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.
“Has Mark given up Primal?” I get this question all the time, and I’m not surprised. Over the past few years, I’ve really focused on exploring the utility, applications, and ins and outs of the ketogenic diet. Why?
I’m still Primal and have been for over a decade. That won’t ever change. And you can go Primal—drop industrial seed oils, added sugar, and grains—and be perfectly fine. Better than 95%. You’ll lose body fat, gain energy and performance, and reduce your risk of degenerative disease. It will always be the foundation of my eating—and living. But I see (and have experienced) keto as a boost, an enhancement, a Reset. A return. Today I’m answering some questions around this idea with a new video.
Ketosis is the metabolic state in which our ancestors—all of them—spent a significant amount of time, whether from low carbohydrate availability, intense and protracted physical activity and exertion, or prolonged caloric deficits. We come from people who had to work for their food, who couldn’t count on a square well-balanced meal with “adequate” carbs, fats and protein, who sometimes simply didn’t have anything to eat for extended periods of time. As a result, they were often in ketosis. Intermittent ketosis is the metabolic milieu in which our physiologies were forged. That’s the metabolic milieu a modern person going keto is trying to emulate. It’s a smart move.
It’s why nearly everyone should spend time in ketosis. It’s why everyone should consider doing a full-on keto reset where you take six weeks to get completely fat-adapted, build up those fat-burning mitochondria, and enhance your metabolic flexibility. But, and this is a big “but,” very few people need to spend the rest of their lives there.
But most of the time I’ll hover somewhere around 50 grams of total carbs a day as defined in the Keto Reset approach.
But because I’ve built up the metabolic flexibility (and continue to refresh that flexibility with an intentional 6-week Keto Reset each year), I don’t have any issues utilizing all the various sources of energy. My energy doesn’t wane whether I eat 100 carbs or 10 carbs. Whether I’ve eaten nothing but meat or had a Big Ass Salad. I can tailor my fuel sources to my desires and requirements. That’s true flexibility. And freedom. It’s a version of Primal that works even better for me, and I’ve seen it benefit many others.
But let me share a video to take this further….
Thanks for stopping in, everybody. I hope I answered some questions here, but shoot me a line if there’s something outstanding or if you’re curious about something in your own Primal or Primal-keto journey. And have a great end to the week.
Olive oil is the great uniter of the dietary tribes. While your Ray Peatians might grumble at the 10% PUFA content and hardcore carnivores will balk at its vegetal origins, the vast majority of dietary camps—vegans, vegetarians, paleo, Primal, keto, Mediterranean, Weight Watchers, etc.—consider olive oil to be a healthy fat. I have it on good authority that Walter Willet oils his mustache with Croatian olive oil, Dean Ornish conditions his hair with Cretan olive oil, and Peter Attia keeps a bathtub full of Damascan olive oil behind a secret panel in his library that only unlocks if you complete a tabata session on his Peloton. I even saw Shawn Baker sneaking sips from a flask with green oily fingerprints when we recently hung out. Everyone likes olive oil. There are almost no exceptions.
This is about where I usually step in to make a contrarian claim about the super-popular food, citing some arcane study or pointing out an evolutionary argument against it.
Not with olive oil. As much as I love my avocado oil, I see no reason to question the legitimacy of extra virgin olive oil as a valid member of your diet. Personally, I include both. Here’s why….
Healthy Components of Olive Oil
Its MUFA content. Monounsaturated fats are pretty much universally lauded. Almost as resistant to oxidation as saturated fats, they raise HDL and lower LDL. Cellular membranes and mitochondria with a lot of monounsaturated fat function better than ones with more polyunsaturated fats. They’re the rock of the fatty acid world.
Its polyphenol content. Extra virgin olive oil is rich in polyphenols. Polyphenols are the plant nutrients that act as antioxidants in the plant—protecting it from predators and oxidative stress and heat and light. They act as minor toxins in us, provoking an adaptive hormetic response that makes us stronger, fitter, and healthier. Polyphenols get mixed reviews from different dietary camps. Carnivores often call them outright toxins with no benefit. Conventional skeptics usually miss the whole “hormesis” thing altogether and assume proponents think polyphenols are antioxidants that directly block oxidative stress in us. My nuanced take is that polyphenols can be pretty useful, but that there’s likely a U-shaped relationship: Too little is suboptimal, and too much is too much, just like with exercise, sun exposure, and any other type of adaptive stress we experience.
Its prominent role in classic Mediterranean cuisine. Olive oil has been eaten (and used in cosmetics, to cleanse gladiator champions, etc.) in the Mediterranean (including areas of Africa, Europe, and Asia) for thousands of years. It’s got a good track record of human use.
Those are all good theoretical reasons to use olive oil. What do human studies say?
Research Supporting Olive Oil Consumption
Overweight women ate one of two breakfasts for a year. The first was supplemented with soybean oil. The second was supplemented with extra virgin olive oil. Both breakfasts were identical save for the fat source. At the end of one year, those who ate the EVOO breakfast had higher HDL, lower inflammatory markers, better blood pressure, and lower body weight.
Dietary EVOO reduced the number of oxidized LDL and increased HDL in proportion to the phenolic content of the oil; the more phenolics, the greater the effect. Tested LDL was also more resistant to oxidation after being removed from subjects and exposed to oxidative stress. Similar effects were found in a more recent study, in which men were given either EVOO with high phenolic content or refined olive oil with zero phenolics present. Men consuming high phenolic EVOO had less oxidized LDL and more phenolics present in LDL, indicating that olive phenolics reach serum LDL and exert antioxidant effects in real live actual humans.
Tips For Incorporating Olive Oil
There aren’t many foods you can’t make better by topping off with a little olive oil. The flavor of a good olive oil is nuanced enough to elevate the simplest dishes, and that’s what I enjoy about it.Think everything from marinated nuts and olives to a light dinner of Cacio e Pepe zoodles.
Cream of garlic (or cream of anything) soup? Better with a drizzle of olive oil before serving. Savory Labneh yogurt? Also better “finished” with olive oil. And don’t forget olive oil sauces. I just shared one of my favorites this week: pesto. It’s a totally modular sauce you can make with your favorite oil, nuts and herbs, but extra virgin olive oil remains the traditional choice.
Okay, so drizzling extra virgin olive oil across your dinner salad is healthy, but isn’t olive oil sensitive to heat? Aren’t you supposed to avoid cooking with it? Actually, no. Extra virgin olive oil is resistant to low and medium heat.
Despite being heated at 180 ºC (356 ºF) for 36 hours, two varieties of extra virgin olive oil exhibited strong resistance to oxidative damage and retained most of their “minor [phenolic] compounds.” Another study added olive phenols to vegetable oil, then heated it. Adding the olive phenols made the vegetable oil more resistant to oxidation and preserved the vitamin E content, offering more protection than even a synthetic antioxidant designed to do the job.
It’s not just that nothing bad really happens when you cook with EVOO. It’s also that uniquely good things happen when you cook with it.
I’ll occasionally take a teaspoon straight up, if it’s good stuff (and I only have good stuff). I really relish that peppery bite you get in the back of your throat—that’s the polyphenol burn.
I drizzle it on cooked lamb—often marinated in nothing but the same olive oil—and follow with flaky salt. Lamb stands up well to more complex marinades, but it’s also great grilled plain and drizzled with good EVOO and salt. Nothing else.
If you haven’t noticed, I like to use good EVOO where I can taste it.
I love preparing fish with olive oil. There’s even evidence that olive oil and fish fat have a synergistic effect on blood lipids and oxidative stress, combining to exert greater benefits than either fat alone or through simple addition.
To sum up…
Olive oil is great for eating cold and dressing salads. This really brings out the flavors and preserves the polyphenols.
But olive oil is great for many cooking methods, too. Olive oil is resistant to heat damage in low and medium heat applications like slow roasting, baking and light sauteing, thanks to the stability of the fatty acids and antioxidant capacity of the polyphenols. It preserves and even enhances nutrient content of vegetables when used to cook.
Olive oil has been around for millennia, and it will continue to stick around. I happen to love Mediterranean food, so you’ll always find it in my kitchen.
In fact, when researchers tried to justify replacing EVOO with canola oil as the primary fat in the Mediterranean diet, they couldn’t do it. Wanted to, but couldn’t. Can you imagine? You’re on your honeymoon, traveling through Tuscany. You stop at a rustic vineyard. The proprietor, Giancarlo, wants to show you his prized homegrown oil, just pressed. He brings in a cask of the finest canola oil; you can still smell the hexane residues.
Thanks for reading, everyone. Do you like olive oil? How do you use it? What’s your favorite way to consume it?
For today’s edition of Dear Mark, I’m answering questions about vitamin K2 and microworkouts. The last two posts on both topics garnered a number of good questions. What’s the best dose of vitamin K2? Should statin users taking vitamin K2, since statins inhibit vitamin K2 activity and production? Can vitamin K2 prevent or reverse arterial calcification? Is butter an adequate source of vitamin K2? What about vitamin D—does it synergize with vitamin K2? Regarding microworkouts, what if you can only do a couple pull-ups at once? Should you alternate muscle groups when doing microworkouts? Can microworkouts work with normal gym workouts? How does one do microworkouts in an office?
Let’s find out:
What’s the recommended dose of vitamin K2?
There’s no official RDA for vitamin K2. For vitamin K in general, it’s 0.09 mg. As some of the commenters have alluded, very few medical professionals have vitamin K2 on their radar. I wonder if the RDA is sufficient.
Up to 45 mg per day of MK4 has been shown to be safe and well-tolerated in women, though I don’t think that much is necessary. Some use close to that much when dealing with osteoporosis, arterial calcification, or dental issues, although the reports are all anecdotal.
Many take 1 mg of vitamin K2 as “maintenance.” I’d be comfortable taking that (and sometimes do).
I put 0.08 mg of K2 (MK7) in my Master Formula supplement. Women who are pregnant and those who take anticoagulant medications should talk to their doctor before taking more than the RDA.
So, would taking K2 make statins safer? Do you think you could take enough K2 to prevent clogged arteries or reverse clogged arteries?
As for clogged arteries, it can definitely reduce the risk of arterial calcification (by putting calcium where it belongs and not where it doesn’t). Reversal? There aren’t any studies in humans, but vitamin K2 MK4 has been shown to reverse clogged arteries in rats.
Do you have a source on muscle meat (of any type) having Vitamin K?
I had read of recommendations of cod liver oil along w K2 which was obtained with grass fed butter. Would grass fed butter be a good source in your opinion
It’s possible, but the sources I’ve read show that majority of butter is very low in vitamin K2. Still, Weston Price swore by concentrated butter oil from grass-fed cows as a source of vitamin K2. You can still buy butter oil if you want to go that route (though you won’t get any solid data on vitamin K2 content).
I wouldn’t rely on straight butter for your vitamin K2.
Isn’t it important to take K2 when supplementing with oral D3? I’ve been seeing liquid D3 preparations with K2/MK7 added.
Yes. Vitamin D3 helps us absorb dietary calcium, and vitamin K2 helps us utilize the calcium in the right way.
What if you can only do 2-3 pull-ups to begin with? ?
That’s the perfect place to start.
Do a single pullup every time you pass the pullup bar (or branch, ledge, gym rings, etc). That’s it. One clean pullup. Don’t struggle. Don’t strain. It should feel easy. Do that single pullup every time you pass the bar. Then, when you feel ready, try doing two each time. And then three.
Suddenly, your max pullups will have doubled.
Should you alternate microworkouts by muscle group each day as with traditional strength training or can you do microworkouts covering all muscle groups each day?
You could, but I find that microworkouts give enough rest that you can work the same muscle on consecutive days. It really depends on the intensity though. If your idea of a microworkout is a 20 rep set of breathing squats with your own bodyweight on the bar, and you do that a few times a day, I would not advise doing it every day.
I don’t claim that microworkouts in this manner will optimize your muscle hypertrophy. I do claim that they’ll keep your days active, keep you healthy, keep you mobile, and get you strong.
I love the idea that any exercise is better than none at all. But I wonder if this style of workout would interfere with recovery from other more regular/scheduled workouts (weightlifting, etc…)?
On the contrary, I find that microworkouts prepare me for the more concerted, formal efforts in the gym.
My buddy Angelo Delacruz is an example of a guy who’s “always on” because he’s always doing little movements throughout the day: dancing to the music playing at the gym, busting out a quick little stretch routine, doing some clapping pushups, breakdancing. He’ll just launch into a set of heavy snatches or clean and jerks without warming up because his joints are all lubed up from the frequent microworkouts.
Well I stand at my computer most of the day 6a-2p with several sets of stairs during that time–I duck into an empty meeting room to run off 15-20 pushups a few times a day, and at lunch a few days a week ( i usually IF til 3-4p ) I do some heavy weights at the local gym for about 20 minutes or so–then comes the yard work on occasion and would you count shopping with the wife at a Big Box store as a micro workout? So How an I doing? I know Mark, Just keep moving!
You’re doing great. I see nothing to add.
As for shopping, sure, why not? Shopping can work.
I’ve been known to curl the groceries as I walk out to the car. Overhead press the cases of mineral water. Plant my feet and do cable crosses with a heavy shopping cart. Sure used to embarrass my kids.
It gets more difficult when on-site for a client. Most offices here aren’t air conditioned, so when it’s warm you’re really going to sweat which makes you less presentable. I try to make it up by picking a hotel in walking distance (~45-60min ish). If there isn’t a private space to knock out a couple of body weight exercises there isn’t a lot you can do without becoming the resident office weirdo. Maybe someone has an idea?
Walking meetings come to mind. Stair stuff—sprints, jumps, or simply just walking all the flights in one fell swoop. Doing as many squats as possible in the elevator before someone else enters and looks at you funny. Pushups in the bathroom stall.
Okay, maybe not that last one.
The AC thing would make it difficult, though. I can see that.
This is it for today, folks. Take care, be well, and ask any other questions you have down below!
This easy, simple pesto recipe offers a perfect go-go recipe when you want that classic basil and pine nut pesto flavor. What will you use it for?
Put torn basil leaves, garlic cloves and pine nuts in a food processor or blender. Pulse for about 10 seconds or until garlic appears well chopped. Add cheese and salt and pepper. Run processor while you pour in oil and blend well into a spoonable sauce. (If you’ll be storing rather than using right away, add a squeeze of fresh lemon juice to maintain color.) Enjoy!
Pasta and meatballs are a classic, comforting dish, but there’s more possibilities than the carb-heavy grain pasta and beef meatball version. You’ll find these chicken hemp meatballs to be a little lighter and more nuanced. Over a helping of spiralized zucchini, it’s the perfect match of freshness and taste, but let’s not stop there. With a rich but bright Romesco sauce, this dish opens up a whole new world of Italian flavor.
Tips: Enjoy these meatballs over your favorite primal noodle. You can use raw zucchini noodles or lightly saute or roast them prior to eating. You can also serve these meatballs over cauliflower rice, spaghetti squash or sweet potato noodles. If you don’t have hazelnuts, you can switch up the romesco sauce by substituting almonds or walnuts. For more flavor, roast the nuts prior to blending them into the sauce.
Prep Time: 25 minutes
Cooking Time: 60 minutes
12 oz. ground chicken thighs
2 Tbsp. EVO Hemp Hearts
2 Tbsp. minced red onion
2 Tbsp. chopped parsley
2 Tbsp. almond flour
½ Tbsp. olive oil or avocado oil
2 cloves garlic, minced
¼ tsp. ground black pepper
¼-1/2 tsp. salt
1 large egg
1 red bell pepper (about 1 cup) + drizzle of Primal Kitchen Avocado Oil
½ roma tomato (about ¼ cup)
3 Tbsp. hazelnuts
2.5 Tbsp. chopped parsley
1.5 Tbsp. olive oil
1/2 Tbsp. red wine vinegar
½ Tbsp. EVO Hempseed Oil
1 clove garlic, minced
2 cups spiralized zucchini
Chopped parsley and hemp seeds, to garnish
Preheat your oven to 375 ºF. Rub avocado oil all over the pepper and tomato and place it in the oven on a parchment covered sheet pan or oven-safe dish. The tomato will only need 15-20 minutes to be nicely roasted. Remove the tomato and set it aside once roasted and soft. Flip the pepper every 15 minutes or so until the skin of the pepper is nicely charred. This will take about 50-60 minutes in all. Set the pepper aside with the tomato to cool.
In a bowl, combine all of the meatball ingredients together. Allow the mixture to rest for 5 minutes. Form 9-12 meatballs from the mixture and place them on a lightly oiled sheet pan or glass dish. Bake for about 20 minutes or until they reach an internal temperature of 165 ºF.
Peel the stem of the pepper off and discard the stem and the seeds inside of the pepper. Run the pepper under water and peel off and discard the skin of the pepper. Place the pepper, tomato, and remaining romesco ingredients in a blender or food processor and blitz until the nuts are small and a sauce forms. You can leave the sauce a little rustic and chunky or blend it more to make it smooth.
Spoon some of the romesco sauce over your zucchini and top with the chicken meatballs. Spoon the remaining sauce on top and garnish with chopped parsley and hemp hearts. Enjoy!
Nutritional Information (3 servings, per serving):
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.
Incentivizing organ donation by giving registered donors priority if they need a new organ increases organ pool but lowers organ quality.
Things I’m Up to and Interested In
News I’m pleased to announce: Primal Kitchen® took first place in several categories of Paleo Magazine’s annual “Best of” awards, including Best New Product (our ketchup and mustard), Best Paleo Food Company, and Best Paleo Lifestyle Company. Thanks, everybody!
Disclaimer: I have not gone through menopause. I am, however, turning 40 this year. Statistically speaking, this is the decade in which I’m likely to enter perimenopause, so I have a vested interest in understanding what might be in store for me.
I’m all too familiar with the stereotype of the belligerent, out-of-control menopausal lady plagued by hot flashes and mood swings, bewildering her poor, beleaguered partner. [Note that for convenience I am going to use “menopause” to include the perimenopausal period as well.] Frankly, this narrative doesn’t suit me at all. I know very well that hot flashes and mood swings can be a part of menopause, but obviously there’s a lot more to it than that.
Of course, I want realistic view of what lies ahead so I might prepare mentally, emotionally, and physically. However, I also want the nuances. Plus, as an optimist I want to know the good, not just the bad and the ugly. To my mind, any major life transition is a chance at a reawakening of sorts, even if the road through it is rocky. My natural tendency is to find the silver lining and reframe situations as growth opportunities.
Menopause is much more than a collection of symptoms that need to be combatted. However, much of what’s written about menopause, from the scientific literature to the blogosphere, focuses on copingwith and dealing with menopause. After a while, one wonders if the scientific and medical communities aren’t overeager to problematize and medicalize menopause by putting all the focus on the symptoms and, naturally, the treatments (they can make money off of). You have to dig deeper to find discussions about the meaning of menopause through the eyes of women who are living it.
Nevertheless, plenty of women and scientists (and women who are scientists!) are exploring how menopause fits into the flow of a woman’s life. I came away from my research seeing that menopause is, in fact, not terrible for many women. There’s tremendous variation in individual women’s experiences of menopause, not only in terms of the actual symptoms but also in the way she appraises them. Menopause is far more nuanced and idiosyncratic than sitcom stereotypes or medicalized portrayals would have us believe. It can be a time of tremendous growth and transformation, and a lot of women embrace that opportunity.
Moreover, although hormone therapy is by far the most loudly promoted remedy, it’s not the only game in town by far. There are actually a wide array of options that women might use to prepare for and alleviate the troublesome aspects of menopause. (Stay tuned for a future post on this topic.)
Why We Go through Menopause: The Value of Elder Women
One of the fun facts I came across in my deep dive into menopause is that scientists have so far identified four non-humans species whose females experience menopause: orcas, narwhals, belugas, and short-finned pilot whales. All toothed whales—fascinating! Other primates probably do not, although chimps and gorillas might (this is controversial, apparently). In other words, we’re pretty special!
While the biology of menopause—the when and what—are well understood, the why is still not totally clear. Human females might spend 40% or more of their lives in the post-menopausal phase. As the authors of this paper bluntly put it, “If the main purpose of women is to propagate the species (survival of the fittest), as postulated by Darwin for all species, then going through menopause many years before dying should be selected against unless there are distinct advantages to it.”
Ouch, but also fair. Scientists have come up with various theories about the nature of those advantages and how they came to evolve. The most compelling explanation is that our post-menopausal longevity directly contributes to the reproductive success of our offspring. Because humans mature slowly, not only do our children require a ton of resources and caretaking, but we also have additional children before our older children are anywhere near self-sufficient.
The Intergenerational Network of Caregiving
The “grandmother hypothesis” proposes that elder women enhance the survival of their lineage by caring for their biological grandchildren, but they also pass down their considerable knowledge and wisdom in and beyond the family itself. Post-menopausal female orcas assume leadership roles in their pods. They’re instrumental in helping other whales find food. Research has shown that their ability to lead others to fruitful fishing grounds is especially important in times of food shortage.
These older females possess skills and knowledge that enhance the survival of their offspring; and their offsprings’ mortality risk increases dramatically following their mothers’ death. The same is probably true for humans. Indeed, there is historical evidence from the 1700s and 1800s that women reproduced earlier and more often if their children’s grandmother was alive. The grandchildren’s odds of surviving to adulthood decreased if grandmothers were distant or deceased.
Competition versus Cooperation
A related theory to the grandmother hypothesis is that intergenerational conflict drove the evolution of menopause. In both human and cetaceans, daughters reach sexual maturity while the mothers are also still capable of reproducing. However, there are only so many resources (both material and energetic) to go around.
When female orcas continue to reproduce once their daughters have themselves started reproducing, the older females’ babies are less likely to survive than the younger females’ babies. The same might have been true for humans. According to this line of thinking, as we age, it’s better that we cease having children of our own and instead step into a supporting role for direct caretaking—and a more expansive role beyond caretaking itself.
Personally, I like the view of our roles changing through the lifespan, providing different types of value at different times. We have different gifts to offer in our post-reproductive years.
Different Women, Different Menopauses
In both the scientific literature and everyday conversation, people tend to talk about menopause as if it were one thing, a singular experience shared by all women. Nothing could be further from the truth.
Although some symptoms are common enough to be considered standard—hot flushes/flashes, night sweats, vaginal dryness, and mood alterations being at the top of the list—the range of possible symptoms is considerably greater than that. Not all women will experience even the most common ones. Among women who do, the severity of those symptoms can vary tremendously. Depending on whom you ask, anywhere from 20-75% of women experience symptoms severe enough to significantly impact their quality of life.
A huge number of factors influences any individual woman’s experience. To start, the onset and severity of symptoms can differ depending on what type of menopause she experiences: if it is premature (younger than 40-years-old) or early (between 40 and 45 years), or if it’s induced by surgical removal of the ovaries versus natural changes in hormone levels. Other factors shown to affect a woman’s symptomatology include her physical and mental health before starting menopause, activity level, lifestyle factors such as smoking, socioeconomic status, and perhaps even geography.
It’s also clear that women’s expectations about and attitudes toward menopause shape her experience. Part of the stereotype is that menopausal women complain and kvetch their way through menopause, periodically pausing to stick their heads in the freezer. (I hear this does help.) However, surveys show time and again that most women actually have neutral to somewhat positive attitudes about menopause.
Many at least hold a mix of positive and negative beliefs and expectations. Understandably, women tend to hold negative attitudes towards hot flashes, night sweats, and other unpleasant physical symptoms. On the other hand, most women are only too happy to stop having monthly periods, and many of them are ready to move past the need for contraception. However, this can be an emotionally fraught time for women who are not ready for their reproductive years to end.
There’s a complex interplay between physical symptoms, attitudes and beliefs about menopause, and psychological well-being. Studies show a bidirectional link between a woman’s attitudes and her subjective experiences. Women who experience disruptive symptoms such as frequent and severe hot flushes understandably have more negative attitudes. The reverse is also true. One prospective study also showed that premenopausal women who had more negative attitudes about menopause later reported experiencing more frequent and more severe symptoms. Another study found that women are less likely to be bothered by menopause if they have other more pressing issues in their lives. (“Pssht, menopause? I can’t be bothered worrying about that, I’m too busy dealing with this crisis over here.”)
Women’s attitudes about menopause are also shaped by her cultural milieu. This could help explain why women around the world have quite disparate experiences in menopause. Not only do women in different cultures report being more or less bothered by menopause overall, the specific symptoms they describe differ as well. The reasons for this are not well understood. It’s not clear whether cross-cultural differences are due to factors like diet, climate, and number of children a woman typically bears, or whether they reflect the varied beliefs and meanings that cultures ascribe to menopause. It’s probably all of the above and more.
Finally, women’s subjective experiences of menopause do not perfectly map onto objective markers such as hormone levels. Two women reporting the same number of hot flashes and sleep disturbances might also report very different levels of distress about those symptoms, for example. This might be due to differences in psychological and emotional well-being, as I will discuss in the next post. Women who have better coping mechanisms, more social support, or higher emotional intelligence are likely more resilient to the physical symptoms.
This all goes to show there is so much more to the menopause story than we’re typically presented with. It’s important that healthcare providers understand this and take the time to understand their patients’ unique situations. Likewise, women should know that there’s no right or wrong way to experience menopause.
“Second Adulthood”—A Lot to Look Forward To
“Menopause starts out as a horror movie, but then transitions into a coming of age story. The time after menopause can truly become the best part of our lives as we create a vibrant second half of life. … Second adulthood is the best!”— Lynette Sheppard, RN
Now for the really good news. As I said above, many women have positive attitudes toward menopause, even when they are in the thick of it. Lotte Hvas is a Danish doctor and author of the book, Menopause—Better Than Its Reputation. Her research shines light on the positive aspects of menopause. In one study, Hvas asked women to reflect in an open-ended manner on how they experienced menopause and how it affected their lives. About half of the 393 women in the study spontaneously offered positive assessments.
Not surprisingly, many women were happy to be done with PMS and monthly periods. (This is something I saw often while reading menopause blogs—”No more cramps, and I can finally wear white pants again!” White pants are apparently a big deal for a lot of ladies.) Others described it as a “wonderful” and peaceful phase in their lives. Still others celebrated the fact that now that their children were grown, they had the time and freedom to explore new areas of interest. Nine of Hvas’ respondents reported that menopause improved their sex lives.
Plenty of women celebrate menopause as the beginning of a new phase of their lives. Menopause coincides with coming into their own in a new way. They talk about exploring new creative channels, experiencing greater patience, and being more selfish in a good way.
As Margaret Mead once said, “There is no greater power in the world than the zest of a post-menopausal woman.” Once women walk through menopause, whether it’s an easy stroll or a walk through fire, they emerge on the other side more confident, with a renewed vigor, and a take-no-baloney attitude. These sentiments were echoed by participants in a study in which Dr. Hvas conducted in-depth interviews with 52- and 53-year-old women. The women perceived themselves as more experienced and more competent than their younger selves, and more assertive about speaking their minds.
As my own mother told me, “Once you get older, you stop giving a $%&! about what other people think.” This theme is echoed time and again by post-menopausal women who say they feel less constrained and more self-confident. Some researchers believe this is actually due to the hormonal changes of menopause, but there are probably psychosocial influences as well. Whatever the cause, a lot of women affirm this, and frankly it sounds pretty great.
A Shift in Perspective
At some point in my reading I came across the term “menostart” as an alternative to “menopause.” This seems apt for the many women who experience menopause as a turning point after which their interests, priorities, and attitudes change.
The psychological principle of socioemotional selectivity theory (SST) offers a lens through which we might understand some of these shifts. The central tenet of SST is that as we age, our future time perception changes. Whereas once we were young and time felt expansive, with aging comes a growing recognition that time is limited. This changes how we approach the world. According to the theory, when time seems expansive in our youth, we focus on future-oriented goals, seek novelty and knowledge, and invest in individual achievement. In contrast, older adults prioritize relational goals and positive emotional experiences.
Three decades of research into SST bears this out. Although SST is not a theory of menopause per se, it does postulate that older individuals facing important life transitions that signal an “ending,” such as retirement, will effortfully focus on positive aspects and downplay negative aspects. Menopause surely falls into this category as well. Older individuals also tend to be better at emotion regulation in everyday life and enjoy more stable positive emotions.
Consistent with this, Hvas relates, “Some women describe that they have used the menopause as a trigger to changing their lifestyles. To others it has meant that they have realised that life is not eternal and that it is important to, ‘use life while you have it’. The statements indicate that the phase has resulted in personal development.” Some of the women in her other study described themselves as more tolerant. “The women also experienced that they had become better at prioritising and at ignoring trifles and instead focus on the important things in life, viz. things that were crucial to themselves.”
I’m Starting Now
No, this isn’t my public announcement that I’m starting “the change.” (Ugh to that term.) I’m laying the foundation upon which I hope a healthy, meaningful “upper middle age” will be built when my husband and I will become empty nesters, and when we fully intend to be healthy, vibrant, active, and on the move.
I’ll talk in my next post about psychological and emotional considerations as well as non-hormonal approaches to easing one’s way through menopause. Hint: I bet you’re already using a few of them to improve overall well-being. I am, and now I see them in a new light.
Because attitude is clearly important, I’m cultivating a positive mindset about menopause. It’s necessary to be intentional about this in a world that often treats menopause like it’s the worst thing ever. One strategy is to gather positive role models of women who are celebrating this period of life. I’m starting with Oprah, who says, “So many women I’ve talked to see menopause as an ending. But I’ve discovered this is your moment to reinvent yourself after years of focusing on the needs of everyone else. It’s your opportunity to get clear about what matters to you and then to pursue that with all of your energy, time and talent.” That sounds good to me.
The fitness industry is in the midst of a renaissance. Flawed and dated strategies like sedentary recovery practices or overly stressful HIIT workouts are being replaced with cutting-edge practices that offer more efficiency and return on investment. Today I’m covering one emerging fitness strategy: performing brief feats of strength in the routine course of a day. Let’s call them microworkouts.
I’m talking here about dropping for a single set of deep squats in the office, hitting a set of max effort pull-ups whenever you pass under a bar in a closet doorway, or stocking your backyard with a hex deadlift bar or bench press and busting out a single set every time you pass by while taking out the garbage.
Banking Benefits With Less Stress
Microworkouts deliver two distinct and awesome benefits: First, when you add up the energy expenditure of these brief but frequent efforts, you obtain an incredible cumulative training effect. In essence, you are banking a lot of strength/power/explosiveness “mileage” without disturbing the necessary stress/rest balance of your official workout schedule or prompting the stress hormone production and cellular depletion that occurs from an extreme weekend warrior-type session. That is, a set of pull-ups, or even three sets over the course of 12 hours on a typical day, is not going to mess up the next day’s CrossFit session or even an ambitious arms and chest session. Rather, these micro sessions (Dr. Phil Maffetone calls the concept, “slow weights”) will raise the baseline from which you launch you ambitious full-scale workouts.
Think about it: If you do a single set of six deadlifts with 200 pounds on the bar every time you take out the garbage, that’s 1,200 pounds of work accomplished. Perhaps you can find your way to doing that 1-2 times a day, five or six days a week? That’s lifting an extra 10,000 pounds a week! When it’s time to perform a formal session, such as the popular 5 x 5 protocol (where you complete five sets of five reps, and perhaps add an upper body exercise to each set), you’re poised for fitness breakthroughs as well as faster recovery times. An “official” workout is no longer this tremendous athletic performance vastly outside the normal pattern of your largely sedentary life, but instead an upgrade of what you do every day to some extent. Does this concept ring a bell? Yes, microworkouts are modeling the behavior patterns of our hunter-gatherer ancestors! Grok and company likely had some harsh days that might rival today’s CrossFit WOD or obstacle course race, but they also likely had routine daily chores entailing lifting heavy things or scrambling up steep embankments in between their legendary leisure time.
Interrupting Prolonged Inactivity
The second benefit of microworkouts is perhaps even more profound: these short efforts help you combat the extreme health hazard of prolonged periods of stillness that characterize hyperconnected modern life. The adverse health consequences of stillness have been well-chronicled, and you’ve heard me talk about them for years. Studies show that even a few days of inactivity can generate a significant decline in glucose tolerance and increase in insulin resistance. In Primal Endurance, I quote Nutritious Movement queen Katy Bowman on the destruction of cellular health caused by stillness: “When you use a single position repetitively, such as curling your body into a comfortable work chair for hours every day, muscles, joints, and arteries will adapt to this repetitive positioning by changing their cellular makeup and becoming literally ‘stiff,’ with reduced ranges of motion and an actual hardening of the arterial walls in those areas.”
Strange as it may seem, it’s now becoming clear that increasing all forms of general everyday movement is a greater health priority than conducting ambitious workouts. Microworkouts, along with continued devotion to JFW (Just F—ing Walk) takes on increasing importance as daily life gets more effortless. Even if you’re a devoted gym rat, those few hours a week when you’re pushing weight around isn’t enough to combat a lifestyle of commuting, office work, and digital entertainment leisure time. The active couch potato syndrome is a scientifically validated concept revealing that devoted workout enthusiasts who lead otherwise sedentary lifestyles are subject to the same level of disease risk as inactive folks.
Optimizing Movement For the Most Advantageous Genetic Signaling
But none of this is new. A decade ago now Time magazine offered a memorable title, “The Myth Of Exercise.” The story detailed how a strenuous workout (particularly the common workout patterns and strategies of today that can become chronically stressful) depletes cellular energy and prompts a compensatory response in the form of an increased appetite along with decreased activity for the rest of the day. More recently, I wrote about the constrained model of energy expenditure as well as the amazing study of the Hadza that’s helping us reframe the purpose and intended benefits of exercise.
As I’ve been saying since the introduction of the 10 Primal Blueprint Laws over a decade ago, it’s not about the calories but about the movement and the genetic signaling that movement prompts. The Myth of Exercise concept aligns with my longtime assertion that 80% of your body composition success is dependent on your diet—specifically, minimizing the wildly excessive insulin production that happens from a grain-based, high carbohydrate diet and prevents you from burning stored body fat.
How To Incorporate Microworkouts
Armed with the insight to no workout is too short, and any kind of movement delivers a health and fitness benefit, you can elevate microworkouts to the forefront of your fitness plan. Reject the all or nothing mentality that causes you to fail with fitness commitments because you get too busy with work and life. We all have time for a set or two or three of deep squats during the workday or during leisure time.
Look for opportunities over the course of every day to put your body under some kind of brief resistance load. Even if you only work hard for one minute (or less) at a time but are relatively faithful incorporating these “micro” opportunities into your daily routine, the cumulative effect will still be incredible.
Word of Caution: Going from a prolonged inactive state to a performing a heavy lift carries an obvious risk factor. Truth be told, I generally precede my random sets of pull-ups, deadlifts or even cords by a minute of walking, a few dynamic stretches, or some specific warm-up moves like doing a set with a much lighter weight, followed by a “real” set with a respectable weight. It’s not a lot of time or effort, but it’s a good habit to add the resistance after you’ve been up and doing something for a few minutes (e.g. taking out the garbage, bringing in groceries, finishing an indoor/outdoor chore).
Beyond that, also realize that when you make micro-workouts a daily habit, you’ll discover that you’re much more adaptable to brief explosive efforts without a long warm-up. You’ll be able to pop up from your work desk to hustle down a flight of stairs at work without hearing the creaks and cracks that are so familiar, especially to aging jocks. My longtime writing partner Brad Kearns (our next book will be a comprehensive education and action plan on the topics of longevity—due out in December) swears that his brief morning flexibility/mobility routine. He says it’s transformed his recovery from sprint workouts. No more next-day stiffness and soreness and occasional minor injuries—just because he spends 12 minutes every morning working on drills specific to sprinting that challenge the glutes, hamstrings and core.
Dr. Art DeVany, Ph.D., author of The New Evolution Diet and one of my earliest and greatest inspirations for Primal-inspired health practices, says that the lion never has to stretch before a workout, and we shouldn’t have to either. No, our modern creakiness can be attributed to overtraining patterns (in the case of morning issues) or extended stillness without a movement break when you get up and hobble during the day. Our ancestors most certainly had to run for their lives with zero warning on a routine basis. It’s a good Primal skill to have still.
Micro workouts are also applicable to cardiovascular fitness. A few minutes here and a few minutes there have a similar cumulative effect. Dr. Phil Maffetone explains that any stimulation of the aerobic system, even really low intensity stuff that a hard-core athlete might not choose to count as an official workout, helps improve your cardiovascular health and fitness. There’s really no lower limit to the aerobic exercise zone.
Anytime you get up from a chair and walk, you’re getting an aerobic benefit. A couple minutes recruiting major muscle groups with Stretch Cordz confers a new advantage. A cruise ship analogy works well here. When the floating city is out on the open ocean, cruising at 20 knots en route to the next port, all twelve turbine engines are cranking at full throttle. When it’s cruising in the harbor at two knots in preparation for docking, only a couple turbines are operating at half power. However, the two turbines operating at half speed in the harbor are still being “trained” to perform when they’re called up on in the open ocean. Note: I’ve revised my position on this concept over the years as research filled in the picture. Early on, I used to designate an aerobic zone of 55-75% of maximum heart rate. I’m not saying abandon time in that range, but know that anything outside of it also counts for something, and that should be good news.
If you so much as jump up from your desk, scramble down the stairs and out to your vehicle, then return with a few floors of ascent and back to your desk—total time five minutes and eight seconds. You’ll be turbocharging fat burning, increasing oxygen delivery and blood circulation to the brain, and flooding the bloodstream with neurotransmitters that elevate mood and improve cognitive focus. Similarly, anytime you haul off a set of pushups or squats, you’re making a meaningful contribution to your fitness and longevity.
Every effort, however modest, can be a small win. How does that shift your mindset? How does it open up possibilities for you? Let me know down below, and share any questions you have while you’re at it. Have a great week, everybody.
For today’s edition of Dear Mark, I’m answering a question about the different forms of vitamin K2. Everyone knows the importance of vitamin K2—at least around these parts—but very few understand the differences between the various forms of vitamin K2. What are the respective benefits of vitamin K1, vitamin K2 MK-4, and vitamin MK-7? Where can we find each one?
Let’s find out:
Have you ever done an in-depth look at the differences between vitamin K2 MK-4 and MK-7?
No. I’ll do one now.
For those who don’t know, vitamin K2 comes in many different forms called menaquinones. MK-4 and MK-7 are the most important menaquinones. Pretty much all the vitamin K2 you’ll encounter in foods and in supplements is either MK-7 or MK-4 (or both), so these are the ones we most care about. There are also ones like MK-11 and MK-10, but we don’t know as much about them. What we do know seems to suggest they act a lot like MK-7. Whatever the case, they’re good.
What Are the General Benefits of Vitamin K2?
It directs calcium where to go in the body, sending it to the right places and preventing it from going to the wrong places. You want calcium in your bones and teeth. You don’t want calcium clogging up your arteries or forming kidney stones in your kidneys. Vitamin K2 is the messenger regulating both good and bad calcification.
It improves energy utilization, partially by increasing insulin sensitivity. The more insulin-sensitive you are, the better you can burn glucose without requiring tons of insulin. This allows you to both handle glucose and keep burning body fat.
It protects tissues against cancer, selectively inducing cell death in cancer cells but not in healthy ones.
It’s a powerful inductor of gene expression. In general terms, it turns good genes on and bad genes off.
What About the Benefits Of Vitamin K1?
Found in many unfermented green plant foods, vitamin K1 isn’t useless by any means. It generally heads straight to the liver, where it contributes toward regulation of blood coagulation—the thinning or thickening of blood. People with problems controlling blood coagulation often end up on warfarin, a drug that promotes blood thinning and prevents blood clots. We can convert vitamin K1 to vitamin K2, but this depends on a number of factors, like gut health (much of the conversion occurs in the gut) and usage of certain medicines (statins inhibit conversion).
Back to vitamin K2. Vitamin K2 does what vitamin K1 can do, but more effectively, and then some.
The most-studied is MK-7. The majority of the MK-7 you consume goes to the bones and liver. In the bones, the MK-7 produces osteocalcin—a hormone which regulates bone health, increases testosterone, improves cognitive function and exercise performance, and maintains healthy insulin and glucose levels. Few people know the power of the bones (they’re actually organs) and MK-7 is one of the most important co-factors for realizing that power.
The best sources of MK-7 are fermented plant foods, like natto (fermented soybeans, but natto made with black beans and presumably other legumes will also be high in MK-7).
MK-4 tends to accumulate and act in the peripheral tissues, helping prevent against unwanted and/or unhealthy calcium accumulation. It’s also integral to gene expression and activation.
The best sources of MK-4 are animal foods, like egg yolks, chicken legs and thighs (and chicken dark meat in general—I bet the oysters on a chicken carcass are incredibly high in K2), and goose liver. Pork is also quite high in MK-10 and MK-11, whose biological activities haven’t been elucidated but are likely to be very helpful.
Another good source of a mix of menaquinones is hard cheese, with emmental, jarlsberg, and edam being highest.
Almost everyone should take a vitamin K2 supplement containing both MK-4 and MK-7. Many of the most troublesome and dangerous foods and drugs wreak havoc by inhibiting vitamin K2-dependent processes.
A group of researchers made a strong case that statins, warfarin, canola oil, and hydrogenated soybean oil trigger a host of metabolic and lifestyle diseases by inhibiting vitamin K2-dependent processes in the body:
Statins reduce levels of a necessary co-factor for converting vitamin K1 into vitamin K2 in the brain, testicles, kidney, bone, and other tissues. So if you’re taking statins and want vitamin K2 improving bone health, sexual function, cognition, and lowering the risk of kidney stones, you need to take extra. You most likely need extra (throw in some CoQ10 while you’re at it, as statins also inhibit its production).
Warfarin—the blood thinning medication—reduces vitamin K recycling in the body, lowering vitamin K2 levels and even inducing arterial calcification. In effect, taking warfarin replaces the body’s need to naturally regulate blood coagulation through vitamin K, and natural processes drop off.
Canola oil and hydrogenated soybean oil both contain compounds that appear to inhibit vitamin K2 production in the body.
If you take statins, warfarin or eat canola oil and hydrogenated soybean oil, you should probably ask your doctor about supplementing with vitamin K2.
Similarly, postmenopausal women should take vitamin K2. In a recent study of postmenopausal women, those with osteoporosis had much lower levels of vitamin K2 (MK-7) than those without.