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Category: Health

Study: Telehealth follow-up linked to return emergency department visits


Patients who participated in a telehealth follow-up visit after being treated in an emergency department were more likely to return to the ED and become hospitalized compared with those who had in-person appointments.

The study, published this week in JAMA Network Open, analyzed nearly 17,000 encounters from two EDs in a single academic health system in Los Angeles between April 2020 and September 2021. To be included, patients had to have a follow-up appointment with a primary care physician within 14 days of their first ED visit.

Researchers found telehealth follow-up was associated with 28.3 more repeated ED visits and 10.6 more return hospital admissions per 1,000 patients compared with in-person follow-up care.

For in-person visits, 16% were followed by a return ED visit and 4% include a hospital admission within 30 days. Among telehealth follow-ups, 18% were followed by another emergency visit and 5% with a hospitalization.

“In this retrospective cohort study, we found that after being discharged from the ED, patients with telehealth post-ED discharge follow-up visits were more likely to return to the ED, even after adjustment for sociodemographic characteristics, insurance type, distance to the ED, severity of illness at the index visit, the time from ED discharge to follow-up and medical complexity (RAF [Risk Adjustment Factor] scores),” the researchers wrote. 

“There were numerically increased subsequent hospitalizations as well, but the difference was not statistically significant. The association of telehealth with increased healthcare utilization warrants further study to evaluate its appropriateness as modality for post-ED follow-up.”


The researchers noted there were some limitations in their analysis. As an observational study, there could have been missing information that wouldn’t be collected in EHRs, like unemployment, income or trust in the healthcare system.

Patients also could have seen a primary care physician outside of the health system studied, while Risk Adjustment Factor scores were often missing for uninsured participants. Future studies should also include more health systems, since the focus on one system could limit the study’s ability to be generalized to other settings. 

Though the study shows concerns with relying on telehealth for post-discharge care, researchers noted it should be considered in context of telemedicine’s benefits, like managing chronic conditions. 

“A potential mechanism to explain increased healthcare utilization after telehealth visits is the inherent limitation in the ability of clinicians to examine patients, which may compel clinicians to have a lower threshold for referring patients back to the ED for an in-person evaluation if they have any ongoing symptoms,” the study’s authors wrote.

“It is also possible that independent of the lack of a physical examination, telehealth clinicians may not be able to communicate as well with patients, leading to an inability to fully evaluate or intervene on evolving illness and leading to deterioration in patient condition and subsequent need for hospitalization.”


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COVID Reset: The Day of Reckoning Is Coming


As noted in an October 10, 2022, GB News article1 by British presenter Mark Dolan, we have a long list of challenges facing us at the moment. There’s the global economic crisis, the European energy crisis, runaway inflation and the threat of escalating war, just to name a few.

But on top of all of that, there’s the “COVID industry,” to use Dolan’s term, which is not about to let go of the pandemic anytime soon. And, why would they? After all, it’s the justification for the global biosecurity state; the perfect excuse to usher in biological surveillance, digital identities, The Great Reset and the Fourth Industrial Revolution (i.e., transhumanism).

Calls for Renewed COVID Measures Are a ‘Sick Joke’

So, as we head into fall and winter, the COVID industry is ramping up for another round of freedom-robbing countermeasures. In the U.K., the BBC has already kicked off the fearmongering, making a big ado about a supposed rise in COVID “cases.” Are people still buying into that worn-out fraud? Must we really spend another winter explaining how the PCR test cannot identify infection? We’ll see, but I hope not. Dolan writes:2

“The Beeb’s [BBC News] obsession with COVID at the expense of everything else was pointed out by former ONS statistician Jamie Jenkins this week.

‘A rise in COVID cases and Hugh Pym at the BBC is all over it for the main news bulletin even when there’s little impact on serious illness — for the majority. Excess deaths for months for non COVID reasons in under 60s, and nothing on main news that I’ve seen. Selective BBC reporting just shocking.’

Isn’t it wonderful that we are paying through the nose — 160 quid [British pounds] a year, for this mental torture. And powerful groups, like independent Sage … will stop at nothing until we’re all masked, working from home, socially distanced, sanitized and freshly jabbed.

At this point, hearing these siren voices calling for more restrictions is just a sick joke, given the damage these people have inflicted on our country — two and a half years of experimental lockdowns that show no discernible benefit to countries and regions that stayed open and carried on as normal.

We borrowed half a trillion quid to pay perfectly healthy people to stay at home, and we closed once viable businesses. All at the behest of those who thought you could control a seasonal respiratory virus.

Well, the data is in, the numbers are there for all to see, and the graphs are clear. Stop it we did not. Can you imagine if we had more economy destroying measures in the months to come? We are surely just a couple of lockdowns away from being so broke as a country, we will be deciding which of our offspring to eat first.”

Refuse All Continued COVID Measures

I can only agree with Dolan, who believes “there should be zero [COVID] measures ever again.” We have up to two years’ worth of data on most of the measures, and NONE has proven fruitful.

Instead, they’ve all been shown to be harmful — to economic stability, mental health, physical health, education, life expectancy, quality of life and more. The global response has been nothing short of disastrous, and following the same playbook once more is pure insanity.

There’s only one reason to return to strategies proven harmful, and that is because the harmful outcomes are actually desired. Unfortunately, that appears to be the case, because COVID tyranny is about to be unleashed yet again.

“Mark my words, the mask mandates will return, economically damaging work from home directives will kick in and vaccine tyranny, will no doubt rear its ugly head,” Dolan writes.3

“Although it’s hard to sell now, given that Denmark have effectively banned the vaccine for anyone under 50 — you’ve got to have a doctor’s note and evidence of a serious medical condition to get the [jab]. And Norway have done the same, for the under 65s. If you are under 65 in Norway you will not be able to get boosted …

[And] news just in — the Australians as well, as revealed by US journalist Alex Berenson. Australia, one of the most jab happy the countries in the world, who have been drinking the zero COVID Kool-Aid for two years have stopped offering the vaccine to under 50s …

Why would that be? I wonder if the Norwegians and the Danes and are concerned about both the efficacy of the vaccine — in other words if it works, and the safety. Perhaps they’ve been looking at a report published in the Lancet from the University of Oxford, suggesting the vaccinated are 44% more likely to get COVID. Get jabbed to get the disease. That’s some vaccine isn’t it …

Perhaps I’m putting two and two together and coming up with five, but it looks to me like these countries — Denmark, Norway and even Australia, are running for the hills. It’s my instinct, that a day of reckoning in regard to the vaccines is coming, and I can’t wait. I’ll be bringing popcorn …

It’s time to live with this virus, as we do with all others, and push back on any measures, that threaten the economy, children’s education, our mental and physical well-being, our freedoms and our way of life. [To] those calling for more measures, which have already broken our country and broken our society, just say no.”

Florida Surgeon General Censored

In the U.S., Florida is pretty much alone in following the path of Norway and Denmark. October 7, 2022, Florida Surgeon General Dr. Joseph Ladapo issued a new COVID jab guidance,4,5 recommending men between the ages of 18 and 39 abstain from the COVID jab, as data show an 84% increase in heart-related death within 28 days of injection.

Ladapo posted the updated guidance on Twitter the same day.6 Twitter promptly removed the tweet for violation of Twitter rules, but eventually restored it. According to the October 7 guidance:7

“The Florida Department of Health (Department) conducted an analysis8 through a self-controlled case series, which is a technique9 originally developed to evaluate vaccine safety. This studied mortality risk following mRNA COVID-19 vaccination.

This analysis found there is an 84% increase in the relative incidence of cardiac-related death among males 18-39 years old within 28 days following mRNA vaccination. Individuals with preexisting cardiac conditions, such as myocarditis and pericarditis, should take particular caution when considering vaccination and discuss with their health care provider.

As such, the Florida Department of Health has issued the following guidance: Based on currently available data, patients should be informed of the possible cardiac complications that can arise after receiving a mRNA COVID-19 vaccine. With a high level of global immunity to COVID-19, the benefit of vaccination is likely outweighed by this abnormally high risk of cardiac- related death among men in this age group.

The State Surgeon General now recommends against the COVID-19 mRNA vaccines for males ages 18-39 years old. Individuals and health care providers should also be aware that this analysis10 found: Males over the age of 60 had a 10% increased risk of cardiac-related death within 28 days of mRNA vaccination …

The Department continues to stand by its Guidance for Pediatric COVID-19 Vaccines issued March 2022, which recommends against use in healthy children and adolescents 5 years old to 17 years old.

This now includes recommendations against COVID-19 vaccination among infants and children under 5 years old, which has since been issued under Emergency Use Authorization.”

Post-Jab Autopsy Results Withheld

Like Dolan, I believe a day of reckoning is coming. It seems our public health authorities know this as well, which is why they’re fighting tooth and nail to slow the release of COVID jab data to a slow drip. They’re probably all hoping they’ll be dead and buried by the time the whole truth comes out.

The U.S. Centers for Disease Control and Prevention spent 15 months fighting a legal battle to prevent the release of V-Safe data11,12 (ultimately losing that fight), and now we find out that the U.S. Food and Drug Administration is refusing to release autopsy results of people who died post-jab. As reported by The Vaccine Reaction:13

“The FDA has refused a Freedom of Information Act (FOIA) request to release the autopsy results of people whose deaths were reported to the Vaccine Adverse Event Reporting System (VAERS) after receiving a COVID-19 shot. The FOIA request was submitted by The Epoch Times newspaper …

According to The Epoch Times, the FDA declined to release any autopsy reports of VAERS deaths, even redacted copies, citing FOIA section (8) (A) which allows federal agencies to withhold information from the public if an agency ‘reasonably foresees that disclosure would harm an interest protected by an exemption,’ with the exemption being ‘personnel and medical files and similar files the disclosure of which would constitute a clearly unwarranted invasion of personal privacy’ …

All of the FDA’s stated concerns about protecting privacy seem rather bogus, as the autopsy results sought through the FOIA request could be released with personal information blacked out.

‘The personal information could easily be redacted without losing the potential learnings from [the] autopsy,’ said Kim Witczak, a drug safety advocate who serves as an adviser to the FDA.

Besides, Witczak logically points out: ‘If someone submits their experience to VAERS they want and expect to have it investigated by the FDA. This includes autopsy reports. Autopsies can be an important part of postmortem analysis and should be done especially with increased deaths following COVID-19 vaccination.’”

CDC Has Ignored Clear ‘Death’ Signal

While the CDC has insisted that no safety signal has ever been triggered in any of the adverse event collection databases, analyses of both the V-Safe and VAERS data suggest otherwise.

Of critical importance is the CDC’s apparent failure to identify a massive warning signal for death. In an October 3, 2022, article,14 Kirsch pointed out that the formula the CDC uses to trigger safety signals — described in its VAERS standard operating procedures manual15 — is “seriously flawed,” as the more dangerous a vaccine is, the less likely it is that a safety signal will be triggered.16,17,18

However, the COVID jabs are so incredibly hazardous that even the CDC’s flawed formula cannot cover up their lethality. Using the CDC formula, “death” still meets all the safety signal criteria and should have been flagged, yet the CDC has kept mum.

The FDA is following the same playbook, refusing to release data that rightfully should be made public. We paid for it. The data belong to the American public, and the only reason the FDA, as the CDC, is hiding it is because it proves they’ve acted in bad faith and haven’t followed the data at all.

A Reckoning Is Surely Coming

The crimes committed by the “COVID military-industrial complex” — which includes governments, Big Tech, media, Big Pharma and the bioweapons research industry worldwide — are now so numerous and so egregious in nature, it’s hard to fathom they’ll get away with it forever.

Surely, a day of reckoning is in the making, as more and more people start to wake up to reality. The CDC and FDA aren’t the only entities whose crimes against humanity are being exposed. Here’s a short-list of other recent exposures:

Getting the COVID jab to protect others was always a lie, and there was never any legal basis for COVID passports — These truths were confirmed by Dutch Parliament member Rob Roos in early October 2022.19

During a COVID hearing, Roos questioned Pfizer’s president of international developed markets, Janine Small, about whether Pfizer had in fact tested and confirmed that their mRNA jab would prevent transmission prior to its rollout. Small responded, “No. We had to really move at the speed of science … and we had to do everything at risk.”20

As noted by Roos, “this means the COVID passport was based on a big lie. The only purpose of the COVID passport: forcing people to get vaccinated.” Roos added that he found this deception “shocking — even criminal.”21

Medical boards are showing their true colors by censoring doctors — The Federation of State Medical Boards (FSMB) is calling on states to create laws that punish doctors for sharing medical information that does not align with “consensus” opinion. Punishment would include stripping doctors of their medical license.

The American Board of Internal Medicine and the American Board of Family Medicine support the FSMB’s position and have warned doctors certified by their boards that spreading misinformation could prompt the board to revoke their certification.

While physicians who are speaking honestly about the vaccine science are labeled “misinformers” and may face disciplinary action, the “consensus” would never be a consensus of physicians treating patients, but of those powerful few who have assumed the role of oversight and whose focus is political policy and future agenda, not patient care.

U.S. government is illegally censoring Americans by proxy — Over the past couple of years, it’s become abundantly clear that government officials are trying to circumvent the U.S. Constitution by calling on and/or threatening private tech companies to censor on their behalf.

Brazenly power-drunk, many have not even tried to hide it. They’ve admitted it publicly. In other cases, FOIA’s and lawsuit discovery procedures have forced the release of documents proving government has been violating Americans First Amendment rights by colluding with private companies on whom and what to censor and ban.

As reported by Tablet magazine, “At least 11 federal agencies, and around 80 government officials, have been explicitly directing social media companies to take down posts and remove certain accounts that violate the government’s own preferences and guidelines for coverage on topics ranging from COVID restrictions, to the 2020 election, to the Hunter Biden laptop.”22

Financial institutions show their colors by punishing users for opinions — We’ve also seen how financial institutions are weaponized to keep the public in check.

For example, the U.S. and European Union banned Russian banks from the Swift system,23 and then seized more than $30 billion in assets owned by Russian oligarchs plus another $300 billion in Russian Central Bank reserves.24 Following that same pattern, Canadian banks froze the bank accounts of hundreds of individuals who donated to or participated in the Freedom Convoy.25,26

This stunning display of authoritarian tyranny shocked many into waking up to the reality that government now views its own citizens as the enemy, and is willing to use any means to control us. Realizing they’d pushed too far too fast, at least one bank apologized for freezing bank accounts,27 but the damage to trust was already done.

Most recently, PayPal sent out a revised terms of service notice announcing it would begin to fine users $2,500 for the spread of misinformation, starting November 3, 2022.28 The updated terms of service resulted in thousands of users swiftly closing their accounts and taking their outrage to social media. Even its own former president, David Marcus, called the new terms “Insanity.”

The backlash was so great, PayPal quickly apologized for causing “confusion,” claiming the new terms of service had been sent out in error. However, this is rather impossible when you consider the many steps a company like PayPal has to go through before a terms of service update actually gets authorized and sent out.

Interestingly, Fortune magazine reported this story October 10, 2022, and within two days, deleted the article. Fortunately, someone archived it.29

We’ve Been Deceived and Sold Out

When you add these and other revelations together, it’s quite clear that we are being “herded” into The Great Reset, and that a wide range of industries have been weaponized against us for this purpose, most notably the medical industry, the financial industry and Big Tech.

Government, which was set up to be “of the people and for the people,” has been infiltrated and turned against us as well, and it’s now using every power at its disposal to suppress and control the population while simultaneously allowing the systems we depend on for life to be dismantled and destroyed, such as the food, energy and financial systems.

There can be only one reason for this, and that is that government (not just the U.S. government but also others around the world) are onboard with The Great Reset, which will result in a totalitarian dystopia.

Stand Up, Speak Out, Turn the Tables

The good news is that we still outnumber these megalomaniacs by tens of millions to one, if not more. And, believe it or not, they need our cooperation. If enough of us withhold our cooperation, their plans start falling apart.

Two of the most important things everyone can do right now is 1) prepare ourselves and our families for hard times (if you were not a prepper before, now’s the time); and 2) start building parallel structures and systems to replace the ones that are being dismantled.

The idea is to survive and rebuild a world of our own choosing rather than being forced to accept theirs out of sheer desperation. Strategies that can strengthen individual and local resilience to the stresses facing us include the creation of local food systems and the strengthening of neighborhood and community connections.

Prepare for the inevitable financial catastrophe and become as independent and resilient as possible. Shore up supplies and figure out how to live in an “off grid” scenario, in case daily conveniences suddenly vanish. This year I have offered many articles on how you can prepare for food, water and other crises, which you can find in my Substack library.

Aside from “investing” in storable food, a water catchment system and other essentials that will only go up in price or become unobtainable, you may also consider buying physical precious metals, which can help protect against currency devaluation. Investing in real assets, such as land could be another.

It’s also essential to become as healthy as possible. A recent study showed that 93% of U.S. adults are metabolically unhealthy, and those stats were four years old. It’s likely that number is now over 95%. You want to be the 1 person in 20 who is healthy. So, make it your goal to be in that group and start getting metabolically fit now.

Also prepare yourself mentally, emotionally and spiritually for what could be stressful and challenging times as the globalist cabal continues to push The Great Reset forward, which will require more “emergencies.”

Lastly, remember professor Mattias Desmet’s instruction that limiting the social harm inflicted by a totalitarian regime requires nonviolent resistance and outspokenness. Continue to speak out against the narrative in clear, rational and nonabusive ways. Dissenting voices keep totalitarian systems from deteriorating into abject inhumanity where people are willing to commit heinous atrocities.


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Emergency response platform RapidSOS raises $75M and more digital health fundings


Data-driven emergency response platform RapidSOS announced closing a $75 million funding round, bringing its total capital raised to more than $250 million. 

The New York-based company provides emergency responders with real-time health and location data before they arrive on the scene, collected from smartphones and other connected devices ranging from wearables to motor vehicles and nearby surveillance systems. 

NightDragon led the latest round of funding, with additional investments from Honeywell, BAM Elevate, Axon, Insight Partners, the Citi Impact Fund, M12, Highland Capital Partners, Playground Global, Forte Ventures, Avanta Ventures and C5 Capital. 

In 2021, RapidSOS announced the close of an $85 million Series C funding round led by Insight Partners, noting its platform was in use among more than 4,800 emergency communications centers across the U.S.

Currently, the company reports a presence in more than 15,000 first responder agencies on four continents. 

“For a decade, we’ve had the privilege to learn from our nation’s first responders to build technology that supports their life-saving work,” Michael Martin, founder and CEO of RapidSOS, said in a statement. “Hundreds of millions of lives are impacted each year by the heroism of these individuals, and we’re honored to have partners in this journey that share in a vision to transform safety, security and emergency response.” 

Chicago-based HealthJoy, a digital employee benefits platform, raised $60 million in Series D funding that it will use to accelerate growth. 

The current round was led by Valspring Capital, with participation from new investors Endeavour Vision and CIBC Innovation Banking, bringing the total raised to more than $108 million. 

Existing investors GoHealth co-founders Brandon Cruz and Clint Jones, US Venture Partners, Nueterra Capital, Health Velocity Capital and Epic also participated in the round.

HealthJoy, founded in 2014, expanded its business from the individual health insurance market to employee engagement and cost containment in 2016. 

The company offers Joy, a virtual assistant that helps users understand their benefits packages and navigate their care options through an AI-guided conversation. Along with displaying an individual’s coverage, the platform includes 24/7 live care provider support and a log of historical claims information and past conversations.

HealthJoy’s recent funding comes after its $30 million Series C funding round in 2020 and $12.5 million Series B funding round in 2019.

School-based pediatric telehealth provider Hazel Health announced the closure of a $51.5 million Series C1 funding round with participation from Owl Ventures, Tao Capital Partners, Memorial Hermann, Firework Ventures and Carrie Walton Penner through Fiore Ventures. 

Hazel Health partners with school districts to offer virtual care clinics inside the school nurse’s office. Hazel also provides equipment to schools, such as thermometers and over-the-counter medication, and trains school nurses and staff on launching a visit and taking students’ vitals. 

The new round of funding will support the company’s expansion and allow for continued product innovation.

Hazel announced a $33.5 million Series C raise headed by Owl Ventures and Bain Capital Ventures in 2020. 

Navina, an Israeli startup developing an AI-based platform for primary care providers, announced a $22 million Series B funding round led by ALIVE Israel HealthTech Fund, with participation from existing investors Grove Ventures, Schusterman Family Investments and Vertex Ventures Israel.

The company’s tool builds “patient portraits” that reorganize disparate patient data for accessible clinician review and highlights information that could be clinically relevant to each case. 

The latest round, which doubles the total investment to date to $44 million, will be used to accelerate the company’s growth and adoption among U.S. physician groups and the enterprise healthcare market. 

Navina will also further invest in its AI technology and clinical algorithms and expand its integration of emerging data sources. 

Galen Robotics, which touts a service model for its surgical robotic platform, announced the first close for an oversubscribed $15 million Series A funding round led by Ambix Healthcare Partners.

Galen used the Series A funding to complete its final robot prototype and submit the new collaborative soft tissue surgical robot for FDA consideration. It will also use the funds to grow clinical care teams, expand engineering, develop surgeon training programs and increase product development. 

The company opened a second close for the Series A funding round for an additional $5 million, which it expects to wrap up soon.

California-based Midi Health, a virtual care clinic for menopause, received a $14 million seed investment co-led by Felicis and SemperVirens.

Other participants in the raise include Emerson Collective, Operator Collective, Icon Ventures, Muse Capital, Steel Sky Ventures, and Anne and Susan Wojcicki. 

Midi Health provides virtual care guided by physicians and researchers who oversee a network of nurse practitioners and provides interventions from lifestyle coaching to prescription medication. 

The company currently provides insurance-covered care in California and will use the new capital to expand operations nationwide and launch partnerships with hospital systems and U.S. employers. 

Lumata Health, a practice management platform for ophthalmology, raised $4 million in a Series A round.

The round, led by Cortago Ventures with participation from Wolfpack Investor Network and 30 practicing ophthalmologists, will help the intelligent eye care management platform scale its presence across the U.S. and enhance its platform, developing predictive analytics and incorporating automated patient communication pathways. 

The startup previously received more than $2 million in research funding from the National Eye Institute. 


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The Past, Present, and Future of the Primal Mission


Mark’s Daily Apple turns 16 today. I guess we could say it’s officially “come of age.” It was the platform that launched the primal mission, and I couldn’t have spread the word without it — and without you, my dedicated readers, of course. So let’s get a little reminiscent, shall we? After all, that’s what birthdays are for. 

Many of you are familiar with my personal journey. A career as an endurance athlete left me sick and injured, making me acutely aware that the standard health and nutrition advice I’d been following was misguided at best and destructive at worst. I’ve always loved challenging my brain as much as I do my body, so I dug into all the science available and began experimenting with a more evolutionary approach to food and fitness. I noticed the benefits right away and wanted to document my journey and help other people reclaim their health as well. I started Mark’s Daily Apple for that very reason, with a measurable goal in mind — to change the lives of 10 million people.

I soon discovered just how many people out there are sick of being failed by mainstream dietary and fitness advice. Visits to Mark’s Daily Apple skyrocketed as more people found their way to the blog, many of whom encouraged me to consolidate my research and way of life — which I call the primal lifestyle — in a book. And so I did.

The Primal Blueprint became an unlikely bestseller, and I followed that up with many other books, including my most recent, The Keto Reset Diet and Two Meals a Day, all while blogging on Mark’s Daily Apple. 

Time passed, and I continued researching and investigating what it means to live primally, sharing my findings with you here. I also hosted in-person retreats and seminars and developed specialized online courses like the 21-Day Primal Reset Course. But I wanted to do more. I wanted to develop a program for those that desired to go beyond the blog and books and take an even deeper dive into the primal lifestyle. 

So the primal mission took another leap and I created the Primal Blueprint Expert Certification program in 2014. It was an incredibly comprehensive exploration of ancestral health — on par with a college-level science course. It was for the primal enthusiast who wanted to become an expert for their own edification, but we soon discovered that the majority of people enrolling in the course had professional aspirations. They were either already a health or fitness professional or wanted to become one. With this discovery, I knew there was an opportunity to take the primal mission even further. 

So I founded Primal Health Coach Institute to train other people in primal health and, with their help, change the lives of 100 million people around the world. 

Primal Health Coach Institute is, in a sense, the culmination of my collective efforts to share the primal message and help people reclaim their health and wellness. I’ve gone from writing about ancestral health through daily articles on this blog to training people to become health and fitness coaches so they can go out and spread the word. And the compounding network effect has been powerful. 

In addition to the Primal Health Coach Certification program, we’ve developed the Primal Fitness Coach Certification, coaching and business development courses, and continuing education programs, including strength training for women and health coaching in medical practices

I’m very proud of what we’ve been able to accomplish with Primal Health Coach Institute. It’s not just an online platform that lets you take your pick of coaching courses. We’ve nurtured a tight community of coaches around the world. And we make sure they have the resources they need to launch and run a successful practice, so we can keep changing lives, one person and one coach at a time. 

We’ve also spun off other endeavors, like myPrimalCoach, which matches users with their very own health coach through a convenient app. You’d better believe once we reach 100 million people, we’re going even bigger. And I know we can do it with everything Primal Health Coach Institute has in the works.

So happy birthday to the blog that started it all and continues to have a massive impact on the world. It’s certainly had a huge impact on mine.



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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Mark’s Daily Apple Sweet 16 Sweepstakes Official Rules


Mark’s Daily Apple Sweet 16 Sweepstakes

Official Rules



MARK’S DAILY APPLE SWEET 16 SWEEPSTAKES (the “Promotion”) starts on October 28th, 2022 at 10am Pacific Time (“PT”) and ends on November 8th, 2022 at 11:59pm PT (“Promotion Period”).

ELIGIBILITY: Promotion is open to residents of the fifty (50) United States and the District of Columbia, who are at least 18 years of age.  Employees of Primal Kitchen (“Sponsor”), and their respective parents, subsidiaries, affiliates, promotion and advertising agencies and members of their immediate family (spouse, parent, sibling or child and their respective spouses, regardless of where they reside) and persons living in the same household of such employees, whether or not related, are not eligible to enter or win. Void where prohibited by lawPromotion is subject to all applicable federal, state and local laws.

HOW TO ENTER:   To enter this sweepstakes during the Promotion Period, complete the entry form, including completing your name, email address, and opt-in, on the dedicated Sweepstakes Landing Page, here: Limit one (1) entry per person/email/household.

All entries must be received between October 28th, 2022 and November 8th, 2022 by 11:59pm PT to be eligible.  Use of any robotic, automatic, programmed or similar entry method or more than the stated number of entries will void your entry/entries and result in disqualification.

RANDOM DRAWING:  One (1) winner will be selected in a random drawing on or about November 9, 2022 from among all eligible entries received. Drawing will be administered by Arrowhead. Odds of winning will depend upon the number of eligible entries received.

WINNER NOTIFICATION: Administrator’s decisions are final and binding on all matters relating to this Promotion.  The potential winner will receive an email from Arrowhead Promotion and Fulfillment Co., Inc., (“Administrator”), to confirm their acceptance of the prize. Potential winner must respond to notification within three (3) calendar days. If the potential winner confirms, he/she will be asked to submit their full name, date of birth, complete mailing address and confirm email address within a time period specified by Sponsor or prize will be forfeited and Sponsor will have no further obligation to such winner.  Potential winners may be required to execute and return an affidavit of eligibility, a liability release and, where lawful, a publicity release, within seven days of date of issuance. If such documents are not returned and signed within the specified time period or if Sponsor is unable to contact a potential winner within such time period, prize or prize notification is returned as undeliverable, or a potential winner is not in compliance with these Official Rules, prize will be forfeited and, at Sponsor’s discretion an alternate may be randomly selected.  If any potential winner is an eligible minor in his/her jurisdiction of residence, prize may be awarded in the name of his/her parent or legal guardian, and such parent or legal guardian will be required to fulfill all requirements imposed on winners set forth herein.

PRIZES: One (1) prize winner will receive the following prize package:

–       One (1) Standard Cold Plunge Tub from Plunge (ARV: $4,990)

–      One (1) gift card to be used for online purchases (ARV: $100)

–       One (1) The Keto Reset Diet Book (ARV: $27.99)

–      One (1) The Keto Reset Diet Cookbook (ARV: $27.99)

–      One (1) Two Meals A Day Book (ARV: $28.00)

–      One (1) Two Meals A Day Cookbook (ARV: $30.00)

Total prize value of all prizes awarded: $5,203.98. All prize details are at the sole discretion of the Sponsor.  All prizes are awarded “as is” with no warranty or guarantee, either express or implied. No substitution, transfer, or cash equivalent of prize is permitted, except by Sponsor, which reserves the right to substitute a prize (or portion thereof) with one of comparable or greater value, at its sole discretion.  Any and all federal, state and local taxes on the prizes, and any other costs, fees, and expenses not explicitly stated herein as being awarded, are the sole responsibility of the winners. Gift Card terms and conditions apply.

GENERAL CONDITIONS:  By participating, each entrant (and, if an eligible minor, his/her parent or legal guardian) agrees: (a) to abide by these Official Rules and decisions of Judges; (b) to release, discharge and hold harmless Sponsor, and their respective parents, affiliates, subsidiaries, and advertising and promotion agencies, and the respective officers, directors, shareholders, employees, agents and representatives of the forgoing (collectively, “Released Parties”) from any and all injuries, liability, losses and damages of any kind to persons, including death, or property resulting, in whole or in part, directly or indirectly, from entrant’s participation in the Promotion or the acceptance, possession, use or misuse of any awarded prize; and (c) to the use of his/her name, voice, performance, photograph/video, image and/or likeness for programming, advertising, publicity and promotional purposes in any and all media, now or hereafter known, worldwide and on the Internet, and in perpetuity by Sponsor and its designees, without compensation (unless prohibited by law) or additional consents from entrant or any third party and without prior notice, approval or inspection, and to execute specific consent to such use if asked to do so.

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ENTRANT’S PERSONAL INFORMATION:  Any personally identifiable information collected during Entrant’s participation in this Sweepstakes will be collected by Sponsor and used by it and its agents for purpose of the proper administration and fulfillment of the Sweepstakes as described in these Official Rules, for any additional opt-in information Entrant agreed to upon participation, and in accordance with Sponsor’s Privacy Policies, posted, respectively at as allowed by law.

REQUEST FOR WINNERS’ NAMES: For of the name of the winner available after November 30, 2022 send a self-addressed, stamped, envelope to Primal Kitchen (Mark’s Daily Apple Sweet 16 Sweepstakes), 1101 Maulhardt Avenue, Oxnard, CA 93030.

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New and Noteworthy: What I Read This Week—Edition 198


Research of the Week

A personalized strength training program using genetic data is very effective.

Compared to real meat, fake meat doesn’t trigger the same rise in essential amino acids when eaten.

Belly fat and death in Europe.

Low light during the day and bright light at night increases the risk of psychiatric disorders.

Exercise remains the best remedy for Alzheimer’s.

New Primal Kitchen Podcasts

Primal Kitchen Podcast: The Link Between Dairy Intolerance and Dairy Genes with Alexandre Family Farm Founders Blake and Stephanie

Primal Health Coach Radio: Where Are the Wellness Jobs? With Carolyn Williams

Media, Schmedia

Zac Efron spells out the dangers of excessive training and leanness.

Where are the dead bugs on windshields?

Interesting Blog Posts

Did heather domesticate humans?

Why I’m not a big fan of anti-depressants.”

Social Notes

The Space Race plotted against Seattle trying to build a bike lane.

AI writes viral thread on productivity hacks.

Everything Else

The corporate capture of the nutrition profession in the US…”

Things I’m Up to and Interested In

No free lunch: Genes that helped people survive the Black Death now increase the risk of autoimmune disease.

Not surprised: Neanderthals may have been carnivores.

Fascinating: The lost forest gardens of Europe.

Interesting: “Today’s older adults are cognitively fitter than older adults from the past.”

More Neanderthal research: Was there really a need for carbohydrates in Neanderthal diets?

Question I’m Asking

What do you do for Halloween?

Recipe Corner

Time Capsule

One year ago (Oct 22 – Oct 28)

Comment of the Week

“13 years later, “Escape from Vegan Island” is still one of the best things you’ve ever written. Thank-you for being a passionate, clear-headed beacon of hope and sanity.”

-Thanks, Kirk. That’s what I try for.


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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What Do We Really Know?


Oct. 28, 2022 — You eat a credit card’s worth of plastic in a week. That may bother you. But does it harm you?

The answer depends on who you ask. Awareness of microplastics in general is certainly increasing; the most recent news is the detection of microplastics in human breast milk. Other research has suggested that we may be consuming up to 5 grams of plastic each week from our food, water, and certain consumer products.

The World Health Organization has been releasing reports on microplastics and human health since 2019. Their most recent report was released in late August 2022. 

“Although the limited data provide little evidence that nano- and microplastic particles have adverse effects in humans, there is increasing public awareness and an overwhelming consensus among all stakeholders that plastics do not belong in the environment, and measures should be taken to mitigate exposure,” the WHO said at the time. 

The WHO can’t go beyond what the data shows, of course. If microplastics are wreaking long-term havoc in our bodies as we speak, science hasn’t connected the dots enough to definitively say “this is the problem.” 

But some researchers are willing to speculate — and, at the very least, the risks are becoming impossible to ignore. Dick Vethaak, PhD, a microplastics researcher and emeritus professor of ecotoxicology at Vrije Universiteit in Amsterdam, Netherlands, is blunt, calling them “a plastic time bomb.”

The Plastic Problem 

Every piece of plastic that has ever been created is still on our planet today, apart from what has been burned. Past estimates show we only recycle about 9% of all plastic, leaving 9 billion tons in our landfills, oceans, and ecosystems. For context, that amount is 1,500 times heavier than the Great Pyramid of Khufu. 

New data is even more dire. A 2022 report from Greenpeace showed a 5% U.S. recycling rate in 2021, with a large portion of what consumers think of as “recycled” still winding up in garbage piles or bodies of water.

And this plastic doesn’t disappear. Instead, it breaks down into smaller and smaller pieces known as microplastics and nanoplastics.

Microplastics have been confirmed in human blood, lung tissue, colons, placentas, stool, and breast milk. But how they impact our health is still unknown.

To assess risk, we must ask, “How hazardous is the material?” says Flemming Cassee, PhD, professor of inhalation toxicology at Utrecht University in the Netherlands and co-author of the WHO’s recent microplastics report. 

There are three potential hazards of microplastics: their physical presence in our bodies, what they’re made of, and what they carry. To determine the extent of these risks, we need to know how much we’re exposed to, says Cassee. 

The first initiative to research the impact of microplastics on human health came from the European Union in 2018. Although microplastics were around before then, we were unable to detect them, says Cassee. 

That’s the real problem: Since the evidence is so new – and there hasn’t been enough of it — it’s not yet possible to draw definite conclusions.

“But looking into the future, I believe that we are likely facing a public health emergency,” warns Vethaak.

What, Exactly, are Microplastics?

Microplastics are plastic particles between 5 millimeters and 100 nanometers in diameter, or the width of a pencil eraser and something 10 times thinner than a human hair. Anything smaller than that is known as a nanoplastic.

“Microplastics include a wide range of different materials, different sizes, different shapes, different densities, and different colors,” says Evangelos Danopoulos, PhD, a microplastics researcher at Hull York Medical School in the United Kingdom. 

“Primary” microplastics are manufactured to be small and used in things like cosmetics and paints. “Secondary” microplastics result from the breaking down of larger plastic materials, like water bottles and plastic bags.

Secondary microplastics are more diverse than primary microplastics and can take forms ranging from fibers shed from synthetic clothing (like polyester) to pieces of a plastic spoon left in our rivers, lakes, and oceans. Any plastic in the environment will eventually become a secondary microplastic as natural forces such as wind, water currents, and UV radiation break it down into smaller and smaller pieces.

Plastic is a diverse material. Heather Leslie, PhD, senior researcher in Vrije Universiteit’s Department of Environment and Health, likens it to spaghetti with sauce. The noodles are the long polymer backbone that all plastic shares. The sauces are “the pigments, the antioxidants, the flame retardants, etc., that make it functional,” she says. 

What Makes Microplastics Dangerous?

There are more than 10,000 different chemicals, or “sauces,”  used to alter a plastic’s physical characteristics—making it softer, more rigid, or more flexible, says Hanna Dusza, PhD, of the Institute for Risk Assessment Sciences at Utrecht University.

As plastics degrade and become microplastics, these chemicals likely remain. Recent research has shown that microplastics leach these chemicals locally in human tissues, or other areas of accumulation, says Dusza. Some 2,400 of the 10,000 chemical additives were classified as substances of potential concern, meeting the European Union’s criteria for persistence, bioaccumulation, or toxicity.

Many of these chemicals also act as endocrine-disrupting compounds, or toxicants that imitate hormones when they enter the body. Hormones are active at very low concentrations in your bloodstream, explains Leslie. To your body, some chemical additives in plastic resemble hormones, so the body responds. 

“Sometimes even a low dose of some of these additives can cause unwanted effects,” says Leslie.

Bisphenol A (BPA), for example, is one of the more infamous endocrine disruptors. It is used as an additive to make plastics more rigid and can be found in any number of plastic products, though areas of concern have been plastic water bottles, baby bottles, and the protective coatings in canned foods. 

BPA may mimic estrogen, the female sex hormone essential for reproduction, neurodevelopment, and bone density. In men, estrogen regulates sperm count, sex drive, and erectile function. BPA exposure has been linked with – but not proven to cause – multiple cancer types, ADHD, obesity, and low sperm count. Most everyone has some amount of BPA circulating within their blood, but microplastics may retain BPA as they degrade, potentially increasing our exposure, leading to its unwanted consequences, says Dusza. 

And BPA is just one of those 2,400 substances of “potential concern.”

The Inflammation Problem

A potentially larger health issue emerges from our bodies yet again doing what they are supposed to do when encountering microplastics. Particles can trigger an immune response when they enter your bloodstream, explains Nienke Vrisekoop, PhD, assistant professor at UMC Utrecht in the Netherlands. 

White blood cells have no issue breaking down things like bacteria,  but microplastics cannot be degraded. When a white blood cell engulfs a certain mass of microplastics — either many small particles or a singular large one — it dies, releasing its enzymes and causing local inflammation.

Meanwhile, the plastic particle remains. So more white blood cells attack.

“This triggers continual activation that can result in various adverse effects, including oxidative stress and the release of cytokines that trigger inflammatory reactions, says Vethaak.  

And “chronic inflammation is the prelude to chronic diseases,” says Leslie. “Every chronic disease, like cancer, heart disease, and even neuropsychiatric diseases like Parkinson’s or major depression, begins with inflammation.” 

Meanwhile, inhaling microplastic particles can lead to respiratory diseases and cancer. 

“The smallest particles – less than one-tenth of a micrometer — penetrate deep into the lungs and even into the bloodstream, causing damage to the heart, blood vessels and brain,” says Vetaak. “The only direct evidence comes from workers in the textile and plastic industries that had been exposed to very high amounts of plastic fibrous dust.” 

Microplastics as Carriers

Microplastics can also pick up harmful substances and deliver them into your body.

“When they’re in an environment, they basically can suck up [chemicals] like a sponge,” says Dusza. “These chemicals are known environmental pollutants, like pesticides, fluorinated compounds, flame retardants, and so on.” 

Once in the body, these chemicals can be released, potentially leading to cancer, chronic inflammation, or other unknown effects. 

Particles can also act as a vector for microbes, bacteria, and viruses. A September 2022 study found that infectious viruses can survive for 3 days in fresh water by “hitchhiking” on microplastics. Their porous nature provides microbes with a perfect environment in which to live and reproduce, says Dusza. If you ingest the plastics, you ingest the microbes.

How to Minimize Exposure

There is no way to avoid microplastics. They’re in the air we breathe, the products we use, the water we drink, and the food we eat. 

Danopoulos reviewed 72 studies to quantify our consumption of microplastics in drinking water, salt, and seafood. 

“We are exposed to millions of microplastics every year, and I was only looking at three food sources, so there are really a lot more,” he says. “Once plastic waste is mismanaged and it enters the environment, there is very little we can do to extract it.” 

That said, we can take steps to lower our exposure and keep the problem from getting worse.

Water filtration is one option, though it is not perfect. Research has shown that municipal water treatment can be effective.  An October 2021 study found that two methods — electrocoagulation-electroflotation and membrane filtration — can be 100% effective in removing microplastics from treated water. The problem? Not all municipal water treatment uses these methods – and you would have to investigate to find out if your locality does.

As for at-home filtration methods, they can be effective but can also be dicey. Some consumer brands claim they remove microplastics, but how well depends on not just the type of filter but the size of the particles in the water. Meanwhile, how do you know if a filter is working on your water without testing it, something few people will do? Best not to take a brand’s claims on face-value, but look for independent testing on at-home brands.

A longer-term project: Reduce our risk by reusing and recycling plastic waste. Limiting our consumption of plastic, especially single use plastic, decreases the amount available to become micro- and nanoplastics. 

We must all learn to not treat plastic as waste, but rather as a renewable material, says Cassee. But if that seems like a tall order, it’s because it is.

“You’re a human being and you have a voice and there are a lot of other humans out there with voices,” says Leslie. 

“You sign a petition in your community. You talk about it with your friends at the pub. If you’re a teacher, you discuss it in your class. You call your elected representatives and tell them what you think and how you want them to vote on bills.” 

When people start working together, you can really amplify that voice, says Leslie.

What’s the Bottom Line Right Now, Today?

Numerous sources have declared microplastics do not impact human health. But that’s largely because no direct evidence of this exists yet.

Even the WHO in its report suggests that progress must happen if we’re to fully understand the scope of the problem. 

“Strengthening of the evidence necessary for reliable characterization and quantification of the risks to human health posed by NMP (nano- and microplastics) will require active participation by all stakeholders,” it says.

All researchers interviewed for this article agree we don’t have enough evidence to draw any definite conclusions. But “if you look at the wrong endpoints, things will look safe, until you look at the endpoint where it’s really causing the problem,” says Leslie. 

We must research our blind spots and continually ask, where could we be wrong?

It is a problem; it’s not going to go away,” says Danopoulos. “It’s going to get worse, and will continue to get worse, not by something that we are doing now but by something we did 5 years ago.”

Perhaps the question to be asked, then, is the hardest to answer: Are we willing to wait for the science?


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Black, Hispanic COVID Patients Less Likely to Get Antiviral Paxlovid


“The issue of equity and distribution of Paxlovid is similar to what we saw in the distribution of the vaccine,” she said. “You have to think about access to primary care pharmacies, particularly in economically disadvantaged communities.”

Community hesitancy also plays a role, Salas-Lopez noted. “These are new vaccines, new treatments, so the familiarity isn’t there with all of our community members, but in particular, our community members who have experienced a lack of trust in the health care system.

“In addition, guidelines for testing and vaccines and medications for treatment can quickly change, making it difficult for providers and community members to stay abreast of all the changes — your head spins,” she said.

Structural racism may also play a role, Salas-Lopez added.

One weakness of the study, she noted, is that the researchers didn’t account for prescriptions given directly at walk-in clinics and drug stores, which gave out thousands of doses of Paxlovid and might have altered the results.

Salas-Lopez said that it’s partly the responsibility of health care systems to end these disparities.

At her health care system, they created a health equity task force to identify the weak spots in health care in their community. They then began outreach programs to close these gaps.

“Health systems have to work hard to address the issue of inequity,” Salas-Lopez said. “It takes a mission and a vision to do that, and then action.”

The report, which followed patients from January to July of this year, was published Oct. 28 in the CDC’s Morbidity and Mortality Weekly Report.

More information

For more on COVID-19, see the U.S. Centers for Disease Control and Prevention.


SOURCES: Tegan Boehmer, PhD, acting lead, Healthy Community Design Initiative, U.S. Centers for Disease Control and Prevention; Debbie Salas-Lopez, MD, MPH, senior vice president, Community and Population Health, Northwell Health, New Hyde Park, N.Y.; Morbidity and Mortality Weekly Report, Oct. 28, 2022

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