Explaining Keto and Hair Loss (and Why Any Dietary Change Might Cause It)

So you start your keto diet, and things are going well. You’re dropping excess fat, your carb cravings are noticeably reduced, your energy is steady throughout the day… and then one day you start to have the sneaking suspicion that you’re shedding more hair than usual. After a few days, it’s unmistakable: your hair is definitely falling out at an alarming rate.

Take a deep breath. Nobody wants to lose their hair, obviously, but it’s probably a harmless and temporary condition called telogen effluvium (TE). Hair growth is cyclical. Each hair follicle goes through a growth phase (anagen) and a rest phase (telogen). Usually the cycles are staggered from follicle to follicle, so some are growing while others are resting and shedding. With TE, more follicles than normal go into resting at the same time, leading to noticeable hair loss.

The good news is that TE usually resolves itself within a few months. For many people the answer is simply to wait it out. However, hair loss can be caused or exacerbated by issues that you can address on your own or with the help of a medical practitioner. Let’s dig into it.

What Causes Telogen Effluvium?

TE is one of those diagnoses that describes what is happening but not why. It’s kind of a catch-all label to describe diffuse but likely temporary hair loss that could be caused by a number of factors, and it’s not terribly well understood. The general consensus is that TE can occur whenever the body experiences stress. Unfortunately, the body can interpret any big changes, even ones that feel positive like the birth of a child, as stressors. Dramatic dietary changes and/or sudden or rapid weight loss, as often occurs when starting a keto diet, are two such potential stressors. (This isn’t unique to the keto diet, by the way!)

If you think back three or so months from the time you started to notice your hair thinning, can you identify a major change or stressful life event that happened around that time? If so, it’s likely that you’re experiencing TE.

Eating in a big caloric deficit and eating too little protein might also trigger TE, and both are potential (and easily remedied) issues for keto dieters. When the body has limited resources to devote to building, repair, and maintenance, hair growth will go on the back burner, since it’s a non-vital process. Specific nutrient deficiencies have also been implicated in TE, particularly iron and zinc. The link between iron deficiencies and TE is stronger for women, while zinc deficiencies might affect men more, but the evidence for both is mixed. In part, it is hard to pin down dietary causes because the same foods that are the best sources of iron are also rich in zinc and amino acids.

Why Doesn’t Everyone Lose Their Hair When They Go Keto Then?

Great question. Whether or not your body interprets any given situation as too stressful is complicated. It’s a factor of your chronic stress levels, other acute stressors that happen to co-occur, your physical health and hormone status, and probably tons of other things. Your mindset undoubtedly has a lot to do with it, too. You can inject stress into a situation with how you think about it, whether you worry or try to micromanage, whether you feel optimistic or pessimistic. It’s also possible that some people who experience TE don’t really notice it because their hair loss is fairly minor.

Is There Anything I Can Do?

First, prevention is the best medicine. There is no way to guarantee that you won’t experience TE when starting keto, but The Keto Reset Diet approach is specifically designed to mitigate stress. Whereas other methods of keto induction involve severe carb restriction and sometimes multi-day fasting to body slam you into ketosis, the Keto Reset is a kinder, gentler process (not to mention a more nutrient-dense approach). First, you get fat-adapted, then gradually lower carb to ketogenic levels to avoid an acute shock to the system. This is also why we ask people to take the midterm exam in the book before even starting keto. The midterm exam looks for signs that you are already stressed (poor quality sleep, for example) in an attempt to prevent your “stress bucket” from overflowing (and the hair from shedding!).

If you’re already thinning, and it’s pretty clear what probably initiated it two to four months prior, then chances are you can just wait it out. Within a few months you should be seeing regrowth, and in six months to a year you’ll be past it. Yes, I know it’s easier said than done to just wait six months to see if your hair is growing back, so if you want to be more proactive, here are a few ideas.

  • Manage stress. While TE usually follows more acute stressors, chronic stress can also contribute. Whatever you can do to reduce your day-to-day stress might help your hair loss and if nothing else will improve your overall quality of life.
  • Look at your diet. If you are eating in a caloric deficit, especially if it’s greater than 20% of your baseline calorie needs, perhaps try adding back some calories. You’ll know if you overshoot it if you stop hitting your weight loss goals or if you start gaining if you were at maintenance already.
  • How’s your protein intake? Too many keto dieters have been scared away from protein by the gluconeogenesis boogeyman. The Keto Reset Diet recommends starting with 0.6 to 0.8 grams of protein per pound of lean body mass. You can increase to 1.0 gram/lb/LMB if it seems appropriate for your situation.
  • Make sure you’re incorporating plenty of iron- and zinc-rich foods. Even though the evidence is not conclusive as to whether iron and zinc are linked to TE, they are still vital for health. The best sources are red meat, seafood (especially oysters), and poultry. You’ll notice these are all animal products, which means if you’re vegetarian or vegan, you have to work extra hard to get these nutrients. Leafy greens, nuts and seeds, and legumes (if you choose to incorporate them) can provide some of what you need, but they are not the best options.

A well-formulated multivitamin/mineral is worth considering if you don’t already take one, but get your iron and zinc levels tested before supplementing either of those on its own. With both, there are concerns about over-supplementing and developing toxicity. Iron overload such as that caused by the genetic condition hemochromatosis can also cause hair loss, so consult a doctor before taking iron supplements. Lastly, some people also swear by adding biotin, a member of the B vitamin family. While biotin is associated with nail and hair health, there is not empirical evidence to support biotin supplementation for TE.

When to See Your Doctor

Now that I’ve spent all this time telling you it’s probably TE and nothing to worry about it, I must add the caveat that TE is only one of many potential causes of hair loss. Be sure to enlist the help of a medical professional if you are experiencing any other unexplained or disruptive symptoms, or if there isn’t an obvious reason why you might be experiencing TE. Do not ignore symptoms such as unexplained weight gain or weight loss, fatigue, sleep disturbances, feeling cold all the time, menstrual irregularities, or digestive issues, especially in combination with significant hair loss. Depending on your symptoms, your doctor may want to test you for nutrient deficiencies, sex hormone imbalances, or thyroid issues.  

Have any follow-up questions? Join the Keto Reset Facebook community for answers to all your keto queries! Thanks for stopping by today, everybody.

References:

Abdel Aziz AM, Sh Hamed S, Gaballah MA. Possible Relationship between Chronic Telogen Effluvium and Changes in Lead, Cadmium, Zinc, and Iron Total Blood Levels in Females: A Case-Control Study. Int J Trichology. 2015; 7(3):100-106.

Harrison S, Bergfeld W. Diffuse hair loss: its triggers and management. Cleve Clin J Med. 2009; 76(6):361- 367.

Malkud, D. Telogen Effluvium: A Review. J Clin Diagn Res. 2015; 9(9): WE01–WE03.

Moeinvaziri M, Mansoori P, Holakooee K, et al. Iron status in diffuse telogen hair loss among women. Acta Dermatovenerol Croat. 2009; 17(4):279-284.

Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002; 27(5):396-404.

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Join Me This Week On the “Whole30® Recipes” Instagram!

Hey, everybody! This week I’m taking over the Whole30 Recipes Instagram. Yup, today through Sunday (1/21-1/27), you can follow me on their feed, where I’ll be posting throughout each day and offering tips and ideas that blend the best of Primal philosophy with Whole30 principles.

It’s seven full days of content—exclusive commentary, delicious recipes and new videos you’ve never seen—all from yours truly. Make sure to check out the Whole30 Recipes static feed and Instagram Stories for all my postings, and let me know what you think.

Looking forward to seeing you there!

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I Feel and Function As If I’m Half My Age

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

Here’s an update to my December 2013 success story.

I have been Primal—Low-carb—Keto for over seven years. I am 49-years-old and my health continues to improve. I am confident I am enhancing my prospects for longevity.
I eat delicious food, rarely feel hungry, enjoy fasting and truly enjoy the many interesting and challenging facets of powerlifting training.

I have been carnivore keto the past 6 months and I completely love the simplicity and feel slightly better from an intestinal standpoint compared to Keto. I lost most of my weight while enjoying Mark’s Big Ass Salads. I keep the Primal philosophy in the front of my mind when I comes to avoiding unhealthy fat, cheat meals, overtraining, rest, sunlight, outdoors and recommendations to someone new to a low-carb lifestyle.

I may not always be in ketosis, but I’m always Primal.

2017 was a fantastic year for my health.

2018 was better:

I have been 95% carnivore keto the past 6 months:

— Lost 17 pounds / decreased body fat

— increased powerlifting personal best lifts

— zero vegetables eaten

— less than 5% calories from occasional nuts, berries, dark chocolate and wine

— Intermittent fast ~18h five days a week and I train fasted

— supplement heavily with Himalayan sea salt (~10 grams sodium per day)

— eat mostly beef, bacon and eggs

— add butter and cheese to lean cuts of meat

— eat fish 2-3 times per week; fish/krill oil daily — eat liver once a week; supplement with desiccated liver daily

The past 2 years of Low-carb Primal Keto diet and powerlifting training:

— including the 6 months of carnivore above — lost 27 pounds

— increased squat and deadlift PR in 4 consecutive competitions (bench in training)

I have been Low-carb Primal Keto for over 7 years.

— lost over 100 pounds in 2012 with minimal exercise — ‘cured’ insulin resistance/metabolic syndrome: prediabetes, hyperlipidemia, fatty liver. Joint pain, GERD, irritable bowel, migraines, insomnia, acne/skin problems.

— continue to decrease body fat with powerlifting training

— my taste preferences have changed: I love what I eat

— fat adaptation enhances long term fasting, which facilitates continued diet adherence — I have learned a great amount of valuable information about serving sizes and counting macros during weeks of micromanaging / weighing foods, but now I easily hit protein and carb targets without detailed macro tracking; I eat fat to hunger/satiety.

— scroll my @joeketone Twitter and Instagram for my training log, food, wine and what’s on my mind

# 1 KEY FACTOR TO ALL OF THIS: I AM RARELY HUNGRY—I am in control of my intake and I eat delicious food.

Yes, I am in a five or ten day net calorie deficit, but it does not feel like I am—I achieve a net calorie deficit without ‘trying’ and I have immense energy.

I am burning stored fat and minimizing health problems associated with hyperinsulinemia and hyperglycemia: enhancing LONGEVITY.

I sleep deeply and when I’m awake I feel and function as if I am half my age.

Many thanks to Mark Sisson and The Primal Blueprint.

Grok on!

Joe Lovely

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

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Weekly Link Love—Edition 12

Research of the Week

Maternal choline supplementation reduces the impact of Alzheimer’s disease across generations (in rodents).

Subtitles are better than dubbing for learning a new language.

Computers (and, though not named in the title, smartphones) can really mess up your neck and shoulders if you’re not careful.

Infant circumcision could increase the risk of sudden infant death.

If you’ve ever skipped breakfast, you’re probably already dead of diabetes.

Body paint: an alternative to DEET?

New Primal Blueprint Podcasts

Episode 304: Dr. Dominic D’Agostino: Host Elle Russ chats with doctor and keto expert Dominic D’Agostino.

Episode 305: Dr. Anthony Gustin: Host Brad Kearns chats with Dr. Gustin, of Perfect Keto fame.

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.

Question From Readers

Hey, Mark, what do you think about the motives behind the new global diet guidelines? Are these guys really sincere or is it something else?

I’ve been discussing the oncoming war against meat for several months, and we’ve all seen it brewing for years. These EAT-Lancet dietary guidelines mark the first major offensive. Don’t expect this to slow down, or for the powers-that-be who want you to eat less meat and buy more plant products to give up. Meat isn’t very profitable. That’s what it comes down to. Not the climate. Not the “health risks.” Profit.

If I’m feeling extra suspicious, I might even consider that the lust of profit may be even deeper, and that they’re banking on an increase in the rate of chronic diseases related to diet—diseases that require ongoing prescriptions and lifelong medical care.

Media, Schmedia

The new evidence-based global dietary guidelines allow 7 grams (yes, GRAMS) of red meat each day. I’ve already blown through my yearly allowance in the past week.

Sunscreen: The new margarine?

Interesting Blog Posts

So, is grain fiber truly the staff upon which all life rests?

20 reasons (at least) why the new dietary guidelines are wrong.

Social Notes

Out for a paddle.

Everything Else

“Hey plebs, how about you guys limit yourselves to a slice of bacon every three days so I can fly around on my private jet guilt-free?”

Nomadic Mongolians were quite healthy.

The observation deck at the Tokyo fish market is now open to the public.

Nothing much going on, just a potential solar sail from an alien spacecraft.

Something to shoot for.

Things I’m Up to and Interested In

Podcast I enjoyed: Johann Hari on Tangentially Speaking discussing the real cause of addiction.

Image I found interesting: All the companies participating in the committee to push this low/no-meat global diet.

Sales figure I found illuminating: Self-improvement books related to mental health are now outselling diet and fitness self-improvement books.

Reddit comment you should read: In which the author compares the macronutrient ratios of the EAT-Lancet guidelines and the classic obesogenic rodent diet and finds them identical.

Article everyone needs to read: When things are going great, think about how they can go very wrong.

Question I’m Asking

Where do you see this “war on meat” leading? How far do you see it going?

Recipe Corner

Time Capsule

One year ago (Jan 13 – Jan 19)

Comment of the Week

“Best cancer theory EVER. Exclamation point in the title got me intrigued, but they had me with the ribbons in fig. 4. You just can’t falsify that sh*t.

This is peak PubMed.”

– Indeed, DBW.

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Instant Pot Sweet Potato Peanut Stew

Stews are perhaps the ultimate comfort and convenience food. Without a lot of prep, you can make a large (leftover-friendly) hearty meal that essentially cooks itself and keeps well. With an Instant Pot, it’s even easier.

The original version of this recipe contains chicken (which can definitely still be added here), but this vegetarian Instant Pot version is just as filling and flavorful.

Servings: 6

Time in the Kitchen: 25 minutes

Ingredients

  • 2 tablespoons Primal Kitchen® Avocado Oil (30 ml)
  • 1 onion, finely chopped
  • 2 inches ginger root, peeled and finely chopped (5 cm)
  • 3 garlic cloves, finely chopped
  • 1 teaspoon ground coriander (5 ml)
  • ½ teaspoon turmeric (2.5 ml)
  • 1 15-ounce can diced tomatoes (425 g)
  • 3 cups vegetable (or beef) broth (700 ml)
  • 2 sweet potatoes, peeled and cut into 1-inch/2.5 cm cubes
  • 8 ounces frozen spinach (226 g)
  • ½ cup natural, unsweetened, creamy peanut butter (256 g)
  • Garnish: 1 or 2 jalapenos or other hot chilies, seeded and minced, chopped cilantro

Instructions

Select the sauté setting on the Instant Pot and heat the oil. Add onion and ginger, sauté about 5 minutes to soften.

Add garlic, cumin, coriander, turmeric and sauté 2 minutes more.

Add diced tomatoes, broth, sweet potatoes and frozen spinach.

Secure the lid and make sure the pressure release valve is set to “sealing.” Select the “manual” setting and set the cooking time for 6 minutes on high pressure. After cooking time, do a quick release by moving the pressure release valve to “venting.”

Open the lid and stir in peanut butter until fully mixed into the broth.

Top stew with sliced hot peppers and cilantro.

Nutritional Facts:

  • Calories: 244 
  • Net Carbs: 15 grams
  • Fat: 16 grams
  • Protein: 9 grams

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Keto for Men: 6 Tips to Optimize Your Results

Men occupy an interesting place in the health sphere. While there’s a disparity—albeit one that’s approaching parity—between men and women in the conventional medical literature, in the alternative health world, it’s flipped. Women are a “special interest” group, and their specific health issues and special considerations related to diet and exercise receive a lot of attention, often as a way to counteract the conventional imbalance—and because women tend to be higher consumers of health information. I have far more posts (including a post on Keto For Women) explicitly directed toward women and women’s issues (and the same can be said across many ancestral health sites).

Men are assumed to be “the default,” requiring no special consideration, but is that actually true?

Today, I’ll be talking about any special considerations men should make when following a Keto Reset plan.

Play At the Margins

Historically, anthropologically, and biologically speaking, men can tolerate great variations in environmental intensity. They’re usually (not always of course) the ones going to war, performing great feats of physical endurance and strength, willingly subjecting themselves to misery and pain, as well as being more violent and getting into the most trouble. (On the whole) carrying more muscle mass, secreting more testosterone, and being physically larger than the opposite sex will tend to make all that possible. We see this kind of sexual dimorphism play out across most mammals, and there’s no reason to think humans are any different.

Most of us don’t have these extreme situations foisted on us any more, but we still thrive doing them. Try a 2-day fast. Do one meal a day. Eat a 3-pound steak, then no meat at all the next day. Eat a dozen eggs for breakfast (whenever that happens). Try lots of seemingly extreme experiments to see what works. It may be that you thrive doing the occasional intense bout of keto bravado. Only one way to find out.

Whereas women tend to have a lower tolerance for perturbations in caloric intake for their potential impact on fertility status, men have far more leeway. Take advantage of that.

Be As Strict As Possible Early On

I’m not going to mince words. Get strict. Most of the men I encounter who are having problems with keto do better the stricter they are. For women, it’s often the opposite—they need to relax their keto adherence and just eat.

Don’t mess around with carb refeeds, pre-workout carbs, or “just one donut hole” until you have a good thing going. Get those fat-burning mitochondria built. Stay strong and stay strict.

Manage Your Stress Levels

This is good general advice for everyone on any diet, but it’s especially so for men eating keto.

A big part of traditional masculinity (for better and worse) is stoicism—the ability to soldier on through a difficult situation. This is, on balance, often a good yet misunderstood trait that gets a bad rap that it doesn’t always deserve. Stoicism isn’t unfeeling. At its healthiest, it’s the ability to address the feelings without being ruled by them. It’s feeling grief without letting your life fall to pieces. These are positive ways to respond to life’s slings and arrows. But this can lead to a denial of the physiological ramifications of stress and a failure to manage them with anti-stress behaviors.

Keto does not make you impervious to stress. Being a man does not make you impervious to stress. There are still limits to the amount of stress we can tolerate, physiological ones that no one should try to transcend. At those levels, “mind over matter” stops working. Stress will spike cortisol, blunt testosterone, and make all that decidedly non-keto junk food all the more attractive and alluring.

Monitor Your Testosterone Levels

For the most part, going keto tends to improve testosterone levels:

It reduces body fat. Researchers have known for decades that carrying extra body fat depresses testosterone levels, and that losing the extra fat restores them. In fact, a recent study found that a man’s body weight is such a fantastic predictor of low testosterone and poor sexual function that the authors recommend it should be used as a standard biomarker for evaluating testosterone levels. If keto is helping you lose body fat, it’s probably improving your T levels.

It increases saturated fat and cholesterol intake. Both nutrients (yes, nutrients) are important building blocks for the production of testosterone. Studies show that low-fat, high-fiber diets lower testosterone in men, while diets higher in saturated fat increase it.

Once the initial exodus of body fat is over, though, you have to be more vigilant. Calories can dip too low. Deficiencies of micronutrients you haven’t been thinking about may start to surface. And this can all impact your testosterone levels.

Make sure you’re not starving yourself. Men are built to handle and even prosper from acute boluses of extreme caloric restriction or expenditure (fasts, heavy training), but extended bouts can destroy our hormonal profile. Just look at what happens to a seasoned bodybuilder preparing for competition with caloric restriction and intense training—their testosterone tanks and their cortisol shoots up.

Make sure you’re getting adequate amounts of the pro-testosterone micronutrients. Zinc, vitamin D (either through sun exposure, vitamin D-rich foods like wild salmon, eggs, cod liver oil, or supplementation), saturated fat, cholesterol, magnesium. Using a tool like Cronometer can help you track them and get your diet in order.

Don’t Let Keto Take Over

Men tend to obsess over things that interest them. We scour the literature, try to optimize everything, spend every waking moment thinking about how to do something—in this case, keto—better. We can get a little iron-willed and myopic if we don’t watch ourselves.

Focus is all well and good, but not if it starts impeding your ability to handle other aspects of health that are no less important.

Don’t stay up ’til 2 A.M. arguing on keto forums and reading PubMed abstracts. Get your sleep.

Don’t become a recluse because none of your friends understand your “weird keto thing.” Maintain your social relationships, your community.

Don’t stop sprinting because you measured your blood glucose once after a hill session and it spiked. Exercise is equally important.

Make Sure You’re Lifting

Keto does not replace strength training.

I’m a firm proponent of weight lifting for everyone—man, woman, elderly, and sometimes child (depending on the child). The benefits are unassailable and vast. Carrying lean muscle mass is a wholly beneficial trait for everyone.

But you have to admit, it’s especially crucial for a man. There’s nothing more indicative of poor metabolic health than the male skinny fat look. I see far too many men on keto diets who carry around the skinny fat look, and it’s usually because they aren’t lifting anything heavy. Yeah, you’re burning a lot of fat. Yeah, you’ve got some nice-looking mitochondria. Yeah, keto is protein-sparing. But are you using those mitochondria? Are you taking advantage of that lost dead weight to do some extra pull-ups? Are you content with merely limiting the number of amino acids your ketogenic metabolic state extracts from your muscle tissue, or are you going to build brand new muscle tissue?

Get to it.

That’s what I’ve got. What about you? Can you folks recommend any special tips, tricks, or tactics for men doing a keto diet?

Thanks for reading, everyone. Take care.

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References:

Masterson JM, Soodana-prakash N, Patel AS, Kargi AY, Ramasamy R. Elevated Body Mass Index Is Associated with Secondary Hypogonadism Among Men Presenting to a Tertiary Academic Medical Center. World J Mens Health. 2019;37(1):93-98.

Wang C, Catlin DH, Starcevic B, et al. Low-fat high-fiber diet decreased serum and urine androgens in men. J Clin Endocrinol Metab. 2005;90(6):3550-9.

Pardue A, Trexler ET, Sprod LK. Case Study: Unfavorable But Transient Physiological Changes During Contest Preparation in a Drug-Free Male Bodybuilder. Int J Sport Nutr Exerc Metab. 2017;27(6):550-559.

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Dear Mark: How Do Fermented Food and Meat Interact?

For this week’s Dear Mark, I’m answering a question from a reader about a topic I thought I’d covered (so did they) already. A quick look through the archives (hey, I can’t remember absolutely everything I ever wrote) showed that I had not, so here we go. It’s all about whether fermented foods—sauerkrauts, kimchis, pickles, yogurts, and any other food that has been acted upon by probiotic bacteria—make eating meat healthier and more enjoyable. From the start, I suspected that they do, but I had to confirm it in the scientific literature.

Let’s find out:

Hi Mark,
I’m trying to find an article on why you should eat ferments with meat, (how it breaks down the fats) our mutual friend Hilary, AKA #thelunchlady ? and I are working on getting some of the high end butcher’s around LA to understand this, so they can help educate their customers. I was hoping to find info on your site, but now hoping you might write one for us

As for the effect you mention—fermented food breaking down the fat in meat—I’m unaware of any evidence. I am aware of a beneficial effect of fermented food on carbohydrate metabolism though. See, lactofermentation produces acetic acid as a byproduct. Acetic acid provides the “sour” flavor, the acidity of a batch of sauerkraut or pickles. It’s also what makes vinegar so sour, and there’s a long line of evidence showing that vinegar improves glucose tolerance and reduces the blood glucose load of high carb meals.

  • A 2017 review of the evidence found that vinegar was significantly effective at reducing both postprandial blood sugar and insulin levels.
  • It works in type 2 diabetics who eat vinegar with their high-carb meals, lowering the blood glucose response.
  • Research shows that acetic acid, rather than some other component in the vinegar, is the active component responsible for the effect on blood sugar. Anything with acetic acid should work, like food ferments.

That’s carbohydrate, and it’s good info, but you didn’t ask about carbs. You asked about meat. So, is fermented food pointless when eating meat? Not at all.

There are many examples of traditional cultures and cuisines making it a point to serve fermented foods with meats:

Koreans, kimchi, BBQ.

Germans, sauerkraut, sausage.

Japanese, pickles/natto/miso, meat/fish.

Indians, yogurt/pickles/chutneys, meat curry/tandoori chicken.

Italians, cheese, salami (itself a fermented meat).

They may not have “known” about the biochemistry. They weren’t citing PubMed studies. But over the many hundreds of years, these pairings emerged as combinations that just worked and made people feel good and the food go down more easily.

What could be going on here?

One thing I’ve stressed over the years is the importance of consuming foods high in polyphenols, not only for their isolated health benefits but for their ameliorative effects on the potential carcinogenicity of meats—particularly high-heat cooked meats (barbecue, grilling, searing). If you eat foods high in polyphenols, like blueberries or leafy greens, with your meat, that meal becomes healthier. It reduces the formation of carcinogenic compounds and reduces the peroxidative damage done to the fat.

And if you take a food high in polyphenols and subject it to fermentation, those polyphenols change and actually become more effective.

Red wine is one such fermented food that is higher in polyphenols than its non-fermented counterpart. The fermentation process alters the polyphenols already present in the grapes, making them more bioavailable and more effective, and creating entirely new compounds in the process. One reason red wine pairs so well with steak on a subjective level is that it actually reduces the formation of toxic lipid oxidation byproducts in “simulated digestion” studies that attempt to recreate the stomach environment after a meal, inhibits the absorption of those toxic lipid byproducts, and, when added to meat marinades, reduces the formation of heat-related carcinogens when you cook the meat, even over open flame. The responsible compound for these effects in red wine isn’t the alcohol, it’s the polyphenols. Grape juice doesn’t have the same effect.

This applies to everything. Fermentation of almost any other food, from beans to cabbage to garlic, also changes and improves the antioxidative capacity of the polyphenols. And the more polyphenols a food has, and the more effective they are at reducing oxidation, the healthier they’ll make any meat we eat.

Fermented foods also contain probiotic bacteria, and there’s some limited evidence that certain bacterial strains can actually enhance metabolism of cooked meat carcinogens.

So, in a roundabout way, fermented foods actually are improving the way we digest the fats in meat. They aren’t quite “breaking them down,” but they are allowing us to metabolize them in a healthier way that produces fewer toxic byproducts and inhibits our absorption of the toxic byproducts that do slip by.

This actually gives me a good idea for a post: A series of elevator pitches that inspired readers can use to lobby restaurant owners, butchers, doctors, and anyone else about the otherwise complicated health and nutrition topics we’ve bandied about on this blog for a decade. Most folks’ brains will glaze over when you start talking “omega-3s” or “peroxidized lipids” or “oxidized LDL particles” or “high heat carcinogens,” but it’s still important information. I think I’ll start putting that together in the next few weeks, starting with today’s topic, and I could really use your help. What other topics have you wanted to broach but can’t figure out how to make relatable, simplistic, or elegant enough to drop in casual conversation with professionals (or friends) who could help make a difference?

Let’s get a list going and try to knock this out.

That’s it for today, folks. Take care and be well. Thanks for reading!

References:

Shishehbor F, Mansoori A, Shirani F. Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Res Clin Pract. 2017;127:1-9.

Liatis S, Grammatikou S, Poulia KA, et al. Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal. Eur J Clin Nutr. 2010;64(7):727-32.

Mettler S, Schwarz I, Colombani PC. Additive postprandial blood glucose-attenuating and satiety-enhancing effect of cinnamon and acetic acid. Nutr Res. 2009;29(10):723-7.

Gorelik S, Ligumsky M, Kohen R, Kanner J. The stomach as a “bioreactor”: when red meat meets red wine. J Agric Food Chem. 2008;56(13):5002-7.

Gorelik S, Ligumsky M, Kohen R, Kanner J. A novel function of red wine polyphenols in humans: prevention of absorption of cytotoxic lipid peroxidation products. FASEB J. 2008;22(1):41-6.

Kanner J, Gorelik S, Roman S, Kohen R. Protection by polyphenols of postprandial human plasma and low-density lipoprotein modification: the stomach as a bioreactor. J Agric Food Chem. 2012;60(36):8790-6.

Harbaum B, Hubbermann EM, Zhu Z, Schwarz K. Impact of fermentation on phenolic compounds in leaves of pak choi (Brassica campestris L. ssp. chinensis var. communis) and Chinese leaf mustard (Brassica juncea coss). J Agric Food Chem. 2008;56(1):148-57.

Kimura S, Tung YC, Pan MH, Su NW, Lai YJ, Cheng KC. Black garlic: A critical review of its production, bioactivity, and application. J Food Drug Anal. 2017;25(1):62-70.

Nowak A, Libudzisz Z. Ability of probiotic Lactobacillus casei DN 114001 to bind or/and metabolise heterocyclic aromatic amines in vitro. Eur J Nutr. 2009;48(7):419-27.

The post Dear Mark: How Do Fermented Food and Meat Interact? appeared first on Mark's Daily Apple.

Nine Doctors Couldn’t Help Me

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

My primal journey started in 2010. I had just attended my last Weight Watchers meeting ever. I had been doing Weight Watchers since 2005, and was at my highest weight ever. I was massively obese, I was severely lethargic, and I lived with daily brain fog. I was having miscarriages, but was being told there was nothing wrong with me. I went to a new doctor who told me that when I got pregnant again, I should come in and immediately start running tests so that when I lost it, we might have some insight as to why.

That was at the end of April. I was depressed and desperate. My dad had stumbled onto Mark Sisson’s website and pushed me to try Primal eating. I was extremely skeptical. In 2001, when I had first started dealing with health issues, I had been diagnosed with peripheral insulin resistance and had tried the Atkins diet. I was living in a dorm room at the time and failed miserably. So I was skeptical about trying another low carb restrictive diet.

But what did I have to lose?

Within a month of going Primal, I had lost several pounds, my brain fog was slowly clearing, and my gut was healing (another problem I hadn’t realized existed!).

And in July, I got pregnant again. This time it stuck. My son was born 9 months later. After 3 miscarriages, I am firmly convinced that I stayed pregnant because of my diet changes, and I became a full Primal convert.

After my son was born, I immediately resumed my Primal lifestyle. His first real food was bacon, and he loved liver as soon as he was old enough for real food. I continued the Primal journey, and continued slowly losing the weight and regaining my health.

Then I got pregnant again. This pregnancy was a whole different situation. I had hyperemesis gravidarum for both pregnancies, but this time I couldn’t eat anything. I lived off of cinnamon rolls, as they were the only thing I seemed able to keep down, and I drank nothing but gatorade. I was miserable, I was unbelievably adverse to the smell of all meat so I couldn’t even try to be Primal. I developed eczema on my arm so badly that I had to wear sleeves to work so my clients wouldn’t think I’d contracted ringworm! Luckily, my daughter was born healthy. I ended that pregnancy 10 lbs above where I started. And then my health disappeared.

The rash on my arm never really went away. I soon had eczema on my legs as well. Furthermore, I was so constipated that I wouldn’t go to the bathroom for days at a time and had constant crippling, severe stomach cramps. I had horrible brain fog, and who knows how much of that was a daughter who wouldn’t sleep versus dietary issues.

But more importantly, when she was not quite a year old, I broke out with hives. At first we didn’t know what they were and thought they were bed bug bites! Finally we clued in and I went to the allergy doctor. I knew I was reactive to wheat. As soon as I had cut it out in 2010, I noticed I got sick every time I ate it. I was suspicious of eggs and dairy. But I tested positive to literally every single food, plant, and animal they tested me for with the exception of white fish!

He immediately confirmed that it was an allergy problem. But that night I ended up in the emergency room with full body, raised, angry red, large diameter hives (like inches in diameter). He put me on all sorts of steroids, antihistamines, and beta-blockers. I cut everything out of my diet, and literally ate nothing but unflavored ground beef and vegetables for months.

And the huge, angry, red, full-body hives never went away.

I went from the allergist through eight other doctors. I went to conventional doctors, homeopathic doctors, acupuncturists, herbalists, etc. The hives never went away. I finally took myself off of all meds because they were turning me into a zombie. Unfortunately, even off of meds, nothing improved. One doctor started me on progesterone, thinking it was a hormonal problem because my cycles were so irregular (they had been like clockwork up until my daughter), and that made me much sicker. Unfortunately, those side effects didn’t go away once I took myself back off the meds.

Finally, out of sheer desperation, I gave up. I stopped going to doctors. I cleaned my diet up to be 100% Primal. I started meditating daily. I changed my job to reduce the stress.

And between less stress and diet improvements, finally, the hives started to go away. It had been a year and a half. They weren’t gone completely until after the two year mark, and even as recently as a few months ago they’d still pop up if I became too stressed or ate the wrong things.

Since then, my health has been a slow improvement. The eczema slowly disappeared. My gut slowly healed. But my weight wouldn’t drop. All the signs that showed up when I was put on hormones (heavier periods, breasts that were so sore you couldn’t look at them for a full 2 weeks each cycle, twenty day cycles) were still present. And I was plateaued. I would drop to 188 lb (I’m 5’3), but could never get below that number.

I was stuck there for nearly 3 years. I was feeling better overall, but I was stuck. I would be extremely clean for about 2 months, then I would give up since my weight wasn’t shifting anyway. Then a week later I’d be back to Primal eating because the brain fog and low energy would have come back.

Finally, this last spring, I broke that plateau. I had been 100% Primal for a few months, finally, and everything suddenly balanced. My cycles regulated, I stopped being in pain, and my weight finally started to drop again.

It’s still a journey. I’m not quite to my ideal weight yet as I’ve hit several other plateaus since. But for someone who has been obese since they were 16, now that I finally know what works for me, I can be patient. And more importantly, being Primal allowed me to heal up such severe disease after nine doctors couldn’t help me that I became an even stronger advocate than I’d been before.

I was already a licensed veterinarian and was using Primal principles in my animal patients, but after finally healing my own body, I became a certified Primal Health Coach so I could help the humans as well!

So what have I done since I received my certification? Since I received my certification, my life has gone in all sort of directions!

I was already using Primal principles in my holistic veterinary practice. I have absolutely continued using those principles to help heal the pups who walk through my door, and I have created an educational website and Facebook group for owners interested in healing their pets through diet!

However, I still wanted to help people, too.

When I first graduated, I obtained two informal coaching clients. One was a friend of my mother’s who had suffered from IBD, allergies, inability to lose weight, and masses around her thyroid (although they said her thyroid values were normal).

When we first started talking, she was eating grains with most meals, avoiding fat, and filling her diet with things like vegetable oil!

The first thing we did was cut the grains and vegetable oil, reintroduce real foods, and increase the healthy fats.

Within a month, she had lost 20 pounds, her energy was returning, and her IBD was feeling more controlled than ever!

My other client was a friend of mine who had also suffered from IBD, but who also had her gallbladder removed a few years before. In addition, she couldn’t lose weight and had all sorts of fluctuations in her hormones.

Again, with nothing more than diet changes, she slowly started to recover. Her weight decreased more slowly, but it was the first time she had ever succeeded in getting it off! More importantly, the IBD that flared with every menstrual cycle started staying controlled, and her hormones started to balance.

However, that wasn’t the end of coaching for me.

Around this time, I started having other veterinarians approaching me, asking how I had changed my life around. I had gone from severely burned out and feeling trapped and desperate in my job to outsourcing myself from my own business, moving to another state, and learning to love life and travel again!

And they wanted to know how I had done it.

Well, the first answer to that question was that when I started to get my stress under control (which started with getting my diet and health under control), then changes just started to take place that allowed me to completely turn my lifestyle around.

So I also began coaching veterinarians and other health care professionals on how to change their lives around. That coaching isn’t just about health, but health is almost always a piece of what we have to cover since these are women under massive loads of stress, and we have to deal with the health effects of that stress.

Today, I do both health coaching and mindset coaching. I believe in helping people live their best lives, and I will use whatever means necessary to help them do that! So while much of my focus is on veterinarians and other health care professionals, I still do regular health coaching as well.

I teach people that it is definitely possible to live the life of your dreams, and in my case, it all started with learning about ancestral health!

– Jenny Elwell-Gerken

Jenny’s listing in the Primal Health Coach Institute Directory

Website: www.drjeg.com

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Weekly Link Love—Edition 11

Research of the Week

Potatoes are more filling than rice or pasta.

The psychological stress response is greater in the morning than the evening.

Despite the absence of a cortex, crows and parrots rival apes in intelligence.

The American Psychological Association issues guidelines saying traditional masculinity is harmful.

“Sure, parents, too much time staring into a screen might be bad for your one-year old, but no screen time at all is even worse!”

New Primal Blueprint Podcasts

Episode 303: Tanya Stewart: Host Elle Russ chats with former high-conflict litigator Tanya Stewart about putting people’s lives back together.

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

Pharmaceutical company GlaxoSmithKline buys large stake in 23andMe, gaining access to genetic data.

The head of the Russian Orthodox Church warns against over-dependence on modern technology, worries about “slavery to smartphones.”

Interesting Blog Posts

How to get your genetic data tested anonymously.

Enough with the speakers in the woods.”

Social Notes

I had a great chat with Dr. Shawn Baker and Zach Bitter on the Human Performance Outliers podcast.

Writer reflects on her Whole30 experience and gives “what I’d do differently” tips, including using the entire Primal Kitchen® line of products to cut down on sugar and improve enjoyability.

Everything Else

What if the sea turtle has celiac?

Interesting claims at an Indian science conference.

A federal judge in the Roundup/cancer trial has issued limits on the evidence plaintiffs can bring to bear against Monsanto.

How old is your mindset?

That’s an interesting way to protest unhealthy fast food.

Things I’m Up to and Interested In

Interesting read: What someone learned wearing a continuous glucose monitor.

This sounds like a positive feat of genetic engineering (but I remain skeptical): Scientists “fix” photosynthesis.

I don’t know how (or why) parents these days do it: The relentlessness of modern parenting.

Book I’m excited to see: Erwan Le Corre’s The Practice of Natural Movement.

A nice glimpse into the minds of researchers: What scientists searched for in 2018.

Question I’m Asking

Are you comfortable with the current consumer-level genetic tests? Do privacy issues worry you?

Recipe Corner

Time Capsule

One year ago (Jan 6 – Jan 12)

Comment of the Week

“I’ll consider Chipotle if they ditch seed oils and E. coli.”

– Agreed, Mantis. E. coli always struck me as an odd ingredient to include.

The post Weekly Link Love—Edition 11 appeared first on Mark's Daily Apple.

Instant Pot Short Ribs with Sesame Ginger Slaw

This meal adds new flavors to the leftover short ribs from last week’s comfort food recipe—and pairs the ribs with a colorful slaw that offers a boost of probiotic magic.

It’s an easy, quick meal that balances the richness of short ribs with fish sauce and balsamic vinegar with the fresh crunchiness of a slaw sweetened (slightly) by our popular Primal Kitchen® Sesame Ginger Dressing. It’s a colorful and flavorful choice for a midweek dinner or a large dinner party.

Ingredients:

For Ribs

  • Leftover short ribs and broth from this companion recipe
  • 2-inches ginger root, peeled and finely chopped (5 cm)
  • 2 tablespoons coconut aminos (30 ml)
  • 1 teaspoon fish sauce (5 ml)
  • 1 tablespoon balsamic vinegar (15 ml)

For Slaw

Instructions:

Add the leftover ribs and broth from earlier companion recipe along with ginger, coconut aminos, fish sauce and balsamic vinegar to the Instant Pot.

Secure the lid and make sure the pressure release valve is set to “sealing.” Select the “manual” setting and set the cooking time for 5 minutes on high pressure. After the cooking time, do a quick release by moving the pressure release valve to “venting.”

While the ribs are in the Instant Pot, make the sesame ginger slaw.

Add napa cabbage, red cabbage, chopped scallions, and diced carrot, and kimchi (optional) to a large serving bowl. Drizzle on a generous amount of Primal Kitchen Sesame Ginger Vinaigrette, and toss.

Top with sesame seeds. Take the ribs out of the pot and select the “sauté” setting. Simmer the sauce 3 to 5 minutes to thicken.

Serve the ribs, with sauce drizzled on top, and the sesame ginger slaw and kimchi on the side.

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