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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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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Success Story Follow-Up: Finding My Passion Through Healing

It’s Friday, everyone! And that means another Primal Blueprint Real Life Story from a Mark’s Daily Apple reader. If you have your own success story and would like to share it with me and the Mark’s Daily Apple community please contact me here. I’ll continue to publish these each Friday as long as they keep coming in. Thank you for reading!

This is a follow-up post from a former MDA success story, Andy Hnilo. In response to his original story, a number of readers had questions about Andy’s routine he used for healing and the ingredients his research showed were effective for various skin repair and restoration purposes. He’s answered those questions in this follow-up post. Enjoy, everyone!

After a car accident left me with seven broken ribs, a collapsed lung and “the worst compound fracture’ the maxillofacial specialist at the hospital had ever seen, my body was wrecked and my confidence not far behind. For any person, this would be a traumatic experience, but as a 30-year-old working actor and model, my future was suddenly completely unsure. As easy as it would have been to give up, my near-fatal accident turned out to be the ultimate blessing in disguise — that experience sparked the fire in my soul’s purpose. A walking ball of inflammation, I began researching ingredients for how I was going to accelerate my healing both internally and externally. Along the way, I shared everything I had learned about nutrition, natural healing, skincare and how to feel better about the reflection in the mirror with the rest of the world.

There came a point in my accident recovery where new passion, fun and hobby displaced my previous worry and intermittent pain. Researching and experimenting with various therapeutic ingredients became a creative outlet for me. While many of my friends found my new ‘hobby’ a bit crazy at times; I never let that stop me. In addition to the obvious results, I found a sense of encouragement for my recovery in researching and learning about certain studies and ingredients that helped others heal their scarring. It gave me hope and further validated the physiological capabilities of my ‘crazy’ concoctions.

For those of you like me, who share in the joy of science, biology and nature’s magic, I would love to share with you some of the most impressive research on the ingredients that accelerated the healing of my skin after my accident.

Skin Restorative Ingredients: What My Research Revealed

Medicinal Clays

It turns out, clays have been used therapeutically throughout various cultures. While one might be quick to discredit someone with mud on their face, the fact of the matter is there are many scientific discoveries associated with use of hydrated clays. There are 2500 scientific articles published in PubMed to sort the scientific works have been done on the effects of this clay on body function.

For example, Illite and Kaolin have ionic properties that affect antibacterial activity. In fact, studies have found that the natural and ion-exchanged illite clays significantly decrease bacterial load, skin inflammation and gross wound morphology. There’s even research that dives deeper into the chemistry of clay’s antibacterial effects, providing evidence that suggest some antibacterial clays can promote similar bactericidal (bacterial death inducing) reactions as effect as synthetic antibiotics. 1,2

Pearl Powder

Pearl Powder is perhaps the most sophisticated exfoliates created by Mother Nature. If you’re unfamiliar, Pearl is one of the well-known traditional Chinese medicine (TCM) tonics used for treating various skin disorders and beautifying the skin, mostly due to its abundant antioxidant, protein and mineral contents.

In one study, pearl powder supplemented people showed a substantial increase in total antioxidant capacity. Tests done found a significant increase in master antioxidants glutathione and SOD (superoxide dismutase) content and activity. It was also found that pearl considerably suppressed lipid peroxidation, which is the oxidative degradation of fats in the body. These outcomes sum up to one clear fact about pearl, it is a supremely potent antioxidant and thereby makes a novel, natural remedy for treating various age-related degenerative disorders. For me, this is the kind of data that helps me make sense of why pearl powder makes my skin soft and smooth. 3

Colostrum

Colostrum is yet another power-house ingredient backed by science. In short, it is a natural source of many important vitamins, minerals, enzymes, and amino acids. However, perhaps the most impressive part of colostrum is its unique content of insulin-like growth factor (IGF-1).

In regards to skin health and regeneration, colostrum and its IGF-1 content sparked great interest for me. IGF factor 1 (IGF-I) is widely distributed in various tissues, including the skin. It turns out, IGF-I is strongly expressed in injured areas, where it plays an important role in epidermal and dermal wound healing. Repeated studies have shown the beneficial effects of topically applied IGF-I on wound healing, due to its stimulating effects on collagen synthesis in skin fibroblasts, the proliferation of fibroblasts and keratinocytes, and angiogenesis. 4,5 As collagen production starts to decline with age, it is essential to make healthy skin care a priority by choosing products with ingredients that will keep your skin functioning at its peak, no matter what age you are. 6,7

In simpler terms, colostrum promotes the regeneration of fresh skin. I greatly attribute my regular use of colostrum and its effects to a surprisingly minimal appearance of scarring after my accident.

Pracaxi/Acai Oil

After my accident, I had the worst compound jaw fracture the resident maxillofacial surgeon of Cedars Sinai had ever seen. We actually had to hire a private surgeon and he assisted him. So you can only imagine the wounds that inflicted my face, negatively affecting the integrity of my skin. Normally, intense wounds means equally intense skin scarring. Luckily, scar formation itself varies based on many factors and can be mitigated by therapeutic agents, such as the beneficial fatty acids found in pracaxi oil.

According to clinical research, the topical application pracaxi oil to injured skin led to considerable improvements in wound healing and scar attributes. Additionally, it has been found that acai oil, applied topically to diabetic ulcerations can dramatically improve healing, up to 100%. With my initial fear of scarring after my accident, discovering natural ingredients with regenerative abilities were a true saving grace. 8 9

Plant-derived Stem Cells

When I said I was willing to try anything to improve my recovery, I meant it. Somewhere along my journey, I came across compelling research on the use of plant stem cells for skin regeneration. The science and use of plant-stem cells is an interest focus for leading edge cosmetic treatment. When you consider the unique self-pairing, tissue regenerative processes of plants; it’s amazing to think that we could utilize their cells to also assist our skin cells in regeneration. That’s what plant stem-cell science is all about and it’s quite intriguing.

According to the research and experimentation, plant-stem cells contain phytohormones that have an antioxidant effect on the skin. In fact, one study found that a product derived of plant-stem cells greatly reduced wrinkles in the crow’s feet area of the face 10. It was found that the depth of face wrinkles became shallower by 8% after 2 weeks and shallower by 15% after 4 weeks. 11

Plant-Derived Vitamin A

Vitamin A plays major regulatory roles in the functioning and health of the skin matrix. Vitamin A is typically found in two forms; carotene or retinol. However, with the help of modern technology, we are capable of extracting a retinol-like plant-based vitamin A, derived of the popular superfood, Alfalfa.

Plant-derived Vitamin A has some amazing science behind it. Sourced organically from France, it contains similar beneficial polysaccharides as retinol, called galactomannans. This gives plant-derived vitamin A retinol-like-activity because it’s working on similar biological markers. Best of all, it achieves these effects without inducing irritancy on the skin like Retinol so often does. It can greatly improve the appearance and health of aged skin by significantly reducing fine lines and Crow’s feet.

In fact, study has found that topical plant-derived Vitamin A improves fine wrinkles associated with natural aging. The induction of glycosaminoglycan; beneficial mucopolysaccharides, increase collagen production and are most likely responsible for the minimization of fine lines. Additionally, plant-derived Vitamin A treated skin improves skin matrix synthesis, making it more resilient to skin injury and ulceration. 12

CoQ10

Also known as ubiquinone coenzyme q10, CoQ10 is an endogenously synthesized lipid-soluble antioxidant, which is essential for cellular energy production. However, like all aging, this precious molecule is diminished with skin aging too. Stress of all sorts all tend to decrease the antioxidant presence and activity of coQ10. Luckily, both dietary and topical Q10 treatment is incredibly beneficial with regard to effective Q10 replenishment.

In study, application of Q10-containing formulas significantly increased the levels of this particular quinone in the skin surface and even in the deeper layers of the epidermis. More importantly was the effect this had on the skin; the results founds that stressed-skin improved by reduction of free radicals and the increase in antioxidant capacity. In other words, the topical use of CoQ10 improves the skin’s resilience to oxidative stress. Considering that oxidative stress results in the well-known signs of skin aging, like the appearance of wrinkles and lines as well as loss of elasticity, CoQ10 application serves as a useful anti-aging novelty. These are just a few of the reasons I feature CoQ10 in both my Night Cream and Gold Serum. 13, 14, 15

How I Applied My Research To My Routine

Purely through self-experimentation and trial and error, what made most sense to me was combining THE best, most effective ingredients that I could source from nature along with the latest and greatest in cutting edge science. The process began by isolating carefully sourced ingredients based on texture alone, then combining them with different carrier oils then moving forward and adding essential oils and extracts that fit my creation and desired emulsion.

I knew I wanted a dense feel that would be there throughout the night, nourishing and healing the scar area through deep hydration. I tried a couple products in the beginning before making my own, and they would absorb quickly leaving me questioning its level of effectiveness if it is gone within minutes. What made the most sense to me is a rich concentrated emulsion that was thicker, therefore moisturizing the target areas for longer periods of time. Devoid of harsh, drying ingredients. In search for the perfect blend of botanicals, it was fascinating to me to learn of certain ingredients like Sea Buckthorn and find out about it’s very rare Omega-7 fatty acid capacity.

In my night cream specifically, in a cast iron pan, I would melt down thicker ingredients like Beeswax, Cacao Butter and Manuka honey then combine with cold-pressed oils to create an highly concentrated, nourishing emulsion for my skin that I would apply after rinsing off The Clay Mask. I still have that first concoction with little dimples of cacao butter strewn throughout, preserved solely by K-Factor 16 Manuka Honey. That concoction turned into what is now, our award-winning Alitura Night Cream.

As you can see, my skin-care craze isn’t as whacky as it seems—there is credible scientific evidence that backs my madness. In a culture that is quick to go under the knife or get an injection it’s imperative to remember that none of those options actually help keeping the appearance of the skin youthful and glowing. Using skincare products that are dense in topical nutrients are vital for healthy looking skin. 16,17 At this point, you’re likely wondering how to put it all to practice. So, without further ado, I’m happy to share with you my personal skincare routine…

Here’s What It Looks Like To Date:

Pearl Cleansing: I start off my skin-care routine with a traditional step; cleansing. However, I use a not-so-conventional cleanser, the Pearl Cleanser. As we discussed, this unique cleanser cleans the skin while protecting it from the stressful effects of free radicals.
*Wet your face with warm, clean water
*Apply the cleanser with your hands, gently working it into the skin
*Wash it off
*Let your face dry

Derma Rolling: Next up is Derma Rolling. Derma rolling is one of the most powerful weapons for getting the what I call the “Alitura Glow.” This is one of the many high-end medi spas best kept secrets. Microneedling, a.k.a. Collagen Induction Therapy, is exactly that: an effective way to stimulate collagen synthesis and simultaneously break down malformed tissue such as acne and surgical scars (keloid scars are the exception as Microneedling can cause more keloid scarring).18 It works by creating “micro-tears” or generating acute, inflammation, that initiates the healing or regeneration of the outer layer of the skin. It also helps open the poors up, allowing any of the medicinal ingredients in your serums or moisturizers to absorb more deeper.

Home-use vs. Medical Microneedling has everything to do with needle size. The Alitura Dermaroller comes in .25 mm, .5 mm, and 1 mm needle sizes making it ideal for safe home use. Within just a few treatments over the course of 6-8 weeks you will notice visible changes in the texture of your skin at the surface level and plumpness and contour since your dermis has more collagen giving the understructure a firmer foundation for a more youthful contour to the jawline and cheekbones.

In addition to these benefits, derma-rolling can improve collagen synthesis, heal scars, prevents premature skin aging, reduces stretch marks and helps balance skin tone. 19

Clay Mask: My third step is to follow up Derma Rolling with The Alitura Clay Mask. As we’ve discussed, the mask on its own is a wonder treatment that thoroughly purifies, exfoliates, detoxifies and revitalizes the skin by stimulating blood flow. Combined with the Derma Roller; however, the benefits are increased exponentially!

Check this article out for full instructions on how to use the Clay Mask.

Alitura Night Cream: I ‘stack’ my Night Cream and Gold Serum before bed. I apply a thin layer of The Gold Serum all over my face, neck and eye area and then follow with thin layer of The Night Cream as a protective, ultra-hydrating barrier that deeply conditions the dermal layer of my skin which is the most important time to do so, while you are in one position for hours. Wake up looking renewed, refreshed and with a plump, radiant complexion. Great way to start the day if you ask me! Enjoy 🙂

To me, there truly is nothing better than feeling good with your what you see in the mirror. One thing I don’t touch on enough is that my journey into skincare really started in college where I became insecure to take my shirt off because of bad back acne that I had. Growing into my body, hormones racing, using poor products and consuming inflammatory dormitory food at UC Berkeley led to it. It was a bit deflating to wake up and see some type of irritation on my face and body and it really bugged me. Made me self conscious. It was then and there that I started to pinpoint the problem. I was a scrawny freshman athlete at Cal, and needed to gain weight quickly as a Division 1 Pac-10 athlete, so I was always scouring the back of food labels for the big three: 1) Protein 2) Calories 3) Fat. That attention to detail on labels led me to look down into ingredients on skin and hair-care as well. Tossing the heavily marketed, big brand name skincare for a better, cleaner ingredient deck yielded results and my knowledge grew year after year.

After my accident that knowledge grew quickly as I voraciously read and researched ingredients and topical remedies to heal myself. It has been said that ‘necessity is the mother of invention,’ and I couldn’t agree more. My accident not only led to me finding my passion through healing myself, but I found my purpose along the way. To be able to share what I have created with people all over the world in an effort to make people feel better about what THEY see in the mirror… it gives me goosebumps as I type this. I am grateful.

I want to give a HUGE thank you to the incredible people at Mark’s Daily Apple, Primal Blueprint, Primal Kitchen, and of course Mark Sisson for letting me share a piece of my journey. Thank you for reading.

All the best,
Andy Hnilo
CEO & Founder
Alitura Naturals

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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References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/26508716
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126108/
  3. https://www.ncbi.nlm.nih.gov/pubmed/29389568
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184407/#b5-ijn-9-4551
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184407/#b6-ijn-9-4551
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4089350/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1606623/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257951/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857298/
  10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674215/#B11
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674215/
  12. https://www.ncbi.nlm.nih.gov/pubmed/17515510
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737275/#biof1239-bib-0004
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737275/#biof1239-bib-0003
  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737275/
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428712/
  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583891/
  18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976400/

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Top 12 Keto Blogs

With the explosion of keto, there’s an ever growing constant stream of new information about the significant benefits, supposed risks, and varying “rules” for how to adopt a keto diet. As with most things, it’s easy to get sucked into information overload. (And that doesn’t even take into account the hype that unfortunately gets distributed like wildfire around the Internet.) You want sources you can count on for facts, reason, and utility. Here are twelve solid sources I’d recommend for intelligent commentary, sound science, and useful ideas.

1) Mark’s Daily Apple

Sure, this isn’t an exclusively keto blog. It’s a Primal living blog—with attention to all the components that figure into a healthy lifestyle and fulfilling life. But keto is a powerful tool I use within the Primal Blueprint template. As most of you already know, I approach keto specifically through a Primal lens—what I call a Primal-keto approach to keto living that prioritizes optimum nutrition with the least amount of pain, suffering and sacrifice. I know it’s been working for a lot of people, and I’ll continue to to write on it as well as all the other elements of a healthy life. Four particular resources I’d suggest to folks new to keto: the MDA Keto Hub, our Keto Recipes, the Primal Blueprint Keto Podcast, and our private Keto Reset Facebook Group. They’re all free resources for anyone to use and enjoy. For those who want to receive an additional Mark’s Daily Apple monthly email with exclusive information and commentary on keto, you can sign up below for the Keto Reset Digest (also free).

2) Virta Blog

Virta is a groundbreaking health organization using keto to treat—even reverse—type 2 diabetes and associated metabolic disorders. The Virta Blog is an must-read, providing a mix of cutting edge science, easy to understand articles regarding practical aspects of going keto, and inspiring success stories.

3) Tuit Nutrition

I love Amy Berger’s common sense approach to keto on Tuit Nutrition. She calls her approach Keto Without the Crazy, and that about sums it up. Her articles are long but very worth reading.

4) Ruled.me

At Ruled.me you’ll find mostly long-form articles that contain a ton of information about the keto diet. The site also provides an extensive recipe collection and other resources.

5) Healthful Pursuit

Healthful Pursuit is the home of Nutrition Educator and keto guru Leanne Vogel. Leanne provides a blend of blog posts, videos, and recipes to help you go keto in a healthy way. Much of the content is focused on keto for women, but men and women alike can benefit from the info provided.

6) Calories Proper

At Calories Proper, Dr. Bill Lagakos covers a wide range of topics related to nutrition, fasting, circadian biology, and much more. While it’s not a keto blog per se, keto is a frequent topic. In any case, you’re sure to learn a lot from the content here, which is heavily focused on reviewing and critiquing empirical research studies in an understandable way.

7) Ketogenic Athlete

Ketogenic Athlete is a well-rounded blog for strength and endurance athletes who are interested in using keto for training and performance.

8) The MAF Files at philmaffetone.com

Dr. Phil Maffetone has been using low-carb and keto diets to help athletes achieve breakthrough athletic performance for decades. His 180-age formula is a cornerstone of my Primal Endurance approach to become and fat- and keto-adapted athlete. The MAF Files covers a variety of topics that will be of interest to Primal and keto athletes.

9) HVMN

HVMN offers the only commercially available ketone ester supplement. The blog reflects their target audience: athletes and other high performers who are interested in using diet and lifestyle modifications—and possibly exogenous supplementation, of course—to harness the power of ketones.

10) Elana’s Pantry

Elana Amsterdam has long been one of my go-to sources for healthy, delicious paleo recipes, but more recently she has been using keto as part of her strategy to address her MS. I’ve never made an Elana’s Pantry recipe that wasn’t excellent. She also writes about a variety of topics related to health.

11) Castaway Kitchen

Christina Kurp shares how she used a combination of AIP and keto to fix her own health issues. Part wellness blog, part scrumptious recipe collection, Castaway Kitchen is a great resource for anyone looking for food inspo, especially if you have dietary restrictions.

12) Cast Iron Keto

Plainly put, Cast Iron Keto has food I like to eat: simple, delicious, keto-friendly. You’ll find lots of keto-fied classics here suitable for kids and non-keto types (making dinner that much easier).

Thanks for stopping in today, everyone. Have a favorite you didn’t see here? Share down below. Take care.

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Keto Waffle Breakfast Sandwich (+ a Giveaway!)

Breakfast: it’s perhaps the menu with the most stumbling blocks for those living low-carb. Eggs are great, but—let’s face it—get old without some variety. At times we may find ourselves missing the traditional breakfast classics we might have enjoyed at one point—even when we know they don’t fit our current health goals.

But who said keto was about deprivation? Not us, for sure. With a huge array of keto-friendly classic recipes, we’re hellbent on showing the world just how great keto eating can be—with real food, full flavor and no compromises. So, back to breakfast now…. We dare you to bring this savory keto waffle breakfast sandwich to work—and see just how many people you convert.

Enjoy—and be sure to check out this week’s giveaway with our friends at Birch Benders (below)!

Servings: 2 sandwiches

Time In the Kitchen: 30 minutes

Ingredients:

  • 3/4 cup Birch Benders Keto Pancake and Waffle Mix
  • 1/2 water
  • 1 tbsp coconut oil
  • 2 eggs
  • 3 slices bacon
  • 2 sandwich slices of cheddar (or cheese of choice)

Instructions:

Mix Birch Benders Keto Pancake and Waffle Mix with water and coconut oil according to package instructions.

Grease mini waffle iron with Primal Kitchen® Avocado Spray Oil. Pour batter into waffle iron and cook according to iron instructions.

While mini waffles are cooking (or before), scramble 2 eggs in small skillet.

Cook 3 strips of bacon (in oven at 400 ºF/205 ºC).

When mini waffles are done, let cool slightly on plate or cooling rack.

When cooled, top two of the waffles with cheese slices, 1 1/2 bacon strips each, and divided scrambled egg. Top with the remaining two mini waffles to make 2 sandwiches.

For a little extra spice, add Primal Kitchen Chipotle Lime Mayo. Now dig in….

Now For the Giveaway…

Have we won you over yet to Birch Benders easy and incredible mixes? (They have a paleo version, too, btw.)

Just follow @marksdailyapple and @birchbenders on Instagram and comment on today’s MDA Instagram giveaway photo with your favorite keto recipe.

One lucky (random) winner will score a Primal Kitchen package worth $100: Vanilla Collagen Fuel, Classic Mayo, Chipotle Lime Mayo, Ranch Dressing, Green Goddess Dressing, and Caesar Dressing.

Good luck—and bon appetit!

Nutritional Information (per sandwich):

  • Calories: 415
  • Net Carbs: 6.6 grams
  • Fat: 32.6 grams
  • Protein: 22 grams

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Ultimate Guide to Non-Dairy Milks

Some people just don’t do milk.

There are many reasons why. Maybe you have a dairy intolerance. Maybe you don’t like the way cow’s milk tastes. Or maybe you think cow milk is unhealthy.

I won’t contest the reasons why. That’s another topic for another post, and I’ve already covered the most common anti-dairy arguments. If you want to read about my stance on the healthfulness (or lack thereof) of dairy, read what I’ve written about raw milk, cheese, yogurt, and dairy in general. If you want to learn how to identify dairy intolerance, read this.

But the fact is, lots of people either need or want a milk alternative. Water is great to drink, but it’s not the right smoothie substrate, and it can’t replace milk in recipes or coffee drinks. You need something vaguely white and thick enough to pass as milk.

Normally in a post like this, I’d cover all the different varieties and what sets each apart—their strengths and weaknesses, their nutrient profiles, their unhealthy ingredients. And I’ll certainly do that today, but first there’s good news and bad news.

The good news is that there are plenty of good choices available. If you want something to drink, use in smoothies, or add to coffee, there are many different plant-based milk that avoid overly offensive ingredients.

The bad news is that most non-dairy milks are usually very low in nutrients. The parent food to these plant-based milks—the almonds, the cashews, the hemp seeds, and so on—are extremely nutrient-dense in and of themselves. Just check out my posts on nuts and seeds to get the nutritional lay of the land. But almond milk isn’t almonds, cashew milk isn’t cashews, and hemp seed milk isn’t hemp seeds.

This isn’t surprising when you think about how nut milks are made: by blending the nuts with a bunch of water and straining out the solids to try to extract some of the nut-ness. It’s pretty inefficient. If you could press an almond to wring out the almond milk, then you’d have something interesting. But that’s not how it works. Most non-dairy milks are superficial mirages of the real thing.

To illustrate this, let’s look at the most popular non-dairy milks and compare the nutrients in the parent nut/seed/plant to the nutrients in the nut/seed/plant-milk (when applicable).

Nutrient Profiles Of Popular Non-Dairy Milks

Almond Milk

This is the go-to option for most strict paleo eaters starting out. It sounds like a great idea. Almonds are a nutritious nut, high in magnesium, copper, vitamin E, and manganese. They have a decent amount of protein, some nice prebiotic fiber. In your head, almond milk is fantastic. Unfortunately—and this goes for most of the other nut milks out there—the average jug of store-bought almond milk contains no more than a handful of almonds.

In an ounce of almonds:

  • 163 calories
  • 6 g carbs: 3.5 g fiber
  • 14 g fat: 8.8 g MUFA, 3.4 g linoleic acid (LA), 1.1 g SFA
  • 6 g protein
  • 50% vitamin E
  • 22% vitamin B2
  • 31% copper
  • 18% magnesium
  • 28% manganese

In a cup of almond milk:

  • 36 calories
  • 1.4 g carbs
  • 2.6 g fat: 1.7 g MUFA, 0.6 g linoleic acid
  • 1.4 g protein
  • 45% vitamin E (added)
  • 17% vitamin A (added)
  • 25% vitamin D2 (added)
  • 4% magnesium
  • 4% manganese
  • 39% calcium (added)
  • 8% copper

Not great carry over. No prebiotic almond fiber. Almost no protein, magnesium, manganese, or copper. The richest nutrients are all the ones they added after the fact.

Cashew Milk

Cashew milk is in the same boat: mostly water, not too much cashew.

In an ounce of cashews:

  • 156.8 calories
  • 8.6 g carbs: 0.9 g fiber
  • 12.4 g fat: 6.7 g MUFA, 2.2 g LA, 2.2 g SFA
  • 5.2 g protein
  • 10% vitamin B1 (thiamine)
  • 69% copper
  • 24% iron
  • 20% magnesium
  • 20% manganese
  • 15% zinc

In a cup of cashew milk:

  • 25 calories
  • 1.4 g carbs: 0.2 g fiber
  • 2 g fat: 1.1 g MUFA, 0.4 g linoleic acid
  • 0.8 g protein
  • 2% vitamin B1
  • 11% copper
  • 4% iron
  • 3% magnesium
  • 3% manganese
  • 2% zinc
  • 17% vitamin A (added)
  • 25% vitamin D2 (added)
  • 18% vitamin E (added)
  • 37% calcium (added)

Coconut Milk

Traditionally, you make coconut milk by pulverizing fresh coconut flesh, blending it with a little water, and passing it through a cheesecloth or fine strainer. This produces a very rich, very high-fat milk that runs about 550 calories per cup. This is the coconut milk used in cooking that comes in cans and cartons. A second pass with the coconut solids produces a thinner, less-rich coconut milk that runs about 150 calories per cup. This is often called “Lite Coconut Milk” and can be used to cook or to drink.

Besides the abundance of medium chain triglycerides and a lot of manganese, neither thick or thin coconut milk are nutrient-dense. A cup of rich, full-fat coconut milk gives decent amounts of magnesium, copper, zinc, selenium, and iron, but you have to realize that it takes 600 calories to get those nutrients. That’s not exactly nutrient-dense; the micronutrient-to-calorie ratio is skewed.

They do sell jugs of thin coconut milk as a milk replacement. Except for the fortifications they add (vitamin D, calcium, riboflavin, and the other usual suspects), these are

Flax Milk

In an ounce of flaxseed:

  • 151.4 calories
  • 8.2 g carbs: 7.7 g fiber
  • 12 g fat: 2.1 g MUFA, 6.5 g ALA (omega-3), 1.7 g LA, 1 g SFA
  • 5.2 g protein
  • 39% vitamin B1 (thiamine)
  • 38% copper
  • 20% iron
  • 26% magnesium
  • 31% manganese
  • 13% selenium
  • 11% zinc

In a cup of flax milk:

  • 25 calories
  • 1 g carbs
  • 2.5 g fat: 1.2 g ALA (omega-3)
  • 5% iron
  • 63% B12 (added)
  • 25% vitamin D2 (added)
  • 17% vitamin A (added)
  • 25% calcium (added)

The main standout is the omega-3 content. Flax milk has a little over a gram of alpha-linolenic acid (the plant form of omega-3) per cup.

Hemp Milk

I’m not talking about the oncoming wave of high-THC cannabis milks. This is hemp milk, produced by blending non-psychoactive hemp seeds with water and straining the solids out.

In an ounce:

  • 149.1 calories
  • 7.8 carbs: 7.8 g fiber (all fiber)
  • 10.1 g fat: 1.1 g MUFA, 2.2 g ALA, 4.8 g LA, 0.8 g SFA
  • 7 g protein
  • 24% vitamin A
  • 63% copper
  • 50% iron
  • 33% magnesium
  • 86% manganese
  • 13% selenium
  • 18% zinc

In a cup of hemp milk:

  • 70 calories
  • 2.2 g carbs, all fiber
  • 6 g fat, 1 g ALA (omega-3), 3 g omega-6
  • 2 g protein
  • 18% copper
  • 13% iron
  • 10% magnesium
  • 24% manganese
  • Plus all the usual fortifications (calcium, vitamin D, vitamin A, riboflavin, vitamin B12

That’s not too bad, actually. It picks up some decent mineral levels, and hemp fat is one of the only fats to contain stearidonic acid, an intermediate omega-3 fat in the conversion pathway from ALA to EPA that increases the EPA content of red blood cells in humans (a very good thing).

Macadamia Milk

There’s a product called Milkadamia. Great name, disappointing result.

In an ounce:

  • 203.5 calories
  • 3.9 g carbs: 2.4 g fiber
  • 21.5 g fat: 16.7 g MUFA, 0.4 g LA, 0.1 g alpha linolenic acid (ALA), 3.4 g SFA
  • 2.2 g protein
  • 28% vitamin B1 (thiamine)
  • 24% copper
  • 13% iron
  • 51% manganese

In a cup of mac nut milk:

  • 50 calories
  • 1 g carbs
  • 5 g fat
  • 1 g protein
  • 125% vitamin B12
  • 17% vitamin D
  • 25% vitamin A
  • 38% calcium

Despite having the best product name and the most potential for being a creamy milk substitute (has anyone tried adding mac nuts to a smoothie?—incredible!), the nutrient profile is low, and there’s not much going on.

Oat Milk

I’ve written about oats before. They have some interesting properties, some beneficial fiber, and a decent mineral profile. Adding oat beta-glucan fibers to fiber-free instant oatmeal reduces the postprandial glucose response, so at least in the context of refined starch, oat fiber can be helpful.

The most popular and widely-available oat milk is called Oatly. The website explains the process: mill raw oats with water, add enzymes to extract the starch, separate the beta-glucan from the bran, discard the bran, pasteurize it, bottle it. This retains the beta-glucans (2 grams of fiber per cup) and starch (16 grams carbs per cup). The only micronutrients they advertise are the ones they add, including calcium, potassium, vitamin A, riboflavin, vitamin D, and vitamin B12; there’s no indication that the normal oat-bound minerals like magnesium, manganese, and zinc make it into Oatly in significant amounts. To top things off, they add canola oil for texture and mouthfeel.

Rice Milk

Rice milk is made by blending water with cooked rice, brown rice syrup, and brown rice starch.

Like the others, its only real micronutrients comes from the ones they add to it. It’s higher in carbohydrates than any of the other milks I found.

Soy Milk

Believe it or not, of all the popular non-dairy milks out there, soy milk contains the most nutrients and is probably the closest to cow milk. It’s high in protein. It contains a nice balanced selection of minerals. A review comparing soy milk, coconut milk, almond milk, and rice milk to cow milk found that soy milk was the closest—mostly because it actually featured measurable nutrients.

In a cup of soy milk:

  • 74 calories
  • 3.6 g carbs; 2 g fiber
  • 4 g fat
  • 8 g protein
  • All the usual additions, like calcium, vitamin B12, vitamin D, riboflavin, and vitamin A
  • 10% magnesium
  • 15% manganese
  • 6% folate
  • 6% potassium
  • 19% copper
  • 10% selenium

It’s not ideal though. People who regularly drink soy milk tend to end up with micronutrient deficiencies. Kids who drink cow milk are less likely to have atopic eczema, while soy milk drinkers have no such protection (and may even have increased risk). The protein in soy milk can help people build muscle, but milk proteins work better and also provide other benefits to the immune system.

I’m not saying you shouldn’t use non-dairy milks. They are inoffensive and helpful for recipes. Just don’t expect any incredible health benefits from them.

3 Notable Brands With Extra Benefits

But there are a few specific non-dairy milk products that deserve a closer look, especially if you’re going to go this route.

Vita Coco Coconut Milk

Instead of blending coconut meat with water and filtering out the solids, Vita Coco mixes coconut cream into coconut water to produce a milk-like product. I haven’t tasted it myself, but the nutrient profile is pretty compelling.

  • Moderate levels of fat (5 grams per cup), primarily from saturated medium chain triglycerides.
  • Low carb (5 grams per cup). Naturally sweet from the coconut.
  • Decent mineral levels (RDIs: 45% calcium, 15% magnesium, 10% potassium, 10% zinc).

Some of the calcium, magnesium, and zinc is added, some is natural (coconut water can be a good source of all three). Still, it’s cool to see magnesium added because so many are deficient and supplementary magnesium is well-tolerated and effective.

Ripple

Back when I was toying with the idea of getting a significant amount of my protein from plant sources for a quick experiment (long story short: I didn’t do it, I like animals too much, and I found myself relying too heavily on processed powders), I got a bottle of something called Ripple. Ripple is pea-based milk, fortified with extra pea protein, algae-based DHA, calcium, iron, and vitamin D. It has as much protein per serving as milk (8 grams), using a type of protein that can promote muscle gain, and it tastes quite good. It uses high-oleic sunflower oil for fat, which is low in polyunsaturated fat. If I truly couldn’t have dairy and desperately wanted something to drink or make smoothies with, I’d probably do Ripple.

Tempt Hemp Milk

I’ve never tried this brand, or hemp milk in general. But just like the generic hemp milk analyzed above, Tempt Hemp Milk has a far better nutrient profile than most of the other nut or other non-dairy milks I ran across. If it tastes anything like hemp seed, which has a nutty, subtle flavor, I can imagine hemp milk having a pleasant taste.

Tips For Making Your Own

You’re all an enterprising bunch. Why not make your own non-dairy milk?

  1. You can make your own nut milk. There are thousands of recipes out there, but they generally seem to involve soaking nuts in water and a pinch of salt overnight, draining them, and blending the nuts with fresh water, straining out the solids, and sometimes adding a date or a dab of maple syrup for sweetening. The higher the nut:water ratio, the richer, more nutritious the milk.
  2. You can also make thicker, more nutrient-dense nut milk by blending nut butter and water until you reach the desired consistency. You aren’t discarding anything with this method.
  3. You can avoid nuts altogether. One scoop of MCT powder, one scoop of collagen peptides, whisked into water makes a decent approximation of milk. Use 3 tablespoons of water to make creamer for coffee. This isn’t a nutrient-powerhouse, but it provides medium chain triglycerides (which boost ketone production) and collagen.
  4. Or how about making a kind of nut broth? The usual audience for non-dairy milks is obsessed with consuming raw foods. They make a point to prevent their food from ever getting warmer than the hemp-clad crotch of a Trustafarian hitchhiking through Joshua Tree in the middle of summer. But consider that applying heated water to pulverized nuts will extract even more nutrients from the nut and deliver them into the water. Then you strain the solids and refrigerate the broth, producing “milk.” I bet that’d be quite tasty and more nutritious than a cold water nut wash.

The Bottom Line on Nut Milks…

Nothing on the market or that you cook up in your kitchen is going to rival the nutrient density of cow’s milk. From the protein to the healthy dairy fats to the dozens of micronutrients we know about and the dozens we have yet to catalogue, actual milk packs a real wallop that your basic almond, cashew, pecan, or flax milk simply can’t defeat. So, you’ll have to shift your view of “milk” as a whole food. Don’t give your kid four glasses of hemp milk and think you’re replacing cow dairy. Don’t wean your infant off the breast and fill a bottle with hazelnut milk instead; it’s not the same. Don’t eat a dog bowl-sized serving of cereal with some rice milk. The only nutritious part of cereal is the milk, and non-dairy milks do not qualify. Don’t rely on non-dairy milks for your nutrient intakes. Those are shoes they’ll never fill.

Instead, use non-dairy milks to make nutrient-dense smoothies. Use them in your coffee. Make protein shakes with them. In short, use these non-dairy plant-based milks to make it easier to eat more nutrient-dense foods.

Before you run out to buy cashew milk or pea milk or something similar, I will say this: I’m a fan of dairy. It’s a nutrient-dense source of bioavailable protein, healthy fat, calcium, vitamin K2, and other important and helpful compounds. If you can eat it without tolerance issues, you probably should. And if you can’t, you may be able to tolerate other animal milks, like goat’s milk. Many people who can’t do cow dairy can handle goat. It’s worth a try.

What about you? What’s your favorite non-dairy milk? Do you have any plant-based milks that you swear by?

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References:

Onuegbu AJ, Olisekodiaka JM, Irogue SE, et al. Consumption of Soymilk Reduces Lipid Peroxidation But May Lower Micronutrient Status in Apparently Healthy Individuals. J Med Food. 2018;21(5):506-510.

Hon KL, Tsang YC, Poon TC, et al. Dairy and nondairy beverage consumption for childhood atopic eczema: what health advice to give?. Clin Exp Dermatol. 2016;41(2):129-37.

Babault N, Païzis C, Deley G, et al. Pea proteins oral supplementation promotes muscle thickness gains during resistance training: a double-blind, randomized, Placebo-controlled clinical trial vs. Whey protein. J Int Soc Sports Nutr. 2015;12(1):3.

Wolever TMS, Jenkins AL, Prudence K, et al. Effect of adding oat bran to instant oatmeal on glycaemic response in humans – a study to establish the minimum effective dose of oat ?-glucan. Food Funct. 2018;9(3):1692-1700.

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Dear Mark: How Does LDL Even Penetrate the Arteries, New Zealand Farmed Salmon, Elevated Ferritin

For today’s edition of Dear Mark, I’m answering three questions. First, can LDL actually infiltrate the arteries, or is there more to the story? Malcolm Kendrick says there’s more to the story, so I dig into some literature to see if they corroborate his position. Second, is New Zealand farmed salmon good to eat? And finally, what should you do about elevated ferritin levels—and why else might they be elevated if not because of your iron?

Let’s go:

My reading of this post by Malcolm Kendrick MD is that LDL particles cannot infiltrate the endothelial lining of our arteries:
https://drmalcolmkendrick.org/2018/08/16/what-causes-heart-disease-part-52/

Great read. Malcolm Kendrick is consistently fascinating, insightful, and enlightening.

He’s basically suggesting that LDL particles can’t manhandle their way into the artery wall, which are equipped with tight junctions—the same kind that regulate passage through our gut lining. Something has to “allow” them in. The something he finds most plausible is injury, trauma, or insult to the endothelial lining (artery wall, for lack of a better phrase).

A free public textbook available on PubMed since last month called The Role of Lipids and Lipoproteins in Atherosclerosis tackles the topic head on. In the abstract, they say:

Population studies have demonstrated that elevated levels of LDL cholesterol and apolipoprotein B (apoB) 100 [note: ApoB is a stand-in for LDL particle number, as each LDL-P has an ApoB attached to it], the main structural protein of LDL, are directly associated with risk for atherosclerotic cardiovascular events (ASCVE). Indeed, infiltration and retention of apoB containing lipoproteins in the artery wall is a critical initiating event that sparks an inflammatory response and promotes the development of atherosclerosis.

This seems to posit that infiltration of the LDL particle into the artery wall is a critical initiating event. But is it the critical initiating event? Does something come before it? How does the infiltration happen, exactly? Moving on:

Arterial injury causes endothelial dysfunction promoting modification of apoB containing lipoproteins and infiltration of monocytes into the subendothelial space. Internalization of the apoB containing lipoproteins by macrophages promotes foam cell formation, which is the hallmark of the fatty streak phase of atherosclerosis. Macrophage inflammation results in enhanced oxidative stress and cytokine/chemokine secretion, causing more LDL/remnant oxidation, endothelial cell activation, monocyte recruitment, and foam cell formation.

If I’m reading this correctly, they’re saying that “arterial injury” is another critical initiating event—perhaps the critical initiating event, since the injury causes “endothelial dysfunction,” which in turn modifies (or oxidizes) the LDL particles. But wait: so they’re saying the LDL particles are already there when the arterial injury occurs. They’ve already made it into the endothelial walls, and they’re just…waiting around until the arteries get injured. Okay, okay, but, just like Malcolm Kendrick points out, nowhere in the abstract have the authors actually identified how the LDL particles enter the endothelial lining. Maybe it’s “common knowledge,” but I’d like to see it explained in full.

Moving on:

In atherosclerosis susceptible regions, reduced expression of eNOS and SOD leads to compromised endothelial barrier integrity (), leading to increased accumulation and retention of subendothelial atherogenic apolipoprotein B (apoB)-containing lipoproteins (low-density lipoproteins (LDL)) and remnants of very low-density lipoproteins (VLDL) and chylomicrons)

Ah ha! So, in regions of the arteries that are prone to atherosclerosis, low levels of nitric oxide synthase (eNOS)—the method our bodies use to make nitric oxide, a compound that improves endothelial function and makes our blood flow better—and superoxide dismutase—an important antioxidant our bodies make—compromise the integrity of the arterial lining. The compromised arterial lining allows more LDL particles to gain entry and stick around. So, are low levels of nitric oxide and impaired antioxidant activity the critical initiators? That’s pretty much what Malcolm Kendrick said in his blog post.

Still—high LDL particle numbers are a strong predictor of heart disease risk, at least in the studies we have. They clearly have something to do with the whole process. They’re necessary, but are they sufficient? And how necessary are they? And how might that necessariness (yes, a word) be modified by diet?

I’ll explore this more in the future.

In regards to the oily fish article (and more indirectly given the omega 6 concern- the Israeli Paradox) What do you think of NZ farmed salmon? I’m in Australia, & occasionally like a fresh piece of salmon- there are no wild caught available here sadly, but I am wondering how it measures up as an alternative?

Last year, I explored the health effects of eating farmed salmon and found that it’s actually a pretty decent alternative to wild-caught salmon, at least from a personal health standpoint—the environmental impact may be a different story.

I wasn’t able to pull up any nutrition data for New Zealand farmed salmon, called King or Chinook salmon. Next time you’re at the store, check out the nutritional facts on a NZ farmed salmon product, like smoked salmon. The producer will have actually had to run tests on their products to determine the omega-3 content, so it should be pretty accurate. Fresh is great but won’t have the nutritional facts available. I don’t see why NZ salmon would be any worse than the farmed salmon I discussed last year.

According to the NZ salmon folks, they don’t use any pesticides or antibiotics. That’s fantastic if true.

I used to eat a lot of King salmon over in California, and it’s fantastic stuff. Very fatty, full of omega-3s. If your farmed King salmon comes from similar stock, go for it.

ok can someone tell me how to reduce ferritin? Is is just by giving blood?

Giving blood is a reliable method for reducing ferritin. It’s quick, effective, simple, and you’re helping out another person in need. Multiple wins.

Someone in the comment board recommended avoiding cast iron pans in addition to giving blood. While using cast iron pans can increase iron intake and even change iron status in severe deficiency, most don’t have to go that far. Giving blood will cover you.

Ferritin is also an acute phase reactant, a marker of inflammation—it goes up in response to infections (bacterial or viral) and intense exercise (an Ironman will increase ferritin). In fact, in obese and overweight Pakistani adults, elevated ferritin seems to be a reliable indicator of inflammatory status rather than iron status.

Thanks for reading, everyone. Take care and be well!

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References:

Birgegård G, Hällgren R, Killander A, Strömberg A, Venge P, Wide L. Serum ferritin during infection. A longitudinal study. Scand J Haematol. 1978;21(4):333-40.

Comassi M, Vitolo E, Pratali L, et al. Acute effects of different degrees of ultra-endurance exercise on systemic inflammatory responses. Intern Med J. 2015;45(1):74-9.

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