Posts Tagged ‘Chris Kresser’

By Chris Kesser (web)

Bone broth and your health

At this point, I hope you have a solid understanding of the components of bone broth. Now let’s get on to the health benefits!

Skin health
Skin is composed of two layers, the epidermis and the dermis. The epidermis, or upper layer, is composed of keratinocytes and is largely responsible for skin barrier function. Underneath is the dermis, a dense matrix of collagen, along with some GAGs, that provides structural and nutritive support (22). Keratin, collagen, and GAGs are abundant in bone broth, particularly if the skin from the animal is included in the cooking process.

In a 2014 randomized and controlled trial, collagen consumption significantly improved skin elasticity and tended to improve skin moisture content (23). Collagen scaffolds are widely used in medical applications to promote tissue regeneration and heal wounds (24). One study in mice found that supplementing the diet with gelatin was able to protect against UV-induced skin damage (25). GAGs offer additional skin benefits. The GAG hyaluronic acid has been shown to promote skin cell proliferation and increase the presence of retinoic acid, which improves the skin’s hydration (26), and dermatan sulfate has been shown to aid in cell turnover and wound repair (27).

Metabolic and cardiovascular health
Remember glycine, an amino acid that is particularly abundant in bone broth? Glycine plays a role in blood sugar regulation by controlling gluconeogenesis, the production of glucose in the liver (28), and has even been suggested to counteract some of the negative effects of dietary fructose consumption (29). Glycine has also been shown to reduce the size of heart attacks (30).

Furthermore, glycine balances out methionine intake. Muscle meats and eggs are high in methionine, an amino acid that raises homocysteine levels in the blood. High homocysteine is a significant risk factor for serious diseases like heart disease, stroke, mental illness, and fractures and increases our need for homocysteine-neutralizing nutrients like vitamins B6, B12, folate, and choline (31). Those eating lots of animal protein need adequate glycine to balance out the methionine from meat, and you’ll get that from bone broth. For more information, check out Denise Minger’s awesome presentation in which she discusses this very issue.

Muscle and performance
Glycine is also important for the synthesis of hemoglobin and myoglobin, which transport oxygen throughout the blood and muscle tissue, respectively (32). Glycine also increases creatine levels, which leads to an increase in anaerobic (high-intensity) exercise capacity, and stimulates the secretion of human growth hormone (HGH), which may enhance muscle repair (33, 34, 35). Recent evidence suggests that proline may play a role in regulating the mTOR cellular signaling pathway, which integrates signals from nutrients, growth factors, stress factors, and cellular energy status to affect cell function and growth. Proline, together with other amino acids, activates mTOR, resulting in enhanced muscle protein synthesis (36).

Adenosine triphosphate (ATP) is the chemical form of energy in the body that can be used to perform work. Phosphorus is required for the formation of this compound, and ATP cannot be biologically active unless bound to a magnesium ion. Phosphorus deficiency has been shown to reduce muscle performance (37, 38). Both phosphorus and magnesium are present in bone broth in modest amounts.

Bones and joints
It should be pretty obvious that the best way to get the nutrients necessary to build bone is from bone itself! Drinking bone broth provides all of the raw material for building healthy bones: calcium, phosphorus, amino acids, and more. A deficiency of the raw materials for building bone can result in a number of different conditions. For example, osteoporosis is associated with reduced levels of collagen and calcium in the bones (39, 40). Of course, you’ll also need the nutrients required to support the building process, like vitamins D, K2, and C. (To learn more about building healthy bones and where to get these nutrients on a Paleo diet, check out this article.)

As for joint health, lubrication by GAGs is the key to a full range of motion, whereby part of one bone can slide smoothly and painlessly over part of another. Sure, you could buy expensive supplements containing glucosamine and chondroitin sulfate to keep your joints healthy, but why, when these and a host of other beneficial nutrients can easily be obtained from bone broth? After all, GAGs are not the only component of broth that improves joint health. Collagen supplementation has been shown to reduce joint pain in athletes (41).

Gut health
A healthy colon contains a single tight layer of epithelial cells, a thick mucus layer, and a diverse collection of microbes. Microbial dysbiosis and a thinning of this mucus layer can quickly compromise the integrity of the epithelial barrier. Microbes and dietary proteins can then “leak” into the bloodstream and invoke an inflammatory response by the immune system. Lipopolysaccharide (LPS), a component of bacterial cell walls, stimulates a particularly robust immune response (42).

Bone broth is a staple of gut-healing diets, and rightfully so! Gelatin absorbs water and helps maintain the layer of mucus that keeps gut microbes away from the intestinal barrier. In a mouse model, gelatin supplementation reduced the severity of colitis by strengthening the mucus layer and altering gut microbiota composition (43). Gelatin and glycine have also been shown to reduce the inflammation caused by LPS (44, 45). Glycine has been shown to protect against gastric ulcers as well (46). Glutamine also helps maintain the integrity of the gut mucosa and intestinal barrier (47).

Bone broth has so many benefits to gut health that I had to make digestion its own section! Drinking broth with meals is an excellent way to aid digestion. Glycine stimulates the production of stomach acid, which is essential for the proper digestion of food (48). Low stomach acid (hypochlorhydria) is surprisingly common in developed countries and can lead to a number of health issues.

Glycine is also an important component of bile acid, which is released to aid in the digestion of fats in the small intestine (49). Bile acid is important for maintaining normal blood cholesterol levels. The presence of gelatin in the gut also draws fluid into the intestine, improving gut motility and supporting healthy bowel movements. Low blood levels of collagen have been associated with inflammatory bowel disease (50).

Detoxification, liver, and kidney health
Recently, there has been some concern regarding the lead toxicity of bone broth. However, the vitamins and minerals that are abundant in bone broth, and in Paleo diets in general, can protect against the harmful effects of toxins like lead. Glycine also stimulates production of glutathione, the body’s master antioxidant (51). In animal models, glycine has been shown to speed recovery from alcohol-induced fatty liver disease (52), protect liver cells against hypoxia (53), and improve survival after liver transplantation (54). In humans, glycine reduces oxidative stress in patients with metabolic syndrome (55).

Proline plays a role in apoptosis, the process by which the body breaks down old cells, clears up waste products, and recycles raw materials for use in healthy cells (56). Proline can scavenge free radicals, effectively acting as an antioxidant (57). Glutamine, on the other hand, acts as a nontoxic nitrogen transporter, carrying amine groups safely through the bloodstream to the kidney. In the kidney, the conversion of glutamine to glutamate regulates acid–base balance by producing ammonium (58).

Eye health
Yes, bone broth may improve eye health. The cornea consists of three primary layers: an outer epithelial layer, a middle layer, and an inner endothelial layer. Hyaluronic acid stimulates proliferation of the epithelial cells that line the cornea (59) and is commonly used during eye surgery to help replace lost fluids (60). The middle, or stromal, layer is largely made of collagen, keratan sulfates, and chondroitin sulfates. Keratan sulfates have been shown to be essential to the transparency of the cornea (61), while chondroitin sulfate has been shown to influence the development of neural pathways in the retina (62). The amino acid glycine has also been shown to delay the progression of cataracts in a rat model of diabetes (63).

Brain health
Numerous components of bone broth influence the nervous system. The healthy fats in bone broth, particularly if made with marrow bones, provide a source of fuel and raw material for the brain. After all, more than 60 percent of the human brain is composed of fat (64). Glycine has been shown to protect against neuronal death after ischemic stroke (65) and likely plays a pertinent role in the development of the brain in the womb and during the first few months after birth (66). Calcium is essential for nerve conduction. When a nerve cell is stimulated, the influx of calcium triggers neurotransmitter release, allowing the signal to be passed on to the next nerve cell. Calcium deficiency affects this transmission and can result in symptoms of depression, insomnia, and hyperactivity. Lastly, chondroitin sulfate plays an important role in regeneration and plasticity in the central nervous system (67), meaning it is essential for learning and memory.

Mood and sleep
Bone broth can also improve both mood and sleep. Glycine is an inhibitory neurotransmitter, meaning it can decrease anxiety, promote mental calmness, and help with sleep (68). One study found that three grams of glycine given to subjects before bedtime produced measurable improvements in sleep quality (69).

Unlike methionine, glycine does not compete with tryptophan for transport across the blood–brain barrier (70). Tryptophan is the precursor (raw material) for serotonin, a neurotransmitter that contributes to feelings of well-being. Serotonin, in turn, is a precursor to melatonin, a hormone that regulates sleep–wake cycles. This is why a diet that includes bone broth and fattier cuts of meat can help prevent the depression and insomnia that some people may experience when eating a diet high in methionine-rich lean meat and eggs.

Immune function
While ancient folk wisdom suggests that bone broth can cure the common cold, modern science has confirmed that the components of bone broth do indeed influence the immune system. For example, glycine receptors have been identified on the outer surface of several different types of immune cells (71, 72). The effect is a dampening of the immune response, resulting in reduced inflammatory signaling molecules and oxidative stress that may reduce damage to lungs and other tissues (73). The GAG heparin sulfate has been shown to influence B cell function, T cell function, and macrophage activity (74).

Where to source bone broth

To summarize, bone broth has an incredible number of potential health benefits and is rooted in a long history of human use. It makes an excellent addition to any diet and can be used in a multitude of dishes. Bone broth can be made at home or it can be bought pre-made.

Homemade bone broth is simple to make. Ask your local farmers if they have soup bones, or roast a whole pastured chicken and save the bones for making broth. Chicken feet, chicken necks, calves’ feet, and marrow bones are particularly valuable additions to broth. You can find a good basic recipe over at the Weston A. Price Foundation website.

Pre-made bone broth is also a good option. Be sure to:

  • Buy broth that is organic and made from pasture-raised animals or wild-caught fish (this minimizes the toxins and maximizes the nutrients you get from the bone broth).
  • Avoid cans and other containers that contain bisphenol A (BPA), a potent endocrine disruptor, or other BPA substitutes.
  • Check out my favorite brand of broth: Kettle and Fire uses bones of organic, pasture-raised animals along with organic vegetables, sea salt, and herbs, all slow-simmered for 24 hours.

However you choose to get your hands on this liquid gold, be sure to make bone broth a staple in your diet!


By Chris Kesser (web)

Bone broth: a nutrient gold mine

Bones contain an abundance of minerals as well as 17 different amino acids, many of which are found in broth as proteThe Bountiful Benefits of Bone Broth: a Comprehensive Guide Vol.1ins like collagen and gelatin. Though the exact nutritional content varies based on the bones used, cooking time, and cooking method, the following nutrients are consistently found in most bone broths.

With 28 different types, collagen makes up about 30 percent of the protein in your body (4) and is the main component of connective tissues like cartilage, ligaments, tendons, bone, and skin. It is also present in the blood vessels, cornea, and lens of the eye. The name collagen comes from the Greek “kólla,” meaning “glue, and the suffix “-gen,” which means “producing.” In fact, early glue was made from collagen more than 8,000 years ago, likely by boiling the skin and sinews of animals (5). In addition to providing structure, collagen also plays an important role in tissue development and regulation (6, 7).

When collagen is simmered, it forms gelatin. This hydrolysis of collagen is irreversible and results in the breakdown of long collagen protein fibrils into smaller protein peptides. However, its chemical composition is very similar to its parent molecule, collagen (8). Gelatin is what gives bone broth or stock its Jell-O-like consistency once it has cooled.

Glycosaminoglycans (GAGs) are complex carbohydrates that participate in many biological processes. They can attach to proteins in order to form proteoglycans, which are integral parts of connective tissue and synovial fluid, the lubricant that surrounds the joint (9). If the connective tissue, such as tendons, ligaments, and cartilage, is still attached, the bones in broth will provide our bodies with the whole spectrum of GAGs, including keratan sulfates, dermatan sulfates, chondroitin sulfates, and hyaluronic acid, which are the raw materials for skin, bone, and cartilage formation.

Glycine is an amino acid that makes up more than a third of collagen. It also acts as a neurotransmitter, binding to glycine receptors present throughout the nervous system and peripheral tissues. Signaling through this receptor is particularly important in mediating inhibitory neurotransmission in the brainstem and spinal cord (10, 11).

Proline is an amino acid that makes up about 17 percent of collagen. The addition of hydroxyl groups to proline significantly increases the stability of collagen and is essential to its structure. Though small amounts of proline can be manufactured in the body, evidence shows that adequate dietary proline is necessary to maintain an optimal level of proline in the body (12, 13). Proline is not typically thought of as a neurotransmitter, but it is able to weakly bind to glutamate receptors and glycine receptors (14).

Glutamine is yet another important amino acid found in bone broth and is the most abundant amino acid in the blood (15). It is one of the few amino acids that can directly cross the blood–brain barrier (16). Intestinal epithelial cells and activated immune cells eagerly consume glutamine for cellular energy (17, 18).

Bone marrow
Inside the center cavity of the bone is the bone marrow, consisting of two types, red and yellow. Both types contain collagen. Red bone marrow is the site of manufacturing for new immune cells and red blood cells, while yellow marrow consists of healthy fats (19, 20). It is thought that important nutritional and immune support factors might be extracted from marrow during cooking, but the bioavailability of these factors has not been studied.

Bone is also full of minerals, including calcium, copper, iron, magnesium, manganese, phosphorus, potassium, sodium, and zinc (21). An acidic medium is necessary to extract these minerals from food. When making broth, always add a splash of vinegar or other acid in order to extract the most minerals from the bone.

Vol.3 coming soon

By Chris Kesser (web)

Traditional cooking uses meat bones as a base for delicious stock because it is the secret to cooking great recipes. But it’s also incredibly nutritious and has scores of health benefits. Read on to learn more about bone broth and why you should make it a staple in your diet.

benefits of bone broth

The Weston A. Price Foundation and advocates of the Paleo and Primal lifestyles favor bone broth for its wide array of nutrients that are difficult to find in any other food source. Dr. Natasha Campbell-McBride has made bone and meat stock the foundation of the GAPS protocol because of its ability to heal and seal the gut lining and reduce overgrowth of harmful microbes. Chicken broth has also been suggested to reduce the migration of immune cells during illness. These are just some of the many reasons to love bone broth.

Bone broth is mentioned in dozens of articles on my blog, but I haven’t really provided a thorough analysis in a single, convenient place for my readers. So here it is: everything you need to know about bone broth! In this research-dense article, I will cover the role of broth in traditional cultures, the nutritive components of bone broth, the numerous health benefits, and the best ways to source it.

Bone broth in traditional cultures

A South American proverb says “good broth will resurrect the dead.” While this is certainly a stretch of the imagination, the ability of broth, and chicken broth in particular, to treat the common cold has long been touted as ancient folk wisdom. Scientists at the University of Nebraska sought to test this folklore in 2000 and found that in vitro (in a Petri dish), some components of chicken soup were able to inhibit the migration of innate immune cells called neutrophils, effectively acting as an anti-inflammatory that could, in theory, reduce symptoms of illness (1). Whether this effect occurs in vivo (in a living organism) is still unclear, but this preliminary data suggests that our ancestors may have been onto something. We’ll explore the bone broth–immune system connection more in a later section.

Evidence of the existence of soup can be found as far back as about 20,000 BC (2), and it’s well accepted that broth of some sort was, and remains, a staple in many traditional cultures. In Danish and German culture, large hens were specifically reserved for making soup, and the cooked meat was retained for other dishes or added back to the soup. In East Asian diets, dishes like miso sometimes contain meat stock. In Greece, beaten eggs mixed with lemon are commonly added to chicken broth as a traditional remedy for colds and digestive upset. Chicken soup in Hungary usually included organs like chicken liver and heart, while in Vietnam and the Philippines, beef bone marrow was used as the base for making soup. In India, chicken soup is popularly sold by roadside vendors in the winter and takes on many different forms. Chicken soup was a traditional dish of Jewish kitchens; it has even been called “Jewish penicillin” and is used to treat and prevent illness. In American tradition, chicken soup was prepared using old hens that were too tough to be roasted or cooked but still made excellent soup. Unfortunately, the only soup that most Americans eat today is canned, highly processed, and devoid of nutrients.

Traditional cultures wisely practiced nose-to-tail eating and consumed all parts of the animal, including the skin, cartilage, tendons, and other gelatinous cuts of meat. This provided a balanced intake of all the amino acids necessary to build and maintain those same structures in the human body. Some anthropologists have even suggested that in some regions of the world, early humans were scavengers rather than hunters, using tools to crack open the bones of carcasses left by lions and other large predators to expose the rich bone marrow (3). Unfortunately, many modern cultures have lost the practice of whole-animal eating, and the old-age tradition of having a pot of broth constantly simmering on the hearth has been lost in favor of modern convenience, microwaves, and highly processed canned soups. Bringing bone broth back into the modern diet offers a simple and delicious means of obtaining the nutrition from parts of the animal that traditional cultures prized.

Vol.2 coming soon

by Chris Kresser (web)

Have you been told you need more vitamin D? Healthcare practitioners are increasingly aware of the risks of low vitamin D levels, but many are not aware that high levels of vitamin D can have toxic effects. Read on to learn the risks of over-supplementation, what factors determine your optimal vitamin D level, and the many reasons to get sunlight exposure beyond just vitamin D.

Vitamin D bottle

Vitamin D is critical for health. Virtually every cell in the body has a vitamin D receptor, which, when bound to vitamin D, can influence the expression of more than 200 genes (1, 2). Vitamin D promotes calcium absorption in the intestine and maintains calcium and phosphate levels in the blood, protecting against osteoporosis, rickets, and bone fracture (3, 4). It also regulates immune function, cell growth, and neuromuscular function (5, 6).

With the many roles that vitamin D plays in the body, deficiency of this fat-soluble vitamin is a real cause for concern. Vitamin D deficiency has been found to increase the risk of heart attack, cancer, diabetes, asthma, and autoimmune disease (7, 8, 9, 10, 11, 12). Our modern indoor lifestyle limits our sun exposure, and we can only get a small amount of vitamin D from diet (13). According to the lower boundary of the U.S. lab range of 30 ng/mL, as many as 70 percent of Americans are considered deficient (14, 15).

It’s great that awareness about vitamin D deficiency is increasing, with more doctors than ever testing vitamin D levels. However, like many nutrients, vitamin D follows a U-shaped curve, meaning that both low levels and very high levels are associated with negative health outcomes (16). Unfortunately, few practitioners are aware of the dangers of vitamin D toxicity, and many just test serum vitamin D once and recommend a daily 5,000 or 10,000 IU supplement to their patients.

In this article, I’ll discuss the risks of over-supplementation, why you should get most of your vitamin D from sunlight, and the reasoning behind my current approach to vitamin D.

Risks of excess vitamin D supplementation

Vitamin D status is measured by 25(OH)D in blood. We’ll dive further into vitamin D metabolism later, but for now, just understand that this is the precursor to active vitamin D and is generally considered the most accurate single marker to assess vitamin D status. The U.S. laboratory reference range for adequate 25(OH)D is 30 to 74 ng/mL, while the Vitamin D Council suggests a higher range of 40 to 80 ng/mL, with a target of 50 ng/mL (17).

But a large body of evidence in the medical literature strongly suggests that optimal vitamin D levels might be lower than these figures. There is little to no evidence showing benefit to 25(OH)D levels above 50 ng/mL, and increasing evidence to suggest that levels of this magnitude may cause harm. Consequences of vitamin D toxicity include heart attack, stroke, kidney stones, headache, nausea, vomiting, diarrhea, anorexia, weight loss, and low bone density (18).

Furthermore, in most studies, taking vitamin D supplements does not decrease risk of death, cardiovascular disease, or other conditions. Based on an exhaustive review of over 1,000 studies in 2011, the Institute of Medicine recommends a much more conservative range of 20 to 50 ng/mL (19).

Some research on Israeli lifeguards suggests that, contrary to popular belief, vitamin D toxicity from sunlight alone (in the absence of supplementation) is possible (20). That said, it is  much more difficult to achieve toxic levels through sun exposure alone. Sunlight is the optimal source of vitamin D, and has numerous  benefits above and beyond improving vitamin D status.

Beyond vitamin D: The many benefits of sunlight

Vitamin D is really just the tip of the iceberg when it comes to the benefits of sunlight. A recent 20-year study following 29,518 subjects found that those individuals avoiding sun exposure were twice as likely to die from all causes (21). While this study did not assess vitamin D levels, findings from other epidemiological studies suggest that this cannot be accounted for by the increase in vitamin D production alone.

Indeed, humans make several important peptide and hormone “photoproducts” when our skin is exposed to the UVB wavelength of sunlight (22). These include:

  • β-Endorphin: a natural opiate that induces relaxation and increases pain tolerance (23, 24)
  • Calcitonin Gene-Related Peptide: a vasodilator that protects against hypertension, vascular inflammation, and oxidative stress (25)
  • Substance P: a neuropeptide that promotes blood flow and regulates the immune system in response to acute stressors (26)
  • Adrenocorticotropic Hormone: a polypeptide hormone that controls cortisol release by the adrenal glands, thus regulating the immune system and inflammation (27)
  • Melanocyte-Stimulating Hormone: a polypeptide hormone that reduces appetite, increases libido, and is also responsible for increased skin pigmentation (27)

Exposure to the UVA wavelength of sunlight has also been shown to have benefits, including increasing the release of nitric oxide from storage (28). Nitric oxide is a potent cellular signaling molecule that dilates the blood vessels and thus reduces blood pressure (29).

In addition to the production of photoproducts and release of nitric oxide, sunlight also entrains circadian rhythms. Exposure to bright light during the day activates neurons in the suprachiasmatic nucleus of the hypothalamus, which sends signals to the pineal gland that regulate melatonin production. Disruption of circadian rhythm has been associated with mood disorders, cognitive deficits, and metabolic syndrome (30, 31).

Vitamin D Optimal Levels

Optimal vitamin D range depends on many factors

So how much do you need? At the first annual IHH-UCSF Paleo Symposium in San Francisco this year, nutritional biochemist Dr. Chris Masterjohn summarized evidence suggesting that optimal vitamin D levels may vary from population to population, despite the fact that there is currently only one reference range used for all patients.

Ethnicity is one major consideration. For example, blacks have lower 25(OH)D than whites in the U.S., yet they typically have much higher bone mineral density. Furthermore, non-Caucasians have lower 25(OH)D levels than Caucasians, even at their ancestral latitudes (32). From these and other studies, it has been suggested that people with non-white ancestry may be adapted to a lower optimal 25(OH)D level than people with white ancestry.

Another factor that influences toxicity is nutritional status. The fat-soluble vitamins A, D, and K work synergistically, and adequate vitamin A and K may protect against toxic effects of excess vitamin D (33). Sufficient levels of potassium and magnesium have also been suggested to protect against vitamin D toxicity (34). Unfortunately, most people are deficient in these micronutrients in the developed world, making them more susceptible to vitamin D toxicity.

What about optimal vitamin D range from an evolutionary perspective? A study on traditionally living hunter–gatherer populations in East Africa found that the Masai and Hadzabe tribes had average 25(OH)D concentrations of 48 ng/mL and 44 ng/mL, respectively (35). These indigenous populations get a great deal of sun exposure but also have very high intakes of vitamins A and K, suggesting that these levels are probably towards the higher end of the optimal range for most people in the modern world.

Using parathyroid hormone levels to individualize vitamin D testing

As we saw in the last section, 25(OH)D lab ranges should vary by population, genetics, and nutritional status. In the absence of specific ranges, we need other biological markers that can help to clarify vitamin D status. To find these biological markers, we need to look at how vitamin D is metabolized.

When UVB contacts the skin epidermis, vitamin D is produced from 7-dehydrocholesterol. This vitamin D then travels in the blood to the liver, where it undergoes primary hydroxylation (the addition of a hydroxyl group, consisting of one oxygen and one hydrogen atom) on the 25th carbon atom. The result is 25(OH)D, which is the metabolite most widely used to assess nutritional vitamin D status. This compound circulates in the blood until it undergoes secondary hydroxylation on the first carbon atom in the kidney, resulting in 1,25(OH)2D, the active form of vitamin D (36).

You might be wondering: why don’t we test the active form? While certainly informative, the amount of active vitamin D is not directly reflective of nutritional vitamin D status because the secondary hydroxylation step is tightly regulated by parathyroid hormone (37). When the parathyroid glands sense a drop of blood calcium levels, they secrete parathyroid hormone (PTH). PTH stimulates the formation of active vitamin D, which increases calcium absorption in the small intestine and calcium release from bone in an attempt to restore normal blood calcium levels (38). High PTH levels can therefore lead to high 1,25(OH)2D, low bone mineral density, increased risk of fractures, and osteoporosis (39).

With a basic understanding of this pathway, we can use PTH, calcium, and active vitamin D3 as markers to give us a more complete picture of someone’s vitamin D status. In his presentation at IHH-UCSF, Dr. Masterjohn suggested that serum PTH levels above 30 pg/mL may be indicative of biological vitamin D deficiency when 25(OH)D levels are borderline low. Conversely, if 25(OH)D levels are borderline low or even slightly below the laboratory reference range (e.g., 25 to 30 ng/mL), but PTH is less than 30 pg/mL, it is unlikely that the patient is vitamin D deficient, and supplementation is not warranted.

Instead of focusing on the 25(OH)D level itself, what we really want to achieve is maximum suppression of PTH levels for optimal calcium homeostasis and bone health. Beyond this level, more vitamin D is not necessarily better.


Based on my assessment of the literature and my own clinical experience, I believe the functional range for 25(OH)D is around 35 to 60 ng/mL. However, I can’t stress enough that there is significant variation among populations. For those with non-white ancestry, the optimal range may be a bit lower. For those with autoimmune disease, the optimal range might be a bit higher (45 to 60 ng/mL) to maximize the immune-regulating benefits of vitamin D. Here are a few recommendations for optimizing your vitamin D level.

  1. Don’t supplement blindly.
    If your 25(OH)D level is:
  • less than 20 ng/mL: you likely need some combination of UV exposure, cod liver oil, and a vitamin D supplement
  • 20 to 35 ng/mL: get your PTH tested. If PTH is adequately suppressed (less than 30 pg/mL), supplementing is probably unnecessary.
  • 35 to 50 ng/mL: continue your current diet and lifestyle for maintaining adequate vitamin D
  • greater than 50 ng/mL: try reducing your vitamin D supplements, and make sure you are getting adequate amounts of the other fat-soluble vitamins to protect against toxicity
  1. Get retested!
    Check your levels after three to four months to see if you have achieved or maintained adequate levels of vitamin D. If not, adjust your diet, lifestyle, or supplements accordingly and check again in another three to four months.
  1. Get sunlight or UV exposure as your primary form of vitamin D.
    Reap the many benefits of sunlight beyond just subcutaneous production of vitamin D, and reduce your chance of achieving toxic levels. Spend about 15 to 30 minutes, or about half the time it takes your skin to turn pink, in direct sunlight. Sunscreens not only block production of vitamin D, but also all of the other beneficial photoproducts produced in the skin in response to UVB.
  1. Mind your micronutrients to protect against toxicity.
    Try cod liver oil as a good source of vitamins A and D and high-vitamin butter oil or pastured butter and ghee for vitamin K. Sweet potatoes, bananas, plantains, and avocados all contain significant amounts of potassium. Considersupplementing with magnesium as it is very difficult to get adequate amounts of this micronutrient from food due to soil depletion.

By Chris Kresser (web)

Paleo has received a lot of attention in the media over the past couple of years—some of it positive, and some of it negative—and there are a lot of misconceptions about what a Paleo approach to nutrition and lifestyle means for most people. With this in mind, here are 20 things I think everyone should know about Paleo.

harvest of fresh greens and vegetables

1. Following a Paleo diet/lifestyle today is not about re-enacting the exact diet/lifestyle of our ancestors.

Instead, it’s about embracing the principles of their diet and lifestyle to a modern context: eating nutrient dense, toxin-free, whole foods, moving our bodies regularly, sleeping at least 8 hours a night, managing our stress, and playing and having fun. But instead of saying all of this each time, it’s a lot easier to just say “Paleo”! Learn more …

2. Most hunter gatherers did not eat a “low-carb” diet.

The average carbohydrate intake of hunter gatherers ranged from 30-40% of total calories. This is not a low-carb diet! It’s a moderate carb diet, and it’s important to realize that virtually all of the research that has shown benefits for the Paleo diet involved a Paleo diet with this carbohydrate range. Learn more …

3. A very-low-carb (VLC) or ketogenic diet and Paleo diet are not the same thing.

Some of the earliest adopters and advocates of the Paleo approach were coming from low-carb diets like Atkins. As a result, the low-carb ideology got mixed together with Paleo, despite the fact that most true Paleolithic diets were not low-carb (as I described above). And while some people do thrive on a low-carb diet over the long-term, many people don’t and can even experience harm. Learn more …

4. It’s best to consider Paleo as a template, rather than a “diet”.

A Paleo diet implies a particular approach with clearly defined parameters that all people should follow. There’s little room for individual variation or experimentation. A Paleo template implies a more flexible and individualized approach. A template contains a basic format or set of general guidelines that can then be customized based on the unique needs and experience of each person. Learn more …

5. There is no single approach that works for everyone.

Just as there was tremendous variation in what our ancestors ate, there is also tremendous variation in what works for each person. Some people clearly do better with no dairy products. Yet others seem to thrive on them. Some feel better with a low-carb approach, while others feel better eating more carbohydrate. Some seem to require a higher protein intake (up to 20-25% of calories), but others do well when they eat a smaller amount (10-15%). The key is to personalize your approach to meet your own unique needs. Learn more …

6. The foods emphasized on the Paleo diet are loaded with the nutrients our bodies need.

The most nutrient dense foods you can eat are organ meats, herbs and spices, nuts and seeds, fish and seafood, beef, lamb, and wild game, eggs, vegetables, and fruits. And those are exactly the foods that a Paleo diet emphasizes! VIDEO

7. Vibrant health is your birthright (chronic disease is not inevitable).

Today, chronic diseases like obesity, diabetes, heart disease, and autoimmune disease are so common we’ve accepted them as “normal”. But humans lived for thousands of generations virtually free from these modern, inflammatory diseases—most of which have only became common in the last 50–100 years ago. VIDEO

8. You don’t have to be 100% compliant to benefit from a Paleo-style diet.

There’s no doubt in my mind that a “Paleo-style diet” is what we’ve evolved to eat. But that doesn’t mean you have to strictly and rigidly follow Paleo diet guidelines 100% of the time in order to be healthy, regardless of what the Paleo zealots will tell you. With some exceptions, you’ll get most of the benefits by following it 80–90% of the time. Learn more …

9. Sugar isn’t “toxic”.

Sugar is neither a toxin nor a replacement for real food. Ultimately, small amounts of sugar can fit into a whole foods, nutrient-dense, Paleo-style diet, as long as you recognize it for what it truly is: a treat. Learn more …

10. You might not instantly feel better when you start eating Paleo.

The reason some people transitioning to a Paleo diet initially feel a dip in overall energy is not that the diet is unhealthy or that they need more simple carbs. It is that their body has been conditioned to rely on sugar for energy and needs time and support to adapt to burning fat for energy instead. Learn more …

11. The Paleo approach is not just about weight loss; it can also prevent and even reverse chronic disease.

Paleo is remarkably effective for weight loss, but it’s benefits extend far beyond that. As a clinician I’ve seen a Paleo-type diet and lifestyle lead to dramatic results in people with a wide range of conditions, from type 2 diabetes, to IBS and other digestive problems, to Hashimoto’s, MS and other autoimmune diseases, to infertility and hormone imbalance. Learn more …

12. Full-fat dairy products can actually be a healthy addition to a Paleo diet—for some people.

Strict Paleo diets exclude all dairy products because our ancestors didn’t eat them. But is that reason enough to eliminate them from our diets? While it’s certainly true that some people are intolerant to the proteins or sugars in dairy products, it’s also true that modern research suggests that full-fat (but not non-fat or low-fat) dairy has several health benefits, including protecting against obesity, diabetes, and heart disease. Learn more …

13. Red meat is one of the healthiest, most nutrient-dense foods you can eat.

Conventional wisdom blames red meat for everything from heart disease to cancer. These claims are ill-founded and misleading; red meat is a healthy and nutrient-dense choice. Learn more …

14. High cholesterol is not the primary cause of heart disease.

For decades we’ve been told that eating saturated fat and cholesterol raises the level of cholesterol in our blood, and high cholesterol in our blood contributes to heart disease. But recent research has shown that 1) there is little evidence to support the idea that cholesterol or saturated fat in the diet affect blood cholesterol levels for most people, and 2) that high cholesterol levels in the blood alone are not a strong risk factor for heart disease. Learn more …

15. Many of the packaged “Paleo friendly” foods are full of modern additives – and some of them are not so friendly to your health.

Just because a packaged food is labeled “Paleo-friendly”, that doesn’t mean it’s good for you. Some of these foods contain modern additives that may cause digestive distress and other problems. Learn more …

16. Eating a Paleo-style diet doesn’t have to be expensive.

While it’s true that real, nutrient-dense foods can be more expensive than highly processed and refined junk food, a Paleo-type diet doesn’t have to break the bank. With a little planning and some smart shopping, there’s no reason that Paleo should cost more than your old way of eating. Learn more …

17. Legumes are more Paleo friendly than you might think.

Paleo dogma holds that we should strictly avoid legumes because 1) they aren’t part of our ancestral diet, and 2) they contain toxic anti-nutrients like lectin and phytic acid. But research suggests that some of our ancestors did, in fact, consume legumes, and that the lectins and phytic acid in legumes are not the “boogeymen” we’ve been led to believe they are. Learn more …

18. Paleo is not just about food.

There’s no question that a nutrient-dense, real-food diet is the cornerstone of health. But it’s also true that lifestyle choices like physical activity, sleep, and stress management play an equally important role in determining our health. Learn more …

19. Paleo-friendly starches are not the same as industrial starches.

Some advocates of the Paleo diet have argued that we should avoid starches because they contribute to obesity and other diseases. While it’s true that highly processed and refined starches like wheat flour are harmful, there’s no evidence that the same is true for whole-food starches like potatoes, sweet potatoes, plantain, or taro root. Our ancestors consumed these foods for millions of years, and there are many examples of cultures around the world that consume a high-(real-food)-starch diet and maintain excellent health. Learn more …

20. Paleo cooking can be both delicious and easy.

You don’t have to be a 5-star chef to make delicious Paleo meals. Armed with the recipes below, you’ll impress your friends and family with delicious meals without spending countless hours in the kitchen. Learn more …