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Protective Progesterone: Menstrual Cycle Related Epilepsy (Catamenial Epilepsy)

Also see:
Epilepsy and Progesterone by Ray Peat, PhD
Estrogen, Glutamate, & Free Fatty Acids
Estrogen’s Role in Seizures
The Brain – Estrogen’s Harm and Progesterone’s Protection
Women, Estrogen, and Circulating DHA
PUFA, Fish Oil, and Alzheimers
Ray Peat, PhD on the Menstrual Cycle
Autoimmune Disease and Estrogen Connection
Estrogen, Progesterone, and Epilepsy: What’s the Relationship?

“Seizures can be caused by lack of glucose, lack of oxygen, vitamin B6 deficiency, and magnesium deficiency. They are more likely to occur during the night, during puberty, premenstrually, during pregnancy, during the first year of life, and can be triggered by hyperventilation, running, strong emotions, or unusual sensory stimulation. Water retention and low sodium increase susceptibility to seizures. When I was in high school, our dog found and ate a pint of bacon grease, and shortly afterward had a convulsive seizure. I knew of veterinarians who treated seizures in dogs with a vermifuge, so it seemed obvious that a metabolic disturbance, especially if combined with intestinal irritation, could cause fits.

It was undoubtedly such observations that led some physicians to advocate removal of the colon as treatment for epilepsy. Pregnancy and the menstrual cycle have been recognized as having something to do with seizures, but when seizures occurred only during pregnancy, they were classified as nonepileptic, and when they had a clear premenstrual occurrence, they were likely to be classified as “hysterical fits,” to be treated with punishment.” -Ray Peat, PhD

Epilepsy Res. 2009 Apr;84(2-3):257-62. doi: 10.1016/j.eplepsyres.2009.01.014. Epub 2009 Mar 3.
Occurrence of menstrual cycle related seizure patterns among epileptic women attending the tertiary neurology clinics of the National Hospital of Sri Lanka.
Kariyawasam SH, Mannapperuma U, Jayasuriya WJ, Weerathunga J, Munasinghe K.
Female sex hormones estrogen and progesterone have effects on seizure activity. Patterns of seizure exacerbations associated with the menstrual cycle have been described as catamenial epilepsy. This study was done to investigate the menstrual cycle related seizure occurrence among female epileptics using seizure-menstrual calendars and sex hormonal assays. Frequency and the patterns of seizure occurrence within the menstrual cycles were determined analyzing seizure-menstrual calendars. Luteal phase serum estradiol and progesterone were determined in those with menstrual cycle related seizure patterns to be compared with that of healthy women. Out of 349 epileptics, 6% showed occurrence of perimenstrual, periovulatory or perimenstrual+periovulatory seizure patterns on analysis of seizure-menstrual calendars. These women showed significantly higher luteal serum estradiol concentrations in comparison to age-matched healthy volunteers. There was no significant difference in the luteal serum progesterone concentrations. This study showed menstrual cycle related patterns of seizure occurrence in a minority of Sri Lankan epileptic women, similar to catamenial epilepsy patterns described by previous studies. These seizure patterns may be due to altered hypothalamo-pituitary-gonadal axis function playing a role in the pathophysiology of epilepsy. We suggest the importance of maintaining seizure-menstrual calendars and hormonal studies in all epileptic women to establish the role of hypothalamo-pituitary-gonadal axis in epilepsy and to achieve efficient control of epilepsy in women of childbearing age.

Epilepsy Res. 1993 May;15(1):47-52.
Patterns of seizure occurrence in catamenial epilepsy.
Herkes GK, Eadie MJ, Sharbrough F, Moyer T.
The pattern of seizure occurrence was analysed over 44 menstrual cycles in 12 epileptic women who considered they had menstrually related seizures. Two peaks in the daily seizure rate were apparent. A significant increase in seizures occurred during the days of menstrual flow and the two days preceding it, with a second peak in the four days at midcycle. The lowest seizure rate was in the late phase of the menstrual cycle. Daily salivary progesterone levels were assayed in 11 women, and 12 ovulatory and eight anovulatory cycles were identified on this basis. No increase in seizures occurred at midcycle if ovulation did not occur, but the perimenstrual increase took place irrespective of ovulatory status.

Epilepsy Res. 1989 Mar-Apr;3(2):100-6.
Unbalanced progesterone and estradiol secretion in catamenial epilepsy.
Bonuccelli U, Melis GB, Paoletti AM, Fioretti P, Murri L, Muratorio A.
Ten women with a documented history of catamenial epilepsy underwent a hormonal study to evaluate hypophyseal-gonadal function. Baseline values of luteinizing hormone, follicle-stimulating hormone and prolactin were similar in catamenial seizure patients and in control groups throughout a complete menstrual cycle. Stimulated secretions of the same hypophyseal hormones in catamenial seizure patients overlapped those of the controls. The luteal secretion ratio of progesterone to estradiol was significantly reduced in catamenial seizure patients versus normal controls. In a subgroup of catamenial seizure patients on antiepileptic therapy, luteal progesterone levels were remarkably decreased compared to normal and epileptic controls. These results indicate that catamenial epilepsy is characterized by an imbalance in ovarian steroid secretion and emphasize the need for an endocrinological assessment in these patients.

Funct Neurol. 1986 Oct-Dec;1(4):399-403.
Neuroendocrine evaluation in catamenial epilepsy.
Murri L, Bonuccelli U, Melis GB.
The hypothesis that catamenial epilepsy depends on abnormal rhythmic hormone activity in the hypothalamus-pituitary-gonadal axis has never been critically tested. No significant modifications in the secretory pattern of pituitary hormones, both basally and in response to stimulatory tests, were found in a group of catamenial epileptic women. On the contrary, our data showed a reduction of luteal phase progesterone secretion. These findings indicate that an imbalanced secretion of ovarian steroids plays a role in the catamenial exacerbation of epilepsy.

Ter Arkh. 1994;66(4):68-71.
[The role of the female sex hormones in the pathogenesis of catamenial epileptic seizures].
[Article in Russian]
Balabolkin MI, Karlov VA, Vlasov PN.
The paper presents the results of evaluation of gonadotropins and female steroids concentrations in 46 female epileptics on catamenia day 1, in the middle of follicular and lutein phases. The control consisted of 7 healthy females of the same age with favourable heredity and free of neuroendocrine diseases. Two groups of patients were distinguished: females with catamenial epileptic seizures and those with catamenia-independent seizures. It is shown that changes in the concentrations of female steroid sex hormones were unidirectional in both the groups with a tendency to deficient luteal phase and relative hyperestrogenemia in all the cycle phases. The involvement of insufficient activation produced by brain stem formation reticularis in pathogenesis of catamenial epilepsy in suggested. A pathogenetic approach to epilepsy treatment in females when hormonal status is considered and psychostimulators are used is proposed.

J Ayub Med Coll Abbottabad. 2006 Jul-Sep;18(3):17-20.
Influence of steroid hormones in women with mild catamenial epilepsy.
Hussain Z, Qureshi MA, Hasan KZ, Aziz H.
BACKGROUND:
In view of considerable differences of opinion regarding the reproductive steroid hormonal pathogenesis in catamenial epilepsy, hormonal analysis of estrogen and progesterone in catamenial epileptics for a precise correlation is of significant importance.
METHODS:
Clinical, neurological and physiological assessments, and radioimmunoassay of plasma estradiol-17beta and progesterone a day prior to the onset of menstruation were carried out in noncatamenial and mild catamenial epileptics having multiple frequency tonic-clonic (primary and secondary generalized) seizures.
RESULTS:
Highly significant rise (p > 0.0001) of estradiol-17beta was obtained for catamenial epileptics compared to normal subjects as well as noncatamenial epileptics (p > 0.02). However, nonsignificant fluctuations of progesterone were found for both catamenial and noncatamenial epileptics against normal subjects as well as catamenial versus noncatamenial epileptics.
CONCLUSIONS:
The present report suggests that estradiol have a precise role in the mild premenstrual exacerbation of seizures. However, no significant change in progesterone levels might have been due to mild exacerbation of seizures in these patients. Furthermore, we suggest the importance of how we collect and categorize the data and which pathophysiologic process/ clinicobiological mechanism is involved in patients with catamenial epilepsy. Contradictory results in literature may be related to differential levels of excitation/inhibition equilibrium during various cycle phases. More precise studies including the determination of the blood levels of antiepileptic drugs, however, are required.

Neurology. 2014 Jul 22;83(4):339-44. doi: 10.1212/WNL.0000000000000619. Epub 2014 Jun 18.
Seizure course during pregnancy in catamenial epilepsy.
Cagnetti C, Lattanzi S, Foschi N, Provinciali L, Silvestrini M.
OBJECTIVE:
Our aim was to evaluate seizure course in catamenial epilepsy (CE) and noncatamenial epilepsy (NCE) during pregnancy.
METHODS:
We prospectively followed women referred to our Epilepsy Center for pregnancy planning to the end of the pregnancy. According to their seizure frequency variations across the menstrual cycle, all patients were divided into either the CE or the NCE group. Data on seizure frequency during pregnancy were collected for each patient and compared with seizure frequency during the pregestational 9 months.
RESULTS:
Fifty-nine women with CE and 215 with NCE were included. Forty-seven subjects (79.7%) with CE and 48 subjects (22.3%) with NCE remained seizure-free throughout pregnancy (odds ratio [OR] = 2.612, 95% confidence interval [CI] 1.901-3.323, p < 0.001), whereas 30 (50.8%) in the CE group and 18 (8.4%) in the NCE group had reduced seizure frequency during pregnancy (OR = 2.427, 95% CI 1.724-3.129, p < 0.001). Decreases in seizures ≥ 50% occurred in 26 women (44.1%) with CE and 14 women (6.5%) with NCE (OR = 2.426, 95% CI 1.679-3.173, p < 0.001). Multiple logistic regression models confirmed the significant role of catamenial pattern as predictor for better outcomes. CONCLUSIONS: Better seizure control during pregnancy in the catamenial group may be attributable to the absence of cyclical hormone variations and the increase in circulating progesterone levels. These data may have practical implications for therapeutic management of patients with CE during pregnancy.

Acta Neurol Scand. 1976 Oct;54(4):321-47.
Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle.
Bäckström T.
Nine periods in seven women with partial epilepsy have been invetigated with respect to frequency of fits, and estrogen-progesterone levels in blood plasma. Six cycles with ovulation showed a positive correlation between the number of secondary generalized seizures and the mean estrogen/progesterone (E/P) ratios and a negative correlation to plasma progesterone levels. Three periods without ovulation showed an increase in the number of fits during days of high estrogen. The number of fits seemed not to be correlated to changes in body weight.

Neurology September 1995 vol. 45 no. 9 1660-1662
Progesterone therapy in women with complex partial and secondary generalized seizures
Andrew G. Herzog, MD MSc
This open trial assessed the effects of adjunctive progesterone therapy on seizure frequency in 25 women with catamenial exacerbation of complex partial (CPS) and secondary generalized motor (SGMS) seizures. Progesterone was well tolerated by 23 of the 25 women and had readily reversible dose-related side effects of asthenia and emotional depression in two. Eighteen women (72%) experienced a decline in seizure frequency during a 3-month treatment period compared with the 3 months prior to therapy (p less than 0.01). Average daily CPS frequency declined by 54% (p less than 0.01), SGMS by 58% (p less than 0.02).

Adv Biomed Res. 2013; 2: 8.
Progesterone therapy in women with intractable catamenial epilepsy
Mohammadreza Najafi, Maedeh Mirmohamad Sadeghi, Jafar Mehvari, Mohammad Zare, and Mojtaba Akbari1
Background:
Catamenial epilepsy is a kind of epilepsy, known in this name, when the periodicity of the exacerbation of the seizure is in association with menstural cycle. The present study examined the progesterone effectiveness as a complementary treatment in women with intractable catamenial epilepsy.
Materials and Methods:
The present study was conducted as a double-blind randomized controlled trial on 38 women with intractable catamenial epilepsy. Patients were assessed in two groups: The case group received in addition to AEDs, two (Mejestrol) 40 mg progesterone tablets in the second half of the cycle from 15th to 25th day. And the control group received in addition to AEDs, two placebo tablets daily. Age, BMI, epilepsy duration, types of the drugs used, progesterone level, and the number of the seizures in 3 months before and after the study were compared.
Results:
Based on the results of which there was no statistically significant difference in regard to age, BMI, epilepsy duration, types of the drugs used, progesterone level between the case and the control groups (P-value > 0.05). The number of the seizures after treatment has significantly decreased compared to before-treatment state. The degree of decreasing in the case group receiving the progesterone was higher than in the control group receiving the placebo. The difference, thus, is significant, based on statistical tests (P-value = 0.024).
Conclusion:
Based on the findings of this study using progesterone in women with intractable catamenial epilepsy has a significant effect on the degree of decreasing in the number of the seizures.

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The Observations of George Catlin

Link to original article.

100 Years Before Weston Price
Written by Nancy Henderson, MFA
Friday, 30 October 2009 14:14

The Observations of George Catlin

In 1860, after thirty years of travel as an artist and ethnographer, after observing over one hundred fifty tribes of Native Americans in both North and South America, after completing over five hundred paintings and publishing several books on his travels in the American frontier and in Europe, George Catlin wrote a short book of observations on the health practices of the American Indians. The forty-page volume became a best-seller and Catlin made sure it was kept in print until his death in 1872; yet the book is almost unknown today, even among the historians who oversee his collection, now housed in the Smithsonian Museum.

The book was called Shut Your Mouth (. . . and Save Your Life); its subject was the superb health of the Native Americans. While Catlin does not give precise details on native diets the way Dr. Price did, he does provide a fascinating corroboration of Price’s findings, one that we come close to explaining only today, after one hundred fifty years of intervening scientific discoveries. George Catlin’s message is timely, and may well provide a missing link for those who have followed Dr. Price’s principles and protocol for some time, but with less success than they had hoped.

ON A MISSION

George Catlin’s artistic career was inspired by a delegate of fifteen “noble and dignified” Indians visiting Philadelphia. The attorney-turned-painter then headed west to document the rapidly disappearing Native Americans, “on a mission of becoming their historian.”1 Making his base in St. Louis, he took five trips between 1830 and 1836, the first accompanied by General William Clark of Lewis and Clark fame. Catlin visited eighteen relatively isolated tribes on the upper Missouri River, including the Pawnee, Omaha, Ponca, Mandan, Cheyenne, Crow, Assiniboine and Blackfeet. Many later trips ranged from the Aleutian Islands to Patagonia.

In the years before photography—and during the time the U.S. government had openly instituted a policy of eradicating the Native Americans—Catlin was the first American artist to travel west of the Mississippi and paint portraits of the American Indians from life in their native habitat. His over five hundred paintings— from portraits to battle scenes—along with hundreds of artifacts and volumes of notes about native traditions amassed during his first six years of study, formed his “Indian Gallery,” which eventually came to rest in the Smithsonian Museum.

Welcomed by the American Indians—before other white men had given them reason to be distrustful—Catlin lived with them as their guest and ate their food. A naturally gifted linguist, he was able to gain access to their sacred rituals, hunting techniques and games. Driven by his own passion, as a “friend to the Indians” before they were “lost forever,” Catlin’s entire thirty years of travel in North and South America were entirely self financed.2

 

Blackfoot Chief

SUPERB HEALTH

As a pioneering anthropologist, Catlin recorded his observations of Native American physical characteristics in a manner remarkably similar to those of Dr. Price in his classic book Nutrition and Physical Degeneration, one hundred years later.3 Like so many early observers, Catlin was struck by the beauty of their teeth. “These people, who talk little and sleep naturally, have no dentists nor dentifrice, nor do they require either; their teeth almost invariably rise from the gums and arrange themselves as regular as the keys of a piano; and without decay or aches, preserve their soundness and enamel, and powers of mastication.”4

Like Dr. Price, George Catlin looked at skulls, noting “the beautiful formation and polish of the teeth in these skulls.” Like Price, he was concerned about the effects of western diets on their health: “. . . the most beautiful of them, which had chewed Buffalo meat for 25 years or a half Century, are now chewing Bread. . . ”

Their traditional food was simple: “Food of this tribe, fish, venison, vegetables. . . This Tribe I found living entirely in their primitive state; their food, Buffalo flesh and Maize, or Indian corn.”

Catlin’s interest in skulls led him to conclude that the death among Native American children was very low. In searching through a graveyard, “I was forcibly struck with the almost incredibly small proportion of crania of children; and even more so, in the almost unexceptional completeness and soundness (and total absence of malformation) of their beautiful sets of teeth, of all ages.”

Shar-re-tar-rushe, an aged and venerable Chief of the Pawnee-Picts, a powerful Tribe living on the headwaters of the Arkansas River, at the base of the Rocky Mountains, told me in answer to questions, ‘we very seldom lose a small child—none of our women have ever died in childbirth—they have no medical attendance on these occasions—we have no Idiots or Lunatics —nor any Deaf and Dumb, or Hunch-backs, and our children never die in teething.’” The food of this tribe was “buffalo flesh and venison.”

In contrast, Catlin observed, “in London and other large towns in England, and cities of the Continent, on an average, one half of the human Race die before they reach the age of five years, and one half of the remainder die before they reach the age of 25 yeas, thus leaving one in four to share the chances of lasting from the age of 25 to old age.” He noted statistics describing 20,000 idiots and 35,000 lunatics in England. “The contrast between the two societies, of Savage and of Civil, as regards to the perfection and duration of their teeth, is quite equal to their Bills or Mortality.”

Like Price, Catlin was struck by the beauty, strength and demeanor of the Native Americans. “The several tribes of Indians inhabiting the regions of the Upper Missouri. . . are undoubtedly the finest looking, best equipped, and most beautifully costumed of any on the Continent.” Writing of the Blackfoot and Crow, tribes who hunted buffalo on the rich glaciated soils of the American plains, “They are the happiest races of Indian I have met—picturesque and handsome, almost beyond description.”

“The very use of the word savage,” wrote Catlin, “as it is applied in its general sense, I am inclined to believe is an abuse of the word, and the people to whom it is applied.”

Like Price, who argued against genetics as a cause of human disabilities, Catlin did not think that the diseases of civilized man were due to inherent flaws in the human physical makeup. “This enormous disproportion might be attributed to some natural physical deficiency in the construction of Man, were it not that we find him in some phases of Savage life, enjoying almost equal exemption from disease and premature death, as the Brute creations [animals]; leading us to the irresistible conclusion that there is some lamentable fault yet overlooked in the sanitary economy of civilized life.”

“I offer myself as a living witness, that whilst in that condition [living among them], the Native Races of North and South America are a healthier people, and less subject to premature mortality (save from accidents of War and the Chase, and also from Small-pox and other pestilential diseases introduced amongst them) than any Civilized Race in existence.”

As did Weston A. Price one hundred years later, Catlin noted the fact that moral and physical degeneration came together with the advent of civilized society. In his late 1830s portrait of “Pigeon’s Egg Head (The Light) Going to and Returning from Washington” Catlin painted him corrupted with “gifts of the great white father” upon his return to his native homeland. Those gifts including two bottles of whiskey in his pockets.

 

Pigeon's Egg Head

SHUT YOUR MOUTH

Returning from his last voyage in 1860, Catlin wrote: “If I were to endeavor to bequeath to posterity the most important Motto which human language can convey, it should be in three words—Shut your mouth.”

Catlin did not completely understand the fact that nutrient-dense diets allow for the development of wide faces with broad nostrils and maximum airway capacity from nose to lungs. Such development allows the well-formed individual to breathe in sufficient oxygen through the nostrils, making mouth-breathing unnecessary. However, he did observe one interesting practice among nursing mothers in all Native American cultures he visited, in both North and South America: In Shut Your Mouth he wrote: “All Savage infants amongst the various Native Tribes of America, are reared in cribs (or cradles) with the back lashed to a straight board; and by the aid of a circular, concave cushion placed under the head, the head is bowed a little forward when they sleep, which prevents the mouth from falling open; thus establishing the early habit of breathing through the nostrils. . . I was soon made to understand, both by their women and their Medicine Men, that it was done to insure their good looks, and prolong their lives.”

In fact, Catlin believed that the habit of sleeping with the mouth closed actually contributed to the optimal development of the teeth: “An Indian child is not allowed to sleep with its mouth open, from the very first sleep of its existence; the consequence of which is, that while the teeth are forming and making their first appearance, they meet (and constantly feel) each other; and taking their relative, natural, positions, form that beautiful and pleasing regularity which has secured to the American Indians, as a race, perhaps the most manly and beautiful mouths in the world.”

Catlin notes: “The Savage Mother, instead of embracing her infant in her sleeping hours, in the heated exhalation of her body, places it at arm’s length from her, [in the cradleboard] and compels it to breathe the fresh air, the coldness of which generally prompts it to shut the mouth . . . The results of this habit are, that Indian adults invariably walk erect and straight, have healthy spines, and sleep upon their backs, with Robes wrapped around them, with the head supported by some rest, which inclines it forward. . . and their sleep is therefore always unattended with the nightmare or snoring.”

Catlin contrasted the universal Native American wisdom of creating a life-long nasal breathing habit both day and night in his illustration of the sleeping habits of “Civilized Man. . . their mouths wide open—the very pictures of distress— of suffering, of Idiocy, of Death. There is no animal in nature, excepting man, that sleeps with its mouth open. . . If man’s unconscious existence for nearly one-third of the hours of his breathing life depends, from one moment to another, upon the air that passes through his nostrils; and his repose during those hours, and his bodily health and enjoyment between them, depend upon the soothed and tempered character of the currents that are passed through his nose to his lungs, how mysteriously intricate in its construction and important in its functions is that feature, and how disastrous may be the omission in education which sanctions a departure from the full and natural use of this wise arrangement!”

 

Cheeahkatchee

THE BREATHING PRINCIPLE

One hundred fifty years ago, George Catlin made a critical observation regarding the hierarchy of physiological functions required for health. “Man can exist several days without food, but about as many minutes without the action of his lungs. . . Rest assured that the great secret to life is the breathing principle.”

According to Dr. Raymond Silkman, “Airway capacity is the biggest and most important part of the well-being of a human being. . . It is important to stress the fact that breathing through the mouth and breathing through the nose have extremely disparate effects on the body. We are not designed to breathe through our mouths. The body is able to live by breathing through the mouth, but it suffers greatly for doing it.”5

To summarize his excellent article, published in Wise Traditions Winter/Spring 2006, Dr Silkman compares an underdeveloped cranium to an “over-packed suitcase,” and discusses how the resultant problems can affect the entire body. Lack of oxygenation or nourishment to cranial tissues and organs and improper drainage of waste products through the lymphatic system, in turn cause nerve conduction issues, hormonal imbalances and negative effects on brain function and mental clarity. Salivary pH drops or becomes acidic in mouth breathing. A forward head posture can develop, which in turn causes spinal misalignments, fatigue and fibromyalgia. The maxilla (upper jaw bone) also becomes underdeveloped, affecting the eyesight and facial aesthetics and further narrowing the nasal passages, which do not drain or function properly.

Mouthbreathing can further depress the development of the maxilla—and this underdevelopment is the main cause of mouthbreathing in the first place. With underdevelopment of the maxilla—due to poor nutrition before conception andin utero—obstruction of the nasal passages sets the stage for sleep apnea, TMJ issues and migraine headaches. With mouth breathing, the lungs cannot oxygenate properly, thereby affecting the heart and even setting the stage for cancer. Cancer thrives in an anaerobic environment. Thus, having an underdeveloped facial structure negatively affects every cell in the body.

Many people struggling with their health may pass over the important clues in Dr. Silkman’s article because they do not think that they breathe through their mouths. But as Catlin points out: “Few people can be convinced that they snore in their sleep, for the snoring is stopped when they wake, and so with breathing through the mouth, which is generally the cause of snoring.” The obvious daytime mouth breathers are easy to spot, but the unconscious nighttime mouth-breathing habit can be present without detection, even with a spouse along side at night. And mouth breathing even at night can undermine our health. As Catlin puts it, ”. . . he renews his disease every night.”

Catlin’s book helped explain my own health problems, which persisted even though I was following a nutrient-dense diet, as I did not get the benefit of good airway development when starting life. Conversely, good facial structure from birth, which allows a person to breathe comfortably through his nose, can explain how a person remains healthy even while living a sedentary life, smoking, drinking and consuming junk foods. Blessed with optimum airway capacity, they function well even in the absence of good nutrition. Many older folks fit into this category, as before 1940 many westerners consumed a fairly good diet and enjoyed excellent facial development.

 

Little Wolf

THE MYSTERIOUS REFINING PROCESS

Wrote Catlin: “The mouth of man. . . was made for the reception and mastication of food for the stomach, and other purposes, but the nostrils, with their delicate and fiborous linings for purifying and warming the air in its passage, have been mysteriously constructed, and designed to stand guard over the lungs. . . we are again more astonished when we see the mysterious sensitiveness of that organ instinctively and instantaneously separating the gases, as well as arresting and rejecting the material impurities of the atmosphere. . . The atmosphere is nowhere near pure enough for man’s breathing until it has passed this mysterious refining process.”

Today we know that nitric oxide is a critical component of that mysterious refining process. Dr. Silkman writes, “Breathing through the nose creates an avenue of air that’s moisturized, humidified and even somewhat filtered. Furthermore, when we breathe through our nose, the air passing through the nasal airway and contacting the turbinates—shelf-like bony structures—is slowed down. This allows the proper mixing of the air with an amazing gas produced in the nasal sinuses called nitric oxide (NO). Nitric oxide is secreted into the nasal passages and is inhaled through the nose. It is a potent vasodilator, and in the lungs it enhances the uptake of oxygen. Nitric oxide is also produced in the walls of blood vessels and is critical to all organs.”

NATURAL AND WHOLESOME AIR

Catlin describes how Native American infants were trained to have good breathing practices from an early age. “I, who have seen some thousands of Indian women giving the breast to their infants, never saw an Indian mother withdrawing the nipple from the mouth of a young infant, without carefully closing its lips with her fingers. . . It requires no more than common sense to perceive that Mankind, like all of the Brute creations, should close their mouths when they close their eyes in sleep, and breathe through their nostrils. . . But in civilized societies, how often do we see the tender mother (if she gives the breast at all) lull it to sleep at the breast, and steal the nipple from the open mouth, which she ventures not to close, for fear of waking it and if consigned to the nurse, the same thing is done with the bottle.

“The Savage infant. . . breathing the natural and wholesome air, generally from instinct, closes its mouth during sleep; and in all cases of exception the mother. . . enforces Nature’ Law . . . until the habit is fixed for life. . . When I have seen a poor Indian woman in the wilderness, lowering her infant from the breast, and pressing its lips together as it falls asleep, fix its cradle in the open air, and afterwards looked into the Indian multitude for the results of such a practice, I have said to myself, ‘glorious education! such a Mother deserves to be the nurse of Emperors.’

“But when we turn to civilized life, with all of its comforts, its luxuries, its science, and its medical Skill, our pity is enlisted for the tender germs of humanity, brought forth and caressed in smothered atmospheres which they can only breathe with their mouths wide open. . . They should first be made acquainted with the fact that their infants don’t require heated air, and that they had better sleep with their heads out of the window than under their mother’s arms.”

Do modern childrearing practices contribute to the scourge of sudden infant death syndrome (SIDS)? In the Archives of Pediatrics and Adolescent Medicine, October 2008, researchers reported that infants are less likely to succumb to SIDS with a fan on in the infant’s room.6 Furthermore, new studies show that swaddling, with the infant placed on the back, reduces SIDS.7 These studies prove the wisdom of the self-contained cradleboard, which protects the infant, as opposed to having the infant sleep with the mother and father, where it might be crushed in sleep or suffocated with loose bedding as it rolls over.

From Catlin’s observations of the universal use of cradle-boards among Native Americans, we can hypothesize that rearing infants in them would be less stressful for the infant, the mother and other family members. The large numbers of historical photographs showing Native Americans with contented and captivating infants in cradleboards also supports this theory.8

SLEEP APNEA

George Catlin’s comments on nightmares and the associated “night terrors” actually describes sleep apnea: “. . . no person on earth who has waked from a fit of the nightmare will dispute the fact that when consciousness came, he found his mouth and throat wide open, and parched with dryness. . . Every attack of the nightmare, I proclaim, is the beginning of death!. . .Though the spasm lasted but a minute. . . death would have been the consequence. . . how awful to be so near death, and so often!”

“It is very evident that the back of the head should never be allowed, in sleep, to fall to a level with the spine; but should be supported by a small pillow, to elevate it a little, without raising the shoulders or bending the back, which should always be kept straight. . . When you lay your head upon a pillow, advance it a little forward, so as to imagine yourself in a gallery of a theater looking into the pit.”

He continues: “Lying on the back is thought by many to be an unhealthy practice; and a long habit of sleeping in a different position from infancy to old age may even make it so; but the general custom of the Savage Races, of sleeping in this position from infancy to old age, affords very conclusive proof, that if commenced in early life it is the healthiest for a general posture that can be adopted.”

Studies show Catlin’s advice to be sound: elevating the head at night is recommended by most sleep apnea websites as a way to reduce sleep apnea.9 From my own experience, elevating the head also has the effect of reducing nasal congestion, which seems to occur when I am in the reclining position. If blood flow to the sinus cavity causes congestion and obstructs nasal breathing when one is lying flat, with only a small pillow under the head, then mouth breathing is the only other option. The “lip seal” that holds the tongue forward and suctioned up in the maxilla at the roof of the mouth and out of the way of the airway, and which naturally occurs with closed-mouth breathing, will be lost. However, when one opens the mouth to breathe, the lip seal is broken. This releases the tongue and allows it to fall back into the throat to obstruct the airway and cause sleep apnea. In order to have a healthy night’s sleep, it is critical to have clear and unobstructed nasal passages in order to breathe only through the nose. By the simple measure of elevating the head to an angle where nasal congestion does not occur and the mouth can be kept shut, snoring and sleep apnea in many cases can be prevented.

Catlin believed that mouthbreathing at night affected the whole facial structure: “The whole features of the face are changed, the under jaw, unhinged, fails and retires, the cheeks are hollowed, and the cheekbones and the upper jaw advance, and the brow and upper eyelids are unnaturally lifted; presenting at once the leading features and expression of idiocy. . . In all of these instances there is a derangement and deformity of the teeth, and disfigurement of the mouth and the whole face.”

Both Dr. Price and George Catlin wondered why tuberculosis claimed so many lives in modern man. In Catlin’s day, the disease was called “consumption.” Catlin lost his wife and one of his children to pneumonia, and in his book he ponders the cause of respiratory illness, linking it to mouth breathing: ”I am compelled to believe . . . that a great proportion of the diseases prematurely fatal to human life, as well as mental and physical deformities, and the destruction of the teeth, are caused by the abuse of the lungs, in the Mal-respiration of sleep.”

“Infected districts communicate disease, infection attracts to it putrescence, and no other infected district can be so near the lungs as an infected mouth.”

Sleep apnea is more than just a minor inconvenience. According to surveys, 30-60 percent of adults snore, depending on age.10 The statistics on sleep apnea in the US show eighteen to twenty million Americans—approximately one in fifteen people—have diagnosed sleep apnea. Undiagnosed sleep apnea afflicts perhaps another seventeen million people.11

Recent studies have shown that Sleep Disordered Breathing is associated with Type II diabetes12—now epidemic of diabetes in this country. Up to 50 percent of people afflicted with diabetes have sleep apnea!13 Still more studies link sleep apnea with diabetes, obesity and GERD.14 Furthermore, people who suffer from sleep apnea are up to four times more likely to have a stroke and three times more likely to have a heart attack.15 Drowsy driving leads to at least one hundred thousand car crashes and over fifteen hundred deaths each year, according to the National Highway Safety Administration.16

A PHILOSOPHY OF LIFE

For the Native Americans, emphasis on conservation of breath at night and during the day was more than practical wisdom—it was a philosophy of life. As Catlin observed, “The American Savage often smiles, but seldom laughs; and he meets most of the emotions of life, however sudden and exciting they may be, with his lips and his teeth closed. He is, nevertheless, garrulous and fond of anecdote. Civilized people, who, from their educations, are more excitable, regard most exciting, amusing, or alarming scenes with the mouth open; as in wonder, astonishment, pain, pleasure, listening, etc. . . [But] the Savage, without the change of a muscle in his face, listens to the rumbling of the Earthquake, or the thunder’s crash, with his hand over his mouth; and if by the extreme of other excitement he is forced to laugh or to cry, his mouth is invariably hidden in the same manner.”

Catlin notes: “The proverb, as old and unchangeable as their hills, amongst the North American Indians; My son, if you would be wise, open first your Eyes, your Ears next, and last of all, your Mouth, that your words may be words of wisdom, and give no advantage to thine adversary.”

In his 1902 book, The Soul of an Indian, an Interpretation, Dr Charles A. Eastman, of the Santee Dakota writes the following: “The man who preserves his selfhood ever calm and unshaken by the storms of existence— not a leaf, as it were, astir on the tree, not a ripple upon the surface of the shining pool—his, in the mind of the unlettered sage, is the ideal attitude and conduct of life. . . . ‘Silence is the cornerstone of character. Guard your tongue in youth,’ said the old chief, Wabashaw, ‘and in age you may mature a thought that will be of service to your people.’”17

Where the yogis of India practice pranayama, the control of the breath, during conscious waking hours, our own American Indian yogis appear to have used control of the breath in the unconscious state while sleeping— by rote habit fixed during infancy—and to have achieved a fortunate conservation of life force to enhance their lives.

George Catlin could have been writing about esoteric yogic breathing practices when he states, “The lungs should be put to rest as a fond mother lulls her infant to sleep.”

“We are told that the breath of life was breathed into man’s nostrils— then why should we not continue to live by breathing in the same manner?”

Scholar Fiona MacDonald explains the history of the breath,18 noting that the ancients commonly linked the breath to a life force. The Hebrew Bible refers to God breathing the breath of life into clay to make Adam a living soul (nephesh, roughly “breather”). For the Greek philosopher Anaximenes (about 550 BC), the breath or pneuma was the primeval life force that bound the universe together; inhaling it invigorated the body. Similarly, in Indian yogic philosophy,prana is the cosmic energy that fills and maintains the body, manifesting in living beings as the breath. The fourth step in Raja Yoga is pranayama, or breath control, practiced because the breath is believed to influence markedly a person’s thoughts and emotions. Similarly, modern medicine relates hyperventilation to a disturbed psychological state.19

VITAL CAPACITY

The forty-year Framingham study,20 provides a surprising validation of Catlin’s conclusion that “the great secret to life is the breathing principal.” Researchers in the famous Framingham heart study found that “force vital capacity,” the maximum volume of air that a person can exhale after a maximum inhalation, is the primary predictor for longterm heath and vitality.21 Framingham researchers William B. Kannel and Helen Hubert state: “This pulmonary function measurement appears to be an indicator of general health and vigor and literally a measure of living capacity.”22According to Dr. Kannel, “Long before a person becomes terminally ill, vital capacity can predict life span.”23

Some 80-90 percent of all of the body’s metabolic energy production is created by oxygen, with only 10-20 percent created from food and water. Furthermore, the respiratory system is responsible for eliminating 70 percent of the bodily metabolic waste. In 1924, Nobel Laureate Dr Otto Warburg linked lack of oxygen with cancer. “Summarized in a few words, the prime cause of cancer is the replacement of the respiration of oxygen in normal body cells by a fermentation of sugar.”24

HABITS AGAINST NATURE

“Life in all its fullness is Mother Nature obeyed,” wrote Dr. Price. Catlin formed a similar opinion: “Most habits against Nature, if not arrested, run into disease.”

“Air is an Elementary principal, created by the hand of God, who. . . creates nothing but perfections. . . sleep, which is the great renovator and regulator of health, and in fact the food of life, should be enjoyed in the manner which Nature has designed.”

Like Price, Catlin discusses the issue of heredity versus environment. “No diseases are natural,” he writes, “and deformities, mental and physical, are neither hereditary nor natural, but purely the result of accidents or habits.”

So wrote Dr. Price: “Neither heredity nor environment alone cause our juvenile delinquents and mental defectives. They are cripples, physically, mentally and morally, which could have and should have been prevented by adequate education and by adequate parental nutrition. Their protoplasm was not normally organized.”

Catlin believed that a change in childrearing practices could remedy the health problems of civilized man. “I have lived long enough, and observed enough, to become fully convinced of the unnecessary and premature mortality in civilized communities, resulting from the pernicious habit above described; and under the conviction that its most efficient remedy is in the cradle.” Of his book Shut Your Mouth, he said, “If I had a million dollars to give, to do the best charity I could with it, I would invest it in four millions of these little books, and bequeath them to the mothers of the poor, and the rich, of all countries. I would not get a monument or a statue, nor a medal; but I would make sure of that which would be much better—self credit for having bequeathed to posterity that which has a much greater value than money.”

We know from the work of Weston Price that attention to mouth closing from infancy is not enough to ensure proper facial development— diet is the key factor, starting from before conception. Nevertheless, Catlin’s observations provide the capstone to Price’s great edifice of nutritional research. By focusing on sleep positions that keep the mouth closed, and by insisting on cool, fresh air while sleeping, we can augment the benefits of a good diet.

We need to learn from the Native Americans and place more emphasis on optimizing “the breathing principle.” Breathing is something we do thirty thousand times a day, and breathing improperly, even for the one-third of our lives spent asleep, may undermine our vitality and even shorten our lifespan. Catlin observed that the American Indians practiced calm nasal breathing both day and night. Spiritual seekers for centuries have claimed that mastering the breath unlocks the mysteries of the universe. But, according to respiratory physiology expert Roger Price, learning to breathe properly is a fundamental, “mainstream” issue, not one to be avoided because it is a “sacred” issue or an “alternative care” issue.25

Thus, the Breathing Principle is a subject worthy of study, beginning with Catlin’s command, “Shut your mouth!”


SIDEBARS

The DANGERS OF Mouth Breathing

• The tongue no longer provides support for the upper jaw with resulting reduced upper arch size.
• The vault rises leading to reduction in the size of the nasal passages contributing to congestion of nose.
• The pH of saliva elevates leading to increased rate of caries.
• A tendency to upper respiratory tract infections often resulting in tonsillitis and enlarged adenoids.
• The medullary trigger resets at lower level leading to hyperventilation.
• The alkalinity of blood increases so less oxygen released from the blood. This is known as the Bohr Effect.
• Oxygen circulates the blood in the form of oxy-haemoglobin but reduced levels of carboxy-haemoglobin mean that less oxygen is released from the oxy-haemoglobin to enter the tissues so cells die.
• Smooth muscle spasm. Gastric reflux, asthma and bed wetting are commonly associated with chronic mouth-breathing. SOURCE: http://www.sleephotline.com/Sleep/categories/Breathing-Sleep.html

NATURAL VERSUS UNNATURAL SLEEP

Sleep Sketch Sleep sketch

Sleep sketch Sleep sketch

Sleep Sketch Sleep Sketch

Amusing drawing of “natural” and “unnatural” sleep from Catlin’s Shut Your Mouth. Says Catlin, “Unnatural sleep, which is irritating to the lungs and nervous system, fails to afford that rest which sleep is intended to give… They should first recollect that their natural food is fresh air…”

CRADLEBOARDS: A UNIVERSAL PRACTICE AMONG NATIVE AMERICANS

Assiniboine mother and child

“Aissiniboine Mother and Child”
Photograph by Edward Curtis, 1928

Nez Perce Baby

“Nez Perce Babe”
Photograph by Edward Curtis, 1911

TREATING SLEEP APNEA

According to Dr. Steven Sue of Honolulu, when the mouth is closed and one breathes through the nose, a vacuum is formed which keeps the tongue up in the roof of the mouth, thereby preventing it from sliding back into the throat to obstruct the airway. “The lip seal is fundamental, almost invisible, and occurs naturally. It is found only in nose breathing! Zen masters since ancient times have known the secret. When the tongue is placed at the roof of the mouth, it prevents the tongue from falling into the back of the throat. The tongue is held forward and away from the back of the throat by the naturally occurring lip seal and a forward ‘tongue suction.’ Pacifiers and sippy cups keep the tongue low and away from the roof of the mouth. They encourage mouth breathing and tongue thrust; the same effects as thumb sucking and therefore, harmful to the developing child.”

Dr. Sue has invented several dental sleep apnea appliances designed with a tongue shelf for the tongue to rest on, which positions the tongue up against the maxilla. The key by which the tongue is held in the optimal upper position is the “lip seal” on his custom-made dental orthotic device, which prevents the vacuum from breaking. A closed mouth and normal nasal breathing creates this vacuum. An open mouth—as a result of structural imperfections, habit or blocked nasal passages—has no vacuum to hold the tongue forward, and therefore is free to fall back into the airway to cause an obstruction. SOURCE: nosebreathe.com

ADVICE FOR TODAY’S MOTHERS

Native American childrearing practices fly in the face of modern customs, and even may strike us as cruel to children. Childrearing experts today believe that infants should at all times be able to move their hands and legs freely, and while frowned on by government officials, sleeping with baby in close contact is highly encouraged in many circles.

The superb physical development of Native Americans is proof that confinement in a cradle board—usually until the second birthday—does not in any way hinder physical development. And while Indian mothers slept with their babies nearby, they did not snuggle them during the night.

According to health workers who have lived with tribes that still use cradle boards, the number one reason given for their use is safety—to keep the babies away from camp fires, and from wondering away while their mothers were working. (In European countries, babies were also swaddled to keep them safe; often the swaddled infants were hung on a hook near the hearth!) Modern mothers do not face the challenge of keeping babies away from fires, so do not need to restrain their infants in a cradle board. Nevertheless, swaddling cloths that keep baby’s arms and legs from moving are coming back into use, as they can have a very calming effect on the infant. And all mothers are now advised to put their infants on their backs to sleep, to reduce the risk of SIDS. Comfortable inflatable head rests are now available for babies, to help keep them on their backs with heads tilted slightly forward. Put to bed in this manner, wrapped in a warm swaddling cloth and with a window open to allow fresh air into the room, babies can receive all the benefits of the cradle board in a modern setting.

And now to answer the question you have all been wanting to ask: Native American mothers didn’t use diapers, of course. Instead, they wrapped the baby in soft, absorbant spagnam moss, replacing it about once every twenty-four hours.
Sally Fallon Morell

HOW TO DETERMINE YOUR VITAL CAPACITY

Vital Capacity is a measure of the amount of air that the lungs can hold; in a clinical setting this is determined using lung volume bags. But it is possible to measure your vital capacity using a balloon, a piece of string and a ruler. The procedure is to blow into a balloon several times to loosen it, then to blow in with one long exhalation, then tie the balloon off and measure the circumference at the widest point. The vital capacity is then determined by comparing the diameter of the balloon to fixed numbers on a graph.

For further information, visit wiki.answers.com/Q/How_do_you_measure_vital_capacity_at_the_bedside orwww.teachingk-8.com/archives/integrating_science_in_your_classroom/measuring_lung_capacity_by_john_cowens.html.


REFERENCES

1. Catlin, George, Letters and Notes on the Manners, Customs and Conditions of the North American Indians, Volume 1, p 2.

2. Ibid, 15-31.

3. Price, Weston A. DDS, Nutrition and Physical Degeneration, Price Pottenger Nutrition Foundation, 1939.

4. This and all quotes following by George Catlin are from: Catlin, George, Shut Your Mouth… and Save Your Life 4th Edition, 1870, N. Truebner and Co, (now available at: Kessinger Publishing, Whitefish, Montana); also available in digital form at http://www.members.westnet.com.au/pkolb/indians.pdf.

5. Silkman, Raymond, DDS. Is it Mental or is it Dental?—Cranial & Dental Impacts on Total Health. Wise Traditions, quarterly magazine of the Weston A. Price Foundation, Spring 2005- Winter 06.

6. Coleman-Phox, Kimberly, MD, and others. Use of a Fan During Sleep and the Risk of Sudden Infant Death Syndrome. Arch Pediatr Adolesc Med. 2008;162(10):963- 968.

7. Gerard, Claudia M. MD. Spontaneous Arousals in Supine Infants While Swaddled and Unswaddled During Rapid Eye Movement and Quiet Sleep. PEDIATRICS Vol. 110 # 6 December 2002, p e70; Franco, Patricia MD, PhD. Influence of Swaddling on Sleep and Arousal Characteristics of Healthy Infants. PEDIATRICS Vol. 115 # 5 May 2005, pp 1307-1311.

8. http://www.care2.com/c2c/photos/view/255/224457095/Cradleboards/.

9. www.sleepassociation.orghttp://www.sleepapnea.org/resources/pubs/treatment. html; Skinner, Margot. Elevated Posture for the Management of Obstructive Sleep Apnea. Sleep and Breathing. Springer Berlin Volume 8, Number 4. October, 2004

10. http://en.wikipedia.org/wiki/Snoring

11. http://en.wikipedia.org/wiki/Sleep_apnea;

12. Reichmuth, Kevin J. Association of Sleep Apnea and Type II Diabetes. American Journal of Respiratory and Critical Care Medicine Vol 172, pp1590-1595, (2005).

13. www.sleepandyou.com/sleep-connections-diabetes.htm.

14. Ayazi, Shahin. Obesity and Gastroesophageal Reflux: Quantifying the Association Between Body Mass Index, Esophageal Acid Exposure and Lower Esophageal Sphincter Status in a Large Series of Patients with Reflux Symptoms.J Gastrointest Surg. 2009 August; 13(8): 1440–1447.

15. National Sleep Foundation, http://www.nlm.nih.gov/medlineplus/sleepapnea.html

16. www.nhtsa.dot.gov/people/injury/drowsy_driving1/human/drows_driving/ – 10k – 2006-03-09.

17. Eastman, Charles A, Dr. Ohiyesa, The Soul of an Indian, an Interpretation. London, 1902, 1911.

18. http://en.wikipedia.org/wiki/Breath.

19. http://www.absoluteastronomy.com/topics/Hyperventilation.

20. http://en.wikipedia.org/wiki/Framingham_Heart_Studyhttp://www.nih.gov/ Also see another 30 year study with the same conclusion: http://www.buffalo.edu/news/4857 (lung function and death risk relationship) Holger Schunemann, MD “It is surprising that this simple measurement has not gained more importance as a general health assessment tool.”

21. Vital Capacity” http://en.wikipedia.org/wiki/Vital_capacity.

22. www.ncbi.nlm.nih.gov/pubmed/ http://www.nih.gov/.

23. http://breathing.com/articles/clinical-studies.htmhttp://www.ncbi.nlm.nih.gov/PubMed/.

24. http://en.wikipedia.org/wiki/Otto_Heinrich_Warburg.

25. www.buteykoabc.comwww.breathingwell.orgwww.levityhealth.com.au.

 

This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Fall 2009.

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Infant Development


https://www.youtube.com/watch?v=4qfVgYse0cs


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Finding Balance – Yin & Yang Videos – Paul Chek

I don’t agree fully with his nutritional insight but the general yin/yang concept is something more westerners need to know and embrace. As a group, we experience too much yang in modern life; Chek’s concept suggests we need more yin (Dr. Diet & Dr. Quiet) to balance.










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Components of Daily Energy Expenditure

Also see:
Exercise and Effect on Thyroid Hormone
Ray Peat, PhD: Quotes Relating to Exercise
Temperature and Pulse Basics & Monthly Log
Ray Peat, PhD on Thyroid, Temperature, Pulse, and TSH
Body Temperature, Metabolism, and Obesity
Thyroid, Temperature, Pulse
Metabolism, Brain Size, and Lifespan in Mammals
Promoters of Efficient v. Inefficient Metabolism
Inflammation from Decrease in Body Temperature
Melatonin Lowers Body Temperature
Menopausal Estrogen Therapy Lowers Body Temperature
Thyroid Function, Pulse Rate, & Temperature
“Curing” a High Metabolic Rate with Unsaturated Fats
Fat Deficient Animals – Activity of Cytochrome Oxidase
Comparison: Carbon Dioxide v. Lactic Acid
Carbon Dioxide Basics
Energy Flow: Plant World and Animal World
Biological Energy & Matter Cycle
Is 98.6 Really Normal?

Components of Daily Energy Expenditure
According to Poehlman (1989), daily energy expenditure is comprised of three major components:

1) resting metabolic rate (RMR) — thyroid hormone, lean body mass ~56-80%
2) the thermic effect of feeding (TEF) — food choice ~10+%
3) the thermic effect of activity (TEA) — movement ~10+%

Components of Daily Energy Expenditure Percentage - Sedentary

Daily Energy Expenditure – Sedentary

RMR accounts for the largest portion of daily energy expenditure no matter whether you’re sedentary or very active — 80 to 56% respectively (Landsberg, et al., 2009). Energy expenditure from exercise/activity is thus small relative to the energy expenditure at rest. On a percentage basis, more bang for your buck comes from analyzing and maximizing the factors that improve the RMR, with special attention to thyroid hormone and the preservation of lean body mass.

How strong is your resting metabolism? A good way to get a picture of your resting metabolism is by charting your resting temperature and pulse on a daily basis. Temperatures below 98F degrees and pulses not between 75-85 beats per minute are a sign of depressed energy metabolism. Using a finger oximeter can provide instant feedback about resting pulse (and Sp02), making charting more convenient.

Exercise, when used correctly (resistance-training centered, training not draining), can enhance or maintain the RMR through preservation of fat free mass without thyroid suppression. Resistance training does not significantly raise non-resting energy expenditure, but its benefits on weight management come about by “its effects on body composition (e.g., increasing fat-free mass)” (Poehlman & Melby, 1998). The preservation of lean mass with aging helps prevent the accumulation of body fat by sustaining the resting metabolic rate and acting as a site that consumes stored fat at rest.

Three quotes by Ray Peat, PhD on muscle, exercise, and fat loss:
“In the resting state, muscles consume mainly fats, so maintaining relatively large muscles is important for preventing the accumulation of fats.”

“Since fat has a very low rate of metabolism, people who lose muscle by fasting are going to have increasing difficulty in losing weight, since they will have less active tissue to consume fat. Building up muscle and lymph tissue for optimal health – even if it initially causes a slight weight gain – will make reducing easier by increasing mass of metabolically active tissue.”

“Many dietitians claim that exercise doesn’t increase the need for protein, but the Russians have found that a combination of exercise and increased protein intake can increase the muscle mass. In a woman, this process can not only improve grace and body proportions, but it also increases the body’s ability to burn up fat. Other nutrients are needed for using protein properly, and for maintaining optimum nerve functioning. However, if the exercise produces too much stress and not enough muscle action, muscle will atrophy as a result of cortisone’s shifting amino acid metabolism into glucose production.”

When exercise is used incorrectly, the loss of fat free mass and suppression thyroid hormone production results in lowering of the RMR, creating poor long-term outcomes from a weight management perspective. Calorie restrictive diets combined with exercise also suppress the RMR, increasing the likelihood of regaining any lost weight.

Protein is a macronutrient identified in the literature as having a beneficial effect on lean mass preservation (Poehlman, et al., 1993). Since ingestion of adequate carbohydrate prevents protein from being use to make glucose, it too has such an effect. According to Ray Peat, PhD, proteolytic enzymes that digest protein are inhibit by polyunsaturated fats (PUFA). PUFA are also antagonistic the thyroid in multiple ways. Eliminate PUFA from the diet in favor of saturated fats.

Quotables about RMR:
1. “Hence, the age-related decline in BMR is partly explained by a reduction in the quantity, as well as the metabolic activity, of DEXA-derived lean tissue components.” -Piers, et al., 1998
2. “The hypothesis is that combining diet and exercise will accelerate fat loss, preserve fat-free weight and prevent or decelerate the decline in resting metabolic rate more effectively than with diet restriction alone. The optimal combination of diet and exercise, however, remains elusive. It appears that the combination of a large quantity of aerobic exercise with a very low calorie diet resulting in substantial loss of bodyweight may actually accelerate the decline in resting metabolic rate. These findings may cause us to re-examine the quantity of exercise and diet needed to achieve optimal fat loss and preservation of resting metabolic rate.” -Poehlman, et al., 1991
3. “Evidence is presented to suggest that although resistance training may elevate resting metabolic rate, it does not substantially enhance daily energy expenditure in free-living individuals…Preliminary evidence suggests that although resistance training increases muscular strength and endurance, its effects on energy balance and regulation of body weight appear to be primarily mediated by its effects on body composition (e.g., increasing fat-free mass) rather than by the direct energy costs of the resistance exercise.” -Poehlman & Melby, 1998
4. “Results showed that body composition did not change in endurance-trained women, but maximum aerobic capacity increased by 18%. Resistance-trained women increased muscular strength and fat-free mass (1.3 kg).” -Poehlman, et al., 2002
5. “Daily energy expenditure is composed of three major components: 1) resting metabolic rate (RMR); 2) the thermic effect of feeding (TEF); and 3) the thermic effect of activity (TEA). RMR constitutes 60 to 75% of daily energy expenditureand is the energy associated with the maintenance of major body functions. TEF is the cumulative increase in energy expenditure after several meals and constitutes approximately 10% of daily energy expenditure.” -Poehlman, 1989
6. “The direct effects of physical activity interventions on energy expenditure are relatively small when placed in the context of total daily energy demands. Hence, the suggestion has been made that exercise produces energetic benefits in other components of the daily energy budget, thus generating a net effect on energy balance much greater than the direct energy cost of the exercise alone. Resting metabolic rate (RMR) is the largest component of the daily energy budget in most human societies and, therefore, any increases in RMR in response to exercise interventions are potentially of great importance…Long-term effects of training include increases in RMR due to increases in lean muscle mass. Extreme interventions, however, may induce reductions in RMR, in spite of the increased lean tissue mass, similar to the changes observed in animals in response to flight.” -Speakman & Selman, 2003
7. “This review reveals that there might be contrasting effects of resting and nonresting energy expenditure on aging, with increases in the former being protective and increases in the latter being harmful.” -Speakman, et al., 2002
8. “We considered the association of several metabolic and lifestyle variables as modulators of the decline in resting metabolic rate (RMR) and fat-free weight (FFW) in 183 healthy females (18-81 yr). RMR showed a curvilinear decline with age, which was significant in women aged 51-81 yr but not in women aged 18-50 yr. FFW Wshowed a curvilinear decline with age, which was significant (P < 0.01) in women 48-81 yr but not in women 18-47 yr. The decline in RMR was primarily associated with the loss of FFW (r2 = 72%), whereas the decline in FFW was explained primarily by differences in maximal O2 consumption (VO2max), age, leisure time physical activity, and dietary protein intake (total r2 = 46%). We conclude that RMR and FFW showed a curvilinear decline with age which was accelerated beyond the middle-age years. Second, the age-related decline in RMR was primarily associated with the loss of FFW. Third, the loss of FFW was partially related to a decrement in VO2max and nutritional factors.” -Poehlman, et al., 1993
9. “An important goal during weight loss is to maximize fat loss while preserving metabolically active fat-free mass (FFM). Massive weight loss typically results in substantial loss of FFM potentially slowing metabolic rate…Despite relative preservation of FFM, exercise did not prevent dramatic slowing of resting metabolism out of proportion to weight loss. This metabolic adaptation may persist during weight maintenance and predispose to weight regain unless high levels of physical activity or caloric restriction are maintained.” -Johannsen, et al., 2012
10. ” The extremely high failure rate (> 80%) to keep the reduced weight after successful weight loss is due to adaptation processes of the body to maintain body energy stores. This so called “adaptive thermogenesis” is defined as a smaller than predicted change of energy expenditure in response to changes in energy balance. Adaptive thermogenesis appears to be a major reason for weight regain. The foremost objective of weight-loss programs is the reduction in body fat. However, a concomitant decline in lean tissue can frequently be observed. Since lean body mass (LBM) represents a key determinant of RMR it follows that a decrease in lean tissue could counteract the progress of weight loss. Therefore, with respect to long-term effectiveness of weight reduction programs, the loss of fat mass while maintaining LBM and RMR seems desirable” -Weck, et al., 2012
11. “The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss. Therefore, with respect to long-term effectiveness of weight-loss programmes, the loss of fat mass while maintaining FFM and RMR seems desirable…The advantages of strength training may have greater implications than initially proposed with respect to decreasing percentage body fat and sustaining FFM. Research to date suggests that the addition of exercise programmes to dietary restriction can promote more favourable changes in body composition than diet or physical activity on its own…These outcomes provide the scientific rationale to justify further randomised intervention trials on the synergies between diet and exercise approaches to yield favourable modifications in body composition.” -Stiegler & Cunliffe, 2006
11. “Declines in energy expenditure favoring the regain of lost weight persist well beyond the period of dynamic weight loss.” -Rosenbaum, et al., 2008
12. “After 2 weeks of energy restriction, measured REE had fallen by 469 and 635 kJ/d more than predicted and this difference reached 963 and 614 kJ/d by week 8 of treatment in men and women respectively.” -Doucet, et al., 2001
13. “Changes in body temperature are associated with significant changes in metabolic rate.

“Resting (or “basal”) metabolic rate (RMR) accounts for approximately 80% of energy output. About two thirds of RMR is for maintenance of homeothermy (warm-bloodedness); about one third is to maintain cellular integrity, ionic gradients, protein turnover, and the like [6-8]. Resting metabolic rate is largely regulated by thyroid hormones, with a minor contribution from the sympathetic nervous system. Resting metabolic rate differs by as much as 600 kcal/d for a 70-kg man [8]. Physical activity (exercise) accounts for about 10% in truly sedentary humans; in addition to intentional activity, this category includes nonpurposeful motion such as fidgeting, which may differ among lean and obese individuals [9], as well as upright posture [10]. The remaining 10% is frequently referred to as thermogenesis, which means heat production unrelated to physical activity.”

It should be emphasized that, for nonsedentary individuals, the activity component may be much greater than 10% of total energy expenditure. Evidence has been developed indicating that the combination of activity plus adaptive thermogenesis accounts for about 44% of total energy expenditure on average, meaning that RMR would constitute about 56% of total energy expenditure in normally active humans [15], as compared with 80% in the truly sedentary.” -Landsberg, et al., 2009

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Am J Clin Nutr. 1992 Apr;55(4):802-10.
The effects of either high-intensity resistance or endurance training on resting metabolic rate.
Broeder CE, Burrhus KA, Svanevik LS, Wilmore JH.
The effects of either 12-wk of high-intensity endurance or resistance training on resting metabolic rate (RMR) were investigated in 47 males aged 18-35 y. Subjects were randomly assigned to either a control (C), resistance-trained (RT) or endurance-trained (ET) group. After training both exercise groups showed significant declines in relative body fat either by reducing their total fat weight and maintaining fat-free weight (ET) or by reducing their total fat weight and increasing fat-free weight (RT). RMR did not significantly change after either training regimen although a small decline in energy intake was observed along with an increase in energy expenditure [ET, 2.721 MJ (650 kcal) per training day]. These results suggest that both endurance and resistance training may help to prevent an attenuation in RMR normally observed during extended periods of negative energy balance (energy intake less than expenditure) by either preserving or increasing a person’s fat-free weight.

Journal of Applied Physiology December 1, 1998 vol. 85 no. 6 2196-2204
Is there evidence for an age-related reduction in metabolic rate?
Leonard S. Piers1, Mario J. Soares2, Leanne M. McCormack3, and Kerin O’Dea1
To determine whether the age-related reduction in basal metabolic rate (BMR) is explained by a quantitative and/or qualitative change in the components of lean tissue, we conducted a cross-sectional study in groups of young (n = 38, 18–35 yr) and older (n = 24, 50–77 yr) healthy individuals. BMR was measured by indirect calorimetry. Body composition was obtained by using dual-energy X-ray absorptiometry (DEXA), which permitted four compartments to be quantified [bone mineral mass, fat mass (FM), appendicular lean tissue mass (ALTM), and nonappendicular lean tissue mass (NALTM)]. Absolute BMR and ALTM were lower, whereas FM was significantly higher in the older, compared with young, subjects. BMR, adjusted for differences in FM, ALTM, and NALTM, was significantly lower in the older subjects by 644 kJ/day. In separate regression analyses of BMR on body compartments, older subjects had significantly lower regression coefficients for ALTMand NALTM, compared with young subjects. Hence, the age-related decline in BMR is partly explained by a reduction in the quantity, as well as the metabolic activity, of DEXA-derived lean tissue components.

Sports Med. 1991 Feb;11(2):78-101.
The impact of exercise and diet restriction on daily energy expenditure.
Poehlman ET, Melby CL, Goran MI.
In addition to the direct energy cost of physical activity, exercise may influence resting energy expenditure in 3 ways: (a) a prolonged increase in postexercise metabolic rate from an acute exercise challenge; (b) a chronic increase in resting metabolic rate associated with exercise training; and (c) a possible increase in energy expenditure during nonexercising time. It seems apparent that the greater the exercise perturbation, the greater the magnitude of the increase in postexercise metabolic rate. An exercise prescription for the general population that consists of exercise of low (less than 50% VO2max) or moderate intensity (50 to 75% VO2max) does not appear to produce a prolonged elevation of postexercise metabolic rate that would influence body-weight. Inconsistent results have been found with respect to the effects of exercise training and the trained state on resting metabolic rate. Whereas some investigators have found a higher resting metabolic rate in trained than untrained individuals and in individuals after an exercise training programme, other investigators have found no chronic exercise effect on resting metabolic rate. Differences in experimental design, genetic variation and alterations in energy balance may contribute to the discrepant findings among investigators. A relatively unexplored area concerns the influence of exercise training on energy expenditure during nonexercising time. It is presently unclear whether exercise training increases or decreases the energy expenditure associated with spontaneous or nonpurposeful physical activity which includes fidgeting, muscular activity, etc. The doubly labelled water technique represents a methodological advance in this area and permits the determination of total daily energy expenditure. Concomitant with the determination of the other components of daily energy expenditure (resting metabolic rate and thermic effect of a meal), it will now be possible to examine the adaptive changes in energy expenditure during nonexercising time. A plethora of studies have examined the combined effects of diet and exercise on body composition and resting metabolic rate. The hypothesis is that combining diet and exercise will accelerate fat loss, preserve fat-free weight and prevent or decelerate the decline in resting metabolic rate more effectively than with diet restriction alone. The optimal combination of diet and exercise, however, remains elusive. It appears that the combination of a large quantity of aerobic exercise with a very low calorie diet resulting in substantial loss of bodyweight may actually accelerate the decline in resting metabolic rate. These findings may cause us to re-examine the quantity of exercise and diet needed to achieve optimal fat loss and preservation of resting metabolic rate.

Int J Sport Nutr. 1998 Jun;8(2):143-59.
Resistance training and energy balance.
Poehlman ET, Melby C.
In this brief review we examine the effects of resistance training on energy expenditure. The components of daily energy expenditure are described, and methods of measuring daily energy expenditure are discussed. Cross-sectional and exercise intervention studies are examined with respect to their effects on resting metabolic rate, physical activity energy expenditure, postexercise oxygen consumption, and substrate oxidation in younger and older individuals. Evidence is presented to suggest that although resistance training may elevate resting metabolic rate, it does not substantially enhance daily energy expenditure in free-living individuals. Several studies indicate that intense resistance exercise increases postexercise oxygen consumption and shifts substrate oxidation toward a greater reliance on fat oxidation. Preliminary evidence suggests that although resistance training increases muscular strength and endurance, its effects on energy balance and regulation of body weight appear to be primarily mediated by its effects on body composition (e.g., increasing fat-free mass) rather than by the direct energy costs of the resistance exercise.

J Clin Endocrinol Metab. 2002 Mar;87(3):1004-9.
Effects of endurance and resistance training on total daily energy expenditure in young women: a controlled randomized trial.
Poehlman ET, Denino WF, Beckett T, Kinaman KA, Dionne IJ, Dvorak R, Ades PA.
There exists considerable controversy regarding the impact of different modes of exercise training on total daily energy expenditure (TEE). To examine this question, young, nonobese women were randomly assigned to a supervised 6-month program of endurance training, resistance training, or control condition. TEE was measured before and 10 d after a 6-month exercise program was completed with doubly labeled water. Body composition was determined from dual energy x-ray absorptiometry, maximum aerobic capacity from a treadmill test to exhaustion, and muscular strength from one-repetition maximum tests. Results showed that body composition did not change in endurance-trained women, but maximum aerobic capacity increased by 18%. Resistance-trained women increased muscular strength and fat-free mass (1.3 kg). TEE did not significantly change when measured subsequent to the endurance or resistance training programs. Absolute resting metabolic rate increased in resistance-trained women but not when adjusted for fat-free mass. No change in physical activity energy expenditure was found in any of the groups. These results suggest that endurance and resistance training does not chronically alter TEE in free-living young women. Thus, the energy-enhancing benefits of exercise training are primarily derived from the direct energy cost of exercise and not from a chronic elevation in daily energy expenditure in young, nonobese women.

Med Sci Sports Exerc. 1989 Oct;21(5):515-25.
A review: exercise and its influence on resting energy metabolism in man.
Poehlman ET.
Daily energy expenditure is composed of three major components: 1) resting metabolic rate (RMR); 2) the thermic effect of feeding (TEF); and 3) the thermic effect of activity (TEA). RMR constitutes 60 to 75% of daily energy expenditure and is the energy associated with the maintenance of major body functions. TEF is the cumulative increase in energy expenditure after several meals and constitutes approximately 10% of daily energy expenditure. Most investigators, however, have examined the thermic effect of a single meal test (TEM). TEA is the most variable component of daily energy expenditure and can constitute 15 to 30% of 24-h energy expenditure. This component includes energy expenditure due to physical work, muscular activity, including shivering and fidgeting, as well as purposeful physical exercise. Participation in purposeful exercise (both acute and chronic) is a subcomponent of TEA and has been found to influence resting energy expenditure (RMR and TEM). Reports in the literature, however, are discrepant regarding the direction and magnitude of the effects of exercise and exercise training on RMR and TEM. Cross-sectional and longitudinal studies that have examined the effects of exercise on RMR and TEM are reviewed. Possible explanations for divergent results in the literature are discussed. The major focus of this review is directed to human studies, although pertinent animal work is included. The role of genetic variation, gender specific responses, and methodological considerations for future studies examining the relation among RMR, TEA, and TEM are considered. Although still controversial, purposeful physical exercise appears to influence resting energy expenditure in man.

Proc Nutr Soc. 2003 Aug;62(3):621-34.
Physical activity and resting metabolic rate.
Speakman JR, Selman C.
The direct effects of physical activity interventions on energy expenditure are relatively small when placed in the context of total daily energy demands. Hence, the suggestion has been made that exercise produces energetic benefits in other components of the daily energy budget, thus generating a net effect on energy balance much greater than the direct energy cost of the exercise alone. Resting metabolic rate (RMR) is the largest component of the daily energy budget in most human societies and, therefore, any increases in RMR in response to exercise interventions are potentially of great importance. Animal studies have generally shown that single exercise events and longer-term training produce increases in RMR. This effect is observed in longer-term interventions despite parallel decreases in body mass and fat mass. Flight is an exception, as both single flights and long-term flight training induce reductions in RMR. Studies in animals that measure the effect of voluntary exercise regimens on RMR are less commonly performed and do not show the same response as that to forced exercise. In particular, they indicate that exercise does not induce elevations in RMR. Many studies of human subjects indicate a short-term elevation in RMR in response to single exercise events (generally termed the excess post-exercise O2 consumption; EPOC). This EPOC appears to have two phases, one lasting < 2 h and a smaller much more prolonged effect lasting up to 48 h. Many studies have shown that long-term training increases RMR, but many other studies have failed to find such effects. Data concerning long-term effects of training are potentially confounded by some studies not leaving sufficient time after the last exercise bout for the termination of the long-term EPOC. Long-term effects of training include increases in RMR due to increases in lean muscle mass. Extreme interventions, however, may induce reductions in RMR, in spite of the increased lean tissue mass, similar to the changes observed in animals in response to flight.

J Nutr. 2002 Jun;132(6 Suppl 2):1583S-97S.
Living fast, dying when? The link between aging and energetics.
Speakman JR, Selman C, McLaren JS, Harper EJ.
The idea that aging should be linked to energy expenditure has a long history that can be traced to the late 1800s and the industrial revolution. Machines that are run fast wear out more quickly, so the notion was born that humans and animals might experience similar fates: the faster they live (expressed as greater energy expenditure), the sooner they die. Evidence supporting the “rate-of-living” theory was gleaned from the scaling of resting metabolism and life span as functions of body mass. The product of these factors yields a mass-invariant term, equivalent to the “amount of living.” There are at least four problems with this evidence, which are summarized and reviewed in this communication: 1) life span is a poor measure of aging, 2) resting metabolism is a poor measure of energy expenditure, 3) the effects are confounded by body mass and 4) the comparisons made are not phylogenetically independent. We demonstrate that there is a poor association between resting metabolic rate (RMR) and daily energy expenditure (DEE) measured using the doubly labeled water (DLW) method at the level of species. Nevertheless, the scaling relation between DEE and body mass still has the same scaling exponent as the RMR and body mass relationship. Thus, if we use DEE rather than RMR in the analysis, the rate-of-living ideas are still supported. Data for 13 species of small mammal were obtained, where energy demands by DLW and longevity were reliably known. In these species, there was a strong negative relationship between residual longevity and residual DEE, both with the effects of body mass removed (r(2) = 0.763, F = 32.1, P < 0.001). Hence, the association of energy demands and life span is not attributed to the confounding effects of body size. We subjected these latter data to an analysis that extracts phylogenetically independent contrasts, and the relationship remained significant (r(2) = 0.815, F = 39.74, P < 0.001). Small mammals that live fast really do die young. However, there are very large differences between species in the amounts of living that each enjoy and these disparities are even greater when other taxa are included in the comparisons. Such differences are incompatible with the “rate-of-living” theory. However, the link between energetics and aging across species is reconcilable within the framework of the “free-radical damage hypothesis” and the “disposable soma hypothesis.” Within species one might anticipate the rate-of-living model would be more appropriate. We reviewed data generated from three different sources to evaluate whether this were so, studies in which metabolic rate is experimentally increased and impacts on life span followed, studies of caloric restriction and studies where links between natural variation in metabolism and life span are sought. This review reveals that there might be contrasting effects of resting and nonresting energy expenditure on aging, with increases in the former being protective and increases in the latter being harmful.

AJP – Endo March 1, 1993 vol. 264 no. 3 E450-E455
Determinants of decline in resting metabolic rate in aging females
E. T. Poehlman, M. I. Goran, A. W. Gardner, P. A. Ades, P. J. Arciero, S. M. Katzman-Rooks, S. M. Montgomery, M. J. Toth, and P. T. Sutherland
We considered the association of several metabolic and lifestyle variables as modulators of the decline in resting metabolic rate (RMR) and fat-free weight (FFW) in 183 healthy females (18-81 yr). RMR showed a curvilinear decline with age, which was significant in women aged 51-81 yr but not in women aged 18-50 yr. FFW Wshowed a curvilinear decline with age, which was significant (P < 0.01) in women 48-81 yr but not in women 18-47 yr. The decline in RMR was primarily associated with the loss of FFW (r2 = 72%), whereas the decline in FFW was explained primarily by differences in maximal O2 consumption (VO2max), age, leisure time physical activity, and dietary protein intake (total r2 = 46%). We conclude that RMR and FFW showed a curvilinear decline with age which was accelerated beyond the middle-age years. Second, the age-related decline in RMR was primarily associated with the loss of FFW. Third, the loss of FFW was partially related to a decrement in VO2max and nutritional factors. Therapeutic interventions designed to increase VO2max by elevating physical activity may preserve fat-free weight and thus offset the decline of RMR in aging women.

J Clin Endocrinol Metab. 2012 Jul;97(7):2489-96. doi: 10.1210/jc.2012-1444. Epub 2012 Apr 24.
Metabolic slowing with massive weight loss despite preservation of fat-free mass.
Johannsen DL, Knuth ND, Huizenga R, Rood JC, Ravussin E, Hall KD.
CONTEXT:
An important goal during weight loss is to maximize fat loss while preserving metabolically active fat-free mass (FFM). Massive weight loss typically results in substantial loss of FFM potentially slowing metabolic rate.
OBJECTIVE:
Our objective was to determine whether a weight loss program consisting of diet restriction and vigorous exercise helped to preserve FFM and maintain resting metabolic rate (RMR).
PARTICIPANTS AND INTERVENTION:
We measured body composition by dual-energy x-ray absorptiometry, RMR by indirect calorimetry, and total energy expenditure by doubly labeled water at baseline (n = 16), wk 6 (n = 11), and wk 30 (n = 16).
RESULTS:
At baseline, participants were severely obese (× ± SD; body mass index 49.4 ± 9.4 kg/m(2)) with 49 ± 5% body fat. At wk 30, more than one third of initial body weight was lost (-38 ± 9%) and consisted of 17 ± 8% from FFM and 83 ± 8% from fat. RMR declined out of proportion to the decrease in body mass, demonstrating a substantial metabolic adaptation (-244 ± 231 and -504 ± 171 kcal/d at wk 6 and 30, respectively, P < 0.01). Energy expenditure attributed to physical activity increased by 10.2 ± 5.1 kcal/kg.d at wk 6 and 6.0 ± 4.1 kcal/kg.d at wk 30 (P < 0.001 vs. zero).
CONCLUSIONS:
Despite relative preservation of FFM, exercise did not prevent dramatic slowing of resting metabolism out of proportion to weight loss. This metabolic adaptation may persist during weight maintenance and predispose to weight regain unless high levels of physical activity or caloric restriction are maintained.

Dtsch Med Wochenschr. 2012 Oct;137(43):2223-8. doi: 10.1055/s-0032-1327232. Epub 2012 Oct 17.
[Strategies for successful weight reduction – focus on energy balance].
[Article in German]
Weck M, Bornstein SR, Barthel A, Blüher M.
The prevalence of obesity and related health problems is increasing worldwide and also in Germany. It is well known that substantial and sustained weight loss is difficult to accomplish. Therefore, a variety of studies has been performed in order to specify causes for weight gain and create hypotheses for better treatment options. Key factors of this problem are an adaptation of energy metabolism, especially resting metabolic rate (RMR), non-exercise thermogenesis and diet induced thermogenesis. The extremely high failure rate (> 80%) to keep the reduced weight after successful weight loss is due to adaptation processes of the body to maintain body energy stores. This so called “adaptive thermogenesis” is defined as a smaller than predicted change of energy expenditure in response to changes in energy balance. Adaptive thermogenesis appears to be a major reason for weight regain. The foremost objective of weight-loss programs is the reduction in body fat. However, a concomitant decline in lean tissue can frequently be observed. Since lean body mass (LBM) represents a key determinant of RMR it follows that a decrease in lean tissue could counteract the progress of weight loss. Therefore, with respect to long-term effectiveness of weight reduction programs, the loss of fat mass while maintaining LBM and RMR seems desirable. In this paper we will discuss the mechanisms of adaptive thermogenesis and develop therapeutic strategies with respect to avoiding weight regain successful weight reduction.

Sports Med. 2006;36(3):239-62.
The role of diet and exercise for the maintenance of fat-free mass and resting metabolic rate during weight loss.
Stiegler P, Cunliffe A.
The incidence of obesity is increasing rapidly. Research efforts for effective treatment strategies still focus on diet and exercise programmes, the individual components of which have been investigated in intervention trials in order to determine the most effective recommendations for sustained changes in bodyweight. The foremost objective of a weight-loss trial has to be the reduction in body fat leading to a decrease in risk factors for metabolic syndrome. However, a concomitant decline in lean tissue can frequently be observed. Given that fat-free mass (FFM) represents a key determinant of the magnitude of resting metabolic rate (RMR), it follows that a decrease in lean tissue could hinder the progress of weight loss. Therefore, with respect to long-term effectiveness of weight-loss programmes, the loss of fat mass while maintaining FFM and RMR seems desirable. Diet intervention studies suggest spontaneous losses in bodyweight following low-fat diets, and current data on a reduction of the carbohydrate-to-protein ratio of the diet show promising outcomes. Exercise training is associated with an increase in energy expenditure, thus promoting changes in body composition and bodyweight while keeping dietary intake constant. The advantages of strength training may have greater implications than initially proposed with respect to decreasing percentage body fat and sustaining FFM. Research to date suggests that the addition of exercise programmes to dietary restriction can promote more favourable changes in body composition than diet or physical activity on its own. Moreover, recent research indicates that the macronutrient content of the energy-restricted diet may influence body compositional alterations following exercise regimens. Protein emerges as an important factor for the maintenance of or increase in FFM induced by exercise training. Changes in RMR can only partly be accounted for by alterations in respiring tissues, and other yet-undefined mechanisms have to be explored. These outcomes provide the scientific rationale to justify further randomised intervention trials on the synergies between diet and exercise approaches to yield favourable modifications in body composition.

Br J Nutr. 2009 Aug;102(4):488-92. doi: 10.1017/S0007114508207245.
Adaptive reduction in thermogenesis and resistance to lose fat in obese men.
Tremblay A, Chaput JP.
Adaptive thermogenesis is defined as a greater than predicted change in energy expenditure in response to changes in energy balance. This issue is particularly relevant in the context of a weight-reducing programme in which diminished thermogenesis can be sufficient to compensate for a prescribed decrease in daily energy intake. In the present pilot study, we investigated the adaptive reduction in thermogenesis in resting state that appears to favour resistance to further weight loss. Eight obese men (mean BMI: 33.4 kg/m2, mean age: 38 years) participated in this repeated-measures, within-subject, clinical intervention. They were subjected to a weight-loss programme that consisted of a supervised diet (-2930 kJ/d) and exercise clinical intervention. The phases investigated were as follows: (i) baseline, (ii) after 5 (SE 1) kg loss of body weight (phase 1), (iii) after 10 (SE 1) kg weight loss (phase 2) and (iv) at resistance to further weight loss (plateau). At each phase of the weight-reducing programme, body weight and composition as well as RMR were measured. A regression equation was established in a control population of the same age to predict RMR in obese men at each phase of the weight-loss programme. We observed that body weight and fat mass (FM) were significantly reduced (P < 0.05), while fat-free mass remained unchanged throughout the programme. In phase 1, measured RMR had fallen by 418 kJ/d, more than predicted (P < 0.05), and this difference reached 706 kJ/d at plateau (P < 0.05 v. phase 1). A positive association (r 0.64, P < 0.05) was observed between the reduction in thermogenesis and the degree of FM depletion at plateau. The adaptive reduction in thermogenesis at plateau was substantial and represented 30.9% of the compensation in energy balance that led to resistance to further lose body weight. In conclusion, these results show that adaptive reduction in thermogenesis may contribute to the occurrence of resistance to lose fat in obese men subjected to a weight-reducing programme.

Am J Clin Nutr. 2008 Oct;88(4):906-12.
Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight.
Rosenbaum M, Hirsch J, Gallagher DA, Leibel RL.
BACKGROUND:
After weight loss, total energy expenditure — in particular, energy expenditure at low levels of physical activity — is lower than predicted by actual changes in body weight and composition. An important clinical issue is whether this reduction, which predisposes to weight regain, persists over time.
OBJECTIVE:
We aimed to determine whether this disproportionate reduction in energy expenditure persists in persons who have maintained a body-weight reduction of > or =10% for >1 y.
DESIGN:
Seven trios of sex- and weight-matched subjects were studied in an in-patient setting while receiving a weight-maintaining liquid formula diet of identical composition. Each trio consisted of a subject at usual weight (Wt(initial)), a subject maintaining a weight reduction of > or =10% after recent (5-8 wk) completion of weight loss (Wt(loss-recent)), and a subject who had maintained a documented reduction in body weight of >10% for >1 y (Wt(loss-sustained)). Twenty-four-hour total energy expenditure (TEE) was assessed by precise titration of fed calories of a liquid formula diet necessary to maintain body weight. Resting energy expenditure (REE) and the thermic effect of feeding (TEF) were measured by indirect calorimetry. Nonresting energy expenditure (NREE) was calculated as NREE = TEE – (REE +TEF).
RESULTS:
TEE, NREE, and (to a lesser extent) REE were significantly lower in the Wt(loss-sustained) and Wt(loss-recent) groups than in the Wt(initial) group. Differences from the Wt(initial) group in energy expenditure were qualitatively and quantitatively similar after recent and sustained weight loss.
CONCLUSION:
Declines in energy expenditure favoring the regain of lost weight persist well beyond the period of dynamic weight loss.

Br J Nutr. 2001 Jun;85(6):715-23.
Evidence for the existence of adaptive thermogenesis during weight loss.
Doucet E, St-Pierre S, Alméras N, Després JP, Bouchard C, Tremblay A.
The present study was performed to further investigate the adaptive component of thermogenesis that appears during prolonged energy restriction. Fifteen obese men and twenty obese women underwent a 15-week weight-loss programme. During this programme, body weight and composition as well as resting energy expenditure (REE) were measured at baseline, after 2 and 8 weeks of energy restriction (-2929 kJ/d) and drug therapy (or placebo), and finally 2-4 weeks after the end of the 15-week drug therapy and energy restriction intervention, when subjects were weight stable. Regression equations were established in a control population of the same age. These equations were then used to predict REE in obese men and women at baseline, after 2 and 8 weeks, as well as after the completion of the programme. In both men and women body weight and fat mass were significantly reduced in all cases) while fat-free mass remained unchanged throughout the programme. At baseline, REE predicted from the regression equation was not significantly different from the measured REE in men, while in women the measured REE was 13 % greater than predicted. After 2 weeks of energy restriction, measured REE had fallen by 469 and 635 kJ/d more than predicted and this difference reached 963 and 614 kJ/d by week 8 of treatment in men and women respectively. Once body-weight stability was recovered at the end of the programme, changes in REE remained below predicted changes in men (-622 kJ/d). However, in women changes in predicted and measured REE were no longer different at this time, even if the women were maintaining a reduced body weight. In summary, the present results confirm the existence of adaptive thermogenesis and give objective measurements of this component during weight loss in obese men and women, while they also emphasize that in women this component seems to be essentially explained by the energy restriction.

Metabolism. 2009 Jun;58(6):871-6. doi: 10.1016/j.metabol.2009.02.017.
Is obesity associated with lower body temperatures? Core temperature: a forgotten variable in energy balance. (full paper)
Landsberg L, Young JB, Leonard WR, Linsenmeier RA, Turek FW.
The global increase in obesity, along with the associated adverse health consequences, has heightened interest in the fundamental causes of excessive weight gain. Attributing obesity to “gluttony and sloth”, blaming the obese for overeating and limiting physical activity, oversimplifies a complex problem, since substantial differences in metabolic efficiency between lean and obese have been decisively demonstrated. The underlying physiological basis for these differences have remained poorly understood. The energetic requirements of homeothermy, the maintenance of a constant core temperature in the face of widely divergent external temperatures, accounts for a major portion of daily energy expenditure. Changes in body temperature are associated with significant changes in metabolic rate. These facts raise the interesting possibility that differences in core temperature may play a role in the pathophysiology of obesity. This review explores the hypothesis that lower body temperatures contribute to the enhanced metabolic efficiency of the obese state.

Some quotables:

Resting (or “basal”) metabolic rate (RMR) accounts for
approximately 80%of energy output. About two thirds of RMR is for maintenance of homeothermy (warm-bloodedness); about one third is to maintain cellular integrity, ionic gradients, protein turnover, and the like [6-8] Resting metabolic rate is largely
regulated by thyroid hormones, with a minor contribution from the sympathetic nervous system.
Resting metabolic rate differs by as much as 600 kcal/d for a 70-kg man [8]. Physical activity (exercise) accounts for about 10% in truly sedentary humans; in addition to intentional activity, this category includes nonpurposeful motion such as fidgeting, which may differ among lean and obese individuals [9], as well as upright posture [10]. The remaining 10% is frequently referred to as thermogenesis, which means heat production unrelated to physical activity.

It should be emphasized that, for nonsedentary individuals, the activity component may be much greater than 10% of total energy expenditure. Evidence has been developed indicating that the combination of activity plus adaptive thermogenesis accounts for about 44% of total energy expenditure on average, meaning that RMR would constitute about 56% of total energy expenditure in normally active humans [15], as compared with 80% in the truly sedentary.

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Supplement Schedule Chart

Also see:
Temperature and Pulse Basics & Monthly Log
Collection of FPS Charts

Use this supplement schedule chart as a means to track your supplementation through a given week. Fill in the supplement name in the left column and the days you take the supplement along with dose and time of dose under the corresponding day of the week.

FPS Supplement Schedule

Posted in General.


Breathing, CO2, Performance, and Health

Also see:
The Nose Knows: A Case for Nasal Breathing During High Intensity Exercise
Adverse Effects of Mouth Breathing
Carbon Dioxide Basics
Carbon Dioxide as an Antioxidant
Bohr Effect and Cells O2 Levels: Healthy vs. Sick People
Comparison: Oxidative Metabolism v. Glycolytic Metabolic
Promoters of Efficient v. Inefficient Metabolism
Altitude Sickness: Therapeutic Effects of Acetazolamide and Carbon Dioxide
Low CO2 in Hypothyroidism
Protective Altitude
Lactate Paradox: High Altitude and Exercise
Protective Carbon Dioxide, Exercise, and Performance
Synergistic Effect of Creatine and Baking Soda on Performance
Ray Peat, PhD on Carbon Dioxide, Longevity, and Regeneration
Altitude Improves T3 Levels
Mitochondria & Mortality
Altitude and Mortality
Lactate vs. CO2 in wounds, sickness, and aging; the other approach to cancer
Carbonic Anhydrase Inhibitors as Cancer Therapy

OxyAthlete






















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Barbara Seaman Interview: Birth Control, Menopause, Estrogen Industry

Also see:
Barbara Seaman Raised Alarms, Answered Every Call
The Pill and I: 40 Years On, the Relationship Remains Wary
The Rise and Fall of Estrogen Therapy: The History of HRT
Hormonal profiles in women with breast cancer
PUFA Increases Estrogen
PUFA Inhibit Glucuronidation
PUFA Promote Cancer
Maternal PUFA Intake Increases Breast Cancer Risk in Female Offspring
Estrogen and Bowel Transit Time
Study: Acquired Breast Cancer Risk Spans Multiple Generations
A Physiological Approach to Ovarian Cancer
Toxic Plant Estrogens
Alcohol Consumption – Estrogen and Progesterone In Women
Estrogen, Endotoxin, and Alcohol-Induced Liver Injury
Soy and Behavior
Estrogen Levels Increase with Age
Fat Tissue and Aging – Increased Estrogen
Estrogen Related to Loss of Fat Free Mass with Aging
PUFA Increases Estrogen
PUFA Inhibit Glucuronidation
PUFA Promote Cancer
Autoimmune Disease and Estrogen Connection
The Dire Effects of Estrogen Pollution
Women, Estrogen, and Circulating DHA
Estrogen, Glutamate, & Free Fatty Acids
Oral Contraceptives and Heart Attack
Oral Contraceptives, Estrogen, and Clotting
High Estrogen and Heart Disease in Men

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