Metabolism is central in brain activity and firing of neurons; in heart and muscle physiology; cancer is a metabolic glutton; accumulation of metabolic waste leads to atheroma; and diabetes, obesity and other metabolic disorders are the plague of modern medicine. Novel metabolites emerge in oncology as drivers of disease; while our microbiome as well as pathogens exert some of their beneficial and detrimental effects via their own unique metabolism. Non-invasive imaging is now crossed with high throughput metabolomics and mathematical analysis of metabolic pathways to produce game-changing concepts.