Dear Mark: Gender and Retirement Mortality, Muscle-Sparing Keto, Freezing Keto Recipes, Net Carbs, and Carb Timing

Dear_Mark_Inline_PhotoFor today’s edition of Dear Mark, I’m answering 5 questions from readers. First, are there differential mortality effects of mortality on men and women? What role do social networks play? Second, is ketosis muscle-sparing? Yes, and here’s why. Third, which of the recipes in Keto Reset can be made ahead of time and frozen? We’ve got some busy parents here, after all. For the fourth question, I clarify my stance on net carbs and whether or not to count vegetables. And last, I explain how is is not necessarily ought.

Let’s go:

Sheila asked:

I noticed that the retirement paragraph was about men. I’m betting that women do better in retirement than men. Perhaps because women often have a better social network??

Great question. Turns out that you’re right—women suffer no hits to mortality with early retirement, whereas men do.

In one study of blue collar workers, each additional year of early retirement increased the risk of early death by 2.4 points in men. Women were unaffected.

You may also be correct about the effects of social networks in retirement. One study tracked a group of retirees with two social group memberships for 6 years. Those who retained both group memberships had a 2% chance of dying. Those who retained one group membership had a 5% chance of dying. Those who lost both group memberships had a 12% chance of dying.

I don’t have any research to cite, but from my extensive dealings with that segment of the population, I’d wager a guess that women are better at maintaining social networks. Just a hunch.

Pcskier followed up from last week:

So there is less risk of accessing lean tissue for energy when in a ketogenic state, since the body is ‘better’ at accessing fat stores and that becomes preferential to accessing muscle stores….?

Precisely. Ketosis evolved as a way to counter lean mass degradation during lean times. Lean mass—muscle, bone, connective tissue, organ—is essential for physiological function, resource acquisition, and general robustness. If the first thing your body starts to do after a half day without food is break down your muscles to convert into glucose, you won’t last very long and you won’t be very good at acquiring food.

Ketosis provides an alternative fuel to glucose. You’ll still need and make glucose, mainly for brain function, but the amount required is much lower than normal. A lower glucose demand means you can get by without eating so much and your body won’t be compelled to break down lean tissue to make it.

Meghan Shaw asked:

Hi Mark, First time caller, long time listener. Just finished reading Keto Reset. As a mom with two young kids I’m going to need to prepare a lot of stuff for the first 21 days in advance. Do you know how well the recipes in the book do if frozen after they are prepared?

Most of the main courses are very amenable to freezing. Many of the snacks and sauces and dressings, if not freezable, can be made ahead of time and stored for days to weeks.

The breakfasts and salads won’t freeze very well, but I don’t think most people expect foods from those categories to freeze well.

We’ll be offering a post in the coming weeks on making recipes freezer-friendly, so be on the lookout for that.

Finally, just curious as to how young? Kids as young as 2 or 3 can “help” around the house. You won’t want them wielding knives or flipping omelets, and they’ll probably make a bigger mess than you would otherwise, and it’s very likely that they’ll slow you down, but at least it keeps them occupied and participating, rather than screaming at you from another room to read the same book for the twentieth time. Get your kids involved in kitchen work as soon as possible.

April Lachlan asks:

The book mentions not counting some carbs such as those in leafy vegetables – do you have a list of items not to count – or is it just lettuce and kale? The book also advises to count all carbs and not calculate net carbs – but other info on primal blueprint mentions net carbs. I’m just looking for a bit of clarity on both of these points please.

Here’s how I see it.

Above-ground vegetables: ignore. They don’t count toward carb counts. You’re not carb loading with broccoli, nor will it knock you out of ketosis.

These include but aren’t limited to:

  • Lettuce
  • Spinach
  • Kale
  • Chard
  • Brussels sprouts
  • Broccoli
  • Broccoli leaves
  • Beet greens
  • Tomatoes
  • Cucumbers
  • Zucchini and other summer squash
  • Olives
  • Leeks
  • Green beans
  • Mushrooms
  • Peppers
  • Scallions
  • Cauliflower
  • Cabbage

For other carb-containing foods, like fruits, starchy vegetables, winter squash, count the total carbs rather than net. Fiber’s great. Fiber doesn’t become glucose. This is all true. Still: count total carbs.

Do I think net carbs is a bogus concept? No. My aim is just to simplify things as much as possible. Having to count non-starchy vegetables and then also having to subtracting fiber from carbs every time you eat some butternut squash are unnecessary complications.

So I’m a liitle confused…, should we eat carbs within 2 hours after training or When Hunger Ensues Naturally (WHEN)?

If you’re trying to use dietary carbs to refill muscle glycogen, and you want to do so as efficiently as possible, eating them within 2 hours after training maximizes glycogen synthesis.

I’m not saying you should do it one way or the other. I was just explaining why some people might find it advantageous to eat carbs shortly after hard workouts. Physiologically, your body’s just better at turning those carbs into muscle glycogen in that time frame—and that means they don’t impact your ketogenic state.

Glycogen debt, once accrued, remains. You can pay it back at any time. There are just certain times and contexts where the payment goes through more quickly.

Thanks for reading, everyone. Take care, be well, and leave a comment or question down below!

TAGS:  Aging, dear mark, Keto

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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51 thoughts on “Dear Mark: Gender and Retirement Mortality, Muscle-Sparing Keto, Freezing Keto Recipes, Net Carbs, and Carb Timing”

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  1. Regarding mortality following early retirement, I doubt that social networks have much to do with it. It might be more about an ingrained belief system. Many women who work also have a home to tend to and children to raise. They see their job as just another facet of an already full life and aren’t that sorry to let it go. With men, however, what they do is often who they are. It becomes their identity. Unless they have hobbies and other outside interests that are equally important to them, retirement can leave them feeling rudderless and lacking in purpose.

    1. I agree. Men tend to attach their identity to work/earning money. Losing that is a pretty big blow to your mental health.

      1. Which is why retirement shouldn’t be a contributing factor toward my demise. I work to live. I do not live to work. I can’t wait to retire, I have so much to do! And I’m only 37.

  2. Mark,

    I have been doing the 21 day plan for 15 days now and feel great. The weight has come off and my hip pain has decreased. Still concerned that somehow I am clogging up my arteries. I don’t want to be a skinny heart attack victim. Can you give some insight?

      1. Heart disease is a very complex situation. There is no correct answer. It’s part inflammation, part blood lipids, part genetic, part diet, part exercise – and even that may still not matter. Some people are just going to die early and some live very long. Turns out I probably have a genetic predisposition to building up plaque in my “window maker” (LAD artery). I have mild calcification there, and only there. The rest of my heart has zero calcification. My brother has a heart attack three years ago. Total anomaly as his lipids are great and the rest of his heart is clean. But he was withing 15 minute of dying from a complete blockage of his main left artery.

        Turns out I’m a hyper responder to saturated fat (jacks both my HDL and LDL way up) But I also seem to be genetically set up for really great lipid ratios, really low inflammation markers, patter A LDL (big and fluffy) and super high HDL ( currently 139).

        So I’m taking supplements to slow the calcification (aged garlic) and going easy on saturated fat – and keeping an eye on my weak link , “the widow maker”.

        Don’t believe the bacon and butter crowd. They are making the same mistakes as the fat fearing crowd. Everyone is different and heart disease is very complex. And, sadly, it may not make any difference anyway.

  3. I was training our five-year-old to use the santoku knife to chop carrots (with close supervision until age 7!) last Wednesday. You are not kidding about that slowing one down.

  4. Hi 🙂 I’m on day 14 of the reset and feel fantastic. My question is how do I determine my goal weight?

    1. Don’t aim for “weight” goals, aim for “appearance” goals… 😉
      The scale is the mirror.

      1. I second the mirror and raise the belt. Dropping a belt loop is the first sign for me.

        1. I see your belt and raise you a “how do you *feel*”. =] All of these are so much more helpful to maintaining healthy decisions.

          “If you don’t feel good about the progress you are making, at least you can feel good about feeling good.”

  5. Wow, last Monday my “Dear Mark” question was answered, and today’s column refers to a followup comment I made last week. This is what I call great service! Thanks Mark/worker bees!

  6. Hi Mark, I’ve been pondering a question in my mind for a while, and the comment on muscle glycogen above made me think of it again so I thought I’d comment here.

    You know that burning feeling you get in your muscles as you use them during a workout – in my case hand weights – does that feeling indicate that the glycogen stored within the muscle is now used up?
    I notice after the workout, my muscles in arms, legs feel sluggish and heavy for a bit, until they recover. Can I take this as meaning that glycogen is used up and ready for replenishment?

    Thanks for all you do Mark, I found your website in 2014, and it’s been a game changer for me.

  7. I must say that getting into the “Keto Zone” has made a huge difference! But, between that and intermittent fasting my calorie intake is down to about 1200-1400 a day (6’1″, 190 lbs). I feel great and don’t seem to have lost any strength at the gym, but do I need to be concerned by my base metabolism rate?

    1. WOW! For a 190 lb guy who I presume lifts weights…I can’t imagine calories that low. At your height/weight you obviously are fairly lean, so it’s not about burning a ton of excess fat stores. If you feel good and it’s not impacting your performance, then what can I say. It just seems to extreme. That’s below starvation level calories, especially someone your size. Your BMR calculates out to 1800 calories a day…that’s just to run your body with zero activity. If lots of fat to burn, maybe this kind of deficit would be productive for awhile…but at your body comp and activity level, I don’t understand how this can be working. Are you losing 2 lbs a week (You are probably close to 1000 cal a day deficit!)

      1. Yes, I am still losing weight, I have lost almost 70 pounds over the last year and a half or so. I plan to level off at around 185 or so. I lost about 8 pounds in October. I don’t eat anything from 8 pm to about noon the next day, then eat 1200-1400 calories between noon and 8 pm. I could try to bump that up a bit in calories, but I feel good. I will definitely try to add some in when I switch to maintenance. I should also mention that I am 51 years old, so it might be that my BMR is a bit lower now. I lift two days a week, but not heavy, I do HIIT two days a week, then walk a lot the rest of the time. So far, this is working, but I am wondering whether I will need to change up at some point.

        1. OK, losing 70 lbs helps explain things…you had plenty of energy stored on your body to access–congratulations! At your start weight your BMR was more like 2100 cal/day. Add in activities, and you had a huge deficit. Turning a year older didn’t make much difference, but losing 70 lbs did, dropping your BMR as much as 400 cal/day, it is now more like 1,760 cal/day. Then add in any movement, your workouts, HIIT, etc and you are still running quite a deficit, but not as wide as before the weight came off.

          Obviously let your body be your guide, but your maintenance calories will ultimately need to be closer to the 2,000 range depending on activity levels–this is according to the math, of course. You’ll know if you need more however, and when. You certainly sound like a prime example of what Mark calls a “Fat-burning beast” though. Awesome job!

  8. Great post, thanks Mark. Any chance you could do a post tackling the issue of dry lips while on keto? Seems it is a oft experienced issue (quick Google search) but with no discernable cause or lifestyle cure – other than applying a thick coating of your favourite grease!

    Thanks for all your work.

    1. Staying hydrated is the key. In keto we lose the habit of snacking. For me that also carried over to drinking water so remember to drink more water.

      1. Thanks Jack. I do drink loads and add a sprinkle of salt. I’ll up it (water not salt!)

        1. You might consider opting for plain water, no salt. Salting the drinking water is both drying and unnecessary since you probably already get plenty of it in your food.

          1. I’ll give that a go too. Drank loads today. Lips still really dry and sore!

          2. Actually, one of the best tips I ever ran into was to use MORE salt when on a keto diet. It helped me to feel better while making the adjustment. Real sea salt contains more minerals than just sodium chloride, so I would go with sea salt.

  9. I love that the Primal approach to keto is so inclusive of vegetables. I think this is such an important point as so many people have the misconception that keto is all meat, butter and cheese. (I actually did an Instagram post about this very subject yesterday!) Thank you for always providing us with such helpful information!

  10. Great questions and answers and especially appreciated the clarification about the veggies. With my first experiments in keto I counted every single carb and made myself crazy. Eating was too much work. But I’ve noticed lately that I have to be careful because I can fill up really quickly on veggies. So I try to get my protein/fat in first. I make a big green drink (just leafy greens, lemon and ginger…blended, not juiced) every morning which helps me get enough veggies in.

  11. In the UK, we don’t count fibre as a “carb”, Total carb content and fibre are totally seperate things on nutritional labels, so there is no subtracting needed here.I never really understood why Americans lump the two together? (If anyone has an explanation I’d love to know!). I will just continue to count what I see as “actual carb” content in the starchy vegetables I eat, because as you said fibre doesn’t turn into glucose.

    1. Hello Reams! Fiber is actually made of chains of sugars just like starch, but humans lack the enzymes necessary to break down those chains (whereas we of course have the enzymes that break down starch).So fiber and starch are alike, but there’s one that we can’t break and use for fuel unlike the other.

  12. Hi
    Great article Mark – and an important issue re retirement. I’m a life coach and definitely see the effects on retirement more in men than in women, though the difference I see seems dependent on two factors: 1. How strongly they identified with their career/job and 2. whether they have planned for their retirement. Those who have always identified themselves as their job (eg “I am an accountant”, ” I am a…”) feel the loss of this identity as a loss of status which affects their confidence and self-esteem, which knocks on to their wellbeing.

    Those who haven’t planned for retirement find themselves missing the sense of purpose that a job gives and the social network of work. They end up bored and feeling purposeless, which again affects their confidence and wellbeing.

    Those who plan their retirement to be busy and maintain social networks and develop a new purpose really thrive!

    1. Yes. Because it’s more about your metabolic needs. 100g carbs per day for a petite woman may be normal maintenance level, but a huge muscular man may go into ketosis on that. Especially with heavy activity. But ketosis is not really the goal anyway, it’s feeling good and not being a slave to carbs for energy. You don’t necessarily have to be in ketosis to achieve that. And it’s common to drift in an out throughout the day as well.

  13. Mark, i am 68 years old and already very skinny, at 125, i am just looking for ultimate health, oh did i mention, i have hashimotos, allergies, asthma, copd, two tumors in right side of lung and an aneurysm on my ascending aorta. I am thinking paleo is the way to go can you please advise

    1. You might want to try Paleo first, then move to AP Paleo (autoimmune protocol). Two great resources are Izabella Wentz and Sarah Ballantyne (aka The Paleo Mom).

      1. i have read Izabella’s book Hashimotos Protocol,and am currently eating no Alcohol. caffeine, dairy, gluten, soy or sugar. 120 days so far but i still don’t seem to be getting any better. After watching the “Perfect Human Diet” last night i realize i need to eliminate all grains meaning for me no bread at all and more meat to be 100%paleo

        1. I haven’t seen any evidence that depressed thyroid production due to Hashimotos is cured by diet. I actually haven’t seen any evidence that you can cure low hypothyroidism at all. You take thyroid medication to solve it. I believe the folks telling people that are selling a fantasy. They mean well, but it’s frustrating to see so many people blaming themselves for something that is not their fault and not in their control.

          It’s a bothersome trend I see in the paleo/primal community. That somehow if we just ate like our ancestors all these problems will disappear. In many cases, it’s just not true.

          1. thanks Clay, great advise i am on Nature Thyroid

          2. Great. Low thyroid production is a serious health issue and readily solved with hormone replacement. I’m classified as having subclinical hypothyroidism. Meaning my TSH levels are elevated, but my T3 and T4 levels are adequate and I’m not symptomatic. So we test my levels once a year to see if I’m slipping or holding steady. My sister had undiagnosed hypothyroidism for decades. When she got on thyroid medication her hair grew back, her dark circles under her eyes disappeared, she slimmed down and her mood is 100% improved. She looks at least ten years younger now. No shame in taking thyroid medication when your body can’t make enough. No different than a type 1 diabetic taking insulin or a far sighted person wearing glasses.

  14. Hey Mark, What would be considered an appropriate calorie deficit to loose weight? Or should I concentrate on grams of micronutrients instead? I am already keto adapted but seem to be stalling on the lost inches and weightloss in general.

  15. Is there a way to calculate the amount of carbs you can tolerate before knocking yourself out of ketosis, during the 2-hour, post workout glycogen replenishment period?

  16. If I can’t find high quality grass-fed meat in my country nor MCT oil, but I’m able to find a lot of fresh wild caught fish and sea food. Should I eat fish everyday and avoid beef and poultry that is grain-fed?

      1. Perú, Lima.
        Food here is not well classified or labeled so I can’t even know from where my beef is coming from

  17. Dear Mark, I just finished the book and have one question that I hope is not silly. The recipe-section offers macro-information (carbs, protein, fat), but is that for the total recipe or per serving? If the recipe says “4 servings”, should i divide the macro-numers by 4?
    Best wishes from Europe! Eveline

    1. Hi Eveline, I believe it must be per serving. Just looking at the recipes and calorie/macro counts the numbers wouldn’t match up if it were for the whole recipe. Good luck!

      1. Thanks Katie! I should have noticed that… my only excuse is not being used to the American measures…

  18. Definite thumbs-up on having the kids “help” with the cooking. My two year old loves to “help” Mama cook. She also insists on taste-testing all the raw veggies before they go into the pot, which I figure is good for her too.

  19. Mark, I appreciate your response to April’s question about how to count carbs on a ketogenic diet. I’ve been reading your new book in preparation for starting keto, and I’m finding it very helpful. FWIW, I don’t think the transition will be all that big of a deal, as I’ve been pretty strict paleo for 7 years. The biggest challenge will be tracking my carb intake, as I’ve never really tallied that. I have two questions about counting carbs. One is about what appears to be a divergence between your response to April, and some mentions in your book, to just ignore the carbs in above-ground vegetables versus the carb counts for the recipes in your book. A clear example is your carb count for the single-serving Bigass Salad – 24 g – when if I compute the carbs in the ingredient list based on your principle of not counting carbs in greens and above-ground veggies I see a max of maybe 12 or so carbs (maybe 1 carb for cheese, 6-7 for nuts, and 3.5 for seeds). My guess is you can only get to 24 if you are counting total carbs in the greens and veggies. Please clarify. Second, I assume the carb count is per serving, not per entire recipe, but so many of the recipe carb counts seem really high that I’m confused.