Dear Mark: Alcohol and LDL, Liverwurst, Coffee and Milk, Kid Snacks, and High Carb Questions

Backlit glass of whiskey with ice on wooden tableFor today’s edition of Dear Mark, I’m answering 14 questions. The first concerns the effect of alcohol intake on LDL. Does it increase it or lower it (or both)? Next, what’s the best liverwurst to eat? After that, I discuss whether drinking coffee with milk makes the coffee antioxidants useless, followed by a quick list of good snacks for kids. The last ten questions concern cycling high-carb feeds on low-carb diets. They all come from one reader, and they’re very specific and well-constructed.

Let’s go:

Mark, I truly appreciate the blog. I’d like to know your thoughts on the correlation, if any, between alcohol consumption and high cholesterol (particularly LDL). I’ve been following an 80-20 Primal lifestyle for about 4 years, but have had stubbornly high cholesterol levels to the point where my PCP wants to put me on a statin. Thanks again for all you do!

Full-on alcoholics tend to have shockingly low LDL levels. This isn’t good; LDL particles, remember, serve important immune functions. But the relationship seems to hold at more moderate levels of intake, too. In middle-aged Japanese men, for example, alcohol intake predicted lower LDL levels.

Alcohol also increases HDL levels, even acutely—just a single dose of alcohol increases it

This jibes with the usually protective association between alcohol intake and heart disease, whether it’s postmenopausal women, Spanish men, or German adults.

Of course, there’s evidence that your genetics determine the effect of alcohol on LDL. In folks with the ApoE2 gene, alcohol lowers LDL. In those with the ApoE4 gene, alcohol increases it.

Mark, I would like to know if liverwurst is an ok way to get some organ meat, is it primal? My wife and I can’t stand organs by themselves, so I thought this may be a way to get some and we like it. I would guess that there are varying qualities and types, so guidance on how to pick would be great. I also enjoy scrapple, same question, is it primal and how to choose the best.

Best liverwurst I’ve ever had comes from US Wellness. It’s 50% beef trim, 20% liver, 15% heart, 15% kidney. All grass-fed. They also have a braunschweiger that’s 60% trim and 40% liver.

Traditional scrapple was great: pig parts, buckwheat (not a grain, not wheat), and bone broth cooked down into sort of a pork polenta that’s chilled and pan-fried. These days, scrapple is more of a mixed bag, since you get it in restaurants and they’ve started using wheat flour and cornmeal instead of buckwheat. If you’re trying to avoid wheat flour—as you probably should—the trick is finding a place that makes scrapple with buckwheat and/or cornmeal.

Or just make your own.

Hi Mark, almost every month I hear new conflicting information about whether coffee is healthy or not. What are your current thoughts on coffee and is it true that the antioxidants in coffee lose their power when consumed with milk?

My stance on coffee is resolute: It is a public good. It’s fueled revolutions and scientific discoveries. Just imagine the wondrous developments that’d result if the ancient Greeks, Romans, and Egyptians had used coffee. Or what if the Mongols had adopted coffee drinking after sacking Baghdad—would we all be drinking fermented mare milk, eating saddle meat (or not), and getting around on horseback? Fun to think about.

As to milk binding the antioxidants and rendering them useless, I wouldn’t worry. A 2010 study found that only non-dairy creamer slowed the absorption of coffee polyphenols. Real milk added to coffee had no effect. Even then, the non-dairy creamer only delayed the appearance of the polyphenols in the blood. They still got there. It just took them awhile.

I would like to see more recipes for primal snacks for my kids…and me too!. It breaks my heart to see them devour a bag of Oreos and then deal with the resulting poor behaviour.

I can do a comprehensive post in the future, but for now, some easy grab-and-go options you might not have considered.

Jerky. A classic.

Epic Bars are pretty good. Great ingredients, almost exclusively grass-fed/pastured animals. They don’t shy away from fat. A mix of sweet-savory and savory flavors.

Aforementioned US Wellness liverwurst and braunschweiger. Get those kids to eat liver.

Hard boiled eggs.


Cheese. Hard, aged ones travel well.


Pork rinds. Make sure you get the ones cooked in their own fat. Beware vegetable oils in the ingredients list.



Also, just trust your kids. They’re usually more adventurous than we assume. You’d be surprised what happens when you plop a cross section of a cow femur loaded with roasted marrow in front of a 5 year old.

Hey Mark, I would like to know know more about how to properly utilize carb-cycling (CC) while integrating intermittent fasting (IF).
1. With CC how do you determine which days to crank up carbs? Every day you lift? Only on Heavy lift days?
2. Do you lose the carb-feed benefits window if you lift in the morning, then fast until noon?
3. Carbs at night when training only in the mornings? Are they effective?
4. What about carb sources with high fat with carb cycling?
5. How many grams of fat allowed on a high carb day?
6. Are there better fat sources than other on high carb days?
7. Is there a specific time of day to eat the limited fat on high carb days?
8. How to determine which carbs are right for you? Sweet potatoes, white potatoes? Rice? Any experiments?
9. Should you have carbs on rest days while Carb Cycling? If so, how many grams?
10. Should fat ever be mixed with carbs? Why or Why not?

That was quite a series of questions. I’ll do a quick run through and maybe expand in the future.

  1. Only on heavy/intense days. Long hike? Stay low-carb; you’re burning almost all fat (or that should be the goal). CrossFit WOD? Carb-up. Heavy squats? Carb-up. Short (5-10 second) sprints with plenty of rest in between, where you’re truly going all out and getting full recovery? Stay low-carb; you likely burned primarily ATP-PC, not glycogen. High-intensity intervals with shorter rest periods that leave you gasping? Carb-up.
  2. You’ve got some time. Insulin-independent glucose uptake increases for around 2 hours after exercise. Insulin sensitivity increases for at least 16 hours after exercise.
  3. Try “sleeping low.” This works best training in the afternoon or early evening. You go into the evening/early evening workout with carbs in your system. This should be a glycogen-depleting workout. You eat a low-carb or zero-carb (or fast) post-workout meal, then go to sleep. Wake up, and do some easy cardio without eating. A brisk hike, some easy cycling, maybe a short jog, always staying in your aerobic HR zone. You’ll get really good at burning fat this way. After the morning workout, eat some carbs.
  4. Unless you’re just a workhorse, expending a ton of energy, training every day, veering close to burning out, you’ll have better luck with keeping your high-carb days relatively lower-fat.
  5. Around 15-20% of total calories. Try for less. You may get better results that way.
  6. PUFAs seem to have a more neutral effect on insulin resistance in the presence of carbs than other fats. Get a “balanced” intake, rather than leaning heavily toward one or the other. Butter, avocados (or avocado oil), almonds, and salmon is a better combo than butter, butter, butter, and butter.
  7. No, it doesn’t matter if you keep it relatively low.
  8. Robb Wolf has been pushing continuous glucose monitoring to track how different carb sources affect your blood glucose minute-to-minute. He’s getting great results. CGMs are prescription only, but I think that’s due to change in the near future. You could also do classic blood glucose prick tests at 1, 2, and 3 hours after your meals.
  9. Keep carbs between 30-150 grams on rest days, depending on how low you enjoy going.
  10. Fat and carbs are delicious together. That’s one reason to eat them—sheer pleasure. It’s also an argument against eating them: We’re liable to eat way too much. If you can keep from going crazy, you’re reasonably active, and you’re happy with your body composition (or its trajectory), fat and carbs are fine together. Fat and carbs become trouble when we eat too many of them at one time, like eating a half plate full of mashed potatoes loaded with butter and cream.

That’s it for this week, folks. Thanks for reading and be sure to help out with your own input down below.


TAGS:  dear mark

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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