Mark Sisson's Blog, page 11

All About the New Obesity Drugs

The United States and much of the industrialized world has an obesity problem. The environment is obesogenic. The food is delicious and engineered by PhDs to target and titillate our brain reward systems. The portions are enormous. Half of our waking hours are devoted to sitting slumped over in a chair staring into an electronic device—for work and for pleasure. We eat carbs we don’t need, use seed oils in quantities our bodies haven’t adapted to handling, and largely avoid the most important food our ancestors evolved consuming: animal protein. The cheapest food is the worst and the healthiest is the most expensive.

It’s a big mess, and many people resist the dietary and lifestyle changes required to fix the issue. It’s no wonder many people have been hoping for a pill or medication that fixes the obesity problem. 

Over the last few years, scientists appear to have found a class of medications that can help: GLP-1 agonists like semaglutide (sold as Ozempic® and Wegovy®) and liraglutide (aka Victoza® and Saxenda®). Hollywood celebrities and fashion models are taking these drugs in vast quantities. Silicon Valley tech circles are taking them—Elon Musk, most famously, is on semaglutide. In short, almost everyone with the money and access and weight to lose is using semaglutide and related drugs to stay thin. I know several docs who prescribe it for overweight patients.

Originally designed as diabetes drugs, these agents mimic the effects of glucagon-like peptide-1, an incretin hormone the body releases when you eat food. GLP-1 has two primary effects:

It stimulates the release of insulin and inhibits the release of glucagon. It slows down gastric motility and the passage of food through the gut, keeping you full for longer. 

GLP-1 is a hormone that “signals” fullness. There are all sorts of positive downstream effects as well:

Lower glucose productionMore glucose uptake by musclesIncreased insulin sensitivity Lower blood pressureImproved endothelial function

The new weight loss drugs bind to the receptors that normally interact with GLP-1 and elicit the same effect as the hormone itself. 

Do the obesity drugs work for losing weight?

Yes. They work. Out of all the weight loss drugs the industry has pushed and tested and tried, the GLP-1 agonists actually help people lose weight.

A recent paper tested semaglutide for two years in obese people.https://www.nature.com/articles/s4159... The average starting body weight was 106 kilos, or 233 pounds. Average starting BMI was 38. Most were women. One group got the drug, the other got placebo. Both groups were counseled to follow a “behavioral intervention,” which probably means exercise and other typical things.

By 104 weeks, the semaglutide group had lost an average of 15.2 percent of their bodyweight. The placebo group had lost an average of 2.6 percent.

Now, this didn’t make them thin. At the end, most were still overweight or obese. 15 percent of 233 pounds is about 35 pounds. That’s a great improvement, but it’s not enough to get you to a normal body weight. Furthermore, there was a major plateau of weight loss in the semaglutide group around 68 weeks. They didn’t really lose any more weight after that (as a group), and they even started to slightly gain by the end of the study. It was a very minor uptick, but an uptick nonetheless.

Semaglutide wasn’t enough for them. They were still mostly overweight, and the weight wasn’t continuing to come off—and it may have been starting to come back on.

But these drugs aren’t just about weight loss. There are other beneficial effects, too:

Reduced blood pressure.https://pubmed.ncbi.nlm.nih.gov/34047... cravings for junk food.https://pubmed.ncbi.nlm.nih.gov/28266... major cardiovascular events (heart attacks, strokes, etc).https://pubmed.ncbi.nlm.nih.gov/32916... glucose tolerance.https://pubmed.ncbi.nlm.nih.gov/34622... visceral fat.https://www.ncbi.nlm.nih.gov/pmc/arti...

So these obesity drugs also improve other health markers. That’s great and suggests that the effects while you’re taking the drug are mostly positive.

 

I see some potential downsides, however.

Potential Downsides of GLP-1 AgonistsYou probably have to take it for life. A recent paper followed a group of people who had taken semaglutide for over a year and lost a lot of body weight in the process.https://www.ncbi.nlm.nih.gov/pmc/arti... Half of them continued taking the med and the other half got placebo injections. This went on for 48 weeks. Those who were still on the sauce kept most of the weight off. Those who went off the drug quickly regained most of the weight and lost almost all of the other health benefits (blood sugar, blood lipids, blood pressure, etc.).It’s expensive. At least as of now, the monthly cost of a GLP-1 agonist subscription is $1500. Insurance may cover much of that, but you have to be severely overweight or wait til these drugs are prescribed for mild overweight—but even then, assuming you have insurance, someone’s paying.Liraglutide has been shown to increase adipogenesis, the creation of new fat cells, at least in mice.https://www.ncbi.nlm.nih.gov/pmc/arti... Even as the rodents lost weight, they increased the number of fat cells in their body. This is a process that normally occurs in childhood. It’s one reason why childhood obesity is so hard to overcome and so often leads to adult obesity. You have a ton of “extra” fat cells from when you were obese as a kid, so filling them up becomes easier and easier. If liraglutide or semaglutide also increase the creation of new fat cells, what happens when you stop taking it? What happens in five or ten years? Do those “empty” fat cells quickly fill up? It’s an interesting question we simply don’t know the answer to. Yet.GLP-1 agonists increase resting heart rate, with the longer-lasting versions like injectable semaglutide (the most common used for weight loss) leading to sustained and long-lasting rises in resting heart rate.https://pubmed.ncbi.nlm.nih.gov/28086... Whether this portends an increase in health issues down the road remains to be seen, but it’s generally accepted that a higher resting heart rate is a bad thing.GLP-1 agonists cause nausea and diarrhea. They’re actually the most common side effects people complain about, and they may even contribute to the disinterest in food people report. It’s hard to be hungry when you feel like throwing up.GLP-1 agonists cause loss of lean mass.https://www.ncbi.nlm.nih.gov/pmc/arti... This isn’t unique to GLP-1 agonist-related weight loss; it’s typical whenever you lose weight, but anecdotally, it doesn’t seem to happen when people lose weight following a Primal way of eating and exercising. This could potentially be avoided by simply emphasizing protein and making sure to lift heavy things rather than relying on the semaglutide to do all the work.The benefits level off after about 68 weeks. They might continue if you bump up the dose, but that will also increase the chance of side effects like nausea, diarrhea, and any issues related to increased adipogenesis.We don’t know what we don’t know. These are fairly new drugs and we don’t have any good long term (10 to 20 years) data.My Final Take on GLP-1 Agonists

It’s not going to fix obesity. All the studies find that it helps users shed significant body weight but that there’s a lull in the loss. It’s not enough. It’s doesn’t get you past obesity and overweight into true leanness. To do that, you also have to address other aspects of your diet and lifestyle to really make the changes stick and extend them into perpetuity.

I do think it can help people stick to a better diet. While the fanfare focuses on the fact that you can “eat whatever you want” and still lose weight, it’s also been shown to reduce cravings for junk food and starches.https://onlinelibrary.wiley.com/doi/1... A smart use of this drug would be to pair it with a healthy low-carb diet based on whole food that emphasizes animal protein. Whole food so you’re getting the micronutrients you need and protein so you’re getting adequate protein to stave off muscle loss.

Ultimately, most people reading this don’t need semaglutide injections. You’re already willing to do the work and make permanent changes to your diet, lifestyle, and exercise habits that set you up for long term success. But millions of people aren’t. While I have some major reservations about the long term effects of these drugs—after all, I strongly suspect there’s no free lunch when it comes to stuff like this—they may be beneficial on net to people who’d otherwise never consider changing their diet and lifestyle.

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References https://www.nature.com/articles/s41591-022-02026-4https://pubmed.ncbi.nlm.nih.gov/34047443/https://pubmed.ncbi.nlm.nih.gov/28266779/https://pubmed.ncbi.nlm.nih.gov/32916609/https://pubmed.ncbi.nlm.nih.gov/34622228/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089287/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9542252/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307265/https://pubmed.ncbi.nlm.nih.gov/28086882/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089287/https://onlinelibrary.wiley.com/doi/10.1002/oby.23673

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New and Noteworthy: What I Read This Week—Edition 208

Research of the Week

Humans got a lot of their circadian genes from Neanderthals.

Caffeine is anti-inflammatory and hepatoprotective.

Scientists urge regulation of eugenic technologies.

Low-carb, high-fat works, but only if you stay on it.

More air pollution, more anxiety.

New Primal Kitchen Podcasts

Primal Health Coach Radio: 2 Krazy Ketos

Media, Schmedia

Vegans and vegetarians are more likely to be depressed.

Neanderthals were on a high-crab diet.

Interesting Blog Posts

On edible survivors.

Is aging a disease?

Weights before cardio or cardio before weights?

Social Notes

Ask me something.

She makes a good case.

Everything Else

When I listen to this, something deep and old within me responds.

Things I’m Up to and Interested In

Important: People with serious mental illness should exercise regularly.

Awkward: More beef, less depression.

Profession I didn’t know existed: Honey sommelier.

Important reminder: Old people need more protein than younger people, including after exercise.

Can you imagine?: A giant 350 pound penguin.

Question I’m Asking

Should we be able to screen embryos for desirable traits?

Recipe CornerArmenian meat patties.Taiwanese popcorn chicken.Time Capsule

One year ago (Feb 4 – Feb 10)

Why Am I Not Losing Weight?—Well, why not?Winter Survival Tips—Make it out alive.Comment of the Week

“I agree with your idea of make the best choice from the choices you have. Someone told me once that the chemicals released by the body when you stress or condemn yourself do more harm than the one time poor choice that you make.”

-I’d agree with that.

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9 Wrist Mobility and Strengthening Exercises

The importance of wrist mobility and strength are almost impossible to overstate. Without a strong, mobile wrist that can fluidly operate across multiple planes, our ability to grab and manipulate things with our hands would be nearly useless. Without the mobile wrist, our manual dexterity doesn’t really exist—our arms become those pincers people use to pick up trash.

You need adequate wrist mobility, whether you work a keyboard for a living (carpal tunnel syndrome), catch barbells in the rack position, throw projectiles, cradle infants, work on cars, cook, drink coffee out of mugs, wave goodbye, play Ultimate Frisbee, or shoot hoops (with good follow through). If you plan on giving awesome high fives or becoming a dominant arm wrestler or engaging at all with the physical world, you absolutely need mobile, strong, durable wrists.

Seriously, though, adequate wrist mobility is important for everyday life and intense exercise alike.

And yet the wrist is a common weak link. Who’s actively training the wrist? There’s no “wrist day” at the gym. Today that changes. Today you learn the proper way to improve mobility and strength at the wrist.

1. Wrist Rolls

Wrist rolls are simple. Lace your fingers together and, using plenty of push-pull oppositional strength, put your wrists through every possible range of motion. Rotation, flexion, extension, adduction, abduction—just make sure you’re fully extending and fully flexing and fully rotating. Roll them through all ranges of motion.

If you work in front of a computer, I’d recommend doing a few sets of these before and after the work day.

2. Prayer Stretches

Wrist prayer stretches are static stretches that increase in intensity. Put your hands in the prayer position in front of your face: palms and fingers flat against each other, fingers pointing up the ceiling (or sun, or heavens).

Then, while keeping your hands together and fingers still pointing up, bring your hands down toward your navel. Continue descending until you can’t keep your palms touching any longer, then hold it there for 3-5 seconds. Repeat, trying to go lower each time. 12 reps.

3. Palm Lifts

Get on your hand and knees, hands flat on the floor and positioned directly underneath your shoulders (so your arms are a straight line perpendicular to the floor). Slowly lift your palms off the floor while keeping your fingers flat on the ground. At the top, your wrist should be stacked directly over your hand. Try to keep your arm perpendicular to the floor. Hold for 2-3 seconds, then slowly lower your palm to the floor. 2-3 sets of 8-10 reps.

4. Rear Facing Palms Up Wrist Stretch

Get on your hands and knees, back of your hands flat on the floor with the palms facing up and your fingers pointing toward you. This places your wrist in flexion, and by shifting your bodyweight backwards by sitting back on your calves, you go deeper into wrist flexion. Do this carefully and slowly. 2-3 sets of 8-12 reps. Avoid pain, but discomfort is fine.

5. Rear Facing Palms Down Wrist Stretch

Get on your hands and knees, palms of your hands flat on the floor and your fingers point back toward you. This places your wrist in extension, and by shifting your bodyweight backward onto your calves, you go farther into extension. Like the last stretch, be careful, move slowly, and avoid pain. 2-3 sets of 8-12 reps.

6. Weighted Wrist Extension/Flexion

Weighted wrist extensions and flexions strengthen the primary movements our wrists perform. However, many people are biased toward either flexion or extension, and training both patterns with weight can help balance out our strength and mobility.

For extensions:

Hold a dumbbell and place your forearm on a surface with your wrist and hand extending beyond the edge.Your palm should be facing the floor.Your wrist should hang down, bent in passive flexion.Bring your wrist into full extension against the weight’s resistance.Hold for a half second, then slowly lower it back. Repeat.

For flexions:

Hold a dumbbell and place your forearm on a surface with your wrist and hand extending beyond the edge.Your palm should face the ceiling.Your wrist should be hanging in extension.Curl your wrist up into full flexion against the weight’s resistance.Hold for a half second, then slower slower it back. Repeat.

For both movements, use a light dumbbell. This isn’t a movement for massive weight. You’re training small but essential movement patterns. 3 sets of 12-15 reps, each wrist.

7. Weighted Pronation/Supination

Beyond just extension and flexion, the wrist can also perform pronation and supination. These are rotational movements at the wrist, used to do things like handle a screwdriver, turn a door handle, or throw an object. They’re important to get strong, because doing so can give you the kind of “farmer strength” that so many people are missing these days.

Supination is moving your wrist in clockwise rotation—external rotation. Palms down to palms up. Pronation is moving your wrist counterclockwise—internal rotation. Palms up to palms down. You need to train both movements, and the best way I’ve found is to do it while holding a heavy mace, club, or sledgehammer in your hands. It’s simple.

Hold the shaft out in front of you with your elbow bent at 90 degrees.Slowly alternate between supinating and pronating your wrist. Rotate the object counterclockwise, then back up clockwise.Control the motion. Don’t rush through the movement.

Don’t go too heavy. If the object is too heavy, you can always slide your grip up toward the head to shorten the lever. As you get stronger and progress in the movement, you can slide your grip farther down the shaft to lengthen the lever.

2 sets of 6 reps (3 in each direction) with each arm.

8. Weighted Radial/Ulnar Deviation

Radial and ulnar deviation refers to moving the wrist from side to side. Flexing and extending along the “edges” of the wrist joint, like when you unscrew or screw on a pickle jar lid. Here’s how to train it:

Hold the same object you used for the supination/pronation exercise down at your side. Your arm should be straight and perpendicular with the ground.

For radial deviation, the head of the mace will be out in front of you. Raise the head of the mace by bending at the edge of the wrist, as if you’re raising a flag up to the sky. For ulnar deviation, the head of the mace is behind you. Raise the head of the mace behind you by bending at the other edge of the wrist. Again, you can adjust your grip to shorten or lengthen the lever and change the resistance.

2 sets of 6 reps (3 in each direction) with each arm.

9. Static Hold

The wrist is also a stabilizer. A wrist that can hold its position even as gravity and exterior forces try to destabilize is a strong wrist. If you throw a punch, hold a wrist lock, or carry anything heavy, you want a stable wrist.

The best way to train wrist stability is to do static holds with the very same object you used for the last two exercises. You will hold the mace/sledgehammer/club out in front of you with your elbow bent 90°, and that’s all you’ll do. Just hold that position.

That’s it! You don’t have to do all these exercises all the time. They are assistance exercises, not primary ones. But keep them in your back pocket for whenever you have a few minutes to train, be consistent, and in no time at all you’ll notice your wrist mobility and strength have improved and that your performance in other areas has as well.

Take care, everyone.

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Feed a Cold, Starve A Fever? What to Eat (Or Not) When You’re Sick

Cold? Flu? Tummy troubles? I know that I don’t have time to be sick, and I’m sure you don’t either. Luckily I don’t get sick very often anymore, but back in my competitive athlete days, it felt like I was constantly battling one cold, cough, or sinus infection after another.  

Not to toot my own horn, but I chalk up my current good health to my Primal lifestyle. I know for sure that there is a marked before and after—before Primal, when I had a medicine cabinet full of OTC remedies, and after, when I rarely take a sick day. On those occasions when I do detect a tickle in my throat or the first signs of sour stomach, my first course of action is to double down on those aspects of my lifestyle that support a robust immune system, particularly nutrient-dense foods, sleep, and time in the sun.

The food piece is what we’re going to talk about today. Everybody has an opinion about what to eat, or not, when you’re under the weather. I’m not claiming that certain foods can cure the flu or prevent you from coming down with that cold even after your sick kid coughs in your face. But once you’re sick, the name of the game is supporting your immune system by providing it with beneficial nutrients and compounds that could aid it in fighting off the viruses or bacteria that are making you sick in the first place. Some foods will also provide welcome comfort, which is nothing to sneeze at, pun intended. 

(I should note that I’m talking today about recovering from short-term issues—common cold, flu, a bout of food poisoning, that sort of thing. Chronic illnesses are a whole other ballgame.)

But maybe you shouldn’t eat anything at all? You’re probably familiar with the old adage, “Feed a cold, starve a fever.” Are you unintentionally doing more harm than good by eating even supposedly “healing” foods? 

Let’s dive into it. 

Feed a Cold, Starve a Fever? Yes or No?

As usual, it’s complicated.

I’ve covered the issue of fasting with a cold or other illness in depth before, but the short answer is that fasting may be beneficial in the case of a bacterial infection like a sinus infection but probably isn’t beneficial when battling viral illnesses like the common cold or coronaviruses. 

Here’s where it gets complicated: bacterial and viral illnesses often go hand-in-hand. You get sick with a virus, your immune defenses become compromised, and a bacterial illness takes root. Thus, it’s not always clear what, exactly, ails you. 

Furthermore, both can cause fever as part of a desirable immune response. The idea behind starving a fever is that eating increases body temperature (true). If you’re already “too hot,” you don’t want to pile on. That makes sense on face value. However, fever (or rather, the underlying immune response it represents) is a calorie-intensive process. For every 1 degree Celsius increase in body temperature (1.8 degrees Fahrenheit), metabolic rate ramps up by an estimated 10 percent.https://www.ncbi.nlm.nih.gov/pmc/arti... ">1 Fasting when you have a fever, regardless of its origin, may make it harder for your body to continue to launch a robust immune response. That’s why the more common recommendation now is to feed a fever—to meet the increased need for energy and nutrients.  

What if you have no appetite when you’re sick?

Ah, another wrinkle to consider. Appetite loss is a common feature of many types of illness, and not just in humans. Animals across the species spectrum display the same anorexic (literally “without appetite”) response to being sick.

Scientists speculate that this is adaptive for a number of reasons.https://pubmed.ncbi.nlm.nih.gov/3050629/ ">2 When a sick animal isn’t driven to go out and find food, it conserves the energy normally spent hunting or foraging. Instead, it can hunker down in its shelter, where it is also safe from predators it may not be able to evade in its current weakened state. 

Fasting has other benefits as well. Yes, you aren’t taking in nutrients and calories that your immune system could use to fight foreign invaders, but you’re also depriving those same invaders of nutrients that they could use to reproduce and make you sicker.https://pubmed.ncbi.nlm.nih.gov/3050629/ ">3 Fasting can also put you in a state of ketosis. Ketones, particularly beta-hydroxybutyrate, have anti-inflammatory and anti-oxidative effects that can protect against acute illness via a variety of complex metabolic pathways.https://www.ncbi.nlm.nih.gov/pmc/arti... ">4

All things considered, I believe that listening to your body is usually the best course of action. If you don’t have any appetite when you’re sick, there’s probably no problem with—and potentially some benefit to—fasting or just eating small meals. Staying hydrated is very important, though. Make sure you stay on top of fluid intake and consider adding electrolytes (especially if you’re feverish or have diarrhea). If appetite loss lasts longer than a couple days, or if you feel yourself becoming weaker or truly unable to eat, contact your doctor. 

4 Foods to Eat When You’re Sick

Ok, but what if you do have an appetite? What if you want to support your immune system with foods that could potentially help it knock out the illness faster? What then? 

Here’s where I’d start.

1. Bone broth and soups

Bone broth is a rockstar when it comes to helping you feel better. Besides the comfort factor of eating a bowl of steaming chicken soup when you’re not feeling well, research affirms that bone broth can help the body recover from upper respiratory infections.https://pubmed.ncbi.nlm.nih.gov/11035... ">5 Hot liquids also keep mucus flowing which, while gross, allows the body to purge infectious agents. Chicken soup seems to be even more effective in this regard than plain hot water.https://pubmed.ncbi.nlm.nih.gov/359266/ ">6 (I expect any type of bone broth would have the same effect.)

The glycine in bone broth is also a natural sleep aid, and we all know that good sleep is key to recuperating from illness or injury. 

How to get it: 

I’m partial to homemade bone broth (here are recipes for chicken broth and turkey broth in the Instant Pot, for example), but store-bought is fine too. Sip it straight or make a bone broth latte. 

Soups that contain meat and vegetables are great ways to get extra nutrients in. I’m especially partial to garlicky soup. There is some evidence, though not always from very high-quality studies, that antibacterial and antiviral compounds in garlic can be useful in combatting everything from the common cold and flu to dengue virus.https://pubmed.ncbi.nlm.nih.gov/11697... ">7 https://www.ncbi.nlm.nih.gov/pmc/arti... ">8 (I hope it goes without saying that you shouldn’t just chomp down on a few cloves of garlic if you have dengue fever. Get to an emergency room!) 

Long-time readers may recall me mentioning that when I feel a cold coming on, my immediate response is to simmer a whole head of crushed garlic in a pot of broth with cayenne pepper. This Garlic Soup with Mushrooms recipe will have the same effect but with even tastier results. 

Or if you’re feeling hardcore, go ahead and eat a clove or two raw. Some people swear by raw garlic for relieving a sore throat. 

2. Turmeric tea, or golden milk

Golden milk is the perfect mix of ingredients, each of which is immune-supporting in its own right:

Turmeric, which contains the anti-inflammatory and anti-oxidative compound curcuminhttps://www.ncbi.nlm.nih.gov/pmc/arti... ">9Ginger, which may be especially beneficial if you’re experiencing nausea or upset stomachHoney, which research has proven effective for relieving sore throathttps://www.njppp.com/fulltext/28-147... ">10 and coughhttp://cochranelibrary-wiley.com/doi/... ">11 (the latter even better than pharmaceuticals in some cases)Recipe: 

A warm mug is just the ticket when you’re not feeling so hot. This golden milk recipe calls for coconut or almond milk, but if you can do cow milk, they whey and lactoferrin may provide an extra boost, helping you feel better if you’re suffering from a cold.https://pubmed.ncbi.nlm.nih.gov/23642... ">12 

If you’re feeling more savory than sweet and want to harness the power of bone broth while you’re at it, try my Ginger Turmeric Chicken Soup instead. There’s a reason it’s one of the most popular recipes on the blog. 

3. Fermented foods

You already know that fermented foods are important sources of probiotics that help nurture a healthy gut microbiome. I recommend increasing your intake of fermented foods any time you have GI issues or immediately if you must take an antibiotic. 

But fermented foods aren’t just for gut health. In one study, researchers asked college students to supplement with probiotics or a placebo for 12 weeks and tracked the incidence of upper respiratory infections during that time.https://pubmed.ncbi.nlm.nih.gov/23020... ">13 Although both groups were equally likely to get sick, the probiotics group had less severe symptoms, missed fewer days of school, and recovered two days faster on average. A meta-analysis of 20 randomized controlled trials found similar results in children and adults with respiratory illnesses.https://www.ncbi.nlm.nih.gov/pmc/arti... ">14 

How to get them: 

Any fermented foods will do, but a bowl of sauerkraut or a giant deli pickle might not sound great when you’re sick. Some spicy kimchi or sambal oelek would do wonders for clearing stuffed sinuses, though! 

Yogurt or kefir are probably your best bets. The studies mentioned above used various probiotic strains, but Lactobacillus rhamnosus was a common one that you can probably find in yogurt from your grocery store.

4. Smoothies

I’m not much of a smoothie guy generally, but I mention them here for a few reasons. They may be more tolerable than a full meal if you have a stomach ache or sore throat. You can incorporate many of the beneficial items above (yogurt, whey, turmeric, etc.) into a smoothie. And smoothies usually contain other ingredients that support the immune system in their own right, such as berries for polyphenols or greens for magnesium and other vitamins.

Recipes:

Now I’m sure some of you are wondering if smoothies are a good idea since sugar suppresses the immune system. That’s true, but I’m less worried about whole fruit in a smoothie than the boluses of sugar often administered in studies, especially if you aren’t eating all that much period because you’re sick. And smoothies don’t have to be loaded with sugar. Check out these smoothie bowls that feature a variety of healthful ingredients. Or try a keto-friendly avocado smoothie. 

What Should You Eat with an Upset Stomach?

I bring this up because it’s a question I get fairly regularly. The standard advice in this situation is to adhere to a BRAT diet. That’s bananas, rice, applesauce, and toast. Not very Primal sounding.

But let’s stop and examine this for a second. The idea behind the BRAT diet is that these foods are fairly well tolerated when you have nausea, vomiting, or other GI issues. They’re bland and easily digested. 

And on the scope of food options, they’re not all that bad, Primally speaking. Of all the grains, rice is arguably the most innocuous. I don’t encourage people to eat rice, but it’s in that gray area of “not the worst, especially if you’re insulin sensitive and want to add some carbs to your diet.” Bananas are the same. I even declared bananas an underrated superfood once, especially when they are on the greener side. Applesauce is just apples with some of the mastication done for you. You could even do toast in a Primal-friendlier way by choosing one of the many gluten-free (even grain-free) options now widely available. 

Am I going to promote the BRAT diet? Not exactly. If you can tolerate some scrambled eggs or a blended soup, go for that. But if you’re sick and hungry, and a banana or some applesauce is all you can tolerate, I don’t want you wondering if the specter of Sisson is looking over your shoulder and tut-tutting.  

And don’t forget that ginger and peppermint are both great for upset stomach. Try some ginger or peppermint tea, or take a few whiffs of peppermint essential oil before trying to eat something. 

Prevention Is the Best Medicine

In terms of dietary components (vitamins, minerals, polyphenols) that support the immune system, it’s better to keep yourself adequately supplied all the time than to try to load up via foods or supplements while you’re already sick. High-dose vitamin C or zinc might help knock out a cold, for example, but a better strategy is to play offense instead of defense by eating nutrient-dense Primal foods consistently. 

I’m sure some of you have foods you swear by when you’re sick. Maybe it’s a special concoction a parent or grandparent used to whip up—your family’s secret, fail-proof recipe. Share your best  illness-combatting tactics in the comments. 

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References https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2590120/pdf/yjbm00086-0013.pdf https://pubmed.ncbi.nlm.nih.gov/3050629/ https://pubmed.ncbi.nlm.nih.gov/3050629/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362813/ https://pubmed.ncbi.nlm.nih.gov/11035691/ https://pubmed.ncbi.nlm.nih.gov/359266/ https://pubmed.ncbi.nlm.nih.gov/11697022/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434784/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6272784/ https://www.njppp.com/fulltext/28-1478482106.pdf http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD007094.pub5/full https://pubmed.ncbi.nlm.nih.gov/23642947/ https://pubmed.ncbi.nlm.nih.gov/23020819/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4054664/

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New and Noteworthy: What I Read This Week—Edition 207

Research of the Week

No clear evidence that masks help against or prevent infection from respiratory illnesses.

Archaeologists unearth a giant 7-foot sword along with an enormous burial site fit for a … giant?

Status has deep roots.

Insulin and peripheral neuropathy.

The influence of kids on their parents.

New Primal Kitchen Podcasts

Primal Health Coach Radio: Jackie Fletcher

Media, Schmedia

Interesting thoughts on diet and the cause of obesity.

Nice talk on sleep, ketosis, and satiety.

Interesting Blog Posts

The canine model of artificial general intelligence.

How Steph Curry practices.

Social Notes

Gifted kids end up with less alcoholism, less divorce, and overall better “outcomes” except for more suicide.

Wagyu and contrast.

Everything Else

Impressive lions who ruled their region with an iron paw.

Young guys think they’re smarter than same age women, while older women think they’re smarter than same age men.

Everything is circadian.

Things I’m Up to and Interested In

Great thread: Problems with “satiety per calorie.”

Awkward: More beef, less depression.

Interesting article: Early Alaskan warfare was brutal.

Important findings: Neanderthals probably ate a LOT of elephant.

Also important: Neanderthals were genetically resistant to pee and sweat odors.

Question I’m Asking

How have your kids influenced or changed you?

Recipe CornerSoubise sauce.French onion chicken.Time Capsule

One year ago (Jan 28 – Feb 3)

What Are the Best Probiotic Strains?—Well, what are they?Why Am I Waking Up at 3am?—Why?Comment of the Week

“Eggs are still pretty easy to find here but a curious thing has happened. The price of local, pastured eggs has not gone up much at all – 0-50 cents a dozen. But low quality factory eggs have skyrocketed. Eggs from the local factory farms are pushing 8 bucks a dozen while organic/pastured eggs are the $6 – $6.50 they have been the last several years. Not sure how to explain this. Maybe the more responsible producers are not having the disease issues that factory farms are seeing. Not affecting my near-daily egg consumption at all, especially since a couple of our ducks started laying due to the freakishly warm winter this year.“

-Good point, Jerry. You may be right.

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What is Abdominal Bracing and How to Do It?

When most people think about lifting weights, they think about their biceps, triceps, shoulders, and lats. Their legs, quads, hamstrings, glutes. They think about what to do with the body parts that move, that hold the weight, that push against the ground—but neglect to think about the abdominal muscles that brace, resist movement and allow you to even lift the weight in the first place. Abdominal bracing isn’t flashy or sexy, but it’s the most important part of lifting weights and moving your body through time and space. The best way to train your abdominal muscles are not sit ups, crunches, or leg lifts- it’s bracing, intra-abdominal bracing, or abdominal bracing.

Whenever you move your body or lift a weight, you practice abdominal bracing. In fact, this bracing, this increase in intra-abdominal pressure, occurs spontaneously whenever you move your limbs.https://journals.physiology.org/doi/f... That’s how central it is to human movement.

If you want to deadlift, squat, or overhead press, you brace. If you want to throw a punch or throw a ball, you brace. If you want to jump over on obstacle or dunk a basketball, you brace.

Abdominal bracing allows force to transfer efficiently throughout your body so you can act on the physical world. If you don’t practice abdominal bracing, you lose energy, drop force production, and open yourself up to injury.

Another reason to focus on and perfect abdominal bracing is that it’s a great “ab workout.” By fulfilling the primary function of the abdominal muscles—to stabilize the body in order to transmit force—you also give your entire abdominal complex the greatest workout ever. The heavier the weight or the faster the movement, the more bracing you require and the greater the training stimulus you’ve just applied. The better your abdominal bracing, the more force you can generate. The more force you generate, the more force your abs will have to resist. The more force your abs resist, the stronger your abdominal muscles—all of them—grow.

Now, the thing about abdominal bracing is that we’re always doing it. It’s a subconscious autonomic response of your body to movement and lifting. Actually, it’s more than a response. It happens before the movement, almost as a forecast or prediction. The contraction of the diaphragm and tensing of the abdominal muscles occur before you actually move.

How to Practice Proper Abdominal Bracing

Stand up right now and try this out. The only way to understand abdominal bracing is to actually do it in practice.

1. Prepare to take a punch.

Imagine you’re about to take a punch. What do you do? You tighten your abs, engage your core, engage your erector spinae (back muscles that run down your spine), tighten your butt hole, and gird your loins. Apologies for the language but there’s no getting around it.

2. Take a breath into your belly.

Keeping your core engaged and tight in preparation for the “punch,” take a nasal breath into your belly. A big one. Now, the air won’t be going into your belly, but this is a great cure to really breathe with and engage your diaphragm.

3. Breathe “downwards.”

In case you don’t know, the diaphragm is a large slab of muscle that sits underneath your lungs, attaches to them, and “pulls” on them to expand and allow air in. The diaphragm pulls the lungs downward. In doing so, the diaphragm also helps compress the entire abdominal musculature and creates more intrabdominal pressure.

You should feel everything tighten up even more.

4. Expand your ribcage.

Proper abdominal bracing means expanding your rib cage as the obliques contract and tighten.

5. Push out, not inward.

Imagine your abdominal musculature pressing out on all sides: against your ribs, your belt, your back. Sucking your abdominal muscles inward will compromise your position and make for suboptimal abdominal bracing.

Tips for Abdominal BracingAbdominals are not just the six pack

You’ve got the classic abdominals that face forward and show prominently in people with low body fat. You’ve got the obliques, which cover the left and right sides of your torso. You’ve got the erector spinae, those large sheathes of muscle that run down your back on either side of your spine. They all matter when abdominal bracing. They all must be engaged.

Think about a can of soda.

A soda can has structural integrity. It’s a vertical column that can support weight without crumpling, but only if the top is closed and it’s full of liquid. That’s intra-abdominal pressure. That’s abdominal bracing. Once you open the top and pour out the soda, the can crumples and can bear no weight. Lifting or moving without abdominal bracing is like standing on an empty soda can.

Maintain proper posture.

Posture comes first. If your spine is not aligned, you’ll be resting on your skeleton rather than using your musculature to brace. Don’t be overly extended with your belly sticking out and your butt sticking out and a big hollow in the small of your back. That’s “tucking” the pelvis, and it’s a recipe for disaster. Aim for a “j-curve” spine: mostly straight back and pelvis with the “curve” coming from your glutes.

Should you always practice abdominal bracing?

If you’re dancing or playing with your kids or jumping or playing tennis, you probably don’t want or need to be consciously bracing the entire time. You also need fluidity and motion, and our bodies are usually very good at modulating the level of abdominal bracing depending on the movement we’re engaging in. Most of us can trust our bodies to handle the bracing we need for basic movements.

However, this kind of conscious bracing becomes particularly important of heavy weight lifting—for movements where you’re “preparing” for a big effort. That could be a heavy set of deadlifts or squats, a max effort lift in competition (or just in the gym), or any situation where you know you’re going to be exerting a huge amount of force. If you’re going for a set of 5-10 heavy squats, you’ll want to consciously and proactively brace before lifting. Many people find that abdominal bracing improves their strength and performance in the gym, giving them a 5-15% boost in strength right away.

Also, if you’ve been out of the game for a long time, or you have a history of tweaking your back or throwing it out during simple everyday activities like picking up a remote control off the ground, you might need to practice conscious abdominal bracing until it becomes second-nature. That would mean following the abdominal bracing steps up above whenever you go to move some furniture, empty the dishwasher, lift your kid up, or do any other activity that requires a stable spine (which is pretty much everything!).

I’d love to hear from you. Do you practice conscious abdominal bracing? How has it helped you in your life—both in the gym and out of it?

(function($) { $("#dfbbwPk").load("https://www.marksdailyapple.com/wp-ad..." ); })( jQuery ); References https://journals.physiology.org/doi/full/10.1152/jappl.2000.89.3.967

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What Is Cryotherapy And Should You Try It?

Technically, “cryotherapy” refers to any method of using cold therapeutically. Icing a sprained ankle, freezing off a wart, or sitting in an ice bath after a game of Ultimate Frisbee are all forms of cryotherapy. Today, though, I’m using the term cryotherapy to refer specifically to whole-body and partial-body cryotherapy chambers.

Cryotherapy chambers use electric cooling or liquid nitrogen to expose users to super-chilled air in order to achieve various (supposed) benefits. The technology dates back to the late 1970s, and it used to be pretty niche, reserved mostly for top-level athletes and people with specialized medical needs. Now, cryo centers have popped up all over the place, and you can easily book yourself an appointment for any old reason. 

Even if you’ve never visited one yourself, you can probably picture what I’m talking about here. A cryo chamber usually looks like a person-sized tin can that you stand up or lie down in, sort of reminiscent of polio-era iron lungs. You might go in with your entire body (whole-body cryo), or your head might stick out the top (partial-body cryo). Sometimes, though, a cryotherapy chamber is just a small room. The air inside isn’t just cold. It’s really, really cold, typically between -200 and -300 degrees Fahrenheit, or below -100 degrees Celsius. (You can also do targeted cryotherapy using a wand to blast a small area with cold air. I won’t be talking about that today because most research focuses on chambers.) 

I’ve extolled the virtues of cold therapy before. Cold exposure is a simple and, I’d argue, adaptive way to fight inflammation, boost immunity, and build mental and physical fortitude. My modalities of choice are cold plunges and taking advantage of cold weather, but cryotherapy potentially offers many, maybe even all, of the same benefits. 

The questions at hand today are whether cryotherapy chambers are worth trying and whether they offer anything special compared to other types of cold therapy.

How Does Cryotherapy Work?

When you go in for a cryotherapy session, you’ll strip down to only the bare essentials needed to protect your extremities and delicate bits (socks, shoes, or booties, gloves, underwear, and, if your head is in the chamber, ear covering and face mask). After a brief cool-down session, you step into the chamber. Due to the extreme temperature, the session will last only one to three minutes, never more than five minutes.

When exposed to very cold stimuli, several important things happen in the body:

Vasoconstriction, which pulls blood toward the core and improves blood oxygenation and subsequent delivery of oxygen to muscles.https://pubmed.ncbi.nlm.nih.gov/25561... ">1 When applied to an injured area, this prevents blood from pooling at the site and helps prevent secondary injury. Anti-inflammatory response, characterized by lower pro-inflammatory and higher anti-inflammatory markers.https://www.sciencedirect.com/science... ">2 https://www.ncbi.nlm.nih.gov/pmc/arti... ">3Analgesic effects to reduce pain.Lowered oxidative stress.https://pubmed.ncbi.nlm.nih.gov/28028... ">4Autonomic nervous system stimulation, or activation of the “rest-digest-repair” nervous system, as evidenced by changes in HRV and catecholamines (stress hormones).https://www.ncbi.nlm.nih.gov/pmc/arti... 

None of these is unique to cryotherapy chambers. Any type of cold exposure elicits these effects. In fact, there’s some evidence that icing and cold water immersion do it better.https://www.ncbi.nlm.nih.gov/pmc/arti... https://pubmed.ncbi.nlm.nih.gov/28141... ">7 Cold air simply isn’t as good at thermal conduction as ice or cold water. 

It’s also worth noting that it’s not clear how long these effects last. Inflammation may go down acutely, for example, but we don’t have long-term studies to show that cryotherapy reduces chronic inflammation (the kind that causes more widespread, long-term health damage). In a study in which ten women did cryotherapy three times per week for three months, researchers observed immediate reductions in HRV right after the cold exposure. However, the women’s baseline HRV did not change from the beginning to the end of the study, meaning that the autonomic response was acute but not long-lasting.https://www.sciencedirect.com/science... ">8 

Potential Cryotherapy Benefits

As with all forms of cold therapy, proponents make big promises about all the things cryotherapy can do. Here are three benefits for which there is enough evidence worth mentioning. 

Recovery and injury prevention

The biggest reasons people seek out cryotherapy are for post-exercise recovery and treating sports-related injuries. 

Overall, the studies in this area are mostly small and not always consistent, but most studies find that cryotherapy reduces pain and subjective fatigue following exercise.https://www.frontiersin.org/articles/... ">9 However, it doesn’t seem to attenuate muscle damage as measured by creatine kinase levels.https://www.ncbi.nlm.nih.gov/pmc/arti... ">10 Nor does it consistently improve performance.https://www.ncbi.nlm.nih.gov/pmc/arti... ">11

Altogether, the evidence points to cryotherapy as being better for subjective recovery (how athletes feel) than objective markers of recovery. 

Chronic pain reduction

A 2020 review found that =whole-body cryotherapy is effective at reducing pain in patients with osteoarthritis, fibromyalgia, rheumatic diseases like rheumatoid arthritis and ankylosing spondylitis disease, and other types of chronic pain.https://www.ncbi.nlm.nih.gov/pmc/arti... ">12 The protocols in these studies varied but generally entailed one or two sessions per day several times per week for a number of weeks. 

Improved sleep

A handful of studies have found that cryotherapy improves sleep in athletes:

7 professional male soccer players did cryotherapy or no cryotherapy (control) after a 90-minute training session. The men moved significantly less during sleep, a measure of sleep quality, following three minutes of cryotherapy. However, these same sleep improvements were not evident when they did only 90 seconds or two 90-second bouts with five minutes of rest in between.https://pubmed.ncbi.nlm.nih.gov/30876... ">1322 young, fit men did a 55-minute run at 7 p.m., followed by three minutes of cryotherapy (at only -40 degrees) or three minutes of sitting quietly. Cryotherapy improved both subjective and objective sleep quality.https://pubmed.ncbi.nlm.nih.gov/30551... ">14 Similar findings were reported with elite male and female basketball players.https://bjsm.bmj.com/content/48/7/572... ">1510 female synchronized swimmers who were preparing for the Olympic trials did either three minutes of cryotherapy or no recovery (control) every day during two-week high-intensity training blocksy. Not only did the athletes sleep better following cryotherapy, but they also seemed to recover better from their workouts.https://pubmed.ncbi.nlm.nih.gov/25314... ">16 

Obviously these findings are limited to highly fit individuals, but it’s possible that cryotherapy might work the same way for the average person. 

Cryotherapy Risks

Given the extreme temperatures, it’s important that you follow basic safety protocols. Go to a reputable place, never go more than a few minutes, and follow all the instructions to a tee. Don’t do cryotherapy without talking to your doctor if you have a heart condition, circulatory issue, or are pregnant.

The FDA put out a statement in 2016 letting everyone know that cryo is not FDA approved, for what it’s worth.https://www.fda.gov/consumers/consume... 

Pros and Cons of Cryotherapy

Given all this, here’s what I see as cryotherapy’s pros and cons.

PROS:

It’s quick. You only need to withstand a few minutes of extreme cold to reap the benefits.Although all cold therapy can be intimidating, I imagine that some folks will find the idea of a cryotherapy chamber easier than jumping into cold water. Cryotherapy seems pretty safe. (Hyperthermia and frostbite are possible, though.)It looks cool. Let’s be honest, standing in a cryo chamber with the liquid nitrogen gas swirling around you feels futuristic and kinda badass. 

CONS:

It’s expensive compared to cold-water immersion, and there’s not good evidence that it’s any more effective. Cryotherapy studies are mostly small, and the results aren’t always consistent, possibly because different researchers use different protocols. Although I highlighted some of the probable benefits above, some studies also find no effects. Like any form of cold therapy, it’s not safe for everyone. 

I wouldn’t discourage anyone from trying cryotherapy if they thought it might help them, but for now I’ll be sticking to my cold plunges. 

I’m interested to hear about your experience with cryotherapy. Tell me in the comments if you used it and whether it helped. I’m especially interested to hear direct experiences comparing cold-water immersion to cryo chambers.

Take care, everyone. 

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References https://pubmed.ncbi.nlm.nih.gov/25561577/ https://www.sciencedirect.com/science/article/abs/pii/S030645650800106X https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145670/ https://pubmed.ncbi.nlm.nih.gov/28028984/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4411165/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956737/https://pubmed.ncbi.nlm.nih.gov/28141620/ https://www.sciencedirect.com/science/article/abs/pii/S0306456506000313 https://www.frontiersin.org/articles/10.3389/fphys.2017.00258/full https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956737/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3956737/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119547/ https://pubmed.ncbi.nlm.nih.gov/30876470/ https://pubmed.ncbi.nlm.nih.gov/30551730/ https://bjsm.bmj.com/content/48/7/572.1.short https://pubmed.ncbi.nlm.nih.gov/25314578/ https://www.fda.gov/consumers/consumer-updates/whole-body-cryotherapy-wbc-cool-trend-lacks-evidence-poses-risks

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New and Noteworthy: What I Read This Week—Edition 206

Research of the Week

Boron helps against COVID.

Your fat cells know when you haven’t gotten sunlight. Don’t let them down.

The gut biome regulates motivation for exercise.

Worse indoor air quality, lower test scores.

Mediterranean diets would work great for IBD if it weren’t for all those darn grains!

New Primal Kitchen Podcasts

Primal Kitchen Podcast: The Link Between Dairy Intolerance and Dairy Genes with Alexandre Family Farm Founders Blake and Stephanie

Primal Health Coach Radio: Danika Brysha

Media, Schmedia

Contraband eggs.

Not a great idea.

Interesting Blog Posts

Great piece on Chinese ancestry. Worth subscribing if you aren’t.

Is long COVID caused by micro clots?

Social Notes

Pretty much.

Why is East Asia less happy than you’d expect given their GDP?

Everything Else

Scientists figured out what made Roman concrete so strong.

You can talk to the Bible now.

Things I’m Up to and Interested In

Great find: A boy and his wolf.

A huge missing piece to the environmental debate: People are underestimating how many herbivores this world once hosted.

Interesting article: The longevity secrets of ant queens.

Important findings: Top discoveries about ancient people from 2022.

Interesting story: When pastoral agriculturalists met Baltic hunter-gatherers.

Question I’m Asking

Are you still able to find eggs? How has it affected your diet?

Recipe CornerItalian sausage breakfast casserole: Genius.Stir fried eggplant. Make sure to swap out the “vegetable oil” for something better like avocado oil, and increase the pork.Time Capsule

One year ago (Jan 21 – Jan 27)

All About the Liver, and How to Support Your Favorite Detoxification Organ—How to keep it going.How to Stop Drinking Coffee, and Why You Should Consider It—Maybe.Comment of the Week

“Mark, the government websites state Linoleic acid, LA, is highly oxidative to our LDL portion of cholesterol.
Do you have data to the contrary?

Seed oils have been the scourge of our creation. Atherosclerosis skyrocketed after the creation of Crisco.

Do you have a contrary position?”

-No, I do not.

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How do Potatoes Fit in a Primal Diet?

Potatoes get a bad rap in many different health and diet communities. The keto and low-carb crowd says they’re too high in carbohydrates and will spike your blood sugar. The paleo guys are against them because they are neolithic foods from the New World that our Paleolithic ancestors had no access to. The autoimmune diet communities eschew them because they have various plant toxins that can cause inflammation and trigger sensitive and vulnerable individuals, and the conventional “healthy diet” people recommend against potatoes because they’re “empty white carbs.”

Is this criticism warranted? Is it true that potatoes have no place in a healthy diet, or are potatoes actually healthy? How do potatoes fit into a Primal diet?

Let’s dig into the actual evidence.

Potatoes are healthier than you think

Potatoes are actually healthier than you’ve been led to believe. Think about what a potato is: it’s a repository of nutrients for growing many new potatoes. It’s an egg. And just like eggs are among the most nutrient dense animal foods on earth, the basic potato is one of the most nutrient dense vegetable foods on earth. In a single large baked potato weighing about 10 ounces, plain, you get a broad assortment of vitamins, minerals, protein, and prebiotic fiber.

Potatoes are high in vitamins and minerals

Here’s the breakdown. Percentages refer to the proportion of the daily recommended intake for each nutrient.

16% of B1 (thiamine)11% of B2 (riboflavin)26% of B3 (niacin)22% of B5 (pantothenic acid)55% of B6 (pyridoxine)21% of folate32% of vitamin C39% of copper40% of iron20% of magnesium28% of manganese34% of potassium10% of zinc6.6 grams of prebiotic fiber7.5 grams of protein

All that for 278 calories and 56 grams of “net” carbs.

Potatoes are rich in potassium

Dietary potassium/sodium ratio is a crucial determinant of endothelial function and blood pressure regulation, most likely more important than sodium alone, and there’s decent evidence that potatoes are a great way to improve potassium status. Potassium from potatoes is as bioavailable as potassium from supplements.https://pubmed.ncbi.nlm.nih.gov/27413... In fact, adding potatoes to the diet can be more effective at lowering blood pressure than adding an equivalent amount of straight potassium.https://pubmed.ncbi.nlm.nih.gov/34064...

Potatoes are higher in fiber and lower in carbs than you realize

Potatoes have the reputation for being a “refined carbohydrate” that “spikes” your blood sugar. They’re supposed to be very high in carbs. That’s true—potatoes are a rich source of starch. But the starch in potatoes is a little different than other starch sources. Going back to that figure up above, of the 56 grams of carbs in a large baked potato, 11 grams will be resistant starch—a prebiotic substrate that feeds your gut biome, produces butyric acid, and is not digested by your body into glucose.https://www.eurekalert.org/news-relea... That resistant starch content goes even higher if you refrigerate your cooked potatoes.

In addition to resistant starch (which acts like prebiotic fiber), potatoes have a significant amount of fiber.

A recent study in type 2 diabetics compared the metabolic effects of an evening meal containing potatoes to an evening meal containing rice. Whether the potatoes were boiled, roasted, or boiled and then refrigerated before consumption, the potato meals elicited a more favorable effect on blood glucose than the rice meal in type 2 diabetes. Same number of calories, same macros (50 carb/30 fat/20 protein), the only difference was potato versus rice. Potatoes won handily, and in type 2 diabetics—the very population that isn’t supposed to be able to handle potatoes.https://pubmed.ncbi.nlm.nih.gov/33069...

However, potatoes only won compared to rice. Potatoes are still high in carbohydrates, and type 2 diabetics, people with insulin resistance, and anyone who has trouble handling carbs should exercise caution with potatoes.

Potatoes are very filling

A 1995 study testing the “satiety index”—a measurement of how filling a particular food is—found that boiled potatoes induced the most satiety of all the foods tested.https://pubmed.ncbi.nlm.nih.gov/74981... Even if potatoes have too many carbs for your liking, they’re less likely than other foods to promote overeating—probably due to the water content, fiber content, and micronutrient density.

Note: plain potatoes are filling. If you throw a half stick of butter into your baked potato or sit down in front of a plate of French fries, they’re not so filling. You can eat far more carbs and calories from French fries that you can from boiled potatoes.

Potatoes have complete protein

While the absolute amount of protein in a potato isn’t very high compared to animal products, what protein it does contain is “complete protein.” That means it contains all the essential amino acids your body needs and cannot produce on its own. In fact, potato protein is probably the most complete plant form of protein.

Potatoes are low in plant toxins

Potatoes, being the reproductive organs of potato plants, have “passive” defenses against predators. They are stem tubers. They can’t run or bare teeth, so they chill underground to stay safe and employ toxic chemical defenders known as glycoalkaloids.

The glycoalkaloids most prevalent in potatoes are alpha-solanine and alpha-chocanine, which the plants use to repel pests. Most of the glycoalkaloids are luckily concentrated in the skin of the potato, forcing less refined pests to eat through the toxic stuff to get to the good stuff. This is probably why traditional potato-eating cultures peel the potatoes they eat. These days, the most common potatoes, like Russets, also tend to have the lowest amount of glycoalkaloids. This is no accident, instead being the product of generations of careful agricultural selection by farmers. Throughout history, then, humans have tended to avoid the bulk of potato glycoalkaloids, either unwittingly, by peeling potato skins, or by selecting the low-glycoalkaloid varieties that didn’t provoke stomachaches, digestive issues, or inflammation and sold well at the market.

But some glycoalkaloids remain. Are they harmful? High dose glycoalkaloids are clearly harmful, but most peeled normal potatoes do not contain high doses of glycoalkaloids. Most studies showing harm used supra-physiological doses of pure glycoalkaloids; one of the only studies to show harm using physiological doses that you’d normally get from eating potatoes used intestinally permeable rats with a genetic proclivity toward inflammatory bowel disease.ncbi.nlm.nih.gov/pubmed/12479649&quot... This is a useful study, though, because it tells us that potatoes might be a danger for humans with leaky guts or existing inflammatory bowel disease.

To ensure you’re avoiding glycoalkaloids, always throw out or discard (or plant) potatoes that have begun to turn green or sprout. That signals an increase in glycoalkaloid content.

There are a couple older studies showing increased inflammation markers upon potato feeding, but one included wheat and other high-glycemic foods in the “potato group” (not just potatoes) and the other used potato chips.ncbi.nlm.nih.gov/pubmed/18469276&quot...ncbi.nlm.nih.gov/pubmed/19158207&quot... Was it the rancid seed oil the chips were fried in, or the potatoes? Was it the wheat bread or the potatoes? These tell us very little about the effects of whole, untarnished potatoes on inflammation.

But if you’re healthy with good gut health and function, I don’t think baked, boiled, or mashed potatoes will have a negative impact on your gut. In fact, the prebiotic effects of potato resistant starch and fiber may even have a beneficial effect on gut health.

Can you eat potatoes on keto?

Classic medical ketogenic diets force you to eliminate potatoes. They simply represent too large a bolus of carbs when your mental and physical health depends on you remaining in ketosis. If you’re more of a casual keto or low-carb dieter, there are instances where a potato can work.

Training: If you incur a “glycogen debt” through intense exercise, you can fill that debt using potatoes without inhibiting ketosis. Exercise up regulates insulin-independent glycogen repletion, so you don’t even need insulin to deposit the glucose into your muscles. High end athletes will often be in ketosis on a regular basis despite eating high carb diets, simply because they train so hard and so often.

Carb refeed: A carb refeed describes the use of intermittent high-carb, low-fat meals to “carb up” against a backdrop of low-carb dieting in order to boost leptin and increase energy expenditure. in many instances, this will kickstart weight loss and make your otherwise low-carb diet easier to stick to and more effective in the long run. If you’re going to do a carb refeed, potatoes are an excellent, nutrient-dense food to use.

Potatoes can be an effective short term weight loss “hack”

Way back in the day, people in the MDA forums and comment sections were doing “potato hacks” to lose weight. I’m no fan of hacks, but I have to admit that this one really does work for some people. How does it work?

For a period of 4-7 days, you eat nothing but potatoes.

Eat potatoes. Nothing else. White potatoes, not sweet potatoes.Use vinegar, hot sauce, mustard, and other low-calorie, low-fat, low-carb sauces and condiments. Mayo and EVOO are off limits. Primal Kitchen ketchup and mustard are perfect.Use minimal fat to heat or cook your potatoes. No more than a teaspoon of fat at each meal.Salt liberally.Eat until full.Eat frequently. Whenever you’re hungry, eat potatoes until you’re not.Keep exercising. This will minimize muscle loss.

Most people find they get tired of potatoes very quickly and end up losing 5-10 pounds over the course of the week. It becomes an exercise in trying to force oneself to eat as much as you can because the potato is so filling and you need to keep up your energy intake and nutrient status. 4-6 pounds of potatoes a day is pretty typical and provides ample levels of most nutrients (and even a decent amount of protein), but that’s hard to keep up. And therein lies the power of the potato hack: you simply can’t eat very many plain potatoes.

Even though I’m generally biased toward lower carb intakes—especially in overweight people with poor insulin sensitivity—I have to admit that if people ate potatoes instead of refined grains and other nutrient-deficient starchy carbohydrates, health would improve across the board. Potatoes are simply one of the safest, most nutrient-dense, and least toxic sources of carbohydrates available.

I hope this article helped you make sense of where potatoes belong in a healthy Primal diet. Take care, and let me know whether you like to eat potatoes or not!

(function($) { $("#df3BcEH").load("https://www.marksdailyapple.com/wp-ad..." ); })( jQuery ); References https://pubmed.ncbi.nlm.nih.gov/27413123/https://pubmed.ncbi.nlm.nih.gov/34064968/https://www.eurekalert.org/news-releases/560070https://pubmed.ncbi.nlm.nih.gov/33069511/https://pubmed.ncbi.nlm.nih.gov/7498104/ncbi.nlm.nih.gov/pubmed/12479649ncbi.nlm.nih.gov/pubmed/18469276ncbi.nlm.nih.gov/pubmed/19158207

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What Does Fiber Do, And Do You Need More?

The health world is fixated on fiber, constantly telling us how important fiber is and how we should all be eating more of it. Back in the day, our cultural obsession with fiber was all about being “regular.” You had to load up on fiber to keep things moving, so to speak. Nothing was more important. So we started our days with bland, tooth-cracking breakfast cereal that tasted like tree bark and sparked no joy. But hey, it was loaded with fiber and therefore good for us, right? 

I’ve long been skeptical of that particular story, mostly because every major health agency that recommends higher fiber intake also says that we should get much of that fiber from whole grains. And you know how I feel about that. If whole grains aren’t essential (or even healthy, if you ask me), then how could the fiber they provide be essential? It doesn’t add up. 

Now, though, as we learn ever more about the emerging science of the microbiome, the fiber story is starting to shift. It’s become less about pushing “roughage” through our colons to create bulkier, more impressive bowel movements (although some people still promote this supposed benefit). Certain types of fiber, it turns out, are essentially food for the microbes living in our guts. 

The health (and composition) of the gut flora helps determine the health of the human host (that’s you). It’s not clear what exactly constitutes “healthy gut flora,” and we’re still teasing out exactly how it affects the various physiological functions, but we know we need them and we know they need to eat something to even have a chance at helping us. Not all fiber is created equal in this respect. 

Thus, when it comes to fiber, it’s important to understand what it does, what you want it to do, and what types are likely to be helpful or harmful. 

Understanding the Types of Dietary Fiber

The tricky thing about fiber is it’s not a monolith. There are dozens of varieties. Some of them perform similar functions in the body, but others have extremely unique effects. We can’t talk about fiber without understanding that the word describes a variety of compounds, and this leads to a lot of confusion. People make blanket statements that might be true for some types of fibers and incorrect for others. 

Broadly speaking, fiber is any plant component that we eat but do not metabolize directly. Since we can’t digest these materials, they pass through our small intestine without being broken down and absorbed—which means they make it to the lower reaches of the GI tract more or less intact. And this is important for reasons we’ll discuss shortly. 

There are various ways of classifying the different types of fiber, the most common one being insoluble versus soluble fiber. Insoluble fiber is a bulking agent, increasing the mass of the stool, which actually moves the stool more quickly through the intestines. Except for perhaps relieving constipation (“perhaps” because it doesn’t work for everyone and may even have the opposite effect), I’m unconvinced that insoluble fiber has much to offer in terms of health benefits. 

Soluble fiber, on the other hand, is interesting. Soluble fiber can absorb water, which enhances the thickness of the stomach’s contents. This slows stomach emptying, which can give the body more time to absorb nutrients. More importantly, most types of soluble fiber are fermentable by gut microbes (psyllium and methylcellulose are exceptions). In other words, they act as food for the trillions of microorganisms that inhabit your GI tract, especially in your colon. Insoluble fiber doesn’t ferment very well, so it does little to support your gut bugs.

Fermentable fibers are also called prebiotic fibers, a term you’re probably familiar with, or microbiota-accessible carbohydrates (aka MACs). There are lots of different types of soluble, fermentable fibers including

Fructo-oligosaccharidesGalacto-oligosaccharidesPectinsInulinBeta-glucanGums (such as xanthan gum, carrageenan, guar gum)Type IV resistant starch

Each has a unique effect on the composition of your microbiome, promoting some beneficial species while suppressing others. 

When gut microbes ferment these types of fibers, they produce a variety of end products, or postbiotics. These include certain vitamins and neurotransmitters and, notably, short-chain fatty acids (SCFAs) like butyrate, propionate, and acetate. SCFAs, it turns out, do all sorts of interesting things in the body. Many of the benefits attributed to “fiber” are probably more accurately characterized as benefits due to the effects of SCFAs.

What Are the Benefits of Fiber Consumption?

The biggest benefit of fiber, based on what we know now, is that fermentable fiber in particular supports a healthy and diverse microbiome.It’s difficult to name a physiological function or health parameter that is not impacted by the gut microbiome, including but not limited to digestive,https://www.ncbi.nlm.nih.gov/pmc/arti... ">1 cognitive and neurological,https://www.ncbi.nlm.nih.gov/pmc/arti... ">2 https://pubmed.ncbi.nlm.nih.gov/23910... ">3 immune,https://pubmed.ncbi.nlm.nih.gov/23298... ">4 psychological,https://pubmed.ncbi.nlm.nih.gov/23910... ">5 metabolic,https://www.ncbi.nlm.nih.gov/pmc/arti... ">6 and liverhttps://pubmed.ncbi.nlm.nih.gov/23463... ">7 health.  

By feeding and bolstering the populations of “good bacteria,” we reduce the amount of available real estate for “bad bacteria” to set up shop. Beyond that, the SCFAs that are byproducts of fiber fermentation, including butyrate, propionate, and acetate, improve our health in many ways. I’ve covered the health benefits of prebiotics and postbiotics in depth in other posts, and many, if not most, of those can be chalked up to SCFAs. 

Butyrate in particular has been shown to have beneficial effects on insulin sensitivityhttps://www.ncbi.nlm.nih.gov/pmc/arti... ">8 and inflammation,https://www.ncbi.nlm.nih.gov/pmc/arti... ">9 both of which contribute to all manner of modern, non-communicable disease. It’s also the preferred fuel source for our native colonic cells. Basically, without enough butyrate (and, by extension, fermentable prebiotic fiber to make it), our colons don’t work as well as they should. This can lead to digestive impairments and perhaps even cancer. Mucin-degrading bacteria predominate in colorectal cancer patients,https://www.ncbi.nlm.nih.gov/pmc/arti... ">10 for example, while butyrate-producing bacteria rule the roost in healthy patients without cancer. Populations with lower rates of colorectal cancer also tend to have higher levels of butyrate.https://www.ncbi.nlm.nih.gov/pmc/arti... Propionate is helpful, too, though not to the extent of butyrate.https://pubmed.ncbi.nlm.nih.gov/21521...

Ok, But What About Poop?

But fiber does help with, ahem, performance in the bathroom, right? 

This one’s a mixed bag. A recent meta-analysis concluded that while increasing insoluble dietary fiber does increase the frequency of bowel movements, it does nothing for stool consistency, treatment success, laxative use, and painful defecation.https://www.ncbi.nlm.nih.gov/pmc/arti... ">13 So it will make you poop more often, sure, but if you’re experiencing pain, each bowel movement is still going to hurt, and you’re still going to need laxatives to do it. Galacto-oligosaccharides, guar gum, and inulin, all prebiotic fibers, also appear to improve constipation.https://pubmed.ncbi.nlm.nih.gov/28262... ">14 https://pubmed.ncbi.nlm.nih.gov/7965214/ ">15 https://pubmed.ncbi.nlm.nih.gov/27492... ">16 However, other research finds that stopping or dialing back dietary fiber intake reduces constipation.https://www.ncbi.nlm.nih.gov/pmc/arti... ">17

Folks with gastrointestinal disorders like IBS and IBD that can cause constipation or diarrhea should proceed with caution, as the evidence for fiber’s benefits is inconsistent in these populations.https://www.cghjournal.org/article/S1... ">18 One survey of Crohn’s patients found that those eating more fiber (23 grams/day) had fewer flare-ups than those eating less (10 grams/day), while colitis patients reported no difference in symptoms based on fiber intake. On the other hand, studies indicate that a low-FODMAP diet, which eliminates most sources of fiber, especially fermentable prebiotic fiber, is an effective treatment for IBS and IBD.https://pubmed.ncbi.nlm.nih.gov/25982... ">19 https://pubmed.ncbi.nlm.nih.gov/26914... ">20  Low-FODMAP diets have been shown to reduce bloating, abdominal pain, quality of life, and overall symptoms in intestinal disorders.https://pubmed.ncbi.nlm.nih.gov/28566... ">21

How Much Fiber Do You Need?

The official recommendations from the Institute of Medicine are 25 grams per day for women under 50 and 38 grams per day for men under 50 (21 grams and 30 grams, respectively, once you enter your sixth decade). The USDA says you should aim for 14 grams of fiber for every 1,000 calories you consume.

However, I have a real problem with those recommendations because they lump all types of fiber together. They make no distinction between the types that serve only to create impressive poops and those that your gut microbes can ferment. It’s all just “fiber” according to these guys. But fiber isn’t fiber isn’t fiber.

And we can’t ignore the elephant in the room: the loud chorus coming from the direction of the carnivore movement proclaiming that dietary fiber is largely or wholly unnecessary. I’m open to the possibility that a properly constructed carnivorous diet (which may, remember, include gristly animal fiber) obviates the need for plant fiber, prebiotic or otherwise. We don’t have strong data to support that claim yet, but it might be true. A person’s microbiome composition shifts in response to dietary changes.https://www.ncbi.nlm.nih.gov/pmc/arti... ">22 It’s possible that people who eat lots of plants need lots of fiber to feed the microbes that are there because they eat a lot of plants. And people who eat mostly meat have a microbiome tailored to a low-plant diet; thus, they don’t need a lot of plant fiber to thrive. Like begets like, as it were. 

That’s possible. The problem is that most humans throughout history and prehistory probably consumed diets that by today’s standards would be considered very high-fiber, perhaps averaging 100 grams or more of fiber per day. Coprolite (read: ancient fossilized stool) studies indicate that our ancestors may have consumed a significant amount of prebiotics.https://pubmed.ncbi.nlm.nih.gov/20416... ">23 That means our bodies have come to expect the metabolites that gut bacteria produce by fermenting that fiber. We can get butyrate from collagen and gelatin, but is it enough?https://www.ncbi.nlm.nih.gov/pmc/arti... ">24 https://www.ncbi.nlm.nih.gov/pmc/arti... ">25 I’m not sure. 

How to Increase Fiber Consumption and Stay Primal

Let’s say you want to experiment with increasing your fiber consumption, perhaps as an experiment to see how it will affect gut health and digestion. You certainly don’t need to increase your grain intake to do so. As you’d expect, I explicitly do not recommend you do that. 

Setting aside the obvious downsides of grain consumption, whole or otherwise, grains contain predominantly insoluble, non-fermentable fiber (oats being the notable exception). The better way to increase your consumption of soluble, fermentable fiber is to eat plenty of vegetables, the more variety the better. You can throw in some legumes if they’re part of your repertoire (watch your total carb intake), but it’s not necessary. Top it off with some fermented dairy like full-fat kefir or yogurt. That provides galacto-oligosaccharides plus beneficial probiotics to further seed the microbiome. 

Especially if you have digestive issues, constipation, or chronic diarrhea, go slowly and pay attention to how fiber affects your symptoms. Allow time for your gut flora to adjust to the new food source. Expect flatulence.

Bottom Line

As you can see, the fiber story isn’t simple. At all. While I don’t think all the pro-fiber furor stands up to scrutiny, I’m also not ready to write it off as immaterial to human health. Heck, the only food that’s actually expressly “designed” to feed humans—breast milk—contains prebiotic compounds whose main purpose is to feed and cultivate healthy gut flora in infants, which suggests that the need for prebiotics is innate.https://pubmed.ncbi.nlm.nih.gov/23434... ">26 

Overall, because the health of our gut community is inextricably tied to the health of our minds and bodies, I think attaining fermentable fiber through the fruits and vegetables we eat is important. Do I think everyone should be supplementing with prebiotic fiber? No. I add inulin to my Primal Fuel protein powder, mostly to improve mouth-feel but also to feed beneficial microbes and increase butyrate production. Sometimes I use raw potato starch for its considerable resistant starch content, often just mixing it into sparkling water and drinking it straight. 

But for the most part, the fiber I eat is incidental to the foods I consume. Berries, non-starchy vegetables, jicama, garlic, onions, mushrooms, green bananas, nuts and seeds—these are all foods rich in fiber, particularly prebiotic fiber. If you’re eating varied and diverse Primal foods, your bases are probably adequately covered when it comes to fiber too. 

What do you think, folks? How has fiber helped or harmed you? I’d love to hear from everyone.

Take care and be well.

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References https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551212/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4875553/ https://pubmed.ncbi.nlm.nih.gov/23910373/ https://pubmed.ncbi.nlm.nih.gov/23298474/ https://pubmed.ncbi.nlm.nih.gov/23910373/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756109/ https://pubmed.ncbi.nlm.nih.gov/23463489/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699871/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213552/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735522/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3683814/https://pubmed.ncbi.nlm.nih.gov/21521227/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544045/ https://pubmed.ncbi.nlm.nih.gov/28262216/ https://pubmed.ncbi.nlm.nih.gov/7965214/ https://pubmed.ncbi.nlm.nih.gov/27492975/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435786/ https://www.cghjournal.org/article/S1542-3565(16)30147-1/fulltext https://pubmed.ncbi.nlm.nih.gov/25982757/ https://pubmed.ncbi.nlm.nih.gov/26914438/ https://pubmed.ncbi.nlm.nih.gov/28566897/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3957428 https://pubmed.ncbi.nlm.nih.gov/20416127/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8401164/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005082/ https://pubmed.ncbi.nlm.nih.gov/23434179/

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