For today’s edition of Dear Mark, I’m answering five questions taken from this Twitter thread. First, does collagen offer anything special above and beyond glycine? Second, what’s the relationship between keto and gallstones? Third, do I recommend eating raw liver, and why or why not? Fourth, why does one reader’s scalp itch when eating stevia? And finally, what’s the best way to lose fat and gain muscle at the same time?
The ketogenic diet has exploded in popularity over the last few years. Hordes of people are using it to lose body fat, overcome metabolic diseases, improve their endurance performance, attain steady energy levels, make their brain work better, and control seizures. And increasing numbers of researchers and personal experimenters are even exploring the utility of ketogenic diets in preventing and/or treating cancer. After all, back in the early part of the 20th century, Warburg discovered an important characteristic of most cancer cells: they generate their energy by burning glucose. If a particular cancer loves glucose, what happens if you reduce its presence in your body and start burning fat and ketones instead?
It’s taken a while, but the research community is finally beginning to take a few swings at this and similar questions.
“Has Mark given up Primal?” I get this question all the time, and I’m not surprised. Over the past few years, I’ve really focused on exploring the utility, applications, and ins and outs of the ketogenic diet. Why?
I’m still Primal and have been for over a decade. That won’t ever change. And you can go Primal—drop industrial seed oils, added sugar, and grains—and be perfectly fine. Better than 95%. You’ll lose body fat, gain energy and performance, and reduce your risk of degenerative disease. It will always be the foundation of my eating—and living. But I see (and have experienced) keto as a boost, an enhancement, a Reset. A return. Today I’m answering some questions around this idea with a new video.
When I say “hack” or “biohack,” what does that call to mind for you? Taking 20 supplements per day, shining special lights into your ears, stem cell injections? Simpler things like wearing blue light blocking glasses or turning your shower to cold for 30 seconds?
The term has become ubiquitous in modern parlance, to the point where its meaning has become blurred. On the one hand, hacking can be about optimizing—taking your health and fitness to the next level once you have the basics dialed in, or adopting strategies aimed at living well over 100. On the other hand, a hack can also be a shortcut or trick designed to reap certain benefits without putting in the usual work. (Whether that’s a clever maneuver or a form of “cheating” depends on the context and whom you ask.)
For today’s edition of Dear Mark, I’m answering a few questions from recent comment boards. First, with all the scary tick-related news coming out lately, are there any non-toxic tick repellents that actually work? Are there essential oils that repel and/or kill ticks? Is there a safer way to use insecticides? Next, were the people in the Mediterranean keto study actually eating a kilo of fish on their fish days? And is the wine an important part of the Mediterranean diet? Is the wine therapeutic or just for pleasure?
Let’s find out:
As I’ve written before, although most people’s lipid numbers improve across the board, some people get interesting cholesterol responses to Primal ketogenic diets. LDL skyrockets, even LDL particle number. The jury’s out on whether or not they indicate negative health concerns or if keto dieters are a special breed that hasn’t received enough study. (There may be a few genetic profiles, such as APOE4 carriers, that react differently to certain dietary inputs.) Either way some people just want their cholesterol numbers to look good in a conventional way. These days, whenever I run into someone in the real world with these or similar concerns, I tell them to try “Mediterranean keto.”
What is that, anyway?
I love dairy. As a man of primarily Northern European descent, my ancestors have been consuming the stuff for thousands of years. It doesn’t give me any issues. You won’t find me chugging tall glasses of straight milk these days, but I’m a big believer in cream, cheese, yogurt, and kefir. Very nutrient-dense food if you can handle it. Lactase persistence? I practically have lactase insistence.
My favorable response to dairy makes keto especially easy. High-fat and fermented dairy is high in nutrients and low in digestible carbs (the bacteria consume most of the lactose). Cheese, cream, kefir, and yogurt all happen to be the most nutritious forms of dairy and the most keto-friendly. Many others getting into keto lean heavily on dairy. It just makes keto easier, especially if you’ve grown up eating dairy.
But globally my reaction to dairy is pretty rare, and that changes the keto landscape for most people.
A criticism often leveled against the keto diet is that it’s more expensive than a “regular” (read: SAD) diet. There’s some truth to that. It does cost more to buy meat than ramen and beans. I personally spend more on groceries now than I did before finding Primal. Not only did I shift to buying different types of food, I also came to care more about food quality. I started choosing more pasture-raised meat and eggs, and more pesticide-free and organic produce and dairy.
However, my grocery bills haven’t changed noticeably since going keto. If you’re already eating Primally, your daily foods don’t have to change that much if you decide to try keto. You’ll remove some (okay, most) of the fruits and root veggies, and sub in more above-ground veggies and probably some healthy fats. It’s not a substantial overhaul. However, if you’re coming from a standard high-carb, lots-of-cheap-packaged-foods diet straight into Primal+keto, it can be a shock to the wallet.
I don’t like being told what to do. That’s why I’m not a fan of hard and fast food rules, as I’ve written before. Don’t get me wrong, that doesn’t mean I believe all foods are created equal. There are foods that aren’t health-promoting in any context. (I’m looking at you, processed chemical nacho cheese-like sauce.) Nevertheless, I’m incredulous when people suggest that they’re not “allowed” to eat certain foods on a Primal or keto diet.
Sure, we Primal folks choose to center our diets around the foods in the Primal Blueprint Food Pyramid. And once you go keto, higher-carb foods—even nutrient-dense ones—are harder to fit into your daily macros if staying in ketosis is important to you. However, I’ve found that keto people are overly prone to policing one another’s food choices based on their notions of keto.
It’s easy to forget how weird we all are.
We spend our days reading this and other health blogs, communing with Primal and keto folks on social media, staying abreast of the nutrition literature, arguing about arcane metabolic minutiae on forums, counting your linoleic acid intake, and you forget that most people don’t know 2% of what you know about diet.
So, when you hear people criticize keto, don’t get exasperated (even if the criticisms are silly). Be ready to respond. And hey, not all criticisms are unfounded. In many cases, wrangling with them will only make you more honest and informed about your diet. Let’s look at some of the more astute keto critiques….