Mark Sisson's Blog, page 256
July 7, 2015
Is the Paleo Diet Supported by Scientific Research? – Part 2
Last week, I countered claims that “paleo gots no science” with summaries of five recent (and not so recent) papers supporting the paleo/Primal approach to diet. The reception to that post was strong enough that I got requests to cover a few more this week. So today, I’m going to explain the findings of five more relevant studies. Not all of these studies come from the original list, but each gives an accurate and important portrayal of the effects of eating in accordance with one’s biology. More importantly, these are all interesting approaches to the diet, with some examining higher-carb paleo, some looking at higher-fat and downright ketogenic paleo diets, and still others trying to disentangle the beneficial effects of the weight loss that normally occurs on paleo diets from the effect of going paleo.
Let’s dig right in:
This was a cool one because researchers were interested in the effect of paleo style eating on the metabolic syndrome absent weight loss. Everyone knows that weight loss on any diet improves symptoms of metabolic syndrome (hypertension, poor lipids, blood sugar disregulation, etc), so this study sought to uncover any effects unique to paleo eating. How’d it go?
First off, it was hard to keep paleo dieters from losing weight. Seven of the 17 subjects in the paleo group lost enough weight that researchers had to provide extra snacks to keep their weight up. Once they got that under control, good things happened:
Waist circumference decreased by 3.1 cm — an indicator of reduced belly fat, which is remarkable especially given the lack of significant weight loss (just 6 pounds on average).
Systolic and diastolic blood pressures dropped by 8.5 and 8, respectively.
Both fasting insulin and glucose decreased, indicating better blood sugar control and more fat burning.
Insulin resistance dropped.
Blood lipids improved, with total cholesterol, LDL, and triglycerides decreasing.
Takeaway: By all indications, metabolic syndrome patients can benefit from going paleo. If they were allowed to also focus on losing weight, I have no doubt that the numbers would improve even more.
At first glance, the abstract of the study suggests a diet at complete and utter odds with paleo. It’s low in fat (under 10% of calories) and protein, and high in “complex carbohydrates.” Complex carbohydrates, in modern parlance, are hearthealthywholegrains: breads, pastas, porridges. But in this study that attempted to recreate the pre-contact Hawaiian diet, complex carbohydrates meant roots and tubers like sweet potato, yam, breadfruit, and taro. In fact, grains were restricted because those were unavailable in the islands before Europeans arrived. The traditional Hawaiian diet used in the study, called the Wainae Diet, consisted of unlimited amounts of sweet potatoes, yams, breadfruits, taro roots, poi (a mashed and fermented taro), fruit, seaweed, and greens from sweet potato, yam, and taro plants. About 200 grams, or roughly half a pound, of chicken and/or fish were also included each day. All cooked foods were steamed, similar to traditional forms of Hawaiian cooking.
The macros are a bit different from what you’d expect from a paleo diet, but the food quality is in lockstep. No grains, legumes, dairy, seed oils, or processed junk food. No acellular carbohydrates (pulverized grains: bread, pasta, flour, etc). Lots of leafy greens and nothing but whole, unrefined foods.
What happened when a group of obese Hawaiians were placed on such a diet for 21 days?
Energy intake dropped by 41%. This is crucial, since food intake wasn’t restricted (except for the fish and chicken). Subjects were encouraged to eat to satiety, indicating this diet was pretty good at keeping them full.
They lost an average of 7.8 kg. They were still obese, but far less so than before.
Blood lipids improved. LDL and triglycerides dropped and even though HDL reduced slightly, the TC:HDL ratio improved.
Blood pressure improved. Systolic dropped by 7.8% and diastolic by 11.5%.
Blood glucose dropped dramatically.
Takeaway: Paleo diets can be high or low carb. Low carb does have a bit more clinical backing, and in my experience is more effective for the severely obese and easier to adhere to, but the important thing appears to be grain/junk food/seed oil avoidance. They had “sugar,” but it was in the form of fruit. They ate “complex carbs,” but in the form of starchy vegetables. Paleo is a framework and this paper illustrates that.
Three paleolithic ketogenic diet case studies.
And last, but not least are three case studies. Because these involve a total of three patients (being case studies), I’ve grouped them together. Alone, a case study does not an argument make. Three separate case studies showing massive benefits for the individuals involved, on the other hand, raise even the most skeptical eyebrow.
In the first, a 19 year old male newly diagnosed with type 1 diabetes (blood glucose levels of 384 mg/dL!) was placed on a ketogenic paleo diet after spending 20 unproductive days on the traditional low-fat, high-carb diabetic diet. This new diet consisted of meat (mostly red and fat-rich meat), eggs, organs, and fat, with insignificant amounts of non starchy vegetables for a fat:protein/carb ratio of 2:1. Plant-based oils and artificial sweeteners were restricted. The only supplement given was 5000 IU of vitamin D3.
Upon going paleo-keto, his blood sugar normalized, even postprandially (after meals). He was able to stop insulin treatment following his first meal. On the original diabetic diet with supplementary insulin, his average blood sugar was 119 mg/dL. On the paleo-keto diet without insulin, his average blood sugar was 85 mg/dL. Blood sugar fluctuations also reduced from a standard deviation of 47 mg/dL to 9 mg/dL.
After 6.5 months of the diet, he had maintained his progress without side effects. His LDL-C and total cholesterol had gone up, but that’s fairly standard on ketogenic diets.
In the second, a 65 year old obese female with high blood pressure, hyperglycemia, angiopathy (likely diabetic), and a history of gall bladder surgery and colonic polyps was placed on a ketogenic paleo diet. She was taking anti-diabetic and anti-hypertensive meds as well. On her new diet, typical foods included broth, stews, pork bone marrow, bacon, steaks, calf liver, and pork greaves (or cracklins/chicharrones). Vegetables like cabbage, onion, and root vegetables were used as garnish.
How’d it go?
Over the course of 22 months, she was able to discontinue eight medicines, her BMI dropped from 37.1 to 31.6 (lost 14 kilos and counting, at the time of the study’s conclusion), and a normalization of both blood pressure (along with no blood pressure spikes in the final six months) and blood sugar. That was purely from diet; no supplementation, no exercise.
In the third, a 7 year old with absence epilepsy was placed on a ketogenic paleo diet. Before the diet, she was socially withdrawn, hadn’t gained weight or height in two years, and wasn’t toilet trained; she was effectively developmentally disabled.
Based on meat, organs, fish, eggs, and animal fat, along with some vitamin D3 and fish oil, the new paleo-keto epilepsy diet had an approximate fat:protein ratio of 4:1, with very little (if any) carbohydrate. And it worked incredibly well. Seizures stopped six weeks in. She grew 3 kilograms and 6 cm in four months. Her mood and social function improved enough for her to attend regular school by study’s end.
Takeaway: A paleo keto diet using whole foods is just as, if not more effective, than a clinical ketogenic diet using refined, processed foods, whether the patient is a youngster with epilepsy, a young man with type 1 diabetes, or a middle-aged woman with metabolic syndrome.
However old (the Hawaiian diet study), limited in scope (the paleo-keto case studies), or small in scale (the metabolic syndrome study) these studies might be, they remain effective ambassadors for the efficacy and diversity of the ancestral approach to diet. So the next time someone says “Yeah, but what about those low-fat native islander groups?” or “But no studies exist showing you can safely eat bone marrow!” or “Ah, it’s just the weight loss helping,” you can direct them kindly to this post.
Again, let’s hear from you down below. What are your thoughts on the studies? Any surprises? Any disagreements?
Thanks for reading, everyone. Take care and good day.
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July 6, 2015
Dear Mark: Exercising (and Eating) in the Heat; Post-Antibiotics Gut Health Support
For today’s edition of Dear Mark, I’m answering a pair of questions from you folks. First up, what with the crazy heat wave sweeping much of the planet, a reader writes in asking about the best way to eat and move in the heat. Should you cease all activity? Should you modify your normal movement patterns and eat and drink differently to keep the heat at bay? Read on to find out. Next, how should a person deal with and support the post-antibiotics gut biome? What can we do to mitigate the negative effects broad-spectrum antibiotics have on our gut bacteria?
Let’s go:
Hi Mark,
Thanks again for all the great work you’re doing here. Having been introduced to Primal living – my latest discovery has been kettlebells, and I’m so happy about it – has been one of the best things in my life.
Now, I have a question that might interest quite some people for this summer: do you have specific thoughts and recommendations about how to manage life during a heat wave? Drinking more of course; but should it impact our diet and exercise too?
Thank you so much!
Remy
Thanks for the kind words. Much appreciated.
When it’s hot out, you have to be really careful with your activity levels. Extreme heat stress reduces the blood flow to the brain by about 30%. By “extreme” I mean extreme — body temperatures approaching 40° C — but any degree of heat stress will reduce blood flow to the brain and increase it to the lower body, albeit not to the same degree. Throwing exercise into the mix, however, will raise your body temperature further, and throwing dehydration into the mix compounds the inhibition of cerebral blood flow.
You know how I rail against the potential dangers of dropping dead from heart attacks during extreme endurance events? Heat stroke is a larger danger. One study in a cohort of endurance athletes found that for every serious cardiac event occurring during a race, ten life-threatening instances of heat stroke occurred. Some researchers even think elevated core body temperature is the proximate cause of most endurance-related events.
A few things to keep in mind regarding heat stress and activity:
Larger people actually have a higher heat tolerance during exercise; whether it’s hot-humid or hot-dry, a larger body mass improves heat loss.
Stay hydrated. I’m not one to freak out about drinking eight glasses of water a day — that’s pretty silly and unnecessary in most cases — but things change when you’re dripping sweat. Exercise in said heat makes it even more crucial. I like a pinch of sea salt and a splash of trace minerals in my water, for the electrolytes and to replace any sodium lost. Coconut water is also helpful, especially if you’re working hard and burning through both glycogen and fluids. But the absolute greatest supplement for hard exercise in hot weather is a glass of fresh squeezed orange juice with a large pinch of sea salt mixed in. I know, I know. Juice is bad, right? No, it’s a tool to be used in special circumstances. And this is a special circumstance. It ends up tasting like really good Sunny-D (not purple stuff). I can remember a backpacking trip where a liter of salted orange juice cobbled together from materials purchased from a small stand along the trail saved me. When I say a pinch, I mean a pinch. Don’t put too much salt in, as its effects on blood flow during heat-stressed exercise are unclear.
Don’t do anything you don’t have to (like marathons). Keep exercising, but do the intense stuff inside, and if you do it outside do it under a tree or an umbrella. I’m totally on board with walking in intense heat. Just let your body be the guide when you do it. If your hands are swelling up, if you feel woozy or dizzy, if you’re not urinating no matter how much you drink, cool it. Take a break. Go inside, read a good book or watch a movie. Find a shady spot under a big green leafy thing growing out of the ground. Take a nap, even.
As for diet, I always heed the traditions of the people who live and cook and eat in warm climates for their entire lives: spicy food. Whether it’s Thailand, Mexico, Ethiopia, Nigeria, India, or Jamaica, the hotter the climate, the spicier the cuisine. Sweating is your body’s way of cooling off, and sweating because you just took a face full of chili paste works, too. I’m not sure if adding chilis to everything when it’s deep summer improves your physiological resistance to the damaging effects of heat stress (though it can reduce microbial growth, another problem common in the tropics), but it sure makes me feel cooler.
Mark,
I’ve been paleo since I experienced the benefits of going gluten-free 30 months ago and dug deeper into the contrarian diet (counter to “accepted” diets) it espouses. The benefits have been life changing (I promise I’ll send in a success story soon), but include blood pressure normalization (no more pills), “cured” my osteoarthritis, lowered my uric acid (no more episodes of gout), and I don’t get colds regularly.
Unfortunately, I’ve reinjured myself and see an arthroscopic surgery on the horizon, and I know this will include antibiotics. Is there anything I can do to protect my precious microbiome, hasten its recovery, and reintroduce what might have been compromised, outside of more fermented foods (dairy and vegetable), raw foods (including oysters and other bacteria-rich yummies)?
Dave
Great question. Prophylactic antibiotics given during surgery are broad-spectrum and thus target just about everything without discrimination. Good for infectious microbes, bad for commensals. There isn’t a ton of research into countering these negative effects. What the literature tends to focus on is preventing or treating antibiotic-related diarrhea. But, since antibiotic-related diarrhea is generally caused by the trashing of the gut biome, any treatment that works against it will probably also benefit your post-antibiotics gut in a more general sense.
Fermented dairy should absolutely appear in your post-surgery (and, heck, pre-surgery) diet. It just works. Yogurt is a good option to try, if a bit inconsistent. Kefir is probably better; it’s been shown to improve patients’ tolerance to triple antibiotic therapy during treatment for H. pylori infection.
Fermented vegetables like sauerkraut are also must-eats. The fermented cabbage contains ample amounts of L. plantarum, a bacteria strain that’s been shown to prevent antibiotic-related diarrhea in piglets. Good options exist in stores, and even more are available in farmer’s markets, but the best way to get the most bacteria-rich vegetable ferments is to make your own. While you’re at it, consider making your own yogurt and kefir as well.
Supplemental probiotics are fantastic here, too: large doses of the desired microorganisms delivered directly to your gut. Some of the strains used in Primal Flora, like B. clausii and S. boulardii, have been shown to be effective against antibiotic-related diarrhea, so that could be a good choice.
Don’t forget the food for your gut bugs: prebiotics. You need to eat fermentable fibers and other prebiotics like resistant starch. Consider eating cooked and cooled potatoes, unheated potato starch, leeks, garlic, onions, green bananas, apples, pears, berries, and pretty much any fruit or vegetable you can get your hands on. Here’s where a wide variety of plant foods becomes even more important to consume because it introduces a wide variety of fermentable substrates for your gut bugs. Oh, and dark chocolate is a great source of fiber and polyphenols which have prebiotic effects in the gut.
Get dirty, too, to introduce potentially helpful bacteria. Go out and garden. Go barefoot at the park and practice tumbling, or roughhouse with your kids (or friends). Don’t immediately rush to wash your hands before eating (unless you’ve been handling raw meat and/or dog poop).
Whatever you do, don’t stress too much about the antibiotics you have to take. Stress is awful for gut health and the antibiotics are actually helpful here. Overall, it sounds like you’re on the right track. Good luck!
That’s it for today, everyone. Thanks for reading and be sure to help out with your own answers down below.
Take care!
July 5, 2015
Weekend Link Love – Edition 355
We’re starting another round of The 21-Day Transformation Challenge on the Vimify app, Monday, July 7th. Whether you’re new to the program, you want to recommit, or you just need a challenge, now’s the time!
Research of the Week
Statin use is linked to lower aggression in men and higher aggression in women.
Taking magnesium during pregnancy had beneficial metabolic effects and improved pregnancy outcomes for Iranian women.
Why don’t Amazonian hunter-gatherers in Ecuador develop myopia? It might be all the phytochemicals they consume.
“Fitness foods” appear to cause consumers to consume more and exercise less.
In a kid suffering from sleep seizures and cortical malformation, a paleo ketogenic diet led to complete resolution.
Creatine supplements protect against pesticide-induced liver and brain damage (PDF).
New Primal Blueprint Podcasts
Episode 74: Christopher Smith: Host Brad Kearns talks with Christopher Smith, speed golf world record holder, about how most people practicing their sport are just wasting their time, his embrace of failure as the ultimate teacher, and how to make your practice more effective. Whether you’re interested in golf or not, Christopher’s insights can help you extract more meaning out of your training and optimize your performance in every facet of life.
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.
Health Check-ups: How Important Are They, Really?
Is the Paleo Diet Supported by Scientific Research?
Precommitment Is Powerful, or Why You Should Be Like Odysseus
7 Ways to Use Stoic Philosophy to Improve Your Health and Happiness
Also, be sure to check out and subscribe to the (relatively) brand new Primal Endurance Podcast.
Weekly sweepstakes: Write a review for The Primal Blueprint Podcast or The Primal Endurance Podcast on iTunes and submit this form for a chance to win a Primal prize package. One new winner is chosen every week!
Interesting Blog Posts
Did you know that E. coli used to be an innocuous resident of the human gut before industrial agriculture transformed it?
Exciting new productivity hack sweeping entrepreneurs everywhere: sleep.
Media, Schmedia
The case for water fluoridation is actually quite weak.
What food additives look like before they end up in your food.
Everything Else
Death by Food Pyramid is the 2014 Gold Winner for the INDIEFAB Book of the Year Award in the Health (Adult Nonfiction) category, and Paleo Girl got an honorable mention in the Young Adult Nonfiction category. Congrats, ladies!
What if Yelp and Google Maps mated and gave birth to Robb Wolf, only Robb Wolf was Australian and actually a smartphone app? You’d get Paleo Paddock, a new app that helps users find paleo-friendly merchants in their area.
A cool movement video by Rafe Kelley: Return to the Source. Now go climb a tree.
GM-wheat is no more effective at repelling pests than regular wheat.
This self-inflating, jet-propelled standup paddleboard looks incredibly cool. I can’t wait to try one.
Recipe Corner
Beet fries beat fries.
In a move sure to anger Texans, Kansas Cityzens, and North Carolinians, NPR claims their pressure-cooked ribs recipe effectively replaces traditional BBQ. They don’t, but they are pretty good.
Time Capsule
One year ago (Jul 7 – Jul 13)
Is the Obesity Epidemic Exaggerated? – Not really, no. Wish I could say the opposite.
7 Powerful Ways to Make Walking More Exciting — Try each of these suggestions once a week. Repeat. Now you’re walking every day!
Comment of the Week
I need to put this website on the self control app…. lol
– Hey now, that’s not what I meant!
July 4, 2015
Creamy Cucumber Noodle Salad with Cherry Tomatoes (Plus Bonus Shopping Guide!)
This is a guest post from Diana Rodgers, the author of Paleo Lunches and Breakfasts on the Go, and The Homegrown Paleo Cookbook: Over 100 Delicious, Gluten-Free, Farm-to-Table Recipes, and a Complete Guide to Growing Your Own Healthy Food. Below is a recipe from her book using Primal Kitchen™ Mayo. In her book, you’ll also learn how to grow tomatoes, cucumbers, and the herbs needed for this recipe yourself! If you don’t have a green thumb and prefer to buy your produce at a farmer’s market, check out Diana’s tips following the recipe about how you can save money and still eat great on a Primal Blueprint diet. You can learn more about Diana at www.sustainabledish.com.
Creamy Cucumber Noodle Salad with Cherry Tomatoes
Serves: 4
Long strings of cucumbers mixed with a creamy herb dressing and cherry tomatoes are so much fun served as a side with fish or grilled meat in the summer. My favorite cherry tomatoes are the variety Sun Gold, which we grow every year at the farm. They are less acidic than red tomatoes and have the most beautiful yellow/orange color, which has been my favorite hue since I was a little kid. If you’ve never used a spiral vegetable slicer before, you’ll be amazed at how easy it is to make noodles out of all kinds of vegetables. Just please watch out for the very sharp blades.
Ingredients:
½ cup Primal Kitchen Mayo
Juice of 1 lemon
½ cup minced fresh dill
¼ cup minced fresh mint leaves
¼ cup very thinly sliced red onion
2 cucumbers, peeled
1 pint cherry tomatoes, sliced in half
Sea salt and ground black pepper
Instructions:
Mix the mayo, lemon juice, dill, and mint together in a small bowl. Set aside.
Using a spiral vegetable slicer, spin the cucumbers into noodles.
Place the cucumbers and red onion in a large bowl and toss with the dressing.
Top with the sliced cherry tomatoes and season with salt and pepper to taste.
Serve at once—this dish does not like to wait.
NOTE: This salad is also great with zucchini instead of cucumber.
How to Save Money and Still Eat
Have a plan
Menu planning is a lost art. If you figure out ahead of time what you’ll be eating when, it’s much easier to economize and save money on your grocery bill.
Cook and buy in bulk
It’s just as easy to roast multiple chickens as one, and with the oven already on, it’s simple to toss in a bunch of sweet potatoes. Is there a sale on your favorite olive oil? Stock up and save! Look for sales on meat at the market and add it to your stash. Not only is buying a whole or half of an animal more economical, it also lets you use more varied cuts than if you just purchase boneless, skinless chicken breasts or specialty steaks—so it’s a great way to explore the different cuts of meat.
Make your own bone broth
It’s the ultimate way to recycle a roast chicken or leg of lamb.
Grow your own food
While having your own chickens might cost more, the quality of the eggs far surpasses what you’ll get at the grocery store, and a veggie patch is a great way to save money. Live in a city? Maybe you can have container vegetables on the rooftop or fire escape, or you could tend a plot at a community garden.
Preserve the harvest
Freeze greens, can tomatoes, and make some sauerkraut. Not only will you save money, you’ll get to enjoy garden-grown produce in the middle of winter.
Dine in
Once you gain some confidence in the kitchen and get used to eating fantastic home-cooked food, you’ll think twice before spending your money on junky takeout or a mediocre steak at the local pub. Stay in and spend half of what you would have at the restaurant on your own home cooking. Don’t have much time? Scrambled eggs take less than five minutes. That’s faster and cheaper than ordering a pizza!
Buy local and in season
Local, seasonal produce is fresher than what you get at a supermarket and will last longer in your fridge. Instead of going to a farmers market and only picking out the most beautiful tomatoes, consider focusing your shopping trip on what is at its peak. Is it June? Strawberries and greens are what’s on the menu in New England. Is it January? Get some local cabbage, potatoes, carrots, and onions for a warm and satisfying stew. It’s much more sustainable and economical to build your weekly menu around what’s local and in season, and not whatever fancy recipe you crave at the moment.
Seek out less-expensive ingredients
Ground meat, organ meats, trash fish—fish that aren’t generally eaten in a particular region, such as carp in America—and unsexy vegetables like cabbage are better bets if you’re on a budget. At the farmers market, ask if they have “seconds”—vegetables that are blemished and not pretty enough for display. You could be canning extra tomatoes with a barrelful of tomato seconds at half price.
Not Sure What to Eat? Get the Primal Blueprint Meal Plan for Shopping Lists and Recipes Delivered Directly to Your Inbox Each Week
July 3, 2015
It’s Not About the Number, It’s About Feeling Good
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!
As you know only too well, I’ve been meaning to write this story for the longest time but never got around to doing it, but I finally have so here goes!
I have included two sets of pictures. The first two (below) are from before I started my fitness journey and I had not yet discovered Primal. These pictures were taken in January of 2013 when I weighed in at 195 lbs. Previously I was 225 lbs after my pregnancy and in a slump for the longest time but did not have the courage to take pictures at that size. I did start on the unhealthy track of HCG therapy and while this might not have been the best nutritional decision of my life it did in fact serve one purpose. It lit the fire! The weight was pouring off but at 195 lbs it all stopped working. This was when I made the decision to join the gym.
When I signed up for the gym, I also signed up on myfitnesspal.com to track my food. I discovered very quickly what I was doing wrong in terms of portion sizes, sugars and carbs. This made me change those aspects of my diet, which was a drastic improvement over previous years. It took a few months, but the changes that were taking place in (and out) of my body, were very clear. Not only was the weight coming off, but my skin started to clear, my left knee which I had surgery on at the age of 15 was no longer hurting, I didn’t need to wear my knee brace any more during workouts, I was becoming happier and my mood swings were disappearing, and finally, I was gaining some self confidence. Since I was a small child, my self confidence and general self love were pretty much non-existent. I always had a few extra pounds that I was walking around with, but I certainly wouldn’t say I was fat. However, I was always taller than everyone else and had a much larger frame. My adult height is 5’10”.
About six months after I started the gym, I stalled at 165 lbs. Then I discovered your wonderful site and dove head first into a primal lifestyle, which is what helped the remainder of the weight to come off. Within a year I had surpassed my goal weight of 155 lbs and actually made it down to 144 lbs. Looking back at those pictures now, I can see the weight loss, but also the frail and bad postured body I had punished for so long.
After the initial weight loss, I decided it was time to start a lifting program to work on building up some muscle tone. I found the Strong Lifts 5×5 program and started slowly with that. My body worked its way up to 155 lbs and eventually back to 165 lbs where it stayed for awhile. Up until the end of 2014, I was still around the 165 lbs mark but decided to switch up my workout program again to get a bit more definition on what I had already built.
I’ve been doing CrossFit now for just over six weeks (pictures below) and I’m enjoying the challenges it’s bringing me. My gym classes in the past two years had not really changed much, so throwing in CrossFit has been just what I was looking for. These days I’m around the 170 lb mark and thinking it’s not so bad to be here. Initially I was very worried about gaining any more weight, and truthfully I don’t want to gain any more, but I do realize it’s not the number, it’s about how my body works for me and how I feel in it.
What this site has done for me is immeasurable in most ways. I’ve gained so much self confidence that for the first time in 11 years, I’ve been able to walk down my beautiful Barbados beaches in a bikini. I’ve been able to buy shorts and not worry about what others will think about “the fat chick in those shorts.” I’ve been able to go out with friends and take pictures without having to worry about if I look good or not. Mirrors are okay now and I don’t find myself avoiding them at all costs.
I’m still working on a few demons, but they are slowing being kicked out one by one. My husband and daughter have been immensely supportive, as has the rest of my family. I’ve still yet to convince anyone else to go all out Primal, but I have been able to encourage better food choices in most of those around me. The truth is that this journey never ends and I’ll continue to learn more from your site everyday. Thank you for your dedication and your wisdom. All of your hard work certainly has not been in vain.
Grok on!
Shannon
July 2, 2015
Health Check-Ups: How Important Are They, Really?
This past weekend’s “Link Love” highlighted an article called “Rethinking Movement: Why You Should See a Physical Therapist Every Year.” Arguing for a systemic approach to movement and a deeper appreciation for the interconnections among the body’s neuromuscular, skeletal, cardiovascular and even endocrine functioning, professor emerita of physical therapy, Dr. Shirley Sahrmann proposes that taking a more preemptive approach to movement (a.k.a. prehab) throughout life can head off injury, osteoarthritis, chronic pain as well as the common surgeries and other intensive or pharmaceutical treatments related to these conditions. Whether you’re an elite athlete or a channel surfer, she claims an annual check-up by a physical therapist should be routine practice. Having seen so many injuries and pain issues as a trainer (and suffered from them myself), I find her proposal very compelling. More than that, however, her reasoning opens up a larger question: what really should we be monitoring on an annual basis?
As many of you know by now, I tend to embrace the devil’s advocate role, particularly in questioning conventional wisdom. It’s not that I’m out for blood or have a chip on my shoulder (although blatant misinformation does get under my skin). I simply don’t believe in accepting a truth or practice on the sole rationale of “that’s just how it’s done.” Standard health care parameters are no exception here.
When we think about preventative care or maintenance checks, what makes the most sense? Currently, protocol is figured mostly around certain collective risks like hypertension, heart disease and specific cancers. As I’ve argued in the past, even these attempts miss the target, however, with their focus on elementary cholesterol panels and single screenings that may say more about a person’s mood that day or white coat syndrome than their actual state of well-being. And aside from honing some of those exam parameters, where else are we missing the mark – either by focusing on the unnecessary or by missing out on pertinent areas?
In the last few years a number of experts, armed with some persuasive research, have suggested doing away with the standard yearly check-up period. Most notable is a 2012 research review done by the Cochrane Collaboration, an international group of medical researchers. They analyzed 16 peer-reviewed studies with a follow-up range of 4-22 years involving nearly 200,000 people (excluding any studies with subjects 65+) to see whether annual exams lowered the rate of mortality, disability or hospitalization. As another earlier review had shown, the evidence suggested no on all counts. The Cochrane review also found that annual physicals had no effect on “patient worry, unscheduled physician visits…or absences from work.”
On the other hand, major concerns exist around the cost, anxiety and even harm imposed by indicated overdiagnosis with annual check-ups of asymptomatic, under-65 individuals. Based on missing or unclear data in the original studies related to these concerns, the Cochrane Collaboration review didn’t assemble statistics for these areas, but its authors did echo an earlier review’s statement that routinely checking asymptomatic, low-risk people sets up a situation in which “potential for harm is likely to exceed the potential for benefit.”
The researchers note that the Canadian Task Force on the Periodic Health Examination advised against routine annual physicals as far back as 1979. The United States Preventative Service Task Force stopped recommending standard annual visits ten years later. What both groups suggested instead was “focused health checks guided by patient-specific risk factors.”
Before we imagine what that could be, let’s look at the standard “check-up” protocol for adults in the U.S. for a minute.
Family history
Height and weight
Blood pressure check
Cholesterol (often only “total” non-fasting cholesterol or a simple rather than comprehensive panel)
Blood sugar (maybe – with fasting blood sugar even rarer)
Physical exam
Pap smear for women
Discussion of diet and exercise habits
Vaccination review
I’m sure we’ve all been there – many, many times. Some of us would claim better experiences with these appointments than others. If we have questions about coming changes or would like to optimize health for certain circumstances (e.g. menopause, fertility), an annual discussion with a doctor can be helpful. If that person knows our medical history and has a good bedside manner, even better.
Regardless of the advice or any treatment offered, placebo research suggests that the care of an attentive individual – particularly one we deem knowledgeable as well as understanding – can confer a measurable benefit to emotional as well as certain physical measures of well-being. In keeping with that principle, those who have seen naturopaths or other “non-standard” wellness care providers often emphasize the duration of time and depth of discussion as one of the most helpful or nurturing elements of that relationship.
So, what does all this point to? What should we desire and expect in terms of preventative care and useful consultation?
For the Cochrane Collaboration authors, a central criticism of the standard check-up procedure was its “generic” nature. How can preventative care offer more genuinely helpful screenings and conversation?
While I’m interested more today in posing this as a question for our community discussion (I’m looking forward to reading your perspectives and anecdotes in the comment board), I will propose a few points based on my specific angle of experience.
I’d suggest we miss a significant chance to help educate and support people in terms of basic lifestyle change. How many doctors include five minutes or less of discussion on stress, nutrition, fitness, sleep and other self-care considerations? I’m not even trying to put physicians in the hot seat here. Many would explain their time is limited and already tightly circumscribed by a clinic protocol not of their individual choosing. Likewise, most doctors have very limited training in nutrition and exercise, let alone other areas of wellness practice. They know the conventionally recommended fundamentals (and some know and embrace a deeper understanding of more updated, results-oriented diet and exercise research – even Primal principles).
That said, what would an annual check-up be if we could re-envision it as a varied, open-ended “check-in” with additional elements? How about a postural alignment check-in physiotherapist even if you’re not having physical pain? How about a consultation with a fitness professional for fitness testing and exercise planning? How about the chance to meet with a mental health professional or complementary therapy practitioner for stress relief or other concerns? What about meeting with a dietitian for food allergy or nutrient deficiency testing or for help redesigning your daily diet?
How about the ability to see a wide variety of professionals within particular fields of expertise – for both consultation and testing interpretation? How about making the overall process patient-directed or at least including a meaningful patient-directed component to regular care? What could health care look like – and what would compliance and outcomes be – if patients were expected to design their own health care in the form of a healthy living plan and then given choice in how they allocated insurance or other medical related savings/resources?
What if patients were more involved in creating their own risk profiles based on not just age and family history but also on dietary and other lifestyle elements – and were held more accountable for seeking out care to monitor and manage their noted risks and/or conditions with more targeted care and detailed screenings? How about funneling money that would otherwise be put into standard check-ups be directed toward more updated screenings for risks that fit a patient’s personal profile?
Again, my intent here is to pose more questions than provide answers. I consider this to be one of the most essential conversations we can have in considering our individual choices (and future policy) around health care – how to get people to re-envision wellness and vitality and to cultivate the genuine health integrity that will allow them to take ownership of their well-being.
I’d love to hear your thoughts on the problems of annual exams – and the possibilities in re-envisioning them. Also, if you have related questions or ideas you’d like to see in future posts, share those as well. Perhaps this might open an interesting conversation and even post series.
Thanks for reading, everyone, and have a great end to the week.
July 1, 2015
Is the Paleo Diet Supported by Scientific Research?
People constantly demand proof for the efficacy of the Primal eating plan. And I’m glad they do. The Primal Blueprint makes sense on an intuitive level, and those success stories we see every Friday sure are persuasive, but it’s also important to see broader support in the scientific literature. Many times, people demand proof without really wanting any; they assume it’s all imaginary just-so stories. “Where are the studies?” has become a retort rather than a legitimate query.
Well, it’s time to retire it. With 22 paleo diet papers and counting, the scientific research is quickly accumulating — and it’s quite positive. In last Sunday’s Weekend Link Love, I shared a list of (most of) the available paleo diet studies. Today, I thought I’d summarize some of these studies for you. Not everyone can be expected to have access to, read, and be able to interpret all of the research that is published. But there’s some really interesting stuff in there that I think you might benefit from knowing (and passing along to interested parties who ask). But be sure to have a look for yourself. Don’t just take my word for it.
Without further ado, here are short discussions of five of my “favorite” studies. These are the ones that leap out at me.
This is one of the earliest-known paleo diet studies, so early that the diet was called a “reversion to traditional lifestyle” rather than paleolithic. In it, 10 diabetic, middle-aged, overweight Australian aborigines were instructed to live as hunter-gatherers for seven weeks, eating only what they were able to collect or hunt on their traditional homelands. Their base “city diet” — the diet that got them diabetic and overweight — consisted of flour, sugar, rice, soda pop, alcohol, powdered milk, cheap fatty meat, potatoes, onions, and various fresh produce.
Their new diet looked very different:
Beef, kangaroo, crocodile, fish, turtle, crawdads. Yams, honey, figs. Fat content of the diet ran between 13%-40%. Protein content ranged from 50% to 80%, and carb content ran between 5%-33%. Overall, 64% of the diet came from animal foods and average caloric intake was 1200/day.
After seven weeks, the subjects had lost an average of 8 kilograms (17.6 lbs), fasting glucose had gone from diabetic to non-diabetic, postprandial glucose had improved, fasting insulin levels had plummeted, and triglycerides had dropped.
Takeaways: Some combination of increased energy expenditure (although the study author estimated that activity levels were higher than normal, but not dramatically so), reduced caloric intake, elimination of processed industrial foods, and consumption of healthy traditional foods caused the massive improvements in diabetic markers. I suspect that the drastic reduction in food intake played the biggest role, but what was it about the traditional diet that allowed such effortless calorie reduction?
Heart healthy diet recommendations are meant to be the gold standard when it comes to reducing the cholesterol of hypercholesterolemic adults. Their entire business model revolves around lowering blood lipids through diet (and maybe a few prescription drugs), so you’d think that the official AHA diet would trounce the supposedly unproven, untested, and dangerously meat-centric and grain-deficient paleo-type diet when it comes to cholesterol numbers.
Not so.
In this study, subjects with high cholesterol spent four months on the sanctioned AHA diet followed by four months on a paleo diet. The AHA diet phase emphasized lots of fruits and vegetables, little to no salt, fish twice a week, tons of whole grains, no more than 7% of calories from saturated fat and no more than 300 mg of cholesterol a day. During this portion of the trial, subjects failed to hit any of the desired blood lipid changes. Neither HDL, triglycerides, LDL, nor total cholesterol got any better or worse on the AHA diet.
The paleo phase emphasized lean animal protein, fruits, vegetables, eggs, and nuts. Dairy, legumes, and grains were all restricted. During this part of the trial, traditional cholesterol markers improved across the board. LDL, TC, and triglycerides went down, HDL went up. Plus, during the paleo phase, patients lost more weight and ate fewer calories (without being instructed to to so).
Takeaway: A paleo-type diet with unlimited eggs, zero grains and legumes and dairy, and no strict caloric limit isn’t just safe but leads to better blood lipids, more weight loss, and greater calorie reduction than an official AHA heart-healthy diet that limits eggs, dietary cholesterol, saturated fat, and places strict limits on total calories.
The Mediterranean diet is typically lauded for its beneficial effect on colorectal cancer. It’s fairly low in red meat (a popular whipping boy in colorectal cancer circles), high in extra virgin olive oil with potent antioxidant effects, rich in whole grains whose fiber is supposed to stave off colon cancer, and features ample amounts of red wine whose polyphenols exert protective effects against colon carcinogenesis. Paleo diets, meanwhile, eliminate whole grains and place no limit on red meat. And while they usually allow both red wine and olive oil, they emphasize neither. So when a team of researchers found that high adherence to paleo diet principles was just as protective against colon cancer as adherence to Mediterranean diet principles, some people were surprised.
I wasn’t.
Takeaway: Assuming this epidemiological research indicates a true causal relationship between diet and colon cancer risk, we can draw a few tentative guesses. You don’t need whole grains to have a healthy colon. You can eat meat and enjoy a healthy colon. You probably still need ample amounts of prebiotic fiber (and there’s evidence that prebiotics are important mediators of the effect dietary red meat has on colon cancer risk), but it doesn’t have to come from grains and legumes; fruit and vegetables and tubers are perfectly adequate.
“Long-term” is relative, and we’d all love to see 30- or 40-year long randomized trials, but those are cost prohibitive. A randomized dietary trial lasting two years is incredibly rare and deserves our full attention. So, what happened in this one?
Subjects were split into two groups. One followed your standard paleo diet, the other followed a high-carb, low-fat Nordic Nutrition Recommendations diet (fairly standard “eat healthywholegrains, avoid arterycloggingsaturatedfat” approach, albeit with higher fat allowances than most heart healthy diets in the US). The group following paleo lost more body fat, especially abdominal fat, at 6, 12, and 18 months. They also had more sustained drops in triglycerides after two years, and their blood pressure improved to a greater degree.
The weight loss and biomarker improvements were accompanied by dietary shifts typical of Primal/paleo diets: reduced carb intake, increased protein intake, increased monounsaturated fat intake, reduced omega-6 intake, increased omega-3 intake.
Takeaway: It’s safe. Two years is usually enough time for some worrying trends to appear. None did, though.
The obese women who lost so much body fat at six months, twelve months, and eighteen months on the paleo diet had pretty much flatlined at 24 months, allowing the Nordic diet group to catch up to them. This was probably because they didn’t stick with the diet, as indicated by their difficulty maintaining the elevated protein intake normally associated with paleo in these studies. For any diet to continue working, you have to actually do it.
Participants in this diet were overweight with big bellies, either glucose intolerance or outright diabetes, and a confirmed diagnosis of ischemic heart disease. In other words, they consisted of the typical people who really need to change their diets. They were randomized to receive either a paleo-like diet or a Mediterranean-like diet.
The paleo diet was based on meat, fish, eggs, nuts, vegetables, fruit, and root vegetables.
The Mediterranean diet was based on whole grains, fish, low-fat dairy, fruits, and vegetables.
Both groups reported high satiation from their respective diets, but the paleo group consumed fewer daily calories and smaller meals to achieve it. While the Mediterranean group needed over 1800 calories a day to feel full, the paleo group ate a hair under 1400 to achieve the same level of satiation. And that’s without eating any more protein (well known for its powerful induction of satiety). Calorie for calorie, the paleo food was simply more filling.
Takeaway: There’s something about eating plants and animals while avoiding grains and other processed junk that improves satiation, beyond the added protein that normally accompanies a lower-carb Primal way of eating.
That was just a small sampling of the available evidence. Go have a look at the rest of the studies, if you’re still interested. But my point: by now, it’s clear — and growing clearer by the day — that this way of eating really does work. Not that we needed these study results to tell us that.
Thanks for reading, everyone. Which of the studies listed is the most significant or relevant to you? Did I miss any great ones?
Prefer listening to reading? Get an audio recording of this blog post, and subscribe to the Primal Blueprint Podcast on iTunes for instant access to all past, present and future episodes here.
June 30, 2015
Precommitment Is Powerful, or Why You Should Be Like Odysseus
Most of the time, we wield willpower like a holstered gun with the safety off. Temptation rears — an ice cream bar, perhaps — and we whip it out, firing blindly and wasting more than a few bullets in the process. The temptation is beat back, and the ice cream goes uneaten, but the willpower that remains is depleted and less effective in subsequent encounters. And the same thing happens every time we’re faced with a decision. That’s a sloppy way of dealing with the constant stream of temptation the modern world presents.
Consider how Odysseus handled the ultimate temptation in Greek mythology. As legend had it, any man who sailed past the island of Anthemoessa would be drawn toward and broken upon the rocks lining its shores by the irresistible song of the Sirens who resided there. No man could resist, and so Odysseus plugged his men’s ears with beeswax and tied himself to the mast with strict orders that no matter what he said and how much he pleaded, he was not to be untied. He didn’t want to be shipwrecked, but he also didn’t want to miss out on hearing the song. Binding himself to the mast before the call rang out was a basic form of what behavioral psychologists call precommitment.
In the modern world, temptation abounds and beeswax in the ears doesn’t work. Willpower only lasts so long, and powerful forces (food chemists, advertisers) actively seek to sap yours. Research indicates that precommitment — removing a future choice from contention and/or making future commitments to avoid temptation before it strikes — is more reliable than willpower, actively preserves it (for later use when you really need it), and helps everyone, especially the people with impulse control, make better decisions. And it’s this population — the high impulsivity group — that’s most at risk for obesity. They eat the most fast food, too, because that stuff looks good and it’s right there and you’re tired and just this once can’t hurt, can it? But with improved impulse control, the obese are able to lose weight and those who’ve lost weight are able to keep the lost weight off.
Precommitment to healthier choices, then, may be an essential tool in the modern world, and a more reliable one than relying on sheer willpower.
How might this look?
Well, precommitment is most effective when willpower fails, or will fail. To figure out when and how to use precommitment in your own life, simply consider the areas in your life where willpower doesn’t work as well as you’d like.
A few examples:
You sit down for a meal and a restaurant known for its complimentary bread. Don’t wait till those crusty, fragrant, just-from-the-oven slabs of sourdough are on your table within easy reach to refuse them. You’ll probably fail, and the sapping of willpower required to prevent failure will make subsequent resistance to dessert futile. Decline the bread basket from the start, preferably before it even makes an appearance.
You find yourself opting for takeout more and more every night after work because cooking seems like a chore and, by dinner time, your willpower is exhausted. You’re eating good takeout, but it’s still eating into your budget and you don’t get to exercise as much direct control over your food as you’d like. There are a few ways you can handle this using precommitment. You could plan the week’s meals ahead of time and gather the necessary ingredients on the weekend so you’re ready to go each week night. Go a bit further and prep the cooking area, chop the veggies, and mix the spices every morning before work so that you can come home and launch immediately into dinner prep.
You’re a digital nomad, working on your laptop from home, cafes, or any place that’ll have you. It’s a great way to make a living and affords a lot of freedom, but you’ve also got a procrastination problem. Whenever you can, you manage to find something else on the Internet that’s more interesting, or at least less demanding, than the task at hand. If you don’t actually need online access to do the bulk of your work — maybe you’re a writer or content creator — find a place to work that doesn’t have Internet, like a park, a beautiful hiking trail (I actually know a guy who frequently uses his laptop out in the woods), some hipster cafe that’s opted not to feature wifi to foster more face-to-face interpersonal communication, or even your backyard or office with the wifi turned off. If you do need online access for your work, use a program like Self Control to restrict access to tempting websites.
Some people thrive on spontaneous workouts. If they feel like working their legs, they’ll find the time to sneak in some squats and Romanian deadlifts. They’ll take a quick detour over to the park at lunch to do some pullup and pushup supersets. Maybe they’ll even sprint back to the office. Their innate drive to move and train is high enough that precommitting to a workout isn’t just unnecessary, it’s stifling. Most people are not this way (just look at the rates of sedentism) and will benefit from precommitting to an exercise schedule. Say you’re about to perform some sprint intervals on the stationary bike. You could hop on without any plans and just “go till you feel like stopping” (something I actually do from time to time when I only have a few minutes available), or you could precommit. In the bowels of an intense interval workout, your willpower will be seriously tested and sapped, and going in without that precommitment to a set amount of work is going to leave you open to premature cancellation. Some work is better than none, but deciding at the start to do 10 rounds will make you more likely to endure the pain and finish the full 10.
You can’t handle everything this way, obviously. Temptation’s just too unpredictable and omnipresent. And even if it were possible to use precommitment to overcome every temptation that might arise, that kind of micromanagement of everyday life would drive a person mad. That’s no way to live.
The Primal Blueprint is the ultimate framework for precommitment. By hewing to a set of principles — avoid/limit grains, seed oils, refined sugar; eat colorful plants and healthy animals — you stop, or at least slow, temptation in its tracks. It never has a grasp on you because you’ve already committed to the Primal way of eating. And because we don’t have the luxury of plugging our ears to block out the temptations offered by the modern world, our best bet is to make like Odysseus and secure ourselves to a healthy way of eating and, most importantly, analyzing food and behavior decisions.
To me, the case for intelligent and targeted usage of precommitment is clear. The world is crazy out there. It’s unpredictable. And sometimes you’re going to need willpower to overcome obstacles. Why not precommit to abstaining from, avoiding, or limiting the temptations we know about so that when spontaneous situations erupt, our willpower is readily available?
I’m interested to hear how everyone out there uses precommitment to handle temptation, even if they don’t call it that. What’s worked? What hasn’t? What kinds of temptations have you used precommitment to overcome? Let me know down below, and thanks for reading!
June 29, 2015
Dear Mark: Vitamin D for Babes, Ingredient Bait and Switch, and Kettlebellin’ for Strength or Cardio?
For today’s edition of Dear Mark, we’ve got a three-parter. First up is a controversial topic: vitamin D supplements for breastfeeding babies. Do they need it? Can they get enough through mother’s milk? Or is there another, better method for ensuring optimal vitamin D levels in breastfeeding infants? Next, what’s my take on the ol’ ingredient bait and switch employed by food manufacturers? And finally, say a person’s trying to program kettlebell training into their weekly routine. Should they consider it cardio, strength, or something else entirely?
Let’s go:
Mark,
First off, a sincere thank you for being such an awesome resource!!
So I was hoping to get your opinion on Vitamin D supplementation in newborn babies.
I have a five week old son, I also have four and 10 y/o old daughters. I was surprised to find out when we were checking out of the hospital with my son that it is now recommended that infants get 1 ML or 400 IUs of Vitamin D daily. This was not the case just four years ago when my daughter was born.
I am a big believer in the benefits of getting the proper amounts of Vitamin D. However, I am not really a big fan of supplements unless medically necessary and something just doesn’t sit right with me giving it to my newborn- especially because we never did with my other children and they are healthy primal kids.
It seems like the rationale for the rec is that babies have sensitive skin so they can’t spend much time in the sun, and Vitamin D does not come through breast milk as much as some other vitamins/ minerals.
Would love to hear your thoughts.
Thanks,
Ryan
Thanks for the kind worsd, Ryan.
Let’s be clear: vitamin D deficiency is a serious issue for anyone, especially infants. In the long term, vitamin D deficiency early in life leads to rickets, skeletal malformation (curved spines, bowed legs, thickened ankles), and poor growth. Infants who are born and stay vitamin D-deficient are also more susceptible to upper respiratory tract infections. Overall, vitamin D plays important roles in endocrine, immune, and heart health, along with cancer prevention, so starting one’s life from a deficit can have major repercussions.
In the US, infant rickets appears almost exclusively in infants who are breastfed. That may come as a surprise to some of my readers, but breastfed infants with rickets were also likely to receive no vitamin D supplementation and very little sun exposure. So it’s probably a combination of poor maternal vitamin D status, inadequate maternal vitamin D intake, lack of sun exposure for both the mom and the infant, and inherently meager levels of vitamin D in breast milk.
Is there anything you can do to increase vitamin D levels in breast milk enough to give your nursing infant enough? Yes.
In one study, mothers taking 3.3 micrograms, or a mere 60-70 IUs, of vitamin D via cod liver oil were unable to impact their breastfeeding infants’ levels.
In another, a much larger maternal daily dose (6400 IUs) was able to replicate the effects of giving infants 300 IU directly.
In another, maternal supplementation with 4000 IUs was superior to supplementation with 2000 IUs for attaining optimal infant vitamin D levels.
So it can be done via supplementation, provided you take enough (~4000 IU minimum). Maternal sun exposure may also work, but I haven’t seen any corroborating evidence.
Supplemental vitamin D is probably fine. 400 IU/day is usually enough to prevent rickets and keep vitamin D levels above 50 ng/mL. Not always, though. In Izmir, Turkey, vitamin D deficiency was “worryingly high” in 4-month old infants despite 400 IU/day supplementation. This was particularly true in winter months. Getting your kid’s levels tested is a good idea if you go the supplementing route. Apply a few drops to the nipple just before feeding. That’s the mother’s nipple, by the way.
Your baby can also supplement with cod liver oil, which has vitamin D (and vitamin A, for that matter) and has been shown to reduce the incidence of upper respiratory tract infections in children. Some tots even like the taste of fermented cod liver oil, which is just crazy if you’ve ever tasted it yourself, but who knows? Kids are weird. I know one guy who actually gives his 2 year old daughter capsules as a treat. He actually has to prevent her from eating too much.
There is another method, of course. I prefer this one to the others, and I think it confers additional beneficial effects beyond improving infant vitamin D status: light but daily sun exposure. Infants aren’t going to burn up because of a minute or two of full sun exposure. Make it a bonding experience. Strip down to your skivvies (the both of you, and bring the other parent along, too) and flop down in the sun. Expose every nook and cranny. Return inside or cover up when the little one’s skin starts to feel warm to the touch. Avoid pinkness. A study from 1985 found that just 30 minutes of full sun per week wearing a diaper was enough to keep vitamin D levels topped off in exclusively breastfed infants — it really doesn’t take much more than five or six minutes a day.
Those expert health recommendations that infants all receive vitamin D drops presuppose that they aren’t getting any sun exposure, which is probably a safe assumption for most. That’s kinda been drilled into parents’ heads for generations: avoid the sun at all costs! Your fragile baby will literally wilt in the sun. But it’s not true. It’s safe, as long as you’re smart about it. It’s most likely how most infants got adequate vitamin D for most of our history.
You’ve got some time to decide. Absent postnatal sun exposure, vitamin D levels last about 8 weeks in the exclusively breastfed baby.
I “tolerate” erithrytol and xylitol, but prefer to use things like stevia, barring that, honey or maple syrup, but categorically refuse Truvia. The reason is that while they advertise it is stevia, the ingredients and nutrition panels reveal that it is mostly erithrytol with barely a nod in the direction of a stevia bush.
Two other examples that come to mind are “honey mustard” that starts with HFCS and has “some” honey halfway down the list. Or the “olive oil mayo” that starts with soybean oil and again has “some” olive oil halfway down the list.
Apparently parity between the front and back labels is too much to ask at the grocery store.
Any thoughts on this?
James
It’s a huge issue, James, and you’re totally right. As you say, even if the “hidden” ingredients aren’t in and of themselves offensive or particularly undesirable, the deception rankles. Take something like Spectrum Organic Olive Oil Mayonnaise, which, going by the words printed on the label and the prominent depiction of an olive branch, should be made of olive oil. But it’s not. The first ingredient is soybean oil, followed by whole eggs and egg yolks. Only then does olive oil appear.
American ingredient labels are arranged in order of quantity. The earlier the ingredient appears in the list, the larger the proportion of the final product it comprises. Anyone who has ever made mayo knows that it’s almost all oil. Most mayo recipes do about a half cup of oil for every egg yolk. So if olive oil comes after eggs on the Spectrum mayo, you’re looking at a pittance of olive oil in the finished product. It’s soybean oil mayo.
Coincidentally, that’s one of the main reasons I started Primal Kitchen — to provide a beacon in the night for all the disaffected mayo (and other condiment) seekers sick of being ripped off with false promises of olive oil. As many of you know, I come up with most of my products to address a deficit or solve a problem in my own life. My reasoning is sound, I think: if I need something, others do, too. And I love mayo, but hated making it. Primal Kitchen™ Mayo is flying off the shelves, so I guess I was right.
Hi, Mark,
I’m working through your program and have a question regarding the strength phase. I’m assuming that keeping heart rate below 75% does not apply since this is difficult to control. I use kettlebells for this, limiting to 20 minutes. However, they are demanding on the heart rate as are lifting heavy things.
Would a 20 minute kettlebell session with limited rest constitute a sprint session and hence substitute. Greatly appreciate your thoughts.
Best regards,
John
A 20-minute kettlebell workout is probably veering toward the cardio side of things. Even still, it’ll make you stronger, too. That’s what’s so cool about kettlebell training: it’s both. Using kettlebells can make you stronger and improve your conditioning.
Kettlebell training with light weights and high volume (12-16 kg bells, 12 30-second rounds of swings with 30 seconds of rest) increase maximal and explosive strength.
The hormonal response to kettlebell training is consistent with muscle adaptations to strength training.
Furthermore, weightlifters who incorporate kettlebells into their training enjoy additional strength and strength-endurance gains. It really can’t hurt (and may help) to add a KB workout once in awhile.
Many people find that regular KB swings improve and even eliminate back pain, and research into muscle loading and activation during the swing supports these anecdotes.
As for aerobic adaptations, KB training’s good for that, too. One study had female college soccer players do 20 minutes of KB snatches using 15 second work/rest intervals. Compared to a control group who performed only circuit weight training, the KB snatch group experienced gains in aerobic capacity over four weeks. Another study found KB training about as good for aerobic fitness as moderate-intensity uphill treadmill walking.
However, there are compromises. When you directly compare it to traditional strength training, kettlebell training doesn’t increase strength to the same extent. And compared to treadmill running, KB training doesn’t elicit as strong an aerobic adaptation. But it does produce gains in both areas.
It’s worth noting that most KB training studies use relatively low weights and still get good results for both strength and aerobic training. If you were to pick up a heavier bell — upwards of, say, 24 kg for women, 40 kg for men — you’d get even greater strength adaptations.
That’s it for this week, folks. Thanks for reading, and be sure to leave a comment down below. I’d love to hear your input on today’s questions.
June 28, 2015
Weekend Link Love – Edition 354
Summer is here and grill season is upon us! As an early 4th of July present, I’m giving away a FREE copy of my Primal Blueprint Healthy Sauces, Dressings and Toppings hardcover cookbook with every Primal Kitchen™ Mayo 3-pack order. Simply add both products to your cart and use coupon code FREEDOM to get the cookbook absolutely free. Expires on July 4.
Research of the Week
The more berries, onions, apples, oranges, and other common sources of dietary flavonoids women ate, the better they aged.
Both strength training and aerobic conditioning have beneficial effects on workplace burnout, despite being stressors in and of themselves.
According to BMI, more Americans are obese than overweight.
New Primal Blueprint Podcasts
Episode 73: Hannah Crum: If you’ve ever wanted to know anything about kombucha — how to make it, how to drink it, why to make and drink it, how to make kombucha cocktails – this episode is for you. Hannah Crum is the Kombucha Mamma, Master Brewer and proprietor of the web’s top kombucha advice site.
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.
9 Primal/Paleo Podcasts You Should Be Listening To
The Pitfalls and Limitations of Self-Experimentation
Also, be sure to check out and subscribe to the (relatively) brand new Primal Endurance Podcast.
Weekly sweepstakes: Write a review for The Primal Blueprint Podcast or The Primal Endurance Podcast on iTunes and submit this form for a chance to win a Primal prize package. One new winner is chosen every week!
Interesting Blog Posts
How an ancient Viking honey liquor could be the answer to antibiotic-resistant bacteria.
George Henderson’s take on the latest PUFA-for-saturated fat meta-analysis. And Steven Hamley’s is also worth a read.
What we know — and don’t know — about Europe’s first humans.
Media, Schmedia
Researchers are calling for the US dietary guidelines to stop placing limits on total fat intake.
Can gut bacteria explain our mood?
Everything Else
The story of the first CrossFit affiliate.
Another sub-par criticism of the ancestral health movement that totally misses the point (and, of course, relies heavily on the existence of lactase persistence).
The case for seeing a physical therapist every year.
If a skeptical acquaintance ever goes “Yeah, but where are the studies?” you can direct them to this page.
Is iron enriched-food at the heart of most modern disease?
So, is obesity really a choice?
Recipe Corner
Who doesn’t love Alton Brown? His recipe for avocado compound butter is incredible.
If you want ribs but don’t want to mess around with the smoker, try these braised country-style BBQ ribs.
Time Capsule
One year ago (Jun 30 – Jul 6)
Why Kids Need the Sun – Before you go slopping a half gallon of sunblock on your kid at sunrise, read this post on why they need some unfiltered UV in their lives.
An Ounce of Prevention is Worth…? – Is prevention really all it’s cracked up to be?
Comment of the Week
In response to the first questioner I recently read a statement that is sticking with me: “Only a fool stumbles on things behind him.” That is helping me let go of my past.
– Nice. I like that.
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