He's dumb, arrogant, condescending, a salesman, so much detritus. Yes, I know, I know but thanks all for reminding me.

Anyway, I didn't want to let any of you down so here is the answer I posted back to my one detractor who believed for sure I wouldn't post.

I'm also curious as to how many of you responded to Taubes article. Did you go after him too? Interesting responses, very much as I expected. But anyway, ya gotta have fun in life.



Thank you for your supportive note.

I can only assume that you have no training in nutrition and therefore an extensive explanation about what you refute to be the known Laws of Thermodynamics is beyond the scope of an email. However, if you want the complete details on this subject, then I would refer you to my book or you could undertake a detailed exploration of the extant scientific literture on the subject of metabolic rates. I'd start my study using keywords in the PubMed database which you can access through any serach engine. Use "metabolism," "calorimeter," "doubly labeled water," and "metabolic rate." Also study the work by Dr. Dale Schoeller and Dr. Susan Jebb.

I don't make this stuff up. This is what one learns in a 43-year study of the subject of nutrition.

It was clearly the point of my piece to point out how everyone is so confused and you fully confirm my ascertation that this is the case.

I took it upon myself, however, for your benefit, to do a quick search for you in the scientific literature to see what we scientists know about cerebral palsy and resting metabolic rate and total daily energy expenditure. This is some of what turned up.

: J Am Diet Assoc 1997 Sep;97(9):966-70 Related Articles, Links


Total energy expenditure in adults with cerebral palsy as assessed by doubly labeled water.

Johnson RK, Hildreth HG, Contompasis SH, Goran MI.

Department of Nutritional Sciences, University of Vermont, Burlington 05405,
USA.

OBJECTIVES: To characterize total energy expenditure (TEE) in free-living adults with cerebral palsy (CP) using the doubly labeled water technique, and to determine those physiologic variables and characteristics of CP that were markers of TEE in adults with CP. DESIGN: TEE was measured using the doubly labeled water technique in 30 free-living adults with CP (12 women, 18 men). To determine the best markers of TEE, the following factors were examined: CP status, resting metabolic rate (RMR), anthropometric characteristics and body composition by means of dual-energy x-ray absorptiometry (DXA) and skinfold thickness measurements, energy cost of leisure-time activities, and oral-motor impairment.

STATISTICAL ANALYSIS: Means +/- standard deviations, t tests, Pearson product-moment correlation
coefficients, Spearman rank correlation coefficients, chi 2, stepwise multiple-correlation regression analysis, and analysis of covariance were used to examine the relationships among variables of interest.

RESULTS: TEE was highly variable in the sample (mean = 2,455 +/- 622 kcal/day for men and 1,986 +/- 363 kcal/day for women). Stepwise regression analysis showed that TEE was best predicted in the sample by RMR, percentage body fat determined
by DXA, ambulation status, and sex (multiple R = .68, P = .003). When practical, easily measured variables were used, TEE was best predicted by height, ambulation status, percentage body fat by skinfold thickness measurements, and sex (multiple R = .61, P. = 018). The contribution of energy expended in physical activity to TEE was significantly higher in the ambulatory subjects than the nonambulatory subjects (25% vs 16%, respectively; P = .009). APPLICATIONS: The high degree of variability in
TEE, largely attributable to high interindividual variation in energy
expended in physical activity, makes it difficult to provide general
guidelines for energy requirements for adults with CP. Because ambulation status was an important predictor of TEE, it must be accounted for in estimating energy requirements in this population.

PMID: 9284872 [PubMed - indexed for MEDLINE]

Am J Clin Nutr 1996 Oct;64(4):627-34 Related Articles, Links


Energy expenditure of children and adolescents with severe disabilities: a cerebral palsy model.

Stallings VA, Zemel BS, Davies JC, Cronk CE, Charney EB.

Division of Gastroenterology, Children's Hospital of Philadelphia, PA 19104, USA. stallingsv~email.chop.edu

Spastic quadriplegic cerebral palsy (SQCP) is a severe disability that is associated with abnormal physical activity, body composition, and food intake and with frequent malnutrition. This study examined the pattern of dietary intake, anthropometry, and energy expenditure in a group of subjects with SQCP aged 2-18 y and a normal control group. The energy expenditure
pattern was determined from resting energy expenditure (REE, n = 61 SQCP; n = 37 control group) by using indirect calorimetry and from total energy expenditure (TEE, n = 32 SQCP; n = 32 control group) by using the doubly labeled water method. Physical activity, including the chronic spasticity of SQCP, was estimated from the ratio of TEE to REE. Abnormal growth and body
composition were common and dietary intake was markedly overreported in the children with SQCP. Children with SQCP were divided according to body fat stores determined by triceps-skinfold-thickness measurements. The children
with low fat stores had a lower REE adjusted for fat-free mass compared with the SQCP and control groups with adequate fat stores. TEE was significantly lower for the SQCP group than for the control group. The ratio of TEE to REE, indicating energy for nonbasal needs, was significantly lower in the SQCP children than in the control group, with the adequately nourished SQCP
children having lower ratios than the more poorly nourished SQCP group. The nonbasal energy expenditure, such as for physical activity and spasticity, of children with SQCP was low. The nutrition-related growth failure and abnormal pattern of REE are likely related to inadequate energy intake.

Arch Phys Med Rehabil 1995 Mar;76(3):281-3 Related Articles, Links


Caloric requirements of a spastic immobile cerebral palsy patient: a case report.

Taylor SB, Shelton JE.

Department of Physical Medicine and Rehabilitation, Eastern Virginia
Graduate School of Medicine, Norfolk 23507, USA.

This article documents the reduced caloric requirements for a spastic, immobile, cerebral palsy patient. We report an 11-year-old immobile, spastic, quadriparetic patient who remained obese despite receiving less than one half of the recommended basal caloric requirements for age. Basal metabolic rate was determined by indirect calorimetry using a Sensor Medics
2900 instrument. Standard reference sources indicate that an able-bodied 11-year-old child of comparable height requires 1,493 kcal/d for support of basal metabolic functions. Our patient was followed for 8 weeks on reduced calories and assessed for adequacy of diet by nitrogen balance studies and other appropriate parameters. Our data suggest that a subset of severely impaired children with cerebral palsy may require much less in total kilocalories per day for nutritional support than previous studies would indicate.

PMID: 7717823 [PubMed - indexed for MEDLINE]

Pediatr Res 1991 Jan;29(1):70-7 Related Articles, Links


Body composition and energy expenditure in adolescents with cerebral palsy or myelodysplasia.

Bandini LG, Schoeller DA, Fukagawa NK, Wykes LJ, Dietz WH.

Clinical Research Center, Massachusetts Institute of Technology, Cambridge 02139.

We measured body composition, resting metabolic rate (RMR), and total energy expenditure (TEE) in a group of adolescents with cerebral palsy (CP) and myelodysplasia (M) aged 13- to 20-y-old using indirect calorimetry and the doubly labeled water method. Fat-free mass (FFM), RMR, and TEE were significantly lower in both the CP and M groups than comparable easurements
in a control group of normal adolescent males and females. The ratio of TEE to RMR did not differ between controls and ambulatory M and CP subjects. However, TEE/RMR was significantly lower in the nonambulatory M and CP subjects than in controls (p less than 0.01). Our data indicate that energy
requirements are reduced in both populations because both FFM and activity are decreased. Although energy requirements were decreased in both groups, the relationships between FFM and body weight differed. FFM and body weight were significantly correlated with RMR only in the M group. These data suggest that the type of paralysis in a handicapped population may affect
resting energy expenditure.

PMID: 2000262 [PubMed - indexed for MEDLINE]

As you can see from the above, you are significantly over-reporting the number of calories that you are feeding your child. This is a common factor in human's belief systems. Just as humans under-report their food intake by 20-50%, you are similarly over-reporting what you are feeding your child.
Clearly, the metabolic needs for calories of those with cerebral palsy is significantly lower than the needs of the healthy and ambulatory.

It would be rather easy to locate a metabolic ward where you live or you could contact a company called www.healthetech.com and look for a fitness center or person who owns their BodyGem portable resting metabolic rate unit and then run this test at home on your child to confirm the above. It is simply impossible for what you say to be true. Impossible. We are all beholden to the Laws of Thermodynamics.

Having these numbers in hand would assist you in making better choices for your child's health and welfare.

Sorry to burst your bubble of comfort, but there are known Laws in operation here and it is my argument that so many are being befuddled by misinformed souls.

It's facinating to me how staunchly those in error hold on to their beliefs in the face of a dissenting view. But, at this juncture, and with what I have presented above, your position is simply untenable in the light of an overwhelming amount of scientific research that's been going on for at least 150 years. And amazingly, I didn't do any of it. Must we then call all of these scientists "know-it-alls" too?

I describe all of these facts for you in my book Ultimate Diet Secrets. It also my contention that the vast majority of nutritionists, doctors, and dieticians are absolutely in the dark over this matter too, another point that you prove for me as well.

So, there is your answer. I have responded and I have answered because there is an answer. And I did all of this for in spite of the tone of your comments which I feel could have been presented in a far less adversarial manner. But that is the nature of the web I guess.

Dr. Gregory Ellis