœ˜Ã]ÊÞiÌÊvˆLiÀ‡ÌÞ«iÊ`ˆÃÌÀˆ 9. www.youtube.com/watch?v!DFDhq4KPVBE&feature!related
LṎœ˜ÊÛ>ÀˆiÃÊVœ˜Ãˆ`iÀ>LÞÊ>“œ˜}ʈ˜`ˆÛˆ`‡ 10. www.youtube.com/watch?v!BCUVDE_Bng8&feature!related
Õ>Ã°Êi˜iÀ>Þ]ʜ˜i½ÃʓÕÃViÊvˆLiÀ‡ÌÞ«

Table 11.3 Classification of Human Skeletal Muscle Fiber Types

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372 • SECTION IV The Physiologic Support Systems

Syringe (generates
A B suction)

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“needle” guilotene
Plunger

C D

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II x

II c II c

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Chapter 11 The Neuromuscular System and Exercise • 373

Muscle fiber composition Maximal oxygen consumption &OR 9OUR )NFORMATION

(% ST fibers) (mL . kg-1 . min-1)
100 80 60 40 20 0 20 40 60 80 100 2)'/2 -/24)3
Cross-country skiing Muscles become stiff and rigid about
Long-distance running 3 hours after death, a condition
Canoeing termed rigor mortis (Latin mors, mor-
Trained nonathletes
tis meaning “of death”). This occurs
Swimming
because ATP no longer functions in
Trained students
Weight lifting
the membrane of the sarcoplasmic
Alpine skiing reticulum to pump calcium ions into
Wrestling the terminal cisternae. When Ca!!
Ice hockey diffuses from a higher concentration
Running 100—200 m in the terminal cisternae and extracel-
lular fluid to an area of lower concen-
tration in the sarcomere, it binds with
troponin to allow crossbridging
Figure 11.23 ÕÃViÊvˆLiÀÊVœ“«œÃˆÌˆœ˜Ê­«iÀVi˜ÌÊϜ܇Ì܈ÌV…ÊvˆLiÀà ivÌÊÈ`i®Ê>˜`
“>݈“>ÊœÝÞ}i˜ÊÕ«Ì>ŽiÊ­Àˆ}…ÌÊÈ`i®Êˆ˜Ê>̅iÌiÃÊÀi«ÀiÃi˜Ìˆ˜}Ê`ˆvviÀi˜ÌÊëœÀÌðÊ/…iʜÕÌiÀ between the actin and myosin
ˆ}…̏ÞÊÅ>`i`ÊL>ÀÃÊ`i˜œÌiÊ̅iÊÀ>˜}i°Ê­œ“Ê iÀ}…]Ê1°]ÊiÌÊ>°\Ê>݈“>ÊœÝÞ}i˜ÊÕ«Ì>Ži proteins. In essence, without ATP,
>˜`ʓÕÃViÊvˆLiÀÊÌÞ«iÃʈ˜ÊÌÀ>ˆ˜i`Ê>˜`Ê՘ÌÀ>ˆ˜i`ʅՓ>˜Ã°i`°Ê-Vˆ°Ê-«œÀÌÃ]Ê£ä\£x£] the myosin crossbridges and actin
£™Çn°® remain attached so the muscle cannot
return to a relaxed state.

܅œÊ…>ÛiÊ>V…ˆiÛi`Ê«Àœ“ˆ˜i˜Viʈ˜Ê>ÊëiVˆvˆ
ëœÀÌÊV>Ìi}œÀÞ°Ê,i}>À`iÃÃʜvÊ«iÀvœÀ“>˜ViÊÃÌ>ÌÕÃ] &OR 9OUR )NFORMATION
“ÕÃViÊvˆLiÀÊVœ“«œÃˆÌˆœ˜Ê`œiÃʘœÌÊiÝVÕÈÛi -53#,% &)"%2 42!).).' 30%#)&)#)49
`iÌiÀ“ˆ˜iÊÃÕVViÃðÊ7ˆÌ…ˆ˜Ê}ÀœÕ«ÃʜvÊÌÀ>ˆ˜i`ʜÀ
Why do some highly trained athletes who switch to a sport requiring
՘ÌÀ>ˆ˜i`ʈ˜`ˆÛˆ`Õ>Ã]ʎ˜œÜi`}iʜvÊ«Ài`œ“ˆ‡
different muscle groups feel essentially untrained for the new activity?
˜>˜ÌÊvˆLiÀÊÌÞ«iÊ«ÀœÛˆ`iÃʏˆ“ˆÌi`ÊÛ>Õiʈ˜Ê«Ài`ˆVÌ
The answer is fairly straightforward—only the specific fibers activated
ˆ˜}Ê«iÀvœÀ“>˜ViʜÕÌVœ“i°Ê
V…ˆiÛi“i˜ÌÊ`i«i˜`Ã
in training adapt metabolically and physiologically to the specific exer-
œ˜Ê>ÊLi˜`ˆ˜}ʜvʓ>˜ÞÊ«…ÞȜœ}ˆV]ÊLˆœV…i“ˆV>]
cise regimen. Thus, swimmers or canoeists do not necessarily transfer
˜iÕÀœœ}ˆV]Ê>˜`ÊLˆœ“iV…>˜ˆV>ÊÃÕ««œÀÌÊÃÞÃÌi“Ã
their upper-body “fitness” to a running sport unless they specifically
>˜`ʘœÌÊȓ«Þʜ˜Ê>ÊȘ}iÊv>V̜ÀÊÃÕV…Ê>ÃʓÕÃVi
train the muscles required for that sport.
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374 • SECTION IV The Physiologic Support Systems

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376 • SECTION IV The Physiologic Support Systems

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C h a p t e r
12
Hormones,
Exercise,
and Training
CHAPTER OBJECTIVES

• Draw the location of the major endocrine glands within
an outline of the human body.
• Describe how hormones alter cellular reaction rates of
specific target cells.
• Describe how hormonal, humoral, and neural factors
stimulate endocrine glands.
• List the hormones of the pancreas’ ! and " cells, their
functions, and how acute and chronic physical activity
affects their release.
• Define type 1 and type 2 diabetes mellitus and give
three differences between these two diabetes
subdivisions.

• List the hormones secreted by the anterior and • List five risk factors for type 2 diabetes.
posterior pituitary glands and explain how acute and • Outline the benefits of regular physical activity for a
chronic physical activity affects their release. type 2 diabetic.

• List the thyroid gland hormones, their functions, and
how acute and chronic physical activity affects their
release.
• List the hormones of the adrenal medulla and adrenal
cortex, their functions, and how acute and chronic
physical activity affects their release.
• Explain the general effects of exercise training on
endocrine function.
• Characterize the functions of opioid peptides, their
response to physical activity, and possible role in the
“exercise high.”

377
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378 • SECTION IV The Physiologic Support Systems

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ENDOCRINE SYSTEM OVERVIEW
Figure 12.1 ŜÜÃÊ̅iʏœV>̈œ˜ÊœvÊ̅iʓ>œÀÊi˜`œVÀˆ˜i
Hypothalamus
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Location

Hypothalamus
Pineal gland
Posterior pituitary
Anterior pituitary
Thyroid
Parathyroid glands Kidney Receptor
Thymus

Pituitary
Heart endocrine cells
Liver
Adrenal medulla
Adrenal cortex
Kidney
Hormone molecules
Stomach and
small intestine
Pancreas

Skin

Adipose tissue
Testes (male)
Ovaries (female)
Placenta
(pregnant Target cell with
females only) hormone binding
to receptor
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Chapter 12 Hormones, Exercise, and Training • 379

Table 12.1 Endocrine Organs and Their Secretions


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380 • SECTION IV The Physiologic Support Systems

Table 12.1 Endocrine Organs and Their Secretions (Continued )


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̅>>“ˆV “ˆŽÊiiV̈œ˜ÊLÞÊ
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>iÃ\Ê՘Ž˜œÜ˜Ê
v՘V̈œ˜

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Lœœ`ÊÛiÃÃiÊ­>ÀÌiÀˆœiîÊ
Vœ˜ÃÌÀˆV̈œ˜

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vi“>i® *i«Ìˆ`i
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Chapter 12 Hormones, Exercise, and Training • 381

Table 12.1 Endocrine Organs and Their Secretions (Continued )


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˜ÌiÀˆœÀÊ«ˆÌՈÌ>ÀÞ ˜…ˆLˆÌÃÊ-ÊÃiVÀ

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̅ޓœ«œˆï˜ >˜`Êv՘V̈œ˜ÊœvÊ/Ê
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+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
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Vœ˜ÌÀ>ÃÌ]ÊVœ˜Ì>ˆ˜ÊÃiVÀi̜ÀÞÊ`ÕVÌÃÊ̅>Ìʏi>`Ê`ˆÀiV̏ÞÊ̜Ê̅iÊëiVˆvˆVÊVœ“«>À̓i˜ i˜`œVÀˆ˜iÊÃÞÃÌi“°
œÀÊÃÕÀv>ViÊ̅>ÌÊÀiµÕˆÀiÃÊ̅iʅœÀ“œ˜i°Ê/…iʘiÀۜÕÃÊÃÞÃÌi“ÊVœ˜ÌÀœÃʓœÃÌ £°
iݜVÀˆ˜iÊ}>˜`ð

What Makes a Chemical a Hormone? Ó°

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˜

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ÃÕ}}iÃÌÊ̅>ÌÊ̅ˆÃʓ>ÞÊLiÊ̜œÊLÀœ>`Ê>Ê`ivˆ˜ˆÌˆœ˜ÊLiV>ÕÃiʓ>˜ÞÊ`ˆvviÀi˜Ìʘœ˜
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Must Hormones Be Transported to Distant Targets? *…ÞȜœ‡

}ˆÃÌÃʅ>ÛiʵÕiÃ̈œ˜i`Ê܅i̅iÀÊ>ÊV…i“ˆV>Ê“ÕÃÌÊLiÊÌÀ>˜Ã«œÀÌi`Ê̜Ê`ˆÃÌ>˜ÌÊÌ>À}iÌÃ
̜ÊV>ÃÈvÞÊ>ÃÊ>ʅœÀ“œ˜i°ÊœÀÊiÝ>“«i]Ê̅iÊ`ˆvviÀi˜ÌʅޫœÌ…>>“ˆV‡Ài}Տ>̈˜}
&OR 9OUR )NFORMATION
…œÀ“œ˜iÃ]Ê̅iÊÌÀœ«…ˆVÊV…i“ˆV>Ê“iÃÃi˜}iÀÃÊ̅>Ìʈ˜VÕ`iÊÀii>Ș}Ê>˜`ÊÀii>Ãi‡ 3-!,, "54 #2)4)#!,
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…œÀ“œ˜iÊV>ÃÈvˆV>̈œ˜ combined, they weigh only about
0.5 kg. Endocrine hormone secre-
Hormones Exert Effects at Low Concentrations 7ˆÌ…Ê̅iÊ`ˆÃ‡ tions occur in minute amounts,
VœÛiÀÞʜvʘiÜÊÈ}˜>Ê“œiVՏiÃÊ>˜`ÊÀiVi«ÌœÀÃ]Ê̅iÊLœÕ˜`>ÀÞÊLiÌÜii˜Ê…œÀ“œ˜i measured in micrograms ("g; 10!6 g),
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ivviV̈ÛiÊVœ˜Vi˜ÌÀ>̈œ˜Ã°Ê
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382 • SECTION IV The Physiologic Support Systems
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Table 12.2 and Receptor-Ligand Binding, and Target Organ Response for the Peptide, Steroid,
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Chapter 12 Hormones, Exercise, and Training • 383

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ΰ
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Hormone Effects on Enzymes
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Hormone–receptor binding serves
i˜âޓi‡“i`ˆ>Ìi`ʓi“LÀ>˜iÊÌÀ>˜Ã«œÀÌÊVœ˜Ã̈ÌÕÌiÊ̅iʓ>œÀʓiV…>˜ˆÃ“ÃʜvʅœÀ“œ˜i
as the first step in initiating hormone
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action. The extent of a target cell’s
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1. Hormone concentration in the
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blood
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2. Number of target cell receptors
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384 • SECTION IV The Physiologic Support Systems
Control of Hormone Secretion
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Figure 12.3 Տ̈«iÊÃ̈“ՏˆÊvœÀʈ˜ÃՏˆ˜ÊÃiVÀ°Ê˜ÃՏˆ˜ ivviV̈Ûi˜iÃðʏÕV>}œ˜Ê>˜`Ê}ÀœÜ̅ʅœÀ“œ˜iÊ­®]
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Chapter 12 Hormones, Exercise, and Training • 385

PATTERNS OF HORMONE RELEASE &OR 9OUR )NFORMATION

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Àii>ÃiÊ>ÌÊÀi}Տ>Àʈ˜ÌiÀÛ>ÃÊ`ÕÀˆ˜}Ê>ÊÓ{‡…œÕÀÊVÞVi]ÊÀiviÀÀi`Ê̜Ê>ÃÊ`ˆÕÀ˜>ÊÛ>Àˆ>‡ Caffeine augments cyclic-AMP activ-
̈œ˜°Ê-œ“iÊÃiVÀi̜ÀÞÊVÞViÃÊë>˜ÊÃiÛiÀ>ÊÜiiŽÃ]Ê>˜`ʜ̅iÀÃÊvœœÜÊ`>ˆÞÊVÞVið ity in fat cells; cyclic-AMP activates
/…iÃiÊVÞVˆ˜}Ê«>ÌÌiÀ˜ÃÊ`œÊ˜œÌʍÕÃÌÊ«iÀÌ>ˆ˜Ê̜ʜ˜iÊV>Ìi}œÀÞʜvʅœÀ“œ˜ið hormone-sensitive lipases to promote

ÃÃiÃȘ}ʫՏÃ>̈iʅœÀ“œ˜iÊÀii>ÃiÊ«>ÌÌiÀ˜ÃÊÀiÛi>Ãʈ˜vœÀ“>̈œ˜Ê˜œÌÊ>Û>ˆ‡ lipolysis and release free fatty acids
>LiÊvÀœ“Ê>ÊȘ}iÊLœœ`ÊÃ>“«i°Ê*>ÌÌiÀ˜ÃʜvÊÀii>ÃiÊ>˜`Ê>“«ˆÌÕ`iÊ>˜`ÊvÀi‡ into the plasma. Increased plasma
µÕi˜VÞʜvÊ`ˆÃV…>À}iÊ«ÀœÛˆ`iʓœÀiʓi>˜ˆ˜}vՏʈ˜vœÀ“>̈œ˜Ê>LœÕÌʅœÀ“œ˜i free fatty acid levels stimulate fat oxi-
`ޘ>“ˆVÃÊ̅>˜Ê>ʅœÀ“œ˜i½ÃÊVœ˜Vi˜ÌÀ>̈œ˜ÊiÝ>“ˆ˜i`Ê>ÌÊ>ÊȘ}iÊ̈“iÊ«iÀˆœ`° dation, thus conserving liver and
muscle glycogen.

RESTING AND EXERCISE-INDUCED

ENDOCRINE SECRETIONS
&OR 9OUR )NFORMATION
/…iÊvœœÜˆ˜}ÊÃiV̈œ˜ÃÊÀiۈiÜʈ“«œÀÌ>˜ÌʅœÀ“œ˜iÃ]Ê̅iˆÀÊv՘V̈œ˜ÃÊ`ÕÀˆ˜}ÊÀiÃÌ
>˜`ÊiÝiÀVˆÃi]Ê>˜`ÊëiVˆvˆVʅœÃÌq}>˜`q…œÀ“œ˜iÊÀi뜘ÃiÃÊ̜ÊiÝiÀVˆÃiÊÌÀ>ˆ˜ˆ˜} 4!2'%4 #%,, !#4)6!4)/.
The activation of a target cell by
hormone–receptor interaction
ANTERIOR PITUITARY HORMONES depends on three factors:
1. Blood levels of the specific
Figure 12.4 ŜÜÃÊ̅iÊ«ˆÌՈÌ>ÀÞÊ}>˜` ­…Þ«œ«…ÞÈî]ʈÌÃÊÃiVÀÃÊ>˜`ÊÛ>ÀˆœÕà hormone
Ì>À}iÌÊ}>˜`Ã]Ê>˜`Ê̅iˆÀÊÀiëiV̈ÛiʅœÀ“œ˜iÊÃiVÀðÊ/…iÊ«ˆÌՈÌ>ÀÞÊ}>˜`Ê 2. Relative number of target cell
Vœ˜ÃˆÃÌÃʜvÊ`ˆÃ̈˜VÌÊ>˜ÌiÀˆœÀÊ>˜`Ê«œÃÌiÀˆœÀʏœLiÃÊi>V…Ê܈̅Ê`ˆvviÀi˜ÌʅœÀ“œ˜i receptors for that hormone
ÃiVÀðÊ/…iÊ}>˜`Ê>ÌÌ>V…iÃÊ̜Ê̅iʅޫœÌ…>>“ÕÃÊLÞʘiÕÀ>Êii“i˜ÌÃÊ 3. Affinity or strength of the union
̅>Ìʈ˜˜iÀÛ>ÌiÊ̅iÊ«œÃÌiÀˆœÀÊ«ˆÌՈÌ>ÀÞ°Ê/…ˆÃʘiÀÛiÊL՘`iÊ­ …Þ«œ«…ÞÃi>ÊÃÌ>Ž® between hormone and receptor
ÃiÀÛiÃÊ>ÃÊ>ÊVœ˜`ՈÌÊvœÀʅœÀ“œ˜iʓœÛi“i˜ÌÊvÀœ“ʈÌÃÊÈÌiʜvÊÃޘ̅iÈÃʈ˜Ê̅i

Target and Non-endocrine

Hypothalamic Anterior pituitary
hormones they targets
hormones hormones
secrete
Hypothalamus
PRH PROLACTIN Breast
Infundibulum
TRH TSH Thyroid gland Different tissues
PROLACTIN
Posterior pituitary
Thyroid hormones
Anterior pituitary
CRH ACTH Adrenal cortex Different tissues

Cortisol

GHRH GH Liver Different tissues

IGFs
GnRH FSH Endocrine cells Different tissues
LH of gonads Germ cells
of gonads

Male: androgen
Female: estrogen,
progesterone

The hypothalamus secretes releasing and inhibiting hormones that act on endocrine cells of the anterior pituitary to influence the secretion
of their six hormones (in column two). Anterior pituitary hormones act on additional endocrine glands or directly on target cells.
PRH = prolactin-releasing hormone; TRH = thyrotropin-releasing hormone; CRH = corticotropin-releasing hormone; GHRH = growth
hormone-releasing hormone; GnRH = gonadotropin-releasing hormone; TSH = thyroid-stimulating hormone (thyrotropin);
ACTH = adrenocorticotropic hormone (corticotropin); GH = growth hormone; FSH = follicle-stimulating hormone;
LH = luteinizing hormone; IGFs = insulin-like growth factors

Figure 12.4 /…iÊ«ˆÌՈÌ>ÀÞÊ}>˜`]ʈÌÃÊÃiVÀÃÊ>˜`ÊÛ>ÀˆœÕÃÊÌ>À}iÌÊ}>˜`ÃÊ>˜`Ê̅iˆÀʅœÀ“œ˜iÊÃiVÀð

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386 • SECTION IV The Physiologic Support Systems

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ÈÝÊ`ˆvviÀi˜ÌÊ«œÞ«i«Ìˆ`iʅœÀ“œ˜iÃÊ>˜`ʈ˜vÕi˜ViÃÊ̅ Փ>˜Ê}ÀœÜ̅ʅœÀ“œ˜iÊ­œÀÊܓ>̜ÌÀœ«ˆ˜®Ê«Àœ“œÌiÃ
ÃiVÀʜvÊÃiÛiÀ>ÊœÌ…iÀð ViÊ`ˆÛˆÃˆœ˜Ê>˜`Ê«ÀœˆviÀ>̈œ˜Ê̅ÀœÕ}…œÕÌÊ̅iÊLœ`Þ°Ê/…ˆÃ
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LÀi>ÃÌÊ>˜`ÊÕÌiÀÕÃÊ̜ÊÃ̈“Տ>ÌiʓˆŽÊ«Àœ`ÕV̈œ˜Ê>˜`ʈ˜`ÕVi “i“LÀ>˜iÃ
>LœÀÊ>˜`Ê`iˆÛiÀÞ]Ê>˜`ÊÛ>Ü«ÀiÃȘʭ>˜Ìˆ`ˆÕÀïVʅœÀ“œ˜i Ó° -̈“Տ>̈˜}Ê,
ÊvœÀ“>̈œ˜
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R®]Ê܅ˆV…Ê>VÌÃʜ˜Ê̅iʎˆ`˜iÞÃÊ̜Ê`iVÀi>ÃiÊÕÀˆ˜iʜÕ̇ ΰ
V̈Û>̈˜}ÊViÕ>ÀÊÀˆLœÃœ“iÃÊ̅>Ìʈ˜VÀi>ÃiÊ«ÀœÌiˆ˜
«ÕÌÊ>˜`ÊVœ˜ÌÀœÊvÕˆ`ÊL>>˜Vi Ãޘ̅iÈÃ

Hypothalamus

Inhibits GHRH Secretes GHRH,

release GHIH, or somatostatin

Feedback Stimulates
control GHIH release

Inhibits
GH synthesis
and release Anterior
pituitary

Growth hormone

Indirect actions
Liver and Direct actions
(promote
other organs (anti-insulin)
anabolism)

Somatomedins

Skeletal Nonskeletal Adipose

effects effects tissue
Hinders glucose
uptake to
maintain blood
Increases Increases synthesis Triacylglycerol sugar level
formation of protein and new release
of cartilage cell growth

Promotes
skeletal
growth

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Chapter 12 Hormones, Exercise, and Training • 387

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Ó°
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…œÀ“œ˜ið ΰ

Exercise, Growth Hormone, and Tissue Synthesis ÊÃiVÀ

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Thyrotropin
/…ÞÀœÌÀœ«ˆ˜ ­Ì…ÞÀœˆ`‡Ã̈“Տ>̈˜}ʅœÀ“œ˜i Q/-R®Ê“>ˆ˜Ì>ˆ˜ÃÊ}ÀœÜ̅Ê>˜`Ê̅އ
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&OR 9OUR )NFORMATION
ViÃ°Ê/…iÊ̅ÞÀœˆ`Ê}>˜`Ê«>ÞÃÊ>˜Êˆ“«œÀÌ>˜ÌÊÀœiʈ˜ÊVœ˜ÌÀœˆ˜}ÊViÕ>ÀʓiÌ>Lœ‡ 4(% 425% -!34%2 ',!.$
ˆÃ“°Ê*…ÞÈV>Ê>V̈ۈÌÞÊÕÃÕ>Þʈ˜VÀi>ÃiÃÊ>˜ÌiÀˆœÀÊ«ˆÌՈÌ>ÀÞÊ/-ʜÕÌ«ÕÌ° The early Greek physicians of antiq-
uity, including Galen (131–201 AD),
Corticotropin described the pituitary gland in their
many treatises on health and disease.
/…iʅޫœÌ…>>“ÕÃÊÃiVÀiÌiÃÊVœÀ̈VœÌÀœ«ˆ˜‡Àii>Ș}ʅœÀ“œ˜iÊ­
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…Þ«œÌ…>>“ˆVq…Þ«œ«…ÞÃi>Ê«œÀÌ>ÊÃÞÃÌi“°Ê
,]ÊÌÀ>˜Ã«œÀÌi`Ê̜Ê̅iÊ>˜ÌiÀˆœÀ role was to drain the phlegm from the
«ˆÌՈÌ>ÀÞ]ÊÃ̈“Տ>ÌiÃÊ̅iÊÀii>ÃiʜvÊVœÀ̈VœÌÀœ«ˆ˜ ­>`Ài˜œVœÀ̈VœÌÀœ«ˆVʅœÀ“œ˜i brain to the nasopharynx. Over the
Q

/R®°Ê

/ʈ˜ÊÌÕÀ˜Ê>VÌÃʜ˜Ê̅iÊ>`Ài˜>ÊVœÀÌiÝÊ̜ʫÀœ“œÌiÊÃޘ̅iÈÃÊ>˜` next 19 centuries, the pituitary gland
Àii>ÃiʜvÊVœÀ̈܏]Êȓˆ>ÀÊ̜ʅœÜÊ/-ÊVœ˜ÌÀœÃÊ̅ÞÀœˆ`ÊÃiVÀðÊ

/ has been considered the body’s master
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/ÊVœ˜Vi˜ÌÀ>‡ controls anterior pituitary activity,
̈œ˜Ãʈ˜VÀi>ÃiÊ܈̅ÊiÝiÀVˆÃiÊ`ÕÀ>̈œ˜ÊˆvÊ̅iʈ˜Ìi˜ÃˆÌÞÊiÝVii`ÃÊÓx¯ÊœvÊ>iÀœLˆV making it the true master gland.
V>«>VˆÌÞ°
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388 • SECTION IV The Physiologic Support Systems

Gonadotropic Hormones
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Prolactin
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iÝiÀVˆÃiÊÀi“>ˆ˜ÃÊ՘Ž˜œÜ˜°
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Larynx
(posterior view)
Thyroid gland
(posterior view)
Parathyroid
glands
Esophagus
(cut away to show trachea)
Trachea
Figure 12.6 /…ÞÀœˆ`Ê}>˜`ʏœV>Ìi`ʜ˜ÊLœÌ…ÊÈ`iÃʜvÊ̅iʘiVŽÊˆ˜
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…œÀ“œ˜iðÊ/-ÊÀii>ÃiÊLÞÊ̅iÊ>˜ÌiÀˆœÀÊ«ˆÌՈÌ>ÀÞÊ}>˜`ÊÃ̈“‡
Տ>ÌiÃÊ̅iÊ̅ÞÀœˆ`Ê}>˜`Ê̜ÊÀii>ÃiʈÌÃʅœÀ“œ˜ið
Thyroid Hormones Affect Quality of Life
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Vˆ>ÞʜvʘiÀÛiÊ̈ÃÃÕi°
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Chapter 12 Hormones, Exercise, and Training • 389

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7…>ÌÊv>V̜ÀÊ}œÛiÀ˜ÃÊ̅iʵÕ>˜ÌˆÌÞʜvÊ>`Ài‡
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Corticotropin

Adrenal
glands &OR 9OUR )NFORMATION
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Depressed thyroid production blunts
Kidneys Cortex the basal metabolic rate (BMR),
which usually leads to gains in body
• Mineralocorticoids
Medulla Aldosterone weight and body fat. However, fewer
Corticosterone than 3% of obese persons show
• Catecholamines Deoxycortocosterone
Epinephrine abnormal thyroid functions, so
• Glucocorticoids
Norepinephrines
Cortisol depressed thyroid activity cannot
• Androgens
explain excessive body fat gain in
more than 60% of adults in the U.S.
population.
Figure 12.7
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390 • SECTION IV The Physiologic Support Systems

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V>ÌiV…œ>“ˆ˜iÊÀi뜘ÃiÊ>ÃÊÀiÛi>i`ÊLÞÊ̅iÊ`ˆÀiVÌÊÀi>̈œ˜‡ ̈ÛiÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ®°
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Adrenal Cortex Hormones
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Figure 12.8 >V̜ÀÃÊ̅>ÌÊ>vviVÌÊVœÀ̈܏ÊÃiVÀÊ>˜`ʈÌÃÊ>V̈œ˜Ãʜ˜ÊÌ>À}iÌÊ̈ÃÃÕið

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Chapter 12 Hormones, Exercise, and Training • 391

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Chronic reduction in renal blood
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flow at rest, perhaps from abnormal
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sympathetic stimulation, activates the
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sion occurs from the prolonged over-
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response of this mechanism with
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œÀ̈Ü High blood pressure associated with
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Õ«Ê̜ÊÓʅœÕÀÃʈ˜ÊÀiVœÛiÀÞ°
1. Decreased salt sensitivity (hence
increased water retention)
Androgens /…iÊ>`Ài˜>Ê}>˜`ÃÊ>˜`ʜÛ>ÀˆiÃÊ­ˆ˜Êvi“>iîÊ>˜`ÊÌiÃÌiÃÊ­ˆ˜ 2. Increased sodium intake
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392 • SECTION IV The Physiologic Support Systems

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Insulin Secretion
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̅iÊLœœ`ÃÌÀi>“Ê̜Ê̅iÊ«>˜VÀi>ýÊ! ViÃ]Ê܅iÀiÊ>
>ÌiÃʈ˜ÃՏˆ˜ÊÀii>Ãi°
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ÌÞ«ˆV>ÞʜVVÕÀÃÊ>vÌiÀÊ>ʓi>]ÊÌÀˆ}}iÀÃʈ˜ÃՏˆ˜ÊÀii>Ãi°
ΰ >ÃÌÀœˆ˜ÌiÃ̈˜>ÊÌÀ>VÌʅœÀ“œ˜iÃ\Ê-iÛiÀ>Ê…œÀ“œ˜iÃ
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High blood
sugar

Insulin stimulates
glycogen formation
to lower blood sugar

Insulin
Glycogen Glucose
Glucagon
Pancreas Liver
Glucagon stimulates
glycogen breakdown
to raise blood sugar

Islets of Langerhans:
Alpha cells (secrete glucagon)
Insulin stimulates
Beta cells (secrete insulin
glucose uptake
and amylin)
from blood to lower
Low blood blood sugar
sugar Tissue cells

Acini cells
(secrete digestive enzymes)

Figure 12.9 /…iÊ«>˜VÀi>Ã]ʈÌÃÊÃiVÀÃ]Ê>˜`Ê̅iˆÀÊ>V̈œ˜Ã°

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Chapter 12 Hormones, Exercise, and Training • 393

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Insulin’s Functions >“iÊ{Êv>V̜ÀÃÊ̅>Ìʈ˜vÕi˜Viʈ˜ÃՏˆ

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',5#/3%n).35,). ).4%2!#4)/.
Blood glucose levels within the
Insulin Secretion pancreas directly control insulin
secretion. Elevated blood glucose
triggers insulin release. This in turn
induces glucose entry into cells by
Most tissues Adipose tissue Liver and muscle Liver
lowering blood glucose, thus remov-
ing the stimulus for insulin release. In
Glucose uptake Fatty acid and Glycogen Fatty acid and contrast, a decrease in blood glucose
(except brain, liver, triacylglycerol synthesis triacylglycerol concentration dramatically lowers
exercising muscle) synthesis synthesis
blood insulin levels to provide a favor-
able milieu to increase blood glucose.
Amino acid uptake Lipolysis Glycogenolysis Glycogenolysis
The interaction between glucose and
insulin serves as a feedback
Protein synthesis
mechanism to maintain blood glucose
concentration within narrow limits.
Protein breakdown Rising levels of plasma amino acids
also increase insulin secretion.
Figure 12.10 ˜VÀi>Ãi`ʈ˜ÃՏˆ˜Ê«Àœ“œÌiÃÊ}ÞVœ}i˜]Ê«ÀœÌiˆ˜]Ê>˜`Êv>ÌÊÃޘ̅iÈð
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394 • SECTION IV The Physiologic Support Systems

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Chapter 12 Hormones, Exercise, and Training • 395

The Genetics of Diabetes +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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The current statistics regarding diabetes prevelance in the United States are staggering!
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Between 2003 and 2006, 25.9% of the United States population 20 years and older had dia-
`ÕVi`ÊLÞÊ̅iÊ«>˜VÀi>ÃÊ̜
betes; for those older than 60 years of age the prevelance was 34%. About 12.0 million, or
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11.2%, of all men and
Ž˜œÜ˜Ê>ÃÊÀi>̈Ûi
11.5 million, or 10.2%, of
ˆ˜ÃՏˆ˜Ê`ivˆVˆi˜V
women age 20 years or older 25
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ˆ˜}Ê̅iʏ>ÃÌÊ`iV>`iʜvÊ̅iÊÓä̅ Use the following Internet site
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have diabetes. Nearly
23.8%
15 million, or 9.8%, of non-
Hispanic whites and 3.7
20
million, or 14.7%, of non-
Hispanic blacks age 20 years or
older have diabetes. The total
number of Americans with dia-
Percentage
15
betes jumped by more than
3 million between 2005 and
2007 to about 24 million, with 10.8%
10
another 57 million categorized
as prediabetic with fasting blood
sugar between 100 and 125
5
mg!dL"1. Nearly one-third of
newly diagnosed cases occur in 2.6%
children younger than 16 years,
which has caused clinicians to 0
20-39 40-59 60+
label diabetes a “childhood dis- Age group (y)
ease.” Experts estimate that up
to 92% of type 2 diabetes can *ÀiÛ>i˜ViʜvÊ`ˆ>}˜œÃi`Ê>˜`Ê՘`ˆ>}˜œÃi`Ê`ˆ>LiÌiÃ
be changed by diet and lifestyle. >“œ˜}Ê«iœ«iÊ>}iÊÓäÊÞi>ÀÃʜÀʜ`iÀ]Ê1˜ˆÌi`Ê-Ì>ÌiÃ]ÊÓääÇ°

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to calculate your diabetes risk: £Ó°Óʓˆˆœ˜]ʜÀÊÓΰn¯]ʜvÊ>Ê«iœ«iʈ˜Ê̅ˆÃÊ>}iÊ}ÀœÕ«
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risk-test.jsp. ۈiÜÊ-ÕÀÛiÞÊiÃ̈“>ÌiÃÊ«ÀœiVÌi`Ê̜Ê̅iÊÞi>ÀÊÓääÇ°®
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396 • SECTION IV The Physiologic Support Systems

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BOX 1 2 .1 CLOSE UP
How to Detect Diabetes Mellitus

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Differences Between the Two Major Forms of Diabetes Mellitus

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Key Blood Tests for Detecting Diabetes Mellitus

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SYNDROME
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Chapter 12 Hormones, Exercise, and Training • 397
&OR 9OUR )NFORMATION
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1. Ingest 15 to 30 g of carbohydrates for each 30 minutes of intense exercise.
2. Consume a carbohydrate snack after exercise.
3. Decrease insulin dose:
a. Intermediate-acting insulin: Decrease the dose by 30 to 35% on the day of exercise.
b. Intermediate- and short-acting insulin: Omit the dose if it precedes exercise.
c. Multiple doses of short-acting insulin: Reduce the dose before exercise by 30% and
supplement carbohydrate intake.
d. Continuous subcutaneous insulin infusion: Eliminate mealtime bolus or insulin
increment that precedes or follows exercise.
4. Avoid exercising for 1 hour those muscles receiving a short-acting insulin injection.
5. Avoid exercising in the late evening.
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1. Engage in 30 to 60 minutes of daily exercise.
2. Keep alcohol consumption at the light to moderate level.
ˆ˜`ÕÃÌÀˆ>ˆâi`ÊVœÕ˜ÌÀˆiðÊˆÃ‡ 3. Do not smoke.
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}i˜ïV]ʅœÀ“œ˜>]Ê>˜`ʏˆviÃÌޏi 36.2 inches for men.
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(vegetable oils, nuts)
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processed meats (bacon,
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beans, soy foods
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Table 12.3 Identifying the Metabolic Syndrome +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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398 • SECTION IV The Physiologic Support Systems
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Chapter 12 Hormones, Exercise, and Training • 399

Potential problems with exercise in type 2 diabetes +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

System Potential Problem ˆÛiÊ̅iÊÕ««iÀʏˆ“ˆÌʜvÊv>Ã̈˜}ÊLœœ`
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• Increased proteinuria
• Acceleration of microvascular lesions
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Cardiovascular • Cardiac arrhythmias £°
• Ischemic heart disease (often silent)
• Excessive rise in blood pressure
• Post-exercise orthostatic hypotension Ó°

Metabolic • Increased hyperglycemia

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• Increased ketosis

Musculoskeletal • Foot ulcers (in presence of neuropathy)

• Orthopedic injury related to neuropathy
• Accelerated degenerative joint disease ˆÃÌÊÎÊ«œÌi˜Ìˆ>ÊVœ“«ˆV>̈œ˜ÃʜvÊiÝiÀVˆÃi
• Eye injuries and retinal hemorrhage vœÀÊÌÞ«iÊ£Ê`ˆ>LïVð
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Growth Hormone and Long-Term Exercise Training œÃÌ • Insulin resistance
ÀiÃi>ÀV…ÊœvÊʈ˜ÛœÛiÃÊÀi뜘ÃiÃÊ̜Ê>ÊȘ}iÊiÝiÀVˆÃiÊÃiÃȜ˜°ÊiÃÃʈ˜vœÀ“>̈œ˜ • Glucose intolerance
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œvÊ̅iÊV>ÕÃ>ÊÀi>̈œ˜Ã…ˆ«ÊLiÌÜii˜ÊÊ>Û>ˆ>LˆˆÌÞÊ>˜`Ê̅iʓ>ˆ˜Ìi˜>˜ViʜvÊv>̇ low-density lipoprotein levels)
vÀiiÊLœ`Þʓ>ÃÃÊ­®Ê܈̅Ê>}ˆ˜}Ê>˜`ÊÜiˆ}…ÌʏœÃð • Stroke
Figure 12.13 ŜÜÃÊ̅iÊivviVÌÃʜvÊ>ÊÀ՘ÊÌÀ>ˆ˜ˆ˜}Ê«Àœ}À>“Êœ˜ÊÓ{‡…œÕÀʈ˜Ìi‡ • Upper-body obesity
}À>Ìi`ÊÃiÀՓÊÊVœ˜Vi˜ÌÀ>̈œ˜Ãʈ˜Êӣʅi>Ì…Þ]ÊiՓi˜œÀÀ…iˆVÊܜ“i˜°Ê/…i • Type 2 diabetes mellitus
ÃÌÕ`Þʈ˜ÛœÛi`ÊÌܜÊÌÀ>ˆ˜ˆ˜}Ê}ÀœÕ«ÃÆʜ˜iÊ}ÀœÕ«ÊÀ>˜Ê>ÌÊëii`ÃÊVœÀÀi뜘`ˆ˜}Ê̜ • Hypertension
̅iʏ>VÌ>ÌiÊ̅ÀiŜ`Ê­J/®]Ê>˜`Ê̅iʜ̅iÀÊ}ÀœÕ«ÊÀ>˜Ê>ÌÊëii`ÃÊ>LœÛiʏ>VÌ>Ìi • Coronary artery disease
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400 • SECTION IV The Physiologic Support Systems

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Chapter 12 Hormones, Exercise, and Training • 401

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402 • SECTION IV The Physiologic Support Systems
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Chapter 12 Hormones, Exercise, and Training • 403

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Training the
C h a p t e r
13
Anaerobic and
Aerobic Energy
Systems
CHAPTER OBJECTIVES

• Define each of the following four principles of exercise • Define the training-sensitive zone.
training: overload, specificity, individual differences,
and reversibility. • Outline a typical exercise training session for aerobic
fitness improvement.
• Discuss the overload principle for training the
• Explain the need to adjust the training-sensitive zone
intramuscular high-energy phosphates and glycolytic
for swimming and other modes of upper-body
systems. Outline the specific adaptations in each
exercise.
system with exercise training.

• Describe how the following five factors affect an aero-
bic training program: initial fitness level, genetics, train-
ing frequency, training duration, and training intensity.
• List five cardiovascular and pulmonary adaptations to
aerobic training.
• Explain the influence of age on maximum heart rate
and the training-sensitive zone.
• Contrast continuous versus intermittent aerobic
exercise training, including advantages and
disadvantages of each.

• Explain how exercise heart rate can establish the • Outline five potential benefits and risks of exercising
during pregnancy.
appropriate exercise intensity for aerobic training.

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410 • SECTION V Exercise Training and Adaptations

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ʓ>݈“Õ“ÊLÕÀÃÌʜvÊivvœÀÌÊvœÀÊ>ÊÌi˜˜ˆÃÊÃiÀÛi]Ê}œvÊÃ܈˜}] ˆ˜Ê“>À>̅œ˜ÃÊ>˜`ÊՏÌÀ>i˜`ÕÀ>˜ViÊiÛi˜Ìð
vÀœ˜ÌÊvˆ«Êˆ˜Ê}ޓ˜>Ã̈VÃ]Ê>˜`ÊiÛi˜Ê>ÊÈä‡ÊœÀÊ£ä䇓ÊëÀˆ˜
ÀiµÕˆÀiÃʈ““i`ˆ>ÌiÊi˜iÀ}ÞÊÌÀ>˜ÃviÀ°Ê/…ˆÃʜVVÕÀÃÊ>˜>iÀœLˆ‡
V>Þ]Ê>“œÃÌÊiÝVÕÈÛiÞÊvÀœ“Ê̅iʈ˜ÌÀ>“ÕÃVՏ>Àʅˆ}…‡
Specificity Principle
i˜iÀ}ÞÊ«…œÃ«…>ÌiÃÊ
/*Ê>˜`Ê*
À°Ê˜Ê«iÀvœÀ“>˜ViÃʏ>Ã̈˜} ÝiÀVˆÃiÊÌÀ>ˆ˜ˆ˜}ÊëiVˆvˆVˆÌ ÀiviÀÃÊ̜Ê>`>«Ì>̈œ˜Ãʈ˜Ê“iÌ>‡
Õ«Ê̜ʙäÊÃiVœ˜`Ãʈ˜Ê`ÕÀ>̈œ˜Ê­i°}°]Ê£ä䇓ÊÃ܈“ÊœÀÊ{{䇓 LœˆVÊ>˜`Ê«…ÞȜœ}ˆVÊÃÞÃÌi“ÃÊ̅>ÌÊ`i«i˜`ʜ˜Ê̅iÊÌÞ«iʜv
À՘®]Ê>˜>iÀœLˆVÊi˜iÀ}ÞÊÌÀ>˜ÃviÀÊÀi>V̈œ˜ÃÊÃ̈Ê«Ài`œ“ˆ˜>Ìi° œÛiÀœ>`ʈ“«œÃi`Ê>˜`ʓÕÃViʓ>ÃÃÊ>V̈Û>Ìi`°Ê˜Ê>ÊLÀœ>`
˜Ê̅ˆÃÊV>Ãi]Ê̅iʈ˜ˆÌˆ>Ê}ÞVœÞ̈VÊ«…>ÃiʜvÊV>ÀLœ…Þ`À>Ìi Ãi˜Ãi]Ê>˜ÊiÝiÀVˆÃiÊÃÌÀiÃÃÊ>ÃÊÃÌÀi˜}̅‡«œÜiÀÊÌÀ>ˆ˜ˆ˜}Ê`iÛi‡
LÀi>Ž`œÜ˜Ê܈̅ÊÃÕLÃiµÕi˜Ìʏ>VÌ>ÌiÊvœÀ“>̈œ˜Ê«ÀœÛˆ`iÃÊ̅i œ«ÃÊëiVˆvˆVÊÃÌÀi˜}̅‡«œÜiÀÊ>`>«Ì>̈œ˜ÃÆʏˆŽi܈Ãi]ÊÀi}Տ>
«Àˆ“>ÀÞÊi˜iÀ}ÞÊÜÕÀVi°Ê"˜i½ÃÊV>«>VˆÌÞÊ>˜`Ê̜iÀ>˜ViÊvœÀ >iÀœLˆVÊiÝiÀVˆÃiÊiˆVˆÌÃÊëiVˆvˆV i˜`ÕÀ>˜Vi‡ÌÀ>ˆ˜ˆ˜}Ê>`>«Ì>‡
>VÌ>ÌiÊ>VVՓՏ>̈œ˜Ê`iÌiÀ“ˆ˜iÊ̅iʓ>}˜ˆÌÕ`iʜvÊi˜iÀ}Þ Ìˆœ˜ÃÊ܈̅ÊiÃÃi˜Ìˆ>ÞʘœÊÌÀ>˜ÃviÀÊivviVÌÃÊLiÌÜii˜ÊÃÌÀi˜}̅‡
}i˜iÀ>Ìi`ÊvÀœ“Ê>˜>iÀœLˆVÊÜÕÀViðÊ/À>ˆ˜ˆ˜}ÊvœÀÊ>˜>iÀœLˆV‡ «œÜiÀÊÌÀ>ˆ˜ˆ˜}Ê>˜`Ê>iÀœLˆVÊÌÀ>ˆ˜ˆ˜}°Ê/…iÊëiVˆvˆVˆÌ
ÌÞ«iÊ>V̈ۈ̈iÃʓÕÃÌÊÀi>V…ÊÃÕvvˆVˆi˜Ìʈ˜Ìi˜ÃˆÌÞÊ>˜`Ê`ÕÀ>̈œ «Àˆ˜Vˆ«iÊ>ÃœÊi˜Vœ“«>ÃÃiÃÊ>V̈ۈ̈iÃÊÜˆÌ…Ê ˆ`i˜ÌˆV> “iÌ>‡
̜ʜÛiÀœ>`Ê̅iÊ}ÞVœÞ̈VÊi˜iÀ}ÞÊÌÀ>˜ÃviÀÊÃÞÃÌi“° LœˆVÊVœ“«œ˜i˜ÌðÊœÀÊiÝ>“«i]Ê>iÀœLˆVÊvˆÌ˜iÃÃÊvœÀÊÃ܈“
7ÀiÃ̏ˆ˜}]ÊLœÝˆ˜}]ʈViʅœVŽiÞ]Ê>ÊÓä䇓ÊÃ܈“]Ê>Ê£xä䇓 “ˆ˜}]ÊLˆVÞVˆ˜}]ÊÀ՘˜ˆ˜}]ʜÀÊÀœÜˆ˜}ʈ“«ÀœÛiÃʓœÃÌ
À՘]ʜÀÊ>ÊvՏ‡VœÕÀÌÊ«ÀiÃÃʈ˜ÊL>ÎiÌL>Ê>ÊÀiµÕˆÀiÊÀ>«ˆ` ivviV̈ÛiÞÊ܅i˜Ê̅iÊiÝiÀVˆÃiÀÊÌÀ>ˆ˜ÃÊ̅iÊëiVˆvˆVʓÕÃVi
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«Ì>À>ʘV

Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 411

Exercise duration +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

0s 4s 10 s 1.5 min 3 min +
ˆÛiÊ>˜ÊiÝ>“«iʜvÊ>ÊëœÀ̈˜}ÊiÛi˜ÌʜÀ
«…ÞÈV>Ê>V̈ۈÌÞÊ̅>ÌÊÀiˆiÃʜ˜Êi>V…ÊœvÊ̅i
ATP ÎÊi˜iÀ}ÞÊÃÞÃÌi“ðÊ
Strength-power
/*‡*
ÀÊÃÞÃÌi“\
(power lift, high jump,
javelin throw, golf swing,
tennis serve)

ÞVœÞ̈VÊÃÞÃÌi“\

ATP+PCr
Sustained power
iÀœLˆVÊÃÞÃÌi“\
Types of performance

(sprints, fast breaks,

football line play,
gymnastics routine)

ATP+PCr+Lactic Acid ˆÃÌÊ̅iÊ{ÊÌÀ>ˆ˜ˆ˜}Ê«Àˆ˜Vˆ«ið

Anaerobic power-endurance
(200-400m dash, 100m swim) £°

Ó°
Electron Transport-
Oxidative Phosphorylation
Aerobic endurance ΰ
(beyond 800m run)

{
Immediate/short-term Aerobic-oxidative system
non-oxidative systems
Predominant energy pathways

Figure 13.1
>ÃÈvˆV>̈œ˜ÊœvÊ«…ÞÈV>Ê>V̈ۈÌÞÊL>Ãi`ʜ˜Ê`ÕÀ>̈œ˜ÊœvÊ>‡œÕÌÊiÝiÀVˆÃ
>˜`ÊVœÀÀi뜘`ˆ˜}Ê«Ài`œ“ˆ˜>˜Ìʈ˜ÌÀ>ViÕ>ÀÊi˜iÀ}ÞÊ«>̅Ü>Þð ˆÃÌÊ{ÊÛ>Àˆ>LiÃÊvœÀʓ>˜ˆ«Õ>̈œ˜Ê̜
>V…ˆiÛiÊiÝiÀVˆÃiʜÛiÀœ>`°
ÀiµÕˆÀi`ÊvœÀÊ̅iÊ>V̈ۈÌްʘÊiÃÃi˜Vi]ÊëiVˆvˆVÊiÝiÀVˆÃiÊiˆVˆÌÃÊëiVˆvˆVÊ>`>«Ì>̈œ˜
£°
VÀi>̈˜}ÊëiVˆvˆVÊÌÀ>ˆ˜ˆ˜}ÊivviVÌÃÊÀiviÀÀi`Ê̜Ê>ÃÊ̅i -
Ê«Àˆ˜Vˆ«ipëiVˆvˆ
>`>«Ì>̈œ˜ÃÊ̜ʈ“«œÃi`Ê`i“>˜`ð
Ó°
Individual Differences Principle

Êˆ˜`ˆÛˆ`Õ>ÃÊ`œÊ˜œÌÊÀi뜘`Êȓˆ>ÀÞÊ̜Ê>Ê}ˆÛi˜ÊÌÀ>ˆ˜ˆ˜}ÊÃ̈“ՏÕðÊ>˜ÞÊv>V̜ÀÃ
ΰ
Vœ˜ÌÀˆLÕÌiÊ̜ÊÛ>Àˆ>̈œ˜Ãʈ˜ÊÌÀ>ˆ˜ˆ˜}ÊÀi뜘ÃiÃÊ>“œ˜}ʈ˜`ˆÛˆ`Õ>Ã]ʈ˜VÕ`ˆ˜}ÊÀi‡
>̈ÛiÊvˆÌ˜iÃÃʏiÛiÊ>ÌÊ̅iÊÃÌ>ÀÌʜvÊÌÀ>ˆ˜ˆ˜}°Ê*iœ«iÊÛ>ÀÞʈ˜Êˆ˜ˆÌˆ>ÊvˆÌ˜iÃÃÊ>˜`ÊÃÌ>ÌiÊ
ÌÀ>ˆ˜ˆ˜}Ê>ÌÊ̅iÊÃÌ>ÀÌʜvÊ>ÊVœ˜`ˆÌˆœ˜ˆ˜}Ê«Àœ}À>“Ê>˜`Ê̅ÕÃÊÀi뜘`Ê`ˆvviÀi˜ÌÞÊ̜ {°
̅iÊÃ>“iÊÌÀ>ˆ˜ˆ˜}ÊÃ̈“ՏÕðʘÈÃ̈˜}Ê̅>ÌÊ>Ê«iÀvœÀ“iÀÃʜ˜Ê>ÊÌi>“ÊœÀÊiÛi˜
̅œÃiʈ˜Ê̅iÊÃ>“iÊiÛi˜ÌÊÌÀ>ˆ˜Ê̅iÊÃ>“iÊÜ>ÞÊ>˜`Ê>ÌÊ̅iÊÃ>“iÊÀi>̈ÛiʜÀÊ>L܏ÕÌi
iÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞÊ`œiÃʘœÌʜ«Ìˆ“ˆâiÊÌÀ>ˆ˜ˆ˜}ÊLiV>ÕÃiʈÌÊ`œiÃʘœÌÊÀiVœ}˜ˆâiÊ ˆ˜`ˆ‡
ۈ`Õ>Ê`ˆvviÀi˜Vià ˆ˜ÊÌÀ>ˆ˜ˆ˜}ÊÀi뜘ÈÛi˜iÃðÊ,>̅iÀ]ÊÌÀ>ˆ˜ˆ˜}Ê«Àœ}À>“ÃʓÕÃÌ ˆÛiʜ˜iÊiÝ>“«iʜvÊiÝiÀVˆÃiÊÌÀ>ˆ˜ˆ˜}
“iiÌʈ˜`ˆÛˆ`Õ>Ê˜ii`ÃÊ>˜`ÊV>«>VˆÌˆiðÊ
œ>V…iÃÊ>˜`ÊÌÀ>ˆ˜iÀÃÊŜՏ`ÊÀiVœ}˜ˆâi ëiVˆvˆVˆÌÞ
…œÜÊ>̅iÌiÃÊ>˜`ÊÌÀ>ˆ˜iiÃÊÀi뜘`Ê̜Ê>Ê}ˆÛi˜ÊiÝiÀVˆÃiÊÃ̈“ՏÕÃÊ>˜`Ê>`ÕÃÌÊ̅i
iÝiÀVˆÃiÊ«ÀiÃVÀˆ«Ìˆœ˜ÊL>Ãi`ʜ˜Ê̅>ÌÊÀi뜘Ãi°

Reversibility Principle
/…iÊÀiÛiÀÈLˆˆÌÞ œvÊÌÀ>ˆ˜ˆ˜}ÊivviVÌÃ]ÊÀiviÀÀi`Ê̜Ê>ÃÊ`iÌÀ>ˆ˜ˆ˜}]ʜVVÕÀÃÊÀi>̈ÛiÞ
À>«ˆ`ÞÊ܅i˜Ê>Ê«iÀܘʵՈÌÃʅˆÃʜÀʅiÀÊiÝiÀVˆÃiÊÌÀ>ˆ˜ˆ˜}ÊÀi}ˆ“i˜°Ê
vÌiÀʜ˜ÞÊ>
ÜiiŽÊœÀÊÌܜʜvÊ`iÌÀ>ˆ˜ˆ˜}]ʓi>ÃÕÀ>LiÊÀi`ÕV̈œ˜ÃʜVVÕÀʈ˜Ê«…ÞȜœ}ˆVÊv՘V̈œ˜
>˜`ÊiÝiÀVˆÃiÊV>«>VˆÌÞ]Ê܈̅Ê>Ê̜Ì>ÊœÃÃʜvÊÌÀ>ˆ˜ˆ˜}ʈ“«ÀœÛi“i˜ÌÃʜVVÕÀÀˆ˜}
܈̅ˆ˜ÊÃiÛiÀ>Ê“œ˜Ì…ðÊFigure 13.2 ŜÜÃÊ>ÛiÀ>}iÊ«iÀVi˜Ì>}iÊV…>˜}iÊÀi«œÀÌi`
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«Ì>À>ʘV

412 • SECTION V Exercise Training and Adaptations

BOX 13.1 CLOSE UP

An Example of Exercise Training Specificity

˜Ê>˜ÊiÝ«iÀˆ“i˜Ìʈ˜Êœ˜iʜvʜÕÀʏ>LœÀ>̜ÀˆiÃʜ˜Ê>iÀœLˆV ˜ˆ˜}°Êvʜ˜ÞÊÌÀi>`“ˆÊÀ՘˜ˆ˜}ʅ>`ÊLii˜ÊÕÃi`Ê̜ÊiÛ>Õ>Ìi
ÌÀ>ˆ˜ˆ˜}ÊëiVˆvˆVˆÌÞ]Ê£xʓi˜ÊÃÜ>“ʣʅœÕÀÊ>Ê`>ÞÊÎÊ`>Þà Ã܈“ÊÌÀ>ˆ˜ˆ˜}ÊivviVÌÃ]ÊÜiÊܜՏ`ʓˆÃÌ>Ži˜Þʅ>ÛiÊVœ˜‡
>ÊÜiiŽÊvœÀÊ£äÊÜiiŽÃÊ>Ì VÕ`i`Ê̅>ÌÊ̅iÀiÊÜ>ÃʘœÊÌÀ>ˆ˜‡
…i>ÀÌÊÀ>ÌiÃÊLiÌÜii˜Ênx¯Ê>˜`Ê ˆ˜}ÊivviVÌ °ÊœÀʓ>݈“Õ“
™x¯Êœvʓ>݈“Õ“Ê…i>ÀÌÊ
° 34 «iÀvœÀ“>˜ViÊ`ÕÀˆ˜}ÊÌiÃ̈˜}]
À>ÌiÊ­, “>Ý®°Ê6 "ӓ>Ý Ü>à 34.0 ÃÕLiVÌÃʈ“«ÀœÛi`ÊÎ{¯Êˆ˜
32
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30
À՘˜ˆ˜}Ê>˜`ÊÌi̅iÀi`ÊÃ܈“‡ œ˜ÞÊ{°È¯Êˆ˜ÊÀ՘Ê̈“iʜ˜Ê̅i
“ˆ˜}ÊLivœÀiÊ>˜`Ê>vÌiÀÊÌÀ>ˆ˜‡ 18 ÌÀi>`“ˆÊÌiÃÌ°
Percent improvement

ˆ˜}°Ê iV>ÕÃiÊۈ}œÀœÕÃÊÃ܈“ 16 /…iÃiÊvˆ˜`ˆ˜}ÃÊ>˜`ʜ̅iÀ

ÌÀ>ˆ˜ˆ˜}ʜÛiÀœ>`ÃÊ̅iÊVi˜‡ 14
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12
LÞʅˆ}…ÊiÝiÀVˆÃiʅi>ÀÌÊÀ>Ìiî] VˆvˆVÊ>iÀœLˆVÊ>V̈ۈ̈iÃʓÕÃÌ
ÜiÊ>˜ÌˆVˆ«>Ìi`Ê>Ìʏi>ÃÌÊܓi 10 11.0 «ÀœÛˆ`iÊ>˜Ê>««Àœ«Àˆ>ÌiÊ}i˜‡
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ˆ“«ÀœÛi“i˜ÌÃÊvÀœ“ÊÃ܈“ 6
ÃÌÀiÃÃÊ >˜` œÛiÀœ>`Ê̅iÊ Ã«i‡
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4 4.6
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VO Max run time VO Max swim time
Ã܈“ÊÌÀ>ˆ˜ˆ˜}° V>«>VˆÌÞʜÀÊiÝiÀVˆÃiÊ«iÀvœÀ“‡
Treadmill Running Tethered Swimming
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° >Liʈ“«ÀœÛi“i˜ÌÃÊi“iÀ}i
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ADAPTATIONS TO EXERCISE TRAINING

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Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 413

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414 • SECTION V Exercise Training and Adaptations

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Figure 13.3 i˜iÀ>ˆâi`Ê«œÌi˜Ìˆ>ÊvœÀʈ˜VÀi>ÃiÃʈ˜Ê>˜>iÀœLˆV >ÃÊ܈̅ÊV>˜ViÀ]ÊVœÀœ˜>ÀÞʅi>ÀÌÊ`ˆÃi>Ãi]Ê`ˆ>LiÌiÃ]ʅޫiÀÌi˜‡
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Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 415

Metabolic Adaptations
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416 • SECTION V Exercise Training and Adaptations

Figure 13.5
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Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 417

Vœ˜ÌÀ>V̈iÊvˆ>“i˜ÌÃÊVœ˜VÕÀ
Ài˜ÌÞʈ˜VÀi>Ãið &OR 9OUR )NFORMATION
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*>Ó>Ê6œÕ“i "˜ÞÊvœÕÀ
ÌÀ>ˆ˜ˆ˜}ÊÃiÃȜ˜Ãʈ˜VÀi>Ãi Prime candidates for the greatest athletes of any species in any sport with sheer capacity
«>Ó>ÊۜÕ“iÊÕ«Ê̜ÊÓ䯰Ê/…ˆÃ for prolonged exercise are multibreed dogs with a little Siberian husky in the mix—the
>`>«Ì>̈œ˜Êi˜…>˜ViÃÊVˆÀVՏ>̜ÀÞ dogs who pull sleds in the Iditarod race across Alaska. Consider the following:
.
>˜`Ê̅iÀ“œÀi}Տ>̜ÀÞÊ`ޘ>“‡ • A VO2max of about 200 mL!kg"1 !min"1 compared to the value of a highly trained
ˆVÃÊ>˜`Êv>VˆˆÌ>ÌiÃʜÝÞ}i˜Ê`iˆÛ‡ human challenger of 80 mL!kg"1 !min"1. .
iÀÞÊ̜ʓÕÃViÊ`ÕÀˆ˜}ÊiÝiÀVˆÃi° • Ability to run up to 100 miles a day at 50% of VO2max for 8 consecutive days.
/…iÊÀ>«ˆ`ʈ˜VÀi>Ãiʈ˜Ê«>Ó> • Ability to maintain a sub-4-minute mile pace for up to 70 miles as part of a team of
ۜÕ“iÊ܈̅Ê>iÀœLˆVÊÌÀ>ˆ˜ˆ˜} dogs pulling a sled.
>ÃœÊVœ˜ÌÀˆLÕÌiÃÊ̜ÊÌÀ>ˆ˜ˆ˜}‡ • Ability to maintain relatively large blood flow to vital organs such as the gastrointesti-
ˆ˜`ÕVi`ÊiVVi˜ÌÀˆVʅޫiÀÌÀœ«…Þ nal tract and splanchnic (liver) region while performing intense endurance exercise.
܈̅ÊVœ˜Vœ“ˆÌ>˜Ìʈ˜VÀi>ÃiÃʈ˜ • Response to just several months of regular exercise with a 50% increase heart size.
ÃÌÀœŽiÊۜÕ“i° • Muscle cells that possess nearly 70% more mitochondria than do humans.
• Ability to dissipate metabolic heat through the tongue, paws, and nose without relying
-ÌÀœŽiÊ6œÕ“i Figure 13.6 on evaporative cooling via
ˆÕÃÌÀ>ÌiÃÊ̅iÊÌÞ«ˆV>ÊÃÌÀœŽi the sweat mechanism, thus
ۜÕ“iÊÀi뜘ÃiÊvœÀÊÌܜ conserving fluid and vital
}ÀœÕ«Ãʜvʓi˜Ê`ÕÀˆ˜}ÊÕ«Àˆ}…Ì electrolytes.
iÝiÀVˆÃiʜvʈ˜VÀi>Ș}ʈ˜Ìi˜ÃˆÌÞ° • Superb fat-burning
"˜iÊ}ÀœÕ«ÊœvÊi˜`ÕÀ>˜ViÊ>̅‡ “machines” with predomi-
iÌiÃÊÌÀ>ˆ˜i`ÊvœÀÊÃiÛiÀ>ÊÞi>ÀÃÆ nant reliance on cooler
Ãi`i˜Ì>ÀÞ]ʅi>Ì…ÞÊ>`ՏÌÃÊVœ“‡ burning, energy-dense fat as
«ÀˆÃi`Ê̅iʜ̅iÀÊ}ÀœÕ«°ÊÀ>`i` an energy substrate source
ÌÀi>`“ˆÊiÝiÀVˆÃiÊiÛ>Õ>Ìi` compared with the heavy
̅iÊÃi`i˜Ì>ÀÞÊ>`ՏÌýÊÀi뜘Ãià reliance of humans on the
LivœÀiÊ>˜`Ê>vÌiÀÊ>ÊӇ“œ˜Ì… limited supply of blood glu-
ÌÀ>ˆ˜ˆ˜}Ê«Àœ}À>“Ê̜ʈ“«ÀœÛi cose and stored glycogen.
>iÀœLˆVÊvˆÌ˜iÃÃ
/…iÃiÊ`>Ì>ÊÀiÛi>Êˆ“«œÀÌ>˜Ì References
­>˜`ÊÀi«ÀiÃi˜Ì>̈Ûi®Êvˆ˜`ˆ˜} McKenzie, E., et al.: Recovery of muscle glycogen concentrations in sled dogs during
Vœ˜ViÀ˜ˆ˜}Ê>iÀœLˆVÊÌÀ>ˆ˜ˆ˜} prolonged exercise. i`Ê-VˆÊ-«œÀÌà ÝiÀ°, 37:1307, 2005.
>`>«Ì>̈œ˜Ã\Ê McKenzie, E., et al.: Hypogammaglobulinemia in racing Alaskan sled dogs. °Ê6ḭʘÌiÀ˜°
i`°, 24:97, 2010.
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1. Reduced state of anxiety (i.e., the level of anxiety at the time of measurement)
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2. Decreased mild to moderate depression
̅iÊ}Ài>ÌiÃÌʈ˜VÀi>Ãiʈ˜
3. Reduced neuroticism (long-term exercise effect)
ÃÌÀœŽiÊۜÕ“iʈ˜
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Sedentary college students
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422 • SECTION V Exercise Training and Adaptations

FACTORS AFFECTING THE AEROBIC

0 TRAINING RESPONSE
5
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from initial work rate

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BOX 13.2 CLOSE UP

American College of Sports Medicine and American Heart
Association Updated Fitness Guidelines and Recommendations

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Table 1 Physical Activity Recommendations by the American College of Sports Medicine and the
American Heart Association for Healthy Adults Ages 18 to 65 Years
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424 • SECTION V Exercise Training and Adaptations
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Training Duration
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Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 425

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How Long Before Improvement Occurs? *œÃˆÌˆÛiÊ>`>«Ì>̈œ˜Ãʈ˜

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Guidelines for Children

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428 • SECTION V Exercise Training and Adaptations

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ˆ˜Ìi˜ÃˆÌˆið
Cardiorespiratory Fitness Standards for Chil-
dren
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Table 13.3 «ÀiÃi˜ÌÃÊÃÌ>˜`>À`ÃÊ­Õ««iÀÊ>˜`ʏœÜiÀÊi˜`®ÊvœÀ
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ESTABLISHING TRAINING INTENSITY
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Ãi`i˜Ì>ÀÞÊ«iÀܘÊv>ÃÊLiœÜÊ>˜ÊiˆÌiÊ>̅iÌi½ÃÊ̅ÀiŜ`
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LiÊ>ÃÃiÃÃi`ÊÀi>̈ÛiÊ̜Ê̅iÊÃÌÀiÃÃʈÌÊ«>ViÃʜ˜Ê>Ê«iÀܘ½ÃÊ>iÀ‡
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œÃiÊ1«Êœ˜Ê«°Ê{Îä®°
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̈œ˜Ãʈ˜ÊÀ՘˜ˆ˜}Êëii`°
.
Train at Percentage of VO2max
°

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°
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°
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°
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Train at Percentage of
Maximum Heart Rate

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VˆÃiÊLÞʈ˜Ìi˜ÃˆÌÞÊ­ÃÌÀi˜ÕœÕØiÃîÊ>˜`ʈ˜`ˆÛˆ`Õ>ˆâiÃÊ>iÀœ‡
LˆVÊÌÀ>ˆ˜ˆ˜}Ê̜ʎii«Ê«>ViÊ>ÃÊvˆÌ˜iÃÃʈ“«ÀœÛiðÊ/…ˆ
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°
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>À“ÊœÀʏi}ÊiÝiÀVˆÃiÊ>“œ˜}ʅi>Ì…ÞÊÃÕLiVÌÃ]ʘœÀ“>ÊÜiˆ}…ÌÊ>˜`
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>À“ÊVœ“«>Ài`Ê܈̅ʏœÜiÀÊLœ`Þʏi}ÊiÝiÀVˆÃiÆʜ˜iʓÕÃÌÊVœ˜‡
È`iÀÊ̅ˆÃÊ`ˆvviÀi˜Viʈ˜ÊvœÀ“Տ>̈˜}Ê̅iÊiÝiÀVˆÃiÊ«ÀiÃVÀˆ«Ìˆœ˜
vœÀÊ`ˆvviÀi˜ÌÊiÝiÀVˆÃiʓœ`iÃÊ­ÃiiÊ

Standards for the Healthy

. Fitness Zone for 1-Mile
Table 13.3 Walk–Run Times and VO2maxa for Children Ages
10 to 17 Years
°
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Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 429

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“>݈“>ÊiÝiÀVˆÃi°Ê/…ÀiiʜÀÊ{ʓˆ˜ÕÌiÃʜvÊ>‡œÕÌÊÀ՘˜ˆ˜}ʜÀÊÃ܈““ˆ˜}ÊiˆVˆÌà +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
,“>Ý Û>ÕiðÊ-ÕV…ʈ˜Ìi˜ÃiÊiÝiÀVˆÃiÊÀiµÕˆÀiÃÊVœ˜Ãˆ`iÀ>LiʓœÌˆÛ>̈œ˜Ê>˜`Êi˜`>˜‡ 7ÀˆÌiÊÓÊvœÀ“Տ>iÊ̜ʫÀi`ˆVÌʓ>݈“Õ“
}iÀÃÊ̅œÃiÊ«Ài`ˆÃ«œÃi`Ê̜ÊVœÀœ˜>ÀÞʅi>ÀÌÊ`ˆÃi>Ãi°ÊœÀÊ̅ˆÃÊÀi>ܘ]Ê«Ài`ˆV̈˜}Ê,
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“i̅œ`Ê܅i˜Ê>««ˆi`Ê̜Ê>Êˆ˜`ˆÛˆ`Õ>Ã°Ê iÜÊvœÀ“Տ>iÊ«Ài`ˆVÌÊ, “>Ý ÀiÃՏÌà Ӱ
܈̅ʏiÃÃÊiÀÀœÀ°Ê
œÃiÊ1«Ê œÝʣΰ{Ê«ÀiÃi˜ÌÃÊ̅iÊvœÀ“Տ>iÊ>˜`ÊVœ““œ˜Ê…i>ÀÌ
À>Ìiʓi̅œ`ÃÊ̜ÊiÃÌ>LˆÃ…ʈ˜`ˆÛˆ`Õ>ÊÌÀ>ˆ˜ˆ˜}ʏiÛiÃ°

Effectiveness of Less Intense Exercise /…iÊÀiVœ““i˜`>̈œ˜Ê̜

ÌÀ>ˆ˜Ê>ÌÊÇä¯ÊœvÊ, “>Ý >ÃÊ̅iÊ̅ÀiŜ`ÊvœÀÊ>iÀœLˆVʈ“«ÀœÛi“i˜ÌÊÀi«ÀiÃi˜ÌÃÊ>
}i˜iÀ>Ê}Ո`iˆ˜i vœÀÊ>ÊVœ“vœÀÌ>LiÊÞiÌÊivviV̈ÛiÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ°Ê/Üi˜ÌÞÊ̜ÊÎä 7…>ÌʈÃÊ̅iÊÀiVœ““i˜`i`ʯÊ,“>Ý ÌÀ>ˆ˜‡
ˆ˜}ʏiÛiÊvœÀÊÃi`i˜Ì>ÀÞʈ˜`ˆÛˆ`Õ>ÃÊÃÌ>À̈˜}
“ˆ˜ÕÌiÃʜvÊVœ˜Ìˆ˜ÕœÕÃÊiÝiÀVˆÃiÊ>ÌÊ̅iÊÇä¯ÊiÛiÊÃ̈“Տ>ÌiÃÊ>ÊÌÀ>ˆ˜ˆ˜}ÊivviVÌÆ
>˜ÊiÝiÀVˆÃiÊ«Àœ}À>“¶
iÝiÀVˆÃiÊ>ÌÊ>ʏœÜiÀʈ˜Ìi˜ÃˆÌÞʜvÊÈä¯Ê̜ÊÈx¯Ê, “>Ý vœÀÊ{xʓˆ˜ÕÌiÃÊ>ÃœÊ«ÀœÛiÃ
Li˜ivˆVˆ>° ˜Ê}i˜iÀ>]ʏœ˜}iÀÊiÝiÀVˆÃiÊ`ÕÀ>̈œ˜ÊœvvÃiÌÃʏœÜiÀÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ]Ê«>À‡
̈VՏ>ÀÞÊvœÀʜ`iÀÊ>˜`ʏiÃÃÊvˆÌʈ˜`ˆÛˆ`Õ>°Ê,i}>À`iÃÃʜvÊiÝiÀVˆÃiʏiÛi]ʓœÀiʈÃʘœÌ
˜iViÃÃ>ÀˆÞÊLiÌÌiÀÊLiV>ÕÃiÊiÝViÃÈÛiÊiÝiÀVˆÃiʈ˜VÀi>ÃiÃÊ̅iÊV…>˜ViÊvœÀÊÃÕÃÌ>ˆ˜ˆ˜}
Lœ˜i]ʍœˆ˜Ì]Ê>˜`ʓÕÃViʈ˜ÕÀˆið

Train at Perception of Effort

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iÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ]ʜ˜iÊ>ÃœÊV>˜ÊÕÃiÊ̅iÊÀ>̈˜}ʜvÊ«iÀViˆÛi`ÊiÝiÀ̈œ˜Ê­,* ®°Ê7ˆÌ…
̅ˆÃÊ«ÃÞV…œ«…ÞȜœ}ˆVÊ>««Àœ>V…]Ê̅iÊiÝiÀVˆÃiÀÊÀ>ÌiÃʜ˜Ê>ʘՓiÀˆV>ÊÃV>iʭܓi‡
̈“iÃÊV>i`Ê̅iÊ œÀ}ÊÃV>iÊ>vÌiÀÊÀiÃi>ÀV…iÀÊ՘˜>ÀÊ œÀ}Ê܅œÊ`iÛiœ«i`Ê̅iÊvˆÀÃ
œvÊ̅iÃiÊÃV>ˆ˜}ÊÃÞÃÌi“îʫiÀViˆÛi`Êviiˆ˜}ÃÊÀi>̈ÛiÊ̜ÊiÝiÀ̈œ˜ÊiÛi°Êœ˜ˆÌœÀˆ˜}
>˜`Ê>`ÕÃ̈˜}Ê,* Ê`ÕÀˆ˜}ÊiÝiÀVˆÃiÊ«ÀœÛˆ`iÃÊ>˜ÊivviV̈ÛiÊÃÌÀ>Ìi}ÞÊ̜ʫÀiÃVÀˆLi
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°
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Ì>ÌiÊVœ˜Vi˜ÌÀ>̈œ˜®°Ê ÝiÀVˆÃiʏiÛiÃÊVœÀÀi뜘`ˆ˜}Ê̜ʅˆ}…iÀʏiÛiÃʜvÊi˜iÀ}Þ
iÝ«i˜`ˆÌÕÀiÊ>˜`Ê«…ÞȜœ}ˆVÊÃÌÀ>ˆ˜Ê«Àœ`ÕViʅˆ}…iÀÊ,* ÊÀ>̈˜}ðÊœÀÊiÝ>“«i]
>˜Ê,* ʜvÊ£ÎʜÀÊ£{Ê­iÝiÀVˆÃiÊ̅>ÌÊviiÃʺܓi܅>Ìʅ>À`»ÆÊFig. 13.14®ÊVœˆ˜Vˆ`iÃ
&OR 9OUR )NFORMATION
2%'5,!2 $/3%3 /& !%2/")#
RPE Scale Equivalent Equivalent %8%2#)3% #/-"!4 /"%3)49
% HRmax % VO2max
Sixty minutes of moderate daily exer-
cise (low-impact walking or aerobic
6
dancing, swimming, stationary
7 Very, very light
cycling) reduces excess body fat.
8
9 Very light Exercise can be divided into 10-, 20-,
10 or 30-minute sessions, as long as the
11 Fairly light 52-66 31-50 daily total equals 60 minutes or more.
12 For an individual who weighs 216
13 Somewhat hard 61-85 51-75 pounds, the caloric expenditure dur-
14 ing slow walking equals 7.8 kCal each
15 Hard 86-91 76-85 minute (470 kCal per hour). Over 1
16 month, total exercise calories would
17 Very hard 92 85 accumulate to 14,100 kCal (470 kCal
18 # 30 days), the equivalent of 4.0 lb of
19 Very, very hard body fat. In 1 year, as long as caloric
intake remains constant, fat loss
Figure 13.14 /…iÊ œÀ}ÊÃV>iÊ>˜`Ê>VVœ“«>˜Þˆ˜}ÊiÃ̈“>ÌiÃʜvÊÀi>̈ÛiÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ (without dieting) would amount to
vœÀʜLÌ>ˆ˜ˆ˜}Ê̅iÊÀ>̈˜}ʜvÊ«iÀViˆÛi`ÊiÝiÀ̈œ˜Ê­,* ®Ê`ÕÀˆ˜}ÊiÝiÀVˆÃi°Ê­œ`ˆvˆi`ÊvÀœ“Ê œÀ} nearly 50 pounds.
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«Ì>À>ʘV

430 • SECTION V Exercise Training and Adaptations

BOX 13.4 CLOSE UP

Predicting Maximum Heart Rate and the
Training-Sensitive Zone

*iÀVi˜Ì>}iʜvʓ>݈“Õ“Ê,Ê«Ài`ˆVÌÃÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ Ó°Ê
>VՏ>ÌiÊ1/, >Ã\
­>˜Ê>V̈ۈÌÞ½ÃÊÀi>̈ÛiÊi˜iÀ}ÞÊÀiµÕˆÀi“i˜Ìî°
,“>Ý ˆ˜ÊLi>ÌÃÊ«iÀʓˆ˜Ê­L«“®ÊV>˜ÊLiÊ«Ài`ˆVÌi`ÊLÞÊ>}i] 1/, ! *Ài`ˆVÌi`Ê,“>ÝÊ#
ˆ˜`i«i˜`i˜ÌʜvÊ}i˜`iÀÊ>˜`Ê«…ÞÈV>Ê>V̈ۈÌÞÊÃÌ>ÌÕðÊœÀ 1««iÀ‡ˆ“ˆÌÊ«iÀVi˜Ì>}iÊvœÀÊ>}i
˜œ˜v>Ì “i˜Ê>˜`Êܜ“i˜]Ê,“>Ý «Ài`ˆVÌÃÊ>Ã\
܅iÀiÊ̅iÊÕ««iÀ‡ˆ“ˆÌÊ«iÀVi˜Ì>}iÊ ! ™ä¯ÊvœÀʓi˜Ê
,“>Ý ! ÓänÊ" ä°ÇÊ# ­
}i]ÊÞ® >˜`Êܜ“i˜ÊÈäÊÞi>ÀÃÊ>˜`Êޜ՘}iÀÊ>˜`Ênä¯ÊvœÀʓi˜Ê>˜`
ܜ“i˜Êœ`iÀÊ̅>˜Ê>}iÊÈäÊÞi>Àð
Example

>VՏ>ÌiÊ̅iÊ,“>Ý vœÀÊ>ÊÓä‡Þi>À‡œ`ʓ>˜°
Example
>Ì>\Ê>i]Ê>}iÊxxÊÞi>Àð
,“>Ý ! ÓänÊ" ä°ÇÊ# ­
}i]ÊÞ®
£°Ê
>VՏ>ÌiÊ«Ài`ˆVÌi`Ê,“>Ý
! £™{ÊL«“
,“>Ý ! ÓänÊ" ä°ÇÊ# ­
}i]ÊÞ®Ê! £ÇäÊL«“
PREDICTING HR max FOR MEN AND /, ! £ÇäÊ# œÜiÀ‡ˆ“ˆÌÊ«iÀVi˜Ì>}iÊvœÀÊ>}i
WOMEN WITH $30% BODY FAT ! £ÇäÊ# ä°Çä
œÀʜÛiÀv>Ìʓi˜Ê>˜`Êܜ“i˜Ê܈̅ʫiÀVi˜Ì>}iÊLœ`ÞÊv>Ìʏiۇ ! ££™ÊL«“
iÃÊÎä¯ÊœÀÊ>LœÛi]Ê,“>Ý «Ài`ˆVÌÃÊ>Ã\ Ó°Ê
>VՏ>ÌiÊ1/,
,“>Ý ! ÓääÊ" ä°xÊ# ­
}i]ÊÞ® 1/, ! ,“>Ý # 1««iÀ‡ˆ“ˆÌÊ«iÀVi˜Ì>}iÊvœÀÊ>}i
Example ! £ÇäÊ# 䰙ä

>VՏ>ÌiÊ̅iÊ,“>Ý vœÀÊ>ÊÓx‡Þi>À‡œ`Êܜ“>˜Ê܈̅Ê>Ê«iÀ‡ ! £xÎÊL«“
Vi˜Ì>}iÊLœ`ÞÊv>ÌʜvÊÎÓ¯°
,“>Ý ! ÓääÊ" ä°xÊ# ­
}i]ÊÞ®
Method 2: Karvonen Method
(Heart Rate Reserve)
! £nnÊL«“
˜Ê>ÌiÀ˜>Ìi]ÊiµÕ>ÞÊivviV̈Ûiʓi̅œ`ÊV>VՏ>ÌiÃÊ̅i
œÜiÀ‡Ê>˜`ÊÕ««iÀ‡Ì…ÀiŜ`Ê,ʏiÛiÃÊ>ÌÊ>Ê«iÀVi˜Ì>}iʜv
COMPUTING LOWER- AND UPPER-LIMIT ̅iÊ`ˆvviÀi˜ViÊLiÌÜii˜ÊÀiÃ̈˜}Ê>˜`ʓ>݈“Õ“Ê,]ÊÌiÀ“i`
TRAINING HEART RATES …i>ÀÌÊÀ>ÌiÊÀiÃiÀÛi ­,,Æ >ÃœÊÀiviÀÀi`Ê̜Ê>ÃÊ̅iÊ>Àۜ˜i˜
œÀʓi˜Ê>˜`Êܜ“i˜Êޜ՘}iÀÊ̅>˜ÊÈäÊÞi>ÀÃʜvÊ>}i]Ê̅i “i̅œ` ˜>“i`Ê>vÌiÀÊ̅iʈ˜˜ˆÃ…Ê«…ÞȜœ}ˆÃÌÊ܅œÊˆ˜ÌÀœ‡
“ˆ˜ˆ“>ÊœÀʏœÜiÀ‡ˆ“ˆÌÊÌ>À}iÌÊ̅ÀiŜ`ʅi>ÀÌÊÀ>Ìi­/,® `ÕVi`Ê̅ˆÃʓi̅œ`®°Ê>Àۜ˜i˜½Ãʓi̅œ`Ê«Àœ`ÕViÃÊܓi‡
Ã̈“ՏÕÃÊvœÀÊV>À`ˆœÛ>ÃVՏ>Àʈ“«ÀœÛi“i˜ÌÊÀ>˜}iÃÊLiÌÜii˜ ܅>Ìʅˆ}…iÀÊÛ>ÕiÃÊVœ“«>Ài`Ê܈̅ʅi>ÀÌÊÀ>ÌiÊVœ“«ÕÌi`Ê>Ã
Èä¯Ê>˜`ÊÇä¯ÊœvÊ, “>Ý]ÊÀi«ÀiÃi˜Ìˆ˜}Ê>LœÕÌÊxä¯Ê̜ÊÈä¯Êœv «iÀVi˜Ì>}iʜvÊ, “>Ý°Ê/…iÊ>Àۜ˜i˜Ê“i̅œ`ÊÕÃiÃÊ>LœÕÌ
°
6"ӓ>Ý°Ê/…iÊÕ««iÀ‡ˆ“ˆÌÊÌ>À}iÌ …i>ÀÌÊÀ>ÌiÊ­1/,®ÊiµÕ>Ã xä¯ÊœvÊ,,Ê>ÃÊ̅iÊ/, >˜`Ênx¯ÊœvÊ,,Ê>ÃÊ1/,°
>LœÕÌʙä¯ÊœvÊ,
° “>Ý]ÊÀi«ÀiÃi˜Ìˆ˜}Ê>LœÕÌÊnx¯Ê̜ʙä¯Êœv £°Ê
>VՏ>ÌiÊ«Ài`ˆVÌi`Ê,“>Ý\
6"ӓ>ݰʘʈ˜`ˆÛˆ`Õ>Ãʜ`iÀÊ̅>˜ÊÈäÊÞi>ÀÃʜvÊ>}i]Ê /,
iµÕ>ÃÊÈä¯]Ê>˜`Ê1/, iµÕ>ÃÊÇx¯ÊœvÊ,“>Ý° ,“>Ý ! ÓänÊ" ä°ÇÊ#
}i]ÊÞ
Method 1: Percentage Method Ó°Ê
>VՏ>ÌiÊ/,\
/…ˆÃʓi̅œ`ÊV>VՏ>ÌiÃÊ̅iʏœÜiÀ‡Ê>˜`ÊÕ««iÀ‡ˆ“ˆÌÊÌ>À}iÌ /, ! Q­,“>Ý " ,ÀiÃÌ®Ê# ä°xäRÊ% ,ÀiÃÌ
…i>ÀÌÊÀ>ÌiÃÊ>ÃÊ>Êȓ«iÊ«iÀVi˜Ì>}iʜvÊ>}i‡«Ài`ˆVÌi`
,“>Ý° ΰÊ
>VՏ>ÌiÊ1/,\
£°Ê
>VՏ>ÌiÊ/, >Ã\ 1/, ! Q­,“>Ý " ,ÀiÃÌ®Ê# ä°nxRÊ% ,ÀiÃÌ

/, ! *Ài`ˆVÌi`Ê,“>Ý # Example

œÜiÀ‡ˆ“ˆÌÊ«iÀVi˜Ì>}iÊvœÀÊ>}i >Ì>\Ê>i]Ê>}iÊxxÊÞi>ÀÃ]Ê,ÀiÃÌ ! ÈäÊL&“ˆ˜"£°
£°Ê
>VՏ>ÌiÊ«Ài`ˆVÌi`Ê,“>Ý\
܅iÀiÊ̅iʏœÜiÀ‡ˆ“ˆÌÊ«iÀVi˜Ì>}iÊ ! Çä¯ÊvœÀʓi˜Ê
>˜`Êܜ“i˜Ê>}iÊÈäÊÞi>ÀÃÊ>˜`Êޜ՘}iÀÊ>˜`ÊÈä¯ÊvœÀÊ ,“>Ý ! ÓänÊ" ä°ÇÊ#
}i]ÊÞ
“i˜Ê>˜`Êܜ“i˜Êœ`iÀÊ̅>˜Ê>}iÊÈäÊÞi>Àð ! £ÇäÊL«“
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«Ì>À>ʘV

Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 431

Ó°Ê
>VՏ>ÌiÊ/,\ Method 3: Perhaps a Modification Required
,iVi˜ÌÊiۈ`i˜ViÊvÀœ“Ê>ʏœ˜}ˆÌÕ`ˆ˜>ÊÃÌÕ`ÞʜvÊ£ÎÓÊ«iÀܘÃ
/, ! Q­,“>Ý " ,ÀiÃÌ®Ê# ä°xäRÊ$ ,ÀiÃÌ
“i>ÃÕÀi`Ê>˜Ê>ÛiÀ>}iÊÃiÛi˜Ê̈“iÃʜÛiÀʙÊÞi>ÀÃʈ˜`ˆV>ÌiÃÊ>ÊLˆ>Ã
! Q­£ÇäÊ" Èä®Ê# ä°xäRÊ$ Èä ˆ˜Ê̅iÊ܈`iÞÊÕÃi`ÊÓÓäÊqÊ
}iÊ«Ài`ˆV̈œ˜ÊœvÊ, “>Ý° /…iÊLˆ>Ã
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Maximum heart rate (b min-1)

195

185

175

165

155

145

135
Age (y) 30 35 40 45 50 55 60 65 70 75
220 — Age 190 185 180 175 170 165 160 155 150 145
206.9 — 0.67 x Age 187 183 180 177 173 170 167 163 160 157
Age-predicted maximum heart rates

220 — Age 206.9 — 0.67 x Age

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Lactate-Generating Capacity
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Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 433

BOX 13.5 CLOSE UP

Determine 10,000-M Running Pace from Lactate Threshold

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Oxygen uptake, mL • kg-1 • min-1

55
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35
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6
COMPUTING EXPECTED PERFORMANCE
5

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Blood lactate, mM

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2 ­Óä{ʓ!“ˆ˜"£ # xʓ!“ˆ˜"£®°

1
DETERMINE THE PROJECTED RACE TIME
0
10 20 30 40 50 60 FOR THE 10,000-M RUN
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BOX 13.6 CLOSE UP

A Typical Aerobic Exercise Session

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200 Resting Warm-up Endurance Cooldown Recovery

(5-10 min) (20-60 min) (5-10 min)
180 Age-predicted Maximum = 170 b•min-1
Heart rate (b min-1)

160 HRR 85% = 154 b•min-1

140

120
HRR 50% = 115 b•min-1
100

80 Target heart rate zone

Check heart rate
60
Start 10 20 30 40 50 Stop
exercise exercise

Exercise duration, min

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Chapter 13 Training the Anaerobic and Aerobic Energy Systems • 435

Table 13.4
Guidelines for Determining Interval-Training Exercise
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C h a p t e r
14
Training Muscles
to Become
Stronger
CHAPTER OBJECTIVES

• Describe the following four methods to assess muscu-
lar strength: cable tensiometry, dynamometry, one-
repetition maximum (1-RM), and computer-assisted
isokinetic dynamometry.
• Outline the procedure to assess 1-RM for bench press
and leg press.
• Explain how to ensure test standardization and
fairness when evaluating muscular strength.
• Compare absolute and relative upper- and lower-body
muscular strength in men and women.
• Describe the rationale for plyometric training to
improve muscular strength and power and give
examples of exercises for these purposes.
• Indicate how psychological and muscular factors
influence maximum strength capacity.
• Outline the major physiologic adaptations to
resistance training.
• Develop a circuit resistance training program to
improve muscular strength and aerobic fitness
simultaneously.

• Define concentric, eccentric, and isometric muscle • Describe tests to assess muscular endurance for the
actions, including examples of each. abdominals and chest–shoulder areas.

• Recommend the appropriate frequency, overload, and
sets and repetitions for dynamic exercise resistance
training.
• Explain the specificity of training response for muscu-
lar strength related to enhanced performance in
sports and occupational tasks.
• Describe delayed-onset muscle soreness (DOMS)
related to (1) type of exercise most frequently associ-
ated with DOMS, (2) best way to minimize DOMS
effects when beginning a training program, and
(3) cellular factors related to DOMS.

• Compare isokinetic resistance training with

conventional dynamic and static resistance training.

443
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444 • SECTION V Exercise Training and Adaptations

Part 1 Muscular Strength
Measurement and
Improvement
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Chapter 14 Training Muscles to Become Stronger • 445

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446 • SECTION V Exercise Training and Adaptations

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Chapter 14 Training Muscles to Become Stronger • 447

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448 • SECTION V Exercise Training and Adaptations

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Chapter 14 Training Muscles to Become Stronger • 449

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Estimating 1-RM Strength Using Submaximum Repetitions-

to-Fatigue Test Scores
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>ÊÃÕL“>݈“>Ê«iÀvœÀ“>˜ViʭLJÊ̜ʣä‡,® 2. Does the child understand proper lifting techniques for each exercise?
>˜`ʓ>݈“>ÊˆvÌÊV>«>VˆÌÞÊ­£‡,®°Êi˜iÀ>Þ] 3. Does the child understand the safety needs?
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450 • SECTION V Exercise Training and Adaptations

BOX 14.1 CLOSE UP

How to Assess and Evaluate One-Repetition
Maximum for Bench and Leg Press

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Chapter 14 Training Muscles to Become Stronger • 451

Procedures for Bench Press Test

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Procedures for Leg Press Test

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452 • SECTION V Exercise Training and Adaptations

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Estimating 1-RM from Submaximum Load (Weight) and Number of Repetitions

To use the table (1) read across the Max Reps (RM) row and find the number of repetitions completed; (2) read
Table 14.2
down the column to the load (weight completed, lb) lifted; (3) read across the row to the far left to find the
estimated 1-RM.


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454 • SECTION V Exercise Training and Adaptations

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BOX 14.2 CLOSE UP

How to Assign Load (Resistance) and Repetition
Number to Achieve Different Training Goals

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Chapter 14 Training Muscles to Become Stronger • 455

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Power–Velocity Relationship
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Force

Shortening
Lengthening Action
Action Maximum
Isometric
Force

Figure 14.5 >݈“Õ“ÊvœÀViqÛiœVˆÌÞ

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Chapter 14 Training Muscles to Become Stronger • 457

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Figure 14.6 *œÜiÀqÛiœVˆÌÞʈ˜ÛiÀÌi`Ê1ÊÀi>̈œ˜Ã…ˆ«°

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Load–Repetition Relationship
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100

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Maximum repetitions

60

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Strength Training Zone
20

0 20 40 60 80 100
Percentage 1-RM

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458 • SECTION V Exercise Training and Adaptations

GENDER DIFFERENCES IN õÕ>ÀiÊVi˜Ìˆ“iÌiÀʜvʓÕÃViÊVÀœÃÇÃiV̈œ˜>Ê>Ài> ­

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̅iʓi˜½ÃÊÃVœÀi]Ê>˜`ʏœÜiÀ‡Lœ`ÞÊÃÌÀi˜}̅Ê>ÛiÀ>}iÃÊÇӯʜv
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Chapter 14 Training Muscles to Become Stronger • 459

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Strength per MCSA, cm2

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460 • SECTION V Exercise Training and Adaptations

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Chapter 14 Training Muscles to Become Stronger • 461

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462 • SECTION V Exercise Training and Adaptations
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Determining Upper-Arm Muscle and Fat Areas
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A Upper-arm composition and area

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Chapter 14 Training Muscles to Become Stronger • 463

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Chapter 14 Training Muscles to Become Stronger • 465

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466 • SECTION V Exercise Training and Adaptations

(A) Knees-to-chest stretch: Lie (G) Dry-land swimming: Lying

supine and pull knees into chest prone with pelvic flextion,
while keeping lower back flat on alternate lifting opposite arm
the surface. and legs.

(B) Cross-leg strech: Cross legs (H) Both legs up: Lying prone
like sitting male. Cross legs and with pelvic flexion, lift both legs
pull 90°-flexed knee toward simultaneously while keeping the
chest. head on the floor.

(C) Hamstring stretch: Wrap (I) Pointer (bird dog): Start with
strap over foot, keeping lower hands and knees on the floor. Flex
back flat; pull leg upward toward pelvis into counter position.
head. Exchange pointing opposite arm
and leg while keeping the torso
level.

(D) Allah stretch: Sit with (J) Upper body up: Lying prone
buttocks on bilateral heels; move with pelvic flexion and arms
hands as far forward along the outstretched or behind the back,
surface as possible. lift the upper torso while keeping
the legs on the floor.

(E) Bent-knee sit-up: Keep hands (K) Prone cobra push-up: Keep
low on neck (or across chest) with the pelvis on the floor while
head positioned over the shoulders. pressing up with the arms,
Roll up slowly, engaging one row causing lower back extension.
of abdominals at a time. Raise
the shoulders 4 to 6 inches off
the surface.

(F) Dying bug: Flex the pelvis to (L) Leg pointer: Lie supine on the
flatten the lower back against the floor and flex the pelvis with the
surface. Over one side, bring an lower abdominals to flatten the
extended arm and flexed knee lower back into the surface.
together. The opposing side Extend one arm upward and one
should extend a straight arm leg outward while keeping the
overhead and straight leg quadriceps level.
backward. Maintain pelvic flexion
while exchanging opposing arms
and legs in this position.

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Chapter 14 Training Muscles to Become Stronger • 467

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General Back Exercises Figure 14.11 ˆÕÃÌÀ>ÌiÃÊ£ÓÊiÝiÀVˆÃiÃÊ̅>ÌÊ«Àœ‡

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>˜`Ê«>ˆ˜°

Experiments with Isokinetic Exercise and Training Ý«iÀˆ‡

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14.12 `ˆÃ«>ÞÃÊ̅iÊ«Àœ}ÀiÃÈÛiÊ`iVˆ˜iʈ˜ÊVœ˜Vi˜ÌÀˆVÊ«i>ŽÊ̜ÀµÕiʜÕÌ«ÕÌÊ܈̅
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Peak torque (N-m . kg BW–1)

3.5

3.0

2.5

2.0

1.5

1.0

0.5

0
90 180 270 360 450 540 630 720 810
Angular velocity (degrees . s-1)

Power athletes >60% FT Endurance athletes <50% FT

Figure 14.12 *i>ŽÊ̜ÀµÕiÊ«iÀÊ՘ˆÌÊLœ`Þʓ>ÃÃÊÀi>Ìi`Ê̜Ê>˜}Տ>ÀÊÛiœVˆÌÞʈ˜ÊÌܜ

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468 • SECTION V Exercise Training and Adaptations

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Rebound Jumping Technique in Polymetric Training

A Stage 1 Stage 2 Stage 3

Rebound jump again

after landing

OBJECTIVE: Complete
2-5 sets of 5-12 repetitions
depending on strength
level and conditioning base
20 inches

23 inches
Starting position Jump onto the box Jump from the box
• Feet shoulder width • After landing, • Upon landing, explode
apart explode upward as upward again onto
• Flex ankles, knees, and high and as far forward another box, or as high
hips and thrust vigorously as possible and far forward before
forward and upward to rebound jumping again
land with both feet
on the box

Figure 14.13 ­
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Chapter 14 Training Muscles to Become Stronger • 469

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0
0 10 20 30 40 50 60 70 80 90 100
Bar position relative &OR 9OUR )NFORMATION
to total concentric movement (%)
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Stretching with fast, bouncing, jerky
Bench throw Bench press
movements that use the body’s
Figure 14.14 i>˜ÊL>ÀÊÛiœVˆÌÞʈ˜ÊÀi>̈œ˜Ê̜Ê̜Ì>ÊVœ˜Vi˜ÌÀˆVÊL>ÀʓœÛi“i˜ÌÊvœÀ momentum can strain or tear muscles
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470 • SECTION V Exercise Training and Adaptations

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Body Weight–Loaded Training
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Chapter 14 Training Muscles to Become Stronger • 471

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̅iÊ«iÛˆVÊvœœÀÊ>˜`ʅˆ«Ê}ˆÀ`iʓÕÃVՏ>ÌÕÀiÊvÀ>“ˆ˜}Ê̅iÊLœÌ̜“°Ê/…iʺVœÀi»Ê`œi iÃVÀˆLiÊ̅iÊÃÌÀiÌV…‡Ã…œÀÌi˜ˆ˜}ÊVÞViÊ>˜`
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܈̅œÕÌÊ>`iµÕ>ÌiʺÃÌÀi˜}̅Ê>˜`ÊL>>˜Vi»ÊܜՏ`ÊLiVœ“iʓiV…>˜ˆV>ÞÊ՘ÃÌ>Li°

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ÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}°
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̈œ˜>]Ê>˜`ÊÅi>Àˆ˜}ÊvœÀViÃʜ˜Êœˆ˜ÌÃÊ>œ˜}Ê̅iʎˆ˜ïVÊV…>ˆ˜Ê̅>ÌʓÕÃÌÊÃÕ««œÀÌÊ̅i
Lœ`ÞÊÜiˆ}…Ì°

iÃVÀˆLiÊ̅iÊLœ`ÞʺVœÀi»°
SPECIFICITY OF STRENGTH-TRAINING RESPONSE

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܅i˜ÊiÛ>Õ>Ìi`ʈ˜ÊÀiÈÃÌ>˜ViÊ>V̈ۈ̈iÃÊ̅>ÌÊÀiµÕˆÀiʓœÛi“i˜Ì°ÊܓiÌÀˆV
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Ý«>ˆ˜ÊÃÌÀi˜}̅‡ÌÀ>ˆ˜ˆ˜}ÊëiVˆvˆVˆÌÞ
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̈œ˜ÊëiVˆvˆVˆÌ i݈ÃÌÃÆʓÕÃVՏ>ÀÊÃÌÀi˜}̅ʜvÊ>˜ŽiÊ«>˜Ì>ÀÊ>˜`Ê`œÀÈviݜÀ
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472 • SECTION V Exercise Training and Adaptations

/…iÊVÀÕVˆ>ÊVœ˜Ãˆ`iÀ>̈œ˜ÊVœ˜ViÀ˜ÃÊ̅iʈ˜Ìi˜`i`Ê«ÕÀ«œÃi
œvʘi܏ÞÊ>VµÕˆÀi`ÊÃÌÀi˜}̅°
Practical Implications
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Chapter 14 Training Muscles to Become Stronger • 473

Model for periodization +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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474 • SECTION V Exercise Training and Adaptations

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Part 2 Adaptations to Resistance
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Generalized response curve for gains in muscle strength with resistance training
occur from both neural (orange) or muscular (yellow) factors. During a typical
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“strength” gains over the first 2
weeks of workouts. In the subse-
Percentage contribution to strength improvement
100
quent 2 weeks, between 40 and
50% of the strength
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ous system adaptation (in the
higher centers and local muscle
60
levels). Thereafter, muscle fiber
adaptations become progressively
more important to strength 40
improvement. Experiments of
this type generally assess the 20
neural contributions from inte-
grated surface EMG recordings
0
0 2 4 6 8 10
Training duration (wk)
other aspects of neural control
involved in timing and Neural Hypertrophic
coordination patterning.
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Chapter 14 Training Muscles to Become Stronger • 479

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Chapter 14 Training Muscles to Become Stronger • 481

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œLÃiÀÛ>̈œ˜Ã°Êˆ“ˆÌi`Ê`>Ì>ÊvÀœ“ÊŜÀ̇ÌiÀ“ÊÃÌÕ`ˆiÃʈ˜`ˆV>ÌiÊ̅>ÌÊܜ“i˜ÊV>˜ÊÕÃi
Vœ˜Ûi˜Ìˆœ˜>ÊÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}ʓi̅œ`ÃÊ̜Ê}>ˆ˜Ê“ÕÃViÊÃÌÀi˜}̅Ê>˜`ÊÈâiʜ˜Ê>Êȓ‡
ˆ>ÀÊ«iÀVi˜Ì>}iÊL>ÈÃÊ>Ãʓi˜°
iÃVÀˆLiʓÕÃViÊvˆLiÀʅޫiÀ«>È>

Muscle Fiber Hyperplasia

ÊVœ““œ˜ÊµÕiÃ̈œ˜ÊVœ˜ViÀ˜ÃÊ܅i̅iÀÊÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}Ê«Àœ`ÕViÃʅޫiÀ«>È>
œÀʈ˜VÀi>Ãi`ʘՓLiÀʜvʓÕÃViÊViÃ°ÊvÊ̅ˆÃÊ`œiÃʜVVÕÀ]Ê̜Ê܅>ÌÊiÝÌi˜ÌÊ`œiÃʈÌ
Vœ˜ÌÀˆLÕÌiÊ̜ʓÕÃViÊi˜>À}i“i˜Ì¶Ê
…Àœ˜ˆVʜÛiÀœ>`ʜvÊÎiiÌ>Ê“ÕÃViʈ˜ÊÛ>À‡
ˆœÕÃÊ>˜ˆ“>ÊëiVˆiÃÊ`iÛiœ«ÃʘiÜʓÕÃViÊvˆLiÀÃÊvÀœ“ÊÃ>ÌiˆÌiÊViÃÊLiÌÜii˜Ê̅ œÊܜ“i˜ÊÀi뜘`Êȓˆ>ÀÞÊ̜ÊÀiÈÃÌ>˜Vi
L>Ãi“i˜Ìʏ>ÞiÀÊ>˜`Ê«>Ó>ʓi“LÀ>˜iʜÀÊLÞʏœ˜}ˆÌÕ`ˆ˜>Ê돈Ì̈˜}°Ê1˜`iÀÊVœ˜‡ ÌÀ>ˆ˜ˆ˜}Ê>Ãʓi˜¶
`ˆÌˆœ˜ÃʜvÊÃÌÀiÃÃ]ʘiÕÀœ“ÕÃVՏ>ÀÊ`ˆÃi>Ãi]Ê>˜`ʓÕÃViʈ˜ÕÀÞ]Ê̅iʘœÀ“>ÞÊ`œÀ‡
“>˜ÌÊÃ>ÌiˆÌiÊViÃÊ`iÛiœ«Êˆ˜ÌœÊ˜iÜʓÕÃViÊvˆLiÀðÊ7ˆÌ…ʏœ˜}ˆÌÕ`ˆ˜>Ê돈Ì̈˜}
>ÊÀi>̈ÛiÞʏ>À}iʓÕÃViÊvˆLiÀÊ돈ÌÃʈ˜ÌœÊÌܜʜÀʓœÀiÊÓ>iÀʈ˜`ˆÛˆ`Õ>Ê`>Õ}…
ÌiÀÊViÃÊ̅ÀœÕ}…ʏ>ÌiÀ>ÊLÕ``ˆ˜}°Ê/…iÃiÊvˆLiÀÃÊv՘V̈œ˜Ê“œÀiÊivvˆVˆi˜ÌÞÊ̅>˜ÊÌ
>À}iÊȘ}iÊvˆLiÀÊvÀœ“Ê܅ˆV…Ê̅iÞʜÀˆ}ˆ˜>Ìi`
i˜iÀ>ˆâˆ˜}Êvˆ˜`ˆ˜}ÃÊvÀœ“ÊÀiÃi>ÀV…Êœ˜Ê>˜ˆ“>ÃÊ̜ʅՓ>˜ÃÊ«œÃiÃÊ>Ê«ÀœLi“
/…iʓ>ÃÈÛiÊViÕ>ÀʅޫiÀÌÀœ«…Þʈ˜Ê…Õ“>˜ÃÊ܈̅ÊÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}Ê`œiÃʘœÌ
œVVÕÀʈ˜Ê“>˜ÞÊ>˜ˆ“>ÊëiVˆiðʘÊV>ÌÃ]ÊvœÀÊiÝ>“«i]ʓÕÃViÊvˆLiÀʅޫiÀ«>È
ÀiviVÌÃÊ̅iÊ«Àˆ“>ÀÞÊVœ“«i˜Ã>̜ÀÞÊ>`ÕÃ̓i˜ÌÊ̜ʓÕÃVՏ>ÀʜÛiÀœ>`
&OR 9OUR )NFORMATION
-œ“iÊiۈ`i˜ViÊÃÕ««œÀ̈˜}ʅޫiÀ«>È>ʈ˜Ê…Õ“>˜ÃÊ`œiÃÊi݈ÃÌ°
Õ̜«ÃÞÊ`>Ì>ÊvÀœ“ -53#5,!2 342%.'4( !.$ 05"%249
ޜ՘}]ʅi>Ì…Þʓi˜Ê܅œÊ`ˆi`Ê>VVˆ`i˜Ì>ÞÊŜÜÊ̅>ÌʓÕÃViÊvˆLiÀÊVœÕ˜ÌÃʜvÊ̅ Until puberty, boys maintain about
>À}iÀÊ>˜`ÊÃÌÀœ˜}iÀʏi}ʭ̅iʏi}ʜ««œÃˆÌiÊ̅iÊ`œ“ˆ˜>˜Ìʅ>˜`®ÊVœ˜Ì>ˆ˜i`Ê£ä¯ 10% greater muscle strength than girls.
“œÀiʓÕÃViÊvˆLiÀÃÊ̅>˜Ê̅iÊÓ>iÀʏi}°Ê
ÀœÃÇÃiV̈œ˜>ÊÃÌÕ`ˆiÃʜvÊLœ` After age 12 years, boys continue to
LՈ`iÀÃÊ܈̅ʏ>À}iʏˆ“LÊVˆÀVՓviÀi˜ViÃÊ>˜`ʓÕÃViʓ>ÃÃÊv>ˆi`Ê̜ÊŜÜÊ̅>Ì increase in strength, but strength
̅iÞÊ«œÃÃiÃÃi`Ê>LœÛi‡˜œÀ“>‡Ãˆâiʈ˜`ˆÛˆ`Õ>Ê“ÕÃViÊvˆLiÀðÊ/…iÊ«œÃÈLˆˆÌÞÊ`œi plateaus in girls. Gender-related
i݈ÃÌÊ̅>ÌÊܓiʜvÊ̅iÊLœ`ÞÊLՈ`iÀÃʈ˜…iÀˆÌi`Ê>˜Êˆ˜ˆÌˆ>Þʏ>À}iʘՓLiÀʜvÊÓ> changes in body composition account
“ÕÃViÊvˆLiÀÃÊ̅>ÌÊ̅i˜Êº…Þ«iÀÌÀœ«…ˆi`»Ê̜ʘœÀ“>ÊÈâiÊ܈̅ÊÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜} for much of the strength difference.
ÞiÌÊ̅iÊvˆ˜`ˆ˜}ÃÊÃÕ}}iÃÌÊ̅iʏˆŽiˆ…œœ`ʜvʅޫiÀ«>È>Ê܈̅ÊViÀÌ>ˆ˜ÊvœÀ“Ãʜ
7 Ç£ä‡V£{Ú{{·{™Ó°µÝ`ÊʙɣÈÉ£äÊÊÇ\£n*ÊÊ*>}iÊ{nÓÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

482 • SECTION V Exercise Training and Adaptations

ÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}°ÊÕÃViÊvˆLiÀÃʓ>ÞÊ>`>«ÌÊ`ˆvviÀi˜ÌÞÊÌ Cardiovascular Adaptations to

…ˆ}…‡ÛœÕ“i]ʅˆ}…‡ˆ˜Ìi˜ÃˆÌÞÊÌÀ>ˆ˜ˆ˜}ÊÕÃi`ÊLÞÊLœ`ÞÊLՈ`iÀà Table 14.6
Resistance Training
̅>˜Ê̜Ê̅iÊÌÞ«ˆV>ÊœÜ‡Ài«ï̈œ˜]ʅi>Ûއœ>`ÊÃÞÃÌi“
v>ۜÀi`ÊLÞÊÃÌÀi˜}̅Ê>˜`Ê«œÜiÀÊ>̅iÌiðÊ
Ûi˜Êˆvʜ̅iÀʅՓ>˜ 6
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Ài뜘ÃiÊÀiviVÌÃÊ>Ê«œÃˆÌˆÛiÊ>`ÕÃ̓i˜Ì]ʅޫiÀÌÀœ«…ÞÊÀi«Ài i>ÀÌÊÀ>Ìi œÊV…>˜}i
Ãi˜ÌÃÊ̅iʓœÃÌʈ“«œÀÌ>˜ÌÊVœ˜ÌÀˆLṎœ˜Ê̜ʈ˜VÀi>Ãi`ʓÕÃViÊÈâi œœ`Ê«ÀiÃÃÕÀi
vÀœ“ÊœÛiÀœ>`ÊÌÀ>ˆ˜ˆ˜}ʈ˜Ê…Õ“>˜Ã° ˆ>Ã̜ˆV iVÀi>ÃiʜÀʘœÊV…>˜}i
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CONNECTIVE TISSUE AND BONE
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ADAPTATIONS ivÌÊÛi˜ÌÀˆVՏ>ÀÊÜ>Ê̅ˆVŽ˜iÃÃ
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˜VÀi>Ãi
œÊV…>˜}i
ivÌÊÛi˜ÌÀˆVՏ>ÀÊV…>“LiÀÊۜÕ“i œÊV…>˜}i
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“ÕÃViÊÃÌÀi˜}̅Ê>˜`ÊÈâiʈ˜VÀi>Ãi° ˜VÀi>ÃiÃʈ˜Êˆ}>“i˜ÌÊ>˜` ivÌÊÛi˜ÌÀˆVՏ>Àʓ>Ãà ˜VÀi>Ãi
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-ÞÃ̜ˆV iVÀi>Ãi
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>À`ˆ>VʜÕÌ«ÕÌ
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̅iʅˆ«Ê>˜`Êvi“ÕÀÊÀi}ˆœ˜ÃÊ̅>˜Ê>}i‡“>ÌV…i`ÊVœ˜ÌÀœÊÃÕL‡
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CARDIOVASCULAR ADAPTATIONS
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6"Ó«i>Ž ˜VÀi>ÃiʜÀʘœÊV…>˜}i
Metabolic Stress of Resistance Training
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vœÀÊLœÌ…ʈÜ“iÌÀˆVÊ>˜`ÊÌÞ«ˆV>ÊÜiˆ}…̇ˆv̈˜}ÊiÝiÀVˆÃiÃÊV>ÃÈvÞ
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«>À̈Vˆ«>˜ÌÃÊÀi«œÀÌÊVœ˜Ãˆ`iÀ>LiʓÕÃVՏ>ÀÊÃÌÀiÃðÊ
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iÝiÀVˆÃiÊÕÃÕ>Þʏ>ÃÌÃʘœÊœ˜}iÀÊ̅>˜ÊÈʜÀÊÇʓˆ˜ÕÌiðÊ/…ˆÃÊÀi‡
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iÛ>Õ>̈ÛiÊVÀˆÌiÀˆ>°Êˆ>̈œ˜Ê>˜`ÊÜi>Ži˜ˆ˜}ʜvÊ̅iʏivÌÊÛi˜ÌÀˆ‡
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LÕÌʅi>ÀÌÊÈâiÊ}i˜iÀ>ÞÊv>ÃÊ܈̅ˆ˜Ê̅iÊÕ««iÀÊÀ>˜}iʜvʘœÀ‡
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BOX 14.4 CLOSE UP
How to Assess Muscular Endurance
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vœÀÊiÛ>Õ>̈˜}ÊÃVœÀiÃʜ˜Ê̅iÊVÕÀ‡Õ«ÊÌiÃÌ°
PUSH-UP MUSCULAR ENDURANCE TEST
/…iÊ«ÕŇիʓÕÃVՏ>ÀÊi˜`ÕÀ>˜ViÊÌiÃÌÊV>˜ÊLiÊ«iÀvœÀ“i`
ˆ˜Êœ˜iʜvÊÌܜÊÜ>ÞÃ\Ê­£®ÊvՏ‡Lœ`ÞÊ«ÕŇիÊ>˜`ʭӮʓœ`ˆ‡
vˆi`Ê«ÕŇիÊ̅>ÌÊÀi`ÕViÃÊ̅iÊLœ`Þʓ>ÃÃÊ>LœÛiÊ̅iÊ>À“Ã
V…iÃÌ]Ê>˜`ÊŜՏ`iÀðÊ/…iʓœ`ˆvˆi`Ê«ÕŇիÊÃiÀÛiÃÊ>ÃÊ>
ÃÌÀi˜}̅ÊvœÀÊܜ“i˜ÊLiV>ÕÃiÊ̅iÞÊ«œÃÃiÃÃÊVœ˜Ãˆ`iÀ>LÞ
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«>Ài`Ê܈̅ʓi˜°
Initial Position
Տ‡ œ`ÞÊ*ÕŇի\ /…iÊ«iÀܘÊ>ÃÃՓiÃÊ>ÊÀi>̈ÛiÞ
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…>˜`ÃÊŜՏ`iÀÊ܈`̅Ê>«>ÀÌÊ>˜`Ê̅iÊ>À“ÃÊvՏÞÊiÝÌi˜`i`
­Fig. 2A®°
œ`ˆvˆi`Ê*ÕŇի /…iÊ«iÀܘÊ>ÃÃՓiÃÊ̅iÊLi˜Ì‡Ž˜ii
«œÃˆÌˆœ˜Ê܈̅ʅˆ«ÃÊ>˜`ÊLÕÌ̜VŽÃÊ«ÀiÃȘ}Ê`œÜ˜Ü>À`ʈ˜
ˆ˜iÊ܈̅Ê̅iʘiVŽÊ>˜`ÊŜՏ`iÀÃÊ­Fig. 2B®°

Table 2 Test Standards to Assess Curl-up Performance

1 ,Ê"Ê
1,‡1*-Ê
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,
/  #Îx Îxq{{ ${x
ÝVii˜Ì
i˜ÊÈä xä {ä
7œ“i˜ xä {ä Îä
œœ`
i˜Ê{x {ä Óx
7œ“i˜ {ä Óx £x
>ˆÀ
i˜ Îä Óx £x
7œ“i˜ Óx £x £ä
*œœÀ
i˜Ê£x £ä x
7œ“i˜ £ä È {

Àœ“Ê>ՏŽ˜iÀ]Ê,°
°]ÊiÌÊ>°\Ê
Ê«>À̈>ÊVÕÀ‡Õ«Ê«ÀœÌœVœÊvœÀÊ>`ՏÌÃÊL>Ãi`ʜ˜Ê>˜Ê>˜>ÞÈÃʜvÊÌܜ
«ÀœVi`ÕÀiðÊ
>˜°Ê°Ê-«œÀÌÊ-Vˆ°]Ê£{\£Îx]Ê£™n™Ê>˜`Ê-«>Àˆ˜}]Ê*° °]ÊiÌÊ>°\ÊiÛiœ«“i˜ÌʜvÊ>ÊV>`i˜ViÊVÕÀ‡Õ«
vœÀÊVœi}iÊÃÌÕ`i˜ÌðÊ,iðÊ+°Ê ÝiÀV°Ê-«œÀÌ°]ÊÈn\Îä™]Ê£™™Ç°

B
Figure 2 -Ì>ÀÌÊ>˜`Êvˆ˜ˆÃ…Ê«œÃˆÌˆœ˜ÃÊvœÀÊvՏ‡Lœ`ÞÊ«ÕŇիÊ
®Ê>˜`ʓœ`ˆvˆi`Ê«ÕÅ‡Õ«Ê ®°

­Vœ˜Ìˆ˜Õi`®
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486 • SECTION V Exercise Training and Adaptations

BOX 14.4 CLOSE UP

How to Assess Muscular Endurance ­
œ˜Ìˆ˜Õi`®
Movement Standards
Տ‡ œ`ÞÊ*ÕŇիÊ>˜`Êœ`ˆvˆi`Ê*ÕŇի /…iÊLœ`ÞʏœÜ‡ Table 3 «ÀiÃi˜ÌÃÊÃÌ>˜`>À`ÃÊvœÀÊÃVœÀˆ˜}Ê̅iÊvՏÊLœ`Þ
iÀÃÊ՘̈Ê̅iÊiLœÜÃÊÀi>V…Ê™ä œvÊvi݈œ˜ÆÊ̅iÊÀiÌÕÀ˜Ê>V̈œ «ÕŇիʭ“i˜®Ê>˜`ʓœ`ˆvˆi`Ê«ÕŇիʭܜ“i˜®ÊÌiÃÌÃ
ÀiµÕˆÀiÃÊ«Õň˜}ÊÕ«Ê՘̈Ê̅iÊ>À“ÃÊvՏÞÊiÝÌi˜`°Ê/…iÊ«ÕŇ
Õ«Ê>V̈œ˜ÊŜՏ`Ê«ÀœVii`ʈ˜Ê>ÊVœ˜Ìˆ˜ÕœÕÃʓœÌˆœ˜Ê܈̅œÕÌ
ÀiÃÌÊ«>ÕÃiÃÊLiÌÜii˜Êvi݈œ˜qiÝÌi˜Ãˆœ˜Ê“œÛi“i˜ÌÃ

Table 3 Test Standards to Assess Push-up Performance of Men

(Full-Body Push-up) and Women (Modified Push-up)
1 ,Ê"Ê*1-‡1*-Ê
"* / 

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Տ‡Lœ`ÞÊ«ÕŇի
ÝVii˜Ì "x{ "{{ "Ι "Î{ "ә
œœ` {xqx{ Îxq{{ ÎäqΙ ÓxqÎ{ Óäqә

ÛiÀ>}i Îxq{{ ÓxqÎ{ Óäqә £xqÓ{ £äq£™
>ˆÀ ÓäqÎ{ £xqÓ{ £Óq£™ nq£{ xq™
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œ`ˆvˆi`Ê«ÕŇÕ
ÝVii˜Ì "{n "Ι "Î{ "ә "£™
œœ` Î{q{n ÓxqΙ ÓäqÎ{ £xqә xq£™

ÛiÀ>}i £ÇqÎÎ £ÓqÓ{ nq£™ Èq£{ Îq{
>ˆÀ Èq£È {q££ ÎqÇ Óqx £qÓ
*œœÀ #È #{ #Î #Ó #£

Àœ“Ê*œœVŽ]Ê°°]ÊiÌÊ>°\Êi>Ì…Ê>˜`ʈ̘iÃÃÊ/…ÀœÕ}…Ê*…ÞÈV>Ê
V̈ۈÌÞ° iÜÊ9œÀŽ\Êœ…˜Ê7ˆiÞÊE
-œ˜Ã]Ê£™n{°

BODY COMPOSITION `i>Þi`‡œ˜ÃiÌʓÕÃViÊÜÀi˜iÃÃÊ­"-®>««i>ÀÃʏ>ÌiÀÊ>˜`

V>˜Ê>ÃÌÊvœÀÊÎʜÀÊ{Ê`>ÞðÊ
˜ÞʜvÊ̅iÊvœœÜˆ˜}ÊÃiÛi˜Êv>V̜ÀÃ
ADAPTATIONS V>˜Ê«Àœ`ÕViÊ"-\
Table 14.8 `ˆÃ«>ÞÃÊV…>˜}iÃʈ˜ÊLœ`ÞÊVœ“«œÃˆÌˆœ˜Ê܈̅ £° ˆ˜ÕÌiÊÌi>ÀÃʈ˜Ê“ÕÃViÊ̈ÃÃÕiʜÀÊ`>“>}iÊ̜ʈÌÃÊVœ˜‡

,ÊÌÀ>ˆ˜ˆ˜}ÊvÀœ“Ê`ˆvviÀi˜ÌÊiÝ«iÀˆ“i˜ÌðÊœÀÊ̅iʓœÃÌÊ«>ÀÌ]
Ó>Ê`iVÀi>ÃiÃʜVVÕÀʈ˜ÊLœ`ÞÊv>Ì]Ê܈̅ʓˆ˜ˆ“>Êˆ˜VÀi>ÃiÃʈ˜
̜Ì>ÊLœ`Þʓ>ÃÃÊ>˜`Ê°Ê/…iʏ>À}iÃÌÊʈ˜VÀi>ÃiÃÊ>“œÕ˜Ì
̜Ê>LœÕÌÊÎʎ}Ê­È°ÈʏL®ÊœÛiÀÊ£äÊÜiiŽÃ]ʜÀÊ>LœÕÌÊä°Îʎ}ÊÜiiŽÞ]
܈̅ÊÀiÃՏÌÃÊ>LœÕÌÊ̅iÊÃ>“iÊvœÀʓi˜Ê>˜`Êܜ“i˜°Ê
`…iÀi˜Vi
̜Ê>ÊÀi`ÕVi`Ê`>ˆÞʈ˜Ì>ŽiʜvÊV>œÀˆiÃÊV>˜Ê>VViiÀ>ÌiÊ̅iÊÜiˆ}…Ì
œÃÃ°Ê œ`ÞÊVœ“«œÃˆÌˆœ˜Ê`>Ì>ÊvœÀʜ̅iÀÊ`ޘ>“ˆVÊÃÌÀi˜}̅ÊÌÀ>ˆ˜‡
ˆ˜}ÊÃÞÃÌi“ÃÊŜÜÊȓˆ>ÀÊÀiÃՏÌÃ°Ê œÊœ˜iÊÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}
ÃÞÃÌi“Ê«ÀœÛiÃÊÃÕ«iÀˆœÀÊvœÀÊV…>˜}ˆ˜}ÊLœ`ÞÊVœ“«œÃˆÌˆœ˜°
œ“Lˆ˜>̈œ˜ÊœvÊ̅iÊ>LœÛiÊv>V̜ÀÃ
MUSCLE SORENESS AND STIFFNESS
œÃÌÊ«iœ«iÊiÝ«iÀˆi˜ViÊÜÀi˜iÃÃÊ>˜`ÊÃ̈vv˜iÃÃʈ˜Ê̅iÊiÝiÀ‡
VˆÃi`ʍœˆ˜ÌÃÊ>˜`ʓÕÃViÃÊ>vÌiÀÊ>˜ÊiÝÌi˜`i`ʏ>ޜvvÊvÀœ“
iÝiÀVˆÃi°Ê/i“«œÀ>ÀÞÊÜÀi˜iÃÃʓ>ÞÊ«iÀÈÃÌÊvœÀÊÃiÛiÀ>Ê…œÕÀÃ
ˆ““i`ˆ>ÌiÞÊ>vÌiÀÊ՘>VVÕÃ̜“i`ÊiÝiÀVˆÃi]ÊLÕÌÊ>ÊÀiÈ`Õ>
ÌÀ>V̈iÊVœ“«œ˜i˜ÌÃÊ܈̅Ê>VVœ“«>˜Þˆ˜}ÊÀii>Ãiʜv
VÀi>̈˜iʎˆ˜>Ãi]ʓޜ}œLˆ˜]Ê>˜`ÊÌÀœ«œ˜ˆ˜Êʭ̅i
“ÕÃVi‡Ã«iVˆvˆVʓ>ÀŽiÀʜvʓÕÃViÊvˆLiÀÊ`>“>}
Ó° "Ӝ̈VÊ«ÀiÃÃÕÀiÊV…>˜}iÃÊ̅>ÌÊV>ÕÃiÊvÕˆ`ÊÀiÌi˜Ìˆœ
ˆ˜Ê̅iÊÃÕÀÀœÕ˜`ˆ˜}Ê̈ÃÃÕiÃ
ΰ ÕÃViÊë>ÓÃ
{° "ÛiÀÃÌÀiÌV…ˆ˜}Ê>˜`Ê«iÀ…>«ÃÊÌi>Àˆ˜}ʜvÊ«œÀ̈œ˜Ãʜv
̅iʓÕÃVi½ÃÊVœ˜˜iV̈ÛiÊ̈ÃÃÕiʅ>À˜iÃÃ
x°
VÕÌiʈ˜v>““>̈œ
È°
ÌiÀ>̈œ˜Êˆ˜Ê̅iÊViÃ½Ê“iV…>˜ˆÃ“ÊvœÀÊV>VˆÕ“Ê
Ài}Տ>̈œ˜
Ç°
Eccentric Actions Produce
Muscle Soreness
/…iÊ«ÀiVˆÃiÊV>ÕÃiʜvʓÕÃViÊÜÀi˜iÃÃÊÀi“>ˆ˜ÃÊ՘Ž˜œÜ˜°
/…iÊ`i}ÀiiʜvÊ`ˆÃVœ“vœÀÌÊ>˜`ʓÕÃViÊ`ˆÃÌÕÀL>˜ViÊ`i«i˜`Ã
7 Ç£ä‡V£{Ú{{·{™Ó°µÝ`ÊʙɣÈÉ£äÊÊÇ\£n*ÊÊ*>}iÊ{nÇÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

Chapter 14 Training Muscles to Become Stronger • 487

>À}iÞʜ˜Ê̅iʈ˜Ìi˜ÃˆÌÞÊ>˜`Ê`ÕÀ>̈œ˜ÊœvÊivvœÀÌÊ>˜`ÊÌÞ«iʜvÊiÝiÀVˆÃiÊ«iÀvœÀ“i`°
/…iʓ>}˜ˆÌÕ`iʜvÊ>V̈ÛiÊÃÌÀ>ˆ˜Êˆ“«œÃi`ʜ˜Ê>ʓÕÃViÊvˆLiÀÊ«ÀiVˆ«ˆÌ>ÌiÃʓÕÃV +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
`>“>}iÊ>˜`ÊÜÀi˜iÃÃ°Ê VVi˜ÌÀˆVÊ>˜`]Ê̜ÊܓiÊiÝÌi˜Ì]ʈܓiÌÀˆVʓÕÃViÊ>V̈œ˜Ã ivˆ˜i "-°Ê
}i˜iÀ>ÞÊÌÀˆ}}iÀÊ̅iÊ}Ài>ÌiÃÌÊ«œÃÌiÝiÀVˆÃiÊ`ˆÃVœ“vœÀÌ]ʓ>}˜ˆvˆi`Ê>“œ˜}ʜ`i
ˆ˜`ˆÛˆ`Õ>Ã°Ê ݈Ã̈˜}ʓÕÃViÊ`>“>}iʜÀÊÜÀi˜iÃÃÊvÀœ“Ê«ÀiۈœÕÃÊiÝiÀVˆÃiÊ`œiÃ
˜œÌÊiÝ>ViÀL>ÌiÊÃÕLÃiµÕi˜ÌʓÕÃViÊ`>“>}iʜÀʈ“«>ˆÀÊ̅iÊÀi}i˜iÀ>̈ÛiÊ«ÀœViÃð

7…i˜Ê`œiÃÊ"-ÊÕÃÕ>ÞÊ`iÛiœ«Ê
vœœÜˆ˜}ÊiÝiÀVˆÃi¶
Cell Damage
/…iÊvˆÀÃÌÊLœÕÌʜvÊÀi«ï̈Ûi]Ê՘>VVÕÃ̜“i`Ê«…ÞÈV>Ê>V̈ۈÌÞÊ`ˆÃÀÕ«ÌÃÊ̅
ˆ˜Ìi}ÀˆÌÞʜvÊ̅iÊViÃ½Êˆ˜ÌiÀ˜>Êi˜ÛˆÀœ˜“i˜Ì°Ê/…ˆÃÊV>˜Ê«Àœ`ÕViʓˆVÀœiȜ˜ÃÊ>˜`
Ìi“«œÀ>ÀÞÊՏÌÀ>ÃÌÀÕVÌÕÀ>Ê`>“>}iʈ˜Ê>Ê«œœÊœvÊÃÌÀiÃÇÃÕÃVi«ÌˆLiʜÀÊ`i}i˜iÀ>̈˜}
ˆÃÌÊ{Êv>V̜ÀÃÊ̅>ÌÊ«Àœ`ÕViÊ"-°
“ÕÃViÊvˆLiÀðÊ>“>}iÊLiVœ“iÃʓœÀiÊiÝÌi˜ÃˆÛiÊÃiÛiÀ>Ê`>ÞÃÊ>vÌiÀÊiÝiÀVˆÃiÊ̅>
ˆ˜Ê̅iʈ““i`ˆ>ÌiÊ«œÃÌiÝiÀVˆÃiÊ«iÀˆœ`°Ê
ÊȘ}iÊLœÕÌʜvʓœ`iÀ>ÌiÊVœ˜Vi˜ÌÀˆV £°
iÝiÀVˆÃiÊ«ÀœÛˆ`iÃÊ>Ê«Àœ«…ޏ>V̈VÊivviVÌʜ˜Ê“ÕÃViÊÜÀi˜iÃÃÊvÀœ“ÊÃÕLÃiµÕi˜Ì
…ˆ}…‡vœÀViÊiVVi˜ÌÀˆVÊiÝiÀVˆÃi]Ê܈̅Ê̅iÊLi˜ivˆVˆ>ÊivviVÌʏ>Ã̈˜}ÊÕ«Ê̜ÊÈÊÜiiŽÃ Ó°
-ÕV…ÊÀiÃՏÌÃÊÃÕ««œÀÌÊ̅iÊ܈Ã`œ“Êœvʈ˜ˆÌˆ>̈˜}Ê>ÊÌÀ>ˆ˜ˆ˜}Ê«Àœ}À>“Ê܈̅ÊÀi«ï̈Ûi]
“œ`iÀ>ÌiÊVœ˜Vi˜ÌÀˆVÊiÝiÀVˆÃiÊ̜ʫÀœÌiVÌÊ>}>ˆ˜ÃÌÊ̅iʓÕÃViÊÜÀi˜iÃÃÊ̅>ÌʜVVÕÀÃÊ>vÌiÀ
iÝiÀVˆÃiÊ܈̅Ê>˜ÊiVVi˜ÌÀˆVÊVœ“«œ˜i˜Ì° ΰ

{°
Altered Sarcoplasmic Reticulum
œÕÀÊv>V̜ÀÃÊ«Àœ`ÕViʓ>œÀÊ>ÌiÀ>̈œ˜Ãʈ˜ÊÃ>ÀVœ«>ӈVÊÀïVՏՓÊÃÌÀÕVÌÕÀiÊ>˜`
v՘V̈œ˜Ê܈̅Ê՘>VVÕÃ̜“i`ÊiÝiÀVˆÃi\Ê
£°
…>˜}iÃʈ˜Ê« >“iÊ̅iÊÌÞ«iʜvʓÕÃViʜÛiÀœ>`Ê̅>ÌÊ
Ó°
…>˜}iÃʈ˜Êˆ˜ÌÀ>“ÕÃVՏ>Àʅˆ}…‡i˜iÀ}ÞÊ«…œÃ«…>Ìià «Àœ`ÕViÃÊ̅iÊ}Ài>ÌiÃÌʏiÛiÊœvÊ"-°Ê
ΰ
…>˜}iÃʈ˜Êˆœ˜ˆVÊL>>˜Vi
{°
…>˜}iÃʈ˜ÊÌi“«iÀ>ÌÕÀi
/…iÃiÊivviVÌÃÊ`i«ÀiÃÃÊ̅iÊÀ>ÌiÃʜvÊ
> Ó! Õ«Ì>ŽiÊ>˜`ÊÀii>ÃiÊ>˜`ʈ˜VÀi>ÃiÊvÀii

>Ó! Vœ˜Vi˜ÌÀ>̈œ˜Ê>ÃÊ̅iʓˆ˜iÀ>ÊÀ>«ˆ`ÞʓœÛiÃʈ˜ÌœÊ̅iÊVÞ̜܏ʜvÊ̅iÊ`>“‡
ÀiÊV…>˜}iÃʈ˜ÊLœ`ÞÊVœ“«œÃˆÌˆœ˜ÊÀiÃՏ̈˜}
>}i`ÊvˆLiÀðʘÌÀ>ViÕ>ÀÊ
Ó! œÛiÀœ>`ÊVœ˜ÌÀˆLÕÌiÃÊ̜Ê̅iÊ>Õ̜Þ̈VÊ«ÀœViÃà vÀœ“Ê
,ÊÌÀ>ˆ˜ˆ˜}Ê̅iÊÃ>“iÊvœÀʓ>iÃ
܈̅ˆ˜Ê`>“>}i`ʓÕÃViÊvˆLiÀÃÊ̅>ÌÊ`i}À>`iÃÊ̅iÊVœ˜ÌÀ>V̈iÊ>˜`ʘœ˜Vœ˜ÌÀ>V̈ >˜`Êvi“>iö
ÃÌÀÕVÌÕÀið

Current Delayed-Onset Muscle Soreness Model

Figure 14.21 `ˆ>}À>“ÃÊ̅iÊ«ÀœL>LiÊÃÌi«Ãʈ˜Ê̅iÊ`iÛiœ«“i˜ÌʜvÊ"-Ê̅>Ì
Տ̈“>ÌiÞʏi>`ÃÊ̜Ê>˜Êˆ˜v>““>̜ÀÞÊ«ÀœViÃÃÊ>˜`ÊÃÕLÃiµÕi˜ÌÊÀiVÕ«iÀ>̈œ˜

Table 14.8 Body Composition Changes with Resistance Traininga

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488 • SECTION V Exercise Training and Adaptations

Unaccustomed exercise using

eccentric muscle actions
(downhill running,
slowly lowering weights)

High muscle forces damage

sarcolemma causing release of
cytosolic enzymes and myoglobin

Damage to muscle contractile

myofibrils and
noncontractile structures

Metabolites (e.g.,calcium) accumulate

to abnormal levels in the muscle cell
to produce more cell damage and
reduced force capacity

Delayed-onset muscle soreness,

considered to result from
inflammation, tenderness, pain.

The inflammation process begins; Figure 14.21 *Àœ«œÃi`ÊÃiµÕi˜ViÊvœÀ

the muscle cell heals; the
adaptive process makes the muscle
iÕ>ÀÊ>`>«‡
more resistant to damage from
subsequent exercise
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C h a p t e r

Factors Affecting
15
Physiologic
Function
The Environment
and Special Aids
to Performance
CHAPTER OBJECTIVES

• Explain the statement: The hypothalamus plays
the most important role in regulating thermal
balance.
• Name four physical factors that contribute to heat
exchange during rest and exercise.
• Describe the physiologic adjustments to cold stress.
• Outline the effects of increasingly higher altitudes on
(1) partial pressure of oxygen in ambient air, (2) satura-
tion of hemoglobin. with oxygen in the pulmonary cap-
illaries, and (3) VO2max (maximal oxygen consumption).

• Describe how the circulatory system serves as a • Describe immediate and long-term physiologic adjust-
“workhorse” for thermoregulation. ments to altitude exposure.

• List desirable clothing characteristics during exercise
in cold and warm weather.
• Describe how cardiac output, heart rate, and stroke
volume respond during submaximal and maximal
exercise with environmental heat stress.
• Describe circulatory adjustments that maintain blood
pressure during hot-weather exercise.
• Quantify fluid loss during hot-weather exercise.
• Outline three approaches for creating an altitude envi-
ronment at sea level so an athlete can spend sufficient
time to stimulate an acclimatization response.
• Describe the typical time course for red blood cell
reinfusion and mechanism for its ergogenic effect on
endurance performance and aerobic capacity.
• Discuss the medical use of erythropoietin and its
potential dangers for healthy athletes.

• Identify the physiologic consequences of dehydration. • Contrast “general warm-up” and “specific warm-up.”

• Explain how acclimatization, training, age, gender, and • Identify potential cardiovascular benefits of moderate
warm-up immediately before extreme physical effort.
body fat modify heat tolerance during exercise.

• Identify factors that comprise the heat stress index. • Provide a rationale for breathing a hyperoxic gas mix-
ture to enhance exercise performance and quantify its
• Explain the purpose of the wind-chill index. potential to increase tissue oxygen availability.
493
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494 • SECTION V Exercise Training and Adaptations
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«Àœ`ÕV̈œ˜Ê>˜`ÊϜÜÃʅi>ÌʏœÃÃÊ>ÃÊ«…ÞȜœ}ˆVÊ>`ÕÃ̓i˜ÌÃÊVœ“L>ÌÊ̅iÊ`iVÀi>Ãi Oral temperature does not accurately
ˆ˜ÊVœÀiÊÌi“«iÀ>ÌÕÀi° measure deep body (core) temperature
after strenuous exercise. For example,
large and consistent differences
occurred between oral and rectal
Table 15.1 Mechanisms for Temperature Regulation temperatures after a 14-mile race in a
-̈“Տ>Ìi`ÊLÞÊ
œ` iV…>˜ˆÃ“ tropical climate; whereas the rectal
iVÀi>ÃiÃʅi>ÌʏœÃà 6>ÜVœ˜ÃÌÀˆV̈œ˜ÊœvÊΈ˜ÊÛiÃÃiÃÆÊ«œÃÌÕÀ>ÊÀi`ÕV̈œ˜ÊœvÊ temperature averaged 103.5!F (39.7!C),
ÃÕÀv>ViÊ>Ài>Ê­VÕÀˆ˜}ÊÕ«® oral temperature remained a normal
˜VÀi>ÃiÃʅi>ÌÊ«Àœ`ÕV̈œ˜ -…ˆÛiÀˆ˜}Ê>˜`ʈ˜VÀi>Ãi`ÊۜÕ˜Ì>ÀÞÊ>V̈ۈÌÞÆʈ˜VÀi>Ãi` 98.6!F (37!C). This discrepancy partly
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-̈“Տ>Ìi`ÊLÞÊi>Ì results from evaporative cooling of the
˜VÀi>ÃiÃʅi>ÌʏœÃà 6>Ü`ˆ>̈œ˜ÊœvÊÃÕLVÕÌ>˜iœÕÃÊΈ˜ÊÛiÃÃiÃÆÊÃÜi>̈˜} mouth and airways from relatively high
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Chapter 15 Factors Affecting Physiologic Function • 497

Air temperature
Sky: thermal
radiation
+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
and humidity ˆÃÌÊÎÊv>V̜ÀÃÊ̅>ÌÊÀi}Տ>ÌiÊLœ`ÞÊÌi“«iÀ>‡
Solar
radiation Evaporation
ÌÕÀiÊ`ÕÀˆ˜}ÊVœ`ÊiÝ«œÃÕÀi°Ê
Evaporation (sweat)
(respiratory)
£°

Body Skin/blood
core convection
Ó°
Metabolic
Convection storage

Radiation Muscle blood ΰ

flow convection

Contracting Mechanical work

muscle
Conduction

Reflected:
Reflected: Ground:
Ground: ˆÃÌÊ{ÊÜ>ÞÃÊ̅iÊLœ`ÞʏœÃiÃʅi>Ì°
solar thermal
radiation radiation Ground:
Ground: £°
conduction

Ó°
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ˆÛiÊ̅iʓ>ˆ˜Êi˜ÛˆÀœ˜“i˜Ì>Êv>V̜ÀÊ̅>Ì
INTEGRATION OF HEAT-DISSIPATING >vviVÌÃÊ̅iʓ>}˜ˆÌÕ`iʜvÊiÛ>«œÀ>̈Ûiʅi>Ì
MECHANISMS œÃð

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VՏ>̈œ˜]ÊiÛ>«œÀ>̈œ˜]Ê>˜`ʅœÀ“œ˜>Ê>`ÕÃ̓i˜Ìð

Circulation
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498 • SECTION V Exercise Training and Adaptations
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Evaporation
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THERMOREGULATION
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Chapter 15 Factors Affecting Physiologic Function • 499

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Part 2 Exercise, the Environment, and

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Thermoregulation >“iÊ̅iʅœÀ“œ˜iÊÀii>Ãi`ÊvÀœ“Ê̅iÊ
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500 • SECTION V Exercise Training and Adaptations

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temperature (°C)
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ÃÌÀœŽiÊۜÕ“i° (% of max)

Vascular Constriction and Dilation
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̜ʏˆÛiÀÊ>˜`ÊÀi˜>ÊVœ“«ˆV>̈œ˜ÃÊܓï“iÃʘœÌi`Ê܈̅Ê
iÝiÀ̈œ˜>Ê…i>ÌÊÃÌÀiÃð Water Loss Per Hour

Maintaining Blood Pressure
ÀÌiÀˆ>ÊLœœ`Ê«ÀiÇ

Moderate Activity

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Lœœ`Ê`ˆÛiÀÌÃÊ̜ʫiÀˆ«…iÀ>Ê>Ài>ÃÊvœÀʅi>ÌÊ`ˆÃÈ«>̈œ˜°Ê/…ˆÃ
0.4 qt. 0.75 qt. 1.0 qt. 1.5 qt.
ÀiviVÌÃÊ̅iÊLœ`Þ½ÃÊ>ÌÌi“«ÌÊ̜ʓ>ˆ˜Ì>ˆ˜ÊV>À`ˆ>VʜÕÌ«Õ 0.1 gal. 0.186 gal. 0.25 gal. 0.375 gal.
`iëˆÌiÊÃÜi>̇ˆ˜`ÕVi`Ê`iVÀi>ÃiÃʈ˜Ê«>Ó>ÊۜÕ“i° 0.378 L 0.71 L 0.946 L 1.42 L

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Light Activity

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…i>Ì…ÊÀˆÃŽ°

Core Temperature During Exercise 0.25 qt. 0.4 qt. 0.75 qt. 1.0 qt.
0.063 gal. 0.1 gal. 0.186 gal. 0.25 gal.
i>ÌÊ}i˜iÀ>Ìi`ÊLÞÊ>V̈ÛiʓÕÃViÃÊV>˜Êˆ˜VÀi>ÃiÊVœÀiÊÌi“‡ 0.237 L 0.378 L 0.71 L 0.946 L
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Rest

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VˆÃiÊ`œiÃʘœÌÊÀiviVÌʅi>̇`ˆÃÈ«>̈œ˜Êv>ˆÕÀi°Ê/œÊ̅iÊVœ˜
0.05 qt. 0.1 qt. 0.25 qt. 0.6 qt.
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̈œ˜Ã…ˆ«ÊLiÌÜii˜ÊiÜ«…>}i>Ê­VœÀi®ÊÌi“«iÀ>ÌÕÀiÊ>˜`Ê
°
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Û>Àވ˜}ÊvˆÌ˜iÃÃʏiÛiÃ°Ê
œÀiÊÌi“«iÀ>ÌÕÀiʈ˜VÀi>ÃiÃʈ˜Ê«Àœ 26.7 32.2 37.8 43.3 °C
«œÀ̈œ˜Ê̜ÊiÝiÀVˆÃiʈ˜Ìi˜ÃˆÌÞ°Ê œÀiÊ̅>˜ÊˆŽiÞ]Ê>ʓœ`iÃÌ Air Temperature
VœÀiÊÌi“«iÀ>ÌÕÀiʈ˜VÀi>ÃiÊÀiviVÌÃÊv>ۜÀ>Liʈ˜ÌiÀ˜>Ê>`ÕÃÌ Figure 15.4
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Chapter 15 Factors Affecting Physiologic Function • 501

Water Loss in the Heat +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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>˜`ʏˆ}…ÌÊ>˜`ʓœ`iÀ>ÌiÊ«…ÞÈV>Ê>V̈ۈÌÞ°

Magnitude of Exercise Fluid Loss œÀÊ>˜Ê>VVˆ“>̈âi`Ê«iÀܘ]ÊÃÜi>Ì

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Consequences of Dehydration

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1.6

1.2

0.8

0.4

0.0
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Wet-bulb temperature

Exercise: 350 kCal . h-1 Rest: 80 kCal . h-1

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502 • SECTION V Exercise Training and Adaptations

BOX 15.1 CLOSE UP

Recognizing and Treating Signs and Symptoms
of Heat-Related Disorders

Փ>˜Ê…i>ÌÊ`ˆÃÈ«>̈œ˜ÊœVVÕÀÃÊLÞ\ SIGNS AND SYMPTOMS OF

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À>̜ÀÞÊ«>ÃÃ>}iÃ
WHAT HAPPENS DURING HEAT STRESS?
HEAT-RELATED DISORDERS
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Heat Illness: Causes, Signs and Symptoms, and Prevention

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Chapter 15 Factors Affecting Physiologic Function • 503

Water Requirements (L#h$1) for Rest and Varying Intensities of Work in the Heat: Indoors
Table 15.2
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Table 15.3
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BOX 15.2 CLOSE UP
How to Optimally Rehydrate for Exercise
PRE-EXERCISE HYPERHYDRATION
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• 505
Optimizing Hydration
Before Exercise
• Drink approximately 17 to 20 oz 2 to 3 hours before activity.
• Consume another 7 to 10 oz after the warm-up (10–15 min-
utes before exercise).
During Exercise
• Drink approximately 28 to 40 oz every hour of exercise
(7–10 oz every 10 to 15 minutes).
• Rapidly replace lost fluids (sweat and urine) within 2 hours after
activity to enhance recovery by drinking 20 to 24 oz for every
pound of body weight lost through sweating.
ELECTROLYTE REPLACEMENT
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506 • SECTION V Exercise Training and Adaptations

39.5
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Chapter 15 Factors Affecting Physiologic Function • 507

Table 15.4
Physiologic Adjustments During Heat
Acclimatization
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ˆ“«>ˆÀi`ʈ˜Ê«…ÞÈV>ÞÊÌÀ>ˆ˜i` American College of Sports Medicine position stand. Exercise and fluid replacement.
xä‡Þi>À‡œ`ʓi˜ÊVœ“«>Ài`Ê܈̅ Med. Sci. Sports Exerc., 39:377, 2007.
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508 • SECTION V Exercise Training and Adaptations

BOX 15.3 CLOSE UP

Assessing Heat Quality of the Environment:
How Hot Is Too Hot?

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`ˆÃÌ>˜ViÊvÀœ“Ê̅iÊiÛi˜Ì°

Black bulb
thermometer
Air temperature (°F)
humidity
Relative

(Radiant heat)
70 75 80 85 90 95 100 105 110 115 120

Heat sensation (°F)

0% 64 69 73 78 83 87 91 95 99 103 107
10% 65 70 75 80 85 90 95 100 105 111 116
20% 66 72 77 82 87 93 99 105 112 120 130
Wet-bulb 30% 67 73 78 84 90 96 104 113 123 135 148
thermometer
(Relative humidity) 40% 68 74 79 86 93 101 110 123 137 151
50% 69 75 81 88 96 107 120 135 150
60% 70 76 82 90 100 114 132 149
70% 70 77 85 93 106 124 144
Dry–bulb 80% 71 78 86 97 113 136
thermometer
(Air temperature) 90% 71 79 88 102 122
100% 72 80 91 108

90°—105°F Possibility of heat cramps

105°—130°F Heat cramps or heat exhaustion likely,
heat stroke possible
130°+ Heat stroke a definite risk
Figure 1
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Core Temperature and Associated Psychological Changes That Occur as Core

Table 15.5
Temperature Falls; Individuals Respond Differently at Each Level of Core Temperature

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EVALUATING ENVIRONMENTAL COLD STRESS
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Wind-Chill Index
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512 • SECTION V Exercise Training and Adaptations

Temperature (˚F)
Calm 40 35 30 25 20 15 10 5 0 -5 -10 -15 -20 -25 -30 -35 -40 -45

5 36 31 25 19 13 7 1 -5 -11 -16 -22 -28 -34 -40 -46 -52 -57 -63

10 34 27 21 15 9 3 -4 -10 -16 -22 -28 -35 -41 -47 -53 -59 -66 -72

15 32 25 19 13 6 0 -7 -13 -19 -26 -32 -39 -45 -51 -58 -64 -71 -77

20 30 24 17 11 4 -2 -9 -15 -22 -29 -35 -42 -48 -55 -61 -68 -74 -81
Wind speed (mph)

25 29 23 16 9 3 -4 -11 -17 -24 -31 -37 -44 -51 -58 -64 -71 -78 -84

30 28 22 15 8 1 -5 -12 -19 -26 -33 -39 -46 -53 -60 -67 -73 -80 -87 Figure 15.8 /…iÊ܈˜`ÊV…ˆÊÌi“«iÀ>‡
ÌÕÀiʈ˜`iÝ]Ê̅iÊ«Àœ«iÀÊÜ>ÞÊ̜ÊiÛ>Õ>Ìi
35 28 21 14 7 0 -7 -14 -21 -27 -34 -41 -48 -55 -62 -69 -76 -82 -89
̅iʺVœ`˜iÃûʜvÊ>˜Êi˜ÛˆÀœ˜“i˜Ì°ˆ}‡
40 27 20 13 6 -1 -8 -15 -22 -29 -36 -43 -50 -57 -64 -71 -78 -84 -91 ÕÀiÊŜÜÃÊ̅iÊ܈˜`‡V…ˆÊÌi“«iÀ>ÌÕÀiÃ
vœÀÊ̅iÊÀi>̈ÛiÊÀˆÃŽÊœvÊvÀœÃÌLˆÌiÊ>˜`Ê̅i
45 26 19 12 5 -2 -9 -16 -23 -30 -37 -44 -51 -58 -65 -72 -79 -86 -93
«Ài`ˆVÌi`Ê̈“iÃÊ̜ÊvÀii∘}ʜvÊiÝ«œÃi`
50 26 19 12 4 -3 -10 -17 -24 -31 -38 -45 -52 -60 -67 -74 -81 -88 -95 v>Vˆ>ÊΈ˜°Ê7iÌÊΈ˜ÊiÝ«œÃi`Ê̜Ê܈˜`
VœœÃÊiÛi˜Êv>ÃÌiÀÊ>˜`ʈvÊ̅iÊΈ˜ÊˆÃÊÜiÌ
55 25 18 11 4 -3 -11 -18 -25 -32 39 -46 -54 -61 -68 -75 -82 -89 -97 >˜` iÝ«œÃi`Ê̜Ê܈˜`]Ê̅iÊ>“Lˆi˜ÌÊÌi“‡
60 25 17 10 3 -4 -11 -19 -26 -33 -40 -48 -55 -62 -69 -76 -84 -91 -98 «iÀ>ÌÕÀiÊÕÃi`ÊvœÀÊ̅iÊ܈˜`‡V…ˆÊÌ>Li
ŜՏ`ÊLiÊ£äœ
ʏœÜiÀÊ̅>˜Ê̅iÊ>VÌÕ>
Wind Chill (˚F) = 35.74 + 0.6215 T - 35.75 (V0.16) + 0.4275 T (V0.16) >“Lˆi˜ÌÊÌi“«iÀ>ÌÕÀi°Ê­Àœ“Ê
“iÀˆV>˜
Where, T = Air Temperature (˚F); V = Wind Speed (mph)
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514 • SECTION V Exercise Training and Adaptations

Hb saturation (percentage) Paco2 (mm Hg)

100 75 50 25 50 0
226 30
Pio2
9
Mt. Everest

282
e Sao2 Pao2 Paco2 25
Barometric pressure (mm Hg)

Altitude (m x 103)
Altitude (ft x 103)
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Upper limit for permanent residence

Quilcha, Chile
Ambient Ambient 5
429 Altitude pressure Po2 15
c Morococha, Peru
m ft mm Hg mm Hg
Mt. Evans, 0 0 760 159
Pikes Peak, CO 1000 3280 674 141
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2000 6560 596 125
Leadville, CO
3000 9840 526 110
Mexico City 4000 13,120 462 97
a 5000 16,400 405 85
632 6000 19,690 354 74 5
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1
8000 26,250 267 56
9000 29,530 230 48
760 0
150 100 50 0
Pao2 and Pio2 (mm Hg)

a) Lightheadedness, headache b) Insomnia, nausea, vomiting, pulmonary discomfort

c) Dyspnea, anorexia, GI disturbances d) Lethargy, general weakness e) Impending collapse

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Chapter 15 Factors Affecting Physiologic Function • 515

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Table 15.6]ÊܓiÊVœ“«i˜Ã>̜ÀÞÊÀi뜘ÃiÃÊ̜Ê>ÌˆÌÕ`iʜVVÕÀÊ>“œÃÌʈ““i`ˆ‡
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&OR 9OUR )NFORMATION
./4 -5#( /89'%. !4 4(% 4/0
Immediate Adjustments
At the summit of Mt. Everest (8848 m;

ÌÊiiÛ>̈œ˜ÃÊ>LœÛiÊÓÎääʓʭÇx{ÈÊvÌ®]ÊÀ>«ˆ`Ê«…ÞȜœ}ˆVÊ>`ÕÃ̓i˜ÌÃÊVœ“«i˜‡ 28,028 ft), the pressure of ambient
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Ì>˜ÌʜvÊ̅iÃiÊÀi뜘ÃiÃʈ˜VÕ`i\ comitant alveolar oxygen pressure of
£° Þ«iÀÛi˜Ìˆ>̈œ˜ÊÌÀˆ}}iÀi`ÊLÞʈ˜VÀi>Ãi`ÊÀiëˆÀ>̜ÀÞÊ`ÀˆÛi\Þ«iÀÛi˜Ìˆ‡ 25 mm Hg or about 30% of the oxy-
>̈œ˜ÊÀi«ÀiÃi˜ÌÃÊ̅iʈ““i`ˆ>ÌiÊvˆÀÃÌʏˆ˜iʜvÊ`ivi˜ÃiÊ̜Ê>ÌˆÌÕ`iÊiÝ«œÃÕÀi gen available at sea level. At this alti-
.

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>ÀÌiÀˆiÃʈ˜Ê̅iʘiVŽÊ`iÌiVÌÊÀi`ÕV̈œ˜Ãʈ˜Ê>ÀÌiÀˆ>Ê*"Ó°Ê
…i“œÀiVi«ÌœÀ level value of an average 80-year-old
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̜Ü>À`Ê̅iʏiÛiÊˆ˜Ê>“Lˆi˜ÌÊ>ˆÀ°Ê
˜Þʈ˜VÀi>Ãiʈ˜Ê>Ûiœ>ÀÊ*"Ó ÜˆÌ…Ê…Þ«iÀ‡ conserving oxygen in the assault on
Ûi˜Ìˆ>̈œ˜Êv>VˆˆÌ>ÌiÃʜÝÞ}i˜Êœ>`ˆ˜}ʈ˜Ê̅iʏ՘}ð Mt. Everest, one experienced
Ó° ˜VÀi>Ãi`ÊLœœ`ÊvœÜÊ­V>À`ˆ>VʜÕÌ«ÕÌ®Ê`ÕÀˆ˜}ÊÀiÃÌÊ>˜`ÊÃÕL“>݈“> mountaineer commented: “This is a
iÝiÀVˆÃi\ -ÕL“>݈“>Ê…i>ÀÌÊÀ>ÌiÊ>˜`ÊV>À`ˆ>VʜÕÌ«ÕÌʈ˜VÀi>ÃiÊxä¯Ê>LœÛi place where people will cut their
Ãi>ʏiÛiÊÛ>ÕiÃʈ˜Ê̅iÊi>ÀÞÊÃÌ>}iÃʜvÊ>ÌˆÌÕ`iÊ>VVˆ“>̈â>̈œ˜]ÊLÕÌÊ̅i toothbrushes in half to reduce weight
…i>À̽ÃÊÃÌÀœŽiÊۜÕ“iÊÀi“>ˆ˜ÃÊiÃÃi˜Ìˆ>ÞÊ՘V…>˜}i`°Ê-i>ʏiÛiÊ>˜`Ê>Ìˆ‡ carried.”
ÌÕ`iÊiÝiÀVˆÃiʜÝÞ}i˜ÊÕ«Ì>ŽiÊÀi“>ˆ˜Êȓˆ>À]ÊLÕÌʈ˜VÀi>Ãi`ÊÃÕL“>݈“>

Table 15.6 Immediate and Longer Term Adjustments to Altitude Hypoxia

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516 • SECTION V Exercise Training and Adaptations

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Ó° ˆ}…‡>ÌˆÌÕ`iʫՏ“œ˜>ÀÞÊi`i“> 2.0 L " min#1, but the rela- 3.0
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Vœ˜`ˆÌˆœ˜Ê̅>Ìʈ˜VÕ`iÃÊvÕˆ`Ê>VVÕ“Õ increases dramatically at 2.0 L . min-1
>̈œ˜Êˆ˜Ê̅iÊLÀ>ˆ˜Ê>˜`ʏ՘}ðÊ*Ài`ˆÃ‡ altitude. In this example,
2.0

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1.0
VO2max VO2max
̈LˆˆÌÞ°Ê-ޓ«Ìœ“ÃÊÕÃÕ>Þʓ>˜ˆviÃÌ .
V. O2max equals 70% of
܈̅ˆ˜ÊÓ{Ê̜ʙÈʅœÕÀÃÊ>vÌiÀÊ>ÊÀ>«ˆ` VO2max at 4300 m. 0
Sea level High altitude
>ÃVi˜Ì°Ê*ÀiÛi˜Ìˆ˜}ÊÃiÛiÀiÊ`ˆÃ>LˆˆÌÞʜÀ 4300 m

`i>̅ÊÀiµÕˆÀiÃʈ““i`ˆ>ÌiÊ`iÃVi˜ÌÊ̜Ê>
œÜiÀÊ>ÌˆÌÕ`iʜ˜Ê>ÊÃÌÀiÌV…iÀʜÀÊLiˆ˜} Steady-rate VO2 at 100-W power output
vœÜ˜Ê̜ÊÃ>viÌÞ°Ê
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518 • SECTION V Exercise Training and Adaptations

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Chapter 15 Factors Affecting Physiologic Function • 519

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520 • SECTION V Exercise Training and Adaptations

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VO2max on Return to Sea Level “Live High, Train Low” >ˆÕÀiÊ̜ʓ>ˆ˜Ì>ˆ˜Ê>L܏ÕÌi
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V…>“LiÀÃÊ`iÈ}˜i`Ê̜ÊȓՏ>Ìiʅˆ}…Ê>ÌˆÌÕ`iÊ«ÀœÛˆ`i`ʘœ
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Li˜ivˆÌÃÊ̜Êi˜`ÕÀ>˜ViÊ>ÌÊÃi>ʏiÛi
}Ài>ÌiÀʜÝÞ}i˜‡V>ÀÀވ˜}ÊV>«>VˆÌÞ°
At-Home Acclimatization ˜Ê̅iÊ>LÃi˜ViʜvÊ>
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Can Sea-Level Training Be Maintained …ˆ}…Ê>ÌˆÌÕ`iÊ­ÃiiʘiÝÌÊÃiV̈œ˜®]Ê>ʘiÜÊ>««Àœ>V…ÊVÀi>ÌiÃÊ>
at a High Altitude? Ãi>‡iÛiÊº>ÌˆÌÕ`i»Êi˜ÛˆÀœ˜“i˜ÌÊ܅iÀiÊ>˜Ê>̅iÌi]ʓœÕ˜‡
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RED BLOOD CELL REINFUSION
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ÊÀiˆ˜vÕȜ˜ ]ʜvÌi˜ÊV>i`Ê ˆ˜`ÕVi`ÊiÀÞ̅ÀœVÞ̅i“ˆ> ]
Does It Work?
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Red blood cell concentration:

̜ÊnÊÜiiŽÃÊLiV>ÕÃiʈÌÊÌ>ŽiÃÊ̅ˆÃÊ`ÕÀ>̈œ˜Ê̜ÊÀiiÃÌ>LˆÃ…Ê
Percent of control value

+12
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i˜`ÕÀ>˜ViÊVœ“«ï̈œ˜°Ê­œ“œœ}œÕÃÊÌÀ>˜ÃvÕȜ˜ ˆ˜vÕÃià +4
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>˜`ʅi“œ}œLˆ˜ÊiÛiÃÊLÞÊn¯Ê̜ÊÓä¯Ê>˜`ʈ˜VÀi>ÃiÃÊ>ÛiÀ>}i
-4
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«iÀÊ`ʜvÊLœœ`Ê̜ʣ™Ê}Ê«iÀÊ`°Ê/…iœÀïV>Þ]Ê̅iÊ>``i` -8
Lœœ`ÊۜÕ“iʈ˜VÀi>ÃiÃʓ>݈“>ÊV>À`ˆ>VʜÕÌ«ÕÌ]Ê>˜`Ê̅i -12
0 2 4 6 0 2 4 6 8 10 12 14 16
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Weeks
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Figure 15.13 /ˆ“iÊVœÕÀÃiʜvʅi“>̜œ}ˆVÊV…>˜}iÃÊ>vÌiÀ
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Chapter 15 Factors Affecting Physiologic Function • 523

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Hormonal Blood Boosting

/œÊiˆ“ˆ˜>ÌiÊ̅iÊܓi܅>ÌÊVՓLiÀܓiÊ>˜`ʏi˜}̅ÞÊ«ÀœViÃÃʜvÊLœœ`Ê`œ«ˆ˜}]
ܓiÊi˜`ÕÀ>˜ViÊ>̅iÌiÃʘœÜÊÕÃiÊ iÀÞ̅Àœ«œˆï˜] >ʅœÀ“œ˜iʘœÀ“>ÞÊ«Àœ‡
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ˆ˜Ê«>̈i˜ÌÃÊ܈̅ÊÃiÛiÀiʎˆ`˜iÞÊ`ˆÃi>Ãi°Ê œÀ“>Þ]Ê܈̅ʏœÜʅi“>̜VÀˆÌʜÀÊ܅i˜
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Physiologic, Performance, and Hematologic Characteristics Before and 24 Hours

Table 15.7
After the Reinfusion of 750 mL of Packed Red Blood Cells
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524 • SECTION V Exercise Training and Adaptations

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vœÀViÃÊ>˜`ʈ˜VÀi>ÃiÃʈ˜Ê“ÕÃViʏi˜}̅Ê̜ʈ˜ÕÀiÊ>ʺÜ>À“i`‡ LÀˆivÊÜ>À“‡Õ«Ê«ÀœÛˆ`iÃÊ>ÊVœ“vœÀÌ>LiÊÜ>ÞÊ̜ʏi>`ʈ˜ÌœÊ“œÀi
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Chapter 15 Factors Affecting Physiologic Function • 525

BREATHING HYPEROXIC GAS +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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° 4. Facilitated nerve transmission and muscle metabolism at higher temper-
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&OR 9OUR )NFORMATION
7!2-
The following five physiologic mechanisms suggest how warm-up may
improve performance:
1. Increased speed of contraction and relaxation of warmed muscles
2. Greater economy of movement because of lowered viscous resistance
within warmed muscles
3. Facilitated oxygen utilization by warmed muscles because hemoglobin
releases oxygen more readily at higher muscle temperatures
atures; a specific warm-up facilitates motor unit recruitment required in
subsequent all-out physical activity
5. Increased blood flow through active tissues as local vascular beds dilate
increases metabolism and muscle temperatures
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526 • SECTION V Exercise Training and Adaptations

A 5.0 B
= 100% oxygen
= Room air

Pedal revolutions · min–1

60 4.0
58

VO2, L· min–1
56 3.0
54
52
50 2.0
48

·
46
44 1.0
42

0 1 2 3 4 5 6 0 1 2 3 4 5 6
Time, min Time, min

Figure 15.14 ­
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Cumulative
revolutions

70
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20
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10
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Ãœ]ʈ˜VÀi>Ãi`Ê«>À̈>Ê«ÀiÃÃÕÀiʜvʜÝÞ}i˜Êˆ˜Ê܏Ṏœ˜Ê܅ˆi Time, s
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6–s by 6–s revolutions

12
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10
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9
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8
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6
5
In Recovery
4
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Chapter 15 Factors Affecting Physiologic Function • 527

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S E C T I O N
VI
Optimizing Body
Composition,
Successful Aging,
and Health-Related
Exercise Benefits
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From the glaciers of the Arctic to
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VՏÌÕÀ>ÊLœÀ`iÀð
South Pacific, there are now more
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Vœ˜Ãˆ`iÀÊnxÊ>ÃÊ>Ê`i“>ÀV>̈œ˜Êœvʺœ`iÃ̇œ`»Ê>˜`Ê>}iÊÇxÊ>Ãʺޜ՘}ʜ`°»Êi“œ}À>‡ fat people in the world than hungry
«…iÀÃÊiÃ̈“>ÌiÊ̅>Ìʘi>ÀÞʜ˜i‡…>vʜvÊ̅iÊV…ˆ`Ài˜ÊLœÀ˜Êˆ˜Ê£™™ÈÊ܈ÊÃÕÀۈÛiÊ̜Ê>}i
people! Obesity has become one
™xʜÀÊ£ääÊÞi>ÀðÊ7ˆÌ…ˆ˜Ê̅ˆÃÊvÀ>“iܜÀŽ]Ê̅iʘiÜÊ}iÀœ˜Ìœœ}ÞÊ>``ÀiÃÃiÃÊ>Ài>Ã
Liޜ˜`Ê>}i‡Ài>Ìi`Ê`ˆÃi>ÃiÃÊ>˜`ÊÀiVœ}˜ˆâiÃÊ̅>ÌÊÃÕVViÃÃvՏÊ>}ˆ˜} ÀiµÕˆÀiÃÊi˜…>˜Vi` of the world’s leading causes of
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morbidity and mortality.
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˜œ˜Þ“œÕÃ
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˜Ê>V̈Ûi
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…i>Ì…°

531
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532 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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vœVÕÃiÃʜ˜ÊÀiÃ̜Àˆ˜}Ê̅iÊ«>̈i˜Ì½ÃʓœLˆˆÌÞÊ>˜`Êv՘V̈œ˜> `i“ˆV]Ê>˜`ÊL>ÈVʈ˜vœÀ“>̈œ˜Ê>LœÕÌʜLiÈÌÞ]ʈ˜VÕ`ˆ˜}Ê̅i
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˜Ê̅ˆÃÊÃiV̈œ˜]Ê
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C h a p t e r
16
Body Composition,
Obesity, and
Weight Control
CHAPTER OBJECTIVES

• Outline body composition characteristics of the “refer-
ence man” and “reference woman.”
• Define lean body mass, fat-free body mass, and
minimal body mass.
• Describe the criterion for obesity.
• Define fat cell hypertrophy and fat cell hyperplasia
and explain how each contributes to obesity and how
changes in body weight can modify these factors.

• Describe Archimedes’ principle applied to human • Outline how “unbalancing” the energy balance equa-
body volume measurement. tion can impact body weight.

• List assumptions for computing percentage body fat • Explain the rationale for including regular physical
from body density. activity in a prudent weight loss program.

• Explain how population-specific skinfold and girth
equations predict body fat.
• Give strengths and weaknesses of the body mass index
to assess excess weight, excess fat, and disease risk.
• Describe the current status of overweight and obesity
among American adults and children.
• List eight significant health risks of obesity.
• Explain how a moderate increase in physical activity
for a previously sedentary, overweight person affects
daily food intake and overall energy expenditure.
• Explain the rationale for and effectiveness of specific
exercise for localized fat loss.
• Give diet and exercise advice to a person who wants
to gain weight to enhance sports performance.

533
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534 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits
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…i>Ì…ÊÃÌ>ÌÕð
Part 1
Gross Composition of the
Human Body
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BEHNKE’S REFERENCE MAN
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Chapter 16 Body Composition, Obesity, and Weight Control • 535

Figure 16.3 «>À̈̈œ˜ÃÊ̅iÊ`ˆÃÌÀˆLṎœ˜ÊœvÊLœ`ÞÊv>ÌÊvœÀÊ̅iÊÀiviÀi˜ViÊܜ“>˜°

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Level I Atomic
Element Amount (kg) % Body Mass
Oxygen 43.0 61.0
Carbon 16.0 23.0
Hydrogen 7.0 10.0
Nitrogen 1.8 2.6
Calcium 1.0 1.4
Remainder 1.2 2.0

Level II Molecular

Mineral
Protein Carbohydrate Lipid Water
compounds

Level III Cellular

Body cell mass ICF Organic and

(does not include
ECF inorganic
storage fat)
Body fluids Extracellular
Fat cells solids

Level IV Tissue

Adipose tissue Skeletal muscle Bone Blood

Level V Whole body

Skinfolds Girths Densitometry Segment volume

Figure 16.1 ˆÛi‡iÛi]ʓՏ̈Vœ“«œ˜i˜Ìʓœ`iÊ̜Ê>ÃÃiÃÃÊ>˜`ʈ˜ÌiÀ«ÀiÌÊLœ`ÞÊVœ“«œÃˆÌˆœ˜°Ê >V…ʏiÛiÊ«Àœ}ÀiÃÃiÃʈ˜ÊVœ“«i݈ÌÞʜv

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536 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

80
Body mass
70 REFERENCE MAN
Body mass component, kg

70.0 kg Age: 20–24 y

60 Lean body Stature: 174.0 cm (68.5 in)
mass
50 61.7 kg
(88.1%)
40
Muscle TOTAL BODY FAT
30
31.3 kg
(44.7%) Total Storage
20 Bone 10.5 kg 8.4 kg Essential
10.4 kg (15.0%) (12.0%)
10 2.1 kg
(14.9%) (3.0%)
0

80

70 REFERENCE WOMAN
Body mass component, kg

Age: 20–24 y
60 Body mass Stature: 163.8 cm (64.5 in)
Lean body
56.7 kg mass
50
48.2 kg
40 (85.0%)
TOTAL BODY FAT
30
Total
Muscle 15.3 kg
20 Bone Storage Essential
20.4 kg (27.0%) 8.5 kg
(36.0%) 6.8 kg 6.8 kg
10 (12.0%) (15.0%) (12.0%)
Figure 16.2 œ`ÞÊVœ“«œÃˆÌˆœ˜Ê
0 œvÊ i…˜Ži½ÃÊÀiviÀi˜Viʓ>˜Ê>˜`ÊÀiviÀ‡
i˜ViÊܜ“>˜°

Fat-Free Body Mass and Lean Body Mass
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•Breast and genitals Reference woman

60 •Lower body subcutaneous
•Intramuscular
•Other
50

40 •Bone marrow •Spleen

Mass (kg)

•Spinal cord •Kidneys

30 •Liver •Other Figure 16.3 /…iœÀïV>
•Heart “œ`iÊvœÀÊLœ`ÞÊv>ÌÊ`ˆÃÌÀˆLṎœ˜
20 36% vœÀÊ̅iÊÀiviÀi˜ViÊܜ“>˜Ê܈̅
Lœ`Þʓ>ÃÃʜvÊxÈ°Çʎ}]ÊÃÌ>ÌÕÀiʜv
10 25% £ÈΰnÊV“]Ê>˜`ÊÓǯÊLœ`ÞÊv>Ì°
15% 12% ­Àœ“Ê>ÌV…]Ê6°°]ÊiÌÊ>°\Ê
œ˜‡
5-9% 4-7%
0 ÌÀˆLṎœ˜ÊœvÊLÀi>ÃÌÊۜÕ“iÊ>˜`
Sex-specific Essential Storage fat Bone Muscle Remainder Üiˆ}…ÌÊ̜ÊLœ`ÞÊv>ÌÊ`ˆÃÌÀˆLṎœ˜
fat (reserve fat (expendable)
storage) ˆ˜Êvi“>iðÊ
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˜Ì…Àœ‡
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Chapter 16 Body Composition, Obesity, and Weight Control • 537

Table 16.1 Percentage Body Fat of Male and Female Athletes +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
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Û>Àˆ>LˆˆÌÞÊ܈̅ˆ˜Êi>V…Ê>̅ïVÊ}ÀœÕ«°

Minimal Leanness Standards

ÊLˆœœ}ˆVʏœÜiÀʏˆ“ˆÌÊ«ÀœL>LÞÊi݈ÃÌÃÊLiޜ˜`Ê܅ˆV…Ê>Ê«iÀܘ½ÃÊLœ`Þʓ>ÃÃÊV>˜˜œÌ
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538 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

Men /œÊiÃ̈“>Ìiʓˆ˜ˆ“>ÊÜiˆ}…ÌÊ­ˆ°i°]Ê ®]ÊÃÕLÌÀ>VÌ LEANNESS, REGULAR EXERCISE,

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AND MENSTRUAL IRREGULARITY
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Chapter 16 Body Composition, Obesity, and Weight Control
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Part 2 Methods to Assess Body Size
• 539
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7(%. ! -/$%, )3 ./4 )$%!,
In 1967, only an 8% difference existed in body weight
between professional fashion models and the average
American woman. Today, a model’s body weight averages
23% lower than the national average. Twenty years ago,
gymnasts weighed about 20 pounds more than their pres-
ent-day counterparts. Thus, it should come as little
surprise that disordered eating patterns and unrealistic
weight goals (and general dissatisfaction with one’s body)
remain so common among girls and women of all ages.
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540 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits
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œ“Lˆ˜ˆ˜} crown had been altered by substitution of silver for gold.
̅iÊ`>Ì>ÊvœÀʓi˜Ê>˜`Êܜ“i˜]Ê̅iÊ>ÛiÀ>}iÊ«Àœ«œÀ̈œ˜ÊœvÊ̅i
70
60
50
Percent body weight
40
30
20
10
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Water Protein Fat Ash
Figure 16.4 6>ÀˆœÕÃÊ̈ÃÃÕiÃʈ˜Ê̅iÊ>`ՏÌʓ>iÊ>˜`Êvi“>i
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iÃ̈˜}ÊVˆÀVՓÃÌ>˜ViÃÊÃÕÀÀœÕ˜`ˆ˜}Ê̅iÊiÛi˜Ì\
King Hieron of Syracuse suspected that his pure gold
The King directed Archimedes to devise a method for
testing the crown for its gold content without dismantling
it. Archimedes pondered over this problem for many
weeks without succeeding, until one day, he stepped
into a bath filled to the top with water and observed the
overflow. He thought about this for a moment, and then,
wild with joy, jumped from the bath and ran naked
through the streets of Syracuse shouting, “Eureka!
Eureka!” I have discovered a way to solve the mystery
of the King’s crown.

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Chapter 16 Body Composition, Obesity, and Weight Control • 541

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Ó°

ΰ
Weight = 2.27 kg

{°

ˆÛiÊ>˜œÌ…iÀʘ>“iÊvœÀÊ՘`iÀÜ>ÌiÀÊ
The crown weighs Üiˆ}…ˆ˜}°
0.13 kg less when
immersed in water.

Ý«>ˆ˜Ê̅iÊ`ˆvviÀi˜ViÊLiÌÜii˜Ê`i˜ÃˆÌÞÊ
>˜`ÊëiVˆvˆVÊ}À>ۈÌÞ
Weight = 2.14 kg

Archimedes’ (APXIMH∆H∑) Principle

Figure 16.5
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542 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits
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Chapter 16 Body Composition, Obesity, and Weight Control • 543

Percentage Body Fat Estimated From Body Density

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Chapter 16 Body Composition, Obesity, and Weight Control • 545

BOX 16.1 CLOSE UP

Predicting Residual Lung Volume

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Փi®°Ê œ`ÞÊۜÕ“iÊiµÕ>ÃÊ̅iÊ`ˆvviÀi˜ViÊLiÌÜii˜ÊLœ`Þ "ÛiÀv>Ìʓi˜Ê­¯>ÌÊ'Óx®Ê>˜`Êܜ“i˜Ê­¯>ÌÊ'Îä®\
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546 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

BOX 16.2 CLOSE UP

When Should Skinfold Readings Be Taken?

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-…œÕ`ÊޜÕʏi>ÛiÊ̅iÊV>ˆ«iÀʜ˜Ê̅iÊÈÌiÊvœÀÊ£]ÊÎ]ʜÀÊxÊÃiV‡ Έ˜Ê>ÃʈÌÊiÝiÀÌÃʈÌÃÊvՏÊ«ÀiÃÃÕÀiÊ>˜`ÊViÀÌ>ˆ˜ÞÊ܈̅ˆ˜Ê£ÊœÀ
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/…ˆÃʓi>˜ÃÊ̅>ÌÊ̅iÊV>ˆ«iÀ 22 ÃÕLiVÌÃʜÛiÀÊÈäÊÃiVœ˜`Ã
21
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Skinfold thickness, mm

20 Female
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10 20 30 40 50 60
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Chapter 16 Body Composition, Obesity, and Weight Control • 547

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548 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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Chapter 16 Body Composition, Obesity, and Weight Control
BOX 16.3 CLOSE UP
Choosing Appropriate Skinfold Equations to Predict
Body Fat of Diverse Populations
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• 549
DIFFERENT EQUATIONS
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Equations to Predict Percentage Body Fat From Skinfolds

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550 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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Girth Measurements Predicting Body Fat from Girths Àœ“Ê̅i

Figure 16.10 ŜÜÃÊ̅iÊÈÝʓœÃÌÊVœ““œ˜ÊÈÌiÃÊvœÀÊ}ˆÀ̅ >««Àœ«Àˆ>ÌiÊÌ>LiÃʈ˜Ê
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1. Abdomen: 1 inch above the umbilicus

2. Buttocks: Maximum protrusion of buttocks with the
heels together
3. Thigh: Upper thigh, just below the buttocks
4. Right upper arm (biceps): Palm up, arm straight and
4 extended in front of the body; taken at the midpoint
5
between the shoulder and the elbow
5. Right forearm: Maximum girth with the arm extended
in front of the body
6. Calf: Widest girth midway between the ankle and knee

1
1
2
2

3 3

6 6

Figure 16.10 >˜`“>ÀŽÃÊvœÀʓi>ÃÕÀˆ˜}ÊÛ>ÀˆœÕÃÊ}ˆÀ̅ÃÊ>ÌÊÈÝÊVœ““œ˜Ê>˜>̜“ˆVÊÈÌiÃÊ­ÃiiÊÌiÝÌÊvœÀÊ`iÃVÀˆ«Ìˆœ˜®°

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Chapter 16 Body Composition, Obesity, and Weight Control • 551

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Bioelectrical Impedance Analysis (BIA) Ó°

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552 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

Voltage Voltage
detector detector
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Impedance

Current Current
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electrodes electrodes
A B

V
I = current
V = voltage

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RA LA

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Chapter 16 Body Composition, Obesity, and Weight Control • 553

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BMD Values in Anorexic Women (n=10)

BMD, g · cm–2 Percent of normals
X SD X SD
Head 1.97 .26 — —
Arms 0.74 .04 99.5 5.9
Legs 1.03 .09 94.1 8.2
Trunk 0.77 .05 76.8 4.6
Spine 0.83 .06 72.8 5.1
Total 0.99 .06 90.3 5.0

L2-L4 0.99 .08 78.5 6.6

Neck 0.87 .09 86.9 9.8

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554 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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TO ESTIMATE BODY COMPOSITION
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Resonance Imaging
Computed Tomography
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556 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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Chapter 16 Body Composition, Obesity, and Weight Control • 557

Average Percentage Body Fat for Younger and Older Women and
Table 16.4
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558 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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DEFINITIONS: OVERWEIGHT, OVERFATNESS,

AND OBESITY

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560 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

Adult Obesity Rate Obese & Overweight Children

WA WA
MT ND ME MT ND ME
MN NH MN NH
OR OR
WI VT WI VT
ID SD NY ID SD NY
WY MI MA WY MI MA
IA PA RI IA PA RI
NV NE OH NV NE OH
IL IN CT IL IN CT
UT UT
CO WV VA CO WV VA
KS MO KY NJ KS MO KY NJ
CA CA
NC DE NC DE
TN TN
AZ OK MD AZ OK MD
NM AR SC NM AR SC
MS AL GA DC MS AL GA DC
LA LA
TX TX
AK AK
FL FL

HI HI

15% to <20%
Top Childhood Percentage
20% to <25% Ten Obesity Highest Obese
25% to <30% Rank To Lowest
Rankings by
30% to <35%
State
35% to <40% 1. Mississippi 32.5%
40% to <45% 2. Alabama 31.2%
3. West Virginia 31.1%
Note: 1 = Highest rate of adult obesity. Rankings are based on
combining three years of data (2006-2008) from the U.S. Centers 4. Tennessee 30.2%
for Disease Control and Prevention's Behavioral Risk Factor 5. South Carolina 29.7%
Surveillance System to "stabilize" data for comparison purposes. 6. Oklahoma 29.5%
This methodology, recommended by the CDC, compensates for any
potential anomalies or usual changes due to the specific sample in 7. Kentuncy 29.0%
any given year in any given state. Additional information about 8. Louisiana 28.9%
methodologies and confidence interval appears at
9. Michigan 28.8%
http://healthyamericans.org/reports/obesity2009/. Adults with a
BMI of 30 or higher are considered obese. 10. Arkansas, Ohio 28.6%

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OBESITY: A GLOBAL EPIDEMIC

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Chapter 16 Body Composition, Obesity, and Weight Control • 561

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Archives of Pediatrics & Adolescent
Ãi˜ÌÃÊ>LœÕÌÊ£Î{ʓˆˆœ˜Ê
“iÀˆV>˜ÃÊ­ÈȯʜvÊ>`ՏÌÃÊ>}iÊÓäÊÞi>ÀÃʜÀʜ`iÀ]ʈ˜VÕ`ˆ˜}
Medicine on a nationally representative
Îx¯ÊœvÊVœi}iÊÃÌÕ`i˜Ìî°Ê
ÕÀÀi˜ÌÞ]ʓœÀiÊ̅>˜Ê{ʓˆˆœ˜Êˆ˜`ˆÛˆ`Õ>ÃÊiÝVii`ÊÎää
sample of preschoolers born in 2001
«œÕ˜`Ã]Ê>˜`ʓœÀiÊ̅>˜Êxää]äääÊ«iœ«iÊ­“œÃ̏Þʓi˜®ÊiÝVii`Ê{ääÊ«œÕ˜`Ãp܈̅
indicates that nearly one in five (more
̅iÊ>ÛiÀ>}iÊܜ“>˜Ê˜œÜÊÜiˆ}…ˆ˜}Ê>˜Ê՘«ÀiVi`i˜Ìi`Ê£ÈxÊ«œÕ˜`Ãt
than half a million) American
,iÃi>ÀV…iÀÃʓ>ˆ˜Ì>ˆ˜Ê̅>ÌʈvÊ̅ˆÃÊܜÀ`܈`iÊÌÀi˜`ÊVœ˜Ìˆ˜ÕiÃ]Ê̅i˜ÊÇä¯Ê̜
4-year-old children are obese with
Çx¯ÊœvÊ̅iÊ1°-°Ê>`ՏÌÊ«œ«Õ>̈œ˜Ê“>ÞÊÀi>V…ÊœÛiÀÜiˆ}…ÌʜÀʜLiÈÌÞÊÃÌ>ÌÕÃÊLÞÊ̅i
an alarmingly high one in three rate
Þi>ÀÊÓäÓä]Ê܈̅ÊiÃÃi˜Ìˆ>ÞÊ̅iÊi˜ÌˆÀiÊ>`ՏÌÊ«œ«Õ>̈œ˜ÊLiVœ“ˆ˜}ʜÛiÀÜiˆ}…Ì
among American Indian children.
܈̅ˆ˜Ê̅ÀiiÊ}i˜iÀ>̈œ˜Ãt
Obesity is also more prevalent among
Hispanic and black children but the
disparity becomes most startling
CAUSES OF OBESITY among American Indians whose
obesity doubles that of whites. The
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alarming statistics are that 13% of
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Asian children, 16% of whites, 21%
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of blacks, 22% of Hispanics, and 31%
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of American Indians are obese.

Classification of Overweight and Obesity by BMI, Waist Circumference, and

Table 16.5
Associated Disease Risk
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562 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

BOX 1 6 .4 CLOSE UP
Predicting Percentage Body Fat From Body Mass Index

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INDEPENDENT VARIABLES
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Chapter 16 Body Composition, Obesity, and Weight Control • 563

Example 4: White man; age, 55 y; BMI, 24.5 ACCURACY

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$ ­ä°ä™£Ê% äÊ% xx® GIVEN CRITICAL BODY MASS
$ ­ä°äÎäÊ% äÊ% xx® INDEX VALUES
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564 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits
Overeating and Other Causative Factors
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Table 16.6 Global and Regional Per Capita Food Consumption (kCal per capita per day)
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Chapter 16 Body Composition, Obesity, and Weight Control • 565

Cultural
transmission
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(30%) (25%)
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(45%)

{°

Percentage Body Fat and Fat Mass x°

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,iÃi>ÀV…iÀÃʘœÜʏˆ˜ŽÊ…Õ“>˜ÊœLiÈÌÞÊ̜Ê> published in the New England Journal of Medicine show that some brown
“ÕÌ>˜ÌÊ}i˜i°Ê-ÌÕ`ˆiÃÊ>ÌÊ̅iÊ1˜ˆÛiÀÈÌÞʜv fat—the “good fat,” which spurs the body to burn calories to generate body

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˜}>˜`ʈ`i˜Ìˆvˆi`Ê>ÊëiVˆv heat—remains in adults. This energy-generating fat form stores mostly
`iviVÌʈ˜ÊÌܜÊ}i˜iÃÊ̅>ÌÊVœ˜ÌÀœÊLœ`ÞÊÜiˆ}…Ì° around the neck and under the collarbone; its energy-storing white
/ܜÊVœÕȘÃÊvÀœ“Ê>Ê*>ŽˆÃÌ>˜ˆÊv>“ˆÞʈ˜ (yellow) fat counterpart concentrates around the waistline to store energy

˜}>˜`ʈ˜…iÀˆÌi`Ê>Ê`iviVÌʈ˜Ê̅iÊ}i˜iÊ̅>Ì and release chemicals that control metabolism and the use of insulin.
Ãޘ̅iÈâiÃʏi«Ìˆ˜]Ê>ÊVÀÕVˆ>Ê…œÀ“œ˜>ÊLœ`Þ Three general findings of the research indicate:
Üiˆ}…ÌqÀi}Տ>̈˜}ÊÃÕLÃÌ>˜ViÊ«Àœ`ÕVi`ÊLÞÊv>Ì 1. Lean individuals have more brown fat than overweight counterparts.
>˜`ÊÀii>Ãi`ʈ˜ÌœÊ̅iÊLœœ`ÃÌÀi>“Ê̅>ÌÊ>VÌÃʜ˜ 2. Brown fat accelerates its energy release in cooler environments.
̅iʅޫœÌ…>>“ÕðÊ
œ˜}i˜ˆÌ>Ê>LÃi˜Viʜvʏi«‡ 3. Women tend to have more brown fat than men, with larger and more
̈˜Ê«Àœ`ÕVi`ÊVœ˜Ìˆ˜Õ>Ê…Õ˜}iÀÊ>˜`ʓ>ÀŽi` active deposits.
œLiÈÌÞʈ˜Ê̅iÃiÊV…ˆ`Ài˜°Ê/…iÊÃiVœ˜`Ê}i˜ïV Devising a means to fully activate the body’s brown fat might serve as the
`iviVÌʜLÃiÀÛi`ʈ˜Ê>˜Ê
˜}ˆÃ…Ê«>̈i˜ÌÊ>vviVÌi` Holy Grail in treating the obese condition.
̅iÊLœ`Þ½ÃÊÀi뜘ÃiÊ̜ʏi«Ìˆ˜½ÃʺÈ}˜>°»Ê/…ˆÃ
7 Ç£ä‡V£ÈÚxΣ‡x™{°µÝ`ÊʙɣÈÉ£äÊÊÇ\ÓÓ*ÊÊ*>}iÊxÈÈÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`
566 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits
ÌÀˆ}}iÀˆ˜}ÊÈ}˜>Ê>À}iÞÊ`iÌiÀ“ˆ˜iÃʅœÜʓÕV…Êœ˜iÊi>ÌÃ]
…œÜʓÕV…Êi˜iÀ}Þʜ˜iÊiÝ«i˜`Ã]Ê>˜`ÊՏ̈“>ÌiÞʅœÜʓÕV… Տ>ÌiÃÊ̅iÊ«Àœ`ÕV̈œ˜ÊœvÊV…i“ˆV>ÃÊ̅>ÌÊÃÕ««ÀiÃÃÊ>««ïÌiʜÀ
œ˜iÊÜiˆ}…ð
/…iÊ}i˜ïVʓœ`iÊˆ˜ÊFigure 16.18 «Àœ«œÃiÃÊ̅>ÌÊ̅iʜL
}i˜iʘœÀ“>ÞÊLiVœ“iÃÊ>V̈Û>Ìi`ʈ˜Ê>`ˆ«œÃiÊ̈ÃÃÕiÊ>˜`Ê«iÀ‡
…>«ÃʓÕÃViÊ̈ÃÃÕi]Ê܅iÀiʈÌÊi˜Vœ`iÃÊ>˜`ÊÃ̈“Տ>ÌiÃÊ«Àœ‡
`ÕV̈œ˜ÊœvÊ>ÊLœ`ÞÊv>ÌqÈ}˜>ˆ˜}]ʅœÀ“œ˜iˆŽiÊ«ÀœÌiˆ˜ÊV>i`
œL «ÀœÌiˆ˜ œÀʏi«Ìˆ˜]Ê܅ˆV…Ê̅i˜Êi˜ÌiÀÃÊ̅iÊLœœ`ÃÌÀi>“°
/…ˆÃÊÃ>̈iÌÞÊÈ}˜>Ê“œiVՏiÊÌÀ>ÛiÃÊ̜Ê̅iÊ>ÀVÕ>ÌiʘÕViÕÃ]Ê>
VœiV̈œ˜ÊœvÊëiVˆ>ˆâi`ʘiÕÀœ˜Ãʈ˜Ê̅iʓi`ˆœL>Ã>Ê…Þ«œ‡
̅>>“ÕÃÊ̅>ÌÊVœ˜ÌÀœÃÊ>««ïÌiÊ>˜`ʓiÌ>LœˆÃ“Ê>˜`Ê`iÛi‡
œ«ÃÊܜ˜Ê>vÌiÀÊLˆÀ̅°Ê œÀ“>Þ]ʏi«Ìˆ˜ÊLÕ˜ÌÃÊ̅iÊÕÀ}iÊ̜Êi>Ì
܅i˜ÊV>œÀˆVʈ˜Ì>Žiʓ>ˆ˜Ì>ˆ˜Ãʈ`i>Êv>ÌÊÃ̜ÀiðÊi«Ìˆ˜Ê“>Þ
1 œLiÈÌÞÊ>œÜÃÊÀiÃi>ÀV…iÀÃÊ̜ÊۈiÜʜÛiÀv>̘iÃÃÊ>ÃÊ>Ê`ˆÃi>Ãi
The ob gene inside of the
>ÀÞʈ`i˜ÌˆvˆV>̈œ˜Êœvʜ˜i
fat cell creates leptin.
2 VՏÌÕÀ>Ê>Ì̈ÌÕ`iÃÊ̜Ü>À`ÊLœ`ÞÊÜiˆ}…Ìʅi«Ê̜ÊiÝ«>ˆ˜Ê̅i
Leptin moves fat cells
and enters the blood
stream.
®]ÊÀi>Ìi`Ê̜ÊÀ>Vˆ>Ê`ˆvviÀi˜ViÃʈ˜Ê ]
>Êi>V…Ê`>ÞÊ`ÕÀˆ˜}ÊÀiÃÌÊ̅>˜
>ÊÀi`ÕV̈œ˜Êˆ˜Ê`>ˆÞ
>vviVÌÊViÀÌ>ˆ˜Ê˜iÕÀœ˜Ãʈ˜Ê̅iʅޫœÌ…>>“ˆVÊÀi}ˆœ˜Ê̅>ÌÊÃ̈“‡
Ài`ÕViÊ̅iʏiÛiÃʜvʘiÕÀœV…i“ˆV>ÃÊ̅>ÌÊÃ̈“Տ>ÌiÊ>««ïÌi°
-ÕV…Ê“iV…>˜ˆÃ“ÃÊܜՏ`ÊiÝ«>ˆ˜Ê…œÜÊLœ`ÞÊv>ÌÊÀi“>ˆ˜Ãʈ˜Ìˆ‡
“>ÌiÞʺVœ˜˜iVÌi`»Êۈ>Ê>Ê«…ÞȜœ}ˆVÊ«>̅Ü>ÞÊ̜Ê̅iÊLÀ>ˆ˜
̜ÊÀi}Տ>ÌiÊi˜iÀ}ÞÊL>>˜Vi°Ê˜ÊiÃÃi˜Vi]ʏi«Ìˆ˜Ê>Û>ˆ>LˆˆÌÞ]ʜÀ
ˆÌÃʏ>VŽ]Ê>vviVÌÃÊ̅iʘiÕÀœV…i“ˆÃÌÀÞʜvÊ>««ïÌiÊ>˜`Ê̅i
LÀ>ˆ˜½ÃÊ`ޘ>“ˆVʺ܈Àˆ˜}»Ê̜ʫœÃÈLÞʈ“«>VÌÊ>««ïÌiÊ>˜`
œLiÈÌÞʈ˜Ê>`Տ̅œœ`°
i˜`iÀ]ʅœÀ“œ˜iÃ]Ê«…>À“>Vœœ}ˆVÊ>}i˜ÌÃ]Ê>˜`Ê̅iÊLœ`Þ½Ã
VÕÀÀi˜ÌÊi˜iÀ}ÞÊÀiµÕˆÀi“i˜ÌÃÊ>ÃœÊ>vviVÌʏi«Ìˆ˜Ê«Àœ`ÕV̈œ˜°
iˆÌ…iÀÊŜÀ̇ʘœÀʏœ˜}‡ÌiÀ“ÊiÝiÀVˆÃiʓi>˜ˆ˜}vՏÞÊ>vviVÌÃ
i«Ìˆ˜]ʈ˜`i«i˜`i˜ÌʜvÊ̅iÊivviVÌÃʜvÊiÝiÀVˆÃiʜ˜Ê̜Ì>Ê>`ˆ«œÃi
̈ÃÃÕiʓ>Ãð
/…iʏˆ˜Ž>}iʜvÊ}i˜ïVÊ>˜`ʓœiVՏ>ÀÊ>L˜œÀ“>ˆÌˆiÃÊ̜
ˆ˜ÃÌi>`ʜvÊ>Ê«ÃÞV…œœ}ˆV>Êv>Ü°Ê
}i˜ïVÊ«Ài`ˆÃ«œÃˆÌˆœ˜Ê̜Ü>À`ʜLiÈÌÞʓ>ŽiÃʈÌÊ«œÃÈLiÊ̜
Li}ˆ˜Ê`ˆiÌÊ>˜`ÊiÝiÀVˆÃiʈ˜ÌiÀÛi˜Ìˆœ˜ÊLivœÀiʜLiÈÌÞÊÃiÌÃʈ˜
>˜`Êv>ÌʏœÃÃÊLiVœ“iÃÊiÝVii`ˆ˜}ÞÊ`ˆvvˆVՏ̰Ê*…>À“>ViṎV>
Vœ“«>˜ˆiÃʓ>ÞÊiÛi˜ÌÕ>ÞÊÃޘ̅iÈâiÊVœ“«œÕ˜`ÃÊ̅>ÌÊ«Àœ‡
`ÕViÊÃ>̈iÌÞʜÀÊ>vviVÌÊ̅iÊÀiÃ̈˜}ÊÀ>ÌiʜvÊv>ÌÊV>Ì>LœˆÃ“°
/…iÃiÊV…i“ˆV>ÃÊܜՏ`Ê«Àœ`ÕViÊÜiˆ}…ÌÊVœ˜ÌÀœÊ܈̅Ê>
Ó>iÀÊV>œÀˆVʈ˜Ì>ŽiÊ>˜`ÊviÜiÀÊviiˆ˜}Ãʜvʅ՘}iÀÊ>˜`
`i«ÀˆÛ>̈œ˜Ê̅>ÌʜvÌi˜Ê>VVœ“«>˜ÞÊVœ˜Ûi˜Ìˆœ˜>Ê`ˆiÌÊ«>˜Ã°
i«Ìˆ˜Ê>œ˜iÊ`œiÃʘœÌÊ`iÌiÀ“ˆ˜iʜLiÈÌÞʜÀÊiÝ«>ˆ˜Ê܅Þ
ܓiÊ«iœ«iÊi>ÌÊ܅>ÌiÛiÀÊ̅iÞÊÜ>˜ÌÊ>˜`Ê}>ˆ˜ÊˆÌ̏iÊÜiˆ}…Ì
܅ˆiʜ̅iÀÃÊLiVœ“iʜÛiÀv>ÌÊ܈̅Ê̅iÊÃ>“iÊV>œÀˆVʈ˜Ì>Ži°
Influence of Racial Factors
,>Vˆ>Ê`ˆvviÀi˜ViÃʈ˜Êvœœ`Ê>˜`ÊiÝiÀVˆÃiʅ>LˆÌÃ]ʈ˜VÕ`ˆ˜}
}Ài>ÌiÀÊ«ÀiÛ>i˜ViʜvʜLiÈÌÞÊ>“œ˜}ÊL>VŽÊܜ“i˜Ê­˜i>ÀÞ
x䯮Ê̅>˜Ê܅ˆÌiÊܜ“i˜Ê­Îί®°Ê,iÃi>ÀV…Ê܈̅ʜLiÃi
ܜ“i˜ÊŜÜÃÊ̅>ÌÊÓ>Ê`ˆvviÀi˜ViÃʈ˜ÊÀiÃ̈˜}Êi˜iÀ}Þ
iÝ«i˜`ˆÌÕÀiÊ­,
Vœ˜ÌÀˆLÕÌiÊ̜Ê̅iÊÀ>Vˆ>Ê`ˆvviÀi˜ViÃʈ˜ÊœLiÈÌÞ°Ê/…ˆÃʺÀ>Vˆ>»
ivviVÌ]Ê܅ˆV…Ê>ÃœÊi݈ÃÌÃÊ>“œ˜}ÊV…ˆ`Ài˜Ê>˜`Ê>`œiÃVi˜ÌÃ]
«Ài`ˆÃ«œÃiÃÊ̅>ÌÊL>VŽÊܜ“i˜Ê“œÀiÊÀi>`ˆÞÊ}>ˆ˜ÊÜiˆ}…Ì
>˜`ÊÀi}>ˆ˜ÊˆÌÊ>vÌiÀÊÜiˆ}…ÌʏœÃðÊ"˜Ê>ÛiÀ>}i]ÊL>VŽÊܜ“i˜
LÕÀ˜Ê˜i>ÀÞÊ£ääÊviÜiÀʎ
܅ˆÌiÊVœÕ˜ÌiÀ«>ÀÌðÊ/…iÊϜÜiÀÊÀ>ÌiʜvÊV>œÀˆVÊiÝ«i˜`ˆÌÕÀi
«iÀÈÃÌÃÊiÛi˜Ê>vÌiÀÊ>`ÕÃ̈˜}ÊvœÀÊ`ˆvviÀi˜ViÃʈ˜ÊLœ`Þʓ>ÃÃ
>˜`ÊLœ`ÞÊVœ“«œÃˆÌˆœ˜°Ê
Ê£ä䇎
“iÌ>LœˆÃ“ÊÌÀ>˜Ã>ÌiÃÊ̜ʘi>ÀÞʣʫœÕ˜`ʜvÊLœ`ÞÊv>ÌÊ}>ˆ˜i`
i>V…Ê“œ˜Ì…°Ê/œÌ>Ê`>ˆÞÊi˜iÀ}ÞÊiÝ«i˜`ˆÌÕÀiÊ­/

®Êœv
3
L>VŽÊܜ“i˜Ê>ÛiÀ>}iÃÊ£ä¯ÊœÜiÀÊ̅>˜Ê܅ˆÌiÃ]ʜ܈˜}Ê̜Ê>
Leptin signals the hypo- x¯ÊœÜiÀÊ,

Ê>˜`Ê£™¯ÊœÜiÀÊ«…ÞÈV>Ê>V̈ۈÌÞÊi˜iÀ}Þ
thalamus to reduce or stop iÝ«i˜`ˆÌÕÀi°Ê
``ˆÌˆœ˜>Þ]ʜLiÃiÊL>VŽÊܜ“i˜ÊŜÜi`
the drive to eat after the
"setpoint" is reached for }Ài>ÌiÀÊ`iVÀi>ÃiÃʈ˜Ê,

Ê̅>˜Ê܅ˆÌiÊܜ“i˜Ê>vÌiÀÊi˜iÀ}Þ
the body's total fat content. ÀiÃÌÀˆV̈œ˜Ê>˜`ÊÜiˆ}…ÌʏœÃðÊ/…iÊVœ“Lˆ˜>̈œ˜ÊœvÊ>ʏœÜiÀʈ˜ˆ‡
̈>Ê,

Ê>˜`ʓœÀiÊ«ÀœvœÕ˜`Ê`i«ÀiÃȜ˜ÊœvÊ,

Ê܈̅
Figure 16.18 i˜ïVʓœ`iÊœvʜLiÈÌÞ°Ê
ʓ>v՘V̈œ˜ÊœvÊ Üiˆ}…ÌʏœÃÃÊÃÕ}}iÃÌÃÊ̅>ÌÊL>VŽÊܜ“i˜Êˆ˜VÕ`ˆ˜}Ê>̅iÌiÃ
̅iÊÃ>̈iÌÞÊ}i˜iÊ>vviVÌÃÊ«Àœ`ÕV̈œ˜ÊœvÊ̅iÊÃ>̈iÌÞʅœÀ“œ˜iʏi«Ìˆ˜° iÝ«iÀˆi˜ViÊ}Ài>ÌiÀÊ`ˆvvˆVՏÌÞÊ>V…ˆiۈ˜}Ê>˜`ʓ>ˆ˜Ì>ˆ˜ˆ˜
1˜`iÀ«Àœ`ÕV̈œ˜Êœvʏi«Ìˆ˜Ê`ˆÃÀÕ«ÌÃÊ«Àœ«iÀÊv՘V̈œ˜ÊœvÊ̅iʅޫœ‡
̅>>“ÕÃÊ­ÃÌi«Êή]Ê̅iÊVi˜ÌiÀÊ̅>ÌÊÀi}Տ>ÌiÃÊ̅iÊLœ`Þ½ÃÊv>ÌʏiÛi° }œ>ÊLœ`ÞÊÜiˆ}…ÌÊ̅>˜ÊœÛiÀÜiˆ}…ÌÊ܅ˆÌiÊܜ“i˜°
­œ`iÊL>Ãi`ʜ˜ÊÀiÃi>ÀV…ÊVœ˜`ÕVÌi`Ê>ÌÊ,œVŽiviiÀÊ1˜ˆÛiÀÈÌÞ] 7…i˜ÊiÛ>Õ>̈˜}Ê«ÕÀ«œÀÌi`ÊÀ>Vˆ>Ê`ˆvviÀi˜ViÃʈ˜ÊLœ`Þ
iÜÊ9œÀŽ°® Vœ“«œÃˆÌˆœ˜ÊV…>À>VÌiÀˆÃ̈VÃÊ>˜`Ê̅iˆÀʈ“«ˆV>̈œ˜Ãʜ˜
7 Ç£ä‡V£ÈÚxΣ‡x™{°µÝ`ÊʙɣÈÉ£äÊÊÇ\ÓÓ*ÊÊ*>}iÊxÈÇÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

Chapter 16 Body Composition, Obesity, and Weight Control • 567

…i>Ì…Ê>˜`Ê«…ÞÈV>Ê«iÀvœÀ“>˜Vi]ʜ˜iʓÕÃÌÊV>ÀivՏÞÊiÛ>Õ>Ìiʓi̅œ`ÃÊ̜
iÝ«œÀiÊÃÕV…Ê`ˆvviÀi˜ViðÊœÀÊiÝ>“«i]ʈ˜ÌiÀi̅˜ˆVÊ>˜`ʈ˜ÌiÀÀ>Vˆ>Ê`ˆvviÀi˜Vià +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
ˆ˜ÊLœ`ÞÊÈâi]ÊÃÌÀÕVÌÕÀi]Ê>˜`Ê̜Ì>ÊLœ`ÞÊv>ÌÊ>˜`ʈÌÃÊ`ˆÃÌÀˆLṎœ˜ÊV>˜Ê“>ÎÊÌÀÕiÊ`ˆv‡ iÃVÀˆLiʅœÜÊv>ÃÌÊvœœ`ÊVœ˜ÃՓ«Ìˆœ˜ÊÀi>ÌiÃ
viÀi˜ViÃʈ˜ÊLœ`ÞÊv>ÌÊ>ÌÊ>Ê}ˆÛi˜Ê °Ê
ÊȘ}iÊ}i˜iÀ>ˆâi`Ê q…i>Ì…ÊÀˆÃŽÊ“œ`i `ˆÀiV̏ÞÊ̜Ê̜Ì>Êi˜iÀ}Þʈ˜Ì>ŽiÊ>˜`ʈ˜ÛiÀÃiÞ
œLÃVÕÀiÃÊ̅iÊ«œÌi˜Ìˆ>Ê̜Ê`œVՓi˜ÌÊV…Àœ˜ˆVÊ`ˆÃi>ÃiÊÀˆÃŽÃÊ>“œ˜}Ê`ˆvviÀi˜ÌÊ«œ«‡ ̜Ê`ˆiÌʵÕ>ˆÌÞ°
Տ>̈œ˜Ê}ÀœÕ«Ã°

Physical Inactivity: An Important Component for Fat Accumu-

lation ,i}Տ>ÀÊ«…ÞÈV>Ê>V̈ۈÌÞ]Ê̅ÀœÕ}…ÊiˆÌ…iÀÊÀiVÀi>̈œ˜ÊœÀʜVVÕ«>̈œ˜]
ivviV̈ÛiÞʈ“«i`iÃÊÜiˆ}…ÌÊ}>ˆ˜Ê>˜`Ê̅iÊ>`ÛiÀÃiÊV…>˜}iÃʈ˜ÊLœ`ÞÊVœ“«œÃˆÌˆœ˜°
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>˜`Êi˜}>}iʈ˜Ê“œÀiÊ«…ÞÈV>Ê>V̈ۈÌÞÊ̅>˜ÊVœÕ˜ÌiÀ«>ÀÌÃÊ܅œÊÀi}>ˆ˜i`ʏœÃÌ
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Benefits of Increased Energy Output with Aging

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).$%8 #54
For the same age and BMI, the percentage body fat of African
American men and women, Asian Indian men and women,
Hispanic women, and Asian women significantly differed from
non-Hispanic white men and women. BMI cut-scores to define
overweight and obesity systematically overestimated overweight
and obesity prevalence of African American men and women and
underestimated prevalence of Asian Indian men and women, Asian
women, and Hispanic women.
Reference
Jackson AJ, et al.: Body mass index bias in defining obesity of diverse
young adults. The Training Intervention and Genetics of Exercise
Response (TIGER) Study. Br. J. Nutr., 102:1084, 2009.
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568 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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84
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82 CRITERIA FOR EXCESSIVE BODY
FAT: HOW FAT IS TOO FAT?
80
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Chapter 16 Body Composition, Obesity, and Weight Control • 569

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Obesity causes more than 100,000
deaths in the United States each year,
according to the latest statistics
released by the American Institute of
Cancer Research ­ÜÜÜ°>ˆV…°œÀ}®.
Waist-to-Hip Ratio Excessive body fat causes nearly
one-half of endometrial cancers and
one-third of esophageal cancers. If
• Waist at navel while standing
Americans maintained normal body
relaxed, not pulling in stomach
weights (BMI !25.0), endometrial
• Hips, over the buttocks where cancer would decrease by 49%,
girth is largest esophageal cancer by 35%, pancreatic
• Divide waist girth by hip girth cancer by 28%, kidney cancer by 24%,
measure gallbladder cancer by 21%, breast
Ratio for significant health risk cancer by 17%, and colon cancer by
Males: !0.95 9%. Obesity-related illness accounts
Females: !0.80 for nearly 10% of all medical costs in
the United States—estimated at
Figure 16.20 >iÊ­>˜`Àœˆ`Ê«>ÌÌiÀ˜®Ê>˜`Êvi“>iÊ­}ޘœˆ`Ê«>ÌÌiÀ˜®Êv>ÌÊ«>ÌÌiÀ˜ˆ˜}] greater than $147 billion yearly.
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570 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

BOX 16.5 CLOSE UP

Calculating and Interpreting the Waist-to-Hip Girth Ratio

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CALCULATING WHR Example 2

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(android) (gynoid)
Abdomen: Minimum Hips: Maximum
Fat Patterning Types girth; standing, feet girth around buttocks;
together standing, feet together
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Chapter 16 Body Composition, Obesity, and Weight Control • 571

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LiœÜÊ{äʈ˜V…iÃÊvœÀʓi˜Ê>˜`ÊÎ{°Èʈ˜V…iÃ
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vœÀÊܜ“i˜Ê̜Ê>ÃÃiÃÃÊ>Ê«iÀܘ½ÃÊÀˆÃŽÊœv ()'( "-) !.$ ,!2'% 7!)34 !##52!4%,9 02%$)#4 (%!24 $)3%!3% 2)3+
…i>Ì…Ê«ÀœLi“ÃÊÀ>˜Ži`ÊvÀœ“ʏi>ÃÌÊÀˆÃŽ A recent study by Dutch researchers measured BMI and waist size in 20,500
̜ÊÛiÀÞʅˆ}…ÊÀˆÃŽ° men and women ages 20 to 65 years and correlated these age- and gender-
adjusted measurements with nonfatal and fatal cardiovascular disease risk over
Fat Cell Size and Number 10 years. More than 50% of all fatal heart disease cases and 25% of nonfatal
heart disease were predicted from having a high BMI or large waist in subjects
/…iÊÈâiÊ>˜`ʘՓLiÀʜvÊv>ÌÊViÃÊ«ÀœÛˆ`i defined as overweight or obese, with the cardiovascular disease risk equally
>ÊۈiÜʜvÊ̅iÊÃÌÀÕVÌÕÀi]ÊvœÀ“]Ê>˜`Ê`ˆ“i˜‡ strong for BMI and waist circumference. Overweight people had BMIs of
Ȝ˜ÃʜvʘœÀ“>Ê>˜`Ê>L˜œÀ“>ÊiÛiÃʜv between 25 and 30 and obese people of 30 or more. Waist circumference in
Lœ`ÞÊv>̘iÃðʘVÀi>ÃiÃʈ˜Ê>`ˆ«œÃiÊ̈ÃÃÕi men was defined as 37.0 to 40.1 inches for overweight and more than 40.2
“>ÃÃʜVVÕÀÃʈ˜ÊÌܜÊÜ>ÞÃ\ inches for obese. In women, these measurements were 31.5 to 34.6 inches for
£° ˜>À}ˆ˜}Ê­vˆˆ˜}®ÊœvÊi݈Ã̈˜}Êv> overweight and more than 34.6 inches for obese.
ViÃÊ܈̅ʓœÀiÊv>ÌÊV>i`Êv>ÌÊVi
Reference
…Þ«iÀÌÀœ«…Þ
Van Dis I, et al.: Body mass index and waist circumference predict both 10-year
Ó° ˜VÀi>Ș}Ê̅iÊ̜Ì>Ê˜Õ“LiÀʜvÊv>Ì
nonfatal and fatal cardiovascular disease risk: study conducted in 20,000
ViÃÊV>i`Êv>ÌÊViÊ…Þ«iÀ«>È>
Dutch men and women aged 20–65 years. Eur. J. Cardiovasc. Prev. Rehabil.
/…iÊÌiV…˜ˆµÕiÊ̜Ê>ÃÃiÃÃÊ>`ˆ«œVÞÌi 16:729, 2009.
ÈâiÊ>˜`ʘՓLiÀʈ˜ÛœÛiÃÊÃÕVŽˆ˜}ÊÓ>
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572 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

BMI category

Normal Overweight Obese class I

Waist girth 18.5 - 24.9 kg . m−2 25 - 29.9 kg . m−2 30 - 34.9 kg . m−2

Men: < 102 cm

Least risk Increased risk High risk
Women: < 88 cm

Men: ≥ 102 cm
Inceased risk High risk Very high risk
Women: ≥ 88 cm

Figure 16.21
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Chapter 16 Body Composition, Obesity, and Weight Control • 573

140 1.4

120 1.2

Micrograms lipid per cell

Cell number, billions
100 1.0

80 0.8

60 0.6

40 0.4

20 0.2

0 0
20 40 60 80 100 120 20 40 60 80 100 120

Total fat, kg Total fat, kg

Figure 16.23
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150 1.0 100

Cell number (billions)
Lipid per cell (µg)
Mass (kg)

100

0.5 50

50

0 0 0
Body mass Fat mass Cell size Cell number

Nonobese Obese

Figure 16.24
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574 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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Chapter 16 Body Composition, Obesity, and Weight Control • 575

+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
ÃÊv>ÌÊViÊ˜Õ“LiÀʜÀÊViÊÈâiÊ̅iʓ>œÀ
Normal ÃÌÀÕVÌÕÀ>Ê`ˆvviÀi˜Viʈ˜Ê>`ˆ«œÃiÊ̈ÃÃÕiʓ>ÃÃ
Potential for success LiÌÜii˜Ê̅iʜLiÃiÊ>˜`ʘœ˜œLiÃi¶
Overweight

Obese
Fa
Severe Ma t
ss
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ˆ˜ˆÌˆ>Ê`i}ÀiiʜvÊv>̘iÃð

Degree of obesity

Figure 16.25 ˆŽiˆ…œœ`ʜvÊÃÕVViÃÃʈ˜Êœ˜}‡ÌiÀ“Ê“>ˆ˜Ìi˜>˜ViʜvÊÜiˆ}…ÌʏœÃÃ

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Percent remaining reduced

100

80

60

40

20

0-6 7-12 13-18 19-24 25-36 37-48 49-84 85-108 108

Months following weight loss

Figure 16.26 i˜iÀ>ÊÌÀi˜`ÊvœÀÊ«iÀVi˜Ì>}iʜvÊ«>̈i˜ÌÃÊÀi“>ˆ˜ˆ˜}Ê>ÌÊÀi`ÕVi`

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576 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

Weight = Total energy Total energy

change intake expenditure

Pro 0
Weight Weight TEF
gain loss Physical
Lipid activity
Carbohydrate Resting
metabolism

Energy input Energy output

Intervention Strategies and Targets

Drugs Surgery Behavior Therapy
Appetite Food absorption Food intake
Figure 16.27 /…iÊi˜iÀ}ÞÊL>>˜ViÊiµÕ>̈œ˜
Thermogenesis Physical activity
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Resting Metabolism Lowered
ÊÀi`ÕV̈œ˜Êˆ˜ÊÀiÃ̈˜}ʓiÌ>LœˆÃ“ÊœvÌi˜

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578 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

BOX 16.6 CLOSE UP

Computing Daily Energy (Caloric) Requirement (Including Exercise)
for Weight Management and for Weight Loss

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COMPUTATIONS OF TARGET
ENERGY INTAKE REQUIRED TO
COMPUTING TOTAL DAILY REDUCE BODY WEIGHT
ENERGY EXPENDITURE TO ˜Ê̅iÊ>LœÛiÊiÝ>“«i]Ê̅iÊ/ Ê̜ʓ>ˆ˜Ì>ˆ˜ÊLœ`ÞÊÜiˆ}…Ì
MAINTAIN BODY WEIGHT iµÕ>ÃÊÓn™äʎ
>°Ê/…iÀivœÀi]Ê̅iÊ̜Ì>ÊŽ
>Êˆ˜Ì>ŽiʓÕÃÌ
Table 1 œ˜Ê̅iʘiÝÌÊ«>}iÊ«ÀiÃi˜ÌÃÊ̅iÊVœ“«ÕÌ>̈œ˜> `iVÀi>ÃiÊLiœÜÊ̅ˆÃÊÛ>ÕiÊ̜ʈ˜`ÕViÊ>ʘi}>̈ÛiÊV>œÀˆVÊL>‡
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Chapter 16 Body Composition, Obesity, and Weight Control • 579

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Table 1 Computation of Daily Total Caloric Requirement and Target Caloric Intake to
Lose Weight
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Table 2 Average 24-h Energy Expenditure Estimated From

Body Weight (lb) Based on Different Physical Activity Levels
for Men and Womena
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580 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

BOX 16.6 CLOSE UP

Computing Daily Energy (Caloric) Requirement (Including Exercise)
for Weight Management and for Weight Loss ­
œ˜Ìˆ˜Õi`®

Table 3 Sample Caloric Expenditures in kCal Per Pound of Body Weight

Per Minute (kCal!lb"1 !min"1)

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Fat Cell Size and Number After Weight Loss +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
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Chapter 16 Body Composition, Obesity, and Weight Control • 583

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584 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

Percentage of Total Weight Loss

Protein
15%
Water 70% Fat 70%
Fat 25%
Fat 85%
Water
20%

Protein 5% Protein 10%

Week 1 Week 2-3 Week 4

Figure 16.29 i˜iÀ>ÊÌÀi˜`ÊvœÀÊ̅iÊ«iÀVi˜Ì>}iÊVœ“«œÃˆÌˆœ˜ÊœvÊ̅iÊÜiˆ}…ÌʏœÃÌÊ`ÕÀˆ˜}Ê{ÊÜiiŽÃʜvÊV>œÀˆVÊÀiÃÌÀˆV̈œ˜°

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POINT IN THE ENERGY
BALANCE EQUATION
Vœ˜VÕÀÀi˜ÌÞ]ÊLœ`ÞÊv>ÌʏœÃÃÊ>VViiÀ>ÌiÃÊvÀœ“ÊÓx¯Ê̜ÊÇ䯰 iëˆÌiÊ`iL>ÌiÃÊ>LœÕÌÊVœ˜ÌÀˆLṎœ˜ÃʜvÊ«…ÞÈV>Êˆ˜>V̈ۈÌÞ
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«Àœ`ÕViÊ>LœÕÌÊnx¯ÊœvÊ̅iÊÜiˆ}…ÌʏœÃÃÊ܈̅œÕÌÊvÕÀ̅iÀ ˆviÃÌޏiÊVœ˜ÃˆÃÌi˜ÌÞÊi“iÀ}iÃÊ>ÃÊ>˜Êˆ“«œÀÌ>˜ÌÊv>V̜Àʈ˜
ˆ˜VÀi>Ãiʈ˜ÊÜ>ÌiÀʏœÃðÊ*ÀœÌiˆ˜½ÃÊVœ˜ÌÀˆLṎœ˜Ê̜ÊÜiˆ}…Ì Üiˆ}…ÌÊ}>ˆ˜ÊLÞÊV…ˆ`Ài˜]Ê>`œiÃVi˜ÌÃ]Ê>˜`Ê>`ՏÌð
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vœÕÀ̅ÊÜiiŽ°Ê˜Ê«À>V̈V>ÊÌiÀ“Ã]ÊVœÕ˜Ãiˆ˜}ÊivvœÀÌÃÊŜՏ`
i“«…>ÈâiÊ̅>ÌÊ̅iÊÜiˆ}…ÌʏœÃÌÊ`ÕÀˆ˜}Ê̅iʈ˜ˆÌˆ>Ê>ÌÌi“«ÌÃ
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Caloric equivalent of each

Ü>ÌiÀÊ>˜`ʘœÌÊv>ÌÆʈÌÊÌ>ŽiÃÊ>««ÀœÝˆ“>ÌiÞÊ{ÊÜiiŽÃÊ̜ÊiÃÌ>L‡ 8000
ˆÃ…Ê̅iÊ`iÈÀi`Ê«>ÌÌiÀ˜ÊœvÊv>ÌʏœÃÃÊvœÀÊi>V…Ê«œÕ˜`ʜv 7000
kg of weight loss

Üiˆ}…ÌʏœÃð 6000
5000
Hydration Level 4000

,iÃÌÀˆV̈˜}ÊÜ>ÌiÀÊ`ÕÀˆ˜}Ê̅iÊvˆÀÃÌÊÃiÛiÀ>Ê`>ÞÃʜvÊ>ÊV>œÀˆ 3000
`ivˆVˆÌʈ˜VÀi>ÃiÃÊ̅iÊ«Àœ«œÀ̈œ˜ÊœvÊLœ`ÞÊÜ>ÌiÀʏœÃÌÊ>˜ 2000
`iVÀi>ÃiÃÊ̅iÊ«Àœ«œÀ̈œ˜ÊœvÊv>ÌʏœÃÌ°ÊœÀiÊ̜Ì>ÊÜiˆ}…ÌʏœÃà 1000
œVVÕÀÃÊ܈̅ÊÀiÃÌÀˆVÌi`Ê`>ˆÞÊÜ>ÌiÀʈ˜Ì>Ži]Ê܈̅Ê̅iÊ>``ˆ‡
3 6 9 12 15 18 21 25
̈œ˜>ÊÜiˆ}…ÌʏœÃÌÊ܏iÞÊvÀœ“ÊÜ>ÌiÀÊ>ÃÊ`i…Þ`À>̈œ˜Ê«Àœ‡
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œvÊvÕˆ`ʈ˜Ì>ŽiʏiÛi
Longer Term Deficit Promotes Fat Loss
>Ê«iÀʎˆœ}À>“Ê>vÌiÀÊÓäÊÜiiŽÃ°Ê/…ˆÃ
Figure 16.30 Àiˆ˜vœÀViÃÊ̅iʈ“«œÀÌ>˜ÌÊ}i˜iÀ>ÊVœ˜Vi«Ì
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Weeks of caloric restriction
Figure 16.30 i˜iÀ>ÊÌÀi˜`ÊvœÀÊ̅iÊi˜iÀ}ÞÊiµÕˆÛ>i˜ÌʜvÊ̅i
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Chapter 16 Body Composition, Obesity, and Weight Control • 585

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i˜iÀ}Þʈ˜Ì>ŽiʜÀÊ̅iʓˆÝÌÕÀiʜvʓ>VÀœ˜Õ‡
LœÌ…Ê“œ`iÀ>ÌiÊ«…ÞÈV>Ê>V̈ۈÌÞʜÀʓœÀiÊۈ}œÀœÕÃÊiÝiÀVˆÃiÊ̅>Ìʈ“«ÀœÛiÃÊV>À`ˆœ‡ ÌÀˆi˜ÌÃÊVœ˜ÃՓi`¶
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̈œ˜>ÊLi˜ivˆÌÃʜvÊÀi}Տ>ÀÊiÝiÀVˆÃiʈ˜VÕ`iÃÊϜ܈˜}ʜvÊ̅iÊ>}i‡Ài>Ìi`ʏœÃÃʈ
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ÈÌއÀi>Ìi`ÊVœ“œÀLˆ`ˆÌˆiÃ]Ê`iVÀi>Ãi`ʓœÀÌ>ˆÌÞ]Ê>˜`ÊLi˜ivˆVˆ>ÊivviVÌÃʜ˜Êi݈Ã̈˜
V…Àœ˜ˆVÊ`ˆÃi>Ãið
ÕÀˆ˜}Ê̅iÊvˆÀÃÌÊÜiiŽÊœvÊÜiˆ}…ÌʏœÃÃ]Ê`œi
̅iÊLœ`ÞʏœÃiʓœÀiÊÜ>ÌiÀʜÀÊv>ÌÊ«iÀÊ՘ˆÌʜv
Two Misconceptions About Exercise Üiˆ}…ÌʏœÃ̶

/ܜÊ>À}Փi˜ÌÃÊ>ÌÌi“«ÌÊ̜ÊVœÕ˜ÌiÀÊ̅iʈ˜VÀi>Ãi`Ê«…ÞÈV>Ê>V̈ۈÌÞÊ>««Àœ>V…Ê̜
Üiˆ}…ÌʏœÃðÊ"˜iʓ>ˆ˜Ì>ˆ˜ÃÊ̅>ÌÊiÝiÀVˆÃiʈ˜iۈÌ>LÞʈ˜VÀi>ÃiÃÊ>««ïÌiÊ̜ʫÀœ‡
`ÕViÊ>Ê«Àœ«œÀ̈œ˜>Ìiʈ˜VÀi>Ãiʈ˜Êvœœ`ʈ˜Ì>ŽiÊ̅>Ìʘi}>ÌiÃÊ̅iÊV>œÀˆVÊ`ivˆVˆÌÊ̅>
ˆ˜VÀi>Ãi`Ê«…ÞÈV>Ê>V̈ۈÌÞÊ«Àœ`ÕViðÊ/…iÊÃiVœ˜`Ê>À}Փi˜ÌÊV>ˆ“ÃÊ̅>ÌÊ̅iÊÀi‡
>̈ÛiÞÊÓ>ÊV>œÀˆi‡LÕÀ˜ˆ˜}ÊivviVÌʜvÊ>ʘœÀ“>ÊiÝiÀVˆÃiÊܜÀŽœÕÌÊ`œiÃʘœÌ 7…>ÌʈÃʜ˜iÊLi˜ivˆÌÊv>V̜ÀÊ`iÌiÀ“ˆ˜iÊ>
ˆ˜VÀi>Ãiʈ˜Ê̅iÊV>œÀˆVÊiµÕˆÛ>i˜Ìʜv
º`i˜Ì»Ê̅iÊLœ`Þ½ÃÊv>ÌÊÀiÃiÀÛiÃÊ>ÃÊivviV̈ÛiÞÊ>ÃÊvœœ`ÊÀiÃÌÀˆV̈œ˜°
Üiˆ}…Ì°

Misconception 1: Increased Physical Activity and Food Intake

-i`i˜Ì>ÀÞÊ«iÀܘÃʜvÌi˜Ê`œÊ˜œÌÊL>>˜ViÊ̅iˆÀÊi˜iÀ}Þʈ˜Ì>ŽiÊ>˜`Êi˜iÀ}ÞÊiÝ«i˜‡
`ˆÌÕÀi°Ê>ˆÕÀiÊ̜Ê>VVÕÀ>ÌiÞÊÀi}Տ>ÌiÊi˜iÀ}ÞÊL>>˜ViÊ>ÌÊ̅iʏœÜiÀÊi˜`ʜvÊ̅i
«…ÞÈV>Ê>V̈ۈÌÞÊëiVÌÀՓÊVœ˜ÌÀˆLÕÌiÃÊ̜Ê̅iʺVÀii«ˆ˜}ʜLiÈÌ޻ʜLÃiÀÛi`ʈ˜
…ˆ}…ÞʓiV…>˜ˆâi`Ê>˜`ÊÌiV…˜ˆV>ÞÊ>`Û>˜Vi`ÊÜVˆïiðʘÊVœ˜ÌÀ>ÃÌ]ÊÀi}Տ>À ˆÃVÕÃÃÊ܅i̅iÀÊiÝiÀVˆÃiÊivviVÌÃÊ>««ïÌi°
iÝiÀVˆÃiÀÃʓ>ˆ˜Ì>ˆ˜Ê>««ïÌiÊVœ˜ÌÀœÊ܈̅ˆ˜Ê>ÊÀi>V̈ÛiÊ✘iÊ܅iÀiÊvœœ`ʈ˜Ì>Ži
“œÀiÊÀi>`ˆÞʓ>ÌV…iÃÊ`>ˆÞÊi˜iÀ}ÞÊiÝ«i˜`ˆÌÕÀi°
˜ÊVœ˜Ãˆ`iÀˆ˜}Ê̅iÊivviVÌÃʜvÊiÝiÀVˆÃiʜ˜Ê>««ïÌiÊ>˜`Êvœœ`ʈ˜Ì>Ži]ʜ˜iʓÕÃÌ
`ˆÃ̈˜}ՈÅÊLiÌÜii˜ÊiÝiÀVˆÃiÊÌÞ«iÊ>˜`Ê`ÕÀ>̈œ˜Ê>˜`Ê̅iÊ«>À̈Vˆ«>˜Ì½ÃÊLœ`ÞÊv>ÌÊÃÌ>‡
ÌÕðÊՓLiÀ>VŽÃ]Êv>À“ʏ>LœÀiÀÃ]Ê>˜`Êi˜`ÕÀ>˜ViÊ>̅iÌiÃÊVœ˜ÃՓiÊ>LœÕÌÊÌ܈ViÊ>Ã
“>˜ÞÊ`>ˆÞÊV>œÀˆiÃÊ>ÃÊÃi`i˜Ì>ÀÞʈ˜`ˆÛˆ`Õ>Ã°ÊœÀiÊëiVˆvˆV>Þ]ʓ>À>̅œ˜ÊÀ՘
˜iÀÃ]ÊVÀœÃÇVœÕ˜ÌÀÞÊΈiÀÃ]Ê>˜`ÊVÞVˆÃÌÃÊVœ˜ÃՓiÊ>LœÕÌÊ{äääÊ̜Êxäääʎ
>Ê`>ˆÞ]
ÞiÌÊ̅iÞÊ>ÀiÊ̅iʏi>˜iÃÌÊ«iœ«iʈ˜Ê̅iÊ«œ«Õ>̈œ˜°Ê"LۈœÕÏÞ]Ê̅iˆÀʏ>À}iÊV>œÀˆV
ˆ˜Ì>ŽiʓiiÌÃÊ̅iÊi˜iÀ}ÞÊÀiµÕˆÀi“i˜ÌÃʜvÊÌÀ>ˆ˜ˆ˜}Ê܅ˆiʓ>ˆ˜Ì>ˆ˜ˆ˜}Ê>ÊÀi>̈ÛiÞ
i>˜ÊLœ`ÞÊVœ“«œÃˆÌˆœ˜°
œÀʜÛiÀÜiˆ}…ÌʜÀʜLiÃiʈ˜`ˆÛˆ`Õ>Ã]ÊiÝÌÀ>Êi˜iÀ}ÞÊÀiµÕˆÀi`ÊvœÀʈ˜VÀi>Ãi`
«…ÞÈV>Ê>V̈ۈÌÞʓœÀiÊ̅>˜ÊœvvÃiÌÃʓœ`iÀ>ÌiÊ«…ÞÈV>Ê>V̈ۈÌÞ½ÃÊÓ>ÊVœ“«i˜‡
Ã>̜ÀÞÊ>««ïÌi‡Ã̈“Տ>̈˜}ÊivviVÌ°Ê/œÊܓiÊiÝÌi˜Ì]Ê̅iʏ>À}iÊi˜iÀ}ÞÊÀiÃiÀÛiʜvÊ>˜
œÛiÀv>ÌÊ«iÀܘʓ>ŽiÃʈÌÊi>ÈiÀÊ̜Ê̜iÀ>ÌiÊÜiˆ}…ÌʏœÃÃÊ>˜`ÊiÝiÀVˆÃiÊ܈̅œÕÌÊ̅i
œLˆ}>̜ÀÞʈ˜VÀi>Ãiʈ˜ÊV>œÀˆVʈ˜Ì>ŽiÊÌÞ«ˆV>ÞʜLÃiÀÛi`ÊvœÀʏi>˜iÀÊVœÕ˜ÌiÀ«>ÀÌð
œÊ`ˆvviÀi˜ViÊi“iÀ}i`ʈ˜Êv>Ì]ÊV>ÀLœ…Þ`À>Ìi]ʜÀÊ«ÀœÌiˆ˜Êˆ˜Ì>ŽiʜÀÊ̜Ì>ÊV>œÀˆiÃ
Vœ˜ÃՓi`ÊvœÀʜÛiÀÜiˆ}…Ìʓi˜Ê>˜`Êܜ“i˜Ê`ÕÀˆ˜}Ê£Èʓœ˜Ì…ÃʜvÊÃÕ«iÀۈÃi`]ʓœ`‡
iÀ>Ìi‡ˆ˜Ìi˜ÃˆÌÞÊiÝiÀVˆÃiÊÌÀ>ˆ˜ˆ˜}ÊVœ“«>Ài`Ê܈̅Ê>ÊÃi`i˜Ì>ÀÞÊVœ˜ÌÀœÊ}ÀœÕ«°Ê ˜
iÃÃi˜Vi]Ê>ÊÜi>ŽÊVœÕ«ˆ˜}Êi݈ÃÌÃÊLiÌÜii˜Ê̅iÊŜÀ̇ÌiÀ“Êi˜iÀ}ÞÊ`ivˆVˆÌʈ˜`ÕVi`ÊL
iÝiÀVˆÃiÊ>˜`Êi˜iÀ}Þʈ˜Ì>Ži°Ê˜VÀi>Ãi`Ê«…ÞÈV>Ê>V̈ۈÌÞÊLÞʜÛiÀÜiˆ}…Ì]ÊÃi`i˜Ì>ÀÞ
ˆ˜`ˆÛˆ`Õ>ÃÊ`œiÃʘœÌʘiViÃÃ>ÀˆÞÊ>ÌiÀÊ«…ÞȜœ}ˆVʘii`ÃÊ>˜`Ê>Õ̜“>̈V>ÞÊ«Àœ`ÕVi
Vœ“«i˜Ã>̜ÀÞʈ˜VÀi>ÃiÃʈ˜Êvœœ`ʈ˜Ì>ŽiÊ̜ÊL>>˜ViÊ>``ˆÌˆœ˜>Êi˜iÀ}ÞÊiÝ«i˜`ˆÌÕÀi°

Misconception 2: Low Caloric Stress of Physical Activity
ÊÃiV‡

œ˜`ʓˆÃVœ˜Vi«Ìˆœ˜ÊVœ˜ViÀ˜ÃÊ̅iʘi}ˆ}ˆLiÊVœ˜ÌÀˆLṎœ˜Ê ̜ÊÜiˆ}…ÌʏœÃÃʜvÊ̅i
7 Ç£ä‡V£ÈÚxΣ‡x™{°µÝ`ÊʙɣÈÉ£äÊÊÇ\ÓÓ*ÊÊ*>}iÊxnÈÊ7 ǣ䇘`ÚÈnx‡È™n°µÝ`

586 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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Effectiveness of Regular Exercise

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EX ˆ«œ«ÀœÌiˆ˜®ÊV…œiÃÌiÀœÊÀ>̈œÊ­Óx°™¯®°
Change in thigh muscle volume (%)

CR œÃÌʜvÊ̅iʅi>Ì…‡Ài>Ìi`ʓiÌ>LœˆVʈ“«ÀœÛi“i˜ÌÃ
5
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Chapter 16 Body Composition, Obesity, and Weight Control • 587

Table 16.7
Effectiveness of a 16-Week Walking Program on
Body Composition and Blood Lipid Changes in Six
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Chapter 16 Body Composition, Obesity, and Weight Control • 589

Dietary Strategies to Achieve Weight Loss of

Participants of the National Weight Control Registry
+ÕiÃ̈œ˜ÃÊEÊ œÌiÃ
Table 16.9 (top) and Effects of Weight Loss on Various ÃʈÌÊ«œÃÈLiÊ̜Ê}>ˆ˜Ê“ÕÃViÊ>˜`ʏœÃiÊv>Ì
Dimensions of Life as Reported by Participants `ÕÀˆ˜}ÊÜiˆ}…ÌʏœÃÃ¶Ê Ý«>ˆ˜°
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Can Targeted Exercise Selectively Reduce

Local Fat Deposits?
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`ۜV>Ìià Each 0.45 kg (1 lb) of adipose tissue
œvÊëœÌÊÀi`ÕV̈œ˜ÊÀiVœ““i˜`Ê«iÀvœÀ“ˆ˜}ʏ>À}iʘՓLiÀÃʜvÊÈ̇իÃʜÀÊÈ`i‡ contains about 87% pure lipid or
Li˜`ÃÊ̜ÊÀi`ÕViÊiÝViÃÈÛiÊ>L`œ“ˆ˜>Ê>˜`ʅˆ«Êv>Ì°Ê/…iÊ«Àœ“ˆÃiʜvÊëœÌÊÀi`ÕV‡ 3500 kcal (395 g " 9 kcal!g–1). An
̈œ˜Ê܈̅ÊiÝiÀVˆÃiÊÃii“ÃÊ>ÌÌÀ>V̈ÛiÊvÀœ“Ê>˜Ê>iÃ̅ïVÊ>˜`ʅi>Ì…ÊÀˆÃŽ excess intake of 3500 kCal accumulates
ÃÌ>˜`«œˆ˜Ìp՘vœÀÌ՘>ÌiÞ]ÊVÀˆÌˆV>ÊiÛ>Õ>̈œ˜ÊœvÊ̅iÊÀiÃi>ÀV…Êiۈ`i˜ViÊ`œià 0.45 kg of extra fat. Magic potions,
˜œÌÊÃÕ««œÀÌʈÌÃÊÕÃi° trick diets, or special formula foods
/œÊiÝ>“ˆ˜iÊV>ˆ“ÃÊvœÀÊëœÌÊÀi`ÕV̈œ˜]ÊÀiÃi>ÀV…iÀÃÊVœ“«>Ài`Ê̅iÊ}ˆÀ̅ÃÊ>˜` cannot undo this strategic ratio.
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590 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits
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Increase Lean, Not Body Fat Mass
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Chapter 16 Body Composition, Obesity, and Weight Control • 591

S U M M A R Y
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Physical
C h a p t e r

Activity, Exercise,
17
Successful Aging,
and Disease
Prevention
At least half of all babies born in America in 2007
will live to the age of 104!

pÊ>˜ViÌ ÎÇ{]Ê"V̜LiÀÊÓää™

CHAPTER OBJECTIVES

• Describe the meaning of the the term healthspan.
• Explain the concept of successful aging compared
with traditional views of the aging process.
• Distinguish between the terms exercise and
physical activity.
• Explain the basis of the Physical Activity Pyramid.
• Describe research showing that regular physical activ-
ity protects against disease and may even extend life.
• List the three major causes of death in the United
States.
• List and describe the four major coronary heart disease
(CHD) risk factors.

• Answer the question, “How safe is exercise?” • List secondary and novel risk factors for CHD.

• Describe the goals of Healthy People 2010.
• What is SeDS, and why is it so important?
• List important age-related changes in muscular
strength, joint flexibility, nervous system function, car-
diovascular function, pulmonary function, endocrine
function, and body composition.
• Describe five field tests to assess the flexibility of
major body areas.
• List specific components of the blood lipid profile and
give values considered desirable for each.
• Discuss factors that affect cholesterol lipoprotein levels.
• Explain how regular physical activity reduces the risk
of CHD.
• Describe the occurrence of CHD risk factors in
children.
• Explain interactions between CHD risk factors.
595
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(AHA) recommendations for healthy adults but with several important differ-
ences. For example, the level of exercise intensity takes into account the older
adult’s relatively lower level of aerobic fitness. Recommended activities also
focus on joint flexibiltiy and balance to reduce risks of falls. Physical activity
in this population emphasizes moderate-intensity aerobic activity, muscle-
strengthening exercises, reduction of sedentary behavior, and lifestyle risk
management. (From Nelson M.E., et al.: Physical activity and public health in
older adults: recommendation from the American College of Sports Medicine
and the American Heart Association. Med. Sci. Sports Exerc., 39:1435, 2006.)

100
90
2000 72
80
2005 101
70
2010 131 60
Age (y)
Year

2020 214 50
40
2030 324
30
2040 447
20
2050 834 10
0
A 0 100 200 300 400 500 600 700 800 900 B 70 75 80 85 90 95 100
Projected population 100 years and over Probability a 65-year old
(in thousands) will live until this age (y)

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85

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Life expectancy (y)

65

60

55

50

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1850 1875 1900 1925 1950 1975 2000

Year

Best-practice England & Wales France Germany (East) Germany (West)

Japan Sweden USA

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Cardiovascular
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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 601

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• TV viewing
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• Excessive reading Ó°
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AT LEAST TWICE WEEKLY
Leisure-lifestyle Flexibility
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aerobic exercise) • easy calisthenics
• golf • yoga
• light gardening • light-moderate
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AT LEAST THREE TIMES WEEKLY

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• walking • tennis
• jogging • hiking
• swimming • racquetball
• bicycling • basketball ΰ
• aerobics

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DAILY (AS OFTEN AS POSSIBLE)
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• stair climbing
• walking to work
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In February 2010 First Lady Michelle Obama with support from the U.S.
government rolled out a national initiative against childhood obesity, dubbed
“Let’s Move.” Along with the First Lady’s influential leadership, the project
received a commitment of $1 billion a year in federal funds for 10 years, and
the first national task force on solving the childhood obesity epidemic with
members from the departments of the Interior, Health and Human Services,
Agriculture and Education.
The initiative has four core pillars: better nutrition information, increased
physical activity, easier access to healthy foods and personal responsibility.
Specific actions revolve around food labeling, school food quality, and encour-
aging kids to exercise each day and doctors to monitor body mass index.
This campaign is comprehensive in nature that builds on effective strategies,
and mobilizes public and private sector resources. Let’s Move will engage every
communities simple tools to help kids be more active, eat better, and get
healthy. To support Let’s Move the nation’s leading children’s health founda-
tions have come together to create a new independent foundation - the
Partnership for a Healthier America - to accelerate existing efforts towards the
national goal of solving childhood obesity within a generation.
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602 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

BOX 17.1 CLOSE UP

How to Assess Joint Flexibility in Common
Body Areas
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FIVE COMMON FIELD TESTS OF
STATIC FLEXIBILITY
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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 603

Test 2: Shoulder–Wrist Flexibility œÛi“i˜Ì\ ÝÌi˜`ÊLœÌ…Ê>À“Ãʈ˜ÊvÀœ˜ÌʜvÊ̅iÊV…iÃÌÊ>˜`

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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 605

AGING AND BODILY FUNCTION +ÕiÃ̈œ˜ÃÊEÊ œÌiÃ

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606 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 607

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other tissues

IGF-1 decreases
(Somatopause) Cortisol
Testes
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decreases decreases ivˆ˜iÊ̅iÊÌiÀ ܓ>̜«>ÕÃi°
(Menopause) (Andropause)

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608 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 609

Aging Response to Exercise Training œÀÊ̅iʅi>Ì…ÞÊi`iÀÞ]ÊiÝiÀ‡

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610 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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400,000

300,000

200,000

100,000

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Nephritis

pneumonia
Influenza

Alzheimer’s

Diabetes

Accidents

respiratory disease
Chronic lower

Stroke

Cancer

disease
Heart

500,000
450,000
Number of Individuals

400,000
350,000
300,000
250,000
200,000
150,000
100,000
50,000
0
Figure 17.10 ­
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Sexual

Firearms

vehicle
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Toxic

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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 611

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Does Exercise Improve Health and Extend Life?

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612 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

50
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40

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a Long Way

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“œÃÌÊvˆÌÊÃÕLiVÌÃ

90
All-cause death risk
Low

80
Number of deaths per 10,000

70
Very active
Moderately
Sedentary

60 64.0
active
High

50 Low High
Aerobic fitness
40
39.5
30 Figure 17.12 *…ÞÈV>ÊvˆÌ˜iÃ
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18.6
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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 613

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>˜`ʅi>Ì…ÞʏˆÛið

Changes in Physical Activity and

Mortality Among Older Women
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Li˜ivˆÌÃÊÌÞ«ˆV>ÞʜLÃiÀÛi`ÊvœÀʓi˜° Figure 17.13
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Researchers monitored two groups of sedentary middle-aged men
and women ages 35 to 60 years during a 2-year clinical trial. One
group exercised vigorously for 20 to 60 minutes by swimming, stair
stepping, walking, or biking at a fitness center up to 5 days a week.
The other group incorporated 30 minutes a day of “lifestyle” exer-
cises such as extra walking, raking leaves, stair climbing, walking
around the airport while waiting for a plane, and participating in a
walking club most days of the week. The lifestyle participants also
learned cognitive and behavioral strategies to increase daily physi-
cal activity. For each of the programs, the intervention consisted of
6 months of intensive exercise followed by 18 months of
maintenance. At the end of 24 months, both groups showed similar
improvements in physical activity, cardiorespiratory fitness,
systolic and diastolic blood pressure, and body fat percentage.
These findings reinforce the conclusion that the health-derived
benefits from regular exercise do not require highly structured or
vigorous exercise.

All-Cause Mortality
0.25
Stayed Sedentary
Cumulative Mortality

0.20 Became Sedentary

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614 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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Percentage breakdown of
deaths from cardiovascular Coronary Heart
100
diseases (male and female) Disease

90 Stroke
7 4 14 85.9
Heart Failure
7 79.3
80 High Blood
73.3 72.6
Pressure
Percentage of Population

70 Diseases of the
17
Arteries
60 52
Other
50

40 37.9 38.5

30

20 15.9

10 7.8

0
20-39 40-59 60-79 80+
Age range (y)

Men Women

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616 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

A
Displaced smooth
Platelets muscle cells

Artery wall Fatty Smooth

deposit muscle

Cholesterol- Cholesterol-
containing LDL gorged macrophages
(foam cells)

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• At least 80 million people (one person in three) has some form of cardiovascular disease.
• Cardiovascular disease is the primary killer of women and men. Diseases of the cardio-
vascular system claim the lives of more than half a million women every year, about one &OR 9OUR )NFORMATION
death per minute.
• Cardiovascular disease accounts for almost 1 of every 2.4 deaths.
(%!24 !44!#+ 6%2353 #!2$)!#
• Since 1900, cardiovascular disease was the leading cause of death every year but
!22%34
1918, and it caused more deaths than the next seven causes combined. • Heart attack: Caused by (1) block-
• Every 37 seconds, a person has a coronary event, and each minute, someone dies from age in one or more arteries supplying
one.
the heart, thus cutting off myocardial
• Among whites, only 11.4% have heart disease, 6.1% have CHD, and 2.2% have had a
stroke. blood supply, or (2) sudden spasms
• Among African Americans, 10.2% have heart disease, 6.0% have CHD, 31.7% have (constrictions) of a coronary vessel,
hypertension, and 3.7% have had a stroke. causing part of the heart muscle to
• Among Asian Americans, 6.9% have heart disease, 4.3% have CHD, 19.5% have die (necrosis) from lack of oxygen
hypertension, and 2.6% have had a stroke.
(anoxia).
• Cardiac arrest: Caused by irregular
neural–electrical transmission within
Cigarette Smoking the myocardium. This produces

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{äÊÞi>ÀÃʅ>ÛiÊvˆÛiÊ̈“iÃÊ>Ãʓ>˜Þʅi>ÀÌÊ>ÌÌ>VŽÃÊ>Ãʘœ˜Ã“œŽiÀÃʈ˜Ê̅iÊÃ>“iÊ>} that physically active men had about
À>˜}i°Ê7…i˜Ê̅iÃiÊÀi>̈ÛiÞÊޜ՘}ÊӜŽiÀÃʅ>ÛiÊ>ʅi>ÀÌÊ>ÌÌ>VŽ]Ê>˜Ênä¯ÊV…>˜Vi half the risk of colon cancer as inactive
i݈ÃÌÃÊ̅>ÌÊӜŽˆ˜}ÊV>ÕÃi`ʈÌÆÊ̅ˆÃÊ«iÀVi˜Ì>}iÊ>ÛiÀ>}iÃʘi>ÀÞÊÇä¯ÊvœÀÊӜŽiÀà classmates. The protection disappeared
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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 619

BOX 17.2 CLOSE UP

How to Classify Cholesterol, Lipoproteins, and
Triacylglycerol Values

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Table 1 Classification of Serum Total Cholesterol, Low-Density

Lipoprotein Cholesterol, and High-Density Lipoprotein
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° children ages 10 to 15 years indicates that lifestyle habits of regular exer-

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620 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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«>µÕiÊLՈ`Õ«Æʜ̅iÀÃʈ˜…ˆLˆÌÊ«>µÕiÊvœÀ“>̈œ˜°
7ˆÌ…ˆ˜Ê̅ˆÃÊvÀ>“iܜÀŽ]ÊÀi}Տ>ÀÊiÝiÀVˆÃiʓ>ÞÊÃ̈“Տ>Ìi
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Àˆ>Ê`ˆÃi>Ãi°ÊœÀÊiÝ>“«i]ÊÓ°xʅœÕÀÃʜvÊÜiiŽÞÊiÝiÀVˆÃi
vœÀÊÈʓœ˜Ì…ÃÊ`iVÀi>Ãi` VÞ̜Žˆ˜iÊ«Àœ`ÕV̈œ˜Ê̅>ÌÊv>Vˆˆ‡
Ì>ÌiÃÊ«>µÕiÊ`iÛiœ«“i˜ÌÊLÞÊxn¯ÆÊVÞ̜Žˆ˜iÃÊ̅>Ì
ˆ˜…ˆLˆÌÊ«>µÕiÊvœÀ“>̈œ˜Êˆ˜VÀi>Ãi` LÞÊÎȯ°
Homocysteine œ“œVÞÃÌiˆ˜i]Ê>ʅˆ}…ÞÊÀi>V̈Ûi]
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̅iÊ}i˜iÀ>Ê«œ«Õ>̈œ˜Ê«Ài`ˆÃ«œÃiÃʈ˜`ˆÛˆ`Õ>ÃÊ̜Ê>̅‡
iÀœÃViÀœÃˆÃÊȓˆ>ÀÞÊ̜ÊiiÛ>Ìi`ÊV…œiÃÌiÀœÊVœ˜Vi˜‡
ÌÀ>̈œ˜°
ՓiÀœÕÃÊÃÌÕ`ˆiÃʅ>ÛiÊŜܘÊ>ʘi>ÀÞʏœVŽÃÌi«
>ÃÜVˆ>̈œ˜ÊLiÌÜii˜Ê«>Ó>ʅœ“œVÞÃÌiˆ˜iʏiÛiÃÊ>˜`
…i>ÀÌÊ>ÌÌ>VŽÊ>˜`ʓœÀÌ>ˆÌÞʈ˜Ê“i˜Ê>˜`Êܜ“i˜Êȓˆ>À
̜Ê̅>ÌʜvÊӜŽˆ˜}Ê>˜`ʅޫiÀˆ«ˆ`i“ˆ>°Ê/…ˆÃʓiÌ>LœˆV
>L˜œÀ“>ˆÌÞʈÃÊ«ÀiÃi˜Ìʈ˜Ê˜i>ÀÞÊÎä¯ÊœvÊ
&OR 9OUR )NFORMATION
&)"%2 ).4!+% !.$ #/2/.!29 (%!24 $)3%!3% ).
4(% %,$%2,9
An inverse association exists between fiber consumption from
cereal sources (including whole grains and bran) and coronary
heart disease risk in elderly men and women (average age, 72 y).
Compared with medical or surgical interventions, increasing
fiber intake by the equivalent of two slices of whole grain bread
per day is easy to incorporate into the daily routine, is low cost,
and is widely available.
&OR 9OUR )NFORMATION
0(93)#!, !#4)6)49 !.$ 7/-%. (/7 -5#( )3 '//$
%./5'(
Modest levels of physical activity (30 minutes per day on most
days) decrease the risk of chronic diseases, including breast cancer.
Appropriate dietary restraint, coupled with increased physical
activity, can help overweight women reduce their weight. When
prescribing physical activity, set a goal of 30 minutes per day of
moderate-intensity activity. This can be accumulated in bouts of at
least 10 minutes daily. For those willing to do more and for whom
Ê«>̈i˜Ìà no contraindications exist, greater duration and increased intensity
>˜`Ê{ä¯ÊœvÊ«>̈i˜ÌÃÊ܈̅ÊViÀiLÀœÛ>ÃVՏ>ÀÊ`ˆÃi>Ãi°Ê
ÝViÇ of activity confers additional benefits. (Jakicic, J.M.: Effect of exer-
ÈÛiʅœ“œVÞÃÌiˆ˜iÊV>ÕÃiÃÊLœœ`Ê«>ÌiiÌÃÊ̜ÊVÕ“«]ÊvœÃ‡ cise duration and intensity on weight loss in overweight, sedentary
ÌiÀˆ˜}ÊLœœ`ÊVœÌÃÊ>˜`Ê`iÌiÀˆœÀ>̈œ˜ÊœvÊӜœÌ…Ê“ÕÃVi women: a randomized trial. JAMA., 290:1323, 2003; Lee, I.-M.
ViÃÊ̅>Ìʏˆ˜iÊ̅iÊ>ÀÌiÀˆ>ÊÜ>°Ê
…Àœ˜ˆVʅœ“œVÞÃÌiˆ˜i Physical Activity and Women: How Much Is Good Enough?
iÝ«œÃÕÀiÊiÛi˜ÌÕ>ÞÊÃV>ÀÃÊ>˜`Ê̅ˆVŽi˜ÃÊ>ÀÌiÀˆiÃÊ>˜`Ê«Àœ‡ JAMA., 290:1377, 2003; and Manson, J.E.: Walking compared
ۈ`iÃÊ>ÊviÀ̈iʓi`ˆÕ“ÊvœÀÊVˆÀVՏ>̈˜}Ê‡
Ê̜ʈ˜ˆÌˆ>Ìi with vigorous exercise for the prevention of cardiovascular events
`>“>}i°Ê˜Ê̅iÊ«ÀiÃi˜Viʜvʜ̅iÀÊVœ˜Ûi˜Ìˆœ˜>Ê
 in women. N. Engl. J. Med., 347:716, 2002.)
ÀˆÃŽÃÊ­i°}°]ÊӜŽˆ˜}Ê>˜`ʅޫiÀÌi˜Ãˆœ˜®]ÊÃޘiÀ}ˆÃ̈V
7 Ç£ä‡V£ÇÚx™x‡ÈÎä°µÝ`ÊʙɣÈÉ£äÊÊÇ\Îx*ÊÊ*>}iÊÈÓÓ

622 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

ivviVÌÃʓ>}˜ˆvÞÊ̅iʘi}>̈Ûiʈ“«>VÌʜvʅœ“œVÞÃÌiˆ˜iʜ˜ C-Reactive Protein œÕ˜Ìˆ˜}Êiۈ`i˜Viʈ˜`ˆV>ÌiÃ

V>À`ˆœÛ>ÃVՏ>Àʅi>Ì…°Ê˜Ê}i˜iÀ>]Ê«iœ«iʈ˜Ê̅iʅˆ}…iÃÌ
µÕ>À̈iÊvœÀʅœ“œVÞÃÌiˆ˜iʏiÛiÃʅ>Ûiʘi>ÀÞÊÌ܈ViÊ̅i
ÀˆÃŽÊœvʅi>ÀÌÊ>ÌÌ>VŽÊœÀÊÃÌÀœŽiÊVœ“«>Ài`Ê܈̅Ê̅œÃiʈ˜Ê̅i
œÜiÃÌʵÕ>À̈i°Ê7…ÞÊܓiÊ«iœ«iÊ>VVՓՏ>Ìiʅœ“œVÞÇ
Ìiˆ˜iʈÃÊ՘ViÀÌ>ˆ˜]ÊLÕÌÊ̅iÊiۈ`i˜ViÊ«œˆ˜ÌÃÊ̜Ê>Ê`ivˆVˆi˜V
œvÊ ÊۈÌ>“ˆ˜ÃÊ­ È]Ê £Ó]Ê>˜`Ê«>À̈VՏ>ÀÞÊvœˆVÊ>Vˆ`®ÆÊVˆ}>‡
ÀiÌÌiÊӜŽˆ˜}]ÊvÀiµÕi˜ÌÊVœvviiʈ˜Ì>Ži]Ê>˜`ʅˆ}…Ê“i>Ì
Vœ˜ÃՓ«Ìˆœ˜Ê>ÀiÊ>ÃœÊ>ÃÜVˆ>Ìi`Ê܈̅ÊiiÛ>Ìi`ʅœ“œVÞÇ
‡Ài>V̈ÛiÊ«ÀœÌiˆ˜Ê­
,*® ˆÃÊ>Ê«ÀœÌiˆ˜ÊvœÕ˜`ʈ˜Ê̅i
Ìiˆ˜iÊVœ˜Vi˜ÌÀ>̈œ˜Ã°
,*Ê܈̅ʈÌÃÊÀii>ÃiÊÃ̈“Տ>Ìi`ÊLÞʈ˜ÌiÀiՎˆ˜ÊÈÊ­‡È®Ê>˜`
Excessive Body Fat
ÝViÃÃÊLœ`ÞÊv>Ìʅ>ÃÊÀiViˆÛi`
,
>ÌÌi˜Ìˆœ˜Ê>ÃÊ>Ê
̅>ÌÊ«>ˆ˜iÃÃÊV…Àœ˜ˆVʏœÜ‡}À>`iÊ>ÀÌiÀˆ>Êˆ˜v>““>̈œ˜
ˆ˜VÕ`ˆ˜}Ê̅>ÌʜvÊ̅iÊVœÀœ˜>ÀÞÊ>ÀÌiÀˆiÃÊÀi“>ˆ˜ÃÊVi˜ÌÀ>Ê̜
iÛiÀÞÊÃÌ>}iʜvÊ>̅iÀœÃViÀœÌˆVÊ`ˆÃi>ÃiÊ>˜`Ê>ʓ>œÀÊÌÀˆ}}iÀ
vœÀʅi>ÀÌÊ>ÌÌ>VŽp“œÀiÊÃÕLÃÌ>˜Ìˆ>ÊiÛi˜Ê̅>˜Ê…ˆ}…ÊV…œiÇ
ÌiÀœ°Ê/…iʈ˜v>““>̈œ˜Ê«Àœ`ÕViÃʅi>ÀÌÊ>ÌÌ>VŽÃÊLÞÊÜi>Ži˜
ˆ˜}ÊLœœ`ÊÛiÃÃiÃÊÜ>Ã]ʓ>Žˆ˜}Ê«>µÕiÊLÕÀÃÌ]Ê>˜`
ˆ˜ÌiÀviÀˆ˜}Ê܈̅ÊÃÕLÃÌ>˜ViÃÊ̅>Ìʈ˜VÀi>ÃiʓޜV>À`ˆ>ÊVˆÀVՇ
>̈œ˜°Ê
Lœœ`Ê̅>Ìʈ˜VÀi>ÃiÃÊ`ÕÀˆ˜}Ê̅iʈ˜v>““>̜ÀÞÊÀi뜘ÃiÊÌ
̈ÃÃÕiʈ˜ÕÀÞʜÀʈ˜viV̈œ˜°Ê/…iʏˆÛiÀÊ«Àˆ“>ÀˆÞÊÃޘ̅iÈâiÃ
œÌ…iÀÊ«Àœˆ˜v>““>̜ÀÞÊVÞ̜Žˆ˜iðÊ-“>Êˆ˜VÀi>ÃiÃʈ˜Ê
ÊÀˆÃŽÊv>V̜À]ÊLÕÌʈÌÃÊÀi>̈œ˜Ã…ˆ«ÊvÀi‡
܈̅ˆ˜Ê̅iʘœÀ“>ÊÀ>˜}iÊ«Ài`ˆVÌÊvÕÌÕÀiÊÛ>ÃVՏ>ÀÊiÛi˜ÌÃʈ˜
µÕi˜ÌÞÊVœi݈ÃÌÃÊ܈̅ʅޫiÀÌi˜Ãˆœ˜]ÊiiÛ>Ìi`ÊV…œiÃÌiÀœ]
>««>Ài˜ÌÞʅi>Ì…Þ]Ê>Ãޓ«Ìœ“>̈Vʈ˜`ˆÛˆ`Õ>Ã°Ê-ÕV…Ê«Ài‡
ÌÞ«iÊÓÊ`ˆ>LiÌiÃ]Ê>˜`ÊVˆ}>ÀiÌÌiÊӜŽˆ˜}°Ê/…iʘՓLiÀʜv
`ˆV̈ÛiÊ>VVÕÀ>VÞʜvÊ
,*ÊiÝÌi˜`ÃÊ̜ʫ>̈i˜ÌÃÊ܈̅ʫÀii݈Ã̇
>˜˜Õ>Ê`i>̅ÃÊ>ÌÌÀˆLÕÌ>LiÊ̜ʜÛiÀv>̘iÃÃʈ˜Ê̅iÊ1˜ˆÌi`
ˆ˜}ÊÛ>ÃVՏ>ÀÊ`ˆÃi>Ãi°Êˆ}…iÀÊ
,*ʏiÛiÃÊ>ÀiÊ>ÃÜVˆ>Ìi`Ê܈̅
-Ì>ÌiÃÊ>`ՏÌÊ«œ«Õ>̈œ˜Êi>ȏÞÊiÝVii`ÃÊÎxä]äää°Ê7iˆ}…Ì
>L`œ“ˆ˜>ÊœLiÈÌÞ]Ê>˜`ʈ˜VÀi>Ãi`ʏiÛiÃÊ«Ài`ˆVÌÊ̅iÊÀˆÃŽÊœv
œÃÃÊ>˜`Ê>VVœ“«>˜Þˆ˜}ÊLœ`ÞÊv>ÌÊÀi`ÕV̈œ˜]Ê܅i̅iÀ
`iÛiœ«ˆ˜}ÊÌÞ«iÊÓÊ`ˆ>LiÌið-ÌÀ>Ìi}ˆiÃÊ̜ʏœÜiÀÊ
,*ʈ˜VÕ`i
̅ÀœÕ}…Ê`ˆiÌʜÀÊiÝiÀVˆÃi]ÊÕÃÕ>ÞʘœÀ“>ˆâiÊV…œiÃÌiÀœÊ>˜`
Üiˆ}…ÌʏœÃÃ]Ê>LÃ̈˜i˜ViÊvÀœ“ÊVˆ}>ÀiÌÌiÊӜŽˆ˜}]ÊVœ˜ÃՓ‡
ÌÀˆ>Vޏ}ÞViÀœÊiÛiÃÊ>˜`ÊiÝiÀÌÊLi˜ivˆVˆ>ÊivviVÌÃʜ˜ÊLœœ
ˆ˜}Ê>ʅi>Ì…vՏÊ`ˆiÌ]Ê>˜`ÊÀi}Տ>ÀÊiÝiÀVˆÃiÊ­i°}°]ÊVœ“Lˆ˜i`
«ÀiÃÃÕÀiÊ>˜`ÊÌÞ«iÊÓÊ`ˆ>LiÌið
>iÀœLˆVÉÀiÈÃÌ>˜ViÊÌÀ>ˆ˜ˆ˜}®°

Physical Inactivity ,i}Տ>ÀÊ«…ÞÈV>Ê>V̈ۈÌÞʜvviÀà Lipoprotein(a) ˆ«œÀœÌiˆ˜­>®ÊQ«­>®R ˆÃÊ>˜Ê‡ˆŽi

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“œÀiÊ«…ÞÈV>ÞÊ>V̈ÛiÊVœÕ˜ÌiÀ«>ÀÌðÊ>ˆ˜Ìi˜>˜ViʜvÊ>iÀ‡ >«œ­>®ÊˆÃœvœÀ“Ê«ÀiÃi˜Ì°Ê«­>®ÊiÛiÃÊÛ>ÀÞʏˆÌ̏iÊ܈̅Ê`ˆiÌʜÀ
œLˆVÊvˆÌ˜iÃÃÊ̅ÀœÕ}…œÕÌʏˆviÊ>ÃœÊ«ÀœÛˆ`iÃÊ«ÀœÌiV̈œ iÝiÀVˆÃi]Ê՘ˆŽiÊ̅iʜ̅iÀʏˆ«œ«ÀœÌiˆ˜ÃÊÊ>˜`Ê°Ê/…i
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VœÕ`Ê>À}ÕiÊ̅>ÌÊ}i˜ïVÊv>V̜ÀÃÊVœ˜ÌÀˆLÕÌiʓœÀiÊ̜ÊvˆÌ˜iÃ
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iÝiÀVˆÃiÊ>ÃÃՓiÊ}Ài>ÌiÀʈ“«œÀÌ>˜ViÊ̅>˜Êȓ«ÞÊ}i˜ïVÃ
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vˆÌð Table 17.3 ÃՓ“>ÀˆâiÃÊ«œÃÈLiÊLˆœœ}ˆVʓiV…>‡
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LÀi>Ž`œÜ˜ÊœvÊVœÌÃÊ­vˆLÀˆ˜œÞÈîÊ>ÌÊ̅iÊÈÌiʜvÊ̈ÃÃÕiʈ˜ÕÀÞ
/…iÃiÊ«Àœ«iÀ̈iÃʓ>ŽiÊ«­>®Ê>ʅˆ}…ÞÊ>̅iÀœÌ…Àœ“LœÌˆV
Ê«Àœ}ÀiÃȜ˜° ˆ«œ«ÀœÌiˆ˜°

Possible Mechanisms for Eight Beneficial Effects of Regular Aerobic Exercise on

Table 17.3
Risk of Coronary Heart Disease and Mortality
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CORONARY HEART DISEASE RISK

FACTORS IN CHILDREN ÀˆivÞÊiÝ«>ˆ˜Ê̅iÊÀœiʜvÊ
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624 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

BOX 17.3 CLOSE UP

Calculate Your Coronary Heart Disease Risk

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Chapter 17 Physical Activity, Exercise, Successful Aging, and Disease Prevention • 625

CHD incidence per 100,000 persons

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400

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Number of CHD risk factors

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628 • SECTION VI Optimizing Body Composition, Successful Aging, and Health-Related Exercise Benefits

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