The Body Fat Setpoint, Part IV: Changing the Setpoint

Prevention is Easier than Cure

Experiments in animals have confirmed what common sense suggests: it's easier to prevent health problems than to reverse them. Still, many health conditions can be improved, and in some cases reversed, through lifestyle interventions. It's important to have realistic expectations and to be kind to oneself. Cultivating a drill sergeant mentality will not improve quality of life, and isn't likely to be sustainable.

Fat Loss: a New Approach

If there's one thing that's consistent in the medical literature, it's that telling people to eat fewer calories does not help them lose weight in the long term. Gary Taubes has written about this at length in his book Good Calories, Bad Calories, and in his upcoming book on body fat. Many people who use this strategy see transient fat loss, followed by fat regain and a feeling of defeat. There's a simple reason for it: the body doesn't want to lose weight. It's extremely difficult to fight the fat mass setpoint, and the body will use every tool it has to maintain its preferred level of fat: hunger, reduced body temperature, higher muscle efficiency (i.e., less energy is expended for the same movement), lethargy, lowered immune function, et cetera.

Therefore, what we need for sustainable fat loss is not starvation; we need a treatment that lowers the fat mass setpoint. There are several criteria that this treatment will have to meet to qualify:

1. It must cause fat loss
2. It must not involve deliberate calorie restriction
3. It must maintain fat loss over a long period of time
4. It must not be harmful to overall health
   

I also prefer strategies that make sense from the perspective of human evolution.

Strategies: Diet Pattern

The most obvious treatment that fits all of my criteria is low-carbohydrate dieting. Overweight people eating low-carbohydrate diets generally lose fat and spontaneously reduce their calorie intake. In fact, in several diet studies, investigators compared an all-you-can-eat low-carbohydrate diet with a calorie-restricted low-fat diet. The low-carbohydrate dieters generally reduced their calorie intake and body fat to a similar or greater degree than the low-fat dieters, despite the fact that they ate all the calories they wanted (1). This suggest that their fat mass setpoint had changed. At this point, I think moderate carbohydrate restriction may be preferable to strict carbohydrate restriction for some people, due to the increasing number of reports I've read of people doing poorly in the long run on extremely low-carbohydrate diets (2).

Another strategy that appears effective is the "paleolithic" diet. In Dr. Staffan Lindeberg's 2007 diet study, overweight volunteers with heart disease lost fat and reduced their calorie intake to a remarkable degree while eating a diet consistent with our hunter-gatherer heritage (3). This result is consistent with another diet trial of the paleolithic diet in diabetics (4). In post hoc analysis, Dr. Lindeberg's group showed that the reduction in weight was apparently independent of changes in carbohydrate intake*. This suggests that the paleolithic diet has health benefits that are independent of carbohydrate intake.

Strategies: Gastrointestinal Health

Since the gastrointestinal (GI) tract is so intimately involved in body fat metabolism and overall health (see the former post), the next strategy is to improve GI health. There are a number of ways to do this, but they all center around four things:

1. Don't eat food that encourages the growth of harmful bacteria
2. Eat food that encourages the growth of good bacteria
3. Don't eat food that impairs gut barrier function
4. Eat food that promotes gut barrier health

The first one is pretty easy: avoid refined sugar, refined carbohydrate in general, and lactose if you're lactose intolerant. For the second and fourth points, make sure to eat fermentable fiber. In one trial, oligofructose supplements led to sustained fat loss, without any other changes in diet (5). This is consistent with experiments in rodents showing improvements in gut bacteria profile, gut barrier health, glucose tolerance and body fat mass with oligofructose supplementation (6, 7, 8).

Oligofructose is similar to inulin, a fiber that occurs naturally in a wide variety of plants. Good sources are jerusalem artichokes, jicama, artichokes, onions, leeks, burdock and chicory root. Certain non-industrial cultures had a high intake of inulin. There are some caveats to inulin, however: inulin and oligofructose can cause gas, and can also exacerbate gastroesophageal reflux disorder (9). So don't eat a big plate of jerusalem artichokes before that important date.

The colon is packed with symbiotic bacteria, and is the site of most intestinal fermentation. The small intestine contains fewer bacteria, but gut barrier function there is critical as well. The small intestine is where the GI doctor will take a biopsy to look for celiac disease. Celiac disease is a degeneration of the small intestinal lining due to an autoimmune reaction caused by gluten (in wheat, barley and rye). This brings us to one of the most important elements of maintaining gut barrier health: avoiding food sensitivities. Gluten and casein (in dairy protein) are the two most common offenders. Gluten sensitivity is widespread and typically undiagnosed (10).

Eating raw fermented foods such as sauerkraut, kimchi, yogurt and half-sour pickles also helps maintain the integrity of the upper GI tract. I doubt these have any effect on the colon, given the huge number of bacteria already present. Other important factors in gut barrier health are keeping the ratio of omega-6 to omega-3 fats in balance, eating nutrient-dense food, and avoiding the questionable chemical additives in processed food. If triglycerides are important for leptin sensitivity, then avoiding sugar and ensuring a regular source of omega-3 should aid weight loss as well.

Strategies: Micronutrients

As I discussed in the last post, micronutrient deficiency probably plays a role in obesity, both in ways that we understand and ways that we (or I) don't. Eating a diet that has a high nutrient density and ensuring a good vitamin D status will help any sustainable fat loss strategy. The easiest way to do this is to eliminate industrially processed foods such as white flour, sugar and seed oils. These constitute more than 50% of calories for the average Westerner.

After that, you can further increase your diet's nutrient density by learning to properly prepare grains and legumes to maximize their nutritional value and digestibility (11, 12; or by avoiding grains and legumes altogether if you wish), selecting organic and/or pasture-raised foods if possible, and eating seafood including seaweed. One of the problems with extremely low-carbohydrate diets is that they may be low in water-soluble micronutrients, although this isn't necessarily the case.

Strategies: Miscellaneous

In general, exercise isn't necessarily helpful for fat loss. However, there is one type of exercise that clearly is: high-intensity intermittent training (HIIT). It's basically a fancy name for sprints. They can be done on a track, on a stationary bicycle, using weight training circuits, or any other way that allows sufficient intensity. The key is to achieve maximal exertion for several brief periods, separated by rest. This type of exercise is not about burning calories through exertion: it's about increasing hormone sensitivity using an intense, brief stressor (hormesis). Even a ridiculously short period of time spent training HIIT each week can result in significant fat loss, despite no change in diet or calorie intake (13).

Anecdotally, many people have had success using intermittent fasting (IF) for fat loss. There's some evidence in the scientific literature that IF and related approaches may be helpful (14). There are different approaches to IF, but a common and effective method is to do two complete 24-hour fasts per week. It's important to note that IF isn't about restricting calories, it's about resetting the fat mass setpoint. After a fast, allow yourself to eat quality food until you're no longer hungry.

Insufficient sleep has been strongly and repeatedly linked to obesity. Whether it's a cause or consequence of obesity I can't say for sure, but in any case it's important for health to sleep until you feel rested. If your sleep quality is poor due to psychological stress, meditating before bedtime may help. I find that meditation has a remarkable effect on my sleep quality. Due to the poor development of oral and nasal structures in industrial nations, many people do not breathe effectively and may suffer from conditions such as sleep apnea that reduce sleep quality. Overweight also contributes to these problems.

I'm sure there are other useful strategies, but that's all I have for now. If you have something to add, please put it in the comments.


* Since reducing carbohydrate intake wasn't part of the intervention, this result is observational.

Pregnancy Naturally

A rush of emotions. A little stick. Will it be pink! Or blue? Who should you tell first? What do you do now?

Pregnancy can be a wonderful experience that is full of excitement and love and anxiety and tension. There are a lot of decisions to be made and you must face the realization (whether it's your first or your 12th) that life will never be the same.

Once you have the details of the actual delivery, the who (midwife or doctor), what (your baby), where (home birth, birthing clinic or hospital) and when (determining your due date) down, you can get on with making sure that baby has the best possible beginning even before you give birth.

Nutrition will be one of the keys to help you to keep your growing baby healthy and safe while still in your womb. And an extra bonus will be helping you to keep up your energy and minimizing the unpleasant effects of carrying your little one inside of you.

If you have a craving, indulge it. If you can't eat something, don't worry about it. The body has different needs during this time and those needs show themselves in various ways. It's a temporary situation and nothing to be concerned about.

Prenatal Vitamins – While many multiple vitamins have the necessary quantities of vitamins and minerals for an average adult, prenatal vitamins have the increased quantities of those vitamins most important during this precious time. In addition, some prenatal vitamins have added the herb Ginger to help with morning sickness.

Calcium and Magnesium – These minerals are important during pregnancy for a number of reasons. If you don't have enough calcium to provide to your baby as he begins to form bones and teeth, your body will naturally compensate by pulling these critical minerals from your own teeth and hair. This is why many women get more cavities and have brittle, dull hair during pregnancy. In addition, adequate levels of calcium may prevent preeclampsia during late pregnancy. Of course, there is the added benefit of avoiding excess leg or muscle cramps, common in pregnant women.

Red Raspberry – This herb is commonly known as the woman's herb and can be taken throughout pregnancy. It has been used traditionally to strengthen the uterus and help women carry full-term reducing the chances of premature birth.

5-W – This is an herbal combination by Nature's Sunshine Products. Many mothers and midwife's insist they would not deliver without it. 5-W (five weeks) should be taken during the last five weeks before the scheduled due date. This product will help to tone the uterus and shorten the duration of labor.

Common ailments and natural alternatives

Sometimes our best efforts aren't enough and we end up getting sick or having other problems that need to be addressed during this delicate time. Because anything that you take will also affect your growing baby, it's best to use safe, natural alternatives whenever possible.

For almost all of the following, the best natural prevention is water. Pregnant women need far more of it than the average adult. Be sure you have water with you every where you go and drink it by the gallon.

Allergies and sinus congestion – Fenugreek may assist by acting as a mild laxative (opening the bowels to flush the irritants and mucus) and by reducing mucus secretions. A side benefit of fenugreek is that it promotes lactation in nursing women.

Back pain – See a good chiropractor and use rice pillows to ease the pain.

Bladder Infections – Use cranberry supplements daily as a preventative if you are prone to bladder infections. Should you contract a bladder infection during pregnancy, you could increase your dosage of cranberry and add colloidal silver, a natural antibiotic. Be sure to do this at the very first sign of the infection as bladder infections that reach the kidneys may increase the risk of preterm labor.

Colds – Echinacea is a safe alternative that can be used during pregnancy. Sip on Echinacea tea or take a few capsules several times a day. Another herb that may be effective is Olive Leaf. Of course, don't forget to increase your vitamin C.

Constipation and hemorrhoids – This sometimes occurs due to the extra iron in prenatal vitamins. While it is generally not safe to take a laxative during pregnancy, there are some things you can do. Increase magnesium. Magnesium is a natural muscle relaxant and will help to relax the sphincter muscle that allows for proper elimination. Increase fiber. Often, due to cravings or specific food aversions during pregnancy, women don't get enough fiber. Supplement if needed. Exercise may also help.

Insomnia – Valerian root acts as a natural sedative and may be just enough to help induce sleep.

Nausea – Ginger or peppermint tea can be very helpful here. Also try aloe vera juice.

This is a time of joy but it may take a little extra strength and willpower to stick to your desire to stay natural. Just remember, the less toxins you put into your body, the healthier your baby will be.

How to prevent bleeding during pregnancy?

After the bleeding on my 13th week gestation, I had 3 times light spotting of bleeding. This Tuesday it happened again! The bleeding is always painless, sometimes bright red. And to me, it always happened during the early morning.

What causes placenta previa? Is there any treament besides just wait and see? How to prevent the bleeding? With all these questions in mind, I went to online today to search for information.

According to the information online, The exact cause of placenta previa is unknown. It may be caused by multiple pregnancy, an abnormally shaped uterus, older age of the mother, a previous cesarean birth or induced abortion. Bed rest, avoiding intercourse, limit traveling and avoiding pelvic exams are the treatment suggested by online resources. Overall, it seems there is not too much I can do besides being careful with myself and taking more rest.

However, to my surprise, there are a lot of worried mothers-to-be seeking for concrete advice on how to prevent or limit bleeding related to placenta previa.

Recalling the last 2 months, I summarized the following tips from my personal experience:

1. Be careful with contipation. The push of the bowel musles can easily cause the bleeding. Eat more vegetables, fruits and drink more water to prevent contipation.

2. No heavy lifting. Don't lift staff heavier than 5 pounds. Seek for others' help when you need to move something.

3. Bend at the knees to pick up something. Don't lift abruptly. Bend at the knees slowly and stand up slowly too.

4. Lie down/get up slowly. Don't jump onto/out of the bed. A good way is before going to bed, go to the edge of the bed, lie down slowly with your side and then turn onto your back. Similarly, when you want to get out of the bed, turn to your side and get up slowly.

5. Don't wear high-heeled shoes. Wear soft and flat bottom shoes.

6. Always hold on something when you climb stairs, especially downwards.

7. Be careful with doing exercise. Avoid those fast-paced exercises.

8. The last but not the least is, being relaxed and happy. You don't need to always keep it in mind!

The Whole Nine Months: Low Carb Diets and Pregnancy

It's very important to watch what you eat. You are eating for two—which doesn't mean that you eat more (so say goodbye to that second slice of cake), but that you eat smart. You are your baby's only source of nutrients, and you need the proper balance of proteins, vitamins, minerals, fiber and carbohydrates.

That being said, most prenatal dieticians strongly advise against adhering to a strict no-carb diet. Without sufficient carbs, your body will produce a by-product called ketones during your blood stream, which can put your baby at risk for brain damage.

But what about low carb diets? Aside from the risk of mental retardation, there are some aspects of low carb diets that can worsen the discomforts of pregnancy. For example, low carb diets tend to have low levels of dietary fiber, which exacerbate the constipation that many pregnant moms suffer because of the required iron supplements. Also, most prenatal dieticians recommend taking a lot of fruit because of its rich vitamin content, but most of the items you'll find in a typical shake are banned by Atkins and South Beach because of the sugars.

But some doctors may recommend taking modified low-carb diets, especially if you are obese, suffer from gestational diabetes or low blood sugar. All three conditions have been proven to have adverse affects on the baby (including prematurity, birth defects, and early rupture of the membranes) so losing weight or controlling intake may actually be the best thing for your baby.

If you are asked to go on a low-carb diet during pregnancy, you will probably be told to go on the maintenance phase of the Atkins Diet, or the second phase of the South Beach Diet. Here, you are allowed a controlled number of carbohydrates, usually from whole grains and fruits, while minimizing white bread, white rice, and pasta. That is fine, as you are still giving your baby the adequate nutrients, while removing processed foods.

If you are not allowed to go low-carb, but still need to control your weight, there are some options open to you. First of all, eat small but frequent meals. If you want a snack, instead of taking junk food or processed meats (which have a lot of calories, but significantly less nutrients), take salads, fruits, nuts and crackers. Choose lean cuts of meat, and minimize salt and rich sauces during cooking. And while you do need carbohydrates, take in moderation. One plate of pasta is good, three servings of it smothered in white sauce is not.

But the most important thing to remember is that before you go on any diet during pregnancy consult your obstetrician-gynaecologist. She or he can properly determine the best course of action given your particular medical history and the condition of your baby. Do not go on any weight management program without the advice and the approval of your doctor. Whether it's low carb or Zone or the Mediterranean Diet, the point is that there is a proven link between prenatal nutrition and the baby's health. Complications can include low birth weight, birth defects, and early delivery.

The California HIPAA Dance

For those who have been following the near-hourly updates on my HIPAA insurance page, the one word I would use to describe the recent activity is--CHAOS.Anthem Blue Cross initiated what has essentially become a "you-know-what contest" between the two Blues concerning their respective HIPAA portfolios.The chronology is as follows:Fall, 2009 - Anthem retires the Share PPO portfolio (retired plans

The New Kid on the Block: 30 Years and Growing

When couples attend Pink Kit classes, they often ask, "Why should we be preparing for birth? We've made our birth plan and chosen our care provider." What is important is that the women is driving the car, not just taking a journey by car, which can imply she is the passenger. What we're trying to get people to understand is that developing birthing skills is a necessity just like learning to drive a car. These couples include people planning homebirths with independent midwives and people planning hospital births with continuity of care team midwives or a GP or obstetrical specialist. Common Knowledge Trust (CKT) has discovered that analogies may help answer this question.

The Journey First, we tell them labour is like taking an unknown journey by car. Even if you've taken this road before, each journey is different and unknown. It can be very strenuous and demanding. It might be long. You might get tired. Someone or a few people might accompany you. Throughout this journey, others might try to help you out in order to safeguard you and make certain you reach the end safely. Some professionals might suggest that you skip the journey. Circumstances might actually require you to do that. Other professionals will encourage you to take the journey because it might become a highlight of your life.

Then we ask, what is the difference between that scenario and labour? After many responses, we tell them the real difference is that you have already learned to drive a car. If you had to take such a journey and didn't know how to drive, would you be willing to spend eight to 12 weeks learning beforehand? Where is the birth professional in this analogy? Some are encouraging you to make the journey and others might think it's too dangerous, or you might think you don't need to do it, fly instead. The birth professional is usually the low or high tech mechanic.

Next, the couples talk about their relationships to the professional care provider. Their midwives are encouraging them to choose a birth plan. They have decided where to birth, and the doctors are often telling them what they need. So we present analogies to other common professional relationships. We are all passive when we go to the dentist, yet most of us take care of our teeth every day. If we took this approach to birth, we would prepare beforehand, but in the presence of the professional we would be passive. Not ideal.

Giving birth is more like learning to sing, dance, paint, throw pots or play an instrument. We probably seek a professional teacher. Yet we have to do the work to learn, as well as show the teacher our progress. If we took this approach to birth, then the birth professionals would be our musical instrument instructors, yet even midwives don't often take that role. The Pink Kit is the driving lessons, so this analogy still doesn't give us a clear understanding of what other similar professional relationship is like labour and being cared for.

By the time the class works through all the analogies, the couples begin to understand: only the woman is going to labour. The father, partner, friend or relative is there to help her on the journey, which will occur around and through whatever professional care they receive.

The Kit Since The Pink Kit information developed in the U.S. in the late 1970s and 1980s, thousands of couples have used the preparation and then laboured in hospital. Having done the preparation ahead of time, the couples work together with directed breathing; they use positions that keep the woman open. There is been a great deal of 'best positions' that have been theoretical and not worked for women, because they didn't know enough about their bony structure or how the muscles reacted to positions. They do hip lifts and sit-bone spreads and carry out sacral rocking so their sacrum is mobile. This developed instead of the counter pressure on the sacrum that closes the space the baby needs, although it relieves the back pain. Learning to keep the sacrum mobile, gives the baby room and the woman relieved regardless of assessments, monitoring or other procedures going on around them. They just go on working through the process of labour. Staff and doctors often comment on what a "good labour" they had. "Weren't they lucky? One woman responded: "I wanted to grab that person by the neck and shout, 'You don't know how hard We worked for that good birth!'"

The Skills When we ask couples what their mothers and fathers taught them about managing labour, most say: "Nothing," "Not much," or "It hurts, you'll get through it." If they haven't been taught by their mothers and fathers how to manage labour, where are they getting the information, and how useful is it?

Whenever people need to accomplish a new task, it's vitally important that they learn appropriate skills and then apply them. Because so few people have been at births, they have no idea what appropriate skills are. If a woman perceives her contractions as manageable, she will use her breath sustainably, create self-relaxation responses, get into" labour and accept the process. If she perceives them as painful or very, very painful, she will respond with ragged breathing, tensing her body and using other struggling behaviours. What CKT is teaching expectant couples (lessons they will eventually teach their own children) are the sustainable behaviours they can put into place regardless of the woman's perception, particularly when she does feel her labour to be "painful

The fact is that these are the universal skills that any woman can use, not just another 'theory' or 'technique'. People are continually saying that what they learned in 'childbirth education' classes went out the window, which means, to date, those skills aren't universal enough or not useable. Why would a woman want to respond to labour with frantic behaviour? It's the lack of appropriately learned skills.

As women learn these appropriate skills and apply them to the task, there is more consistency in how women respond to the process of labour and how their partners can help them stay on a sustainable behaviour track. Because labours are so similar, we can define, hear, see, experience, practice, model, remind, encourage, remember and know appropriate responses to the experience. A woman who is struggling with labour may hold her breath or scream, groan and moan, whereas a woman who is managing her responses to the sensations will tend to breathe in through her nose and out through either her nose or mouth in a manner that sounds "right." Because most people have no idea what sounds right, we have to show them so they can develop the skills.

We ask fathers or the support people to look at the woman's face and forehead when she is relaxed during labour . Usually when relaxed, a person's forehead is smooth. When a woman wrinkles her forehead in labour, the father understands that her internal sensations are intense, and he can observe whether she is responding to them with tension. He can then help her reduce the tension using "common body language" or "common body touch." If she is breathing more raggedly, he can model directed breathing to remind her to use breath as a focus.

If the partner sees the woman standing on her toes, with shoulders around her ears and bum muscles tight, a father working with The Pink Kit is less likely to tell her to relax, drop her shoulders or come off her toes. Using his skills and knowledge, he'll just tell her to relax inside the pelvic clock and minnie mouse muscles (her bum muscles). She'll know what he is talking about. She would have done that herself, except the sensations were a bit too much at the time. She still might not like the experience, but she'll love how she managed herself. She'll love her partner for knowing specifically what she needed to do rather than giving her a general direction that could elicit: "I'm trying to relax!" "Shut up!" or "You try!"

One woman said after her birth: "Before each contraction, I set up my directed breathing. The contractions were fine. So I thought to myself, 'maybe the breathing has nothing to do with it,' and I just let the next contraction happen. It was off the planet in intensity. What scared me was that it took me four to five more contractions to get it back."

What the statistics (on our website) don't show is how empowered both mothers and fathers feel; that the woman knew she could turn to her partner for the coaching skills; that their partnering and parenting relationships are enriched.

There is no doubt that if we had all been at 100 births, we would see and hear which mannerisms are sustainable and which indicate that a woman is struggling with her perception of the experience. But the skills haven't been passed on generation to generation. Common Knowledge Trust wants that to change. All the couples who use these resources tell us the same thing—they will pass the knowledge on to their sons and daughters. Women will labour, whether at home, in hospital, with a midwife, with a doctor, whether having a natural or a medical birth. Skills work well in all situations.

Knowledge is power. It reduces fears, increases confidence, builds skills and encourages conscious response rather than impulsive reaction to an intense experience. It develops a strong and deeply personal sense of accomplishment for both women and men. Most important, we'll pass it on to our children.

Pregnancy Chat Rooms – Where Experience Meets Apprentice

If you are pregnant for the first time, bless you! You are probably tired, sore for no reason, and questioning the usefulness of your husband. You quite possibly are starving all the time, sick when you eat, and betting that God is indeed male and laughing at your pain. If you are with child and looking for answers to life's little questions about childbearing and life after baby, pregnancy chat rooms are the perfect place to meet other women that are in your shoes and those that hold the answers.

Pregnancy chat rooms are available all over the internet. They are places where women meet to speak candidly about what happens to your body and mind during pregnancy. Some of them may even have men that want to learn more about their wives' condition…but don't bet on it! At this point, men tend to be more intent on running from pregnant women than learning from them, but we can all hope!

Common issues that women are faced with during pregnancy are fatigue, hunger, and morning/all day/every second sickness. Often times, these issues are not things your doctor can really answer, as they are not medical in nature. However, women that have experienced being pregnant often know those tips and tricks to help make it through the day and, God willing, the pregnancy.

To find pregnancy chat rooms, you can check with several of the major chat arenas, such as AOL or Yahoo. However, there are many other private chat rooms available in other sites you may not know about. In fact, many motherhood, pregnancy, and parenting websites have chat sections that you would otherwise never be aware of unless you looked. Many of these pregnancy chat rooms can be very useful also.

As with any other chat room, you want to be careful not to talk to any crazies. The possibility always exists that someone could be out there that is a predator. Refrain from giving personal information out to anyone unless you are really comfortable with them and convinced they are sane…or at least not insane enough to be dangerous. If you only talk to completely sane people in pregnancy chat rooms, it may be a pretty quiet conversation, as pregnancy makes everyone a little crazy.

Once you have an opportunity to talk to other women that are going through the same thing you are, you will begin to feel a little better. Even if they can not tell you how to fix it, just knowing someone else out there has swollen feet, too, provides a little bit of comfort.

Dubrovnik in south of Croatia

Dubrovnik is rich in culture and history. Dubrovnik is located on the extreme south of Croatia , the city enjoyed immense growth in trade and naval power in the Middle Ages. The city of Dubrovnik has since relinquished its position as a Mediterranean power player.Today the city of Dubrovnik is a peaceful and children-friendly haven for tourists and locals. Zagreb , its capital, offers a glimpse

Tips for a Smooth Start to Breast Feeding

Many different sources were used while writing this article; I hope you find it informative and helpful.

There are many ways to plan to be a mother and to breast feed for the first time.

First find out as much as you can, this can involve reading about breastfeeding during your pregnancy, check out our web site there is a mass of information on it, so you will know what to do once your baby is in your arms, attending antenatal lessons and learning `about breast feeding there, or you can even join a support group and enjoy mingling with other mothers who can give you lots of tips and guidance.

During pregnancy, it is very important you take good care of yourself. This ensures when it comes to the time to have your baby, it is as stress free and healthy a birth as it can possibly be.

There are plenty of things you can do to prepare yourself for feeding your baby whilst you are still pregnant; these include ensuring your breasts are prepared for the feeding experience. It's always a good idea to tell your midwife or obstetrician of any breast surgery you may have had as this might influence your abilities to feed your baby. Also check your nipples to see if they have become inverted, this can present difficulties when the time comes for the baby to latch on,

Speak to your friends and family about their breastfeeding experiences, or go to a breastfeeding support group so you can meet and chat to other breastfeeding mothers.

Once your baby has been born, its important that the baby is put to the breast immediately. This is because the suckling instinct in a baby is very strong when they are first born. If you can get your baby to latch on inside those first few minutes of life, it is imprinted on them and subsequent breast-feeding experiences should become a lot easier.

Most maternity hospitals give you the opportunity to let your baby stay in the same room as you overnight. This is a good idea, so make certain you take advantage of it. It will give you that added time to both get to know one another and create the mother and baby bond that is so important.

If your baby does sleep in the nursery it's important that the nursery staff don't feed your baby formula whilst you are sleeping. Insist that when he awakens he is brought to you for feeding from your breast even if it is the middle of the night.

Don't be concerned that you are not producing much milk to start off with, this is normal. The thin liquid that is created just after your baby is born is rich in nutrients and antibodies. It is enough to keep your baby happy until your milk "comes in" a few of days after your baby is born.

I hope you found the above helpful and you have a good experience breastfeeding your baby.

Roger Overanout

The Body Fat Setpoint, Part III: Dietary Causes of Obesity

What Caused the Setpoint to Change?

We have two criteria to narrow our search for the cause of modern fat gain:

1. It has to be new to the human environment
   
2. It has to cause leptin resistance or otherwise disturb the setpoint
   

Although I believe that exercise is part of a healthy lifestyle, it probably can't explain the increase in fat mass in modern nations. I've written about that here and here. There are various other possible explanations, such as industrial pollutants, a lack of sleep and psychological stress, which may play a role. But I feel that diet is likely to be the primary cause. When you're drinking 20 oz Cokes, bisphenol-A contamination is the least of your worries.

In the last post, I described two mechanisms that may contribute to elevating the body fat set point by causing leptin resistance: inflammation in the hypothalamus, and impaired leptin transport into the brain due to elevated triglycerides. After more reading and discussing it with my mentor, I've decided that the triglyceride hypothesis is on shaky ground*. Nevertheless, it is consistent with certain observations:

• Fibrate drugs that lower triglycerides can lower fat mass in rodents and humans
  
• Low-carbohydrate diets are effective for fat loss and lower triglycerides
• Fructose can cause leptin resistance in rodents and it elevates triglycerides (1)
• Fish oil reduces triglycerides. Some but not all studies have shown that fish oil aids fat loss (2)
  

Inflammation in the hypothalamus, with accompanying resistance to leptin signaling, has been reported in a number of animal studies of diet-induced obesity. I feel it's likely to occur in humans as well, although the dietary causes are probably different for humans. The hypothalamus is the primary site where leptin acts to regulate fat mass (3). Importantly, preventing inflammation in the brain prevents leptin resistance and obesity in diet-induced obese mice (3.1). The hypothalamus is likely to be the most important site of action. Research is underway on this.

The Role of Digestive Health

What causes inflammation in the hypothalamus? One of the most interesting hypotheses is that increased intestinal permeability allows inflammatory substances to cross into the circulation from the gut, irritating a number of tissues including the hypothalamus.

Dr. Remy Burcelin and his group have spearheaded this research. They've shown that high-fat diets cause obesity in mice, and that they also increase the level of an inflammatory substance called lipopolysaccharide (LPS) in the blood. LPS is produced by gram-negative bacteria in the gut and is one of the main factors that activates the immune system during an infection. Antibiotics that kill gram-negative bacteria in the gut prevent the negative consequences of high-fat feeding in mice.

Burcelin's group showed that infusing LPS into mice on a low-fat chow diet causes them to become obese and insulin resistant just like high-fat fed mice (4). Furthermore, adding 10% of the soluble fiber oligofructose to the high-fat diet prevented the increase in intestinal permeability and also largely prevented the body fat gain and insulin resistance from high-fat feeding (5). Oligofructose is food for friendly gut bacteria and ends up being converted to butyrate and other short-chain fatty acids in the colon. This results in lower intestinal permeability to toxins such as LPS. This is particularly interesting because oligofructose supplements cause fat loss in humans (6).

A recent study showed that blood LPS levels are correlated with body fat, elevated cholesterol and triglycerides, and insulin resistance in humans (7). However, a separate study didn't come to the same conclusion (8). The discrepancy may be due to the fact that LPS isn't the only inflammatory substance to cross the gut lining-- other substances may also be involved. Anything in the blood that shouldn't be there is potentially inflammatory.

Overall, I think gut dysfunction probably plays a major role in obesity and other modern metabolic problems. Insufficient dietary fiber, micronutrient deficiencies, excessive gut irritating substances such as gluten, abnormal bacterial growth due to refined carbohydrates (particularly sugar), and omega-6:3 imbalance may all contribute to abnormal gut bacteria and increased gut permeability.

The Role of Fatty Acids and Micronutrients

Any time a disease involves inflammation, the first thing that comes to my mind is the balance between omega-6 and omega-3 fats. The modern Western diet is heavily weighted toward omega-6, which are the precursors to some very inflammatory substances (as well as a few that are anti-inflammatory). These substances are essential for health in the correct amounts, but they need to be balanced with omega-3 to prevent excessive and uncontrolled inflammatory responses. Animal models have repeatedly shown that omega-3 deficiency contributes to the fat gain and insulin resistance they develop when fed high-fat diets (9, 10, 11).

As a matter of fact, most of the papers claiming "saturated fat causes this or that in rodents" are actually studying omega-3 deficiency. The "saturated fats" that are typically used in high-fat rodent diets are refined fats from conventionally raised animals, which are very low in omega-3. If you add a bit of omega-3 to these diets, suddenly they don't cause the same metabolic problems, and are generally superior to refined seed oils, even in rodents (12, 13).

I believe that micronutrient deficiency also plays a role. Inadequate vitamin and mineral status can contribute to inflammation and weight gain. Obese people typically show deficiencies in several vitamins and minerals. The problem is that we don't know whether the deficiencies caused the obesity or vice versa. Refined carbohydrates and refined oils are the worst offenders because they're almost completely devoid of micronutrients.

Vitamin D in particular plays an important role in immune responses (including inflammation), and also appears to influence body fat mass. Vitamin D status is associated with body fat and insulin sensitivity in humans (14, 15, 16). More convincingly, genetic differences in the vitamin D receptor gene are also associated with body fat mass (17, 18), and vitamin D intake predicts future fat gain (19).

Exiting the Niche

I believe that we have strayed too far from our species' ecological niche, and our health is suffering. One manifestation of that is body fat gain. Many factors probably contribute, but I believe that diet is the most important. A diet heavy in nutrient-poor refined carbohydrates and industrial omega-6 oils, high in gut irritating substances such as gluten and sugar, and a lack of direct sunlight, have caused us to lose the robust digestion and good micronutrient status that characterized our distant ancestors. I believe that one consequence has been the dysregulation of the system that maintains the fat mass "setpoint". This has resulted in an increase in body fat in 20th century affluent nations, and other cultures eating our industrial food products.

In the next post, I'll discuss my thoughts on how to reset the body fat setpoint.


* The ratio of leptin in the serum to leptin in the brain is diminished in obesity, but given that serum leptin is very high in the obese, the absolute level of leptin in the brain is typically not lower than a lean person. Leptin is transported into the brain by a transport mechanism that saturates when serum leptin is not that much higher than the normal level for a lean person. Therefore, the fact that the ratio of serum to brain leptin is higher in the obese does not necessarily reflect a defect in transport, but rather the fact that the mechanism that transports leptin is already at full capacity.

When To Take A Pregnancy Test

Knowing when to take a pregnancy test will help you know whether or not you're pregnant. If you're wanting to know when to take a pregnancy test, the timing depends on the type of test.

There are two basic types of pregnancy tests - the urine test and the blood test. Both tests look for the hormone that is only present if a woman is pregnant. This hormone is called 'human chorionic gonadotropin', also referred to as 'hCG'. Blood tests can detect hCG about 6 to 8 days after you have ovulated. In general, urine tests can detect hCG about 14 days after ovulation.

When to take a pregnancy test at home is done by many women using a pregnancy test that will test the urine to determine if they are pregnant. Home pregnancy tests are convenient, inexpensive and are private. The urine test should be done using your first urine when you awake in the morning. When you have a positive home pregnancy test result, you should then see your health care provider soon. Your health care provider will confirm your home test result with a blood test plus a pelvic exam.

When to take a pregnancy test is important, because if you test too early in your pregnancy, there may not yet be enough of the pregnancy hormone in the urine to provide a positive test result. Most of the home pregnancy tests will be 90% accurate if you wait and test yourself one day after your missed period is due. If you feel you are pregnant but the home pregnancy test is negative, repeat the test again in a week if you still have not had your period. And if you are still getting negative test results and think you are pregnant, be sure and see your health care provider right away.

Pregnancy is a wonderful event that is complex, frustrating, satisfying and exciting. Your desire to become pregnant and having a child will have even more significance to you if it means you'll be taking better care of yourself and your partner. Besides knowing when to take a pregnancy test, learn as much as you can about improving your own health so you'll be providing that special little one the very best start to life that is possible.

Copyright 2005 InfoSearch Publishing

Fertility Test: One Effective Way to Ensure Pregnancy

From the early generations up to the contemporary times, infertility is a problem that continuously presses on individuals of all times. Infertility is a medical and social concern that dawn on almost everybody regardless of the economic and social statuses, age, religion, color, and race. As far as medical science is concerned, infertility is a disease that affects the reproductive system. Infertility on either of the parties can cause a severe trauma to both the psychological and emotional well-beings of both the male and the female partner.

Couples feel all the happier when the news of pregnancy hits them. They feel almost complete by the mere thought that their beloved child is on the way. The husbands somewhat become more careful and more loving to their wives. On the other hand, the expectant mothers are more health-conscious as they do want to secure that their baby will be healthy. The moment of truth now lies in the couple's capacity to conceive. Both partners may seem normal and health-wise. But there are still millions of cases when fertility seems to be far within reach of plenty of married individuals.

Some women are blessed with the gift of getting pregnant hassle-free while there are those who face traumas and a lot other difficulties to conceive. Women who don't easily get pregnant must face the fact that there are a lot of factors which may bring about a difficulty in their fertility. Among the many reasons are one's physical condition, age, and stress.

Are you experiencing various difficulties in getting pregnant? Have you tried all methods but still your efforts are for nothing? It may have been several years since you've tried conceiving but then there is no positive result that greets both of you. Now you should come to terms with understanding the truth that women are all different. But to make things easy for you, the medical society makes available the necessary tools for you to take the fertility test.

Types of Fertility Test

The fertility test allows you to know the very reason as to why you find it hard to get pregnant. You may consult your most trusted fertility specialist for this matter.

The Hormone Testing. Various blood tests taken in diverse times are required for the hormone testing. The test is chiefly for the detection of the normal production of hormone. The test hence evaluates the quantity of progesterone you possess and if you will be able to sustain a pregnancy. One of the blood tests done is to verify your prolactin level. It is the hormone that produces the breast milk. Another test is to examine how your thyroid functions.

The Ovulation Test. For this process, your gynecologist will be looking into the regularity of your menstrual cycle. The tool to be used is called the ovulation prediction kit.

The Chlamydia and Gonorrhea Cultures. This test is performed in order to detect the possible presence of these viruses which are possible causes of infertility. They can be prevented but then its detection is difficult.

The Sperm Analysis. The test is conducted to your partner to see the quality and count of the sperm.

The fertility test is one way which helps your doctor detect where the problem lies. Getting pregnant may be possible when the mistake in your body system is corrected.

Pregnancy And What To Expect

There are no two pregnancies that are alike so, while it is difficult to say exactly how each will progress, there are certain factors that are common among all women going through pregnancy. Quite often, early symptoms of pregnancy will appear and prompt the soon-to-be mom to purchase a home pregnancy test. These can be found at virtually every retail and/or grocery store. It is important to remember that pregnancy tests, while designed to be accurate, are sometimes wrong. Regardless of the result, it is recommended that women experiencing pregnancy symptoms should schedule an appointment with a health care professional who will accurately test for pregnancy.

Among the pregnancy symptoms that most women experience are heightened sensitivity to certain smells and/or food, exhaustion, recurring morning sickness and mood swings. During the entire pregnancy, it is very important that the woman participate in a healthy lifestyle. Among other things, this would include not smoking or being near secondhand smoke, avoid drinking alcohol, etc. In addition, the mom-to-be should drink plenty of milk and eat healthy foods. This will help to promote good development for the child and will be a healthy start for him/her.

Once a woman is confirmed with pregnancy, the next step is shopping for maternity clothes. There is generally a maternity section of every store, but many women simply wear oversized shirts and comfortable elastic waist pants. Preparing for a new baby will include shopping for nursery items, including a rocking chair, bassinet, baby blankets, clothes and toys. If there are plans to convert any room in the house into a nursery, it's best to start early. It's also very important that the mom-to-be not be near any paint or harmful products that may cause her, or her unborn child, any problems.

During the nine months of pregnancy, women will go through a lot of changes - both physically and mentally. Mood swings will become more intense and there may be frequent trips to the bathroom as the pregnancy progresses and the growing child begins to press more heavily on the bladder. After the baby is born, the woman will likely have a desire to lose her pregnancy weight. Immediately following birth, it may be a good idea to rest before starting on any exercise program. A licensed medical doctor will be able to prescribe a timeline for such things as physical activity, which will greatly be determined by the mom's overall health.

This article is to be used for informational purposes only. It is not designed to be used in conjunction with, or in place of, professional medical advice. Any woman who believes she may be experiencing pregnancy symptoms, or has reason to believe that she may be pregnant, should consult a licensed medical physician for proper testing and determination.

Krauss's New Article on Saturated Fat Intervention Trials

Dr. Ronald Krauss's group just published another article in the American Journal of Clinical Nutrition, this time on the intervention trials examining the effectiveness of reducing saturated fat and/or replacing it with other nutrients, particularly carbohydrate or polyunsaturated seed oils. I don't agree with everything in this article. For example, they cite the Finnish Mental Hospital trial. They openly acknowledge some contradictory data, although they left out the Sydney diet-heart study and the Rose et al. corn oil study, both of which showed greatly increased mortality from replacing animal fats with polyunsaturated seed oils. Nevertheless, they get it right in the end:

Particularly given the differential effects of dietary saturated fats and carbohydrates on concentrations of larger and smaller LDL particles, respectively, dietary efforts to improve the increasing burden of CVD risk associated with atherogenic dyslipidemia should primarily emphasize the limitation of refined carbohydrate intakes and a reduction in excess adiposity.

This is really cool. Krauss is channeling Weston Price. If this keeps up, I may have no reason to blog anymore!

What To Expect From A Twin Pregnancy: ABC’s Of Multiple Birth

Imagine wishing and trying for one baby and ending up with two! Statistics show that there has been an increase in twin pregnancy the past few years and this short guide should answer any questions you have to giving birth to multiples!

How do twins begin? There are two kinds of twins: identical twins and fraternal twins. In the case of identical twins, the egg is fertilized and then splits into two cells. Each cell carries identical DNA and so both children will look exactly the same with only slight differences such as height or birthmarks. Fraternal twins are not identical. Instead of having one egg that splits into two, there are two eggs that are fertilized by two different sperm at the same time so they could be of two different sexes with different physical characteristics.

Early signs of twin pregnancy An early sign of twin pregnancy is excessive morning sickness and extreme fatigue. Morning sickness is common with all pregnant mothers but those who are giving birth to multiples tend to experience more morning sickness than usual. Exhaustion is another early sign of twin pregnancy. Again, it is not uncommon for pregnant women to be more tired than usual but those who are having twins tend to undergo enhanced exhaustion. Twins are hereditary and so if you are feeling excessively tired, are often nauseous and twins run in your family, you very well could be giving birth to multiples!

Twin pregnancy facts With twins, you'll have to prepare for double the trouble! This means you will probably be gaining more weight than with a single pregnancy. Due to this extra weight, a pregnancy with twins can often be more uncomfortable – severe exhaustion, stronger backaches and headaches, etc. So get plenty of sleep and rest. Try a pregnancy massage, a great stress reliever to those giving birth to multiples. Also be prepared for a possible c-section, as with multiples this is the more common way of giving birth. Because a twin pregnancy is considered a high risk pregnancy, you will probably need to consult your obstetrician more often than if you were having a regular pregnancy. Do not be fazed as this is quite common with twins.

Having a twin pregnancy is most certainly a mixed blessing. Whilst having two children is an amazing experience, the pregnancy itself can be tough so make sure to take care of yourself.

Different Types Of Pregnancy Tests

If you believe yourself to be pregnant and are interested in using a test to determine the results factually, know that the tests sold over the counter that use urine to detect the pregnancy hormone are incredibly effective. Unlike in days gone by when the only reliable way to determine whether you are indeed pregnant was to visit your primary health care provider's office, these home tests allow you to determine whether or not you need to see a provider. Keep in mind that if you test positive for any type of home pregnancy test, you should be sure to immediately schedule an appointment with your primary health care provider. This is essential due to complications like an ectopic tubal pregnancies, where the egg lodges in the Fallopian tube and can cause a great deal of pain and medical issues if left untreated. A test will still determine that you are pregnant, although the pregnancy may not be normal or necessarily healthy.

There are two main types of pregnancy tests, those that use urine and those that use blood. Both tests are designed to detect the hormone known as human chorionic gonadotropin. Commonly known as hCG, this hormone is produced when the placenta begins to develop once the embryo successfully attaches to the uterine lining. Although blood tests tend to have less false readings, the presence of this hCG hormone can easily be found in a urine based test. Generally, doctors will perform a blood test in order to determine whether or not you are pregnant. In addition to testing for the presence of hCG, a doctor may wish to run another panel to determine your overall health and levels of vitamins or nutrients. This will provide your physician with a base line for which to prescribe prenatal vitamins and medications that will ensure both mother and child are kept healthy.

If you purchase a urine based pregnancy test, there are two main options available. The first option sees the woman urinating in a cup and then inserting a special stick into the cup for a given period of time. This test generally has more accurate results since the instructions are more likely to be followed. Usually, if you visit a clinic and they issues you a urine based test, this is the type of test that you will receive. However, the most popular method of pregnancy tests available over the counter are those that require the woman to hold a special stick in a stream of urine for a certain amount of time. These tests tend to be the most popular since there is less mess and clean up required in this method. There are even versions of this test that can detect the hCG pregnancy hormone almost immediately after the embryo has implanted in the uterine wall.

For those individuals who are far too anxious to receive the news than the necessary waiting period required for even the earliest versions of the urine tests, a blood test should be used. Blood tests can be administered up to seven days after a possible conception, so they are a favorite among couples that are experiencing infertility problems. Furthermore, a blood test can more accurately measure the level of hCG found in a woman's body so that potential problems or complications with the pregnancy can be immediately identified. However, keep in mind that you must visit a doctor's office in order to have a blood test to determine whether or not you are pregnant. This will often cause you to incur costs associated with the visit and the testing fees. If money is a concern, many women's clinics provide pregnancy testing for a minimal cost.

Sigiriya in Sri Lanka

Nothing in Sri Lanka captures the imagination more than a 200 meter lump of granite that rises starkly above the flat central plains about three and a half hours' drive from Colombo. Sigiriya has it all -- a blood-stained history full of intrigue, astonishing frescos of bare-breasted maidens painted 15 centuries ago, a wall covered in graffiti that is more than 1,000 years old and, to top it all,

Is Pregnancy Ultrasound Risky?

No one knows the long-term effects of ultrasound use. Many practitioners feel that the technology is perfectly safe since studies of babies and their mothers have not determined any effects. Other practitioners are not so convinced of ultrasound safety and feel that judicious use is advised.

It should be remembered that x-rays were in use for 50 years before the public became aware of detrimental effects. DES and thalidomide alsso were deemed safe and were later found to be the cause of cancer, sterility and anomalies.Possibly the greatest risk of overuse of ultrasound technology is that if an ultrasound raises a question of fetal well-being, invasive and high risk procedures and technologies may be instituted which do have clear risks to the mother or her baby.

STUDIES

Non-diagnostic ultrasound has demonstrated b8iological effects such as cell heating or thermal effects and cavitational activities using plants and animals. These experiments have had various outcomes and are difficult to equate with human outcomes. Also, diagnostic ultrasound uses far lower intensities. The current epidemiologic data finds no adverse outcomes from ultrasound use. Many researchers believe that the benefits of diagnostic ultrasound outweigh the risks. Human studies have not documented negative outcomes except for one study which shoed increased fetal activity for the majority of exposed babies when scanned with the Doppler.

OVERUSE OF TECHNOLOGY

Some consumer groups have questioned the need for ultrasound equipment in doctor offices. They claim that in order to pay for the equipment, physicians will order unnecessary ultrasounds. Not only does this increase the exposure of unnecessary technology, but it also raises the total cost of care and may lead to additional unnecessary and costly interventions. They claim that in order to pay for the equipment, physicians will order unnecessary ultrasounds. Not only does this increase the exposure of unnecessary technology, but it also raises the total cost of care and may lead to additional unnecessary and costly interventions.

Odds Of Getting Pregnant And Age

The odds of getting pregnant decline with age. The odds of getting pregnant are the greatest for a woman in her early twenties and then slowly decline with the passing years. Here are some numbers related to the chances of getting pregnant and age:

1. For ages early to mid-thirties - a woman in general will be about 15-20% less fertile.

2. For ages mid to late thirties - fertility will generally decline by up to 50%.

3. For women ages early to mid-forties - fertility declines by over 90%.

Why do the odds of getting pregnant generally decline as the woman gets older? Studies have indicated the reasons for fertility decline are related to the quality of the woman's eggs as well as the quantity. A woman in her lifetime will typically produce about 400 fully developed eggs (usually one per month) that are capable of becoming implanted in the uterus and causing pregnancy. As these eggs get used up over thirty years or so and estrogen production slows so that the uterine and vaginal linings are no longer properly stimulated, pregnancy becomes less and less likely.

And what about the male's role, age and the odds of getting pregnant? Studies have found that the probability of causing pregnancy for a man in his late thirties declines by about 40% from the probability during his twenties to mid-thirties.

How does a woman increase the odds of getting pregnant? Here are some tips:

• Know your fertile time - ovulation generally happens about 14 days before your next period begins. For women with cycles of 28 days, that could make day #14 your most fertile for getting pregnant (day #1 being the first day that your last period began).

• Monitor your basal body temperature - the slight elevations in your body temperature upon awakening each day will signal your most fertile time.

• Monitor your cervical mucus - ovulation will cause a change in the appearance and consistency of cervical mucus. Check yourself each day and you'll be able to see the 'egg-white-like' vaginal discharge that indicates ovulation and your most fertile time.

• Adopt a healthy lifestyle - the odds of getting pregnant increase the more healthy you are. Healthy living includes a sensible diet, nutritional supplements, adequate quality sleep, managing stress, some exercise and weight management.

Planning to start a family, getting pregnant and pregnancy can be exciting, frustrating, fulfilling and without any certain outcome. Improving your health will add to the likelihood that you can become pregnant and have a healthy baby.

Copyright 2005 InfoSearch Publishing

The Body Fat Setpoint, Part II: Mechanisms of Fat Gain

The Timeline of Fat Gain

Modern humans are unusual mammals in that fat mass varies greatly between individuals. Some animals carry a large amount of fat for a specific purpose, such as hibernation or migration. But all individuals of the same sex and social position will carry approximately the same amount of fat at any given time of year. Likewise, in hunter-gatherer societies worldwide, there isn't much variation in body weight-- nearly everyone is lean. Not necessarily lean like Usain Bolt, but not overweight.

Although overweight and obesity occurred forty years ago in the U.S. and U.K., they were much less common than today, particularly in children. Here are data from the U.S. Centers for Disease Control NHANES surveys (from this post):

Together, this shows that a) leanness is the most natural condition for the human body, and b) something about our changing environment, not our genes, has caused our body fat to grow.

Fat Mass is Regulated by a Feedback Circuit Between Fat Tissue and the Brain

In the last post, I described how the body regulates fat mass, attempting to keep it within a narrow window or "setpoint". Body fat produces a hormone called leptin, which signals to the brain and other organs to decrease appetite, increase the metabolic rate and increase physical activity. More fat means more leptin, which then causes the extra fat to be burned. The little glitch is that some people become resistant to leptin, so that their brain doesn't hear the fat tissue screaming that it's already full. Leptin resistance nearly always accompanies obesity, because it's a precondition of significant fat gain. If a person weren't leptin resistant, he wouldn't have the ability to gain more than a few pounds of fat without heroic overeating (which is very very unpleasant when your brain is telling you to stop). Animal models of leptin resistance develop something that resembles human metabolic syndrome (abdominal obesity, blood lipid abnormalities, insulin resistance, high blood pressure).

The Role of the Hypothalamus

The hypothalamus is on the underside of the brain connected to the pituitary gland. It's the main site of leptin action in the brain, and it controls the majority of leptin's effects on appetite, energy expenditure and insulin sensitivity. Most of the known gene variations that are associated with overweight in humans influence the function of the hypothalamus in some way (1). Not surprisingly, leptin resistance in the hypothalamus has been proposed as a cause of obesity. It's been shown in rats and mice that hypothalamic leptin resistance occurs in diet-induced obesity, and it's almost certainly the case in humans as well. What's causing leptin resistance in the hypothalamus?

There are three leading explanations at this point that are not mutually exclusive. One is cellular stress in the endoplasmic reticulum, a structure inside the cell that's used for protein synthesis and folding. I've read the most recent paper on this in detail, and I found it unconvincing (2). I'm open to the idea, but it needs more rigorous support.

A second explanation is inflammation in the hypothalamus. Inflammation inhibits leptin and insulin signaling in a variety of cell types. At least two studies have shown that diet-induced obesity in rodents leads to inflammation in the hypothalamus (3, 4)*. If leptin is getting to the hypothalamus, but the hypothalamus is insensitive to it, it will require more leptin to get the same signal, and fat mass will creep up until it reaches a higher setpoint.

The other possibility is that leptin simply isn't reaching the hypothalamus. The brain is a unique organ. It's enclosed by the blood-brain barrier (BBB), which greatly restricts what can enter and leave it. Both insulin and leptin are actively transported across the BBB. It's been known for a decade that obesity in rodents is associated with a lower rate of leptin transport across the BBB (5, 6).

What causes a decrease in leptin transport across the BBB? Triglycerides are a major factor. These are circulating fats going from the liver and the digestive tract to other tissues. They're one of the blood lipid measurements the doctor makes when he draws your blood. Several studies in rodents have shown that high triglycerides cause a reduction in leptin transport across the BBB, and reducing triglycerides allows greater leptin transport and fat loss (7, 8). In support of this theory, the triglyceride-reducing drug gemfibrozil also causes weight loss in humans (9)**. Guess what else reduces triglycerides and causes weight loss? Low-carbohydrate diets, and avoiding sugar and refined carbohydrates in particular.

In the next post, I'll get more specific about what factors could be causing hypothalamic inflammation and/or reduced leptin transport across the BBB. I'll also discuss some ideas on how to reduce leptin resistance sustainably through diet and exercise.


* This is accomplished by feeding them sad little pellets that look like greasy chalk. They're made up mostly of lard, soybean oil, casein, maltodextrin or cornstarch, sugar, vitamins and minerals (this is a link to the the most commonly used diet for inducing obesity in rodents). Food doesn't get any more refined than this stuff, and adding just about anything to it, from fiber to fruit extracts, makes it less damaging.

** Fibrates are PPAR agonists, so the weight loss could also be due to something besides the reduction in triglycerides.

Fitness While Pregnant - Information You Should Know

Pregnant women can and should exercise in moderation unless there are health factors or risks that prevent them from participating in a fitness program. This should consist of intervals of no more than thirty minutes at a time, several days each week if not every day of the week. Exercising has been proven to help pregnant women feel and look better, and also will help in minimizing the amount of weight gained during pregnancy.

Keep fit during pregnancy can help prevent or avoid problems such as gestational diabetes, a common form of diabetes that sometimes develops during pregnancy. It will also help increase stamina, which will be needed for labor delivery and increase your physical and emotional well being before and after delivery. Staying in shape will also help speed your recovery after the birth of your baby. Always be sure to consult with your physician before beginning any type of fitness program while you are pregnant.

Fitness programs that are appropriate for pregnant women include walking, swimming, low or no-impact aerobics (done at a mild pace), yoga, and Pilates for as long as you are able to complete the required moves. You should always avoid activities that can put you at a high risk for injury. Forms of sports or exercise that may cause you to be hit in the abdomen or are performed lying flat on your back are considered high risk. This is extremely important after the third month. Another sport you will need to avoid during pregnancy is scuba diving. While this may seem completely harmless, especially since being in the water makes you feel lighter and more agile, it can cause dangerous gas bubbles to form in an unborn child's circulatory system.

There are numerous benefits that exercise can bring to a pregnant woman. You will burn calories, which will help prevent any excessive weight gain. If you work out on a regular basis, you will improve the condition of your joints and muscles, which will be very helpful during the birth of your baby. The long-term effects will also continue after giving birth and will also help you lower your risk of heart disease and many other serious illnesses.

Staying in shape will help to relieve any anxiety and stress you may feel. It will also help to prevent the "baby blues" that many new mothers experience after the birth of their child. This is valuable information since so many new mothers worry if postpartum depression will affect their lives and the lives of their family. Participating in fitness programs while pregnant gives many emotional as well as physical benefits.

Once your doctor give you the go ahead to begin a fitness program, decide on a program that fits both your likes and schedule. Keep in mind that it is best if you do not exceed a 30-minute period of time while exercising. If you are finding it difficult to pick a program, try several different types of exercises that are appropriate for pregnant women then decide which you enjoy the most. You may want to incorporate a variety of exercises into your routine to help prevent boredom and discouragement. Exercising while you are pregnant is one of the best things you can do for yourself and your unborn child.

Birth Control needs, methods and information available for today’s women

Need for birth control in today's world

With the rapid growth of the population in the world as well as the increased sense in general awareness for HIV/AIDS, has forced to think on birth control methods. The current world's population is estimated to be around 6.4 billion with annual growth of 76 million and hence, it is estimated to reach 9 billion by year 2050. In next two decades, world's two highly populous countries, China & India are expected to reach the population of 1.5 billion each i.e more than one third of the total world population of that time. It is alarming situation for the world to control this "population explosion". Therefore, United Nations are urging countries specially highly populated countries to control their population.

As per the survey report for birth control methods if applied in 169 countries, 137 million women willing to delay their contraceptives, 64 million women are using less effective birth control measures. If these women are helped with adequate birth control treatment (like pills, condoms), 23 million of unplanned births, 22 million induced abortions and 1.4 million infants could be avoided as estimated by United Nations Population Fund.

Besides population, HIV/AIDS is also very important factor forcing the need for birth control. An estimated, world has 38 million people have either AIDS or infected with HIV (human immunodeficiency virus). In seven African countries, one out of 5 adults is infected with HIV. Birth control methods are, therefore, become imperative to control further spread of HIV/AIDS, particularly in these countries. The population in these countries is projected at 35% lower by 2025 free from HIV/AIDS. It will further reduce the total life expectancy by an average of 29 years in these countries.

History of Birth Control 200 AD, Greek gynecologist Soranus said that women become fertile during ovulation. He suggested some birth control tips for women to avoid unwanted pregnancy like smearing olive oil, pomegranate pulp, ginger, or tobacco juice around vagina to kill sperm, drinking water used by blacksmith to cool hot metals and jumping 7 times backward after the sexual intercourse. Many birth control methods like ayurvedic treatments used centuries ago (aside from sexual abstinence). However, there are some historical records of Egyptian women are found who were using some herbal or acid substances like crocodile dung or lubricants like honey or household olive oil as vaginal suppository, which they may have found effective at killing sperm.

However, commercial use of birth control method started in 1960 in the form of birth control pill. It was in 1950, when Planned Parenthood Federation of America invited biologist Dr. Gregory Pincus to develop oral contraceptive pill that would be harmless, universally acceptable and safe for husband and wife. After under going many tests with more than 6,000 women in Puerto Rico and Haiti , it was 1960 when the first commercially produced birth control pill called Enovid-10 was introduced to women in USA . This first oral contraceptive was made with two hormones Estrogen (100 to 175 microgram) and Progestin (10 mg). They were proved to be 99% effective if taken as directed. With estimation, more than 18 million women in US are relying on birth control pills

Types of birth control pills Unlike the decades old oral contraceptive pills (which had higher number of hormones), today's birth control pills are in low-dose forms with health benefits. So, women can take birth control pills with much fewer health risks.

Generally there are three types of birth control pills available 1. Progestin only pills (POP) It is also known as "mini-pill" containing no estrogen. It is recommended for breastfeeding women because estrogen reduced milk production. This POP pill works by thickening the cervical mucus and thus preventing sperm to enter uterus

2. Combination birth control pills The widely known birth control pills are having combination of two hormones progestin and estrogen. These types of oral contraceptive pills come with the pack of 21 "active pills" and 7 "placebos" , which do not contain any hormones. These are, in fact, known as "reminder pills"

These combination pills are further sub-divided into three types of pills due to the level of two hormones progestin and estrogen.

i) Monophasic birth control pills Here, every active pill contains the equal number of progestin and estrogen. The other seven pills are placebo having no hormones. Menstruation starts when these placebo pills are taken

ii) Multiphasic birth control pills They are also known as biphasic or trphasic oral contraceptive pills due to different levels of hormones in active pills. These pills are required to be taken at specific time in its entire pills schedule. Multiphasic birth control pills help offsetting the risks of oral contraceptives.

iii) Continuous birth control pills it is also known as 365 days pills to be taken continuously throughout the year without the year. This is the new entry of oral contraceptive pills in the birth control market. Food and Drug Administration (FDA) has approved Lybrel, which is the only continuous birth control pill approved so far and available for general women use. Women do not get menstrual period while they are under the treatment of Lybrel, however, they might find some breakthrough bleeding or spotting, particularly at the initial stage.

3) Emergency birth control pills Also known as "morning after pills", these are designed for immediate pregnancy protection after the unprotected sex. It is highly recommended to take emergency pills within 48 hours and maximum 72 hours to be effective in avoiding pregnancy. These are different than usual oral contraceptive pills where you plan your birth control much in advance. Emergency pills are also taken when the women are sexually assaulted. FDA has approved Plan B as the safest emergency pills. Due to OTC (over the counter) approval by FDA for women above 18 years, Plan B can now be ordered behind pharmacy counter.

Induced Abortion

Induced abortion is the deliberate termination of pregnancy in a manner that ensures that the embryo or fetus will not survive. Attitudes of society toward elective abortion have undergone marked changes in the past few decades. In some situations the need for abortion is accepted by most people, but political and medical attitudes regarding induced abortion have continued to lag behind changing philosophies. Some religious concepts remain unchanged, resulting in personal, medical, and political conflicts.

About one-third of the world's population lives in nations with nonrestrictive laws governing abortion. Another third live in countries with moderately restrictive abortion laws, ie, where unwanted pregnancies may not be terminated as a matter of right or personal decision but only on broadly interpreted medical, psychologic, and sociologic indications. The remainder live in countries where abortion is illegal without qualification or is allowed only when the woman's life or health would be severely threatened if the pregnancy were allowed to continue.

An estimated 1 out of every 4 pregnancies in the world is terminated by induced abortion, making it perhaps the most common method of reproduction limitation. In the U.S., estimates of the number of criminal abortions performed prior to legalization of the procedure ranged from 0.25-1.25 million per year. The number of legal abortions now being performed in this country approximates 1 abortion per 4 live births. In 1997, there were 1.33 million induced abortions compared to 3.88 million live births.

Legal Aspects of Induced Abortion in the United States The United States Supreme Court ruled in 1973 (1) that the restrictive abortion laws in the U.S. were invalid, largely because these laws invaded the individual's right to privacy, and (2) that an abortion could not be denied to a woman in the first 3 months of pregnancy. The Court indicated that after 3 months a state may "regulate the abortion procedure in ways that are reasonably related to maternal health" and that after the fetus reaches the stage of viability (about 24 weeks) the states may refuse the right to terminate the pregnancy except when necessary for the preservation of the life or health of the mother. Still, much opposition is raised by various "right-to-life" groups and religious groups. In spite of this opposition, over 1 million procedures are still performed annually in the United States, with about one-third being performed on teenaged women. This dramatically emphasizes the inadequacy of sex education and the need for greater availability of adequate contraceptive methods in order to avoid such pregnancy wastage.

Evaluation of Patients Requesting Induced Abortion Patients give varied reasons for requesting abortion. Since in some cases the request is made at the urging of the woman's parents or in-laws, husband, or peers, every effort should be made to ascertain that the patient herself desires abortion for her own reasons. In addition, one should be certain that she knows she is free to choose among other methods of solving the problem of unplanned pregnancy, eg, adoption or single-parent rearing.

Although the majority of abortions are performed as elective procedures, ie, because of social or economic reasons as opposed to medical reasons, some women still request such services for medical or surgical indications. For example, for women with certain medical conditions, such as Eisenmenger's complex and cystic fibrosis, continuation of pregnancy may pose a threat to the life of the mother. Other indications are pregnancy resulting from a rape or pregnancy with a fetus affected with a major disorder, eg, trisomy 13. In any event, the ultimate decision rests with the pregnant woman.

Please visit Induced abortion, Contraception and Methods of contraceptionfor more information.

New Saturated Fat Review Article by Dr. Ronald Krauss

I never thought I'd see the day when one of the most prominent lipid researchers in the world did an honest review of the observational studies evaluating the link between saturated fat and cardiovascular disease. Dr. Ronald Krauss's group has published a review article titled "Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease". As anyone with two eyes and access to the medical literature would conclude (including myself), they found no association whatsoever between saturated fat intake and heart disease or stroke:

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of CHD or CVD.

Bravo, Dr. Krauss. That was a brave move.

Thanks to Peter for pointing out this article.

Losing Weight After Pregnancy

You could be lucky. I was - just once. When my middle daughter was born I actually weighed 10 pounds less than I had when I'd conceived her. That's not something you can count on, though, and I can tell you that from experience as well. Most women start their lives as a new mom with an extra 8 to 15 pounds that they didn't have pre-baby.

There's a very good reason for that. God designed our bodies with nurture in mind. Part of that weight that you put on during pregnancy was meant to nurture your baby AFTER birth. While your body requires an extra 300 calories a day to keep up with the nutritional demands of your baby during pregnancy, a breastfeeding mother requires at least 500 extra calories a day to produce enough milk and remain healthy. Your body stores up a little extra nutrition for after the birth just in case there isn't enough food for its needs when it's time to feed the new little critter.

If you're breastfeeding, that's part of the good news. You'll automatically be burning an extra five hundred calories a day - which will make it considerably easier for you to lose the extra weight. In fact, you may not need to do anything special at all to lose weight. Just focus on eating a normal, healthy, well-balanced diet. If you're not breastfeeding, you won't find it quite as easy. Your focus should still be on healthy eating, with moderate exercise to burn extra calories.

Here's more good news for new mothers. Exercising is easier. Actually, that's not quite right. Burning more calories is easier. Walking alone for an hour burns 200 calories. Walking while pushing a stroller ups that figure considerably. Push a stroller uphill, and it's even higher. You'll get extra duty out of things you never thought of like lifting the stroller and car seat in and out of the car, carrying the baby up and down stairs and just plain carrying the baby.

Still. If you find yourself with stubborn pounds that simply won't come off, exercise and a moderate reduction in calories is the way to go. Just like pregnancy isn't the time for weight loss, just after pregnancy isn't the time to stress your body further with severe dietary restrictions. Aim for losing about a pound a week, though chances are you'll find it coming off faster than that. Being a mom is a high-energy proposition!

The Importance of Bonding, and Touch; Advice for First-Time Parents

Fist time parents are in for the experience of a lifetime!

After surviving 9 months of pregnancy, a wardrobe of maternity clothes, baby showers, and decorating the nursery with care, you have gone through the exciting, heroic experiences of labor and delivery. You are ready to leave the hospital to begin your new life as first-time parents!

Handling the First-Time Parent Jitters

For many first-time parents, bringing a baby home from the hospital is an exciting experience mixed with apprehension. Silent questions such as "How will I know…," "How will I cope…," and "But, what if…" mingle with exuberant joy as you look down at the precious bundle sleeping in your arms. You've got the first-time parent jitters!

Not to worry! Siblings and friends with children, parents, and in-laws have been waiting for this moment, too. They will offer expert advice on feeding, diapering, and proper baby care. Books galore are also available, written by baby doctors and psychologists offering guidance on parenting, and the latest in child development research.

When it comes to reading material, be prudent about book selection. And, don't be afraid to set down boundaries on visiting times for over-eager friends and relatives. While you can learn proper baby care from the expertise of others, you and your spouse also need time alone with your baby, to bond.

Bonding with Baby

More frequently than not, bonding with baby will include touch. This is important, because it is through touch your baby will come to know you.

Cradling your baby in your lap, and gently stroking him or her is the most basic form of bonding between baby and parent. Nestling the newborn at your neck is another bonding-touch that provides baby with a sense of security. Support the baby's head and neck with one hand, and his or her bottom with the other.

Forget the old wives' tale that holding a baby too much will spoil the child. Yes, it is true a baby should not be picked up each and every time they cry. As long as they have been adequately fed, are clean and dry, warm and comfortable, a baby does need to learn there are times when they should rest, or entertain themselves.

However, quiet moments alone with baby without distractions are necessary to form the emotional connection between parent and child, essential to a healthy attachment. An important bonding process noted by pediatricians in the late 1970s. This process has been proved vital for both parent and child.

Parents who form this type attachment with their newborn make better parents. They are better equipped and more willing to make the necessary sacrifices to care for their child; during infancy as well as through childhood.

Newborns provided the benefit of gentle contact and tender touch by parents feel loved and secure. This sense of well-being impacts both their emotional growth and physical development.

The Importance of Touch

The importance of touch - gentle, loving contact when holding your baby, cannot be emphasized enough. Rough handing and harsh jostling, especially with a newborn, can not only frighten your baby, but be life-threatening, as well.

Always be careful to support your newborn's head and neck when you pick them up, or lay them down. If you need to wake up your newborn, don't startle them by jostling or shaking them. Instead, gently tickle their feet, softly blow on their cheek, or tenderly rub the side of their head while speaking softly and saying their name.

Relish time with your baby. Gently cradle him or her in your arms, and tenderly rub his or her back using slow, wide circles. Or, caress your baby soothingly as you rock them.

Talk in a low, comforting tone, or quietly sing to them. When eye contact is made smile, even if you aren't sure whether or not their eyesight has developed enough yet to see clearly.

At Savvy Baby Gear.com we care about you and your child! That is why we offer the very best in baby-related items, as well as child development tools, and articles of interest for parents of young children. Visit http://www.savvy-baby-gear.com today.

While it is true the importance of proper baby care (bathing, adequate nutrition, a safe, clean environment, play and nap time, and comfortable, warm clothing) cannot be over emphasized, neither can the healthy-bonding process between parent and child and the importance of touch. Both vital ingredients that say, "You are loved!"

Lori S. Anton Savvy Baby Gear editor

How to Improve Your Chances of Getting Pregnant

For countless women, becoming pregnant is relatively easy. For others, it can be far more complicated. Many women feel helpless if they do not conceive quickly, and they begin to think there may be a serious fertility problem. There are many things women can do to increase their fertility levels and therefore, improve their chances of having a baby.

Keep a Positive Attitude

Research has shown that physical health is not the only issue, where conception is concerned. Having a positive mental attitude can make an enormous difference. Negative thoughts will often hinder your chances of conceiving. As stress level rise, fertility levels can fall. Try not to worry too much about getting pregnant quickly. Take time out of your busy schedule to unwind. Everyone has different methods of relaxing, so think about what you can do to achieve this.

For some, it can be as simple as taking a warm, candlelit bath. Others may need more help. Aromatherapy massages and reflexology are wonderfully calming and can make a huge difference to your state of mind. Aromatherapy may also be used to regulate menstrual cycles. Certified aroma therapists can be found on the internet or in your local business directory.

Just spending some quality time with your partner can help. Try to do activities together in your spare time and make sure that you both enjoy them. This alone can heighten the emotional aspects of your relationship and remove some of the stress that so easily builds up when you are trying for a baby.

Acupuncture

Acupuncture has been known to have a very positive affect on fertility, when used in conjunction with IVF. Research in to its effects on fertility alone, are incomplete. Though, smaller studies have shown that it can be beneficial.

Acupuncture has been used by Chinese medics for around 5,000 years and is renowned for having amazing effects on a variety of ailments. However, its benefits have only been recognised by American medics for the past few decades.

If you are interested in trying out acupuncture, always find a reputable, certified acupuncturist. The National Institutes of Health and The American Academy of Medical Acupuncture are reliable sources for finding licensed acupuncturists.

Ovulation

Your chances of becoming pregnant greatly depend on your menstrual cycle and its regularity. Ovulation usually occurs between the twelfth and eighteenth day of your cycle. During this time, you are at your most fertile and your chances of falling pregnant are maximized.

It is thought that ovulation is most likely to happen on day fourteen (this is based on a regular, twenty-eight day cycle.) A way of predicting your most likely day of ovulation is to subtract fourteen from the total length of your own menstrual cycle. For example, if your cycle is twenty-eight days, subtract fourteen to arrive at your optimum date of fertility, (in this is case, it would be day fourteen.) Nevertheless, women's menstrual cycles do vary greatly; consequently, your day of ovulation may either be before or after day fourteen.

Ovulation predictor tests can also be bought from a pharmacy or drugstore. Having sexual intercourse when you are ovulating will obviously increase your chances of getting pregnant. Although, couples should try to have sex at least three times per week if they are trying for a baby. The human body is a miraculous thing and ovulation does not always occur when it should take place. Regular sex not only strengthens a relationship, it is a way of making sure that no opportunities are missed.

After you have had intercourse, try not to get up or move around for at least twenty minutes, this will help to keep your partner's sperm inside your body, again, increasing the likelihood of falling pregnant.

Nutrition and Diet

Having good nutrition and eating a sensible, healthy diet plays a hugely important role. Try to eat a diet rich in fruit and vegetables, lean protein and wholegrain, fiber-rich foods, such as brown bread, rice and pasta. The vitamins and nutrients that are found in certain foods can also help you become pregnant. Here are some examples:

• Leafy, green vegetables, such as cabbage, kale, broccoli, lettuce and spinach, are high in folic acid, a vitamin which is incredibly important for both mother and child. Folic acid supports the development of a fetus and can prevent debilitating defects, including spina bifida. It is also essential for the reproductive and general health of a woman. Folic acid can also be found in bread and cereals and taken as a vitamin supplement.

• Lean meat or beans and pulses are very rich in protein and iron. These important nutrients help to keep iron levels high in the body. A blood count low in iron, can affect the general health of the ovaries, and may interfere with ovulation.

• healthy eggs and can be found in nuts and seeds, dairy products, yeast, wholegrain foods, lean meat and shellfish.

• Dairy products are rich in calcium, which everyone needs to maintain healthy bones and teeth. If you are trying to get pregnant, make sure that you consume enough calcium, in order for your body to support a developing fetus

If you have been trying to get pregnant for more than one year, or you are feeling very unhappy. It is best to make an appointment, to discuss any issues you may have, with your doctor. If your doctor thinks there is a genuine complication, they will arrange for you to see a fertility specialist as soon as possible.