Lectures

Introduces foundational concepts of physical activity and exercise in relation to energy expenditure and metabolic strain. Covers short-term homeostatic balancing during exercise, including cardiovascular, respiratory, metabolic and thermoregulatory responses. Presents homeostasis and hormesis as complementary frameworks for exercise-induced inflammation, contrasting negative feedback dynamics with biphasic dose-response adaptation, and discussing implications for healthy athletes and clinical populations (ME/CFS, Long COVID). Explores the physiology of sleep and wakefulness, including sleep architecture, NREM/REM cycles, and the bidirectional relationship between exercise and sleep quality.

Examines the immune system's role in protecting bodily integrity, covering innate and adaptive immunity, acute vs. chronic inflammation, and the effects of exercise on immune regulation. Defines the physiological and sports-medical limits of physical performance, including the influence of ageing, determinants of performance capacity, and the extended definition incorporating age-related mortality. Introduces energy balance, macronutrient metabolism (carbohydrates, lipids, proteins), and the pathways by which energy enters and is utilised by the organism.

Provides a detailed treatment of energy expenditure, from basal and resting metabolic rate through total daily energy expenditure (TDEE) to the Weir formula and respiratory exchange ratio (RER). Links oxygen uptake (V̇O₂) to daily behaviour, physical activity levels, and energy supply under normoxic and hypoxic conditions, including the MET concept and MET-minutes. Covers threshold concepts — ventilatory, lactate, and anaerobic thresholds — and their physiological significance for exercise prescription and performance diagnostics. Presents standardised exercise intensity terminology (Very Low to Very High) based on the joint ACSM/ESSA consensus, with methods for determining and monitoring cardiorespiratory and resistance exercise intensity using metabolic thresholds, RIR, and RPE.

Examines the molecular and metabolic foundations of exercise, covering ATP production through the phosphagen, glycolytic, and oxidative energy systems. Provides an in-depth treatment of glucose utilization pathways based on Lehninger's Principles of Biochemistry - glycolysis, pyruvate fates (aerobic oxidation, lactic acid fermentation, ethanol fermentation), the Warburg effect, gluconeogenesis, and the pentose phosphate pathway. Covers substrate utilization at different exercise intensities, hormonal regulation of exercise metabolism (catecholamines, insulin/glucagon, cortisol/growth hormone), and the lactate paradigm shift — including lactate production, clearance, MCT transport, the lactate shuttle, GPR81 signalling, and protein lactylation as an epigenetic mechanism. Addresses muscle fiber types, biochemical adaptations to endurance and resistance training (AMPK, mTOR, PGC-1α signalling), reactive oxygen species and hormesis, recovery metabolism (EPOC, glycogen resynthesis, muscle protein synthesis), and clinical applications of exercise biochemistry.

Defines the anaerobic threshold as the upper border of the aerobic–anaerobic transition (MLSS), compares fixed (4 mmol/L) and individualised threshold concepts, walks through a Stegmann tangent worked example, and derives heart-rate–anchored training zones — with a critical look at why %VO₂max and %HRmax fall short as prescription anchors.

Traces the evolution of lactate from a metabolic byproduct to a central regulator of human physiology, highlighting its continuous aerobic production, role as a primary fuel source, and function as a signaling molecule across cellular and systemic levels. It also introduces lactate-based performance diagnostics, emphasizing individualized thresholds and curve analysis to assess training adaptation, endurance capacity, and metabolic dysfunction in conditions such as Long COVID and ME/CFS.

Evidence-based comparison of cardiorespiratory fitness (CRF) measured in METs versus VO₂ max, based on Eric Topol's *Ground Truths* analysis and reconstructed figures from major cohort studies. Demonstrates that CRF/METs underpins >99% of the outcome literature linking fitness to all-cause and cardiovascular mortality, drawing on the JAMA 2009 meta-analysis (n=102,980), the Cleveland Clinic cohort (n=122,007), and the Veterans Affairs cohort (n=750,302). Critically evaluates consumer wearable VO₂ max estimates (7–16% MAPE) and the data imbalance between METs-based and direct VO₂ max evidence, concluding that METs are clinically superior for most healthy adults.

Presents the evidence base for Exercise Snacks — brief, intense physical activity bouts (≤1–10 min) repeated throughout the day — as a time-efficient strategy for cardiometabolic and immunological health improvement. Covers effects on glucose regulation (insulin-independent GLUT4 translocation), muscular adaptations, cardiovascular risk reduction (38–49% mortality reduction from 3×1–2 min VILPA/day), and immune function (myokine signalling, NF-κB suppression). Includes detailed physiological mechanism charts (energy metabolism, muscle signalling, aerobic capacity via Fick equation, immunological pathways), an interactive dashboard, and an example Exercise Snack protocol for clinical application.

Protein intake is a critical yet nuanced aspect of sports nutrition. While the recommended daily allowance for the general population stands at 0.8 g·kg⁻¹·day⁻¹, athletes typically require elevated amounts ranging from 1.2 to 2.0 g/kg/day, depending on the type of sport, training intensity, and individual goals. However, current scientific evidence cautions against excessively high intakes substantially exceeding 1.6 g/kg/day.

Explores how wearable devices enable continuous monitoring of physiological signals to better understand, predict, and manage infection-associated chronic illnesses such as Long COVID and ME/CFS. It highlights how changes in heart rate, heart rate variability, and activity patterns can reveal risk factors, predict symptom flare-ups, and support personalized pacing strategies, bridging the gap between real-world physiology and episodic clinical care.