The precise, individualized adjustment (titration) of metabolic fuel sources (substrates) and their associated cofactors to maximize physical and cognitive performance while maintaining metabolic health. This process involves strategically shifting the body’s primary energy utilization between glucose and fatty acids, a concept known as metabolic flexibility. The clinical objective is to find the optimal fuel mix that supports sustained high energy output with minimal systemic oxidative stress.
Origin
The term merges “performance” (maximal output) and “substrate” (metabolic fuel source) with “titration” (a chemical method of determining concentration by measured addition). This language reflects the precise, quantitative nature of advanced metabolic management in a clinical setting.
Mechanism
Titration works by monitoring key metabolic indicators, such as blood glucose, ketones, and lactate, in response to diet and activity patterns. Hormones like insulin, glucagon, and thyroid hormone are the primary endogenous regulators of substrate partitioning and utilization within the cell. By carefully adjusting nutrient timing and composition, the goal is to optimize mitochondrial respiration and reduce reliance on a single fuel source, thereby enhancing endurance and resilience to metabolic stress.
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