The physiological ability of the body to rapidly and efficiently transition between utilizing different primary energy substrates—such as glucose, fatty acids, and ketones—to meet the energetic demands of various tissues under different physiological conditions. This metabolic flexibility is a hallmark of excellent health and insulin sensitivity.
Origin
This concept is central to the study of metabolic health and insulin resistance, with the term reflecting the cellular machinery’s ability to adapt its fuel source based on availability and demand. Impaired capacity is a core feature of many chronic metabolic diseases.
Mechanism
The capacity for fuel switching is primarily regulated by key enzymes and transcription factors, notably the activity of pyruvate dehydrogenase and carnitine palmitoyltransferase I (CPT1), which control the entry of glucose and fatty acids into the mitochondria. Hormones like insulin and glucagon act as systemic regulators, signaling nutrient abundance or scarcity, thereby directing the cellular decision to favor either glucose oxidation or fat oxidation to generate ATP.
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