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, the four-phase inflammatory cascade, acute vs. chronic inflammation, and the effects of acute and chronic exercise on immune regulation. Defines the physiological and sports-medical limits of physical performance, including the influence of ageing, the primary and secondary determinants of performance capacity, and the extended definition incorporating age-related mortality. Introduces bioenergetics and energy balance — energy-supply systems and their flow rates, ATP as the energy currency, gross vs. physiological energy values, and the metabolic roles of carbohydrates, lipids and proteins.

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.

Introduces the three energy systems (ATP-PCr, glycolytic, oxidative) by time-course, ATP rate and capacity, and the concept of metabolic thresholds. Treats glucose biochemistry after Lehninger — the four fates of glucose and three fates of pyruvate, glycolysis regulation, the Pasteur and Warburg effects, GLUT4 and type 1 diabetes, fermentation and the Cori cycle, gluconeogenesis, and the pentose phosphate pathway. Covers substrate utilisation across exercise intensities and its hormonal control by catecholamines, insulin/glucagon and cortisol/growth hormone. Develops the lactate paradigm shift — production and clearance, MCT transport and the lactate shuttle, GPR81 signalling, histone lactylation, and the lactate threshold. Closes with fibre-type biochemistry, endurance vs resistance adaptations (AMPK, mTOR, PGC-1α), ROS and hormesis, recovery metabolism (EPOC, glycogen resynthesis, muscle protein synthesis), and exercise as medicine.

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 concept and clinical evidence base for Exercise Snacks — isolated, brief, intense bouts repeated through the day — across four domains, namely glycaemic control, muscular adaptation, cardiovascular mortality (VILPA) and immune regulation. Develops the underlying physiological mechanisms — the AMPK-convergent GLUT4 and LPL axes, the three phases of muscular adaptation, the Fick-equation framework for aerobic gains, and the three immunological axes converging on NF-κB suppression. Translates the evidence into prescription, with intensity anchors (%HRmax, RPE CR10), an example one-day protocol, and the safety limits that apply in cardiac rehabilitation and post-exertional malaise.

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.