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Oxygen, Carbon Dioxide and the Metabolic Types

by Dr. Harold J. Kristal & James M. Haig, N.C.
As we all know, oxygen plays a central role in the oxidation process, the intracellular creation of energy in the form of ATP. Oxygen is alkaline forming in the blood, while carbon dioxide - which is produced as a by-product of the oxidation process - is acid forming. The ratio between them is intimately connected with maintaining the optimal blood pH of 7.46, which is the primary goal of the nutritional protocols of Metabolic Typing. At this pH level, all of the systems of the body are encouraged to function harmoniously. If there is an excess of oxygen (or deficit of CO2) the blood will be overly alkalized. Conversely, if there is an excess of carbon dioxide (or deficit of oxygen) the blood will be overly acidified.

This observation is used during the Metabolic Typing testing protocol to help determine an individual's Metabolic Type. After taking a series of baseline readings, we administer a modified glucose challenge drink (containing significantly less glucose than the medical glucose tolerance test, as well as some added potassium). This drink is acid forming to the two Oxidative types (Fast and Slow Oxidizers), thereby increasing their blood levels of CO2 and decreasing their levels of oxygen. This has the effect of increasing the respiration rate, as the body tries to compensate by breathing in more oxygen, while decreasing the ability to hold the breath, due to a deficit of oxygen. Individuals who demonstrate these traits during the testing procedure (determined by comparing the baseline readings with readings taken at a specified time after ingesting the modified glucose challenge drink) will generally, therefore, be one of the two Oxidative types.

Conversely, the glucose challenge drink is alkalizing to the Autonomic types (Sympathetics and Parasympathetics), thereby increasing blood levels of oxygen and decreasing levels of CO2. (This phenomenon illustrates one of the key observations of Metabolic typing, that the same nutrients produce opposite pH effects at the level of the blood in the Oxidative and the Autonomic Metabolic Types). Accordingly, their respiration rate will tend to drop, due to the presence of more than adequate amounts of oxygen, while their ability to hold their breath will increase. These traits would therefore suggest that an individual demonstrating such a shift is one of the two Autonomic types.

The Krebs Cycle Revisited
Inside each of the cells of our body (except mature red blood cells) are several microscopic, oval-shaped organelles known as mitochondria. The mitochondria (or mitochondrion, in the singular) are often referred to as the body's energy furnaces, because it is here that the nutrients extracted from our foods are converted into energy. This happens through a complex set of interactions known as the Krebs cycle (named after its discoverer, Sir Hans Krebs), in association with the electron transport chain, which completes the work started by the Krebs cycle.

Essentially the Krebs cycle (also known as the citric acid cycle) involves a series of enzymatic reactions that transform proteins (in the form of their constituent amino acids), fats (as their constituent fatty acids) and carbohydrates (as glucose) into intermediate substances. These intermediates are then passed into the electron transport chain where they undergo a further series of reactions - receiving and donating electrons down the chain - to produce energy, in the form of ATP (adenosine triphosphate), CO2 and water. The presence of sufficient oxygen within the cells is essential to the success of this entire procedure, as the term oxidation itself indicates. The primary substrates, or raw materials, for the Krebs cycle are glucose (extracted from carbohydrate foods) and fatty acids. Most of the glucose forms oxaloacetate in the Krebs cycle, while the remaining glucose combines with the fatty acids and amino acids to form acetyl coenzyme acetate (acetyl CoA). These substances are then further spun around the Krebs cycle with the help of additional amino acids, vitamins, enzymes and organic acids. In a dizzying whirl of back-and-forth biochemical transmutations, acetyl CoA reacts with oxaloacetate to produce citrate (citric acid), which then reconverts back into oxaloacetate until the coenzyme intermediates are shuttled out the bottom of the Krebs cycle into the electron transport chain to complete the production of ATP.

If insufficient oxygen is delivered to the cells, this entire enterprise will be compromised. Insufficient oxygen delivery can be due to any of the following: (a) a lack of oxygen in the blood, if the blood is in an overly acidic state; (b) an excess of oxygen in the blood in the case of an overly alkaline venous blood pH; this is accompanied by a concomitant lack of CO2, which, among its many other functions, acts as a catalyst to release oxygen from the hemoglobin, freeing it up so that it can be absorbed into the tissue cells; or (c) to an insufficiency of the enzyme 2,3-DPG, which is also required to release the oxygen molecule from the red blood cell. Alternately, an imbalance of raw materials fed into the Krebs cycle will result in less than optimal energy production, as both the oxaloacetate and acetyl CoA "sides" of the Krebs cycle need to balance each other out for its full energy potential to be realized.

To further complicate matters, each of the two Oxidative Metabolic Types - whose energy levels are directly tied to the functioning of the Krebs cycle - require a different fuel mix. Fast Oxidizers tend to burn up glucose too rapidly, therefore requiring more proteins and fats to slow down the rate of glucose combustion in the Krebs cycle. Conversely, Slow Oxidizers do not burn up glucose rapidly enough; therefore they require a higher percentage of glucose (and less protein and fats) to be fed into the Krebs cycle to fan the flames of oxidation. If either of the Oxidative types eats a diet that is inappropriately weighted in the wrong direction, the result is insufficient ATP production and metabolic imbalance.

ATP is needed to carry out all of our biological functions. One of its primary responsibilities is protein synthesis, which itself is essential for the production of the special class of proteins known as enzymes. Enzymes are the necessary catalysts (or "spark plugs") for every single biochemical reaction in the body, from digestion to the production of neurotransmitters and hormones, and from immune function to tissue growth and DNA repair. Impaired energy production can be seen as the central malfunction that underlies all chronic disease. Thus, we can see that feeding the body the wrong "fuel mix" for its Metabolic Type can have far-reaching consequences, and it is precisely these negative consequences that the nutritional protocols of Metabolic Typing seek to avoid.

Approximately 80% of the body's energy is generated through the Krebs cycle, in concert with the electron transport chain. The other 20% is produced through the less efficient process of glycolysis, in which a portion of the glucose that would otherwise be fed into the Krebs cycle is siphoned off and converted into pyruvate, then ATP. Glycolysis can only use glucose as its raw material - very little of which can be stored in the body at any one time - whereas the Krebs cycle also uses fat, a far more abundant energy source. However, glycolysis does not require the presence of oxygen (defining it as an anaerobic process), unlike the Krebs cycle, which can only function in the presence of oxygen (defining it as an aerobic process). Because the 20% of energy produced through glycolysis is not enough to drive our metabolic processes, it alone is insufficient to sustain human life; hence the need for oxygen for our survival. Furthermore, while the energy produced through the Krebs cycle generally burns "clean", the energy generated by glycolysis produces "smoke" in the form of lactic acid, a potentially damaging waste product that places a serious burden on the body's detoxification systems.

Case Histories
In our nutrition clinic, we see clients with a broad spectrum of health concerns. These range from a lack of energy or weight issues, to hypoglycemia, diabetes, endocrine problems, cardiovascular disease and cancer. We do not diagnose or treat disease, but we do provide nutritional counseling based on the individual's Metabolic Type. By pointing individuals at the foods and supplements that are best suited to them metabolically, we are able to optimize the functioning of the Krebs cycle and positively impact their health.

An example of this is a middle-aged man with chronic fatigue syndrome who was barely able to function when he first came to see us. He was only able to muster up enough energy to work for two or three hours each day, before needing to rest for the remainder of the day. After running him through the Metabolic Typing protocol, we determined that he was a Slow Oxidizer, with an excessively alkaline blood pH. Simply by changing his diet to emphasize oxaloacetate forming foods (rather than acetyl CoA forming foods) we were able to balance out his blood pH, and return him to his normal energy level in a few short weeks.

A woman in her mid 50's recently came to our clinic complaining of chronic flu-like symptoms, fatigue, muscle pains, digestive problems and depression. We determined her to be a Fast Oxidizer, so, in her case, we put her on a program that emphasized acteyl CoA forming foods. When she came back to see us a month later she was a changed woman, with a significant increase in energy and emotional well-being, with greatly improved digestion, and a marked lessening of her other symptoms. Significantly, though fatigue was a key element of her symptomatic presentation, she required a totally different diet than the gentleman described above.

The Autonomic Types
All humans produce energy through the Krebs cycle, but in the Autonomic Metabolic Types this process is overshadowed by the action of the autonomic nervous system (ANS), in collaboration with the endocrine system. Accordingly, the Autonomic types (Sympathetics and Parasympathetics) are not so dependent on the Krebs cycle as the Oxidative types for their sense of well-being. This accounts for a phenomenon commonly noted by practitioners of Metabolic Typing. Fast Oxidizers process glucose very rapidly. After ingesting the glucose challenge drink during the Metabolic Typing testing protocol, the blood sugar levels of a Fast Oxidizer will rapidly rise, then fall in a sharp curve. As the blood sugar crashes, so too does the individual's sense of energy and well-being. An Autonomic Sympathetic, however, can exhibit a similar or even identical blood sugar curve to the Fast Oxidizer, but the Sympathetic individual is generally unaffected when the blood sugar levels plummet; in fact, in many cases the sense of well-being will even increase. This phenomenon, which is at first quite baffling, is simply explained by the dominance principle. The metabolism of the Sympathetics is primarily driven by the activity of the autonomic nervous system, rather than by the oxidative system, so the dynamic energy of the sympathetic branch of the nervous system carries them through a blood sugar crash that would sink a Fast Oxidizer.

While we do not as yet understand the mechanics of Autonomic dominance as clearly as we do the mechanics of Oxidative dominance, the fact of its existence is quite apparent to the practitioner of Metabolic Typing. In the Autonomic types, the activity of the nervous system overrides the oxidative process; but energy production and processing is as central to the health of the Autonomic types as it is to the Oxidative types. It is this fundamental mechanism underlying all bodily processes that Metabolic Typing addresses, by matching each of the Metabolic Types with the correct diet designed to optimize their production and processing of energy.

Dr. Harold J. Kristal was a pioneer in the emerging field of Metabolic Typing. We are dedicated to carrying on his work in the field. For a schedule of up-coming one-day seminars for health professionals on the theory and practice of Metabolic Typing, please e-mail pmn@bloodph.com, or call (800) 772-0646.


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