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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Weekly Link Love—Edition 20

Research of the Week

Neolithic Brits hosted massive feasts that drew people and pigs from all over the island.

Researchers say they’ve found a cholesterol-lowering drug without the muscle-damaging side effects of statins.

Among people with kidney disease, higher oxalate excretion in the urine predicts kidney disease progression.

Our estimates imply that prescription opioids can account for 44 percent of the realized national decrease in men’s labor force participation between 2001 and 2015.”

High intensity interval training slows colon cancer cell growth.

After age 70, your fitness is the best predictor of lifespan.

Maternal infection during pregnancy increases the risk of neuropsychiatric disorders in the kids.

New Primal Blueprint Podcasts

Episode 319: Gretchen Rubin: Host Elle Russ chats with bestselling author, happiness expert, and good habit purveyor Gretchen Rubin.

Episode 320: Keto: Tippy Wyatt, Author of Asian Keto and Low Carb Cookbook: Host Brad Kearns chats with Tippy Wyatt in a wide ranging conversation about health, success, family, and balance.

Health Coach Radio Episode 3: Ali Watts: Hosts Erin Power and Laura Rupsis chat with Ali Watts about the differences between being a health coach and running a business.

Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

Media, Schmedia

Parents blame a nearby cell tower for an increase in cancer diagnoses at their elementary school.

“Trip of Passion,” a new film exploring the use of MDMA therapy for PTSD.

Interesting Blog Posts

Why the strange collection of sounds called music is a uniquely human obsession.

How the miniaturization of tools might have made us human.

Social Notes

My pantry staples.

Everything Else

Doctor delivers the bad news to his dying patient via robot.

Medieval diseases returning to Southern California.

Chickens gang up to kill intruding fox.

Things I’m Up to and Interested In

Film project you should back: Defying All Odds, the story of Dr. Terry Wahls astonishing lifestyle-based recovery from multiple sclerosis. This is an important story that people should know about.

Article I found fascinating: How the Inuit Teach Their Kids to Control Their Anger

I hope they look further into this: Inactive ingredients aren’t so inactive.

I’m not there yet: At what age do you feel 65?

Question I’m Asking

With “keto bloat,” the media seems primed to launch another barrage of “terrible keto side effect” coverage. Do you think this is legit concern or malicious fear mongering?

Recipe Corner

Time Capsule

One year ago (Mar 10 – Mar 16)

Comment of the Week

“For sure, ground sloth is slow food.”

– Excellent, Walter.

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The post Weekly Link Love—Edition 20 appeared first on Mark's Daily Apple.

Dear Mark: Protein Efficiency in Seniors, Earned Carbs, Hardgainer with Limited Time

For this week’s edition of Dear Mark, I’m answering three questions from readers. First, is the reduced protein efficiency in older adults due to inactivity, or is it something inherent to the aging process, or both? Second, how does a person know if they’ve actually “earned” any carbs? Does everyone on a keto diet earn carbs by virtue of exercising, or is there more to it? And finally, how can a hardgainer with a packed schedule all week long and limited gym time maintain what little muscle mass he’s managed to gain?

Let’s find out:

Interesting observation on protein needs and training in Sunday with Sisson – general consensus is that older folks need more protein as they age but maybe that’s because they are less active and not simply a result of aging.

That’s probably part of it, but it’s not all of it.

In studies where they compare resistance training seniors who eat extra protein with resistance training seniors who don’t, only the seniors eating extra protein gain muscle mass.

Now, it may be that a lifetime of inactivity degrades your ability to utilize protein, and if these older adults had always lifted weights they would have retained their protein efficiency. But maybe not. As it stands, all else being equal, an older adult needs more protein to get the same effect, even if he or she is lifting weights.

Enjoyable read. As someone who lives a ketogenic lifestyle, and who is athletically active, I am not sure exactly how to go about consuming the carbs I’ve “earned.” I rarely run into problems with athletic energy, at least not below anaerobic threshold. Not sure that eating more carbs will improve my performance. And, if they would improve my performance, how does one go about calculating earned carb replacement without losing the fat burning benefits of ketosis?

It sounds like you’re in a good place.

When I say “eat the carbs you earn,” I’m talking to the people who do run into problems with athletic energy, poor performance, insomnia, and other symptoms of exercise-induced stress. Typically, the people who “earn their carbs” are doing stuff like CrossFit, high volume moderate-to-high intensity endurance work, martial arts training, and team sports.

I doubt extra carbs will improve your performance if most of your training takes place in the aerobic zone. But if you wanted to experiment, you could try a small sweet potato immediately after a workout where you passed the anaerobic threshold.

That’s the best way to determine if you’ve earned carbs. Eat 20-30 grams after a workout and see if you enjoy performance gains without gaining body fat. There’s no consumer-friendly way to directly calculate carb debt; self-experimentation is it.

I recently took a job that has me out of bed at 4am and not home until 6pm Monday Through Friday. Is there an efficient way I can maintain muscle mass only lifting weights Saturday and Sunday? I’m a hardgainer at 5’10” and only 140lbs. I’m afraid giving up my 5 day split will ruin what muscle I’ve been able to gain.

Any hardgainer has to eat, and eat, and eat. Increase your food intake. Just eat. Stick to healthy Primal fare, but pack in the food. Meat, milk, veggies, potatoes, rice, eggs, avocados, fruit. Throw some liver in, too (old bodybuilder staple). It doesn’t sound like fat gain is an issue for you, so I’d take advantage of that and just consume calories.

As for training, get some exercise snacks in during the week.

As soon as you wake up, do a quick superset of pushups. Do as many pushups as you can. Wait 30 seconds. Do as many pushups as you can. Wait 30 seconds. Do as many pushups as you can. There you go. That shouldn’t take more than 5 minutes in the morning. Can you squeeze that in?

Repeat this every morning with a different exercise. Pullups, bodyweight rows, kettlebell swings, handstand pushups, dips, bodyweight squats, goblet squats, reverse lunges, reverse weighted lunges. Just choose one thing to do every morning, cram as many reps as you can using the same format (max reps, 30 s rest, max reps, 30 s rest, max reps). Buy any equipment you can if you choose to use weights.

When you get home at night, do the same thing with a different exercise. Morning pushups, evening KB swings, etc. That way, you get about 10 minutes per weekday of intense strength training without impacting your sleep or schedule in any real meaningful way.

Make sure your sleep hygiene is rock solid. Dim those lights at night, turn on f.lux or night mode, wear the blue blocking goggles, get to bed (ideally) by 8:30, 9 to give you 7 to 7.5 hours of sleep. Sleep is essential for gaining lean mass (and staying healthy in general).

On the weekend, hit the weights hard on both days, hitting the entire body. Go high volume/reps. If size is your goal, dropping the weight a bit and focusing on range of motion and a high rep count (10-15 per set) is very effective.

Food, sleep, reps. Good luck!

Thanks for stopping in today, everybody. Additional thoughts for these folks—or questions of your own? Share them below.

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References:

Tieland M, Dirks ML, Van der zwaluw N, et al. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2012;13(8):713-9.

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What’s the Pegan Diet? (And How Does It Compare To Primal?)

Because people don’t have enough diets to choose from already, there’s a new one on the scene: the Pegan diet. Actually it’s not that new—Dr. Mark Hyman started writing about it back in 2014, but it’s gained traction since he published his latest book last year, Food: What the Heck Should I Eat?

According to Hyman, Pegan is a somewhat tongue-in-cheek play on the fact that it’s not quite Paleo and it’s not really vegan, hence Pegan. It claims to combine the best of both diets, namely a focus on eating lots of vegetables, as well as an emphasis on sustainable agriculture and ethical and ecologically sound animal farming.

Setting aside the obvious issue that it’s 100% possible to be a vegan who eats few to no vegetables, or to be a paleo dieter who cares naught about the environment, Pegan is touted as being easier to stick to than either vegan or paleo (presumably because Pegan allows for consumption of foods not allowed on either). Frankly, trying to frame it as a bridge between the two hasn’t proved to be a seamless, happy compromise based on social media conversation, but that’s probably of little surprise to anyone here.

I’ve had some readers ask me about the merits of Pegan and whether it offers any particular advantages over paleo/Primal, and I’m taking up that question today. (Note that I’m only focusing on the Pegan diet proposed by Dr. Hyman, not the “Pegan 365” diet offered by Dr. Oz. The latter isn’t paleo at all, allowing whole grain bread and pasta, corn, tofu, and a weekly “cheat day.” You can imagine my response to this version.)

Defining the Pegan Diet

These are the basic tenets of the Pegan diet in a nutshell:

Focus on sourcing high-quality food – Prioritize organically grown and pesticide-free produce as well as meat, eggs, and fats from pasture-raised and grass-fed animals and finally sustainably harvested seafood. Choose seafood with the lowest possible mercury content. Buy local when you can. Avoid CAFO meats and foods containing chemical additives.

Eliminate processed modern food-like substances and franken-fats – Processed carbohydrates have a high glycemic load and lead to excessive insulin production. Refined vegetable and seed oils such as canola and sunflower are pro-inflammatory. Avoid all such products.

Go gluten-free – Even if you don’t have celiac disease or an obvious gluten sensitivity, modern wheat is still a frankenfood, and gluten can damage the gut. Occasional consumption of heirloom wheat (e.g., einkorn) is ok if you tolerate it.

Go dairy-free – Dairy is problematic for most people and is best avoided. If you do decide to include some dairy, consider choosing goat and sheep milk products instead of cow. Grass-fed butter and ghee are acceptable.

Make vegetables the centerpiece of your diet – Vegetables (mostly non-starchy) should comprise 75% of your diet.

Enjoy healthy fats – Focus on omega-3s, as from small, oily fish. Eat plenty of healthy fats from grass-fed and pastured meats and whole eggs, nuts and seeds, avocados, and coconut products. Use olive oil, avocado oil, and coconut oil for cooking.

Eat meat sparingly – Dr. Hyman uses the term “condi-meat” to emphasize that meat should be a side dish, not the focus of the meal. He recommends no more than 4 – 6 ounces of meat per meal.

Include gluten-free grains and legumes in small quantities – You may eat ½ cup of gluten-free grains like amaranth or quinoa, plus ½ – 1 cup of legumes (preferably lentils) per day. If you are insulin resistant, you should limit these or refrain altogether.

Limit sugar – Avoid refined sugar and conventional “treats.” The bulk of your vegetable intake should be from non-starchy varieties, and opt for low-glycemic fruit. Natural sweeteners like honey should be used only sparingly for the occasional treat.

How Does Pegan Compare to Primal?

If you’re reading this and thinking, “Gee, Mark, this sounds an awful lot like the Primal diet,” I agree. While there are some differences between Pegan and Primal, they aren’t particularly dramatic:

Primal allows full-fat dairy consumption. Pegan discourages but doesn’t outright ban dairy.

I don’t actively encourage people to consume gluten-free grains and legumes, but I’m not as strongly opposed to them as others are in the ancestral community. I’ve said before that I consider quinoa, amaranth, wild rice, and legumes to be moderation foods (when well-tolerated, which is more an individual thing). They deliver pretty substantial carb hits relative to their nutritional value, but they certainly aren’t the worst options out there. I don’t think they should be dietary staples by any stretch—and daily consumption is too much in my opinion—but if Primal folks want to eat them occasionally, I’ve seen it work for people.

The biggest difference is in regard to protein. The Pegan diet explicitly limits protein consumption, while the Primal Blueprint recommends moderate protein consumption tailored to your activity levels, goals, age, and medical needs. On the surface, this might seem like a substantial difference, it’s probably not very disparate in practice. If a Pegan eats 3 eggs for breakfast, a large salad with 4 ounces of sardines at lunch, and 4 ounces of skin-on chicken thigh at dinner, that gets him or her to about 70 grams of protein, not counting the (admittedly incomplete) plant protein from the salad and any additional veggies included with breakfast and dinner, plus nuts and seeds. That’s within the realm of Primal guidelines, albeit less than I’d recommend for some populations.

That said, if Pegans are taking the whole “treat meat as a condiment” mantra to heart, they are probably at greater risk of underconsuming protein compared to the average Primal eater. This could present a problem for athletes and older folks looking to preserve lean mass. Likewise it is surely harder to get enough protein while also practicing time-restricted eating—and perhaps only eat one or two meals per day—and trying to follow Pegan guidelines. That isn’t a knock against Pegan per se, just a cautionary note.

Finally, while we’re on the subject of protein, I must object to Dr. Hyman’s appeal to environmentalism as a reason to limit meat consumption. I’m not at all convinced that raising livestock taxes the environment more than monocropping acres and acres of corn and soybeans.

In my opinion, Pegan could simply be called “vegetable-centric Paleo with permission to eat small amounts of quinoa and lentils if it suits you.” That isn’t catchy, though, so Pegan it is.

That said, I appreciate how Dr. Hyman for his version of the Pegan Diet emphasizes that there is no single diet that is exactly right for each individual and, like me, he advocates for self-experimentation. Dr. Hyman also speaks out against diet dogmatism and encourages his followers to focus on big-picture health. These are obviously messages I can get behind.

The Bottom Line

I’m a fan of anything that gets people thinking about food quality instead of just robotically tracking macronutrient intake and/or plugging calories into a magic weight-loss formula. Supporting sustainable agricultural practices, eating locally and seasonally, and avoiding environmental pollutants have always been part of the Primal Blueprint recommendations. In short, there is a lot I like about the Pegan diet.

However, I don’t agree that the Pegan diet is necessarily easier to implement than vegan or Paleo, which is supposed to be one of its big draws. If you’re a vegan who gets by on bagels, pasta, and Oreos, or a Paleo person who dutifully eschew grains but relies on the myriad processed, packaged Paleo food options, Pegan is not going to be easier. Changing your diet to focus on carefully sourced “real food” is still going to be a massive shift. It’s going to be much more expensive and time consuming to prepare your meals, and it will probably be incredibly burdensome at the beginning.

Sure, being able to include a small serving of gluten-free grains and legumes might make life a little easier for Paleo folks… but how much really? (For this reason I’d be skeptical if you’re considering using the Pegan diet to lose weight.) Are a lot of Paleo folks really falling off the wagon because they are feeling deprived of ½ cup of lentils? Dr. Hyman has said that his issue with Paleo is “some use the paleo philosophy as an excuse to eat too much meat and too few plant-based foods.” I’m not really seeing this pervasively in the Paleo/ancestral community, to be honest (intentional carnivore dieters notwithstanding). This strikes me as an attempt to solve a problem that didn’t need solving.

Truthfully, the things I like about Pegan are all the ways in which it is similar to Primal, which are many. Both Primal and Pegan have vegetables as the base of their food pyramids. They similarly emphasize the importance of choosing healthy fats and oils, avoiding grains and processed modern junk foods, and moderating carbohydrate intake (which Dr. Hyman frames as maintaining low glycemic load, but the effect is the same). Still, for many people the tighter Primal guidelines around carbs are probably better suited for weight loss and even weight maintenance.

Most days, if you were a fly on the wall in my kitchen, you’d see me eat a big-ass salad for lunch and a piece of meat with several types of vegetables on the side for dinner, and you wouldn’t be able to discern if I was Primal or Pegan. Then again, those nights when I tear into a giant steak would you most certainly be able to tell… and, trust me, I’m not giving those up any time soon.

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Does Vegetarian Collagen Exist?

I’ll start with the bad news: There are no vegetarian collagen sources. Every collagen supplement you see on the shelf came from a living organism. Though somewhere down the line someone will probably grow legitimate collagen in a lab setting, it’s not available today or for the foreseeable future.

Now, some good news: Vegans and vegetarians probably need less dietary collagen than the average meat eater or Primal eater because a major reason omnivores need collagen is to balance out all the muscle meat we eat. When we metabolize methionine, an amino acid found abundantly in muscle meat, we burn through glycine, an amino acid found abundantly in collagen. If you’re not eating muscle meat, you don’t need as much glycine to balance out your diet, but it’s still a dietary necessity.

Collagen isn’t just about “balancing out meat intake.” It’s the best source of a conditionally essential amino acid known as glycine. We only make about 3 grams of glycine a day. That’s not nearly enough. The human body requires at least 10 grams per day for basic metabolic processes, so we’re looking at an average daily deficit of 7 grams that we need to make up for through diet. And in disease states that disrupt glycine synthesis, like rheumatoid arthritis, we need even more.

What About Marine Collagen?

Okay, but eating a product made from a cuddly cow or an intelligent pig is off limits for most vegetarians. What about marine collagen—collagen derived from fish bones, scales, and skin?

Back about twenty years ago, “vegetarians” often ate fish. A number of them still exist out in the wild, people who for one reason or another avoid eating land animals (including birds) but do regularly consume marine animals. If it jibes with your ethics, marine collagen is a legitimate source of collagen for vegetarians. The constituent amino acids are nearly identical to the amino acids of mammalian collagen with very similar proportions and properties.

It’s highly bioavailable, with the collagen peptides often showing up intact in the body and ready to work their magic—just like bovine or porcine collagen. In fact, if you ask many marine collagen purveyors, it’s even more bioavailable than mammalian collagen owing to its lower molecular weight.

I’m not sure that’s actually accurate, though.

According to some sources, marine collagen comes in smaller particles and is thus more bioavailable than mammalian collagen, but I haven’t seen solid evidence.

There’s this paper, which mentions increased bioavailability in a bullet point off-hand, almost as an assumption or common knowledge.

This analysis found low molecular weights in collagen derived from fish waste. Mammalian collagen generally has higher molecular weights, so that appears to be correct.

However, a very recent pro-marine collagen paper that makes a strong case for the use of marine collagen in wound repair, oral supplementation, and other medical applications does not mention increased bioavailability. It may be slightly more bioavailable—the lower the molecular weight, the more true that is—but I don’t think the effect is very meaningful. Mammalian collagen is plenty bioavailable (most efficacious studies use collagen from cows or pigs), even if it’s a few dozen kilodaltons heavier.

But even if marine collagen isn’t particularly superior to mammal collagen, it is equally beneficial.

For skin health: Fish collagen improves hydration, elasticity, and wrinkling in humans who eat it. And again.

For metabolism: Fish collagen improves glucose and lipid metabolism in type 2 diabetics. HDL and insulin sensitivity go up, triglycerides and LDL go down.

And although fish collagen hasn’t been studied in the treatment of joint pain, if it’s anything like other types of collagen, it will help there too.

What Are Strict Vegetarian Options?

What if you absolutely won’t eat collagen from marine sources? Is there anything you can do as a vegetarian to make up for it?

Make Your Own

You could cobble together your own facsimile of collagen by making an amino acid mixture. Glycine, proline, and arginine don’t cover all the amino acids present in collagen, but they’re widely available and hit the major ones.

Still, eating the amino acids that make up collagen separately doesn’t have the same effect on those collagenous tissues as eating them together in a collagenous matrix. One reason is that the collagen matrix can survive digestion more or less intact, giving it different biological properties and effects.

In one study, rats with osteoporosis ate collagen hydrolysate that scientists had marked with a radioactive signature to allow them to track its course through the body. It survived the digestive tract intact, made it into the blood, and accumulate in the kidneys. By day 14, the rats’ thigh bones had gotten stronger and denser with more organic matter and less water content.

Another study found similar results, this time for cartilage of the knee. Mice who ate radioactive collagen hydrolysate showed increased radioactivity in the knee joint.

In both cases, the collagen remained more or less intact. A blend of the isolated amino acids would not. The fact is that collagen is more than glycine. When you feed people collagen derived from pork skin, chicken feet, and cartilage, many different collagenous peptides appear in the blood. You don’t get any of those from isolated glycine.

That’s not to say it’s pointless. Pure glycine can be a helpful supplement, used in several studies to improve multiple markers of sleep quality. Just don’t expect it to have the same effect as full-blown collagen.

Get Adequate Vitamin C

Acute scurvy, caused by absolute vitamin C deficiency, triggers the dissolution of your connective tissue throughout the body. Teeth fall out, no longer held in by gums. Wounds don’t heal, your body unable to lay down new collagen.

Vegetarians usually don’t have any issues getting adequate vitamin C.

Get Adequate Copper

Copper is a necessary cofactor in the production of collagen. Studies show that you can control the production of collagen simply by providing or withholding copper.

The best vegetarian source of copper is probably dark chocolate, the darker and more bitter the better.

Get Adequate Lysine

Lysine is another amino acid that’s necessary for the production of collagen.

The best sources of lysine are in meat of all kinds, but vegetarian options include hard cheeses like parmesan and pecorino romano, as well as eggs.

True vegetarian collagen doesn’t exist. Strict vegetarians will balk. But if you can bend the rules a bit, realize that making marine collagen out of fins and scales and bones is far less wasteful than just throwing it away, and look at the benefits with an objective eye, you’ll be pleasantly surprised. Even if you don’t end up using marine collagen, at least you have a few tools for getting many of the benefits with quick shortcuts and optimizing your own production of collagen.

Have you ever tried marine collagen? If you’re a vegetarian, would you consider it?

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

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Dear Mark: Iron Followup

Last week’s post on iron levels got a big response and garnered a ton of questions from you guys. Today, I’m going to clarify a few things and answer as many questions as I can. First, do iron and ferritin levels mean different things for men and women? If so, how do those differences manifest? What about premenopausal women vs postmenopausal women? Second, what do we make of the fact that ferritin is also increased in times of inflammation? Is there a way to distinguish between elevated ferritin caused by inflammation and elevated ferritin caused by high iron? Third, is desiccated liver a good option for liver haters? And finally, I share some exciting plague news.

Let’s go:

Emma wrote:

I’d love to see more info on iron levels as they relate to men and women differently. I recently had an iron infusion for low ferretin, not thinking much would change I actually experienced so many positive effects I didn’t even know were coming my way. I’m less cold, no more afternoon fatigue, less hair falling out, no more random palpitations, improved restless leg syndrome and the number one big change is it improved anxiety levels – in fact my anxiety is now gone. The last two are due to a connection between iron and dopamine. I learnt that children with mental health issues are often treated for low ferretin where possible, elevating levels to around 100 showing positive results (would love to see literature on this), for me my ferretin went from 20 to 130 and its changed my life, at 31 I haven’t felt this good in years. Yay iron!

That’s awesome to hear. Yes, it’s important to stress the very basic essentiality of iron. Without it, we truly cannot produce energy. And since energy is the currency for everything that happens in the body, an iron deficiency makes everything start to fall apart.

As for gender and iron, there’s a lot to discuss.

A good portion of women with hemochromatosis never actually express it phenotypically, meaning their lab tests don’t show evidence of dysregulated iron metabolism or storage. According to one study of hemochromatosis homozygotes (people who inherited the mutation from both of their parents), being a woman makes it 16x more likely that your hereditary hemochromatosis won’t actually present as iron overload.

Another study found that among mostly-age-matched men (42 years) and women (39 years) with hemochromatosis, 78% of the men had iron overload while just 36% of the women had it. Iron overload was defined as transferrin saturation over 52% combined with ferritin levels of 300 ng/mL for men and 200 ng/mL for women.

High iron levels are more of an issue for postmenopausal women than premenopausal women. The latter group regularly sheds blood through menstruation, and if anything, they’re at a higher risk of low iron. Plus, estrogen is a key regulator of iron metabolism. As menopause sets in and estrogen diminishes, that regulation suffers.

For instance:

In postmenopausal Korean women, high ferritin levels predict metabolic syndrome and subclinical atherosclerosis.

High ferritin predicts metabolic syndrome in postmenopausal but not premenopausal women.

In premenopausal Korean women, higher ferritin levels predict better bone mineral density; menopause nullifies this relationship.

Remember that ferritin is actually a measurable protein bound to iron, so testing a ferritin level is technically an indirect way to measure iron. Why is this important? Another characteristic of ferritin (the protein) is that it is an ACUTE PHASE REACTANT. This means that ferritin levels can fluctuate with illnesses and other inflammatory states in the body that drive up a ferritin value that is not related to an actual iron level fluctuation. Don’t get ferritin checked when you are sick with a cold or other illness.

This is a great point.

Ferritin is marker of long term iron storage, but it’s also an acute phase reactant that up regulates in response to inflammation or oxidative stress.

If you want to be really careful, you should get a HS-CRP test—that measures your overall inflammatory status. If CRP is elevated, ferritin can be elevated without saying anything about your iron status.

Come to think of it, if elevated ferritin can be a marker of inflammation and oxidative stress, the inflammation could be responsible for some of the negative health effects linked to high ferritin. Or, if having too much iron in the body can increase oxidative damage, it may be that high iron levels are increasing inflammation which in turn increases ferritin even further. Biology gets messy. Lots of feedback loops. However, the fact that many studies cited in the previous iron post that use blood donation to treat high ferritin have positive results indicates that for most people, ferritin can be, in most situations, an accurate estimation of your iron status.

To make sure it’s an iron problem, get a transferrin saturation test as well. That indicates the amount of iron you’re absorbing, with below 20% being low and over 45% being high. People with high ferritin and high transferrin saturation do have high iron levels. People whose ferritin is artificially enhanced by inflammation will have normal transferrin saturation levels.

I have one last question on this. You say “Don’t stop eating liver every week.” If you can’t stand the taste of liver, what do you think about taking liver capsules made from grass-fed New Zealand beef every day instead?

That’s a great option. Go for it.

People should generally aim for 4-8 ounces of fresh liver a week. Note the amount of desiccated liver in your capsules and multiply by 3 to get the fresh liver equivalent, then take enough each day (or all at once) to hit 4-8 ounces over the week. I hear good things about this one.

Mark,
Thank you for your article on HH. I carry the gene but have been managing my iron levels through phlebotomies. I am full Keto, meat and all and have found my iron levels have not been effected by going Keto. Early detection is the key and ongoing monitoring. Bring on the plague!!!

You joke about that now, but there’s a startup that’s breeding heritage rat fleas that produce a mild strain of the plague that evades the attention of the immune system and proliferates throughout the body to keep iron levels in check without killing you. I’m an early investor, have a couple swarms installed in my condo, and (knock on wood) so far have avoided anything worse than a sore throat and maybe a mild open sore or two. There’s actually a big rift forming between the techs who want to keep the fleas heritage and those who want to go ahead with CRISPR and engineer them. One variant has had a deer tick gene inserted that adds an anesthetic compound to the flea’s saliva. That way you can have a personal swarm on you and never feel any bites or itches.

I’m not sure about CRISPR just yet, but I gotta say it’s pretty nice to be covered in fleas and not feel the bites. Time will tell.

Ok, I’m joking.

That’s it for today, folks. I hope I’ve answered some of your concerns, and if not, let me know down below. Thanks for reading!

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References:

Lainé F, Jouannolle AM, Morcet J, et al. Phenotypic expression in detected C282Y homozygous women depends on body mass index. J Hepatol. 2005;43(6):1055-9.

Qian Y, Yin C, Chen Y, et al. Estrogen contributes to regulating iron metabolism through governing ferroportin signaling via an estrogen response element. Cell Signal. 2015;27(5):934-42.

Seo SK, Yun BH, Chon SJ, et al. Association of serum ferritin levels with metabolic syndrome and subclinical coronary atherosclerosis in postmenopausal Korean women. Clin Chim Acta. 2015;438:62-6.

Cho GJ, Shin JH, Yi KW, et al. Serum ferritin levels are associated with metabolic syndrome in postmenopausal women but not in premenopausal women. Menopause. 2011;18(10):1120-4.

Chon SJ, Choi YR, Roh YH, et al. Association between levels of serum ferritin and bone mineral density in Korean premenopausal and postmenopausal women: KNHANES 2008-2010. PLoS ONE. 2014;9(12):e114972.

The post Dear Mark: Iron Followup appeared first on Mark's Daily Apple.

13 Functional Exercises You Can Do At Work

Good morning, folks. After a awesome week (and weekend) taking over the Whole30® Recipes Instagram (you can still check out all the great videos, tips and recipes I shared here), my team and I are taking a breather. Look for a success story later in the week. In the meantime, we have some practical ideas for your Monday morning. We’re shaking things up with a movement guide you can put into action at work today. Thanks to Jessica Gouthro of PaleoHacks for these awesome suggestions, and let us know which you’ll be adding to your routine. 

Working at your desk all day doesn’t have to mean poor posture and an achy body. Whether you sit or stand at work, remaining sedentary for hours takes its toll on the body. After just a few hours, your body will begin to stiffen, your lower back will ache, and you’ll grow sluggish.

But you can free yourself from common aches and pains associated with desk work in just a few minutes with these easy stretches to release the lower back and hips. You don’t have to do all 13 of these stretches at once. Instead, use this list as a guide and choose two or three stretches you think your body needs. Perhaps you’re looking for a nice stretch through your shoulders, or maybe you could really benefit from moves that help open up your hips. Every little bit of movement adds up when you’re sitting for long periods of time, and doing just one of these stretches every day will help you look and feel better, and avoid pain.

Try each of these 13 functional workspace stretches to relieve aches and pains and instantly improve your posture.

1) Standing Overhead Reach | 5 Breaths, 3x

Stand up from your chair with your feet about hip-width apart and toes pointed forward.

Clasp your fingers together and turn your palms facing up toward the ceiling.

Reach your clasped hands overhead, and press your palms upward while keeping your shoulders and core engaged.

Hold for five deep breaths and enjoy the stretch. Release. Repeat three times.

2) Butterfly Elbows | 4 Reps

Sit tall in your chair and place your fingertips gently behind your ears. Do not interlock fingers or apply any pressure to your neck.

Lift your chest and ribs up as you stretch your elbows back to feel a lengthening across your chest. Breathe in deep to fill your lungs. On the exhale, round your back, drop your chin and bring your elbows to meet in front of you. Gently press your elbows forward to feel a stretch across your upper back and shoulder blades.

Inhale to return to the starting position. Continue alternating one movement per breath until you have completed four reps.

3) Chair Chest Opener | 5 Breaths, 2x

Scoot towards the front of your chair, and sit on the very edge. Reach your hands back with thumbs pointing down and grasp onto the sides of your chair.

Lift your chest and roll your shoulders back and down. Elongate your neck by imagining you can press into the ceiling with the top of your head.

Lean deeper into the stretch to feel the opening across your chest.

Take five deep breaths, then rest. Repeat a second time.

4) Standing Chair Lat Stretch | 5 Breaths, 2x

Stand facing your chair, about three feet away.

Keep a slight bend in your knees, then hinge at your hips and reach your arms long to grasp onto the back of the chair. Make sure your arms are straight.

Lengthen your shoulders and flatten your lower back, forming a straight line from hands to hips. Align your head in between your arms and take five deep breaths.

Release, then repeat a second set.

5) Standing Chair Lat Twist | 3 Reps Per Side

In the same position as the stretch above, reach your right hand down to your left foot to create a twist in your upper body.

Hold for two breaths, then return to the starting position with both hands on the chair and switch to twist in the other direction. Maintain a flat lower back and slightly bent knees the whole time.

Repeat three times per side.

6) Mirrored Chair Pose | 3 Reps

Stand facing your chair with your feet together.

Hinge at the hips to squat down, aiming to mimic the height of the chair with the top of your thighs.

Keep your spine straight. Reach your arms up overhead with palms facing each other.

Hold for five full breaths, then release.

Repeat three times.

7) Seated Figure 4 Hip Stretch | 3 Breaths, 2x Per Side

Sit on your chair with both feet flat on the ground.

Lift your right leg and place your ankle across your left knee. Keep your right foot flexed.

Sit up nice and tall, then lean slightly forward as you gently press down on your right knee—just enough to feel a stretch in the hips.

Hold for three breaths, then release and switch sides.

Repeat two times per side.

8) Seated Spinal Twist | 2 Breaths, 3x Per Side

Sit on your chair with both feet flat on the ground.

Reach your left hand to your right knee and your right hand to the back edge of the chair.

Press gently with both hands as you look over your shoulder and rotate your torso. Lean slightly forward to allow more space for the twist.

Take two deep breaths, then switch to the other side.

Repeat three times per side.

9) Bound Neck Stretch | 2 Breaths, 3x Per Side

Sit up tall in your chair and reach your right arm straight down by your side.

Reach your left hand behind your back to clasp your right wrist, then tilt your neck to the right.

To increase the stretch, gently press your arm away from your torso.

Hold for two deep breaths, then release and switch to do the other side.

Repeat three times per side.

10) Alternating Fingers Wrist Stretch | 2 Breaths, 3x Per Side

Sit up tall in your chair. Reach your right arm straight out in front of you with fingers pointing down towards the ground.

Use your left hand to gently pull on the back of your right hand to stretch the top of your wrist. Hold for two breaths.

Flip your right hand up so that your palm is facing out, and pull back with your left hand to stretch the bottom of your wrist. Hold for two breaths.

Alternate between stretching the top and bottom of your right wrist three times, then switch to the other side.

11) Hamstring Stretch | 3 Breaths, 2x Per Side

Stand up and face your chair. Step back about two feet.

Raise your right foot and place the heel on the middle of the chair with your foot flexed.

Place your hands on your hips and hinge forward, until you feel a stretch through your hamstring. Keep a slight bend in both knees to maintain muscular engagement.

Take three deep breaths, then switch to the left leg.

Repeat two times per side.

12) Chair Pigeon Pose | 3 Breaths, 2x Per Side

Stand facing your chair.

Place your right shin across the front of the chair, with your knee on the chair and foot off the edge. Keep your foot flexed.

Grasp onto the edges of the chair with both hands and step your other leg back to straighten out the knee and hip. You can control the depth of this hip stretch by bending or straightening your elbows.

Take three deep breaths, then switch to the other leg.

Repeat two times per side.

13) Single Leg Toe Pull | 2 Breaths, 3x Per Side

Stand facing your chair. Hinge forward at the hips and place your hands on the chair.

Grab your right toes with your right hand. Keep your left hand on the chair and a microbend in your left leg.

Pull slightly upward on your right toes until you feel a stretch in your calf and hamstring. Make sure to keep your hips square and your lower back as flat as possible.

Hold for two breaths, then switch sides.

Complete three sets per side.

Thanks again to Jessica Gouthro of Paleohacks. Questions or other ideas for staying relaxed and limber at work? Shoot me a line in the comments below. Have a great week, everyone. 

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Weekly Link Love—Edition 13

Research of the Week

Gene drives—genetic engineering that the recipients pass along to all their offspring—now work in mammals.

Researchers fix Alzheimer’s in mice by targeting epigenetics.

Skipping dinner three times a work helps overweight women drop body fat.

During the age of great migration, Scandinavians with an individualist streak were more likely to move to the U.S. than Scandinavians with a collectivist streak.

Turns out that every single gene is probably important for every single cell.

Facial recognition is being used to fight illegal chimp trading.

New Primal Blueprint Podcasts

Episode 306: Logan Schwartz: Host Elle Russ chats with movement coach Logan Schwartz about strength, performance, movement, and mobility.

Each week, select Mark’s Daily Apple blog posts are prepared as Primal Blueprint Podcasts. Need to catch up on reading, but don’t have the time? Prefer to listen to articles while on the go? Check out the new blog post podcasts below, and subscribe to the Primal Blueprint Podcast here so you never miss an episode.

Media, Schmedia

Coming soon: GOOP ayahuasca ceremonies presided over by Gwyneth Paltrow.

Super poo wanted.

Interesting Blog Posts

Asking patients to draw their illness.

How pigs made it to Okinawa.

Social Notes

Ten wellness leaders (including yours truly) gave their opinion on the best snack to curb cravings.

Paleo Magazine’s annual “Best of” contest is on, and it’s time to vote for your favorite [enter paleo-themed thing here]. There are some good selections in the Best Paleo Cookbook, New Product, Food Company, Lifestyle Company, Nut-Based Bar, and Paleo-Related Story sections.

Everything Else

Big data changed the way basketball is played in the NBA, and Carmelo Anthony is its most notable victim.

Seed sovereignty for small farmers and local varieties passes in the U.N.

Aging and tennis.

Did a planet crashing into Earth seed us with the ingredients for life?

Horrible bullying from this elephant. Toxic.

Fighting fungi.

Things I’m Up to and Interested In

I’d play this: Boardgame about the conflict between Viking settlers, Inuit settlers, and native Greenland Tunit peoples.

Article I found interesting: After getting a taste of freedom abroad, kids who move back to the U.S struggle with overparenting.

Something I always considered but never followed up with: Homeschooled kids tend to be better-educated and more tolerant, and homeschooling is on the rise.

Deal I’m happy to share: Trying to prep for the Big Game? Want something everyone will love, Primal or not? Just really, really love wings? Sign up for a membership at Butcher Box and get three pounds of organic chicken wings added free to every order for life. Get your orders in by 1/28 to ensure your wings arrive in time for the game.

I’m reminded of an oft-forgotten Primal Law: Avoid Stupid Mistakes.

Question I’m Asking

What do you think of homeschooling? Tried it, experienced it, for it, against it?

Recipe Corner

Time Capsule

One year ago (Jan 20 – Jan 26)

Comment of the Week

“Hey Mark,
I assume your referencing the article regarding a supposed link between skipping breakfast and increased risk of diabetes due to how absurd it is?
Just checking, because otherwise my whole fasted morning routine from the last few years now seems that it could be my undoing.
Cheers!”

– I’d love to respond in full, Josh, but sadly I skipped breakfast and now I’m in an ambulance headed to emergency.

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The post Weekly Link Love—Edition 13 appeared first on Mark's Daily Apple.

Warm Mushroom and Chard Salad with Bacon and Mustard Dressing

Salads aren’t just for summer, and this recipe proves it. Warm, hearty, rich, with the deep flavors of mixed mushrooms, bacon (we have you at that, right?) and mustard dressing, this delicious side—or full-on meal—will make a believer out of you. Salads, done well, are for all seasons.

But there’s more…. We’re loving the crunch of toasted pine nuts and the addition of poached eggs. It might just be the quintessential winter salad—and we’re guessing a new Primal favorite for your health-conscious table.

Servings: 4

Time In the Kitchen: 20 minutes

Ingredients:

  • 2 bunches rainbow or Swiss chard
  • 2 cups sliced mushrooms (any variety; a mix is great, too)
  • 6 strips crisp, cooked bacon, crumbled
  • ½ cup toasted pine nuts
  • 1/3 cup plus 2 teaspoons Primal Kitchen® Avocado Oil
  • 2 tablespoons apple cider vinegar
  • 1/3 cup Primal Kitchen Organic Spicy Brown Mustard
  • 1 large shallot, minced
  • 1 garlic clove, finely minced
  • 1 teaspoon dried thyme
  • Salt and pepper to taste
  • Optional: Poached eggs

Instructions:

Wash, dry and chop rainbow/Swiss chard (Tip: Tear leaves off first and then chop stems.)

Heat 2 teaspoons avocado oil in a large skillet over medium heat. Add sliced mushrooms, sprinkle with salt and pepper, and saute until lightly browned, about 7 minutes.

Remove mushrooms from skillet and set aside.

Add chard to the pan and cook until wilted, about 3–4 minutes. Sprinkle with salt, stir, and add to a large mixing bowl.

Add remaining avocado oil, vinegar, mustard, shallot, garlic, thyme, salt and pepper to a mason jar. Shake well until emulsified, and add dressing to bowl with the chard.

Add mushrooms, bacon, and pine nuts to bowl. Toss well to mix.

Optional: Serve with chopped hard-boiled eggs or one poached egg per salad.

Nutritional Information (per serving, with one poached egg):

  • Calories: 474
  • Net Carbs: 9 grams
  • Fat: 39 grams
  • Protein: 18 grams

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Is Iron the New Cholesterol?

One thing I’ve realized being in this game for so long is that if you’re convinced that meat truly is deadly, you’re not going to stop looking for reasons why. They’ve tried blaming just about every part of meat over the years, including the protein itself, the saturated fat, the cholesterol, the methionine, the char on BBQ, and even the obscure compounds like TMAO or Neu5gc. The latest component of meat they’ve zeroed in on is iron—the essential mineral responsible for energy production and a host of other vital functions.

The experts’ track record with all the other “evil meat components” has many of my readers skeptical, so they asked me to weigh in on iron.

Iron is an essential mineral, integral in the production of energy and the creation of blood cells. If pregnant women don’t get it, they can’t deliver oxygen and nutrients to their growing babies. If kids don’t get it, they shortchange their mental and physical development. If adults don’t get it, their basic day-to-day physiological function falls apart. Without adequate iron, our antioxidant defenses, our immunity, and our metabolic function all suffer. Hell, most countries even mandate the fortification of refined flour with large amounts of iron to prevent these tragedies.

Iron also has a dark side. A large body of observational evidence links elevated iron levels to diseases and disease states like type 2 diabetesheart diseaseinsulin resistanceinflammation, Alzheimer’s disease, hypertension, fatty liver, hypothyroidism, arthritis, and cancer. You name it, it’s probably linked to elevated iron. And as much as I’d like to, I can’t dismiss these connections as non-causal.

For one, iron is inherently reactionary: The very same proclivity for electron exchange that makes iron so integral in biochemical reactions that address stress and support health means it can also create free radicals that damage DNA, cells, blood lipids, and increase stress and harm health.

Two, there’s a little something called hereditary hemochromatosis.

Hereditary hemochromatosis is a genetic condition increasing a person’s absorption and retention of dietary iron. This has benefits in certain contexts—carriers have a natural resistance to the bubonic plague, as one effect of hemochromatosis is to render white immune cells iron-deficient and thus resistant to the plague which feeds on iron—but it’s mostly negative in today’s relatively plague-free world. Most of the hemochromatosis literature focuses on homozygotes (carriers of two copies of the gene) and specific “iron overload-related diseases,” which include cirrhosis, liver fibrosis, liver cancer, elevated liver enzymes, “physician-diagnosed symptomatic hemochromatosis,” or finger arthritis. Those are bad conditions to have, to be sure, but that’s not even a complete list. Homozygous carriers of the mutation also have greater risks for diabetes, arthritis, fatigue, liver disease, and frailty and muscle loss. They’re more likely to experience neurodegenerative diseases like Parkinson’s and Alzheimer’s. Even heterozygous carriers (those who carry just one copy of the variant) have an elevated risk of iron overload compared to the general population.

Okay, okay. But couldn’t it be that the hemochromatosis gene is increasing disease risk through another, non-iron route? Perhaps high iron is just a marker of disease, not a cause. After all, most genes are pleiotropic—they have more than one effect.

Probably not. The most reliable treatment for hereditary hemochromatosis is phlebotomy. Literally removing iron from the body by draining blood is the first (and often only necessary) line of defense against hereditary iron overload. And it works really well.

Besides, phlebotomy may also be beneficial in people without clinical iron overload or hemochromatosis. It’s the most effective way to reduce iron stores and tends to increase insulin sensitivity. In insulin resistant men with fatty liver, blood donation normalized insulin sensitivity and liver enzymes. In meat eaters, blood donation reduced ferritin levels to match those of lacto-ovo-vegetarians and improved insulin sensitivity. One study even tested the effect of randomized phlebotomy on cancer incidence. After four and a half years, those subjects placed in the phlebotomy group lived longer, had less cancer, and had lower ferritin levels than the subjects who didn’t donate blood.

I can’t argue with the research, but the idea that a primary component of a food we’ve been eating for millions of years and to which we may even owe much of our brainpower—the iron in meat—still rankles. Is iron truly inherently “bad,” or is there anything about our modern environment that makes it so?

Possible Modern Influences On Iron Levels

Less Bleeding

One factor is that we don’t shed as much blood as before. Most men engage in far fewer bouts of direct violent conflict. Most people have fewer parasites feasting on their blood. And when’s the last time you exchanged blood oaths with anyone? We have fewer opportunities to bleed, in other words. That’s why regular phlebotomy can be such a useful tool for men (and some women) with too much iron in their bodies—it emulates all the bloodletting we used to do in a controlled, safe fashion.

Less Intense Activity

We use iron to generate energy. The more physical activity in which we engage, the more iron we utilize. This is usually couched in warnings for female athletes engaged in intense training, but it can also explain the beneficial effects of exercise in people with iron overload. There are even cases of “mild exercise” causing iron deficiency, so everything that increases energy expenditure—walking, gardening, hiking—will at least subtly reduce iron stores. More activity, less iron sitting around idle getting into trouble.

Too Many Seed Oils

I strongly suspect that the unprecedented dissemination of high-omega-6 seed oils throughout our food systems, our body fat, and our cellular membranes are exacerbating—if not causing—the relationship between excess iron and various diseases. Take the supposedly ironclad (pun intended) relationship between heme iron and colon cancer, which is mediated by iron’s peroxidative alteration of fatty acids in the colon. In animal studies that seek to show this relationship, you can’t get the colon cancer to “take” unless you feed the animal high-PUFA oils along with their heme iron. In one studyfeeding heme iron to rats promoted colon cancer only when fed alongside high-PUFA safflower oil. Feeding MUFA-rich and far more oxidatively-stable olive oil alongside the heme prevented the colon carcinogenesis. In another paper, only mice consuming fish oil-based and safflower oil-based diets exhibited carcinogenic fecal peroxides after eating heme iron; a coconut oil-based group of mice had no negative reaction to heme.

Among a cohort of US nurses, where PUFA intake is around 7% of calories and comes from seed oil, iron intake has moderate links to colon cancer. Among a cohort of Swedish women, where PUFA intake is under 5% of calories with a greater proportion coming from fish, the association is far weaker.

What To Do About All This?

First, men and postmenopausal women should figure out their hemochromatosis status. Both men and women with hereditary hemochromatosis have elevated risks of iron overload-related diseases, but they are much higher for men. (Premenopausal women have a handy built-in mechanism for shedding excess iron—menstruation.) Modern men and older women, with our absence of intestinal parasites and our lower tendency to engage in bloody hand-to-hand fighting, have few opportunities to shed iron. Your doctor will be able to order the test, or you can go through a genetic testing service and look for positive hits on C282Y and H63D.

Do it earlier rather than later. Studies indicate that one of the biggest predictors of whether someone with genetic iron overload develops liver cancer is their age at diagnosis of hemochromatosis. Those who wait risk incurring more damage.

Even if you’re negative for hereditary hemochromatosis, you can still have iron overload. Determine this by asking your doctor for a ferritin test. According to the Mayo Clinic, for men, the ferritin reference range is 24 to 336 ng/ml, and for women, it is 11 to 307. That is a wide range, and levels that your doctor would probably classify as technically normal have been associated with insulin resistance, atherosclerosis, and reduced telomere length (a marker of aging).

From what I can tell, levels approaching 200 ng/ml in men should definitely be classified as “high.” And lower may be even better. In one study, egg-and-dairy-eating vegetarian men had ferritin levels of 35 ng/ml and better insulin sensitivity than meat-eating men with ferritin levels of 72 ng/ml. After donating enough blood to hit 35 ng/ml, the meat eaters insulin sensitivity improved.

Dr. F. S. Facchini has used blood donation to induce “near iron deficiency”—the lowest body iron store that allows normal red blood cell production—in his gout patients, clearing them of gout attacks for as long as they maintained it. His patients at high risk for heart disease also saw major benefits from hitting very low ferritin levels (“to levels commonly seen in premenopausal females”), including increased HDL and lower blood pressure, even if they started with normal ferritin.

What seems safe is to stay on the low end of normal—say, from 50-150 ng/ml—as long as no symptoms of low iron arise.

As for women? Higher levels don’t seem to correlate with the same health issues in women. Lucky.

Now, say you have high iron, whether it’s hereditary hemochromatosis or just high normal ferritin levels….

What Should You Do About High Iron Levels?

Donate Blood

The quickest, safest way that also does the most social good (if you care about that sort of thing) is to donate blood. When you donate blood, your body must upregulate hemoglobin production to replace the lost blood. That requires iron, which is taken from body stores.

Don’t Manage Iron Overload With Diet

By that I mean stuff like:

  • Don’t give up red meat.
  • Don’t stop eating liver every week.
  • Keep eating oysters.
  • Don’t religiously adhere to reverse-kosher (only eating meat in the presence of dairy to inhibit iron absorption).

If you make dietary iron the focal point, you’ll miss out on all the incredible nutrients iron-rich foods like red meat and liver can offer. Besides, you’ll run yourself ragged following even more food restrictive rules that increase the chance of other nutrient deficiencies.

Don’t Manage an Iron Overload That Doesn’t Exist

I’ve seen people go down the rabbit hole of iron obsession without actually confirming they even had too much iron. They started giving blood (even self-administered), trying to reduce iron absorption by pairing dairy and calcium with their iron-rich foods, avoiding iron-rich foods—totally blind. Iron is an important nutrient. Deficiency is real. Anemia is no joke. Get tested before you start messing around with iron.

Follow a Healthy Primal Eating Plan

Whether it’s keto, low-carb, moderate-carb, or even vegetarian, going Primal will mitigate many of the potential effects of high iron by:

  • Avoiding Seed Oils and Excess Omega-6 Fats. Seed oils almost certainly make the “iron overload problem” worse, and may even be responsible for its negative effects and link to various diseases.
  • Including Phytonutrient-rich Fruits, Vegetables, Herbs, Teas, and Coffee. Polyphenols both inhibit iron absorption and reduce the oxidative interaction between iron and lipids.

So to sum up, get tested and be aware of the iron issue, but don’t let it rule you. It’s iron overload, not overlord.

Take care, everyone. What do you think of iron? Ever get tested? Ever give blood? See any benefits?

Let me know down below!

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Note: This information isn’t intended as and shouldn’t be considered medical advice. Always consult your doctor in the management or treatment of any health issue.

References:

Tamosauskaite J, Atkins JL, Pilling LC, et al. Hereditary Hemochromatosis Associations with Frailty, Sarcopenia and Chronic Pain: Evidence from 200,975 Older UK Biobank Participants. J Gerontol A Biol Sci Med Sci. 2019;

Burke W, Imperatore G, Mcdonnell SM, Baron RC, Khoury MJ. Contribution of different HFE genotypes to iron overload disease: a pooled analysis. Genet Med. 2000;2(5):271-7.

Allen KJ, Gurrin LC, Constantine CC, et al. Iron-overload-related disease in HFE hereditary hemochromatosis. N Engl J Med. 2008;358(3):221-30.

Nowak A, Giger RS, Krayenbuehl PA. Higher age at diagnosis of hemochromatosis is the strongest predictor of the occurrence of hepatocellular carcinoma in the Swiss hemochromatosis cohort: A prospective longitudinal observational study. Medicine (Baltimore). 2018;97(42):e12886.

Larsson SC, Rafter J, Holmberg L, Bergkvist L, Wolk A. Red meat consumption and risk of cancers of the proximal colon, distal colon and rectum: the Swedish Mammography Cohort. Int J Cancer. 2005;113(5):829-34.

Liu B, Sun Y, Xu G, et al. Association between Body Iron Status and Leukocyte Telomere Length, a Biomarker of Biological Aging, in a Nationally Representative Sample of US Adults. J Acad Nutr Diet. 2018;

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