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Should You Try Intermittent Fasting While Doing Long Term Keto?

You’ve been keto for a few months now (or longer). You know what you’re doing. You feel good about where you are. You’re fat-adapted. You’ve got a slew of recipes under your belt, your gym performance has normalized, the keto-flu is a distant memory. And now, you’re looking to explore further. The natural next step is intermittent fasting.

But is it the right move?

Does intermittent fasting work if you’re keto?

The short answer is: Yes. Intermittent fasting works really, really well if you’re on a ketogenic diet.

Why?

Keto smoothes the fasting transition

One way is that being keto makes the transition into fasting smoother and easier.

Fasting shifts you into fat-burning mode. You have no exogenous food coming in, and your only source of energy is the fat that sits on your frame. Anyone who fasts, whether they’re coming from a high-fat diet or a high-carb diet, will end up burning fat.

Keto is fat-burning mode. You have very little dietary carbohydrate coming in, and your body must deal with the “glucose deficiency” by converting fat into ketone bodies—an alternative fuel source that can power many of the same tissues that normally run on glucose.

Long-term keto is even better for fasting. Since you’ve taken the time to get truly fat-adapted, you’ve built the metabolic machinery—the actual mitochondria, the power plants of your individual cells that convert nutrients into ATP—necessary to burn free fatty acids directly. Your reliance on actual ketones goes down, your ability to burn fat directly goes up, and your ability to seamlessly switch between eating and fasting skyrockets.

The problem with going from a high-carb diet to intermittent fasting is that you have to start all over again each time. You have to go through the process of converting your metabolism from sugar-burning mode to fat-burning mode. That takes time and energy, and it often triggers the “keto flu”—that collection of symptoms ranging from headaches to fatigue to brain fog to irritability.

When you fast on a ketogenic diet, there’s no keto flu because you’re already in ketosis and fat-burning mode. The transition is easy because your body has already made the transition, and you can move on and start reaping the benefits of fasting more rapidly.

Keto speeds up fat loss while fasting

Another way fasting works better when you’re in ketosis is for losing weight, specifically body fat.

A 2013 study compared low-fat dieters on an alternate day fasting schedule with low-carb dieters on an alternate day fasting schedule. Both groups lost weight and improved metabolic health markers, but the low-carbers lost more body fat. They were already in “fat-burning mode.” Fasting just kicked it up a notch. Meanwhile, the high-carb group had to take extra time to start burning body fat, and as a result, they lost less overall.

A more recent study putting low-carbers on a fasting schedule for six months saw their body fat drop, lean mass remain stable, and fasting insulin decrease. However, there was no control group and the low-carb diet was still 30% carbs. I think you’d see better results if you dropped those carbs down even lower to full-on ketogenic status.

Keto keeps appetite down while fasting

A third way keto improves the fasting experience is through appetite reduction. Most fasts fail because the faster gets too hungry, too quickly. In the modern food environment where tens of thousands of delicious calories beckon from all angles at any given time, hunger is difficult to resist. And once you eat, the fast is over.

Ketosis suppresses appetite, setting you up for a successful fast free of the kind of ravenous hunger you can’t ignore. This occurs on a physiological level, with keto actively lowering the increase in hunger hormones that normally occurs with caloric restriction. When people attempt to eat less—or no—food despite wanting more, they butt up against their own physiology. Few win that battle.

Is intermittent fasting healthy if you’re in ketosis?

Okay, so we’ve established that intermittent fasting works when you’re on a long-term ketogenic diet, and that it works even better than it does on a higher-carb diet. You lose weight more easily, your metabolism doesn’t have to “switch” to fat-burning mode because you’re already in it, and you often find yourself forgetting to eat rather than fighting off cravings. But what about the health effects—is fasting a good idea from a health perspective if you’re already in ketosis?

Muscle loss

One potential problem people new to fasting worry about is muscle loss. After all, if you’re not eating any food at all, it seems possible that you’ll burn through muscle to make up for the lack of incoming energy. This can happen, but not always.

If you’re coming off a high-carb diet, fasting is more likely to result in muscle loss. Your body still expects, still wants sugar, and it will extract and convert the amino acids found in your muscle tissue to get it. This gives you the glucose you (think you) require, but it results in loss of lean muscle mass. Since lean mass is one of the most important markers of good health, any loss of lean mass is undesirable, unwanted, and unhealthy.

If you’re coming off a long-term ketogenic diet, fasting is less likely to result in muscle loss. Ketones spare muscle tissue by reducing your need for glucose. It turns out that a fair number of tissues that would otherwise run on glucose can run on ketones instead. Being in a ketogenic or low-carb fat-burning state before you fast accentuates this effect.

Stress and cortisol

Another potential issue is stress. Food availability can be a major stressor in the human body, and and if zero food is coming in, that’s a whole of potential stress. Intermittent fasting can increase cortisol, which is the hormone released when the body responds to a stressful situation.  How does keto affect the cortisol-stress response to fasting?

Your body induces a stress response to fasting in order to procure more glucose. Cortisol is released to trigger gluconeogenesis in the liver, which creates glucose out of amino acids (usually taken from muscle tissue). Your body perceives the lack of incoming glucose as a stressor, and activates the stress response.

This stress response doesn’t happen to the same extent if your body doesn’t perceive the lack of incoming glucose as a problem. The harmful cortisol spike only occurs if your body needs glucose and can’t get it. What if your body doesn’t feel the need for glucose? What if you’re, say, on a long-term ketogenic diet, have full adaptation to ketones and free fatty acids, and simply don’t need very much glucose?

Your body won’t have the same negative stress response to intermittent fasting, nor will it accumulate all that cortisol.

How to Fast on Keto: Tips to Make it Easier

As I said earlier, keto and fasting go hand in hand, but there are a few key things to keep in mind for making your fast a success.

Take electrolytes—sodium, magnesium, potassium
Drink coffee or tea
Take walks
Lift weights
Start small—14 to 24 hours

Take electrolytes

One major reason why people complain about energy and fatigue when intermittent fasting is they’re not eating enough salt and other electrolytes. Try 4.5 grams sodium (about 2 teaspoons of fine salt or a little under 3 teaspoons of kosher salt), 300-400 mg magnesium, and 1-2 grams of potassium each day on top of your normal food.

Drink coffee or tea

Both coffee and tea are non-caloric, so they won’t break the fast. They give your mouth something to do, in case you do get hungry. And they contain caffeine, which increases fat-burning and should make the fast more tolerable and more beneficial.

Take walks

Keeping active with walks and other types of low-level physical activity will get your mind off any residual hunger and increase fat oxidation. Anything that speeds up your fat utilization will increase ketone production and enhance the beneficial effects of the fast.

Lift weights

Lifting weights staves off any muscle loss that can occur on a fast by sending an anabolic message to your body: that your lean mass is important, that you’re still using it, that you can’t afford to lose it.

Start small

If you’re fasting for the first time, aim small and start with a fast lasting 14-24 hours. Women may need special considerations, however, so read this post summing up all the possible interactions between sex and fasting.

To answer the question posed in the title: Yes, it’s probably a good idea to try intermittent fasting while on a long-term ketogenic diet. If nothing else, it’s safe and should be easy to do—and it may offer many benefits.

References

Klempel MC, Kroeger CM, Varady KA. Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet. Metab Clin Exp. 2013;62(1):137-43.

Kalam F, Gabel K, Cienfuegos S, et al. Alternate day fasting combined with a low-carbohydrate diet for weight loss, weight maintenance, and metabolic disease risk reduction. Obes Sci Pract. 2019;5(6):531-539.

Sumithran P, Prendergast LA, Delbridge E, et al. Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur J Clin Nutr. 2013;67(7):759-64.

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Emotional Awareness and Processing Emotions Through Hard Times

There is so much about our current situation that is challenging. There’s the obvious: job loss, financial insecurity, fear about the virus itself, uncertainty about the future. We’re living in a state of limbo, waiting for (more) bad news while trying to figure out what, if anything, we can do to reassert control and order over our lives.

If you’re feeling… well, like you don’t even know what you’re feeling, you’re not alone. All of us are experiencing this massive disruption to our lives, and the collective fear and uncertainty that go along with it, for the first time. We’re learning to navigate and adapt in real time to a world that feels foreign.

It’s normal to feel adrift, to run the gamut of emotions, and experience conflicting emotions sometimes simultaneously.

Emotional Awareness as a First Step Toward Working Through Emotions

It feels like emotions just happen to us. Especially strong negative emotions can feel like they overtake us, inhabiting our body without our permission. To some extent that’s true. What we call “emotions” or “feelings” are our subjective experience of our brain and body’s reaction to a situation. We can’t control the initial physiological response. However, we can shape emotional experiences—how strongly we feel emotions, how the thoughts we have about why we’re feeling a certain way, and how we cope. This process is called emotion regulation.

The first step in any kind of emotion regulation strategy is awareness. We must recognize that we are having an emotional experience and then discern what, exactly, we are feeling. Anger, frustration, and fear all feel bad, but they are very different emotions that should prompt different responses if we are trying to help ourselves feel better.

Mental health professionals suggest that simply naming our emotions, bringing awareness to how we are feeling, can be a first step in coping with emotional upheaval. Putting words to our inner states is one of the goals of therapy. It’s also a tool you can use to help yourself in the moment. When you’re hit with strong feelings, and you don’t know what they mean or what to do about them, simply pausing to say, “I’m feeling _____” can offer a bit of relief.

I’m not suggesting that naming your emotions will magically fix everything, of course. That’s not reasonable. However, it is a tool you can add to your coping toolbox. If you’re like me, you need all the tools you can get right now.

Naming emotions, or affect labeling

Neuropsychiatrist Dan Siegel has coined the phrase “name it to tame it.” He explains that emotions come from a region of the brain known as the limbic system. Using language to describe our emotions recruits a different part of the brain, the cortex, which is less stress-reactive. By naming the emotion, we actually “calm” the activity within the limbic system that is triggering such strong emotions.

This is supported by fMRI research conducted by Matthew Lieberman and colleagues. They have shown that “affect labeling” (naming feelings) increases brain activity in the prefrontal cortex, which houses the part of your brain that regulates emotions, and correspondingly decreases amygdala activity, which is the part of the brain responsible for the fight or flight response. Other studies similarly confirm that affect labeling is an effective emotion regulation strategy. Simply naming what you are feeling attenuates negative emotional experiences. It can be as effective as other well-studied regulation strategies like reappraisal and distraction.

Creating Distance

When we’re in the throes of a powerful emotional experience, especially a negative one, we can feel completely out of control. Taking a moment to name what you’re feeling forces you to pause. You have to step outside of your experience to create enough distance to “see” what is happening.

The self-reflection process puts you in the state of “observer” rather than “feeler,” even if just for a moment. Shifting to an “observer” perspective can be enough to break the powerful hold the emotion has over you, turning the out-of-control feeling into a strong-but-manageable feeling.

Now that you have loosened the emotion’s grip, and you know what you’re dealing with, you can move on to coping—self-soothing or asking for help from others.

How Are You Feeling?

Ok.

Fine.

Not great.

Can you be more specific? Many of us struggle to put words to what we’re feeling. It’s usually easy to distinguish between good and bad, but going beyond a few basic emotions requires us to build our emotional vocabulary as well as our connection to our inner selves.

Use an Emotions List or Emotions Wheel

Cheat sheets are perfectly fine when you’re working through a tough time. If you often feel tongue-tied when it comes to describing your emotions, consider consulting an emotions wheel. Here are two versions:

Plutchik’s Wheel of Emotions – Devised by psychologist Robert Plutchik. He believed there were eight basic emotions, which he organized into four positive-negative pairings: joy and sadness, trust and disgust, fear and anger, anticipation and surprise.

His wheel is organized around these eight emotions. Visually, you can see that each emotion can be felt with more or less intensity, creating new emotional experiences. Anger, for example, might be felt as rage (high intensity) or annoyance (low intensity). More complex emotions arise from combinations of the basic one. For example, in his model, joy and trust combine to create love, while disgust plus anger breeds contempt.

I find the emotional pairings idea to be useful for discerning what I’m feeling especially when it feels like I’m experiencing multiple emotions at once. It can help to try to break the feelings apart and see where they are rooted and how they are interacting.

Junto Emotion Wheel – I like the simplicity of this one. It starts with six core emotions: joy, love, fear, anger, sadness, surprise. Each emotion is then broken down with greater and greater specificity. You can start in the middle and work your way out figuring out what labels do and do not fit what you’re feeling.

Neither one encompasses the whole range of human emotions, of course, but emotion wheels can be good tools for growing your emotional vocabulary. Even if you’re struggling to name your exact feeling, it’s a good exercise to consider what “family” of emotion you are feeling and also what you aren’t feeling.

Is What You’re Feeling Right Now Grief?

If you haven’t suffered an acute loss due to the pandemic, your gut reaction to this question might be “no.” Grief isn’t just something we feel after a death or a great personal tragedy, though. Grief is a response to loss, and we all have experienced losses already. If nothing else, we’ve lost personal freedom and autonomy, being able to go where we want and when. Students and parents are navigating the loss of a school year. Some of us have lost jobs. We’ve lost our sense of “normal.”

What we’re experiencing right now is a type of ambiguous loss. Nobody knows how long this will take or what the new normal will look like once we make it to the other side of this. Pauline Boss, who researches ambiguous loss, says the nature of the ambiguity makes it especially pernicious. We question whether we have a right to feel how we feel. (For the record: YES, you do have the right to feel whatever cocktail of emotions this situation stirs.) Then there’s the comparative suffering—am I allowed to feel bad if other people have it worse? We may be reluctant to call it grief because we know this is temporary—but this keeps us from honoring what we’re actually feeling, so we don’t fully feel it and work through it.

I’m not saying you are for sure experiencing grief. You might not be, and that’s ok. However, I’d encourage you to check in with yourself and see. This is not a label that might initially come to mind but which might feel relevant.

Tools We Can Use Once We Name Our Emotions
Self-Compassion

At a time when so much is out of our control, one thing you can always do is offer yourself compassion. Self-compassion is a powerful tool for helping to relieve the suffering associated with painful experiences and troubling emotions.

Kristin Neff, who pioneered the field of self-compassion research, identifies three components of self-compassion. The first is mindfulness, which entails being aware of our suffering without getting too wrapped up in it. This is where naming comes in.

In self-compassion practice, it’s enough to just recognize that you are having a hard time: “This is suffering” or “I’m struggling right now.” However, you can enhance your mindfulness by going deeper and naming the emotion, making it more specific: “This is fear.” “This is sadness.” “I’m feeling angry.” “I’m feeling hopeless.” Another way of mindfully observing without being completely wrapped up in the emotional experience is to say to yourself, “My body is telling me that I’m experiencing ______.”

In addition to mindfulness, the other components of self-compassion are recognizing the common humanity of your experience and offering yourself kindness. Both can offer you some measure of peace once you’re aware of what you’re feeling. For example, you might say to yourself, “I am feeling anxiety about whether my family will get sick. [Mindfulness] This is a normal reaction to this situation. Lots of people are also experiencing this same type of anxiety. [Common humanity] I wish peace for myself. [Kindness]”

Self-compassion is especially helpful in times like these where we have limited control over the causes of our negative emotions. Next time you are feeling a strong negative emotion, try pausing, naming the emotion, and offering yourself kindness. The wonderful thing about self-compassion, too, is that it gets easier the more you do it.

For more guidance, self-compassion experts Chris Germer and Kristin Neff recently put out an article on practicing self-compassion during these crazy times. You can find it here.

Note that number four on their list is “Being with Difficult Emotions.” They say, “Isolation is not natural for human beings. Just being alone with ourselves for an extended period of time usually brings up challenging emotions. Labeling what we’re feeling while we’re feeling it calms the body, finding the emotion in the body anchors the experience, and responding to ourselves with compassion is the connection we’ve probably needed all along.” (emphasis added)

If you’re struggling with self-compassion, try this guided self-compassion break.

Journaling

Psychologist James Pennebaker began conducting research on expressive writing almost four decades ago. His early studies were inspired by research suggesting that trauma can manifest as physical health symptoms when we keep it locked inside. He thus began a program of research looking at why and how writing about our traumatic experiences helps physical and mental well-being.

Thousands of studies have since been conducted by Pennebaker and others trying to understand exactly how this works. To be honest, we still don’t really understand the mechanisms, but meta-analyses confirm a small but robust effect: writing about our feelings improves well-being.

It’s certainly worth trying. Keep in mind that there are myriad ways to journal, from writing pages and pages to doodling to making lists. In the research on expressive writing, different strategies seem to work better depending on the person and the situation. You might feel better if you purge all your fears and anxieties onto paper. Or, it might be more helpful to focus on the positive things that are coming out of this experience or, along those same lines, to keep a gratitude journal.

Play around and see what feels right to you.

Final Thoughts

Your emotions are likely to fluctuate. That’s not a sign that you’re coping poorly. It’s a reflection of the stress you’re under right now. Working on developing a self-compassion practice can really help with that. (Read that self-compassion article I linked above! Here it is again.)

Still, you’re going to have ups and downs. I certainly don’t mean to imply that naming your emotions will solve all your problems, nor that it’s a substitute for seeking professional help if you’re really struggling. If you’re having significant trouble coping, please seek help from a qualified mental health professional. Your primary care doctor can provide guidance and a referral as a starting point. Situations like these can be especially difficult for people with a past history of trauma. If you’re feeling triggered by current events, don’t wait to seek help. If you’re not able to reach out to your doctor or therapist, the CDC has a list of mental health resources, including a distress helpline. All the therapists I know are practicing remotely right now, so care is still available.

Please take care of yourself during this time and don’t add to your distress by judging yourself harshly for your emotional responses. The goal here is non-judgmental awareness, knowing what you are feeling so you can move forward from a place of self-understanding.

Be well.

References

Boss, P. (2007). Ambiguous Loss Theory: Challenges for Scholars and Practitioners. Family Relations, 56(2), 105–111.

Burklund, L. J., Creswell, J. D., Irwin, M. R., & Lieberman, M. D. (2014). The common and distinct neural bases of affect labeling and reappraisal in healthy adults. Frontiers in Psychology, 5, 221.

Gallo, I., Garrino, L., & Di Monte, V. (2015). The use of expressive writing in the course of care for cancer patients to reduce emotional distress: Analysis of the literature. Professioni Infermieristiche, 68(1), 29–36.

Kircanski, K., Lieberman, M. D., & Craske, M. G. (2012). Feelings Into Words: Contributions of Language to Exposure Therapy. Psychological Science, 23(10), 1086–1091.

Lieberman, M. D. (2019). Affect labeling in the age of social media. Nature Human Behaviour, 3(1), 20–21.

Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M. (2007). Putting feelings into words: Affect labeling disrupts amygdala activity in response to affective stimuli. Psychological Science, 18(5), 421–428.

Lieberman, M. D., Inagaki, T. K., Tabibnia, G., & Crockett, M. J. (2011). Subjective responses to emotional stimuli during labeling, reappraisal, and distraction. Emotion (Washington, D.C.), 11(3), 468–480.

Niles, A. N., Haltom, K. E. B., Mulvenna, C. M., Lieberman, M. D., & Stanton, A. L. (2014). Randomized controlled trial of expressive writing for psychological and physical health: The moderating role of emotional expressivity. Anxiety, Stress, and Coping, 27(1), 1–17.

Pennebaker, J. W. (1997). Writing about Emotional Experiences as a Therapeutic Process. Psychological Science, 8(3), 162–166.

Pennebaker, J. W. (2018). Expressive Writing in Psychological Science. Perspectives on Psychological Science, 13(2), 226–229.

Pennebaker, J. W., & Smyth, J. M. (2016). Opening Up by Writing It Down, Third Edition: How Expressive Writing Improves Health and Eases Emotional Pain. Guilford Publications.

Smith, S., Anderson-Hanley, C., Langrock, A., & Compas, B. (2005). The effects of journaling for women with newly diagnosed breast cancer. Psycho-Oncology, 14(12), 1075–1082.

Stanton, A. L., Danoff-Burg, S., Sworowski, L. A., Collins, C. A., Branstetter, A. D., Rodriguez-Hanley, A., Kirk, S. B., & Austenfeld, J. L. (2002). Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 20(20), 4160–4168.

Torre, J. B., & Lieberman, M. D. (2018). Putting Feelings Into Words: Affect Labeling as Implicit Emotion Regulation. Emotion Review, 10(2), 116–124.

Weir, K. (2020). Grief and COVID-19: Mourning our bygone lives. (n.d.). Retrieved April 2, 2020, from https://www.apa.org/news/apa/2020/04/...

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How to Strengthen Tendons and Ligaments for Injury Prevention

People do not pay much attention to how to strengthen tendons and ligaments, until they suffer a tendon injury. Only then do you realize that training your tendons is just as important as working on muscle strength and endurance.

Our bodies “expect” a lifetime of constant, varied movement. From a very early age, most humans throughout history were constantly active. They weren’t exercising or training, per se, but they were doing all the little movements all the time that prepare the body and prime the tendons to handle heavier, more intense loads and movements: bending and squatting and walking and twisting and climbing and playing and building. It was a mechanical world. The human body was a well-oiled machine, lubed and limber from daily use and well-prepared for occasional herculean efforts.

We don’t have that today. We spend most of our workday sitting, clacking away on keyboards and swiping through touch screens. Yet, we have an ingrained need for physical training written in our DNA. Some of us go from couch potato to budding powerlifter, from desk jockey to CrossFit competitor. But unlike our predecessors, we haven’t applied the lube of daily lifelong movement that makes those intense physical efforts safe. Everyone seems to be lifting weights nowadays, but few have the foundation of healthy, strong, durable connective tissue necessary for safe, effective training.

How to Strengthen Tendons: Training Tendons vs. Muscle

The good news is, if you’re doing resistance training, you’re already training your tendons. Muscle isn’t the only thing you’re impacting when you lift heavy things, though. You’re also imposing stress on your tendons and demanding an adaptive response. They do need a more focus than you’re giving them, though.

Blood carries nutrients and cells used to repair and rebuild damaged tissue. Because tendons receive less blood flow than muscle, they take a lot longer to respond to training than muscle. In one study, it took at least 2 months of training to induce structural changes in the Achilles’ tendon, including increases in collagen synthesis and collagen density. Other studies have found that it takes “weeks to months” of training to increase tendon stiffness. Meanwhile, we see structural changes to muscle tissue with just eight days of training.

This basic physiological fact shouldn’t impede our progress and tissue health, but it does.

What do Tendons Do?

Before we make any decisions, let’s understand exactly what tendons do.

Tendons and ligaments attach muscles to bones. It is through tendons that muscles transmit force and make movement possible. Contracting your muscles pulls on the tendons, which yanks on the bone, producing movement.
Tendons and ligaments also provide an elastic response, a stretch-shortening recoil effect that helps you jump, run, lift heavy things, and absorb impacts. Think of it like a rubber band.

Tendons have two primary properties that determine how they function:

Tendon Stiffness (Strength)

Tendon stiffness sounds bad, but it refers to the strength of your tendon. Tendon stiffness is the degree to which a tendon can withstand elongation and maintain form and function when placed under stress. Contrary to how we usually think about stiffness, a stiff tendon can help us transmit more force and be more stable in our movements. It takes a lot more force to get a stiff tendon to elongate, but they reward your efforts with a powerful recoil.

Stiff tendons are stiff. More elastic tendons are compliant. We need a mix of compliant and stiff tendons, depending on the tendon’s location and job.

Tendon Hysteresis (How Stretchy Tendons Are)

Tendon hysteresis refers to how well your tendons stretch and resume their original form – the efficiency of the recoil response. If you waste a lot of energy in the rebound, you have high hysteresis. If your recoil is “snappy,” your tendons have low hysteresis. Low is better.

Other things matter, of course, like where the tendon “attaches” to the muscle. The farther it attaches from the axis of rotation, the stronger you’ll be (imagine holding the baseball bat in the center or the handle and trying to swing; which grip position will allow greater force?). Another is length; longer tendons have greater elastic potential than shorter ones, all else being equal. But that’s determined by genetics and out of our control.

Children Have Natural Tendon Strength

Just look at kids. The health of their connective tissue has three main advantages over adults:

They practice constant varied movement. They’re flopping down in distress because you turned the TV off. They’re climbing the bookcase, crawling like a dog, leaping like a frog, dancing to every bit of music they hear, jumping from objects twice their height.

They’re still young. Kids simply haven’t been alive long enough to accumulate the bad habits that characterize sedentary life and ruin our connective tissues. They aren’t broken yet.

Their connective tissue is highly vascular. Early connective tissue has a dense network of capillaries, meaning it receives ample blood flow. It regenerates quickly and has a faster response to stress. Mature tendons are mostly avascular and receive very little blood. To stay healthy and heal and respond to stress, they require diffusion of the synovial fluid filling our joints. Vascular blood flow is passive and subconscious; it’ll happen whether you move or will it to or not. Synovial fluid only diffuses through movement. You have to consciously move your joints to get the synovial fluid flowing.

How to Strengthen Tendons and Ligaments

“Just move constantly like a six year old” is nice and all, but not everyone can crawl through the office, practice broad jumping across the board room, or run the stairwells with a software engineer on their back. Besides, we have a lot of catching up to do. More concerted, targeted efforts are required to overcome a lifetime of linear, limited movement and tons of sitting.

11 Movements to Increase Tendon Strength and Elasticity

There are 11 exercise types that help increase tendon strength and elasticity:

Eccentric exercises – the negative movement
Partial reps
Plyometrics – explosive movement
Explosive isometrics – quick forceful movements against an immoveable force
Volume-increasing exercises
Intensity training
Stretching – using full range of motion
Seeking mild discomfort while avoiding pain and injury
Daily connective tissue training
Avoiding rushing
Massage and myofascial bodywork

1. Eccentric Exercises – training “the negative”

Many studies indicate that eccentric exercises (lowering the weight) are an effective way to treat tendon injuries. In one trial, ex-runners in their early 40s with chronic Achilles’ tendonitis were split into two groups. One group had conventional therapy (NSAIDs, rest, physical therapy, orthotics), the other did eccentric exercises. Exercisers would do a calf raise (concentric) on the uninjured foot and slowly lower themselves on the injured foot (eccentric heel drop) for 3 sets of 15 reps, twice a day, every day, for 12 weeks. Once this got easy and pain-free, they were told to increase the resistance with weighted backpacks. After 12 weeks, all the ex-runners in the exercise group were able to resume running, while those in the conventional group had a 0% success rate and eventually needed surgery.

If heel dips can heal Achilles’ tendinopathy and single-leg decline eccentric squats can heal patellar tendinopathy, I’d wager that eccentric movements can strengthen already healthy tendons. Any tendon should respond to eccentrics. Downhill walking, slowly lowering oneself to the bottom pushup position, eccentric bicep or wrist curls; anything that places a load on the muscle-tendon complex while lengthening it should improve the involved tendons.

2. Partial reps

Early 20th century strongman George Jowett developed a program for “strengthening the sinews” that involved partial reps of extremely heavy weights. He focused on the final 4-6 inches before lockout of the primary exercises, like bench press, overhead press, squat, and deadlift.

3. Plyometrics

Explosive movements utilizing the recoil response of the tendons can improve that response. In one study, 14 weeks of plyometrics (squat jumps, drop jumps, countermovement jumps, single and double-leg hedge jumps) reduced tendon hysteresis. The trained group had better, more efficient tendon recoil responses than the control group. Tendons didn’t get any bigger or longer; they just got more efficient at transmitting elastic energy. A previous 8-week plyometric study was unable to produce any changes in tendon function or hysteresis, so you need to give it adequate time to adapt.

4. Explosive isometrics

Explosive isometric training involves trying to perform an explosive movement against an immoveable force, like pushing a car with the parking break on, trying to throw a kick with your leg restrained by a belt, or placing your fist against the wall and trying to “punch” forward. In one study, explosive isometric calf training 2-3 times a week for 6 weeks was just as good as plyometric calf training at increasing calf tendon stiffness and jump height while being a lot safer and imposing less impact to the joints.

5. Volume-increasing exercises

Volume clearly matters. Just look at the beefy fingers of free climber Alex Honnold, who relies on them every day to support his bodyweight. Those aren’t big finger muscles. They’re thick cords of connective tissue. Pic not enough? In performance climbers with at least 15 years experience, the finger joints and tendons are 62-76% thicker than those of non-climbers. And a study showed that the extremely common crimp hold—where all five finger tips are used to hold a ledge—exerts incredible forces on the finger connective tissues, spurring adaptation. So if you’re up to the challenge, rock climbing (indoor or outdoor) is a great way to increase tendon volume.

6. Intensity training

You have to actually stress the tendons. We see this in the eccentric decline squat study mentioned earlier, where decline squats (which place more stress on the patellar tendon) were more effective than flat squats (which place less stress on the patellar tendon) for fixing patellar tendinitis. In another study, women were placed on a controlled bodyweight squat program. They got stronger, their musculature improved, and their tendons grew more elastic, but they failed to improve tendon stiffness, increase tendon elastic storage capacity, or stem the age-related decline in tendon hysteresis. The resistance used and speed employed simply weren’t high enough to really target the connective tissue. A recent study confirms that to induce adaptive changes in tendon, you must apply stress that exceeds the habitual value of daily activities. So, while walking, gardening, and general puttering about is great for you, it’s probably not enough to coax an adaptive response out of your ailing tendons. You need to increase the magnitude of the applied stress through tinkering with volume, speed, resistance, range of motion, and the proportion of eccentric vs. concentric movement.

7. Stretching – full range of motion

Deeper, longer stretches are probably best. Some examples:

Front squat. An ass-to-grass front squat, where the hip crease drops below the knees, will stretch/stress the patellar tendon that attaches the quad to the shin bone to a greater extent than squatting to just above parallel.
Pectoral stretch. You can use a door frame to take your pec stretch a little further, which will work the connective tissue in your shoulders.
Calf stretch. Instead of stretching your calves in a basic lunge, you can use stairs or a curb to lift your toes closer to your shins, targeting the achilles tendon.

8. Avoid pain, seek mild discomfort

Tendon discomfort is okay. Stress isn’t comfortable. Tendon pain is not and should be avoided. You want just enough discomfort to provoke a training stimulus, but not outright pain.

9. Daily practice to strengthen tendons

How to train strengthen your tendons and ligaments may not always be top of mind, but it’s best to think about — and train — your connective tissue every day. That could range from random sets of eccentric heel drops and static squat holds done throughout the day. I like Dan John’s “Easy Strength” program, where you basically pick a few movements to do each day—every day—with a fairly manageable weight. Front squat, Romanian deadlift, and pullups, for example. 2 sets of 5 reps each day for each exercise. Only add weight when it feels “too easy.”

10. Don’t rush; take it easy

Pick a load and stick to it until it gets easy. In a pair of incredible appearances on Robb Wolf’s Paleo Solution Podcast, Christopher Sommer of Gymnastic Bodies explains how he puts together a tendon-centric program for an athlete. He has them stick with the same weight for 8-12 weeks. The first few weeks are hard. The weight feels heavy. At 4 weeks, it’s a lot easier but still a challenge. At 8 weeks, you start feeling like it’s too easy. And that’s where the tendon-building magic happens. By 12 weeks, what felt tough when you started is now “baby weight.” Your muscles are stronger and your tendons have had enough time to build collagen density. You’re able to manhandle the weight without a problem.

Like I just mentioned above, another example is Dan John’s “Easy Strength,” which has you lift almost every day using light-moderate loads, only adding weight when 2 sets of 5 reps becomes really easy. You won’t see the rapid progression of Starting Strength, but it’ll also be easier on your body, prepare your tendons for higher loads, and remove the need for a gallon of milk a day.

11. Massage and myofascial bodywork

Massages can increase blood flow to the otherwise avascular tendons. Self myofascial release using foam rollers or lacrosse balls (or even the good ol’ elbow) is worth doing, too. A qualified massage therapist knows exactly how to strengthen tendons, manipulating them in just the right way.

12th way to strengthen tendons and ligaments: collagen

Collagen isn’t a movement. It is a nutrient. Collagen is in every cell throughout the human body, and it is highly concentrated in your connective tissue.  Studies show you need 10 grams of glycine, a component of collagen, every day for collagen maintenance, more if you are recovering from an injury. It’s not easy to get 10 grams of glycine unless you are eating tough cuts of meat or offal every single day. For the rest of us, collagen peptide supplements fill in the gaps. Powdered collagen peptides are easy to use – you can get collagen powders that are flavored or unflavored, and they mix into virtually any liquid. You can read more about collagen here.

Why you should focus on tendon health

Tendon health isn’t just for preventing injuries. It will make you stronger, too. Every person aged 16 to 28 knows about “old man strength.” It’s that phenomenon of otherwise unimpressive looking old guys crushing your hand when shaking it, being immovable statues down low in pickup basketball games, and generally tossing you around like you were a child in any feat of strength. What explains it? It’s not the muscles (yours are bigger). It’s not the speed (you’re younger and faster). It’s gotta be the connective tissue made thick and strong from decades of hard living.

And so in real-world, full-body movements and compound exercises like squats, deadlifts, pullups, and gymnastics work, healthy and strong tendons increase performance. They make you stronger, more explosive, more powerful, and more resilient. They allow your big impressive muscles to actually express themselves and reach their full potential. A healthy tendon is a conduit for your muscle to express its power.

Muscles are cool and all, but don’t neglect tendon strength. Feel the stretch and when you feel some weirdness in a tendon, back off. Throw in some eccentric movements and explosive isometrics. Practice hops and broad jumps. Do a joint mobility drill regularly, and consider adding a morning movement practice. Don’t feel guilty for not going hard all the time. Get really comfortable with the weight and the movements before increasing the intensity. The important thing is to be mindful of how to strengthen tendons while you train.

There’s more to the tendon story, but these are a few easily implementable suggestions for improving your tendons with physical training.

How do you train your tendons? Have you ever considered such a thing?

The post How to Strengthen Tendons and Ligaments for Injury Prevention appeared first on Mark's Daily Apple.

Dairy-free Dalgona Whipped Coffee: the Viral TikTok Drink Recipe Made Primal

Dalgona coffee, or whipped coffee, is the viral TikTok drink that’s suddenly plastered all over your feeds. To be perfectly honest, it couldn’t have hit the waves at a better time. Staying at home means you are your own barista, and your kitchen becomes your new favorite coffee shop. And the new shelter-in-place lifestyle leaves us with a few extra minutes in the morning to make a fancy coffee drink every now and again.

What is Whipped Coffee, aka Dalgona Coffee?

Dalgona coffee is basically an upside-down iced latte. Instead of coffee on the bottom and frothy milk on top, you have milk on the bottom and fluffy a fluffy coffee whip on top. The contrast looks incredible in a glass, and according to the Internet, it tastes amazing.

The problem with most whipped coffee recipes is that sugar and milk are the star ingredients. For most of us, drinking that much sugar and dairy first thing in the morning would knock us down when we’re trying to wake up.

The solution? Make it Primal. Swap the dairy, and add skin nourishing collagen powder for morning protein to get you going. As a bonus, the collagen adds structure, so that your whipped coffee stays fluffy. Most whipped coffee recipes will fall flat after a few minutes.

How to Make Whipped Coffee: Dairy-free Dalgona Coffee Recipe

Servings: 1

Time in the kitchen: 5-8 minutes (depending on how fast you can whip)

3 Tbsp. water
3 Tbsp. instant coffee
1 scoop unflavored collagen peptides
3 Tbsp. granulated monkfruit sweetener
1c almond or coconut milk
Optional: a sprinkle of cinnamon or cocoa powder

Instructions:

Combine the water, instant coffee, collagen, and monkfruit sweetener. Whisk, whisk, and whisk some more until it takes on the appearance of fluffy peanut butter. If you’re not up for an arm workout, use a hand mixer or stick blender for this step.

Fill a glass with ice, then fill the glass halfway with almond or coconut milk. Float your whipped coffee mixture carefully on top of your iced coconut milk. Make sure you snap a pic of your creation before you sip. You didn’t do all of that whisking for nothing!

Nutrition Information (1 glass):

Calories: 120

Total Carbs: 46 grams

Net Carbs: 10 grams

Fat: 4.5 grams

Protein: 11 grams

The post Dairy-free Dalgona Whipped Coffee: the Viral TikTok Drink Recipe Made Primal appeared first on Mark's Daily Apple.

Weekly Link Love – Edition 75

Research of the Week

Can anti-aging drugs and supplements help against coronavirus?

Hydroxychloroquine shows promise in another small trial.

Sulforaphane may be effective in autistic patients.

Ferrets and cats may be vectors for COVID-19 transmission.

Coronavirus found in Dutch sewage.

New Primal Blueprint Podcasts

Episode 415: Abel James: Host Elle Russ chats with the one and only Fat Burning Man himself.

Media, Schmedia

A smart thermometer company reports fewer fevers nationwide. Good.

Astrophysicist gets magnets stuck up his nose while testing a new coronavirus medical device.

Interesting Blog Posts

Is fake meat approaching the uncanny valley?

Why has California been spared (so far)?

Social Notes

The new normal (for now).

Everything Else

New dental proteome from Homo antecessor, an ancient hominid who lived in Spain 800,000 years ago.

Co-morbidities in the USA.

I bet this becomes more viable in the future.

Potential pandemic effects on food.

Things I’m Up to and Interested In

Important to keep in mind: Stay fit.

Interesting research: Decontaminating masks without destroying them.

I certainly hope it works (without side effects): Treating COVID-19 patients with plasma from people who recovered from the disease seems to improve recovery.

Article I found interesting: How Stone Age humans unlocked the glucose in plants.

Fascinating line of thought: Can a TB vaccine help fight the coronavirus?

Question I’m Asking

Gym owners, coaches, and personal trainers, how are you handling things? How are you adapting?

Friends of MDA, Thom and Tracey Downing, run a fantastic personal training gym called FIT in Los Altos, CA that’s been shuttered for the time being. They’ve come up with a series of innovative workarounds to keep their clients healthy and their coaches working: loaning out almost all the gym equipment—kettlebells, bands, dumbbells, and the like—to clients in the area and setting up online training sessions, cooking classes, and guided meditations via Zoom, running “PE classes” for kids, and posting home workouts and updates on Instagram. This is adaptation in real time. It’s hard, but it’s also cool to see.

Recipe Corner

Egg foo young, paleo style.
Greek-style chicken bowls. Pretty accurate.

Time Capsule

One year ago (Mar 29 – Apr 4)

How I Take My Coffee – What happens in the morning.
The Definitive Guide to What Breaks a Fast– What actually breaks a fast?

Comment of the Week

“Good information. Thanks for doing articles like this. Right now, with so much fear in the news, it truly helps to have calm, collected posts that just talk about the current science with this thing.

A funny aside, my kids are currently in the kitchen eating grassfed beef burgers and spinach from local farms, and rice covered in butter. I got a kick out of reading that at the same time this was going on in my house.”

– Sounds like you’ve got the right approach, Casey.

The post Weekly Link Love – Edition 75 appeared first on Mark's Daily Apple.

Ask a Health Coach: Stress, Self-Compassion, and Strategies for Working Out at Home

Hi folks, in this edition of Ask a Health Coach, Erin discusses how to roll with the stresses and change in routine that come with life during a global crisis. Keep your questions coming in the MDA Facebook Group or in the comments section below.

We’re all feeling the impact of the COVID-19 coronavirus pandemic in one way or another. In this week’s edition of Ask a Health Coach, I’ll be answering questions from the Mark’s Daily Apple community and sharing strategies I use with my own health coaching clients about everything from maintaining your sanity while stuck at home, to bouncing back after a day of stress-induced snacking, to embracing the potential suck of at-home workouts.

I’m here for you guys, so keep your questions coming in the MDA Facebook Group or post them in the comments section below.

How to cope with the stress of staying at home

“Like many people, we’re staying close to home to avoid spreading the COVID-19 virus. Any advice for families coping with the stress of being cooped up indoors?” -Michelle

This is a question I’m hearing a lot lately. Most people’s routines have been completely turned upside down for the time being, even in areas where there’s not a mandatory shelter-in-place. Schools and businesses are temporarily shut down. Some parks and outside gathering spots are closed, too. So, I get it. It’s really easy to feel a little stir crazy, especially if you’ve got kids at home.

Like Mark Sisson wrote in this post a few weeks ago, avoiding stress is going to be your best bet right now. Not only does stress increase ACE2 expression and hinder your general immunity, it makes it harder to relax and enjoy spending time with your family.

I know that a lot of things can seem out of your control right now. The good news is, there are specific things you can do to help your household feel less anxious and stressed out. Remember, your kids are looking to you to see how you deal with a challenging situation like this — and how you react makes all the difference. This could be an incredible learning and growth opportunity for your kids; the kind they don’t get in school. How did mommy or daddy handle it when things got weird?

Talk it out. Self-isolation doesn’t mean keeping your feelings all bottled up. Be present and start a conversation about what’s going on, letting everyone share what feels stressful or different for them right now. Creating a safe space for family members to talk about what’s going on for them can help alleviate extra anxiety.
Reframe your situation. It’s easy to think about all the things you can’t do, but what about all the things you can do? Instead of dwelling on the negative or looking at the world through a fear-based lens, appreciate and have gratitude for all the positives in your life. Create a practice of writing down three things you’re grateful for every day.
Take easy action. Perhaps you’ve heard of the concept of “messy action,” the notion of just getting out there and doing it even if it’s not perfect. I’ve been trying to popularize the idea of “easy action.” Taking action can provide a much-needed sense of control during uncertain times like these, but I’m also encouraging my clients to be easy on themselves. This is uncharted territory and none of us is hitting it out of the park right now, so manage your expectations. Get outside for an impromptu soccer match even if the kids are technically supposed to be learning geography. Prioritize self-care, now more than ever; even if (especially if) you’ve never practiced self care before. Explore yoga or deep breathing exercises. Plant a garden or learn a new recipe. Get creative: have a drawing contest, or learn to play an instrument and have a family jam session. Fun can often be the antidote to stress.

How to bounce back from stress eating and snack attacks

“Thoughts on getting back on track after a day of binge eating?” – Justin

Every once in a while, a client will email me with a similar question. I can almost hear the guilt, shame, and panic jumping off the page. Should I do fasted sprints? Micro-manage my macros? Lift heavy for a few days? Listen, it doesn’t really work that way — and that’s okay! If you have a day where you indulged more than you intended, you just have to file it away as something that happened.

Maybe watching the morning news induced a day of stress eating. Or you got overly hungry. Or you bought a few too many bags of chips at the grocery store. Whatever the reason, the most effective thing you can do to get back on track is to have self-compassion.

Where compassion is the ability to show love, empathy, and support for others who are suffering, self-compassion is about having that same kindness for yourself, which can be incredibly hard to do. After all, if you have a lifetime of beating yourself up, treating yourself with kindness probably won’t come naturally. Thankfully, it’s a skill anyone can learn.

This is an exercise I have my clients do when they’re having trouble getting in the self-compassion space:

Think of what you’d say to a good friend if they were in the same boat. Often times, taking yourself out of the equation can make it easier to be empathetic.
Give yourself permission to be imperfect. You’re human, so give yourself room to make a mistake here and there.
Practice mindfulness. If you’re caught up in a storm of self-criticism, just be aware of how your inner critic might be trying to protect you — without judgement. Acknowledge your actions and then move on.

What are the best at-home workouts?

“I can’t seem to wrap my head around at-home workouts. Should I just wait until my gym opens back up in a few weeks?” –

Annette

Great question, Anette. For those of us who are used to hitting the gym during lunch hour or after work, not having that as an option can completely disrupt our flow. Right now, there are so many yoga studios and personal trainers sharing at-home workouts (I’ll be sharing one here on Mark’s Daily Apple soon as well!), but there’s a difference in having the ability to work out at home and actually doing it.

For you, home might be a place to relax, eat, and sleep. But just like people who’ve made the transition to working at home, you can adjust your mindset to accommodate at-home workouts too. The simplest way is to stick with a routine. Do you usually take a break at lunch to lift weights? Take that same break at home. Do yoga after work? Get out your mat after shutting your laptop for the day. I’ve been scheduling my home workouts into my day in between my client calls. One of the beautiful opportunities of at-home workouts I’ve found, as opposed to trekking all the way into the gym, is that you can try microworkouts on for size. You can find video demos of two-minute microworkouts here. I’ve enjoyed them a lot more than I thought I would, and I am delightfully sore!

Also, make sure you have a designated space for your workouts. It doesn’t have to be a fancy at-home gym either; you can set up an area in the corner of your bedroom, living room or garage. By setting your environment up this way, you’re setting yourself up for success. Even though your habit of going to the gym is temporarily off the table, your habit of working out doesn’t have to be.

That said, it wouldn’t kill you to take a few weeks off. Overtraining syndrome is one of the most common themes I see in the athletes and fitness lovers I work with, so instead of your daily intense gym session, grab the kids and go for a walk or lace up your hiking boots and hit the trails (if that’s currently allowed in your region of the world). You might be surprised how great a non-gym day can feel. Mark has been touting the benefits of walking for well over a decade now. The man knows what he’s talking about so, give it a try! For every hour you once devoted to crushing it in the gym, redirect that time to taking a walk. Outside. At least six feet away from anyone else around you, and far, far away from the news.

The post Ask a Health Coach: Stress, Self-Compassion, and Strategies for Working Out at Home appeared first on Mark's Daily Apple.

Dear Mark: Coronavirus Edition 2 – COVID-19 Questions, Answered

For today’s edition of Dear Mark, I’m answering more COVID-19 (coronavirus) questions. If you’re getting tired of coronavirus content, I understand, but I also owe it to my readers to give them my take on the research—and the questions have been pouring in. Information is coming out at a rapid pace and there are a lot of wild claims and recommendations flying around. With any luck, we’ll all be able to focus on something else in the near future. Thanks for your understanding.

Let’s go:

Is the fever threshold higher in hypothyroid?

I work in the health care field and need to be at work but also must remain healthy. I take my temperature often. There are still no cases reported in my county. Over the years I randomly have taken my temp. It is always low…ranging from 95.5 to rarely over 97. If my temp suddenly approached 98 or over would I be considered to possibly have a fever?

That is a great question. I’ve actually wondered the same thing.

We know that mice with hypothyroidism have delayed “sickness behavior” when challenged with an immune stimulus (in this case, endotoxin). Whereas normal mice with healthy thyroid function display normal reactions and symptoms to the endotoxin, the hypothyroid mice take much longer to show symptoms and change their behavior. That study doesn’t say anything about body temperature or fever, but I can imagine that if other sickness behaviors and symptoms are inhibited, fever might be as well.

Does asthma increase the risk of coronavirus?

So what’s a 62 yo with asthma as general anxiety to do? Gotten lots of sleepless nights. BTW, my wife is a GP and will be continuing to work, oh…and I’m going to be taking care of my autistic teenage daughter.

That’s a lot to handle. Hats off to you.

There (may) be good news. Asthma does not seem to increase the risk of coronavirus severity. In an early study out of Wuhan, China, neither asthma nor other allergic diseases were risk factors for it. Meanwhile, metabolic diseases and conditions were.

This is a preliminary result using a small sample size (140 patients). So it may change.

Can colostrum help against coronavirus? How can you increase nitric oxide?

Mark, thank for the usual thoughtful post. Is there any usefulness in taking supplementing with colostrum at this time? Also, aside from exercise are there other ways to increase nitric oxide?

thanks again

I don’t think colostrum will be much help. It can help with leaky gut, but I haven’t seen anything about that being linked to coronavirus.

As for nitric oxide, which has shown efficacy against SARS (a related virus), there are other ways to increase it. My favorite way is to get sunlight. Even in the absence of vitamin D-giving UVB, sunlight increases nitric oxide synthesis.

Does melatonin help against coronavirus?

Children have up to 10x more melatonin than adults. Melatonin inhibits the NLRP3 inflammasome protein from inciting cytokine storms. Coincidence?

That’s very possible. Melatonin (and circadian rhythm) has its mitts in just about every physiological function of which we’re aware, including innate immunity, so I could see disrupted sleep and poor melatonin status helping. I don’t know this means you should start megadosing melatonin, of course, but it does suggest you should—as always—practice proper sleep hygiene.

Of course, there is no “one factor.” There are probably dozens of factors that predispose a person or a population or a region to coronavirus susceptibility.

Does iron help against coronavirus?

I would encourage any women who are anaemic to remedy that immediately.

Increasing iron increases haemoglobin and the oxygen-carrying ability in your blood.

COVID patients get interstitial pneumonia and require oxygen!

There is an interesting (and awful) connection to iron. Check out this paper:

The coronavirus produces these “extra” helper proteins that aren’t even part of the virus itself. It sends the proteins out into the blood to attach to our red blood cells and remove the heme iron. This reduces the ability of our RBCs to deliver oxygen to the rest of our body, so even if you’re on a ventilator and having fresh oxygen pumped into you, your ability to utilize that oxygen and deliver it via RBCs is reduced.

This is probably why coronavirus patients are often presenting with elevated ferritin levels: the iron is removed from the RBCs and has to be stored as ferritin.

I’m not in a position to say if eating more heme iron can help overcome the virus’ tendency to remove it from your red blood cells. I can imagine that early intervention with anti-virals or perhaps chloroquine could help before the virus gets really embedded. I can imagine that fresh blood transfusions could help.

Can coconut oil kill coronavirus?

Also, coronavirus is one of 14 RNA and DNA viruses whose envelopes are lipid coated. It’s been shown that monolaurin (extracted from lauric acid from coconut oil) dissolves these envelopes and the virus loses its protective envelope and dies.

Dietary coconut oil will not kill coronavirus (unless, perhaps, you slathered it in the stuff directly). Monolaurin has proven effective mainly in in vitro studies using isolated cells and viruses. Applying monolaurin directly to coronavirus in a lab setting probably will have an effect. There was a study where they applied vaginal monolaurin in female macaques prior to HIV exposure (a simulation of how infection occurs), and it was effective at preventing infection. But that was direct topical contact. Eating coconut oil or even taking monolaurin supplements probably won’t.

That’s not to say you shouldn’t eat coconut oil. It’s a great fat to eat and cook with, and doing so will probably improve your metabolic health and reduce the tendency of your tissues to oxidize and improve the resilience and function of your mitochondria—all of which will improve your general health and innate immunity. But it’s not a magic bullet and I don’t think the monolaurin has much to do with it.

Are asymptomatic people contagious?

Do aymptomatic people and especially children continue to shed indefinitely or does their body take care of the virus?

I don’t think we know for sure. I’ve seen references to viral shedding that lasts for weeks. We know that nasal swabs of both asymptomatic and symptomatic people show similar levels of viral loads, so the potential for transmission exists regardless of symptoms.

Asymptomatic people will probably be coughing and sneezing less, so that should reduce the amount of viral particles they release. But they’ll also be unaware of their condition, so they may be more likely to mingle with people and less likely to self-isolate. That will increase the number of people they’re exposed to.

This is where universal mask use can really help.

Does NAC help against coronavirus?

What about N-acetyl-cysteine?

NAC is worth a try. I don’t see any indication that it will reduce the chance of infection, but if you are infected and progress to ARDS (acute respiratory distress syndrome), it shows promise in protecting your lungs from damage.

NAC isn’t the only factor here. A major part of this is nutrition. For instance, a previous paper in elderly folks homes found that just giving each person 8 grams of high quality amino acids lowered the infection rate—not of this latest coronavirus, but in general.

Does sauna kill coronavirus?

Mark, do you think it worth using a sauna every day, ie would that keep the virus from taking hold if one was exposed?

20 minutes above 135f, for example.

Saunas won’t hurt. They’ve been linked to improved resistance to colds and a reduction in the incidence of pneumonia. All good things.

The only angle I can think of for this in an acute sense is that the virus is sensitive to heat. If you’ve only just been exposed to the virus and it’s hanging out in the throat and nose, perhaps breathing in hot air from the sauna can reduce its activity.

According to a new study (pre-print only), the coronavirus initially infects the throat and nasal passage before eventually replicating enough to make it to the lungs. If that’s true, and you can breathe in enough 135 degree sauna air through both nose and mouth, you may be able to reduce the activity of the virus.

That’s very speculative, however, and there are many reasons to think it’s probably not enough.

By the time the air gets into your throat and nose, it’s already cooled off.
The heat exposure isn’t consistent. Breathing in means a second or two of sufficient heat exposure (assuming the air remains hot enough). Then you’re breathing cooler air out. Then you breathe in again. You’re not holding the temperature at a consistent 135 degrees for the 15 minutes it takes to really reduce activity.
The original SARS coronavirus from the 2000s is sensitive to 135 degrees. We don’t know for sure if this latest one has the same sensitivity.

Another reason to be suspicious of relying on the sauna is that getting to the sauna will mean possible exposure, particularly if you’re in an area with high infection rates. If you have one at your house, then have at it! I don’t see it hurting and it could help your overall health.

Does healthy eating prevent coronavirus?

Mark, I’m surprised that you didn’t come right out and suggest the Primal Blueprint as an effective way to fight co-morbidities that are responsible for 99% of covid-19 deaths. In the end, isn’t it all about our metabolic health?

Yes, metabolic health seems to play a huge role in how patients are handling COVID-19. That is, many of the hardest hit people appear to have metabolic co-morbidities like heart disease, diabetes, and hypertension. For example, in Italy And in China, patients with one or more co-morbidities were more likely to progress to severe symptoms.

There’s a study just out in kids showing that a fairly healthy “immune-boosting” (their words) diet consisting of green vegetables, beef, and dairy (whole milk, butter on bread) reduced the incidence of upper respiratory tract infections. Again, this wasn’t COVID-19, but it suggests that diet plays a role in immune health and resistance to infectious disease.

We also know that the really severe consequences seem to operate via pro-inflammatory cytokine storms, specifically IL-6 and IL-1B. The balance between inflammatory and anti-inflammatory cytokines rests largely upon the omega-3/omega-6 balance of our tissues, so I think there’s probably a role for improving that O3/O6 ratio in our diets. I’d be curious to see the breakdown of tissue or red blood cell O3/O6 ratio in coronavirus patients and outcomes.

That said, it’s upon us. I don’t want people cutting out grains and eating more meat and thinking they’re all of a sudden immune to the disease. This is something you should be doing as a lifestyle from the very beginning. This is something you should be preparing for, for life. Diet matters in the short term, but it’s most important taken as a long game.

That’s it for today, folks. I’ll definitely be revisiting this topic, as new information is coming out every day. One thing I’m still pondering and researching is the vitamin D issue. Does it increase ACE2 expression and does this result in an increase in susceptibility? Or can it help?

If you have any other questions, ask away.

References:

Silva VC, Giusti-paiva A. Sickness behavior is delayed in hypothyroid mice. Brain Behav Immun. 2015;45:109-17.
Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020;
Anderson RC, Dalziel JE, Haggarty NW, Dunstan KE, Gopal PK, Roy NC. Short communication: Processed bovine colostrum milk protein concentrate increases epithelial barrier integrity of Caco-2 cell layers. J Dairy Sci. 2019;102(12):10772-10778.
Haase AT, Rakasz E, Schultz-darken N, et al. Glycerol Monolaurate Microbicide Protection against Repeat High-Dose SIV Vaginal Challenge. PLoS ONE. 2015;10(6):e0129465.
Zhang Y, Ding S, Li C, Wang Y, Chen Z, Wang Z. Effects of N-acetylcysteine treatment in acute respiratory distress syndrome: A meta-analysis. Exp Ther Med. 2017;14(4):2863-2868.

The post Dear Mark: Coronavirus Edition 2 – COVID-19 Questions, Answered appeared first on Mark's Daily Apple.

Learning Through Play: 101 Ways To Keep Young Minds Occupied At Home

Parents, right off the bat, let me say that there is no right way to be feeling about the current situation. Relief, anxiety, excitement, dread are all normal. We’re all figuring this out as we go along and doing the best we can. Virtual high-five!

This is not a homeschooling post per se. This is about the importance of play as learning, and letting our kids play to restore some balance we don’t always manage in our typical over-scheduled lives.

Here’s the good news if you’re stressed about making sure your kids are still learning why they are at home: they are. I recently attended a workshop with a local homeschool coordinator. The biggest thing I took away was a reminder that all play is learning.

Why Kids Need to Play

Play is how kids learn about the world. Theoretical and Applied Playworker Bob Hughes (awesome title!) lists 16 different types of play that are central to physical, mental, emotional, and social development. By manipulating objects and trying things out (“I wonder what will happen if I give the dog a haircut?”), using their imaginations to role play different scenarios, and moving and challenging their bodies, kids play to learn:

How their bodies work
Laws of physics
Laws of nature
How to interact with other people, and the consequences of breaking social norms
How to follow rules, and the consequences of breaking those, too

Play builds neural connections and motor skills. Through play, kids get to act out adulting (as in playing house), tap into their creativity, and discover their passions.

Importance of Play

Play is not optional. There is a reason that it’s Primal Blueprint Law #7 and Mark has written about it frequently here. (I’ll put some links at the bottom.) Yet, we all know that kids don’t play today like they used to for a variety of reasons. If this time at home offers one thing, it’s time for playing. This means getting free play, movement time, social time, music and arts time, and family time—checking a bunch of Primal boxes.

I’m not just talking about the kids, by the way. I’m talking about the adults in your house too. How much do YOU play in your normal life? I’m guessing not enough. A lot of the ideas here are fun for the whole family.

Play to Learn: Indoor and Outdoor Activities for Kids

For obvious reasons, I’m not listing things that involve going to parks or other public places. If you can still go for bike rides or kick the soccer ball around outside, great! You can do these inside or in your yard if you have one. I also didn’t list too many options that might necessitate shopping for materials. Pick the ideas that work for you given the ages of your kids, what stuff you already have at home, and how much space you have.

Before You Begin…

If you’re like us, you have a stash of art supplies, board games, boxes of legos and blocks, and sports equipment stuck on shelves and in closets. Dig it out and take inventory. What do you already have in your home that your kids can play with? Even bigger kids enjoy revisiting things like blocks and playdough, especially when they’re stuck at home.

Creativity Stations

I have a friend who, when her kids were little, would put out a craft or art project every night. When her boys woke up in the morning, it was waiting for them to explore at their leisure. It made for a lot of fun and peaceful mornings in their house. (Yes, she’s a supermom.)

I’m adapting this idea by designating a “creativity station.” Realistically, you might as well call this the “mess station.” Maybe it’s a card table in a corner of the living room, on the deck, or in the garage. I’m just giving up my kitchen table for now. Lay out a bunch of supplies and let them have at it. These stay out for several days at my house, then we clean it up and get out something else. Here are some ideas:

Art labs
Coloring/painting

Supplies: paper, coloring books, crayons, markers, paint, stamps, stickers—whatever you have!
Ideas: Encourage kids to explore textures by using different types of objects as stamps: sponges, cookie cutters, leafs and sticks from the yard, legos, etc. Make footprints with action figures. Keep a bowl on hand that they can put dirty stuff in to wash. Also keep a pile of rags nearby for wiping dirty hands before they touch the wall.

Collage

Supplies: Paper; old magazines, newspapers, circulars, coupon mailers; glue; safety scissors
Ideas: Give kids a theme (e.g., food, their favorite person) or just let them make whatever they want.

Mosaic

Supplies: Construction and tissue paper in different colors; glue; scissors (optional); bowls to keep colored confetti separated (optional)
Ideas: Have kids cut or tear colored paper into small pieces like confetti, then use the pieces to create mosaic art. You can use coloring book pages as a “pattern,” or they can draw their own or make it free-form.

Science lab

Supplies: Plate or baking sheet; plastic table cloth or drop cloth (optional); containers of different sizes for mixing and pouring; water; food coloring; baking soda; pipettes, medicine droppers, etc. (raid the medicine cabinet); measuring spoons; baking soda; vinegar in a spray bottle; dish soap
Ideas: Let kids make “potions” and practice pouring from one container to another. Sprinkle baking soda on a plate, “decorate” with drops of food coloring, then spray with vinegar.
There are a ton of ideas for easy and fun science experiments online, too. Check out this lemon volcano and these 10 experiments you can do with water.

3-D creations

Supplies: Clay, playdough, tape, toothpicks, chopsticks, straws, rubber bands, paper clips, corks, pipe cleaners, anything else you can find around
Ideas: This is fun for free play, or you can challenge your kids to build something specific, like a bridge that will actually hold a small weight.
Make your own playdough recipes here and here. (Yes, these are not Primal recipes!)

Archeological dig

Supplies: Plastic tub with moon sand, kinetic sand, or dirt; small toys (e.g., plastic animals, blocks, marbles, plastic eggs filled with “treasure”); spoons, paint brushes
Ideas: Bury objects for your kids to “excavate.” Have them build ancient ruins.
Make your own moon sand recipes here and here.

Family Time

Family dance party

Let older kids create a custom playlist
Freeze dance: Let someone control the pause button; when the music stops, freeze and hold the position


Minute to win it games (check Pinterest for ideas)
Family book club
Sing-alongs
Card games
Board games
Dice games
Have a “campout” in your backyard. Make a campfire in a fire pit, place a bunch of candles in a circle, or have your kid make a pretend fire out of sticks and paper.
Make a family tree (including genealogy research if you want)
Go on a family vacation without leaving the house! There are so many ways to “travel” online. Here are some ideas to get you started:




Visit the Tembe Elephant Park in South Africa
Watch the Northern Lights live (best viewing hours are 10 p.m. to 4 a.m. EDT.)
Tour the Carlsbad Caverns
Visit a museum
See the Great Wall of China
Tour the Vatican
See the animals at the San Diego Zoo and the Monterey Bay Aquarium
Go to the opera
Take in a Broadway play
Go scuba diving
Go to outer space



71 More Activities for Kids

Color the driveway with chalk
Use chalk (outside) or masking tape (inside) to make hopscotch or foursquare
Make noodle or bead necklaces
Draw a comic
Illustrate a favorite book or story
Listen to a song and “draw” what you hear
Origami
Make a flexagon
Gather up broken crayons make something new with them
Move like an animal; take turns guessing which animal the other person is being
Primal essential movements
Resistance exercise with (light) hand weights and resistance bands
Make an obstacle course
Jump rope
Hopping on one foot contest
Do a handstand
Play hacky sack (make your own filled with rice or flour)
Put on as many clothes as you can, then try to do jumping jacks or burpees
Learn to breakdance
Yoga
Meditate
Make a drum kit with bowls and buckets
Make “instruments” like castanets and boomwhackers with household objects
Build a pillow fort
Build a cardboard box fort, paint and decorate it
Build a catapult
Build a Rube Goldberg machine
Make a birdhouse
Identify birds or bugs in your backyard
Learn about animal tracks and make your own
Weed the garden
Dig a hole
Plant an indoor herb garden
Cook together
Learn about food preservation; make sauerkraut or yogurt
Smell boxes: place objects with a distinctive smell—a candle, an orange cut in half—inside an empty tissue box and take turns guessing what’s in there
Touch boxes: same as above, but you have to reach in and feel the object without looking
Learn to tie knots
Make a solar oven
Learn how to build a fire (supervised, obviously)
Make a sundial
Learn how to use a compass
Get a bucket of water and test what sinks or floats
Learn to sew
Follow a finger knitting tutorial
Crochet a small project
Make a t-shirt scarf out of an old shirt
Make tissue paper flowers
Play charades
Make puppets and put on a show
Play hide and seek
Play sardines (the opposite of hide and seek – rules here)
Make the letters of the alphabet with your body
Play 20 questions
Play I spy
Make a word chain
Dig out the old point-and-shoot camera and learn to take pictures
Cloud watching
Build towers and knock them down
Yard scavenger hunt
Find something in the house for every letter of the alphabet
Make a yarn spider web
Juggle
Speak pig latin
Learn a new language
Use a magnifying glass to explore objects up close
Freeze little plastic toys, marbles, etc. in bowls of water, then test ways to free the toys most quickly. Try different techniques like rubbing, spraying with warm water, or sprinkling with salt.
Blow bubbles; make your own bubble solution and bubble makers
Bring some flashlights in a dark room or closet and make shadow puppets
Balloon “hockey” with balloons and brooms
In the snow: fill spray bottles with water and food coloring and “paint” the snow

Give the Kids — AND YOURSELF — A Break

The idea isn’t to keep your kids occupied every minute of the day. It’s ok if they complain about being bored every once in a while. If they are like most modern kids, they aren’t used to having a ton of time on their hands. Present them with options, but let them figure it out on their own if they are old enough.

Your house might be messy and chaotic right now. Your kids might be too. They are certainly not immune to the stress and anxiety in the world, especially your older kids. It’s ok if you don’t have a schedule with neat blocks of school time, movement time, snack time, and chore time, and if your kids haven’t gotten out of their pajamas in a week. Your kids are going to be fine no matter what.

This is not nearly an all-inclusive list. What else has your family been doing to have fun while #stayinghome?

Resources

More play activities and lots of homeschooling resources from Unschool.school

100 Ways to Play from the Boston Children’s Museum

More play activities and homeschool ideas from Beyond the Chalkboard

Related posts from Mark’s Daily Apple

The Definitive Guide to Play

The Lost Art of Play: Reclaiming a Primal Tradition

15 Concrete Ways to Play

Why You Absolutely Must Play, Every Day! (plus 10 Pointers for Successful Playtime)

The post Learning Through Play: 101 Ways To Keep Young Minds Occupied At Home appeared first on Mark's Daily Apple.

Success Story: Life After Cravings

It’s Monday, 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 Monday as long as they keep coming in. Thank you for reading!

Folks, I have been grateful for every story that has come my way over the years. It’s an incredible privilege being on the receiving end of your reflections and evolutions, and they are why I’ve kept at it all these years—knowing the message and information have made a difference in people’s lives. I appreciate every single one. Here, you’ll read about a woman who went through a long period of trial-and-error and ultimately realized that conventional advice was hindering her progress. Thank you to reader, Karine, for sharing your story, and for using your personal transformation to inspire others as a health coach and mentor!

 

Switzerland, April 2008, I decide to get ski-fit. I think I am healthier than the average. I am not eating junk food, not smoking and not drinking alcohol. But I am very sedentary, apart from a bit of skiing in winter. I am already a decent skier but need to be fitter to go back-country skiing. This is when you climb the mountain with skins under your skis to find true off-piste skiing.

I buy a gym membership and quickly become addicted. I start lifting (very light) weights every day. I also throw in some cardio to lean out and increase my stamina. I start reading articles about nutrition and fitness and change my nutrition. I follow the nutritional advice from the fitness industry: 5 to 6 meals a day, very high in lean proteins for muscle synthesis and very high in carbs for energy. I am not a big meat eater and there is just so much chicken breast that I can eat everyday! I have to supplement with a lot of protein powder. I am convinced I am doing the right thing.

Australia, 2017. After 9 years of training, I am much fitter, have more stamina and can lift “decent” weights. But I still do not look lean and toned. My first DEXA scan gives me 26% body fat. Very average and unfair, considering that I am training 2.5 hours a day and not over-eating! And I am starving ALL THE TIME. I cannot go 2 hours without eating. Food becomes an obsession and a constant struggle. I also have really bad cravings for sugary food. I need so much will-power to resist banana bread and cookies or not to go overboard with fruits. I eat about 2,200 calories a day, as I exercise a lot, but I am never satiated. According to the calorie in / calorie out principle, I should be losing weight. But this is just not happening. It DOES NOT WORK. Something has to change.

The Shift to a Life Without Cravings

July 2018, I start the Primal Health Coach course. This is a revelation. My big AHA moment. I understand that if I eat a lot of carbs or even very lean proteins, I raise my insulin, which puts me in a fat storage mode. And it is even worse as I eat 6 meals a day. I remain in a fat storage mode all day! The calories in / calories out concept just doesn’t take into account the physiology of our body and how different macronutrients are metabolized differently. It suddenly all makes sense!! I understand why I am so hungry all the time, why I am bloated and have cravings. This is such a relief: I now know what to do. But it is also so frustrating. I have basically wasted 9 years working out super hard to improve my body composition, without any success.

I change my nutrition right away. I start with paleo, low carb, high fat. Mind-blowing! After one week, all my hunger and cravings are gone. I am not bloated anymore. After two weeks, I start losing weight. I decide to go full keto. So easy, and the food is delicious. I love all the healthy fats: avocados, macadamia and pecan nuts, olive oil, fatty pieces of meat. Yum! I don’t feel restricted at all. On the contrary, I don’t think about food all the time anymore and don’t even crave unhealthy processed and sugary foods. After 6 months, my body fat percentage is down to 21%. I still eat the same amount of calories as before, but with different macro nutrients.

I am no longer hungry in the morning and it is also very convenient. I continue to lose some excess fat. After a year and a half on keto, I am now around 16% body fat, which seems to be my happy set point. I am now regaining a bit of weight, but it is only muscles! Six months in, I stop the cardio. I realize that I was overtraining, and my stress levels are a bit high. I also start time restricting eating. I skip breakfast and have a larger lunch and dinner. It is actually very easy.

Not bad for a 47 year old. And all these improvements without much effort. I really wish I had known all this back in 2008…

Mental Benefits of Keto

The other benefits I can see of going keto are that I am far less anxious and stressed than before, and my mood is more stable. I have never suffered from brain fog, but my brain feels super clear in the morning, when I am fasted. And if I am away from home without access to healthy food, I can skip a meal without being hungry.

In the meantime, I discover that I am highly toxic in heavy metals, especially arsenic and mercury. Probably from low-quality protein powders, tap water, dental fillings and conventional food. Another big awakening! I ditch all my conventional cosmetics and cleaning products and replace them with organic non-toxic products. I install a reverse osmosis water filtration system and start buying organic veggies, pasture-raised and grass-fed meat. The heavy metals are going down, but I probably need another year or two to get rid of them.

Sharing what I’ve learned

After taking the Primal Health Coach certification course, I continue studying nutrition with two courses from the Nutrition Network: Low Carbohydrate High Fat / Ketogenic Nutrition & Treatment and LCHF in Clinical Practice. I also start studying the other pillars of a healthy lifestyle: sleep optimization, stress management, exercise and toxin reduction. I am now officially a health coach and nutritionist and start coaching friends and relatives.

The more I learn, the more frustrated I am with the poorly researched, wrong or conflicting mainstream information about nutrition and so-called healthy lifestyles. I realize that, when I talk to people about bad oils, added sugar, excess carbs and gluten, about going to bed at 10 pm to get 8 hours of sleep, about grounding or turning off their phone at night, they look at me as if I were coming from another planet. They have heard a different message pretty much since they were born and it is difficult for me to prove my point over a fifteen-minute conversation.

September 2019. I set up my own website and start blogging about nutrition, sleep, stress, toxins, exercise and anything that can help people getting healthier and feel better. I keep the articles short: a bit of information on how our physiology works and many practical tips that are easy to squeeze into our busy days and have be proven by the research to work.

I just want to raise awareness. It is not because a product is sold in our favorite supermarket that it is healthy. Our modern lifestyles are harmful in so many ways and it is not enough to just avoid junk food and give up smoking. We need to do much more than that: pay attention to what we buy, how much we move, what we think about, the water we drink and how we use technology. We all need to be so much more mindful. We can no longer be on auto-pilot and hope that we will stay healthy. This was my realization anyway. I hope it will make your readers think about it.

Karine

The post Success Story: Life After Cravings appeared first on Mark's Daily Apple.

Keto Bacon Ranch Chicken Casserole

It’s a common misconception that casseroles are off the table once you shift to a Primal lifestyle or start a keto diet. After all, the casseroles you grew up with were likely packed with noodles or rice, had very little vegetable, and were almost universally held together by a can of condensed soup.

With a few ingredient swaps, casseroles are back, and just as cozy as ever. This Keto Bacon Ranch Chicken Casserole recipe has the creamy, dreamy consistency you know and love, without the digestive upset that comes with a heavy, cheesy casserole. Plus, everyone loves the convenience of a one-pan meal – less cooking and clean up time!

Instead of using cream-of-whatever soup, you’ll create the velvety effect by combining dairy-free ranch dressing with a cashew sauce so good that it stands on its own as an addictive vegetable dip. (Do yourself a favor – make a little extra cashew sauce.) The nutritional yeast is optional, but can give your keto chicken casserole a “cheesier” flavor if that’s how you like it.

This recipe uses homemade almond milk which is mild in flavor and higher in fat than a store bought dairy-free milk, but store-bought will work for this recipe if that’s what you have on hand. Aim to use something with a neutral flavor to allow the bacon and ranch to shine through.

Keto Bacon Ranch Chicken Casserole Recipe

Servings: 4-5

Time in the kitchen: 40-45 minutes (including 15 minutes cook time)

Ingredients:
Cashew Sauce:

3/4 c raw cashews, soaked for minimum two hours
1/2 c unsweetened almond milk
2 tsp lemon juice
1/2 tbsp tahini
1/2 tsp apple cider vinegar
1/4 tsp salt and pepper
1/4 tsp mustard powder
3 tbsp chopped fresh chives
2 tbsp chopped fresh dill
Optional: 1-2 tbsp nutritional yeast

Casserole:

5 oz bacon
1.25 lb boneless skinless chicken thighs
1/2 c chopped onion
2 chopped cloves garlic
3 c cauliflower rice
3 c spinach
1/4 c Primal Kitchen Ranch Dressing
1/4 c unsweetened almond milk

Directions:

Drain the cashews and place them in a high-speed blender with 1/2 cup almond milk, lemon juice, tahini, apple cider vinegar, salt, pepper and mustard powder. Blend until very smooth. Mix in the fresh dill and chives.

Preheat your oven to 375 degrees Fahrenheit. Place the bacon in an oven-safe pan. Place the pan in the oven for 15-20 minutes, or until the bacon reaches the doneness of your liking. Remove the slices of bacon and set them aside. You may want to drain out a little bacon fat if there’s a lot in the pan.

Heat the pan on the stovetop over medium heat. Add the chicken thighs and season them with a pinch of salt and pepper. Sear for 1-2 minutes on either side. Add the diced onion and mix it around in the pan. Transfer the pan to the oven until the chicken reaches an internal temperature of 165-170 degrees Fahrenheit. Chop the chicken and bacon and set aside.

Place the pan back over the stovetop and add the chopped garlic. Once it is fragrant, add the cauliflower rice and stir. Stir for a few minutes or until it begins to soften, then add the ranch dressing and almond milk. Once the cauliflower rice is soft, add the spinach. Fold the spinach into the cauliflower rice and remove the pan from the heat. The residual heat from the pan will wilt the spinach. Mix in the chopped bacon and spinach, and 2/3 of the cashew “cheese” mixture. Season with salt and pepper to taste. You can also add in some chopped fresh herbs like parsley or dill, if you’d like.

Grease a baking dish with avocado oil (avocado oil spray works well for this) and pour the casserole mixture into it, using a spatula or a spoon to spread it out evenly. Pour the remaining cashew cheese mixture on top of the casserole and spread it out evenly. Place the casserole in the oven for about 15 minutes, or until the top turns slightly golden. Top with black pepper and chopped chives.

Nutrition Information (1/5 of casserole):

Calories: 415

Total Carbs: 11 grams

Net Carbs: 8 grams

Fat: 28 grams

Protein: 28 grams

Nutrition calculated using Cronometer

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