Different types of nuts offer slightly different nutrition. Here, dietitians weigh on on the low-carb nuts to add to your healthy diet.
The post 10 Healthy Low-Carb Nuts You Can Eat On The Keto Diet, According To Nutritionists appeared first on Women’s Health.
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There was a time when food tracking was treated like a given, a necessary tool for anyone wanting to lose weight or better their health. Thankfully, there’s more nuance to that conversation now. The fact is, tracking your food can be a useful exercise for gaining more insight into what you’re putting in your body. It can also be a tedious endeavor that sucks all the joy out of eating.
If you’re going to invest the time—and it can be quite time-consuming if you include any variety in your diet—let’s make sure it’s not a waste.
You Might Want to Track Your Food If…
- You have a goal where hitting a specific macronutrient and/or caloric intake is important. This includes cutting before a bodybuilding competition, starting a ketogenic diet, or even just losing weight.
- You’re conducting an experiment. Maybe you want to see how your hunger changes when you eat more protein and less fat, or if your sleep improves if you increase your total carbs by a certain amount. Maybe you’re going to try a month of strict carnivore and plan to track your micronutrient intake.
- You suspect you aren’t eating the right amount. If weight loss has stalled, your total calorie intake might be higher than intended. On the flip side, if you’re an athlete whose performance and recovery have been subpar lately, perhaps you are eating too little. Some people find that keto dramatically suppresses their appetites to the point where they need to intentionally eat more. In any case, you can’t make the necessary adjustments unless you know how much you consume on a typical day.
You Don’t Need to Track Your Food If…
- You feel good and aren’t looking to change anything. If it ain’t broke, don’t fix it.
- You stick to the same basic meals most of the time. Even if you’re trying to manage your macros, if you’re a creature of habit, you can probably get away without tracking. Once you know the nutritional info for your standard meals, there’s no reason to input them in a food tracker over and over.
- You’ve been keto for a while. You have a good sense of how to keep your carbs low enough to stay in ketosis, and/or being in ketosis 24/7 isn’t that important to you.
- You just don’t want to. Your desire to eat intuitively outweighs your desire to manage your food intake.
You SHOULDN’T Track Your Food If…
- It triggers unhealthy eating behaviors or anxiety, or it otherwise messes with your mental and emotional well-being.
Is Food Tracking Reliable?
There will always be some error in food tracking. Besides measurement error on your end (we’ll get to that in a minute), there is natural variation in foods. One ribeye is fattier than the next. This apple contains more water. That cabbage was grown in more nutrient-depleted soil.
The FDA allows for up to 20% error on packaged food labels. That means that any information you get off the package might be wrong by 20% in either direction. Likewise, if you’re eating in restaurants and relying on the nutritional info they provide, consider it a rough estimate. Depending on how the food is prepared and the portion size you are given, your specific meal might vary a little or a lot.
All this is to say that food tracking is not an exact science. That doesn’t mean it’s futile—it can still be useful for the reasons I gave above. However, there’s no point in stressing if you’re off your daily targets by 25 calories or 7 grams of fat. You should view tracking as a helpful but imprecise method of gathering data. Don’t micromanage to the point of causing yourself grief or anxiety.
How to Track for Maximum Accuracy
That said, there are steps you can take to improve the accuracy of your tracking:
Weigh, Don’t Measure
If you care about precision, invest in a food scale. While tablespoons (mL) work for liquid measurements like salad dressing, weight is much more accurate for proteins, fruits and veggies, nuts and seeds, and legumes.
Weigh Foods Raw
This is true even if you intend to cook them. When you enter them in your food tracker, make sure you select the entries for the raw items (e.g., “Celery, raw” instead of “Celery, cooked”).
Do NOT Use Pre-entered Recipes
For example, if you make a pot of chili, do not simply select the entry for “Chili” in your food tracking app. Your version of chili might differ substantially from what’s considered “average” chili by the app.
Most tracking apps will allow you to input custom recipes, which is helpful for foods you will make again and again. Alternately, you can enter the ingredients separately into your daily food log.
If you are cooking big batches of multi-ingredient recipes, the best way to figure out exactly how much you ate is to weigh the final product and then weigh your portion. In the chili example, you’d create a custom chili recipe in your app and enter all the raw ingredients. After it’s cooked, weigh the entire batch, then weigh your portion. If you make 800 grams of chili and eat 150 grams, you ate 18.75% of the recipe.
If this sounds like a lot of work, you’re right. Food tracking is so much easier if you prepare simple meals: protein, side of vegetables, add healthy fat. It can be a major bummer for those of us who like to experiment in the kitchen and prepare more elaborate meals.
What’s the Best App?
There are lots of options here. I personally like and recommend Cronometer. The free app and desktop version have everything you need, but there is also an inexpensive premium version. The entries are all based on official food databases, so it’s as accurate as you can get, and it provides pretty granular nutritional info. You can input your own macronutrient targets and also add custom recipes.
Primal folks might also prefer Cronometer because, unlike a lot of food tracking apps, it doesn’t assume you are trying to be keto or even low carb. If you are keto, Carb Manager and KetoDiet App are two popular options. Personally, I don’t like that Carb Manager grades foods based on what it considers acceptable for keto. My beloved Japanese sweet potato gets an F—no thanks (even if I can’t eat a big portion on keto). I’ve never tried KetoDiet App because it costs $8.99, whereas Cronometer is free and gives me everything I need. If you have tried it, let us know what you think about it in the comments below.
Whatever app you choose, don’t assume that the default macro settings are right for you. A lot of keto apps will set your carb limit at 20 to 25 grams, for example, whereas The Keto Reset Diet recommends starting with 50 grams total. (This usually works out to 30 to 35 grams net in my experience.) The calories might not be appropriate for your activity level. Either set custom macros or simply ignore the app when it says you are over your carb limit or calories or whatever.
How Do I Track Cooking Fat?
It’s impossible to know how much fat you leave in the pan when you sauté your veggies or how much oil is absorbed you fry chicken. Since most people are more concerned with eating too many calories than too few, the more conservative approach is to add all the cooking fat to your food diary when sautéing or roasting (i.e., assume you consume it all). When frying, the best answer is to weigh your cooking oil before and after frying to estimate how much is absorbed. Neither will be precise, but it’s the best you can do, so don’t stress about it.
Is There a Preferred Time/Method For Tracking?
How and when you track your food depends on why you’re tracking in the first place. If you’re trying to get an unbiased look at how you’re currently eating, I recommend logging your food on paper for a few days, then entering it into an app to get the nutritional info. Logging makes us more mindful of what we are eating. This is generally a good thing, but if you’re trying to get an accurate snapshot, you don’t want to change how you’re eating based on the data.
If you’re trying to manage what you eat, it’s best to enter your food before you eat it. This keeps you from accidentally eating more or less than you want, and it helps you balance your macros according to your goals.
Whatever you do, log foods as you weigh/measure/eat them. Don’t think you’ll remember exactly what you ate earlier today, much less yesterday or the day before. You won’t.
Do I Have To Track My Food If I’m Keto?
You never have to track your food. However, if you’re serious about being in ketosis, I do recommend tracking your food for at least a week or two at the beginning just to make sure you’re on track. Most people don’t know how many carbs are in foods, so it can be easy to go over your limit. Managing your electrolytes is also very important. Apps like Cronometer will show you how much sodium, potassium, and magnesium you are getting from food so you can supplement appropriately.
Can I Just “Lazy Track”?
Sure, you can eyeball portion sizes of steak and measure your broccoli in a measuring cup instead of buying a food scale. It won’t be particularly accurate. As long as you understand that, go ahead. I wouldn’t bother taking the time to track for this level of (im)precision though.
Thanks for reading today, everybody. If you track your food, what insights or benefits have you gotten? What app do you prefer and why? Let us know below.
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When I did my first earnest attempt at a keto diet a few years ago, one of the benefits I quickly noticed was improved wakefulness and energy during the day. I chalked this up to sleeping better on keto.
It turns out that I might have been one of the lucky ones. While plenty of people report improved sleep, a fair number also complain of insomnia, sleep disruptions (waking frequently during the night), and generally poor sleep once they go keto.
Can a keto diet really impact sleep quality? What might be the mechanism behind a correlation? And how does one work around any potential effect?
I’ve written a lot about sleep over the years, and I don’t intend to rehash what I’ve already written. Rather, I want to explore why a very-low-carb ketogenic diet specifically might impact sleep. I’ll link to some of my past posts at the bottom for those interested in improving overall sleep hygiene.
What is “Keto Insomnia?”
Insomnia disorder, as defined in the DSM-5, involves the following:
- Difficulty falling asleep, difficulty staying asleep, and/or waking too early without being able to fall back to sleep
- Symptoms occur at least three nights per week for at least three months
- Sleep problems are not explained by other illness, medication, and so on
- Distress and/or impaired ability to function in daily life
Acute insomnia is similar, but it’s short-term and might be attributable to a specific trigger, such as a stressful event, major life change, or travel.
People who complain about “keto insomnia” seem to mean one of two things:
- Sleep disruptions that occur during the transition phase—the days or weeks immediately after starting keto (acute)
- Sleep issues that start after being keto for a few months or longer (might be acute or chronic)
It can be hard to know whether the latter are actually related to keto at all. However, if diet is the only obvious change these folks have made, keto seemingly takes the rap.
Why Might Keto Mess with Your Sleep?
On possible clue is this oft-cited study in which participants experienced decreased REM and increased slow-wave sleep when following a keto diet. Decreased REM sleep can contribute to the subjective experience of insomnia. However, total sleep was not impacted. This study was also small, involving 14 participants who followed a keto diet for just two days.
Other than that, however, there’s not much to go on. A couple studies found no change in sleep quality among healthy adults following a keto diet, and a handful of others reported improved sleep quality (in epileptic children and obese adolescents).
Moreover, the team at Virta Health recently released their findings after one year of treating diabetic and prediabetic patients with keto diet interventions. Their patients enjoyed significant improvements in sleep quality and daily functioning compared to baseline and compared to individuals who didn’t go keto.
All together, the research so far suggests that when it comes to sleep, keto is neutral-to-positive for healthy adults and beneficial for individuals struggling with certain health conditions. Of course, the data are still quite sparse.
A somewhat larger, but still limited, body of research has looked more generally at how the macronutrient composition of one’s diet affects sleep. To be blunt, the results of these studies are all over the map. There’s tremendous variation from study to study in terms of how diets were constructed or measured, food timing, other relevant dietary factors such as total calorie intake and fiber content, as well as what aspects of sleep were assessed and how. Depending on which study you’re reading, consuming fat, protein, or carbohydrates might seem to help, hurt, or have no effect on sleep.
In short, there’s no compelling scientific explanation for when or why keto would harm your sleep. I know this is no comfort to those of you who are experiencing sleep disruptions now, however. Let’s turn to some things you can try if you’re not in the camp of good sleep while keto.
Despite the dearth of research, it’s possible to make some reasonable guesses about what might be causing your sleep issues. Of course, before trying any of the supplement suggestions below, consult your doctor. Likewise, get help if your sleep is so poor that you are having trouble functioning.
First, the obvious: basic sleep hygiene. These are the things I harp on all the time, like avoiding blue light at night and honoring a consistent bedtime. Sure, you probably didn’t change any of these when you went keto. However, it might be that something about keto eating—like getting less tryptophan to your brain (I’ll explain in a minute)—is making you more sensitive to poor sleep habits. Refer to my other sleep posts linked below for more details.
Check your electrolytes. Especially if you’re new to keto, electrolytes are the most likely culprit for sleep issues. You want to aim for the following daily:
- 3-5 grams of sodium on top of what you get from food
- 3-5 grams of potassium
- 500 mg of magnesium
Most keto newbies drastically underestimate how important electrolytes are, not just for sleep but for energy, workout performance, and avoiding the keto flu. Check out this post for more details.
For sleep issues, start with magnesium. Make sure you’re including plenty of magnesium-rich foods such as leafy greens, dark chocolate, and hemp seeds in your diet. You can also supplement with magnesium—the glycinate form is preferred for sleep—starting with 100-400 mg as needed.
Also consider adding a mug of warm bone broth to your evening routine. Besides being soothing, it’s a great way to get sodium and the amino acid glycine. Glycine is the most abundant amino acid in collagen. Supplementing with 3 grams of glycine before bed has been shown to improve sleep.
Make sure you’re neither too hungry nor too full at bedtime. As you adjust to your new way of eating, try to avoid extremes of hunger in the evening. If you’re practicing intermittent fasting, make sure your fasting window isn’t leaving you stuffed or famished at when it’s time to hit the hay.
Dial back the caffeine. Is it possible you’ve been a little too enthusiastic about fatty coffee since going keto?
Get your stress in check. We all know that stress is a sleep killer, and I see stress running high in the keto community. Micromanaging macros, worrying about which foods are and are not “allowed,” trying to do too much too soon—keto folks can really get themselves worked up. If this sounds familiar, you need to take a step back and work on stress reduction.
Try adding a small amount of high-glycemic carbs to your dinner. Wait, what? Am I really telling you to eat more carbs on keto? Yes, for a good reason.
As you probably know, melatonin is the hormone primarily responsible for regulating your sleep-wake cycle. The amino acid tryptophan is a precursor of melatonin. In the brain, tryptophan converts to 5-HTP, then serotonin, then melatonin. To get into the brain, tryptophan relies on protein transporters, which also carry other amino acids across the blood-brain barrier. When there is too much traffic—that is, too many other amino acids trying to use the protein transporters—not enough tryptophan can get across.
Insulin shuttles those competing amino acids into muscles, leaving the roads clear for tryptophan so to speak. By adding some high-GI carbs to your last meal of the day, you bump up insulin and facilitate this process.
Now, I wouldn’t recommend this as your first option if you are brand new to keto. However, if you’re one of those people who is suddenly struggling with sleep after being keto for a while, this is worth trying. Michael Rutherford, NTP, Primal Health Coach, and moderator of our Keto Reset Facebook group says his clients have had good results adding ~20 grams of carbs to their last meal of the day. Potatoes or sweet potatoes are good choices.
If you just can’t bring yourself to eat more carbs, you can also supplement with tryptophan. A dose of 250-500 mg is a good place to start, increasing as needed. Chris Masterjohn recommends taking tryptophan on an empty stomach and as far as possible from other sources of protein.
Another possible workaround is to supplement with 5-HTP, which is a common ingredient in sleep aids. Rutherford advises his clients to start with 100 mg of 5-HTP taken 30-60 minutes before bed. Be cautious with this supplement if you have depression or anxiety.
Skip the middlemen and supplement melatonin. Melatonin supplementation is somewhat controversial. It’s not my first choice—I’d rather you start by addressing sleep hygiene and tweaking your diet—but I’m not opposed to supplementing as needed.
Doses as low as 0.5 mg can be effective, although as much as 5 mg is generally regarded as safe. I recommend starting at the bottom end, since lower doses are closer to normal physiological levels. Take melatonin at least an hour after eating your last food of the day.
Get your thyroid and cortisol levels checked. If none of your self-experimentation works, or if you’re having other signs of thyroid imbalance, get your thyroid function and cortisol levels checked. While I don’t believe keto is inherently bad for thyroid or adrenal health, it’s certainly worth a trip to your doc.
What’s your experience? Are you sleeping like a baby on low-carb/keto—or not? Have you found any solutions other than those suggested here? Comment below, and have a great week, everyone.
More sleep tips from Mark’s Daily Apple
Herrera CP, Smith K, Atkinson F, Ruell P, Chow CM, O’Connor H, Brand-Miller J. High-glycaemic index and -glycaemic load meals increase the availability of tryptophan in healthy volunteers. Br J Nutr. 2011 Jun;105(11):1601-6.
Levenson JC, Kay DB, Buysse DJ. The pathophysiology of insomnia. Chest. 2015;147(4):1179–1192.
Peuhkuri K, Sihvola N, Korpela R. Diet promotes sleep duration and quality. Nutr Res. 2012 May;32(5):309-19.
Riemann D, Spiegelhalder K, Nissen C, Hirscher V, Baglioni C, Feige B. REM sleep instability–a new pathway for insomnia? Pharmacopsychiatry. 2012 Jul;45(5):167-76.
Silber BY, Schmitt JA. Effects of tryptophan loading on human cognition, mood, and sleep. Neurosci Biobehav Rev. 2010 Mar;34(3):387-407.
St-Onge MP, Mikic A, Pietrolungo CE. Effects of Diet on Sleep Quality. Adv Nutr. 2016 Sep 15;7(5):938-49.
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Spend 90-minutes in the kitchen on a Sunday and you’ll be thanking yourself all week long. This low-carb, keto-friendly meal prep stocks your refrigerator with five ready-to-eat meals.
Combining home-cooked ingredients (like pot roast) with convenient store-bought ingredients (like rotisserie chicken) keeps the prep work manageable. Herbs, spices, sauces, and keto-friendly condiments keep the flavors fresh and new each night.
Menu (each meal serves 4):
Meal 1: Pot Roast with Roasted Asparagus and Honey Mustard Slaw
Meal 2: Chicken Coconut Curry over Cauliflower Rice
Meal 3: Beef Carnitas with Spicy Jalapeno Slaw and Guacamole
Meal 4: Asparagus and Mushroom Scramble with Arugula Salad
Meal 5: Chicken Noodle Soup
What You’ll Need…
- 4 pounds/1.8 kilograms beef chuck roast
- 1 rotisserie chicken
- Eggs (half dozen)
- 1 package/7 ounces/200 grams shirataki angel hair noodles
- 2 onions
- 1 head garlic
- 2 pounds/1 kilogram asparagus
- 4 medium zucchini
- 8 ounces/226 grams sliced mushrooms
- 1 12- to 16-ounce/453-gram bag frozen cauliflower rice
- 1 package shredded red or green cabbage (coleslaw)
- 1 6-ounce/170-gram bag arugula
- 2 limes
- 2 avocados
- 1 jalapeno
- 3 cups (24 fluid ounces) beef stock
- 8 cups (64 fluid ounces) chicken stock
- 1 can coconut milk (13.5 fluid ounces/400 ml)
- 1 bay leaf
- Curry powder (1 tablespoon/15 milliliters)
- Cumin (1 teaspoon/5 milliliters)
- Chili powder (1 teaspoon/5 milliliters)
- Salt and pepper
- Primal Kitchen® Avocado Oil and/or extra virgin olive oil
- Coconut oil
- Soy sauce or tamari or coconut aminos (2 tablespoons/30 milliliters)
- Red wine vinegar (1 tablespoon/15 milliliters)
- Slivered almonds (1 cup/300 grams)
- Parmigiano-Reggiano cheese (1 cup/90 grams grated)
- Primal Kitchen Honey Mustard Vinaigrette (or your favorite homemade vinaigrette)
- Instant Pot
- 3 half-size rimmed sheet pans (13”x18”)
- Parchment paper or foil (for easier cleanup)
Here’s the Plan…
Prep and Cook the Meat:
First, get the pot roast going because it takes the longest amount of time to cook. Season the beef by rubbing 1 heaping teaspoon salt and ½ teaspoon black pepper into the roast.
Roughly chop two onions. Use one chopped onion for the pot roast and set the other aside for later.
Peel 6 cloves garlic and smash them with your palm.
Turn the Instant Pot sauté setting to high. Drizzle a tablespoon or two of avocado oil into the pot. Put the roast in the Instant Pot and sprinkle one chopped onion around it.
Sear the meat, turning as needed, until all sides are nicely browned (about 2 minutes per side). Mix the onions occasionally, so they become soft and nicely browned.
Add the garlic cloves, 3 cups beef stock, 1 tablespoon red wine vinegar, a few sprigs of thyme and one bay leaf.
Put the lid on the Instant Pot and set the pressure release valve to “sealing.” Use the manual setting to cook on high pressure for 50 minutes. When 50 minutes is up, let the pressure release naturally.
When the pot roast is done, remove it from the Instant Pot and let the meat cool on a cutting board. Shred the meat and store in two separate food storage containers for two separate meals.
While the pot roast is cooking, get to work on the other ingredients.
Prep and Cook the Sheet Pan Veggies:
Heat oven to 425ºF/218ºC.
Cover three sheet pans with parchment paper (optional, for easier cleanup).
Sheet Pan #1: Trim the bottom off the asparagus stalks. Lay the asparagus out on a sheet pan. Lightly coat the asparagus with oil and salt.
Sheet Pan #2: Slice the zucchini into ½-inch rounds. Combine on a sheet pan with the chopped onion that was set aside earlier. Lightly coat zucchini and onion with oil and salt.
Sheet Pan #3: Spread the sliced mushrooms out on a sheet pan. Lightly coat mushrooms with oil and salt.
Put all three of the sheet pans in the oven. Roast for 20 to 35 minutes, stirring occasionally, until vegetables are tender and lightly browned.
While the veggies are roasting, make the coconut curry sauce.
Make the Curry Sauce:
To make the coconut curry sauce, heat a few tablespoons coconut oil in a pot over medium heat. Add 3 finely chopped garlic cloves. Add 1 tablespoon curry powder and sauté 30 seconds. Add 1 can coconut milk and 2 tablespoons soy sauce (or tamari or coconut aminos). Bring to a boil then turn the heat down slightly and simmer 15 to 20 minutes.
While the curry sauce is simmering, slice the white meat from the rotisserie chicken and chop into small pieces. Add to the coconut curry sauce.
Organize the Ingredients For the Week:
Pull all of the dark meat from the rotisserie chicken. Put the dark meat in a zip-top freezer bag.
When the veggies are done, let them cool. Store the asparagus and mushrooms in separate food storages container and refrigerate.
Add half of the zucchini and onion to the coconut curry sauce. Store the coconut curry sauce (with chicken, zucchini and onion) in a food storage container (or just keep it in the pot!) and put it in the refrigerator.
Add the other half of the zucchini and onion to the freezer bag with the dark chicken meat. Make sure to push out all the air when sealing the plastic bag. Put the bag in the freezer.
Serve Your Meals:
Meal #1: Pot Roast with Roasted Asparagus and Honey Mustard Slaw
Serve half of the pot roast with half of the roasted asparagus. Toss half of the shredded cabbage with a few handfuls of arugula. Dress the slaw with Primal Kitchen Honey Mustard Vinaigrette, or your favorite homemade salad dressing. Sprinkle slivered almonds over the asparagus and slaw.
Meal #2: Chicken Coconut Curry over Cauliflower Rice
Reheat the chicken coconut curry over medium heat. Heat the frozen cauliflower rice either in the microwave or in a sauté pan. Serve the curry over the cauliflower rice and garnish with fresh basil.
Meal #3: Beef Carnitas with Spicy Jalapeño Slaw and Guacamole
Reheat the remaining pot roast by adding the shredded meat to a hot skillet with a thin layer of oil. Cook until the meat is hot and a little bit crispy. As the meat cooks, season it with 1 teaspoon of cumin and chili powder. Mash 2 avocados with lime juice and salt to make guacamole. Add a sliced jalapeño to the remaining sliced cabbage, tossed with lime juice and fresh cilantro.
Meal #4: Asparagus and Mushroom Scramble with Arugula Salad
Chop the leftover asparagus into ½-inch pieces. Sauté asparagus and mushrooms in a skillet with a little bit of oil to reheat. Whisk 6 eggs and add to the pan, stirring to combine with the veggies. Serve the scramble with a side salad made from the remaining arugula and your favorite salad dressing. Grate Parmigiano-Reggiano cheese over the scramble and salad.
Meal #5: Chicken Noodle Soup
Put the frozen dark chicken meat and zucchini in the refrigerator in the morning to defrost. At dinnertime, heat 8 cups chicken broth. Add the chicken and zucchini with rinsed shirataki noodles and simmer until warm.
Thanks for reading today. What cooking tips or meal prep ideas are you looking for? Share what you’d like to see us cover in future recipe and cooking articles in the comment board below.
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For today’s edition of Dear Mark, I’m answering five questions taken from this Twitter thread. First, does collagen offer anything special above and beyond glycine? Second, what’s the relationship between keto and gallstones? Third, do I recommend eating raw liver, and why or why not? Fourth, why does one reader’s scalp itch when eating stevia? And finally, what’s the best way to lose fat and gain muscle at the same time?
If collagen is broken down into amino acids in the gut before being absorbed, is it just the amino acid profile (i.e. high glycine) that makes it so beneficial? Anything else?
Glycine is a major reason why we need collagen in our diets, but it’s not the only one.
When you feed people collagen derived from pork skin, chicken feet, and cartilage, many different collagenous peptides appear in the blood. You don’t get any of these from isolated glycine:
Proline-hydroxyproline, a peptide with protective effects on osteoarthritic cartilage degradation.
Glycine-proline-hydroxyproline, a peptide that makes it into the blood and turns into proline-hydroxyproline, which makes it into the skin.
Collagen peptides have beneficial effects above and beyond glycine alone—although glycine is great for balancing out methionine intake from muscle meat consumption. It’s also been used in several studies to improve multiple markers of sleep quality.
A family member has a complicated health history including cancer and wants to eat keto. But, now she finds she has gallstones. Any thoughts on a good way to attack this complicated issue?
Has your family member already gone keto? Did going keto come before the gallstone reveal?
If so, that’s actually normal.
The primary role of the gallbladder is to collect bile from the liver, concentrate it into potent super-bile (my term), and release the concentrated bile to break up incoming dietary fat into smaller molecules that lipase can attack and digest. Dietary fat is the biggest driver of gallbladder emptying.
If the gallbladder isn’t regularly emptied, gallstones can form. Usually made of hardened cholesterol, gallstones are quite common and often produce no symptoms. Problems arise when normal gallbladder emptying flushes out a stone small enough to make it into but too large to pass through the bile duct and a blockage occurs. Gallstones can also directly damage the walls of the gallbladder, leading to cholecystis, or gallbladder inflammation.
A high-fat diet can exacerbate or even uncover gallstone issues by increasing gallbladder emptying. Remember: the more fat you eat, the more often you empty your gallbladder—and everything in it.
But high-fat diets don’t generally cause gallstones to form. They only reveal pre-existing ones. The biggest risk factors for gallstone formation are:
- A high intake of high-glycemic carbohydrates.
- High estrogen levels, which concentrate cholesterol deposition in the gallbladder. This is why women, especially pregnant women and/or those taking hormonal birth control, are more likely to have gallstones.
- Obesity, which also increases cholesterol levels in the gallbladder.
- Weight loss, with a caveat: high-fat weight loss diets reduce and even prevent gallstone formation. In fact, when you compare people who lose weight on a low-fat diet to those who lose it on a high-fat diet, research shows that 45% of the low-fatters develop gallstones while none of the high-fatters develop them.
Once the gallstones are all clear, keep up with the keto eating, as eating more fat will keep your gallbladder regularly flushed and clear of stones.
Is Raw Liver safe to eat?
I’ve eaten raw liver before. I know people who eat raw liver. I can’t recommend it, however, because I don’t know what kind of liver you have access to. Who raised the animal? What did it eat? What were the processing conditions?
But because I know people are going to try this…
Freeze it first for several days.
Buy from a trusted source.
Buy only liver from well-raised, grass-fed, organic animals.
If it looks unhealthy, it probably is. I would never eat a pale, flaccid liver with ugly spots, cooked or raw.
Don’t eat raw (or even medium) pork liver. A huge percentage of pigs carry the Hepatitis E virus, which is transmittable to humans and concentrates in the liver.
Why does stevia make my scalp itch?
Stevia can be an allergen actually. It’s not very common, but as more and more people use stevia, more will be revealed to have an allergic reaction.
I’d just skip it.
Is it possible to gain muscle and lose weight with properly timed IF around workouts?
It is possible, although you may not actually lose weight, but rather body fat (which is better).
The best way I’ve seen people do it is the classic Leangains method.
Fast from 8 p.m. to 12-1 noon.
Fasted workout in the afternoon, perhaps with a little BCAA or whey isolate before the workout. Lift heavy, compound movements.
After the workout, walk for 20 minutes. Brisk pace to utilize all the free fatty acids swimming around.
Then eat. If you’re going to eat carbs, do it in this meal and keep the fat low-to-moderate. Load up on protein.
Eat as much as you like until 8 p.m.—the end of your eating window. Favor protein and, again, if you’re eating carbs keep fat lower than usual.
Maintain the fasting period every day. On rest days, eat low/no carb and higher fat. Protein always high. Go for walks on rest days.
That’s it. That usually works really well, but it presupposes you have a flexible schedule and can actually train in the afternoon whenever you want. Your mileage may vary—though it will work at any time.
Muscle gain won’t be as rapid as it would drinking a gallon of milk a day, eating pizza smoothies, and cramming ice cream made with whey protein at night, but it will minimize fat gain and perhaps even help you lose fat as you gain muscle. No guarantees, but it’s the best method I’ve seen.
That’s it for today, folks. Thanks for reading, take care, and be sure to leave a comment down below if you have any questions.
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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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“Has Mark given up Primal?” I get this question all the time, and I’m not surprised. Over the past few years, I’ve really focused on exploring the utility, applications, and ins and outs of the ketogenic diet. Why?
I’m still Primal and have been for over a decade. That won’t ever change. And you can go Primal—drop industrial seed oils, added sugar, and grains—and be perfectly fine. Better than 95%. You’ll lose body fat, gain energy and performance, and reduce your risk of degenerative disease. It will always be the foundation of my eating—and living. But I see (and have experienced) keto as a boost, an enhancement, a Reset. A return. Today I’m answering some questions around this idea with a new video.
Ketosis is the metabolic state in which our ancestors—all of them—spent a significant amount of time, whether from low carbohydrate availability, intense and protracted physical activity and exertion, or prolonged caloric deficits. We come from people who had to work for their food, who couldn’t count on a square well-balanced meal with “adequate” carbs, fats and protein, who sometimes simply didn’t have anything to eat for extended periods of time. As a result, they were often in ketosis. Intermittent ketosis is the metabolic milieu in which our physiologies were forged. That’s the metabolic milieu a modern person going keto is trying to emulate. It’s a smart move.
It’s why nearly everyone should spend time in ketosis. It’s why everyone should consider doing a full-on keto reset where you take six weeks to get completely fat-adapted, build up those fat-burning mitochondria, and enhance your metabolic flexibility. But, and this is a big “but,” very few people need to spend the rest of their lives there.
That’s where I am.
I’m in the Keto Zone.
Once in a while I’ll have 175 grams of carbs, usually after intense training.
Other days I might have close to zero carbs.
But most of the time I’ll hover somewhere around 50 grams of total carbs a day as defined in the Keto Reset approach.
But because I’ve built up the metabolic flexibility (and continue to refresh that flexibility with an intentional 6-week Keto Reset each year), I don’t have any issues utilizing all the various sources of energy. My energy doesn’t wane whether I eat 100 carbs or 10 carbs. Whether I’ve eaten nothing but meat or had a Big Ass Salad. I can tailor my fuel sources to my desires and requirements. That’s true flexibility. And freedom. It’s a version of Primal that works even better for me, and I’ve seen it benefit many others.
But let me share a video to take this further….
Thanks for stopping in, everybody. I hope I answered some questions here, but shoot me a line if there’s something outstanding or if you’re curious about something in your own Primal or Primal-keto journey. And have a great end to the week.
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