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7438911 
Journal Article 
Exercise Metabolism in Health and Disease 
Philippou, A; Chryssanthopoulos, C; Maridaki, M; Dimitriadis, G; Koutsilieris, M; , 
2019 
Springer International Publishing 
Cham 
Cardiorespiratory Fitness in Cardiometabolic Diseases 
57-96 
Maintaining metabolic homeostasis is of paramount importance for the human organism. Accordingly, adenosine triphosphate (ATP) levels, the energy currency of the human body, are adequately maintained in skeletal and heart muscle by the continuous formation of ATP aerobically and anaerobically. The main substrates used for ATP formation are phosphocreatine, carbohydrates, and free fatty acids, while branched-chain amino acids contribute to a smaller extent. The main factor dictating the dominant metabolic pathway and the type of substrate used is exercise intensity, whereas other factors such as exercise duration, fitness status, gender, diet, and environmental conditions may also influence exercise metabolism. The metabolic pathways do not function independently. Rather, they interact via extracellular and intracellular signals from the exercising muscles and communicate with distant organs such as the liver, heart, and brain. Moreover, hormones secreted by cells of the endocrine system regulate activity of cells in other parts of the body, they can be released in response to exercise-induced stress, and, among other multiple functions, they modulate metabolism during exercise. Several clinical implications for health benefits of special populations rely on exercise metabolism alterations.