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Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...

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June 30, 2014

Dear Mark: Red Meat and Breast Cancer, Net Carbs, and Solutions for Excess, Unavoidable Sun

By Mark Sisson
46 Comments

Processed Red MeatFor today’s Dear Mark, we’ve got a three-parter. First up, I discuss the latest study claiming that red meat will kill us all. Or maybe it’ll be killing roughly half of us all, seeing as how this paper concerns red meat and women’s breast cancer risk. Next, I give my position on the “net carbs” issue. Do we subtract fiber, leave it as is, or do something else entirely? And finally, I talk a lot about the importance of getting enough sunlight. But what happens when getting enough sun isn’t the problem? What can an outdoor worker do about too much sun?

Let’s go:

Hi Mark,

I would love to hear your take on the new study claiming that red meat raises women’s breast cancer risk. This has been all over the news without any dissuasion of other variables such as: it was a “recall” study where subjects were asked what they ate over the past 20 years, was there a category distinguishing McDonald’s cheeseburgers vs. grass fed filet, were the participants who remembered eating less red meat consistently active, how did the subjects obesity levels factor into the results, etc. It seems that this is a big leap to take in a study based on memory of what nurses ate. Thanks!

K. Hunter

Oh look, Walter Willett has authored another study condemning red meat. I’ll always respect and admire his voluminous mustache, but I don’t think much of this latest paper. You point out a lot of shortcomings in your question. Yes, it was a recall study. No, they didn’t distinguish between fast food burgers and pastured steak. They didn’t control for activity levels (which definitely affect the risk of getting breast cancer), though they did for obesity. The biggest thing that jumps out is that they didn’t separate unprocessed red meat from processed red meat. From the Methods section:

Total red meat items listed on the food frequency questionnaire included unprocessed red meat (beef, pork, or lamb as a sandwich, pork as a main dish, beef or lamb as a main dish, and hamburger) and processed red meat (hot dogs, bacon, and other processed meat such as sausage, salami, bologna).

That’s pretty unforgivable, and if you stopped reading now to go eat a beef shank, I wouldn’t blame you. Confounding processed and unprocessed red meat means that a nurse who brought in leftover osso buco would be lumped in with the  nurse who ate microwaved Oscar Mayer hot dogs for lunch everyday. Does anyone really think that hot dogs and braised veal have the same effect on breast cancer risk? Or even a similar effect? “Red meat” is not a monolith. It’s just a term we use to categorize foods that share a few characteristics. This makes discussing foods easier, but our discussions become less precise and any conclusions gleaned from them less meaningful. I don’t blame them, really. Breaking up “red meat” into grain-fed beef, grass-fed and grain-finished beef, grass-fed/finished beef, pastured pork, conventional pork, and so on would produce the most accurate results, but it would make research difficult to conduct.

Such categories may make research easier, but you’re not eating “red meat.” You’re eating from among the thousands of foods that qualify as red meat. And since this study didn’t even distinguish between the most basic sub-categories (processed red meat and unprocessed red meat), it’d be unwise to ascribe it any significance, let alone modify our diet based on its conclusions.

It’s not like this is a novel pursuit, a foray to an untapped reservoir of nutritional epidemiology. It’s old news. People have been looking for evidence that red meat increases the risk of breast cancer for years. By and large, they’ve come up empty. Even looking at the constituents of red meat for evidence of a link hasn’t gone anywhere. Heme iron, the type found abundantly in red meat, is not associated with breast cancer risk. Fried meat is sometimes associated with breast cancer, but other studies have found that a person’s intake of heterocyclic amines, the carcinogens that form when meat is cooked and seared under high heat, has no association (but omega-6 intake seems to be connected). Oh, and how about animal fat? No relationship with breast cancer risk.

Even if this paper was sound and relevant to a healthy Primal eater, we know that many nutrients found in red meat, like conjugated linoleic acid (CLA), are associated with a reduced risk of breast cancer. Another one, carnitine, appears to be protective once a person has breast cancer. I’m not saying that eating steak will cure or prevent breast cancer. That’s not really supported by the evidence, though a few potential mechanisms (CLA, carnitine) look promising. I’m saying that the opposite statement – that red meat increases the risk of breast cancer – has even less support in the literature. It’s the same crazy situation where even though gouda is one of the best sources of vitamin K2, a heart-protective nutrient widely recognized by health experts, they tell heart disease patients to get their vitamin K2 from supplements, not gouda, because “full-fat cheese is bad for your heart.”

So yeah, this paper isn’t groundbreaking, and I don’t think it tells us anything about the effects of eating grass-fed lamb, but it’s still not a very good idea to eat a lot of fried, well-done, and/or processed meat. And make sure you exercise.

Hello

I picked up The Primal Blueprint about a year ago, and have been following it ever since. I am not overweight for the first time in my adult life, and feel incredible. I am still struggling to lose the last 10 or so pounds, and get my body fat into a healthier range. I am diligently staying within the 50-100g/day carb range, with a few days here and there of below 50, and seem to be stuck on this plateau. My question is, are you recommending to stay within 50-100g of total carbs, or factor in the fiber and go by net carbs? I have been going by total carbs, which means I’m netting around 40-60 carbs a day (around 60-90 total carbs). I’m not sure if this is my sweet spot, since I can’t seem to get this last bit of weight off, and would love your opinion!

Betsy

I don’t really do the “net carb” thing. That often leads to micromanagement, which is bad for some people. If you love to micromanage and thrive doing it, have at it.

I find it easier (and more helpful) to think of non-starchy vegetables as “free” than to subtract fiber from total carbohydrate, and it accomplishes similar things. Leafy greens? Broccoli? Bok choy? Summer squash? Zucchini? Cabbage? Eat as much as you want. The carbohydrates are negligible (you probably use more glucose digesting non-starchy vegetables than they contain) and they’re inherently self-limiting. No one is carbing up with a salad bowl full of a couple pounds of steamed kale before a race; it simply wouldn’t work. No one is carb-binging on spinach the way they might binge on roasted potatoes; spinach technically has carbs, but not really. No one is getting fat because they ate too much lettuce unless it’s drowning in dressing; you’d get sick of it before you could consume a significant enough amount of lettuce calories.

The carbs on the Primal Blueprint Carb Curve primarily refer to carbohydrates from starchy vegetables (winter squash, beets, etc), tubers, roots, and fruit.

What’s up, Mark? I just started a new job at a marina. It’s great – I’m outdoors for much of the day, I’m active and moving, and I’m doing something that I love which is working on boats.

Here’s my question: Since I am outdoors much of the day, I’m concerned about getting too much sun. I love getting some sunshine and I know the sun isn’t poisonous, but sometimes I’m out in it for 6 to 7 hours at a time (minus a few breaks here and there).

You usually recommend people head inside or get out of the sun when they feel like they’ve had enough, but that’s not always an option when I’m working. Since summer’s here now, and people are going to be on the lake or at the beach, I’m curious what you would recommend when getting out of the sun isn’t necessarily an option.

Should I use sunscreen? Another alternative? The main goal is just to keep from burning, right?

Thanks!

John

First off, the fact that you’re moving around all day helps. Rather than laying out and exposing a big uniform slab of flesh to direct sunlight for an extended, unbroken amount of time, your work on the boats has you bending, pulling, crawling, and contorting yourself and exposing different bits of skin to the sun. This is safer than direct protracted exposure. It’s known as “occupational sun exposure,” and it’s usually linked to less skin cancer than intermittent sun exposure.

Second, not burning is a good sign. It’s certainly better than burning, which definitely increases the risk of melanoma. And people with the innate (or cultivated through dietary and other lifestyle measures) ability to tan rather than burn are less likely to develop deadly skin cancer. Despite the conventional wisdom, a light base tan is not a definite indicator of irreparable skin damage. Assuming you go about attaining it the right way – through steady and measured, rather than intermittent sun exposure – it indicates good sun resistance.

However, six or seven hours is still a long time to be out in the sun and sunscreens may be a good bet. Some sunscreens work better (and are less toxic) than others. Zinc oxide – the white, goopy stuff that doesn’t really disappear after application – actually provides a physical, rather than chemical, barrier that protects against both UVA and UVB; most chemical barriers block only UVB, thus preventing the synthesis of vitamin D that helps protect your skin from the UVA. Some of the latest zinc oxide sunscreens are better at blending in, but they’re not perfect. You’ll still give off a faint white sheen (which is better than a burn). Focus on the areas of your body that receive the most direct sun, like your shoulders, neck, nose bridge, and clavicles. The Badger Balm line of zinc oxide sunscreens provides a physical barrier and manages to be somewhat inconspicuous.

Cover up. Get a wide-brimmed hat if your job allows it. Bucket hats, or fishermen’s hats, are designed to ward off sun and do a good job at it. Clothing is good, too. UV-protective clothing, or “sunware,” is designed to protect you from the sun. If you want protective clothing but would rather not wear a skin-tight rash guard, go to a hiking/camping/backpacking store. They’ll have UV-protective clothes that look like normal shirts, shorts, and pants. For regular clothing, color matters, with blue and red having the best UV-blocking capacity.

Make sure your diet is replete with nutrients that bolster your sun resistance. I’ve outlined eight of the main ones in this post. The biggest change I’ve seen has come from limiting omega-6 fatty acid intake (particularly from seed or vegetable oils; nuts and eggs and other whole food sources of PUFAs are more desirable and less problematic than the oils), eating more saturated fat to make up for it, and getting sufficient omega-3 from fish, shellfish, or fish oil supplements.

That’s it for today, folks. Thanks for reading and be sure to leave a comment!

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46 Comments on "Dear Mark: Red Meat and Breast Cancer, Net Carbs, and Solutions for Excess, Unavoidable Sun"

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Dr. Anthony Gustin
2 years 2 months ago

Maybe appropriate TIMING of the 50-100 carbs would net a greater result of fat loss? (after workouts, later in the day)

Jacob
2 years 2 months ago

It might also be good to have an occasional higher carb day to help break plateaus. I think Mark mentioned this in an old article.

Vince
2 years 2 months ago

Completely agree with this one…made a huge difference for my friends and me

Diane
Diane
2 years 2 months ago

I call those sun-protective backpacking shirts “desert shirts”. Some companies make nylon that has a dry feeling to it. I find that comfortable. I don’t see any reason to get special UV clothing. Usually a light color works well enough to reflect enough sun away to keep you comfortable. If you don’t want to spend the money for something at a backpacking/outdoors store, a polyester/cotton man’s dress shirt from a thrift store also works great.

Shary
Shary
2 years 2 months ago

Regarding UV clothing, I think it’s mostly designed to enrich the manufacturer’s bank account. I have never, ever known anyone who got sunburned through ordinary clothing. Obviously, if the item is made of some type of mesh that allows the sun to penetrate through to the skin, this wouldn’t hold true. Most street and sport clothes have a much tighter weave that sunlight can’t penetrate.

BillC
2 years 2 months ago

“Desert shirts” is a good name and a hint for where to look for inspiration. Traditional mariner’s clothing would also be a good.

Florence
2 years 2 months ago

I’ve also been curious about fiber and carbs and whether to pay attention to net carbs closely or not. I’m a person who can’t be hyper focused like that though without getting obsessive and miserable– I think the carb thing is definitely common sense, like kale carbs = good and I eat a ton of them but I do try to go easy on bananas.

Jacob
2 years 2 months ago

I’ve never been one to try calculating net carbs…seems like way too much of a hassle. I figure if I’m keeping the carbs low, and laying off the grains, starches, candies, I’m pretty well off.

Shary
Shary
2 years 2 months ago

Exactly. I see no reason to turn my meals into a math exercise. I guess some people are just more into keeping track of numbers and measurements than I am.

Curtis
Curtis
2 years 2 months ago

Lol, totally agree. Eating healthy food should be about good choices and not nitpicking about everything.

Michele
2 years 2 months ago

I really wish everyone would get that you need to take reported study results with a grain of salt. I’m glad you take the time to go over these points with many different studies, but unfortunately the people who really need to hear these things don’t come to your website!

Also loved the advice on sun exposure, and the info on how nutrition relates to our bodies resistance to it as well.

victor
victor
2 years 2 months ago

The people that need this imformation the most seem to have the old food pyramid ingrained in their minds and because they are in such bad shape they actively seek out info that will validate what they think they know. I work with quite a few obese people and their knowledge of nutrition is substantial. The problem is a what they know is just dated 70s and 80s stuff so they continue to take their diabetics medication, statins, etc.. and fill up a lot of other health blogs with their “knowledge”.

Brenda
Brenda
2 years 2 months ago

Regarding plateaus, you may want to check out the book “Living Low Carb” by Jonny Bowden, PhD, CNS. This is the book that pointed me to Mark’s Primal Blueprint (VERY highly rated by Bowden) There is a section on plateaus that I found interesting and helpful.

John Finn
2 years 2 months ago

I’ve read this book and I agree, Living Low Carb can help on plateaus.

Shary
Shary
2 years 2 months ago
Regarding the latest red meat nonsense, I always wonder what else these study participants were eating. Also, who is paying for the study and what is their motivation? I like red meat and eat it frequently. Apparently my body needs quite a bit as I tend to crave it if I don’t get enough. I never worried about eating eggs either, back when they were being demonized for supposedly causing high cholesterol. Again, you have to ask: what else were the study participants eating? Was it perhaps an overkill of grain products and sugar/sweeteners? Why are those things such a… Read more »
Stephen
2 years 2 months ago

I’ve never calculated net carbs. Net carbs has always seemed like a way to justify eating more carbs. I prefer to just know the general carb count on my favorite fruits and veggies keep a running total in my head as I go throughout the day.

Erica
2 years 2 months ago

I worry about sun exposure myself as an endurance runner in Florida – great advice!

Dan
Dan
2 years 2 months ago

I’m convinced that Walter Willet is being payed off by the canola oil industry, he always recommends canola oil. Even Wikipedia knows canola oil, full of polyunsaturated fats is rancid garbage.

KariVery
KariVery
2 years 2 months ago
From a person of very Caucasian descent (Irish, English, Norwegian and Scottish)….let’s just say I burn easily. I have noticed that I burn much less often and if I do get pink it turns to tan very easily with no peeling now that I take a vitamin D, E and cod fish oil supplement. I am still careful and don’t stay out during peak sun times and all, but these supplements have definitely made a huge difference for me. And, my dermatologist told me he thinks that the “sun burn proof” clothing is a scam. Good ol’ breathable cotton is… Read more »
Swan Ronson
Swan Ronson
2 years 2 months ago

So what does that mean for us pale people? We’re doomed? Can’t make enough Vit D without exposing ourselves to the sun and incurring damage?

Jacob
2 years 2 months ago

I believe Mark mentioned in a previous article that Vit D actually protects the skin from sun damage (can anyone find the correct link or am I just going crazy?). I suggest taking a good Vit D supplement and see if that helps.

k-del
k-del
2 years 2 months ago

I wouldn’t sweat it too much. Just try to get 10-15 minutes of “direct” exposure on sunny days, and you will be fine. If you work and can go out during your lunch hour, a quick stroll outside will serve, also. I am also very fair and the sun and I have never gotten along. I do supplement with D3 for other, pre-existing reasons. If you are worried, have your D levels checked and/or pop a supplement.

Jessica
Jessica
2 years 2 months ago

Of course not. The human body is not inherently so flawed. I am, too, a very pale person, but I don’t burn because my diet prevents this from happening. Pre-paleo, I would burn very easily. Also, certain oils like coconut, olive and sesame have a certain amount of UV protection that can provide a little extra protection when applied to the skin. I believe I also read somewhere that moisturizer skin absorbs vitamin D better than dry skin (and burns less easily as well).

Janknitz
Janknitz
2 years 2 months ago
Men can and DO get breast cancer, especially if they have a variant of the BRACA gene. It’s not as common, but any male who finds a lump anywhere near their nipple area or underarm should not wait to get it checked out. I think the death rate for men is higher, probably because they wait too long, and don’t have regular mammograms for earlier detection. My sun exposure is sadly intermittent, and my biggest issue right now is finding a sunscreen I can use when I’m going to be outdoors for a while. I’m sensitive to fragrances, and I… Read more »
PawPrint
PawPrint
2 years 2 months ago

As someone whose husband had breast cancer (no genetic basis, though), I heartily concur with your wise words. It’s disheartening to realize how many men don’t understand that they, too, can get breast cancer.

Jack Lea Mason
Jack Lea Mason
2 years 2 months ago
Mix some the 100% zinc oxide stuff with coconut oil. I use about 1 part ZnO to 4-6 parts coconut oil. just enough to see some white reflection off the skin. Sometimes I add a little aloe vera gel to thin it out to make it easier to apply to a larger area. The coconut oil makes it somewhat water-resistant and ZnO has been used for skin ailments for centuries. It is as close to primal sunscreen as you can get. I think Grok kept out of the mid-day sun i.e. took a siesta. just like the animals he hunted.
Animanarchy
Animanarchy
2 years 2 months ago
I’m just in the library for a little break from the sun and heat before I go buy some red meat: pork liver paté. I have an irresistible craving for it. It should be a nice change because recently I’ve been mostly eating sardines and though I like them a lot I eventually tend to get (usually just a little bit) sick or bored of them after a while and like to cycle with some other protein sources and eat more animal fat, plus I make sure I regularly eat liver anyways. I’m fairly lean right now so I think… Read more »
Markus I
Markus I
2 years 2 months ago

Help in prevention of sunburns? Ingesting astaxanthin, beta-carotine and polypodium leucotomos extract will help you a lot.

Wenchypoo
Wenchypoo
2 years 2 months ago

Walter Willett can kiss my entire basckside! I’ve got a stack of mammograms that say he’s DEAD WRONG about red meat and breast cancer.

Leila
Leila
2 years 2 months ago

I am amazed how much my diet affects my tendency to burn. I am fair skinned and growing up I ate lots of sugar and grains–and I always started burning within minutes during peak sun hours. Now I eat strict primal/paleo and never have sugar (health issues) and I can be in the midday sun for almost half an hour without burning. I actually tan without burning first for the first time ever!

victor
victor
2 years 2 months ago

Same here Leila, just came in from doing yard work after an hour in the sun. Never burn and I’ve always burned in the past.

Pdawg
Pdawg
2 years 2 months ago

Me too!! I swear it’s the pastured meat. Once my family switched to it we rarely burn and we are in the pool at least 3 to 4 times per week. Someone should do a study on that!!!

C L Deards
2 years 2 months ago

Being about as pale-skinned as they come I’ve noticed that I do not burn like I used to now that I eat primally and supplement with vitamin D, fclo, and k2. I don’t get cavities anymore either.

Getting grains out of your life, flossing, and taking the tri-fecta of k2, fclo, and vitamin D would save people so much money in health and dental bills.

Leila
Leila
2 years 2 months ago

What is ‘fclo’? Been thinking about adding vitamin k to my regimen for those benefits…

PrimalGrandma
PrimalGrandma
2 years 2 months ago

fclo = fermented cod liver oil perhaps? just a guess, but that would make sense with the K2 and the Vit. D ——

C L Deards
2 years 2 months ago

That is correct. I take 1/2 to 1 teaspoon of fermented cod liver oil from Green Pastures.

Sometimes I’ll take a break from fclo and just take a combination of Super Vitamin K2, vitamin A extracted from cod liver, and vitamin D.

My teeth are much happier now. Of course, my wife would say that going primal and supplementing are minor compared to the fact that I completely gave up Dr. Pepper upon going Primal.

Kevin Grokman
Kevin Grokman
2 years 2 months ago
I am way too lazy on counting anything nutrient related, be it carbs, protein, fat, or whatever else. I tend to eat vegetables when I want them, limiting the starchy vegetables, and doing whatever “feels” good in regards to eating veggies throughout my day. I liked the reminder about UVA vs UVB and the fact some sunscreens hamper your body’s ability to produce Vitamin D if they block only the UVB while letting the UVA negatively impact you. I tend to take 15-minute walks once or twice each day during work hours because I am so frequently enclosed in an… Read more »
Tassie
Tassie
2 years 2 months ago
Working on my Protea farm, I spend long hours in the sun especially during summer as the days are so much longer here in Tasmania than in winter. As I also spend time outside all during the year, I think my face, neck and lower arms are used to the sun. However, as we move towards more exposure to the sun during spring and expose more skin, I tend to use a low grade sunscreen to the parts of my body which hasn’t been exposed to the sun during winter. I only need to use sunscreen for about a week… Read more »
John
John
2 years 2 months ago
It is rare that I disagree with Mark, but I have long disagreed on his dichotomy of red meat good, processed meat bad. First, “processed” is a vague term. Just about anything we do before the food hits our mouth (and after, for that matter) is processing food. So just what’s the culprit in “processed food”? If I take lean grass fed beef, add some spices and salt, and dry it, I have beef jerky, a processed food. If I take grass fed beef, add some organically raised lard (ok, the pig is raised organically, not the lard, but you… Read more »
Chris
Chris
2 years 2 months ago

I think you’re right, but I would also suggest that virtually all processed meat that “regular folks” are eating are not the high quality product that you’re describing. Also I too have concerns about smoked meat.

Coco
Coco
2 years 2 months ago

I just wanted to add that as someone who recently converted to minimalist sandals. Don’t forget to put sunscreen on your feet if you happen to not wear closed shoes. Feet are always in the worst angle for getting sunburns. Also, you should get a sunscreen that you can put on your lips too (gentle remainder that we shouldn’t put on our skin anything that you would not eat). Sunburned lips are very painful.

shannon
shannon
2 years 2 months ago

I have had rosacea in the past (although it’s gone now mostly) and so I use a sunscreen when I will be outside for a while and it’s sunny. I only use it on my face, as it seems the most sensitive to sun. The one I use is Clinique City Block. It is non-toxic. It is a bit pricey but a little goes a long way.

Harry Mossman
2 years 2 months ago

For those who do need more sun protection than merely clothes, Sunguard can be washed in. Seems safer than putting chemicals on skin.

Dymphna
Dymphna
2 years 2 months ago
Here’s something I’d like clarified for me: I’m mostly paleo for a good 2 years now and I’ll never go back. But I’m pale and I’ve spent most of my life coating all visible skin with high spf lotion; last year I switched to zinc oxide (if you apply and wait a bit, it does seep into your skin). And I do this because I want to look as young as I feel. The age spots have started on my hands and arms and I’ve tried: 10 minutes of sun makes them darker. (I get them zapped off with a… Read more »
hollyofspades
hollyofspades
2 years 2 months ago

Hey everyone! I had a question…

Mark says that he find’s “it easier to think of non-starchy vegetables as ‘free’… ” and goes on to say that “the carbs on the Primal Blueprint Carb Curve primarily refer to carbohydrates from starchy vegetables, tubers, roots, and fruit.”

My question is… What about nuts and avocados? Are they considered “free” like the non-starchy vegetables? Or do you count them towards your daily carb intake?

Krimson Rose
Krimson Rose
2 years 2 months ago
I have fair skin, light hair and freckles; I burn easily. One hour in the sun without protection means I get a burn. That was pre-change my dietary habits and toxic topical habits. Coconut oil is fabulous. Ingesting it makes my skin more resistant to burns, and now I use it as my only sunscreen. I am tanning for the first time, and I can be in the sun for about two hours before I feel the need to reapply coconut oil. As an added benefit, if I use it on my scalp, my psoriasis itch nearly disappears. Coconut Oil:… Read more »
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