Evidence map›Paper›PMID 29697773›Full record

ReviewEndocrine reviews2018

Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease.

Reuben L Smith, Maarten R Soeters, Rob C I Wüst, Riekelt H Houtkooper

3 registry-linked trialsAbstract readReview
In one paragraph

Review in Endocrine reviews, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 420 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
420citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06336070 narecruitingnot on this mapstarted 2024, after this paper: background citation

Postmenopausal Oncological Women Exercising for Recover Their Health. Associations and Changes in Metabolic Flexibility and Autonomic Control After Two Training Programs (Muscle Power vs Metabolic Power): the POWER Health Study

TypeinterventionalSponsorUniversity of ValenciaRan2024 to 2028Enrolled56ConditionsBreast Cancer Female, Cardiometabolic Syndrome, Metabolism Disorder, Lipid, Autonomic DysfunctionArmsHIIT program (8 weeks), MPI program (8 weeks)
NCT06878781 narecruitingnot on this mapstarted 2024, after this paper: background citation

Standardized Meals With Different Macronutrient Ratios on the Postprandial Metabolome and Metabolic Flexibility

TypeinterventionalSponsorInstituto Nacional de Medicina GenomicaRan2024 to 2026Enrolled300ConditionsFasting, Postprandial Hyperglycemia, Lipid Metabolism Disorders, Glucose Metabolism DisordersArmsHigh carbohydrate challenge, High lipid challenge, High proteinchallenge
NCT07484776 naactive not recruitingnot on this mapstarted 2026, after this paper: background citation

Metabolic Flexibility in Patients With Early Triple-negative Breast Cancer and the Possible Effect of a Physical Exercise Intervention

TypeinterventionalSponsorUniversidad Europea de MadridRan2026 to 2028Enrolled40ConditionsTriple-Negative Breast Cancer (TNBC)ArmsCardiovascular training at maximal fat oxidation (FATmax), Cardiovascular training at maximal aerobic power (MAP), Resistance training
3 · Its place in the literature

Who cites it

420 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. NMR in biomedicine · 2025
    Pooled it
  2. Pooled it
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  9. Successfully Reducing Sitting Time Can Improve Metabolic Flexibility.Scandinavian journal of medicine & science in sports · 2025
    Trial
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  12. Article
  13. Multi-omic analysis reveals that theAnimal nutrition (Zhongguo xu mu shou yi xue hui) · 2026
    Article
  14. Article
  15. Article
  16. Article
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  18. Impaired mTOR/SREBP1-Mediated Lipogenesis as a Mechanism of Hepatic Glycogen Accumulation in a Carnivorous Fish Model, Largemouth Bass (Micropterus salmoides).FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2026
    Article
  19. Review
  20. Article

360 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Reuben L SmithLaboratory of Genetic Metabolic Diseases, Academic Medical Center, AZ Amsterdam, Netherlands.
Maarten R SoetersAmsterdam Gastroenterology and Metabolism, Academic Medical Center, AZ Amsterdam, Netherlands.
Rob C I WüstLaboratory of Genetic Metabolic Diseases, Academic Medical Center, AZ Amsterdam, Netherlands.
Riekelt H HoutkooperLaboratory of Genetic Metabolic Diseases, Academic Medical Center, AZ Amsterdam, Netherlands.

Funding

European Research Council 638290
6 · The paper itself

Abstract

The ability to efficiently adapt metabolism by substrate sensing, trafficking, storage, and utilization, dependent on availability and requirement, is known as metabolic flexibility. In this review, we discuss the breadth and depth of metabolic flexibility and its impact on health and disease. Metabolic flexibility is essential to maintain energy homeostasis in times of either caloric excess or caloric restriction, and in times of either low or high energy demand, such as during exercise. The liver, adipose tissue, and muscle govern systemic metabolic flexibility and manage nutrient sensing, uptake, transport, storage, and expenditure by communication via endocrine cues. At a molecular level, metabolic flexibility relies on the configuration of metabolic pathways, which are regulated by key metabolic enzymes and transcription factors, many of which interact closely with the mitochondria. Disrupted metabolic flexibility, or metabolic inflexibility, however, is associated with many pathological conditions including metabolic syndrome, type 2 diabetes mellitus, and cancer. Multiple factors such as dietary composition and feeding frequency, exercise training, and use of pharmacological compounds, influence metabolic flexibility and will be discussed here. Last, we outline important advances in metabolic flexibility research and discuss medical horizons and translational aspects.

Indexed as

Adaptation, PhysiologicalAnimalsEnergy MetabolismHumansInflammationMetabolic DiseasesMetabolic Networks and PathwaysMitochondriaNeoplasmsSignal Transduction

Identifiers

PMID29697773
PMCPMC6093334

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.