intermittent fasting

Body temperature and health

Most people are so confused as to what constitutes good health these days and when they turn up to my office in low metabolic states with digestion, sleep, energy, mood and other issues. One of the first things that they say is that they eat really healthily. If you throw into the melting pot the obsession with the keto diet, chronic calorific restriction (CR) or other modalities, those short term gains have turned into long term deficits. I’ve long opined that health in general terms can be defined by:

 

·      Good energy

·      Good Digestion 2-3 bowel movements per day

·      Restorative sleep

·      Balanced mood free of depression or anxiety

·      Desire for life, motivation, hobbies and interests

·      Healthy libido

·      Absence of pain

Humans are endotherms that regulate their temperature at 37 degrees centigrade.jpg

What does your body temperature suggest about your health?

Get cold…read on

I’ll also add to that list a warm body and the ability to generate efficient energy,  a phrase biologists might use is a state of negative entropy. Entropy is a state associated with decay and disorder and as entropy increases, equilibrium is achieved - where a state of no energy in and no energy out or death of a living system occurs. The basis for life and metabolism is governed by the enzymes. Enzymes function well in an appropriate temperature and in a medium that is neither too acidic nor too alkaline. Mammals and specifically humans are endotherms that regulate their temperature in  tight range at approximately 37 degrees Centigrade (C) or 98.6 Fahrenheit (Bicego, Barros, & Branco, 2007). The central compartment theory of temperature  suggests that the head and the core should maintain a relatively stable temperature, due to the rich vascular supply and that the periphery may vary some 2-4 C.  

In a recent study that I conducted I suggested that the peripheral and core temperatures should remain at a similar level of about 37 C . The suggestion that a decreased body temperature recorded in the head, might be the last place that you would see a reduction due to the large quantities of glucose that the brain uses to maintain function. It’s possible to suggest that the slowing of function in low energy and hypothyroid states might be observed initially in the trunk or core. The well documented symptoms of constipation, decreased heart rate, slowed contraction relaxation of the heart and arteries and reduced peripheral relaxation of tendons (Achilles tendon reflex) might appear in the trunk and peripherally due to the preferential oxidation of glucose initially. Due to the vast systemic implications of low thyroid function, many different paths of decreased function might occur, dependant on nutrition, environmental stimulus and other stressors. In my study I didn’t find this but what I did find is strong linear correlations between low body temperature in both the mouth and armpit, multiple low thyroid symptoms (mean 6.8 per subject) and yet normal blood values.

Humans are endotherms that regulate their temperature at 37 degrees centigrade-2.jpg

Thyroid hormone affects all aspects of biology

 

There are many factors that can decrease body temperature such as CR, fasting, estrogen, stress, pollution, over exercise and more. CR has been suggested as a mechanism for maintaining longevity but studies lack any conclusive evidence (Carrillo & Flouris, 2011) and a theory that a cold body, decreases metabolism, oxidation and damage therefore preserving tissues. Another emergent theory and results show in rodent studies, that mammals with a high energy intake, high metabolism and organised biology can increase life span (John R. Speakman et al., 2004) (J. R. Speakman, 2005). Think about this for a minute:

Calorific restriction makes the body cold, decreases metabolic rate  (via inhibition of thyroid hormone) and disorganisation of tissues. Entropy State

Adequate energy, maintains body temperature and organises tissues to function at their best. Negative entropy state.

From an evolutionary perspective fasting due to lack of food was a necessity. Fasting these days could be a useful tool, if you were prone to constant overeating but if your system lacks the flexibility to do so problems can occur. That’s not to say that calorie restriction for weight loss isn’t helpful but sustained CR in a system that doesn’t respond well might be counterproductive. Pollution has increased at a phenomenal rate clearly affecting physiology and hormones (Gore et al., 2015). Does it make sense that a so called detox diet, low in calories, protein, carbohydrates can enhance the function of detoxification, when liver function is energy and thyroid dependant? Skipping breakfast alone in some is associated with increased cortisol, glucagon and metabolic inflexibility (Jakubowicz, Wainstein, Ahren, et al., 2015) (Jakubowicz, Wainstein, Ahrén, et al., 2015). These factors can also decrease the mitochondrial uncoupling proteins which are responsible for increased body temperature.

Ageing is also associated with decreased metabolic rate, colder bodies and accepted increases in thyroid hormone stimulating values (TSH) (Laurberg, Andersen, Pedersen, & Carlé, 2005) . If symptoms of failing biology are present with isolated thyroid symptoms such as increased cholesterol,  , high blood pressure and sugar, cardiovascular issues and even cancer the acceptance of TSH and other thyroid hormone analysis to accurately predict hypothyroidism should be considered. Body temperature and metabolic rate was reliably used in the last century to diagnose hypothyroidism with qualitative analysis of symptoms and symptoms resolved with thyroid hormone treatment (Barnes, 1942) (McGavack, Lange, & Schwimmer, 1945) (Peat, 1999). Whilst thyroid is useful for restoring function, food and other factors can be used to restore and maintain function (previous blog on maintaining the aerobic system)

Certain nuances exist in temperature regulation that are dependant on acute or chronic exposure to stressors and a slowing down of the system through  a functionally, subclinical or overt hypothyroid state. In short term fasting, TSH is initially raised then decreases, negating thyroid blood tests. In the same manner the time frame of any stressor can dictate whether short or long term compensations of  the sympathetic adrenergic system is supporting the system. In well established feedback mechanism it’s known that as TSH increases so does cortisol and as body temperature approaches hypothermic levels (around 35C) cortisol, adrenaline and noradrenaline can increase body temperature as a protective response.

In a world where excess environmental and social stressors are ever increasing - it might make sense to maintain an efficient, organised warm body rather than reducing its function and heat.

 

References:

 

Barnes, B. (1942). Basal temperature versus basal metabolism. Journal of the American Medical Association, 119(14), 1072–1074. http://doi.org/10.1001/jama.1942.02830310006003

Bicego, K. C., Barros, R. C. H., & Branco, L. G. S. (2007). Physiology of temperature regulation: Comparative aspects. Comparative Biochemistry and Physiology - A Molecular and Integrative Physiology. http://doi.org/10.1016/j.cbpa.2006.06.032

Carrillo, A. E., & Flouris, A. D. (2011). Caloric restriction and longevity: Effects of reduced body temperature. Ageing Research Reviews. http://doi.org/10.1016/j.arr.2010.10.001

Gore, A. C., Chappell, V. A., Fenton, S. E., Flaws, J. A., Nadal, A., Prins, G. S., … Zoeller, R. T. (2015). Executive Summary to EDC-2: The Endocrine Society’s second Scientific Statement on endocrine-disrupting chemicals. Endocrine Reviews. http://doi.org/10.1210/er.2015-1093

Jakubowicz, D., Wainstein, J., Ahrén, B., Bar-Dayan, Y., Landau, Z., Rabinovitz, H. R., & Froy, O. (2015). High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial. Diabetologia, 58(5), 912–919. http://doi.org/10.1007/s00125-015-3524-9

Jakubowicz, D., Wainstein, J., Ahren, B., Landau, Z., Bar-Dayan, Y., & Froy, O. (2015). Fasting until noon triggers increased postprandial hyperglycemia and impaired insulin response after lunch and dinner in individuals with type 2 Diabetes: A randomized clinical trial. Diabetes Care, 38(10), 1820–1826. http://doi.org/10.2337/dc15-0761

Laurberg, P., Andersen, S., Pedersen, I. B., & Carlé, A. (2005). Hypothyroidism in the elderly: Pathophysiology, diagnosis and treatment. Drugs and Aging. http://doi.org/10.2165/00002512-200522010-00002

McGavack, T. H., Lange, K., & Schwimmer, D. (1945). Management of the myxedematous patient with symptoms of cardiovascular disease. American Heart Journal. http://doi.org/10.1016/0002-8703(45)90476-5

Peat, R. (1999). Thyroid Therapies, Confusion and Fraud. Retrieved from www.raypeat.com/articles/articles/thyroid.shtml

Speakman, J. R. (2005). Body size, energy metabolism and lifespan. Journal of Experimental Biology. http://doi.org/10.1242/jeb.01556

Speakman, J. R., Talbot, D. A., Selman, C., Snart, S., McLaren, J. S., Redman, P., … Brand, M. D. (2004). Uncoupled and surviving: Individual mice with high metabolism have greater mitochondrial uncoupling and live longer. Aging Cell. http://doi.org/10.1111/j.1474-9728.2004.00097.x

 

Is your functional training making you dysfunctional?

Buzz words of the last decade in the health and fitness industry were terms such as functional, core, ground reaction, Paleo, intermittent fasting etc etc. It is an easy approach for people to throw around these types of phrases, impressing clients without having a true understanding of what they really mean. Like many it took me some time to realise that to get people strong you need a combination of good therapy, improved movement patterns and ultimately lifting well.  The emphasis on functional training has contributed to increased facilitation patterns which contribute to musculo-skeletal issues, much in the same way that the circuit training phase of the 90’s did. Now there are increased loads and patterns of dysfunction by methodologies such as Boot Camps, Cross Fit, TRX classes, Endurance events and the like and more than ever, I (and my peers) am seeing the incidence of overuse injuries created by inhibition and facilitation from poorly constructed exercise programming.

Let’s take this guy below. His exercise using the TRX must be functional , it must be making him strong right? Well no and here’s why? This gym dude like millions of others makes the mistake of utilising balance with strength as an exercise. The net effect of this type of exercise is facilitation when there is instability without the ability to stabilise.

trxjpg

You can clearly note here a rounding of the upper back   and cranial extension caused by inability to stabilise using the cervical flexors, mid and lower trapezius.

Facilitated                                                                          Inhibited

Upper traps/Scalenes                                                     Cervical flexors

Levator Scapula                                                              Middle and lower trapezius

Pec minor and probably major in this case                    Latissimus dorsi

Sternocleidomastoid                                                      Subscapularis and other structures

The cervical extensors, upper traps and pec minor amongst other structures have the ability to disrupt breathing patterns, gait and decrease strength in patterns such as the squat and dead lift. Those who teach these type of exercises should be skilled in spotting movement dysfunction, inhibition and facilitation and understand strategies of how to correct these issues or at least understand that if you keep exercising in this way you will lead to breakdown of key stabilising structures.

Is it a ‘core’ problem?

The core is really the interaction of all the muscles in the body but specific attention has been paid areas such as the ‘inner unit’ which comprises of the Tranversus Abdominus (TrA), multifidus, diaphragm and pelvic floor and the outer unit which comprises of the abdominals and internal and external obliques which interlink with many larger muscles.  In reality these muscles work in tandem with other muscles to create structural balance.  Many people think that to train their core they have to blitz their abdominals, obliques and back muscles with intensity which creates dysfunction.

This is where common misconceptions occur. The core more often than not, needs to be recruited appropriately and that should occur with proper movement development and determining what other structures beyond the core (such as previous injuries) are prevalent. Many of these problems can occur as a result of many factors. Children who don’t develop crawling patterns, who are either rushed into walking or put into baby crawlers can be at risk in later life of poor breathing patterns and core dysfunction. The seated position is not great for the spine and muscles can develop inhibition as other muscles get overworked and the nervous system will always take the least path of resistance when it comes to movement and muscle activation. Additionally the seated position also helps to create inverted breathing patterns, which disrupts the stabilising capacity of core muscles.

Many people make the mistake of activating the TrA in all the time (or drawing the belly in), even when walking. This is a disaster as it creates facilitation of the accessory muscles of breathing, creating a forward head posture, rounded back and weak links in the chain from head to the toe. In fact in some schools of thought letting your belly out and pushing outwards  also increases abdominal pressure and stabilising mechanisms that are just as good if not better for ‘core’ recruitment. Sometimes we are so fixated about our weight that we constantly walk around with our belly drawn in…let it hang out I say.

References:

  1. DNS technique according to Kolar. Training Manual Rehabilitation School of Prague
  2. Hodges, P. W. Is there a role for Transversus Abdominis in Lumbo-Pelvic  Stability? Manual Therapy (1999) 4(2), 74±86
  3. Kolá, P. Importance of Developmental Kinesiology for Manual Medicine.1996
  4. Weinstock, D. Neuro Kinetic Therapy. North Atlantic Books 2010