My take on The Primal Blueprint

Most current popular paleo books tend to ignore or reject endurance sports, my favorite form of exercise. The Primal Blueprint (PB) by Mark Sisson is not an exception.

However, since PB is one of the few books recommended by paleonu.com I got interested and chose to review it.



Mark Sisson is certainly knowledgeable and experienced in the field of endurance sports, as he used to be an elite marathon runner as well as a coach to pro triathletes.

"For several years of my youth, I ran in excess of 100 miles a week with a single-minded focus toward competing in the 1980 U.S. Olympic Marathon Trials. At my peak, I was considered by many to be a picture of health: 6 percent body fat, a resting heart rate of 38 beats per minute, and a marathon time of two hours, eighteen minutes....

Soon after my best marathon performance, the monumental physical stress of my training regimen and the state-of-the-art 'high-energy' diet that fueled it resulted in a succession of serious overuse injuries, illnesses and burnout."

This seems inevitable to me, if you are on a high-carb diet and train at 'elite level', ie. way too hard. That would indeed be possible only with a little help from carbs and other hormone-stimulating substances.

The solution is simple: change to a low-carb diet and train with a lower heart rate. I don't understand why the author seems to think that if you are an endurance athlete, then you must carb-load daily and train like crazy. Not everyone wishes to rise to the elite level of competition, if it means losing your health in the process.

"The exercise gospel for decades has been to pursue a consistent routine of aerobic exercise... supposedly leading to more energy, better health, and weight control. However too many length workouts at elevated heart rates (between 75 percent and 95 percent of maximum) can put you at risk of exhaustion, burnout, injury and illness. The high-carbohydrate diet required to perform these workouts day-in and day-out only adds to the problem. At the extreme - such as with the overtrained marathon runner or ironman triathlete - a commitment to fitness can actually accelerate the aging process."

What PB calls 'Chronic Cardio' is indeed a harmful way of training, but I don't see why anyone would need to train that way. It certainly seems much harder than my normal daily training. I agree chronic anaerobic exercise would be harmful.

Mark Sisson claims you generally can't combine PB or any paleo diet with marathon running, which is not true in my experience.



Surprisingly, PB seems to be well aware of Dr. Phil Maffetone and his healthy training methods, which he recommends, sort of.

"Mike Pigg and Mark Allen, world champion professional triathletes who dominated the sport... both claimed their careers were elevated to the next level - and extended by several years - when they moderated their training pace to stay below an individually determined maximum aerobic heart rate with great discipline. Guided by applied kinesiologist and endurance training pioneer Dr. Phil Maffetone, they were able to improve their aerobic conditioning... by training at a sensible, comfortable pace that represented about 80 percent of their maximum heart rate. (I advocate an upper limit of 75 percent for all but the most highly trained endurance athletes.)"

Maffetone's greatest invention was the 180-Formula, which he developed to determine max aerobic heart rate. It is simply 180 minus your age. It doesn't require max total heart rate to be determined at all, and unlike PB 75% of max heart rate, it works very well in practice.

PB certainly tries hard to scare people away from endurance events. The following is a good example of this.

"Interestingly, after extreme endurance events like a marathon or ironman race, blood levels of CPK (creatine phosphokinase) can be elevated for weeks afterward. In fact, if you presented in the ER with such levels and didn't explain that you had recently run a marathon, the doctor might think you were suffering from a heart attack!"

This refers to a well-known phenomenon since the early days of the marathon boom. While it is true that in some cases blood levels of creatine kinase may be elevated for a week or so after an endurance event, it has from the beginning been clear that there is no evidence that this would in any way damage a healthy person. Although it has been shown repeatedly that marathon running does not adversely affect the hearts of healthy runners, tales suggesting otherwise seem to live forever.

Also Mark's Daily Apple never seems to miss an opportunity to link marathons and heart damage. And he never gets tired of repeating the old tale that the first marathon runner in died.

In fact there is no risk to speak of when you are fit and healthy. Let's take a brief look at a recent study showing how an experienced ultramarathon athlete can withstand daily marathons without any harmful effects or damage.



Dean Karnazes was subjected to ten blood draws during his Endurance 50 project. In the book '50/50: Secrets I Learned Running 50 Marathons in 50 Days' Bryan Bergman, PhD had the following to report.

First, the case of Dean's CPK:

"We expected to see fairly dramatic increases in Dean's blood markers of muscle damage. The principle marker was creatine phosphokinase (CPK), an enzyme found principally inside muscle cells that leaks into the bloodstream when cells are damaged. A typical marathon runner has dramatically elevated CPK after one marathon, and it stays elevated for up to a week. Dean, however, is no typical marathoner. He had some muscle damage associated with the event. However, at his muscle damage high point, near the end of Endurance 50, his CPK concentration was still one-fourth of what it would be for a typical runner completing only one marathon! This was a surprise, but shows how well Dean's body has adapted to the demands of ultrarunning."

To be safe, they also monitored Dean's IL-6:

"We also measured blood levels of an inflammatory marker called interleukin-6 (IL-6). IL-6 is a cytokine (a special type of white blood cell) that is receiving a lot of attention in the scientific world right now because of the link between inflammation and heart disease... Much to our surprise, IL-6 concentrations did not change very much during this event."

And just in case, they also checked Dean's immune function:

"Many publications have pointed to an increased risk of upper respiratory tract infections and decreased immune system function after one marathon... However, other than probable viral infection during the first part of the event, we observed no changes in blood markers that would suggest a compromised immune system." 

They also measured how stressful 50 consecutive days of marathon running was for Dean's body:

"We were also on the lookout for possible suppression of bone marrow red blood cell production that also can occur during periods of high stress. Dean's bone marrow continued to produce red blood cells throughout the event and showed no signs of slowing. Clearly, his body did not perceive this event to be as stressful as we expected!"

If you are not 100% healthy, very young or old, or an absolute beginner, then you should take it relatively easy. If you are healthy and fit, and well-trained, you can safely participate in all endurance events, but only if you take it relatively easy. Aerobic training or racing should never feel like an epic struggle against your own body.

Supplements like protein powder are slipped into the diet with a couple of weak excuses:

"...we often run short of convenient, transportable, unperishable options for an afternoon pickup snack or mini meal. While not exactly Primal, protein powders do combine the best of 21st century technology with a true Primal intent: get me a fast, good-tasting source of protein without too many carbs or unhealthy fats."

I think most people would agree that Grok would choose natural foods instead of supplements. That doesn't stop PB Store from selling 'Primal Fuel'.

What about the recipes? For that there is a new book: The Primal Blueprint Cookbook.



Primal cooking shouldn't obviously be rocket science, so a recipe book is not that essential. What's odd is that this Cookbook is strictly dairy-free, while the original PB book has a fairly relaxed attitude towards using dairy.

My final verdict for the PB is 6/10 - some parts of it are slightly interesting, but as a whole it cannot be recommended.  I feel it's a confusing collection of sales pitches, aimed at selling us 'Primal' stuff we don't need. Robb Wolf likes PB, but Grok would probably run away!