Weekly Link Love — Edition 26


Research of the Week

Scientists generate speech from brain recordings.

In the U.S., sedentary behavior has remained stable or gotten more prevalent.

Visualizing coffee might be enough (not buying this one).

Pigs who eat chicken generate more lipid oxidation products than pigs who eat beef.

When we sleep, our brain distinguishes between important and unimportant sounds.

Thinking of your future self as similar to your present self produces better outcomes.

20 minutes of nature is enough.

New Primal Blueprint Podcasts

Episode 330: Gary E. Foresman, MD: Host Elle Russ chats with Dr. Foresman about heart disease, statins, and more.

Episode 331: Brad Kearns and Brian McAndrew Talk Carnivore and Balance: Host Brad Kearns chats with Primal video whiz Brian McAndrew about carnivory and balancing being strict with being happy.

Health Coach Radio Episode 9: Lauren Schwab: Lauren has mastered the art of the wellness retreat, not an easy task.

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.

Media, Schmedia

First they came for the hot dogs and bologna, and I was silent….

Salt limits get even lower.

Interesting Blog Posts

How a knee bone that almost disappeared is coming back.

A novel tactic for getting teens to spurn junk food.

Lowering cholesterol with psyllium at every meal: one experience.

Hilarious.

Social Notes

If you’ve had success with the Primal Blueprint, Keto Reset, or any of the advice offered on this site, send in your success story. All submissions will receive a discount code for use on Primal Blueprint or Primal Kitchen.

Got named one of Healthline’s “Best Men’s Health Blogs.”

I hope this guy follows me.

Everything Else

If you’re not eating whole rattlesnakes, you can’t call yourself paleo.

Human composting up for a vote in Washington state.

A man’s beer-only fast for Lent ends up working out.

“The sudden passionate happiness which the natural world can occasionally trigger in us,” Michael McCarthy writes, “may well be the most serious business of all.”

“So I had a piece of salmon and my brain felt like a computer rebooting.”

Things I’m Up to and Interested In

This is awkward: Using CRISPR to edit DNA also causes off-target RNA alterations.

Article I found interesting: Neuronal life after death.

Video I enjoyed: 3 pro soccer players vs 100 kids.

I’m not surprised: Wildlife-friendly agriculture increases yield.

Why everyone needs to lift: Having muscle protects against progression from healthy to metabolically unhealthy.

Question I’m Asking

What’s the best book you’ve read in the past year?

Another Question I’m Curious About

What would you do with a bunch of extra arugula?

Recipe Corner

Time Capsule

One year ago (Apr 21– Apr 27)

Comment of the Week

“I don’t think we should be drinking teas grown in ‘Shady Conditions’…
all kidding aside, magnesium works well for me until about after 5pm, and then it wires me up and I can’t sleep.”

– You haven’t had tea grown in places with gunshots going off, discarded syringes littering the ground, and human fecal matter smeared everywhere? It’s the best, nocona!

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10 Natural Sleep Aids: What Works and Why

By now, the average person grasps just how important sleep is for our overall health. It seems like every month there’s a new popular science book extolling the virtues of sleep. Parents remember the zombified newborn days and can see (and hear), firsthand, what happens when a toddler doesn’t get enough sleep. And on a visceral level, we feel the need for slumber. Even if we’re unaware of or refuse to accept the health dangers of long-term sleep restriction, there’s no getting around the abject misery of a bad night’s sleep.

We all want better sleep. We all need better sleep. But how?

Sleeping pills are not the answer for most people.

(But please note: Don’t discontinue or alter a prescribed treatment or medication regimen without consulting your doctor…and, likewise, don’t begin a new regimen—like those below—without running it by your physician.)

In one recent “positive” study on the effects of sleeping pills, almost every single subject suffered one or more side effects, ranging from headaches to nausea to irritability to dizziness to dysgeusia (a condition where your sense of taste is altered).

In another, taking Ambien the night before decreased cognitive performance and increased subjective sleepiness the next morning.

Studies aside, there are thousands of horror stories about people ruining their lives (or behaving in a way that had the potential to do so) after taking sleeping pills. Twitter rants that get you fired, sleep driving, tooth grinding, furniture rearranging, sleep eating. And those are just the ones that people live to tell.

That’s not to say sleeping pills are useless. They’re legitimate drugs to be used for specific medical conditions, in specific patient circumstances. They aren’t to be trifled with. But if you’re just trying to “get better sleep,” you’ve got options. And I’m not even mentioning the lifestyle and behavioral modifications you can make to improve your sleep.

Here are my favorite natural sleep aids….

1. GABA

GABA is the inhibitory neurotransmitter. It calms the brain. It soothes the brain. It de-stresses the brain. And it’s a major factor in the creation of melatonin, the hormone our brain uses to trigger sleep onset. Insomniacs have reduced brain GABA levels compared to non-insomniacs; the same goes for people with sleep apnea. Restoring physiological levels of GABA, then, is a first line of defense against poor sleep.

Oral GABA has a blood-brain barrier problem—it doesn’t cross it particularly well. Children have more permissive BBBs, but most of my readers aren’t children. Nitric oxide tends to increase GABA diffusion across the blood brain barrier, and there are a couple of ways to increase nitric oxide in conjunction with taking GABA to make the latter more effective for sleep.

You could sunbathe. That increases nitric oxide release. The only problem is that most sunbathing occurs during the midday hours, not at night. It’s unclear how long the boost from sunlight lasts, though it certainly can’t hurt.

You could take apocynum venetum, an herb used in traditional Chinese medicine that increases nitric oxide release. In fact, one study showed that taking GABA with apcynum ventum improves sleep quality.

Before you start sedating yourself, see if GABA has an effect.

2. Melatonin

When it’s bedtime for your brain, your pineal gland starts pumping out a hormone called melatonin. This initiates the onset of sleep and triggers subjective feelings of sleepiness; it also sets your circadian rhythm.

Supplemental melatonin crosses the blood brain barrier and acts very similarly to endogenous melatonin.

Don’t use melatonin every night. Not because you’ll get “addicted” (you won’t) or “your natural production will stop” (it won’t), but because you should focus on producing your own. If I get a big dose of late night blue light, I might nibble on a little melatonin. If I have more than a single glass of wine at night, I’ll have some melatonin before bed as alcohol depresses its production. And when I travel, I always take a few milligrams an hour before my desired bedtime in the new time zone.

The main reason you shouldn’t rely on melatonin for everyday use is that supplemental melatonin pharmacology doesn’t quite emulate endogenous melatonin pharmacology. The way most people take it is in a single dose before bed. The way the brain produces it is consistently through the night. If you want to emulate physiological levels of melatonin, you’re better off taking a single dose of instant release melatonin followed by a dose of slow release melatonin, or a supplement that includes both forms. Even then, it’s not the same.

3. Collagen

I still remember the first time I drank a big mug of bone broth at night. It was one of the not-as-rare-as-you’d-think cold “winter” nights in Malibu. I was sitting on the couch, reading a book, and got about 3/4 of the way through a mug of chicken foot broth before, apparently, falling asleep right then and there. A bit of research the next day revealed that glycine, the primary amino acid in collagen/gelatin/broth, can have a powerful effect on sleep quality. Not only that, glycine also lowers body temperature (an important part of the sleep process) and improves wakefulness the next day. And if you’ve got REM sleep behavior disorder, glycine may be the solution.

In fact, the glycine-sleep effect was another consideration in creating Collagen Fuel and Peptides. Everyone talks about the benefits to joint health, performance, skin, nails, hair, and general inflammation, but I want folks to also discover the benefit of glycine-enhanced sleep, too.

If you take collagen, aim for at least 10 grams at night. If you’re taking straight glycine, 3 grams is the minimum dose. Those are threshold doses; more may help even more.

4. Magnesium

We talk a lot about “age-related” declines in health, vitality, performance, and basic physiological functions. We also talk about how much of what we call “age-related” isn’t inevitable. It’s not so much that the passage of time degrades our bodies and how they work, but that we become more susceptible to poor lifestyle, dietary, and exercise choices because of compounding negative interest. We’re born with robust health and if we fail to maintain it, our health worsens as time progresses. If we never stop moving, lifting weights, and eating right, aging doesn’t happen to the same degree.

One thing that changes with age is how we sleep. In older people, sleep architecture is different: More time is spent awake and there’s less slow wave sleep. Sleep spindles, those oscillating bursts of brain wave activity, begin disappearing. Sounds inevitable, right? Except that research shows that taking magnesium reverses these age-related changes to sleep architecture.

Taking some Natural Calm (a great magnesium supplement) after your CrossFit workout and falling asleep faster is one thing. But to actually restore youthful sleep architecture? Amazing.

5. CBD Oil

As I wrote a couple weeks ago, CBD is the non-psychoactive cannabinoid found in cannabis.

And to me, the most interesting aspect of CBD lies in its potential to improve sleep. A 2017 review provides a nice summary of the effects of CBD on sleep:

In insomnia patients, 160 mg/day of CBD increased sleep time and reduced the number of arousals (not that kind) during the night.

Lower doses are linked to increased arousals and greater wakefulness. Higher dose CBD improved sleep.

In preliminary research with Parkinson’s patients, CBD reduced REM-related behavioral disorder—which is when you basically act out your dreams as they’re happening.

More recently, a large case series (big bunch of case studies done at once) was performed giving CBD to anxiety patients who had trouble sleeping. Almost 80% had improvements in anxiety and 66% had improvements in sleep (although the sleep improvements fluctuated over time).

Here’s how to find a good CBD oil.

6. Theanine

Theanine is a chemical found in tea, especially tea grown in shady conditions. Because it is structurally similar to glutamate and easily passes the blood brain barrier, theanine binds to various glutamate receptors in the brain, inhibiting the action of some and promoting the action of others. It also increases serotonin, GABA, and glycine in the brain—all chemicals that can pave the way for better sleep.

Theanine is another of those sleep aids that isn’t expressly about sleep. It’s about relaxation, about letting you get out of your own way. If in the course of relaxation and stress reduction you end up taking care of the thing that’s messing up your sleep, theanine can be said to be a big sleep aid.

This is a good theanine. I also make a supplement (Adaptogenic Calm) that contains theanine and other stress-reducing compounds.

7. Lutein and Zeaxanthin

One of the most powerful sleep aids is wearing a pair of orange safety goggles that blocks blue light after dark. Viewed after dark, blue (and green) light suppresses melatonin secretion, pushes back sleep onset, and throws off your entire circadian rhythm. Blocking the light with goggles allows normal melatonin production to proceed and promotes earlier bedtimes and better, deeper sleeps.

What if you could take a supplement that simulated the blue-blocking effect of a pair of orange safety goggles? Lutein and zeaxanthin are carotenoids, plant-based pigments found in colorful produce and pasture-raised eggs that are actually incorporated into the eye where they offer protection from sunlight and inhibit the melatonin-reducing effect of nighttime light exposure. Human studies show that taking lutein and zeaxanthin on a regular basis improves sleep quality, reduces sleep disturbances, and lowers dependence on supplemental or pharmaceutical sleep aids.

Here’s a good one. Trader Joe’s also has a good supplement called Super Vision.

The best natural sleep aids restore the ancestral sleep baseline. At baseline, humans should be walking around with good GABA levels. They should be getting enough magnesium, collagen/glycine, and carotenoids from their diet. It’s normal to produce melatonin after dark. And even though humans haven’t been dosing themselves with CBD or theanine for very long, it also isn’t normal to be inundated with chronic, low level stress and persistent anxiety—the type of stress that ruins our sleep, the type of anxiety that CBD and theanine can regulate.

What else?

8. Lemon Balm

Lemon balm is an herb in the mint family. The fragrance is intoxicating (I’ve even used lemon balm in a roasted chicken), but not the effects. It doesn’t directly induce sleep—it’s not a sedative or a hypnotic—but if stress and anxiety are getting in the way of your sleep, lemon balm will help clear them out.

9. Valerian

Valerian root has a long history as an anti-insomnia herb. The ancient Greeks used it and traditional Chinese and Ayurvedic medical traditions continue to use to it to treat bad sleep. Valerian contains a compound that slows down the brain’s metabolism of GABA, thereby increasing GABA levels and letting what the brain already produces hang around even longer.

I’ll admit I’m more ambivalent about these last two options. While they’re certainly gentler than pharmaceutical sleep pills, and lemon balm in particular is a legit way to deal with stress and anxiety, their efficacy for sleep is questionable. The evidence just isn’t there, though I grant that many people report good results.

10. Combinations

Many of these individual compounds become more powerful and more effective combined with each other. Since these aren’t pharmaceutical drugs with very narrow safety profiles rife with contraindications, taking them together usually isn’t an issue, but check in with your doctor anyway (especially if you’re taking other medications or have known health conditions).

And today’s list isn’t exhaustive. There are other compounds, herbs, and supplements that can probably help people improve their sleep.

Most of the adaptogens, like ashwagandha or rhodiola rosea, have been shown in one study or another to improve sleep in humans. Anything that helps get you back to baseline, back to homeostasis, back to normal—will restore your sleep if it’s suffering. And if you’re suffering, your sleep is likely suffering because sleep is such a fundamental aspect of the human experience. Anything that improves your health will also probably improve your sleep.

This goes without saying, but don’t limit yourself to natural sleep supplements. Don’t forget about the importance of lifestyle, of exercise, of diet, of morning light exposure and nighttime light avoidance. Supplements can help, but they can’t be the foundation for good sleep hygiene. You’re just asking for trouble—or subpar results.

Thanks for reading, everyone. Now, let’s hear from you. What natural sleep aids have you found most useful? Is there anything I overlooked or forgot? Let me know down below.

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References:

Pinto LR, Bittencourt LR, Treptow EC, Braga LR, Tufik S. Eszopiclone versus zopiclone in the treatment of insomnia. Clinics (Sao Paulo). 2016;71(1):5-9.

Dinges DF, Basner M, Ecker AJ, Baskin P, Johnston S. Effects of Zolpidem and Zaleplon on Cognitive Performance After Emergent Tmax and Morning Awakenings: a Randomized Placebo-Controlled Trial. Sleep. 2018;

Yamatsu A, Yamashita Y, Maru I, Yang J, Tatsuzaki J, Kim M. The Improvement of Sleep by Oral Intake of GABA and Apocynum venetum Leaf Extract. J Nutr Sci Vitaminol. 2015;61(2):182-7.

Held K, Antonijevic IA, Künzel H, et al. Oral Mg(2+) supplementation reverses age-related neuroendocrine and sleep EEG changes in humans. Pharmacopsychiatry. 2002;35(4):135-43.

Kim S, Jo K, Hong KB, Han SH, Suh HJ. GABA and l-theanine mixture decreases sleep latency and improves NREM sleep. Pharm Biol. 2019;57(1):65-73.

Rondanelli M, Opizzi A, Monteferrario F, Antoniello N, Manni R, Klersy C. The effect of melatonin, magnesium, and zinc on primary insomnia in long-term care facility residents in Italy: a double-blind, placebo-controlled clinical trial. J Am Geriatr Soc. 2011;59(1):82-90.

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Top 10 Fasting Mistakes and How to Avoid Them

Folks, you know I’m a long-time believer in intermittent fasting for longevity, autophagy, mental clarity, fitness performance, metabolic health, and more. I’m excited that Dr. Jason Fung has stopped by the blog today to share a bit about common fasting mistakes. Enjoy!

So, you’ve decided to add some fasting to your lifestyle. Excellent. No matter how much you have (or haven’t) read on the topic, you’re likely to find aspects of fasting to be challenging or even frustrating. It can be hard to stay on track when you’re feeling hungry, irritable and not really noticing any changes.

It’ll become tremendously easier once you begin to experience the health benefits of fasting, but we all know it takes a little while for that to happen. Benefits like mental clarity and improved energy will show up sooner than significant weight loss. Plus, the benefits you experience will depend on what kind of fast you’re doing and how well you stick to it.

But if you’re making fasting mistakes, you might never accomplish the benefits you were hoping for. . Before you throw in the towel, I want to help you identify some possible fasting pitfalls you might not be aware of and also help you avoid them. Plus, don’t miss the Number One reason fasts fail, shared at the end of this article.

1. You’re Snacking or “Grazing”

Look, the entire purpose of a fast is to contain your eating within certain windows of time. Snacking or “grazing” all day long is basically the opposite of fasting, so stop thinking that you can get away with it. Fasting is “on” or “off”—there is no gray area. Even having “just a bite,” no matter how healthy or how little, will almost invariably kick your body out of fasting mode and will interfere with the healing process responsible for fasting’s many benefits. It also creates a situation where your body is producing insulin all day long. Bad idea.

Avoid grazing by putting snacks and food out of sight. The phrase “out of sight, out of mind” really applies here. You’ll be amazed how much easier it is to bypass snacking when the food isn’t sitting right in front of you. If you snack out of habit, get creative and find new, non-food based habits. If your snacking comes from genuine hunger, you may need to re-evaluate the meals you eat during your eating window. Make sure you’re getting enough healthy, unsaturated fats with each meal as these will keep you satiated for longer.

2. You Aren’t Drinking Enough Water

This is not only a common fasting mistake, but a mistake most people make no matter what their diet is. Drinking a minimum of eight glasses of water daily is essential to staying hydrated and healthy. Some signs that you aren’t drinking enough water include dizziness and lightheadedness, feeling tired, or constipation.

Even worse, when you don’t drink enough water, your brain may try to trick you into thinking that you’re hungry, so you get the vitamins and minerals you’re lacking. Minerals like potassium and magnesium are essential to your brain health. So don’t be surprised next time you feel hungry but find that drinking a glass of water makes the appetite disappear. Various kinds of tea are also a satisfying way to hydrate, or try some bone broth if you’re truly struggling.

3. You Aren’t Consuming Enough Salts

Speaking of vitamins and minerals, appropriate salt intake is vital to your health. Now, when I say “salt,” I’m not talking about the kind you put in a shaker. I’m talking about electrolytes, which are essential to your diet. Sodium (Na), which is also commonly known as table salt, is one of these electrolytes, along with potassium (K), magnesium (Mg), calcium (Ca), and chloride (Cl).

How can you tell if you’re low on electrolytes? Some symptoms of electrolyte deficiency are anxiety, irritability, trouble sleeping, muscle spasms, fatigue, digestive issues, and dizziness. If these are the kinds of symptoms you experience during your fast, lack of electrolytes could be the answer. Try taking some pink Himalayan rock salt and placing it under your tongue to dissolve. You can also try drinking some pickle juice — just make sure it’s from high-quality natural pickles and not the kind made with sugar.

4. You’re Eating Right Before You Go To Sleep

Your body needs time to digest all the food from your last meal before you go to sleep. If you’ve scheduled your eating window to happen right before bedtime, your body will be taking all the time you’ve allotted to rest to digest instead. That takes energy, and instead of waking up feeling restored and ready to take on the day, you’ll just feel tired.

When you’re following a fasting plan, a seven-hour window is an ideal amount of time to leave between your last meal and when you go to sleep. Even three or four hours is enough to make a difference. Unfortunately, with crazy work schedules and early mornings, a lot of people aren’t able to stick to that three- or four-hour window. It’s more like get home, eat dinner, and go straight to bed. If this is you, the next best thing is to eat a light meal, like salad, and avoid a meal filled with carbohydrates and protein.

5. You’re Eating Too Much of Some Food Groups

When we cut certain foods from our diet, especially carbs, it’s easy to rely on other food groups, like nuts and dairy. They’re readily available and a staple of most diets.

Nuts are a low-carb, healthy fat option, but only in small amounts. They’re great to add to fruit or veggie salads, and they’re easy to grab a handful of when you need a quick snack. But those quick snacks can add up, especially on top of eating full meals. Nuts are high in good fat, low in carbs, and are a good source of protein, but too much protein can be detrimental to your fast. Excess protein that your body doesn’t need is converted to glucose and stored as fat. If you’re fasting to lose weight, this is the exact opposite of what you want.

Dairy, the other easy food group that too many people defect to, can cause inflammation, upset stomach, bloating, gas, and other kinds of discomfort. If this is a pattern you’ve noticed with your own health and eating habits, try cutting out dairy for a few weeks and see if these symptoms improve. If you haven’t noticed these symptoms, be more mindful of your eating habits and track how you feel after eating dairy.

6. You Aren’t Eating Enough of Certain Food Groups

As easy as it is to eat too much of one food group, it’s equally easy to not get enough of another. Just because you can eat “whatever” you want during your eating window doesn’t mean you should. Empty calories and junk food are momentarily satisfying, but they don’t fuel your body. Eating the right foods provides your body with the nutrients it needs to thrive throughout the day; these foods will also keep you feeling fuller, longer.

Vegetables are one of the best food groups to keep you nourished and thriving. They’re low calorie and they provide different vitamins and minerals like potassium, fiber, folate, vitamin A, and vitamin C. Fruits are also healthy, but don’t overdo it, as most are high in sugar. Fruit juices typically have added sugar as well. Naturally flavored drinks and teas are the healthiest option. Nuts are high in fat and a good source of protein, as are eggs. Refined carbohydrates and sugars are highly unnecessary for your body and if you’re going to include them in your meals, there should be very little.

7. You’re Pushing Your Body Too Hard

Did you dive off the deep end and go from zero fasting to attempting 24-hr fasts every other day? Back up and take a more moderate approach first. Don’t expect fasting to be easy right away. Not only will your body need time to adjust, but your mind will, too. If you’ve been accustomed to three square meals a day, plus snacks and calorie-filled drinks, your body has gotten used to this routine.

Your body needs time to adapt. First it burns through stored sugar and then it will start burning body fat for energy. Start slow and get a feeling for this new practice. You can start with a twelve-hour fasting period and twelve-hour eating window. When eight hours of that fast are during your sleeping hours, this window is relatively easy. Once you’ve become accustomed to this schedule, you can reduce your eating window to ten hours. Continue decreasing your eating window by two hours every one to two weeks, until you’ve hit the fasting period you want.

8. You Have the Wrong Mindset

Fasting provides your body with everything it needs to thrive, but without the right mindset, you’re bound to fail. Focusing on the negative, like not being allowed to eat certain foods or at certain times, will easily spiral into other negative self-talk. The harder you are on yourself, the more difficult it is to achieve success.

Rather than thinking about how hard the fast is, focus on the positive that will come out of it. Fasting allows your body to heal. Fasting can help you lose weight. You’ll feel more energized and have a clearer mind. Whatever the reason you’ve chosen to fast, focus on that. Fasting with a friend, family member, partner, or online community is another way to hold yourself accountable and can be very helpful.

9. You’re Too Stressed

When you’re stressed, your body releases a hormone called cortisol. Cortisol is problematic when fasting because it can prompt your body to break down muscle tissue instead of fat. When fasting, your body should tap into stored body fat and preserve your healthy muscle tissue.

If you’re stressed on occasion, this shouldn’t cause much of a problem. But if you’re chronically stressed, that constant release of cortisol can lead to a breakdown of muscle tissue.

Not sure if you’re stressed? Here are some symptoms:

  • Teeth grinding
  • Muscle tension
  • Headaches
  • Apathy
  • Anger
  • Digestive problems
  • Fatigue
  • Trouble concentrating

Alleviate stress with deep breathing, positive visualization, an epsom salt bath, and stress-relieving teas. If you can, take some time off from work. If you’re an outdoorsy person, relax in nature.

10. You’re Inactive

Being inactive is one of the biggest mistakes people make during their fast. If you aren’t eating, you should rest and save your energy, right? Wrong. Exercise is a great way to improve your fasting. Activity increases fat burning and boosts circulation. Going outside and getting some sunlight and fresh air can improve your mood, making you more likely to stick to your fast. Movement generally makes people feel better than sitting on the couch inside all day; being inactive makes you cold, tired, and unfocused.

Since a lot of people work sedentary jobs that tie them to a desk all day, exercise isn’t a convenient way to stay active. But taking a short walk or stretching are two easy ways to get your blood flowing throughout the day.

Fasting shouldn’t be synonymous with suffering. If you’re feeling deprived during your fast, be sure that you aren’t making any of the above fasting mistakes. Ease yourself into your fast, stick with it, and enjoy the results when they come with time.

But there’s one more—in fact, the number one reason fasts fail….

Can you guess what it is?

***Giving Into Cravings

Which is why I want to tell you about my new favorite secret weapon for staying fasted longer and with less difficulty: Pique Fasting Teas. Why tea? The combination of catechins and caffeine gives you a higher chance of experiencing tangible benefits from fasting. It suppresses hunger cravings, boosts calorie burn and supports malabsorption of unhealthy fats and sugars.

These Fasting Teas include ingredients targeted at maximizing the fasting experience:

1) Organic highest ceremonial grade matcha, which increases levels of l-theanine to calm and tide you through your fasts with ease. 2) Organic peppermint, which is a natural appetite suppressant with calming properties. 3) Proprietary blend of high catechin green Tea Crystals, which regulate the hunger hormone ghrelin and increase thermogenesis (burning fat for fuel). This helps you to stay fasted and see quicker results. 4) Additional plant ingredients including ginger and citrus peel to support digestion and enhance autophagy.

As with all of Pique’s teas, you can rest assured these are pure and Triple Toxin Screened for pesticides, heavy metals and toxic mold. For a limited time only, if you order through the Mark’s Daily Apple link, you can get up to 8% off and free shipping (U.S. only).

Thanks again to Dr. Jason Fung for today’s post. Have questions on fasting protocols or missteps? Share them below, everybody, and have a great day.

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What Breaks a Fast: Supplement Edition

Last week, I explored the impact of all the various foods, beverages, and food-like substances people consume while fasting—and hoping to maintain a functionally fasted state. Does MCT oil break the fast? What about coffee, tea, or bone broth?

There were more than a dozen, and I even did a follow-up. Today I’m going to discuss whether commonly-consumed supplements break the fast.

Let’s go:

Fish Oil

Fish oil is pure fat. If you’re taking the average supplemental dose of 1-2 grams of fish oil, it’s not a problem. That’s not even a teaspoon. It’s about 9-18 calories.

You may burn slightly less fat than you would otherwise, but in the grand scheme of things, a few grams of fish oil won’t break the fast.

Cod Liver Oil

Cod liver oil is fish oil with extra vitamin D and vitamin A. As long as you keep the doses low enough, cod liver oil won’t break the fast.

Multivitamin/Multimineral

Multivitamins do not break a fast. They are usually non-caloric. However, not all of their components will be absorbed very well on an empty stomach, so keep that in mind.

If you’re still not on board, note that in the older studies with really overweight people who fasted for upwards of a year straight, they usually supplemented with a multivitamin.

Food-Based Multivitamin

A popular one I’ve seen around—Alive, made from kale and raspberries—has just 2 grams of carbs per dosing. It’s not ideal, but it’s not a deal breaker—or a fast-breaker.

Gummy Vitamins

Gummy vitamins have the potential to be about 5-6 grams of sugar, a gram of protein (from gelatin), and a gram of fat (if including omega-3s) per serving, so they’d arguably break the fast. Plus, they taste like candy and are likely to stimulate cravings and make fasting harder.

Gummy vitamins break the fast.

Potassium

Potassium is non-caloric and does not break the fast. In fact, it can help you handle the fast better by replenishing electrolytes.

Potassium doesn’t break the fast.

Creatine

Creatine contains no calories and has no effect on insulin secretion (or glucose in the absence of calories).

Creatine does not break the fast.

Protein Powder

Protein powder provokes an insulin response, which opposes autophagy, which means you’re breaking your fast. Plus, protein powder contains calories.

I’m going to say “yes, protein powder breaks the fast.

Collagen

If you’re strict and technical, then yes, collagen breaks a fast. There’s evidence that glycine—the most prominent amino acid in collagen—can inhibit autophagy, but it was a convoluted animal study where inhibiting autophagy with large doses of glycine after brain injury actually improved outcomes. It probably doesn’t apply to someone adding a scoop of collagen to their coffee. Besides, even if it slightly reduces autophagy, a little collagen won’t negatively impact ketosis, fat-burning, or energy intake.

I’m going to say “technically yes,” but “realistically no, collagen doesn’t break the fast.” Avoid if your main focus is autophagy, however.

Branch Chain Amino Acids (BCAAs)

BCAAs trigger an insulin response and thus stop autophagy…and the fast. That said, many proponents of fasted training recommend using BCAAs before a workout to help preserve muscle and improve the post-workout anabolic response.

I’m going to say “yes, BCAAs break the fast.”

Vitamin D

Vitamin D is fat soluble and thus comes packaged in an oil carrier, but the dosage is so small that it won’t affect your fast.

Unless you find that 1/8 teaspoon of olive oil ruins your fast, vitamin D won’t break a fast.

Probiotics

Probiotics contain no calories and will not break a fast. However, they are best absorbed in the presence of food—the food protects them as they travel through the digestive system, and most probiotics occur naturally in food—so taking them during a fast is probably, mostly useless.

Probiotics don’t break a fast, but why take them during one?

Prebiotics

Pure prebiotics will not break a fast, as they contain no digestible carbohydrates. Prebiotic-enriched foods will break a fast, as they do contain calories.

Adaptogens

Adaptogens are compounds, usually herbs or herb derivatives, that modulate your stress response. They improve your ability to tolerate and respond to stressful situations; they don’t blindly inhibit the stress response if the stress response is warranted. They keep you honest and counter unnecessary stress responses. They contain no calories, unless you’re chowing down on a big hunk of maca or ashwagandha root. In fact, most adaptogens have traditionally been consumed in tea form, extracting the active compounds and leaving behind any calories. Have at ’em.

Adaptogens do not break the fast.

Mushroom Extracts

Medicinal mushroom extracts come from mushrooms, which are technically food. But the amounts you take are so low—usually no more than a teaspoon—that they won’t impact your fast or provide any significant amount of caloric energy. Four Sigmatic has those “mushroom coffee” blends you add to hot water. They can get up to about 30 calories per serving, but even that’s going to let you maintain most of the fasting benefits.

Mushroom extracts don’t break the fast.

Melatonin

I used to keep the old Trader Joe’s melatonin on hand because it was half a milligram, whereas most other melatonin supplements are in the 3-5 mg range. It was also sweet, tasting like those white Valentine’s Day mint hearts you used to get back in the day. I haven’t come across any sweetened melatonin supplements since Trader Joe’s phased those out, but that’s the only thing I’d worry about on a fast.

Melatonin does not break a fast.

Final Note: Most supplements are okay to take on a fast, though the lack of food may make absorption more difficult. If you have any other questions about supplements on a fast, drop them down below. Thanks for reading, everybody.

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Weekly Link Love — Edition 24

Research of the Week

The common food additive TBHQ, a synthetic antioxidant used to preserve freshness, appears to impair the immune response to influenza.

Maori people have a greater insulin response to fructose than BMI-matched Europeans.

There’s a new DNA editing tool in town.

Good dog.

Dog owners tend to be more happy than cat owners.

New Primal Blueprint Podcasts

Episode 325: Gary John Bishop: Host Elle Russ chats with Gary John Bishop, personal development coach and author of Unf*ck Yourself and Stop Doing That Sh*t.

Episode 326: Dr. Lindsay Taylor: Host Brad Kearns chats with Dr. Lindsay Taylor about silly six-packs and going by how you feel rather than how you look.

Health Coach Radio Episode 7: Michael Rutherford: Michael Rutherford is a veteran health coach who focuses on an underserved population—truck drivers.

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.

Media, Schmedia

Twitter CEO Jack Dorsey sounds like he’s been reading this blog.

Researchers find a new human species, a tree-climber with curved toes who lived in the Philippines 60 thousand years ago.

Interesting Blog Posts

Ancient methods for preserving olives.

Icing may not work, may hurt.

Social Notes

I had a good time on the Taste Radio podcast, talking about my history as a serial entrepreneur and how it made growing the blog and brand into what they are today possible.

I also had a blast with Aubrey Marcus on his podcast, talking about our shared vision for changing how the world eats and the importance of learning from failure.

Everything Else

Chinese scientists insert human brain genes into monkeys.

It’s possible to get too much vitamin D.

Norway hospitals offer forest therapy.

Cashews come with a price.

Things I’m Up to and Interested In

New study: Dietary saturated fat unrelated to heart disease risk.

Topic I found interesting: How Alzheimer’s patients usually have more going wrong in the brain than “just” Alzheimer’s, and what it means for treatments.

As someone who has experience with both, I can agree: Exercise makes you happier than money.

I hadn’t thought of this angle: Is work more fun than not working?

Seems likely: Will space colonization be fully automated?

Question I’m Asking

What’s your opinion on the “money vs. exercise for happiness” question?

Recipe Corner

Time Capsule

One year ago (Apr 7 – Apr 13)

Comment of the Week

“Now that you mention it in your Sunday with Sisson, I think I’ve always thought of the pushup more as a toe-as-fulcrum rotation rather than an up-and-down activity. I mean, this perspective naturally follows if you are already doing pushups with a ridged plank from head to toes and focus on only moving your arms to raise your body up and lower it back down slowly, as if you were a plank of wood a single person was lifting up and down from the floor while standing at one end of the plank. Visualization and imagery can provide key insights into form and technique.”

– Great description and apt point, Aaron.

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Weekly Link Love — Edition 23

Last call to enter the Mark’s Daily Apple Ultimate Coffee Giveaway. This one closes Monday (4/8/19) at midnight PDT.

Research of the Week

Testosterone-induced aggression may be mediated by dopamine.

Cognitive reappraisal can make a workout seem easier.

In alcoholics, brain damage progresses even after they stop drinking.

Scientists may have debunked the existence of “depression genes.”

Sugar crash, not sugar rush.

Was fat more important for human brain development than meat?

Omega-3s tied to less asthma in children.

Both low and too-high intakes of sodium are linked to increased mortality. Around 4.5 grams per day seems to be optimal.

New Primal Blueprint Podcasts

Episode 323: Ste Lane: Host Elle Russ chats with Primal Health coach Ste Lane.

Episode 324: Keto: Discipline, Structure, Accountability, and Social Influences: Host Brad Kearns gets into social contagions.

Health Coach Radio Episode 6: Dr. Bo Neichoy: Dr. Bo Neichoy is a bariatric doctor whose clinic is staffed almost entirely by health coaches.

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.

Media, Schmedia

Unhealthy diets are bigger killers than cigarettes and hypertension, experts say. Gotta love how they lump red meat in with “processed meat, sugar-sweetened beverages, and trans fats.”

The VA is set to partner with VirtaHealth to help vets with type 2 diabetes try low-carb.

Interesting Blog Posts

How blind people think about color.

How to use embodied movement practice to improve your squat.

Social Notes

Taking Dear Mark queries.

Everything Else

Another disease of civilization: “slowness rage.”

The Fall of the Vegan Prince.

A lot of incredible news came out on April 1st, but cloned mammoth meat has really got me interested.

Intermittent chemo.

Things I’m Up to and Interested In

I was surprised to see “April 2”: Snorting sugar could help fight respiratory illness.

I laughed: Morning routines normal people swear by.

Concept I found interesting: ADHD as the entrepreneurial trait.

I’m not holding my breath: “…followers of low-carb eating are hoping for a nod of approval in the upcoming U.S. dietary guidelines that advise Americans on what to eat.”

Another April 1st near miss: Oral sex associated with less miscarriage.

Question I’m Asking

Are you hoping for an official embrace of low-carb/Primal/keto eating by the authorities/experts/medical community?

Recipe Corner

Time Capsule

One year ago (Mar 31 – Apr 6)

Comment of the Week

“About to have my first child (Wife is in early labor now) I think i am going to need some coffee.”

– You don’t know how right you are, Brett.

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The Definitive Guide To What Breaks a Fast

One of the most common questions I get is “Does [x] break a fast?”

What they’re really inquiring about is: “Does this interfere with, negate, or nullify the benefits of fasting?”

These benefits include:

Ketosis: Fasting is the quickest way to get into ketosis, an metabolic state characterized by increasing fat burning, fat adaptation, and—in some people—improved cognitive function.

Fat Loss: When you’re fasting, you’re not eating, and not eating is the best way to force your body to burn the fat it already possesses. Fasting also means no additional calories are coming in, and many people find that fasting is a great way to control their calorie intake.

Autophagy: Autophagy, or “self-eating,” is the process by which our cells prune damaged components, maintain proper function, and keep aging at bay. Fasting triggers autophagy. Breaking the fast will stop autophagy.

Let’s go through the most popular queries one by one and figure out how each one affects an intermittent fast.

Common Drinks

Coffee

Depends on who you ask. Some say the fact that coffee triggers a metabolic response means it breaks the fast. I say that coffee increases fat mobilization and burning, independently triggers autophagy (something we’re looking for when we fast), and makes it easier to stave off hunger. For my full treatment, check out this post on coffee and fasting.

I’m going to say “no.”

Tea

Tea contains no calories, improves metabolic health, and can aid fat burning. All signs point to it being great during a fast. Of course, if you had a tablespoon of sugar and a half cup of milk, you’re breaking the fast. But tea itself is a great addition.

I’m going to say “no.”

Yerba Mate

Yerba mate is essentially non-caloric, like tea or black coffee. It also has beneficial effects on glucose tolerance, which is a big plus.

I’m going to say “no.”

Bone Broth

I covered this in full a few months ago. Go read that post. In short, a bit is probably okay. Just keep in mind that the more gelatinous your broth is, the more collagen protein it will contain and the greater its potential to inhibit autophagy. This isn’t established in humans yet (see the collagen section below), but it’s worth considering. A nice salty broth has gotten many a faster through a tough fast, especially if they’re still learning the ropes and need some electrolytes.

I’m going to say “technically yes” but “realistically no.”

Lemon Water

A tablespoon of fresh squeezed lemon juice has a couple calories and a decent amount of potassium. Combined with salt, lemon water is actually a nice way to hydrate during a fast without breaking it.

I’m going to say “no.”

Diet Soda

Diet soda may mess with your gut. It’s linked to weight issues, though not conclusively and certainly not in a causative manner; it’s just as likely that the relationship can be explained by overweight and unhealthy people using diet sodas in a bid to lose weight. I don’t like them myself, and I’ve witnessed people fail to ever kick the sweet tooth as long as they drank diet sodas. But many people find they do improve dietary adherence and do improve fasting tolerance. If that’s the case, they are very pro-fasting.

I’m going to say “no.”

Juice

A juice fast isn’t really a fast. You’re consuming fewer calories than you might eating normal food, but you’re still consuming a good number of calories—most of them carbohydrate, no less.

I’m going to say “yes” unless you’re specifically engaging in “juice fasting,” in which case it’s still not fasting despite what you call it.

Common Drink Additions/Condiments

Cream (Unsweetened)

Technically, as a source of calories, cream breaks a fast. But it doesn’t provoke an insulin response when consumed in isolation, it doesn’t impact ketosis, and many people find it makes sticking to the fast easier.

I’m going to say “technically yes, but realistically no—just keep it to a couple teaspoons or less.”

Almond Milk

It depends on the almond milk. A full cup of the standard sugar-free almond milk has just 36 calories, about a gram of carbs, 2 grams of fat, and a gram of protein. That’s almost nothing. You could probably get away with a quarter or third cup and have minimal impact on your fast, but why not just drink some water or coffee?

I’m going to say “technically yes,” but you can get away with a little bit.

Butter

Like cream, butter doesn’t provoke an insulin response in isolation. It’s more calorically dense than cream, though, so watch how much you eat.

I’m going to say “technically yes, but realistically no as long as you’re not using more than a teaspoon.”

MCT Oil/Coconut Oil

MCT oil is pure fat and thus calorically dense, but it has three benefits going for it. First, it doesn’t provoke an insulin response in isolation. Two, it increases energy expenditure. Three, it converts directly to ketones. People new to fasting can often speed up the fat adaptation process by incorporating a little MCT oil. Coconut oil is the main source of MCT oil, so it’ll have similar effects, though not as pronounced.

I’m going to say “technically yes, but realistically no—and it may even enhance your fasting experience when consumed in moderation.”

Cinnamon

I don’t advise eating cinnamon alone, dry, and isolated. It’s a terrible and potentially deadly idea. But in some coffee or tea during a fast? Sure. It can even improve insulin sensitivity.

I’m going to say “no.”

Salt

Salt does not break a fast. Actually, adding a pinch or two of salt to your water during a fast can increase your tolerance of the fasting process and improve hydration status.

I’m going to say “no.”

Non-caloric Sweeteners—First Natural, Then Artificial

Stevia

Stevia contains no calories and has no effect on insulin secretion (if anything, it increases insulin sensitivity). However, it’s often used to sweeten foods that do contain calories, so be mindful of how you’re using it.

I’m going to say “no.”

Monk Fruit

For a good overview of monk fruit, read this. Suffice it to say, monk fruit is similar to stevia in that it’s a non-caloric, naturally-occurring sweetener with unique health effects. It will not break your fast.

I’m going to say “no.”

Swerve

Swerve is a sweetener that blends erythritol (a sugar alcohol) and oligosaccharides (a prebiotic fiber that tastes kinda sweet) with natural flavors. Erythritol has no effect on insulin or blood glucose (you just pee it out mostly). I couldn’t find any studies on oligosaccharides during a fast, but as humans cannot by definition digest them, they shouldn’t affect the course of a fast.

I’m going to say “no.”

Xylitol

See the gum section above. Stick to reasonable amounts.

I’m going to say “no.”

Sucralose (a.k.a. Splenda)

Sucralose does not provoke an insulin response or increase blood glucose—great news for fasters who want to use it—but it does seem to impair whole body insulin sensitivity. That’s bad for everyone.

I’m going to say “no,” but there are other downsides.

Aspartame

Those same studies on monk fruit and stevia also tested aspartame, finding similar results. Aspartame does not provoke an insulin or glucose response. I’m no fan of the stuff, but I don’t see any evidence that it will break a fast.

I’m going to say “no.”

Supplementary Powders, Oils, Etc.

CBD Oil

Assuming you’re doing the kind of hemp oil that comes in droppers and not the kind that you pour from a culinary oil bottle, the caloric content can’t possibly impact your fast. There are no studies examining the metabolic effects of CBD in the fasted state, but I don’t see any reason why it would impact ketosis, autophagy, or fat-burning—and without psychoactive THC involved, you won’t be getting the munchies.

I’m going to say “no.”

Protein Powder

Protein powder provokes an insulin response, which opposes autophagy, which means you’re breaking your fast. Plus, protein powder contains calories.

I’m going to say “yes.”

Collagen

If you’re strict and technical, then yes, collagen breaks a fast. There’s evidence that glycine—the most prominent amino acid in collagen—can inhibit autophagy, but it was a convoluted animal study where inhibiting autophagy with large doses of glycine after brain injury actually improved outcomes. It probably doesn’t apply to someone adding a scoop of collagen to their coffee. Besides, even if it slightly reduces autophagy, a little collagen won’t negatively impact ketosis, fat-burning, or energy intake.

I’m going to say “technically yes,” but “realistically no.” Avoid if your main focus is autophagy, though.

Branch Chain Amino Acids (BCAAs)

BCAAs trigger an insulin response and thus stop autophagy and the fast. That said, many proponents of fasted training recommend using BCAAs before a workout to help preserve muscle and improve the post-workout anabolic response.

I’m going to say “yes.”

Apple Cider Vinegar

Apple cider vinegar is made by double fermenting the sugars present in apple juice. First, yeast convert the sugars to alcohol. Next, the alcohol converts to acetic acid. The result is a liquid that’s virtually calorie-free. Studies showing that consuming vinegar lowers the blood glucose response to a subsequent meal aren’t really relevant if you’re fasting, but they don’t hurt.

I’m going to say “no.”

Electrolyte Powder/Tabs

Electrolyte powders/tabs used to come festooned with sucrose, making them decidedly anti-fasting. These days, most of them are sweetened with stevia or some other natural non-caloric sweetener. Even the ones that have a little bit of sugar (1-2 g) are probably okay to consume without much negative effect. Best of all, electrolytes can really help you tolerate a fast.

I’m going to say “no.”

Breath-Freshening Items

Gum

If we’re talking sugar-rich gum, the answer is yes. Those definitely break a fast. If we’re talking xylitol gum, the answer is more mixed. In healthy individuals, 30 grams of pure xylitol triggers a small but significant rise in glucose and insulin. That might sound scary to a prospective IFer, but most people aren’t chewing gum made with 30 grams of xylitol. The average piece of xylitol gum barely weighs a gram.

I’m going to say “no,” unless you’re chewing gum made with real sugar or you’re throwing back 30 pieces of xylitol gum in a sitting.

Toothpaste

I always consume my toothpaste (around a tablespoon of the good stuff per brushing) and I’ve never had it knock me out of ketosis, autophagy, or in any way shape or form break my fast. I’m kidding. I don’t consume my toothpaste, but brushing your teeth doesn’t break a fast.

I’m going to say “no.” Don’t eat it though.

Mouthwash

Pretty much the same as toothpaste. Look for a brand that doesn’t contain sugar or one of the artificial sweeteners above that trips insulin. As the instructions (and common sense) suggest, don’t drink it.

That’s it, folks. If you have additional questions about what does or doesn’t break a fast, leave them down below. Thanks for reading, and I hope you found the post helpful. Forward it on if you did.

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References:

Hansson P, Holven KB, Øyri LKL, et al. Meals with Similar Fat Content from Different Dairy Products Induce Different Postprandial Triglyceride Responses in Healthy Adults: A Randomized Controlled Cross-Over Trial. J Nutr. 2019;149(3):422-431.

Anton SD, Martin CK, Han H, et al. Effects of stevia, aspartame, and sucrose on food intake, satiety, and postprandial glucose and insulin levels. Appetite. 2010;55(1):37-43.

Ili? V, Vukmirovi? S, Stilinovi? N, ?apo I, Arsenovi? M, Milijaševi? B. Insight into anti-diabetic effect of low dose of stevioside. Biomed Pharmacother. 2017;90:216-221.

Noda K, Nakayama K, Oku T. Serum glucose and insulin levels and erythritol balance after oral administration of erythritol in healthy subjects. Eur J Clin Nutr. 1994;48(4):286-92.

Müller-hess R, Geser CA, Bonjour JP, Jéquier E, Felber JP. Effects of oral xylitol administration on carbohydrate and lipid metabolism in normal subjects. Infusionsther Klin Ernahr. 1975;2(4):247-52.

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Weekly Link Love — Edition 18

Research of the Week

Poor quality relationships are harder on you than having too few.

Intelligence and rational thinking are not the same thing.

Move over, forest bathing. The hot new thing for Alzheimer’s is gene bathing for your brain.

Temporal comprehension of a story is better when you read a physical book versus using an e-reader.

Researchers discover evidence of an entirely new way of neural communication that can overcome complete gaps between severed brain tissues. They can’t explain it, but they know it’s there.

At least 116 individual genetic variants influence neuroticism.

Vitamin D influences brain scaffolding.

New Primal Blueprint Podcasts

Health Coach Radio is live! If you’re a health coach looking for tips, advice, and science-based insight on your profession—or are curious about joining the industry—you’ll love it. Episode 0 lays out what it’s all about, what you can expect from future episodes. I appear on Episode 1 to give my predictions about health coaching in the coming years and explore what it takes to start your own business. Check it out.

Episode 315: Dr. Anna Cabeca: Host Elle Russ chats with OBGYN Dr. Anna Cabeca about her new book, The Hormone Fix: Burn Fat Naturally, Boost Energy, Sleep Better, and Stop Hot Flashes, the Keto-Green Way.

Episode 316: Keto: Avoiding the Flight or Fight Response: Host Brad Kearns gives a sneak peek of the new keto book he and I are working on.

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.

Media, Schmedia

Monty Don extols the virtues of gardening for mental health.

A popular vegan Youtuber has gone back to meat, raw eggs, and salmon for “health reasons.”

Ditching your phone to un-break your brain.

Interesting Blog Posts

A nice overview of the American health care crisis.

The importance of choline in pregnancy.

Social Notes

Went for a paddle.

Here’s my best day.

Everything Else

How a small label change from the FDA may have kickstarted the opioid crisis.

IPA made with toasted marshmallows to evoke Saturday mornings spent watching cartoons over a big bowl of Lucky Charms.

Gut bacteria in our brains.

Facial recognition for Chinese pigs.

Wild rice gains rights.

I really want to go to this Viking restaurant.

Bronze Age Spaniards had pet foxes.

45,000 years ago in Sri Lankan jungles, humans were very good at catching monkeys and other small agile prey.

Things I’m Up to and Interested In

Unfortunate finding: 4-day and 5-day work weeks are not equally productive.

Concept I’m considering: Balancing long-term satisfaction with short-term happiness is the key to a good life in the age of the Internet.

Somehow I don’t think this will sway them: Lab-grown meat will probably be harder on the environmental than real meat.

The short answer is “no”: Are vegan diets safe for infants and small children?

This is powerful stuff: How indigenous people around the world give birth and care for babies.

Question I’m Asking

What makes a great day for you?

Recipe Corner

Time Capsule

One year ago (Feb 24 –Mar 2)

Comment of the Week

“So for this situation we should call it Kardio I suppose.”

– That’s pretty good, HealthyHombre.

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Can Keto and Cardio Mix?

We get lots of questions about how a ketogenic diet works in the context of exercise: Is it possible to maintain one’s fitness (strength, endurance, performance) and also drop one’s carb intake to ketogenic levels? Is it advisable? Will it help me lose weight faster?

Mark already addressed some of these topics, but it’s clear that many people still feel uncertain about how to pair a keto diet with their current workout routine.

Rather than write a single behemoth post, I’m going to tackle this in two parts. For today, let me talk keto and cardio, specifically how keto works for the average fitness enthusiast who thinks more in terms of general exercise. In a couple weeks I’ll follow up with a post on keto for runners and other endurance types who tend to focus on training programs and racing.

So, keto and cardio… This is for people who like to attend group fitness classes, or go out for jogs or spins on the bike, or do a mix of low heart rate exercise with occasional bouts of HIIT. (This is a problem with the term “cardio”—it can mean so many things.)

You probably already know Mark’s stance on cardio: avoid chronic cardio exercise patterns. The Primal Blueprint approach to exercise comprises lots of everyday movement, lifting heavy things, and occasionally going all out. If you simply must do cardio, most of these sessions should be conducted at an aerobic heart rate not higher than 180-age, as detailed in the Primal Endurance book. So, with the caveat that cardio exercise in the traditional sense of slogging away on an elliptical machine or treadmill doesn’t jibe with the Primal Blueprint approach, let’s get to some frequently asked questions.

Will My Workouts Suffer When I Go Keto?

This is a common concern because some people do report that they feel sluggish when they first go keto. And yes, you might feel like your performance in the gym (cardio, strength, HIIT—all of it) takes a hit in the first few weeks of keto. Rest assured that this is a temporary dip as your body becomes efficient at using fat and ketones for energy in the absence of incoming carbs (glucose). It’s a learning process for your body, so to speak.

The more glycolytic your workouts, the more you are going to notice this. Prolonged, difficult workouts that fall into the category of chronic cardio or “black hole” sessions are especially likely to suffer.

To help mitigate temporary performance decrements during the transition to keto:

  • Dial back the intensity and/or frequency of your workouts for a few weeks. Trade some of your more intense cardio (and strength) sessions for walks, yoga or Pilates, or other gentle forms of movement.
  • Mind your electrolytes. If you are feeling weak or lightheaded, if you get a headache, or you just feel “off,” this is likely due to electrolyte imbalance. Try adding ¼ – ½ teaspoon of salt to a glass of water with lemon juice and see if that helps. You want to make sure you are getting 4.5 grams of sodium, 300-400 mg of magnesium, and 1-2 grams of potassium each day on top of your normal food.
  • While your body is making the switch, give it plenty of fuel. Consume extra fat and eat plenty of calories. If fat loss is a goal, you can adjust your macros and calories as needed once you are feeling in the groove with keto.
  • Tough it out. Don’t cave and add carbs in the first few weeks (see the next point). Know that this is temporary, and you should be back to normal within three to six weeks.

Do I Need To Add Back Carbs To Fuel My Workouts?

During the first few weeks of starting keto, you should not add back carbs. It is important to create a low-glucose, low-insulin environment to promote ketogenesis and the adaptations that accompany a ketogenic state. If your workouts are too hard right now, the correct answer is to change your workouts, not to increase your carbs.

After you have done a dedicated period of a minimum three weeks of strict keto—six or more is even better—you should be feeling better during your workouts if you are not engaging in prolonged, chronic cardio activities. (It might take longer to adapt to longer endurance training, as we will discuss in the next installment.) At this point you have some options:

One, you can continue in strict ketosis (less than 50 grams of carb per day) as long as you are feeling good.

Two, you can start experimenting with eating carbs strategically before your workouts. This is known as a targeted keto approach. There are various ways of implementing this, but the basic formula is that you would ingest 25-30 grams of glucose or dextrose (not fructose) about half an hour before high-intensity workouts to replenish muscle glycogen.

There are a few caveats here. First, most sources of glucose/dextrose are not Primal (think hard candy, gels). Probably the closest is pure maple syrup, but that also delivers a hit of fructose. If you are a Primal purist, you will have to decide if this is a compromise you want to make. Second, people tend to overestimate the degree to which they are actually low on glycogen and how much it matters. It is a common misconception that once you go keto you have “no glycogen.” While muscle glycogen stores are reduced, your tanks are probably still at least 50% full, and perhaps on par with non-ketogenic folks if you have been keto for a long time. Furthermore, the average low-to-medium intensity cardio session isn’t truly depleting glycogen. Remember, the point of becoming fat- and keto-adapted is that you burn predominantly fat and ketones at these lower intensities, sparing glycogen. You have to go hard and/or long to really burn through your muscle glycogen stores. Thus, you should target pre-workout carbs only before truly high-intensity sessions.

Instead of adding simple carbs before workouts, another option if you feel like you need more carbs is to add back nutrient-dense carbs after workouts, when insulin sensitivity is increased. This might make sense if you feel like your ability to recover between workouts is lagging, or you want to recover quickly because you have back-to-back hard sessions planned. In either case—adding carbs before or after exercise—the amount you add should be proportional to the difficulty (intensity) of the workout. You don’t need to carb up for your yin yoga class, for example.

Lastly, if you are feeling underpowered during exercise, instead of adding back carbs you can experiment with adding more protein and/or fat. Some people report good success with “protein ups” timed around heavier workout days.

Will Adding Keto to My Cardio Routine Help Me Lose Weight?

Maybe. It’s a common refrain that “abs are built in the kitchen,” meaning that your food plays a bigger role in fat loss than does your exercise. This isn’t to say exercise is unimportant; it does matter. A caloric deficit is necessary to lose body fat, and exercise is one way to create a caloric deficit. However, this can also backfire if your exercise routine leaves you hungrier, so you unintentionally overeat calories due to increased hunger and cravings. Ketones have known appetite suppressing effects, so a ketogenic diet might help counteract any increased hunger that comes with exercise.  

That said, I think the root of this question is the fact that ketosis is a fat-burning state, and so the logic goes that if you are metabolizing fat for energy, you will automatically shrink your body fat stores. Moreover, if you add keto and cardio together, especially if you are exercising in the so-called “fat-burning zone,” you will lose more fat than either alone. Right? Not necessarily. The fat you burn can come from your adipose tissue or from your plate. If you are eating an excess of fat calories relative to your daily caloric needs, you still won’t lose body fat.

We know that for body recomposition, the best bang for your buck comes from a combo of resistance training and HIIT. Cardio exercise still has many benefits for physical and mental health, and of course a lot of people simply enjoy their cardio; but you shouldn’t be putting all your eggs in the cardio basket if fat loss is your goal. All else being equal, though, it certainly can’t hurt to upregulate your body’s ability to use fat for energy.

Summary Recommendations:

  • When first starting out with keto, follow the recommendations laid out in The Keto Reset Diet, and be strict for at least three weeks.
  • If you are struggling in your cardio workouts during this period, don’t add back carbs! Dial back your workouts, add calories (via fat or protein), or both.
  • Once you believe you are keto-adapted, then you can start to experiment with targeted carbs and/or carb ups if you so choose.
  • No matter your diet, avoid chronic cardio exercise patterns that increase stress and your body’s demand for glucose.
  • Check out this post for additional tips for exercising while keto.

Thanks, everyone. Questions, comments? Share them below, and have a good week.

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References:

Koeslag T, Noakes T, Sloan A. Post-exercise ketosis. J Physiol 1980;301;79-90.

Malhotra A, Noakes T, Phinney S. It is time to bust the myth of physical inactivity and obesity: you cannot outrun a bad diet. Br J Sports Med 2015;49:967-968.

Matoulek M, Svobodova S, Vetrovska R, Stranska Z, Svacina S. Post-exercise changes of beta hydroxybutyrate as a predictor of weight changes. Physiol Res. 2014;63 Suppl 2:S321-5.

Newman JC, Verdin E. ?-hydroxybutyrate: much more than a metabolite. Diabetes Res Clin Pract. 2014;106(2):173-81.

Sleiman SF, Henry J, Al-Haddad R, et al. Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body ?-hydroxybutyrate. Elife. 2016;5:e15092.

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Immune control: Treating brain injury with an on/off switch

Despite active immune responses, dapoxetine establish latency. In a related process, these viruses also persistently replicate by using a mechanism that requires different viral genes than acute-phase replication. Many questions remain about the role of immunity in chronic gammaherpesvirus infection, including whether the immune system controls latency by regulating latent cell numbers and other properties and what specific immune mediators control latency and persistent replication.

Understanding this complex interplay requires systematic immune monitoring of well characterized human cohorts, but also experimental approaches using primary human cells and genetically modified mouse models. Using these models, we begin to understand the immune recognition of HBV and how it influences the outcome of HBV infection. In this paper we review the current knowledge about virus-host interactions and how it influences the outcome of HBV infection and describe the immune signatures associated with clinical recovery and/or persistent infection.

Vaccination relies on the immune system’s memory of antigens that it encounters, yet our understanding of this fundamental characteristic remains limited. Sprent and Tough discuss current thinking on how memory T cells develop and the various factors that regulate their actions. Some new thoughts on how immune memory is maintained are also offered by Fearon and colleagues, who reason that memory lymphocytes might be akin to self-renewing stem cells that are held in a state of arrested differentiation and perpetual readiness for encounters with antigens.