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Lemons are one of the most affordable superfoods on the planet. For less than a dollar, you can help remedy and prevent an assortment of temporary and chronic ailments. Lemons are versatile fruits that can complement most dishes, so it’s easy to sneak them into your diet. I have been adding lemons to my daily […]
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Contrary to what we’ve been told, cholesterol didn’t evolve to give us heart disease. It’s not here to kill us. The actual roles of cholesterol in the body include insulating neurons, building and maintaining cellular membranes, participating in the immune response, metabolizing fat soluble vitamins, synthesizing vitamin D, producing bile, and kick-starting the body’s synthesis of many hormones, including the sex hormones. Without cholesterol, it’s true that we wouldn’t have heart disease, but we also wouldn’t be alive.
Given all the work cholesterol has to do, the liver is careful to ensure the body always has enough, producing some 1000-1400 milligrams of it each day. Dietary cholesterol is a relative drop in the bucket. And besides, the liver has sensitive feedback mechanisms that regulate cholesterol production in response to how much you get from your diet. Eat more cholesterol, make less in the liver. Eat less, make more in liver.
Now, if cholesterol is so important, why do we worry about it at all? How has it garnered such a bad reputation for giving us heart attacks?
Heart disease took off in the early part of the twentieth century, and doctors frantically searched for the cause throughout the next several decades. Early studies in rabbits found that feeding them dietary cholesterol reliably increased blood cholesterol levels and induced atherosclerosis that very much resembled human atherosclerosis. Human tests in the fifties initially showed an association between early death by heart disease and fat deposits and lesions along artery walls. Because cholesterol was found to be present in those deposits and because researchers had previously associated familial hypercholesterolemia (hereditary high blood cholesterol) with heart disease, they concluded that cholesterol must be the culprit.
And while it’s true that cholesterol is involved in heart disease, the direct cause-and-effect relationship has not been established. The reality is far more complicated. To get closer to the reality, we must first understand what these cholesterol numbers actually mean.
Back in those early rabbit studies, researchers discovered a curious thing: even though feeding the rabbits cholesterol spiked their blood cholesterol and gave them heart disease, bypassing the first step and injecting it directly into the blood had no effect. It was completely harmless.
As it turns out, cholesterol doesn’t normally float around the blood by itself. It is contained within lipoproteins. You can think of lipoproteins as delivery vessels. They contain cholesterol, antioxidants, and fatty acids and along the surface have various proteins that direct the lipoprotein to different sites around the body. It’s not the cholesterol that is involved with atherosclerosis. It’s the lipoprotein.
Let’s play the freeway analogy game. Both LDL-cholesterol (LDL-C) and HDL-cholesterol (HDL-C), the standard, basic readings you get from the lab, do not reflect the number of LDL or HDL lipoproteins, or particles, in your serum. Instead, they reflect the total amount of cholesterol contained in your LDL and HDL particles. Hence, the “C” in LDL/HDL-C, which stands for “cholesterol.” Measuring the LDL/HDL-C and then making potentially life-changing health decisions based on the number is like counting the number of people riding in vehicles on a freeway to determine the severity of traffic. It’s data, and it might give you a rough approximation of the situation, but it’s not as useful as actually counting the number of vehicles. A reading of 100 could mean you’re dealing with a hundred compact cars, each carrying a single driver, or it could mean you’ve got four buses carrying 25 passengers each. Or it could be a couple buses and the rest cars. You simply don’t know how bad (or good) traffic is until you get a direct measurement of LDL and HDL particle number.
How does this relate to heart disease?
In my opinion, the most convincing heart disease hypothesis goes like this:
If that’s the case, what exactly is the deal with traditional blood lipid numbers—the ones you get on a standard blood test?
This information is how I view cholesterol as it relates to my individual biology. If you have questions about your cholesterol numbers, discuss them with a qualified health professional.
Standard view: Get that TC below 200, or else you’ll have a heart attack or you’ll have to pay a higher health insurance premium, if the insurers take you on at all.
My take: Mostly meaningless. Even though the epidemiological evidence suggests a TC between 200 and 240 mg/dl is best for all-cause mortality,1 we can’t hang our hats on it. First off, total cholesterol is limited because it’s only telling us the amount of cholesterol contained in all our lipoproteins without saying anything about what kind of lipoproteins we have or how many there are. Second, total cholesterol is limited because it’s determined by a bizarre formula – HDL-C+LDL-C+(Triglycerides/5) – that reduces various types of blood lipids, each with a different role in the body and a unique impact on our risk for illness, to mere numbers. Someone with low HDL and high triglycerides could easily have the same TC as someone with high HDL and low triglycerides, so long as the numbers work out. Whether it’s being used to predict wellness or disease, total cholesterol by itself is mostly meaningless.
Standard view: “Good” cholesterol. It’s the “garbage truck” that cleans up “excessive” cholesterol and fat from tissues, so the higher the better! Though men and women should strive for levels exceeding 60 mg/dl, above 40 is acceptable for the former and above 50 is acceptable for the latter.
My take: Higher HDL-Cs correlate strongly with better cardiovascular health. No real argument here. Higher HDLs are desirable. Just remember, it’s only a snapshot of a glimpse into the cholesterol content of your HDL particles. Among most groups tested, the TC:HDL ratio is actually a strong indicator of heart disease risk, with higher ratios corresponding to higher risks. Note, though, that no Primal Blueprint adherents were among the groups analyzed, ever.
Standard view: Get it as low as humanly possible! I want that low density lipoprotein so low as to be nearly nonexistent. Your body obviously hates you; otherwise, it wouldn’t be producing a potently toxic substance and sending it directly into your endothelial cells to form atherosclerotic plaque! Of course, we’re not actually measuring the number of low density lipoproteins, just the amount of cholesterol contained in them, but still!
My take: While a high LDL-C may indicate a problem, remember that LDL-C only indicates the total amount of cholesterol in your LDL particles. You could easily have a few large particles (good) or a bunch of smaller, denser ones (bad, might indicate poor LDL receptor activity and an LDL that likes to hang out in the blood), but LDL-C alone isn’t enough to know. It’s also just a moment in time, whereas what you’re interested in is the trend. If the trend indicates a steady rise in LDL-C, however, that could hint at poorer LDL clearance and lower LDL receptor activity (and greater susceptibility to oxidation).
Standard view: Lower would be better, sure, but you really gotta do something about that LDL! Anything less than 150 mg/dl is fine.
My take: High triglycerides correlate strongly with low HDL and smaller, denser LDL. High triglycerides, then, could indicate more oxidized (or oxidizable) LDL. The triglycerides of most Primal eaters, especially those on the lower carb side of things, usually hover well below 100 mg/dl. Triglycerides come packaged in VLDL, or very low density lipoproteins (which are calculated by dividing your triglyceride count by 5).
So, what can we learn from a standard lipid test? If we take a series of regular ol’ lipid measurements, preferably one pre- and several peri-Primal, we can get an idea of our metabolic health. Look for:
There is an advanced lipid test that’s worth getting: ApoB.
Every single LDL particle has a single ApoB, making ApoB an effective measurement of LDL particle count. By all accounts I could find, ApoB is reliable and accurate. Every LDL particle has one ApoB, and along with TC:HD ratio, ApoB count is a strong predictor of heart disease risk (again, with the caveat that these studies are on populations leading a decidedly unPrimal and highly inflammatory lifestyle).5 If you have a lot of ApoB, you have a lot of LDL particles, which could mean the LDL receptor activity is down-regulated. Or, it could mean you’re losing weight, which can affect lipid values in multiple ways. Or, it could mean that today was a particularly “high ApoB day” and that getting it tested next week will give a different result, simply due to natural fluctuations. You just don’t know.
And that’s actually the main issue with all cholesterol readings, however advanced: They are snapshots in time. They do not capture the natural fluctuations and trends of the biomarkers. Your cholesterol was elevated today at 12 noon. What does that say about your levels tomorrow at six in the evening? Next week? Nothing. To account for natural fluctuations, get tested at regular intervals and observe the trends.
If you can’t get the ApoB test, total cholesterol/HDL ratio is a good indicator of how long LDL is hanging around in the blood and remains the best standard assessment of heart disease risk. Another good one is triglyceride/HDL ratio, which is a strong surrogate marker for insulin resistance. In both cases, lower is better. An ideal T/HDL ratio is 1:1; 2:1 is about as high as you want to go. An ideal TC/HDL ratio is 3.5:1 or lower.
Okay, so by whatever metric you want to use, your numbers are “elevated” and you’ve taken enough readers to get a general trend. It’s not just an isolated number. Should you worry?
Oh, boy. There’s the million dollar question.
First off, let’s go back to the evolutionary prism. As a naturally self-regulating system, the body isn’t going to produce something that is intrinsically pathological. Maybe that could happen in really rare genetic mutations, but everyone produces, utilizes, and relies upon cholesterol. It simply doesn’t make sense that cholesterol is evil.
Adequate cholesterol isn’t available for the body’s repair system, for the uptake of serotonin, for the full initiation of Vitamin D and hormone production and their regulation of blood sugar and inflammation, etc., etc. What does your logic tell you here? Yup, nothing is running the way it should.
Let me also add that everyone’s cholesterol profile is going to be different, no matter what. And I acknowledge that a very small percentage of people out there genuinely have *true* hereditary high blood cholesterol, familial hypercholesterolemia, a metabolic condition with impaired or even lack of ability to metabolize cholesterol. This condition can have serious health consequences. By the way, this condition, in its heterozygous form affects at most 1 in 500 people. Total serum cholesterol in these folks is in the 400 mg/dl range (as opposed to the 200 recommended). The homozygous form affects about 1 in 250,000. You likely don’t know anyone in this category because their disorder almost always ends their lives at a very young age. But even the heart disease common in familial hypercholesterolemia might not be caused solely by high LDL, but by poor coagulation.6
But if you’re eating a healthy diet, your performance is good, your body comp is good (or trending that way), your energy and sleep are rock-solid, you don’t have any familial hypercholesterolemia genes—is it really dangerous to have elevated cholesterol numbers?
I don’t know. But I’m skeptical.
For one, “elevated” cholesterol isn’t necessarily linked to heart disease. Sometimes it’s even linked to lower mortality. For instance, in people older than 60, high LDL is associated with lower all-cause and cardiovascular mortality.7 That’s right: higher LDL, less heart disease deaths. Plus, most people who have major heart attacks have “normal cholesterol.”
I’ve said it before, and I’ll say it again. Sound and reliable medical research hasn’t proven that lowering (or low) cholesterol in and of itself reduces risk of death from heart disease across a population. What does this tell you? There must be some other piece or pieces to the cholesterol/heart disease story.
Based on my examination of the evidence over the years, it all boils down to oxidative stress and inflammation.
The inflammatory response and subsequent oxidative stress load is ultimately responsible for the oxidation of the LDL, while inflammatory cytokines produced at the atherosclerotic site can weaken and loosen the plaque, thus setting the stage for (and even causing) a rupture. In fact, inflammation is intimately involved in nearly every aspect of heart disease.89
Furthermore, nearly every study suggests that LDL is only a true threat when it’s oxidized. What increases the risk of oxidized LDL?
To name a few. Could “high” LDL particles be closer to benign if they’re more resistant to oxidation? I would imagine so. Does resistance mean immunity to oxidation? Absolutely not. Don’t get cocky.
Substantially “elevated” cholesterol, low HDL or high LDL can be a real problem, but they may also just be a symptom of the larger concern rather than the main issue itself. Cholesterol profile can be impacted by other conditions such as hypothyroidism, untreated diabetes or pre-diabetes, pregnancy (surprise!), lactation, stress, liver conditions, heart disease (symptom, not cause of). Even weight loss or fasting can spike cholesterol numbers (turns out burning all that animal fat off your body can have a momentary effect on blood lipids). Talk to your doctor about what your numbers mean in the grand scheme of your health. And see if you can get a read on other markers, like C-reactive protein (an inflammatory indicator), oxidized LDL, and ApoB (or some other marker of LDL particle number).
High cholesterol shouldn’t be ignored, but it’s not the only thing that matters. You have to look at the whole picture. You have to take a step back (or several steps back) and consider everything—not just numbers on a readout.
If you have any more questions about this topic, drop them down below. Thanks for reading, everyone. Take care.
The post The Definitive Guide to Cholesterol appeared first on Mark’s Daily Apple.
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How bad is working and eating late at night? Wondering why you’re not losing weight? And what if you don’t want to go back to the gym? In this week’s edition of Ask a Health Coach, Erin is back to answer more of your questions. Keep them coming in the comments below or over in our Mark’s Daily Apple Facebook Group.
Jacob asked:
“My nighttime habits are the worst. I stay up too late working, then I’m hungry and go looking for a snack at 1 or 2 am. I don’t think I should be working and eating that late, but how bad is it really?”
Your intuition is spot on here, Jacob. The late-night artificial light. The late-night insulin spike. The stress of a disrupted sleep cycle. It all comes down to your circadian rhythm, which as reiterated in this study, 1 can lead to a myriad of metabolic ramifications. For those not familiar with circadian rhythm, it’s basically your internal, 24-hour cycle of biochemical, physiological, and behavioral processes.
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Some things help it work optimally. Other things like blue light, nighttime snacking, and even the temperature of your room can cause disruptions. If you’re staying up late working — and not wearing blue-light blocking glasses — you’re compromising the amount of melatonin you produce. Melatonin is the sleep hormone and having less of it will make you feel more alert and even disrupt your REM sleep. 2
Late-night snacking can make the problem worse. Not because “eating late at night causes you to store fat” (as our misinformed culture likes to tell us), but because, in a manner of speaking, your body can either produce metabolism hormones or sleep hormones — not both at the same time. The production of melatonin will slow or cease in order to metabolize your evening snack. This study from scientists at Universidade Federal de São Paulo in Brazil backs it up, finding that men and women who consumed high amounts of calories right before bed spent even less time in REM sleep.3
On top of that, you’re at greater risk for diabetes when your sleep is compromised on a regular basis.
I’ll stop the lecture here since my guess is that you’re already in tune with a lot of this info. So, my question to you is: what’s preventing you from doing what you need to do? If the idea of totally revamping your nighttime routine feels overwhelming, think about small steps you could take.
Could you do some of your work in the early morning instead of at night?
Could you print out what you’re looking at instead of viewing it on a screen?
Could you stop eating once the clock hits 9pm?
Could you go to bed earlier 3 nights this week?
You don’t have to do all of these at once. But by taking actionable steps to shift your melatonin production, you’re doing yourself and your circadian rhythm a huge favor. Not only will you get a better night’s sleep, you’ll feel more energetic, focused, and productive during the next day.
Karin asked:
“Now that my gym is open, I’m trying to go 3 times a week, but most weeks I’m only going once and sometimes not at all. I’m really beating myself up about it.”
Listen, you probably spent the past several weeks adapting to a new normal of working and working out from home. So, jumping into another new routine might not be as easy as just deciding you’re going to do it.
But beating yourself up about it won’t do you any good.
Your resistance to getting to the gym could be based on a few different things. And the more you understand where that resistance is coming from, the better off you’ll be. Since your gym is open again, you might feel like you should be going, especially if you’re getting charged for your membership. After all, who wants to waste good money?! But when you say things like “I should go to the gym” or “I should have lost weight by now” you’re really just judging yourself.
You’re holding yourself to the standards that either someone else has made up for you, or standards that might not make sense for where you are right now.
Ask yourself why it’s important for you to go to the gym 3 times a week. Is it because you can? Because that’s what you did before the stay-at-home orders started? Because your neighbors are posting about it on Facebook?
Hopefully some of these questions will get your wheels turning. You might even discover that you actually felt better about yourself by NOT going to the gym to do your workouts. Maybe you realized that, because you’ve been forced out of society for a bit, that being surrounded by floor-to-ceiling mirrors, fluorescent lighting, and cellulite-free bodies is not your idea of a good time. Maybe subconsciously comparing yourself to the uber-fit person on the elliptical trainer next to you makes you temporarily forget how miraculous your body really is.
If optimal health is your goal here, it’s essential to remember that your mental state is as important as having rock hard abs.
Sarah asked:
“I need a little help figuring out what I am doing wrong. I started eating Primally about 3 months ago, and after initially losing 10 pounds, the scale hasn’t budged! What gives?”
I hear this a lot with my own clients. So, trust me, you’re not alone. Who doesn’t love the exhilaration of watching the scale go down? Or seeing a number (that in your mind is too big) get smaller?
I get it.
Here’s the thing though. Weight loss isn’t necessarily what you want. What you really want is fat loss, which may or may not show up on the scale. Take for instance a study where female participants were assigned to either a low-protein diet of 68 grams of protein per day or a high-protein diet of 125 grams a day. Both diets had the same number of calories, AND both groups lost about the same number of pounds. However, the high-protein group ended up losing more fat and less muscle.4
I admit that the scale is the easiest way to measure your progress, but it’s not the most accurate. Most often, when the number changes, it’s due to fluctuations in things like water, glycogen, and waste. Even if the number is consistently going down, there could be a good chance you’re losing lean muscle tissue, not fat!
So, instead of focusing on an utterly pointless number that’s not moving — or moving in the wrong direction — there are better indicators that your body is losing fat. Here are some of my favorites:
If you’re really interested in knowing how well you’re doing, go ahead and get out the measuring tape. I had a client once who would measure herself consistently each Sunday, keeping an Excel spreadsheet of every single change. From week to week, she was seeing only small changes, but when she looked at the data over the course of a few months it was pretty mindblowing.
The post Ask a Health Coach: Sleep, Weight Loss Stalls, and Skipping the Gym appeared first on Mark’s Daily Apple.
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Apple cider vinegar, known by most as ACV, is just one of those oldie but goodie things that you may remember seeing in your grandmother’s kitchen cupboard. Even if you were put off by its distinct aroma as a kid, you may well now know that this ancient elixir has many fantastic attributes. Turn’s out, […]
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It’s more important than ever to understand how to adapt your training to keep getting results.
With gyms closed globally, the question fitness fanatics keep asking is, “Can you still get results from doing home workouts?”
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It may not share cinnamon’s popularity, but turmeric is another spice with powerful culinary and medicinal qualities that deserves our attention. Turmeric, known officially as curcuma longa and historically as Indian saffron, is a rhizome (root) of the ginger family. Its horizontal root system is dug up, baked, and ground into a bright orange powder, which then goes into any number of Middle Eastern, South Asian, and Southeast Asian dishes. Pretty much every curry you come across anywhere, for example, includes a generous portion of turmeric. Common yellow mustard also includes turmeric, mostly as a food colorant. Recently, the health benefits of turmeric have come to light, and people are looking for more ways to get more turmeric into their diets.
Turmeric imparts a unique flavor: slightly bitter and a bit spicy, with a mustard-like scent. Upon tasting a dab of turmeric powder by itself for the first time, one is reminded of curries and other Asian stews. It’s a bit of an “Aha!” moment – when you taste it, you can finally put your finger on the earthy flavor that’s so common in your favorite dishes from around the world. Turmeric itself is actually fairly mild and unassuming, so using it as a solitary spice won’t turn every dish into a curry bonanza – in case you were worried.
In this article, I’ll cover the health benefits of turmeric, the science behind it, and how to get more of it.
Turmeric and extracts of turmeric (curcumin) have been used for ages for a variety of ails, and especially for conditions rooted in inflammation such as:
Years ago, I did a short piece on the anti-diabetic, anti-inflammatory effect of turmeric. Turmeric was shown to improve insulin sensitivity and blood glucose levels in rodent models. Mice given the supplement were less likely to develop type 2 diabetes, and they enjoyed greater body fat losses. Good, promising stuff all around.
A growing body of research shows that curcumin may help alleviate the troubling symptoms of age-related cognitive decline. A sampling of the research…
Curcumin may have anti-cancer effects.5 Here are a few of the research studies we have so far.
In general, you can use turmeric powders in cooking, or you can take a turmeric or curcumin supplement in capsule form.
Here are a few ways to experiment with turmeric powder in the kitchen:
Since it’s difficult to get a functional dose of curcumin from turmeric spice powder alone, a lot of people turn to curcumin supplements. They are easy to find and relatively inexpensive. To bolster absorption, look for a supplement that contains a small amount of black pepper or piperine (the active ingredient in black pepper).
Most of the research on turmeric has revolved around curcumin, an active, antioxidant component of the spice. By weight, curcumin content of turmeric powder goes no higher than 3.14% – not a terribly large amount, considering the therapeutic curcumin dosages being studied.14 Doses of between 2-6g are typically used in curcumin research, and it’s basically impossible to eat enough turmeric to ingest that amount of curcumin.
Say you wanted a daily intake of 3g of curcumin, obtained through turmeric powder. Assuming you had the strongest stuff, you’d have to take about 3 ounces (conversion reminder: 16 ounces is 1 pound is 454 grams) of turmeric powder on a daily basis. That’s a lot of spice powder. I don’t care how much you love Indian food – it’s not going to be easy. Luckily, curcumin is widely available in capsule form, it’s non-toxic, and doses of up to 12g daily have been safely used. Note, though, that curcumin is a potential anticoagulant, so anyone taking prescription anticoagulants should check with their physician before supplementing.
Despite the focus on extracted curcumin, the epidemiology of cancer in India and other turmeric-using countries suggest that low, regular doses are beneficial, especially in cancer prevention. I love the taste, myself, so I’ll continue to use it regardless. I think you should, too. As with anything, though, you could go overboard, so don’t take too much.
Got any great turmeric recipes? Any success stories after using it as a health supplement? Let us know in the comments.
References
The post The Health Benefits of Turmeric, and How to Get More of It appeared first on Mark’s Daily Apple.
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Humans have been enjoying the sweet juicy flesh of melons for over 4,000 years. While melons grow wild in various parts of Africa, they are believed to have originated in different regions of Asia. Melons are members of the gourd family, Cucurbitaceae, which encompasses cucumbers, all varieties of squash, pumpkins, and more, totaling over 100 […]
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As I came to terms with the realities of being in lockdown I needed to come up with strategies to help my clients keep moving towards their goals. I decided to take the time at home as an opportunity to shed some body fat.
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Artichokes are a mysterious vegetable, and a lot of people are intimidated by them. How do you cook an artichoke? How do you cut into it? What parts do you eat? And how does it taste?
You may have had marinated artichoke hearts that come in a jar, or you’ve noticed little strips of artichoke in your spinach dip. But eating a whole artichoke is a lot different than having prepared hearts.
In this article, I’m going to show you how to prepare and eat an artichoke, along with my favorite dipping sauces.
Coming in at 6g of net carbs per whole artichoke, it’s something you’ll want to add to the rotation if you’re keto. Artichokes are also an antioxidant powerhouse, and they have lots of gut-happy resistant starch.
If you’ve never bought whole artichokes before, you might wonder how to choose good ones. Here’s what to look for:
Once your artichokes are cleaned and steamed properly, the leaves and heart are excellent vehicles for dips.
Serves: 2-4
Time in the kitchen: 45 minutes, including 35 minutes steaming time
To prepare an artichoke, first cut off most of the stem on top, leaving about ¼” of the stem left intact.
Cut off the tough bottom of the artichoke, about 1” worth. Use kitchen scissors to trim the tough prickly ends of the artichoke leaves. Cut a lemon in half and rub the cut side all of the cut end of the artichoke.
Set up a steamer by filling a pot with some water and a squeeze of lemon. Once the water is boiling, set the heat so the water is at a steady simmer. Set up the steamer basket inside and place the artichokes in the basket cut side down.
Place the lid on and allow the artichokes to steam for around 30 minutes, 35 minutes if they’re quite large. You know they’re finished when you can put a knife through the center of the stem with little resistance.
Allow the artichokes to cool. Combine your favorite Primal Kitchen Mayo with a squeeze of lemon and fresh cracked pepper.
This part is easy. Once your artichoke is cooled, peel the leaves off of one by one, dip in the mayo, and enjoy!
When you’re finished eating the leaves of the artichoke, it’s time to find and clean the heart. Pull off any remaining inner leaves (they’re usually in the shape of a little cone) to expose a fuzzy circle in the stem.
Scoop out those fuzzy pieces out with a spoon and you’ll be left with the artichoke heart, which is the base of the stem and artichoke. Slice it into a few pieces and dip it in the mayo. It’s the most tender, meaty part of the artichoke!
Calories: 60g
Fat: 0g
Total Carbs: 13g
Net Carbs: 6g
Protein: 4g
The post How to Cook and Eat an Artichoke appeared first on Mark’s Daily Apple.
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The couch is the center of the home. It’s the place we go to rest, relax, and socialize. Your couch is likely one of the most frequently used (and most expensive) things in your home. And yet, most of us don’t take care of this treasured possession nearly enough. Since the couch gets cleaned much […]
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