Dear Mark: Protein for Pregnancy and Nursing, Reversing Sun Damage, Inflammatory Eggs

Broken EggIt’s Monday, which means it’s time for another edition of Dear Mark. This time, I’m covering three topics. First up is optimal protein intake for breastfeeding and pregnant women. I’m not sure how I forgot to include those groups in last week’s protein post, but I did, and you guys called me out on it. Then, I discuss several different topical supplements you can try for reducing UV-induced skin damage. There may be damage that simply can’t be reversed, but I suspect you can improve the situation to some extent. And finally, I field a question from a reader who’s worried about eggs being inflammatory. It seems he’s just read a book whose author classifies over 2,000 foods by their “inflammation factor,” and eggs scored really, really low (i.e. bad).

Let’s get to it:

What about protein intake for pregnant and/or breastfeeding mammas? Over the past 3 years I have between either one or both of those.


It’s difficult to find “grams per pound of bodyweight” recommendations, simply because you’re not really eating for just yourself during pregnancy – you’re actually building and supporting an entirely different human being growing inside you! Here’s what we do know about protein intake during pregnancy:

“Isocaloric protein supplementation,” where protein is substituted for equal caloric energy from another macronutrient, is associated with an increased risk of having a small-for-gestational-age baby (SGA). Underweight babies are at a greater risk of health issues, especially later on in life. So don’t drop the fat and/or carbs in favor of more protein.

“High protein supplementation,” where protein is increased to 25% or more of total calories, is associated with a nonsignificant reduction in mean birthweight, a significantly increased risk of SGA birth, and a nonsignificantly increased risk of neonatal death. One study even found that the offspring of mothers on a high-protein pregnancy diet were more susceptible to stress, tending to release more cortisol when exposed to psychological stressors than offspring of mothers on a lower protein diet. Don’t do a protein sparing modified fast (high protein, low calorie, low fat, low carb diet bodybuilders use to cut) while pregnant.

Energy and protein restriction for overweight pregnant ladies reduced both maternal and baby weight without improving hypertension or preeclampsia. You know what? Don’t diet at all when you’re pregnant.

Balanced protein energy supplementation, however, seems to be helpful. That’s where you eat sufficient protein and overall calories while keeping protein under 25% of calories. Particularly in undernourished pregnant women, balanced protein energy supplementation decreases the risk of SGA. In other words, eating protein as part of a balanced overall diet is best, while eating an explicitly high-protein diet is probably ill-advised.

Don’t avoid or consciously limit protein when pregnant, of course. Why, during the first trimester, protein meals can even reduce nausea. Eat to appetite. Follow your protein cravings. From what I can tell, undernourished women will naturally desire more protein during pregnancy (take the common phenomenon of the vegan suddenly craving rare steak during the first trimester) while women who are already getting enough protein to support their pregnancy will crave it less. That’s fine.

As for nursing women, protein needs will definitely increase because you’re producing nearly a liter of protein-containing breast milk a day. Now, human milk isn’t particularly protein-rich – it’s 14–16 g/L during early lactation, 8–10 g/L at 3–4 mo of lactation, and 7–8 g/L at 6 months and later – but it does have a significant amount of “non protein nitrogen.” Non protein nitrogen still has to be produced by the mother from dietary protein. Some sources suggest an increase of 20 grams protein per day is enough. I think what’s important is overall caloric intake from healthy Primal foods. You don’t want to eat so few calories that you have to resort to burning amino acids for energy or converting protein into glucose.

Except for being more cautious about sun exposure in the future, are there any tips on how to manage the problems of damaged skin and minimising future damage? Someone on the forums mentioned vitamin E oil and the primal favourite, coconut oil, to aid skin recovery, would you agree? Thanks!


Be sure to check out the two posts I did a couple years ago on preventing and treating sunburns. Those tips will be helpful, particularly in prevention. As for treating damaged skin, there are some things you can try. I can’t personally vouch for any of these, but I’ll present the evidence for each and let you decide what to try. At the worst, they just won’t work and you can move on to the next one. They certainly won’t hurt to try (with perhaps one exception), though. Sound good?

Curcumin, the “active” ingredient in turmeric, seems to be effective at healing sun damaged skin. Both oral and topical supplementation appears to help improve resistance to the development of skin cancer.

A “fruit blend” of sea buckthorn extract, blueberry extract, and collagen prevented skin aging in hairless mice subjected to 6 weeks of UV radiation.

Topical testosterone, progesterone, and pregnenolone all reduced the symptoms of aging in actual human skin (still attached to humans). They reduced wrinkling, restored hair growth, and restored sweating capability (PDF). Meanwhile, topical estrogen sped up the aging process, and topical stress hormones sped it up even more. Hormones aren’t to be trifled with lightly, though, so don’t mess around with these unless you know you’re doing or under the guidance of someone who does.

Topical vitamin C has been shown to improve collagen synthesis (important for restoring the quality of skin), reduce hyperpigmentation, and act as an anti-inflammatory agent to many skin disorders. Furthermore, it can protect you from UV damage in the first place. Unfortunately, vitamin C is somewhat unstable, so making your own ointment, balm, salve, or serum can be a way to make sure yours is active and effective.

Topical retinol, a popular component of skin creams, improves the quality and appearance of photo-aged human skin. Topical retinoids have also been shown to manage acne, psoriasis, photoaging, and cutaneous T-cell lymphoma. If you’re averse to the use of skin creams, I suppose you could always go to sleep with a polar bear liver mask.

Topical vitamin B3 in the form of niacinamide reduced the prevalence and intensity of sun spots in women aged 40-60.

I couldn’t find much on vitamin E or coconut oil as agents of sun damage reversal. Can’t hurt to moisturize with a bit of coconut oil, of course. Red palm oil might work even better, as it’s a rich source of both vitamin E and vitamin A (in the form of carotenoids). Only problem is it stains clothes, if you apply it topically.

Hope you find something that helps!

Hi Mark, I took the time to copy Monica Reinagel’s entire list of foods and their “inflammation factor”, and this list has eggs as one of the most inflammatory foods on the entire list of 2100 items. Any idea why? Is she just off base? Maybe she is talking about eggs from factory farms? I love eggs and eat them a lot, so I’m concerned.



Hey Mark, cool name!

I just checked out her “inflammation factor formula” to see how she arrives at her conclusions. It “includes more than 20 different factors that affect a food’s inflammatory or anti-inflammatory potential,” such as the amount and types of fat (more is worse, I’m guessing, and saturated fats are particularly dangerous), the presence of essential fatty acids (like linoleic acid, of course), the vitamins, minerals, and antioxidants, the glycemic index, and the anti-inflammatory compounds present in the food. The lower the IF rating, the more inflammatory the food. An egg yolk has an IF rating of -173, more inflammatory than french fries (-51), white flour (-142), and corn oil (-54).

I’m trying to figure out why she hates egg yolks so much. It could be the PUFAs, since she’s definitely aware of their inflammatory potential (high-PUFA linoleic sunflower oil runs -82 while high-MUFA sunflower oil runs 108). It could be the cholesterol; from a blog post detailing her diet plan, she seems to fear animal fat (“look for well-trimmed cuts” of red meat). She’s also not so crazy about grains (“grains aren’t needed”) and prefers that people focus on protein and vegetables. She even says two eggs a day are fine, highly inflammatory yolks included. I’m not really sure what to make of it. It all ends up sounding like your typical low-fat, low-carb, high-protein recipe for metabolic disaster.

Anyway, you were worried about eggs. After all, she had to arrive at that -173 because of something, right?

Battery-fed eggs definitely aren’t as healthy as pasture-fed eggs, with one study even showing that hens fed high-omega-6 diets (corn and soy) produced eggs that led to increased levels of oxidized LDL in people who ate them. And pasture-fed eggs contain more vitamin E, more omega-3s, and more vitamin A, among other nutrients. Reinagel almost certainly used standard eggs to render her decisions.

Bottom line: eggs are healthy. They just are. For all the studies Reinagel has apparently poured over to support her classification of egg yolks as extremely inflammatory, eggs have never been shown to be unhealthy. They are the best source of choline (save for perhaps brain), an essential nutrient that protects us from fatty liver (or is having a fatty liver anti-inflammatory?) and helps build robust baby brains. They are full of vitamin A and vitamin E and iodine and selenium. They contain highly available protein. They’re strongly associated with beneficial metabolic effects when compared to egg substitutes (which, sure enough, gets a certified anti-inflammatory IF rating of 13). That’s what you should be thinking about, not some arcane rating system that apparently fails to take all relevant criteria into account.

Enjoy your eggs.

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

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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