Mark Sisson's Blog, page 132

How Much Exercise Do Kids Need? Plus, 30 Activities to Get Them Moving

There’s good news and bad news. The bad news is that kids aren’t getting enough physical activity.

Inadequate amounts of physical activity are a strong risk factor for obesity and metabolic dysfunction in kids.  It’s most likely causal, too, because as much as people question the usefulness of only exercising to lose weight, there’s no question that exercise and physical activity in general is important for preventing obesity from occurring. 

Kids are getting so obese that a new RCT came out showing metformin can help them lose weight and normalize metabolic biomarkers.

It’s not just that inadequate physical activity is destroying the physical vitality, body weight, and metabolic health of children. It’s also ruining their movement skills and general athleticism. I don’t work with kids directly, but I have many friends who do. And all of them, from gymnastics coaches to running coaches to basketball/base/football coaches report that the athleticism of the beginners has degraded over the years. Fewer kids are coming into practice for the first time with that raw movement ability. They’re clumsier, clunkier, and more confused than ever before.

Childhood is a big window, but it’s a crucial one. All that time spent throwing a ball—or sitting on the couch manipulating an Xbox controller so that the character onscreen throws a ball—establishes neural pathways. Do you want those pathways to enable efficient, competent throwing (a skill that may have required our big brains and allowed humans to conquer the world), or do you want those pathways to enable skillful button and joystick maneuvering?

The good news is that kids love to move. Even the ones who don’t look it. Go down to a park, the beach, or walk through the city square on a hot day when the fountains are flowing and kids of all shapes and sizes will be moving frequently at slow, moderate, and fast paces. They’re playing tag. They’re roughhousing. They’re jumping from ledges twice their height. They’re all over the place.

And that’s how it works: Get even the most screen-obsessed kid in a fun, physical environment with plenty of opportunities for movement and he or she will move. The innate desire for physicality and play exists in all children.

Overweight kids aren’t too far gone either, and exercise can work wonders. According to a 2015 meta-analysis, there’s “moderate” evidence that exercise by itself is an effective way to reduce bodyweight in overweight and obese children. Another study concluded that strength training and aerobic exercise are more effective at lowering children’s BMI than either alone. I imagine you could optimize a kid’s training regimen even further and get even better results.

How Much Exercise Do Kids Need?

Ethnographic studies have found that, by and large, kids in hunter-gatherer groups play all day long with little to no supervision (PDF). They don’t have scooters and Laser Tag, or barbells and kettlebells, but they also don’t have smartphones and televisions. For these kids, play is movement and movement is play. There’s no other way. Of course, contemporary hunter-gatherer groups are a very rough approximation of our hunter-gatherer ancestors. The former have been pushed onto marginalized land by better-armed and more numerous city folk; the latter ranged across an untouched world teeming with large game. Even still, they’re the best model we have for ancestral childhood physical activity.

But we don’t even have to go back to the paleolithic to illustrate the amount of physical activity the average kid should be getting. Just talk to an elderly neighbor. Talk to an older colleague. Or heck, search within your own memory bank. What were summers like as a kid for you? I for one was out all day long if school was out, exploring the neighborhood, roaming the woods, getting into trouble. And I rarely stopped moving.

Anecdotes and personal memories not enough? The data tells the same story. The parents of today’s children got over 8 hours a week of outdoor play (which is still too little). Today’s children get under four. That trend is likely to continue as you go back in time, with outdoor play doubling in frequency and lack of supervision with each previous generation.

These are averages, of course. Some kids get quite a lot. Others don’t.

Kids in Denmark aged 6-12 average 90 minutes of moderate-to-vigorous physical activity (MVPA) per day. It’s highest in the six-year-olds and declines by 3.5 minutes each year.

Elementary school kids in Qatar average around 28 minutes of MVPA per day, with a large discrepancy along gender lines. By age 9, for example, boys are getting over 40 minutes a day and girls are getting just 23 minutes.

Even the Danes aren’t doing enough, in my book.

Kids should be moving all day. I won’t mince words. Look, my kids probably could have moved more, and I knew about this stuff. It’s hard. I get it. But that doesn’t negate that the ideal situation is for kids to be constantly moving. After all, kids have fatigue-resistant muscles akin to elite athletes’. That’s why they can run all day without getting tired, and that’s a fairly strong indicator they’re meant to move all day.

That’s not in the cards, though, so what should kids aim for?

To stave off overweight/obesity, 60 minutes of MVPA (moderate-to-vigorous physical activity) with at least 15 minutes of genuinely vigorous physical activity each day is the absolute minimum. That’s not optimal. That’s barebones.

Kids should be:

Swimming
Running (sprinting rather than jogging)
Squatting (the movement pattern more than heavy weight)
Lifting/hip hingeing
Climbing
Throwing
Supporting their own bodyweight
Jumping
Landing
Balancing
Playing, ideally using all the skills and movements I just mentioned

Ideas To Get Kids Moving

What are some ideas? How can we get kids to get enough exercise while having fun and developing skill? Many need a little nudge. There are innumerable ways to unlock what’s already inside. I’ll throw out 30 of them right here.

Walk to School. If you can make it work, walking to and from school will contribute a good amount of MVPA to a kid’s life. Extra points for getting into trouble on the way.
Swim underwater as far as you can.
Dive for Objects. Give kids a goal, make it a game. Throw a handful of quarters into the pool; see if they can get them all in with one breath. Toss a kettlebell into the deep end and have them bring it back up.
Biggest Splash Contest. Who can make the biggest splash into the pool? Encourage different dives, cannonballs, jackknives, and other jumps.
Water Polo. An excellent training stimulus. One of the hardest sports around.
Lift Weights. Real ones. In Germany, 11-year-old soccer players and 12-year-old Olympic weightlifters are safely front squatting their bodyweight.
Race the Dog (with a Head Start). Tell your kid to make a break for it, hold your dog for a few seconds, then release.
Play Catch. Great way to practice throwing and catching, the latter of which is particularly tricky (and useful to learn).
Barefoot Hike. Your kid will thank you when she’s all grown up and thinks nothing of walking across gravel.
Creek Walk. Jump from rock to rock, climb over logs, balance on fallen trees, take a little dip.
Check Out the local rec center schedule. You’d be surprised at the quality of some of these classes. Gymnastics, dance, martial arts are all good options for building good movement skills.
Get a pullup bar in the house. Place it at a level your kid can reach. Start with hanging, swinging, and various holds, but work your way up to pullups. Give incentives (“do 5 pullups and I’ll give you $20”).
Get the dog they’ve always wanted, with the stipulation being they have to walk it and play with it.
Set up an obstacle course. It doesn’t have to be fancy. Just give them things to climb under/over, crawl under/through/, leap over.
Hill Sprints. If you want a killer workout, sling that kid over your shoulder in between his sprints and run some of your own.
Gymnastics. Great foundation for movement later in life. Just stop short of elite competition unless it’s something they really want to commit to.
Have them race. If you catch kids at the right age, they love races without being attached to the outcome. They’ll just let it rip and go all out, all smiles. Winner and loser both have fun.
Roughhouse. Roughhousing is a lost art that helps kids establish boundaries and limits, learn what hurts and what doesn’t, grasp when something is “too rough.” Plus, it’s fun.
Try Parkour. Parkour isn’t something a seven year old just leaps into (go to a parkour gym for formal instruction),but they can certainly start playing around on manmade structures. Visit a business park for good climbing and play.
Animal Impersonations. Crawl like a bear. Hop like a rabbit. Leap like a frog. Slither like a snake. Walk like a duck. These are very difficult modes of transportation that make for great exercise. To keep things fresh and playful, come up with other animals to emulate.
Play Fetch. Throw the ball, they go chase it and bring it back. Same concept as running your dog.
Reverse Box Jumps. That cool Persian tot aside, it makes more sense for small children to practice jumping down from tall objects than trying to jump up them. Besides, landing is where the danger lies later.
Trampoline. Studies indicate they’re responsible for a large number of emergency visits, but a properly set-up trampoline enclosed by a protective net can be a great place to learn how to jump with good form. And again, fun.
Keep a scooter/bike/skateboard around. Kids love zooming around on wheels.
Chore Duty. Give them a standing order to help with bags/groceries/trash. There’s always something they can carry, and every little bit helps make them stronger and more resilient.
Kettlebell Challenge. Keep a kettlebell in the living room and have him or her lift it every day. Marvel at the perfect deadlift form.
Build forts, then destroy them.
Try conventional sports. Although specialization isn’t advised at such an early age (it can actually increase the risk of overuse injuries and inhibit the athletic growth of children), sports are fun and do offer a great path to overall athletic development.
Build up to a mile run. Start by walking it. Throw in some quick sprints in the middle. Then a full on mile run. Then unleash the offer: “I’ll give you [x] if you can run a mile in [x-amount of time].”
Set a good example. If you fail to embrace physical culture while demanding your child do the opposite, that’s a strong nudge in the wrong direction. Make sure you’re moving, too.

That’s it for today, folks. I’d love to hear from you.

What kinds of games, sports, and other activities do you use to increase your children’s physical activity and help them develop a positive relationship with exercise? What’s worked, what hasn’t, and what’s the most unconventional activity you’ve had success with?

Take care all.

The post How Much Exercise Do Kids Need? Plus, 30 Activities to Get Them Moving appeared first on Mark's Daily Apple.

Dear Mark: Is Farmed Salmon Worth Eating?

For today’s edition of Dear Mark, I’m answering just one question from the comment section of last week’s omega-3 post.

It’s a short one, maybe one of the shortest reader questions ever, and it represents one of the few cut-and-dry stances in ancestral health. Humans are omnivores, seed oils are bad for you, no curls in the squat rack, and farmed salmon is toxic poison.

Right? Maybe not.

Mike asked:

What’s with the pic of the farm raised salmon?

First of all, I’m not certain that salmon was actually farm-raised. Second, while I’m on the topic, allow me to make the case for farmed salmon. That may surprise you. For years, I’ve been a huge proponent of wild-caught salmon. It’s the only one I ever buy or consciously seek out at restaurants. I’ll eat farmed salmon if it’s the best option available, or if I’m a guest and that’s what’s for dinner—and do so happily, by the way—but I’ve always been a wild salmon guy.

However, not everyone has the means to buy fresh or frozen wild-caught salmon on a regular basis, and not everyone wants to eat canned salmon. Sometimes you just want a big slab of tender salmon with a swathe of crispy, salty skin. Sometimes all five members of your family want their own big slab of tender salmon with the crispy skin. Is farmed salmon a good, safe, effective option?

Let’s look at the evidence. First, what are the benefits of salmon, and how does farmed salmon compare?

Omega-3s

The main reason people eat salmon is to get the long chained omega-3 fatty acids—the ones we use to quell inflammation, balance our omega-6 intake, and shift the membrane composition of our cells and structures.

Farmed salmon is a great source. A 6-ounce portion of farmed Atlantic salmon has 4.4 grams of omega-3 fatty acids, which is actually more than wild. A 6-ounce portion of wild sockeye salmon has 2 grams of omega-3s.

But what about the omega-6 fats? Isn’t farmed salmon “loaded” with them? Well, that same portion of farmed salmon has 3.3 grams of omega-6 fats to the wild salmon’s 0.3 grams. The ratio is “worse” than the wild salmon’s. But even then, it’s great. While the wild salmon’s omega-3:omega-6 ratio of 1:0.15 is about as perfect as you can get, the farmed salmon’s ratio of 1:0.75 is fantastic. Besides, it’s also the absolute amount of omega-6s that matter. Admittedly, 3.3 grams is nothing compared to what most people are getting from seed oils, junk food, or even random handfuls of almonds and pecans throughout the day.

There’s more to fish fats than the omega-3s. For instance, many fish fats have subfractional layers with specific health effects. Fats derived from organic Irish farmed salmon possess anti-thrombotic qualities—they reduce the formation of blood clots.

Astaxanthin

Astaxanthin is a carotenoid that gives salmon its pink hue and may provide neuroprotective effects, especially combined with omega-3s. Wild salmon obtain astaxanthin from the krill and other pink sea creatures they consume. Farmed salmon obtain it from the feed they eat, which has it added. Both farmed and wild salmon provide astaxanthin to those who eat it, but a recent study found that the astaxanthin in wild salmon has higher bioavailability.

What about the drawbacks of farmed salmon, like contaminants?

Even this issue isn’t so clear cut. For example, a 2017 study found higher levels of persistent organic pollutants, metals, and DHA in wild Atlantic salmon compared to farmed Atlantic salmon. Farmed salmon had more overall fat, mostly from saturated, monounsaturated, and omega-6 fats, but farmed was still loaded with omega-3s.

A recent study actually tracked the changes in blood markers of contaminants in response to a high intake of farmed salmon. Eating almost a pound of farmed salmon each week had no effect on blood levels of persistent organic pollutants or mercury.

Surprisingly, European farmed salmon seems to have the biggest contamination issue. Good news, though: a 13-year study of contaminant levels in Norwegian farmed salmon found that toxins are dropping as the years go on.

What about when the rubber hits the road, when actual living and breathing humans eat farmed salmon? Does it help or harm? Let’s see what’s out there:

In one 2016 study, overweight men and women who ate farmed salmon twice a week for 4 weeks had higher HDL, larger LDL particles, lower triglycerides, and an overall improved cardiovascular risk profile. Their large LDL particle number also increased, but I’m not sure what happened to their overall LDL particle number. Another study found farmed salmon reduced triglycerides and increased HDL compared to lean chicken.

Eating farmed salmon twice a week modified the plasma phospholipid composition in a favorable way, increasing DHA and EPA and decreasing omega-6 fats.

Chinese men with a high risk for heart disease improved cardiovascular biomarkers after adding farmed salmon to their diets.

This was an interesting one. A group of otherwise healthy overweight adults were told to eat add a large dose of either fatty fish or lean fish to their normal diets for 8 weeks. The fatty fish was farmed salmon. The lean fish was wild cod. What happened?

Cod increased DHA in white blood cell membranes. Farmed salmon increased overall omega-3s and reduced omega-6s in white blood cell membranes.
Farmed salmon improved postprandial blood glucose control. Cod did not.
Farmed salmon resulted in a smaller increase in postprandial insulin than cod.

I’m not suggesting farmed salmon is better than wild, or even equivalent, but I want to impress upon everyone who reads this blog that you don’t have to drop $15 a pound for wild caught salmon if your budget doesn’t allow it. Those $6 a pound Atlantic salmon fillets might not be as vibrantly red, might have a couple more grams of omega-6, and might have more or less pollutants depending on where they were farmed, but they’ll still have way more omega-3 than omega-6, they’ll still have astaxanthin, and they can still be part of an overall healthy diet.

Thanks for reading, everyone. I’d love to get your thoughts on this down below.

The post Dear Mark: Is Farmed Salmon Worth Eating? appeared first on Mark's Daily Apple.

Weekend Link Love — Edition 515

Research of the Week

“Good cholesterol” may not be so good in postmenopausal women.

The path to a man’s heart is through his gut bacteria.

60% of babies born worldwide fail to breastfeed within the first hour, missing a crucial window of nutrition.

Giving doctors a little “nudge” triples statin prescription rates.

Using ultrasound to open the blood brain barrier in Alzheimer’s patients could enable delivery of helpful drugs.

We’re doomed. Robots can guilt us out of turning them off.

New Primal Blueprint Podcasts

Episode 267: CJ Hunt: Host Elle Russ chats with CJ Hunt, producer and host of the first ever Paleo documentary, The Perfect Human Diet.

Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

Interesting Blog Posts

Does butter give you fatty liver?

Media, Schmedia

Which states exercise the most (and least)?

Guess I’ll have to shelve the undenatured centipede protein powder Primal Kitchen® was about to unveil.

Everything Else

I dig this Hollywood nutritionist’s smoothie template.

Just do squats.

Things I’m Up to and Interested In

10-point plan I agree with: Laird Hamilton’s, for defying your age and supercharging your body.

Quick Q&A I enjoyed: The one I did with Vibram.

Concept I’ve pondered: Why are people willing spend hundreds of dollars on painful, objectively unpleasant obstacle course races?

Nice post from Gary Taubes: “Thoughts on a Black Swan 2: The Hadza and Honey”

Miscellaneous news I enjoyed: Crickets are good for your gut.

Recipe Corner

Fried green plantains with mango avocado salsa.
Instant Pot baingan bharta—vegetarian (unless you dip meat in it) and keto-friendly.

Time Capsule

One year ago (Jul 29– Aug 4)

The Definitive Guide to Bone Broth Benefits – The lowdown on the liquid gold.
CrossFit Training: How to Add Mass and Build Strength with Primal – Gain lean, functional mass without resorting to junk food.

Comment of the Week

“Just the other day I was thinking about frozen animals “coming back to life”. I once carried in firewood for the wood stove in the winter with two wasps encased in ice on one or two pieces. I had the fire going after and was on the computer, which was next to the stove, when I felt something on my arm. It was one of the wasps. Then after I got rid of it, I saw the other one crawling around, which I got rid of too (they went from cold to really, really warm). Prior to that experience I was not aware that wasps had the ability to be cryogenically preserved.”

– Interesting, Animanarchy.

The post Weekend Link Love — Edition 515 appeared first on Mark's Daily Apple.

Guest Recipe: Low Carb BBQ Ribs

Today’s recipe might just become tonight’s dinner, it’s so tempting. Thanks to Bailey Ryan of Whole Kitchen Sink (formerly Paleo Bailey) for today’s awesome dish. 

These fall-of-the-bone BBQ ribs might first appear to be a bit of a time investment, but I promise you they’re worth the wait! Once they’re on the grill they’re pretty much hands off, leaving you free to enjoy the afternoon knowing dinner will be delicious! The trick to making these ribs perfect is to first remove the skin-like membrane on the underside of the ribs.

It’s a step a lot of us skip, but it makes a huge difference. You simply need to slide a knife between the membrane and the meat on one end of the rack of ribs and make an initial cut. Once you have one end separated from the meat, you can use a cloth or a paper towel to grab onto it and pull the rest away from the ribs.

Make sure to do this prior to seasoning! Then, make sure not to add the BBQ sauce until the last half hour on the grill. If you put it on too early it will burn onto the meat, instead of becoming a delicious caramelized glaze. Of course, this simple BBQ is made with the latest and greatest member of the Primal Kitchen® family, the Organic, Unsweetened Ketchup!

I KNOW you will love this ketchup, because I put it to the test with my (not paleo) boyfriend. I handed him dinner one night with Primal Kitchen’s Ketchup already on his plate, watched him eat it ALL, and then told him it was not his beloved highly processed ketchup. He was so impressed with the flavor and smooth consistency. It’s now our staple ketchup, and I’m thrilled I’ve converted him and gotten to toss out yet another conventional product and replaced it with a Primal Kitchen one!

Ingredients

For the Ribs:

1 rack of ribs, fat trimmed, and membrane removed
1/2 tablespoon garlic powder
1/2 tablespoon chili powder
1 teaspoon salt
1 teaspoon pepper

For the Sauce:

1 cup Primal Kitchen Organic Unsweetened Ketchup
1 tablespoon Dijon mustard
1 tablespoon Worcestershire sauce
1 tablespoon apple cider vinegar
2 teaspoon liquid smoke
1 teaspoon smoked paprika
1/2 teaspoon garlic powder
1/2 teaspoon salt
1/2 teaspoon onion powder
1/4 teaspoon cayenne powder
Keto sweetener: 1/2 teaspoon liquid stevia -OR-

Paleo sweetener: 1 1/2 tablespoon coconut sugar

Instructions

Rinse ribs with water and pat dry. Put a large sheet of tin foil on the counter. If it’s not wide enough, layer another one wide enough that you can tent the rib rack.

Lay the ribs bone side up and remove the membrane by sliding a knife underneath the membrane between the bones. Once it’s loosened you can peel it all off.

Combine the rib seasoning in a small dish, and then season the rack of ribs on both sides. Loosely wrap the ribs with the tinfoil forming a “tent” so the sides aren’t touching the ribs and seal closed at the top.

Heat grill to 250-300 ºF. Place the tinfoil tent onto the grill. You want to keep the temperature right around 250-300. Let cook for 2 hours.

Carefully open the tinfoil tent and brush liberally with BBQ sauce. Gently close tent again, it does not need to be sealed again. Let cook for an additional 1/2 hour until BBQ looks caramelized and like a glaze on the ribs.

Ribs are done cooking when the meat has shrunk, and 1/4 inch of the bone is exposed at the thinner end of the ribs. Remove from grill and let rest for 15 minutes in the foil prior to slicing.

Slice by cutting between the bones, add additional BBQ if you desire, and enjoy!

Bailey spent the last 2 years changing her relationship with food and herself. She lost 120 pounds while working 12-hour overnight shifts in a Minneapolis hospital and is now living a “whole” new life. She shares it all on her Instagram, @wholekitchensink and writes about healthy living, easy yet delicious recipes, and the ups and downs as she navigates finding overall wellness on her blog www.wholekitchensink.com.

Bailey Ryan www.wholekitchensink.com | IG: @wholekitchensink

The post Guest Recipe: Low Carb BBQ Ribs appeared first on Mark's Daily Apple.

I Feel Better Than I Ever Did In My Life

It’s Friday, everyone! And that means another Primal Blueprint Real Life Story from a Mark’s Daily Apple reader. If you have your own success story and would like to share it with me and the Mark’s Daily Apple community please contact me here. I’ll continue to publish these each Friday as long as they keep coming in. Thank you for reading!

When I first started on a low-carb diet, I lost 35 lbs (16 kg) in five months. I had 24 conditions! But not all my ailments healed.

I went down the rabbit’s hole and was able to turn my health around and cure a myriad of health issues with some additional measures. This is what I did.

My story began in 2013, where I adopted an eating protocol via Dr. Mark Hyman’s Ultrametabolism, after discovering my cholesterol was high. Following that plan, I lost 35 pounds (16 kg) in five months and had more energy for a period of time. But I started getting tired, having palpitations, wake-ups at night where I couldn’t go back to sleep, and others. I had already, over my lifetime, been diagnosed with being overweight, high blood pressure, tachycardia, chronic migraines, lumbago, bulging disks, ADHD, generalized anxiety disorder, fibromyalgia, various nutrient and vitamin deficiencies, and others. I presented my issues to my doctor, whose only answer was the old, tired adage…”You are getting older, and this is what happens when you get older.”

I have autoimmune disease (discovered myself by literally forcing the conventional docs to test me for thyroid antibodies) based on my research of my symptoms from various functional medicine doctors whom I follow…so I began researching healing autoimmunity within functional medicine and Mark’s Daily Apple. I eliminated gluten, dairy and similar proteins completely from my diet. This includes all store-bought breads, pastries, pastas, and milk and milk products, and replaced them with my own, home-baked, (primarily coconut flour) products, and nut milks, primarily coconut milk. This is where my fibromyalgia, headaches and lower back pain went away for good, I hope indefinitely.

I gave up beans completely (too difficult to absorb, even when soaked), nuts (too much phytic acid in a healing gut). I gave up all processed/packaged foods, and bought and ate/eat only organic (unless ewg.org’s list says I can eat conventional). I consume pastured eggs only, grass-fed beef 1-2 times/week, wild-caught fish, and only hormone- and antibiotic-free chicken and turkey. I don’t use any conventional oils, only olive for my homemade salad dressings (your dressings are the only ones around with completely good for you ingredients, by the way!) , and coconut oil and grass-fed butter for higher-heat cooking. I eat an 80/20 raw diet. I have eliminated soy, and soy products, though I must admit, I still consume soy lecithin, as Chris Kresser, whom I admire, says it shouldn’t be problematic. I have an adoration of dark chocolate, you see…

Omega-3 for Health: What the Latest Research Shows

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

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

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

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

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

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

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

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

How Omega-3s Benefit Health
Arthritis

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

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

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

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

Depression

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

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

Yes.

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

Stress Reactivity

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

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

General Inflammatory and Immune Responses

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

Reduced inflammatory markers (HS-CRP) in Type 2 diabetes patients.
Improved inflammatory markers in colorectal cancer, including HS-CRP.
Reduced airway inflammation in asthma patients.
Pre-op fish oil improved post-op inflammatory and immune markers in cancer surgery patients.
Reduced inflammatory marker IL-10 in chronic Chagas cardiomyopathy, a serious heart condition.
Reduced inflammatory gene expression in humans.

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

Fish Oil and Cardiovascular Disease

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

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

How To Improve Bioavailability

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

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

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

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

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

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

Making It Easier To Get Your Omega-3s…

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

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

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

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

Metabolism and Menopause: What Does Research Suggest Is the Best Dietary Strategy?

After my recent post on keto for women, I got a lot of feedback. One of the most common themes: “But what about menopause?” I heard from dozens of women in both the comment section and in emails who were having trouble losing weight and dealing with the varied symptoms of menopause. Was keto the answer? Was Primal? Were they doing something wrong?

Rather than start with the assumption that going keto or Primal is the best way to deal with menopause, I figured I’d start from ground zero, drawing on the extensive scientific literature on diet and menopausal symptoms to see if I could arrive at some general trends and make recommendations.

But first, why do we even experience menopause? In the big picture, menopause is rather rare. Besides humans, orcas and pilots whales are the only other species where the females live significantly beyond their reproductive age. The average age of menopause hovers around 50, and most women can expect to live another 30 years or so. That indicates its importance. It wouldn’t have been uniquely established and preserved in just a couple species if it didn’t provide huge benefits to those species. And sure enough:

The presence of grandmothers in a population enhances maternal survival during childbirth.
They provide childcare so parents can be more productive, whether it’s going back to work in the office or foraging for nuts and tubers in the bush.
They impart wisdom to the youngsters—and to the community as a whole.
And, though parents probably wouldn’t count this as a positive, they spoil grandkids rotten.

To boot, many women I know say menopause ushers in the most focused, creative time of their lives. If their reproductive years (particularly perimenopausal ones) were characterized by hormonal chaos, they often find themselves grateful to be free of the perpetual fluctuation. But mostly they say they’ve entered a time of life when they feel more confident and self-possessed. (Joan Erikson, wife of noted psychologist Erik Erikson as well as author, psychologist, teacher, and artisan, writes insightfully about this transition.)

All this said, menopause can also present its share of physical difficulties for many, if not most, women at some point. But do these effects need to be as unpleasant as they often are? I’d venture to say no. I have a few posts in mind here, but let’s dig into dietary strategy today.

First, let’s establish what changes physiologically during menopause. What are the most common symptoms of menopause? And what does the evidence say about how diet affects those symptoms?

Weight Gain

This might be the most common complaint women have during and after menopause: Weight goes on more easily and is harder than ever to scale back. Nothing seems to work, even the dietary interventions that previously did.

Why is weight loss so hard after menopause?

Energy expenditure and basal metabolic rate both drop with menopause.
Lower levels of estrogen increase appetite and reduce satiety.
Lower levels of estrogen reduce activation of brown fat, the metabolically-active body fat which burns energy.
If you’re experiencing another common side effect of menopause—insomnia—your sleep-deprived brain’s reward system will be more susceptible to the allure of junk food.
You’re older. As we age, weight becomes easier to put on and harder to remove for both men and women.

Despite these roadblocks, there is hope. Something has to work. And even if it doesn’t work as well as you’d like, there’s something that works less badly than the others.

For one, glycemic load matters. Many studies find that the glycemic load of a postmenopausal woman’s diet is a strong predictor of her fat mass. Remember that glycemic load is often a roundabout way of indicting carbohydrates without saying “carbohydrates.”

What really does seem to work is the classic paleolithic diet: lean meat, fruit, nuts, vegetables, eggs, berries, and fish with no grains, legumes, sugar, dairy, potatoes, or added salt. 40% of energy from fat, 30% from protein, 30% from carbohydrate. Over 24 months, menopausal women on a paleo diet lost more fat, more waist circumference, and more triglycerides than those on a standard “healthy” diet.

Perhaps it’s the protein. Another study found that postmenopausal women who ate the least protein (under 0.8 g protein per kg bodyweight) had the most body fat and were physically weak. Those who ate the most (over 0.8 g per kg, 1.1 g/kg on average) had the least body fat and were more physically capable.

What’s clear is that weight loss has beneficial effects on menopause symptoms. It reduces inflammation, improves cancer biomarkers, regulates sex hormones, and improves endothelial function—to name a few. What’s also clear is that weight loss can have negative second-order effects in menopausal women, like bone mineral loss and loss of lean mass. So, it’s worth doing, and doing right. You have to strike a fine balance between losing weight and avoiding muscle loss. As your satiety signaling is likely thrown off, you might have to make a more conscious effort to track your food intake and make sure you’re not overdoing it.

Heart Disease

Before menopause, most women are protected against heart disease, at least compared to men. Once menopause sets in, a woman’s heart disease risk goes way up. A good diet for menopause, then, would have to reduce heart disease risk. What does the evidence say?

In overweight post-menopausal women, high-fat diets (where the fat came from cheese or meat) improved atherogenic biomarkers compared to a high-carb diet. Both the cheese-based and meat-based diets increased HDL and Apo-A1; the high-carb diet did not.

Meanwhile, high-carb diets were persistently linked to chronic low-grade inflammation and an elevated risk of heart disease in postmenopausal women.

Moving beyond broad macronutrient ratios, are there any specific foods or nutrients that play an outsized role in menopasual women’s heart health?

Dark chocolate may help with reduced endothelial function, another risk factor for heart disease. Postmenopausal women who consumed high-cacao chocolate saw their endothelial function improve in one study.

Green tea appears to help postmenopausal women reduce fasting insulin, a major but underappreciated risk factor for heart disease (and a host of other bad conditions).

Bone Loss

As estrogen plays a big role in the maintenance of bone mineral density and overall bone health, bones get weaker and lose density during menopause. A woman’s risk of osteoporosis, fractures, and other bone-related incidents skyrocket during and after the transition.

Intake of long-chain omega-3 fatty acids—found in fish, shellfish, and fish oil supplements—is associated with higher bone mineral density at the hips and spine (the most crucial parts for aging people) in osteopenic women. Osteopenia is lower than normal bone mineral density. It isn’t quite osteoporosis, but osteopenia can often progress into it.

Glucose loading actively impairs bone remodeling in postmenopausal women. The problem doesn’t go away just because you exercise, either. And it gets worse the higher your postprandial blood glucose goes.

The normal bone-relevant nutrients become even more relevant after menopause:

One study in postmenopausal women found that yogurt fortified with vitamin D3 improved bone mineral density, while regular yogurt without the vitamin D3 worsened it.
Another found that a gram of calcium a day wasn’t enough to stave off bone mineral loss in menopausal women during weight loss; they needed at least 1.7 grams per day.
Another study found that a collagen supplement increased bone mineral density in post menopausal women.

Brain Fog

Everyone’s heard of “pregnancy brain.” There’s also “menopause brain.” It’s characterized by brain fog, memory loss, lack of focus, and other cognitive symptoms.

Postmenopausal women who ate low-glycemic breakfasts had better cognitive function than those eating high-glycemic breakfasts.

Some research also suggests a role for micronutrient supplementation in menopausal cognitive symptoms:

Vitamin C can help. In one study, postmenopausal women who took 500 mg of vitamin C a day improved verbal recall, naming, and repetition. These improvements were accompanied by reductions in beta-amyloids linked to Alzheimer’s disease.
Resveratrol may help. In one study, it increased cerebral blood flow and improved overall cognitive performance during a series of tests, particularly in verbal memory.

Hot Flashes

Both fish oil and soy isoflavones have been shown to reduce hot flash occurrence, with soy acting faster on severe hot flashes and fish oil doing a better, but slower job of targeting both moderate and severe hot flashes.

Folic acid supplementation reduced the severity, duration, and frequency of hot flashes. A better source for folic acid are folate-rich foods, like leafy greens or liver.

Breast Cancer

A woman’s risk of breast cancer rises after menopause. After menopause, the inflammatory status of the breast goes up almost as a general rule. This explains at least part of the elevated risk for breast cancer postmenopausal women exhibit, and it’s true whether or not the woman is overweight or not. Menopausal breast fat is inflammatory fat.

Among Japanese women, those who ate the most noodles and other carbohydrates had higher levels of estradiol, which other studies have found correspond to a higher risk of postmenopausal breast cancer. Those who ate the most fish, fish fat, and saturated fat had lower levels, which correspond to a lower risk. Of course, the authors opine that this suggests eating more fish and say nothing about saturated fat, but we can’t really expect them to contradict decades of propaganda—I mean, evidence.

Oxidative Stress

Menopause is generally inflammatory; along with waist circumference, menopause status is an independent predictor of low-level inflammation and elevated hs-CRP (one of the most fundamental markers of inflammation). There’s a low level simmer going on, and it can cause a lot of problems. Diet can make it worse, or make it better.

High-glycemic diets—also known as diets high refined carbohydrates—are associated with more oxidative stress in post-menopausal women (for what it’s worth, the same is true in premenopausal women). Intakes of insoluble fiber and PUFA, including omega-3s and healthy sources of omega-6s like nuts, were linked to lower levels of oxidative stress.

Paleolithic diets, on the other hand, reverse inflammatory markers in postmenopausal women.

Folate supplementation reduces oxidative stress and normalizes blood pressure in postmenopausal women.

Genetics matter, of course. A growing body of evidence indicates that various genetic variants can influence the effects of some of these dietary interventions on the symptoms and risks associated with menopause.

Among Japanese and Japanese-Brazilians, for example, soy isoflavone intake protects against breast cancer only in those with certain genetic variants. It’s neutral otherwise.

There’s more to managing menopause than just diet, of course. Lifestyle decisions matter too. But that’s beyond the scope of today’s post. Maybe in the future.

So, can we make any recommendations? What are the takeaways? We see some trends emerge.

Dietary Takeaways
Avoid Refined Carbohydrates

Pretty much every study that looked at fast-digesting, low-nutrient sources of carbohydrates found they have a negative effect on most concerns of menopause, including bone health, breast cancer risk, heart health, weight gain, inflammation. Now more than ever, don’t eat them.

Limit Carbs To Only What You Use

If you’re an incredibly active woman, someone who CrossFits and runs sprints and swims laps and plays with grandkids, you can get away with more carbohydrates, and may even thrive with a few extra. But make sure you actually need those carbs.

Soy Isn’t a Bad Idea

I know, I know. Soy is evil, or something. But a number of studies indicate that soy can improve the overall menopause experience. Stick to whole soy vs isolated soy components. (And avoid GMO.) If you can include something like natto—fermented soybeans—a few times a week, you’ll get the benefits of soy isoflavones and vitamin K2.

Drink Green Tea

Several studies show that green tea (or green tea extracts) counters or ameliorates multiple menopause symptoms.

Eat Leafy Greens

Greens are a great source of folate and calcium, critical nutrients for postmenopausal health.

Eat Adequate Protein

1.1 g/kg should be the lower limit.

Eat Fish

A can of sardines (bone-in) provides omega-3s, calcium, and excellent protein.

Lean Toward a Higher-Fat-AND-Protein, Lower-Carb Diet

Make sure to stick with Primal foods.

Menopause isn’t easy for most women. Things are changing, hormones are in flux, and eating strategies you once employed may no longer work the same way. There’s no magic diet that fixes everything, but there are lots of little changes that can tilt the scales in your favor.

Try them out and let me know what you think.

In the meantime, I’d love to hear how you’ve handled menopause via diet. Thanks for reading, and take care, everybody.

The post Metabolism and Menopause: What Does Research Suggest Is the Best Dietary Strategy? appeared first on Mark's Daily Apple.

What Are Exogenous Ketones and Who Should Take Them?

Interest in the ketogenic diet is at an all-time high, and for good reason. It’s a great way to lose body fat, gain steady energy throughout the day, increase fat-burning capacity at rest and during exercise, reduce inflammation, and improve cognitive function. Keto also has a number of promising medical applications, including seizure control, enhanced efficacy of chemotherapy, and abatement of age-related cognitive impairment.

But going keto takes work. You have to overhaul your diet, restrict certain classes of foods, and pay close attention to what you eat. People prefer to avoid work if they can. They like shortcuts. Exogenous ketone supplements promise a shortcut—swallow this pill or mix this powder into your water and see your ketones skyrocket without changing the rest of your diet.

Although I’ve discussed exogenous ketones in the past, I’ve had many readers ask for a straightforward primer and takeaway recommendations for exogenous ketones. Here it is. Before I evaluate the proper role of ketone supplements, let’s dig into some basic questions.

What Are Exogenous Ketones?

There are two main types: ketone esters and ketone salts.

Ketone esters are ketone bodies bonded to an alcohol molecule. They taste terrible but are more potent than ketone salts. The rise in ketones after ketone ester supplementation is more pronounced but doesn’t last as long.

Ketone salts are ketone bodies bonded to a salt, such as sodium, magnesium, or potassium. They taste better (but not good) but are less potent than esters. The rise in ketones after ketone salt supplementation doesn’t get as high but lasts longer.

Do They Work?

Exogenous ketones increase blood, urine, and breath levels of ketone bodies. In that sense, they “work.”

Are they an effective substitute for actually following a ketogenic diet? Probably not.

First, there’s something unnatural about having elevated levels of ketones and glucose together. It’s really hard to make that happen using traditional whole foods. The closest natural approximation you could get to it would be the traditional coconut-rich diets of the Kitava people in the South Pacific, where the medium chain triglycerides (MCT) in the coconut fat increased ketone production alongside the carbs in the fruit and tubers they ate. They had excellent metabolic health, but they weren’t anywhere close to a ketogenic diet. Coconut fat isn’t as ketogenic as purified MCT oil, let alone exogenous ketones.

That alone gives me pause. The evolutionary novelty raises my hackles.

Second, there are inherent metabolic differences between boosting ketones via diet and boosting ketones via supplements. On a ketogenic diet, ketones go up because you’re converting body and dietary fat into ketone bodies. A rise in endogenous ketones means you’re burning fat and building the requisite machinery to metabolize the new energy source. On exogenous ketones, ketones go up because you ate some ketones; conversion of body and dietary fat into ketone bodies goes down if anything.

Take this study where human volunteers drank either ketone ester or ketone salt beverages alongside their normal diet. It worked. They got into ketosis, showed elevated levels of ketone bodies, and did this without changing their diet. Their conclusion says it all: “exogenous ketone drinks are a practical, efficacious way to achieve ketosis.”

Another effect of the ketone drinks was to lower blood glucose, free fatty acids, and triglyceride levels. This sounds great. Elevated levels of all those markers are harbingers of disease, particularly if they remain chronically elevated. But think about what this means. If free fatty acids go down, that means adipose tissue isn’t being liberated for burning.

That’s exactly what ketones do: inhibit lipolysis, the breakdown of body fat into triglycerides and free fatty acids for burning. In normal conditions where ketones are produced endogenously, this is expected and beneficial. If homemade ketones increased lipolysis, you’d end up with ketoacidosis. You’d make ketones which released more body fat which got turned into more ketones which released more body fat which became more ketones. And on and on. It simply wouldn’t stop.

But if you’re taking exogenous ketones to lose weight, you’re going to be disappointed.

Although they aren’t officially classified as a macronutrient, they are a source of energy. If you’re consuming exogenous ketones, you’re burning less of another energy source. And you’re making less ketones.

That’s not to suggest that exogenous ketones are useless. They have many potential uses, as I’ll explain. They just aren’t the same as getting into ketosis using diet or fasting.

What Are Their Practical Benefits?

Exogenous ketones can lower appetite during a fast. After an overnight fast, normal weight human subjects either drank a ketone ester supplement or a calorie-matched glucose drink. Compared to the glucose drinkers, the ketone drinkers had lower insulin, lower ghrelin, greater satiety, and less hunger. This can be useful for people trying to extend their fast who don’t want to or can’t yet deal with the hunger. You’re still taking in energy, but the metabolic profile remains similar to that of a fasted person.

Exogenous ketones can acutely improve the glucose response. After an overnight fast, healthy, normal weight humans drank a ketone ester supplement which spiked their ketone levels up to 3.2 and remained elevated throughout the oral glucose tolerance test. This reduced their blood glucose response and increased their insulin sensitivity.

Exogenous ketones can suppress expression of an inflammatory pathway linked to several disease states, including arthritis.

As it stands now, there are two areas where exogenous ketones show great potential.

Where Do Exogenous Ketones Make the Most Difference?
Medical Applications

For whatever reason, many patients won’t attempt a ketogenic diet—even if the evidence is clear that it could help. Doctors are often hesitant to recommend dramatic dietary shifts—even if they believe in their efficacy—to patients who are already dealing with difficult health issues. If you’ve got a picky kid with epilepsy, a pickier adult with Alzheimer’s, or a cancer patient who refuses to give up the familiar-yet-non-ketogenic foods that give him some small manner of comfort in this trying ordeal, exogenous ketones could make a big difference.

The human studies aren’t quite there yet, but it seems likely that they’d help. A recent human case study found that ketone esters added to the regular diet improved Alzheimer’s symptoms. Animal studies indicate that adding exogenous ketones to a regular lab (read: not ketogenic) diet can reduce seizure activity and improve overall symptoms in epilepsy animal models, reverse early neuronal hyperactivity in Alzheimer’s animal models, and reduce anxiety in rats.

High Performance Endurance Athletics

Alongside a normal high-carb athlete’s diet, the provision of exogenous ketones before a race increased performance over carbohydrate alone. It increased fat utilization and preserved glycogen reserves until the later part of the race—just like fat-adapted training, only with carbs in the diet.

Exogenous ketones don’t seem to improve high-intensity, glucose-intensive exercise, increasing fat burning during steady state exercise but dropping top-end high-intensity performance. Another study found that ketone dieters reduced 50-minute time trial performance in cyclists, though another group of researchers have criticized the methods. Even when a ketone ester didn’t improve performance in the shuttle run to exhaustion and 15 meter sprint repeats, it did reduce the drop in brain function following the exercise.

There’s a lot more research coming down the pike in this area, but there’s clearly some efficacy in endurance athletics, and maybe athletics in general.

Suggestions for Purchasing Exogenous Ketone Supplements

Ketone supplement choices include a variety of products with beta-hydroxybutyrate or those containing medium-chain triglycerides (liquid or powder), which will help boost liver ketone production if you’re already following a keto dietary approach. Products with beta-hydroxybutyrate often include additional agents like amino acids or minerals.

As for MCT oil (and oil powders), powder formulations tend to cause less digestive distress (e.g. probiotics), but some folks object to the additional ingredients like sunflower lecithin or soluble corn fiber). Even if you’d like to eventually settle on an oil, I’d recommend starting with a powder to see how you respond and to give your body the chance to adapt over time.

Over the past couple years, I’ve tried a number of ketone supplements, generally to enhance a longer fast or to offer an edge before one of my Ultimate Frisbee evenings. This Kegenix variety is one I’d recommend. I’ve also used Quest Nutrition MCT oil powder with good results as well, but there are plenty of other solid formulations to choose from.

Are There Side Effects?

The most common side effect is GI distress. In my experience, it’s urgent GI distress. If you decide to try an exogenous ketone supplement, do so slowly. Space out your doses. Remain close to a trusted bathroom.

They also taste terrible, although that’s improving. If you don’t think “tastes bad” is a side effect worth mentioning, you haven’t take a shot of ketone esters.

If you take exogenous ketones, use them for something of substantial benefit:

Seizure cessation.
Cognitive improvement in dementia.
Increased fasting tolerance.
High-end performance, especially endurance training.

But don’t sit around and take ketone esters or salts because you want to “bump your ketones up” for some vague reason. Or because you think they’ll be a miracle weight loss supplement (they won’t be). Have a purpose. Give those ketones something to do. Have a specific, appropriate, research-affirmed job for them.

Finally, don’t expect them to be a replacement for regularly spending time in an endogenously-ketogenic state. Living keto is considerably more effective than trying to supplement your way to it.

Thanks for stopping in, everybody. I’d love to hear your thoughts and questions. As I mentioned, I intended this as a basic primer for beginners and visitors to the site. (Welcome, by the way!) If questions warrant, I’ll do a follow-up post that gets more granular.

The post What Are Exogenous Ketones and Who Should Take Them? appeared first on Mark's Daily Apple.

Dear Mark: Following the Money, HIIT Workouts, HIIT and ACL Recovery, Spinach, Collagen Timing

For today’s edition of Dear Mark, I’m answering six questions from readers. First, is funding from a biased source sufficient to negate a study’s results? Second, what are some good high intensity interval training workouts that people might not have considered? Third, what can someone recovering from an ACL tear do for HIIT without triggering knee pain flareups? Fourth, how do I like to eat spinach? And finally, how and when do I like to take collagen?

Let’s go:

On the nuts vs. carbs study, I want to say ‘follow the money’ since it was funded by the International Tree Nut Council Nutrition Research and Education Foundation. Then again, it was also funded by the Peanut Institute, so I don’t know what to think…

“Following the money” isn’t enough to come to any conclusions about the worth of a study. We can’t declare a study tainted based on bias alone, especially because we can’t avoid bias. Every person reading studies and deciding which one to write about is biased. Every organization meting out funding has biases. Every entity in the known universe has an agenda. It’s not “bad” (or good). It simply is.

If the cow consortium funds the “red meat is actually good for you” study, red meat is still good for you. The bias doesn’t negate the facts. Big Soy funds the “don’t worry about the quarter cup of soybean oil in your restaurant food” study, but it’s only a mark against the paper if the science was shoddy and the conflict of interest exerted influence (which it probably was and did).

But I totally understand where you’re coming from. There’s an entrenched bias against most of the health advice we support. The powers that be have spent decades telling us to avoid the sun, restrict meat (especially red meat), go vegetarian, eat low-fat, get “more complex carbohydrates,” use seed oils, do cardio over weights, eat less salt, and blindly drink more water. They’re not just going to go away—and they aren’t.

So whenever I see a study’s been funded by an obviously biased source, I can’t help but wonder and look more deeply at the paper with a skeptical eye. It sounds like you do the same. That’s great. It’s the kind of healthy skepticism we should all have and employ in our search for good information.

We just can’t stop there.

If the results  of a study are unfavorable to the funders, it’s a strong indication that the funding didn’t interfere with the science.

If the results are favorable to the funders, our hackles rise. We examine the study methods, design, and results to see if bias affected the results. Many times it doesn’t. Sometimes it does.

Can you point us in the direction of a good HIIT workout and what it should look like?

Here are a couple ideas:

Hill sprints. Find a hill and run up, then walk down. Walking down serves as active recovery. Steeper hills, shorter sprints with more rest. Hills with a gradual incline, longer sprints. All permutations work. Though extremely difficult, hill sprints are good options for many people with lower body injuries that flare up on flat ground sprints; running up a hill is gentler on your joints.

Barbell complexes. Pick 3-4 barbell movements. Clean and press for 5 reps. Romanian deadlift for 5 reps. Clean to shoulders, then front squat for 5 reps. Finish with 5 bent over rows. Do that without stopping or dropping the weight. That’s a complex. Drop the bar and rest a minute or two, then do another complex. Repeat. This works with any barbell movement, and you can even do kettlebell or bodyweight complexes. Adjust weight and reps accordingly. These complexes should be hard (but over quickly).

I tore my ACL 6 months ago. Although I am walking 5-7 miles a day and doing heavy lifting for my upper body. I am only able to do ball squats carefully at this point. Any HIIT ideas for me at this point? The bike causes pain on the front of my knee still.

Check with your doctor, but deadlifts are probably safe during knee rehab. Do them right and there’s very little knee flexion (it sounds like flexion hurts the knee); it’s all hip extension.

Deadlifts can become “cardio” if you drop the weight and increase the reps. Just maintain impeccable form. Don’t sacrifice technique (and back health) for a couple extra reps.

If you can deadlift safely for high reps without pain, the next thing to try is the kettlebell swing. Swinging a kettlebell is very similar to deadlifting a barbell—it’s all hip extension—and lends itself well to high-rep, HIIT-style workouts.

I’m one of few people I know who enjoys eating basically any type of offal (no problems with raw), but can’t handle spinach by itself. Any advice? Also, ever tried meditatin’?

And here’s where I’ll get thrown out of my own movement because of one of the ingredients.

Sauté spinach (frozen or fresh) in butter for a minute, add a handful of corn kernels (fresh or frozen, but organic or at least non-GMO), add salt, pepper, and dried chipotle pepper powder (as much as you can tolerate), cover, and turn heat to low. After about ten minutes, it’s ready. Finish with grated sharp cheddar or pecorino romano.

I don’t eat this often (never while keto), and it’s certainly not the only way I enjoy spinach. A good raw spinach salad is fantastic, as is basic sautéd spinach without the corn. But I’ve never met anyone who didn’t like the spinach-corn-chipotle recipe, even avowed spinach haters like yourself.

I’m curious about when Mark was supplementing heavily with collagen. Did he do that at breakfast as his only food, lunch in lieu of some other protein, a shake between lunch and dinner? What have other folks done?

I’m wary of too much protein in one sitting.

I would have 2-3 tablespoons of collagen with a little vitamin C half an hour before a workout. That’s been shown to increase collagen synthesis, a necessary step for healing tendons and other tissues.

That’s it for today, folks. Thanks for reading and take care!

Be sure to add your own comments, questions, and input down below.

The post Dear Mark: Following the Money, HIIT Workouts, HIIT and ACL Recovery, Spinach, Collagen Timing appeared first on Mark's Daily Apple.

Weekend Link Love — Edition 514

Research of the Week

Replacing some linoleic acid with omega-3s reduces liver fat and oxidative stress.

The long term economic impacts of salt iodization in the United States (were good).

Cornflakes spike glucose (more than you think).

Cat poop parasite may boost entrepreneurialism. I smell a new supplement.

Plastics could be altering male genitalia.

Late dinners increase breast cancer risk. More time between dinner and sleep reduces it.

New Primal Blueprint Podcasts

Episode 265: Jezlan Moyet: Host Elle Russ chats with Jezlan Moyet, the host of the first-ever live-streaming talk show—Good Morning LaLa Land.

Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

Interesting Blog Posts

I wouldn’t necessarily take all these foods camping, but the ones I would are great.

Dom D’Agostino’s first meal of the day (and what it does to his blood markers).

Squeezing through a 7 inch passage to see your ancestors.

Media, Schmedia

Is an antiseptic used in poultry processing making workers sick?

Forgetting to remember.

The power of a good friend (or four).

Everything Else

A worm that’d spent 42,000 years frozen in permafrost just came back to life.

Imagine being the person who eats a 1.5 pound pretzel at the movies or willingly chooses to consume “chopped chicken breast coated with breadcrumbs” and “topped with angel hair pasta in a cream sauce.”

I don’t blame those kids.

In a few years, they’ll ban lunch skipping. Intermittent fasters will be forced to skip dinner instead.

Make sure you really need that antibiotic.

When real life is hard and unfulfilling, video games are an attractive alternative to a growing number of young men.

Mars has a big body of water.

Things I’m Up to and Interested In

Wearable I’d try: The new noninvasive continuous glucose monitor.

Study that surprised me: In a placebo-controlled trial of fecal transplants in IBS patients, placebo won.

Article I’m pondering: “Yes, You Can Catch Insanity.”

Research I found very interesting: Trends in food avoidance.

Realization I came to a long time ago: We shouldn’t eat what urban raccoons eat (but we do; urban raccoons only eat what we throw out).

Recipe Corner

I teamed up with Sprouts Farmers Market to make one of my signature salads on Facebook Live.
A salmon BLT Cobb salad is quickly becoming one of my favorites.

Time Capsule

One year ago (Jul 22– Jul 28)

CrossFit Training: How to Lose Fat With Primal – It’s not just about performing well.
Stop Obsessing Over the Numbers – I mean it. Knock it off.

Comment of the Week

“Though I changed my mind; how ’bout Metabolistopheles?

‘Ah! Now I’ve done the sigmoidoscopy,

All is settled; fiber bulk reigns my entrails.

Yet no leaner than before I stand — nay, tread,

Over insulin’s winding curves and opaque trails.

My crawling underbelly, quenched only by bread,

Fiddles to the tune of my fat’s scarcity swerves.

Or a mocking allele expressed by ravaged chemistry,

Tangled in miserable knots, escapes my bosoms:

Falling down towards Earth by the shortest path.’”

– I love it, Stefan.

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