Unleashing the Power of Plant-Based Diets Brenda Davis RD, Canadian Plant-Based Nutrition Conference

good morning everyone this morning we are going to be unleashing the power of plant-based diets and i’m so delighted to be here thank you so much to the organizers for putting on this amazing conference first my disclosures no potential conflicts of interest and i will begin with a very brief outline we are going to start by talking about the strength of the link between diet and disease we’ll move on to talking about the evidence for plant-based diets and we will conclude the presentation with a practical piece seven steps to an optimal plant-based diet for disease prevention and reversal i would like to begin by sharing a little story about my dad this happened oh it was for sure 40 years ago i was in university and i was visiting my parents um during march break and i can remember being in the kitchen preparing some food and my dad walking by me with two cigarettes hanging out of his mouth and and the chips and licorice and and uh coke underneath his arms and he turned to me with this big cheeky grin stuck his belly out as far as it would go and uh just kind of sauntered by me and of course i gave him the look of utter disgust and a couple of hours later i went to him and i said dad i don’t understand why you’re doing this we love you and we want you to be around for a long time and he said to me he said you know bran he said i would rather spend 50 years or live 50 years having the freedom to enjoy what i enjoy i want to be buried with my cigarettes and blueberry pies and and he said you know i could get hit by a truck tomorrow and i looked at him and i said i know dad but it doesn’t mean you should be walking out in front of one this is what we know we know that 70 of deaths globally are due to chronic diseases of our own making an estimated 90 percent of type 2 diabetes 80 percent of heart disease and 40 to 70 percent of cancers are considered entirely preventable ten years ago the world health organization identified what they believed to be the four big lifestyle culprits sedentary lifestyle alcohol tobacco and an unhealthy diet and they defined an unhealthy diet as one that is based on processed foods with added fat sugar and salt and animal products rich in saturated fats it’s low in vegetables fruits legumes whole grains nuts and other high fiber foods at the highest risk are inactive populations consuming western style diets the highest rates globally are in north america northern europe australia and of course all of the developing countries that are adopting our western ways the lowest risk are populations who live simply are physically active and consume unprocessed plant-based diets the lowest rates globally are some parts of rural asia south america and of course the people of the blue zones where there are more centenarians than anywhere else on the planet this is where people live the longest healthiest lives and there are five blue zones the the uh loma linda california with seventh-day adventists there the nikoia peninsula in costa rica sardinia italy icarua greece and the oak and okinawa japan and some of the lifestyle practices are unique to each blue zone some are shared by two or more blue zones as you can see in this venn diagram to the right and some are common to every single blue zone that we know of and those are strong families they’re socially engaged they do constant moderate physical activity they tend not to smoke and where diet is concerned they all consume plant-based diets and they all use legumes as dietary staples and the evidence for plant-based diets continues to mount and i think some of the most compelling evidence is

Similar Healthy Lifestyles; Different Dietary Patterns

by looking at cohorts of individuals who live similar healthy lifestyles but have different dietary patterns and there are three cohorts we’ve been or three populations we’ve been following for some time one in north america and this is the adventist health study 2 with over 96 000 participants this study began in 2002 and is ongoing the second is in the uk it’s called epic oxford with over 65 000 participants it began in 1993 and is ongoing and then a population in taiwan where there are two uh separate uh uh study groups one is the tsuchi health study with over six thousand participants which began in 2007 and then the such vegetarian uh study with over 12 000 participants that began in 2005. now what’s really interesting about these cohorts is people in these health conscious cohorts die at about half the rates of the general population in their region which means that when we compare vegans in these cohorts with omnivores in these cohorts we’re not comparing vegans with people who are sitting on the couch eating a sad or standard american diet we’re comparing vegans with omnivores who are health-conscious who eat well who exercise about the same amount smoke about the same amount drink about the same amount so we’re comparing uh very very people with very similar uh lifestyle so we’re really looking at the consequences of the diet and so what are the findings of these studies well for ischemic heart disease compared to similar health conscious meat eaters ischemic heart disease rates were about 13 lower and this is epic oxford among pesco vegetarians and 22 percent lower among the lacto-ovo vegetarians and vegans in the adventists tell study too they were 23 percent lower among pesco vegetarian men 24 lower among lacto-ovo vegetarian men and 55 percent lower among vegan men now interestingly there were no significant differences among the women in this cohort uh hypertension in the adventist health study 2 was 55 lower among lacto-ovo vegetarians and 75 lower among vegans compared again to the health conscious non-vegetarians now stroke uh there was a study that that came out in 2019 uh that that was very concerning to the vegetarian world and that was uh epic oxford and what they found was that stroke was actually higher among the vegetarians and vegans it was a total stroke was 20 percent higher and hemorrhagic stroke was 40 percent higher and the the researchers felt that it may have been because of the low levels of vitamin d b12 essential amino acids and long chain omega-3 fatty acids in this particular cohort so is this something that we find in all vegetarian cohorts and the answer is no in fact stroke risk was actually found to be lower among lacto-ovo vegetarians and vegans in the adventist house study two cohort uh there was a systematic review of eight studies that showed vegetarians had a twenty-nine percent risk reduction for super cerebrovascular disease and in su chi compared to non-vegetarians in cohort one the sushi health study ischemic stroke was 74 percent lower among vegetarians and in cohort two in the sushi vegetarian study total stroke was 48 lower ischemic stroke 59 and hemorrhagic stroke was actually 66 lower and then we have another study that that is a brand new study um 2021 that looked at plant-based diets and plant-based diet quality and risk of stroke and what they found and this is the harvard study with the nurses health study and in the nurse’s health study too and the health professionals follow-up study over 200 000 participants and they they looked at the plant-based diet index how plant-based is your diet and stroke risk and what they found was compared to participants with the lowest plant-based diet index the risk of stroke was six percent lower in those with the highest plant-based diet index but it was 10 lower in those with the highest healthy plant-based diet index and it was actually five percent higher in those with the highest unhealthy plant-based diet index and what this means essentially is is the unhealthy plant-based diet index is is folks who are eating a lot of refined carbohydrates and fried foods and processed foods or heavily processed foods and and the conclusion of the researchers was overall a vegetarian diet is not associated with total stroke although lower total stroke was observed in those with a healthful plant-based diet and the take-home message here is diet quality matters for all chronic diseases plant-based diet uh plant-based or otherwise for diabetes compare it again to similar health-conscious meat-eaters the risk in adventist health study too was 21 percent lower among pesco vegetarians 38 lower among lacto-ovo vegetarians and 62 percent lower among vegans epic oxford was 35 lower among lacto-ovo 47 lower among vegans and actually 53 percent lower among pesco vegetarians in the su chi uh study they found that diabetes risk was 51 percent lower among vegetarian near vegan men and 75 percent lower among the vegetarian women and the reason i say near vegan is because the people in this cohort eat very little if any dairy there’s just a little bit of egg so it really is quite close to vegan and i wanted to mention the pictures on this slide because i i had the privilege of of being a presenter at the sutra international medical association conference and and uh you can see on the top this meal is actually a typical meal at the in the cafeteria of the sushi hospitals all such hospitals are completely vegetarian uh and in the lower picture i was invited to have a tour of the kitchen and i went into the kitchen and the first thing i saw was just these massive numbers of huge huge plastic bags filled with greens and i said to the people that were were providing the tour i said well what is this and they said well this is the um organic greens that the nuns these are buddhist hospitals that the nuns picked from the gardens this morning they said this is the most important food for our patients because it helps them to heal and i thought what a concept can you imagine uh hospitals doing this it just uh is is uh we have a lot to learn um from one another uh non-alcoholic fatty liver disease uh and this again was a su chi study was 21 lower among the vegetarians and replacing soy with meat or fish increased risk by 12 to 13 percent replacing whole grains with refined grains increased risk three to twelve percent cancer was in epic oxford 11 lower among lacto-ovo vegetarians 12 among pesco vegetarians and 19 percent lower among vegans in the adventist health study too eight percent lower among lacto ovo 12 among pesco and 16 percent lower among vegans uh breast cancer in sushi uh was 58 lower among the vegetarian participants and those that had daily isoflavone intake uh it had a 63 uh risk reduction so soy tending to be uh especially protective uh cataracts in epic oxford were 21 percent lower among pesco vegetarians 30 percent lower among lacto-ovo and 40 percent lower among vegans uh uh the risk was 20 percent lower among vegetarians and actually 30 lower among overweight vegetarians which i found to be uh very odd i’m not sure why um but that was their uh results and diverticular disease in oxford 10 lower among the pesco vegetarians 27 percent lower among lacto-oil vegetarians and 72 percent lower among vegans not surprisingly uh urinary tract infections were 16 percent lower uh among the vegetarians in su chi and the association was especially strong for females a goat in suchi was 77 77 percent lower among the vegetarians and this was the tsuchi health study and it was 39 percent lower in the tsuchi vegetarian study and they even had results at zuchi for depression and it was 30 percent lower among the vegetarians kidney disease was 52 lower in that adventist child study too

Kidney Disease

and uh kidney stones epic oxford found compared to meat-eaters that consumed at least a hundred grams or three and a half ounces of meat a day they had they had 27 percent less kidney stones for pesco vegetarians and 31 fewer kidney stones in vegetarians and vegans and of course not only do plant-based diets protect against many chronic diseases but they provide us safe and powerful treatment options in some cases a treatment option in some case cases even reversing disease as i have seen over and over again with clients and with my work in the marshall islands and our research in lithuania our research demonstration project we see this everyone who’s using plant-based diets to treat chronic disease sees this on a regular basis the good news of course is only an estimated five to ten percent of chronic disease is actually caused by your genes healthy lifestyle choices can actually flip genetic switches to help provide uh protection and this was illustrated beautifully in this prostate cancer re research study by dean ornish back in 2008 and what he did was use his you know his uh intensive lifestyle intervention which includes stress management and exercise and so forth but also a plant-based diet for three months and the usual lab measures all improved but what blew people away was genetic expression change nearly 500 cancer promoting genes were down regulated and nearly 50 can cancer preventing genes were upregulated so you really your your genes are not as the time magazine articles that are not your destiny so why are plant-based diets so effective well plant-based diets are so effective because they get to the root causes of disease they put a lid on inflammation and lipotoxicity and dysbiosis and oxidative stress thereby helping to you know get our bodies back to healthy working order the most effective dietary patterns minimize pathogenic dietary components and maximize protective dietary components and when you start to think about the components of food that really offer the greatest protection for human health you think about things like fiber and phytochemicals and plant enzymes and antioxidants and anti-inflammatory compounds and plant sterols and stenos and pre and probiotics and and macro and micronutrients that come from from food sources that have all of the above and when you look at this list the thing that just jumps off the page at you is these components are found either exclusively or predominantly in whole plant foods

Pathogenic Factors

and if you look at the most pathogenic factors in in food the trans fats and the excessive saturated fat and the refined carbohydrates and excessive sodium and the pro-inflammatory molecule new 5-gc and chemical contaminants and the products of high temperature cooking and the pro-oxidants the tmao and the endotoxins that you know that all serve to work against us are concentrated in the two categories of foods that the world health organization warned us about highly processed foods and animal products and the sad reality is most of what consumers eat is a threat to health and and this unfortunately i couldn’t find canadian data for this but you if we don’t eat that differently us food consumption as a as a percent of calories uh 39 from added fats oils and sugar 30 from animal products 22 from grains 90 plus of which are refined nine percent from fruits vegetables and legumes and hence we can understand uh why we have a problem fortunately we have a choice or most of us have a choice in what we eat and here i’d like to share a story um about a friend of mine uh by the name of andreas and andreas i i had the privilege of being his dietitian when he received a rare cancer diagnosis at the age of 36 years andreas made a 180 degree shift from being a food and wine aficionado to a whole food plant-based diet devotee and his cancer went into remission and this doesn’t happen for everybody but i can tell you nobody was more diligent than andreas uh with his diet it was incredible and and the story uh that is the most fascinating about andreas is when he got put on this uh pretty high raw hardcore uh organic plant-based diet his entire family his wife and his brother and his brother’s wife and his mom and dad said andreas whatever diet you’re on were on with you and it transformed the health of the entire family it was amazing the the results that that they all had but none was more amazing than what happened to andreas father carlos you see carlos had been diagnosed with type 2 diabetes back in 93 he had had a serious heart attack the year before andreas diagnosis he had hypertension and high cholesterol and peripheral artery disease and he was going into renal failure he had recurring gout and his prognosis uh was not good he was told that he had progressive irreversible diseases and he could expect to live not more than probably a couple of years he was being treated with 17 pills and 35 to 40 units of insulin per day after less than one year on a whole food plant-based diet carlos was taking zero insulin and zero pills and you know when carlos went to his doctor to say why didn’t you tell me that this was possible just by changing my diet his doctor said i didn’t tell you carlos because i didn’t know uh and now i do um but if you look at the changes in his health and his lab results his fasting glucose is now 4.4 to 4.9 millimoles per liter a1c 5.1 blood pressure 115 over 70 with no medications his arteries opened up without surgery his peripheral artery disease disappeared his kidney function normalized he didn’t have one single further recurrence of goat and nine years later he’s still free of these diseases and these medications and just um uh to to share with you his uh coronary artery disease reports you can see in 2005 he had pretty severe heart disease he had an inferior wall in infarct with superimposed ischemia he had an inferior he had inferior wall hypokinesis he had a reduced ejection fraction of about 50 percent in 2017 no evidence of abnormal cardiac activity no evidence of ischemia normal chamber size normal ejection fraction it’s really quite uh amazing and and you know the the take-home message here is this is what is possible and i know not everyone is willing to make the kinds of changes that carlos made but i believe that everyone has a right to know that lifestyle changes are a safe and highly effective treatment option and a right to choose that as a treatment option the bottom line is we know enough we know enough to make lifestyle medicine the first line therapy for individuals with lifestyle induced diseases and at this point i would like to move on to talking about the practical steps that people can take so seven steps to an optimal plant-based diet step number one make whole plant foods the foundation of the diet and what we want to aim for is at least nine servings of colorful vegetables and fruits every day at least at least two servings of legumes preferably in the whole form or minimally processed form legumes tofu peas lentils even peanuts or peanut butter count we want to be choosing whole grains mostly intact and to vary our intake with our energy needs we want to include at least one serving of nuts and seeds with an omega-3 source in the mix we want to be very generous with our use of herbs and spices and why well many reasons as i mentioned all of the protective components that are concentrated in these foods but one of the most important reasons is these are the only foods with fiber and fiber as we know promotes regularity it’s the source of our prebiotics which is the food for our absolutely essential uh health microbiome health microbe or a healthy gut microbiome and and this food uh affects for the microbiome affects every system in our body it’s extremely important uh fiber increases satiety and reduces cravings it reduces risk of colorectal cancer it reduces cholesterol levels it stabilizes blood sugar it reduces our risk of gi disorders it enhances our immune immune function and it lessens hormonal imbalances and if we look at how much we need well the rda is 14 grams per thousand calories that’s about 38 grams a day for men and 25 grams a day for women optimal intakes are probably closer to 40 to 60 plus grams a day if you look at actual intakes people eating a standard north american diet consume about 15 to 17 grams a day on average people eating a whole food plant-based diet consume about 40 to 80 grams of a on average if you look at paleolithic intakes they range from an estimated 70 to 150 plus grams a day human beings are meant to be eating a fair bit of fiber step number two is to be very picky about uh the carbohydrates we choose contrary to popular opinion carbohydrates are not the enemy carbohydrates from whole foods are consistently protective to health if you look at average intakes in the

Blue Zone Average Intakes

blue zones 62 percent of calories from carbohydrates uh even the same from bolivia south america that live a traditional hunter-gatherer lifestyle and have the lowest repeat rates of of heart disease of any population on the planet consume an average of 72 percent of calories from carbohydrates if you look at the data on carbohydrate intake and mortality this was a study from 2018 with over 100 000 individuals being followed for for up to 25 years you can see that they they found the lowest rates of mortality around 50 to 55 percent of calories on average they found the highest mortality with the lowest carbohydrate intakes and they found a slightly increased mortality with very high carbohydrate intakes but only when those carbohydrates came from refined sources so this was in poor populations who were eating a lot of white rice and a lot of white flour products now they also found the very lowest mortality rates with people at the higher end of the carbohydrate spectrum that we’re not getting those carbohydrates from refined sources and if we look at longevity and low-carb diets and this is the same study looking at some of their their additional data their air their uh eric cohort of over 15 000 individuals compared to the reference 50 to 55 carbohydrate intake um risk of mortality was 58 higher for those with carbohydrate intakes of less than 30 percent now the carbohydrate intake of people on a keto diet is about five to ten percent on a paleolithic diet or the new uh paleo diets it’s usually around twenty percent so these are low carb diets for sure um it was 32 percent higher for people eating 30 to 40 percent of calories from carbohydrate and 12 percent higher for those eating 40 to 50 percent of calories from carbohydrates you know this is what carbohydrate naysayers forget plant foods are carbohydrate rich foods they’re high carbohydrate foods plant foods provide 60 approximately 60 to 90 percent of calories from carbohydrates there’s only one exception and that’s nuts and seeds which are our predominant sources of healthy fats and of essential fatty acids on the other hand refined carbohydrates are bad news what are refined carbohydrates well their foods have been stripped of their nutrients by food processing techniques refined sugars are part of the picture and refined starches are part of the picture refined carbohydrates increase our risk of overeating and obesity non-alcoholic fatty liver disease insulin resistance and diabetes high triglycerides and heart disease the problem is is that most of the carbohydrates people are eating are refined if we look at again this is u.s data because i couldn’t find canadian data but almost half of the refined sugars in the diet are coming from liquid sugar from beverages which is quite shocking and i’m sure it’s not that much different in canada

Safe Level of Added Sugars

if we look at safe levels of added sugars well the world health organization suggests not more than 10 of calories which is 12 teaspoons in a 2 000 calorie diet that’s the same as the recommendation for the dietary guidelines for canadians and the dietary guidelines for americans now the world health organization takes it a step further and says less than five percent or six teaspoons for additional health benefits so if you really want to do well you should be aiming for not more than six teaspoons of sugar a day average intakes are 17 teaspoons of sugar a day and for teenagers it’s far higher than that how much sugar do we get in food well if we’re aiming for six teaspoons a day we exceed that with with a 12 ounce can of soda or a large flavored coffee or a fruit yogurt or a cinnamon bun one item in one day we get close to that just by eating things that we don’t even think of as sugar sources like an an energy bar or a quarter cup of barbecue sauce or a package of flavored oatmeal now refined starches if we take wheat and and turn it into white flour we lose about 80 to 90 percent of the fiber 70 to 80 percent of the vitamins and minerals and 95 of the protective phytochemicals and then of course nobody eats a bowl of white flour what do we do before we eat the white flour well we add fat and sugar and salt and all sorts of food additives and then we eat the white flour and therein lies the problem not only have we stripped the flour of everything of value to human health but we’ve added a bunch of pathogenic dietary components before we actually eat the stuff on the other hand whole grains are healthy foods we have a 2016 meta-analysis of 45 studies looking at the mortality the reduced risk of mortality per 90 grams of intake that’s about three servings or three ounces of whole grain intake all-cause mortality was reduced 17 percent disease was reduced 22 diabetes by 51 cancer 15 and respiratory disease is 22 but one thing that we need to be aware of is that all whole grains are not created equal a granola bar doesn’t equal a bowl of oatmeal and a box of kamut flakes does not equal a kamut berry salad there is a hierarchy of

Whole Grain Hierarchy

whole grains and that hierarchy begins with intact whole grains grains with nothing harmful added nothing healthful removed like wheat or camuter spelt berries barley oat groats or quinoa next on the list are broken whole grains like steel cut oats and cracked wheat and then rolled whole grains like rolled oats or rolled barley or rye then shredded whole grains like shredded uh wheat then ground whole grains like whole wheat flour products then flaked whole grains like cold flaked cereals and at the bottom of the list are puffed whole grains like puffed wheat rice or millet and please remember this this this chart doesn’t include refined grains at all this is just whole grains and as the degree of processing increases in those whole grains as you go down this chart what you see is an increase in the glycemic index you see an increase in the surface area of the grain and the rate at which the grain will be absorbed into the bloodstream as you go down this list and you get more and more processing you also see destruction of nutrients they are exposed to heat and light and air and so forth and so what you want to do if you’re trying to prevent disease or reverse especially reverse disease you want to stay as high on that whole grain hierarchy as possible so carbohydrate common sense is simple get your carbohydrates from high fiber whole plant foods avoid added sugars especially in beverages and minimize all refined carbohydrates both starches and sugars step number three get your protein from legumes instead of meat why because when you look at the protective components in food legumes are consistently high or very high in those components and meat has basically nothing it’s all zero or extremely low in these components when you look at the components that we’re trying to minimize to reduce our disease risk they’re either low or zero in in legumes and they are generally moderate or high in meat and of course when we look at the stats

Legumes and Mortality

on mortality legumes are consistently associated with reduced mortality we have a 2017 meta-analysis that reported a seven percent risk reduction in in the highest versus the lowest intake groups and the reason it wasn’t higher in my opinion is because the highest intake groups hardly ate any legumes they were eating very small amounts so there wasn’t that big of a difference we have another study that’s even more powerful that looked at people 70 years of age or more and they reported a seven to eight percent reduction in mortality for every two thirds of an ounce of legumes consumed or 20 grams so that’s what two tablespoons or less it’s it’s quite shocking now if on the other hand we

Red Meat and Mortality

look at red meat and mortality we see a very different picture i couldn’t find a meta-analysis or study looking at this that didn’t find an increased risk with red and processed medium taken you can see the process made in light pink has a more profound impact than than unprocessed red meat but regardless they all increase risk of mortality as they do diabetes heart disease cancer very very consistently there was a study from harvard looking at over 130 000 individuals followed for 30 years that found that replacing only 3 percent of calories from animal protein with plant protein reduced risk of death and 3 percent of calories amounts to about 60 calories in a 2000 calorie diet replacing 60 calories from red meat or i’m sorry processed red meat with plant protein reduces risk of death by 34 or reduced risk of death by 34 in this cohort uh replacing uh egg protein with plant protein 19 and that’s 60 calories worth of egg protein that’s not even one large egg uh um unprocessed meat it reduced risk by 12 percent replacing it with with uh plant protein for dairy it was eight percent and for fish and chicken it was six percent we have another study that had even more powerful uh impact by replacing three percent of calories from meat with plant protein this study came from japan over 70 000 individuals followed for about 20 years and replacing just three percent of red meat with plant protein reduced risk of total mortality 34 if it was processed meat it was 46 for cancer mortality replacing red meat with plant protein to 60 calories in a 2 000 calorie diet reduced risk of death by 42 and by 50 for processed red meat and then finally a study that just came out in 2020 with over 400 000 individuals followed for 16 years they found replacing 3 percent of calories from animal protein with plant protein reduced mortality by 10 percent and if you replaced eggs it was 24 for men and 21 percent for women if it was red meat it was 13 for men 15 for women for dairy it was eight percent and for uh poultry it was or for white meat it was two percent for men and five percent for women so not quite as strong and yes people can get enough protein from eating plants as do all of the the men in this picture each one of them is a hundred percent plant-based step number four is to replace harmful fat with healthful fat high fat whole plant foods are rich in fiber and antioxidants and plant sterols and stenos and phytochemicals and all of these good things whereas concentrate concentrated fats and oils i have a low nutrient density they have a lot of calories with few nutrients so we want to limit those sources especially for people who are trying to reverse disease we want to cut back on saturated fat now the american heart association the american college cardiology guidelines for heart disease risk reductions actually suggest no more than five to six percent of calories from saturated fat and that would be about 11 to 13 grams on a 2000 calorie diet if you look at the amount of saturated fat in various foods you can see animal products uh just you know couple slices of meat lovers pizza a double cheeseburger a soft taco with beef and cheese and you’re already way above the upper limit you know a cup of milk uh seven uh grams uh an ounce of cheese five grams these numbers add up very quickly by contrast if you look at the saturated fat in high fat plant foods like nuts and seeds and tofu and olives and these high-fat plant foods you’re getting you know a gram or less in most of these foods two grams in avocado the only exceptions in the plant-based world are of course tropical oils and coconut which is a little higher in saturated fat we also when it comes to fat want to minimize our exposure to damaged fats uh when we fry high-fat foods or we fry in oil we produce products of oxidation that can be very damaging to human health and we want to minimize oils in cooking and if they’re used we don’t want the heat to be high enough that the oils will actually smoke and we want to store high high-fat foods including shelled nuts and seeds in the refrigerator or freezer if possible we want to optimize omega-3 so we need to ensure a source of alpha-linolenic acid get at least two to four grams a day and consider direct sources of epa and dha those very biologically active long-chain omega-3s so plant sources of omega-3 ala well we get about 2.6 grams

Plant Sources of Omega-3 (ALA)

in an ounce of walnuts about 2.5 in a tablespoon of of chia seeds to 1.6 in a tablespoon of ground flaxseed about a gram and a tablespoon of hemp seeds we we get less than 0.1 gram in a cup of greens even though half the fatting greens is omega-3 uh we would have to eat 20 or 30 cups a day to to meet our two to three gram [Music] intake now the other thing is we can consume microalgae based supplements and and a lot of people don’t realize but but fish actually get their omega-3s from tiny little plants in the ocean called microalgae microalgae is where and dha are essentially manufactured and what we can do is we can you know culture this stuff and and extract the epa and dha and take it in supplement form some people are not very good at converting technically humans can convert plant omega-3s into these biologically active long-chain omega-3s but some people aren’t very efficient at conversion particularly people that have diabetes or hypertension or other metabolic disorders epa and and dha microalgae supplements are very widely available and they’re not that expensive anymore generally what is recommended is two to three hundred milligrams per day some people may need a little bit more than that step five is to maximize our intake of phytochemicals and antioxidants how do we do that think variety we want to think variety for many reasons antioxidants and phytochemicals are another reason the greater the variety we consume the greater the variety of these compounds we’ll be consuming we want to also think color because the richest sources of phytochemicals and antioxidants are often also the most colorful so to maximize protective phytochemicals and antioxidants you want to choose purple instead of white onions black instead of brown rice dark instead of light greens for example you want to eat the entire rainbow of vegetables and fruits so what i would recommend is at least three green two orange yellow two pink red one purple blue one white beige every day and one of the things that i try to do as a personal challenge is to get every color in the rainbow represented in my salads which i consume on a daily basis the other thing we can do is to eat more raw foods and people will wonder why

Eat More Raw Foods

more raw foods but the one of the reasons that plant enzymes can be protective is because these enzymes like myrosinase can help actually help to convert the phytochemicals into foods into their bioactive metabolites so for example myrocinais and cruciferous vegetables helps us to convert glucosinolates to isothiocyanates which are more biologically active like sulforaphane which helps to you know kick the phase two enzyme system into full gear and and helps to you know get rid of uh carcinogens and uh turn them into water-soluble compounds and excrete them uh it also alanis in in the allium vegetable family helps to convert alan to the active form allicin and allicin is associated with antiviral and antifungal and all sorts of um benefits as well we can start sprouting the phytochemical army that’s poised to protect these delicate new little plants actually multiplies 5 to 50 times when we sprout foods and we can pile on the herbs and spices because there are no foods that are actually more concentrated per gram in antioxidants and phytochemicals than than herbs and spices we can also drink antioxidants antioxidant rich teas like hibiscus tea and ginger tea and turmeric tea and matcha tea and all of these uh these different teas and step six

Minimize Dietary Contaminants

is to minimize dietary contaminants so the worst offenders are environmental contaminants and byproducts of high temperature cooking so let’s talk about a little bit about environmental contaminants like pesticides in conventional produce or in animals that have eaten a lot of pesticide-laden food heavy metals like mercury and fish and seafood and arsenic and rice chicken and uh fish and seaweed and and persistent organic pollutants like pcbs ddt and dioxins which move up the food chain and are concentrated in animal products so the solutions here are really to eat lower on the food chain to choose organic when we have that option or when we’re able to choose that option and if we’re not able to choose organic all the time one of the things we can do is use tools like the environmental working groups dirty dozen and clean 15 and try to choose organic as much as possible for the dirty dozen and if we buy conventional to buy conventional in that clean 15 list that have lower levels of pesticides we want to vary our grains inorganic arsenic can cause cancer and increase the risk of diabetes and rice is one of our most concentrated source of inorganic arsenic so we want to just eat you know just a wider variety of grains we want to when we do eat rice or rice is a staple for us carefully select it for example rice from california has less arsenic than rice grown in in some of the um you know more eastern or central uh states uh and if we cook rice uh that we’re not sure about cook it in a lot of water it works out perfectly you can do six to ten times more water than rice and then just drain it and when you drain that water you’re getting rid of some 80 to 85 percent of the arsenic uh the products of high temperature cooking like heterocyclic amines and polycyclic aromatic hydrocarbons and acrylamide and advanced glycation end products need to be minimized as well and we need to be aware of these things these are the products of high temperature cooking so heterocyclic amines are carcinogens they’re known carcinogens they’re formed only from animal products like meat poultry fish and eggs when they’re cooked at high temperatures plant foods don’t form heterocyclic amines because they don’t contain creatine or creatinine and those are required for the formation of heterocyclic amines polycyclic aromatic hydrocarbons are known mutagens linked with a number of cancers they are present in grilled or charred or blackened foods if you will and it doesn’t matter if they’re plant or animal any food you blacken will contain polycyclic aromatic hydrocarbons it’s just really formed from the incomplete burning of carbon containing substances in food that’s heated above 392 degrees fahrenheit or 200 degrees centigrade advanced glycation end products impair immune system function they accelerate aging and they contribute to multiple disease processes including alzheimer’s diabetes heart disease and cancers if we look at the amounts in foods what you see is uh at the top of the the list is uh things that are things like bacon and broiled uh frankfurters and boiled frankfurters so processed meat and then next on the list you see you know grilled or fried meat poultry fish butter grilled or fried tofu and then uh other foods uh including roasted nuts or seeds especially if they’re roasted to fairly dark uh snack foods and and those kinds of foods uh acrylamide uh is formed when uh high carbohydrate foods are heated above 248 degrees fahrenheit or 120 degrees uh centigrade and and foods um are that are rich in the amino acid asparagine uh form the greatest amounts of acrylamide and acrylamide has been classified as a probable human carcinogen and if you look at acrylamide in foods uh you can see at the very top of the list are sweet potato chips and potato chips because potatoes are high in asparagine and so they’re they’re right up there and then going down the list you see rye crisp bread and french fries and coffee and and nut and seed butters and so on very very uh low amounts in those foods but any carbohydrate-containing food can form acrylamide and the solutions here just avoid charred or blackened foods especially meat poultry or fish avoid fried foods and use moist cooking methods when you can like steaming and stewing and boiling and water sauteing because they produce fewer products of oxidation eat whole foods avoid highly processed foods and finally step number seven is to meet your need for all nutrients you don’t want to develop nutritional deficiencies without overeating calories you want to maintain a healthy body weight throughout life and when you’re consuming a plant-based diet you’ll be focusing on on different micronutrients that then you might need to be really focused on with an omnivorous diet with an omnivorous diet you might not get enough potassium you might not get enough vitamin e there are other nutrients of concern of course one of the foods that we can do to help ensure that we’re eating a healthful diet is to use a food guide and i think canada’s food guide is something we can be very very proud of it’s probably the most progressive food guide on the planet uh with half the plate as fruits and vegetables a quarter as grains and a quarter as protein foods with an emphasis on choosing mainly uh plant sources of protein and the guides in our our um in in the books that i’ve co-authored are similar we’ve got a plate but we’ve also got these add-ons at the top of the plate where it you know even if you eat this entire plate there are some nutrients that you still need to think about omega-3s b12 iodine and vitamin d and a similar guide in becoming vegan as well and so we want to really focus on eating more nutrient dense foods and and what are the most nutrient dense foods on the planet well number one is green leafy vegetables this is the aggregate nutrient density index by dr joel furman and it’s based on vitamins minerals fiber and orax score so it’s it’s a it’s an interesting compilation of you know just all of these things and so fruits and vegetables at the top and then other plant foods and fish somewhere in the middle and then we’ve got milk meat poultry eggs cheese and then at the bottom of the barrel french fries vegetable oil and the only thing that’s below that is pure sugar so those are those are things to be aware of we want to be drinking water not sugar and to minimize food with added fat sugar and salt and to increase our physical activity i think an hour a day of moderate to vigorous activity is ideal but we want a minimum of 150 minutes per week of moderate to vigorous activity we want to avoid sizing except for salad and the take home message here is every time you eat or drink you either feed disease or you fight disease well well designed whole food plant-based diets provide a powerful and effective means of fighting disease the good news is that the power of plant-based diet of plant-based diets extend far beyond ourselves there is probably no more powerful step that any individual human being can take towards the preservation of planet earth than to consume a plant-based diet it’s simply the most ecologically sustainable way of eating that we know of and there was a study that just came out in 2020 looking at climate change mitigation through dietary change and it was a systematic review of 18 studies and what they found was compared to current food consumption patterns greenhouse gas emissions would be about 25 lower with sustainable diets diets that are lower in animal foods higher in plant foods but 70 percent lower with vegan diets and the greatest benefits for both health and the environment were associated with vegan diets and of course a plant-based diet is a as an ethically justifiable way of uh eating when we look around the world over 70 billion land animals and that’s you know not including anything from the ocean are slaughtered for food every year globally over 90 percent of those are raised in cafos or essentially factory farms eating plants bears animals and to me it makes no sense to cause pain suffering and death in other living beings when it is not only unnecessary but it undermines the life support systems of humanity you know animal-based diets breed human hunger the greater our meat intake the more resources we use and the fewer people we feed if everyone ate plant-based the global calorie supply would increase by an estimated 50 which could effectively wipe out hunger by getting our nutrition from plants we all win and we have a choice when we consider the consequences of our food choices both for ourselves and beyond ourselves a plant-based diet becomes both an ecological and an ethical imperative and i would like to conclude my presentation by telling you the rest of the story about my dad you see about two years after that interaction we had my dad had a stroke he was rushed to the hospital by ambulance and hadn’t seen a doctor for 20 years his blood pressure was 220 over 110 his blood sugar was almost 29 to 30 millimoles uh per liter or over 500 milligrams per deciliter uh his um his blood vessels were in really really rough shape and i can remember the doctor telling my dad that if you stop smoking you might live three years my dad wasn’t even 50. he wasn’t even 50. he was 49 years of age and if you don’t stop smoking you have about three months and after the doctor left i i remember sitting on my dad’s bed and the two of us we were in tears and my dad said to me he said i don’t want to die and i think it was at this point that my dad first realized that without health your freedom is very quickly snatched away and um he said i i don’t even have grandchildren yet i want to see my grandchildren grow up he said i want to dance with my sweetheart oh my sweetheart at her 50th wedding anniversary he and my mom were always madly in love and um and you know my dad made some changes he never made the changes the kind of extreme changes that carlos made but he made enough changes to beat the odds and dance with my mom at their 50th wedding anniversary and and that for me my dad died in 2011 and so i am very grateful for the extra years we had and that he did get to see his grandchildren grow up and with that uh i will um these are uh just some of my books and i will conclude and say thank you very much