Mark Sisson's Blog, page 240

Winter Blues: How Cold, Dark Days Can Take a Mental Toll

After last week’s look at what winter does in terms of physical symptoms, I’d be lax to not address the obvious elephant in the living room: mental health in the colder, darker season. I’ll admit I don’t know too many people who look forward to this time of year past the holidays. The adventure of winter sports aside (for those who love them) and the chance for a little social hibernation (for those who prefer that), winter can take an exponential toll on people past the New Year. That said, just how much is relative inconvenience versus clinical reality? Do our moods collectively change? Why do some people experience more significant effects? What are the real hormonal influences this time of year, and what (if anything) can or should we do about them?

To present one novel research context, even analysis of Google searches seems to point to some kind of seasonal shift in mental well-being. Researchers studied four years of Internet queries across countries in both the Southern and Northern hemispheres and observed that Internet searches for every major mental illness or condition—everything from schizophrenia to ADHD, anxiety to OCD—consistently rose during the winter months. While some categories like searches for bipolar disorder differed by 16-18%, others like eating disorders were 37-42% higher in winter than in summer. Internet searches for suicide rose 24-29% in winter compared to summer, even though actual suicide rates peak in late spring.

Of course, the most common (or at least commonly known) seasonal responses is Seasonal Affective Disorder, a.k.a. SAD, an ongoing form of depression in which symptoms annually subside during certain seasons (usually but not always summer). As with many forms of depression, people can experience a sense of hopelessess, a glut in energy, and sleep difficulties among other symptoms. Researchers estimate around 6% of the U.S. population (varying extensively from 1-10% based on latitude) experiences SAD and an unknown but much larger number go through a lesser form known as the “winter blues” in which similar symptoms occur but in milder forms.

Experts have long debated the causes of SAD, but the central assumption focused on reduced natural light exposure. That said, it’s not simply an isolated factor but a constellation of influences (including apparent genetic propensities, biological nuances and demographic facets). Women are much more likely than men to experience SAD symptoms with studies suggesting anywhere from a 2:1 to 9:1 ratio. Likewise, the initial cause becomes a more complex picture when researchers look at the cascade of presumed physiological effects.

In PET scans of live brain tissue, for example, researchers have discovered greater levels of serotonin transporters (which bind with and ferry serotonin to the nerve cells, in essence reducing serotonin activity) in the brain during the fall/winter months. Because serotonin is believed to help maintain emotional balance as well as influence energy levels, sleep/wake cycles and even to a certain extent appetite, the potential impact is obviously significant.

That said, just as not everyone would say they truly experience seasonal affective disorder, not everyone’s brain processes the seasonal serotonin change the same. Researchers have observed this shift as more of a “dial” than a switch, with those who experience SAD symptoms demonstrating a 5% increase in their serotonin transporter levels compared to their summer measures, while those without SAD showing no substantial rise.

Yet, it’s not only depression some of us may be dealing with. Animal research suggests that shorter days shift female hormone levels in such a way to promote more aggression. Female hamsters exposed to shorter days displayed more aggressive tendencies and had increased levels of both melatonin and DHEA than those exposed to longer days. Among the hamsters who experienced the longer light exposure, even an injection with ACTH (which spurs the release of DHEA) didn’t show the same responses as the short-day animals.

As the researchers note, it pays from an evolutionary perspective, to be more scrappy and aggressive during bouts when there is inevitably more competition for fewer food resources. If this pattern is applicable for humans, maybe it can partially explain why people go so insane on Black Friday….

Aggression aside, the evolutionary angle would seem to suggest people should conserve more energy in winter, that they would attempt to sleep longer and rest more. That said, we moderns live literally more sheltered lives than our primal ancestors did. Because of our housing and cars and offices, we are outside very little. We have plenty of elements to our modern lifestyle that already put our circadian rhythms at risk. We’re already chronically deficient in vitamin D. We’re stressed by too little sleep, too much stress, too little movement and too little genuine nutrition.

If we know a problem is seasonal in nature, the logical idea is to utilize whatever means we have available to minimize the seasonal deficits. We can spend more time outside during peak sunlight hours, use light boxes—still the most recognized and recommended SAD and winter blues treatment— and go to bed earlier without an evening’s worth of blue light from our T.V.s and gadgets. Likewise, we can supplement vitamin D (here’s the one I take), given our lower overall direct light exposure in the winter months and in certain cases with melatonin for realignment of our bodies’ cues with external timing. Finally, experts also increasingly emphasize that traditional talk therapy can for some people be even more effective than the use of any single traditional physical therapy. And if all else fails, try this one weird trick known as koselig.

As we so often recognize, Primal living takes the long view in resetting as much of ours lifestyles as possible, sometimes with traditional activities and sometimes with strategic stand-ins.

Have you experienced the winter blues or SAD? Share your perspectives on seasonal mood and treatment options. Thanks for reading, and have a great end to your week.

Is There Really an Obesity Paradox?

A couple weeks ago, I linked to an article discussing the “obesity paradox”—the idea that across many different studies and populations, people with slightly overweight and even obese BMIs often have the lowest mortality risk. The author is Harriet Brown, a supporter of the “Health At Every Size” movement, comes down hard on the side of overweight/obesity as safe and even beneficial. At first glance, she makes a strong case. She appears to cite compelling research. She talks to obesity researchers who’ve found protective links between higher BMIs and better health and been lambasted by their colleagues. And if the general consensus is right, and carrying extra weight is so unhealthy, why are obesity and overweight consistently associated with a lower risk of death?

 

Brown claims that no other researchers “have been able to make the paradox go away.” She highlights and dismisses two possible explanations for the paradox. First, that heavier people visit the doctor more often and receive more and better medical treatment than normal weight people. Although Brown calls this “the most popular” of the explanations before proceeding to (rightly) demolish it, I haven’t heard many obesity researchers give it serious thought. The second explanation is the “unhealthy weight loss” one. If people who are normal weight because they lost weight due to cancer, smoking, sarcopenia, or another wasting condition are lumped in with people who are normal weight because they’re lean, fit, and healthy, the correlation between normal BMI and mortality is skewed. After admitting “there’s some evidence to back up this argument,” Brown pivots to the opinion of a single researcher, who says “it certainly does not seem to make the paradox go away.”

Okay. How comprehensive was Brown’s coverage of the explanations for the paradox? Did she leave anything out?

As it turns out, there are several other explanations for the obesity paradox.

Body fat as glucose sink for diabetics.

Somewhat higher BMIs than normal are associated with improved mortality risk in type 2 diabetics. We often forget that body fat isn’t just there for the hell of it; it acts as a storage facility for excess fat and glucose that cause health problems if allowed to circulate unchecked. Having high levels of sugar circulating throughout your body is dangerous. Unchecked hyperglycemia creates too many reactive oxygen species, depletes glutathione, increases AGE formation, and hyper-activates the enzyme responsible for many diabetes complications; it can increase the risk of complications requiring amputation, cause neurons to shrink, pancreatic beta cells to die, and endothelial function to plummet. When you’re insulin-resistant and your tissues aren’t responsive to insulin-mediated glucose transport, body fat becomes a useful, if unattractive glucose sink. That may be why a recent study found that among type 2 diabetics who’d just had heart attacks, the obese patients had lower rates of kidney disease (which is a byproduct of unchecked hyperglycemia) and lived longer than the normal weight patients. It also explains why increased BMI (at least until you hit extreme obesity) lowers the risk of amputation in diabetics.

Of course, that doesn’t mean everyone worried about diabetes should gain weight. For one, losing weight is a great way to reduce one’s chances of becoming diabetic in the first place. Two, diabetics who attempt to lose weight live longer than those who don’t and those who successfully lose weight enjoy drastic improvements to lifespan. Only unintentional weight loss was linked to increased mortality.

BMI as marker of lean mass reserve in heart disease patients.

BMI measures weight, nothing else. It doesn’t distinguish between muscle, bone, fat, tendon, or the rolls of quarters in your pockets. If gravity acts on it, it’ll show up in BMI. One study examined BMI, body composition, and mortality risk in men with coronary heart disease. Sure enough, overweight BMIs were the most protective against mortality in this population. But when you looked closer and incorporated body composition in the analysis, it turned out that lean muscle mass was responsible for the high BMI-low mortality link. Another study found that among heart failure patients, BMI was a better predictor of lean mass than body fat.

Low-normal BMI as marker of disease.

When an obese person develops cancer, they’ll often lose enough weight (from the disease itself and the treatments) to reach a normal or even underweight BMI. If they die from the disease, their BMI is noted and that death counts as a “normal BMI death.” But the thing that killed them happened when they were obese. A recent study examined this exact issue, using “maximum BMI” to control for the disease-induced weight loss confounder. They found that “the percentage of mortality attributable to overweight and obesity among never-smoking adults ages 50-84 was 33% when assessed using maximum BMI. The comparable figure obtained using BMI at time of survey was substantially smaller at 5%.” when you include the obese and overweight people who got sick and then lost weight before they died, obesity and overweight is responsible for a third of deaths in non-smoking elderly. When you don’t, obesity and overweight is only responsible for 5% of deaths.

I’m sorry. I’m not buying it. There’s no paradox. The relationship between bodyweight and mortality is complex and complicated, but there’s always an explanation—and it’s not “being obese is healthy!” Higher BMIs might be associated with improved mortality, particularly in certain populations. But what exactly do you mean when you say “BMI”? Body fat? That contributes to BMI. Muscle? That, too. What about the distribution of the body fat? Does that matter?

Yes. “Weight” doesn’t have an effect. What comprises the “weight” determines the effects.

BMI isn’t the best way we have to assess obesity and the associated health and mortality risks. It’s just the easiest and the cheapest.

It comes down to body fat. If you’re of normal weight but obese based on the amount of body fat you carry, you have a much higher cardiometabolic mortality risk.

It comes down to where you carry your body fat. Abdominal obesity is consistently associated with poorer health outcomes, metabolic dysfunction, and mortality.

It comes down to gender. In women compared to men, slightly higher body fat levels in general and lower body fat (within reason) in particular are linked to better health.

It comes down to muscle mass, the single best predictor of longevity in the elderly. If you’re strong, you’ll live longer than if you weren’t.

When you factor in things like disease-induced weight loss, smoking-related low BMI, and loss of lean mass, the ideal BMI for health and longevity is actually around 20-21. That’s exceedingly normal. Overweight is 25-29. Obese is 30 and up. Having a decent amount of lean muscle will increase the “low-mortality” BMI allowance.

If you want a simple measurement that can replace BMI, waist circumference—the distance around your belly—is a better predictor, and it lines up with conventional views on health and obesity. Higher waist circumference, worse health outcome and higher mortality.

And even if you take at face value the author’s claim that being overweight or obese either improves or has no impact on lifespan and only “slightly” increases the risk of heart disease and “other life threatening conditions,” what about the other things that matter, things that might not show up in studies? What about climbing the stairs without huffing and puffing? What about chronic joint pain preventing a heavy person from going on hikes, starting a training program, keeping up with their kids? What about sex drive and frequency, both of which studies show drop in the overweight and obese and increase with weight loss?

I’m not disparaging overweight or obese people. Heck, they’re the people I set out every day to help! I care deeply about them. And I know how hard weight loss can be.

I just don’t think articles like these are helpful. The author ignores a huge body of research showing the damaging health effects of excess body fat and tries to normalize an extremely dangerous mindset: complacency and apathy. After her review of the evidence, Brown even wonders if there’s “any point trying to diet to lose weight.” Yes, for the majority of people, there absolutely is a point. Just ask my readers.

Losing weight isn’t easy, but it’s not impossible. Losing weight may not be a panacea, but it’s certainly not a waste of time and it does provide health benefits across the board. Intentional weight loss—the kind achieved through dieting, rather than wasting away from disease or smoking—is actually linked to a 15% reduction in all-cause mortality.

That’s where I stand. There’s no paradox. There’s just a complicated relationship between bodyweight, muscle, body fat, body fat allocation, and health that shouldn’t be reduced to “gaining weight is healthy.” That’s just dishonest and it does the people who need the most help a major disservice.

What do you think, everyone? Where do you stand on the obesity paradox?

Thanks for reading, everyone.

Primal Endurance Is Here Early – Grab One with Special Christmas Promo!

You’ve seen a few enthusiastic messages about the upcoming release of Primal Endurance. Well, I’ve received some exciting news from our new Oxnard warehouse (yep, the company is in the process of moving from Malibu to Oxnard, complete by June, 2016. We needed more space for mayonnaise and salad dressing—seriously!). A couple of pallets of books have arrived early, and we’ve decided to throw together a special promo in case you have some endurance athletes on your Christmas list that deserve a life-changing gift!

Does life changing sound a little presumptuous? Well, I’ll stand my ground here and assert that endurance sports are extremely popular these days, and that the conventional approach is flat out unhealthy and leading to all sorts of breakdown, burnout and attrition in the ranks. Regular readers know that I’ve railed on chronic cardio for nearly a decade, but now I’m pleased to finally be able to present a compelling and thoroughly researched program that in essence says, “Okay, if you insist on doing this wacky stuff, here’s how to do it right—to go faster on less training time, to preserve your health instead of compromise it, and to enjoy your experiences without the pain, suffering and sacrifice that seems to be the essence of the endurance scene.

If you—or someone on your Christmas list—is into the scene a lot (as in Ironman or ultramarathon endeavors) or even just a little (as in joining a group training club to run your first 13.1-mile event, or bicycle a metric century), this book is a necessity to support (instead of compromise) your health and allow your endeavors to bring you joy and vitality instead of become an unbalanced obsession.

Here is the offer—and it’s limited to what little advance inventory we’ve received, so act immediately if you are interested: Order a copy of Primal Endurance and we’ll throw in a free physical copy of the Primal Blueprint 90-Day Journal ($22.95 value—a perfect companion guide since many book topics relate to the journal format). We’ll ship your order free anywhere in the continental USA, and I’ll sign any copies of Primal Endurance you purchase. This special offer expires on December 12, 2015, so we can make sure to get you your copies before Christmas.

Although this book has been in development for much longer than we thought (it also came out to be much longer than planned!), the timing is wonderful because the, ahem, slightly stubborn and all-knowing endurance community seems to be having a bit of an awakening as of late. First, more and more science is revealing cardiac risk factors associated with serious endurance training. This Outside magazine article, “Cycling to Extremes,” should be required, and disturbing, reading for any longtime endurance enthusiast. Dr. James O’Keefe’s TED Talk, “Run For Your Life! At a comfortable pace and not too far”, offers a great primer on how moderate endurance exercise is super-healthy, but quickly becomes unhealthy as you extend beyond moderate into chronic patterns. Here I could say, “told ‘ya so in 2007,” but I’m just glad for the message to become more popular in recent times.

Secondly, low-carb and ketogenic endurance training is starting to garner more attention. Elite performers like triathlon world champion Sami Inkinen and elite ultrarunners Timothy Olson and Zach Bitter have delivered phenomenal fat-adapted endurance performances. Low carb endurance pioneers Dr. Stephen Phinney and Dr. Jeff Volek (authors of The Art and Science of Low Carbohydrate Performance), have substantiated the anecdotal evidence from elite and casual athletes alike in the laboratory, with the 2015 FASTER study turning endurance exercise physiology on its ear. Dr. Timothy Noakes, from his perch as one of, if not the, leading endurance exercise physiologist in the world for decades, has also made a marvelous effort to validate the necessary shift in conscience to the fat burning beast paradigm. Check out my podcast interview with him.

Read an excerpt of Primal Endurance:

These recent doings have shattered the underpinnings of the carbohydrate paradigm that endurance athletes have been myopically trapped in for decades. Now, it’s apparent that you can perform magnificent endurance feats in a healthy manner, with less oxidative damage and inflammation, when you operate as a primal-aligned fat burning beast then when you operate in the gel slurping, Gatorade chugging, pasta chowing carbohydrate paradigm. Furthermore, instead of being confounded by having excess body fat despite 10, 15, or 20 hours of weekly training volume, you can, in a few short months, slip into something more comfortable when you become fat adapted.

It is my sincere hope that this book does nothing less than revolutionize the conventional approach to endurance training, just as the primal/paleo movement has revolutionized conventional wisdom about healthy eating, healthy living, weight loss and more. Why not be one of the first people to embrace the Primal Endurance movement, and chart your progress with the most comprehensive and thoughtful training journal you will find anywhere? Thanks for your interest and I wish you the best this holiday season!

Dear Mark: Foods for a One-Year-Old, Vegan to Primal, and Low-Carb Failing Fibromyalgia

For today’s edition of Dear Mark, I’m answering three reader questions. The first comes from Chris, who’s a little worried his one-year-old isn’t eating a wide enough variety of foods. As it turns out, he doesn’t need to worry, though I do offer a few suggestions for foods to include or offer. Next, how should Verria, a long-time vegan, transition to Primal? Is there anything to watch out for? What physiological and psychological issues will Anita have to face and overcome? And finally, what tips do I have for a fibromyalgia patient whose condition hasn’t improved on a strict very low-carb, high-fat diet?

Let’s go:

Hello Mark,

I just want to thank you for the plethora of free knowledge that you make available on your website.

I have a 12 month old and his diet mainly consists of avocado, sweet potato, eggs (mostly pasture raised from local farms, but in the winter I buy some store bought because chickens don’t lay nearly as much in the cold IL winter) banana and berries. He also drinks coconut water, raw milk from a local farm, some formula and takes a cod liver oil supplement from green pastures. He strays from these main foods occasionally, but they make up the majority of his calories. Is this enough variety for him? How hard should I try to get him to eat a wider variety of foods?

I try to keep broth on hand because of its many benefits, is broth from conventional supermarket chickens and turkeys still good to consume, or should it be avoided?

Thanks again and Grok on,

Chris

That looks pretty solid. You’re doing great.

A 12 month old “needs” about 1000 calories each day. The needs vary on the particular child, of course, and it’ll change from day to day. My kids sometimes seemed to eat nothing at all for an entire day without any ill effect. The key is learning how not to freak out and just let them lead the way. But I digress. Back to your kid.

I plugged 1000 calories of those foods into Cronometer to gauge his nutrient intake, guessing on the amounts and proportions.

A medium banana, a medium sweet potato, two cups of whole milk, a small avocado, a teaspoon of cod liver oil, a cup of blueberries, two eggs, half cup of coconut water. That’s a hair over 1000 calories and gives him a lot of vitamins and minerals. Far more variety than his peers eating rice puffs and carrot sticks and mac ‘n’ cheese, even though the average pediatrician would probably wonder where the hearthealthywholegrains are.

I have a few suggestions.

Try some green vegetables. These won’t provide many calories, or even much micronutrition (you’ve got that covered well already). It will help him develop the taste for vegetables. He may hate what you’ve offered thus far, so keep trying different ones. A kid might detest lacinato kale but love purple kale. Vary the cooking methods. He could hate steamed spinach but love it sautéed in butter. Kids are just people, which means they’re as weird as the rest of us.

Try some meaty bones. Yes, I know your kid isn’t a dog. But toss him a roasted marrow bone. Hand him a chicken drumstick from those pastured chickens. Offer a beef shank. He doesn’t have the teeth to do much, but it’ll help him develop a taste for meat and he’ll gum that thing for an hour. It’s the Primal version of shutting the kid up with an iPad.

Try some white potatoes, cooked and cooled to increase the resistant starch content. It wouldn’t hurt for your kid to eat more prebiotic fiber. These can sometimes replace the sweet potatoes.

Consider some kefir or yogurt. You can easily replace some of the milk with fermented dairy. Get those taste buds exposed to the tang of dairy ferments.

Good job! Oh, and I’m obliged to say, check with your pediatrician, too!

I’ve been vegan for awhile and now that I’ve been diagnosed with an autoimmune illness I’ve done research and maybe I need to eat meat….the challenge is how do I transition back to meat after being vegan for over 10 years? I suspect I no longer have the enzymes to digest meat and I had problems with eggs the last time I tried them. Any advice?

Verria

Studies show that going vegan for a month down-regulates production of the pancreatic enzymes used to digest animal protein. This may happen more quickly than a month, but it’s the only data we have. Either way, it shouldn’t take any longer—and likely much shorter—than a month for your digestive enzymes to catch up and start facilitating meat digestion. Until they ramp up, go easy on meat. Don’t eat a full rack of ribs or go or the 40 ounce ribeye challenge for your first meal.

That’s not the biggest issue, even though it’s what most focus on. After all, humans are obligate omnivores. We’ve been eating meat for millions of years. The scrawniest vegan is built to eat meat, even if the machinery responsible for its digestion is a bit rusty. But that’s temporary and easily overcome.

The biggest impediment will probably be the psychology of meat consumption: you’re suddenly eating flesh. You’re “responsible” for the death of a cute, fuzzy animal, a sentient being robbed of its existence so that you can chow down. That’s heavy. And even if you intellectually acknowledge the benefit of eating meat, your subconscious must grapple with its ramifications.

Gotta turn that around on itself. Give thanks to the animal for its sacrifice. Invoke a higher deity if that’s how you roll. But don’t hide from the fact that you’re supporting death; that’ll only gnaw at your subconscious. Acknowledge that you’re a willing participant in the cycle of life and death which has gone on for millions upon millions of years. The flesh of the animal provides the sustenance you and your ancestors have been relying upon for many millennia. That’s beautiful. That’s your heritage. It made you who you are, even if you ran from it for awhile.

Own it.

I am a 61 yr old female. I’ve been on an LCHF/banting diet for a year now as I have a family history of diabetes and I was diagnosed with fibromyalgia. I have gone down to a very low level of carbs 25g a day been, in ketosis for a few months and lost only a few kilo in weight (my weight is 72kg).

My main concern is that I haven’t felt any benefit from LCHF diet; no energy, no relief from pain in my muscles and joints. In actual fact I have less energy which was already at a low.

Is there anything I can do to enjoy the benefits that LCHF diet is suppose to give?

Anita

For those who don’t know, the Banting diet is Dr. Tim Noakes‘ take on low-carb, high-fat diets. Based on William Banting, a formerly obese Englishman from the 19th century who lost weight by reducing simple carbs, the Banting diet will be familiar to everyone reading this: emphasize animal fat, reduce carbs (especially sugars and other simple carbs), load upon on green vegetables, limit fruit and nuts and dairy if weight loss slows.

It’s usually a great way to eat, but as a fibromyalgia patient you might have to take special considerations.

There’s not a ton of good diet research into fibromyalgia. Or research at all, for that matter. For years, it was the “invisible illness.” Patients were told it was “all in their head” or that they were “making it up.” How do you run dietary studies into treatment for a disease that doesn’t even exist?

It’s real, of course. But science is still catching up. Let’s look at what little there is for any clues.

Magnesium: In a recent paper (in Portuguese, but the tables are easy enough to read without translation), researchers compared the diets of people with fibromyalgia to those of healthy controls. 100% of fibromyalgia patients had inadequate intakes of magnesium. This jibes with other studies that have found low levels of magnesium (and manganese, calcium, iron) in hair samples from fibromyalgia patients. Studies indicate that the relationship between magnesium deficiency and fibromyalgia may be causally related. In one, transdermal magnesium (4 sprays per limb, twice a day, using magnesium chloride oil) improved quality of life. In another, oral magnesium citrate reduced the spot tenderness and intensity of fibromyalgia, especially combined with amitriptyline (an antidepressant often used in fibromyalgia).

Try taking 200-300 mg of magnesium (if oral, try citrate, malate, or glycinate forms; if transdermal, go with the oil linked above).

Calories: Fibromyalgia patients ate around 1400 calories to the controls’ 1700 calories, a likely artifact of the lower metabolic rates normally found in this population. Going low-carb, high-fat is a fantastic way to spontaneously reduce appetite, increase satiety, control calorie intake, and lose weight, but if the problem is not eating enough food—as it may be for fibromyalgia—VLCHF may push things unnecessarily low. You probably don’t need to go as low as 25 grams of carbs per day.

Try eating a few more carbs.

Vitamin D: Low vitamin D is linked to fibromyalgia symptoms. One recent trial showed that women with fibromyalgia who test low for vitamin D benefit from supplementation, reporting less pain and fatigue.

Test your vitamin D levels and supplement if you need it.

Light exposure: Getting UV exposure on your skin, even from a tanning bed, can ease fibromyalgia symptoms. Getting natural light exposure in the morning and early afternoon and limiting light exposure after dark can improve your sleep and optimize your circadian rhythm, two major factors in fibromyalgia.

Get light during the day and limit it at night.

Exercise: Typical exercise might not help as much as normal. Intense exercise performed to exhaustion, normally beneficial and anti-inflammatory, has paradoxical, inflammatory effects in fibromyalgia patients. This means if you train like I advise, you’ll want to drop everything down a notch. Sprint, but do really short sprints. Lift heavy things, but keep the reps low. Walk as often as you can (especially in natural settings, which may improve your symptoms), but don’t push yourself too hard or too long. Going so hard and long that your lungs and muscles burn is probably counterproductive. A good barometer is how the exercise makes you feel. If you feel good, if your symptoms improve, it’s “good” for you. If the exercise makes you feel bad or worsens your symptoms, it’s probably “bad.” Aquatic exercise can help. Easy stationary (or mobile) cycling can help.

Exercise, but not too hard. Focus on gentle, enjoyable, frequent movement.

And again, talk with your doctor. Hope it helps!

That’s it for today, everyone. If you’ve got input on any of the questions, leave it down below!

Thanks for reading.

Weekend Link Love – Edition 377

That delicious avocado oil we use in our mayo? It’s now available for purchase. Pick up a 3-Pack of Primal Kitchen Avocado Oil today.

Watch me whip up some Primal chipotle lime mayo and Primal curry chicken salad. If you like those recipes and want to make your own, hurry and grab a free (just pay S&H) jar of Primal Mayo from Thrive Mark with this special offer while supplies lasts.

Research of the Week

Running a 4500 km ultra-ultramarathon in nine weeks across Europe appears to shrink your brain, albeit temporarily.

For most people, adopting a new exercise routine displaces TV.

Gluten intolerance is on the rise in Scotland.

Eating garlic makes your body odor more attractive.

Having a pet is great for a kid’s anxiety and stress levels, especially if it’s a dog.

Longer rests between sets are better for strength and size gains.

New Primal Blueprint Podcasts

Episode 96: Elle Russ and Brad Kearns: Hosts Brad and Elle discuss Brad’s career as an endurance athlete: the (time) trials, the tribulations, the first time he and I met, the point where he realized “too much was too much” and what should be done. Brad also reveals how he’d train for a marathon if he were running one today, what it means to be truly fit, and why so many people are still getting it so wrong.

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.

8 Common Cold Cures That Actually Seem to Work
Antibiotic Resistance: Are We All Doomed?
5 Responses When Relatives Ask Why You’re Not Eating Stuffing This Thanksgiving

Also, be sure to check out and subscribe to the Primal Endurance Podcast.

Interesting Blog Posts

Bariatrics might just be surgically-enforced fasting.

Kelly Starrett mansplains manspreading.

The health benefits of dog ownership.

Media, Schmedia

The Weston A. Price Foundation urges the FDA to reconsider its stance on the safety of raw milk cheese (PDF).

Speaking of which, Prince Charles fears the fate of traditional French cheese.

The EPA revokes approval of a new herbicide designed for GMO crops.

Everything Else

What you might learn climbing the same hill every week.

Terrorism as supernormal stimuli.

Nailed it.

A call to action.

How new technology could improve retirees’ quality of life.

Stunning photos of “the North American Indian” around the turn of the century.

Recipe Corner

If you do dairy, you need to make this Brussels sprouts and radicchio gratin.
Leftover turkey carnitas: genius.

Time Capsule

One year ago (Dec 8 – Dec 14)

The Quest for a Healthy Primal Mayonnaise – How’d I come to create Primal Mayo?
9 Worthy Alternatives to the Back Squat – If you don’t want to back squat, do some of these instead.

Comment of the Week

I’ve been mega dosing vitamin C again with this cold I just came down with on Sunday night and I seem to be managing it pretty well yet again, but I of course can’t say for sure whether or not it’s because of the vitamin C. I wish I had an alternate dimension version of myself where I didn’t take vitamin C so I could actually know! (Or maybe they could just do some studies on this? C’mon…)

– Man, randomized parallel dimension-controlled trials would be the true gold standard.

Primal Salmon Spread with Nori Chips

This salmon spread, made from both poached and smoked salmon mashed with butter, is a version of French rillettes. Rillettes, which are similar to pâté, are made from blending together protein and fat. Could there be a better snack?

Rillettes are often made with pork, duck or rabbit meat and lard, but using salmon and butter is easier and a genius way to make creamy salmon spread without adding mayonnaise, cream cheese or sour cream. The blend of salmon and butter (with just a drizzle of olive oil) is flavored with chives, capers and lemon.

There’s really no reason not to treat this “spread” like a salad and eat it with a fork, but if you want finger food then serve salmon rillettes on crispy nori chips.

This salmon rillettes recipe is adapted from the book “Cooking at Home on Rue Tatin.”

Servings: 4

Time in the Kitchen: 25 minutes

Ingredients:

8 ounces raw boneless, skinless salmon (230 g)
4 ounces smoked salmon, cut into tiny pieces (113 g)
4 tablespoons unsalted butter, room temperature (60 g)
2 tablespoons extra virgin olive oil, divided (30 ml)
2 tablespoons chopped chives (30 ml)
2 tablespoons capers, drained (30 ml)
2 tablespoons lemon juice (30 ml)
2 teaspoons unseasoned rice vinegar (10 ml)
4 sheets toasted nori

Instructions:

Season raw salmon with salt. Bring 1 cup water to boil in a small saucepan. Reduce heat to low. Add salmon and put a lid on the pan. Poach until opaque in center, 5 to 8 minutes, depending on how thick the fillet is. Remove salmon and let cool.

In a medium bowl, mash the butter and 1 tablespoon (15 ml) olive oil together with a fork until the mixture is very smooth and spreadable. Mix in the chives and capers.

Flake the cooked salmon into the bowl. Add the smoked salmon and lemon juice. Mash together with a fork.

To make nori chips, preheat oven to 300 °F. Line a rimmed baking sheet with parchment.

In a small bowl mix together the remaining tablespoon (15 ml) olive oil with the rice vinegar.

Brush one side of each nori sheet with the olive oil and rice vinegar. Cut or tear the nori sheets in half, then cut or tear each half into 4 triangles. Bake the triangles for 4 minutes, then turn the pan in the oven. Bake 4 to 6 minutes more, until the edges of the nori have curled up. Remove and cool.

Spoon a dollop of salmon spread in the middle of a nori chip and enjoy!

Note: The nori chips will get soggy if the salmon spread sits on them for too long, so it’s best to spoon the salmon on right before eating.

50 Pounds Down and Never Turning Back

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!

I feel like now is the time for me to finally share my success story, though I will be the first to tell you the journey certainly continues!

I was an active teenager and fit all the way into my college days. While no one would have ever said I was skinny, having a thicker bone structure and build, I was certainly never fat or even overweight.

Enter the college experience. Most guys will know the college routine. Pizza, video games, football games, beer, wash, rinse repeat. Do that for a few months, let alone years and well… you start wearing all that sugar and grain from both solid and liquid forms.

After getting married I pretty much continued on with that pattern. The next thing I know, I have put on some pretty significant weight… I mean a lot! What I didn’t realize though was how all the inflammation and other symptoms like bloating, gas, and how my skin reflected my eating pattern. Having two little sons running around the house made me seriously reevaluate how long I was going to continue running my health into the ground. Having been a high school athlete I knew what it was to workout and get in shape, but the uphill battle with food seemed nearly insurmountable.

On a visit from my dad, who is an executive coach and in the process of completing The Primal Blueprint Expert Certification, we had yet another talk about my weight, eating and love of all things hoppy. He left me the web address of MarksDailyApple.com and I began digging. Between lots of talks with my dad, and deep diving on the website, I decided to go all in for at least 30 days to see if this really was all it was cracked up to be.

All I can say is wow!

Oh initially I had to deal with the carb cravings, my desire for a cold one and pizza while watching football. But I got through my 30 days with radical changes in how I felt. I had not only lost a chunk of weight but I felt better than I had felt in a long long time.

I was quite shocked to be honest. What I realized was how sub-par I really felt without actually knowing it! The brain fog, groggy post meal lethargy and constant heart burn were such constant companions they just seemed normal. I knew that feeling this good after 30 days meant there was no going back for me.

Dad told me I had to take photos at the beginning of this because the results would be worth seeing. Reluctantly I took the photos (above). At the six month mark I have lost 51 lbs, have just had my lipid panel done with my doctor… and I am in an excellent range.

What’s more is I love to cook and have taken on coming up with primally aligned meals and recipes, and Instagram them frequently . All I can say is thank you for this website and for all the knowledge and encouragement I have received. I hope my story can help encourage someone else to take the plunge to get on the primal path. I thank you, my beautiful wife Mina thanks you, and two little dudes, Ty and Dom, thank you every time I am out coaching one of their baseball or soccer games or rough housing with them.

I am incredibly grateful!

RJ

4 Ways Winter Affects Your Physical Health

With winter all but officially upon us, we might already be feeling the season, maybe even planning warm weather vacations. I venture most of us have wondered if we’re not somehow healthier during the summer months. Is it just a mental vitality from the additional daylight hours and relative ease of outdoor time, or is there something more at work? Does our health really take a hit in winter? For those who enjoy this brand of trivia, there’s an actual field of study devoted to this called biometeorology. And with the minutely detailed research into epigenetic activity, we’re getting a fuller picture all the time of astonishing nuances as well as big picture shifts. To a Primal mind, it all makes sense. Humans evolved within a seasonal context—without any of the modern accommodations that would buffer climate or weather influences. Why would our bodies not have adapted with responsive wiring?

With the span of modern research—everything from massive epidemiological analysis to epigenetic science—we’re seeing both the finer nuances and the global patterns in environment-biology interaction. One recent study earlier this year, for example, revealed the activity of nearly a quarter of our genes varies depending on time of year—with seasonality cues that are remarkably geographically specific. The shifts influence our immune function as well as the composition of our blood and even fat.

I’ll admit this is exactly the kind of thing you could get me talking about for hours, but let’s keep things simple and look at a few of the most common and significant seasonal health patterns. It might just have you rethinking your annual exam routine—or at least its place on the calendar.

Your Cardiac Health and Risk

It’s no one’s imagination that we see more cardiac deaths during the winter months. The seasonal blood vessel narrowing may push those with arterial build-up, for example, over the edge in terms of blockage.

Oddly, it doesn’t seem to matter how hard winter hits your region. One study followed the incidence of cardiac-related deaths in seven U.S. locations (ranging from Los Angeles County to Massachusetts. Both total and cardiac death rates rose during winter months at roughly the same (26-36% compared to summer deaths) across all locations. Researchers often speculate that people move less in winter, even in warmer climates, and that this discrepancy could be a major contributing factor.

Yet, there may be other factors at work, particularly for those who live in colder climates. Blood viscosity (thickness) increases substantially in cooler temperatures. In one study, viscosity rose more than 26% when temperatures dropped from 98 degrees Fahrenheit to 72. The thicker our blood, the higher our risk for stroke and ischaemic heart disease.

Your Blood Pressure

In response to the lower temperatures of winter, blood vessels constrict, which raises your blood pressure and, particularly for those with higher measures to begin with, puts added stress on the heart and circulatory system. The rise in blood viscosity and decrease in blood flow rate naturally requires a corresponding increase in blood pressure to compensate.

For anyone who’s been diagnosed with high or borderline high blood pressure during the winter months, it’s important to take into account the seasonal shift. Get your levels tested throughout the year to get a more accurate picture. You may have what’s called “seasonal hypertension,” which research suggests is more common in certain people. Knowing that your numbers vary during the year will help you make a more informed decision about any given treatment your doc might recommend.

Your Lipid Profile

Researchers studied a group of men and women over a twelve month period, recording biomarker results for each season and collecting records for diet, activity and sun exposure during the year as well. Results showed that total cholesterol peaked in winter (as did HDL). (PDF)

Women showed the greater increase in total cholesterol at 5.4 mg/dL (a January peak) compared to 3.9 mg/dL (a December peak) for men. Those who had higher cholesterol levels to begin with showed the biggest seasonal rise. The researchers found no overall significant difference in dietary intake among the seasons and attributed a substantial portion of the increase to seasonal shifts in relative blood plasma volume.

As the researchers note, these differences have been demonstrated in other studies and suggest that seasonal shifts should be considered in medical testing. In other words, if you get your cholesterol tested in July and then in December, your numbers have a greater chance of looking “worse.” If you get them tested in December and then in July, they’re more likely to show “an improvement” when all that’s happened is natural seasonal shift. Obviously, these varying numbers would probably influence your doctor’s recommendations.

Your Body Fat

In a less expected twist, much has been made of the so-called “brown fat” that can convert fat into heat to warm the body. The more brown fat we have, it appears, the more adept we are at regulating our blood sugar, the more insulin sensitive we are and the better we are at burning our fat stores. Researchers have discovered how the body has an innate ability to convert typical “white” fat into “beige” fat when exposed to cold temperatures (a process hampered in obese people).

It may be one of our body’s innate bits of genius, but unfortunately the process may not be the completely seamless miracle you might think in our modern age. The activation of brown fat, it appears, causes more fat to be stored into the blood. Because vessels are constricted in cooler temps and cold can make atherosclerotic plaque less stable, the end result can be a greater risk for cardiac events, particularly in those with a history and propensity for atherosclerosis.

Our innate responses to our environments without question served our survival thousands of years ago. Today, they still serve our basic biology but not necessarily the ways modern life has skewed our daily behavior toward unhealthy diets and relative inactivity. Winter, I think few of you in the northern regions will doubt, imposes physiological stress on our bodies—the kinds of stresses we were designed to be able to incorporate and match with our own adaptations. The colder season, if you’re healthy, can make you that much healthier with some Primal behaviors (and vitamin D supplementation) Grok and his crew would’ve participated in. If the winter season is, instead, highlighting our current health limitations, we can consider it a call to live more, not less, in tune with the challenges our Primal roots were designed to anticipate.

Thanks for reading, everyone. Share your thoughts and questions in the comment board, and enjoy the end to your week.

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8 Common Cold Cures That Actually Seem to Work

Winter is nearly here, and it’s getting cold out there. We’re staying inside, cloistered together, sharing bodily fluids, and trading germs. The sun is weak, if it’s out at all, our vitamin D levels are shot, and our immune system is suffering. Many of us are traveling in planes, trains, and automobiles tightly packed with other people in the same immune predicament. It’s the perfect breeding ground for the dozens of viruses responsible for upper respiratory tract infections like the common cold and flu.

What can we do?

People have been catching the common cold for millennia. Hop in your Delorean and travel to any time or place and you’ll hear people complaining about runny noses, sore throats, and persistent coughs and see others hawking cures and treatments. Some remedies are pure hogwash. Some aren’t. Today, I’m going to look at a few of the ones that work.

For each remedy, I’ll present the available evidence and any potential or confirmed mechanisms for its effects. None are dangerous, so feel free to give them a shot. Even if they don’t eliminate your cold, you won’t be any worse off for having eating a bunch of garlic or turmeric. What I won’t do is cover the remedies without any corroborating evidence. You can type almost any food into the search bar and Google will offer “cold remedy” up as an option. So, sorry, apple cider vinegar fans. Tough luck, people who stuff onions in their socks at the first hint of a sniffle. While I support your free will, I’m unable to produce any serious evidence that your remedies work.

Let’s take a look:

Golden Milk

Ayurveda is the traditional Indian system of medicine. Although talk of chakras and levitating gurus lets rational skeptics dismiss it entirely, modern science has vindicated many Ayurvedic therapies, herbs, and concepts. Golden milk is one, and it’s really simple. Add turmeric to milk and it turns gold. In Ayurveda, golden milk is used to fight sore throats, colds, and flus. Does it work?

Well, turmeric is absolutely rife with potent pharmacological effects. It may be able to relieve cough and clear up excess mucus, at least according to animal studies.

Milk might actually be a bigger aid. Research has shown that a combo of two milk components—whey protein and lactoferrin—is able to reduce the incidence of the common cold in people. That was a concentrated supplement, however. Your standard glass of milk doesn’t have nearly as much whey or lactoferrin. Raw milk may be a better option, as it contains more lactoferrin than pasteurized milk, and raw whey provides more glutathione-boosting effects than heat-treated whey. To preserve these benefits, you’ll have to drink your golden milk unheated, of course.

Chicken Soup

People call it “Jewish penicillin,” and they’re not lying: evidence has confirmed that chicken soup eases nasal congestion, improves the function of the nasal cilia protecting us from pathogen incursions, and reduces cold symptoms.

Does it have to be chicken? As most cultures include soup in their list of effective cold remedies, I suspect it’s the goodness of the broth that’s important and any true bone broth-based soup will work.

Spicy Food

Some people, when ill, swear that spicy food helps them “sweat it out.” Maybe, but a better bet lies in its effect on our nasal cavities. Capsaicin, the chili pepper component that produces a burning sensation in mammalian tissue, reduces nasal inflammation. When your nasal blood vessels are inflamed, the walls constrict; the space gets tighter and you have trouble breathing. Studies indicate that capsaicin is effective against most symptoms of nasal congestion.

Cabbage Palm Fern (polypodium leucotomos)

Polypodium leucotomos is native to Central and South America, where it’s a folk medicine typically used to treat skin and joint disorders. Modern research indicates polypodium leucotomos may actually be “sunscreen in a pill,” as oral doses protect human skin from UV damage. That’s cool, but it’s not why we’re talking about it today.

A 2012 paper in hard-charging, elite athletes—the type of people who subject their bodies to extreme hardships and often have the perpetual upper respiratory tract infections to prove it—found that a polypodium leucotomos extract reduced the incidence of viral infections by 75%, improved symptoms, and reduced relapses. Fewer colds, milder symptoms, and, after you’ve recovered, a lower chance of getting sick again? Sounds great.

Vick’s VaporRub

You’re balking. I can tell. But many people don’t realize that Vick’s is essentially just essential oils—of menthol, of camphor, of eucalyptus, of cedar, of nutmeg. That means it’s the latest (and quite possibly greatest) in a long line of natural herbal blends used by humans to clear congestion and improve sleep. It may not “cure” a cold, but few of the remedies mentioned today do. What it does is reduce some of the symptoms and help you get out of your own way so that your immune system can do its job. If you’re not sleeping, you’re not recovering from anything.

I asked a lot of my friends of different ethnicities (Mexican, Filipino, Thai) for some leads on popular folk cold remedies they or their folks might have used, and Vick’s was the one that kept coming up. It just works.

Neti Pots

In Sanskrit, “neti” means “nasal cleansing.” The neti pot is a exactly what it sounds like. You fill a tiny plastic kettle with warm saline water, tilt your head over a sink, and pour the water into one nostril. It flows out the other one, clearing your nasal cavity and letting you breathe again. The scientific term is “nasal irrigation,” and it really does work, albeit only against one cold symptom. But let’s face it: the worst part of a bad cold is the stuffy nose that keeps you up at night, gives you dry mouth, and makes food taste bland. Neti pottin’ can fix that right up.

Also, it’s better than antibiotics in kids with rhinosinusitis. It even improves symptoms in infants with bronchiolitis, another kind of viral infection.

There were a couple close misses that may be hits in the future:

Ginger and just about anything

Traditional Chinese medicine has dozens of recipes to treat the common cold, and they all seem to involve ginger. There’s ginger with orange peel, ginger with garlic, ginger with scallions, ginger with brown sugar, ginger with brown sugar and scallions. But while ginger is a powerful food, I just couldn’t find any strong evidence that it does anything at all for upper respiratory tract infections.

Vitamin C (till you poop)

This is a tough one. Although I don’t use it for cold relief, prevention, or treatment, there’s the argument that the majority of studies purporting to show inefficacy simply aren’t dosing correctly. Pro-vitamin C researchers argue that attaining the pharmacological benefit for upper respiratory tract infections requires megadosing until the patient reaches bowel tolerance, or that point where you just gotta go.

What do I do?

The foundation for my resistance and response to upper respiratory tract infections isn’t any specific food or supplement, of course. It’s everything. It’s my sleep, my stress, my training, my play. And yes, my food. But it does happen to the best of us, and it’s the worst. We shouldn’t accept being sick. I never do.

I’ve mentioned my common cold medicine: an entire head (yes, a head) of crushed garlic lightly simmered in a mug of bone broth. If I feel a cold coming on, I’ll drop whatever I’m doing and prepare it. This is a potent combination of two of the cold-busting ingredients with the most support in the literature (broth and garlic).

If I have a sore throat, heating up and drinking a blend of lemon juice (lime works too), water, and raw honey in a 4:4:1 ratio always makes me feel better. I tend to use a wild neem honey harvested in India. It’s available at Trader Joe’s and is quite reasonable. I’m not sure if the bees feeding on neem makes a difference, though the plant does possess antiviral and immunomodulatory effects.

What are your cold and flu remedies? How do you stay healthy—or nurse yourself back to health—when a bug’s going around?

Thanks for reading, everyone.

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Antibiotic Resistance: Are We All Doomed?

The future prospects of antibiotics look grim. Headline after headline proclaims the mounting resistance to antibiotics among pathogenic bacteria and the impending inefficacy of our best drugs to fight them. Antibiotic-resistant “pig MRSA” has been documented moving from pigs to people in several countries, including Denmark and Holland. That same MRSA has also been found in the US, England, and is likely brewing wherever pigs and other animals are intensively raised. And just recently, researchers discovered that MCR-1, the gene responsible for resistance to the “last line of defense” antibiotic—polymixin, the one we use when everything else has failed—is transferable between different strains of E. coli. Formerly relegated to pigs, E. coli and K. pneumoniae bacteria with the MCR-1 mutation have appeared in human subjects in several Chinese hospitals. Transferring the gene between different bacterial species is theoretically harder, but that it’s possible at all has raised alarms in the scientific community.

It’s not just industrial farms and antibiotic overuse causing the resistance. Even the scientists studying the problem and running experiments with antibiotics could very well be promoting antibiotic resistance on a larger scale.

This isn’t a modern phenomenon. Humans and bacteria have been embroiled in the antibiotic arms race for at least as long as we’ve had modern antibiotics. Heck, a few months after penicillin was released to the general public, scientists identified several strains of staph that had developed complete resistance. This happens every time. An antibiotic is released, bacteria become resistant, a new antibiotic comes out to counter the resistance, the bacteria develop resistance to the new drug. It never ends, and because their generations are so much shorter than ours, the bacteria have the advantage.

So, are we doomed? Will antibiotic-resistant superbacteria take over the world? Will bacterial biofilms blanket the globe, supplant nations, and battle each other for global supremacy? Will the few human survivors be forced into personal bubbles, impermeable to any and all microbes, gathering resources until the chosen one (who looks a lot like Keanu Reeves) emerges to lead a Purel-soaked rebellion against the microbial overlords?

Don’t despair. All is not lost. We don’t have to wait for Keanu to save us. There is hope.

New research subjects.

Most antibiotics come from studying how bacteria attack each other. Turns out it takes one to know one. But we’re limited in how many different types of bacteria we can study because 99% of the bacteria you’d encounter in the outside environment simply don’t grow under normal laboratory conditions. This drastically shrinks the window of research you have and makes creating effective therapies next to impossible.

Earlier this year, researchers figured out a way to get those ornery wild-type bacteria to grow and prosper in controlled settings: by bringing their native dirt into the lab. Once established and happy in their soil, the bacteria are slowly weaned off and “domesticated.” Then they move to petri dishes, where they thrive and the researchers can get studying. This method has already produced one viable candidate—teixobactin—which some are calling “resistance-resistant.” While that smacks of human hubris, it does look good thus far in animal trials, demolishing event resistant gram-positive bacteria like MRSA and C. dif while failing to confer any resistance to them during extended low-dose exposures. Unfortunately, teixobactin can’t touch gram-negative bacterial pathogens like K. pneumoniae or V. cholerae.

Still, the research field just opened up. 99% is a lot of bacteria and I bet they’ve got some nifty antibacterial tricks we can utilize.

Going back.

In the “golden age” of antibiotics research, around the middle of the last century, many potential antibiotics were discovered but shelved due to low commercial appeal or toxic side effects. Even mild side effects could get an antibiotic relegated to the dustbin. By and large, antibiotics just “worked,” so employing a wide and varied arsenal was neither necessary nor financially lucrative. With antibiotic resistance reaching critical levels, microbiologists are going back to the well and tweaking the older, more toxic antibiotics to be safer for us and worse for bacteria.

There’s another advantage to going back to older antibiotics: sometimes it’s been so long the resistance has disappeared. After all, maintaining resistance to specific antibiotics requires constant exposure to the antibiotic. If the antibiotic’s no longer in use, resistance to it no longer provides a fitness advantage and resistance—at least in theory—can wane. The flipside of generations lasting a day or two is that non-essential traits get quickly weeded out.

Going WAY back.

Researchers have unearthed ancient medical texts to trawl for herbal remedies that actually work. And, guess what: some appear to be especially effective against medication-resistant infectious microbes.

Christina Lee is an Anglo-Saxon linguistics expert at the University of Nottingham. During the course of translating and searching an Old English medical textbook from the ninth century called Bald’s Leechbook for potential antimicrobial remedies, one entry in particular intrigued her. It read “the best of leechdoms” (in ninth century England, leeches were doctors and leechdoms were medical interventions and remedies; we call blood-sucking parasites leeches because the original leeches used them for phlebotomy) and called for a specific, complicated nine day-long preparation.

Garlic and leeks or onions were to be crushed, steeped in wine, mixed with ox bile, and stored in brass pots for nine days and nine nights. The result was a salve used to cure styes, an eye infection that we now know to be caused by staphylococcus. Lee enlisted the help of Dr. Freya Harrison, a microbiologist at the U of Nottingham, to determine if the millenia-old folk remedy really worked. They parsed the texts, hashed out the finer details (they added copper pennies instead of using a brass pot), followed the directions, waited nine days and nine nights, and tested it on some staphylococcus in simulated wounds.

It worked. The salve eliminated almost 100% of the staph. Several other trials confirmed the results. But that was regular old staphylococcus. For the next step, Harrison and Lee sent a sample of the salve to a colleague at an American university who had access to the good stuff: medication-resistant staphylococcus. The colleague was stunned, calling the results “astonishing”; the salve killed over 90% of the MRSA, even when it was protected by a sticky, mostly-impervious biofilm designed to resist antimicrobials. As to why it works, the mode of action hasn’t been identified. There are probably several different modes of action, since ox bile, garlic, wine, copper, and onions (or leeks) all have antimicrobial activity on their own.

Another group of scientists out of Sweden have amassed an impressive swathe of research into the antimicrobial potential of honey and honey bee bacteria. In one, they took isolates of infected wounds from human subjects and applied a combination of heather honey and 13 different types of lactobacillus bacteria found in honeybee guts. Thanks to the antimicrobial metabolites produced by the bacteria and the innate healing factor of the honey, the wound isolates healed faster. They also used the honey/bacteria salve to cure treatment-resistant infected wounds in horses.

They’re close to market with Honey Hunter’s Elixir, an old-style mead fermented using all 13 bee bacterial strains and the wild yeasts naturally found in raw honey that they claim “can actually be transferred to your blood and help you when you are infected with dangerous bacteria or promote health, preventing infections.”

So, folks: the world’s not ending. Science is a powerful tool, particularly when it expands its gaze to encompass the wider world and heeds, investigates, and analyzes past knowledge and traditions. And that’s exactly the direction microbiology appears to be heading.

What are your thoughts on antibiotic resistance and what it means for the world? Are there any other glimmers of hope you’ve seen or read about? If you’ve got news that dashes my sense of optimism into pieces, I’ll take that, too.

Thanks for reading, all.