Dear Mark: Marine Fat Sources, Not Gaining/Losing, Keto Breastfeeding

July 16, 2018

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For today’s edition of Dear Mark, I’m answering three questions. First, what are some less expensive sources of marine fat high in omega-3s? Is canned salmon a good, safe, effective option? Second, a reader is training hard, eating low-carb/keto, doing IF, and feels pretty good despite not losing or gaining any weight? What should she do? What could she be doing wrong? And third, should you go keto while nursing?

Let’s go:

Marine fat. Good examples? I have tried to eat sardines, I really have. I don’t know why they repulse me so. Where else can I turn? Safe salmon is just so expensive unless you get canned, and even then, can you trust it? If it’s true satiety I’m going for, a supplement (cod liver oil?) is probably not going to give me that.

I hear you on the canned salmon. When I was first looking into this years ago, I worried that canned fish would be damaged by heat and perform worse than supplements. Turns out it’s very useful. In one study, researchers gave women with a high risk of breast cancer omega-3 fats via fish oil caps or canned salmon. Both “supplements” worked at increasing levels of DHA and EPA. Fish oil increased the EPA content of red blood cells and plasma four-fold; canned salmon increased it two-fold. The change in DHA was similar in both groups, as was the overall change in breast tissue fatty acids. Fish oil may be more potent, but it’s unclear if quadrupling your RBC EPA is necessarily more desirable than doubling. You also have to consider the two things the fish eaters got that the fish oil quaffers didn’t: all the micronutrients (selenium, iodine, astaxanthin, etc) and macronutrients (protein) salmon provides.

Canned salmon is a good option, and most of it is BPA-free these days (but verify). If you enjoy it (some do not), look for salmon that includes the bones and skin. Tons of benefits there—calcium, collagen, extra oil. Trader Joe’s used to carry one like that. They still might.

Fresh mackerel is good. Here’s a buying and cooking guide to mackerel I did awhile back. It’s affordable and full of omega-3s.

If you can find them, fresh sardines are a totally different animal. Just make sure the fish smells clean, has clear eyes, is firm, and resists sagging when held parallel to the floor by the tail.

Canned cod liver exists. It’s tastier and milder than you’d expect, canned in its own oil, and Northern Europeans have been eating it for years. Here’s smoked cod liver. Here’s regular.

Jennifer asked:

#6 is me right now. I am eating low carb (maybe even Keto), and I’m IF’ing every day (allowing only coffee w/ a splash of cream in the morning). My appetite is finally feeling quite suppressed. The nice thing is that I’m not counting. I am eating intuitively; and at the end of the day, I log what I ate as best as I know how (since I didn’t measure), to just check, and everything seems to be on point with my calories and macros. I train brazilian jiu jitsu several times a week, as well as do HITT style workouts, with strength training on my off days. I usually have a couple days a week that I don’t train.

My question is, I’m not losing and I’m not gaining – so do I keep doing what I’m doing? Or do I change things up? I feel fine – plenty of energy, and I’m not hungry. If I were hungry, I’d eat. My goal is to lose another 15 lbs, and I love the keto/IF style for me because it works well with my lifestyle.

First, make sure you actually need to lose another 15 pounds. 15 pounds of what? Fat, lean? Rather than thinking in terms of bodyweight, it’s often more helpful to have concrete goals. Is there an article of clothing you want to be able to fit into?

You’re training a ton. That’s great, it can be incredibly rewarding—I know the feeling. But that, paired with “my appetite is finally feeling quite suppressed” is a bit of a warning sign. When I trained daily, my appetite was through the roof. I couldn’t get enough food. You’re hitting it really hard. BJJ, extremely demanding, glucose-intensive. HIIT, extremely demanding, glucose-intensive. Weights, extremely demanding. You should be hungrier, not less.

All in all, the message your training and restricted eating may be sending to your body is one of scarcity. It’s good that you’re neither gaining nor losing and have plenty of energy, but that could change quickly. Try giving your body a few more signals of abundance; it may be exactly what you need, and it could help you avoid problems in the future.

Try eating breakfast, a real breakfast. Have some eggs, bacon, half a cantaloupe. If you insist on IFing, try doing a lighter/no dinner instead of no breakfast.

Try eating a few more carbs and calories on your training days, timed after your workouts. You’re burning through a lot of glycogen, and if you’re eating keto with IF you’re probably not replenishing it.

Good luck and keep us posted.

Akrol asked:

Is it safe to do a moderate keto diet while breast feeding?

If you recall from previous posts, oxaloacetate is necessary for finishing the Krebs’ cycle and producing ATP from fat and glucose. Running out of oxaloacetate means we can’t make ATP from fat and glucose and need an alternate energy source: Ketones. Lactating women also use it to produce lactose, the milk sugar that provides much of the nursing baby’s energy needs. That means that lactating women can eat more carbs and protein and still remain in ketosis. It also means that eating a strict ketogenic diet extremely low in carbs and protein is likely to impair milk production.

While many women report remaining ketogenic while nursing without issue, there are a few case studies of breastfeeding women suffering lactation ketoacidosis, a dangerous condition where chronically low insulin prevents the cells from accessing blood glucose and promotes unchecked ketone production that make the body overly acidic. This can be life threatening. Triggers of lactation ketoacidosis have included starvation (don’t starve yourself or even fast while breastfeeding), twin lactation (feeding two increases the amount of lactation substrate you need to consume), and a low-calorie/low-carb/high-fat diet (bad combo).

Had I a set of breasts from which an infant would be suckling, I’d just opt for a regular old low-carb diet, Primal style. I wouldn’t worry about ketone production so much as eating enough calories.

That’s it for today, folks. Thanks for reading, take care, and chime in down below with your own input!