Dear Mark: Unraveling a Stress Ball, Fiber for Plant-Hating Tot, Offal with Grains, and Exercising with a Cold

PatésFor today’s Dear Mark, we’ve got a four-parter. First up is one from a woman in her mid-30s trying to recover from a three-year bout of chronic stress — and all the metabolic fallout that entails. Are there any supplements to help with her situation? Second, what do you feed a picky kid who hates vegetables, hates fruit with peels, and needs more prebiotic fiber? I give a quick list of ideas for getting things moving again. Third, are traditional foods like haggis and liver pâté worth eating if they contain non-Primal ingredients you’d usually avoid? Are the nutrients found in offal really that important? And finally, I help a reader figure out whether she should be exercising while sick.

Let’s go:

Dear Mark,

I understand first-hand about the nasty effects of chronic, long-term stress. For three years, I had a stressful job I absolutely hated, and it negatively affected my sleep, my weight, my alcohol consumption, everything. I was a constant ball of anxiety who was gaining probably a pound a month, almost all around my waistline.

I left that job about five months ago and have moved on to something better. My weight has stabilized (heavy, but stable), I sleep better, and I’ve basically quit drinking. I also gained some muscle mass in all that extra weight, and now I can do 5×5 chest press with 60# dumbbells (I’m a 5’5″ female in my mid-30s.)

I have a couple questions, though, that I haven’t been able to find a solid answer to anywhere on the internet, and I’m hoping you can help.

Approximately how long will it take to undo the internal effects of all that stress? In other words, how long before the metabolic damage from the constant cortisol/adrenaline bath is reversed, and my system recalibrates itself?

Are there any supplements I can take, or activities I can practice, to help encourage the healing process?

Thank you,


The good news is that recovery from chronic stress can happen fast. You just have to break the cycle.

The bad news is that you have to break the cycle. You have to break out of the dreaded “stress loop,” where you stress out about something going on in your life, stress out about how bad you’re feeling because of the stress, and stress out some more about what all that stress is doing to your physical health. From your email, it seems you’ve progressed to the “stressing about stress” stage.

A large amount of stress is caused by how we approach and think about stress, especially among the health-conscious. You’ve left the job and thus removed the primary stressor, but the way you handle stress and compound its effects internally probably remain. So, first, be sure to read the post I did awhile back on changing your relationship to stress. As you’ll see, if we can perceive stress as a “good thing” that helps us meet a challenge head on, our physiological response to it changes for the better.

Supplements? Certainly.

Supplements help us handle unprecedented environmental situations our naked physiologies aren’t equipped to handle. Vitamin and mineral supplements help us deal with the low nutrient food and depleted soils our ancestors never did. Antioxidant supplements help us deal with oxidative damage wrought by industrial pollutants, food-borne toxins, and the demands modern life places upon us. The amount of chronic stress we deal with today is also unprecedented and evolutionarily novel, and stress-reducing and mitigating supplements can help deal with it.

In fact, to battle my own ongoing struggles with chronic stress, one of the first supplements I put together was Primal Calm, a blend of adaptogens and anti-anxiety nutrients designed to mitigate some of the effects of stress and improve your ability to roll with the punches. It quells stress in the short term while teaching your body to be more resilient.. Primal Calm has:

  • Phosphatidylserine: If there is one supplement I’d recommend for its immediate stress mitigating effects, this would be it. The body doesn’t make much of it (and we don’t get much from our diets), but stress depletes what little we have. Since we get so much stress these days and it’s vital to the healthy functioning of nerve cell membranes, you could probably use some. PS works on both mental and physical stress, improving mood and blunting cortisol after physical exercise.
  • L-Theanine: Found most abundantly in green tea (especially matcha), L-theanine reduces anxiety and attenuates the rise in blood pressure associated with stress. It also increases GABA levels (GABA is the same “chill out” neurotransmitter targeted by Xanax and liquor) and increases brain wave activity in the alpha frequency, improving relaxation without inducing drowsiness.
  • Magnolia bark: This is one of my favorites. Magnolia bark also enhances the activity of GABA receptors in the brain and reduces stress hormones. In post-menopausal women, magnolia bark reduces anxiety and stress levels, and it’s even helped people lower body weight by reducing “stress eating.”
  • Rhodiola rosea: Rhodiola rosea is an adaptogen, meaning it helps normalize your stress response. It essentially improves your ability to handle stress. If you’re lagging, it’ll bring things up. If you’re freaking out, it’ll bring you closer to baseline.

You can also grab these supplements individually, of course, along with any of the others mentioned in my previous series on stress-reducing teas. Ashwagandha, for example, is a powerful adaptogen with the ability to normalize stress hormones in adults suffering from chronic stress after just 60 days. But give Primal Calm a look. I think you’ll find it really effective.


My 3 year old son frowns at all vegetables (no fibers there). He also dislikes eatable peel on fruit and veggies (no fibers there either!). And for the next two years we live in China so forget whole wheat bread or pasta. Looking at what I manage to get into him he basically doesn’t eat any fibers… which is also becoming clear when he goes to the bathroom.

But he loves rice. So I’m thinking brown rice. High in fibers, but also high in anti-nutrients. So, would you say that the benefits of the fibers in brown rice outweigh the negatives of the phytates?

Many thanks,

Christine (Swedish reader, now living in Guangzhou)

You’re right to think about this. A healthy, diverse population of gut bacteria is important in childhood, arguably moreso than in adulthood because the immune system is still developing, and gut bacteria need fiber (and other nutrients that act like fiber) to eat, go forth, and prosper.

Okay. So I’m just going to rattle off a few options for you to consider. More than a few, actually. And then you can take all the suggestions and see what your kid will eat.

Brown rice is relatively (but not astronomically) high in fiber, and there’s evidence that a mere half cup of brown rice per day can improve the gut biome in adults (a toddler would need about a quarter of that), but there’s another good rice option to consider: parboiled rice. Parboiled rice is partially cooked, then allowed to cool, then packaged for sale. This increases the resistant starch content (PDF). As you may have already learned from previous posts on the subject, resistant starch isn’t a fiber but acts like one. It’s good food for your gut bacteria, and toddler gut bacteria can degrade it.

Resistant starch flours can help. Raw unmodified potato starch, banana flour, plantain flour, and/or mung bean starch (should be readily available in China) are all easy ways to get some prebiotics into your kid’s diet.

Does he like potatoes? Cooked and cooled potatoes contain lots of resistant starch. I bet he loves French fries (what kid doesn’t?). Cutting up cooked and cooled potatoes into strips and lightly sautéing them produces delicious fries with extra resistant starch. Sweet potatoes are good here, too.

Dates are an option. High in fiber and delicious and kids seem to love them. Yes, they’re also loaded with sugar, but that’s offset by the minerals, vitamins, and phytonutrients which make them a whole food with different physiological effects than an equivalent amount of pure sugar. Plus, an active toddler doesn’t need to worry about the carbs in fruit. Another benefit: the texture of the skin coupled with the fleshy tenderness of the fruit makes them dead ringers for severed zombie toes. Some kids dig eating zombie toes, so consider that angle if he initially balks at a proffered date.

Will he eat nuts? They’re great sources of prebiotic fiber. Almonds and pistachios in particular can really help the gut bacteria flourish.

There are tons of examples of edible, fiber-rich plants that are neither obviously vegetable nor come with “peels”: mushrooms, berries, winter squash (butternut, acorn, kabocha), leeks/onions/garlic, and jicama.

Jerusalem artichokes/sunchokes? Call them fartichokes and he might succumb.

Fruit flesh contains fiber, too — it’s not exclusively in the peels — so any peeled fruit is certainly better than none.

Smoothies can make anything work if he absolutely refuses to eat any of this stuff. Just get a good blender. Something like a Vitamix or a Blendtec, the kind that can make smoothies out of smartphones. I imagine your son is weird about textures in foods (many kids are), and a good strong capable blender is necessary for rendering unrecognizably smooth everything that enters its confines. Include some kefir or yogurt, which should also improve the bowel movements.

Good luck! I imagine our readers will have a ton of recommendations for you in the comment section (hint, hint).

Hi Mark,

I’ve recently been trying to incorporate more organ meats into my diet, with only limited success. I cannot abide most organ meats on their own (even the much loved combination of liver and bacon I find unpalatable, alas) and haven’t had any success hiding them amongst my meals.

Fortunately, I have found some types of offal I enjoy; traditional recipes such as haggis, black pudding, faggots and liver pâté. Unfortunately, most of these are made with added and non-primal ingredients, such as oatmeal in haggis and black pudding, or (sometimes) breadcrumbs in faggots.

What is your take on these sorts of foods? Is it worth eating them for the benefit of the organ meats? Or is it better to stay away from the ones with added ingredients?

Many thanks,

Alessa, UK

First choice: Stay away from the ones with added, non-Primal ingredients and lovingly embrace the ones without those ingredients. If better ingredients are available, I’ll always choose those.

Second choice if the first isn’t available: Eat them anyway. It’s worth eating them for the organ benefits, even if they have a few breadcrumbs (unless you’re sensitive/allergic to gluten) or some oatmeal (ditto).

Breadcrumbs don’t worry  me too much. As offal is a supplemental food rather than a staple, you wouldn’t be eating something like a faggot (the traditional UK food containing heart, liver, pork belly, herbs, and sometimes breadcrumbs) often enough that the breadcrumbs would pose serious issues. That goes out the door, of course, if you’re celiac or gluten sensitive. But most other people with generally healthy guts can probably handle a few breadcrumbs every other week if it means they’re also getting liver and heart.

You could also do a whole lot worse than the oats in haggis. Oats aren’t the worst grain. While the oat protein avenin appears to have some of the same problems as gluten in certain sensitive individuals, it doesn’t appear as if the problem is widespread or as serious. For example, kids with celiac disease produced oat avenin antibodies at a higher rate than kids without celiac, but neither group was on a gluten-free diet. When you put celiacs on a gluten-free diet, they don’t appear to show higher levels of avenin antibodies. It’s a familiar story: once you remove gluten or any other foods or behaviors that exacerbate leaky gut, other proteins become less problematic. The leaky gut is the main issue, and gluten just happens to be good at making guts leaky in almost everyone.

Liver pâté is probably your best bet. It’s usually made with butter instead of vegetable oil, it rarely contains any grains (I don’t see how it would improve the taste or texture), and since it’s to be eaten infrequently, one can more easily justify spending the money to obtain grass-fed or pastured liver pâté.

And finally, fork over the money for the best, freshest offal you can find because offal, particularly liver, breaks down quickly after slaughter. If you can nab a flash frozen lamb, beef, or chicken liver from the farmer who raised its former owner, there’s a good chance it’ll be sweet and smooth, rather than bitter and grainy. That’s the liver glycogen talking. Get a really good, sweet one and you can eat it sliced raw, sashimi-style.

Quick question, Mark: I have been under the weather this week – just slightly, but still so. I have been working out regardless, as I just needed the energy boost. However, I feel like perhaps it has left me needing more rest than my schedule allows. What is your advice on working out/exercising while nursing a cold?

I am 39 and have been following the Primal Blueprint lifestyle for about a year and a half.



In this case, the conventional view is righter than not: don’t exercise if your symptoms are “below the neck.” That means fever, chills, fatigue, sensitive skin that’s painful to the touch, diarrhea, vomiting, aches — any symptom like that means exercise should be avoided.

If your symptoms are “above the neck” — stuffy nose, headache, sore or scratchy throat — feel free to exercise. Just keep it lighter than you would otherwise and avoid exercise altogether if the symptoms are really intense, even if they’re “just” above the neck. You don’t want to be a stuff-nosed mouth breather with a ball of pounding pain for a head in the gym. That isn’t good for anyone.

If you’re unsure of where your symptoms fall, err on the side of caution and skip the tough workout. Instead, go for a walk. Do some stretching or mobility exercises. Try VitaMoves. Grab a yoga video off YouTube and try it out. Stuff like that is safe and helpful for recovery.

That’s it for today, folks. If you have anything to add that might be of service, add your comments below!

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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