Limits to sustainable human metabolic rate.

There is a limit to the performance of an organism set by energy intake and energy mobilization. Here, the focus is on humans with unlimited access to food and for whom physical activity can be limited by energy mobilization. The physical activity level (PAL) in the general population, calculated as doubly-labelled-water-assessed average daily metabolic rate as a multiple of basal metabolic rate, has an upper limit of 2.2-2.5. The upper limit of sustainable metabolic rate is approximately twice as high in endurance athletes, mainly because of long-term exercise training with simultaneous consumption of carbohydrate-rich food during exercise. Endurance athletes have an increased fat-free mass and can maintain energy balance at a PAL value of 4.0-5.0. High altitude limits exercise performance as a result of combined effects on nutrient supply and the capacity to process nutrients. Thus, trained subjects climbing Mount Everest reached PAL values of 2.0-2.7, well below the observed upper limit at sea level.