Vander et al.

: Human Physiology: The Mechanism of Body The GrawHill

Companies, 2001

Chapter18
Regulation of Organic Metabolism,
Growth, and Energy Balance
SECTION A
CONTROL AND INTEGRATION OF CARBOHYDRATE, PROTEIN, AND FAT
METABOLISM
Events of the Absorptive and Postabsorptive States
Absorptive State
Postabsorptive State
Endocrine and Neural Control of the Absorptive and
Postabsorptive States
Insulin
Glucagon
Epinephrine and Sympathetic Nerves
to Liver and Adipose Tissue
Other Hormones
Summary of Hormonal Controls
Fuel Homeostasis in Exercise and Stress
Diabetes Mellitus
Hypoglycemia as a Cause of Symptoms
Regulation of Plasma Cholesterol
SECTION A SUMMARY
SECTION A KEY TERMS
SECTION A REVIEW QUESTIONS
SECTION B
CONTROL OF GROWTH
Bone Growth
Environmental Factors
Influencing Growth
Hormonal Influences on Growth
Growth Hormone and Insulin-Like
Growth Factors
Thyroid Hormones
Insulin
Sex Hormones
Cortisol
Compensatory Growth

SECTION B SUMMARY
SECTION B KEY TERMS
SECTION B REVIEW QUESTIONS
SECTION C
REGULATION OF TOTAL-BODY ENERGY BALANCE AND TEMPERATURE
Basic Concepts of Energy Expenditure
Metabolic Rate
Regulation of Total-Body Energy Stores
Control of Food Intake
Overweight and Obesity
Eating Disorders: Anorexia Nervosa
and Bulimia
What Should We Eat?
Regulation of Body Temperature
Mechanisms of Heat Loss or Gain
Temperature-Regulating Reflexes
Temperature Acclimatization
Fever and Hyperthermia
SECTION C SUMMARY
SECTION C KEY TERMS
SECTION C REVIEW QUESTIONS
CHAPTER 18 CLINICAL TERMS
CHAPTER 18 THOUGHT QUESTIONS

SECTION A
CONTROL AND INTEGRATION OF CARBOHYDRATE,
PROTEIN, AND FAT METABOLISM
Events of the Absorptive and Postabsorptive States
Mechanisms have evolved for survival during alternating
periods of plenty and fasting. We speak of two
functional states or periods: the absorptive state, during
which ingested nutrients are entering the blood
from the gastrointestinal tract, and the postabsorptive
state, during which the gastrointestinal tract is empty
of nutrients and energy must be supplied by the bodys
own stores. Since an average meal requires approximately
4 h for complete absorption, our usual threemeala-day pattern places us in the postabsorptive
state during the late morning and afternoon and almost
the entire night. We shall refer to going more than
24 h without eating as fasting.

During the absorptive period, some of the ingested

nutrients supply the energy needs of the body, and the
remainder are added to the bodys energy stores, to be
called upon during the next postabsorptive period.
Total-body energy stores are adequate for the average
person to easily withstand a fast of many weeks (provided
that water is available).
Figures 181 and 182 summarize the major pathways
to be described in this chapter. Although they
may appear formidable at first glance, they should
present little difficulty after we have described the
component parts, and these figures should be referred
to constantly during the following discussion.

Absorptive State

We shall assume, for this discussion, that an average

meal contains all three of the major nutrients
carbohydrate, protein, and fatwith carbohydrate
constituting most of the meals energy content (calories).
Recall from Chapter 17 that carbohydrate and