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Although we have a lot to learn about food intolerances, ever-growing research proves that they aren’t psychological or make-believe. Read on to learn the differences between a true food allergy and a food intolerance, some examples of common food intolerances, and how healing your gut can, in some cases, alleviate the problem.

Food intolerances are very real—and can have serious consequences if they’re ignored. Check out this article to find out the difference between a food allergy and a food intolerance. #wellness #chriskresser

Food Allergy vs. Food Intolerance—They’re Not the Same

Food allergies are on the rise, especially in children:

• Between 1997 and 2011 food allergies increased by 50 percent in American children (1)
• Today, around 1 in 13 children and 1 in 25 adults in the United States suffer from a life-threatening food allergy (2)

In a true food allergy, a person’s immune system produces immunoglobulin E (IgE) antibodies in response to her consumption of a particular food. These IgE antibodies initiate a cascade of events that can affect the skin (hives), the respiratory tract (wheezing), and/or the GI tract (vomiting).

Even more common than food allergies, food intolerances are estimated to affect up to 20 percent of the population in industrialized countries. (3, 4, 5) Food intolerances are not IgE mediated and are thought to be caused by specific enzyme deficiencies, impaired food absorption, and other GI issues. (6) In many cases, other immunoglobulin antibody responses may also be involved (IgA and IgG)—but more on that later.

If unmanaged, food intolerances can have serious health consequences too. If you don’t know you have a food intolerance and keep eating the offending food(s), you increase your risk of developing an autoimmune disease, neurological disorders, and more. (7, 8, 9, 10)

Five Common Food Intolerances

Let’s explore some common food intolerances that affect millions of people.

1. Celiac Disease

Often confused with a wheat allergy, celiac disease (CD) is not an allergy but rather an autoimmune disease, characterized by an inflammatory immune response to wheat gluten, rye, barley, and related proteins. Affecting 1 to 5 percent of Americans, CD usually manifests as GI disturbances like abdominal pain and diarrhea, but many patients with CD have no GI symptoms and may not even know they have it. (11, 12)

These atypical, or “silent,” forms of CD are far from harmless. Silent CD is associated with higher rates of iron deficiency, anemia, osteoporosis, neurological symptoms, and a nearly fourfold increase in the risk of death. (13, 14)

2. Non-Celiac Gluten Intolerance

CD screening only tests for antibodies to a few components found in gluten, but people can react to many other components of wheat and gluten in a condition called non-celiac gluten sensitivity (NCGS). (15, 16, 17, 18, 19) No robust diagnosis yet exists for NCGS. The best clinical description is: “a reaction to gluten that resolves when gluten is removed from the diet, and CD and allergy have been ruled out.” (20)

Despite its inexact diagnosis, NCGS is real—and studies are proving it. Double-blind, placebo-controlled trials indicate that a subset of people who do not have CD or a wheat allergy can and do indeed react horribly to gluten when they don’t know whether they are being given gluten or not. (21, 22, 23)

Up to one in 20 Americans may have NCGS, which can affect the brain, skin, endocrine system, stomach, liver, blood vessels, and more. NCGS can produce a wide range of symptoms: (24, 25, 26)

• Bloating
• Abdominal pain
• Gas and related pain
• Diarrhea
• Constipation
• Tiredness
• Headache
• Anxiety
• Foggy mind
• Eczema
• Chronic fatigue
• Joint and muscle pain
• Asthma
• Depression

Unfortunately, many health professionals still don’t take NCGS seriously, which does a huge disservice to those suffering. In fact, NCGS, especially if undiagnosed, can be even more serious than CD. Epithelial damage to the gut, systemic immune activation, and systemic inflammation are all linked to NCGS. (27) By continuing to eat gluten, patients with NCGS are at higher risk of developing arthritis, thyroiditis, multiple sclerosis, ataxia, diabetes, and even amyotrophic lateral sclerosis (Lou Gehrig’s disease). (28, 29, 30, 31)

3. FODMAP Intolerance

Sometimes, people who think they are sensitive to gluten may actually be intolerant to FODMAPs, or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. FODMAPs, a type of carbohydrate, are found in many common foods besides wheat, including:

• High-fructose fruits
• Asparagus
• Brussels sprouts
• Garlic
• Onions

In the case of FODMAP intolerance, the GI tract isn’t fully digesting and absorbing these short-chain carbs, which are then fermented by gut bacteria, creating gas and increasing fluid movement into the large bowel. (32)

FODMAP intolerance is common in people with irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO). By adhering to a low-FODMAP diet, up to 75 percent of people have relief from functional gut disorder symptoms, especially IBS. (33, 34, 35, 36, 37). However, a low-FODMAP diet is not advisable long term because it can decrease microbial diversity and density of beneficial bacterial species. (38, 39)

4. Lactose Intolerance

Up to 65 percent of the world’s population—literally billions of people—may be lactose intolerant. (40) Lactase, the enzyme that digests the milk sugar lactose, is present in infants and young children, presumably to digest breast milk, but many people don’t maintain full lactase function beyond childhood. (41, 42)

Why Eat Dairy, Anyway?

Most iterations of the Paleo diet don’t include dairy. But, if well tolerated, dairy can be a nutritious and beneficial part of a Paleo template. If you’re not eating fish heads, bones, and skin, getting adequate calcium without dairy isn’t easy. Pastured dairy is a great source of fat-soluble vitamins A, D, and K2 and is a primary source of conjugated linoleic acid (CLA), a beneficial, naturally occurring trans fat thought to have anti-cancer properties. (43)

5. IgG- and IgA-Mediated Food Intolerances

Many prominent immunologists argue that some (maybe even most) food intolerances do activate the immune system, but rather than being IgE mediated like a food allergy, they are mediated by IgG and IgA antibodies. IgG- and IgA-mediated food intolerances are thought to be related to increased gut permeability and are often implicated in Crohn’s disease and other GI conditions. (44, 45) If the gut is permeable, food molecules can escape and be detected by the immune system.

Symptoms of these intolerances range from allergy-like reactions such as rashes and asthma to GI symptoms like cramps, constipation, and diarrhea and neurological symptoms such as migraines. (46) Unlike IgE-mediated responses, IgA- and IgG-mediated responses can take days or even months to occur, which makes identifying the culprit(s) more difficult. (47)

How to Overcome a Food Intolerance

People with food allergies generally have them for life, although children sometimes can “outgrow” allergies to milk, egg, wheat, or soy. But you might be able to do something about a food intolerance by healing your gut.

Here are some ways to fix your gut:

• Increase stomach acid using supplementation and herbs. Stomach acid is needed for digestion. Although many people think they have too much stomach acid, they may in fact have too little.
• Get tested and treated for SIBO or intestinal pathogens to reestablish a healthy gut flora.
• Eat sauerkraut and other fermented foods and consider taking a probiotic supplement.
• Eat fermentable fiber, as prebiotics can be even more effective than probiotics at improving the microbiota profile.
• Drink bone broth. The gelatin, glycine, and glutamine in bone broth all have beneficial effects for the gut.

Should You Get Tested for a Food Intolerance?

If your suspected food intolerances seem linked to severe reactions or conditions like inflammatory bowel disease (IBD), IBS, or ulcerative colitis, the Paleo autoimmune protocol (AIP) diet, which goes a step beyond Paleo by also initially removing eggs, nightshades, coffee, nuts, and seeds, might be prudent. In a study published in 2017, 11 of the 15 IBD patients who adopted an AIP diet achieved clinical remission in just six weeks! (48) This further supports the idea that the gut and food intolerances are intricately linked.

But because reactions don’t always appear right away, these rudimentary dietary experiments can be incomplete. The next option would be IgA- and IgG-based blood tests.

A lot of controversy surrounds blood tests that screen for food intolerances based on IgA and IgG levels. Some scientists and immunologists claim that levels of IgG and/or IgA antibodies in the blood merely reveal that a patient has been exposed to certain foods, not that they are necessarily intolerant to these foods. (49, 50, 51) I interviewed Dr. Aristo Vojdani, a respected immunologist with many peer-reviewed papers, on this very subject. We explored some of the reasons why not all food intolerance tests are created equal, such as how testing cooked versus raw foods can yield different outcomes, but not all tests measure both. (52)

It’s clear we need more research surrounding reliable, reproducible, and scientifically founded food intolerance testing. However, food exclusion diets based on IgG and/or IgA antibody testing have provided relief for symptoms of:

• Ulcerative colitis (53)
• IBD (54)
• Migraines (55)
• Skin disorders (56)

At my clinic, we use the IgG/IgA tests offered by Cyrex Labs. (Your healthcare provider will have to order this for you as this is not a direct-to-consumer lab.) Array 3X identifies gluten and gluten-related protein intolerances. If a patient has celiac disease or NCGS, they are very likely to have other food sensitivities, and I might follow up with Array 4 or Array 10. (57)

Now I’d like to hear from you. Did you know the details of a food allergy vs. food intolerance? Have you ever been dismissed or mocked for claiming to have a food intolerance? Let me know in the comments!

The post Food Allergy vs. Food Intolerance: Why the Difference Matters appeared first on Chris Kresser.

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Pull-ups are an incredibly badass bodyweight exercise, and the possibilities for creativity and play are endless. This is one of many reasons why the pull-up is possibly my favorite exercise in the world.

Contrary to what some people might suggest, the pull-up is not just an upper body movement.

It is an extremely technically demanding full-body exercise. Therefore, there are many different elements of the pull-up you can train for. Also, no matter where you are in your current pull-up journey, there is an abundance of exercise variations from the different pull-up pre-requisite categories that will meet your current fitness level and ability. So training for pull-ups is something most people can do.

Are you still struggling to excel at pull-ups? Check out this article where I discuss some extremely common mistakes in great detail.

Let’s suppose you’ve honed your craft and have mastered all of the pull-up pre-requisites, and are now able to bang out multiple reps of pull-ups. Does this mean your journey is over? Absolutely not! Now it is time for you to have some fun.

In this article, I am going to share 10 of my favorite advanced pull-up variations. You might not even have seen or tried some of them before!

Before you sink your teeth into any of these advanced variations, I highly recommend that you are able to perform at least 8–10 perfectly executed strict pull-ups. While this is not a black and white recommendation, you don’t want to perform these advanced variations before you are ready. Also, if any of these advanced variations give you even the smallest amount of discomfort, avoid doing them.

1. Mixed-Grip 180-Degree Pull-Ups

In this badass pull-up variation, you adopt a mixed grip, which means that one palm is facing you (supinated grip), and the other is facing away from you (pronated grip). Place your hands so they are slightly closer together than they would be for regular pull-ups.

As with all pull-ups, initiate the movement by drawing each shoulder blade in towards your spine and down towards your opposite hip, not by pulling with your arms. After you have initiated the scapular movement and as your body is traveling towards the bar, perform a 180-degree turn with your body, and in the direction of the palm that is facing you.

During the lowering portion of the movement, reverse the movement. As with all pull-ups, do not keep your shoulder blades pinned — they are meant to move! During the eccentric component of the pull-up (i.e., on the way down), your shoulder blades should be doing the opposite movement as they did during the concentric component (on the way up).

With this advanced variation, you likely want to keep the number of reps you perform on the lower side. Avoid performing this movement if it bothers your elbows or shoulders.

2. Two-Finger Pull-Ups

In this advanced pull-up variation, you perform the movement with just two fingers per hand on the bar. While this variation might seem flashy, it absolutely serves a purpose.

If you are performing pull-ups correctly, the muscles in your mid and upper back — not your arms — should be doing the majority of the work. The shoulder blades — again, not the arms — should be initiating the movement.

This exercise forces you to stop relying on your arms, and is fun to do! If using two fingers per hand is too challenging, start out by using three fingers per hand.

3. Pull-Ups With Lateral Glides

This might be my favorite advanced pull-up variation as it adds an element of play. Make no mistake: while this exercise is fun, it is exceptionally challenging.

Do a pull-up. Once your chest reaches the bar, perform lateral gliding movements with your upper body, while keeping your chest at bar height — this part of the exercise absolutely torches the lats!

Once you’ve completed about 2–5 lateral glides per side, lower your body down to the starting position, by reversing the movements you did on the way up.

4. Band-Resisted Pull-Ups

I bet you’ve heard of band-assisted pull-ups, but have you heard of band-resisted pull-ups?

In this advanced pull-up variation, rather than using a band for assistance, you are using one to make the exercise more challenging. Set up a band so it is across the base of a squat rack, and so it is resting on your forefeet. Ideally, there should be tension in the band for 100 percent of the movement.

As the band is resting on your feet, this essentially forces you to dorsiflex your feet, fully extend your knees, and engage the muscles in your quads. This is how I coach people to perform pull-ups.

Also, the additional resistance the band provides increases the overall demand for upper body strength, shoulder and scapular controlled mobility, lumbopelvic stability, and grip strength.

5. Pull-Ups With Weighted Dowel On Feet

Proper body positioning, as well as generating the requisite levels of tension in the lumbopelvic region and lower body, play a key role when it comes to excelling at pull-ups.

In this advanced variation, rest a weighted dowel on your forefeet, and perform pull-ups. If you do not maintain proper body positioning, engage the muscles in your lower body, and dorsiflex your feet, the dowel will fall.

The weight of the dowel also increases the overall demand for upper body strength, shoulder and scapular controlled mobility, lumbopelvic stability, and grip strength. You may start out using an unweighted dowel, and build from there.

6. Pull-Ups While Balancing a Book On Your Head

Many people struggle to reach their chin or chest to the bar when performing pull-ups, and try to complete the rep by reaching for the bar with their chin — this is not a complete rep!

In all seriousness, your head, torso, and hips should remain in a stacked position for the duration of the movement (think of your body as a canister). Rather than reaching up to the bar with your chin, you want to keep your chin tucked and neck in a neutral position.

In this variation, I’m performing the movement while balancing a book on my head. This helps keep optimal head and neck positioning — if you lose it, the book will fall.

7. Single-Arm-Assisted Pull-Ups

Many people have the goal of being able to do a single-arm pull-up. While this is an extremely lofty goal, this advanced variation is an in-between.

With this type of pull-up, hold onto the bar with one hand, grab onto your opposite forearm with the hand of the non-working arm, and perform pull-ups while using as little assistance from the non-working side as possible.

This exercise demands a lot of shoulder and scapular controlled mobility, grip strength, and lumbopelvic stability, and is extremely anti-rotational in nature. While you may use any grip, I find that adopting a neutral grip works and feels best.

8. Corner Rack Pull-Ups

I got this innovative advanced pull-up variation from my friend Nick Nilsson, who calls these corner rack pull-ups with lateral band tension, and they are awesome!

With this variation, wrap a mini-band around your forearms and grip onto the top cross beams, positioning your palms so they are facing outward. For the duration of the movement, press outward or laterally against the band and into the beams as this increases the amount of work the lats are required to do. Make sure there is tension in the band for 100 percent of the movement.

9. Pull-Ups With Band-Resisted Psoas Marches

This advanced pull-up variation is extremely unique as it combines pull-ups and band-resisted psoas marches. With this movement, you simultaneously pull yourself up to the bar while performing band-resisted psoas marches, using a mini-band wrapped around the front of your feet.

In order to execute both of these movements to perfection, you likely need to perform both movements using a slower speed, which makes the exercise even more challenging. Once you reach the top position, pause for a brief count, and return to the bottom position while reversing the movements you did on the way up.

10. Single-Arm Pull-Ups Using Band Assistance

Here is another single-arm assisted pull-up variation you can try out. In this exercise, fasten a band around the pull-up bar, and grab onto the band with your non-working hand. Perform pull-ups while using as little assistance from the non-working arm and band as possible.

Like the other single-arm assisted variation I shared, this exercise also demands a lot of shoulder and scapular controlled mobility, grip strength, and lumbopelvic stability, and is extremely anti-rotational in nature.

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The post 10 Advanced Pull-Up Variations You Haven’t Tried Before appeared first on Girls Gone Strong.

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Your favorite athlete continuously works on the fundamentals, so why don’t you?

Not to sound like an ass, but what do you think gives you the right to skip building a foundation?

Answer: No one has that right.

The strongest people in the world have built their strength through years of consistently training the foundational exercises and building a base. Without a base, you have nothing to build off of and rather than getting bigger and stronger, you crash and burn.

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Originally posted at: http://www.nerdfitness.com/

If your hotel doesn’t have a gym, is your training routine doomed?

Should you just turn on HBO and get back to exercising when you’re home?

Not so fast! If you have 20 minutes, and a cozy hotel room, you can still get a great workout in!

I have a simple routine that I use when I’m stuck in a hotel room, and you can try it too!

Let’s get your heart racing and roaring, and then you can get back to complimentary cable.

Also, if you’re prioritizing working out while traveling because you don’t want to lose momentum on your fitness journey, you’ve come to the right place!

We have tons of resources for you to check out. If your hotel does have a gym, we have a Strength Training 101 guide that will show you exactly how to use it. If your diet suffers when you’re traveling, our healthy eating guide will provide tips on what to keep in your mini-fridge. And if you want more exercises to do from your hotel room, our Beginner Bodyweight Workout will walk you through another full routine you can do from anywhere.

You can grab them, and our other free guides when you join the Rebellion below!

THE HOTEL ROOM WORKOUT

Whenever I create a workout, I always aim for a complete full body routine that will build muscle, burn fat, and also exercise your heart. 

And when I’m pressed for time, I do it in a circuit, so I can jump from one movement to the next.

I hit four types of exercises for my routines:

• Legs – working both the front and back of your legs
• Push – chest, shoulders, triceps
• Pull – back, biceps, forearms
• Core – abs and lower back

That means that you can work out almost every muscle in your body with just four exercises – simplicity for the win!

Always start with a warm-up (to get your core temperature up and muscles loose): 25 jumping jacks, 15 bodyweight squats, 10 push ups, 10 lunges (each leg), 10 hip raises, 25 jumping jacks. Do one exercise right after another – this should take you probably 3-4 minutes.

After that, move into your workout – set your watch/laptop for 15 minutes and then do as many full circuits as possible in that time frame, using PERFECT FORM for each repetition. I’ve split the workout into three levels – beginners should start at level 1 until they feel comfortable enough to advance to levels 2 and 3.

Do each exercise, one after another, without stopping if possible. If you need to stop between exercises or even in the middle of the set, go for it. Just remember you’re trying to complete as many circuits as possible within the 15 minutes without compromising your form. Advance to the more challenging exercises at your own pace, and if some exercises are too difficult or it’s too many reps, adjust them to fit your experience level – just make sure you are getting stronger and challenging yourself with each additional hotel stay. For example, if you can only do 5 incline push-ups…aim for six when doing the workout next time. So, here it is!

LEVEL 1

• 20 Body Weight Squats (you don’t need a chair like in video, that’s just if you need help)
• 15 Incline Push-Ups (feet on floor, hands on edge of bed or desk)
• 10 One-Arm Luggage Rows (each arm, use your suit case as your weight)
• 10 Reverse Crunches

LEVEL 2

• 25 Overhead Squats
• 20 Push-Ups
• 10 Inverted Rows (using the desk in your hotel room…just don’t break it!)
• 15 Reverse Crunches

LEVEL 3

• 25 Jumping Squats
• 20 Decline Push-Ups (feet up on bed or desk chair)
• 10 Inverted Rows (with feet elevated onto desk chair)
• 15 Reverse Crunches

After your workout (you should be sweating like crazy if you did it right), ALWAYS remember to stretch. 

Here’s a cool down sequence you can try:

MORE WORKOUTS BUILT FOR HOTELS AND TRAVELLING

If you’re a road warrior and find yourself in hotels often, we have many resources here at Nerd Fitness to offer you.

If you enjoyed the Hotel Room Workout Circuit, it and others just like it can be found in our article “15 Free Circuit Training Routines: Build Strength and Stamina.”

If you like working out in unconventional places, like a hotel room, check it out! It’ll cover training in playgrounds, living rooms, or a gym (okay, that last one is 100% conventional).

Plus, there’s a circuit routine inspired by Batman.

You’re welcome.

The next resource I would toss your way is the article “How to Stay in Shape While Travelling.”

I took an epic quest of awesomeness for half a year, and while living out of a backpack, got in some of the best shape of my life. You can read all about it right here.

The last resource I will mention is our uber-popular 1-on-1 Online Coaching Program. Many of our clients travel quite a bit, and having an accountability partner that is available in any part of the world has been a game changer for many Rebels.

Are you trying to learn a new exercise, lose weight, or build muscle, but find doing it on the road a challenge? I’d love for you to click below and find out if we are a good fit for each other:

WHY YOU SHOULD WORK OUT IN YOUR HOTEL ROOM

Even when I’m living out of hotel rooms, I prioritize working out.

I find that on days when I exercise, I eat better. Something activates in my brain when exercising that says “I’m trying to be healthy, so I’m going to eat healthy.” On days when I don’t exercise at all, I tend to say things like “meh, I’ll do it tomorrow” or ‘it’s only one meal” or “it’s only a few beers.”

Not good, because as we continuously remind Rebels, diet is 80-90% of fitness equation.

That’s why a workout, even if it’s for only 20 minutes, can be very critical while traveling. It really does have a way of stopping you from gorging yourself silly on pizza later.

The next time you’re in a hotel room, or any room, try our 20-Minute Hotel Room Workout. If you find even Level 3 too easy, try this one instead. I’ll warn you though, I don’t hold back on this more advanced circuit.

Alright, now I want to hear from you:

Do you spend a lot of time in hotels?

Travel a lot for work?

What are your tips and tricks for staying healthy while living in hotels?

Let us know in the comments!

-Steve

PS: I mentioned above that what you eat will be responsible for 80-90% of your fitness journey. If you have no idea where to even begin on eating healthy, like a lost sheep with no shepherd, I encourage you to check out our 10-Level Nutrition Guide.

It’s designed for beginners, with easy simple progressions, each level getting a bit more challenging and healthier. You also progress at your own speed, to make sure your dietary changes stick!

You can download it for free by signing up to the Rebellion below:

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All photo sources can be found right here.^[1]

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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.

The post What’s the Pegan Diet? (And How Does It Compare To Primal?) appeared first on Mark’s Daily Apple.

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It’s called intuitive eating, and it goes against the grain of all popular dieting methodologies. No need to weigh food, count calories or stress over the numbers on the scale. Intuitive eating spits in the face of conventional dieting wisdom, much of which has not yet yielded consistent results for millions who struggle with their […]

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I have a confession to make: I, Mark Sisson, suffer from keto crotch.

It’s embarrassing, really. I thought maybe it was just the change in climate moving from Malibu to Miami—the humidity, the heat, the fact that I’m paddling and swimming more often now. There’s a whole lot of moisture down there. Perpetual steaminess.

But then I met up with my writing partner and good pal Brad Kearns, who’s been working with me on my upcoming book. Brad lives in Northern California, which is far from hot or humid right now. He’s also a staunch keto guy most of the time, and, well, let’s just say I could smell him before I could see him. We met up at a coffee shop and cleared out everyone in a fifteen foot radius. We sampled a new exogenous ketone product he’s been trying and not one, not two, but three separate individuals approached to inquire if we were salmon fishermen.

Okay, let’s get serious. Does “keto crotch” really exist? And, if it does, what can you do to prevent it?

I’m writing this not because of overwhelming demand from loyal followers of the Keto Reset plan. In fact, I hadn’t ever heard of “keto crotch” before last week. There’s a good chance almost no one heard of it before March 2019, if Google Trend data for “keto crotch” searches is any indication. I’m writing this post because the barrage of news articles, Twitter hashtag campaigns, and extremely serious warnings from people with lots of acronyms after their name has led people to ask me if it’s a legitimate phenomenon. A few acquaintances have brought it up in social situations. Our marketing director found herself fielding keto crotch questions at a dinner for Expo West last week.

So, are women following a ketogenic diet experiencing an epidemic of stinky vaginas?

Probably not.

Is Keto Crotch Even Physiologically Plausible?

Vaginal odor does change. It fluctuates naturally, and sometimes it can get worse. The most common cause of unpleasant changes to vaginal odor is bacterial vaginosis, which occurs when something upsets the balance between the beneficial lactobacilli bacteria that normally live in the vagina and pathogenic bacteria. What can upset the balance?

The vagina is supposed to be an acidic environment; that’s how the healthy lactobacilli thrive. If something upsets that pH balance, tilting it toward alkalinity, unhealthy bacteria gain a foothold and become predominant, and begin producing unpleasant-smelling amines like putrescine, tyramine, and cadaverine. This is bacterial vaginosis. As it turns out, the lactobacilli bacteria normally present in the vagina are instrumental in maintaining an acidic pH. They consume glycogen, spit out lactic acid, and exert antimicrobial and antifungal effects that block common vaginal pathogens like candida, e. coli, and gardnerella from taking hold and causing trouble.

The interaction between diet and vaginal biome is understudied. To my knowledge, there exist no direct controlled trials that address the issue. It’d be great to have a study take a cohort of women, split them up into different dietary groups, and follow them for a year,  tracking their vaginal pH and bacterial levels. Alas, we do not.

We do have a study that provides a hint. In 2011, researchers looked for correlations between dietary patterns and bacterial vaginosis in a cohort of nearly 2000 non-pregnant mostly African-American women aged 15-44. While there probably weren’t many keto dieters, and the diets as a whole were of the standard American variety, glycemic load—which basically boils down to carb load—was the strongest predictor of bacterial vaginosis. Other markers of food quality, like a person’s adherence to “healthy eating guidelines,” initially seemed to reduce the chance of bacterial vaginosis, but those relationships were almost abolished after controlling for other factors. Only glycemic load remained highly significant.

This connection between dietary glycemic load and bacterial vaginosis starts looking more causal when you realize that diabetes—a disease where one’s “glycemic load” is perpetually elevated and exaggerated—is another risk factor for bacterial vaginosis.

There’s also a 2007 study that found “high” intakes of dietary fat, particularly saturated and monounsaturated fat, were a significant predictor of bacterial vaginosis. In this study, “high fat” meant around 39% of energy from fat. That leaves 61% of energy from carbohydrate and protein, the kind of “high-fat, high-carb” Standard American No-Man’s-Land that’s landed the country in the current metabolic predicament. High-fat intakes in the presence of high-carb intakes may very well be bad for your vagina, but it says nothing about the likelihood of keto crotch.

At any rate, neither study was a controlled trial, so we can’t say anything about causality.

What about a yeast infection? The most common offender is candida, which usually favors sugar for fuel, but there’s also evidence that it can metabolize ketones. Could keto make a latent yeast infection worse and lead to smelly “keto crotch”?

Perhaps keto can make candida worse (that’s for another day), but that’s not the cause of “keto crotch.” Candida vagina infections don’t smell very much, if at all, and they certainly don’t smell “fishy.” That’s only caused by bacteria and the aforementioned amines they can produce.

Free glycogen levels in vaginal fluid are a strong predictor of bacterial vaginosis. If ample glycogen is available, the good lactic acid bacteria have plenty of food and produce plenty of lactic acid to maintain the acidic pH conducive to vaginal health. If inadequate glycogen is present, the lactic acid bacteria have less food and produce less lactic acid, increasing the chances of the pH tilting toward alkalinity. An alkaline vagina is a vagina where pathogenic bacteria—the ones that produce stinky amines—can establish themselves.

The question then is if ketogenic diets lower free glycogen in the vaginal fluid. That’s a fair question. I wasn’t able to find any solid answers. I guess “ketosis effect on vaginal glycogen” isn’t the most lucrative avenue of scientific inquiry.

Should I Worry?

Even assuming this is a real phenomenon, it’s a rare one. The vast, vast majority of people following a ketogenic diet aren’t coming down with keto crotch. Other than a few Reddit posts from the past 5 years, I haven’t seen anyone at all in our neck of the woods complain.

Maybe people doing Primal keto are eating more nutrient-dense ketogenic diets than people doing conventional (or caricature) keto. Salads, steaks, eggs, and lots of non-starchy veggies are a great way to stay keto and obtain micronutrients. And there are links between micronutrient status and bacterial vaginosis. The most common relevant deficiencies include vitamin D (correcting the deficiency can cure the vaginosis) and folate. Hard to get adequate folate if your diet is based on salami and cream cheese.

We also know that the health of your skin biome tracks closely with that of your gut, and that eating plenty of non-starchy veggies, fermented foods (yogurt, kefir, sauerkraut, kimchi, etc), and colorful produce can provide prebiotic fiber, prebiotic polyphenols, and probiotic bacteria that nourish your gut biome. If the vaginal biome is also connected to the gut biome (and it is), tending to the latter should also have positive effects on the former.

The Primal brand of keto tends to emphasize micronutrients and gut health a bit more than some other types of keto I see floating around. If—and it’s a very big “if”—keto crotch is legit, that may explain some of the discrepancy.

Finally, be sure to check out this very interesting Twitter thread where the author lays out his suspicions that the whole “keto crotch” phenomenon might be a manufactured stunt designed to vilify the ascendant ketogenic diet. Nothing definitive, but it’s certainly food for thought.

If You’re Concerned…

Okay. Say you’ve recently gone keto and your vagina is smellier than usual. (And you’ve ruled out other, more obvious potential causes like changes in soaps, etc.) It’s hard to ignore, and I wouldn’t want you to. What can you do?

• Confirm that you have bacterial vaginosis. Seriously, get it checked out.
• Make sure you’re getting enough folate and vitamin D. Supplement if need be.
• Eat prebiotics and probiotics. Fermented food and/or a good probiotic supplement.
• Try a carb refeed. If ketosis depletes vaginal glycogen and increases pH, the occasional carb refeed could restore glycogen by 30-50 grams and should do the trick. Note that this is entirely theoretical; I’m not saying it’s a “problem” on keto.
• Hang out in the keto zone. I’ve written about the keto zone—that metabolic state where you’ve reached full keto and fat-adaptation and find yourself shifting in and out of ketosis as you please due to increased metabolic flexibility. A few carbs here, a fasting day there, a few more days of keto. Again, if full keto is theoretically depleting vaginal glycogen, maybe relaxing your restrictions will solve the issue while maintaining your fat adaptation. This is actually where I hang out most of the time.

That’s it for today, folks. Do you have “keto crotch”? Do you know anyone who does? Or did your vaginal health improve on keto? I’m curious to hear what everyone’s experiences have been, so don’t be shy.

Take care and be well.

References:

Thoma ME, Klebanoff MA, Rovner AJ, et al. Bacterial vaginosis is associated with variation in dietary indices. J Nutr. 2011;141(9):1698-704.

Kalra B, Kalra S. Vulvovaginitis and diabetes. J Pak Med Assoc. 2017;67(1):143-145.

Taheri M, Baheiraei A, Foroushani AR, Nikmanesh B, Modarres M. Treatment of vitamin D deficiency is an effective method in the elimination of asymptomatic bacterial vaginosis: A placebo-controlled randomized clinical trial. Indian J Med Res. 2015;141(6):799-806.

Dunlop AL, Taylor RN, Tangpricha V, Fortunato S, Menon R. Maternal vitamin D, folate, and polyunsaturated fatty acid status and bacterial vaginosis during pregnancy. Infect Dis Obstet Gynecol. 2011;2011:216217.

The post The Curious Phenomenon of “Keto Crotch” appeared first on Mark’s Daily Apple.

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Most of us who train frequently are familiar with the psoas muscle, short for iliopsoas, and commonly referred to as the hip flexor.

“My hip flexors are tight.” “My hip flexors hurt.” “My hip flexors are pinching.” You name it, and I’ve heard it. We’re familiar, for the most part, with what hip flexors are. However, a lot of us are lost on what to do to help them.

read more

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A few weeks ago, I was working with a female runner who asked me, “Will I ever run pain-free again?”

This is a question that I receive regularly, and one which I have to admit having a really tough time answering.

Pain is a part of the running experience, there is absolutely no doubt about it. The best — and possibly the only — way to mitigate your risk of a running-related injury is to stop running.

I’m not saying this because I don’t believe that you can run pain-free. I’m saying it because I believe in transparency and it doesn’t make sense for me to lie to you.

So what did I say to that runner? I turned to her and said, “There is pain, and then there is suffering, I’m OK with a little bit of pain; it’s when the joy of the activity is lost that we might want to course correct.”

And herein lies the crux of pain and running: no one other than you can decide where that line is drawn between pain and suffering.

This can be a very difficult thing to understand — in your body and in your mind — when you are scared about what you’re feeling, fearful of the future, or simply uncertain about how to proceed. Below are five important things I usually recommend to runners to help them:

• Reduce pain with running.
• Foster a sense of hope.
• Increase their resiliency.

Please know that it is wise to speak to your physical therapist if you find that your running-related pain is disconcerting and is causing challenges in your life.

1. Prioritize Training Consistency

One of the best strategies to reduce pain with running — believe it or not — is to run more frequently.

Of course, I say this with a bit of caution because some conditions, such as bone stress injuries, definitely don’t get better by running more and there certainly are situations where we might want to advise refraining from running altogether. However, for most runners, consistency in training is key.

The number one problem that I see with my clients who run, by far, is a lack of consistency in training habits and routines. This creates a number of different challenges, but the most notable one is the lack of opportunity for your tissues to build their capacity and eventually tolerate running.

Running is a skill after all: the more you run, the better you get at that skill, and the better your tissues also adapt to that skill.

2. Increase Your Step Rate

This is an important window of opportunity to help reduce running-related pain.

Step rate, or cadence, is defined as the number of steps you take per minute. Research suggests that subtle changes to your preferred step rate can make a world of difference to the pain you feel in your legs when running.

Specifically, one study showed that by increasing your preferred step rate by 5 to 10 percent, you can reduce the loading to your hip and knee joints fairly substantially.¹  By reducing the loading to your hip and knee joints this way, you might find that running is more comfortable and even more efficient.

3. Strength Train

Strength training is an underutilized golden nugget for runners. An appropriately loaded strength training routine goes a long way to support a runner’s quest to feel strong and healthy while running.

Strength training has been shown to:

• Increase your tissue tolerance.
• Improve your running
• Delay fatigue.
• Improve endurance performance.
• Improve maximal speed.
• Increase your rate of force development
• Make you stronger (that’s the most obvious).²

And while stronger doesn’t mean injury- or pain-free, it does mean that you unlock a certain level of badassery that can foster the sense of resiliency you need to feel good — dare I say it, great — in your body as a runner.

I have some favorites exercises that I like with runners and they include the following:

Bulgarian Split Squats

Step Downs

Heavy Deadlifts

Heavy Carries

4. Sleep and Recover Adequately

I cannot emphasize this enough: your sleep and recovery are vital to your training success and pain reduction. If you aren’t sleeping enough, you better believe that you’ll have a harder time feeling good as a runner.

I get asked all the time, “What is recovery supposed to look like?” Here’s the short and probably disappointing answer: nothing in particular. To me, as the professional, recovery is going to be anything that fills you up and recharges your batteries.

Recovery is made up of the things that nurture your soul and don’t stress your ecosystem as an athlete.

While sleep is considered a huge part of recovery for me and the athletes I work with, so is joy. There is nothing more wonderful than sitting on the couch after a long run or waking up after a full eight hours of sleep and drinking a cup of coffee in the morning. These are the things that fill me up and recharge my batteries.

5. See Yourself as the Badass Runner You Are

Finally, the last thing that I’m going to include here, is that you absolutely need to believe in yourself and in your body’s ability to adapt.

It is very easy to think, “I’m not made to be a runner,” when culturally we are conditioned to think runners need to look a particular way. But I am here to dispell those inaccurate notions: you are absolutely made to be a runner!

When you start believing in your most badass self as a runner, your body will start to embody it.

So here’s the deal: running isn’t a pain-free sport. But remember, you don’t have to suffer, and that there are teams of people (including me) who are ready, willing and able to help you reach your potential.

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References

1. Heiderscheit BC, Chumanov ES, Michalski MP, Wille CM, Ryan MB. Effects of step rate manipulation on joint mechanics during running. Med Sci Sports Exerc. 2011;43: 296–302. https://www.ncbi.nlm.nih.gov/pubmed/20581720
2. Rønnestad BR, Mujika I. Optimizing strength training for running and cycling endurance performance: A review. Scand J Med Sci Sports. 2014;24: 603–612. https://www.ncbi.nlm.nih.gov/pubmed/23914932

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Growing up, I was very bookish and avoided all forms of exercise despite my parents’ best efforts to get me involved in some sort of sport. I was also a very picky eater, especially when it came to veggies, so my diet wasn’t the greatest.

Throughout high school, I always carried an extra 10-15 lbs and my lunch consisted of stuffed crust pizza, strawberry milk and fries swimming in ranch dressing.

My weight yo-yoed in college depending on how excited I was about the gym and whether I was on a salad bar or buffalo chicken wrap kick. I did gain a lot of weight after I got married and hit my all time high of 170 lbs. I was able to lose most of the weight through a low carb diet, though I still avoided the gym.

My first experience with primal eating came in 2014 when my husband came home talking about this paleo diet he’d heard about from a colleague. I started doing a lot of research and decided to start this new way of eating. We weren’t super strict about, using dressings and condiments that were not ideal and I refused to give up cheese (I now know that including dairy is more aligned with the primal way of eating). My husband lost a bunch of weight, and I felt really good even though the scale didn’t move.

Unfortunately, after only about two months, we went on vacation and fell back into our SAD eating habits even after we returned. Fast forward to 2016 and I had moved to another state, finally gotten a full-time job after a year of under employment/unemployment and was steadily gaining weight again. I didn’t realize how lucky I’d been to have been able to walk or bike to work before moving to a bike and pedestrian unfriendly area! I started calorie restricting, but that just left me feeling hungry all the time and my pants were too tight. I weighed in at 155 lbs.

In January, I finally gave in and let my husband sign me up for a gym membership. As much as I disliked exercise, I knew that I had to get my body moving if I didn’t want to look like a lot of the people in my office when I got to middle age. I started strength training which was way more fun than cardio and lost 5 lbs in the first month. But despite hitting the gym 3 times and week and participating in a Crossfit style workout once a week, my weight loss stalled after that. I knew I was building up muscle mass that I’d never had before, but I was mostly motivated to not have to buy new, bigger pants at this point.

By the end of March, I realized that I had to make some serious diet changes if I wanted to get my health completely under control, so I decided to do my first Whole30. It was hard but amazing! I felt great, finally kicked my diet soda habit, reset my taste buds and learned that dairy gives me migraines and makes my seasonal allergies go crazy. I also rediscovered MDA during this time and read years of primal success stories which gave me the courage to keep up this style of eating long term using the 80/20 principle. I also made it a point to try every (primal) food I thought I hated one more time and now I eat many of them regularly. Hello onions, peppers, brussels sprouts, squash, zucchini, fish, nuts, carrots, pineapples, sweet potatoes, tea, and so many more. I’m still working up the nerve to try sardines but there’s a tin of them in my pantry for the day I’m feeling brave!

For the first time in my life, I felt fit and strong. My body learned to love and crave veggies, even at breakfast. I was empowered to make better food choices. I still get anxious about food in social situations sometimes when my social anxiety combines with my fear of accidentally eating dairy and getting really sick, which has, unfortunately, happened. Now if I don’t feel comfortable with my food options, I eat beforehand or bring my own food. My health is totally worth being that weird person for. I have also learned that most people have no idea what is in their food or what is actually good for their bodies. I am so glad to have come upon this way of eating while I’m still young.

My next big health change occurred in the fall of 2018 when I started getting into long distance running. I came into running knowing that I wanted to do it in a way that aligned with my health and nutritional values that I’d worked so hard to get straight. This led me to using the run walk run method to decrease risk of running injuries and to primal keto to avoid all of the sugary fuel and recovery products aimed at endurance athletes. I do all my training runs fasted and eat a bit more carbs right before and after races. I also make sure to focus on keeping up my strength training by incorporating the Primal Essential Movements, even the two I dread-pushups and planks. There is something awesome about being able to take yourself 13 miles on your own two feet, but nothing makes me feel as badass as using the assisted pullup machine.

Doing keto while staying dairy free, maintaining a high veggie intake and properly fueling my athlete body has taken some extra effort but the benefits are amazing. I no longer get hangry if a meal is delayed. I feel strong and powerful in my own body. I weigh less than I did in high school. I have way fewer migraines. I even have abs. I have learned so much about my body and my personal nutrition needs. I still ended up needing to buy new pants twice but smaller rather than larger. I have so much more energy to do the things I love. Most importantly, I now know how to take care of my body properly for a long and healthy life.

Stephanie

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.

The post I Feel Strong and Powerful In My Own Body appeared first on Mark’s Daily Apple.