This chapter discusses how metabolic pathways are integrated and directional in living systems. It explains that catabolic and anabolic reactions must be regulated as a coordinated whole. Key small molecules like ATP, NADPH, and acetyl-CoA connect major metabolic pathways. The number of ATP produced in pathways is an evolutionary compromise that allows reactions to be driven far from equilibrium but not so far that too much substrate is consumed. Specific tissues also have adaptations - brains use ketone bodies from fasting, muscle uses creatine phosphate for rapid energy, and muscle proteins provide amino acids during fasting.