Back in June during the 21-Day Challenge, I asked you to share questions you had about my personal health routine, and I’m looking forward to answering those in the coming months. We talk a lot about generalities here, and for good reason. Research can and should drive principle, but oftentimes while we wait around for it (or have questions about the overall validity of what’s out there), n=1 self-experimentation can tell us a lot.

Over the years, I’ve gathered ideas for that experimentation by reading the studies and listening to others talk about the choices they make. All of it together has—and continues to—inform the routine I follow to live the life I want. Among the many questions you sent were inquiries about my supplement regimen. Today I’m sharing what I take, when I take it, and why.

As a former endurance athlete, supplements were tools of the trade. I fielded recommendations from coaches and specialists of course, but I also studied the subject intently on my own. To push my performance further, I even began developing my own formulas for training recovery back then. Though I’m not in the competitive athletic world anymore, I still feel the benefits of certain supplements in my personal health and performance, and I’ve continued to formulate those I wish to take.

Here’s a bit about my choices for supplementation and the changes I’ve made over the years in how I take them.

I’d love to hear your thoughts and any questions you have about what I take (or don’t take). And if you have other kinds of questions about my routine (or anything health-related of course), shoot me a message on the comment board. Thanks for stopping by, everyone.

Finally, for those who are curious about the supplements I’ve shared today, I have a deal on two of my favorites. Order Adaptogenic Calm today, and I’ll include a bottle of Primal Sun entirely free. Just add both Adaptogenic Calm and Primal Sun to the cart, and use the code FREESUN at checkout to redeem this offer. Valid on One-Time Purchases only. Offer expires 8/30 at midnight PDT.

The post My Supplement Routine: What I Take, When I Take It, and Why appeared first on Mark’s Daily Apple.

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It’s been a long time since I published the Definitive Guide to Fish Oils.

Oh sure, here and there I’ve cited some research supporting the beneficial effects of fish fat, but it almost goes without saying that omega-3s are important. Everyone knows it. Even the most curmudgeonly, conventional wisdom-spouting, statin script-writing, lifestyle modification-ignoring doc will tell you to take fish oil. And research in the last few years has not only continually confirmed the health advantages but illuminated new applications—and new physiological explanations—for their essential function in the body.

But what are those benefits, exactly? Why should we be eating fatty fish or, barring access to high quality edible marine life, taking fish oil supplements?

A major reason is that fish oil can help us reclaim our ancestral omega-3:omega-6 ratio and thus restore the inflammatory backdrop of the human body.

Polyunsaturated fats convert to eicosanoids in the body. Both omega-6 and omega-3-derived eicosanoids are important signaling molecules, but each has different effects, both figuring prominently in the body’s response to inflammation. Omega-6 eicosanoids are generally pro-inflammatory, while omega-3 eicosanoids are anti-inflammatory. Omega-3-derived eicosanoids (the type we get from taking fish oil or eating fatty fish) actually reduce inflammation; in an unbalanced diet heavy in vegetable oils, the omega-6 eicosanoids far outnumber the omega-3s and contribute to a lot more inflammation.

The best available evidence points to ancient humans having an omega-3:omega-6 ratio of around 1 to 1. A typical ratio these days is 1 to 16!

As most diseases and health conditions have an inflammatory component, such lopsided ratios can predispose us to any number of health problems. Conversely, correcting those ratios with smart supplementation of fish oil has the potential to correct or prevent those health problems.

Let’s look at some of them and what the most recent research tells us.

How Omega-3s Benefit Health

Arthritis

Arthritis is an inflammatory disease, whether we’re talking autoimmune arthritis or wear-and-tear arthritis.

The potential mechanisms are there. In vitro studies using isolated joint tissue show that both DHA and EPA increase joint lubrication. Studies in people show that fish oil reduces inflammatory markers and may even stop the progression of inflammation into inflammatory arthritis.

In a recent study out of Thailand, knee arthritis patients who took fish oil improved their walking speed. “Everyone felt good and happy with the fish oil.” In psoriatic arthritis, fish oil reduced inflammatory markers and lowered patients’ reliance on pain meds.

Fish oil also helps reduce the symptoms of autoimmune rheumatoid arthritis (RA). In one paper, fish oil supplements had additive effects on top of RA drugs. 3-6 grams appears to be an effective dose range. If that sounds high, it is—but you need that much to quell the exaggerated inflammatory responses of RA.

Depression

Depression is another one of those conditions that we don’t often think of as an inflammatory disease, but it is. The evidence is considerable. Vets with the most severe depression also have the highest levels of inflammatory markers. Among Type 2 diabetes, depression and inflammation go hand in hand, with the latter appearing to play a causative role in the former.

There’s considerable evidence that the causation goes both ways: depression can increase inflammation, and inflammation can increase depression. Thus, treating one may treat the other. Since omega-3s are potent and broad-reaching anti-inflammatories, could fish oil treat depression?

Yes.

Fish oil has proven effective  with EPA having a greater effect than DHA. It’s even effective in patients with and without an official diagnosis of major depressive disorder. It’s effective in type 2 diabetics with depression.

Stress Reactivity

The stress response is an inflammatory one. A healthy omega-3:omega-6 ratio—the foundation of our inflammatory response system—should produce a healthy stress response. Does it?

In response to mental stress, fish oil promotes a healthy, less reactive neurovascular response. It lowers resting heart rate, a good indicator of general stress resilience. When taken post-trauma, it even reduces psychophysiological symptoms (like pounding heart) in car accident survivors. And in alcoholics, fish oil reduces both perceived (subjective) stress and basal cortisol (objective).

General Inflammatory and Immune Responses

Name a disease and “elevated inflammation” or “exaggerated immune response” is probably part of the pathology. What effect does fish oil have on some of these inflammatory pathologies?

I could go on and on. And these are just studies done in the last year or two.

Fish Oil and Cardiovascular Disease

Not everything is so cut and dry. When it comes to certain conditions, like cardiovascular disease, the fish oil literature is confusing. Sometimes it helps, sometimes it doesn’t. What are we to make of it?

One thing that is unequivocal is that a high omega-3 index—the proportion of omega-3 fatty acids in the red blood cell membrane—is protective against cardiovascular disease (see the chart; as omega-6 content goes up, so does cardiovascular mortality). So the question isn’t if long chain fatty acids from fish oil are helpful. It’s: Are those fatty acids reaching your red blood cell membranes and being incorporated?

How To Improve Bioavailability

Several factors affect whether fish oil will increase omega-3 index and thus have the effects we’re looking for:

Omega-6 fats and omega-3 fats compete for space in the red blood cell membranes. If omega-6 intake is too high, fewer omega-3s will make it into the membranes, thereby inhibiting or even abolishing the positive effects of fish oil.

If omega-3 index is low, we’ll see effects. If it’s high enough, further fish oil has no additive effect. We see this in studies such as this one, where only older adults with a low omega-3 index experienced cognitive benefits from omega-3 supplementation. In another study of older adults and cognition that didn’t control for omega-3 index, they found no benefit.

Or in this study, where fish oil had benefits in congestive heart failure patients because they had low baseline levels of omega-3.

Or this study, where autistic patients—who tend to have lower omega-3 statuses than the general population—improved some behavioral measures after taking fish oil.

To take advantage of the full effects of fish oil, however, one must also limit the amount of omega-6 fats they eat. In one study, taking fish oil with saturated fat increased incorporation of omega-3s into red blood cell membranes, while taking it with omega-6 prevented omega-3 incorporation. The best way to do it is to eliminate seed oils—the most concentrated source of omega-6 fatty acids in the modern diet. If you don’t limit seed oils and other dense sources of omega-6s, you’ll have to consume extremely high doses of fish oil to make a dent in your inflammatory status.

Making It Easier To Get Your Omega-3s…

Thanks for reading today, folks. I take this information very personally in my life and business. To that end, this week I just released a new formula of Primal Omega-3s that enhances bioavailability and adheres to stricter environmental sustainability standards—all in a smaller capsule. The idea was to optimize benefits and maximize ease. And right now I’m also offering a deal to make this level of quality more affordable….

I’m kicking off the new formula with a BOGO deal. Buy one new Primal Omegas, get the second bottle free now through 8/10/18 at midnight PDT. Just add two Primal Omegas to your cart and use code NEWOMEGAS at checkout. Limit 1 per customer. One-time purchase only.

Thanks again, everybody. Have a great end to the week.

The post Omega-3 for Health: What the Latest Research Shows appeared first on Mark’s Daily Apple.

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One of the biggest mistakes I see among people who exercise is they forget this core truth: we get fitter not from training, but from recovering from training. This doesn’t just occur in beginners either. Some of the most experienced, hardest-charging athletes I know fail to heed the importance of recovery. Hell, the reason my endurance training destroyed my life and inadvertently set the stage for creation of the Primal Blueprint was that I didn’t grasp the concept of recovery. I just piled on the miles, thinking the more the merrier.

It didn’t work.

What is recovery, anyway?

There’s short-term recovery. Your heart rate slows back down, your body temperature drops, your sweat dries, your muscles and lungs stop burning.

Long-term recovery is less conspicuous, more internal. You replace lost energy stores, repair damaged muscle, clear out waste products, and begin the process of adaptation to the training.

When both short- and long-term recovery happen together, you “feel ready” to go again.

Some portion of how quickly we recover from training is out of our direct control.

Genetics is one factor we can’t control. Researchers have found genetic variants of collagen-encoding genes that increase or decrease the rate at which we recover from exercise-induced muscle damage, muscle tissue genes that increase resistance to exercise-induced muscle soreness, immune genes that affect the speed of adaptation to training. But even many genetic variants purported to affect recovery act through decisions carriers make. A carrier of a genetic variant linked to muscle power experienced more muscle damage and required more recovery after a soccer match, but only because that carrier “performed more speed and power actions during the game.”

Age is another factor out of our direct control. Sure, living, eating, and training right can stave off many of the worst effects of aging. Sure, a sedentary 70-year-old will recover from a workout far more slowly (if he or she can be cajoled into training) than a 70-year-old master athlete. But time does tick on. Following training that fatigues but doesn’t damage the muscles, like easy cycling, light weight training, or a sub-aerobic threshold jog, older athletes recover muscle function and performance at similar rates to younger athletes. After intense exercises that damage the muscles, like sprints, heavy lifting, intervals, or longer race-pace runs, however, older athletes recover more slowly than younger athletes.

Other factors, while preventable and modifiable over the long haul, inexorably inhibit workout recovery once they’re in place:

If you’re sick, you won’t recover as quickly. Illness diverts some of the resources that would otherwise be used to recover from training.

If you have heart disease, you’ll recover more slowly. In one study, having heart disease was the greatest predictor of a slower rate of heart rate recovery after exercise.

If your hormones are out of whack, you’ll likely recover more slowly. Hormones are the messengers and managers that tell our cells what to do. That includes muscle repair, hypertrophy, fuel replenishment, inflammatory signaling, and every other cellular function related to recovery.

Now I’ve got bad news and good news. Everything else that slows down workout recovery is under your direct control.

Factors We Can Control

Stress

Stress is stress. Traffic is a stressor. A job you hate is a stressor. Procrastinating until you absolutely must get working is a stressor. And yes, exercise is a stressor. Too much of the psychological, lifestyle, or mental stress we all face impairs our ability to recover from exercise-induced stress.

Recent research confirms that “mental stress” impairs workout recovery, and it doesn’t speak in generalities. Thirty-one undergrads were assessed for stress levels using a battery of psychological tests, then engaged in a heavy lower body strength workout. At an hour post-workout, students in the high stress group had regained 38 percent of their leg strength, while students in the low stress group had regained 60 percent of their strength.

I developed my anti-stress supplement Primal Calm (now, Adaptogenic Calm) back in the chronic cardio days as a way to improve my training recovery. That’s what gave the product so much momentum in the endurance community—it turns out that beating back stress of all kinds quickened recovery from a very specific type of training stress.

Some stress is unavoidable. But most of us create additional stress in our lives and fail to do enough to counter or manage it. Stop making unforced errors.

Poor Sleep

Sleep debt impairs exercise recovery primarily via two routes: by increasing cortisol, reducing testosterone production, and lowering muscle protein synthesis; and by disrupting slow wave sleep, the constructive stage of slumber in which growth hormone secretion peaks, tissues heal, and muscles rebuild. That’s probably why sleep deprivation has been linked to muscular atrophy and increased urinary excretion of nitrogen, and why the kind of cortisol excess caused by sleep deprivation reduces muscle strength.

Additionally, sleep loss can increase the risk of injuries by decreasing balance and postural control. If you trip and fall, or throw out your back due to poor technique, you won’t even have a workout to recover from.

Most people think bad sleep is unavoidable. It happens to the best of us from time to time, but a night of bad sleep here and there isn’t going to slow down recovery. The real recovery killer is chronically bad sleep, and that’s the kind most of us can avoid by sticking to a good sleep hygiene regimen.

Nutrient Deficiencies

Since every physiological function requires a micronutrient substrate—vitamin, mineral, hormone, neurotransmitter, etc.—and physiological functions increase with exercise and recovery, active people require more micronutrients in their diet. “More of everything” is a safe bet, but there are a few key nutrients that working out especially depletes:

Zinc: Exercise, especially weight training, works better with plenty of testosterone on hand to build muscle and develop strength. Zinc is a key substrate for the production of testosterone, and studies show that exercise probably increases the need for zinc. In fact, one study found that exhaustive exercise depleted testosterone (and thyroid) hormones in athletes, while supplementing with zinc restored it.

Magnesium and Other Electrolytes: Magnesium is required for a number of physiological processes related to workout recovery, including oxygen uptake by cells, energy production, and electrolyte balance. Unfortunately, as one of the main electrolytes, lots of magnesium is lost to sweat during exercise. The same could be said for other electrolytes like calcium, sodium, and potassium, but most people get plenty of those minerals from a basic Primal eating plan. Getting enough magnesium, however, is a bit tougher, making magnesium deficiency a real issue for people trying to recover from workouts.

Iron: Intense exercise depletes iron, which is instrumental in the formation of red blood cells and oxygen delivery to your tissues during training and the immune response after it. They even have a name for it—exercise-induced anemia.

Soreness

Post-workout delayed onset muscle soreness, or DOMS, is no joke. While many of you folks reading this probably enjoy DOMS and take it as feedback for a job well done, it’s a hurdle that many beginners never move past. They join a gym, d0 a workout, feel great, go to bed feeling awesome, sleep like a baby, then wake up and find they have the bipedal capacity of a three-month-old. They can barely walk. Lifting their arms to brush their teeth is agony. Walking downstairs is out of the question. Some will move past the DOMS and get back into the gym. Many will not.

Low Fuel Availability

Working out expends energy. That energy must be replenished before you’re fully recovered and prepared to do another workout. Unless you’re trying to increase efficiency by training in a state of low fuel availability, like the “train low-carb, race high-carb” method, you should recover what’s been lost. What you replenish is conditional on the type of exercise you did. If you went for a long hike or easy bike ride that burned primarily body fat, you don’t need to—and probably shouldn’t—”replenish what you lost.” If you’re coming off a 30-minute full body CrossFit session that left you gasping on the ground in a puddle of sweat, you probably have some glycogen stores to refill.

This is a common issue for folks trying to lose weight through diet and exercise. Inadequate calorie intake coupled with intense exercise sends a “starvation” signal to the body, causing a down-regulation of anabolic hormones. Instead of growing lean mass and burning body fat, starvation (whether real or simulated) promotes muscle atrophy and body fat retention. Either alone can be somewhat effective, but combining the two for too long will only impair recovery.

Alcohol

Drinking directly impairs muscle protein synthesis, the essential step in muscle recovery and adaptation to training. Moderate or “social” drinking is probably safe (just don’t use alcohol as a post-workout recovery drink), but even just a single day per week of binge drinking is linked to 4x the risk of sarcopenia, or muscle-wasting. It’s hard to recover from your workouts if your muscles are atrophying.

Oddly, drinking directly after a training session also increases testosterone levels. One theory is that testosterone levels rise after drinking because it becomes less bioavailable; your muscle cells’ resistance to testosterone goes up, so it just circulates and gives “false” readings.

Things You Can Try

The obvious thing to try is the opposite of all the modifiable and preventable recovery-inhibitors mentioned above. Get good sleep, don’t drink too much (especially post-workout), get a handle on your stress, eat enough food, eat enough protein, get your micronutrients. What else?

Watermelon

L-citrulline is an amino acid found in watermelon that shows a significantly ameliorative effect on post-workout muscle pain, or delayed onset muscle soreness (DOMS). You can also supplement directly with L-citrulline, which may work, but watermelon is so good right now with a little salt, lime juice, and cayenne pepper, and it’s actually lower in carbs than you probably think (about 10 grams per cup of watermelon). I recommend fresh watermelon over pasteurized juice, as heat treatment reduces the effect.

Beets

Beets (and beet juice) aren’t only good for exercise performance. They also reduce DOMS. Nitrates have been posited as the primary constituent responsible for the effect, but beet juice works better than pure sodium nitrate.

Tart Cherry Juice

Tart cherry juice is best used to recover during competition, when your primary concern is to get back out there and perform. Its extreme effectiveness at killing muscle pain, reducing local and systemic inflammation and exercise-induced muscle damage suggests it may hamper training adaptations, however. It does also improve sleep, which should translate into better adaptations.

Massage

Massage feels great, and the evidence shows that it’s great for recovery from exercise. It alleviates DOMS. It speeds up the recovery of muscle strength and enhances proprioception. It improves central nervous system parasympathetic/sympathetic balance, even if the masseuse is one of those weird back massage machines.

Compression Garments

These aren’t just for show. A recent meta-analysis of the available research concluded that compression garments enhance muscle recovery after strength training and improve next-day cycling performance.

Whey

Compared to other proteins, whey protein accelerates muscle adaptation to eccentric exercise.

Creatine

Although we get creatine from red meat and fish, supplementary creatine can boost our recovery from exercise via a couple mechanisms. First, it increases muscle content of phosphocreatine. That’s the stuff we use for quick bursts of maximal effort, so carrying a little extra can do wonders for our ability to perform. Second, it enhances muscle glycogen replenishment without increasing insulin.

Fish Oil (or Fatty Fish)

Adding fish oil to a recovery drink reduced post-workout muscle soreness without affecting performance. Fish oil may also enhance muscle recovery from and adaptation to strength training.

Cold Water

A cold water plunge after training enhances the recovery of muscle function. However—and this is a big “however”—post training cold water plunges also seem to impair long term muscular adaptations to resistance training. In other words, a cold plunge might help you get back in the game for the short term at the cost of long-term adaptations.

More Carbs

I always say “Eat the carbs you earn.” While that often means eating fewer carbs than before, it can also mean eating more if you’ve trained hard enough to warrant them. This even applies to keto folks; depleting glycogen through exercise creates a “glycogen debt” that you can repay without inhibiting ketosis or fat-adaptation too much. The carbs—which you don’t need much of—go into muscle glycogen stores for recovery and later use without disrupting ketosis.

Don’t take this final section as a blanket recommendation, however. Before taking ice baths, dropping $500 on massages every week, taking a long list of expensive supplements, and walking around in a full body compression suit, make sure you’re sleeping, eating enough food, and giving yourself enough time between workouts. Quite often, handling the basics will be enough.

What have you found to be the best way to recover from your training? What are the biggest roadblocks? Let me know down below, and thanks for reading!

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The post What Causes Slow Post-Workout Recovery—and What Can You Do About It? appeared first on Mark’s Daily Apple.

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Inline_Lymphatic Health.jpegI get more questions these days about lymphatic health—particularly lymphedema. Sometimes it’s an issue related to a reader’s cancer recovery or a co-occurring symptom seen with a loved one’s other health concerns. While I might take up specific conditions in future posts (let me know if you have suggestions there), I thought I’d spend today taking apart the basics of lymphatic health. As with many of the body’s core operating functions, the real story often gets camouflaged within vague, consumer-based terms that end up being only medically tangential. Consider today’s post a trip into the weeds and (maybe) the beginning of an ongoing conversation on the topic.

In essence, the lymphatic system is the body’s filtration system, helping to sample incoming substances, filter out waste products from cells, regulate fluid homeostasis, and prime the immune system for action when a threat is located. Central to the entire system is the transportation of lymph, a clear fluid that stores and transports white blood cells, proteins, salts, glucose, bacteria and certain waste products.

Lymphatic vessels perform a similar role to the blood circulatory system, carrying lymph to virtually all areas of the body other than bone marrow.  Unlike the blood system, however, a series of valves force lymph to travel in just one direction, taking it ever-upward towards the neck, whereupon it re-enters the venous circulatory system. New lymph is formed when specialized lymphatic capillaries allow soluble materials and cells to court their way back into the lymphatic vessels.

Lymphatic vessels are connected to lymph organs. These organs are where the lymph is filtered and lymphocyte is created—arguably where most of the exciting action happens.

Red bone marrow and the thymus gland are considered the primary lymphoid organs and act as incubators for maturation of lymphocytes—a type of white blood cell. As these lymphocytes get older, they’re sent into the lymphatic vessels to hunt down and attacking infected or cancerous cells.

Secondary lymphoid organs, which include the lymph nodes, tonsils and spleen, act as traps for incoming pathogens, whereupon foreign bodies are set upon by mature lymphocytes.

Your Lymphatic System In Action

Up until quite recently, the lymphatic system was considered secondary to the blood circulatory systemA series of groundbreaking discoveries in the 90s changed all this, and we’ve been learning since.

For one, the lymphatic system plays a key part in our adaptive immunity. Antigens that make their way into the body or develop within our cells are recognized primarily by the lymphocytes produced by the thymus and bone marrow, or picked up as they pass through the secondary lymphatic organs. Upon detection of the antigen, the lymphatic system initiates a immunological cascade that activates or produces more and more lymphocytes to wipe out the threat. Lymph nodes and other secondary lymphatic organs are strategically located around the body where they are well placed to sample incoming materials and intercept potential threats.

Beyond immunity, there’s the equally important fluid homeostasis role that the lymphatic system plays. Lymphatic vessels act as conduits, allowing surrounding tissues to expel or absorb fluid in order to maintain homeostasis and prevent excess swelling. Recent research has even discovered an element of the lymphatic system devoted to draining interstitial fluid from in and around the brain, thereby exhibiting a critical function in alleviating pressure in the CNS.

Add to that the lymphatic system’s roles in lipid absorption and transportation from the digestive system, and the efficient removal of metabolic wastes from tissue, organs and the central nervous system, and it’s not hard to see why the lymphatic system is so nuanced (not to mention critical).

Lymphatic Dysfunction

It’s all well and good when the lymphatic system is doing what it ought to, but lymphatic disruption can portend unfortunate news for your health: compromised immune function and lymphedema for starters. 

Like any system within the body, factors like chronic inflammation, lifestyle choices, and toxin exposure can all place stress on the lymphatic system. Problems often occur when the flow of lymph is disrupted, whether with systemic inflammation or localized swelling at the nodes and vessels, whereby the entire system can become compromised as it relies on that constant movement of lymph to do its job.

And then there’s the fact that the lymphatic system acts as a sort of microbiological conveyor belt—fundamentally useful when antibodies can be released in a timely and efficient fashion to dispatch any antigens, but highly problematic when the system is overwhelmed or overrun. In these scenarios, the lymphatic system can quickly become a means by which infection can rapidly disseminate throughout the body.

Common diseases associated with the lymphatic system include:

  • Lymphedema—pooling of lymph fluid in the surrounding tissue, typically in the feet or lower legs.
  • Lymphadenitis—inflammation of a lymph node or nodes due to an infection of the tissue, usually in the neck.
  • Lymphoma—a group of cancers that develop in the lymphatic system, involving multiplication of lymphocytes eventually forming a malignant tumor in the lymph nodes and other parts of the body.
  • Non-Hodgkin Lymphoma—another subset of lymphatic cancers that can involve either B cells or T cells.
  • Splenomegaly—more conveniently known as an enlarged spleen. This is caused by several possible factors, including infection or cancer.
  • Tonsillitis—recurrent infection of the lymphoid tissues in the back of the mouth and top of the throat, which together form the tonsils.

There’s plenty more where that came from, but it’s fair to say that if your lymphatic system is ailing, your health in general will be lacking.

Factors That Help or Hinder Lymphatic Health

Inflammation (or Lack Thereof)

While the lymphatic system plays a key role in regulating inflammatory response within the body, it’s also susceptible to inflammation-driven dysfunction. As with every other angle of health, keeping inflammatory foods to a minimum, and anti-inflammatory foods on the regular, is definitely a plus for supporting lymphatic health. 

I’ve periodically shared my thoughts on the most anti-inflammatory foods, so be sure to check out the likes of this post if you’re not already familiar. Foods like wild fish oil/fat, berries, turmeric and pastured animal fat have all been shown to significantly lower chronic inflammation patterns. One interesting case study showed that MCT oil along with fat soluble vitamins helped to improve symptoms of intestinal lymphangiectasia.

Aside from anti-inflammatory foods, there’s the usual lifestyle choices that can make or break an anti-inflammatory way of life: getting plenty of sleep, regular (but not excessive) exercise, and avoiding chronic stress wherever possible.

Movement

Whereas the blood circulatory system is propelled by the pump-like workings of the heart, our lymphatic system relies on the contraction and relaxation of a complex series of smaller muscles to keep lymph continually flowing. While lymphatic vessels are equipped with their very own smooth muscle cells, research shows that “outer” forces such as skeletal muscle motion help to maintain healthy lymphatic flow.

Logically-speaking, the more movement you get, the better off your lymphatic system should be—and the literature seems to support this notion. A 2012 literature review concluded that exercise is an effective therapy for the treatment of lymphedema, while a considerable number of other studies indicate that water exercise in particular is a proven, safe way to treat swelling associated with secondary lymphedema.

Rebounding (e.g. jumping up and down on a trampoline), for one, has attained something of akin to cult status, and anecdotal evidence at least suggests there might be something in it. According to its proponents, rebounding helps to stimulate and maintain the flow of lymph by the dual action of weightlessness and “double gravity,” in addition to providing passive lymphatic muscular stimulation throughout many of the major muscle groups.

From a theoretical standpoint, it makes a lot of sense. While there are plenty of enthusiasts, I haven’t been able to dig up direct (confirmed) links between rebounding and lymphatic health. That being said, there’s no doubt that rebounding is good for our general health, so I see no reason not to give it a go.

Stress

Stress, as it happens, can exhibit a direct negative effect on the lymphatic system. A study published a couple of years ago, for example, showed that “chronic stress restructures lymphatic networks within and around tumours to provide pathways for tumour cell escape.” Not an ideal scenario…

Consciously pursuing a limited stress lifestyle (and taking advantage of stress reduction strategies) is critical for promoting a robust lymphatic system that’s still capable of fighting infection, regulating fluid, and removing waste. As always, daily meditation is a big step in the right direction, along with regular movement (somehow we keep coming back to that), plenty of social interaction, and getting out into nature as much as possible.

Lymphatic Massage

Lymphatic massage, otherwise known as lymphatic drainage, was developed in Germany specifically for the treatment of lymphedema. While the massage technique varies depending on the location and nature of the lymphedema (lymphatic blockage leading to painful swelling), it generally involves a practitioner gently rubbing, stroking and manipulating the skin in directions that follow the structure of lymphatic pathways. In this way, accumulated lymph fluid is forced to drain from the area of swelling.

And as far as the literature is concerned, lymphatic massage produces tangible results. A 2015 review of six applicable trials found that lymphatic massage was at least moderately effective across the board, particularly when combined with compression bandaging or sleeves. A recent Chinese study also showed that a combination of lymphatic drainage massage and exercise were beneficial in the treatment of axillary web syndrome, a common lymphatic condition in post-op breast cancer patients.

Far-Infrared Saunas

An alternative therapy for lymphatic conditions like lymphedema that shows some promise (although peer-reviewed research is thus far lacking) is far-infrared treatment. 

Disclaimer aside, the premise of infrared sauna treatment is thus: it purportedly stimulates mitochondrial function directly beneath the skin, which just so happens to be where some of the lymphatic system (and action) resides. In theory, more red light means more cellular energy, thereby encouraging more efficient flow of lymph and the possible treatment of conditions like lymphedema. With the cell-repairing, wound-healing, and other probable/confirmed benefits of far-infrared, it’s probably a therapy worth considering if lymph dysfunction is an issue.

Thanks for stopping by. Have you or anyone you know suffered from lymphatic issues? What treatments and/or lifestyle changes have been pivotal? Share your thoughts and questions below, and have a great end to your week, everyone.

The post A Primal Primer: Lymphatic Health appeared first on Mark’s Daily Apple.

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inline_Cold Water Therapy.jpegCold is really catching these days. Aubrey Marcus, whom I recently filmed a nice podcast with, was asked about his winning daily behaviors on another show. The very first thing he mentioned was “exposure to cold.” His practice is finishing his morning shower with a three-minute stint at full cold setting. He mentioned the hormonal benefits but also the mental edge he gets from psyching up and accepting the challenge instead of wimping out. He also cited research that people who engage in therapeutic cold exposure catch fewer upper respiratory infections. Hence, like many other elements of conventional wisdom, the old wives tale is backwards. Of course, we are talking about acute and optimal duration cold exposure, not prolonged exposure to elements that weaken your resistance and contribute to immune disturbances.

As with keto, there’s much more to be learned in this burgeoning field before we can operate in definitive (hence today’s title). Today, however, I’ll expose you (the first of more double entendrés to be on the lookout for) to important concepts and best practices so that you may enjoy the vaunted benefits and avoid some of the negative effects of going about cold exposure wrong.

Cold therapy has been around forever as in the athletic world—a central element of injury treatment and post-workout recovery. Ice packs wrapped on aching joints are a staple of every high school, college and professional team locker room. The iconic stainless steel cold whirlpool has been a post-workout destination of professional ballers for decades, and Olympic distance runners have inspired millions of recreational runners to dutifully wade into a cold stream, lake or pool after long runs to soothe and revitalize inflamed muscles. In recent years, whole body cryotherapy clinics have exploded in popularity, making grand promises in return for $45-$90 (the latter in NYC) for a three-minute session in a chamber blowing air at 190-255 degrees below zero Fahrenheit. I haven’t tried cryo, but let’s just say I’ve heard it stings.

In writing Primal Endurance, my co-author Brad Kearns and I studied the cold therapy subject extensively to convey some best practices in the recovery chapter of the book. For this article, we also consulted with Dr. Kelly “K-Starr” Starrett—thought leader on all things mobility, rehab, prevention, and performance (check MobilityWOD.com or Becoming A Supple Leopard for cutting edge strategies that will keep you moving optimally and avoiding breakdown and injury) and reviewed numerous articles, which you will find linked or at the end of the post.

It appears that while cold therapy can offer some proven benefits for inflammation control, enhanced cellular, immune, and cognitive function, and recovery from exercise, numerous elements of cold therapy claims seem to be hype, notably the expensive cryochambers (cold water is better) and the potential of cold exposure to reduce body fat (cut grains and sugars instead!) Worse, the prominent cold therapy practice of post-exercise immersion into cold water or application of ice appears to be counterproductive, compromising potential fitness gains generated by hard workouts.

What NOT To Do…

The most emphatic suggestion made by K-Starr is that cold exposure should happen far away from the stimulus of workouts. While it feels soothing to wade into the icy river right after a run or to relax with an ice pack on your back after a pickup basketball game or CrossFit session, blunting post-exercise inflammation can compromise the adaptive response to workouts, of which inflammation is a critical component. Your muscles becoming inflamed during exercise—and remaining that way for hours afterward are part of how they become stronger and more resilient for future performances. In the hours after workouts, your muscles and other body systems are challenged to naturally repair exercise-induced damage, recalibrate to homeostasis, and replenish depleted cellular energy. Cold exposure also inhibits the function of the lymphatic system in clearing inflammatory toxins from the bloodstream. The takeaway: while cold feels great after workouts, don’t do it.

Furthering this concept about letting inflammation run its course, I know world ranked pro triathletes are experimenting with a complete avoidance of not just cold therapy, but also stretching, massage, and myofascial release (foam rolling.) The thinking here is that when those lower back muscles stiffen after 80 miles of hilly cycling, or hamstrings tighten up after a set of 800s on the track, loosening them up with massage strokes or foam rolling will weaken them and counteract the training stimulus. Again, these unwinding therapies might feel great, but you are teaching the central nervous system to relax the muscles that you just asked to contract with great force and duration for the workout. Andrew MacNaughton, former elite pro triathlete and current coach of both top professionals and recreational endurance athletes, says succinctly: “Don’t help your body, otherwise you lose some of the adaptation you’re seeking through your challenging workouts.”

The stuff is so counterintuitive that it becomes intuitive. Are you with me? Consider how it’s now widely understood that static stretching weakens muscles for up to 30 minutes and that you should not static stretch before workouts. This seems like a related principle applied to post workout. Keep in mind that we are isolating this “leave it be” concept to the topic of fitness adaptation. If you are trying to recover from (or prevent) injuries, massage, stretching, and foam rolling can make a valuable contribution—even in and around workouts as directed by an expert. Good old ice is still a recommended treatment in the immediate aftermath of an acute injury to help contain the swelling to the injured ankle (e.g., pickup basketball game) or eye (e.g., parking lot fight after pickup basketball game.)

However, the now dated RICE (Rest, Ice, Compression, Elevation) protocol for injury healing after the ~24-hour acute phase has been replaced by ECM (Elevate, Compress, and Move). Starrett is a leading advocate for ECM, with the emphasis on Move as the top priority for those sprained ankles or stiff calves. Look at some of K-Starr’s stuff on YouTube (like the amazing Voodoo Floss treatment), or read Becoming a Supple Leopard, and you’ll realize that many of today’s soothing therapies and gadgets can be bested by flexibility/mobility drills to help you move with more efficiency and less injury risk in the first place.

Back to cold therapy—it appears the greatest benefits accrue to the central nervous system, cardiovascular system, and immune system rather than the muscles. It’s difficult if not impossible for cold exposure to speed the healing of muscle damage incurred during training. Patience and increased general everyday movement are the big ticket items here.

In recent years, I’ve made a concerted effort to take frequent short walks or perform very light calisthenics or mobility sequences in the hours after a high intensity sprint workout or Ultimate Frisbee match, and it really seems to help me wake up the following day with less stiffness. My Primal Collagen Fuel regimen deserves tons of credit here too; it’s been an absolute game changer, particularly as I continue to insist on doing explosive jumps, burst and lateral movement against fit 20- and 30-somethings on the Ultimate field (yes, I’ve discovered that there are some big time gamers in Miami too!)

So, Should I Shell Out Like Cristiano Ronaldo For Cyrotherapy?

I was suspicious of the cryotherapy craze from the start, and Starrett concurs. Research is building that cryotherapy doesn’t deliver the same level of benefit that water exposure does. Starrett even observes that folks following a devoted cryo regimen don’t seem to tolerate cold water very well! Instead, for the price of only a handful of cryo sessions, I suggest you instead go to the cutting edge of cold therapy with an inexpensive and easily-accessible chest freezer regimen—details shortly.

When Is The Best Time For Cold Therapy?

Allow for a minimum of a couple hours, preferably more, after workouts before introducing cold exposure. Perhaps the best time for cold exposure is first thing in the morning for a cellular and central nervous system energizer, and also right before bed in order to help lower body temperature—a key element of transitioning into a good night’s sleep.

Chest Freezers: Not Just For Grass-Fed Beef Anymore

If you’re in Finland or in the Colorado rockies and have a year-round cold lake or river nearby (shout out to body hacking guru Ben Greenfield, author of Beyond Training and host of Ben Greenfield Podcast, who indeed has a cold river running through his property outside Spokane, WA), hey—you’re good to go! For the rest of us who don’t have a readily available natural source of cold water that’s reliably under 60 degrees (a good upper limit to observe for therapeutic practices, down to a lower limit of just above freezing), it’s time to talk about the wonder world of the chest freezer. Yep, the same item previously recommended on MDA for storing big orders of Internet-sourced grass-fed beef and other bulk-order treasures.

The idea here is to repurpose a chest freezer into a readily available, any time, any place cold plunge (even Miami, although I don’t think my high rise would allow me to sneak one into the first floor fitness center.). My Primal Endurance and Keto Reset Diet co-author Brad Kearns has plunged deep into the cold therapy scene (that’s #3 double-e if you’re keeping score) with a deluxe chest freezer setup and twice-a-day regimen of brief immersion into near-freezing water.

What you do here is take a 12-15 cubic foot, top opening chest freezer, fill it with water, and then run the motor on a timer for only around 1.5-4 hours per day—depending on the power of your unit, your ambient temperatures, and your desired exposure temperature. For a moderate investment of perhaps $200 on Craigslist or $400 for an ample-sized new unit (Brad grabbed this one with free home delivery), you are in the cold therapy business.

Brad’s preferred water temperature is 33 ºF (icicle alert!), maintained through continual tweaking of the 24-hour timer. Other enthusiasts like to keep water anywhere from 45-60 degrees, with exposure times ranging from 4 minutes at 44 degrees (easy to remember, per Dave Kobrine in Newport Coast, CA—Brad’s initial inspiration for cold therapy) to nearly 10 minutes at 60 degrees. Starrett, who keeps his water in the forties and has twice-weekly gatherings of friends for what he calls “church services” consisting of contrast therapy between chest freezer and hot sauna, confirms that there are no strict protocols to tout as superior to others, and surely significant individual variation in cold tolerance. “Get out before you start shivering!,” Starrett exclaims. “Never stay in to the extent that you suffer or experience pain or burning. Gabby and Laird suggest that if you’re in there long enough to shiver, you’re just showing off.”

Brad describes how he used to set a timer for three minutes at 33 ºF and tried to last that long but then realized that this could compromise the intended purpose of enjoying a Zenlike, mood-elevating start to the day. Instead, he prefers to start with a full submerging, then move hands and head out of water to complete a cycle of 20 slow, deep, diaphragmatic breaths while otherwise fully immersed—which ends up taking around three minutes. As cold water master Wim Hof has popularized lately, pairing a breathing regimen with your cold water immersion will enhance the circulation and oxygen delivery benefits.

Check out Brad’s video (completed in only one take), in which he describes (coherently, while sitting in freezing water) the benefits and setup logistics—everything you need to get started:

Benefits of Cold Exposure

The shock of cold exposure stimulates assorted fight or flight hormonal processes, which deliver an adaptive benefit because the stressor is brief. Contrast the prolonged fight or flight stimulation of hectic modern life (or exposing yourself to cold for too long and catching a cold—duh), which leads to breakdown and burnout.

Optimally brief cold exposure is a hormetic stressor—a natural stressor that delivers a net positive effect. Your heart rate and respiration increase as a way to try and keep warm, increasing blood flow and oxygen delivery throughout the body. Norepinephrine floods your brain, boosting vigilance, focus, attention and mood, and reducing pain and inflammation. The norepinephrine spike from cold exposure delivers what we often call an endorphin rush—natural pain relief and an enhanced sense of well-being.

Dr. Rhonda Patrick, one of the absolute best communicators of cutting edge health and longevity science anywhere, cites research that norepinephrine can rise 200-300 percent with just a 20-second immersion into freezing water a couple times a week (imagine going three minutes, twice a day like Brad—no wonder he was such a big help with this article). Patrick explains that norepinephrine also helps reduce inflammation by inhibiting inflammatory cytokines like the noted bad guy TNF-alpha, a known accomplice in many modern disease patterns.

Quelling inflammatory cytokines is also believed to help battle anxiety and depression. A researcher named Nikolai Shevchuk was quoted in a Fast Company article by Chris Gayomali, speculating about the mechanisms by which cold exposure can boost mood: “probably the stimulation of the dopaminergic transmission in the mesocorticolimbic and nigrostriatal pathway. These dopaminergic pathways are known to be involved in the regulation of emotions. There is a lot of research linking these brain areas to depression.” Indeed, it’s been chronicled that VanGogh was treated in an asylum for depression with two-hour cold baths, twice a week, to combat his well-known condition of depression.

Further tidbits were offered in the Fast Company article from Australian cold water researcher Ned Brophy-Williams on the anti-inflammatory benefits of cold water immersion: “It moves blood from the peripheral to deep blood vessels, thereby limiting inflammation and swelling and improving venous return. Metabolites and waste products built up during exercise can be efficiently removed by the body and nutrients quickly replenished to fatigued muscles.”

Carrying on if you’re still not convinced… Your lymphatic system is activated by cold exposure, helping speed the clearance of toxins from tissues throughout the body. You also elicit an enhanced anti-oxidative defense with increased T cell activity to improve your immune function.

Finally, you may have heard Dr. Patrick promoting the hot topic of heat shock proteins, and how sauna/heat exposure can deliver assorted health benefits. Patrick also informs us that cold exposure releases so-called cold shock proteins such as RNA binding motif 3 (RBM3) that are linked to the regeneration of synapses in the same manner as heat shock proteins. As the Finns have known for centuries, it seems like temperature alterations—deliberate exposure to both cold and hot—deliver phenomenal health benefits.

Cold Exposure—The Right Way—To Boost Recovery

For fitness enthusiasts looking to speed recovery with cold therapy, it’s now clear that the immediate post-exercise inflammation reduction is potentially harmful, and that implementing a simple daily regimen of morning and/or evening exposure can deliver the aforementioned benefits without compromising fitness adaptations. In recent years during the winter months in Malibu, Carrie and I would end our evenings with some 104F spa time, interspersed by quick visits to the sub-60F pool and back to the spa. I’d always end with a few minutes in the pool, leaving me wonderfully relaxed, cool, and ready for sleep. Brad’s morning chest freezer ritual looks as good or better than a morning caffeine blast to get going on a busy, productive day.

Beyond the exciting emerging science, anecdotal evidence from enthusiasts also suggests that toughing out a cold shower or committing to a focused cold therapy regimen has profound mood elevating effects. Primal Blueprint’s own Brian McAndrew (yeah, check out what our guy behind the camera looks like!), who produces our podcasts and fabulous videos on both our YouTube Channel and our comprehensive online multimedia educational courses, has dabbled in cold exposure, using contrast therapy at his health club (going back and forth between the ~50F cold plunge and the sauna at his Portland, OR health club), or just lingering up to his torso in a wintertime cold swimming pool. Brian relates, “All I know is that the worse I made myself feel in the moment [by staying longer in the cold], the better I felt afterwards in regards to mood. This was true for both cold and hot. Having the cold plunge and sauna together lets you go to further extremes, because you know you can get immediate relief at any moment with contrasting cold or warmth.”

Cold Exposure Gives Meaning And Richness To Life—Really!

I believe there are other profound cold therapy benefits that are hard-to-quantify. Starrett contends that your cold exposure practice can serve as a good barometer for your state of recovery and desire to train. He asserts that sore, stiff, or poorly functioning muscles seem to be more sensitive to cold exposure, and that if you’re in a fatigue/overtraining rut, your tolerance to cold diminishes accordingly. K-Starr notices that when he’s fried from big workouts or stressful travel, the cold water stings and he wants out quickly. When he’s less stressed and more rested, he has no problem relaxing in there for up to eight minutes. Remember, he’s jumping right into a dry sauna. As Brian described, your exposure times can increase when you have access to a sweet contrast setup.

Starrett’s “desire to train” concept deserves further appreciation. In his set of exclusive video interviews in the Primal Endurance Mastery Course and the Keto Reset Mastery Course, he references studies with athletes suggesting that a subjective “desire to train” score is a more accurate indicator than any of the modern high tech biofeedback metrics like Heart Rate Variability, pulse oximeters, blood lactate meters, sleep cycle apps and all the rest. As an old timer whose endurance exploits predate even heart rate monitors, I strongly agree that your intuition, mood and motivation level should take center stage for making workout decisions, especially when it’s time to downsize grand ambitions. I know that when I take a few moments to sit quietly and reflect on my planned workout, sometimes profound insights occur, and I roll over and go back to sleep. Ditto for when I hesitate to jump into a routine cold shower or pool plunge (or get out earlier than usual)—it’s a reliable indicator that I’m overstressed or overtired.

Furthering Brian’s comments about the mood elevating effects of cold therapy, I’d also suggest that cold exposure helps improve your focus, confidence, and mental resilience—particularly since you will improve your tolerance and appreciation over time—and that these benefits will carry over into all other areas of life. Lift heavy things, sprint once in a while, get adequate sun exposure, plunge into cold water—these are all hormetic stressors that help you bring your A-game to everything you do. I’m not saying sitting in a chest freezer every morning will help you muster the courage to ask for a promotion, commit to enter an adventure race, or ask for a date with that certain person in the office, but it might help….

If you’re content to spend almost all 24 daily hours in a climate controlled home, car, and office, enjoy the wholly modern luxury of a hot shower a couple times a day, and never voluntarily subject yourself to the beautiful moments of discomfort like a cold plunge, the final few reps of a tough set in the gym, or the final few miles of a tough session on the roads, that’s fine. We can still be friends. But as many of us living Primally can attest, there are benefits to challenging the perceived limits of mind and body in order to stimulate peak performance and happiness. Sir Roger Bannister, the legendary first sub-four minute miler who passed in March at age 88, offered up a memorable quote in his 1954 biography, The Four Minute Mile: “Struggle gives meaning and richness to life.” One thing’s for sure after you try it out: you will appreciate a warm shower or a warm bed like never before.

Does Cold Exposure Stimulate Fat Reduction? Mehhh…

You may have heard exciting news about something called Brown Adipose Tissue (aka BAT, or brown fat), a special type of adipose tissue that has a different role in the body than the fat that accumulates across the body when you store more calories than you burn; this stuff is known as white adipose tissue. Instead of just storing calories like white fat, brown fat is also able to generate heat to help maintain the body’s ideal core temperature. Infants have lots of brown fat for extra protection. Brown fat levels dwindle as we age, and interestingly, obese people have lower than normal levels of brown fat.

The excitement about brown fat emanates from research showing that cold exposure spurs a fifteen-fold increase in brown fat activation. It’s theorized that this increase in cellular activity in brown adipose tissue can help stimulate the burning of additional white fat, making cold exposure an effective weight loss catalyst. The idea here is that the caloric energy your brown fat generates for rewarming will be burned instead of otherwise stored as white fat.

Research is not conclusive in the brown fat area, and scientists assert that it’s very difficult to measure the effect of environmental temperature on metabolism. It’s virtually certain that getting cold and then forcing yourself to warm naturally (no saunas or hot showers allowed!) will boost metabolic rate. However, I’d hesitate to put this in the forefront of fat reduction techniques. Even as drug companies are spending millions to unlock the power of brown fat (via cold exposure or drug-related means) to burn white fat, I’ll argue that ditching grains, sugars and refined vegetable oils to minimize insulin and boost fat metabolism might be a much better area of focus. What’s more, there is a logical counterargument that cold exposure might stimulate a corresponding increase in appetite that would counteract any potential fat reduction benefits. This makes sense along the lines of the compensation theory of exercise, detailed in a recent post about Rest and Recovery.

Ray Cronise, a former NASA materials scientist who oversaw Space Shuttle experiments and has been a prominent voice in progressive health circles for the past decade, has performed some increasingly sophisticated experiments that suggest the potential of cold exposure to boost fat loss. Cronise lost a remarkable 27 pounds in six weeks with a regimen of cold showers, talking neighborhood walks while purposely way underdressed, and sleeping with open windows and/or little or no covering. Cronise’s experiment was inspired by that infamous viral news story about Olympic swimming legend Michael Phelps eating 12,000 calorie per day that I discussed in the recent Sami Inkinen post. Doing some basic metabolic calculations, Cronise speculated that Phelps was eating vastly more calories than he burned during his intense workouts, and that hence a significant portion of his caloric expenditure must be going toward maintaining his core temperature while spending hours in the water.

Tim Ferriss brought more attention to Cronise’s work and the concept of burning off brown fat through cold exposure when he covered the matter in his bestseller, The Four Hour Body. Google brown fat and you will find assorted chatter jumping to the conclusion that brown fat stimulation promotes weight loss, but the hard science is just not there—yet anyway. For now, I wouldn’t put much emphasis on cold exposure for fat loss, and instead be content to enjoy the many other benefits of cold therapy.

Nothing left to say but get yourself a chest freezer (another chest freezer?) and get started! Let me know what you think, and thanks for stopping by today.

A Few More Links For Your Enjoyment:
Tapping the Power Of Cold To Lose Weight
Scientific Case For Cold Showers
Top 7 Reasons You Should Take Cold Showers
Brown Fat Burns White Fat Studies
Surprising Benefits Of Cold Showers
Dr. Rhonda Patrick on health benefits of cold and sauna

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The post The (Maybe Not So) Definitive Guide to Cold Therapy appeared first on Mark’s Daily Apple.

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