While there’s nothing particularly wrong with potatoes (in fact, we happen to love this recipe for scalloped potatoes), not everyone in the Primal—let alone keto—camp wants to serve potatoes at the holiday. They’re a technically Primal choice, but they’re decidedly high in carbs and not as high in nutrients as other options. Primal and Primal-keto eating shouldn’t be about deprivation—just thoughtful decision-making on what’s a good choice for you when it comes to holiday eating. Today we’ve got 13 delicious side dish recipes that stay true to the richness and flavors of traditional holiday cooking. Which ones will you be serving?

Green Bean Casserole

Maple Roasted Butternut Squash

Celery Root Soup

Spicy Squash and Sausage Stuffing

Shaved Brussels Sprouts Salad

Cranberry Sweet Potatoes

Cheesy Keto Biscuits

Ranch Cauliflower Mash

Garlic and Mushroom Soup

Harvest Salad Bowl

Mashed Parsnips

Keto Turkey Gravy

Warm Mushroom and Chard Salad

Tell us which are your favorite inspirations for your holiday table, or let us know what you’ll be serving up for the perfect Primal dinner. Thanks for reading.

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The post 13 Holiday Side Dishes (That Aren’t Potatoes) appeared first on Mark’s Daily Apple.

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For today’s edition of Dear Mark, I’m answering a bunch of questions from readers. The first one concerns another inflammatory marker, homocysteine. How could CRP be low but homocysteine be high? What could cause that? Next, I answer a barrage of kefir questions, including ones on kefir carb counts, pasteurized kefir, and water and coconut kefir. Finally, I address the elephant in the room: stressing out about your diet.

Let’s go:

How do Homocysteine levels figure in this equation? I have C-reactive protein under 1, but Homocysteine levels of 15, slightly high. Seems odd one so low and one a bit high.

Both indicate elevated inflammation, but they can have different causes. There are many nutrient deficiencies and interactions that go into elevated homocysteine levels—that’s why they indicate inflammation. What are they?

It all comes down to methionine. That’s the essential amino acid most abundant in muscle meats, the one most of you are getting a ton of if you’re eating a standard Primal, keto, or carnivore diet. We use it to perform cellular communication, regulate gene expression, repair cells, and build new tissue. It does some really important stuff, but it needs several different co-factors to work properly.

B12 and Folate—Vitamin B12 is a major one. So is folate. In fact, I lumped them together in one section because they are co-dependents. Vitamin B12 requires folate to do its job. Folate requires vitamin B12 to do its job. Both vitamins are necessary co-factors for methionine to do its important cellular work. Without either one, methionine builds up and contributes to homocysteine.

They even tested this in a controlled human trial. Giving a big dose of methionine without increasing B12 or folate increased homocysteine levels. Supplementing with B12 and folate protected against the methionine-induced increase in homocysteine.

Riboflavin—Some groups may need extra riboflavin to deal with homocysteine levels.

Glycine—After teaming up with the B-vitamins to do the gene expression and cellular repair/buildup, any excess methionine combines with glycine to form glutathione. That’s the body’s main antioxidant, and it’s very helpful to have. If you have low glycine levels/intake, then any leftover methionine goes into the homocysteine cycle.

B6—Vitamin B6 is also used to mop up and convert into glutathione any excess methionine after methylation.

Betaine—Similar to glycine, betaine acts as a buffer for excess methionine. In fact, high intakes of methionine deplete the body of betaine, while supplementing with betaine reduces homocysteine levels.

Choline—Choline is another methionine buffer. High methionine increases the need for choline, while adequate choline or supplementation reduces homocysteine.

If you’re missing those co-factors, methionine fails to assist with cellular communication, gene expression, cellular repair, or new tissue formation. Instead, it generates homocysteine.

For a primer on obtaining adequate B-vitamins, read this post. Meat of all kinds, eggs, organ meats, seafood, dairy, green vegetables, and even legumes are ways to obtain them.

For a primer on obtaining adequate glycine, read this post. You can get it through collagen, gelatin, bone broth, or bone-in, skin-on meats with a lot of gelatinous connective tissue.

To get enough betaine, include some beets and/or spinach in your diet. Wheat germ is the best source, but most of you aren’t eating wheat germ (nor would I recommend you start).

To get choline, eat egg yolks. That’s the single best source. If you’re not going to eat betaine-rich foods (beets, spinach, wheat), eat extra choline; you can make betaine from choline.

Isn’t there a relatively large amount of carbs in kefir, when consumed in quantity?

The fermentation process digests most of the lactose present in milk. The sourer the product, the lower the residual lactose. The sweeter the product (or even just less sour), the higher the residual lactose. At any rate, I wouldn’t worry too much about the carb content of kefir. It’s assuredly lower than advertised, and probably low enough for even keto eaters to incorporate at least a little.

There are even lactose-free kefirs that will be definitely near-zero in carbs. If that’s the case, it will be prominently displayed on the label.

Mark, don’t they at least partially”clean up” kefir? Does it really contain all that good stuff, or is pasteurized?

Commercial kefir uses pasteurized dairy, but the fermentation takes places after pasteurization. This means the finished product is fermented with living bacteria (and yeast, in the case of kefir).

I’ve never seen a commercial kefir that pasteurized after fermentation. If you’re worried, you can always get your own kefir grains and make your own kefir. It’s pretty easy and delicious.

Kefir – I just did a test of dairy and it definitely gives me a reaction. I’d love to read your take on water kefir though I’m not pleased that the recipes use sugar. What about coconut milk kefir?

Don’t worry about water kefir that uses sugar. All the sugar gets consumed by the kefir grains, leaving little to no residual sugar for you. You can tell by the taste (and I admit I’m no fan/expert of water kefir, only because I can tolerate dairy kefir). If it’s sweet, it contains sugar. If not, it doesn’t. Even if it has some sugar left, it’ll be far less than indicated on the label.

Coconut milk kefir is a good option too. Again, I prefer the dairy kefir, but I see nothing wrong with coconut milk kefir. I even put up a coconut milk kefir recipe some time ago.

Funny you mentioned to drink bone broth (for the glycine) to help with sleep. I have been keto-carnivore for 9 months and recently realized that the high level of histamines in bone broth was giving me insomnia. I can eat most foods that contain a moderate level of histamines, but canned fish and long-cooked bone broth have derailed my sleep on carnivore.

If that’s the case, straight glycine can work. That’s what several studies actually used to improve sleep in humans—isolated glycine.

Collagen may also work for you.

Could all this be too much worry from being obsessed with checking if they are doing the keto diet “right” ?

Ha! Yeah. That’s the issue with a certain subset of the Primal/keto crowd. Worrying about every little thing until it becomes a stressor. Ketone numbers running through the head as you lie awake. Waking up at 2 AM to test your urine. “Did I remember to Amazon Prime the MCT oil?” Wondering “Is the olive oil in my canned sardines truly the highest quality olive oil?”

Then there’s the true classic: stressing out about the stress you’re inducing from worrying about your diet. Educate yourself, but don’t forget to enjoy life. There’s only so much diligence we can orchestrate without losing the forest through the trees.

That’s it for today, everyone. Take care and be well, and make sure to leave any comments or questions down below.

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The post Dear Mark: Homocysteine, Some Kefir Questions, and the Stress of Worrying appeared first on Mark’s Daily Apple.

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Cold season is upon us. Vitamin D levels are down. People are cloistered indoors. Kids are walking petri dishes. Drug stores are advertising free flu shots. It’s that time of year. I’m sure a few of you are even sniffling as you read this, or maybe trying to ignore the pain of swallowing with a sore throat.

Colds seem like an inevitability, maybe not so much since you’ve cleaned up your diet, but nothing is 100% fool-proof. You will get sick. You will catch a cold. Or someone close to you will. What can you do for yourself? For your sick kid or partner? Are there any natural cold remedies that actually work?

Let’s look at them.

High Dose Vitamin C

Most studies find that vitamin C supplementation has little to no effect on the duration or severity of a cold. But not all. What seems to help, if anything, is a mega-dose of vitamin C.

In one study, taking 8 grams on the first day of the cold reduced illness a bit more than taking 4 grams.

A meta-analysis of studies concluded that taking 1 gram as a daily supplementary dose and 3-4 grams as a therapeutic dose at the onset of a cold could reduce the duration and severity.

Verdict: Vitamin C can’t hurt, so it’s worth a shot. Try 3-8+ grams when you feel the cold coming on, and supplement 500 mg-1 g during cold season.

Zinc

Having good zinc levels are a great preventive. A strong baseline intake of zinc-rich foods like shellfish and red meat is the first line of defense against upper respiratory infections.  But once you have a cold, or you feel one coming on, pounding zinc citrate lozenges or smoked oysters won’t make much of a difference. What can work is taking a specific type of zinc acetate, highlighted here by Chris Masterjohn.

Studies show that zinc acetate works very well at reducing the duration of colds, especially when you catch it early. Chris recommends using these lozenges every 1-2 hours when a cold first hits and letting them dissolve slowly in the mouth. It takes about 20-30 minutes for a single lozenge to dissolve, but this slow process is vital for actually getting the cold-busting effect. Don’t chew.

Verdict: Zinc acetate taken at the onset can help. Other forms of zinc are important for prevention (and general health), but probably aren’t therapeutic.

Elderberry

Elderberry probably has the coolest name ever—like some folk medicine out of a Tolkien story. Plus, it works.

In intercontinental air travelers (a population at much greater risk for colds), taking elderberry syrup reduced total days with a cold (57 versus 117) and cold symptom score (247 versus 583, with higher being worse).

In a meta-analysis of controlled trials, elderberry syrup was also shown to reduce overall cold symptoms.

This elderberry syrup is very high quality, and even comes in a sugar-free (glycerin-based) form if you want to avoid any excess fructose.

Verdict: Works.

Chicken Broth

Does “Jewish penicillin” work? Yes, yes it does. Evidence confirms that chicken soup made from real chicken broth eases nasal congestion, improves the function of the nasal cilia protecting us from pathogen incursions, and reduces cold symptoms.

Does it have to be chicken? As most cultures include broth-based soup in their list of effective cold remedies, I suspect it’s the goodness of the broth that’s important and any true bone broth-based soup will work.

Verdict: Yes.

Garlic

Garlic is legit. Garlic can improve immune function and reduce the occurrence of common colds. In my opinion, it’s one of the best anti-cold foods around.

If I feel a cold coming on, I’ll crush and dice up an entire head of garlic and lightly simmer it in a big mug of bone broth. I find I am usually able to ward off whatever’s headed my way. Of course, that’s just an anecdote and the available evidence is more equivocal.

Another way I’ll eat garlic is to use black garlic—garlic that’s been aged for months until it turns black, soft, and sweet. Delicious and even more potent.

Aged garlic extract can also be an effective supplement.

Verdict: It works.

Acupuncture

Acupuncture is controversial. I’m no expert myself—I’ve gotten it a a few times at urging from friends who swear by it—and while I found it relaxing and enjoyable, I didn’t get any amazing results. Then again, I wasn’t going in for anything in particular, nor did I stick with it for very long (apparently you need ongoing therapy). This article by Chris Kresser (who in addition to being a nutrition expert is a licensed acupuncturist) explains the effects and benefits of acupuncture from a Western perspective; it’s worth reading if you’ve been wondering about the therapy.

Does it work for colds?

There are some studies where it seems to help against the common cold. Like this study out of Japan or this series of case studies out of Korea. Both studies indicate the need for placebo-controlled trials to truly determine the efficacy, though. In 2018 there was a published “protocol” for just such a study, but as far as I can tell the results haven’t been published.

Even if it doesn’t lessen the severity of the cold itself, I know some friends who go for acupuncture toward the end of a cold to help speed sinus drainage.

Verdict: Unknown but perhaps.

Echinacea

Echinacea is a medicinal herb native to North America, where it was traditionally used as a painkiller, laxative, and anti-microbial agent (although they didn’t know what microbes were of course). Today, it’s best known as an immune modulator that reduces symptoms of the common cold. Does it work?

A Cochrane analysis of controlled trials found no benefit against colds, but it did note that “individual prophylaxis trials consistently show positive (if non-significant) trends.”

In other words, it very well might work, but we don’t have gold standard evidence in either direction.

Verdict: Might work.

Oregano Oil

Oregano oil has a long history of traditional use in treating infectious diseases, and it has potent anti-bacterial effects against a broad range of microbes. It fights athlete’s foot. It’s broadly anti-fungal. But there simply isn’t any strong evidence that it works against the common cold.

Verdict: Not much evidence it works for colds.

Steam

Back when I was a boy, my favorite thing to do when I had clogged up nostrils was to get in a really hot shower, close all the windows and doors, and read a good book as the steam loosened up the nasal passages. It really did work, albeit not for long. If the cold virus was still present, my nose would usually clog right back up afterwards.

Verdict: Good for momentary relief of clogged nostrils, like right before bed.

Spicy Food

Spicy food probably won’t destroy a cold outright, but it can safely (and deliciously) reduce the most annoying cold symptom: stuffy noses. Capsaicin, the chili pepper component that produces a burning sensation in mammalian tissue, reduces nasal inflammation. When your nasal blood vessels are inflamed, the walls constrict; the space gets tighter and you have trouble breathing. Studies indicate that capsaicin is effective against most symptoms of nasal congestion.

Verdict: Good for stuffy noses.

Nasal Irrigation

In Sanskrit, “neti” means “nasal cleansing.” The neti pot is a exactly what it sounds like. You fill a tiny plastic kettle with warm saline water, tilt your head over a sink, and pour the water into one nostril. It flows out the other one, clearing your nasal cavity and letting you breathe again. The scientific term is “nasal irrigation,” and it really does work, albeit only against one cold symptom. But let’s face it: the worst part of a bad cold is the stuffy nose that keeps you up at night, gives you dry mouth, and makes food taste bland. Neti pottin’ can fix that right up.

Also, it’s better than antibiotics in kids with rhinosinusitis. It even improves symptoms in infants with bronchiolitis, another kind of viral infection.

Verdict: Works.

Cod Liver Oil/Fish Oil

Standard childcare practice across the world, but especially in Northern European countries, used to be a big spoonful of cod liver oil every day on your way out the door. Cod liver oil is a great source of vitamin D, vitamin A, and omega-3s—all of which figure prominently in immune function. But studies of the individual nutrients in cold prevention or treatment have had unimpressive results. What might work, though, is cod liver oil.

One recent study found that while vitamin D levels or supplements had no effect on whether a person got a cold or not, the only thing that was associated with lower incidences of colds was taking cod liver oil (or even just regular fish oil) in the last 7 days. It’s not a huge effect, and it’s not necessarily causal, but it’s good enough for me to recommend it.

This is a great cod liver oil. This is a great fish oil (made by yours truly).

Verdict: Works (and is healthy otherwise, so might as well).

So, there you go: a good list of therapies, supplements, foods, and nutrients to include (or not) in your anti-cold regimen this season. If you have any suggestions, any recommendations, or questions, throw them in down below.

Thanks for reading, folks, and be well.

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References:

Quidel S, Gómez E, Bravo-soto G, Ortigoza Á. What are the effects of vitamin C on the duration and severity of the common cold?. Medwave. 2018;18(6):e7261.

Anderson TW, Suranyi G, Beaton GH. The effect on winter illness of large doses of vitamin C. Can Med Assoc J. 1974;111(1):31-6.

Hemilä H, Petrus EJ, Fitzgerald JT, Prasad A. Zinc acetate lozenges for treating the common cold: an individual patient data meta-analysis. Br J Clin Pharmacol. 2016;82(5):1393-1398.

Tiralongo E, Wee SS, Lea RA. Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients. 2016;8(4):182.

Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019;42:361-365.

Nantz MP, Rowe CA, Muller CE, Creasy RA, Stanilka JM, Percival SS. Supplementation with aged garlic extract improves both NK and ??-T cell function and reduces the severity of cold and flu symptoms: a randomized, double-blind, placebo-controlled nutrition intervention. Clin Nutr. 2012;31(3):337-44.

Lissiman E, Bhasale AL, Cohen M. Garlic for the common cold. Cochrane Database Syst Rev. 2014;(11):CD006206.

The post 12 Natural Cold Remedies Examined: What Works and What Doesn’t appeared first on Mark’s Daily Apple.

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Inflammation gets a bad rap in the alternative health world: “Inflammation causes heart disease, cancer, and autoimmune disease! It’s at the root of depression.” These are all true—to some extent.

Name a disease, and inflammation is involved.

Crohn’s disease is inflammatory.

Major depression is inflammatory.

Heart disease is inflammatory.

Autoimmune diseases, which involve an inflammatory response directed at your own tissues, are inflammatory.

Arthritis is inflammatory.

Even obesity is inflammatory, with fat cells literally secreting inflammatory cytokines.

Yes, but the story is more complicated than that. Inflammation, after all, is a natural process developed through millions of years of evolution. It can’t be wholly negative. Just like our bodies didn’t evolve to manufacture cholesterol to give us heart disease, inflammation isn’t there to give us degenerative diseases.

So, Why Does Inflammation Happen?

When pain, injury, or illness hit, the first responder is the acute inflammatory response. In other words, it is brief, lasting several days or less. All sorts of things can cause an acute inflammatory response. Here are a few:

  • Trauma (punch, kick, golf ball to the head)
  • Infection by pathogens (bacterial, viral)
  • Burn (sun, fire, seat belt buckle on a summer day)
  • Chemical irritants
  • Frostbite
  • Stabbing/Cut/Laceration
  • Allergic reaction

Things happen pretty fast in an acute inflammatory response and involve several different players, including the vascular system (veins, arteries, capillaries and such), the immune system, and the cells local to the injury.

  1. First, something painful and unpleasant happens; choose one of the above injury options.
  2. Then, pattern recognition receptors (PRR) located at the injury site initiate the release of various inflammatory mediators, which in turn initiate vasodilation (or widening of the blood vessels). This allows increased blood flow to the injury site, which warms the site, turns it the familiar red, and carries plasma and leukocytes to the site of the injured tissue.
  3. The blood vessels become more permeable, thus allowing the plasma and leukocytes to flow through the vessel walls and into the injured tissue to do their work. Emigration of plasma into tissue also means fluid buildup, which means swelling.
  4. At the same time, the body releases an inflammatory mediator called bradykinin, which increases pain sensitivity at the site and discourages usage of the injured area. These sensations—heat, redness, swelling, pain, and a loss of function—are annoying and familiar, but they’re absolutely necessary for proper healing.

Why Is (Acute) Inflammation Essential?

Allow me to explain why the four primary symptoms of acute inflammation are necessary, despite being unpleasant:

  1. Increased blood flow warms the injury and turns it red, which can be irritating and unsightly, but it also carries the guys—leukocytes—that will be cleaning up the injury site, mopping up pathogens, and overseeing the inflammatory process.
  2. Swollen body parts don’t fit into gloves, are really sensitive, and don’t work as well as their slim counterparts, but a swollen finger is a finger that’s full of a plasma and leukocyte slurry and therefore on the road to recovery.
  3. Pain hurts, but if an injury doesn’t hurt and it’s serious, you’ll keep damaging it because you won’t know not to use it.
  4. Loss of function prevents you from using what could be one of your favorite body parts, but you don’t want to make it worse be re-injuring it. Besides, it’s only temporary.

What About Chronic Inflammation?

These symptoms both indicate and enable inflammation (and, thus, healing), but what’s the deal with inflammation being linked with all those chronic illnesses—like obesity, heart disease, and depression? How does something normal and helpful go haywire and become implicated in some of the most crushing, tragic diseases of our time?

When inflammation becomes chronic and systemic, when it ceases to be an acute response, when it becomes a constant low-level feature of your physiology that’s always on and always engaged, the big problems arise.

The inflammatory response is supposed to be short and to the point. And because a big part of inflammation is breaking the tissue down, targeting damaged tissue and invading pathogens, before building it back up, the inflammatory response has the potential to damage the body. That’s why it’s normally a tightly regulated system: because we don’t want it getting out of hand and targeting healthy tissue. But if it’s on all the time—if chronic inflammation sets in—regulation becomes a lot harder.

Acute vs. Chronic Inflammation

A perfect example of the acute inflammation versus chronic inflammation dichotomy is exercise.

A single hard workout raises inflammation. It’s a stressor, a damaging event imposed upon your body. See for yourself.

A hard run spikes C-reactive protein for up to two days.

During exercise, skeletal muscle releases the inflammatory cytokine IL-6, a marker of damage.

Volleyball practice elicits spikes in IL-6 in both male and female elite volleyball players.

Acute exercise spiked CRP in cardiovascular disease patients (but a four-month exercise program lowered it).

This table of inflammatory responses to strenuous endurance events shows some massive spikes in CRP, some up to 20-fold the baseline value.

Yet, study after study (epidemiological and clinical alike) shows that extended exercise programs generally reduce markers of inflammation (like C-reactive protein) over the long-term:

  • In elderly Japanese women, a 12-week resistance training program reduced circulating levels of inflammatory markers compared to baseline; reductions in CRP were associated with increases in muscle thickness.
  • American adults who engaged in frequent physical activity tended to have lower CRPs than adults who were more sedentary.
  • In type 2 diabetics, (key term coming up) long-term high intensity resistance and aerobic training reduced inflammatory markers over the course of a year (independent of changes in body weight, meaning activity was the key factor).
  • Endurance combined with resistance training reduced CRP in young, healthy women better than endurance training alone.
  • In obese, post-menopausal women, a basic moderate cardio program lowered CRP without really affecting body weight either way over the course of a year.

There are many more out there, but the general gist is that regular exercise tends to lower markers of systemic inflammation while acute exercise increases markers of acute inflammation. And sometimes what’s acute can become chronic. How do we make sense of this? How do we avoid making those acute spikes a chronic, constant thing?

Identifying Chronic Inflammation: Objective Markers

First, we need to be able to identify chronic inflammation. What symptoms and biomarkers can we use to track our inflammation levels?

CRP, or C-Reactive Protein

CRP is a protein that binds with dead and dying cells and bacteria in order to clear them from the body. It can always be found (and measured) in the bloodstream, but levels spike when inflammation is at hand. During acute inflammation caused by infection, for example, CRP can spike by up to 50,000-fold. CRP spikes due to acute inflammation peak at around 48 hours and declines pretty quickly thereafter (post acute-phase inflammation CRP has a half life of 18 hours). Thus, if the incident causing the inflammation is resolved, CRP goes back to normal within a few days. If it persists, the infection/trauma/etc. probably persists as well.

Highly sensitive to many different kinds of stressors, CRP rises in response to essentially anything that causes inflammation. This makes it valuable for determining that inflammation is occurring, but it makes it difficult to determine why that inflammation is occurring—because it could be almost anything. But if you’re looking for confirmation that you are chronically, systemically inflamed, an elevated CRP (in absence of any acute infections, injuries, burns, or stressors) is a useful barometer.

“Normal” CRP levels are supposedly 10 mg/L. Absent infection or acute stressors, however, ideal CRP levels are well under 1 mg/L. You want to stay well below 1; you don’t want “normal.” Between 10-40 mg/L (and perhaps even 1-9 mg/L, too) indicates systemic inflammation (or pregnancy), while anything above that is associated with real acute stuff. Note that exercise can elevate CRP, so don’t get tested if you’ve worked out in the last couple days.

IL-6, or Interleukin-6

T cells (type of white blood cell that plays a huge role in the immune response) and macrophages (cells that engulf and digest—also known as phagocytosing—stray tissue and pathogens) both secrete IL-6 as part of the inflammatory response, so elevated IL-6 can indicate systemic inflammation.

Tissue Omega-3 Content

This is a direct measurement of the omega-3 content of your bodily tissue. It’s not widely available, but it is very useful. Remember that anti-inflammatory eicosanoids draw upon the omega-3 fats in your tissues and that inflammatory eicosanoids draw upon the omega-6 fats. People having a higher proportion of omega-6 fats will thus produce more inflammatory eicosanoids. Now, we absolutely need both inflammatory and anti-inflammatory eicosanoids for proper inflammatory responses, but people with high omega-6 tissue levels make way too many inflammatory eicosanoids. Studies indicate that people with the highest omega-3 tissue levels suffer fewer inflammatory diseases (like coronary heart disease).

Research (highlighted and explicated here by Chris Kresser) suggests that omega-3 tissue concentrations of around 60% are ideal, which is a level commonly seen in Japan—the seemingly paradoxical land of high blood pressure, heavy smoking, and low coronary heart disease rates.

Omega-3 Index

This measures the EPA and DHA, the two important omega-3 fatty acids, as a percentage of total fatty acids present in your red blood cells. It doesn’t correlate exactly to tissue amounts, but it’s pretty good and a powerful predictor of cardiovascular disease risk. The omega-3 index doesn’t measure omega-6 content, but those with a low omega-3 index are probably sporting excessive omega-6 in their red blood cells.

Anything above 8% corresponds to a “low risk,” but levels of 12-15% are ideal and roughly correspond to the 60% tissue content mentioned by Chris’ article. Four percent and below is higher risk and can be viewed as a proxy for increased inflammation (or at least the risk of harmful systemic inflammation developing from normal inflammation).

Heart Rate Variability

I’ve written extensively on HRV in the past. Long story short, high HRV predicts lower levels of inflammation.

Systemic Inflammatory Response Syndrome Score

There’s the systemic inflammatory response syndrome, which is incredibly serious and has four criteria. If you have two or more of them at once, congratulations: you qualify—and should probably see a health professional immediately. This isn’t relevant for low-grade systemic inflammation, like the kind associated with obesity or autoimmune disease.

  • Body temperature less than 96.8 F (36 C) or greater than 100.4 F (38 C).
  • Heart rate above 90 beats per minute.
  • High respiratory rate, 20 breaths per minute or higher.
  • White blood cell count fewer than 4000 cells/mm³ or greater than 12,000 cells/mm³.

Of these objective markers to test, I’d lean toward CRP, HRV, and one of the omega-3 tests. CRP is pretty comprehensive, HRV is a two-fer (inflammation and general stress/recovery), and, while omega-3 tissue or blood cell content doesn’t necessarily indicate the existence of systemic inflammation in your body, it does indicate the severity of the inflammatory response you can expect your body to have. Taken together, these tests will give you an idea of where you stand.

Identifying Inflammation: Subjective Markers

There are also subjective markers. They may be harmless artifacts, but they may indicate that something systemic is going on.

Flare-up of Autoimmune Conditions You Haven’t Heard From In Ages

Sore joints, dry, patchy, and/or red skin, and anything else that indicates a flare-up. For me, this is usually mild arthritis.

Water Retention

Acute inflammation is often characterized by swelling at the site of injury. The same effect seems to occur in states of systemic inflammation, although they aren’t localized, but rather generalized.

Stress Load

If you feel stressed, you’re probably inflamed. I’m talking about the kind that has you rubbing your temples, face palming, sighing every couple minutes, and pinching the space between your eyes very, very hard.

Persistent But Unexplained Nasal Congestion

Could be allergies, sure, but I’ve always noticed that when I’m under a lot of stress and generally in an inflamed state, my nose gets clogged. Certain foods will trigger this, too, and I think it can all be linked to a persistent but subtle state of inflammation.

Overtraining

If you fit the bill for the eight signs of overtraining listed in this post, you’re probably inflamed.

Ultimately, though? It comes down to the simple question you must ask yourself: How do you feel?

I mean, this seems like an obvious marker, but a lot of people ignore it in pursuit of numbers. If you feel run down, lethargic, unhappy, your workouts are suffering, you struggle to get out of bed, you’re putting on a little extra weight around the waist, sex isn’t as interesting, etc., etc., etc., you may be suffering from some manner of systemic, low-grade inflammation. Conversely, if you’re full of energy, generally pleased and/or content with life, killing it in the gym, bounding out of bedlean as ever or on your way there, and your sex drive is powerful and age appropriate (or inappropriate), you’re probably not suffering from chronic inflammation.

Causes of Chronic Inflammation

We need to determine why inflammation is “on” all the time—and then take the steps to counter it. I’m going to fire off a few things that both induce inflammation and tend toward prevalence in developed countries. You let me know if anything sounds familiar to you.

  • Toxic dietsHigh-sugarhigh-processed carb, high-industrial fat, high-glutenhigh-CAFO meat, low-nutrient food is a pretty accurate descriptor of the modern Western diet.
  • Insufficient omega-3 intakeOmega-3 fats form the precursors for anti-inflammatory eicosanoids, which are an integral part of the inflammatory response. Poor omega-3 status means insufficient production of anti-inflammatory eicosanoids and a lopsided inflammatory response to normal stimuli.
  • Excessive omega-6 intake: Omega-6 fats form the precursors for inflammatory eicosanoids, which are an integral part of the inflammatory response. High omega-6 status (especially when combined with poor omega-3 status) means excessive production of inflammatory eicosanoids and a lopsided inflammatory response to normal stimuli. The more omega-6 you eat, the more omega-3 you crowd out for anti-inflammatory eicasonoid formation.
  • Lack of sleepPoor sleep is linked to elevated inflammatory markers. Poor sleep is a chronic problem in developed nations. Either we go to bed too late, wake up too early, or we use too many electronics late at night and disrupt the quality of what little sleep we get. Or all three at once.
  • Lack of movement: People lead sedentary lives, by and large, and a lack of activity is strongly linked to systemic, low-grade inflammation. People don’t have to walk to get places, they take escalators and elevators, they sit for hours on end, and they don’t have time for regular exercise.
  • Poor recovery: Other people move too much, with too little rest and recovery. When I ran 100+ miles a week, I certainly wasn’t sedentary, but I was chronically inflamed. Overtraining is a form of chronic inflammation.
  • Chronic stress: Modern life is stressful. Bills, work, commuting, politics, exercise that you hate – it all adds up and it doesn’t seem to let up or go away. And if it becomes too much for you to handle (I know it’s too much for me at times), your body will have a physiological, inflammatory response to emotional stress.
  • Lack of down time: When you’re always on the computer, always checking your email/Facebook/smartphone, you are always “on.” You may think you’re relaxing because your body is stationary, but you’re not relaxing.
  • Lack of nature time: We spend too much time contained in cubicles, cars, trains, and cities, away from trees, leaves, and soft earth. In a way, nature is home for us. Going home certainly has its measured benefits.
  • Poor gut health: The gut houses the bulk of the human immune system. When it’s unhealthy, so is your inflammatory regulation. A healthy gut is also selectively permeable, allowing beneficial compounds passage into the body and keeping toxins out. An unhealthy gut often becomes leaky, allowing toxins into the body to stimulate an immune, inflammatory response.
  • Poor acute stressor/chronic stress ratio: We respond far better to acute stressors than repeated, sustained stress – even if the latter is of a lower intensity.

See what I mean? Since we’re set up for acute stressors requiring an acute inflammatory response, all this other low-level, evolutionarily-discordant, superficially mild stuff set against a backdrop of misaligned fatty acid ratios and impaired gut health throws us off and sets us up for a lifetime of chronic inflammation.

Inflammation is a complex physiological process that can go wrong in a lot of ways. But luckily, sticking to the tried and true dietary and lifestyle measures will get you most of the way toward preventing inflammation from becoming chronic and untamed.

If you have any further questions about inflammation, fire away down below! Thanks for reading.

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References:

Eliakim A, Portal S, Zadik Z, et al. The effect of a volleyball practice on anabolic hormones and inflammatory markers in elite male and female adolescent players. J Strength Cond Res. 2009;23(5):1553-9.

Lara fernandes J, Serrano CV, Toledo F, et al. Acute and chronic effects of exercise on inflammatory markers and B-type natriuretic peptide in patients with coronary artery disease. Clin Res Cardiol. 2011;100(1):77-84.

Ford ES. Does exercise reduce inflammation? Physical activity and C-reactive protein among U.S. adults. Epidemiology. 2002;13(5):561-8.

Balducci S, Zanuso S, Nicolucci A, et al. Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutr Metab Cardiovasc Dis. 2010;20(8):608-17.

Daray LA, Henagan TM, Zanovec M, et al. Endurance and resistance training lowers C-reactive protein in young, healthy females. Appl Physiol Nutr Metab. 2011;36(5):660-70.

The post The Definitive Guide to Inflammation appeared first on Mark’s Daily Apple.

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There was a time when food tracking was treated like a given, a necessary tool for anyone wanting to lose weight or better their health. Thankfully, there’s more nuance to that conversation now. The fact is, tracking your food can be a useful exercise for gaining more insight into what you’re putting in your body. It can also be a tedious endeavor that sucks all the joy out of eating.

If you’re going to invest the time—and it can be quite time-consuming if you include any variety in your diet—let’s make sure it’s not a waste. 

You Might Want to Track Your Food If…

  • You have a goal where hitting a specific macronutrient and/or caloric intake is important. This includes cutting before a bodybuilding competition, starting a ketogenic diet, or even just losing weight.
  • You’re conducting an experiment. Maybe you want to see how your hunger changes when you eat more protein and less fat, or if your sleep improves if you increase your total carbs by a certain amount. Maybe you’re going to try a month of strict carnivore and plan to track your micronutrient intake.
  • You suspect you aren’t eating the right amount. If weight loss has stalled, your total calorie intake might be higher than intended. On the flip side, if you’re an athlete whose performance and recovery have been subpar lately, perhaps you are eating too little. Some people find that keto dramatically suppresses their appetites to the point where they need to intentionally eat more. In any case, you can’t make the necessary adjustments unless you know how much you consume on a typical day.

You Don’t Need to Track Your Food If…

  • You feel good and aren’t looking to change anything. If it ain’t broke, don’t fix it.
  • You stick to the same basic meals most of the time. Even if you’re trying to manage your macros, if you’re a creature of habit, you can probably get away without tracking. Once you know the nutritional info for your standard meals, there’s no reason to input them in a food tracker over and over.
  • You’ve been keto for a while. You have a good sense of how to keep your carbs low enough to stay in ketosis, and/or being in ketosis 24/7 isn’t that important to you.
  • You just don’t want to. Your desire to eat intuitively outweighs your desire to manage your food intake.

You SHOULDN’T Track Your Food If…

  • It triggers unhealthy eating behaviors or anxiety, or it otherwise messes with your mental and emotional well-being. 

Is Food Tracking Reliable?

There will always be some error in food tracking. Besides measurement error on your end (we’ll get to that in a minute), there is natural variation in foods. One ribeye is fattier than the next. This apple contains more water. That cabbage was grown in more nutrient-depleted soil. 

The FDA allows for up to 20% error on packaged food labels. That means that any information you get off the package might be wrong by 20% in either direction. Likewise, if you’re eating in restaurants and relying on the nutritional info they provide, consider it a rough estimate. Depending on how the food is prepared and the portion size you are given, your specific meal might vary a little or a lot. 

All this is to say that food tracking is not an exact science. That doesn’t mean it’s futile—it can still be useful for the reasons I gave above. However, there’s no point in stressing if you’re off your daily targets by 25 calories or 7 grams of fat. You should view tracking as a helpful but imprecise method of gathering data. Don’t micromanage to the point of causing yourself grief or anxiety.

How to Track for Maximum Accuracy

That said, there are steps you can take to improve the accuracy of your tracking:

Weigh, Don’t Measure

If you care about precision, invest in a food scale. While tablespoons (mL) work for liquid measurements like salad dressing, weight is much more accurate for proteins, fruits and veggies, nuts and seeds, and legumes. 

Weigh Foods Raw

This is true even if you intend to cook them. When you enter them in your food tracker, make sure you select the entries for the raw items (e.g., “Celery, raw” instead of “Celery, cooked”).

Do NOT Use Pre-entered Recipes

For example, if you make a pot of chili, do not simply select the entry for “Chili” in your food tracking app. Your version of chili might differ substantially from what’s considered “average” chili by the app.

Most tracking apps will allow you to input custom recipes, which is helpful for foods you will make again and again. Alternately, you can enter the ingredients separately into your daily food log. 

If you are cooking big batches of multi-ingredient recipes, the best way to figure out exactly how much you ate is to weigh the final product and then weigh your portion. In the chili example, you’d create a custom chili recipe in your app and enter all the raw ingredients. After it’s cooked, weigh the entire batch, then weigh your portion. If you make 800 grams of chili and eat 150 grams, you ate 18.75% of the recipe. 

If this sounds like a lot of work, you’re right. Food tracking is so much easier if you prepare simple meals: protein, side of vegetables, add healthy fat. It can be a major bummer for those of us who like to experiment in the kitchen and prepare more elaborate meals. 

Tracking FAQs

What’s the Best App?

There are lots of options here. I personally like and recommend Cronometer. The free app and desktop version have everything you need, but there is also an inexpensive premium version. The entries are all based on official food databases, so it’s as accurate as you can get, and it provides pretty granular nutritional info. You can input your own macronutrient targets and also add custom recipes. 

Primal folks might also prefer Cronometer because, unlike a lot of food tracking apps, it doesn’t assume you are trying to be keto or even low carb. If you are keto, Carb Manager and KetoDiet App are two popular options. Personally, I don’t like that Carb Manager grades foods based on what it considers acceptable for keto. My beloved Japanese sweet potato gets an F—no thanks (even if I can’t eat a big portion on keto). I’ve never tried KetoDiet App because it costs $8.99, whereas Cronometer is free and gives me everything I need. If you have tried it, let us know what you think about it in the comments below.  

Whatever app you choose, don’t assume that the default macro settings are right for you. A lot of keto apps will set your carb limit at 20 to 25 grams, for example, whereas The Keto Reset Diet recommends starting with 50 grams total. (This usually works out to 30 to 35 grams net in my experience.) The calories might not be appropriate for your activity level. Either set custom macros or simply ignore the app when it says you are over your carb limit or calories or whatever. 

How Do I Track Cooking Fat?

It’s impossible to know how much fat you leave in the pan when you sauté your veggies or how much oil is absorbed you fry chicken. Since most people are more concerned with eating too many calories than too few, the more conservative approach is to add all the cooking fat to your food diary when sautéing or roasting (i.e., assume you consume it all). When frying, the best answer is to weigh your cooking oil before and after frying to estimate how much is absorbed. Neither will be precise, but it’s the best you can do, so don’t stress about it. 

Is There a Preferred Time/Method For Tracking?

How and when you track your food depends on why you’re tracking in the first place. If you’re trying to get an unbiased look at how you’re currently eating, I recommend logging your food on paper for a few days, then entering it into an app to get the nutritional info. Logging makes us more mindful of what we are eating. This is generally a good thing, but if you’re trying to get an accurate snapshot, you don’t want to change how you’re eating based on the data

If you’re trying to manage what you eat, it’s best to enter your food before you eat it. This keeps you from accidentally eating more or less than you want, and it helps you balance your macros according to your goals.

Whatever you do, log foods as you weigh/measure/eat them. Don’t think you’ll remember exactly what you ate earlier today, much less yesterday or the day before. You won’t. 

Do I Have To Track My Food If I’m Keto?

You never have to track your food. However, if you’re serious about being in ketosis, I do recommend tracking your food for at least a week or two at the beginning just to make sure you’re on track. Most people don’t know how many carbs are in foods, so it can be easy to go over your limit. Managing your electrolytes is also very important. Apps like Cronometer will show you how much sodium, potassium, and magnesium you are getting from food so you can supplement appropriately.

Can I Just “Lazy Track”?

Sure, you can eyeball portion sizes of steak and measure your broccoli in a measuring cup instead of buying a food scale. It won’t be particularly accurate. As long as you understand that, go ahead. I wouldn’t bother taking the time to track for this level of (im)precision though.

Thanks for reading today, everybody. If you track your food, what insights or benefits have you gotten? What app do you prefer and why? Let us know below.

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The post Tracking Your Food: When, Why and How appeared first on Mark’s Daily Apple.

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For today’s edition of Dear Mark, I’m answering a couple questions. The first one is a big one, one that multiple people have asked me across several different mediums: why don’t I do a full review of “Game Changers,” the vegan documentary on Netflix, or at least watch the film? I explain why I won’t watch it, why I don’t think it’s worth your time, and why I’ve already addressed it all before. Then, I answer why sugar is such a fixation for us and give some options for avoiding or mitigating it.

Let’s go:

Mark,

How come you dismissed the “Game Changers” documentary without watching it?

Because it’s not worth my time. The premise is simply preposterous.

Humans are omnivores. We have eaten meat for millions of years. And not just “eaten meat.”

We used animal femurs as bone marrow storage containers. We fought off massive African predators just to get at the meat and crack the bones for the goodness inside. We slurped brains. We smashed bones to bits and boiled them in animal skin bags to extract every last ounce of collagen and fat. We drove entire species to extinction in our lust for large portions of fatty animal meat.

Even after we were hunter-gatherers, the importance of animal products persisted. The biggest influx of humanity that provided a large portion of extant DNA across Europe and huge parts of Asia were livestock-driving nomadic herdsmen who ate cheese and yogurt (animal products—and not low-fat), drank blood, and hunted game. They farmed a little but relied so heavily on animal products for their calories that they had to borrow the agricultural words from the populations they displaced. To give you a taste of how important animal products were to them, their word for wealth was the same as the word for cattle.

What—that just goes away? Those millions of years of slurping and gnawing and atlatl-ing and spear throwing and stalking and weapons-craft and herding…don’t matter?

So, when a persuasive documentary comes out preaching about the evils of red meat (and let’s face it: it’s always about red meat) and the benefits of excising all meat from your diet in favor of plants, I laugh. I shrug. I smirk even.

Red meat consumption is down across the board. People listened to the “experts.” And guess what? Health got worse. Waists grew. Healthcare spending shot up. Diabetes spiked. Heart disease persisted (deaths decreased, thanks to better emergency care, but incidence is still there).

Does the documentary address all that? Does it mention the word “evolution”?

My time matters too much to me to waste it on the documentary. The arguments I’ve laid out in other responses to attacks on meat eating stand and, most likely, apply to the arguments in the documentary. Check these out for a few of my explorations of the “meat is bad” topic:

Is meat as bad as smoking?

Will meat give you diabetes?

Is charred meat bad for you?

Does red meat give you colon cancer?

Will red meat kill you?

Is saturated fat deadly?

Read those, then get back to me. And I probably still won’t watch the documentary.

I’d rather spend my time:

Helping people who want the help.

Coming up with interesting new products that help people make better choices in the grocery store.

Standup paddling.

Playing Ultimate frisbee (and playing in general).

Writing about new topics or new developments of old topics.

I have yet to see a new argument from the plant-based crowd. I’ve heard the same things for years upon years. Nothing changes. “There’s nothing new under the sun.”

We have better things to do. Bigger fish to fry (in a gluten-free breading using low-PUFA oil kind of way).

How to conquer sugar addiction and is there a primal need to eat something sweet? Would Grok ever get the urge for something sweet?

Our relationship with sugar goes way back. In ancestral situations, sugar was rare. The urge to eat something sweet was so strong because it was so hard to get—a powerful urge was required to coerce the organism to do the work required to get the sugar. And in those situations, sugar was beneficial. An odd trove of honey represented a potent source of caloric energy, a way to replenish glycogen stores. Acute doses versus chronic overload. We have old cave paintings from 25000 years ago of honey hunters climbing trees to grab hives; that’s how much they prized it. Fruit, while not always plentiful or as oversized as today’s fruit, definitely existed—albeit to varying degrees depending on the climate and region. The farther you got from the equator, the scarcer sweet tastes became.

Even up to a few hundred years ago, when sugar was actually available, it remained a luxury item. It had to be imported, out of reach for most regular people.

Today, sugar is everywhere. We’re glutted with the stuff. We can’t escape it. And yet we still retain that ancestral mindset of sugar scarcity. Our bodies still crave it. Our physiological desires were molded in the context of low sugar availability. Introduce them to a sugar-replete environment and you get obesity, diabetes, heart disease, metabolic syndrome, and tooth decay.

I’m not sure if there’s a physiological need today to consume sugar. But there’s certainly a physiological desire to consume it. And really, the only way past it is to erect artificial barriers to sugar consumption.

Don’t keep sugar in the house.

Don’t use artificial sweeteners or even natural ones like stevia or monk fruit if they trigger the craving for real sugar.

Just say no. Sheer willpower may not hold out forever, but in those instances where you’re faced with an intense dose of sugar and you don’t want to eat it, don’t give in. You can do this.

Chronic doses of sugar are the real killer: those little peanut butter cups at the co-worker’s desk you grab every time you walk by, those peanut M&Ms at the secretary’s desk, those half donuts in the break room—they add up. They always add up. Acute doses of sugar probably aren’t a big deal for most reasonably healthy people. High quality dessert after a great dinner out? Birthday party and the host is a legit whiz in the kitchen? Try it.

Avoid anything you’re intolerant of or allergic to, of course. Avoid gluten whenever possible.

Whatever you do, don’t waste your acute doses of sugar on garbage. Don’t eat a Hostess donut. Don’t eat a half gallon of low-fat frozen yogurt from those places that charge you by the ounce.

Eat real ice cream made with great ingredients—just a child’s scoop. Don’t get the weird “ice cream” shake from the fast food joint.

Don’t get the microwaved lava cake from the chain restaurant. Share a portion of real panna cotta from the fancy restaurant.

That’s it for today, folks. If you have any other suggestions or comments or questions, throw them in down below.

Take care, everyone.

The post Dear Mark: Why “Game Changers” Isn’t Worth My Time and Sugar Addictions appeared first on Mark’s Daily Apple.

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When I did my first earnest attempt at a keto diet a few years ago, one of the benefits I quickly noticed was improved wakefulness and energy during the day. I chalked this up to sleeping better on keto.

It turns out that I might have been one of the lucky ones. While plenty of people report improved sleep, a fair number also complain of insomnia, sleep disruptions (waking frequently during the night), and generally poor sleep once they go keto.

Can a keto diet really impact sleep quality? What might be the mechanism behind a correlation? And how does one work around any potential effect?

I’ve written a lot about sleep over the years, and I don’t intend to rehash what I’ve already written. Rather, I want to explore why a very-low-carb ketogenic diet specifically might impact sleep. I’ll link to some of my past posts at the bottom for those interested in improving overall sleep hygiene.

What is “Keto Insomnia?”

Insomnia disorder, as defined in the DSM-5, involves the following:

  • Difficulty falling asleep, difficulty staying asleep, and/or waking too early without being able to fall back to sleep
  • Symptoms occur at least three nights per week for at least three months
  • Sleep problems are not explained by other illness, medication, and so on
  • Distress and/or impaired ability to function in daily life

Acute insomnia is similar, but it’s short-term and might be attributable to a specific trigger, such as a stressful event, major life change, or travel.

People who complain about “keto insomnia” seem to mean one of two things:

  • Sleep disruptions that occur during the transition phase—the days or weeks immediately after starting keto (acute)
  • Sleep issues that start after being keto for a few months or longer (might be acute or chronic)

It can be hard to know whether the latter are actually related to keto at all. However, if diet is the only obvious change these folks have made, keto seemingly takes the rap.

Why Might Keto Mess with Your Sleep?

On possible clue is this oft-cited study in which participants experienced decreased REM and increased slow-wave sleep when following a keto diet. Decreased REM sleep can contribute to the subjective experience of insomnia. However, total sleep was not impacted. This study was also small, involving 14 participants who followed a keto diet for just two days.

Other than that, however, there’s not much to go on. A couple studies found no change in sleep quality among healthy adults following a keto diet, and a handful of others reported improved sleep quality (in epileptic children and obese adolescents).

Moreover, the team at Virta Health recently released their findings after one year of treating diabetic and prediabetic patients with keto diet interventions. Their patients enjoyed significant improvements in sleep quality and daily functioning compared to baseline and compared to individuals who didn’t go keto.

All together, the research so far suggests that when it comes to sleep, keto is neutral-to-positive for healthy adults and beneficial for individuals struggling with certain health conditions. Of course, the data are still quite sparse.

A somewhat larger, but still limited, body of research has looked more generally at how the macronutrient composition of one’s diet affects sleep. To be blunt, the results of these studies are all over the map. There’s tremendous variation from study to study in terms of how diets were constructed or measured, food timing, other relevant dietary factors such as total calorie intake and fiber content, as well as what aspects of sleep were assessed and how. Depending on which study you’re reading, consuming fat, protein, or carbohydrates might seem to help, hurt, or have no effect on sleep.

In short, there’s no compelling scientific explanation for when or why keto would harm your sleep. I know this is no comfort to those of you who are experiencing sleep disruptions now, however. Let’s turn to some things you can try if you’re not in the camp of good sleep while keto.

Possible Solutions

Despite the dearth of research, it’s possible to make some reasonable guesses about what might be causing your sleep issues. Of course, before trying any of the supplement suggestions below, consult your doctor. Likewise, get help if your sleep is so poor that you are having trouble functioning.

First, the obvious: basic sleep hygiene. These are the things I harp on all the time, like avoiding blue light at night and honoring a consistent bedtime. Sure, you probably didn’t change any of these when you went keto. However, it might be that something about keto eating—like getting less tryptophan to your brain (I’ll explain in a minute)—is making you more sensitive to poor sleep habits. Refer to my other sleep posts linked below for more details.

Check your electrolytes. Especially if you’re new to keto, electrolytes are the most likely culprit for sleep issues. You want to aim for the following daily:

  • 3-5 grams of sodium on top of what you get from food
  • 3-5 grams of potassium
  • 500 mg of magnesium

Most keto newbies drastically underestimate how important electrolytes are, not just for sleep but for energy, workout performance, and avoiding the keto flu. Check out this post for more details.

For sleep issues, start with magnesium. Make sure you’re including plenty of magnesium-rich foods such as leafy greens, dark chocolate, and hemp seeds in your diet.  You can also supplement with magnesium—the glycinate form is preferred for sleep—starting with 100-400 mg as needed.

Also consider adding a mug of warm bone broth to your evening routine. Besides being soothing, it’s a great way to get sodium and the amino acid glycine. Glycine is the most abundant amino acid in collagen. Supplementing with 3 grams of glycine before bed has been shown to improve sleep.

You can also supplement collagen for its many benefits. Aim for at least 10 grams at night. Maybe whip up a batch of Chocolate Collagen Pudding (sweetened with stevia or monk fruit for keto).

Make sure you’re neither too hungry nor too full at bedtime. As you adjust to your new way of eating, try to avoid extremes of hunger in the evening. If you’re practicing intermittent fasting, make sure your fasting window isn’t leaving you stuffed or famished at when it’s time to hit the hay.

Dial back the caffeine. Is it possible you’ve been a little too enthusiastic about fatty coffee since going keto?

Get your stress in check. We all know that stress is a sleep killer, and I see stress running high in the keto community. Micromanaging macros, worrying about which foods are and are not “allowed,” trying to do too much too soon—keto folks can really get themselves worked up. If this sounds familiar, you need to take a step back and work on stress reduction.

Try adding a small amount of high-glycemic carbs to your dinner. Wait, what? Am I really telling you to eat more carbs on keto? Yes, for a good reason.

As you probably know, melatonin is the hormone primarily responsible for regulating your sleep-wake cycle. The amino acid tryptophan is a precursor of melatonin. In the brain, tryptophan converts to 5-HTP, then serotonin, then melatonin. To get into the brain, tryptophan relies on protein transporters, which also carry other amino acids across the blood-brain barrier. When there is too much traffic—that is, too many other amino acids trying to use the protein transporters—not enough tryptophan can get across.

Insulin shuttles those competing amino acids into muscles, leaving the roads clear for tryptophan so to speak. By adding some high-GI carbs to your last meal of the day, you bump up insulin and facilitate this process.

Now, I wouldn’t recommend this as your first option if you are brand new to keto. However, if you’re one of those people who is suddenly struggling with sleep after being keto for a while, this is worth trying. Michael Rutherford, NTP, Primal Health Coach, and moderator of our Keto Reset Facebook group says his clients have had good results adding ~20 grams of carbs to their last meal of the day. Potatoes or sweet potatoes are good choices.

If you just can’t bring yourself to eat more carbs, you can also supplement with tryptophan. A dose of 250-500 mg is a good place to start, increasing as needed. Chris Masterjohn recommends taking tryptophan on an empty stomach and as far as possible from other sources of protein.

Another possible workaround is to supplement with 5-HTP, which is a common ingredient in sleep aids. Rutherford advises his clients to start with 100 mg of 5-HTP taken 30-60 minutes before bed. Be cautious with this supplement if you have depression or anxiety.

Skip the middlemen and supplement melatonin. Melatonin supplementation is somewhat controversial. It’s not my first choice—I’d rather you start by addressing sleep hygiene and tweaking your diet—but I’m not opposed to supplementing as needed.

Doses as low as 0.5 mg can be effective, although as much as 5 mg is generally regarded as safe. I recommend starting at the bottom end, since lower doses are closer to normal physiological levels. Take melatonin at least an hour after eating your last food of the day.

Get your thyroid and cortisol levels checked. If none of your self-experimentation works, or if you’re having other signs of thyroid imbalance, get your thyroid function and cortisol levels checked. While I don’t believe keto is inherently bad for thyroid or adrenal health, it’s certainly worth a trip to your doc.

What’s your experience? Are you sleeping like a baby on low-carb/keto—or not? Have you found any solutions other than those suggested here? Comment below, and have a great week, everyone.

______________

More sleep tips from Mark’s Daily Apple

7 Ways You Might Be Inadvertently Sabotaging a Good Night’s Sleep

10 Natural Sleep Aids: What Works and Why

Does “Sleep Hacking” Work?

How to Manufacture the Best Night of Sleep in Your Life

The Definitive Guide to Sleep

______________

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References

Herrera CP, Smith K, Atkinson F, Ruell P, Chow CM, O’Connor H, Brand-Miller J. High-glycaemic index and -glycaemic load meals increase the availability of tryptophan in healthy volunteers. Br J Nutr. 2011 Jun;105(11):1601-6.

Levenson JC, Kay DB, Buysse DJ. The pathophysiology of insomnia. Chest. 2015;147(4):1179–1192.

Peuhkuri K, Sihvola N, Korpela R. Diet promotes sleep duration and quality. Nutr Res. 2012 May;32(5):309-19.

Riemann D, Spiegelhalder K, Nissen C, Hirscher V, Baglioni C, Feige B. REM sleep instability–a new pathway for insomnia? Pharmacopsychiatry. 2012 Jul;45(5):167-76.

Silber BY, Schmitt JA. Effects of tryptophan loading on human cognition, mood, and sleep. Neurosci Biobehav Rev. 2010 Mar;34(3):387-407.

St-Onge MP, Mikic A, Pietrolungo CE. Effects of Diet on Sleep Quality. Adv Nutr. 2016 Sep 15;7(5):938-49.

The post Is Keto Insomnia a Common Problem? appeared first on Mark’s Daily Apple.

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Spend 90-minutes in the kitchen on a Sunday and you’ll be thanking yourself all week long. This low-carb, keto-friendly meal prep stocks your refrigerator with five ready-to-eat meals.

Combining home-cooked ingredients (like pot roast) with convenient store-bought ingredients (like rotisserie chicken) keeps the prep work manageable. Herbs, spices, sauces, and keto-friendly condiments keep the flavors fresh and new each night.

Menu (each meal serves 4):

Meal 1: Pot Roast with Roasted Asparagus and Honey Mustard Slaw

Meal 2: Chicken Coconut Curry over Cauliflower Rice

Meal 3: Beef Carnitas with Spicy Jalapeno Slaw and Guacamole

Meal 4: Asparagus and Mushroom Scramble with Arugula Salad

Meal 5: Chicken Noodle Soup

What You’ll Need…

Shopping List:

  • 4 pounds/1.8 kilograms beef chuck roast
  • 1 rotisserie chicken
  • Eggs (half dozen)
  • 1 package/7 ounces/200 grams shirataki angel hair noodles
  • 2 onions
  • 1 head garlic
  • 2 pounds/1 kilogram asparagus
  • 4 medium zucchini
  • 8 ounces/226 grams sliced mushrooms
  • 1 12- to 16-ounce/453-gram bag frozen cauliflower rice
  • 1 package shredded red or green cabbage (coleslaw)
  • 1 6-ounce/170-gram bag arugula
  • 2 limes
  • 2 avocados
  • 1 jalapeno
  • Cilantro
  • Basil
  • Thyme
  • 3 cups (24 fluid ounces) beef stock
  • 8 cups (64 fluid ounces) chicken stock
  • 1 can coconut milk (13.5 fluid ounces/400 ml)
  • 1 bay leaf
  • Curry powder (1 tablespoon/15 milliliters)
  • Cumin (1 teaspoon/5 milliliters)
  • Chili powder (1 teaspoon/5 milliliters)
  • Salt and pepper
  • Primal Kitchen® Avocado Oil and/or extra virgin olive oil
  • Coconut oil
  • Soy sauce or tamari or coconut aminos (2 tablespoons/30 milliliters)
  • Red wine vinegar (1 tablespoon/15 milliliters)
  • Slivered almonds (1 cup/300 grams)
  • Parmigiano-Reggiano cheese (1 cup/90 grams grated)
  • Primal Kitchen Honey Mustard Vinaigrette (or your favorite homemade vinaigrette)

Tools:

  • Instant Pot
  • 3 half-size rimmed sheet pans (13”x18”)
  • Parchment paper or foil (for easier cleanup)

Here’s the Plan…

Prep and Cook the Meat:

First, get the pot roast going because it takes the longest amount of time to cook. Season the beef by rubbing 1 heaping teaspoon salt and ½ teaspoon black pepper into the roast.

Roughly chop two onions. Use one chopped onion for the pot roast and set the other aside for later.

Peel 6 cloves garlic and smash them with your palm.

Turn the Instant Pot sauté setting to high. Drizzle a tablespoon or two of avocado oil into the pot. Put the roast in the Instant Pot and sprinkle one chopped onion around it.

Sear the meat, turning as needed, until all sides are nicely browned (about 2 minutes per side). Mix the onions occasionally, so they become soft and nicely browned.

Add the garlic cloves, 3 cups beef stock, 1 tablespoon red wine vinegar, a few sprigs of thyme and one bay leaf.

Put the lid on the Instant Pot and set the pressure release valve to “sealing.” Use the manual setting to cook on high pressure for 50 minutes. When 50 minutes is up, let the pressure release naturally.

When the pot roast is done, remove it from the Instant Pot and let the meat cool on a cutting board. Shred the meat and store in two separate food storage containers for two separate meals.

While the pot roast is cooking, get to work on the other ingredients.

Prep and Cook the Sheet Pan Veggies:

Heat oven to 425ºF/218ºC.

Cover three sheet pans with parchment paper (optional, for easier cleanup).

Sheet Pan #1: Trim the bottom off the asparagus stalks. Lay the asparagus out on a sheet pan. Lightly coat the asparagus with oil and salt.

Sheet Pan #2: Slice the zucchini into ½-inch rounds. Combine on a sheet pan with the chopped onion that was set aside earlier. Lightly coat zucchini and onion with oil and salt.

Sheet Pan #3: Spread the sliced mushrooms out on a sheet pan. Lightly coat mushrooms with oil and salt.

Put all three of the sheet pans in the oven. Roast for 20 to 35 minutes, stirring occasionally, until vegetables are tender and lightly browned.

While the veggies are roasting, make the coconut curry sauce.

Make the Curry Sauce:

To make the coconut curry sauce, heat a few tablespoons coconut oil in a pot over medium heat. Add 3 finely chopped garlic cloves. Add 1 tablespoon curry powder and sauté 30 seconds. Add 1 can coconut milk and 2 tablespoons soy sauce (or tamari or coconut aminos). Bring to a boil then turn the heat down slightly and simmer 15 to 20 minutes.

While the curry sauce is simmering, slice the white meat from the rotisserie chicken and chop into small pieces. Add to the coconut curry sauce.

Organize the Ingredients For the Week:

Pull all of the dark meat from the rotisserie chicken. Put the dark meat in a zip-top freezer bag.

When the veggies are done, let them cool. Store the asparagus and mushrooms in separate food storages container and refrigerate.

Add half of the zucchini and onion to the coconut curry sauce. Store the coconut curry sauce (with chicken, zucchini and onion) in a food storage container (or just keep it in the pot!) and put it in the refrigerator.

Add the other half of the zucchini and onion to the freezer bag with the dark chicken meat. Make sure to push out all the air when sealing the plastic bag. Put the bag in the freezer.

Serve Your Meals:

Meal #1: Pot Roast with Roasted Asparagus and Honey Mustard Slaw

Serve half of the pot roast with half of the roasted asparagus. Toss half of the shredded cabbage with a few handfuls of arugula. Dress the slaw with Primal Kitchen Honey Mustard Vinaigrette, or your favorite homemade salad dressing. Sprinkle slivered almonds over the asparagus and slaw.

Meal #2: Chicken Coconut Curry over Cauliflower Rice

Reheat the chicken coconut curry over medium heat. Heat the frozen cauliflower rice either in the microwave or in a sauté pan. Serve the curry over the cauliflower rice and garnish with fresh basil.

Meal #3: Beef Carnitas with Spicy Jalapeño Slaw and Guacamole

Reheat the remaining pot roast by adding the shredded meat to a hot skillet with a thin layer of oil. Cook until the meat is hot and a little bit crispy. As the meat cooks, season it with 1 teaspoon of cumin and chili powder. Mash 2 avocados with lime juice and salt to make guacamole. Add a sliced jalapeño to the remaining sliced cabbage, tossed with lime juice and fresh cilantro.

Meal #4: Asparagus and Mushroom Scramble with Arugula Salad

Chop the leftover asparagus into ½-inch pieces. Sauté asparagus and mushrooms in a skillet with a little bit of oil to reheat. Whisk 6 eggs and add to the pan, stirring to combine with the veggies. Serve the scramble with a side salad made from the remaining arugula and your favorite salad dressing. Grate Parmigiano-Reggiano cheese over the scramble and salad.

Meal #5: Chicken Noodle Soup

Put the frozen dark chicken meat and zucchini in the refrigerator in the morning to defrost. At dinnertime, heat 8 cups chicken broth. Add the chicken and zucchini with rinsed shirataki noodles and simmer until warm.

Thanks for reading today. What cooking tips or meal prep ideas are you looking for? Share what you’d like to see us cover in future recipe and cooking articles in the comment board below.

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The post 90-Minute Low-Carb, Keto Meal Prep appeared first on Mark’s Daily Apple.

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Older people (and those headed in that direction, which is everyone else) are really sold a bill of goods when it comes to health and longevity advice. I’m not a young man anymore, and for decades I’ve been hearing all sorts of input about aging that’s proving to be not just misguided, but downright incorrect. Blatant myths about healthy longevity continue to circulate and misinform millions. Older adults at this very moment are enacting routines detrimental to living long that they think are achieving the opposite. A major impetus for creating the Primal Blueprint was to counter these longevity myths. That mission has never felt more personal.

So today, I’m going to explore and refute a few of these top myths, some of which contain kernels of truth that have been overblown and exaggerated. I’ll explain why.

1) “Don’t Lift Heavy: You’ll Throw Out Your Back”

Obviously, a frail grandfather pushing 100 shouldn’t do Starting Strength right off the bat (or maybe ever, depending on how frail he is). That’s not my contention here. My contention:

Lifting as heavy as you can as safely as you can is essential for healthy longevity. That’s why I put it first in the list today. It’s that important.

For one, lean muscle mass is one of the strongest predictors of resistance to mortality. The more muscle a person has (and the stronger they are), the longer they’ll live—all else being equal. That’s true in both men and women.

One reason is that the stronger you are, the more capable you are. You’re better at taking care of yourself, standing up from chairs, ascending stairs, and maintaining basic functionality as you age.

Another reason is that increased lean mass means greater tissue reserve—you have more organ and muscle to lose as you age, so that when aging-related muscle loss sets in, you have longer to go before it gets serious. And that’s not even a guarantee that you’ll lose any. As long as you’re still lifting heavy things, you probably won’t lose much muscle, if any. Remember: the average old person studied in these papers isn’t doing any kind of strength training at all.

It doesn’t have to be barbells and Olympic lifts and CrossFit. It can be machines (see Body By Science, for example) and bodyweight and hikes. What matters is that you lift intensely (and intense is relative) and safely, with good technique and control.

2) “Avoid Animal Protein To Lower IGF-1”

Animal protein has all sorts of evil stuff, they say.

Methionine—linked to reduced longevity in animal models.

Increased IGF-1—a growth promoter that might promote unwanted growth, like cancer.

Yet, a huge study showed that in older people, those 65 or older, increased animal protein intake actually protected against mortality. The older they were and the more protein they ate, the longer they lived.

Meanwhile, low-protein diets have been shown to have all sorts of effects that spell danger for older people hoping to live long and live well:

And about that “excess methionine” and “increased IGF-1”?

You can easily (and should) balance your methionine intake with glycine from collagen, gelatin, or bone broth. In animals, doing so protects against early mortality.

In both human and animal studies, there’s a U-shaped relationship between IGF-1 levels and lifespan. Animal studies show an inverse relationship between IGF-1 and diabetes, heart disease, and heart disease deaths (higher IGF-1, less diabetes/heart disease) and a positive association between IGF-1 and cancer (higher IGF-1, more cancer). A recent review of the animal and human evidence found that while a couple human studies show an inverse relationship between IGF-1 and longevity, several more show a positive relationship—higher IGF-1, longer lifespan—and the majority show no clear relationship at all.

3) “You’re Never Getting Back That Cartilage—Once It’s Gone, It’s Gone”

Almost every doctor says this. It’s become an axiom in the world of orthopedics.

But then we see this study showing that people have the same microRNAs that control tissue and limb regeneration in lizards and amphibians. They’re most strongly expressed in the ankle joints, less so in the knees, and even less so at the hip—but they’re there, and they’re active.

I’ve seen some impressive things, have been able to personally verify some stunning “anecdotes” from friends and colleagues who were able to regrow cartilage or at least regain all their joint function after major damage to it. Most doctors and studies never capture these people. If you look at the average older person showing up with worn-down joints and degraded or damaged cartilage, how active are they? What’s their diet?

They are mostly inactive. They are often obese or overweight.

They generally aren’t making bone broth and drinking collagen powder. They aren’t avoiding grains and exposing their nether regions to daily sun. They aren’t doing 200 knee circles a day, performing single leg deadlifts, and hiking up mountains. These are the things that, if anything can, will retain and regrow cartilage. Activity. Letting your body know that you still have need of your ankles, knees, and hips. That you’re still an engaged, active human interacting with the physical world.

4) “Retire Early”

This isn’t always bad advice, but retiring and then ceasing all engagement with the outside world will reduce longevity, not increase it. Having a life purpose is essential for living long and living well; not having one is actually an established risk factor for early mortality. And at least when you’re getting up in the morning to go to work, you have a built-in purpose. That purpose may not fulfill your heart and spirit, but it’s a purpose just the same: a reason to get up and keep moving.

Retiring can work. Don’t get me wrong. But the people who retire early and make it work for their health and longevity are staying active. They’re pursuing side projects or even big visions. They have hobbies, friends, and loved ones who they hang out with all the time.

The ones who don’t? Well, they are at at increased risk of dying early.

You don’t have to keep working a job you hate, or even a job you enjoy. You can retire. Just maintain your mission.

5) “Take It Easy As You Get Older”

As older people, we’re told that sex might be “too strenuous for the heart” (Truth: It’s good for it). We’re told to “take the elevator to save our knees.” They tell us “Oh, don’t get up, I’ll get it for you.”

They don’t tell me that because, well, I’m already up and doing the thing. I’m active and obviously so. I don’t take it easy.

Stay vigorous, friends. Stay vivacious. Don’t be foolhardy, mind you. Be engaged.

“Take it easy” quickly becomes “sit in the easy chair all day long watching the news.” Don’t let it happen.

That’s not to say you shouldn’t rest. Rest is everything. Sleep is important. But you must earn your rest, and when you have the energy, take advantage of it. Don’t rest on your laurels.

As you can see, there are tiny kernels of truth in many of these myths. We should all be careful lifting heavy things and pay close attention to technique and form. Everyone should care for their cartilage and avoid damage to it. No one should continue working a job that sucks their soul and depletes their will to live if they can move on from it. And so on.

What we all need to avoid is sending the message to our brain, body, and cells that we’re done. That we’ve given up and our active, engaged life is effectively over. Because when that happens, it truly is over.

Someone asked me when aging begins. How old is “old”?

I think I know now. Aging begins when you start listening to conventional longevity advice. As I said on Twitter earlier today, healthy aging begins when you do the opposite.

Want more on building a life that will allow you to live well into later decades? I definitely have more on that coming up. A perceptive reader shared the news in one of the Facebook groups already, so let me mention it here. My new book, Keto For Life: Reset Your Biological Clock In 21 Days and Optimize Your Diet For Longevity, is coming out December 31, 2019. I’ll have more info, including a special bonus package for those who preorder, in just a few weeks. In the meantime, you can read more about it here on our publisher’s page.

That’s it for today, friends. Chime in down below about longevity or any other health topics you’re thinking about these days. What are the most egregious aging myths you’ve heard? What do you do instead? Take care.

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References:

Karlsen T, Nauman J, Dalen H, Langhammer A, Wisløff U. The Combined Association of Skeletal Muscle Strength and Physical Activity on Mortality in Older Women: The HUNT2 Study. Mayo Clin Proc. 2017;92(5):710-718.

Malta A, De oliveira JC, Ribeiro TA, et al. Low-protein diet in adult male rats has long-term effects on metabolism. J Endocrinol. 2014;221(2):285-95.

Carrillo E, Jimenez MA, Sanchez C, et al. Protein malnutrition impairs the immune response and influences the severity of infection in a hamster model of chronic visceral leishmaniasis. PLoS ONE. 2014;9(2):e89412.

Castaneda C, Charnley JM, Evans WJ, Crim MC. Elderly women accommodate to a low-protein diet with losses of body cell mass, muscle function, and immune response. Am J Clin Nutr. 1995;62(1):30-9.

Gaine PC, Pikosky MA, Martin WF, Bolster DR, Maresh CM, Rodriguez NR. Level of dietary protein impacts whole body protein turnover in trained males at rest. Metab Clin Exp. 2006;55(4):501-7.

Wu C, Odden MC, Fisher GG, Stawski RS. Association of retirement age with mortality: a population-based longitudinal study among older adults in the USA. J Epidemiol Community Health. 2016;70(9):917-23.

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Whether you’re a big breakfast person or not, everyone enjoys something warm and comforting in the morning, right?

From Primal pancakes to frittatas, we’ve got 10 delicious ideas for those who crave the savory or the sweet—as well as some filling coffees for those who prefer to keep the routine simple and the fare light in the a.m.

Enjoy any of these great dishes and drinks anytime of the day….

1) Butternut Squash Waffles

2) Vegetable Latkes

3) Egg Coffee

4) Apple Cinnamon Primal Pancakes

5) Bacon Pancakes

6) Pumpkin Spice Collagen Latte

7) Sweet Potato Toast With Avocado and Egg

8) Almond Butter Banana Pancakes

9) Curried Pork Frittata

10) Grain-Free Pumpkin Spice Granola

Have a favorite Primal or keto breakfast or questions about what to eat in the a.m.? Share your ideas and inquiries below.

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