This paper presents a model to evaluate the nutritional status of trained athletes based on work in our laboratory as well as others. The model proposes that substrate use is set by the muscle fibers recruited, based on the exercise intensity. Second, the substrate available is primarily determined by the intramuscular stores. In trained athletes, intramuscular fat plays an important role in metabolism at exercise intensities as high as 80% of maximal aerobic power. Based on these factors, increasing the fat in the diet (while maintaining adequate intramuscular glycogen) increases VO2max and intramuscular stores of fat (presumably due to increased mitochondrial volume). These two factors result in a significant increase in the time to exhaustion at set levels of exercise (endurance). It also appears that fatigue is associated with depletion of either glycogen or fat. These conclusions hold true for athletes on diets where sufficient calories are taken in to meet demands and for exercise levels below 80% of VO2max, where primarily slow-twitch oxidative fibers are used. These data may not apply in exercise where predominantly fast-twitch fibers are used. Also, these data do not apply to runners eating a hypocaloric diet, where reducing the percentage of carbohydrates may compromise their glycogen stores. It would appear that the fat in the diet can be increased to a very high level without compromising the cardiovascular or immune systems of athletes. Moreover, it can be proposed that these data could be applied to sedentary persons, as long as they are isocaloric. This would imply that the fat consumed in the diet would be used in the muscle, as in the runners, although at a lower level. Thus, the dietary intake should be matched in both total calories and percentage of fats and carbohydrates to calories consumed by daily activity. It should be cautioned that if glycogen and fat stores are compromised, protein resynthesis is inhibited and loss of muscle mass may result. This has a negative effect on the athlete's ability to perform at high levels.
