Though she is at the forefront of functional medicine, what sets Dr. Wahls apart is her experience using nutrition and lifestyle interventions to treat progressive health problems and heal her own MS, and later that of others.

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For today’s edition of Dear Mark, I’m answering three questions. First, can LDL actually infiltrate the arteries, or is there more to the story? Malcolm Kendrick says there’s more to the story, so I dig into some literature to see if they corroborate his position. Second, is New Zealand farmed salmon good to eat? And finally, what should you do about elevated ferritin levels—and why else might they be elevated if not because of your iron?

Let’s go:

My reading of this post by Malcolm Kendrick MD is that LDL particles cannot infiltrate the endothelial lining of our arteries:
https://drmalcolmkendrick.org/2018/08/16/what-causes-heart-disease-part-52/

Great read. Malcolm Kendrick is consistently fascinating, insightful, and enlightening.

He’s basically suggesting that LDL particles can’t manhandle their way into the artery wall, which are equipped with tight junctions—the same kind that regulate passage through our gut lining. Something has to “allow” them in. The something he finds most plausible is injury, trauma, or insult to the endothelial lining (artery wall, for lack of a better phrase).

A free public textbook available on PubMed since last month called The Role of Lipids and Lipoproteins in Atherosclerosis tackles the topic head on. In the abstract, they say:

Population studies have demonstrated that elevated levels of LDL cholesterol and apolipoprotein B (apoB) 100 [note: ApoB is a stand-in for LDL particle number, as each LDL-P has an ApoB attached to it], the main structural protein of LDL, are directly associated with risk for atherosclerotic cardiovascular events (ASCVE). Indeed, infiltration and retention of apoB containing lipoproteins in the artery wall is a critical initiating event that sparks an inflammatory response and promotes the development of atherosclerosis.

This seems to posit that infiltration of the LDL particle into the artery wall is a critical initiating event. But is it the critical initiating event? Does something come before it? How does the infiltration happen, exactly? Moving on:

Arterial injury causes endothelial dysfunction promoting modification of apoB containing lipoproteins and infiltration of monocytes into the subendothelial space. Internalization of the apoB containing lipoproteins by macrophages promotes foam cell formation, which is the hallmark of the fatty streak phase of atherosclerosis. Macrophage inflammation results in enhanced oxidative stress and cytokine/chemokine secretion, causing more LDL/remnant oxidation, endothelial cell activation, monocyte recruitment, and foam cell formation.

If I’m reading this correctly, they’re saying that “arterial injury” is another critical initiating event—perhaps the critical initiating event, since the injury causes “endothelial dysfunction,” which in turn modifies (or oxidizes) the LDL particles. But wait: so they’re saying the LDL particles are already there when the arterial injury occurs. They’ve already made it into the endothelial walls, and they’re just…waiting around until the arteries get injured. Okay, okay, but, just like Malcolm Kendrick points out, nowhere in the abstract have the authors actually identified how the LDL particles enter the endothelial lining. Maybe it’s “common knowledge,” but I’d like to see it explained in full.

Moving on:

In atherosclerosis susceptible regions, reduced expression of eNOS and SOD leads to compromised endothelial barrier integrity (Figure 1), leading to increased accumulation and retention of subendothelial atherogenic apolipoprotein B (apoB)-containing lipoproteins (low-density lipoproteins (LDL)) and remnants of very low-density lipoproteins (VLDL) and chylomicrons)

Ah ha! So, in regions of the arteries that are prone to atherosclerosis, low levels of nitric oxide synthase (eNOS)—the method our bodies use to make nitric oxide, a compound that improves endothelial function and makes our blood flow better—and superoxide dismutase—an important antioxidant our bodies make—compromise the integrity of the arterial lining. The compromised arterial lining allows more LDL particles to gain entry and stick around. So, are low levels of nitric oxide and impaired antioxidant activity the critical initiators? That’s pretty much what Malcolm Kendrick said in his blog post.

Still—high LDL particle numbers are a strong predictor of heart disease risk, at least in the studies we have. They clearly have something to do with the whole process. They’re necessary, but are they sufficient? And how necessary are they? And how might that necessariness (yes, a word) be modified by diet?

I’ll explore this more in the future.

In regards to the oily fish article (and more indirectly given the omega 6 concern- the Israeli Paradox) What do you think of NZ farmed salmon? I’m in Australia, & occasionally like a fresh piece of salmon- there are no wild caught available here sadly, but I am wondering how it measures up as an alternative?

Last year, I explored the health effects of eating farmed salmon and found that it’s actually a pretty decent alternative to wild-caught salmon, at least from a personal health standpoint—the environmental impact may be a different story.

I wasn’t able to pull up any nutrition data for New Zealand farmed salmon, called King or Chinook salmon. Next time you’re at the store, check out the nutritional facts on a NZ farmed salmon product, like smoked salmon. The producer will have actually had to run tests on their products to determine the omega-3 content, so it should be pretty accurate. Fresh is great but won’t have the nutritional facts available. I don’t see why NZ salmon would be any worse than the farmed salmon I discussed last year.

According to the NZ salmon folks, they don’t use any pesticides or antibiotics. That’s fantastic if true.

I used to eat a lot of King salmon over in California, and it’s fantastic stuff. Very fatty, full of omega-3s. If your farmed King salmon comes from similar stock, go for it.

ok can someone tell me how to reduce ferritin? Is is just by giving blood?

Giving blood is a reliable method for reducing ferritin. It’s quick, effective, simple, and you’re helping out another person in need. Multiple wins.

Someone in the comment board recommended avoiding cast iron pans in addition to giving blood. While using cast iron pans can increase iron intake and even change iron status in severe deficiency, most don’t have to go that far. Giving blood will cover you.

Ferritin is also an acute phase reactant, a marker of inflammation—it goes up in response to infections (bacterial or viral) and intense exercise (an Ironman will increase ferritin). In fact, in obese and overweight Pakistani adults, elevated ferritin seems to be a reliable indicator of inflammatory status rather than iron status.

Thanks for reading, everyone. Take care and be well!

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References:

Birgegård G, Hällgren R, Killander A, Strömberg A, Venge P, Wide L. Serum ferritin during infection. A longitudinal study. Scand J Haematol. 1978;21(4):333-40.

Comassi M, Vitolo E, Pratali L, et al. Acute effects of different degrees of ultra-endurance exercise on systemic inflammatory responses. Intern Med J. 2015;45(1):74-9.

The post Dear Mark: How Does LDL Even Penetrate the Arteries, New Zealand Farmed Salmon, Elevated Ferritin appeared first on Mark’s Daily Apple.

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If you’re one of the many Americans who has had one-too-many sugar cookies, here is a seven-step detox to cure your post-holiday weight gain, legendary bloat, and molasses-like blood.

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Winter is here. It’s cold outside—often cold and snowy and/or rainy enough to dissuade most people from extensive outdoor activities—and extremely warm indoors. Families are getting together, companies are throwing holiday parties, we’re eating, drinking and merry-making. Alcohol is everywhere, and many of us will be drinking more than we usually do. In fact, this time of year presides over a sharp spike in alcohol consumption.

What’s it mean for your workout?

After looking at the research, at first glance, I’m going to be honest with you: It doesn’t sound good.

But it’s also not the end of the world.

The Bad News: Alcohol’s Impact On Exercise

Alcohol Dehydrates You

Alcohol is one of the worst diuretics, impairing the body’s ability to reabsorb water and increasing the amount we urinate.

Going into a workout with suboptimal hydration levels is a serious handicap.

It increases your cortisol:testosterone ratio after a session, reducing your gains and making the workout more stressful than it should be. A big part of the “workout afterglow” is the rush of testosterone; with that effect blunted and stress heightened, you’ll miss out on the sense of well-being a good workout provides.

It reduces performance during a cycling time trial, making the workout feel harder and increasing the amount of glycogen you burn.  The same thing happens when you lift; dehydration reduces performance, impairs heart rate recovery, decreases the number of reps, and makes the lifts feel harder than normal.

Dehydration also increases injury risk. Your tendons, ligaments, and other bits of connective tissue require optimal hydration to stay supple and strong. Demand too much from a dehydrated Achilles’ tendon and you may regret it.

These things are likely to happen if you fail to rehydrate after drinking and before you train. They are avoidable, provided you rehydrate with some water, salt and lime.

Alcohol Can Impair Your Body Control

Postural control degrades rapidly under the influence of alcohol. Even low-dose alcohol has an immediately negative effect on your ability to control your body through space and time. This has major ramifications for training, particularly full-body, compound lifts like squats, deadlifts, or complex skill-based training. Just as driving after drinking is dangerous, so is lifting (even the day after in many cases).

Alcohol Can Be Bad For Sleep

Alcohol might “knock you out” at the end of the night, but it does not give a restful, restorative sleep.

Alcohol starts by inhibiting melatonin secretion. Yes, when you fall asleep after alcohol, it’s not because of your usual melatonin release. It’s because alcohol is a good old fashioned muscle relaxant and sedative. With alcohol, you’re “forcing the issue,” rather than allowing your circadian clock to gently lull you off to peaceful slumber. This inhibits the growth hormone release that normally follows melatonin-induced sleep onset, so you miss out on the muscle-building, fat-burning effects of a good GH session.

Then, once your body clears the alcohol, you get the “rebound effect”—which throws your sleep cycle into immediate disarray, waking you up, leaving you scrambled and confused, and further disrupting the muscle recovery process.

To top things off, the next day you’ll often feel trashed, hungover, and exhausted. If you were planning on getting in another workout, you’ll have a more difficult time convincing yourself after a night of drinking (and, given the previous point, a more difficult time performing certain workouts as safely).

Alcohol Can Potentiate Fat Storage

If you’re exercising as part of a larger strategy to lose body fat and improve body composition, alcohol can “affect your workout” by impairing fat oxidation. When you drink alcohol, it gets precedent over the other macronutrients. Fat, carb, and protein metabolism all take a back seat to alcohol metabolism. Too many carbs and fatty acids floating around your blood might cause problems in the long term, but ethanol is truly toxic—its removal gets top priority.

This is good for your acute health, but it also means that fat and carb oxidation are suppressed, and any food you consume alongside the alcohol is more likely to be stored as body fat.

The Big Picture: Choosing Wisely

So, never drink? No.

But be smart about it.

Don’t Drink and Then Train

Almost no one is doing this, except rats in studies and guys doing pushup competitions in the alley outside the bar at 2:15 A.M. All the studies indicate that you’ll lose power, strength, endurance, and performance while increasing your risk of injury and getting subpar training effects.

Don’t Drink Every Day

Especially don’t drink to excess every day. Chronic intakes of alcohol mean you’re never quite off the sauce, and studies in alcoholics indicate that chronic drinking does impair hormonal health and reduce muscle protein synthesis.

Keep It Moderate

When you binge on alcohol (1.5 g alcohol per kg of bodyweight or more, about 9 drinks), muscle protein synthesis and the hormonal cascade related to it are blunted for several days. When you drink smaller amounts of alcohol (under 1.5 grams per kg), testosterone actually goes up.

If You’re Going To Drink, Make Sure You’ve Already Worked Out

A hard workout before you drink alcohol improves your ability to metabolize that alcohol, reduces its negative effects, and gives a psychological boost (“I earned this glass of wine”) that improves the subjective experience of drinking. However, your strength may take longer to recover if you decide to drink after a workout, especially if you’re a man. Post-workout alcohol consumption doesn’t seem to affect women’s muscle performance recovery.

If Alcohol Ruins Your Sleep, Know It Will Limit Your Training Adaptation

Either avoid drinking—that’s what I did when I found alcohol had terrible effects on my sleep—or take a few steps to improve your alcohol clearance. Start and finish drinking earlier to give your body more time to clear it out before bed. Try some or all of the hangover prevention methods I outlined here. At the very least, drink water alongside alcohol and (before bed) take some supplemental melatonin and drink salty sparkling mineral water with the juice from a couple limes.

Alcohol has the potential to destroy your gains, impair your sleep, increase your risk of injury, and dehydrate you—but only if you overdo it. Figure out what “overdo it” means for you, and avoid stepping over that line.

How do you handle exercise and alcohol? Does alcohol hurt your training? Have you changed your drinking habits for the sake of training?

Thanks for reading, everyone. Take care.

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References:

Judelson DA, Maresh CM, Yamamoto LM, et al. Effect of hydration state on resistance exercise-induced endocrine markers of anabolism, catabolism, and metabolism. J Appl Physiol. 2008;105(3):816-24.

Logan-sprenger HM, Heigenhauser GJ, Jones GL, Spriet LL. The effect of dehydration on muscle metabolism and time trial performance during prolonged cycling in males. Physiol Rep. 2015;3(8)

Logan-sprenger HM, Heigenhauser GJ, Jones GL, Spriet LL. Increase in skeletal-muscle glycogenolysis and perceived exertion with progressive dehydration during cycling in hydrated men. Int J Sport Nutr Exerc Metab. 2013;23(3):220-9.

Kraft JA, Green JM, Bishop PA, Richardson MT, Neggers YH, Leeper JD. Impact of dehydration on a full body resistance exercise protocol. Eur J Appl Physiol. 2010;109(2):259-67.

Modig F, Patel M, Magnusson M, Fransson PA. Study I: effects of 0.06% and 0.10% blood alcohol concentration on human postural control. Gait Posture. 2012;35(3):410-8.

Kakarla P, Kesireddy S, Christiaan L. Exercise training with ageing protects against ethanol induced myocardial glutathione homeostasis. Free Radic Res. 2008;42(5):428-34.

Barnes MJ, Mündel T, Stannard SR. Acute alcohol consumption aggravates the decline in muscle performance following strenuous eccentric exercise. J Sci Med Sport. 2010;13(1):189-93.

Preedy VR, Paice A, Mantle D, Dhillon AS, Palmer TN, Peters TJ. Alcoholic myopathy: biochemical mechanisms. Drug Alcohol Depend. 2001;63(3):199-205.

The post How Does Alcohol Affect a Workout? appeared first on Mark’s Daily Apple.

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For today’s edition of Dear Mark, I’m answering four questions. First, is air-frying gentler than deep-frying? Does it produce less acrylamide? Second, what do I think of a reader’s Primal-style plant-based way of eating? It’s actually quite good. Third, why didn’t I mention the Perfect Health Diet in last week’s post on top trending diets? And last, did I make a typo or grammatical error when I wrote “bad rap”?

Let’s find out:

Russian squat thing is great.

Anyone know if air frying potatoes creates acrylamide to the same degree normal deep frying does?

Wasn’t it? It’ll obviously never happen around here, and it would raise all sorts of civil rights issues if adopted across the board, but man would it be effective.

Turns out that air-frying is way more gentle on potatoes than deep-frying. Compared to deep-frying, air-frying potatoes reduced acrylamide formation by 90%.

And if you “pre-treated” the potatoes with a solution of nicotinic acid, citric acid, glycine, and salt, you’d get a further reduction of 80-90%.

I don’t know. The initial 90% sounds good enough that I’d hold off on that strange pre-treatment. In fact, I bet you could get a decent approximation of the benefits with a simple marinade on the potatoes. Maybe lemon juice and thyme?

Great round up Mark!

I’m just wondering what you think of a very ‘primal’ 95% vegan like diet?

I have Chron’s disease, but despite the data showing a carnivorous diet helps IBD I have found through a lot of trial and error I cannot handle cooked muscle or organ meat of any kind without a lot of pain.

I eat a vast variety of gently cooked vegetables, massaged salads, cooked and cooled legumes (also potatoes) Seaweed, some cooked and cooled buckwheat & rice, plus the occasional raw dozen oysters or fresh sashimi (Around once a week, expensive & I find it feels like enough). I only use olive oil (I have a Mediterranean background and find I tolerate it better than Butter or coconut oil)

I feel best on this, but wouldn’t really quantify it as any of the above diets.

Anything you think I could be missing out on eating this way? I’m a slim female with a high glucose tolerance if that helps.

Cheers Sophie

That’s a solid way to vegan. It’s quite close to what I recommend plant-based dieters do. You’re eating real food. You’re eating actual plants, not plant-based junk food. You’re avoiding seed oils. You’re eating oysters and raw fish—that’s huge. You’re treating your legumes right, and you don’t appear to be overly reliant on grains. Rice is one of the more innocuous grains, and buckwheat is actually a pseudo-cereal (and quite a nutrient-dense one at that).

A few suggestions:

Supplement creatine. It’s only found in red meat and fish, and most vegans are deficient. Correcting the deficiency tends to improve cognitive function. Since you eat fish once a week, you won’t be quite as deficient as others, but it’s still a good idea (and really inexpensive) to take 5 grams a day. Here’s a good creatine supplement.

Supplement carnosine and taurine. These are two other nutrients found primarily/only in animal foods. They act as antioxidants in the brain and play big roles in health and disease. Here’s a good carnosine supplement. Here’s a good taurine supplement.

Eat some raw egg yolks. I love a handful of raw egg yolks. One of my favorite ways to get choline, a true nootropic. It’s a decent, gentle source of uncooked high quality animal protein, too, which you can probably use.

How could you not mention the Perfect Health Diet?

The Perfect Health Diet is a great way to eat. Back in 2012, I even wrote the foreword to The Perfect Health Diet book. The problem is that it doesn’t qualify as a “popular diet trend.” It should be. I’d love for Dr. Oz to plug the PHD, for Oprah to include it in her book club. The world would be a much healthier place. But that’s not where we are.

The article was designed to inform newcomers to the diet scene while still providing enough meat for the more advanced readers. There just aren’t all that many newcomers looking for info on the Perfect Health Diet.

Speaking of which, if you guys have noticed a dearth of activity on Paul Jaminet’s part, it’s for good reason: He and his wife have been developing a new cancer drug that, according to his preliminary animal research, looks to be effective against every tumor they tested. Even the really malignant ones. Phase 1 human trials are set to begin in 2020. I really, really hope it all works out.

Typo heads-up…
You said: “Atkins gets a bad rap”. It should be Atkins gets a bad “rep”. The correct word (rep) is short for reputation. Thought you might like to know. Loved the post though!

Thanks for the tip!

I actually intended to use “rap,” though, in the sense of “criticism.” Think of the “rap sheet,” a list of a person’s crimes or offenses. Or “rap” as in “sharp blow,” sort of a physical manifestation of criticism or reprimand.

That’s it for today, folks. Thanks for reading and be sure to comment down below if you have any input or additional questions.

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References:

Sansano M, Juan-borrás M, Escriche I, Andrés A, Heredia A. Effect of pretreatments and air-frying, a novel technology, on acrylamide generation in fried potatoes. J Food Sci. 2015;80(5):T1120-8.

Antioxidant activity of carnosine, homocarnosine, and anserine present in muscle and brain. Proceedings of the National Academy of Sciences. 1988;85(9):3175.

Yamori Y, Taguchi T, Hamada A, Kunimasa K, Mori H, Mori M. Taurine in health and diseases: consistent evidence from experimental and epidemiological studies. J Biomed Sci. 2010;17 Suppl 1:S6.

The post Dear Mark: Air-Frying, “Primal” Vegan-ish, Perfect Heath Diet, and Bad Rep or Rap appeared first on Mark’s Daily Apple.

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A few months ago, I explored the benefits and applications of cold therapy. Today, I’m going to talk about the benefits and applications of heat therapy—one of the most ubiquitous and ancestral therapies in the history of humankind. You name a culture and—as long as they didn’t live in perpetual tropical heat—they probably had some form of heat therapy. Native Americans had the sweat lodge, those of Central America the temazcal. The Romans had the thermae, which they picked up and refined from the Greeks. Other famous traditions include Finnish saunas, Russian banyas, Turkish hammams, Japanese sentó (or the natural spring-fed onsen), and the Korean jjimjilbang. People really like the heat.

Right off the bat, that’s one major benefit to heat therapy compared to cold: It’s an easy sell. “You can luxuriate in a sauna for half an hour or lower your naked body, genitals first, into a bathtub filled with ice water. Your choice.” People are far more likely to sit in the hot room for 20 minutes than they are to sit in an ice bath for 3 minutes or even take a cold shower. Short-term heat exposure is generally regarded as pleasant. Cold exposure is generally regarded as torture. If heat therapy offers legit health benefits, this is a major point in its favor. So, does it?

Oh, yes.

In a recent review of the available observational studies, controlled trials, and interventions, researchers found evidence that sauna usage has an impressive array of beneficial effects on health and wellness:

  • Increased lifespan and decreased early mortality.
  • Reduced cardiovascular disease.
  • Lowered blood pressure.
  • Improved cognitive function and reduced the risk of neurodegenerative disease.
  • Improved arthritis symptoms.

What’s going on here? How could sitting in a hot room do so many good things?

Stress, in a word. One of the coolest things about us is that encountering, facing down, and then growing resistance to one type of stress tends to make us better at dealing with stress from other sources. A 30-minute sauna session at 174 ºF/80 ºC raises body temperature by almost 1 degree C, spikes your flight-or-flight hormones, raises cortisol, and triggers a powerful hormetic response by the rest of your body. That’s a stressor. After such a session, subjects report feeling “calm” and “pleasant.” This isn’t a surprise. Intense exercise also raises cortisol in the short term. And like regular exercise, longer term sauna usage (daily for four weeks in one study) actually reduces stress hormones.  It’s a classic hormetic response, where acute doses of the stressor increase oxidative stress enough to provoke a compensatory adaptation by the organism.

What does this sauna-induced hormetic stress do for us?

Benefits of Heat Therapy

It reduces oxidative stress. Short term, it increases stress (that’s why we see the transient spike in cortisol and other stress hormones). Long term, it reduces oxidative stress. Long-term sauna use has an inverse association with levels of C-reactive protein (CRP), a “catch-all” biomarker for oxidative stress and inflammation. The more often you use the sauna, the lower your CRP.

It may reduce mortality. The more frequently a person visits the sauna, the lower his risk of premature death from heart attack and all causes. There is a dose-response relationship happening here, which has me leaning toward “causal.” Those using the sauna two to three times a week had a 23% lower risk of fatal heart attack compared to men who used it just once a week. Men who used the sauna four to seven times a week had a 48% reduced risk of fatal heart attack compared to once-a-weekers. The more frequently men used the sauna, the greater the protection (for other causes of mortality, too).

It improves vascular function. A single bout of sauna (or exercise, for that matter) reduces vascular resistance—the amount your blood vessels “resist” blood flow—in hypertensive patients for up to two hours.

It’s good against type 2 diabetes. Sauna use has been shown to improve almost every marker related to type 2 diabetes, including insulin sensitivity, fasting blood sugar, glycated hemoglobin, and body fat levels.

It can improve depression scores. Patients with depression who underwent heat therapy saw improvements in their Hamilton Depression Rating.

If you’re an athlete, or exercise at all, you should try the sauna. Training magnifies the benefits of the sauna.

Finally, pairing exercise and heat therapy together is a boon for cardiovascular health. For instance, people who frequent the sauna and the gym have a drastically lower risk of heart attack death than people who do either alone. That combo also reduces 24-hour blood pressure in hypertensive patients and confers special protection against all-cause mortality above and beyond either variable alone.

Post-Workout Benefits

Post-workout sauna sessions improve endurance performance in runners: For three weeks, endurance runners sat in 89° C (+/- 2° C) humid saunas for 31 minutes following training sessions. This amounted to an average of 12.7 sauna sessions per runner. Relative to control (no sauna), sauna use increased time to exhaustion by 32%, plasma cell volume by 7.1%, and red cell volume by 3.2% (both plasma cell and red cell volume are markers of increased endurance performance).

Post-workout sauna use increases plasma volume in male cyclists: Following training sessions, cyclists sat in 87° C, 11% humidity saunas for 30 minutes. Just four sessions were sufficient to expand plasma volume. This is important because increasing plasma volume improves heat dissipation, thermoregulation, heart rate, and cardiac stroke volume during exercise.

Post-workout sauna—either dry or steam—can also alleviate muscle fatigue.

How About Pre-Workout?

The effects are more mixed. In one study, pre-workout sauna reduced strength endurance and 1 rep max leg press, had no effect on 1 rep max bench press, and improved maximum power (vertical leap). Another study found that in female athletes but not in males, maximum power decreases after sauna use. It’s possible that these performance disturbances are caused by dehydration rather than the heat itself, so make sure you rehydrate if you’re planning on training after a sauna session.

If you want to apply heat pre-workout without overdoing it, I’ve always liked a nice hot bath to help limber up, mobilize my joints, and clear out any stiffness for the coming workout session.

Oh, and It Can Help You Detox

I was going to write the full word “detoxification,” but I figured I’d write “detox” just to trigger the hardcore skeptics reading this…. Heat exposure can augment your natural detoxification capacities by at least two mechanisms.

First, exposure to extreme heat increases something called heat shock proteins, or HSPs. HSPs are responsible for many of the benefits of heat therapy, including enacting beneficial hormetic effects on our detoxification capacity. They trigger compensatory adaptations and activate antioxidant defenses in the blood of healthy volunteers. They even increase regeneration of the body’s main detoxifying organ—the liver—after it’s been damaged.

Second, contrary to popular belief, sweating can aid detoxification. Sweat itself contains bioaccumulated toxins, including BPA—even when it doesn’t show up in the blood or urine. Sweat also contains certain phthalate compounds and their metabolites, none of which we want. Sweat also contains arsenic and lead in people exposed to high levels of the metals. Sweating may even improve the function of another important detoxification organ—the kidney—by restoring nitrogen excretion in people with kidney disease. In one study, police officers with chronic illnesses caused by exposure to high levels of meth lab chemicals experienced major improvements after sauna therapy.

What If You Don’t Have Access To a Sauna?

There are other options.

Steam rooms work. Only problem with them is it’s difficult to remain in one long enough to trigger the necessary stress response. Saunas, with their dry heat, are easier to stick with. Steam rooms feel different enough that I wonder if there’s something unique about them. Not enough evidence to go on, unfortunately. Perhaps I can revisit this later.

Jacuzzis and hot baths work. A recent paper found that taking regular hot baths at home improved insulin sensitivity and increased nitric oxide synthase activity about as much as working out. Another found that, compared to showering, bathing improved mood, perceived stress, blood flow, and accumulation of metabolic waste products.

You could probably sit in a black car on a hot day with the windows rolled up and get an effect.

Just get hot, as hot as you can stand. Then stay a little longer. (As always, be sure to talk to your doctor. Certain conditions and scenarios, like pregnancy, require extra caution with saunas or other forms of heat therapy.)

Have you used the sauna? Are you a regular attendee? Or do you use other means of heat therapy? I’m curious to hear your experiences, tips, and stories below.

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References:

Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence. Mayo Clin Proc. 2018;93(8):1111-1121.

Leppäluoto J. Human thermoregulation in sauna. Ann Clin Res. 1988;20(4):240-3.

Sutkowy P, Wo?niak A, Rajewski P. Single whole-body cryostimulation procedure versus single dry sauna bath: comparison of oxidative impact on healthy male volunteers. Biomed Res Int. 2015;2015:406353.

Laukkanen JA, Laukkanen T. Sauna bathing and systemic inflammation. Eur J Epidemiol. 2018;33(3):351-353.

Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med. 2015;175(4):542-8.

Krause M, Ludwig MS, Heck TG, Takahashi HK. Heat shock proteins and heat therapy for type 2 diabetes: pros and cons. Curr Opin Clin Nutr Metab Care. 2015;18(4):374-80.

Laukkanen JA, Laukkanen T, Khan H, Babar M, Kunutsor SK. Combined Effect of Sauna Bathing and Cardiorespiratory Fitness on the Risk of Sudden Cardiac Deaths in Caucasian Men: A Long-term Prospective Cohort Study. Prog Cardiovasc Dis. 2018;60(6):635-641.

Kunutsor SK, Khan H, Laukkanen T, Laukkanen JA. Joint associations of sauna bathing and cardiorespiratory fitness on cardiovascular and all-cause mortality risk: a long-term prospective cohort study. Ann Med. 2018;50(2):139-146.

Gayda M, Paillard F, Sosner P, et al. Effects of sauna alone and postexercise sauna baths on blood pressure and hemodynamic variables in patients with untreated hypertension. J Clin Hypertens (Greenwich). 2012;14(8):553-60.

Hedley AM, Climstein M, Hansen R. The effects of acute heat exposure on muscular strength, muscular endurance, and muscular power in the euhydrated athlete. J Strength Cond Res. 2002;16(3):353-8.

Gutiérrez A, Mesa JL, Ruiz JR, Chirosa LJ, Castillo MJ. Sauna-induced rapid weight loss decreases explosive power in women but not in men. Int J Sports Med. 2003;24(7):518-22.

Genuis SJ, Birkholz D, Rodushkin I, Beesoon S. Blood, urine, and sweat (BUS) study: monitoring and elimination of bioaccumulated toxic elements. Arch Environ Contam Toxicol. 2011;61(2):344-57.

Genuis SJ, Beesoon S, Birkholz D, Lobo RA. Human excretion of bisphenol A: blood, urine, and sweat (BUS) study. J Environ Public Health. 2012;2012:185731.

Khodarev VN, Zhemchuzhnova NL, Olempieva EV, Kuz’menko NV. [The influence of general infrared sauna on the antioxidant systems in the blood of volunteers]. Vopr Kurortol Fizioter Lech Fiz Kult. 2013;(5):10-3.

Shi Q, Dong Z, Wei H. The involvement of heat shock proteins in murine liver regeneration. Cell Mol Immunol. 2007;4(1):53-7.

Mccarty MF, Barroso-aranda J, Contreras F. Regular thermal therapy may promote insulin sensitivity while boosting expression of endothelial nitric oxide synthase–effects comparable to those of exercise training. Med Hypotheses. 2009;73(1):103-5.

Goto Y, Hayasaka S, Kurihara S, Nakamura Y. Physical and Mental Effects of Bathing: A Randomized Intervention Study. Evid Based Complement Alternat Med. 2018;2018:9521086.

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Morning, everyone. Hope you all enjoyed a happy and safe holiday. I’m turning over the reins to one of our Worker Bees today as I spend some time on a book project (more to come on that). I know many of you have asked about natural skin care ideas in the comment board, and we’ve got some great suggestions today. I hope you’ll welcome our Worker Bee to the fold (she just joined us recently) and offer up your own ideas below. (And for those who may have missed it, I shared several of my own favorites last spring.) Have a good end to the week. 

Spend any amount of time perusing the shelves at your local supermarket or beauty supply store and you may notice that all the skin care products have something in common: a long ingredient list. I’m afraid to say most commercially-packaged bottles, jars, and tubes contain potentially harmful ingredients in the form of preservatives, stabilizers, artificial colors, and/or added fragrances, which could have negative long-term health effects when absorbed through the skin.

Thankfully, there are plenty of all-natural skin care options out there that not only provide better results, but usually cost a fraction of what you’d pay for the store-bought version. Here are 10 skin care solutions backed up by research (and self-experiment).

1. Scrub With Sea Salt

Sea salt is one of the best all-natural exfoliators, and chances are it’s already hiding in your kitchen cabinet. While most of the time we can let nature take its course, now and then we might exfoliate as a means to remove layers of dead skin cells when our skin is itchy and flaky or to encourage skin cell turnover for a fresher appearance. Sea salt is also full of nutrients found in sea water—and in our bodies—including calcium, magnesium, and potassium. Combine sea salt with raw honey or coconut oil and gently rub it into your skin. Just be sure to check the texture of the salt before you use it on your face: the salt should be smooth, with no rough edges. You want it to gently remove that layer of dead skin cells, not rub your skin raw.

2. Heal Skin With Raw Honey

Raw honey is widely recognized for its antimicrobial properties, and has long been used as a natural treatment for wounds and burns. This sweet, golden nectar contains a variety of proteins, amino acids, vitamins, enzymes, and minerals, which all work in tandem to speed the healing process. After cleaning skin, apply a layer of honey directly onto scars, cuts, and burns. Make sure to choose raw, unprocessed honey, as the commercial honey you’ll find in most grocery stores is highly processed and lacking in nutrients.

3. Moisturize With Avocado Oil

Pure avocado oil is a great stand-in for commercial creams and lotions, which are usually loaded with questionable ingredients you can barely pronounce. There’s no secret as to what you’re getting in a bottle of avocado oil: pure, fatty goodness. It’s packed with good-for-your-skin nutrients, like carotenoids, healthy fat, and vitamins A, D and E. Together, these nutrients can boost collagen production, fade age spots, calm inflammation, and treat sunburns. Pour a few drops in your hand and work it into clean, dry skin. (By the way, it’s part of Mark’s personal daily routine.)

4. Clean Skin With Apple Cider Vinegar

Apple cider vinegar is a potent anti-fungal solution that’s especially helpful for acne prevention. To make it, producers ferment cider so the sugars turn into alcohol, and ferment it again so the alcohol turns into acetic acid. It’s this acetic acid—as well as the lactic acid, citric acid, and succinic acid—that makes apple cider vinegar such an effective cleanser. Some studies have even shown that these acids can prevent acne-causing bacteria from growing. Soak a cotton ball in apple cider vinegar and use it as a facial toner morning and night.

5. Treat Acne With Tea Tree Oil

In a recent pilot study published in the Australasian Journal of Dermatology, researchers found that a treatment of tea tree oil gel was more effective at improving mild to moderate acne than a face wash. You can a find pre-made tea tree oil cleanser or make your own by adding a few drops of pure tea tree essential oil to honey. In general, tea tree oil is well-tolerated, but it may cause peeling and dryness for some people.

6. Soothe Redness With Aloe Vera

For soothing sunburns, fighting inflammation, and tempering itchiness, look no further than the aloe vera. This tropical plant contains a host of good-for-you ingredients including vitamins, minerals, fatty acids, and enzymes. What’s more, aloe has been shown to have anti-microbial effects, making it the ideal all-natural therapy for healing skin. Look for aloe gel with at least 97.5 percent aloe (or keep your own collection of aloe plants in your home or garden).

7. Moisturize With Shea Butter

It’s no secret: Shea butter smooths dry skin like no other. This fatty substance—packed with stearic, palmitic, linoleic, and oleic acids, as well as vitamins E and A—has already been incorporated into commercial creams and lotions. Like most things, however, shea butter is best when used in its purest, rawest form, so seek out unrefined shea butter. It can be used as is or mixed with essential oils. Just keep in mind that those with tree nut allergies should avoid shea butter. An added bonus: a study in the American Journal of Life Sciences suggests that shea butter can also boost collagen production.

8. Remove Makeup With Jojoba Oil

Swap out commercial makeup removers—which usually contain harsh chemicals—with a healthier option: jojoba oil. You can even use jojoba oil to wipe away eye makeup. It’s not only safe to use on sensitive skin, including the eye area, but it’s moisturizing. Apply jojoba oil to a cloth or cotton ball and use it to gently clean off makeup and bacteria.

9. Shave With Coconut Oil

Commercial shaving lotions and creams often fall short on their promise to protect the skin from irritation and razor burn. A very link layer of coconut oil can deliver on both fronts—plus, it smells amazing! Thanks to its low molecular weight and ability to bond to proteins, coconut oil can sink deeper into the skin than other oils. Scoop a small amount into the palm of your hand to warm it up and apply directly onto the area to be shaved. I’d recommend washing your hands with soap and water before picking up the razor, however, since coconut oil will leave your hands slippery.

10. Protect Skin With Lemon Essential Oil

Lemon oil, like other citrus oils, has powerful antioxidant properties (and a fresh, energizing scent). One natural compound in lemon essential oil in particular has been shown to be capable of protecting skin against the aging effects of free radical damage. Lemon essential oil can even fade scars and age spots. Safely dilute for everyday use by mixing a few drops of lemon essential oil with a simple “base” like jojoba or avocado oil and massage into your skin.

Here are ten ideas to try. What would you add? Share your recommendations in the comments below, and thanks for reading.

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Inline Carnivore Diet.jpegAll-meat diets are growing in popularity. There are the cryptocurrency carnivores. There’s the daughter of the ascendant Jordan B. Peterson, Mikhaila Peterson, who’s using a carnivorous diet to stave off a severe autoimmune disease that almost killed her as a child. The most prominent carnivore these days, Dr. Shawn Baker (who appears to eat only grilled ribeyes (at home) and burger patties (on the go), recently appeared on the Joe Rogan Experience and Robb Wolf’s podcast, and is always breaking world records on the rower. Tons of other folks are eating steak and little else—and loving it. There are Facebook groups and subreddits and Twitter subcultures devoted to carnivorous dieting.

What do I think?

I’m no carnivore. I love my Big Ass Salads, my avocados, my steamed broccoli dipped in butter. My blackberries, blueberries, raspberries, and strawberries. My spoonful of coconut butter.

Yet, I get the appeal.

We’ve been eating meat for three million years. Its caloric-and-nutrient density allowed us to dispense with the large guts needed to digest fibrous plant matter and build massive, energy-hogging brains. There isn’t a traditional culture on Earth that wholly abstains or abstained from animal products. Nearly every human being who ever lived ate meat whenever he or she could get it.

Thus, meat appears to be the “baseline food” for humans. If you look past the cultural conditioning that tries to convince us that meat will give us heart disease, cancer, and diabetes, meat looks pretty damn good as a place to start.

The question is if it’s where we should stay exclusively…. 

All this said, I’m skeptical about the “steak and water” or “ground beef and water” diets of modern carnivory. Let me explain….

A Few Key Arguments For It (and My Feedback)

“In its natural state, meat is relatively safe as far as toxins go.”

Animals can run and bite and claw and fly to get away from predators; most don’t need to employ any chemical warfare that causes problems when you eat the meat. Sure, allergies and intolerances can arise, like if you get bitten by the Lone Star tick and pick up a red meat allergy, but those are quite rare.

“Whereas plants’ phytonutrients are pesticides.”

This is technically true. They are toxins the plant produces to dissuade consumption by predators—toxins that the plants manufacture to maim, poison, kill, or even just make life uncomfortable for the animals who eat it.

But just as we can do with many other “harmful” inputs, we tend to treat plant phytonutrients as hormetic stressors that make us stronger, healthier, and more robust. 

There’s an upper limit, of course. And many of the phytonutrients have been primarily applied either to populations eating normal omnivorous, often downright unhealthy diets or to unhealthy subjects trying to improve a disease marker. As I’ve said before, there aren’t any real studies in healthy human carnivores, so we don’t know one way or the other whether the promising results of the extant studies apply to people eating only animal products. 

“Meat nutrients are highly bioavailable.”

The protein has all the amino acids we need to live and thrive. We readily absorb and utilize the vitamins and minerals in meat; they already come in “animal form,” requiring little to no conversion before we can start incorporating them into our physiology. Plant nutrients usually undergo a conversion process before humans can utilize them, and not every human has the same conversion capacity.

Some of those essential and/or helpful nutrients only occur in meat, like creatine, carnosine, vitamin B12. There’s literally no realistic way to obtain them without relying on supplementation, which didn’t exist until the last hundred years.

“Nutrient requirement studies don’t apply to us.”

I could see that. They haven’t tested the requirements for selenium, magnesium, and iodine on a zero-carb carnivorous diet. Do they go down? Can you therefore get by and thrive on lower intakes—the low levels found in muscle meat?

It’s a tough call.

It hasn’t been empirically tested. That’s true. It largely hasn’t undergone a series of RCTs. You can’t pull up a Cochrane meta-analysis of carnivore studies. All we really have are anecdotes.

I’m not disregarding the power or relevance of anecdotes and testimonials. Those are real. They’re not all suffering from a mass delusion. They’re not all lying. Peer-reviewed? No. Admissible in a scientific paper? Not unless you call it a case study. When you’re there in the room with someone pouring their heart out because something you wrote helped them drop 50 pounds and reclaim their lives, you don’t go “Yeah, but where are the clinical trials?” At some point, the weight of anecdotes adds up to something substantial, something suggestive. And hey, if it’s working for you, there’s no arguing that. 

But I can’t point to anything solid and totally objective in the research. Not yet anyway.

Still, any time you embark on a historically unprecedented way of eating, whether it’s pure muscle meat carnivore or vegan, you should be a little more careful about what you think you know. 

What Do We Know About Carnivory in Human History?

We don’t know if there have been any purely carnivorous human cultures. We haven’t found any yet, and you can’t prove a negative, so I won’t say “there were none.”

In all the best candidates so far, though, plants sneak into the diets. The Inuit actually utilized a wide variety of plant foods including berries, sea vegetables, lichens, and rhizomes. They made tea from pine needles, which are high in vitamin C and polyphenols.  The Sami of Finland, who primarily live off a low-carb, high-fat diet of meat, fish, and reindeer milk (I have to imagine that’s coming to Whole Foods soon), also gather wild plant foods, particularly berries and mushrooms (Finland’s forests produce 500 million kg of berries and over 2 billion kg of mushrooms each year!), sometimes even feeding their reindeer hallucinogenic mushrooms to produce psychoactive urine. The Maasai are known for their meat, milk, and blood diets, but they often traded for plant foods like bananas, yams, and taro, too, and they cooked their meat with anti-parasitic spices, drank bitter (read: tannin- and polyphenol-rich) herb tea on a regular basis, and used dozens of plants as medicines (PDF). Even Neanderthals used plants as food and medicine, we’re learning.

Even if we discover evidence of carnivory in human prehistory or in some extant group, the emerging science of genetic ancestral differences suggests that the habitual diets of our recent ancestors shapes the optimal diet for us today. If your close ancestors weren’t carnivores, you might not have the adaptations necessary to thrive on an all-meat diet.

Still, what about Vilhjamjur Stefansson, an Arctic explorer who came away very impressed with the native Inuit diet and underwent a series of studies on the effect of an all-meat diet in man? He and a colleague did great for over a year eating only meat. But Stefansson wasn’t eating ground beef. In his own words, he ate “steaks, chops, brains fried in bacon fat, boiled short-ribs, chicken, fish, liver, and bacon.” Definitely carnivorous. Definitely not just steak or ground beef, as many modern carnivores seem to be eating. All those “weird” cuts gave him critical micronutrients otherwise difficult to get from just steak.

How To Best Optimize a Carnivore Diet

While you won’t find me switching to the carnivore side, if I were to do a carnivorous diet, here’s how I’d try to optimize it (and why).

Take Magnesium

A recent paper showed that the majority of people following a “paleolithic ketogenic diet” with at least 70% of calories from animal foods and including offal had adequate serum magnesium levels. That’s a great start. But earlier studies show that serum magnesium may not be the definitive marker. A person can have normal serum levels but inadequate tissue levels—and in the tissues is where magnesium does its work. A person can have normal serum levels but still be deficient.

Eat Eggs

They’re not quite animals, but they contain everything you need to build a bird from scratch. That’s cool·—bite-sized whole animal.

Eat Liver

Liver is unabashedly animal flesh. It absolutely qualifies for a carnivorous diet. Loaded with choline, folate, vitamin A, copper, and iron, it’s nature’s most bioavailable multivitamin. There’s no reason not to include it. If you get your hands on some fish livers, you’ll get a ton of vitamin D along for the ride.

  • There’s frozen liver tabs, where people dice up liver into little chunks and swallow them hole.
  • There’s liver smoothies, where absolute savages blend raw liver and drink it. I know a guy who fixed severe iron deficiency by drinking raw chicken liver orange juice smoothies, with the vitamin C in OJ meant to enhance iron absorption.
  • Liver is also great sauteed with fish sauce, citrus, salt, pepper, and sesame oil. Do it quick, don’t overcook.

Eat Seafood

A few oysters, some mussels, a filet of wild sockeye salmon… You’ll get vitamin D, long-chained omega-3s (which tend to rare even in pastured ruminant flesh), selenium, iodine, copper, iron, manganese. Not every meal has to—or should— be a New York strip. 

Implement Intermittent Fasts On a Regular Basis

A constant influx of muscle meat will keep mTOR topped up. That’s great for muscle growth and general robustness. Just do something to stop the protein intake for a day or two to  lest you start fueling unwanted growths.

Treat Spices and Other Low/Non-Calorie Plant Foods As Medicinal Supplements That Don’t “Count”

All the nearly-carnivorous cultures we have good data on did similar things, using bitter herbs and barks and the like as supplements to their diets. You’re not getting calories from this stuff. You’re getting non-caloric compounds that provide health benefits.

Get the Best Quality Meat You Can Find and Afford

While I’m sure a diet of snare-caught hare, Alaskan elk, and choice sockeye salmon you wrest from the grasp of picky grizzlies poised over rivers preparing for a long winter would be ideal, it’s not necessary. Yes, grass-fed and -finished/pastured as well as organic are ideal, but do the best you can with what you have.

Use Bone Broth

It’s a great way to get collagen and the glycine it contains to balance out all the methionine you’re eating, especially if you’re doing the muscle meat-only thing and avoiding most gelatinous cuts of meat.  Make it yourself or buy. Collagen supplementation, of course, works here, too.

The carnivore diet isn’t for me. I like plants way too much. But I’m cautiously optimistic that it could work for more people than you’d expect, provided they heed as many of my suggestions as possible.

That’s it for me, folks. What about you? Have any experience eating a carnivorous diet? Interested in trying? Let me know what you know!

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