What does "Grass-Fed" Meat Mean?

If you shop for the food in your family you have probably started to see the term “Grass-Fed” on more and more meat products.   You may have wondered what it means and what significance it has for human health.

To make it more confusing this term is often thrown in with other terms such as “Organic” and “Grass-Finished”.       To understand all this let’s start with talking about Grass as opposed to Grain Fed.     Cows and other Ruminants including cattle, goats, sheep, giraffes, deer, moose, and caribou to name a few have a natural diet based on what they have eaten for hundreds of thousands of years.     Their bodys' and specifically their digestive systems were shaped by evolution to eat green plants!

For thousands of years that is what they did eat, but in modern times cattle farmers learned that feeding a ruminant grains and corn will put weight on them much faster than their ancestral diet of green plants consistently mostly of grasses.      This translates to quicker time to slaughter, lower costs, and higher profits for the farmer!  Grain and corn is the metabolic equivalent of feeding cows a diet of “Twinkies” with all the consequences.      In addition, grain fed cows have a particular taste and Americans in particular have become used to it and partial to it.

Unfortunately, grain fed animals have a very different fatty acid composition than animals fed a grass diet.      Grass-fed cattle contain much higher levels of many beneficial compounds including anti-oxidants, Omega-3 Fatty Acids, Conjugated Linoleic Acid (CLA), Trans-Vaccenic Acid (TVA), Trace Minerals, and vitamins.      

The worst part is that most meat is not just grain fed it is injected with hormones and antibiotics that also speed up weight gain and the corn and grain is very low quality and heavily sprayed with pesticides so you’re eating tons of toxins when you consume meat raised this way!

Omega 3 Fatty Acids are essential fatty acids as our Omega 6 Fatty Acids meaning we must consume them and cannot manufacture them in our bodies.   We need both in a balance.     Unfortunately the American diet is way too high in Omega 6 fatty acids and this has big-time consequences to human health (see this previous blog post to understand the need for lower intake of Omega 6 Fatty Acids and Higher intake of Omega 3 Fatty Acids and how and where to get both - http://workoutanytime.blogspot.com/2016/11/omega-3-fatty-acids-and-health.html )

Anti-Oxidants are crucial for health and grass-fed meat has much higher levels of carotenoids like Beta-Carotene and others.    Carotenoids are fat-soluble meaning they tend to get stored in fats making the fat look yellow.      Yellow fat (like butter from grass-fed cows) is a sign of high nutrient density.    More carotenoids = more antioxidants and more nutrients (plus richer flavor!).  

CLA provides several key benefits including:

Improving weight loss and specifically reduces bodyfat! 

Helps increase lean mass including muscle and bone!

Potent Anti-Cancer Effects

Helps reverse atherosclerosis (hardening of arteries)

Improved digestions

Helps balance inflammation and immune function

Reduces food allergies and sensitivities.

TVA – aka Trans Vaccenic Acid is technically a trans-fatty acid, but unlike man-made transfats which are unquestionably NOT healthy – there are benefits to TVA.    Naturally occurring TVA in grass fed animal products may help lower cholesterol and LDL cholesterol in particular along with lowering triglycerides.  TVA can also be converted to CLA in your body.     Like CLA TVA seems to reduce risk factors associated with heart disease, diabetes, and obesity according to research from the University of Alberta.

Grass-Fed vs Grass Finished

Grass-Fed means that cattle ate nothing but grass and other forage (like hay or silage) for their entire lives.   This means they were never fed grain at any point. 

As the name implies Grass-Finished means the animal was fed grains but was “finished” eating grass before slaughter.    How much time eating grass vs grains and the quality of grains makes a BIG difference.      Just 90 days of grain feeding destroys all the benefits of grass feeding so knowing what the animal ate and for how long is key which is why you ideally buy beef from a farmer you know and trust!    

Alternatively buying meat that is organic AND grass-fed is by far the best option.     Just Organic means the grain fed to the animal was not sprayed with pesticides which is good, but this does not provide the many benefits of feeding the animal a grass diet as described above.

See next Month's Blog for a detailed explanation of the term "Organic" and how to interpret all those differrent lables such as "Certified Organic", "100% Organic", "All Natural", etc.

Do You Really Need to Drink Eight Glasses of Water Each Day?

Everyone knows you need 8 glasses of water each day to stay healthy right?    Wrong!   Of course, drinking water is essential and the best way to get the water you need is by drinking water (not soda, juice, or sports drinks), but it is a misconception that you need to drink 8 glasses per day and that more is always better.    

The National Academy of Sciences recently concluded that most Americans are adequately hydrated.   Direct Quote “The vast majority of healthy people adequately meet their daily hydration needs by letting thirst be their guide.”

Typically, about 80% of your total water intake comes from water and other beverages with about 20% from the food you eat.

Another associated myth is that if you wait until you are thirsty it is too late because you are already dehydrated.   For the vast majority of people your physiological thirst mechanism is triggered before you become dehydrated.

Another myth is that if your urine is yellow or deep yellow you are dehydrated.     This could indicate dehydration but urine color is also strongly affected by other factors including intake of certain vitamins and other chemicals we take in from food and drinks.

Dangers of too much water intake

There is a very real danger from excessive water intake and the number of people affected by this is growing – particularly in sports.   This may all stem from a paper published by the US Military stating that soldier should drink 64 ounces of water per hour in order to improve performance.  It was and still is widely embraced although there is not scientific support for this advice.  Even the American College of Sports Medicine recommends “…drinking ahead of thirst.”   The problem is this can be taken too far and in fact excess water impairs performance and actually can kill someone if it is excessive enough.   It is important to note that data demonstrates mild degrees of dehydration do not impair performance.

Excessive water intake coupled with exercise can result in exercise-associated hyponatremia (EAH).   EAH is also commonly referred to as “Water Intoxication.”   In EAH, the body’s cells, including those in the brain, swell with too much water, which can be fatal.    When the body has too much water relative to its salt level, the salt level in the blood drops too low which leads to significant problems.

The Right Strategy for Water Intake

The easy answer to proper hydration is to pay attention to your thirst and drink accordingly.     This applies to sports drinks as well.   Also it goes without saying that not getting enough water is not advisable.  When you do not drink enough water it puts you at a much higher risk for kidney stones and this is one of the most painful conditions there is!   Dehydration can also negatively impact cognitive function and mood.

Dehydration is more common in children and the elderly, and risks of dehydration get higher as the temperature and humidity rise.   During hot humid weather the body sweats profusely but because of the humidity sweat does not evaporate so cooling is not nearly as effective and the body just keeps sweating without much effect on body temperature.   Dehydration is also much more common in extremely cold temperatures below freezing because the air becomes extremely dry and with each breath moisture is lost.     In addition, in cold temperature the thirst mechanism can fail to kick in.     The end result is that dehydration is a very serious risk in prolonged exposure and exercise in cold environments!

So How Much Water Do You Need?

While you probably do not need 8 glasses of water per day – it probably is not going to hurt you in most cases.    Actual fluid intake and needs will vary from individual to individual depending on their size, activity level, and the amount of water present in the foods they eat each day.

However, the take home message is simple – pay attention to thirst and drink when you are thirsty and try to stick with good ole H20 rather than juice or soda.      It is what your body needs without all the extra calories!

Kneeling High to Low Chop - The Best Core Exercise You are Not Doing!

Core stability is a big buzzword in fitness, and for very good reason.     The ability to keep the core stable is essential for proper movement and prevention of injury.      Stability has three aspects related to the planes of movement:

Sagittal Plane Stability – is the ability to prevent flexion and extension of the core from the low back to the top of the head.

Front Plane Stability – is the ability to prevent lateral flexion of the core from the top of the head to the low back.

Transverse Plan Stability – is the ability to prevent rotation of the core from the top of the head to the low back

Stability is about preventing movement – not creating movement!   All muscles can act as stabilizers, movers, or absorbers, but the muscles of the core spend a lot of time preventing movement in many activities from running to walking to jumping.    This is why exercises like the plank are considered functional because the plank is about using core muscles to prevent movement of the core as opposed to exercises like a crunch which is about creating movement.

To have a strong and stable core it is important to perform stability exercises in all three planes of movement.     The plank and side plank do a great job of challenging muscles to prevent movement in the sagittal and front planes, but that leaves the Transverse Plane.    This is significant because the vast majority of injuries occur in the Transverse Plane with Frontal Plane injuries close behind.

It is also important to note that rotational movement (movement in the transverse plane) is fundamental to human movement in general and the generation of explosive force in many activities from Golf to Tennis to Boxing.

One of the best ways to develop rotational stability in the Transverse Plane is doing high to low anti-rotation chops in a half kneeling position using either resistance bands or cable resistance with a rope handle or pole attached.

Execution

The anchor point of the resistance band/location of the cable handle should be position up high.     Your body should be facing perpendicular to a line from the handle/anchor point straight down and across your body.     You should be in a half kneeling posture down on one knee (the leg closest to the cable/band should flexed with foot flat on the floor and hip and knee bent at 90 degrees.   

The other knee should be down on the floor (use a cushion or mat!) with shin and top of foot along the ground directly behind the knee.   It is important that the knee is directly under the hip.  It is also important that the spine be held straight with a straight line from top of head through the spine and hip to the knee on the ground.    Extend the spine fully and keep your spine fully elongated throughout the exercise.

Reach across the body and place both hands on the resistance band/rope spread apart with hands shoulder width apart.gripping the band/rope.

Keeping the shoulders and hips facing forward the entire time pull the rope/band directly down and across the body and pause in the bottom position making sure there is no movement to in the shoulders or hips while maintaining a fully lengthened spine.   Then slowly return to the starting position.    Form is VERY important in this exercise.

Here are two great instructional videos:

http://www.stack.com/video/3730538400001/elite-performance-with-mike-boyle-increase-core-strength-with-anti-rotation-exercises

http://www.muscleandfitness.com/workouts/abs-and-core-exercises/videos/half-kneeling-stability-chop

Squats and Anatomical Variation Among Individuals

Squatting is one of the fundamental movement patterns everyone should train, but it is very important to understand and consider the effect that individual variations in limb length and anatomical variances can have on exactly how each person can and should squat.

Everyone cannot and should not squat the same way!  Many trainers and individuals try to squat in “perfect” form with feet flat, no heel lift, feet pointing forward, with back upright and straight with butt to the grass but this is not only not possible for some people – it can actually get them hurt!

One of the biggest factors determining how an individual can squat is the relative length of their femur (upper leg bone) relative to their lower leg and upper body length.       In general, the longer the femur  and the shorter the tibia (lower leg) the more a person MUST lean their upper body forward in order to get thighs parallel to floor much less going below parallel.     This puts a TON of stress on the low back and in extreme examples trying to get to parallel is a BIG MISTAKE – swap for another exercise like a lunge or step up – nobody wins when you get hurt exercising!

To gain a really strong understanding of these concepts check out this fantastic article on this subject by Bret Contreras that includes video links to a short, but powerful video presentation on this subject using a stick model: https://bretcontreras.com/how-femur-length-effects-squat-mechanics/  .     Once you see it you will never try to force someone into a fixed squat pattern again without really thinking it through.      Also check out these videos from Tom Purvis which show this clearly in a way that is very easy to comprehend https://www.youtube.com/watch?v=Av3LO2GwpAk and   https://www.youtube.com/watch?v=KGEKRjlZKf8 

In addition to limb length differences there can be dramatic differences in the shape of the acetabulum (the hip socket), the head of the femur (ball of femur) and femoral neck angle.   The end result can mean very different squatting mechanics are required.     Here is a great article showing how these differences manifest themselves in squatting:  https://bretcontreras.com/no-two-hips-are-the-same-how-anatomical-variance-can-affect-your-range-of-motion/

Does Weighing Yourself Help You to Lose Weight?

Do weight changes translate into fat loss?

On a day to day basis a scale is an extremely poor tool for giving you information on changes in bodyfat levels which are very small.  Daily weight changes are mostly accounted for by four factors:  bowel movements, urination, starch and sugar intake, and blood volume.    Since your blood volume typically does NOT vary that much the other factors are more relevant.

Bowel Movements and Urination vary a lot between different people anywhere from 1.3lbs to 5.7lbs in a single day.    This is one of the reasons to consistently weight yourself after you wake up and go to the bathroom and before you eat or drink much.

However, the biggee when it comes to daily weight fluctuation, is usually glycogen storage levels.    Glycogen is just the storage form of glucose aka blood sugar.    All starch and sugar ultimately end up as glucose, glycogen or fat.     

For example, on the front end of a low carb diet you will show big weight loss which is almost all water because you store glucose/glycogen with water – hence the term carbo “Hydrate”.  Muscle and organs contain the highest levels of water, and this is significant because most of your bodyweight comes from muscles and organs. 

  

So daily changes in weight are NOT a good reflection in changes in bodyfat levels!

Can daily weighing help with long-term weight loss and fat loss?

In order to answer this question let’s review the scientific studies that have looked at this issue.     The recent advent of WIFI scales is allowing much more accurate weight records because prior to that people had to take the time to write down their weight each day.

In a recent WIFI scale study called the Weight Trial here were the results:

Over a six-month period, those who weighed daily lost about 13 lbs more than the control group.

Even those who weighed themselves up to five times each week lost less weight than the daily weighers.

Daily Weighers were more likely to do things like eating less food and watching less television so clearly the weighing helped by changing behaviors!

Although this study did not measure body fat, it is quite likely that the body weight loss did translate into significant fat loss.

For certain groups, daily weighing is a bad idea such as people with eating disorders and other psychological disorders including extremely low self-esteem.     In addition, daily weighing does not work for everyone.   For some people the inevitable plateaus or variations in weight loss can very frustrated and quit the whole process!

So daily weighing may be helpful for you, but it is not perfect and it does not accurately measure changes in bodyfat levels so it is important to do use some method of body composition testing to measure these changes which should be your ultimate goal!

Zucchini Noodle with Avocado Pesto Sauce

Most people love pasta, but regular pasta is not exactly a nutritional bonanza!   Pasta is basically pure starch which immediately is converted to sugar in your body and has no real micronutrient content.   But if you substitute zucchini pasta with avocado, pine nuts, and parsley it is a whole different ballgame!

Not only does it taste great – it has very little sugar, and plenty of healthy fats along with tons of fiber.  From a micronutrient standpoint, it is packed with nutrients including:

High levels of vitamin C

High levels of potassium and magnesium

Vitamin B-6

Recipe Ingredients:

2 Large Organic Zucchini

2 small ripe avocados

1 cup fresh flat leaf parsley

3 tablespoons of avocado oil

3 tablespoons of pine nuts

Juice from 1 organic lemon

½ teaspoon crushed red pepper flakes

Salt and Pepper to taste

Instructions:

1.       Spiralize zucchinis and then set aside.    Great article on how to spiralize veggies here:  http://ohsheglows.com/2012/08/27/how-to-spiralize-vegetables-without-a-spiralizer-2-veggie-pasta-dishes/  and you can buy the hand peeler mentioned here:  https://www.amazon.com/gp/product/B0018ICHH2/ref=as_li_tf_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=B0018ICHH2&linkCode=as2&tag=ohshgl02-20

2.       In a food processor or blender, add avocados, pine nuts, lemons, red pepper flaxes, salt and pepper.   Blend on high for 2-3 minutes until creamy then slowly drizzle in the avocado oil while it continues to blend and emulsify.

3.       Heat a large skillet on medium heat.   Once it is hot, add the zucchini noodles to the pan tossing them around 5 for minutes.   Add ¼ cup of the pesto sauce to the pan.   Using tongs, coat the zucchini noodles thoroughly.

4.       Serve it while it is hot garnishing with parsley.

The Incredible Pistol Squat

The pistol squat requires mobility and strength from the entire lower body and core, and once you work up to being able to complete them you can get a great lower body workout anywhere with no equipment. 

Most people will not be able to perform the pistol squat properly without working through several progressions that help develop the specific mobility, strength and stability required to get through the exercise for repetitions.

Pistol Squat Progressions

There are two basic ways to progress to a full pistol squat. Either use a progressively lower bench or step, or use something to hold onto while doing a full pistol to help pull yourself up and progressively use it less and less until it is no longer required.

For the step progression, you can use actually stairs or use a chair to start.    Stand facing away from the chair or staircase and put all your weight on one leg keeping the other leg straight with the hip flexed slightly so the non-standing foot is held off the ground in front of you.     Flex the hips and reach back with your butt towards the staircase or chair and lower yourself down under control keep your arms straight and in front of you parallel to the floor to counterbalance your hips moving backwards.    Let the standing knee and ankle flex along with your hip as you reach your butt backwards and go down.    However, you MUST keep the heel of the standing leg down and this requires a lot of flexibility of the soleus tendon (soleus is the single joint calf muscle).    

Try to lightly touch your butt down to a stair or the chair then drive the standing foot down, squeeze the glute extending your hip, knee and ankle to the starting position.  Perform sets of 5 – 10 reps each leg.    Overtime find progressively lower steps, benches or individual stairs so that you are progressively squatting lower and lower until you can perform a full squat on one leg all the way down to the ground and back up again keeping your non-standing leg straight and parallel to the floor while the hip is flexed.

The second option to progress to full pistol squats is to hold onto something that you can pull on while doing a full pistol squat thereby assisting the stance leg.    You can hold onto a suspension trainer, a cable machine handle, door frame, chair or table, or resistance training band or rope anchored above you.    A great way to do this is to anchor a suspension trainer or resistance band above you to a secure point then grasp the two handles and pull on them as required to do a full pistol squat.    Over time progressively use less and less assistance from the upper body, switch to just one hand, then lessen grip and assistance until you can perform full pistol squats.

Videos:  https://youtu.be/It3yvU0fomI or https://www.youtube.com/watch?v=PPksQCbeVZw

How to Obtain the Benefits of Broccoli without Eating Broccoli!

Regular consumption of Broccoli has many proven benefits, but the most significant set of benefits come from two key compounds:   Glucoraphanin and Sulforaphane.     They have been the focus of over 650 scientific publications. 

Sulforaphane is responsible for the following benefits:

Supports the body’s detoxification processes

Protects cells and more importantly cellular DNA from damage which is the instigator of cancer!

Activates more than 200 genes

Supports normal cell division and growth

Boost endogenous anti-oxidant production

Supports gut health

Supports regeneration of cartilage

Supports Bladder and Prostate Health

Supports Respiratory Health

Helps prevent and treat multiple forms of cancer including prostate, stomach cancer, oral cancer, lung cancer, cervical cancer, throat cancer, colon cancer, esophageal cancer, kidney cancer, and breast cancer to name a few!

Sulforaphane is actually produced from Glucoraphanin in broccoli through the action of an enzyme called myrosinase produced by intestinal bacteria or contained in some foods. 

  

Here is where the challenge lies!    Cook broccoli too much and you destroy the Glucoraphanin and the myrosinase.    Eating it raw is problematic for sulforaphane production as well so it is really hard to get this just right.  Also for many people the taste of broccoli is really unpleasant.   In addition to obtain therapeutic amounts of sulforaphane you need to eat about 2 pounds of broccoli each week!

Endogenous vs Exogenous Anti-Oxidants

Everyone has heard of anti-oxidants which are a crucial part of our physiology.   Anti-oxidants come through two key sources:   from chemicals in food (particularly plants) know as exogenous antioxidants, and from the body producing its own supply of anti-oxidants known as endogenous anti-oxidants.    Although both play important roles in health, endogenous anti-oxidants are much more crucial and important to overall health and disease prevention.

In general, Endogenous Anti-Oxidants cannot be consumed and must be generated by the cells of the body.    As we age the body produces progressively lower quantities of these vital substances, but there are substances which ramp up endogenous anti-oxidant production.   Sulforaphane is one of the most potent substances for increasing the production of endogenous anti-oxidant production and dramatically increasing the detoxification of the many toxins that we encounter in our environment, food and drink.    This is critically important for health and one of the most important ways to prevent cancer!

Obtaining Sulforaphane without eating broccoli 

The good news is that broccoli sprouts contain 10 – 50 times more sulforaphane that one ounce of broccoli sprouts contain the same amount of sulforaphane as 1.5 pounds of broccoli.   So fresh broccoli sprouts are a great alternative and have a light taste.     However, some people’s gut contains less than optimal levels of the right types of bacteria which are key for producing the necessary quantities of myrosinase so production of sulforaphane can be limited.

A great way to insure you get myrosinase is to add a little horseradish, mustard, or wasabi (has to be REAL wasabi which is rare) because all of these foods are high in myrosinase.    Horseradish contains much larger amounts of myrosinase than broccoli or broccoli sprouts and ALSO contains glucoraphanin so adding a little to broccoli or broccoli sprouts will dramatically boost the benefits.   Just a little real horseradish (teaspoon is more than enough) is all you need!

Sulforaphane Supplements

Sulforaphane is not stable as a supplement so consuming it by itself is not a good strategy.     That being said there are supplements made from broccoli sprouts and broccoli seeds that contain significant quantities of Glucoraphanin and Myrosinase which generate significant quantities of Sulforaphane when consumed.      Broccomax contains standardized quantities of myrosinase and glucoraphanin and is proven to generate significant quantities of sulforaphane in the body, and Mercola Fermented Broccoli Sprouts also provides similar benefits.   Both can be found from multiple sources on the internet.

Reverse Lunge with Diagonal Lift

Lunges are a fantastic functional lower body exercise, and the benefits can be enhanced by adding an upper body component to the basic lunge movement pattern. One of the most productive total body lunge variations is the reverse lunge with a diagonal lift.

The exercise improves hip mobility in the front of the rear leg, while also increasing strength and stability in the front leg and increasing core strength and mobility. Specifically, it improves hip flexor mobility while training the body to move smoothly in the spiral line. It also encourages proper tri-planar movement.

Start standing with feet shoulder width apart in upright posture. Hold a medicine ball, dumbbell, or kettlebell (or even a body bar) positioned at the right hip pocket region. Step back with the right leg to perform a reverse lunge. At the same time move both arms diagonally up and back over the left shoulder until a comfortable stretch is felt in the anterior (front) of the right hip. Do NOT allow the back to arch. Pause in this position for one or two seconds.

Do 10 – 15 repetitions on one side then repeat on the other side. It is important that you keep both feet facing forward and keep your trunk upright throughout the movement.

Regressions:

Perform the movement without a medicine ball, dumbbell, or bar

Start in the split stance lunge position instead of having to step back

Progressions:

Increase weight you are holding.

Perform the movement in an alternating side manner vs one side at a time.

Video Links: https://www.youtube.com/watch?v=JDyGhcm-aVs

Astaxanthin – Anti-Oxidant Superstar

While many antioxidants can be obtained by eating organic fruits and vegetables, astaxanthin is derived only from a specific microalgae called Haematococcus pluvialis.  The algae uses astaxanthin to protect itself from intense sunlight, ultraviolet radiation and low nutrition.

There are two natural astaxanthin sources: the microalgae that produce it and the salmon and krill which consume the algae directly. The best resources for these foods are wild-caught Alaskan Salmon and Krill Oil Supplement, which offer many other nutritional benefits.

Research indicates astaxanthin may benefit those suffering from inflammatory conditions including arthritis, rheumatoid disorders, metabolic disease, as well as cardiovascular, neurological and liver diseases.

Astaxanthin can also help to increase your muscle capacity and stamina, decrease workout recovery time, and decrease muscle pain.  Other proven benefits include:

Reduction of Inflammation

Protects Vision

Enhances Heart Health

Decreases Oxidative Stress

Protects Against Sunburn

Boost Your Immune System

Helps Prevent and Fight Cancer

Astaxanthin and Eye Health

Astaxanthin is an extremely powerful anti-oxidant:  65 times more powerful than vitamin C, 54 times more powerful than Beta-Carotene and 14 times more powerful than Vitamin E. Astaxanthin crosses the blood-brain barrier AND the blood-retinal barrier which is a huge deal for your brain AND your eyes! Astaxanthin is a member of the carotenoid family of anti-oxidants that include beta-carotene, lutein and zeaxanthin.   Of all the carotenoids, only zeaxanthin and lutein are found in the retinas of your eyes.  This is because your eye is a highly light and oxygen rich environment, and it needs a large amount of free radical scavengers to prevent damage.  Scientists have specifically studied astaxanthin for its effects on the eyes and discovered that it is completely safe, and much more potent than all the other carotenoids.   Specifically it has been shown that astaxanthin supplementation can be effective in preventing a whole list of eye diseases including: Age-Related Macular Degeneration Diabetic Neuropathy Cystoid Macular Edema Central Retinal Arterial and Venous Occlusion Glaucoma Inflammatory Eye Diseases including retinitis, iritis, keratitis, and scleritis Astaxanthin is one of the few anti-oxidants that you should consider supplementing because you cannot obtain the recommended dosage from your diet alone.      The good news is that there are excellent Astaxanthin Supplements available from companies like Jarrow, Doctors Best, and Swanson to name a few.   It should be taken with a meal with fat because it is fat soluble with dosage from 4mg – 12mg per day although there are no harmful effects from higher dosages.