Health & Fitness

Your body uses a complex thermoregulatory system to maintain a homeostatic body temperature, protecting your heart and other organs as well as your circulatory and immune systems.¹ For more than 100 years, a normal internal body temperature has been defined as 98.6 Fahrenheit (37 Celsius). 

However, this “normal” temperature is affected by the time of day, your environment, your hydration status and whether you’ve been exercising, to name a few variables. Your temperature is regulated by the hypothalamus, a small portion of the brain located between the pituitary gland and the thalamus.² 

Your temperature plays a significant role in keeping the body in homeostasis (in balance) affecting temperature regulation, thirst, sleep cycles, blood pressure and heart rate by secreting hormones telling your nervous system what to do.

Body temperature increases may be caused by environmental factors, an infection, a reaction to a vaccination or medication or even an allergy.³ Also called a fever, when high body temperature is not caused by a viral or bacterial infection it doesn’t usually trigger the same body aches or headaches you experience with an infection.

Conversely, hypothermia, or a low body temperature, is a medical emergency occurring when your body is losing heat faster than it can generate it.⁴ As your body temperature drops, your organs, respiratory system and nervous system are unable to work appropriately. Left untreated it leads to death.

To regulate temperature your hypothalamus communicates with your skin, body fluids, salt concentrations, blood vessels and sweat glands⁵ in a process called thermoregulation.

Upper Limit of Normal Temperature Lower Than You Thought

Body temperature has become an integral part of measuring illness, yet the origin of the generally accepted 98.6 F as a normal temperature is linked to a single study.⁶ Carl Reinhold August Wunderlich is credited with the clinical application of a thermometer and the determination of a normal temperature.

Most medical professionals classify a temperature greater than 100.4 F as a fever.⁷ However, you may have felt like you had a fever, but the thermometer didn’t break 100 F. Analysis of daily average temperatures in research participants show what you’re feeling is likely a fever.⁸

Researchers evaluated the current temperature axiom and designed a study using 148 healthy men and women ages 18 to 40 years. Temperatures were taken throughout the day for three consecutive days.

The researchers found the results conflicted with the historical normal temperature, finding 98.6 F (37 C), instead of 98.2 F (36.8 C), was the mean temperature in all subjects. The upper limit was not 100.4 F (38 C), but 99.9 F (37.7 C) instead.

The participants’ maximum temperature and mean temperatures were different during different times of the day. The data did corroborate that mean temperature was lowest at 6 a.m. and highest from 4 p.m. to 6 p.m. They recommended abandoning the concept of 98.6 F (37 C) as relevant and that the upper limit of those younger than 40 years should also be revised.

Diurnal Temperature Variability Factors Into Fever

Similar findings were published in research from 2018.⁹ Scientists wrote that despite earlier data describing lower temperature averages and fluctuations based on demographics and circadian rhythms, the most widely used definition of fever, a temperature greater than 100.4 F (38 C), continues to drive medical decisions, including those related to invasive procedures, hospitalizations and the use of antibiotics.

Dr. Jonathan Hausmann, rheumatologist at Boston Children's Hospital gathered temperature data using an iPhone app the team developed called Feverprints. Participants downloaded the app, provided consent and manually recorded temperatures along with information on symptoms and antipyretics use, if any.

The researchers used data to calculate normal temperature from those who presented without symptoms or medication. Fever was defined as those in the 99th percentile for normal temperature; the analysis was restricted to oral temperatures to limit variability.

The study was conducted from March 2016 to June 2017 and included 329 participants. Researchers found the mean normal temperature was 97.7 F (36.5 C). Fever was defined as a temperature of 99.5 F (37.5 C) or higher; both temperatures are slightly lower than norms from the previous study.

Hausmann stressed that a “normal temperature” is a flexible concept, saying,¹⁰ "A temperature of 99 at 6 o’clock in the morning is very abnormal, whereas that same temperature at 4 o’clock in the afternoon can be totally normal."

Female Hormones Affect Temperature and Sleep

In both studies, data showed women had slightly higher normal temperatures than men. This higher core temperature may mean cool air “feels” even colder, which may be one explanation why many women feel colder at the same time men are peeling off layers of clothing.

Reproductive hormones, including estrogen and progesterone, affect a woman's core temperature. These affect thermoregulation and sleep. In one study,¹¹ researchers investigated body temperature and sleep in young women taking oral contraceptives throughout the active and placebo phases of the steroid pill pack.

This was compared against a similar group of women during their ovulatory cycles. In those taking the oral contraceptives, body temperature was higher in the 24 hours of the active phase in a similar way for those women who were not taking oral steroids.

However, during the placebo phase, the women on oral contraceptives continued to have higher body temperatures indicating there was a prolonged action from the synthetic steroids. The data also showed sleep was influenced independent of body temperature in those taking oral contraceptives as measured by stage-2 non-rapid eye movement sleep.

Men Have Higher Resting Metabolic Rate Than Women

As with most processes, the human body is a complex organism depending on several systems to maintain the balance of others. While a woman's core body temperature is higher, potentially because of hormones, a man's resting metabolic rate is faster, which produces heat.

In one study¹² researchers examined gender differences across a broad age range for resting metabolic rate. They included 328 healthy men and 194 healthy women from 17 to 81 years.

The participants had their resting metabolic rate, body composition, peak oxygen consumption, energy intake and other factors measured. Gross measurements demonstrated that the males’ resting metabolic rate was 23% higher than that of the females’. Analysis showed that 84% of the variation in individuals was explained by fat mass, peak oxygen consumption and gender.

Even after controlling for these differences women continued to have a lower resting metabolic rate compared to men. The researchers concluded the lower rate was not dependent on body composition or fitness.

Should You Feed a Cold and Starve a Fever?

Moving into cold and flu season, it is helpful to know what temperature may or may not be within normal range. Colds and flu are more commonly diagnosed during the fall and winter months, although you may get them at any time during the year.

In 2018, the CDC found on average 8% of the U.S. became sick with flu. A recent animal study showed eating a high-fat, low-carbohydrate diet could reduce the inflammatory response and improve the ability of the animal to withstand the flu virus.

Mice eating a standard diet were all infected, compared to 50% of those eating a ketogenic diet. Those on a keto diet that did get infected did not lose did not lose as much weight — a sign of the severity of flu infection in animals.

The researchers evaluating the animals eating a keto diet found they had an immune response that promoted gamma-delta T cells in the lungs. These cells line the lungs, increasing mucus production and protecting the animal from viral infection by trapping the virus and keeping it from spreading.

To follow a ketogenic diet, aim for eating 50% to 85% of your daily calories from healthy fat and limiting your net carbohydrates to 20 to 50 grams per day. Your net carbohydrates are measured by subtracting grams in fiber from your total carbohydrates. Aim to cut out carbohydrates from grains and all forms of sugar, including high fructose fruit.

Add healthy sources of fat, including avocados, coconut oil, animal-based omega-3 from fatty fish, butter, seeds, olives and olive oil. Macadamia nuts and pecans are high in healthy fat and low in protein, making them ideal to add into your meals or as snacks. Seek to include organic, pastured egg yolks, grass fed animal products, MCT oil and raw cacao to raise your level of healthy fats.

Avoid all trans fats and vegetable oils as they trigger more cellular damage than excess carbohydrates. For more benefits, seek to incorporate a cyclical ketogenic diet with intermittent fasting to support your immune system and overall health.

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If you’re like most, you’re probably not in the habit of scheduling play time, and if you have kids, they’re probably not spending much time playing outdoors with their friends. After watching the DW documentary, “The Power of Play,” you may reconsider these choices. As noted in the video, humans, like most other animals, have a natural play instinct, and this instinct has important benefits.

Far from being a total waste of time, play allows us to fine-tune our motor skills, develop social skills and emotional resilience and learn our limitations, and is actually essential for normal, healthy brain development. In animals, play even boosts their chances of survival. Sadly, the youth of today play nowhere near as much as previous generations. As noted in “The Power of Play,” children now play outdoors half as much as their parents did.

It is clear that nearly everyone will benefit from play time. After watching this documentary I realized my play time is being in the ocean most every day I am home and playing in the waves riding the surf. It is something I never seem to tire of. What is your play time?

Play Makes You Smarter, Kinder and Braver

The replacement of physical play with technological gadgetry has many experts worried, as research shows playing makes people smarter, braver and kinder. The documentary features Dr. Stuart Brown, founder of the National Institute for Play, a nonprofit corporation “committed to bringing the unrealized knowledge, practices and benefits of play into public life.”¹

As noted by Brown, play is hardwired into most animals, and even has a language of its own. When dogs play, for example, you’ll see a lot of play bows, paw slapping, tail wagging and so on. All of these are part of dogs’ play language.

Importantly, animals will instinctively keep the play going without one taking over and dominating the other. There’s a distinct give and take in the interaction. It’s also infectious — it draws other participants in and encourages social interactions.

5 Criteria of Play

So, what exactly is play? Gordon Burghardt, a reptile ethologist at the University of Tennessee, has come up with five criteria of play. As explained in “The Power of Play,” to qualify as play, the behavior must:

1. Be done for no apparent reason
2. Be done repetitively
3. Sometimes in an exaggerated way
4. Be spontaneous
5. Be done when relaxed and not stressed

Burghardt came up with these criteria after learning about the importance of play and realizing — after careful observation — that even reptiles exhibit play behavior. Fish, another animal you wouldn’t necessarily think of as playful, also enjoy it and demonstrate these play behaviors.

Play Is an Interspecies Form of Communication

Again and again, researchers are surprised by how common play is in the animal kingdom, and how it has the ability to bridge the gap between wildly differing species. One example featured in the video is the playful game that spontaneously developed between a giant Pacific octopus and a zoo handler.

While we don’t yet fully understand how, it’s clear that play allows us to communicate on a deep, nonverbal level with a whole range of life, not just our own species. “The impulse to have fun seems to cross all sorts of boundaries in the animal kingdom,” the narrator says.

Evidence of this continues to grow, as people film and share interspecies interactions on YouTube and social media. Seals and dogs, kangaroos and deer, cats and squirrels, elephants and birds — the examples of interspecies play go on.

What Bonobos Can Teach Us About Play

“The Power of Play” also features Elisabetta Palagi, a primatologist at the University of Pisa, Italy, who studies the play of bonobos. As one of our closest primate relatives,² bonobos “can give us a lot of information about the development of our behavior,” she says.

Interestingly, bonobos are known not just for their playfulness but also their peacefulness. They do not kill each other. When two groups of chimpanzees meet, they will fight to establish supremacy. When bonobos meet, they play.

According to Palagi, play allows the bonobos to establish strong interpersonal bonds, and these bonds increase everyone’s chances of survival. She also points out that play is important for the development of social skills, and this is true both for monkey and humans.

A major part of being able to interact peacefully within a social group is the ability to perceive and interpret the emotional states of others, and play allows youngsters to build and perfect this important skillset.

Play Fosters Empathy

To assess how well bonobos can read each other’s emotions, Palagi records the bonobos’ reactions to avatars expressing various emotions. Yawning after you see another person yawning is a telltale sign of empathy, for example, and bonobos will do this as well.

Around the age of 4, human children begin exhibiting this kind of mimicking behavior. As explained by Palagi, mimicking or mirroring is a way to put yourself in the same emotional state as the other.

Bonobos, she found, will repeatedly mimic the expressions of the avatars, which raises the possibility that it is their ability to read each other’s facial expressions that allows them to maintain such peaceful interactions.

Palagi points out that it’s still unclear whether empathy is the basis of play, or play the basis of empathy, but the two clearly appear to go hand-in-hand. Science is also starting to uncover the intricate connections between play and the development of compassion, and empathy plays a big role.

Not Just Practice for Adulthood

Researchers used to think play was little more than practice for adulthood, but more recent studies have found gaping holes in this theory. Kittens that play more than others do not become better hunters, for example, and bear cubs that play with their siblings still spend most of their adult life alone.

“Clearly, there’s more than meets the eye,” the narrator says. Research by Jonathan Pruitt, a behavioral ecologist at McMaster University, has helped shed more light on the purpose of play.

He studies social spiders — spider species that, contrary to the norm, will form large colonies and inhabit the same web. Of the 50,000 or so species of spider we know of, only 20 of them fall into this category.

Pruitt is particularly interested in the social spiders’ courtship play. Mature males will perform a courtship dance for immature females that are still too young to mate. In response, the female will enter a receptive posture, and the male will place his genitals on the outside of hers. This is repeated multiple times.

At first, Pruitt assumed this allowed the spiders to practice for mating in maturity, but as his studies continued, he began to believe that this behavior was simply a form of play — and a very important kind of play at that.

Pruitt and his team eventually discovered that females allowed to play in this manner produced much larger egg cases — and thus more offspring — than females that had been prevented from playing, and the size of the egg cases were in proportion to the amount of play they’d been exposed to.

Females that play also live longer than those prevented from playing, and are less aggressive and less likely to kill their partner after mating. Pruitt has come to believe play has deep and purposeful evolutionary roots, as it appears virtually all over the animal kingdom. Indeed, it appears it may play a much more important role than we’ve ever imagined.

The Purpose of Play

Canadian research also provides significant clues about the purpose of play. As shown in the video, young domesticated rats will playfully attack each other, trying to get to the opponent’s neck. The opponent will roll and wrestle free. As in all play, the animals take turns during this mock-attack, rough-and-tumble play.

In one experiment led by behavioral neuroscientist Sergio Pellis, juvenile rats were removed from other juveniles and raised with adult rats only, which are not prone to playing. What they discovered is that play-deprived rats fail to develop normal social skills.

At the end of the experiment, the brains of the play-deprived rats were also examined, revealing underdevelopment in the part of the brain responsible for impulse control and decision making. In other words, play actually alters the prefrontal cortex of the brain.

Compared to rats that played, the play-deprived ones also had disorganized neuronal growth and irregular neuronal cells. It was the biggest breakthrough of Pellis’ career, but it also caused him serious worry. If rat brains are unfavorably altered by lack of physical play, what’s happening to the children of our day?

“My concern is that denying young children to engage in play has led them to not getting the kinds of experiences that actually prepare them to live effectively in an unpredictable world,” Pellis says.

He cites research showing that as childhood play has declined, rates of depression and psychopathology have increased. Pellis’ groundbreaking work is now being expanded on by University of Tennessee researcher Matthew Cooper, a behavioral neuroscientist, who is investigating the connection between childhood play and the “ability to deal with life’s hard knocks.”

Play Is Crucial for Development of Emotional Resiliency

The prefrontal cortex plays an important role in our ability to deal with and bounce back from stress. Cooper works with juvenile Siberian hamsters, which instinctively engage in mock-attack play. Adult hamsters prefer solitude, and putting two of them together typically results in vicious fighting.

The loser suffers what’s referred to as “social defeat.” Normal hamsters, meaning those who have grown up play-fighting, will shrug it off and recover rather quickly. When faced with another opponent, it will fight to win again.

Play-deprived hamsters, on the other hand, are far less resilient. After losing one fight, the play-deprived hamster simply submits when faced with another opponent. They act fearful and run away rather than defending their turf, which is suggestive of social anxiety.

“Whether it’s in the animal world or in the school yard, play helps us prepare to cope with life’s ups and downs,” the narrator says. “But the way children play has changed dramatically. A generation ago, it didn’t take much to have fun. A piece of rope. A few twigs.

Children in the United States now spend less time outdoors than any previous generation — [just] four to seven minutes a day of outdoor play, versus 7.5 hours a day in front of a screen. And they’re missing out on a lot more than just fresh air and exercise.”

There’s More to Play Than Meets the Eye

Brown understood the importance of play long before there was science to back up his suspicions. In the past, it was considered unimportant and unnecessary, and if children could be doing something else, they should. We’re now starting to realize the true importance of play, and the ramifications of play-deprivation.

Having investigated the play background of 6,000 individuals, Brown has shown that having fun is indeed a serious matter. “What you find is that it’s necessary for a sense of optimism and fulfillment,” Brown says, “for a sense of competency, for a sense of authentic self.”

In short, play is important for the generation of well-being. Like Pellis, Brown is extremely concerned about the dramatic drop-off in play. He believes the lack of play we see in today’s children is a real crisis, and is at the heart of the shocking rise in mental health problems and behavioral problems among our youth.

The Risky Play Paradox

Another remarkable and paradoxical scientific finding is that engaging in risk during childhood is a crucial factor of preventing injuries. As noted by Mariana Brussoni, a developmental psychologist at UBC/BC Children’s Hospital, by engaging in risky play, children learn how their bodies work, they discover what they’re comfortable with and what they’re not, and they learn their own limits and how the world works.

In short, “they’re learning crucial risk-management skills,” Brussoni says. Far from keeping your kids safe, discouraging them from outdoor play can actually backfire, as play-deprived children fail to gain this fundamental knowledge, which places them at greater risk for serious injury — and phobias.

A child that has never experienced climbing, for example, is far more likely to develop a fear of heights than a child who has explored and has gotten used to the “fear-fun” of heights.

In short, the research strongly shows that risky play — play where there is a chance of injury and where the paths and outcomes aren’t certain — is important for character-building, emotional resilience and self-development. The sense of freedom that outdoor play brings also encourages creativity.

Brussoni encourages parents to weigh the possibility of an unlikely event (your child being seriously injured) versus the very real impact that outdoor play-deprivation has on your child’s long-term mental and physical health and development.

It’s Time to Bring Back Outdoor Peer Play

Interestingly, Brussoni’s research also shows that children, especially girls, are far more likely to play outdoors when unsupervised. What this tells us is that having a sense of independence and self-determination encourages the willingness to be playful, and indeed, the opposite is precisely what feeds depression and anxiety.

As noted in “The Power of Play,” outdoor play began diminishing in the 1980s, and those born around that time are now entering parenthood without the many fond memories of rough-and-tumble, sometimes risky peer play that their own parents grew up with.

As a result, they’re less likely to understand the value of outdoor play, and less likely to encourage it. The end result could be that we’re entering a sort of amnesia, where people simply cannot remember what it’s like to play in the woods or climb trees, because they’ve never done it.

And, far from being a loss of simple fun, this can have serious consequences for the health of future children, as it actually prevents the normal brain development necessary for empathy, compassion and personal well-being. The answer is self-evident: Encourage your kids to play, especially outdoors — and play more yourself too, regardless of your age.

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Researchers have engineered a patch or bandage that captures a pro-healing molecule called adenosine that briefly surges at the site of a bone break or fracture to accelerate and improve the natural healing process. In a proof-of-principle study with mice, the bandage helped to accelerate callus formation and vascularization to achieve better bone repair by three weeks.

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Researchers have engineered a patch or bandage that captures a pro-healing molecule called adenosine that briefly surges at the site of a bone break or fracture to accelerate and improve the natural healing process. In a proof-of-principle study with mice, the bandage helped to accelerate callus formation and vascularization to achieve better bone repair by three weeks.

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A research team has previously shown that fatty particles from the bloodstream may boost the growth of breast cancer cells. They now show that through an unexpected mechanism not previously described in cancer cells, the fat particles bind to the breast cancer cell surface and are then taken into the cell, providing a large supply of fuel that drives proliferation of the cancer cells.

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A research team has previously shown that fatty particles from the bloodstream may boost the growth of breast cancer cells. They now show that through an unexpected mechanism not previously described in cancer cells, the fat particles bind to the breast cancer cell surface and are then taken into the cell, providing a large supply of fuel that drives proliferation of the cancer cells.

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Right now, one in 12 children and adolescents in the US are severely obese. If that isn’t startling enough, consider this: among 12-to-15-year-olds, that number jumps to one in 10 — and among 16-to-19-year-olds, it is one in seven. According to the American Academy of Pediatrics (AAP), the best hope for many of these youths may be bariatric surgery. Bariatric surgery is surgery that helps with weight loss by making the stomach smaller and making other changes in the digestive system.

It’s jarring to think about doing irreversible surgery on an adolescent — or a child, as the AAP discourages age limits for bariatric surgery. But the reality is that obesity, with all of its risks, can be equally irreversible.

In children and teenagers, obesity is defined as a body mass index (BMI) greater than or equal to the 95th percentile for age and sex. If you are obese by the time you are 12, research suggests you have a 98% chance of being obese as an adult. Those are not good odds — and they are made more alarming by the complications of obesity. Diabetes, high blood pressure, fatty liver disease, and obstructive sleep apnea (which can lead to further problems, including heart disease) are the most common complications among younger people. In adults, the list expands to include even more problems, such as stroke, arthritis, and cancer.

Clearly, this is not a problem we can ignore.

When obesity isn’t severe, lifestyle changes such as eating a healthy diet and getting more exercise are absolutely the go-to methods of care. But once you get into severe obesity — usually a BMI of 35 or higher — lifestyle changes just don’t do the trick. (Severe obesity is a BMI greater than or equal to 120% of the 95th percentile for age and sex.) If lifestyle changes are all we suggest for children with severe obesity, we are condemning them to obesity and all of its complications. It’s that simple.

What does research on bariatric surgery tell us?

In the longest study of the effectiveness of bariatric surgery in youths, which followed patients for eight years on average, those that had surgery lowered their BMI by 29%. Those that didn’t have surgery? Their BMI went up by an average of 3.3 points.

Of course, the idea of surgery raises concerns. Yet bariatric surgery is actually safe and effective if done by experienced surgeons working in a high-quality center, with a strong multidisciplinary team that can give patients and families the ongoing education and support they will need, including psychological support. Surgical complications are infrequent and usually minor. The most common complication is micronutrient deficiencies, such as iron deficiency. While these can be prevented by taking supplements regularly, the reality is that adolescents are not always great about taking anything regularly. That’s why it’s important that the surgery be done at a center that offers a team approach and follow-up care in years to come.

Which children might benefit from weight loss surgery?

According to the AAP, parents and pediatricians can consider bariatric surgery if a child or teen

• has a BMI greater than or equal to 35 and one or more complications of obesity
• has a BMI greater than or equal to 40 whether or not they have complications.

Not everyone who falls into those groups should have surgery, though. It is not recommended for youths who

• have untreated or poorly controlled substance abuse problems
• have eating disorders
• are pregnant or planning pregnancy.

It is also not recommended for those who can’t follow all the post-operative recommendations, including all the lifestyle and eating changes that are mandatory after surgery. Anyone who has had bariatric surgery needs to be very careful and thoughtful about what they eat, not just in the weeks and months after surgery, but for the rest of their lives. They’ll also need to take supplements every day.

The bottom line

While bariatric surgery is clearly not a decision to be taken lightly, it’s not a decision we should be avoiding, either. If we want to give severely obese youth their best chance of a healthy life, we have to get over our fear of surgery — and the common bias that obesity is just a matter of personal responsibility (think willpower) and not the medical problem that it is. Our children deserve better.

The post Weight loss surgery for children and teens struggling with obesity appeared first on Harvard Health Blog.

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