Have food ready and on the table in under half an hour with these keto-friendly weekday meals!
One of the hardest parts about sticking to any diet is the amount of time you have to dedicate to preparing food. Gone are the days when you could run through the drive-thru on a particularly crazy day—at least, not without ketosis-wrecking consequences.
The next time you’re in a pinch, forget the fast food and check out this list. If you have a well-stocked pantry, you’re guaranteed to be able to make many of these 30-minute, keto-friendly meals at any given time. In other words, you can feed yourself in the amount of time it would take to run through the drive-thru.
You’ve got options for every meal of the day. Whip up delicious keto breakfasts like bacon and avocado burritos or stick-to-your-ribs keto “oatmeal” first thing in the morning, assemble a satiating Tex-Mex salad or three-ingredient salmon zucchini pasta for lunch, make a Korean beef bowl after work and indulge in a creamy bacon and shrimp skillet for a post-workout dinner.
Whatever time of day, there’s a keto meal on here for you.
Psst: If you’re looking for low-carb munchies in between meals, look no further than these 23 keto snack ideas!
#1 PaleoHacks | Easy Low Carb Keto “Noatmeal”
Start your morning off right with a warm bowl of oatmeal without all the carbs. This version simmers cauliflower rice in coconut milk with hemp seeds and chia seeds for a cozy breakfast.
#2 The Nourished Caveman | Keto Creamy Shrimp and Bacon Skillet
Few things are more succulent than the combination of shrimp, bacon, and coconut cream. Bonus: This meal comes together in minutes.
#3 PaleoHacks | Keto Breakfast Burrito with Bacon and Avocado
This ketosis-fueling burrito is technically made for breakfast, but we’d scarf this down any time of day.
#4 Healthful Pursuit | 5-Minute Cream of Tomato Soup
If you only have five minutes to spare, look no further. This creamy soup gets its richness from a surprise ingredient: macadamia nuts.
#5 PaleoHacks | Keto Breakfast Burger with Avocado Buns
Looking for a way to jazz up your keto breakfasts? Make “buns” out of avocado! Yes, this is a fork and knife burger.
#6 I Heart Umami | Paleo Filipino Skirt Steak with Cauliflower Rice
If you’re craving Filipino comfort food, give this low-carb version of steak and rice a try.
#7 PaleoHacks | Easy Buffalo Chicken Salad
This creamy, bright and spicy buffalo chicken salad is wrapped in crunchy lettuce cups for a healthy lunch your coworkers will surely envy.
#8 Wholesome Yum | Crispy Pan-Fried Brussels Sprouts with Bacon and Balsamic Vinegar
How do you pack a ton of flavor into Brussels sprouts? You pan-fry them with crunchy bacon and top with tangy balsamic vinegar.
#9 PaleoHacks | Keto Turkey and Egg Breakfast Skillet
Ground turkey and eggs make for a quick and delicious breakfast any morning, but this recipe works for any time of day, too.
# 10 Wholesome Yum | Italian Marinated Artichoke Salad
This artichoke salad is super close to antipasto—go ahead and add some meat if your macros can take it!
#11 PaleoHacks | 15-Minute Pesto Shrimp Pasta with Zucchini Noodles
Put a spin on pasta night with these zucchini noodles, slathered in Paleo pesto and topped with succulent shrimp.
#12 Nom Nom Paleo | Paleo Sausage Egg McMuffin
Craving fast food? Opt for this ketosis-fueling version, which builds a “McMuffin” out of fried egg patties and nixes the cheese for creamy avocado.
#13 Keto Summit | 3-Ingredient Keto Salmon Pasta
Filled with satiating fats, this three-ingredient “pasta” requires only zucchini noodles, cooked salmon, and your favorite mayo. Top with your favorite seasonings, and dig in!
#14 Wholesome Yum | Keto Coconut Curry Chicken
Before you head out to an Indian restaurant to gorge on rice and naan, reconsider: Can you make a low-carb version at home? This recipe proves you can.
#15 PaleoHacks | Kale and Mushroom Sausage Patties
These savory sausage patties are so versatile—use them to make a sandwich with this keto bread, serve them alongside eggs, or dip in your favorite keto sauce.
#16 Wholesome Yum | Oven Roasted Mushrooms with Balsamic, Garlic and Herbs
You can serve this hearty side alongside a thick steak, but these mushrooms are meaty enough to work as a main dish all by themselves.
#17 The Nourished Caveman | Kale and Eggs Benedict
Skip the English muffin and top hearty kale and fatty eggs with a creamy, keto-friendly hollandaise sauce. Perfect for brunch!
#18 Wholesome Yum | Broccoli Cauliflower Salad with Bacon and Mayo
All you need is 10 minutes to whip up this hearty cruciferous salad with creamy mayo and salty bacon, and you’ll be fueled for hours.
#19 Diethood | Steak Fajita Roll-Ups
Here’s a fun way to serve up your steak and veggies: make steak wraps out of them!
#20 Bulletproof Blog | Low Carb Beef Stir-fry
This Asian-inspired beef stir-fry with zucchini noodles boasts tons of flavor with very few carbs.
#21 Little Spice Jar | Garlic Butter Baked Salmon in Foil
This easy-peasy, low-mess dinner cooks up quick and produces the most flavorful salmon, ever. Be sure to opt for grass-fed butter.
#22 Bulletproof Blog | Poached Cod in Tomato Broth
Looking to switch up your seafood intake? Try poached cod in a vibrant, fragrant tomato broth. The whole meal comes together in just 20 minutes!
#23 Eat Well 101 | 15-Minute Cowboy Butter Chicken with Zucchini Noodles
Grass-fed butter elevates the humble butter chicken in this 15-minute recipe.
#24 That’s Low Carb?! | Bok Choy Chicken Stir-Fry
It’s hard to beat a quick-cooking stir-fry, thanks to its ability to pack in tons of flavor in just a few minutes.
#25 Life Made Sweeter | Tex-Mex Chicken Salad
Packed with fajita chicken and veggies, this hearty and filling salad is always a safe bet!
#26 Primavera Kitchen | Shrimp Avocado Cucumber Salad
This colorful salad is just what you need on a warm day.
#27 A Sweet Life | Sheet Pan Chicken Fajitas
Grab a sheet pan for a super quick meal with easy cleanup. Then, grab some lettuce leaves and instead of tortillas and dig in!
#28 Happy Body Formula | Low Carb Korean Beef Bowl
Ginger, garlic, chili, fish sauce—while quick, nothing about this meal is boring.
#29 All Day I Dream About Food | Lemongrass Chicken with Cilantro Cauliflower Rice
Fragrant lemongrass gives this 30-minute keto meal a distinctive Asian flair. Use whichever keto/Paleo sweetener you’d prefer here.
#30 Physical Kitchness | Easy Paleo Greek Chicken Skillet
If you’re a fan of Mediterranean food, you’ll love this chicken skillet with Greek seasonings, lemon, olives, and artichoke hearts.
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If you read any of those “10 Reasons Keto is the Worst” articles out there, the common anti-keto argument you’ll see is that it’s too hard. The premise: keto must be unsustainable because eating meat, eggs, avocados, veggies, nuts, coconut, etc. is just too arduous long term. I’m sure you can guess how I feel about that.
Nonetheless, when you switch from a SAD diet to Primal or Primal-keto it genuinely becomes harder to grab convenience foods. It’s not that you can’t. The selection of packaged foods being marketed to keto folks has exploded in the past year or so. Rather, your growing awareness of ingredient quality, coupled with a desire to control your food and nutrition, makes it feel harder… and probably less desirable.
For that reason, many people end up doing more cooking at home, which means more time devoted to grocery shopping and meal prep. This is good news. But once in a while, especially during busy weeks, it’s nice to give yourself a break and grab something easy. Plus, sometimes you find yourself stuck somewhere without a lot of food options. And then there’s the craving for foods you once loved and wish you could find keto-friendly versions of….
So, while I think that preparing your own food is a great ideal, I also want to cover keto where keto dieters actually live—in the (generally speaking) non-ideal world. I’ve always said, “Don’t let the perfect be the enemy of the good.” How can we apply that to keto convenience food?
My readers know I’ve always advocated for the 80/20 principle: aim for 100% compliance, but give yourself the freedom to respond to your circumstances and (occasionally) your desire for wisely-chosen indulgences. Primal and keto eating have to be enjoyable to be truly sustainable. If this means you sometimes incorporate convenience foods, so be it.
Convenient “Whole Foods”
Pre-made frozen hamburger patties and pre-cooked chicken skewers were in heavy rotation when my kids were deep in the school-sports-homework-friends circus. Rotisserie chickens are usually not the “cleanest” (look for “naked” organic options if you can), but they aren’t the worst thing in the store by far.
Bone broth is easy and economical to make, especially if you have a slow cooker or pressure cooker, but there are several companies now offering high-quality bone broth that I enjoy sipping on throughout the day.
While fresh is best when it comes to vegetables, I haven’t riced a head of raw cauliflower in ages now that frozen organic cauliflower rice is available in every market we frequent. Frozen veggies retain most of their nutrients. Pre-cut vegetable noodles are an easy time-saver.
With all these foods, you’ll definitely pay a premium over doing the work yourself. However, if you can afford them, and it buys you some time in your busy schedule, don’t let concerns over small nutritional trade-offs get in the way. Grab that rotisserie chicken and a bagged salad, or pre-made zucchini noodles and a jar of (extra virgin olive oil) pesto guilt-free.
Convenient “Packaged Foods”
Basically I’m talking here about eating food with labels, foods specifically meant to make your life easier or to quell a craving for a SAD food.
Spoiler alert: I’m not going to give you a straight up NO to any of these. If you want to eat them, ingredients should be your primary consideration. There are plenty of foods being marketed as keto and low-carb that are not at all Primally aligned. Carb count doesn’t matter to me—if a product contains hydrolyzed wheat gluten and canola oil, I’m out. Yes, some of these you can make yourself—and I’ll provide some recipes for alternative options within each category even though I know this misses the point of convenience foods.
Breakfast is such a sticking point for people when they go Primal or keto. It’s the area in which folks seem to feel the most “deprived.” One of the most common questions we get in our Facebook groups is, “What do I eat for breakfast if I’m sick of eggs?” It’s no surprise then that you can now buy keto pancake and waffle mix, and grain-free “oatmeal” and granola. There are even keto cereals creating quite a buzz in the marketplace. Honestly, I don’t have a problem with these products occasionally. While you can find a thousand ways to do keto-friendly breakfasts that offer more nutrition, I know Americans have a particularly nostalgic attachment to our conventional breakfast foods. If eating keto cereal once in a while is the thing that makes the rest of your diet smooth sailing, go for it.
I’m not a neutral bystander here—Primal Kitchen makes a keto-friendly protein bar. Primal Kitchen or not, however, I’m not opposed to bars as a snack, as a quick pre- or post-workout bite, or as a lunchbox treat. Personally, I like to take a bar during a long paddle or bike ride. This is a category, though, where you really want to check labels. A lot of manufacturers fill their bars with fiber (to drive down the net carbs) and sweeteners, which some folks are sensitive to.
Make-it-yourself alternative: Vanilla Coconut Collagen Bites
Meal Replacement Shakes and Powders
Again, I have skin in the game here, since Primal Fuel was one of my flagship products. I still love and use it regularly, so obviously I have no problem with whey protein shakes. At the same time, I’d offer this caution: if you’re consuming a protein shake most days but otherwise aren’t eating a variety of complete proteins—ideally animal based—you should aim to diversify your protein sources.
You’ll find a variety of keto shakes on the market being sold as complete meal replacements. I have to admit I’m leery of these, perhaps because they harken back to traditional diet shakes promising quick weight loss, nutrition be damned. A popular diet brand that shall remain nameless—you know the one—is even marketing keto shakes now.
Since whey protein powder is already so convenient, I’d suggest whipping up a quick smoothie with veggies and a few high-antioxidant berries, plus some MCT oil if that’s your thing. However, if you can find a meal replacement shake with ingredients that pass your personal bar, I’m not going to tell you no. Just use them sparingly, not to regularly replace meals of whole foods.
My favorite basic smoothie: Keto-Friendly Chocolate Protein Smoothie (I usually add a big handful of baby spinach too!)
If a plate of cheese and crackers is what you crave the most, a couple brands make seed-based crackers that are actually pretty tasty. On the other hand, you can just get crackers made of dehydrated cheese and double down. Every year at the various conferences I attend there are more and more chip substitutes made with unconventional ingredients like chicken. Unfortunately, there isn’t any way to make popcorn keto (sorry), and I’ve yet to see a good keto pretzel, although I’m sure someone’s working feverishly on it.
My sense is that when people want snack foods, it’s really the crunchy texture and salty taste, and the easy, even mindless, quality that they crave. Unlike the breakfast foods, it’s not so much an emotional or nostalgic attachment to specific foods. For those reasons, I think this is one category where it’s usually just as easy and satisfying to find different snack options altogether rather than seeking out keto-fied versions of the old SAD foods.
Try this instead: Bacon Guacamole with Cheddar Chips
Keep It In Perspective
At the end of the day, it’s all about choices. We live in a food environment where temptation is everywhere. Our lives are too often over-busy and over-stressed, and sometimes reaching for a convenience food option is something we depend on.
Let me be very clear: I’m not suggesting that these are on par nutritionally with whole, “real” foods, nor do I think they should be staples in your diet. Of course, it’s best to treat these foods like occasional treats or fallback rations. If being able to grab convenience foods here and there makes keto living possible for you, then go for it. Just be intentional about it, and don’t let it become a slippery slope. As you become more accustomed to keto, you might find yourself reaching for them less frequently.
What say you? Which keto convenience items, if any, do you enjoy? Have your choices changed over time? Thanks for reading.
The post Keto Convenience Foods: What To Try (and What To Skip) appeared first on Mark’s Daily Apple.
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For today’s edition of Dear Mark, I’ll be answering your CBD questions from the past few weeks. CBD, or cannabidiol, is exploding in popularity, but there are many unknowns. People have a lot of questions and there aren’t many definitive or comprehensive guides, so today I’ll do my best to make sense of it. We’re all piecing things together based on limited data—which, I suppose, is the fundamental human experience.
What’s the difference between hemp and CBD?
Hemp is a (recently legalized) industrial form of cannabis used in the production of paper, textiles, clothing, biodegradable plastics, and overpriced Bob Marley shirts sold along Venice Beach. Hemp seed can be eaten (and is a fantastic source of magnesium, one of the best). Hemp is the plant.
CBD is cannabidiol, a non-psychoactive cannabinoid found in both hemp and cannabis. Unlike THC, CBD won’t get you high.
Due to legal issues, most big name online retailers won’t allow sellers to list “CBD oil” or “CBD” products, let alone CBD content. Descriptions like “full spectrum hemp extract” often mean CBD is present in the hemp oil, but it’s tough to know exactly how much. I recommend investigating the product, searching for the company that makes it, and seeing if they give more explicit details on their website. Even then, make sure the company is the actual seller on Amazon or else you may end up with a counterfeit product sold by wholesalers.
The best bet is to buy directly from the product website.
Is there oil for diabetics??
Although there aren’t any human trials that give CBD to diabetics to see what happens, there are some reasons to think it could be helpful:
Lowering stress. As stated in previous posts, CBD is an effective anti-stress agent. Stress is awful for anyone with diabetes. It increases blood sugar levels. It induces insulin resistance. And if you’re a stress eater, it can increase cravings for high-carb junk food that you really shouldn’t be eating in the first place. In other words, stress exacerbates all the physiological conditions a diabetic is already experiencing.
Improving sleep. Perhaps the most popular use of CBD is to improve poor sleep. Just about the best way to induce some serious glucose intolerance is to get a bad night’s sleep. A diabetic already has poor glucose tolerance; it’s pretty much the defining characteristic of diabetes. What’s worse, a bad night’s sleep has been shown to make a person more susceptible to the allure of junk food.
Inadequate sleep is a strong and independent predictor of type 2 diabetes risk. The less sleep you get, the higher your chance of developing diabetes.
Anything that reduces stress and improves sleep will improve a diabetic’s health. If CBD does that for you, it’ll probably help someone with diabetes. So in a roundabout, not direct way, CBD oil has the potential to help reduce the risk of diabetes and improve the symptoms.
Good MDA folks … does anyone have any experience using CBD oil in lieu of an SSRI to help with anxiety and panic? I’m using CBT techniques to deal with anxiety and panic episodes, and cutting back on my dosage of my SSRI with the intent to eliminate over the next couple of months. I was considering giving CBT oil a try (organic, full spectrum), starting out with just a drop or two and building up to a therapeutic dosage. Also, does CBT oil cause fatigue for anyone? It’s the last thing I want to happen as it’s a big reason I want to eliminate taking the SSRI?
Give it a try, making sure you keep your doctor in the loop.
There are several parallels between anti-depressants and CBD. Both antidepressants and CBD interact with the endocannabinoid receptor systems in the brain. Both antidepressants and CBD can stimulate neurogenesis and counter the depression-related reduction in brain-derived neurotrophic factor.
Any compound that’s used for sleep has the potential to increase fatigue. Sleep is fatigue at the right time. Fatigue is sleep at the wrong time. In an Israeli study of 74 pediatric epilepsy patients using CBD to quell their seizures, 22% reported unwanted levels of fatigue, so it’s a common complaint. Just consider that these were kids taking fairly high dose CBD to quell seizure activity, and that you may not have the same issue taking lower doses at a higher body weight.
Does CBD oil break my fast?
The dosages involved in most CBD oils include at most 1/8 teaspoon of carrier oils, so that’s not enough calories to impact your fast in any meaningful sense.
I haven’t seen any evidence that CBD itself inhibits or impedes ketosis, autophagy, or fat-burning. So, no, there is no indication that CBD oil breaks your fast.
How do I figure out how much cbd is in hemp oil?
As I indicated earlier, it’s impossible to know unless you buy a hemp oil that explicitly states the CBD content.
CBD oil is so expensive. Are there any other options for getting CBD?
You could make your own. It’s actually legal to buy “CBD flower,” which basically looks exactly like the cannabis or weed you’d buy on the street or at a legal dispensary, only it contains little to no THC and tons of CBD. One recipe I saw involved slow-cooking an ounce of the CBD flower in a cup of coconut oil for 8 hours, then straining out the solids. Whatever method you use to cook it, it requires fat, as cannabinoids are fat-soluble.
Here’s a place you can buy CBD flower online. (Note: I don’t have any experience with that company or any other that markets CBD flower or CBD products, so buyer beware.) There are many such places. Just search for them.
CBD is everywhere these days. Should I definitely use it?
Not necessarily. Like anything, it has its uses, there’s great potential, and as new research comes out I foresee the discovery of new modes of action and new applications. However, in all fairness, it’s being overhyped when promoted as a cure-all or panacea.
For what it’s worth, I’m not using it myself. I don’t feel the need, haven’t felt a “CBD deficit.” Don’t assume it’s yet another essential supplement that you simply must have. The basics are the important things—sleep, food, exercise, community, love, micronutrients.
CBD is best used for people who have an established need for it. Chronic pain patient who wants to stop using so many opioids? Great candidate. Kid with epilepsy for whom keto and meds aren’t working? Give it a try. Anxiety and insomnia? Better than just going with narcotics right off the bat. (But as always, work with a physician for any medical issue.)
That’s it for today, folks. If you have any more CBD questions, write them down below and I’ll be sure to answer them!
Rudnicka AR, Nightingale CM, Donin AS, et al. Sleep Duration and Risk of Type 2 Diabetes. Pediatrics. 2017;140(3)
Mcneil J, Forest G, Hintze LJ, et al. The effects of partial sleep restriction and altered sleep timing on appetite and food reward. Appetite. 2017;109:48-56.
Fogaça MV, Galve-roperh I, Guimarães FS, Campos AC. Cannabinoids, Neurogenesis and Antidepressant Drugs: Is there a Link?. Curr Neuropharmacol. 2013;11(3):263-75.
Tzadok M, Uliel-siboni S, Linder I, et al. CBD-enriched medical cannabis for intractable pediatric epilepsy: The current Israeli experience. Seizure. 2016;35:41-4.
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A couple months ago, a study came out that seemed to show that cheating on your keto diet with a high-carb meal opened you up to severe blood vessel damage. Nine healthy, normal weight adults followed a keto diet (70% fat, 20% protein, 10% carbs). Then they ate a high-carb “cheat meal,” measured their blood sugar, and measured their endothelial microparticles—a marker of damage to the endothelial lining and potential harbinger of impaired vascular function. Their blood sugar went way up, and so did their endothelial microparticle count, leading researchers to conclude that keto dieting makes people more susceptible to hyperglycemia-induced endothelial damage.
So, is keto cheating unhealthy? Let’s take a closer look….
My Analysis Of the Study:
Here’s why I don’t think this study applies to most of you:
These people were on keto diets, but they weren’t keto-adapted (let alone fat-adapted). They’d only been doing the diet for a week. Bare minimum, it takes three weeks to a month for full keto-adaptation to occur—and often longer. We’d have to see what happens to endothelial microparticle count when someone who is fully keto-adapted is exposed to higher carb intakes.
The “cheat meal” was 75 grams of pure glucose. This is the oral glucose tolerance test—the disgusting, cloyingly sweet drink they give people to test for diabetes. It measures your ability to handle pure glucose. It’s not a meal. It’s not actually food even. There are no mitigating micronutrients. There are no other macronutrients included. It’s just a shot of pure sugar, down the hatch. I don’t know about you, but that’s not my preferred method of a high-carb cheat meal.
However, it does illustrate the importance of sticking with the diet—any diet—for way longer than a week before assessing the effects or stepping out to indulge.
Look at the big picture. Acute perturbations to endothelial homeostasis can look bad in the short term and good over time. Hell, when you ask overweight women to engage in a single bout of high intensity exercise, their endothelial microparticle count goes up just like it went up for the guys in this study who drank the glucose water. They “damage” their vascular function. But if they keep training regularly, their endothelial microparticle count goes down. Acute stressors can look bad when applied once and awesome when applied consistently. That’s not to say that drinking 75 grams of glucose consistently will suddenly become healthy. I’m just showing how looking at a single short term reaction doesn’t give the entire story, or even accurately portray the effects of the same stimulus applied consistently over the long term.
A Better Perspective On Cheat Meals
Cheat meals can actually help you lose more weight. In one study, women were placed on a cyclic diet consisting of three phases. For each phase, they reduced calories for 11 days followed by 3 days of ad libitum (i.e. at one’s pleasure) eating. After the three phases, they’d lost an average of 8 kg (about 17 lbs) of pure body fat. This surpassed the amount predicted by calories in, calories out. This study didn’t employ all-out cheat days, or call them cheat days, but the concept of “ad libitum” is pretty similar.
If you cycle in high carb days or high carb meals into your keto diet, and you end up getting leaner and performing better in the gym because of it, are you really hurting yourself? Are you really setting your vascular system up for impending doom? I doubt it. One of the best ways to improve endothelial function is to lose excess body fat. Whatever helps you get to that goal should also improve vascular function.
If You’re Going To Cheat On Keto:
Get fully adapted.
The people in this study were not keto-adapted. They’d only been eating the diet for a week before taking the test. Stay with the diet for two months—strictly—before venturing out with cheat days.
Don’t cheat with an oral glucose tolerance test.
While some folks undoubtedly get off on drinking 75 grams of pure glucose, there are better ways to cheat. Like with food. Also, food tends to include mitigating factors—phytonutrients, fiber, vitamins, minerals—that improve the metabolic response to the macronutrients contained therein. For instance, including some natural cocoa in the cheat meal can drop your endothelial microparticles by 60% alone.
Be relatively lean and experienced.
Cheat days are more effective for fairly lean-ish people to kickstart the loss of those last few pounds. They’re designed for long-time keto eaters to replenish glycogen stores and improve training. They’re designed for people who have been strict for long enough that they just need a break. They just aren’t going to work the same for obese people who’ve been keto for a little while who still have a lot of easy weight to lose on strict keto.
Cheat after a big workout.
Exercising increases insulin sensitivity. And if you lift heavy things, you increase something called non-insulin dependent glucose uptake in the muscles. That means your muscles can actually refill their glycogen content without using insulin to do it. If you’re keto and want to incorporate high carb meals/days or cheat meals, legitimate training is pretty much required. After all, why do you need the carbs if you’re not training?
Cheat if you need it.
If things are stalling, and you’ve tried being even stricter to no avail, perhaps momentarily loosening up with a cheat meal is exactly what you need. Read this post to get the lowdown on why carb refeeds can help break weight loss stalls and how to do them.
This study shouldn’t be ignored. Big boluses of sugar are never a good idea, especially when you’ve only been eating low-carb or keto for a week and have yet to adapt. I find it plausible that such excursions can induce acute damage to the vascular system in anyone with impaired glucose tolerance—even if that glucose intolerance is transient, as it is in short term keto dieters—but I don’t think it means much for people with good heads on their shoulders who do keto the right way.
What do you think, folks? Do you cheat on your diet, whether you’re keto or just Primal? What steps do you take to make sure you’re getting the most out of your dietary excursions?
Thanks for reading, everyone. Take care!
Durrer C, Robinson E, Wan Z, et al. Differential impact of acute high-intensity exercise on circulating endothelial microparticles and insulin resistance between overweight/obese males and females. PLoS ONE. 2015;10(2):e0115860.
Mcfarlin BK, Venable AS, Henning AL, et al. Natural cocoa consumption: Potential to reduce atherogenic factors?. J Nutr Biochem. 2015;26(6):626-32.
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With warmer temps come lighter fare…and the spring produce to inspire it.
Whether you’re a Big-Ass Salad fan or more of a side salad connoisseur, we’ve got seven great tastes for you to enjoy this spring. Recreate them as pictured, or customize with your favorite ingredients, right down to DIY dressings.
We couldn’t think of a better salad to celebrate spring than this. Simple, fresh, and sweet, it’s a perfect accompaniment to an omelet breakfast or a grilled chicken dinner, but it’s also a satisfying light meal in its own right. With just 6 ingredients (including the dressing) and 10 minutes of prep time, you have a delicious salad (and nutrient powerhouse) on the table.
Salads can be as Big-Ass or as simple as mood and time dictate, but they always should be flavorful. We love this classic (and keto-friendly) recipe for a quick side or (topped with some bacon crumbles) a light lunch or dinner. The best part…it’s made with staple ingredients that are easy to keep on hand.
Bright, colorful, crisp and rich, it’s a great choice for a midweek family supper or even an impromptu dinner party.
Are you (like us) rejoicing yet that it’s almost summer—a season of warm days and light meals? Throw together this beautiful salad with baby spinach leaves, avocado slices, cherry tomatoes, shredded carrots, grilled chicken and Dreamy Italian Dressing & Vinaigrette for a fragrant and delicious Mediterranean flavor.
Here’s proof that you don’t need a lot of ingredients for big nutrition, taste and presentation. Kale and carrot strips (use mixed color carrots for an even brighter look), your favorite crunchy seeds, along with a Honey Mustard Vinaigrette, and you’ve got the perfect accompaniment for pork, chicken and more.
There’s something about spring and the fresh taste of citrus…. We love the blend of avocado and grapefruit in this hearty, simple salad. Just add leftover chicken and a healthy dose of Mark’s (current) favorite dressing, Lemon Turmeric.
This upgraded classic can be plated at home like a regular salad, or cleverly brought to work in a glass jar. Layering the dressing and ingredients in a jar stores everything neatly (no salad dressing leaks!) and keeps the salad crisp and fresh. When it’s lunchtime, just shake the salad into a bowl. Sub grilled chicken for salmon if you prefer!
As a light accompaniment to fish or poultry or a omelet, you can’t go wrong with spring greens and radishes—especially when topped with one of the most classic (and tangy) dressing tastes around.
What’s your favorite way to the lighter, fresher fare of spring? Or do you have a recipe you’d like us to whip up (or remake Primal or Primal-keto style)? Let us know down below, and thanks for stopping in today.
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Have you heard? There’s a new “red meat will kill you” study. This time, it’s colorectal cancer.
Here’s the press release.
Here’s the full study.
I covered this a couple Sundays ago in “Sunday with Sisson.” If you haven’t signed up for that, I’d recommend it. SWS is where I delve into my habits, practices, and observations, health-related and health-unrelated—stuff you won’t find on the blog. Anyway, I thought I’d expand on my response to that study here today.
How the Study Was Conducted
It’s the basic story you see with most of these observational studies. Around 175,000 or so people were asked to recall what they ate on a regular basis—a food frequency questionnaire. This is the exact questionnaire, in fact. The research team took the answers, measured some baseline characteristics of all the subjects—socioeconomic status, exercise levels, whether they smoked, education level, occupation, family history of colorectal cancer, and a few others—and then followed up with participants an average of 5.7 years later to see how many had developed colorectal cancer.
What the Study “Showed”
Those who had moderate amounts of red meat had a 20% higher chance of getting cancer.
And in the end, the increased risk was a relative risk. It wasn’t a 20% absolute increase in risk. It was a relative increase in risk. The subjects started with a 0.5% risk of getting bowel cancer. In those who ate the most processed meat and red meat, that risk increased 20%—to 0.6%!
From 0.5 to 0.6%. Sure, that’s an increase, but is it something to overhaul your entire diet for? To give up the best sources of zinc, iron, B vitamins, protein, carnosine, creatine? All that for a measly 0.1% that hasn’t even been established as causal?
Study Findings Most News Outlets Won’t Include
One head scratcher that leaps out: the link between unprocessed red meat and colon cancer was not actually statistically significant. Only processed meat was significantly linked to colon cancer.
Another head scratcher: red meat, whether processed or unprocessed, had no significant association with colorectal cancer in women. Why didn’t they highlight the fact that in women, eating red meat was completely unrelated? That’s half the world’s population. That’s you or your mom, your daughter, your grandmother, your girlfriend. And unless they were to look at the full study and read the fine print, they’d never know that red meat actually had the opposite relationship. You’d think the authors would want to mention that in the abstract or see that the press releases and media treatments highlighted that fact.
It’s probably because mentioning that red meat was neutral in women and had no statistically significant link to colon cancer in men and women would have destroyed their case for red meat as an independent carcinogen. See, carcinogens are supposed to be carcinogens. There are many meaningful differences between men and women, but a poison is a poison.
What’s the proposed mechanism for red meat triggering colon cancer in men but not in women? If they didn’t have one (and I imagine they wouldn’t have mentioned it if they did), then there’s probably something else going on.
Besides, the literature is far from unequivocal.
What Other Research Says About Red Meat and Bowel Cancer
In analyses that include consideration of cooking methods and other mitigating factors, red meat has no relationship with colon cancer.
Or what about this study, where colon cancer patients were more likely to eat red meat, but less likely to have type 2 diabetes? Should people avoid red meat and work toward getting diagnosed with type 2 diabetes?
Or how about this study, which found no difference in colorectal cancer rates between people who ate red meat-free diets and people who ate diets containing red meat? Shouldn’t the diet without any red meat at all have some effect?
Or this classic study, where rats on a bacon-based diet had the lowest rates of colon cancer. In fact, bacon protected them from colon cancer after they were dosed with a colon cancer promoter, while rats on normal “healthy” chow were not.
The Blind Spot In Red Meat Research
I don’t need to go into all the confounding factors that might predispose conventional red meat lovers to bowel cancer. Nor will I mention that it’s impossible to fully control for variables like the buns and bread and fries you eat the red meat with and the industrial seed oils it’s cooked in.
That last bit is crucial: the seed oils. It’s what nearly every cancer researcher misses. It’s not just a minor variable; it’s quite possibly the most important determinant of whether meat is carcinogenic in the colon or not. Heme iron—the compound unique to red meat that usually gets the blame for any increase in cancer—is most carcinogenic in the presence of the omega-6 fatty acid linoleic acid.
In one study, feeding heme iron to rats promoted colon cancer only when fed alongside high-linoleic acid safflower oil. Feeding MUFA-rich and far more oxidatively-stable olive oil alongside the heme prevented the colon carcinogenesis.
Another study had similar results, finding that meats containing medium to high amounts of heme—beef and beef blood sausage—promoted carcinogenic conditions in the colon when the fat sources were linoleic acid-rich corn and soybean oil.
And most recently is this paper. Mice were split into three groups. One group got heme iron plus omega-6 PUFA (from safflower oil). One group got heme iron plus omega-3 PUFA (from fish oil). The third group got heme iron plus saturated fat (from fully hydrogenated coconut oil, which contains zero PUFA). To determine the carcinogenicity of each feeding regimen, the researchers analyzed the effect the animals’ fecal water (which is exactly what it sounds like) had on colon cells. The fecal water of both PUFA groups was full of carcinogenic indicators and lipid oxidation byproducts, and exposing colonic epithelial cells to fecal water from PUFA-fed mice was toxic. The coconut oil-derived fecal water had no markers of toxicity or lipid oxidation.
I never see these (animal) studies cited in observational studies of meat and colon cancer. I think that’s a huge blindspot, and it’s one of the reasons I rarely put any stock in these scary-sounding studies.
That’s it for today, folks. Thanks for reading. Now go enjoy a steak.
Bylsma LC, Alexander DD. A review and meta-analysis of prospective studies of red and processed meat, meat cooking methods, heme iron, heterocyclic amines and prostate cancer. Nutr J. 2015;14:125.
Alsheridah N, Akhtar S. Diet, obesity and colorectal carcinoma risk: results from a national cancer registry-based middle-eastern study. BMC Cancer. 2018;18(1):1227.
Rada-fernandez de jauregui D, Evans CEL, Jones P, Greenwood DC, Hancock N, Cade JE. Common dietary patterns and risk of cancers of the colon and rectum: Analysis from the United Kingdom Women’s Cohort Study (UKWCS). Int J Cancer. 2018;143(4):773-781.
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Folks, you know I’m a long-time believer in intermittent fasting for longevity, autophagy, mental clarity, fitness performance, metabolic health, and more. I’m excited that Dr. Jason Fung has stopped by the blog today to share a bit about common fasting mistakes. Enjoy!
So, you’ve decided to add some fasting to your lifestyle. Excellent. No matter how much you have (or haven’t) read on the topic, you’re likely to find aspects of fasting to be challenging or even frustrating. It can be hard to stay on track when you’re feeling hungry, irritable and not really noticing any changes.
It’ll become tremendously easier once you begin to experience the health benefits of fasting, but we all know it takes a little while for that to happen. Benefits like mental clarity and improved energy will show up sooner than significant weight loss. Plus, the benefits you experience will depend on what kind of fast you’re doing and how well you stick to it.
But if you’re making fasting mistakes, you might never accomplish the benefits you were hoping for. . Before you throw in the towel, I want to help you identify some possible fasting pitfalls you might not be aware of and also help you avoid them. Plus, don’t miss the Number One reason fasts fail, shared at the end of this article.
1. You’re Snacking or “Grazing”
Look, the entire purpose of a fast is to contain your eating within certain windows of time. Snacking or “grazing” all day long is basically the opposite of fasting, so stop thinking that you can get away with it. Fasting is “on” or “off”—there is no gray area. Even having “just a bite,” no matter how healthy or how little, will almost invariably kick your body out of fasting mode and will interfere with the healing process responsible for fasting’s many benefits. It also creates a situation where your body is producing insulin all day long. Bad idea.
Avoid grazing by putting snacks and food out of sight. The phrase “out of sight, out of mind” really applies here. You’ll be amazed how much easier it is to bypass snacking when the food isn’t sitting right in front of you. If you snack out of habit, get creative and find new, non-food based habits. If your snacking comes from genuine hunger, you may need to re-evaluate the meals you eat during your eating window. Make sure you’re getting enough healthy, unsaturated fats with each meal as these will keep you satiated for longer.
2. You Aren’t Drinking Enough Water
This is not only a common fasting mistake, but a mistake most people make no matter what their diet is. Drinking a minimum of eight glasses of water daily is essential to staying hydrated and healthy. Some signs that you aren’t drinking enough water include dizziness and lightheadedness, feeling tired, or constipation.
Even worse, when you don’t drink enough water, your brain may try to trick you into thinking that you’re hungry, so you get the vitamins and minerals you’re lacking. Minerals like potassium and magnesium are essential to your brain health. So don’t be surprised next time you feel hungry but find that drinking a glass of water makes the appetite disappear. Various kinds of tea are also a satisfying way to hydrate, or try some bone broth if you’re truly struggling.
3. You Aren’t Consuming Enough Salts
Speaking of vitamins and minerals, appropriate salt intake is vital to your health. Now, when I say “salt,” I’m not talking about the kind you put in a shaker. I’m talking about electrolytes, which are essential to your diet. Sodium (Na), which is also commonly known as table salt, is one of these electrolytes, along with potassium (K), magnesium (Mg), calcium (Ca), and chloride (Cl).
How can you tell if you’re low on electrolytes? Some symptoms of electrolyte deficiency are anxiety, irritability, trouble sleeping, muscle spasms, fatigue, digestive issues, and dizziness. If these are the kinds of symptoms you experience during your fast, lack of electrolytes could be the answer. Try taking some pink Himalayan rock salt and placing it under your tongue to dissolve. You can also try drinking some pickle juice — just make sure it’s from high-quality natural pickles and not the kind made with sugar.
4. You’re Eating Right Before You Go To Sleep
Your body needs time to digest all the food from your last meal before you go to sleep. If you’ve scheduled your eating window to happen right before bedtime, your body will be taking all the time you’ve allotted to rest to digest instead. That takes energy, and instead of waking up feeling restored and ready to take on the day, you’ll just feel tired.
When you’re following a fasting plan, a seven-hour window is an ideal amount of time to leave between your last meal and when you go to sleep. Even three or four hours is enough to make a difference. Unfortunately, with crazy work schedules and early mornings, a lot of people aren’t able to stick to that three- or four-hour window. It’s more like get home, eat dinner, and go straight to bed. If this is you, the next best thing is to eat a light meal, like salad, and avoid a meal filled with carbohydrates and protein.
5. You’re Eating Too Much of Some Food Groups
When we cut certain foods from our diet, especially carbs, it’s easy to rely on other food groups, like nuts and dairy. They’re readily available and a staple of most diets.
Nuts are a low-carb, healthy fat option, but only in small amounts. They’re great to add to fruit or veggie salads, and they’re easy to grab a handful of when you need a quick snack. But those quick snacks can add up, especially on top of eating full meals. Nuts are high in good fat, low in carbs, and are a good source of protein, but too much protein can be detrimental to your fast. Excess protein that your body doesn’t need is converted to glucose and stored as fat. If you’re fasting to lose weight, this is the exact opposite of what you want.
Dairy, the other easy food group that too many people defect to, can cause inflammation, upset stomach, bloating, gas, and other kinds of discomfort. If this is a pattern you’ve noticed with your own health and eating habits, try cutting out dairy for a few weeks and see if these symptoms improve. If you haven’t noticed these symptoms, be more mindful of your eating habits and track how you feel after eating dairy.
6. You Aren’t Eating Enough of Certain Food Groups
As easy as it is to eat too much of one food group, it’s equally easy to not get enough of another. Just because you can eat “whatever” you want during your eating window doesn’t mean you should. Empty calories and junk food are momentarily satisfying, but they don’t fuel your body. Eating the right foods provides your body with the nutrients it needs to thrive throughout the day; these foods will also keep you feeling fuller, longer.
Vegetables are one of the best food groups to keep you nourished and thriving. They’re low calorie and they provide different vitamins and minerals like potassium, fiber, folate, vitamin A, and vitamin C. Fruits are also healthy, but don’t overdo it, as most are high in sugar. Fruit juices typically have added sugar as well. Naturally flavored drinks and teas are the healthiest option. Nuts are high in fat and a good source of protein, as are eggs. Refined carbohydrates and sugars are highly unnecessary for your body and if you’re going to include them in your meals, there should be very little.
7. You’re Pushing Your Body Too Hard
Did you dive off the deep end and go from zero fasting to attempting 24-hr fasts every other day? Back up and take a more moderate approach first. Don’t expect fasting to be easy right away. Not only will your body need time to adjust, but your mind will, too. If you’ve been accustomed to three square meals a day, plus snacks and calorie-filled drinks, your body has gotten used to this routine.
Your body needs time to adapt. First it burns through stored sugar and then it will start burning body fat for energy. Start slow and get a feeling for this new practice. You can start with a twelve-hour fasting period and twelve-hour eating window. When eight hours of that fast are during your sleeping hours, this window is relatively easy. Once you’ve become accustomed to this schedule, you can reduce your eating window to ten hours. Continue decreasing your eating window by two hours every one to two weeks, until you’ve hit the fasting period you want.
8. You Have the Wrong Mindset
Fasting provides your body with everything it needs to thrive, but without the right mindset, you’re bound to fail. Focusing on the negative, like not being allowed to eat certain foods or at certain times, will easily spiral into other negative self-talk. The harder you are on yourself, the more difficult it is to achieve success.
Rather than thinking about how hard the fast is, focus on the positive that will come out of it. Fasting allows your body to heal. Fasting can help you lose weight. You’ll feel more energized and have a clearer mind. Whatever the reason you’ve chosen to fast, focus on that. Fasting with a friend, family member, partner, or online community is another way to hold yourself accountable and can be very helpful.
9. You’re Too Stressed
When you’re stressed, your body releases a hormone called cortisol. Cortisol is problematic when fasting because it can prompt your body to break down muscle tissue instead of fat. When fasting, your body should tap into stored body fat and preserve your healthy muscle tissue.
If you’re stressed on occasion, this shouldn’t cause much of a problem. But if you’re chronically stressed, that constant release of cortisol can lead to a breakdown of muscle tissue.
Not sure if you’re stressed? Here are some symptoms:
- Teeth grinding
- Muscle tension
- Digestive problems
- Trouble concentrating
Alleviate stress with deep breathing, positive visualization, an epsom salt bath, and stress-relieving teas. If you can, take some time off from work. If you’re an outdoorsy person, relax in nature.
10. You’re Inactive
Being inactive is one of the biggest mistakes people make during their fast. If you aren’t eating, you should rest and save your energy, right? Wrong. Exercise is a great way to improve your fasting. Activity increases fat burning and boosts circulation. Going outside and getting some sunlight and fresh air can improve your mood, making you more likely to stick to your fast. Movement generally makes people feel better than sitting on the couch inside all day; being inactive makes you cold, tired, and unfocused.
Since a lot of people work sedentary jobs that tie them to a desk all day, exercise isn’t a convenient way to stay active. But taking a short walk or stretching are two easy ways to get your blood flowing throughout the day.
Fasting shouldn’t be synonymous with suffering. If you’re feeling deprived during your fast, be sure that you aren’t making any of the above fasting mistakes. Ease yourself into your fast, stick with it, and enjoy the results when they come with time.
But there’s one more—in fact, the number one reason fasts fail….
Can you guess what it is?
***Giving Into Cravings
Which is why I want to tell you about my new favorite secret weapon for staying fasted longer and with less difficulty: Pique Fasting Teas. Why tea? The combination of catechins and caffeine gives you a higher chance of experiencing tangible benefits from fasting. It suppresses hunger cravings, boosts calorie burn and supports malabsorption of unhealthy fats and sugars.
These Fasting Teas include ingredients targeted at maximizing the fasting experience:
1) Organic highest ceremonial grade matcha, which increases levels of l-theanine to calm and tide you through your fasts with ease. 2) Organic peppermint, which is a natural appetite suppressant with calming properties. 3) Proprietary blend of high catechin green Tea Crystals, which regulate the hunger hormone ghrelin and increase thermogenesis (burning fat for fuel). This helps you to stay fasted and see quicker results. 4) Additional plant ingredients including ginger and citrus peel to support digestion and enhance autophagy.
As with all of Pique’s teas, you can rest assured these are pure and Triple Toxin Screened for pesticides, heavy metals and toxic mold. For a limited time only, if you order through the Mark’s Daily Apple link, you can get up to 8% off and free shipping (U.S. only).
Thanks again to Dr. Jason Fung for today’s post. Have questions on fasting protocols or missteps? Share them below, everybody, and have a great day.
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It seems every “keto for women” forum abounds with stories about menstrual cycles gone wild in the first few months of keto. Irregular cycles, breakthrough bleeding, and periods lasting much longer than normal are common complaints. Sometimes these stories are cited as evidence that keto isn’t good for women, at least not premenopausal women, and that we need carbs for healthy hormones. Yet, many women don’t notice any changes in their menstrual cycles at all, while others report improvement in PMS symptoms and cycle regularity from the get-go.
What gives? Why do some women’s cycles apparently become wacky when they start keto, while others feel like keto is the key to period bliss? Can keto “mess up” the menstrual cycle?
We know that diet—what and how much we eat—can profoundly affect our hormones. This is true for both women and men. One of the reasons people are so excited about ketogenic diets is specifically because keto shows promise for helping to regulate hormones and improve cellular sensitivity to hormones such as insulin and leptin.
At the same time, women’s hormones are especially sensitive not only to dietary changes but also to downstream effects such as body fat loss. Furthermore, one of the ways women’s bodies respond to stressors is by turning down the dial on our reproductive systems. It’s reasonable to hypothesize, then, that women might have a tougher time adapting to or sustaining a ketogenic diet. Keto can be stressful depending on one’s approach, and that might negatively impact women’s reproductive health. But do the data actually bear that out, or is so-called “keto period” more misplaced hype than genuine fact?
Note that throughout this post, I’m going to use the term “reproductive health” to refer to all aspects of women’s menstrual cycle, reproductive hormones, and fertility. Even if you aren’t interested in reproducing right now, your body’s willingness to reproduce is an important indicator of overall health. When your reproductive health goes awry—irregular or absent periods (amenorrhea) or hormone imbalances—that’s a big red flag. Of course, post-menopausal women can also experience hormone imbalances that affect their health and quality of life (and low-carb and keto diets can be a great option for them).
Menstrual Cycle 101
Let’s briefly review what constitutes a normal, healthy menstrual cycle, understanding that everybody’s “normal” will be a little different. A typical cycle lasts from 21 to 24 days on the short end to 31 to 35 days on the long end, with 28 days being the median. Day 1 is the first day of your period and begins the follicular phase, which lasts until ovulation. Just before ovulation, levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), and estradiol (a form of estrogen) spike. Next comes the luteal phase covering the approximately 14 days from ovulation to menses. LH, FSH, and estradiol drop, while progesterone rises. Estradiol bumps up again in the middle of the luteal phase. If a fertilized egg is not implanted, menstruation commences, and the whole cycles starts over again. All this is regulated by a complex communication network under the hypothalamic–pituitary–gonadal (HPG) axis, which is closely tied to the actions of the adrenal (the A in HPA axis) and thyroid glands.
Across the cycle, fluctuations in body weight are common as fluid is retained and then released along with shifts in estrogen and progesterone. Changes in blood glucose are also normal, and insulin-dependent diabetics often find that they need to adjust their dose at different times of their cycles to keep their blood sugar in check. The most common pattern is higher blood glucose readings in the pre-menstrual period (the second half of the luteal phase), and lower readings after starting your period and before ovulation. This is generally attributed to the fact that progesterone, which is highest during the luteal phase, is known to reduce insulin sensitivity. However, different women experience different patterns, which can also be affected by other factors such as oral contraceptive use.
Normal fluctuations in insulin resistance and blood glucose can mean that women get lower ketone readings at certain times of the month than others. When these occur premenstrually—and so they tend to coincide with a period of (transient) weight gain and food/carbohydrate cravings—women often feel as though they are doing something wrong. Rest assured that these variations reflect normal physiology.
The many factors that affect your cycle and the levels of your sex hormones include: other hormones, gut health and microbiome, metabolic health (e.g., insulin sensitivity), environmental toxins, stress, sleep, immune health, nutrient deficiencies, activity level and energy expenditure, and age. Each affects the others, and all (except age of course) can be affected by diet. It’s no surprise, then, that it can be extremely difficult to pin down a root cause of menstrual changes or reproductive issues.
What the Research Tells Us About Keto and Menstruation
As I said at the outset, there are lots of anecdotes, both positive and negative. In my experience, most women whose cycles seem to go crazy when they start keto find that things get back to normal—and often a better version of normal—after a few months.
First, it’s tricky to determine the effects of keto per se, since many people combine a ketogenic diet with calorie restriction (intentionally to lose weight or unintentionally due to the appetite suppressing effects of keto) and with fasting (intermittent and/or extended). Each of these can independently impact the factors listed above, lead to weight loss, and affect the menstrual cycle and reproductive health.
So, is there any evidence that keto itself causes changes to menstruation?
The scientific evidence is scant….
The one statistic you’ll see floating around the interwebs is “45% of (adolescent) females experience irregular menstrual cycles on keto.” This statistic comes from one small study of adolescent girls using a therapeutic ketogenic diet to treat epilepsy. Six of the twenty girls reported amenorrhea (loss of period) and three were diagnosed with delayed puberty. However, the ketogenic diet used for epilepsy is different and usually much stricter than an “everyday” keto diet needs to be, and epilepsy is frequently associated with menstrual dysfunction regardless of diet.
To extrapolate the findings of this study and argue that nearly half of teenage girls (or women generally) are likely to experience menstrual problems from going keto is a huge leap.
The fact is, I’m unable to find any studies done in healthy human females (or mice for that matter) demonstrating that otherwise normal menstrual cycles are disturbed by going keto.
5 Ways Keto-Related Factors *Might* Affect Your Menstrual Cycle
With the limited amount of research looking directly at keto and menstruation, let’s look first at whether there are direct effects of carbohydrate restriction or elevated ketone production on the menstrual cycle. Those are the defining characteristics of keto and what differentiates keto from other ways of eating. Then we can examine indirect effects that occur due to factors such as weight loss. These are not unique to keto, though they might be more likely on a ketogenic diet compared to other ways of eating.
There is no real body of evidence that looks at ketogenic levels of carb restriction and menstruation, but there are some clues. In this small study, functional hypothalamic amenorrhea (FHA) was associated with dietary fat restriction; women with FHA actually ate non-significantly more carbs than matched controls and nearly identical total calories. Likewise, in this small study, FHA was associated with lower fat intake but no significant difference in carb intake.
This meta-analysis looked at the effect of low-carb (not keto) diets on markers of reproductive health among overweight women. The researchers found four studies that examined effects on menstruation; all showed improved menstrual regularity and/or ovulation rates. Of six studies that looked at levels of reproductive hormones, five reported significant improvements.
Carb restriction also results in decreased insulin production. Hyperinsulinemia and insulin resistance are frequently associated with polycystic ovarian syndrome (PCOS), one of the leading causes of female infertility and a frequent cause of menstrual irregularity. There is currently a lot of interest in using keto to treat PCOS, but only one small study has so far directly tested the effectiveness of a ketogenic diet to treat PCOS, with positive results.
No studies have looked at the direct effects of ketones on menstruation.
Of course weight loss is not unique to keto, but keto can be very effective for weight loss. Some women experience rapid weight loss when first starting a keto diet. Weight loss in and of itself can impact menstruation through a variety of pathways. A key way is by reducing the hormone leptin. Leptin’s main job is to communicate energy availability to the hypothalamus—high levels of leptin tell the hypothalamus that we have enough energy on board, which also means we can reproduce. Low leptin can disrupt the menstrual cycle and is linked to hypothalamic amenorrhea.
Body fat loss can also affect estrogen levels since estrogen is both stored and produced in adipocytes (fat cells). While fat loss in the long term will decrease estrogen production, it is possible that rapid fat loss might temporarily raise estrogen levels and can also affect estrogen-progesterone balance. These transient changes in estrogen levels might underlie some of the menstrual irregularities women report.
Stress can impact the menstrual cycle in myriad ways. Cortisol acts on the hypothalamus and pituitary glands, affecting hormone levels, sleep, immune function, and gut health, to name a few. Diets can be a source of stress, both at the physiological and psychological levels. Keto has a reputation for being especially stressful because it is more restrictive than other low-carb diets, but this can be mitigated by following the Keto Reset tips for women.
Thyroid dysregulation is another common cause of menstrual irregularities, and there remains a pervasive belief that keto is bad for thyroid health. Indeed, the thyroid is sensitive to nutrient deficiencies and caloric restriction, and thyroid hormones, especially T3, do frequently decline on keto. However, as Mark has discussed in a previous post, changes in T3 levels might not be a problem, especially in the absence of other problematic symptoms. Moreover, many practitioners now use keto as a cornerstone in their treatment of thyroid disorders.
What Should I Take From These Findings?
The first takeaway: there just isn’t much direct evidence about how keto might affect your menstrual cycle, positively or negatively. We have some studies suggesting that low-carb diets improve some aspects of menstruation and reproductive health, but keto is more than just another low-carb diet. Ketones themselves have important physiological properties, such as being directly anti-inflammatory, which might positively impact women’s reproductive health.
Second, the ways that keto is likely to (negatively) affect menstruation aren’t unique to keto, they’re common to any diet: hormone shifts mediated by energy balance, stress, and weight loss.
Furthermore, since keto is so often combined with caloric restriction, time-restricted eating, and fasting, even the anecdotal evidence might not be able to tell us all that much. If a woman is eating ketogenically, in a big caloric deficit, and doing OMAD (one meal a day), and her leptin plummets, how are we to know what really caused it? We don’t have good evidence that otherwise healthy women start a well-executed ketogenic diet and end up messing up their menstrual cycles.
That said, women do need to be cognizant of the sum total of the signals they are sending their bodies when it comes to energy availability and stress. A lot of women come to the keto diet with a history of adrenal, thyroid, metabolic, and reproductive issues. It’s important that they’re extra careful about how they approach keto. Done correctly, it might be just what the doctor ordered. I encourage any woman who’s dealing with other hormonal issues to work with a medical practitioner to tailor a keto diet to her unique needs.
But I’m Telling You, Keto Made My Period Go Haywire!
Ok, I believe you, really! But changes do not necessarily equal dysfunction. It is normal to experience hormone fluctuations when you make a massive—or even a relatively small but important—shift in your nutrition. Sometimes those fluctuations are unpleasant or unwanted, such as a period that lasts 14 days or one that arrives a week before you planned while you’re on vacation. However, that doesn’t make them bad from a health perspective. We need to respect that our bodies are dynamic systems. Changing the input will invariably change the output, and the system might need a few months to adapt to a new normal.
If your cycle goes wonky but you’re otherwise feeling good, give it a few months to sort itself out. If after a few months it’s still all over the place (or definitely if you’re having other disruptive symptoms), enlist help. In the meantime, check to make sure you’re not short-changing yourself nutritionally or calorically. Scale back on fasting efforts, and consider shifting more toward a traditional Primal way of eating.
At the end of the day, if you go keto and experience negative effects, stop. Keto is super hyped right now, but if your body is sending you clear signals that keto is not a good approach for you at this time, don’t do it. You can always try again later. It might be that your first attempt at keto didn’t work, but with a few adjustments and some experimentation over time you can find a version of keto that works for you.
Thanks for reading, everyone. Do you have comments, questions, or feedback? Let me know below.
Comninos AN, Jayasena CN, Dhillo WS. The relationship between gut and adipose hormones, and reproduction. Human Reproduction Update 2014; 20(2): 153–174.
Fontana R, Della Torre S. The Deep Correlation between Energy Metabolism and Reproduction: A View on the Effects of Nutrition for Women Fertility. Nutrients. 2016;8(2):87.
Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obesity Reviews 2007;8(1):21-34.
Meczekalski B, Katulski K, Czyzyk A, Podfigurna-Stopa A, Maciejewska-Jeske M. Functional hypothalamic amenorrhea and its influence on women’s health. J Endocrinol Invest. 2014;37(11):1049–1056.
Tena-Sempere M. Roles of Ghrelin and Leptin in the Control of Reproductive Function. Neuroendocrinology 2007;86:229-241.
The post Keto and the Menstrual Cycle: Is There Reason To Worry? appeared first on Mark’s Daily Apple.
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Last week, I explored the impact of all the various foods, beverages, and food-like substances people consume while fasting—and hoping to maintain a functionally fasted state in the post, “The Definitive Guide To What Breaks a Fast.” Does MCT oil break the fast? What about coffee, tea, or bone broth?
There were more than a dozen, and I even did a follow-up. Today I’m going to discuss whether commonly-consumed supplements break the fast.
Fish oil is pure fat. If you’re taking the average supplemental dose of 1-2 grams of fish oil, it’s not a problem. That’s not even a teaspoon. It’s about 9-18 calories.
You may burn slightly less fat than you would otherwise, but in the grand scheme of things, a few grams of fish oil won’t break the fast.
Cod Liver Oil
Cod liver oil is fish oil with extra vitamin D and vitamin A. As long as you keep the doses low enough, cod liver oil won’t break the fast.
Multivitamins do not break a fast. They are usually non-caloric. However, not all of their components will be absorbed very well on an empty stomach, so keep that in mind.
If you’re still not on board, note that in the older studies with really overweight people who fasted for upwards of a year straight, they usually supplemented with a multivitamin.
A popular one I’ve seen around—Alive, made from kale and raspberries—has just 2 grams of carbs per dosing. It’s not ideal, but it’s not a deal breaker—or a fast-breaker.
Gummy vitamins have the potential to be about 5-6 grams of sugar, a gram of protein (from gelatin), and a gram of fat (if including omega-3s) per serving, so they’d arguably break the fast. Plus, they taste like candy and are likely to stimulate cravings and make fasting harder.
Gummy vitamins break the fast.
Potassium is non-caloric and does not break the fast. In fact, it can help you handle the fast better by replenishing electrolytes.
Potassium doesn’t break the fast.
Creatine contains no calories and has no effect on insulin secretion (or glucose in the absence of calories).
Creatine does not break the fast.
Protein powder provokes an insulin response, which opposes autophagy, which means you’re breaking your fast. Plus, protein powder contains calories.
I’m going to say “yes, protein powder breaks the fast.”
If you’re strict and technical, then yes, collagen breaks a fast. There’s evidence that glycine—the most prominent amino acid in collagen—can inhibit autophagy, but it was a convoluted animal study where inhibiting autophagy with large doses of glycine after brain injury actually improved outcomes. It probably doesn’t apply to someone adding a scoop of collagen to their coffee. Besides, even if it slightly reduces autophagy, a little collagen won’t negatively impact ketosis, fat-burning, or energy intake.
I’m going to say “technically yes,” but “realistically no, collagen doesn’t break the fast.” Avoid if your main focus is autophagy, however.
Branch Chain Amino Acids (BCAAs)
BCAAs trigger an insulin response and thus stop autophagy…and the fast. That said, many proponents of fasted training recommend using BCAAs before a workout to help preserve muscle and improve the post-workout anabolic response.
I’m going to say “yes, BCAAs break the fast.”
Vitamin D is fat soluble and thus comes packaged in an oil carrier, but the dosage is so small that it won’t affect your fast.
Unless you find that 1/8 teaspoon of olive oil ruins your fast, vitamin D won’t break a fast.
Probiotics contain no calories and will not break a fast. However, they are best absorbed in the presence of food—the food protects them as they travel through the digestive system, and most probiotics occur naturally in food—so taking them during a fast is probably, mostly useless.
Probiotics don’t break a fast, but why take them during one?
Pure prebiotics will not break a fast, as they contain no digestible carbohydrates. Prebiotic-enriched foods will break a fast, as they do contain calories.
Adaptogens are compounds, usually herbs or herb derivatives, that modulate your stress response. They improve your ability to tolerate and respond to stressful situations; they don’t blindly inhibit the stress response if the stress response is warranted. They keep you honest and counter unnecessary stress responses. They contain no calories, unless you’re chowing down on a big hunk of maca or ashwagandha root. In fact, most adaptogens have traditionally been consumed in tea form, extracting the active compounds and leaving behind any calories. Have at ’em.
Adaptogens do not break the fast.
Medicinal mushroom extracts come from mushrooms, which are technically food. But the amounts you take are so low—usually no more than a teaspoon—that they won’t impact your fast or provide any significant amount of caloric energy. Four Sigmatic has those “mushroom coffee” blends you add to hot water. They can get up to about 30 calories per serving, but even that’s going to let you maintain most of the fasting benefits.
Mushroom extracts don’t break the fast.
I used to keep the old Trader Joe’s melatonin on hand because it was half a milligram, whereas most other melatonin supplements are in the 3-5 mg range. It was also sweet, tasting like those white Valentine’s Day mint hearts you used to get back in the day. I haven’t come across any sweetened melatonin supplements since Trader Joe’s phased those out, but that’s the only thing I’d worry about on a fast.
Melatonin does not break a fast.
Final Note: Most supplements are okay to take on a fast, though the lack of food may make absorption more difficult. If you have any other questions about supplements on a fast, drop them down below. Thanks for reading, everybody.
On a related note, with supplements on my mind this week I thought it would be a good time to offer one of my favorite deals—just for the MDA community: 20% off my full supplement line, plus Primal Fuel and Collagen Fuel. It’s a great time to stock up on favorites or to try something new. Offer ends 4/24/19 midnight PDT. Use code WELLNESS20 at checkout. (Offer doesn’t apply for autoship orders.)
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For today’s edition of Dear Mark, I’m answering a round of questions drawn from the comment section of the “What Breaks a Fast” post. You folks had tons of follow-up questions about whether other types of foods or compounds break a fast. Does a teaspoon of honey? Does elevated insulin from BCAAs? Does coconut milk? Does pure prebiotic fiber? What about longer fasts—are they recommended? And how about unsweetened cocoa powder? What explains my ability to predict your questions? Do sausages break a fast? Does liquor? How should you exercise?
Let’s dig right in:
Hey, what about honey? 1 tsp in morning tea?
A teaspoon or less of honey is fine and won’t negate the benefits of fasting. I alternate between doing collagen coffee and coffee with cream and teaspoon of sugar (which was my typical morning coffee for over a decade). No reasonable person should fear a teaspoon of sugar or honey.
For what it’s worth, honey isn’t “just” sugar. It elicits a more beneficial (or less negative) metabolic response than other forms of sugar.
I’m shocked about the BCAA. I used to fast and take BCAA’s (yes, to continue dynamic exercise). I used to find it extremely difficult to fast compared to now when I fast without taking them. Does that mean that the insulin response made fastic more difficult?
It’s possible. Insulin impairs lipolysis—the release of stored body fat into circulation for energy usage—and the success of fasting depends on lipolysis. Without lipolysis, you can’t access all that stored energy.
Thank you very much for this info!! I am a butter-coffee-for-breakfast drinker, and I always worry about the ingredients breaking a fast. Could you please comment on coconut milk (in the can)? I love putting that in my coffee/breakfast.
Coconut milk is a less concentrated source of medium chain triglycerides, or MCTs (as in MCT oil). MCTs convert directly to ketones, making MCT oil and to a lesser extent coconut oil or coconut milk a potential “boost” for fasting. Still, energy is energy, and any energy you take in is energy you won’t be pulling from your body.
I find MCTs and coconut to be more useful when someone is just getting the hang of fasting or ketosis—as a nice boost to get things moving in the right direction.
Keep your coconut milk under a tablespoon and you’ll be fine.
Does prebiotic (resistant starch) fiber break a fast? Acacia senegal or potato starch? Thanks!
No. If you’re worried, test your postprandial blood sugar after eating the fiber.
Great input Mark as someone 3days into a 7day water fast with electrolytes of course what’s your view on longer fasts.
Check out the post I wrote on long fasts. Potentially beneficial but the risks accumulate the longer you go. You just have to be even more careful and methodical.
How about unsweetened cocoa?
A tablespoon runs just over 12 calories (depending on the brand; some cocoa powders contain more fat and thus more calories), with around a gram of net carbs and a gram of fat. Also a nice source of potassium and magnesium, along with a ton of polyphenols which can have fasting-mimicking effects on their own.
Eating enough unsweetened cocoa powder to knock you out of your fast would be incredibly repulsive. Probably impossible.
Cocoa is definitely a nice addition.
Okay it’s almost creepy the way Sisson answers my questions before I even ask them! I was wondering about this yesterday and then this post popped up in my inbox.
How does he do that…?
Kraft-Heinz has a strong relationship with Google and Amazon, and the Kraft acquisition gave me access to Alexa/Google Home datasets and the ability to predict what my readers are wondering about.
Just kidding, though it’s scarily not out of the realm of possibility anymore.
What about a small snack of paleo sausages, smoked or dried? So meat and fat (beef, pork or lamb), and some spices. Maybe 100g worth.
Well, that’s a legit snack bordering on a small meal. That will break the fast, but it’s not all for naught. There is the whole “fasting-mimicking diet,” where you eating very few calories for several days out of the week and retain many if not most of the benefits of full-on fasting.
Let’s just say if you ate a small snack of paleo sausages on your “fasting” days, you’d still be way ahead of 99% of people.
But do try a full-on fast at least once. You might surprise yourself.
Great post! What about alcohol? Specifically, a shot or 2 of liquor. I would assume beer and wine would break a fast, but what about whiskey or tequila?
When alcohol enters the system, utilization of all other energy sources is suspended until the alcohol is burned. Back in 1999, researchers did a study where they gave fasting adult men the equivalent of a couple shots of liquor. They stopped releasing stored body fat, stopped burning body fat, and began burning way more acetate (a product of ethanol metabolism). They didn’t exactly “break” the fast, but all the metabolic trajectories we love about fasting took a big pause.
Good morning Mark,
How does one exercise in the morning while fasting? When to eat?
You can exercise any way you like, but I change how I train based on when I’m going to break the fast with food.
If I’m going to break the fast with a meal right after, I train any way I like. I’ll do sprints, HIIT, weights, anything.
If I’m going to keep fasting after the workout, I like to stick to strength training and low-intensity movement (walking, hiking, standup paddling). The strength training is essential during a fast because it’s an anabolic signal to your muscles—move it or lose it. Simply lifting heavy things during a fast can stave off muscle loss.
That’s it for today, folks. Stay tuned later this week for “What Breaks a Fast: Supplements Edition.”
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