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(Image credit: Courtesy of Cool Whip)

About once a year, if you open my freezer for something normal, like ice, you’ll find a big tub of Cool Whip — and that’s never going to change. I indulge when I’m making my grandmother’s family famous coconut cake because there’s no substitution for the sweet and creamy goodness that is Cool Whip. It brings back great memories for me. It means a special occasion, a surprise dessert, and family fun.

I love fresh, hand-whisked whipped cream. There’s no denying how perfect it is over strawberries and homemade sweet biscuits, even if you use Bisquick to make them. Bisquick, which, by the way, is another product you can pry out of my cold, dead hands because, goshdarnit, it makes things easier. But that’s another story for another day.

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Inline_Lomo Saltado1Lomo Saltado turns an Asian stir-fry into a uniquely Peruvian meal. The recipe starts out in familiar stir-fry territory: thinly sliced steak cook with red onion, soy sauce and vinegar. But then tomatoes are added. And French fries. A fiery green sauce made from PRIMAL KITCHEN® Mayo,
jalapenos, cilantro, and lime finishes the dish, officially turning Lomo Saltado into a stir-fry like no other.

Lomo Saltado isn’t Lomo Saltado without the French fries. There’s just no way around it. For this recipe, the potatoes are fried in tallow, cooled, and then reheated before serving for the sake of the resistant starch. If you’re going to eat French fries, the ones here are probably your best bet. Eat them occasionally, in moderation, and enjoy every crispy, salty bite.

If you don’t want to splurge on French fries (or maybe you do, but you just don’t want to deal with frying them) then you can skip the fries and still enjoy this meal. It won’t be Lomo Saltado, but it will be a delicious stir-fry with a creamy, spicy sauce you’re gonna love.

Servings: 4

Time in the Kitchen: 1.5 hours, plus 3 hours to soak potatoes in water before frying

Ingredients

Primal

  • 3 russet potatoes, peeled and cut into ½-inch/13 mm thick French fries*
  • Beef tallow, for frying
  • 1 head cauliflower, made into cauliflower rice
  • 3 tablespoon avocado oil, extra virgin olive oil or coconut oil (45 ml)
  • 1 to 1 ½ pounds sirloin steak, cut into thin slices and seasoned with salt (450 to 680 g)
  • 1 red onion, cut into medium slices
  • 2 cloves garlic, finely chopped
  • 2 plum tomatoes, cut into wedges
  • 1 hot pepper, (jalapeno or other type) sliced
  • 2 tablespoons tamari, soy sauce or coconut aminos (30 ml)
  • 2 tablespoons red wine vinegar (30 ml)

Cilantro Mayo

  • 1 to 2 jalapenos, chopped
  • 1 cup loosely packed cilantro leaves (some small stems are okay too) (240 ml)
  • 1 clove garlic, finely chopped
  • 1 teaspoon lime juice, plus more to taste (5 ml)
  • ½ cup PRIMAL KITCHEN® Mayo (100 g)

Instructions

Primal

Lomo Saltado has several different parts that come together into one dish.
This is the game plan:

1. Cut potatoes and soak in water at least 3 hours, or overnight
2. Fry French fries
2. Make cauliflower rice
3. Make Cilantro Mayo
4. Stir fry the beef, onions, and tomatoes
5. Combine everything!

*To cut French fries, slice the potato lengthwise into 4 or 5 pieces. Lay the pieces flat and cut into sticks.

Put the raw French fries in a bowl and cover with water. Store in the refrigerator for at least 3 hours or overnight (soaking the potatoes in water helps make crispier French fries). Drain the fries. Blot dry with a dish towel or paper towel (wet fries put into hot oil will splatter a lot)

Slowly heat tallow in a heavy, deep pot. You should end up with at least 2 inches of melted tallow. When the temperature of the tallow reaches 300º F, add the French fries. Don’t overcrowd the pot; keep fries in a single layer while frying. Cook until the fries are soft and easily pierced with a knife, about 5 minutes (the fries will not be very brown at this point) Remove the fries with tongs or a slotted spoon and set on paper towels to blot excess fat.

Heat tallow up to around 400º F. This final time in the fryer is to brown the fries.

When the fries are golden and crispy around the edges, remove from the tallow. Sprinkle with salt. Set aside.

Make the cauliflower rice. Set aside.

Make the cilantro mayo. Combine jalapenos, cilantro, garlic, and lime juice in a food processor. Scrape down sides and process until ingredients are finely chopped. Add PRIMAL KITCHEN® Mayo, and blend until all ingredients are smoothly combined. Set aside.

Preheat oven to 350º F. Spread the fries out on a sheet pan and reheat in the oven while you make the stir-fry.

Heat a wok or wide cast iron skillet over high heat. Add 2 tablespoons oil. When the oil is hot, add the meat in small batches, cooking each batch 2 to 3 minutes before removing from the pan. Set meat aside.

Add remaining tablespoon of oil. Add onion. Cook 1 to 2 minutes.

Add garlic, tomato and hot pepper. Cook 1 minute.

Add meat back to the skillet.

Add soy sauce and vinegar. Cook 1 to 2 minutes until most of the liquid is gone.

Serve over cauliflower rice with French fries on the side. Drizzle cilantro mayo over the top.

Lomo Saltado2

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The post Lomo Saltado appeared first on Mark’s Daily Apple.

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(Image credit: Christine Han)

Spring celebrations — like bridal showers, baby showers, and graduation parties, or even book club, picnics, and brunch with friends — call for the prettiest of sweet treats. Whether it’s a stylish naked cake piled high with fresh fruit or pillowy sweet rolls you can serve at a morning get-together, we’ve got recipes that will work for any occasion. They come together quickly, taste delicious, and look gorgeous on any party table. And it’s all thanks to fast and fancy baking.

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Originally Posted At: https://breakingmuscle.com/feed/rss

Respect this rest day because next time we’re going to be finishing this challenge on a high note.

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There’s nothing like getting a baguette straight out of the oven from your local bakery. It’s perfect to eat by itself or as the bookends to a wonderful sandwich. Why is it just so delicious? It turns out the secret may be in the crust. According to research published in the American Chemical Society’s Journal of Agricultural and Food Chemistry, the crackly crust is a non-negotiable, as it gives the bread its aroma and, in turn, its perceived flavor.

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Your iced coffee from Starbucks might just get a whole new makeover. Starbucks is currently experimenting with coffee ice cubes, which means your favorite summer beverage won’t be diluted after a few minutes in the sun. The new offering is coming to select franchises and its going to cost customers 80 cents more. But what people get in return may be well worth the extra money.

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Wine and food pairings don’t need to be as complicated as they are often made out to be. Sure, there are certain wines that work better with certain foods, but you don’t need to overthink it too much. That’s especially the case when it comes to pre-dinner snacks and sips. When you’re easing into the evening, whether it’s a dinner party with friends or a quiet Sunday on the couch, the best approach is the most causal approach: Pop open whatever you most enjoy drinking, be it white, rosé, red, or even bubbles, and snack on whatever you’re in the mood for. These 20 appetizers work with just about any bottle of wine and I have a good feeling that at least one of them is what you’re in the mood for.

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(Image credit: Maria Siriano)

Let’s all thank the Brits for the trifle, which we are going to take full advantage of here to turn leftover cake into breakfast. Breakfast trifle will make you look like the Patron Saint of Brunch (or hey, just a cool mom) and it’s easy, pretty, and delicious.

So what is a breakfast trifle, you ask? It has layers of tangy yogurt, studded with ripe blueberries and candied ginger, all sandwiched between vanilla cake and granola. Sounds like a real treat, right? That’s because it is!

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revolution health radio

In this episode we discuss:

  • The problem with conventional B12 serum testing
  • The prevalence of B12 deficiency
  • Why even omnivores may be deficient
  • The serious consequences of B12 deficiency going undiagnosed
  • Lab results: what to look for
  • Nutrients rich in vitamin B12

Show notes:

[smart_track_player url=”http://traffic.libsyn.com/thehealthyskeptic/RHR_-_Why_B12_Deficiency_Is_Significantly_Underdiagnosed.mp3″ title=”RHR: Why B12 Deficiency Is Significantly Underdiagnosed ” artist=”Chris Kresser” ]

Chris Kresser: Hey, everybody, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week, we have a question from Kristin. Let’s give it a listen.

Kristin: Hey, Chris, my name is Kristin. I have a question for you in regards to vitamin B12 and deficiency in it. I was doing some research on vitamin B12 a while back because I have severe anxiety and panic attacks, and I noticed that sometimes people that have symptoms like that have B12 deficiency. But I also came across some articles in regards to our fingernails and how the half moons will be gone if we have vitamin B12 deficiency. I don’t know if that’s something that is common in functional medicine to look at, is the fingernails, or stuff like that. But that’s really been interesting to me lately and I would just really love to know your opinion on that. Thanks.

Chris: That’s a great question. I often get questions like this related to the fingernails as markers of nutritional deficiency, and there is some limited data on nutritional deficiency showing up in the fingernails. It can be one of the many diagnostic criteria for nutritional deficiencies, but in some cases, the data is stronger than they are in other cases, and I wouldn’t use fingernails as the sole way of diagnosing a nutritional deficiency. I would think about it as one sign that could point us toward doing further diagnostic workup for nutritional deficiencies that would include lab testing, blood testing in most cases, sometimes urine testing. But I would never make a definitive diagnosis of a nutritional deficiency just based on the fingernails alone.

Why you should have your vitamin B12 tested—and the right way to test it

Let’s talk a little bit more about B12 and diagnosing the B12 deficiency because it’s really, really important. B12 deficiency turns out to be much more common than statistics indicate, and it can have really devastating consequences. B12 deficiency has been associated with or can actually cause premature aging or logical disorders that are similar in presentation to MS or even Parkinson’s, brain fog, memory problems, cognitive decline; stroke, heart disease, and other vascular problems, primarily due to elevated homocysteine levels—B12 is required to convert homocysteine back into methionine; developmental or learning disabilities in children; impaired immune function, autoimmune disease, and cancer; male and female infertility; and numerous other symptoms because B12 plays a very, very important role in the body. As you can see, when you don’t have enough B12, it can affect virtually every system and tissue in the body.

The problem with conventional B12 serum testing

Now, one of the biggest issues with diagnosing B12 deficiency is that the conventional serum B12 test that most doctors use only picks up a small fraction of people who are actually B12 deficient. I mean, that’s a big enough problem on its own. I suppose we could say an even bigger problem is that very few doctors even use that conventional serum B12 test. I’ve had so many patients that I have diagnosed with B12 deficiency in their 40s, 50s, even 60s or older who have never once in their entire life been tested for B12, which is just crazy to me given how important it is, given how easy it is to test for B12 and how cheap that serum B12 test is. That’s a big problem. A lot of doctors aren’t including serum B12 in their workup.

But as I just said, even if they are including it, chances are they’re missing a lot of people with B12 deficiency because the serum B12 test measures a total amount of B12 in the blood, but it doesn’t rule out functional B12 deficiency.

There are more sensitive markers for B12 deficiency that are now available including methylmalonic acid (MMA), which can be measured both in the serum or the urine. And not so much in the US but in Europe and other parts of the world, there’s another marker called holotranscobalamin II, or holoTC. That’s in fact the most sensitive marker for B12 deficiency. It is capable of detecting B12 deficiency at the earliest stage, stage one. These markers are much more sensitive to B12 deficiency than serum B12, which means they’ll go out of range at an earlier stage of B12 deficiency.

Then we also have homocysteine, which is a marker of B12 deficiency, although it’s not exclusively related to B12. Homocysteine can be high in cases of folate deficiency or even B6 deficiency as well. Homocysteine is more sensitive than serum B12, but it doesn’t only reflect B12 deficiency. If you see it high, that tells you that either B12, folate, or B6 is low, and you need to do some additional testing with these other markers to determine whether the cause of the elevated homocysteine is related to B12 or if it’s related to folate or B6.

Those are the additional markers you can use. Serum B12 is still a useful test and can still detect deficiency in some patients, but those people are people that are in stage three or four of 12 deficiency. There are four stages: One, two, three, and four—and serum B12 doesn’t typically go out of range until stage three or four, so you’re missing people in stage one or two if that’s the only marker that’s used. Homocysteine and methylmalonic acid can detect people in stage two deficiency. Holotranscobalamin or holoTC is the only marker, unfortunately, that they can detect people in stage one deficiency. It’s a mystery to me why it’s not available in the US. It is in a few teaching hospitals—I think Mayo Clinic, maybe Cleveland Clinic and a few other places around the country offer it—but you can’t get it drawn at your typical lab. I’ve been hoping that that will change for years, but unfortunately, it hasn’t yet.

The prevalence of B12 deficiency

We talked a little bit about the important roles of B12 and why you should get tested, but I want to mention a little bit more about the prevalence of B12 deficiency because there is an incorrect notion in the medical world that B12 deficiency is rare and it only really affects people on a plant-based diet like vegans and vegetarians. There is even a bigger myth in the vegan and vegetarian world that B12 deficiency is not common in those worlds.

The problem is, those ideas are based in using only serum B12 as a marker for B12 deficiency. If you use serum B12 as the only marker for B12 deficiency rather than some of these newer tests, the statistics suggest that only 7 percent of vegetarians are B12 deficient. Interestingly enough, they still show that 52 percent of vegans are deficient. Even using a relatively insensitive marker like serum B12, you still see over 50 percent of vegans deficient in it, 7 percent of vegetarians. But in a more recent study, using the more sensitive markers that I just talked about that are capable of detecting B12 deficiency at an earlier stage, a whopping 83 percent of vegans were B12 deficient and 68 percent of vegetarians were B12 deficient. Now remember, only 7 percent were deficient using serum B12, but 68 percent were deficient using these more accurate and sensitive markers.

Why even omnivores may be deficient

Now in terms of omnivores, only 5 percent were deficient. But I can tell you having worked with patients for a very long time—most of whom are on a Paleo type of diet or a nutrient-dense diet where they’re consuming animal products—I see B2 deficiency fairly regularly. One of the reasons for that is that deficiency of a certain nutrient doesn’t just come down to how much of that nutrient you’re getting from your diet. It comes down to how well you are absorbing that nutrient in the gut and also what the demand for that nutrient is because of certain physiological processes in the body. It also comes down to whether you have genetic polymorphisms that affect your utilization of that nutrient.

Let’s use folate as an example—well, let’s use B12 as an example since that’s what we’re talking about here. There are some polymorphisms that affect B12 metabolism and the use of B12 in the body. MTRR and MTR are both genes that are connected to B12 metabolism. If you have single nucleotide polymorphisms or SNPs in those genes, MTRR and MTR, that can be measured with a test like 23andMe, those can impact B12 metabolism and they may indicate a greater need for B12 than you would have if you didn’t have polymorphisms in those genes.

And then there are conditions like SIBO, bacterial overgrowth in the small intestine, that have been shown to decrease absorption of B vitamins like B12 in the small intestine because the bacteria in the small intestine can actually utilize B vitamins as well. They’ll take them for themselves and you will get less of them. Hypochlorhydria, or low stomach acid, which, as I’ve written and spoken about elsewhere, I think is a major cause of reflux in people and a very common condition that can also decrease the absorption of B12. Even if someone is consuming enough B12, if they have low stomach acid, they have SIBO or they have genetic polymorphisms that affect their ability to absorb and then utilize B12, then these people can also be deficient even though they’re not vegetarian or vegan and so that’s really important to understand.

The serious consequences of B12 deficiency going undiagnosed

Another crucial concept to get is that B12 depletion can take years to become clinically evident. I mentioned that there are four stages of B12 deficiency. In stage one and two, there will be no observable … usually no signs or symptoms of B12 deficiency. In other words, it’s not measurable using any other markers. It doesn’t start to cause anemia at that level and it’s not going to show up in other markers and it may even be completely asymptomatic. In fact, B12 deficiency doesn’t cause macrocytic anemia until stage 4, so that’s in the very last stage of B12 deficiency.

Unfortunately, some of the more serious effects of B12 deficiency such as nerve damage are irreversible. We have this really tricky situation where B12 deficiency is underdiagnosed because it’s not being adequately tested for. The symptoms and clinical signs can take years to become evident, but some of the more serious effects of B12 deficiency can actually be irreversible if the B12 deficiency has progressed to an advanced stage and has gone on for long enough.

I think it’s a major issue. This is why I’ve written two really detailed articles about the important effects of B12 and the problems with diagnosis and how to accurately diagnose it. We’ll definitely include a link to those articles in the show notes for the show. There are actually books that have been written about B12 deficiency. Sally Pacholok and Jeffrey Stuart have a book, Could It Be B12?: An Epidemic of Misdiagnoses, that covers this topic in great detail and goes into even some of the history and all of the conditions that can be caused by B12 deficiency and more background on what we’ve been talking about in this podcast.

Lab results: what to look for

I would encourage everybody to, at the very least, have their serum B12 measured. But as I have mentioned, that’s in many cases inadequate to detect stage one and stage two deficiency. Homocysteine is a marker that you shouldn’t have any trouble getting your primary care practitioner to order. It’s well known. It’s recognized as a marker for cardiovascular disease, and it’s pretty cheap. They should at least be familiar with that, and if you request a serum homocysteine, that’s probably a good starting place. Remember though, if it comes back high, it doesn’t guarantee you a B12 deficiency. It could also be folate or B6, but that might be enough ammunition to then get your clinician to order some of the more advanced tests for detecting B12 deficiency like serum or urine methylmalonic acid. I personally have found that urine methylmalonic acid is superior to serum, possibly because it’s more concentrated in urine than in the blood. I’ve just seen it be more sensitive and more consistent with the other markers of B12 deficiency then than serum methylmalonic acid. If you live in Europe or outside of the United States, you also might be able to get a holotranscobalamin, or a holoTC, which is again, the most sensitive marker for B12 deficiency.

If you can’t get your doctor to order those tests, you can order some of these tests perhaps through companies like DirectLabs.com, although there is quite a bit of nuance to interpreting these tests. It’s really helpful to have somebody who is experienced in interpreting these tests.

Another thing I want to say about these labs, if you’ve been listening to my work for any length of time, you may be aware that the conventional lab ranges that are used for these markers and many other lab markers are often not accurate. Conventional ranges are typically designed to detect frank disease rather than an optimal level, and serum B12 and even homocysteine are no exception. Most labs define B12 deficiency at less than 200 pg/mL, but it is well documented in the scientific literature that many people experience signs and symptoms of B12 deficiency at levels between 200 and 350. In Japan and Europe, I believe the lower end of the range is 400 and up or even 500 and up in either Japan or Europe. I can’t recall.

And so, if you get the B12 tests back and the level is 300, it’s going to be marked as normal, but at that level there’s a really good chance that you are in the earlier stages of B12 deficiency, and then if you were to measure homocysteine or MMA, that those would be out of range as well. With homocysteine, the range typically goes up to 13, 14, or even 15 in some labs, but I’ve seen lots of research suggesting that with B12 or folate deficiency, that can show up on homocysteine levels, start getting higher than eight. Homocysteine level above eight doesn’t necessarily reflect B12 deficiency, but it would be cause in my mind for doing further testing. Keep in mind that homocysteine is an inverse marker, which means when it’s high, that suggests B12 is low, and both serum and urine methylmalonic acid are also inverse markers, so when they’re high, that suggests that B12 is low.

Be aware that high serum B12 does not necessarily rule out functional B12 deficiency. This is what I was referring to when I said there’s some nuance on how to interpret these markers. In fact, I have come to view a high serum B12 when the patient is not supplementing or not eating really extreme amounts of B12 foods like liver as a potential red flag for active B12 deficiency.

Nutrients rich in vitamin B12

If you do actually have B12 deficiency, then there is much bigger discussion about how to address that. Eating B12-rich foods in my opinion is the best way. If you do eat animal products, B12 is richest in liver, clams, oysters, organ meats, and shellfish—once again, top of the list in terms of the most nutrient-dense foods. If you just ate a serving of liver and a serving of clams, oysters, or mussels each once a week, you would probably be able to meet your needs for B12 for the entire week. Other seafood like fish eggs, octopus, crab, and lobster are good sources for B12. Beef, lamb, even cheese and eggs are good sources of B12 as well, but they pale in comparison to the organ meats and shellfish in terms of the amount of B12 per serving.

A common myth amongst vegetarians and vegans is that it’s possible to get B12 from plant sources like seaweed, fermented soy, spirulina, brewer’s yeast, etc., but many of those plant foods actually contain B12 analogues called cobamides that block the intake of and increase the need for true B12. My intention here is not to bash vegetarian and vegan diets. As many of you know, I was a macrobiotic vegan myself at one point, but just helping to educate people about how to make wise choices. If you are on a vegetarian or vegan diet, you should be definitely getting your B12 levels measured with the more sensitive markers that I have mentioned, and then if your levels are low, you should be supplementing with B12, which is really quite easy to do.

We won’t go into a lot of detail on supplementation because I’ve written about that before, and I will just provide a link to the articles, which have some recommendations there.

Okay. Thanks again, Kristen, for sending in your question, and please do continue to send in your questions, everybody, to chriskresser.com/podcastquestion. Thanks for listening. Talk to you next time.

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