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For today’s edition of Dear Mark, I’m answering one question from a reader. It’s all about synthetic peptides, small chains of amino acids with potentially huge effects on your health and physiological function. In most cases, these synthetic peptides are based on naturally-occurring compounds found in the human body. Scientists isolate the “active component” of the compound and whip it up in a lab by stringing together the right amino acids. Many of these peptides are available for purchase online, strictly “for research purposes.” But people are using them.
Are these safe for humans? Are they effective?
Mark, I would love if you did a write-up on BPC-157 and LL-37 with regards to gut health. I’m surprised with all your articles on collagen peptides you haven’t written once about “synthetic” peptides. Thanks!
Let Me Cover PBC-157 First….
BPC-157 is a partial reconstruction of a string of 15 amino acids that’s already found in Body Protection Compound, a naturally occurring healing compound the body produces. Its creators took the natural BPC and figured out the most “biologically active” section of its amino acid chain, then synthesized that section alone. You can find the real thing in human stomach juice (and presumably throughout the body doing its job). You can buy the synthetic version online.
What Does BPC-157 Allegedly Do?
It enhances healing and recovery from injury. In one study, BPC-157-treated Achilles’ tendon tissues were more resistant to injury, spread more quickly on a petri dish, and recovered faster than untreated tendon tissues.
In another rat study, their cecums—the beginning of the large intestine—were perforated. Applying BPC-157 enhanced healing, stopped bleeding, and sped up recovery.
It counteracts NSAID toxicity. BPC-157 blocks aspirin-induced bleeding and improves healing of NSAID-mediated lesions in the gut, brain, and liver.
Another rat study even used BPC-157 to improve healing from a spinal cord injury. BPC rats regained functional autonomy, had better control over their tails, and were less spastic.
It can treat periodontal disease, reversing inflammation and reducing bone loss.
It can treat colitis, reducing gut inflammation and restoring mucosal integrity.
Briefly looking through all the anecdotes online, most people are using this peptide to heal joint or tissue injuries, which seems to be the best use. Ben Greenfield swears it healed his tennis elbow and hamstring damage. I even saw one person who used it to improve brain health and function after years of stimulant abuse. Some research does show that BPC-157 can restore dopaminergic function in the brain. Some are even reporting restored sensitivity to stimulants (although using a healing peptide just to restore your ability to get high off Adderall again seems counterproductive).
What Are the Downsides?
It must be subcutaneously injected for maximal efficacy. This isn’t as hard as it looks (millions of diabetics do it every day) but some people are really nervous around needles. Orally-active BPC-157 is available, but I’m not sure how it compares.
There is the small problem of the total lack of published human studies. If there are any, I didn’t see them. The animal studies are impressive, though, and the fact that the peptide chain does naturally occur in our bodies suggests it’s relatively safe, but we don’t know for sure.
A big problem is that you can’t verify the purity of the products available online. You have to read reviews, know the right people, and do the research. These aren’t legally intended for human consumption, so there’s no testing authority regulating the safety and content of these products.
Now For LL-37….
LL-37 is an anti-microbial peptide found naturally in people. It’s heavily involved in the immune response, and its role in health isn’t very clear. It isn’t consistently “good” or “bad.” For instance, its presence can suppress tumor growth in colon and gastric cancer, but it’s been shown to promote tumor growth in ovarian, lung, and breast cancers. But it’s also able to bind to and negate the effects of lipopolysaccharide, the bacterial endotoxin secreted by many gut pathogens, and selectively target apoptotic white blood cells while leaving viable ones unaffected.
Why Are People Using It?
There are online forums populated by people who are using this peptide to heal gut issues, deal with inflammatory diseases, and treat autoimmunity—or, they’re at least buying the peptide, injecting it, and hoping that it works and not always following up with the results. I’m skeptical about using these as justification to experiment. As one recent paper put it, LL-37 is a tiny peptide with huge effects:
Some of the functions of LL-37 are anti-inflammatory, particularly those involved in blocking Gram-negative signaling pathways through TLR4. However, in the context of the inflammatory response, this peptide may also provide proinflammatory signals that can propagate inflammation, stimulate type I IFN production, and result in induction of autoimmune diseases. Further research is needed to fully understand the big effects of this little peptide on immune system function so that potential therapeutic uses can be explored.
Sticking Points With LL-37
Much of this could be a guilt by association situation: LL-37 is often found elevated at disease sites and in diseases states because it’s part of the inflammatory response. It isn’t necessarily causing the disease. But the immune response is a delicate one with huge ramifications. I’d be very careful with injecting a peptide that the body normally produces in times of acute inflammation. That sounds a lot like trying to attempt top-down regulation of innate immunity—a decidedly bottoms-up process. Probably better to wait for human trials rather than rely on positive anecdotes from unsourced forum posts. I’m not saying these people aren’t helping themselves with this compound. I’m saying the risk of complications or unwanted effects would be too high for me.
That’s it for today, folks. Thanks for reading and be sure to comment down below. Do you have any experience using these synthetic peptides? How about any others?
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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.
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.
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.
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).
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.
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.
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 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.
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.
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 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 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 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.
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 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.
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.
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.
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.
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
- 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.
- First, something painful and unpleasant happens; choose one of the above injury options.
- 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.
- 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.
- 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:
- 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.
- 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.
- 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.
- 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.
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
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.
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.
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.
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 bed, lean 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 diets: High-sugar, high-processed carb, high-industrial fat, high-gluten, high-CAFO meat, low-nutrient food is a pretty accurate descriptor of the modern Western diet.
- Insufficient omega-3 intake: Omega-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 sleep: Poor 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.
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.
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The ketogenic diet has exploded in popularity over the last few years. Hordes of people are using it to lose body fat, overcome metabolic diseases, improve their endurance performance, attain steady energy levels, make their brain work better, and control seizures. And increasing numbers of researchers and personal experimenters are even exploring the utility of ketogenic diets in preventing and/or treating cancer. After all, back in the early part of the 20th century, Warburg discovered an important characteristic of most cancer cells: they generate their energy by burning glucose. If a particular cancer loves glucose, what happens if you reduce its presence in your body and start burning fat and ketones instead?
It’s taken a while, but the research community is finally beginning to take a few swings at this and similar questions.
So, what do we know?
First, let’s just go through a few recent human studies and case studies.
Keto and Cancer Treatment
Women with endometrial or ovarian cancer improved energy levels, appetite, and physical function on a ketogenic diet.
A Bayesian approach to studying the effects of ketogenic diets in humans and animals with high grade glioma (a brain cancer) found an “overall survival-prolonging effect.”
In gliomas, an analysis of available case studies using ketogenic diets found increased overall or progression-free survival. These were not randomized controlled trials, however, so they say nothing definitive.
A recent review paper gives a good overview of the current state of ketogenic diet and cancer research, finding that:
- Ketosis targets tumor metabolism.
- Ketosis improves effectiveness of conventional therapies.
- Ketosis has favorable effects of anti-cancer gene expression.
One thing you might notice is that there are no studies showing that standalone ketogenic diets cure cancer. There aren’t very many randomized controlled trials in general.
What there are are studies showing that ketogenic diets are safe and potentially effective adjuvant treatments—treatments that supplement conventional cancer treatments. You don’t see keto “defeating” cancer alone. You see keto enhancing the effect of chemotherapy. You see keto enhancing the effect of radiation. You see keto protecting normal cells and increasing the vulnerability of cancer cells to conventional treatment.
That’s not to say that keto can’t beat cancer. Maybe it can. But the clinical research simply isn’t there to say one way or the other.
Where keto seems even more promising is in prevention of cancer.
Keto and Cancer Prevention
Diabetes is a disease of carbohydrate intolerance. It’s a disease in which carbohydrate consumption results in elevated blood sugar, exaggerated insulin response. The way most people with diabetes eat leads to chronically high levels of insulin and blood sugar. Yeah, yeah, I know about all the badass Primal eaters who are “technically” diabetic but keep their blood sugar pristine and insulin minimized by watching what they eat, exercising regularly, and just generally leading a healthy lifestyle—but those people aren’t a large enough a group to have an effect on the category known as (and studied as) “diabetics.” Most people with diabetes unfortunately keep eating the same junk that got them there.
What does research say about the cancer rate of most people with diabetes? It’s usually higher.
One of the most consistent risk factors for many types of cancer is having diabetes and experiencing all the metabolic fallout that entails—high fasting insulin, insulin resistance, elevated blood glucose. Cancers of the liver, pancreas, breast, endometrium, bladder, and kidney all have strong associations with type 2 diabetes. This should come as no surprise. Not only do many cancers thrive on glucose as fuel, the high insulin levels typical of people with diabetes and insulin resistance increase the availability of growth factors that promote cancer growth.
Meanwhile, therapies that are known to reduce the symptoms of diabetes—lower fasting insulin, increase insulin sensitivity, normalize blood sugar, etc—tend to lower the risk of cancer. A perfect example is metformin.
Metformin activates AMPK, the same autophagy pathway activated by exercise, fasting, polyphenol consumption, and reduced calorie intake. It lowers blood sugar, increases insulin sensitivity, and extends the lifespan of type 2 diabetics.
Metformin also seems to protect against cancer. It lowers hyperinsulinemia and may protect against insulin-related cancers (breast, colon, etc). Early treatment during adolescence, for example, protects rats against later tumor growth.
What does this have to do with ketogenic diets?
Ketogenic diets have many similar effects. They activate AMPK. They lower blood sugar. They’re great for fat and weight loss, which enhances insulin sensitivity. Recently, researchers have even used ketogenic diets to resolve type 2 diabetes.
Now, not all cancers are linked to diabetes. For example, diabetes doesn’t increase the risk of gastric cancer. That’s because it’s linked to bacterial infection, not elevated blood sugar. And that’s why taking metformin doesn’t reduce the risk of gastric cancer. This actually supports my hypothesis that, when diabetes does not increase the risk of a cancer, neither does metformin reduce it—like gastric cancer. Diabetes doesn’t increase it, so metformin doesn’t reduce it. That’s the mechanism in play.
Nor do all cancers burn glucose exclusively. Some thrive in a ketogenic environment.
There is a mutation called BRAF V600E in certain cancer cells that allows them to utilize ketone bodies to stimulate growth. About 50% of melanoma, 10% of colorectal cancer, 100% of hairy cell leukemia, and 5% of multiple myeloma cases exhibit the ketone-utilizing BRAF V600E mutation. Indeed, a cancer cell’s inability to break down and metabolize ketone bodies is the best predictor of whether a ketogenic diet can even help against a given cancer.
But if we’re talking prevention. If we accept that not developing diabetes—all else being equal— probably reduces the risk of getting cancer, then using ketosis to improve all the same symptoms linked to diabetes should also reduce the risk of getting cancer. And if it doesn’t reduce the risk, it probably won’t hurt. I mean, is there a doctor alive who claims that increasing insulin sensitivity, lowering hyperinsulinemia, and losing body fat will increase the risk of cancer?
A Few Takeaways To Consider
As I see it—and this is not medical advice—the most promising use of ketogenic diets in cancer are as follows.
Adjuvant therapy: Using ketosis to enhance the efficacy of conventional therapies like chemotherapy and radiation, increasing the susceptibility of cancer cells to treatment and increasing survival of healthy host cells.
Prevention: Using ketosis (whether intermittently or long term) to lower fasting blood glucose, reduce diabetes risk (or resolve extant diabetes), and improve your ability to burn fat and not rely on exogenous glucose so much should in theory reduce your risk of most cancers.
Whatever you do, if you’re an actual cancer patient, discuss this with your doctor. Make sure your particular variety of cancer isn’t partial to ketones. Make sure it’s one of the cancers that actually craves glucose. If you end up with a cancer that thrives on ketone bodies, and you go deep into perpetual ketosis, you could be making an enormous mistake.
But the bottom line is that, assuming you don’t already have one of the cancers known to utilize ketones, going into ketosis from time to time isn’t going to hurt—and it will probably help reduce the risk of cancer.
I’m going to close this post with an anecdote from one of my employees. His father passed away a dozen years ago from multiple myeloma, a type of white blood cell cancer. This was before he worked at Primal Nutrition; he was just getting involved in alternative forms of health and nutrition research. What struck him most, particularly in retrospect, was how his father’s appetite changed during his battle with cancer. He began craving candy—Reese’s peanut butter cups, Hershey’s kisses, Now-and-Laters, and all other kinds. As he says it, looking at his dad’s snack drawer was like looking at the archetypal bag of Halloween candy.
I don’t know if this is evidence of anything. Can cancer actually tap into your specific appetites? Can it change how you perceive and desire specific foods? Was his father actually being programmed by his cancer to over-consume sugar?
What I do know is that no one needs garbage candy. A few seconds of momentary gustatory pleasure, followed by regret and the incessant need to repeat—is it worth it? Is it worth the off chance that eating lots of sugar feeds and promotes cancer? Don’t do it, folks. I know my longtime readers are right there with me. I know you guys who’ve been here from the beginning are probably getting egged on Halloween because you’re giving out collagen packets and mini-kettlebells. But if you’re new to this site and way of eating in general—maybe a co-worker passed my info along to you, maybe you’re trying to make a big change in the way you eat and live—avoiding the obviously terrible-for-you stuff like candy and baked goods is the biggest change you can make. And not just for cancer.
So, do I want you to walk away from this post thinking that keto is a cancer cure? No. I’m a fan of ketosis, and I think almost everyone should spend time in that metabolic state, but I don’t consider it to be magical. The jury is definitely still out. Does ketosis look like a strong candidate for improving efficacy of various therapies in certain cancer patients? Yes. Can keto improve health markers shown to reduce a person’s risk of getting cancer in the first place? Yes.
The keys to good health are generally speaking pretty consistent.
- Maintain good insulin sensitivity.
- Avoid glucose intolerance.
- Get plenty of sleep.
- Consume hormetic stressors.
- Avoid obesity. Lose body fat.
- Exercise, or at least move every day.
- Dip into ketosis on a regular basis, either from ketogenic dieting, fasting, meal skipping, or (non-chronic) hard training—or all of the above.
There’s no guarantee against cancer, but I think the advice I just mentioned supports a good fighting chance.
Take care, everyone. Be well.
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The fitness world is booming these days. You can see it in the popularity of CrossFit boxes, obstacle course and endurance events, and record-breaking gym construction. It’s encouraging. Inspiring even. But there’s also a downside to the rising gym memberships and event registrations. There are still too many people dealing with recurring patterns of breakdown, burnout, illness and injury. More people are trying to do the right thing, but the flawed approaches they often gravitate to end up derailing them.
Nonetheless, there are changes afoot. It’s an evolution of thinking that’s slowly spreading its way through fitness circles. More forward-thinking coaches, trainers, and researchers are helping right the wrongs of the fitness boom with a general rejection of the “more is better” approach for one that respects the importance of balancing stress and rest, one that moves toward an intuitive approach to workout planning.
More people are implementing strategies to maximize workout return on investment and minimize the risk of injury and burnout that too often result from an indiscriminate approach. The endurance world, for example, is finally rejecting the narrowly focused, overly stressful chronic cardio approach of old in favor of emphasizing aerobic development at lower heart rates, avoiding chronic patterns, and becoming fat adapted instead of sugar addicted. Endurance athletes are embracing the importance of strength training and explosive sprinting just as strength/power athletes are doing more aerobic conditioning. The CrossFit movement itself is an ode to the health and longevity benefits and increased enjoyment that comes from achieving broader fitness competency.
What’s Wrong With HIIT?
I’ve talked recently about microworkouts and recovery-based workouts. Today, I want to delve in further and share a radical transformation in the way high intensity workouts are conducted that will generate fitness breakthroughs while simultaneously minimizing the risk of exhaustion. Specifically, I’m taking aim at the extremely popular workout pattern known as HIIT—High Intensity Interval Training. Sprinting is a part of the Primal Blueprint Fitness Pyramid, but I’ve been wary of the details around traditional HIIT practices because these workouts are quite often too stressful and exhausting to deliver the intended fitness boost they promise.
Yes, you have to challenge your body regularly with hard efforts to build fitness, but most of us do it the wrong way. When you complete a killer HIIT session at morning boot camp or spin class, at home on your Peloton bike, or with the Tuesday night track group, you get a tremendous sense of accomplishment and a flood of feel-good endorphin chemicals into your bloodstream. Unfortunately, the typical HIIT workout can also be depleting, exhausting, and stimulate an assortment of unnecessary cellular damage and inflammation.
It doesn’t have to be that way. Be redesigning your high intensity workouts, you can get leaner and fitter with higher quality, more explosive, less physically stressful workouts that are easier to recover from and thus can be performed more frequently. In short, a better approach involves transitioning from HIIT to HIRT, High Intensity Repeat Training. HIRT is an acronym coined by Dr. Craig Marker, psychologist, certified strength and conditioning coach, and CrossFit instructor from Florida.
Here’s a compare and contrast that can revolutionize your approach to intense workouts….
Comparing HIIT and HIRT
The problem with a typical HIIT workout is that it’s too strenuous—too many repetitions of hard effort that (each) last too long, and with insufficient rest between hard efforts. This results in cumulative fatigue during the workout, a diminishing quality of performance over the course of the workout, increased cellular damage due to this cumulative fatigue, and extended recovery time afterward. These kinds of sufferfests are a great source of satisfaction and personal growth when you high five your fellow bootcamp classmates after an hour of power, or cross the finish line of a big event in which you’ve trained for months to prepare. But including them as a major and recurring element of your training program is a really bad idea. Unfortunately, the sufferfest mindset is incredibly common these days, perhaps suggesting that the ego has more influence that strategic planning or intuitive decision making.
A HIRT workout stops short of the exhaustive nature of HIIT. The essence of HIRT is to conduct maximum efforts, typically of shorter duration, with much longer recovery, and fewer total efforts than a HIIT session. The word “Repeat” in the acronym suggests that you maintain a consistent quality of effort on every repetition of hard work. This means not only the same performance standard, but also the same level of perceived exertion.
For example, say your workout entails running 100-meter sprints across a football field, and you hit 18 seconds for your first sprint. This is a nice controlled, explosive effort with excellent technique, and you assign a perceived exertion level of around 90 out of 100. Hence, you’ll want to do successive sprints in 18-19 seconds each, preserving explosiveness and excellent technique—delivering what you still discern to be 90 out of 100 on the effort scale. If you have to “dig deep” (the implicit objective, and badge of honor, with a HIIT session) just to arrive at 19 seconds on your fourth effort, that’s it, you’re done. If you notice a slight attrition in explosiveness or breaking form during the effort, you’re done. Typically, this might be a little twinge in the hamstrings or lower back, a tensing of the face or chest, or any other indicator that you have played your best cards of the day.
In Dr. Marker’s landmark article titled “HIIT versus HIRT” at www.BreakingMuscle.com, he explains that after HIIT sessions we bask in self-satisfaction of a job well-done, but disregard the health-destructive consequences of these sufferfests: “[Y]our subjective feeling of the effectiveness of a workout is not as important as what science tells us is important to building an impressive base of endurance and changing your body composition.” (That sound you hear is a slap to the face of highly motivated, goal oriented, Type-A fitness enthusiasts across the land. Don’t worry, I’ve been there, too….)
This admonition applies to everyone from elites to novices. Elite athletes are notorious for constantly pushing the envelope and frequently succumbing to injuries or periods of declining performances. Novices generally don’t concern themselves with training strategies, often leaving their fates in the hands of the bootcamp instructor. Without sufficient experience or reference points, they exercise themselves into exhaustion, believing that pain and suffering are part and parcel of the fitness experience.
The (too often) result? Ambitious, well-meaning enthusiasts burn themselves out and then are down for the count. The most dedicated keep going to their detriment, all the while accumulating fatigue, injuries and even pounds. Others simply stay away from the gym by invisible magnetic force. Alas, the subconscious is very good at avoiding sources of pain and suffering. Can we dump this suffering-and-attrition dynamic already?
Side note for those who love to read about sports: For inspiration, check out this article about the greatest marathon runner in the history of the planet, the amazing Kenyan Eulid Kipchoge. The article describes his training regimen as extremely devoted and incredibly impressive, yet he maintains a relaxed mindset, remains in control of his energy output, and never extends beyond his limits into exhaustion. Even the march to the unthinkable two-hour marathon (Kipchoge’s current world record stands at a mind-bending 2:01.39) comes from a sensible approach instead of an extreme one.
Marker explains that there’s an optimal duration for sprinting where you can obtain maximum benefits with minimal cellular destruction, and this is typically around 15-20 seconds. Try to maintain maximum effort for any longer than that and you’re not really sprinting anymore anyway, since it’s impossible to maintain maximum energy output.
Here’s why this works:
Look at what’s happening physiologically over the duration of a near-maximum intensity sprint of any kind (running, cycling, rowing, or kettlebell swings). During the first five seconds of your sprint, lactate starts to accumulate in the bloodstream. Lactate levels double between five to ten seconds, then double again from 10 seconds to 20 seconds—up to what Marker calls the highest acceptable level. As you increasingly feel the burn, lactate doubles again from 20 seconds to 30 seconds. It doubles again from 30 seconds to 60 seconds, causing cellular destruction, ammonia toxicity, and extended recovery time.
As Marker explains, “The amount of lactic acid produced up to 20 seconds [of sprinting] is still manageable, but the next doubling is over the top. Even a single 30-second sprint spikes ammonia levels almost five times! Why trash the body for no good reason? Rebuilding broken down cells is a costly and time-consuming process. And while it’s taking place, you feel tired and run down, with your ATP short of a full stack.”
You may be familiar with the Tabata concept of interval training, which entails a repeating pattern of work efforts lasting twice as long as rest intervals until you complete a Tabata set of a certain total duration. The original Tabata protocol, developed by Japanese physician and researcher Dr. Izumi Tabata and colleagues at the Japanese Institute of Fitness and Sport in Tokyo, calls for four minutes of a 20-second sprint, 10-second rest, 20-second sprint, 10-second rest pattern. In the original studies, Japanese Olympic speed skaters achieved massive boosts in VO2 Max in a short time with Tabata training. Unfortunately, the original Tabata concept has been widely misappropriated into workouts that honor the 2:1 work-to-rest ratio, but carry on for too long and generate cellular damage and exhaustion: multiple sets of kettlebell swings, pushups, box jumps, running sprints, cycling sprints, and so forth. Bottom line with sprint workouts: a little goes a long way, and too much can really mess you up.
How To Transition From HIIT To HIRT
To transition into a more effective, less stressful high intensity workout pattern, pick the sweet spot of 10-20 seconds for your explosive efforts. Take what Marker calls “luxurious” rest intervals to ensure that your cells have a chance to partially or fully regenerate ATP (takes around three minutes) and minimize the disassembling and deamination that occur when you ask your body to perform again and again with rapidly depleting cellular energy.
Finally, conduct between 4 and 10 sprints. You should be able to manage four shorts sprints even if you’re a novice. If you claim you can complete more than 10 and feel great, you’re better off going faster and doing fewer more explosively.
Keep in mind that a properly conducted HIRT workout is going to feel different than a HIIT sufferfest. It may require an adjustment in your mindset to feel confident and satisfied that you’re training with maximum efficiency and minimal suffering like a “real athlete.” If you’re a focused, driven, goal-oriented type, be vigilant about resisting the addictive allure of the endorphin rush that happens after a sufferfest. Remember, the blissful feeling of powerful pain-killing chemicals flooding your bloodstream is a fight or flight reaction to the extreme stress of the workout. Realize that the genetic purpose of the endorphin response is to help you continue to run for your life instead of lay down in exhaustion! If you abuse this delicate mechanism with a chronic pattern of extreme workouts, you’re going to pay a heavy price. Dr. Tommy Wood calls this overactivation of the fight or flight response, “liquidating your assets,” and I couldn’t agree more.
Several friends who have recently updated their approach to a HIRT protocol report feeling much better in the days following their most challenging sessions—more energy, less soreness and stiffness. That’s how it should be.
Combine the HIRT strategy with recovery-based workouts and walking. See how it goes for you, and let me know. Thanks for stopping in. Share your questions and thoughts below, too.
The post HIIT vs. HIRT: Reducing Workout Stress To Increase Fitness appeared first on Mark’s Daily Apple.
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For the vast majority of human history (and prehistory), men, women, and children had near-constant contact with the natural world around them. They were walking on the ground. They were playing in the dirt. They were digging for roots and grubs. They were eating with their hands. They were field dressing animals and wiping their hands on the grass. Nothing was sterilized; the tools to sterilize the environment didn’t exist. You could boil water, but that was about it. Bacteria were everywhere, and humans were constantly ingesting it. Even as babies, preindustrial infants nursed for almost four years, so they were getting a steady source of breastmilk-based probiotic bacteria for a good portion of their early lives.
The Agricultural Age: Farms and Fermented Foods
After agriculture and animal husbandry hit the scene, human diets changed, but their environmental exposures didn’t so much. Every day they interacted closely with the soil and/or animals (and their respective bacteria). And they also continued ingesting probiotic bacteria on a regular basis through the use of fermented food—for at least the last 10,000 years. Honey into mead, grains into beer, fruit into wine, alcohol into vinegar.
We know that fermented dairy has been an integral part of any traditional dairy-eating culture because fermentation is the natural result of having milk around without refrigeration. You take raw milk and leave it out for a couple days at room temperature, and it will begin to separate and ferment. Introduce an animal stomach and you can make cheese. Introduce specific strains of bacteria, and you can make yogurt or kefir. But the point is that dairy fermentation—and, thus, the consumption of dairy-based probiotics—was unavoidable in pre-industrial dairy-eating societies.
Modern Diets, Modern Environments
Here’s my point to all this: probiotics in one form or another have been a constant input in the human experience… until today.
Today? We live sterilized lives.
- We wipe everything down with anti-microbial agents.
- We wash all our plates and eating utensils with ultra-hot water and powerful soaps.
- We wear shoes.
- We don’t touch (or see) dirt for days, weeks at a time.
- We stay indoors most of the day.
- We pasteurize our dairy. We render shelf-stable (and thus inert) our sauerkraut and pickles.
- We sterilize our water.
- We take antibiotics.
- We eat processed, refined food that’s been treated with preservatives and anti-microbial additives designed to remove all traces of bacteria.
- We employ tens of thousands of scientists, bureaucrats, and agents whose primary role is to ensure our food supply is as sterile as possible.
I get all that. There are good reasons for doing all these things, and on the balance I’d of course rather have clean water, clean food, and antibiotics than not, but there are also drawbacks and unintended consequences. We live in a sterile world, and our guts weren’t built for a sterile world. They’re meant to house a diverse array of bacteria.
What Are the Consequences Of Living a Sterile Life?
Hippocrates, the father of medicine, said that “all diseases originate in the gut.” The most obvious example, digestive issues, are some of the most common in the post-industrial world. Constipation, diarrhea, bloating, and general digestive distress affect tens of millions. Food intolerances and allergies, which also have a link to gut health, are rising.
At least since Biblical times (and probably earlier), humans have identified a connection between the gut and our emotions. “I’ve got a gut feeling…” or “I feel it in my gut.” Though it’s usually portrayed as “merely metaphor,” this connection isn’t spurious and can feel quite real. Remember when you held hands with that pretty girl or handsome guy for the first time? You felt those butterflies in your gut. Or how you had to rush to the bathroom before giving that big talk in front of your college class? You felt the nervousness and anxiety in your gut.
Evidence is accumulating that our gut bacteria can manufacture and synthesize neurotransmitters like serotonin and GABA, and even sex hormones like testosterone. We’ve even identified a legitimate physiological pathway running from the gut to the brain and back again. Couple that with the fact that gut health seems to play a role in depression, anxiety, and other related conditions, and it starts looking like our lack of exposure to probiotic bacteria could be triggering (or at least exacerbating) the rise in mental health issues.
Supporting Our Guts In the Age of Sterility
The foundation of gut health has to be diet: 1) Eating fermented foods to provide probiotic bacteria and 2) eating plant and animal foods that provide prebiotic substrate to feed and nourish those bacteria. That’s been the way of humans for tens of thousands of years—from ingesting soil-based and animal-based bacteria on the food we ate as foragers to directly producing and consuming fermented food—and it should remain the primary mode of probiotic procurement.
But there’s also a place for probiotic supplementation. Food alone probably can’t atone for the sterile existence we’ve built for ourselves. Food alone can’t counteract the several years of breastfeeding you didn’t get, the dirt you didn’t play with, the antelope colons you didn’t handle with bare hands, the untreated water you didn’t drink. You may get it now, but what about ten years ago? What about when you were a kid?
Evolutionarily novel circumstances often require evolutionarily novel responses to restore balance.
And probiotics aren’t even that “novel.” We’re clearly designed to consume probiotics in the food we eat, and probiotic supplements utilize the same ingestion pathway, especially if you consume them with food. The dosages may sound high. Primal Probiotics, the one I make (and take), contains 5 billion colony forming units (cfu, a measure of bacteria that are able to survive digestion and establish colonies in the gut) of good bacteria per dose—but that’s right in line with (or even well under) the dose of probiotics found in common fermented foods.
A single milliliter of kefir can have up to 10 billion cfu.
A cup of yogurt can contain up to 500 billion cfu.
A tablespoon of sauerkraut juice can contain 1.5 trillion cfu. Kimchi is probably quite similar.
A single gram of soil can contain almost 10 trillion cfu. A gram of soil is easy to consume if you’re eating foods (and drink water) directly from the earth.
Now, Primal Probiotics isn’t the only option. It may not even be the best option if you have specific conditions that other strains are particularly adept at addressing. (I’ll cover this in a future post.) But the way I designed Primal Probiotics was to be a good general, all-purpose probiotic with particular applications for Primal, keto, and other ancestrally-minded people living their modern lives.
For instance, one of my favorite strains I’ve included is Bacillus subtilis, the very same bacterial strain that’s found in natto, the traditional Japanese fermented soybean. B. subtilis addresses many of the issues we face in the modern world. It helps break down phytase in the gut and turn it into inositol, an important nutrient for brain and mood and stress. It helps convert vitamin K1 (from plants) into vitamin K2 (the more potent animal form of the vitamin). It can even hydrolyze wheat and dairy proteins to make them less allergenic.
There’s also Bacillus clausii, an integral modulator of the innate immune system (PDF)—the part of the immune system that fights off pathogens, toxins, and other invading offenders. Innate immunity is ancient immunity; it’s the same system employed by lower organisms like animals, plants, fungi, and bacteria. It’s the foundation of what we know as the immune response. What’s funny is that B. clausii has such a powerful effect on our innate immunity that one could argue B. clausii is an innate aspect of our gut community.
I’ve also included a small amount of prebiotic substrates in the latest iteration. I use raw potato starch (for resistant starch) and a blend of fructooligosaccharides and galactooligosaccharides. The prebiotic doses are low enough that they shouldn’t exacerbate any gut problems or FODMAPs intolerances and high enough to provide enough food for the probiotics to flourish.
Again, you don’t have to take Primal Probiotics. It’s my opinion that they provide the perfect combination of strains for most people’s needs, especially when combined with regular intakes of fermented veggies like sauerkraut and fermented dairy like yogurt, cheese, and kefir, but the actual strains themselves aren’t proprietary. You can find them elsewhere if you want to get individual probiotics. Hell, you may not even need a probiotic supplement. Depending on your personal health background, the level of sterility in your life history and current life (if you grew up on a farm drinking raw milk, for example), and the amount of fermented foods you currently consume, you may not need supplemental assistance.
But it’s sure nice to have around.
Anyway, that’s it for today.
How do you get your probiotics? Do you find them necessary for optimum health? What kind of benefits have you experienced from taking probiotics, either via food or supplementation?
Thanks for reading, everyone. Take care.
The post Life In the Sanitized Bubble (Or Why Probiotics Are So Important) appeared first on Mark’s Daily Apple.
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For my entire athletic career, I considered the gold standard of recovery to be sleeping, resting on the couch watching T.V., and generally being still and inactive. Come on, what could be more effective than couch potato mode to recover from the hormonal and inflammatory stresses of marathon training runs or long days of extreme swim-bike-run workouts? I’m kidding (mostly), but it’s not a total exaggeration. Our understanding of fitness recovery has grown exponentially since I was in the elite arena, and it’s exciting to see new and better approaches taking root that genuinely speed recovery and stave off burnout. I’m sharing two such techniques today. They’re simple, mostly free, and accessible to anyone with the most basic fitness opportunities and venues.
Note: Here’s the thing…. This is the stuff you should focus on before considering advanced techniques like exposure to cold or heat, Theragun treatments (although I happen to be a fan of this device), hyperbaric oxygen chambers, etc.
The first recovery technique is to move more instead of just sit around. That’s right, science is validating the idea that if you make a concerted effort to increase all forms of general everyday movement in the hours and days after strenuous workouts, you will help minimize the inflammation and oxidative stress caused by strenuous workouts.
Let’s call this strategy JFW—Just F—ing Walk.
Moving your body through space helps you burn fat better, which will maximize the fat reduction goals of your workouts. Walking also helps boost brain function. A 2017 UCLA study comparing MRI scans revealed that active older folks (over 60 and walking more than three kilometers per day) have faster brain processing speed, better working memory for quick decisions, and better memory consolidation than inactive folks. In his book, The Real Happy Pill: Power Up Your Brain By Moving Your Body, Swedish researcher Dr. Anders Hansen reports that just taking a daily walk can reduce your risk of dementia by 40 percent.
Walking and general movement of any kind improve lymphatic function for a huge recovery boost. The lymphatic system is a plumbing network running throughout your body that detoxifies every cell, tissue and organ through a separate operating system from the cardiovascular system. The lymphatic system operates through a pumping process instead of a beating heart. This means that you’re obligated to move your muscles and joints to turbocharge lymphatic detoxification and avoid the pooling of lymphatic fluid caused by chilling on the couch in the hours and days after heavy workouts. Even the old-time exercise apparatus of the mini-trampoline has come into vogue recently because bouncing around for even a few minutes has been shown to significantly boost lymphatic function.
To help your lymphatic system function optimally, be sure to hydrate adequately at all times. While my original Primal Blueprint presentation suggested that you simply honor your thirst to achieve good hydration, recent science suggests that successful hydration can be a little more complicated. Stacy Sims, Ph.D., a hydration expert who studied thermoregulation at Stanford and is currently a senior research fellow at University of Waikato in New Zealand, is doing some great work in this field. Check out this fantastic infographic. Her research suggests that the female menstrual cycle can influence hydration needs and strategies. Another breakthrough insight is that strenuous workouts have the potential to mute your thirst mechanism; you may become too hot and tired or distracted to notice that you’re actually getting dehydrated. For most minimally active folks, going by thirst might be just fine; the kidneys do an excellent job regulating fluid and sodium balance in the body.
If you are a novice fitness enthusiast, a high performing athlete, or routinely exercise in hot temperatures, a deliberate pre- and post-workout hydration is a strategy worth considering and implementing. Sprinkle some high quality natural mineral salt in each glass of fluid, which will help it become better absorbed in the tissues throughout your body.
Joel Jamieson, a noted trainer of world-champion MMA fighters in Washington (8WeeksOut.com—as in eight weeks out from a title bout), and developer of the Morpheus Recovery app, advocates a system called Rebound Training where specially designed workouts can actually speed recovery time in comparison with total rest. The idea that a Rebound Workout can boost recovery is validated through the tracking of Heart Rate Variability. Joel is a pioneer in Heart Rate Variability and has been tracking his fighters and other high performing athletes for decades. Yes, decades, as in dating back to the original hospital grade $30,000 units that required placement of a dozen electrodes on your skin.
The idea that a Rebound workout can beat couch time is an extraordinary revelation. Amazingly, when you drag your tired, stiff, sore body into the gym and do some foam rolling, deep breathing exercises, dynamic stretches, and even very brief explosive efforts, such as short sprints with long recovery on the bike, or “positive-only” deadlifts (lift the weight then drop it to the ground to prevent soreness caused by eccentric contractions), you can stimulate parasympathetic nervous system activity and actually accelerate recovery. The parasympathetic is known the “rest and digest” component of autonomic nervous system, and counterbalances the sympathetic “fight or flight” component.
You can learn more about Rebound Training and see a sample workout here. If you just want to dabble in the concept, know that increasing your walking and general movement in the hours and days after a challenging training session will help boost blood circulation and lymphatic function to speed recovery. I always find ways to walk more and spend more time at my stand-up desk in the 24 hours following a tough Ultimate Frisbee match or sprint workout.
Sample Restorative Workout
The next time you throw down a killer workout, trying heading to the gym the following day and creating a restorative experience.
Start by lying flat on the mat and completing 20 deep diaphragmatic breath cycles. When you’re in the prone position, you can hone good technique by placing your hand on your abdomen and making sure that the abdomen expands upon inhalation. First expand the abdomen, which enables the chest cavity to then expand outward and enable the full use of the diaphragm for a powerful breath. You notice this sequence better when laying down.
After 20 deep breaths, commence 10 minutes of foam rolling, dynamic stretches and flexibility drills.
Then, get a little sympathetic stimulation going with some bike sprints or positive only deadlifts as follows:
- Exercise bike: Warmup five minutes, then sprint for 10 seconds, followed by 60 seconds of easy pedaling. Repeat for five repetitions.
- Deadlift: With 70% of your one rep maximum weight, raise the bar three-quarters of the way to the top, then allow it to fall to the ground with minimal muscle engagement. Repeat five times.
The idea with these efforts is that you’ll trigger a brief stimulation of fight or flight sympathetic nervous system activity, but because the effort is so brief, you’ll prompt a compensatory parasympathetic reaction during the recovery period. The net effect of the session is to turbocharge parasympathetic for hours afterward to a greater extent than just chilling on the couch watching Netflix.
Thanks to the gentle nature of the session, you enjoy an increase in energy and alertness from getting the oxygen and blood flowing throughout the body—but without the cellular breakdown and glycogen depletion of a more strenuous workout. You should leave the gym feeling relaxed and a little looser than before the workout.
Implementing “Rebound”-style workouts, along with making a general effort to walk around more in the hours following your most challenging sessions aren’t just fun diversions; they’re part of putting recovery as the central element of your training program.
Speaking of HRV, Jamieson offers a breakthrough insight that has helped me further appreciate the value of tracking HRV over time, and also alleviate some confusion that arose during some data accumulation over the past several years. If you’re a fan of HRV, you know a high HRV on the familiar 1-100 scale is indicative of a strong and rested cardiovascular system. You have a greater variation in beat-to-beat intervals than a lower score, indicating a harmonious balance between fight or flight sympathetic nervous system function and rest and digest parasympathetic nervous system function. A low HRV indicates a more metronomic heartbeat, and sympathetic nervous system dominance over parasympathetic. These are reliable signs of overtraining or a general overstress condition in life, or a weak cardiovascular system in general.
By tracking HRV for several weeks, you can establish a healthy baseline, then gauge your level of stress and readiness to train based on daily HRV fluctuations. Low equals overstressed, high equals healthy. That’s all well and good, but here’s an important nuance I learned from Joel about HRV readings significantly higher than your baseline: An 86 seems better than the usual 72-75, but actually an abnormally high HRV could be an indication of parasympathetic dominance versus a sympathetic-parasympathetic balance. When your parasympathetic kicks into overdrive, it’s possibly because you trashed yourself way beyond healthy limits, and you’re struggling to return to a rested and stress-balanced state. This explained some strange outlier readings where I felt pretty cooked after coming off a jet travel binge or a series of extreme workouts in a tight time frame but delivered a rock star HRV reading.
As I’ve written about before, I’m not a fan of overdoing biofeedback devices. I’ve used them and still do occasionally when I’m attempting something new or just want to check in with some hard data, but too much tech can disconnect you with your intuition—what should always be front and center in your assessments. Dr. Kelly Starrett references scientific research indicating that the single most valuable and accurate metric for your state of recovery is “desire to train.” I wonder how this goes up against the blood lactate meters at the U.S. Olympic Training Center and any ring or watch data you can accumulate. I have confidence it would hold its own in most scenarios.
Thanks for stopping by today, everybody. How do you do recovery? What have you learned over the years in your own study and experience. Have a great end to the week.
The post Recovery Workouts: Two Simple But Powerful Ways to Speed Fitness Recovery appeared first on Mark’s Daily Apple.
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