Physiology of Everyday Life

• Metabolic rate and Energy expenditure of the

body
• Body temperature regulation
• Physiology of aging??
• Exercise??

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Outlines:
• Metabolism
• Metabolic rate
• Energy requirement of the body
– Energy substrates
– Caloric value of food staff
• Basal metabolic rate
• Energy balance
• Regulation of Food Intake
• Pathophysiology of obesity
• Regulation of body temperature

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Introduction:
We eat, we digest, we absorb, then what?
3 fates for food (nutrients);
1. Energy supply
2. Used to synthesize structural/functional
molecules
3. Stored for future use
• Cells use energy to perform the various forms of
biological work, such as muscle contraction, active
transport, and molecular synthesis.

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Metabolism:
• Defn: all chemical reactions necessary to maintain
life.
 Two categories:
1. Anabolic Reactions
 Buildlarger molecules for growth, repair, reproduction
 Dehydration Synthesis Reactions
 require energy and nutrients

2. Catabolic Reactions
 Breakdown larger molecules
 Hydrolysis Reactions
 mobilize nutrients for energy making it available to the cell

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Fuel Requirements of the body
1. CH2O Requirement:
End products of CH2O digestion are glucose
(80%), fructose and galactose.
95% of all circulating monosaccharides is
glucose
minimal requirement = 125-175gm/day
Enough to spare proteins!

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2. Lipid requirement:

 Major source of energy!

 The liver and adipose tissue control lipid
metabolism
 80–100 g/day

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3. Protein Requirement:
 Varies according to:
Body size
Metabolic rate
Nitrogen balance condition
• Average adult = 0.8gm/Kg /day
- Pregnant woman – additional 30gm/day
- Nursing mother – additional 20gm/day

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 Fuel composition of the average 70-kg man
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Metabolic Rate
• Is the amount of energy liberated per unit of
time.
• Some of the energy is used to produce ATP, and
the rest is released as heat.
• Heat is a form of energy that can be measured
as temperature and expressed in units called
calories.
• A calorie (cal) is defined as the amount of heat
energy needed to raise the temperature of 1g of
water by 1ºC .
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• kilocalorie (kcal) = Calorie (Cal) (uppercase C) is
often used to measure the body’s metabolic rate
and to express the energy content of foods.
• kcal =1000 calories.
• Calorie =1000cal = 4.187 KJ.

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Energy /Caloric values of food stuff:
• A bomb calorimeter is used to measure caloric contents of
foods.
• The heat released is a
measure of caloric value of
food staffs!

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Basal Metabolic Rate (BMR):

• = ? Resting Metabolic Rate(RMR)

• Amount of energy expended by the body at rest.
• It Is a measure of the energy required to maintain life.
• The BMR is defined as the energy expenditure of a person
mentally and bodily at rest in a thermoneutral environment
12 to18 hours after a meal(Basal conditions).

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 Measurements of Metabolic Rate

production

Good agreement between direct and indirect calorimetry

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 Measurements of Metabolic Rate

• The rate at which heat is

produced by the body is
equal to the rate at which
chemical energy is
expended.
• Therefore, the heat
production is a direct
measure of metabolic
rate.
1. Direct calorimetry: -
Measures energy
expenditure by assessing
body heat loss within a
metabolic chamber.  The rise in water temperature is directly related to
the heat produced by the person’s body.

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2. Indirect Calorimetry:
 Assessing energy expenditure from measurement of
O2 consumption and CO2 production.

= Substrate + O2 oxidation CO2 + H2O+ Heat

• TEE = 1.44 x [(VO2 X 3.94) +(VCO2 X1.11)]

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Energy Expenditure of the Body:

2000-2500 kcal/day

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Factors affecting metabolic rate;
 Exercise - ↑-es 20-50 times

Type of work performed

 Specific dynamic action (SDA).

-Recent ingestion of food stimulates metabolic rate
for 3 to 12 hrs after meal.
* proteins by ~30%
* CH2O and fat meal ~4%

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 Age- two times higher in children than an old
man b/s of rapid synthesis and growth

 Thyroid hormone - rises by 50 – 100%

 Male sex hormones - ↑ 10-15%

 Growth Hormone - ↑ 15-20%

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 Sympathetic stimulation
 Fever -For every 100C rise in temp., rate of
chem. rxn rise by 120%.
 Environmental temperature- (increased in
cold)
 Sleep ; ↓10-15%
 Prolonged Malnutrition : ↓ 20-30%

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 Metabolic States of the Body

 Absorptive State(12 hrs):

Digested nutrients enter the blood from GIT and
 utilized by the cells.
 Post-Absorptive State(12 hrs):
The GIT is empty of nutrients and
 The body’s own stores supply energy.

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 Absorptive State(=Anabolism)

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Postabsorptive State(= catabolism)

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 The Physiology of Regulation of
Food Intake
‘We are what we eat’

Energy Imbalances

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Body Weight depends on caloric balance.

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• Central Regulation:
Hypothalamus
Neurohormones(MSH, Neuropeptide Y, AgRP)
• Peripheral regulations:
GIT hormones
Adipose tissue hormones
Pancreatic hormones

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 Hypotalamic satiety centre
Genetic background (neuropeptides, leptin, insuli

Energy
Food intake
expenditure
Sympathetic nervous system
Life style - Energy expenditure, lipolys

Gastrointestinal tract
ghrelin, peptide YY

Adipose tissue
Leptin

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i. Neural Regulation:
a. Lateral Hypothalamus;
 Hunger (feeding) center.

 When stimulated → Hyperphagia

Operates by directly exciting the emotional drive
to search for food.
b. Ventromedial nuclei of the hypothalamus:
Satiety center(feeling of “fullness)
When stimulated → Aphagia
 Operates by inhibiting the feeding center

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ii. Hormonal factors
a. GIT Hormones:
1. CCK; PYY; GLP-I:
• Secretion rises during and immediately after a
meal and suppresses hunger (promotes satiety).
• Involves in the regulation of hunger on a short-
term, meal-to-meal basis.
• Stimulate sensory neurons of the vagus nerve, which
communicate the satiety signals to the CNS.

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2. Ghrelin:
• Secreted by the stomach.
• Secretion rises between meals, when the
stomach is empty, and stimulates hunger.
• Stimulate the release of neuropeptide Y and
agouti-related protein.

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b. Adipose Tissue Hormone
• Leptin:
• Leptin secretion increases as the amount of
stored fat increases.
• Involved in more long-term hunger regulation.
• Suppresses appetite and thus reduces calorie
intake.
• Inhibits the release of neuropeptide Y and
AgRP, and stimulates the release of MSH.

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Hormonal signals that regulate feeding and energy expenditures;
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Summary of Effect of Regulatory Signals on Appetite

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Clinical Application: OBESITY

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Obesity:
Definition:
• Obesity is clinically defined as a weight more than 20%
above the recommended norm for one’s age, sex, and
height.
• Abnormal or excessive fat accumulation that may
impair health.
• Results from excess energy input over energy
expenditure.
• A surrogate marker for body fat content is the body
mass index (BMI), which is calculated as:
BMI =Weight in kg/Height m2
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Key Facts

• Worldwide obesity has nearly tripled since 1975.

• In 2016, more than 1.9 billion adults, 18 years and older, were
overweight. Of these over 650 million were obese.
• 39% of adults aged 18 years and over were overweight in 2016,
and 13% were obese.
• 41 million children under the age of 5 were overweight or obese in
2016.
• Over 340 million children and adolescents aged 5-19 were
overweight or obese in 2016.
• Obesity is preventable.

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 Obesity is classified by
Body Mass Index (BMI)

Weight (kg)
BMI =
Height (m2)

Clasification BMI (kg/m2) Metabolic c.

Normal weight 18.524.9 average

Overweight 2529.9 increased

Obesity I 30.034.9 middle
Obesity II 35.039.9 high
Obesity III 40.0  Very high

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 Causes of Obesity:

1. Abnormal Feeding Regulation

a) Psychogenic factors:
Children are forced to overeat by parents;
Weight gain during or after stress;
b) Hypothalamic abnormalities
 damage to the Ventromedial nuclei of the

hypothalamus
2. Genetic factor
3. Childhood over nutrition

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 Complications of obesity
 Mechanical; joint illness, dyspnea, sleep apnea,
heart hypetrophy,…..
 Metabolic; diabetes, hypertension,
hyperlipoproteinemia, ischemic heart disease,
tumours, sterility, depression…

What Should We Eat?

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Inanition:
• It is the opposite of obesity
• Causes:
Inadequate food supply
Psychogenic (anorexia nervosa) = loss of desire for
food, or even nauseated by food
Hypothalamic damage by vascular thrombosis →
Cachexia - severe inanition

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More slim and more fit means more success
and beauty……..??

……….. but sometimes this motto of modern societies

leads to death
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Anorexia Nervosa (AN)
• Severe psychiatric disorder of unclear etiology
associated with significant morbidity and mortality .

• Prevalence; 0.3% of young girls, mortalty of

6%/decade

• Irrational fear of becoming fat even if patient is of

normal or usually underweight

• Phobic response to food, abnormal eating behavior,

hyperactivity, weakness, muscle aches, sleep
disturbances, GIT complications, mood disturances,
alterations of wide variety of hormonal and metabolic
systems

• Combination of cultural-social, psychological,

biological factors

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Body Weight depends on caloric balance.

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 Regulation of Body Temperature

36.5 – 37.50C

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• Body temperature reflects the person’s metabolic
rate and overall clinical states.
1. Core Temperature:
– Is the temperature in body structures deep to the skin and
subcutaneous layer.
– remains constant within 0.6 0C under temperature variation
of 12 0C and 60 0C.

2. Shell/Skin Temperature:
– Is the temperature near the body surface—in the skin and
subcutaneous layer.
– rises and falls with the rate of heat exchange with the
surrounding.
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Why it is important to maintain body temperature ?

• A core temperature that is too high denatures proteins;

• A core temperature that is too low causes cardiac
arrhythmias.
• T changes electrochemical properties and fluidity of cell
membranes
 Affects the rate of chemical reactions

NB: a patient’s fluid and caloric needs are increased 10%

above normal for each 1°C of fever.

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 Fig. Balance of heat input, output, and production
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Fig. Heat exchange with the environment
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  Model
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 Feedback regulation of body temperature
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Temperature Increasing Mechanisms:
1. Skin vasoconstriction
2. Shivering
3. Chemical thermogenesis
- Sympathetic activation
4. Increased thyroxine output
5. Nonshivering thermogenesis(Brown fat)

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Mechanism of Heat Loss from the body:
1. Radiation (60%)– heat loss in the form of infrared heat
rays (a type of electromagnetic wave)
2. Conduction (3%)– transfer of heat through physical
contact
3. Convection (15%) - transfer of heat between the skin
and air or water
4. Evaporation (22%)- transfer of heat that occurs when
water changes from a liquid to a gas(Each gram of
water takes 0.58 Kcal of heat along with it).

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Role of the Hypothalamus in Temperature
Regulation
• Serves as body’s thermostat.
• Integrates thermosensory inputs.
1. Heat Sensitive Neurons:
• Anterior hypothalamus
• stimulated by a rise in temperature.
• Effects - Profuse sweating
- Vasodilation
- Body heat production inhibited

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2. Cold sensitive neurons:
• Posterior hypothalamus
• Stimulated by a fall in body temperature.
• Effects - - shivering
- inhibition of sweating
- vasoconstriction
- ↑-ed thyroxine output

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Abnormalities of body temp. regulation

1. Fever:
• Is an increase in body temperature due to a resetting of
the “thermostat” in the hypothalamus to a higher level.
• Associated with infection, dehydration or thyrotoxicosis.
• Is one of the body’s immunologic responses to a
bacterial or viral infection.
• E.g. Bacterial infections →↑-es the set- point →↑ heat
production and ↑heat conservation → ↑-ed body
temperature → FEVER.

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Characteristics of Febrile Conditions:

1. Chill; Extreme cold feeling

• an increase in the temperature set point →
body temp. is lower than the set point →
extreme cold feeling → the person shivers
until the set point reaches.

Shivering despite high temp.!!

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2. The crisis or ”Flush” ;
• If the factor causing high temp. is removed → the set
point suddenly lowers → the hypothalamus feels
excess heat → intense sweating and vasodilatation →
sudden development of hot skin = Flush.

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 Hypothermia
 Hypothermia: < 33 ⁰C
• Depresses enzymatic activity,
• Interferes with physiologic functions (e.g.,
clotting, respiration, cardiac conduction and
rhyhm)
• Impairs expression of cytokines
• Can induce cellular injury and death.
• Prolonged cold exposure=> frost bite

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PHYSIOLOGY OF AGING

“Age is an issue of mind

over matter.
If you don't mind, it
doesn't matter."
Mark Twain
(1835-1910)

SO

“You're Only As Old As

You Feel”.
Characteristics of Aging
• Physiologic deterioration
• Increased mortality with age following
maturation
• Increased vulnerability to disease
• Decreased ability to adapt to stress
– impaired homeostasis
“O” Complex of Geriatric Medicine
“The secret of staying young is to live
honestly, eat slowly, and…….
lie about your age.”
Lucille Ball