Does Red Meat Give You Colon Cancer?

Have you heard? There’s a new “red meat will kill you” study. This time, it’s colorectal cancer.

Here’s the press release.

Here’s the full study.

I covered this a couple Sundays ago in “Sunday with Sisson.” If you haven’t signed up for that, I’d recommend it. SWS is where I delve into my habits, practices, and observations, health-related and health-unrelated—stuff you won’t find on the blog. Anyway, I thought I’d expand on my response to that study here today.

How the Study Was Conducted

It’s the basic story you see with most of these observational studies. Around 175,000 or so people were asked to recall what they ate on a regular basis—a food frequency questionnaire. This is the exact questionnaire, in fact. The research team took the answers, measured some baseline characteristics of all the subjects—socioeconomic status, exercise levels, whether they smoked, education level, occupation, family history of colorectal cancer, and a few others—and then followed up with participants an average of 5.7 years later to see how many had developed colorectal cancer.

What the Study “Showed”

Those who had moderate amounts of red meat had a 20% higher chance of getting cancer.

And in the end, the increased risk was a relative risk. It wasn’t a 20% absolute increase in risk. It was a relative increase in risk. The subjects started with a 0.5% risk of getting bowel cancer. In those who ate the most processed meat and red meat, that risk increased 20%—to 0.6%!

From 0.5 to 0.6%. Sure, that’s an increase, but is it something to overhaul your entire diet for? To give up the best sources of zinc, iron, B vitamins, protein, carnosine, creatine? All that for a measly 0.1% that hasn’t even been established as causal?

Study Findings Most News Outlets Won’t Include

One head scratcher that leaps out: the link between unprocessed red meat and colon cancer was not actually statistically significant. Only processed meat was significantly linked to colon cancer.

Another head scratcher: red meat, whether processed or unprocessed, had no significant association with colorectal cancer in women. Why didn’t they highlight the fact that in women, eating red meat was completely unrelated? That’s half the world’s population. That’s you or your mom, your daughter, your grandmother, your girlfriend. And unless they were to look at the full study and read the fine print, they’d never know that red meat actually had the opposite relationship. You’d think the authors would want to mention that in the abstract or see that the press releases and media treatments highlighted that fact.

It’s probably because mentioning that red meat was neutral in women and had no statistically significant link to colon cancer in men and women would have destroyed their case for red meat as an independent carcinogen. See, carcinogens are supposed to be carcinogens. There are many meaningful differences between men and women, but a poison is a poison.

What’s the proposed mechanism for red meat triggering colon cancer in men but not in women? If they didn’t have one (and I imagine they wouldn’t have mentioned it if they did), then there’s probably something else going on.

Besides, the literature is far from unequivocal.

What Other Research Says About Red Meat and Bowel Cancer

In analyses that include consideration of cooking methods and other mitigating factors, red meat has no relationship with colon cancer.

Or what about this study, where colon cancer patients were more likely to eat red meat, but less likely to have type 2 diabetes? Should people avoid red meat and work toward getting diagnosed with type 2 diabetes?

Or how about this study, which found no difference in colorectal cancer rates between people who ate red meat-free diets and people who ate diets containing red meat? Shouldn’t the diet without any red meat at all have some effect?

Or this classic study, where rats on a bacon-based diet had the lowest rates of colon cancer. In fact, bacon protected them from colon cancer after they were dosed with a colon cancer promoter, while rats on normal “healthy” chow were not.

The Blind Spot In Red Meat Research

I don’t need to go into all the confounding factors that might predispose conventional red meat lovers to bowel cancer. Nor will I mention that it’s impossible to fully control for variables like the buns and bread and fries you eat the red meat with and the industrial seed oils it’s cooked in.

That last bit is crucial: the seed oils. It’s what nearly every cancer researcher misses. It’s not just a minor variable; it’s quite possibly the most important determinant of whether meat is carcinogenic in the colon or not. Heme iron—the compound unique to red meat that usually gets the blame for any increase in cancer—is most carcinogenic in the presence of the omega-6 fatty acid linoleic acid.

In one study, feeding heme iron to rats promoted colon cancer only when fed alongside high-linoleic acid safflower oil. Feeding MUFA-rich and far more oxidatively-stable olive oil alongside the heme prevented the colon carcinogenesis.

Another study had similar results, finding that meats containing medium to high amounts of heme—beef and beef blood sausage—promoted carcinogenic conditions in the colon when the fat sources were linoleic acid-rich corn and soybean oil.

And most recently is this paper. Mice were split into three groups. One group got heme iron plus omega-6 PUFA (from safflower oil). One group got heme iron plus omega-3 PUFA (from fish oil). The third group got heme iron plus saturated fat (from fully hydrogenated coconut oil, which contains zero PUFA). To determine the carcinogenicity of each feeding regimen, the researchers analyzed the effect the animals’ fecal water (which is exactly what it sounds like) had on colon cells. The fecal water of both PUFA groups was full of carcinogenic indicators and lipid oxidation byproducts, and exposing colonic epithelial cells to fecal water from PUFA-fed mice was toxic. The coconut oil-derived fecal water had no markers of toxicity or lipid oxidation.

I never see these (animal) studies cited in observational studies of meat and colon cancer. I think that’s a huge blindspot, and it’s one of the reasons I rarely put any stock in these scary-sounding studies.

That’s it for today, folks. Thanks for reading. Now go enjoy a steak.

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References:

Bylsma LC, Alexander DD. A review and meta-analysis of prospective studies of red and processed meat, meat cooking methods, heme iron, heterocyclic amines and prostate cancer. Nutr J. 2015;14:125.

Alsheridah N, Akhtar S. Diet, obesity and colorectal carcinoma risk: results from a national cancer registry-based middle-eastern study. BMC Cancer. 2018;18(1):1227.

Rada-fernandez de jauregui D, Evans CEL, Jones P, Greenwood DC, Hancock N, Cade JE. Common dietary patterns and risk of cancers of the colon and rectum: Analysis from the United Kingdom Women’s Cohort Study (UKWCS). Int J Cancer. 2018;143(4):773-781.

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Fasting Gave Me a Better Approach To Maintain My Weight Without Restrictions

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!

My name is Garland Niblett and I am a nutritional consultant and co-owner of Fit & Faithful Wellness. This is my story.

In 2011 I was admitted to the Veterans Affairs hospital and diagnosed with PTSD. From there, I basically gave up on myself, both mentally and physically. I was once a 195 lbs., 3% body fat natural bodybuilder; and then, while I was in the VA hospital, I became a 301 lbs. “unrecognizable” individual. I had become overweight and was even classified as morbidly obese.

Benztropine, diazepam, cholecalciferol, Etodolac, methocarbamol, mirtazapine, amlodipine, aripiprazole, prazosin, quetiapine, and simvastatin. These were all prescribed to me while I was in the hospital. I had plenty of psychiatrists and psychologists but ultimately, I connected with a holistic therapist who helped me accept what happened to me in my past and how to manage my PTSD. Since 2016, I have managed to use only quetiapine for sleep.

By accepting my PTSD, I was able to move forward with my life. My therapist taught me how to be mindful about what was around me, emotionally, mentally and of course, nutritionally. I was more conscious of what I was putting in my body. In 246 days, I was able to lose 105 lbs. I felt great, but I fluctuated with my weight and wanted to find a better approach to maintaining my weight without restrictions. I was used to consuming over 5,000 calories, spread out during the day, eating most of my calories in the morning. During this time, I wasn’t overweight, but I still had chronic pain throughout my body. My stomach was constantly upset, bloated and felt sore from my workouts and daily movement.

Looking into the research on Intermittent Fasting, I became fascinated and wondered if this would work for me. And so, the journey of fasting began.

I started with the basic 16/8, giving up my 2,000-caloric breakfast. I struggled and was a bit hungry and moody but was persistent and did not give into my cravings. Soon thereafter, I was doing 18/6, 20/4 and now, 24-48 hours fasting. I noticed a momentous change with my body composition but most importantly, I felt great. I had more energy, an incredible amount of endurance and basically no soreness or inflammation. I had become Fat Adapted. No hunger cravings, stable mood and plenty of energy. My average blood sugar levels are 64 ml/dl, with mental clarity, balanced hormones, low inflammatory levels and a healthy stress response. My current weight is 195 lbs. and I have maintained this weight for the past two years.

Intermittent Fasting has been part of life now for over two years. Before intermittent fasting, my weight fluctuated from 220-240 lbs. I would have never thought it would be possible for me to run 8-10 miles in the morning and not desire food until later in the evening. No muscle loss but plenty of body fat reduction. I truly believe that fasting may be an alternative for individuals that are seeking healthier lifestyle options, weight loss, better mood and mental awareness.

I recommend intermittent fasting to my clients that struggle with weight loss, type 2 diabetes, and if they have chronic inflammation. I also recommend to my clients that they read The Primal Blueprint and The Keto Reset Diet, which talk about fasting and being mindful of the nutrients you choose to put in your body.

Intermittent fasting is amazing and since the beginning of this year I no longer have to rely on Quetiapine to help me sleep. I am now 100% medication free, thanks to intermittent fasting.

The readers featured in our success stories share their experiences in their own words. The Primal Blueprint and Keto Reset diets are not intended as medical intervention or diagnosis. Nor are they replacements for working with a qualified healthcare practitioner. It’s important to speak with your doctor before beginning any new dietary or lifestyle program, and please consult your physician before making any changes to medication or treatment protocols. Each individual’s results may vary.

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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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I’m Hell-Bent On Creating a Healthier Fire Service

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!

I was over being a factory worker. I spent my lunch breaks smoking cigarettes and eating 5 dollar footlongs. Who knew that footlong subs weren’t healthy? I wanted to reclaim my health and find a more exciting career. Being a firefighter seemed cool and different. When I decided to take the upcoming firefighter exam for the city of Columbus, I knew that the physical portion would be difficult. I hadn’t worked out since childhood sports and smoked a pack a day. That’s when I started researching the optimal diet and workout routines. Like everyone in the early stages of their health journey, I tried everything.

Jogging had become my salvation. No matter how long my workday was, or how physically drained I was after clocking out, I would run 3 or 4 miles on the trail. I was trying to out-train my diet. I felt prepared to take on the physical exam after months of cardio training and zero strength training. The test was pretty easy besides dragging a 200 lb dummy around. I did fine, but I didn’t stand out. Onward and upward. I was now “skinny-fat” with no idea how to eat. It didn’t take long to realize that the fad diets and chronic cardio weren’t going to cut it. I wasn’t seeing the results I had hoped for. This was motivation for me to get better—to get stronger and wiser.

Thank you, Google, for introducing me to Mark’s Daily Apple and the Primal community. When I discovered the treasure that is the Primal Blueprint, everything got easier. It provided clarity on how to eat and move like I was meant to. Implementing the lifestyle laws that Mark created was easy: lift heavy shit a couple times a week and keep it moving. I ditched the 5Ks in favor of HIIT and hill sprints. My kettlebell and cobweb-covered pull up bar in the basement were the only gym equipment I needed. Once I could do twenty strict pull ups in a row, I began adding weight by hanging a bowling ball in the bag over my shoulders like a backpack. I quickly worked my way up to “mastery level” on the PEMs.

My diet was simplified. I found three or four go-to Primal meals and cycled through them weekly. Steak and cauliflower mash with greens is still a favorite of mine. No more Miller High Life, more Cab Francs. No more cigarettes, more kettlebell swings. Friends and family noticed my transformation and from there I became their ancestral health advocate (AHA). I became deeply passionate about ancestral health and teaching people how to eat. Once you go Primal there is a tendency to want to pay it forward.

Throughout this shift towards a Primal lifestyle, I was still grinding and testing my way into the fire service. I finally landed a job! I was officially a full-time firefighter and paramedic. Things did not get easier from there, however. I had job stability and my money problems went away, but my health suffered—mainly my sleep quality. Like most first responders, I developed shift work sleep disorder and chronic stress. My days off were now dedicated to recovery from sleep deprivation. Grumpy and tired was my new default. I realized early on that this would not be a sustainable career path if I valued my health and longevity.

Around the same time, Mark developed the Primal Health Coach Institute. After many discussions with admissions director Laura Rupsis, I decided to pull the trigger and enroll in the course. Four months later I was certified, smart AF, and ready to coach.

Now my off-duty days are spent researching and coaching first responders (my niche) to better health. I teach firefighters across the nation how to survive the fire service by incorporating ancestral health techniques. My philosophy on health has now been published in Firehouse Magazine and EMS World Magazine. If you can get through to firefighters, you can get through to anyone. Eventually, hangry firefighters will be a thing of the past and the fat-adapted will prevail. So here I am, having steak and eggs with broccoli and having a lasting impact on the fire service.

Ancient philosophy has provided me with a guide to the good life. The Primal Blueprint and ancestral health have provided me with a guide to the healthy life. By combining the two, I provide clients with peace of mind and peace of body. Mark Sisson wants to change the lives of 100 million people. I am hell-bent on creating a healthier fire service. Here’s to a life full of good food and gratitude. Your health, your hands.

Nick Holderbaum

Primal Health Coach profile

The readers featured in our success stories share their experiences in their own words. The Primal Blueprint and Keto Reset diets are not intended as medical intervention or diagnosis. Nor are they replacements for working with a qualified healthcare practitioner. It’s important to speak with your doctor before beginning any new dietary or lifestyle program, and please consult your physician before making any changes to medication or treatment protocols. Each individual’s results may vary.

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Weekly Link Love — Edition 25

Research of the Week

Statins linked to diabetes, again.

A ketogenic diet helps relapsing MS patients lower fatigue, reduce depression, and lose weight.

Indigenous Australians traded pottery with Papua New Guineans for thousands of years.

A fatty liver epidemic in young people is bad news and simply shouldn’t be happening (but is).

Narcissists make better citizens.

New Primal Blueprint Podcasts

Episode 328: Dr. Loren Cordain: Host Elle Russ chats with the creator of the original Paleo Diet, Dr. Loren Cordain PhD.

Episode 329: Dr. Lindsay Taylor: Host Brad Kearns chats with Dr. Lindsay Taylor, PhD and co-author of the Keto Passport.

Health Coach Radio Episode 8: Kama Trudgen: Kama Trudgen runs health retreats for the indigenous Yolngu people of Northeast Arnhem Land, Australia, helping them reclaim health using traditional diets and lifestyle practices.

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

Not grazing on junk all day long is “starving,” apparently.

Irish soil contains microbes that fight drug-resistant bacteria.

Interesting Blog Posts

Ancient animal urine could reveal the history of animal agriculture.

A sandwich with pickles instead of bread? Sure, why not.

Social Notes

Enter now to win a Cuisinart Airfryer, $200 in Primal Kitchen loot, and a $100 gift card to PrimalKitchen.com.

My quick, effective road workout when I’m traveling light without gym access.

Everything Else

This seems like a good use of GMO technology: blight-resistant American chestnut.

Google pulls the plug on its glucose-monitoring “smart lens” they’d been working on since 2014.

Raw eggs in milk, carrots, steak, lamb chops, liver, and the odd ice cream sundae: Marilyn Monroe’s diet.

Things I’m Up to and Interested In

Virtual health summit you should attend: Habits to Thrive, a 7-day summit hosted by Deanna Wilcox, Anya Perry, and 17 other Primal Health Coaches.

Study I found interesting: Drug and alcohol use and life satisfaction.

Positive side effect I’m hoping develops: Scientists are mad that T-rex bones are going for millions on eBay rather than remain in the public trust. But what if high prices and private sales spur more finds and more discoveries?

I think there are better ways to lose weight: Than swallowing 3-dimensional cellulose matrix tabs that expand in your stomach and take up space.

I can’t think of a better way to gain weight: “…eating behaviors of modern consumers may be guided by a predominant goal to attain the subjective experience of complete fullness.”

Question I’m Asking

Some high-end coffee places are banning milk, sugar, and cream, arguing that the extra additions detract from the true coffee experience. What do you think of food establishments with draconian policies like that—snobs or real artisans?

Recipe Corner

Time Capsule

One year ago (Apr 14– Apr 20)

Comment of the Week

“What about a half scoop of metagenics thermaphaseprotein detox powder in water? Will this break my fast?”

– Depends which ThermaPhase tier you’ve reached. Tier 2 and below you’d better go a quarter scoop if you want to maintain the fast. Tier 3 ThermaPhase or higher actually extracts calories from you.

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Keto and the Menstrual Cycle: Is There Reason To Worry?

It seems every “keto for women” forum abounds with stories about menstrual cycles gone wild in the first few months of keto. Irregular cycles, breakthrough bleeding, and periods lasting much longer than normal are common complaints. Sometimes these stories are cited as evidence that keto isn’t good for women, at least not premenopausal women, and that we need carbs for healthy hormones. Yet, many women don’t notice any changes in their menstrual cycles at all, while others report improvement in PMS symptoms and cycle regularity from the get-go.

What gives? Why do some women’s cycles apparently become wacky when they start keto, while others feel like keto is the key to period bliss? Can keto “mess up” the menstrual cycle?

We know that diet—what and how much we eat—can profoundly affect our hormones. This is true for both women and men. One of the reasons people are so excited about ketogenic diets is specifically because keto shows promise for helping to regulate hormones and improve cellular sensitivity to hormones such as insulin and leptin.

At the same time, women’s hormones are especially sensitive not only to dietary changes but also to downstream effects such as body fat loss. Furthermore, one of the ways women’s bodies respond to stressors is by turning down the dial on our reproductive systems. It’s reasonable to hypothesize, then, that women might have a tougher time adapting to or sustaining a ketogenic diet. Keto can be stressful depending on one’s approach, and that might negatively impact women’s reproductive health. But do the data actually bear that out, or is so-called “keto period” more misplaced hype than genuine fact?

Note that throughout this post, I’m going to use the term “reproductive health” to refer to all aspects of women’s menstrual cycle, reproductive hormones, and fertility. Even if you aren’t interested in reproducing right now, your body’s willingness to reproduce is an important indicator of overall health. When your reproductive health goes awry—irregular or absent periods (amenorrhea) or hormone imbalances—that’s a big red flag. Of course, post-menopausal women can also experience hormone imbalances that affect their health and quality of life (and low-carb and keto diets can be a great option for them).

Menstrual Cycle 101

Let’s briefly review what constitutes a normal, healthy menstrual cycle, understanding that everybody’s “normal” will be a little different. A typical cycle lasts from 21 to 24 days on the short end to 31 to 35 days on the long end, with 28 days being the median. Day 1 is the first day of your period and begins the follicular phase, which lasts until ovulation. Just before ovulation, levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), and estradiol (a form of estrogen) spike. Next comes the luteal phase covering the approximately 14 days from ovulation to menses. LH, FSH, and estradiol drop, while progesterone rises. Estradiol bumps up again in the middle of the luteal phase. If a fertilized egg is not implanted, menstruation commences, and the whole cycles starts over again. All this is regulated by a complex communication network under the hypothalamic–pituitary–gonadal (HPG) axis, which is closely tied to the actions of the adrenal (the A in HPA axis) and thyroid glands.

Across the cycle, fluctuations in body weight are common as fluid is retained and then released along with shifts in estrogen and progesterone. Changes in blood glucose are also normal, and insulin-dependent diabetics often find that they need to adjust their dose at different times of their cycles to keep their blood sugar in check. The most common pattern is higher blood glucose readings in the pre-menstrual period (the second half of the luteal phase), and lower readings after starting your period and before ovulation. This is generally attributed to the fact that progesterone, which is highest during the luteal phase, is known to reduce insulin sensitivity. However, different women experience different patterns, which can also be affected by other factors such as oral contraceptive use.

Normal fluctuations in insulin resistance and blood glucose can mean that women get lower ketone readings at certain times of the month than others. When these occur premenstrually—and so they tend to coincide with a period of (transient) weight gain and food/carbohydrate cravings—women often feel as though they are doing something wrong. Rest assured that these variations reflect normal physiology.

The many factors that affect your cycle and the levels of your sex hormones include: other hormones, gut health and microbiome, metabolic health (e.g., insulin sensitivity), environmental toxins, stress, sleep, immune health, nutrient deficiencies, activity level and energy expenditure, and age. Each affects the others, and all (except age of course) can be affected by diet. It’s no surprise, then, that it can be extremely difficult to pin down a root cause of menstrual changes or reproductive issues.

What the Research Tells Us About Keto and Menstruation

As I said at the outset, there are lots of anecdotes, both positive and negative. In my experience, most women whose cycles seem to go crazy when they start keto find that things get back to normal—and often a better version of normal—after a few months.

First, it’s tricky to determine the effects of keto per se, since many people combine a ketogenic diet with calorie restriction (intentionally to lose weight or unintentionally due to the appetite suppressing effects of keto) and with fasting (intermittent and/or extended). Each of these can independently impact the factors listed above, lead to weight loss, and affect the menstrual cycle and reproductive health.

So, is there any evidence that keto itself causes changes to menstruation?

The scientific evidence is scant….

The one statistic you’ll see floating around the interwebs is “45% of (adolescent) females experience irregular menstrual cycles on keto.” This statistic comes from one small study of adolescent girls using a therapeutic ketogenic diet to treat epilepsy. Six of the twenty girls reported amenorrhea (loss of period) and three were diagnosed with delayed puberty. However, the ketogenic diet used for epilepsy is different and usually much stricter than an “everyday” keto diet needs to be, and epilepsy is frequently associated with menstrual dysfunction regardless of diet.

To extrapolate the findings of this study and argue that nearly half of teenage girls (or women generally) are likely to experience menstrual problems from going keto is a huge leap.

The fact is, I’m unable to find any studies done in healthy human females (or mice for that matter) demonstrating that otherwise normal menstrual cycles are disturbed by going keto.

5 Ways Keto-Related Factors *Might* Affect Your Menstrual Cycle

With the limited amount of research looking directly at keto and menstruation, let’s look first at whether there are direct effects of carbohydrate restriction or elevated ketone production on the menstrual cycle. Those are the defining characteristics of keto and what differentiates keto from other ways of eating. Then we can examine indirect effects that occur due to factors such as weight loss. These are not unique to keto, though they might be more likely on a ketogenic diet compared to other ways of eating.

Carbohydrate Restriction

There is no real body of evidence that looks at ketogenic levels of carb restriction and menstruation, but there are some clues. In this small study, functional hypothalamic amenorrhea (FHA) was associated with dietary fat restriction; women with FHA actually ate non-significantly more carbs than matched controls and nearly identical total calories. Likewise, in this small study, FHA was associated with lower fat intake but no significant difference in carb intake.

This meta-analysis looked at the effect of low-carb (not keto) diets on markers of reproductive health among overweight women. The researchers found four studies that examined effects on menstruation; all showed improved menstrual regularity and/or ovulation rates. Of six studies that looked at levels of reproductive hormones, five reported significant improvements.

Carb restriction also results in decreased insulin production. Hyperinsulinemia and insulin resistance are frequently associated with polycystic ovarian syndrome (PCOS), one of the leading causes of female infertility and a frequent cause of menstrual irregularity. There is currently a lot of interest in using keto to treat PCOS, but only one small study has so far directly tested the effectiveness of a ketogenic diet to treat PCOS, with positive results.

Ketones

No studies have looked at the direct effects of ketones on menstruation.

Weight Loss

Of course weight loss is not unique to keto, but keto can be very effective for weight loss. Some women experience rapid weight loss when first starting a keto diet. Weight loss in and of itself can impact menstruation through a variety of pathways (and, of course, keto isn’t the only way people lose weight). A key way is by reducing the hormone leptin. Leptin’s main job is to communicate energy availability to the hypothalamus—high levels of leptin tell the hypothalamus that we have enough energy on board, which also means we can reproduce. Low leptin can disrupt the menstrual cycle and is linked to hypothalamic amenorrhea.

Body fat loss can also affect estrogen levels since estrogen is both stored and produced in adipocytes (fat cells). While fat loss in the long term will decrease estrogen production, it is possible that rapid fat loss might temporarily raise estrogen levels and can also affect estrogen-progesterone balance. These transient changes in estrogen levels might underlie some of the menstrual irregularities women report.

Stress

Stress can impact the menstrual cycle in myriad ways. Cortisol acts on the hypothalamus and pituitary glands, affecting hormone levels, sleep, immune function, and gut health, to name a few. Diets can be a source of stress, both at the physiological and psychological levels. Keto has a reputation for being especially stressful because it is more restrictive than other low-carb diets, but this can be mitigated by following the Keto Reset tips for women.

Thyroid Function

Thyroid dysregulation is another common cause of menstrual irregularities, and there remains a pervasive belief that keto is bad for thyroid health. Indeed, the thyroid is sensitive to nutrient deficiencies and caloric restriction, and thyroid hormones, especially T3, do frequently decline on keto. However, as Mark has discussed in a previous post, changes in T3 levels might not be a problem, especially in the absence of other problematic symptoms. Moreover, many practitioners now use keto as a cornerstone in their treatment of thyroid disorders.

What Should I Take From These Findings?

The first takeaway: there just isn’t much direct evidence about how keto might affect your menstrual cycle, positively or negatively. We have some studies suggesting that low-carb diets improve some aspects of menstruation and reproductive health, but keto is more than just another low-carb diet. Ketones themselves have important physiological properties, such as being directly anti-inflammatory, which might positively impact women’s reproductive health.

Second, the ways that keto is likely to (negatively) affect menstruation aren’t unique to keto, they’re common to any diet: hormone shifts mediated by energy balance, stress, and weight loss.

Furthermore, since keto is so often combined with caloric restriction, time-restricted eating, and fasting, even the anecdotal evidence might not be able to tell us all that much. If a woman is eating ketogenically, in a big caloric deficit, and doing OMAD (one meal a day), and her leptin plummets, how are we to know what really caused it? We don’t have good evidence that otherwise healthy women start a well-executed ketogenic diet and end up messing up their menstrual cycles.

That said, women do need to be cognizant of the sum total of the signals they are sending their bodies when it comes to energy availability and stress. A lot of women come to the keto diet with a history of adrenal, thyroid, metabolic, and reproductive issues. It’s important that they’re extra careful about how they approach keto. Done correctly, it might be just what the doctor ordered. I encourage any woman who’s dealing with other hormonal issues to work with a medical practitioner to tailor a keto diet to her unique needs.

But I’m Telling You, Keto Made My Period Go Haywire!

Ok, I believe you, really! But changes do not necessarily equal dysfunction. It is normal to experience hormone fluctuations when you make a massive—or even a relatively small but important—shift in your nutrition. Sometimes those fluctuations are unpleasant or unwanted, such as a period that lasts 14 days or one that arrives a week before you planned while you’re on vacation. However, that doesn’t make them bad from a health perspective. We need to respect that our bodies are dynamic systems. Changing the input will invariably change the output, and the system might need a few months to adapt to a new normal.

If your cycle goes wonky but you’re otherwise feeling good, give it a few months to sort itself out. If after a few months it’s still all over the place (or definitely if you’re having other disruptive symptoms), enlist help. In the meantime, check to make sure you’re not short-changing yourself nutritionally or calorically. Scale back on fasting efforts, and consider shifting more toward a traditional Primal way of eating.

At the end of the day, if you go keto and experience negative effects, stop. Keto is super hyped right now, but if your body is sending you clear signals that keto is not a good approach for you at this time, don’t do it. You can always try again later. It might be that your first attempt at keto didn’t work, but with a few adjustments and some experimentation over time you can find a version of keto that works for you.

Thanks for reading, everyone. Do you have comments, questions, or feedback? Let me know below.

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References:

Comninos AN, Jayasena CN, Dhillo WS. The relationship between gut and adipose hormones, and reproduction. Human Reproduction Update 2014; 20(2): 153–174.

Fontana R, Della Torre S. The Deep Correlation between Energy Metabolism and Reproduction: A View on the Effects of Nutrition for Women Fertility. Nutrients. 2016;8(2):87.

Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obesity Reviews 2007;8(1):21-34.

Meczekalski B, Katulski K, Czyzyk A, Podfigurna-Stopa A, Maciejewska-Jeske M. Functional hypothalamic amenorrhea and its influence on women’s health. J Endocrinol Invest. 2014;37(11):1049–1056.  

Tena-Sempere M. Roles of Ghrelin and Leptin in the Control of Reproductive Function. Neuroendocrinology 2007;86:229-241.

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Dear Mark: What Breaks a Fast Followup

For today’s edition of Dear Mark, I’m answering a round of questions drawn from the comment section of the “What Breaks a Fast” post. You folks had tons of follow-up questions about whether other types of foods or compounds break a fast. Does a teaspoon of honey? Does elevated insulin from BCAAs? Does coconut milk? Does pure prebiotic fiber? What about longer fasts—are they recommended? And how about unsweetened cocoa powder? What explains my ability to predict your questions? Do sausages break a fast? Does liquor? How should you exercise?

Let’s dig right in:

Hey, what about honey? 1 tsp in morning tea?

A teaspoon or less of honey is fine and won’t negate the benefits of fasting. I alternate between doing collagen coffee and coffee with cream and teaspoon of sugar (which was my typical morning coffee for over a decade). No reasonable person should fear a teaspoon of sugar or honey.

For what it’s worth, honey isn’t “just” sugar. It elicits a more beneficial (or less negative) metabolic response than other forms of sugar.

I’m shocked about the BCAA. I used to fast and take BCAA’s (yes, to continue dynamic exercise). I used to find it extremely difficult to fast compared to now when I fast without taking them. Does that mean that the insulin response made fastic more difficult?

It’s possible. Insulin impairs lipolysis—the release of stored body fat into circulation for energy usage—and the success of fasting depends on lipolysis. Without lipolysis, you can’t access all that stored energy.

Thank you very much for this info!! I am a butter-coffee-for-breakfast drinker, and I always worry about the ingredients breaking a fast. Could you please comment on coconut milk (in the can)? I love putting that in my coffee/breakfast.
Thanks.

Coconut milk is a less concentrated source of medium chain triglycerides, or MCTs (as in MCT oil). MCTs convert directly to ketones, making MCT oil and to a lesser extent coconut oil or coconut milk a potential “boost” for fasting. Still, energy is energy, and any energy you take in is energy you won’t be pulling from your body.

I find MCTs and coconut to be more useful when someone is just getting the hang of fasting or ketosis—as a nice boost to get things moving in the right direction.

Keep your coconut milk under a tablespoon and you’ll be fine.

Does prebiotic (resistant starch) fiber break a fast? Acacia senegal or potato starch? Thanks!

No. If you’re worried, test your postprandial blood sugar after eating the fiber.

Great input Mark as someone 3days into a 7day water fast with electrolytes of course what’s your view on longer fasts.

Check out the post I wrote on long fasts. Potentially beneficial but the risks accumulate the longer you go. You just have to be even more careful and methodical.

How about unsweetened cocoa?

A tablespoon runs just over 12 calories (depending on the brand; some cocoa powders contain more fat and thus more calories), with around a gram of net carbs and a gram of fat. Also a nice source of potassium and magnesium, along with a ton of polyphenols which can have fasting-mimicking effects on their own.

Eating enough unsweetened cocoa powder to knock you out of your fast would be incredibly repulsive. Probably impossible.

Cocoa is definitely a nice addition.

Okay it’s almost creepy the way Sisson answers my questions before I even ask them! I was wondering about this yesterday and then this post popped up in my inbox.

How does he do that…? ?

Kraft-Heinz has a strong relationship with Google and Amazon, and the Kraft acquisition gave me access to Alexa/Google Home datasets and the ability to predict what my readers are wondering about.

Just kidding, though it’s scarily not out of the realm of possibility anymore.

What about a small snack of paleo sausages, smoked or dried? So meat and fat (beef, pork or lamb), and some spices. Maybe 100g worth.

Well, that’s a legit snack bordering on a small meal. That will break the fast, but it’s not all for naught. There is the whole “fasting-mimicking diet,” where you eating very few calories for several days out of the week and retain many if not most of the benefits of full-on fasting.

Let’s just say if you ate a small snack of paleo sausages on your “fasting” days, you’d still be way ahead of 99% of people.

But do try a full-on fast at least once. You might surprise yourself.

Great post! What about alcohol? Specifically, a shot or 2 of liquor. I would assume beer and wine would break a fast, but what about whiskey or tequila?

When alcohol enters the system, utilization of all other energy sources is suspended until the alcohol is burned. Back in 1999, researchers did a study where they gave fasting adult men the equivalent of a couple shots of liquor. They stopped releasing stored body fat, stopped burning body fat, and began burning way more acetate (a product of ethanol metabolism). They didn’t exactly “break” the fast, but all the metabolic trajectories we love about fasting took a big pause.

Good morning Mark,
How does one exercise in the morning while fasting? When to eat?

You can exercise any way you like, but I change how I train based on when I’m going to break the fast with food.

If I’m going to break the fast with a meal right after, I train any way I like. I’ll do sprints, HIIT, weights, anything.

If I’m going to keep fasting after the workout, I like to stick to strength training and low-intensity movement (walking, hiking, standup paddling). The strength training is essential during a fast because it’s an anabolic signal to your muscles—move it or lose it. Simply lifting heavy things during a fast can stave off muscle loss.

That’s it for today, folks. Stay tuned later this week for “What Breaks a Fast: Supplements Edition.”

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The Primal Blueprint Is For Life!

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!

Most of the people whose amazing and life-altering stories appear on MDA are submitted by people aged 50 or younger. Here is one to inspire not only you “young puppies” but hopefully “geezers” like Mark and me. I am the same age as our fearless leader Mark Sisson, and while my story and my life have gone totally differently than Mark’s [I was never a triathlete or even close], the end result is just as rewarding!

My name is Lloyd and I am 65, and in the best shape of my life – almost. In my late 20’s I smoked 2 packs a day and drank two or three mixed drinks every night – and I sported a 42 inch waist. A neighbor convinced me to start running [he ran marathons and weighed like 140 lbs.]. I started running 2 miles a day around a golf course in the neighborhood and ran a very slow 10 minute pace at first. I really liked the feel of the endorphins kicking in and I took to exercise for the first time in my life. Fast forward a few years and I was running 8 miles every day, rain or shine, in around 55 minutes. I had lost weight, but was still eating poorly, whatever my wife put on the table, and often second helpings.

Then we had a freak snow and ice storm, and running was out of the question – for weeks. I was used to doing something physical late in the afternoon so I bought a beginner set of weights and got hooked on bodybuilding. Even after the streets were passable, I kept lifting and soon joined a gym.

I didn’t realize this because I was a neophyte, but the gym I joined was very hardcore. Incandescent lights, bare floors, hard rock music, all guys, chalk flying, grunting and screaming everywhere, and lots of the members were on steroids. No, I never partook, but I did start lifting very heavy weights, and found I could. By two years later, I was very strong and about as big as a natural guy could be. I loved lifting heavy weights and having big muscles. I received a lot of encouragement from the other members and many gave me diet tips as they could see I was serious. The diet? Low fat, high protein and lots of carbs. Some days I ate almost 5-6,000 calories a day and had a 34 waist. At my peak I weighed about 250, with very low body fat. But I was in my 30s. As we age, a lot of things change.

Year after year, I trained the same way, and ate the same way, but by my mid 50s I could see changes happening – my weight was staying the same, but my waist was getting bigger. So I started doing a lot of cardio, all high-intensity, close to my max heart rate, big puddles of sweat under my exercise bike at the gym, and no weight loss!

I was really discouraged, began doing internet research, and I found MDA when it was pretty new. I bought Mark’s first edition of The Primal Blueprint, and it all made so much sense, I dove in 100%. No cheat days, no 80% 20%, I was all in. I started this new eating style at [you’ll love this] at a Thanksgiving Day buffet, lost 2 pounds the first day and about 25 pounds in a few months. Blood pressure went down, bad cholesterol down, good cholesterol up, my doc was amazed, as he was ready to put me on a statin.

I maintained the weight for years until Mark started talking about Keto. Once again, I went all in immediately [I had been eating Primally for so long that I passed Mark’s “test” with flying colors]. I also started using the myfitnesspal app to keep track of my food and nutrient intake. My goal was to lose another 10 pounds and get to 215, but it was so easy, I ended up as low as 204 and I have stayed within a few pounds of that for about 18 months now.

Like Mark, I stay right on the edge of ketosis, some days I might have 60g of carbs, but most of the time, under 40g. I also have found fasting for 24 hours easy to do with my travel schedule and about half of the time, with the exception of coffee and maybe a piece of cheese, I eat nothing until dinner. And I am NOT hungry!

Just one thing more I want to add. From all the years of heavy lifting, I have had back surgery, two total shoulder replacements, and one hip replacement. Yes, I am a poster child for getting rid of old joints that don’t work well anymore.

During each recovery period, I had to stop lifting and curtail cardio, which by the way is now mostly elliptical limited to 75% of my max heart rate. Because of my primal eating style, even sitting around with little to no exercise other than PT] while recovering from surgery, I never gained weight!

So am I a huge fan of Mr. Sisson and this lifestyle? Absolutely! It works, it’s not hard, and it’s for LIFE!

The readers featured in our success stories share their experiences in their own words. The Primal Blueprint and Keto Reset diets are not intended as medical intervention or diagnosis. Nor are they replacements for working with a qualified healthcare practitioner. It’s important to speak with your doctor before beginning any new dietary or lifestyle program, and please consult your physician before making any changes to medication or treatment protocols. Each individual’s results may vary.

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13 Keto-Friendly Fiber Foods

While some keto or low-carb proponents claim fiber is useless at best and actively harmful at worst, I come down on the side that says fiber is probably helpful for most people. Some folks have persistently better responses to low- or no-fiber keto diets, and I won’t argue with that—I’ve seen it happen and I’ve read the studies where de-emphasizing fiber can actually improve constipation, for example.

I’ll just say that I have an opposite reaction, and, most importantly, I love eating a variety of plant foods that also happen to contain a ton of great nutrients in addition to fiber.

Do I buy into the idea that fiber is important because it is every human being’s responsibility to produce as much colonic bulk as humanly possible? No.

Do I think we should be consistently pushing the limits of our digestive tracts, performing feats of bathroom heroism so momentous they border on Herculean, and making sure the toilet bowl buckles beneath us? No.

The real value of fiber lies not in its coarseness, its tendency to form colonic bulk, to keep us topped off. The true value lies in its fermentability. A fermentable fiber is a prebiotic fiber—fiber that feeds our gut bacteria.

I won’t get into the many roles our gut bacteria play in our health today (I’ve covered that before. 1, 2, 3).

I will, however, explain why we need to be feeding our gut bacteria. Our gut bacteria form a physical barrier against incursions and colonization by pathogenic bacteria; they take up room along the gut lining so pathogens can’t. If we don’t feed our gut bacteria with prebiotics, it won’t be around to protect us. After antibiotic treatment where both good and bad gut flora are indiscriminately targeted and wiped out, pathogenic obesity-promoting bacteria take advantage of the open space. That’s a worst-case scenario, but it shows what can happen when the harmony of the gut is disturbed by antibiotics or, to a less extent, a lack of fermentable prebiotic fibers.

When our gut bacteria eat prebiotics, they also give off metabolites like butyric acid—a short chain fatty acid that our colonic cells use as an energy source and which improves metabolic health.

Gut bacteria also convert antinutrients like phytic acid into nutrients like inositol. The almond meal-obsessed keto eater would do well to have a powerful gut biome set up to convert all that phytic acid to inositol.

Now, some writers will come up with specific blends of fibers, powders and gums to create the “optimal” prebiotic diet for your gut bacteria, but that’s pretty silly. The gut is a complicated place. We’ve barely begun to even identify all its inhabitants. To think we know the precise blend of isolated fiber that will make them flourish, and then act on that, is a mistake.

A better option is to eat foods that contain fiber. Some of the prebiotic fibrous foods with the best nutrient profiles also happen to be extremely keto-friendly.

1) Almonds and Pistachios

Nuts are usually favored in health-conscious circles for a few reasons. They like the monounsaturated fat. They like the mineral profile, or the complete protein, or their ability to dissemble into nut meals and form baked goods. But what gets short shrift is the fiber content. Now, I can’t speak for other nuts, but almonds and pistachios in particular contain fiber with potent prebiotic effects. People who eat almonds and to an even greater extent pistachios end up with improved gut bacteria profiles.

2) Green Bananas

Ripe bananas are difficult to squeeze into a ketogenic diet. The green banana—an unripe one—is mostly resistant starch, a type of starch that cannot be digested and travels untouched until colonic bacteria metabolize it. It’s one of the best stimulators we know of butyric acid production. And sure, you could do a spoonful of raw potato starch to get your resistant starch, but the beauty of the green banana is that it also provides potassium, another nutrient that some find difficult to obtain and stay keto.

3) Wild Blueberries

Blackberries, boysenberries, raspberries, and strawberries are all loaded with fiber, and you should eat them. They’re lower carb than you think, they’re loaded with polyphenols, and topped with some real whipped cream they make a fantastic dessert. But wild blueberries are special. They’re smaller than other berries, which increases the amount of skin per ounce you get, and skin is where all the polyphenols and fiber lie. Heck, even the blueberry’s polyphenols have prebiotic effects on the gut biome.

4) Mushrooms

A few years ago, I wrote a whole post on mushrooms. Suffice it to say, they’re quite wonderful, bordering on magical. I did not discuss the fiber they contain. It turns out that all the various mushroom polysaccharides/fibers, including beta-glucans, mannans, chitin, xylans, and galactans also act as potent prebiotics that improve the health of the host.

5) Avocado

Your standard avocado has about 12-15 grams of fiber, if you eat the whole thing. I

6) Jicama

Great with chili powder, salt, and lime juice, jicama is about 11 grams of carbs per cup, but half of those are inulin, a potent prebiotic fiber with a tendency to really ramp up butyrate production.

7) Onions

Onions are another fantastic source of inulin. They go into almost every dish of every cuisine, so there’s no excuse not to be eating onions.

8) Garlic

I’ve been known to treat garlic like a vegetable, roasting an entire cast iron pan full until brown and sweet and chewy. They’re another great source of prebiotic fiber.

9) Leeks

Leeks have more inulin than onions. Try them crispy in egg scrambles.

10) Broccoli

Broccolini is a major part of my favorite meal of the day—my Big-Ass Keto Salad. Broccoli (and cruciferous vegetables in general) has been shown to have modulatory effects on the gut biome.

11) Sauerkraut

Kraut gives you two in one. It’s a fermented food, which is great for the gut biome. And it’s cabbage, which is very fibrous. Even pasteurized kraut improves gut health.

12) Dark Chocolate

Dark chocolate, the good stuff with a high cacao content (85%+) and low sugar content, is an incredible source of prebiotic fiber. Eat more of it.

13) Animal Fiber

Obligate carnivores like cheetahs who don’t eat any plants (willingly) still have gut bacteria. These gut bacteria thrive on “animal fiber,” the gristle and cartilage and other bits of connective tissue that comprise a good 20-30% of the walking weight of a prey animal. Humans are not obligate carnivores, but eating the entire animal has been a mainstay of advanced hominid existence for millions of years. I find it very likely that something, someone, somewhere inside our guts is breaking down the animal fiber we eat—so you’d better be eating some!

Not so tough, is it? It’s not like I’m suggesting you load up on bran muffins, psyllium smoothies. I don’t want you dumping flax meal into everything or munching on those awful fiber gummies. Just eat some basic, healthy, low-carb plant matter—foods that don’t really scream “fiber”—and the rest will take care of itself.

What’s your favorite low-carb source of fiber? Let me know down below.

Thanks for reading, everyone.

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References: 

Hernández E, Bargiela R, Diez MS, et al. Functional consequences of microbial shifts in the human gastrointestinal tract linked to antibiotic treatment and obesity. Gut Microbes. 2013;4(4):306-15.

Ukhanova M, Wang X, Baer DJ, Novotny JA, Fredborg M, Mai V. Effects of almond and pistachio consumption on gut microbiota composition in a randomised cross-over human feeding study. Br J Nutr. 2014;111(12):2146-52.

Jiao X, Wang Y, Lin Y, et al. Blueberry polyphenols extract as a potential prebiotic with anti-obesity effects on C57BL/6 J mice by modulating the gut microbiota. J Nutr Biochem. 2019;64:88-100.

Jayachandran M, Xiao J, Xu B. A Critical Review on Health Promoting Benefits of Edible Mushrooms through Gut Microbiota. Int J Mol Sci. 2017;18(9)

Nielsen ES, Garnås E, Jensen KJ, et al. Lacto-fermented sauerkraut improves symptoms in IBS patients independent of product pasteurisation – a pilot study. Food Funct. 2018;9(10):5323-5335.

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