Brenda Davis – Becoming Vegan: The Guide to Adopting a Healthy Plant-Based Diet – Offstage

[Music] I’ve been plant-based for I would say 30 years to be honest more like 40 years but the first 10 of those years was a slow transition so you know gradually dropped red meat and then slowly you know just eating less and less of the animal products and so it was it’s been 30 years that I can say I’ve been pretty much entirely plant-based I that happened after I became a dietitian so I’ve been a dietitian for 1982 I graduate 1983 so you know 35 years I’ve been a registered dietitian so so yeah it happened after and and I can tell you it was not an easy decision because I had actually only met one real live vegetarian in my life and it was my grade eight science teacher and he was a hippy he had the long hair and I thought he was really cool my dad taught in the classroom opposite him and and he thought it was just absolutely insane that he was eating a vegetarian diet and feeding it to his kids of all things so when I you know when I made the decision to become completely plant-based my family didn’t exactly do a you know celebration party I had at that time I had a four year old daughter and a one-year-old son so they were still very very young and you know what what triggered it for me I was actually at the time I was a community nutritionist so my job was teaching Canada’s Food Guide in the four food groups to of the four of which were animal products and and and so and I mean I I led a nursing moms group I did you know I I often spoke on CBC on the radio I did yeah had to call him in the newspaper I just was doing a wide variety of things but it was really based on the traditional teachings of my profession and so the decision to make this extreme to a plant-based diet was a little you know it’s a little concerning because I didn’t know if you could be a dietitian and people at based but anyway what triggered my change was I I found myself shifting in a direction of more plant foods fewer animal foods because of health I thought it just made sense to me fiber and and all of the wonderful things you find in plants and it made sense to be eating lentils and tofu instead of you know red meat and and so I I slowly was making that shift but but what actually was kind of the final straw was an interaction I had with my husband’s best man at our wedding he was on his way deer hunting and he called and he said can I stop by for coffee on my way deer hunting and I said sure no problem and and so he and as he’s driving over I’m thinking to myself how can I make this man feel very guilty about killing another deer because I just I didn’t like the idea of hunting and and so when he was when he was visiting I I said to him you know I I don’t understand how you can feel good about you know going into the woods with your big gun and shooting a beautiful innocent animal that to me doesn’t deserve to die what did that animal ever do to you and you know he call it a sport but it’s like usually in sports both teams have the same equipment I don’t consider it a sport it’s just it just seems mean-spirited and and it was what he said back to me that changed the course of my life he said you know just because you don’t have the guts to pull the trigger does not mean you’re not responsible for the trigger being pulled every time you buy your piece of meat comma flushed in cellophane in the grocery store he said at least the animals I eat have had a life I wonder if you can say the same for the ones that are sitting on your plate and it he just i was silenced I was absolutely silenced because I knew that he was right and I had never taken responsibility for the food that I was putting in my mouth and and you go to the grocery store and it’s so simple and we we don’t look beyond that and and really understand where food is coming from and so after that interaction I really thought about it and I started researching how we’re raising animals and and what’s involved and what I learned filled me with shame guilt remorse you know I was raised as a little kid I can still remember picking worms off the sidewalk for fear they were gonna you know dry up after the rain I I used to talk to animals on my way to school I did I had a big heart for animals I can remember being at a bullfight when I was about three years old and you know it was elk or Dobies the hero of Spain and we’re there and and all of a sudden I realized what a bullfight was that we’re they were gonna kill this ball and and when the bull scored a couple of points or whatever he did I jumped up on my seat I mean you could have heard a pin drop in the entire stadium of 10,000 people there’s this little three-year-old jumping up and down yeah oh and so I always had that hard as I think many children do but we get desensitized as we grow up and we get removed from our you know where the food is really coming from and and so I made a decision at that point and I thought to myself I don’t want my life to be about contributing to pain suffering and death any more than it has to be I don’t need to be a part of this system of cruelty and you know my mom grew up on a farm and they had names for the animals and the animals did have a bit of a life until we went to the slaughterhouse or they were killed at the farm whichever it was but today animals don’t have a life there you know ninety percent are raised in chaos confined animal feeding operation and they I mean literally when you think about the you know the paint for example they you know pigs have been rated to have the intelligence of a three-year-old child and dogs about a two and a half year old child and they they are very intelligent beings and yet these pigs that would live 15 years live six months in in a prison a hellish prison that’s so bad that they go insane they you know so in order to prevent them from biting one another’s tails off in that little stall they you know they they cut their you know tails off and they cut their ears they dock their ears they cut their genitals off so they don’t have as many hormones going on and all without any anesthetic when they’re just little babies it’s just horrendous what we do to these creatures and I can’t justify it I don’t understand how the human race is justifying it the only thing I can think of is that people have these blinders on because they’re just buying this piece of meat at the grocery store and it’s got to stop it we’re killing ourselves by eating animals that are you know raised and in this way we’re eating so much of it and we’re destroying the planet and we’re you know causing unthinkable suffering in these creatures for nothing it’s totally unnecessary and so when I came to that realization even as a dietitian I thought I I just I can’t do this and so I went to my husband of about ten years at that time we’d been married about ten years and I said to mom would you be willing to become a vegetarian well he’d never even met a real live vegetarian I mean he you know he didn’t have the same science teacher I did and and he said I thought you’d never ask I’d love to be a vegetarian he said I’ve always wanted to live a lifestyle that would leave a softer footprint on the planet and I can’t think of a better way of doing that so I thought to myself boy I married pretty young but I’m very pretty well so it worked out very nicely well I can tell you that the Dietetic profession 30 years ago I’ll even go a step further back when I was in university and again this was in the late 70s early 80s I learned two things about vegetarian nutrition in school one was that vegetarian diets were risky and should never be fed to children or pregnant or lactating women and vegan diets were downright dangerous nobody should be eating them period that’s pretty much all I learned so you can imagine five or six years later in practice the you know the the sentiment hadn’t shifted a lot so the idea of a dietitian being not only you know vegetarian but pretty much vegan was almost unheard of as a matter of fact I didn’t know if I was the only vegan dietitian on the planet and it was scary I I thought I might be ousted from the profession but I and I considered you know another profession I thought do I need to leave but I thought you know if everybody who starts to see a bigger picture the the ethical picture the environmental picture the you know even recommendations of the World Health Organization at the time that that a lot of North Americans weren’t very familiar with if if if everybody who started to see these things just exited the profession I thought will never it will take much longer to affect change within the profession I thought I’ve got to have the courage to stay and to speak with some knowledge and I’m a I need to make sure that I am very very well versed with the literature I need to be very professional in what I do and I just need to stay and I wanted so desperately to help people who were choosing a plant-based diet to do it well I thought I enough from my education that I can help people to design diets that work really well because to me a failed vegetarian or a failed vegan is really exhibit number one for why everybody around them is justified in eating meat they kind of prove you need me to be healthy and and so I was really determined to try to help change that and when I moved to you know within a year or two of becoming plant-based I moved to Vancouver from Northern Ontario Northern Ontario is kind of hunting fishing beer and bingo kind of crowd and no wonderful people don’t get me wrong just wonderful wonderful people but but that more of that mentality where’s Vancouver much more veg friendly I thought I’m gonna meet real live vegetarians for the first time in my life and so we moved there and you wouldn’t believe the first few dietitians I met I met two one was moving towards plant-based the other one was a Seventh day Adventists vegetarian so I learned that there actually was more than even one other vegetarian dietitian on the planet so within fairly short order I met another one vesanto melina who became my writing partner and and we began writing books together and at the first book we had a third author as well Victoria Harrison but vesanto and I went on and we’ve written now many books together I’ve I’m on mine I’ve ninth I think she’s on her twelfth or thirteenth we just are completing two more this year and so we’ve been providing the resources we believe people need and vasanta was actually the senior author on the Academy of Nutrition and Dietetics a position statement on vegetarian nutrition as well so we and I was a past president of the vegetarian arm of the Academy of Nutrition and Dietetics so we’ve been very active within our professions and and as for the shift you know at first our peers were a little you know skeptical but they were inviting us to speak to what we had to say and I can remember feeling that it’s it’s we’ve really arrived when a few years ago I was speaking at dietitians of Canada and one of the the leaders the CEOs I was doing an interview like this and after the interview she came up to me with a little gift and she said I I just want to tell you how proud you make me to be a dietitian thank you for the work you’ve been doing for the last many years and it just it it just made me feel so validated and and it made me feel like what I’ve been doing is not just helping vegetarians but helping my fellow colleagues as well who are really coming along and then my my writing partner vesanto this year one I shouldn’t say this year last year 2017 one the highest award offered to only one person a year from dietitians of Canada the Riley Jeffs Memorial Lecture Award for her work over you know the past 30 or 40 years and so it’s our our profession many people think dietitians are in the dark ages still but it’s it’s really quite extraordinary the number of new young dietitians that are graduating as plant-based diet ish ins and also the number of older dietitians that are interested I can remember once speaking at the American you know it was at that time the American Dietetic Association but the you know Academy of Nutrition and Dietetics and I was in a room and speaking on vegetarian nutrition and there was room for 900 people in in that room there were so many people there that I I bet we had 300 people on the floor and 200 people out the door and I was told when I went to pick up my little CD of the lecture it was the second biggest selling CD of the entire conference and so there’s interest and we as people that are especially interested in plant-based you know a plant-based or more plant-based world don’t don’t discount that physicians even mainstream and means dream dietitians are interested in this you know this option for people it’s it’s really happening one of the great advantages of a plant-based diet is it is less energy intensive it demands less of our very precious resources including water it reduces problems with reduced biodiversity desertification deforestation species extinction and and there are many reasons for that but if you look at you know a lot of people think this is you know it’s sort of out there environmental groups that might be saying these things but in fact in 2010 and 2015 the latest paper I think was either 2017 or just out in 2018 the a group called the United Nations environmental program has been saying that the two biggest factors in green in in climate change are animal agriculture and transportation and what we know is animal agriculture is even more significant than all forms of transportation combined just slightly so but still it’s most people would just be stunned by that and in fact they said that their recommendation for the entire planet was a global shift towards a plant-based diet there was an award-winning study done in I think was 2008 at it was I think was Carnegie Mellon University they won the environmental study of the year they showed that you would reduce greenhouse gas emissions more by eating vegan one day a week than by eating a hundred percent local seven days a week 24/7 just one day a week my son is a he did environmental studies at University and I can remember in his fourth year the he called me after class and he said mom you’re not gonna believe this we had to calculate our carbon footprint today and he said he said I beat everyone in the class by a mile and they were all shot because they do these two minute showers and ride their bike to school and I live far enough from school that I’m driving a car and I still came up way lower than them and everyone was like sir sir huh that’s not fair how come hisses and the professor said to the class read my lips he doesn’t eat meat and you need to get that and it’s hard to be an environmentalist truly when you’re consuming animal products because they require so many resources in their production in fact the you know they the Proceedings of the National Academy of Sciences a study came out in 2016 saying that if we all continue on this path you know looking at what would be expected you know sort of greenhouse gas emissions by 2050 well if everybody instead adopted sort of the diet the World Health Organization is recommending a diet that’s higher in fruits and vegetables lower in meat and dairy products and sugar that we could reduce greenhouse gas emissions by twenty nine percent by twenty nine fifty compared to doing the what we’re doing now but if everyone went vegan we would reduce greenhouse gas emissions by 70% and that’s from the Proceedings of the National Academy of Sciences so this is not stuff that that is really debatable anymore and in fact there there are a few studies out of California that are that are worth considering even even a vegetarian diet with milk and eggs you know we’re looking at compared to an omnivorous diet with meet the the omnivorous diet takes you know three times more water it takes ten times more or I think 13 times more fertilizer it’s just you wait when you funnel you know plants through animals you lose a lot in the process so much so in fact that another study out of California showed that that chicken takes about to produce we’re looking at sort of the energy protein efficiency ratio of of animal products in comparison to wheat for example or grains it four times more to raise chicken forty times more to raise beef so just huge huge differences I think people need to understand that really people that really care about the environment you know we see all of these people talking about paleo diets and how paleo diets are so wonderful well if everyone ate paleo that you know just do the math and and dr. David Katz who’s a leading nutrition authority and professor of U at Yale he did the math and he said we would need fifteen planet Earth’s today if everybody on the planet was paleo we can’t you know we’ve got to start to look beyond ourselves and recognize that they’re our choices have consequences and it just doesn’t make sense to be funneling you know plant foods through animals when we don’t have to you know another thing that that I think people should know is during the entire Ethiopian famine back in the 80s if Nokia was shipping grains to feed our animals because they they had this huge debt to pay well they’re there people are starving to death animals require a lot of grains to you know to grow to the size they do and most of that is lost it takes you know pounds and pounds of grain to produce a pound of meat and so people that care about the environment and care about leaving you know a planet that is intact for their children and grandchildren really need to be considering this for many many years when I was in university we were told it wasn’t safe unless you were an adult only an adult and unless you also consumed eggs and dairy products and and so for many dietitians and doctors and especially in Europe they’re probably 20 years behind where we are in North American thinking about plant-based diets and they there there are position statements all over Europe saying that plant-based diets are not safe and adequate especially for growing children so we have a position statement from the Academy of Nutrition and Dietetics 2016 that says that that vegetarian including pure vegetarian or vegan diets are safe and adequate and actually may provide health benefits in disease prevention they go on to say that they are safe and adequate at every stage of the lifecycle from infancy through childhood adolescence during the senior years for athletes the works that there’s an you know no life cycle category that they would not be appropriate for if they’re appropriately planned and that’s the key and that’s you know what my my career has been about is to help people appropriately plan them because of course there are adequate and annete inadequate vegetarian diet does vegan ensure good nutrition absolutely positively not not a chance so well when you think about it potato chips are vegan coca-cola is vegan or any other soda you could be living on junk food you could be eating white toast with margarine and jam for breakfast with you know a soda and and french fries with vegan gravy for lunch you could be eating junk all day long and and be in worse much much worse shape than the than an omnivore eating even a semi-decent diet so absolutely positively not there you know at both ends of the extreme so you’ve got sort of the the folks that may say well oh I care about his animal rights or the environment my I’m not that concerned about my health only whatever well there’s concerns there about nutritional adequacy of the diet and then on the other end of the spectrum people that are really rigid that that you know it’s it’s whole food plant-based but that say you know want to be a hundred percent natural don’t think we should need any kind of supplementation at all they can end up b12 deficient they can end up vitamin D deficient they can end up iodine deficient they can end up with iron deficiency or even zinc deficiency and so the diet needs to be appropriately planned wherever on this spectrum you lie so definitely being vegan does not guarantee better health and an omnivore but that having been said we know that the average vegan is at some benefit compared to the average omnivore when people first become vegan depending on why they’ve made that choice so for example if they’re doing it for animal rights or the environment they may you know just simply drop the meat and dairy and continue eating whatever they were eating so they end up with a diet that’s very high in refined carbohydrates so lots of pasta and lots of bagels and and just not again a balanced diet and what we know is when you replace meat with refined carbohydrates you experience no health benefits whatsoever one is pretty much as bad as the other so that’s something I think is really important for for people to understand the second mistake I think people make and of course there are several mistakes to be made but I think the other mistake is is is just simply ignoring the sort of the nutrition priorities so you know making sure you’ve got good sources of all of these nutrients of concern so when you look at omnivorous diet so there are certain nutrients you don’t really worry about you get plenty of sometimes you get too much of with a plant-based diet it’s different nutrients and so when you remove meat you’re removing a major source of protein iron and zinc when you remove dairy you’re removing a major source of calcium and vitamin D so so you need to make sure that the plant foods you’re eating provide those nutrients so for example with you know removing meat our richest source of protein and iron and zinc would be legumes when you remove milk well one of the richest sources of calcium would be low oxalate green vegetables beans provide some some nuts and seeds and so you need little bits from all of these foods vitamin D while some plant-based foods are fortified but if you’re eating a whole food diet you don’t use any fortified foods where’s your vitamin D come from well if you get enough warm sunshine throughout the year you don’t have a problem but most of us live you know in in places where we don’t get out of quit warm sunshine throughout the year I sure don’t I live in Kelowna British Columbia well our winter months we get very little sunshine and even if I’m exposed to sunshine it’s not warm sunshine it’s very cold sunshine and so we don’t produce any vitamin D from probably late October through to March and and so we need to make sure we have a source of that nutrient so these are the big concerns I would say vitamin b12 deficiency of vegan diets definitely vegans are at higher risk for b12 deficiency now there’s a lot going on here so what people need to know is vitamin b12 is made by little microorganisms and and you know we have lots of those microorganisms that produce b12 in our body but most of them are in our large intestine and b12 is absorbed mostly and are small and things don’t usually go backwards so at that point once there is large intestine so we don’t get a lot of b12 week if you had really bad oral hygiene you might have some bacteria in your mouth that produce b12 but you probably don’t want to have really bad oral hygiene because it’ll cut about ten years off your life so so we need to have a source of b12 and what you know just a couple of things to be aware of plant foods are not reliable sources because we try to get rid of pathogenic bacteria we get rid of other bacteria as well if we fermented foods in dirty vessels like a you know tempeh and wooden vats that had bacteria between the you know the the layers of wood we might get some there are some studies from Indonesia for example that show tempeh being a b12 source but in North America we actually produced tempeh in stainless steel vats that are very clean and so the amounts of b12 there would be very limited and some people say well what about seaweed it has b12 and C we does have b12 however there’s a combination of true b12 and what we call inactive non cobalamin coronoid or b12 analogs that attach to b12 receptor sites but don’t function as b12 and can actually contribute to a functional b12 deficiency so and when you dry seaweed the act of b12 gets good some of it at least gets converted into these inactive forms as well so chlorella may be a source you know AFA there’s a few of the blue-green out it may may be a source but we don’t have enough good solid evidence to say people can rely on those and only those so right now most experts are saying rely on something other than seaweed as your primary b12 source and so what is that something you’ve got two choices fortified foods and if you’re a whole foods person you might not be using fortified foods or you can be using supplements and if you’re using supplements you need a thousand micrograms at least twice a week if you’re using that’s if you’re using cyano Cabala man if you’re using methyl cobalamin or adenosylcobalamin you may need it more often you know a thousand micrograms a day because it’s a little bit less stable than cyano cobalt man so we need a source of b12 if we look at all of the studies I’ve done searches in the literature to see about b12 status and vegans the the folks that have the highest b12 status are generally omnivores then lacto-ovo vegetarians then vegans then raw vegans at the bottom of the the barrel because raw vegans aren’t using fortified foods and so they need to include a supplement and if they’re not they have low status so we have studies out of Germany we have studies out of Finland we have studies under the United States showing very low levels in a lot of raw vegans and in if that happens they also have very high homocysteine levels which can increase risk of cardiovascular disease which is ridiculous it’s like shooting ourselves in the foot we’re such an advantage where cardiovascular disease is concerned we don’t we just don’t want to ignore b12 it’s imperative that we include a source and it’s it’s not difficult the other thing to know is that the IOM or the Institute of Medicine recommends that everyone over 50 not rely on animal products for b12 and the reason being is that in animal products b12 is bound to protein and in order to get the b12 off the protein it’s bound to you need to be producing enough stomach acid and enough enzymes to cleave that b12 off so you can absorb it into your bloodstream and it’s estimated ten to thirty percent of people over 50 don’t so so it’s if you’re relying only on animal products for your b12 at that age there’s a possibility you’re not actually getting it and you can become quite b12 deficient and one of the symptoms can be you know the beginnings of dementia so it’s it’s it’s not a nutrient to fool around with if you are a vegan or a raw vegan mom who you know who has a baby and you are b12 deficient that baby could have irreversible brain damage within a few months of of birth it this is not an optional nutrient it is absolutely necessary for blood cell formation for the functioning of our nervous system it’s a critical nutrient and so we just can’t ignore it so we need to be responsible and make sure there is a source in the diet period protein of course that is the first question everyone gets asked is where do you get your protein because in our culture we put animal protein on this kind of pedestal and it’s the protein source if you’re not eating meat and eggs and poultry and fish how can you get enough protein and that’s what most people really believe the reality of course is different it is absolutely possible to get enough protein on a plant-based diet there are really two issues where protein is concerned one is the issue of quantity can we get any you know enough grams of protein the other is the issue of quality is the quality of plant protein sufficient to support sort of the growth of a child or is it enough to support you know muscle building and all of these things so looking at issue number one can we get enough protein from a plant-based diet well we can get again the answer is absolutely not a problem we need about 10 to 15% of calories from protein you know and that sort of World Health Organization recommendation which allows some you know there’s a little bit of padding there so so 10 to 15% well if you look at the percent of calories from protein and plant foods what you see is the we’re right in there so for example we get about 15 to 40 percent of calories from protein from beans and from non starchy vegetables so green leafy vegetables about 15 to 40 percent of the calories in these foods is coming from protein and and so look at those and then you look at grains it’s about 7 to maybe 17 or 18 percent of calories from protein nuts and seeds well nuts of you know 5 to 15 seeds probably 12 to 20 percent of calories from protein the only categories of plant foods that are under 10 percent our starchy vegetables at about 8 to 12 so a few starchy vegetables that come in a little bit low and and fruits which are probably 1/2 10% of calories from protein so if you eat a mix of whole plant foods and you get enough calories it’s almost impossible not to get enough protein the only ways that you can really blow it aren’t number one by eating a lot of junk so you eat a lot of oil which has no protein a lot of sugar which has no protein you get 50% of your calories from oil and sugar you’re not gonna get enough protein but if you’re eating whole plant foods it’s just not a problem the second way of blowing it would be to eat mostly fruit if all you’re eating is fruit for completely fruitarian diet protein could be an issue and I’ve seen people on fruitarian diets where they start to lose their hair their skin kind of gets you know let just thinner or something like that and so we see some protein deficiencies but generally if people are eating a variety of food and getting enough calories which isn’t an issue for most North Americans a protein is not not a big deal and and then the second part of the equation is quality and so one of the things that people often say is well plant protein is deficient in or limited in essential amino acids or what we also call indispensable amino acids and the reality there is that plant plant foods or plants are actually the sources of essential amino acids it makes zero sense to think we can’t get them from plants it’s where they come from they all come from plants animals have lots of essential amino acids in you know a really good amount but they got them at some point along the food chain from the plants so we can get them from plants to it and and it’s true that some plants have a little less you know grains have less lysine and-and-and-and beans may have a little bit less Metheny but the reality is if we eat a variety of foods over the course of the day we actually store amino acids and protein pools in our bodies and and so let’s say all you eat lentils at one meal and all you eat is you know bread at another meal you would actually be drawing on when you eat the bread you would be drawing on the pools of amino acid to get the extra lysine you need to build the proteins that you need to build so it’s it’s really not not a huge issue now the the other part of that question is is it ever a concern ten people you know eating plant-based diets fall short and it’s a concern for a few groups number one small children they need more protein we need adults need about 0.8 grams per kilogram body weight if you’re eating purely plants you digest a little less protein it more goes out in your stools so we would up at 10 percent and say probably 0.9 grams per kilogram body weight a children need more they’ll need you know 1 1.2 1.4 depending on how young they are and and so we need to be more conscious because children quite often they like to eat their pasta they like to eat their bread they like to eat their crackers and they may not like to eat their beans as much and so we need to be a little more you know conscious about giving them good sources of protein the other groups are athletes and seniors believe it or not so athletes require if they’re competitive athletes somewhere usually between 1.2 or 1.3 and 1.7 or up to one point nine grams of protein per kilogram body weighted if they’re competitive and it’s not an usually much of an issue because a lot of these athletes are eating four or five thousand calories a day so it’s easy to get that amount of protein but it they do if especially if they’re you know really conscious of weight and and restricting calories a bit then they do need to be somewhat more conscious now for these seniors what’s happening with seniors is they are less able to break protein down into amino acids and absorb the protein into the bloodstream so there are actually some countries saying that if they actually they’re their national recommendations are for 25 percent your protein in takes four seniors than four other adults and and why is this a problem this is a problem because you take a man who’s 40 years old and he’s eating 2800 calories and he’s getting 20% of his calories from protein he’s eating 140 grams of calories from protein you eat a man are you you look at a man who’s and this is a lot of protein 20% this is not 10 or 15 but you take a man who’s 80 and he’s eating 20% of calories from protein but he’s only eating 60 cat 1600 calories this protein intake could be 80 grams which is right what is recommended for seniors by a lot of countries now so but it means that if they’re eating a you know a smaller number of calories they need to be including more of those legumes and protein rich foods in their diet the seeds and so forth iron deficiency is a really common myth in the nutrition world that vegetarians are somehow a greatly increased risk in fact if you look at the research vegetarians and vegans aren’t really at increased risk for iron deficiency now I do see iearnt the the vegetarians that I see iron deficiency in our the vegetarians that are usually lacto-ovo and they’re consuming a lot of their calories from Dairy Dairy is very poor source of iron and it’s also it actually inhibits the absorption of iron so it’s like a double whammy so people that you know think this is we see this sometimes people switching from a meat and potatoes diet to you know pizza with cheese and macaroni and cheese and grilled cheese sandwiches because those are comfortable familiar foods for them and and so they they can end up with problems with iron when when you do that but for most vegetarians and vegans what’s really surprising to people is vegans actually eat consume more iron than omnivores almost everything they eat has iron whereas dairy has so little iron when it takes a chunk of your calories it and you know it adds up to less than what you would think so so no there’s not more iron deficiency however we still need to be conscious about iron and so there are few things that people need to know and there’s one other thing I want to say there’s a difference between the type of iron implants and the type of iron in animals so the type of iron in animals there are actually two types heme and non-heme so probably about 40 percent of the iron in animal products is heme iron which is the iron associated with blood okay and then the rest will be non heme and in plants it’s all non heme well non heme iron is absorbed very differently than heme iron so your body has a filter for heme iron or I’m sorry for non heme iron it’s absorbed more slowly some types of heme iron like ferritin it’s absorbed in this molecule with a thousand or more atoms of iron and and that iron is released slowly as your body needs it which is it’s a protection for the really whereas heme iron there’s no filter it just gets absorbed floods your body and and if you end up with a lot of heme iron in your blood it can actually act as a pro-oxidant which is of course the exact opposite of an antioxidant which we want a lot of in the pro oxidant can actually accelerate rates of certain types of diseases so it can increase your risk for things like heart disease and diabetes and stroke and and other diseases even dementia so we need there are some advantages to getting our iron from plants and with that having been said a couple more things for people to know the the sort of richest iron sources would be things like legumes of course lentils are a good source and other legumes as well we get some from nuts and seeds we get some from some dried fruits we get some from you know blackstrap molasses if you use it and of course from green vegetables and so you get little bits from all sorts of foods but the major source is legumes and so the other thing to know is that you can reduce the absorption of non heme iron by about 50 to 90 percent by consuming a lot of what we call fight AIDS or tannins with your meal phytates it’s a most concentrated source is wheat bran so you know some people sprinkle bran on their cereal to get the extra fiber vegetarians and vegans should never do that you get plenty of fiber in your diet if you’re eating whole plant foods you don’t need to sprinkle phytates on your food because we want to enhance the absorption of iron and zinc not diminish the absorption of these nutrients and and then tannins which would come from teas even some herbal teas but mainly black and green teas and when you drink those with your meal you inhibit the absorption of iron so if you have any concerns about iron you would want to keep your tea drinking an hour to before or after rather than drinking it with your meals and then the other thing to know is there some things actually enhance the absorption of iron and and the main ones we know about our organic acids and vitamin C and vitamin C can increase the absorption of iron two to six times don’t have the sort of organic acids well quantified yet but also some phytochemical components from from turmeric and ginger and even carotenoids and these things can actually help absorption of iron as well are taught from the time we’re very young that milk build strong bones and there is no question that cow’s milk is a very rich source of calcium you get about 300 milligrams of calcium per cup of cow’s milk interestingly you get about 600 milligrams from a cup of moose milk or a cup of deer milk it doesn’t make them essential foods for humans so just because cow’s milk me see every species produces a milk to support the growth of their offsprings and if they’re large animals with big bones of course their milks can be very rich in calcium you need a lot for building bones and so it doesn’t you know we’re not saying cow’s milk isn’t a rich source of course it is but it’s not an essential source of cow that you know it’s not an essential food for humans anymore than moose are doing deer milk as I said but what you need to know is during the Paleolithic period from for millennia and human beings seemed to amble along reasonably well without a single drop of milk they were consuming between 1 and 2 thousand milligrams of calcium a day and they were getting most of it from leafy greens which they ate constantly and and so we can – it’s just you know to get enough calcium from kale you’d need to eat 11 cups and so not everybody would eat 11 cups of kale so we need to be looking at what are all the sources and so you can get calcium from low oxalate leafy greens so you get a little bit from high oxalate greens but you only absorb about 5% so if you look on a chart and you see you know 200 and whatever milligrams of calcium and spinach you’re only getting about five percent of that so spinach is not a good source of calcium nor is Swiss chard nor our beet greens these very high oxalate greens are not reliable calcium sources because you can’t absorb this stuff it’s bound to oxalates where’s the low oxalate greens like the kale and and the the Chinese greens and the broccoli and all of those greens the turnip greens and so forth you can absorb 40 to 70% of the calcium now we absorb about 32 percent of the calcium from cow’s milk some would say 34 somewhere in there you observe about the same amount from tofu you absorb just a little bit less from soymilk from beans you absorb you know maybe 25 percent so we absorb you know varying amounts from from different plant foods but generally you can get enough when you include a variety of those foods eaten throughout the course of the day and for people that have a really hard time getting up to the sort of a thousand or you know with the the RDA is a thousand milligrams up to the age of fifty for women and 70 for men after 50 for women after 74 minutes 1200 and and so for for for that age category to meet those RDAs some people what they do is add a cup or two of a non-dairy milk it’s fortified and so that’s an option of boosting your intake quite easily so one cup has the exact same amount of calcium as a cup of cow’s milk about 300 milligrams and and so that’s that’s an option for people that just want to boost their intake a little bit but it is absolutely possible to get enough without doing that but you do need to be conscious about your choices so for example if you’re eating fruit oranges a dried figs are better calcium choices then would be an apple or you know a some other dried fruit so so if you’re looking at you know with the calcium rich foods within each group the legumes and then within the nuts and seeds the more calcium rich choices would be almonds or sesame seeds and and so it’s you know just choosing carefully within each food group and you can do it oh and I have to say know that we’re talking what calcium I like to tell my little story because I we have a lot of osteoporosis in my family my mom developed osteoporosis by the time she was 50 and so when I was nearing 50 I thought you know I wonder if I should see where I stand and and my doctor said absolutely we need to do a complete you know the gold standard bone density complete DEXA scan or whatever and and so he said you’ve been vegan for many years you don’t you know you’re not drinking milk you’ve got the family history your small Caucasian female you’re very high-risk and when my results came back I can still remember his face when he opened my chart to give me the results and and his jaw dropped and he went oh it’s best he couldn’t believe it he said I’m absolutely stunned your bone density is two and a half standard deviations above norm for your age and and it’s you know for your I think was for my femur and two standard deviations above norm for my age for my for my spine and he said it’s that’s almost unheard of he said I don’t know what you’re doing but whatever you’re doing keep doing it and the moral of that story is is even as a vegan you can have exceptional bone health if you’re conscious about I’m conscious about and and bone health isn’t just about calcium by the way it’s it’s about vitamin C and vitamin K and it’s about vitamin E and it’s about essential fatty acids and and and many other nutrients magnesium and potassium and all of these things come play a role in building strong even protein we need to get enough protein to build the bone matrix all of that matters but what may matter even more than all of that is exercise weight-bearing exercise and I’ve been an exercise enthusiast Oh since I was a teenager I do exercise pretty much every day unless I’m really sick or on the plane somewhere but even if I’m travelling so so I’m I’m you know taking a flight somewhere I don’t use the escalators I use the stairs and I try to walk as much as I can within the the airport and and so there are ways that you can kind of build exercise into your day when I’m at hotels I I walk the stairs and instead of taking the elevators as much as possible so I think there are ways of doing that and that’s I really think that’s what has helped my bones to be to be what they are and so I I’m grateful for that but just know that you can do it being vegan doesn’t mean that you’ll be sacrificing your bones so high oxalate greens are greens that have this higher content of this compound we call oxalates and the these oxalates bind with or the they’re really oxalic acid found with you know calcium or iron or whatever it is and and making the minerals unavailable for absorption and so oxalates increase when we consume a lot can increase our risk of kidney stones and kidney stones are not good news it for anyone that’s ever experienced them you know just not good news so so what I would suggest is it’s okay to consume high oxalate greens if you’re not at high risk for kidney stones it’s okay to consume some in the mix but I wouldn’t make my primary greens high oxalate greens like spinach Swiss chard and beet greens I would you know mix them in with others and I would generally eat them whole rather than juicing them and the reason is is you can eat probably ten times and even higher than normal oxalate intakes when you juice because you’re eating so many greens and so I would say stick more to the low oxalate greens for juicing and if you’re eating them eat them in a salad or something like that so one of the big concerns about plant-based diets is where do we get our long-chain omega-3s you know 40 percent of the gray matter of the brain or so maybe even more is DHA and when we think about DHA and EPA so just stepping back a little bit there are two essential fatty acids linoleic acid which is an omega-6 fatty acid and alpha-linolenic acid which is an omega-3 fatty acid we must have both we can’t manufacture them in our bodies we have to have both and we have to get them from the diet simple as that we get plenty of Omega 6s because Omega 6 is grains the main fats are Omega 6s many of our seeds like poppy seeds and sesame seeds and pumpkin seeds and sunflower seeds are mainly omega sixes and so we get lots of Omega 6s the oils that are used in processed foods are largely omega sixes and and so sunflower oil safflower oil corn oil are all mainly Omega 6s and and so Omega threes can be a little bit more of a problem and Omega threes come from you know or the the alpha linolenic acid or parent Omega 3 the plant Omega 3 comes from flax seeds and chia seeds and hemp seeds and walnuts about half of the fat in green leafy vegetables is omega-3 as well but there’s so little fat in greens you would have to eat you know 20 to 30 cups of them to get enough so so and and so what what happens in in vegans is you need to take these plant omega-3s and through a series of desaturation and elongation you would convert them into EPA or otherwise known as I cosas pentanoic acid or DHA known which the long version is that docosahexaenoic acid these fats are very biologically active they’re extremely important in the brain the eyes and the cell membranes of the human body and so there we need them now these these fats are highly unstable they’re the most unsaturated fats in the human diet and so they need to be treated with with some care as well but the conversion our ability to convert to you know take the plant form turn it into the biologically active form and to get back to that buy of those biologically active forms the EPA gets converted into something we call eicosanoids prostaglandins prostacyclin leukotrienes from Bach Saenz these kinds of things and and and the DHA and EPA also can get converted into other compounds like we call them resolve ins and protect ins and these are just hugely important in the human body and protective and so we need these things so so vegans generally have lower levels in their bodies maybe a third to a half at most compared to omnivores vegetarians a little more because they get some DHA from eggs from egg yolks but but generally people eating plant-based make less and have lower levels in their bodies and so there’s a couple of ways they can overcome that one is to make sure you get enough alpha-linolenic acid so you’re eating enough of the flax and Chia and hemp and so on and you’re not eating too much omega-6 because the omega-6s and omega-3s that linoleic acid and alpha-linolenic acid compete for the conversion enzymes so if you get too much omega-6 the the omega-6 will win out so so we need to make sure we have a reasonable balance if we’re plant-based and then the second thing we can do is to make sure we’re getting the nutrients we need because conversion requires that we be nutritionally replete in a number of nutrients so we you know we just have to be cautious of having a balanced diet and then the other things that that we need to do and you know not smoking not drinking too much all of those things can depress desaturates enzymes as well so and then people that that their heritage sort of fish eating populations Island people are Japanese they may not make as many conversion enzymes so their levels may be low as well because they lack conversion enzymes so so for some people they you know would be well-advised to consume direct sources of epa and DHA so a lot of people think that means I need to eat fish and actually again it’s sort of another similar story to the essential fatty acids the the these these are I’m sorry essential amino acids implants the essential fatty acids are these but these long-chain fatty acids are actually made by microalgae in the ocean so fish get them at some point along the food chain from microalgae and so what’s happening now is manufacturers are actually culturing the microalgae and extracting the deep DHA and EPA and so we can purchase it as supplements they’re adding it to some oils and other things as well but we can purchase the stuff without raping the oceans you know there have been estimates that by 2050 we will have fished out all of the fish in the oceans basically the the fish stocks will be either you know what we call endangered or threatened or whatever or extinct completely and so there’s concern about how we’re taking fish stocks and and and so when you think about that it makes such sense you know also when you culture it you’re not at risk for any of the persistent organic pollutants that that move up the food chain you’re not at risk for the mercury and the other heavy metals that can contaminate fish and seaweed and so it’s it makes sense to get it that way and and the other thing is when you consume huge amounts of fish oil you’re these again are very highly unstable fats you flood your body with what is not physiologically a kind of natural amount to be consuming your body may not be able to deal with it and some of it may get oxidized and so these smaller amounts you get from the micro algae supplements two or three hundred milligrams a day I think your body could deal with quite easily so I think it’s a it’s a good plan so who needs it well I would say the people that aren’t converting well so people with diabetes hypertension may be well advised to take it people that come from fish eating populations may be well advised to take it pregnant and lactating women may want to boost their levels because they’re growing a new baby brain and and so that’s you know those are populations would everybody need it we don’t really know but it might make sense for people to take it even two or three times a week to kind of keep their levels a little bit above what we see in the average vegan population the question is about raw vegan versus a conventional vegan diet and are there advantages potential advantages to raw and I would say there are possibly advantages in its sort of both camps but the main advantages for raw is what when you do a raw food diet you’re eliminating two categories of foods you’re eliminating animal products and processed foods when you do a vegan diet you’re eliminating animal foods you may not necessarily be eliminating processed foods so the the raw diet would be it tends to be a very clean diet often organic and and no processed foods you’re not getting all of the additives and preservatives and artificial sweeteners and the white flour and all of that’s gone and so it’s this is a highly potentially very highly therapeutic diet if it’s designed properly now a whole food plant-based diet where you’re doing some oh the other thing about the raw diet is you’re minimizing your intake of the products of oxidation that occur with cooking and and that’s that’s you know potentially quite a huge benefit because we’re looking at you know polycyclic aromatic hydrocarbons advanced glycation end-products the acrylamide and other products if you’re especially cooking with oil that you would form the Accra liens and so on aldehydes that form with cooking oils and so definitely some huge advantages in that direction now a conventional vegan diet if it’s a whole food plant-based diet where you’re not using you’re not frying foods you’re not adding sugars you’re not using white flour and the way that you cook foods is is you know you steam your vegetables are you you know you’re doing things very consciously in those ways then that diet would be much more comparable to a raw food diet absolutely there we we actually have a really truckloads of evidence at this point that plant-based diets may offer significant advantage in terms of disease risk reduction and some of the most powerful studies that I’ve seen our studies that compare populations that researchers have been following for many years and within these populations they’re comparing similar health-conscious individuals who eat different dietary patterns so within the health-conscious cohort you have health-conscious meat-eaters health-conscious semi vegetarians health-conscious fish eaters health-conscious lacto-ovo vegetarians and health-conscious vegans and so and they’re controlled for exercise smoking alcohol intake you know all of these con founding variables are being controlled for so we’re isolating out the differences between the meat eating meat and eating plants for example so that probably that they’re they’re really three studies that are ongoing the two biggest are the Adventist Health Study two ninety six thousand participants began in 2002 and is ongoing the second and that’s in North America and the second is epic Oxford in the UK about sixty five thousand individuals began in I think it was 1992 or 93 and it’s ongoing so it’s been going on for a long long time the third is a smaller cohort of about maybe forty four hundred individuals in Taiwan and they’re comparing similar health-conscious Buddhists who are omnivores versus Buddhists who are vegetarians and so we’re just starting to see the results of those studies as well and so when we look at these studies and look at the differences what we see is in terms of mortality we see reduced mortality among vegans the the greatest risk reduction was for vegan men by far much greater risk reduction than anyone else and and vegans on the whole I think was about 15 percent risk reduction in mortality and then in and then for for heart disease a 32% risk reduction for epoch Oxford for men in the Adventist Health Study – it was about a 42% risk reduction 55 percent risk reduction for ischemic heart disease and for women not not any significant differences in it for vegan or lacto-ovo vegetarian women compared to the health-conscious omnivorous but then for hypertension for both men and women 75% less hypertension among vegans 55 among lacto-ovo vegetarians in epic oxford slightly lower numbers for earth sorry in Adventist I’ll study to slightly know lower numbers for epoch Oxford but similar and and I think about a 31% difference in the Taiwanese study and then if we look at diabetes 62 percent less in vegans I think it was 38% less in lacto-ovo vegetarians and that was Adventist Hall study to cataracts 40% lower for vegans 30% lower for lacto-ovo vegetarians that was in epic Oxford and then cancer in epic Oxford it was 19% lower for vegans and and about 11% for vegetarians and then in how Adventist Health Study – it was 16% for vegans and 8 for lacto-ovo vegetarians and then for diverticular disease it was 72% lower for vegans 27% lower for lacto-ovo vegetarians and then the other one that they we’ve got some data on is kidney disease 52% lower for lacto-ovo vegetarians and vegans combined and then and that was Adventist Health Study to an epoch Oxford a very recent study showing a 31% risk reduction in kidney stones for people eating plant-based so so yes we have some evidence and it’s it’s a very sound evidence and and and so and you know what’s what’s really interesting is the entire cohort is that half the risk of has half the risk of mortality compared to the general population so imagine how much bigger those numbers would be if we weren’t comparing to health conscious you know controlling for body weight and for for you know exercise and all of those things the numbers would be much much greater so we’re not comparing to the general population we’re comparing to very similar omnivores and and and so it’s it’s very very compelling research and the other thing to remember is that the people in epic Oxford and the people in the Adventist Health Study – they’re not eating truly whole food plant-based diets they’re not eating raw food diets they’re eating you know the Adventists eat diets that have a lot of meat analogues and a lot of bread and a lot of you know processed foods really a lot of press it’s the same and they eat way better or significantly better more fruits and vegetables than the epic Oxford people so it’s you know imagine what the numbers would be if we were looking at people eating truly whole food plant-based diets so so there’s so I think some pretty sound convincing evidence there reversal of heart disease is is so interesting because there was a time where we believed once plaque was laid down you couldn’t nothing could could change that that it would just continue to get worse and worse and worse until the lifestyle heart trial in 1990 and Dean Ornish did a study where he used a low-fat plant-based diet about 10% fat stress management a group therapy exercise and 82% of his group his experimental group actually had reversal and and what was really interesting is these people were basically people who were told by their doctors you’re done there’s nothing more we can do for you we’ve done the triple bypasses get your affairs in order you’re you’re gonna be gone within a year and you know 12 14 18 20 years later they’re still doing well and and so this was really earth-shattering and then not not so long after dr. Caldwell Esselstyn who will be here speaking as well did his his research and and and actually with Dean Ornish’s he his experimental group five years later had two and a half times fewer cardiac events than the control group that was doing you know this sort of standard of care American Heart Association diet but with dr. Esselstyn nobody that stuck to his program had recurrence nobody and and so and he came out with another study in 2014 where I think point six percent of the people sticking to his diet had recurrence and 62 or 63 percent of the people in the in the you know in the control or wasn’t really it wasn’t a control it was the people that didn’t follow the diet that that 62 percent actually had an event so this is really quite astounding I don’t know of any diets that I’ve ever shown cardiac disease or heart disease reversal and so this is this is important and and we can’t underestimate the value of this and you know I’ve had I talking to physicians I have the privilege of talking to physicians quite often and I’ve had physicians say to me and and on a regular basis I I believe you but III don’t think my patients would ever do that and and so one of the things that I like to remind them of is what their responsibilities as a physician really is and their responsibility is to lay the options out on the table of course your patients won’t do it if they don’t even know about it don’t it’s so important not to be paternalistic and to assume you know what your patient will or will not do you don’t I can remember working in a in a cardiology clinic years ago it was probably 25 years ago and and there was this big truck driver that came in he must have been 300 pounds and I remember thinking to myself this guy was going to be dead in five years he was in his 30s and I thought his his cholesterol and triglycerides were so high and and so I thought you know he eat he was eating a hot beef sandwich with gravy and french fries and pop for lunch and dinner pretty much every day that’s the truck stops that’s what they served that’s what he ate and I can remember thinking to myself like why should I waste my breath there’s no way this guy’s gonna do anything but I thought to myself don’t you know you just don’t you you need to lay his options out so I told them that you can do a low-fat plant-based diet and see a reduction of you know Dean Ornish on average it was 37% reduction in cholesterol and reversal of disease or you could do a Heart Association kind of diet that’s the you know 20 to 30% of calories from fat and low saturated fat and so on and so forth and you’ll get a 5% reduction in in in cholesterol and you’ll be on medication for the rest of your life or you can continue doing as you’re doing and die you know it’s your it’s really your choice and he looked at me and he said why would I do anything other than what would give me the very best chance of survival I don’t want to die I’m 35 years old and it was a real it hit me that we don’t we cannot decide for our patient what they are not willing to do all we can do is lay out those options and we need to let them know what is possible because when people make these choices it is absolutely life-changing you can rebuild your body your body wants to heal itself it will do everything in its power if you put the right tools in your mouth the building blocks to rebuild your body properly and magic will happen and so people need to know about that they’ve got to know and so we just we just have to have the courage to tell them and then let them decide we can’t decide for them but they’re the captains of their own ship i I’m a dietician of physicians we can’t eat a we can’t exercise for anybody they’re the only ones that can do that all we can do is tell them what’s possible so I think that’s really really important and yes heart disease is absolutely reversible no I don’t and and with all due respect to my absolutely cherished colleagues

1. Esselstyn dr. Ornish and others that are promoting a very low-fat plant-based

diet I believe that the research shows definitively that these diets work for reversing heart disease and there’s a little bit of research even with diabetes that they may be effective for that as well but I think what people need to understand is just because a diet is effective for a very sick person to reverse heart disease that works to reverse heart disease does not make it the gold standard for everyone I think it’s risky to use a very low fat diet for young children even for athletes you you we you know fat is actually important it’s important for our brains and our eyes our our cell membranes for all of those things fat also I prefer it it’s what provides us with our essential fatty acids but some of the very low fat diets aren’t providing enough essential fats also it’s very important for the absorption of fat soluble nutrients so for example you know vitamin A a carotenoids vitamin E vitamin D you know these kinds of nutrients many phytochemicals are fat soluble and in order to absorb them we need to have some fat so like let’s say for example some people just pour a dressing on their salad they’ll buy a fat-free dressing and think it’s all healthy well you’ll observe you know a fraction of the phytochemicals from your salad that you would if you put tahini based dressing or a hemp seed you don’t bet base dressing on your salad so I think it’s I actually believe and I think the evidence is pretty clear that nuts and seeds are protective avocados are protective that some of these higher fat plant foods are very very beneficial and the other thing is sometimes when people shift to a very low-fat plant-based diet and not they’re not conscious of refined carbohydrates they end up eating a lot of refined carbohydrate their triglycerides go up their HDL goes down and they can actually increase risk by doing that so we people need to be careful the other thing I’ve seen which is people choosing foods on the basis of whether or not it contains fat so they would choose a loaf of white bread over a loaf of bread with flax seeds because flax seeds have fat and fats bad so there’s a you know it was sort of an extreme example but I’ve actually seen that in in people though if if something’s fat-free it must be good so there’s the fat-free snack Wells cookies or whatever and and they must be good and so I think we need to be cautious so to me for you know the World Health Organization recommends a minimum of 15 percent of calories from fat and I think for the average healthy individual that’s a really good starting point because that 15 percent then you’ll be ensuring sufficient absorption of these protective nutrients and enough essential fatty acids so I would say 15 to 25 is probably a good range when the fat is coming from whole fat whole plant foods higher fat whole plant foods well cancer is tricky so one of the things let’s say you had a hundred people with colon cancer and a you know you divided you put half on conventional treatment give them chemo radiation whatever they need the other half you said well we’re gonna put you on green juices and you’re gonna do this diet it would never pass any ethical board because basically you’ve got what is considered the evidence-based standard their standard of care and so you couldn’t just use an unproven therapy for these other people that might die if they don’t receive this treatment so that makes it really difficult however we have evidence that people consuming plant-based diets have less DNA damage better DNA repair they have fewer toxic metabolites in their stools they have better gut microflora they have better lower levels of inflammation lower levels of igf-1 so all of these factors that you know are kind of cancer promoters are reduced so that that’s some decent evidence and then the other evidence that I think is among the most compelling bits of evidence we have is from dean ornish again so after he finished his cardiovascular disease research he went on to prostate cancer research in 2005 he did a study that showed that PSA levels on people doing plant-based were reduced about 4% and well first of all he had a group of men who chose not to get treatment for their very slow-growing prostate cancer and so you know he put that before I think 49 of them on just control and 44 went on this this lifestyle program and the ones that went on the lifestyle program their PSA decrease the ones that we’re doing nothing their PSA increased after a year six of the people that were in the control group actually had to start treatment because their disease had progressed sufficiently that they they felt they needed to start therapy and then the the thing that was very cool was the serum of the people on the plant-based diet killed killed 70% let’s see 70% more cancer cells than the people in the in the 70% yeah what said it was 70 percent versus some other percent of cancer cells that were killed and so it was eight times more as what it was than the people in the control group so very very interesting and then he went on to prove that you could actually change the expression of your genes by doing plant-based for just three months he reported it was about 453 I think close to 500 disease cancer promoting genes that were down regulated and and and about 48 cancer preventing genes that were upregulated by going on a plant-based diet unbelievable this was earth-shattering we can change the expression of our genes and then he went on to show in 2013 that you could actually change the length of your telomeres by eating a healthy diet so telomeres are the ends of the chromosomes that sort of tell you how long you’re gonna live and normally as you get older they just shrink and drink and drink well docking a healthy lifestyle and they actually start to get bigger and and so this was again it was pretty earth-shattering so he’s he’s done some some work that would give us indication that adopting a plant-based diet could be a very effective strategy for cancer treatment even if you’re doing it in conjunction with conventional treatment it that it it can do nothing but good and the answer is a very very clear yes so we have several dozen studies even I looked at studies between 1994 and 2008 and there were 24 studies and it’s very consistent they both are very highly protective against cancer but raw vegetables are more protective and there are several reasons for that number one is that they’re higher in phytochemicals number two is is that when you cook vegetables you change the affect of the fiber in in the food and that can alter the effect they have on your gastrointestinal system number three is raw vegetables contain enzymes that convert phytochemicals into their active forms and so one of those enzymes is called myrosinase in cruciferous vegetables and it actually turns on phase 2 enzymes which help to change carcinogens into water-soluble compounds so we can excrete them from the body so we’ll so for example in cruciferous vegetables you have these compounds called glucosinolates that get converted into isothiocyanates like sulforaphane and solve for fame is needed in this you get kicks in this this phase 2 enzyme system so it’s it’s that’s another reason that you know raw vegetables may may provide some advantage and of course when you cook you lose some nutrients that may be cancer fighting nutrients as well so there are several reasons why raw foods may provide an advantage over or do provide an advantage over over cooked both the the more vegetables you eat the better you do but raw are more powerful in terms of cancer prevention than cooked and we do we have actually the the Physicians Committee for Responsible medicine did a few reasonably small studies but following people for a good period of time showing that that what they actually did was used a low-fat vegan diet and that their their control was people doing an American Diabetes Association diet and actually both diets showed benefits in terms of you know insulin resistance and lowering blood glucose levels and a one C’s and body weight and cholesterol and all of those things but the vegan diet consistently did better than the American Diabetes Association diet so we have those studies we have some studies out of the Czech Republic a study from 2014 I think it was showing again comparing a vegetarian diet and the only animal product they used was one serving of yogurt low-fat yogurt per day otherwise there were no animal products in the diet and in that study again they found that they and they compared it to the conventional diabetic diet that the the vegetarian diet did better on every single count and then the the work that I’ve actually been doing some work in the Marshall Islands where and we’re worked where we’re just writing it up now but we actually found very significant advantages to doing plant-based as well by the Marshall Islands for those people that aren’t familiar with Marshall Islands they’re a small group of many islands in the South Pacific and the Pacific about 2,300 miles southwest of Hawaii so they were it’s sort of a strategic location some people may remember bikini island being atomic bomb testing grounds after the Second World War but anyway the marshalese people went from having absolutely no diabetes a hundred years ago to having among the highest rates in the world and they literally went from living off the land where they were eating coconut and green leaves and whatever taro root and bananas and and fish whatever fish they could catch with their little Spears to living off of having more people on the islands than what the islands could sustain so the the main island Majuro has 30,000 people it might sustain a thousand if we were lucky so so they they have to import food and so what the import is because people are very poor and there’s not a great economy is the cheapest food you can think of so they import things like turkey tails and and spam and you know the parts of the animals we don’t want so because they’re cheap white rice sticky rice luau which is high fructose corn syrup drink lots of ramen so they eat dry ramen noodles and they sprinkle kool-aid powder on top to make it taste good the kids do it’s it’s really I couldn’t design a diet to induce diabetes that would be more efficient than the diet they’ve adopted and it’s just so sad because they are uh I just I love I it’s like a second home to me I’ve been there maybe ten times now and I stayed the first time I was there eight months and and I worked on a diabetes research research project and I continue to go go back on a regular basis but they are just absolutely the most beautiful people in the way they laugh the way they enjoy every moment together and they tease one another and they sing and you you never you never feel judged you can walk down the street and sing to the top of your lungs and people just start singing with you it’s it’s a really a beautiful place and and so it really saddens me to see people suffering the way they’re suffering so needlessly and so we went in and we did this control group usual care and and very fairly aggressive whole food plant-based diet and we saw average blood sugar drops of 70 points within two weeks we saw average a1c drops of two points within 12 weeks we you know we saw a one seized or sorry HS CRP is down by about one point two points so we saw some really big changes and even going back like last year when I went back or 2016 when I went back we actually had blood glucose drops of over a hundred points on average so we’re seeing we’re getting better and better at what we’re doing there and seeing better and better results and we saw several people who were able to completely reverse their their diabetes and it’s it’s very very encouraging to see and what’s happening now is that the government is so interested in helping the people that that I just went to a couple of months ago two months ago in in November of 2017 we along with a colleague to create a program that that would would new curriculum for schools from kindergarten to grade six so that the teachers and we trained all the teachers in the public school as well we were there so that the kids could start to learn they’ve got new rules new laws where people are not allowed to sell unhealthy foods near the schools in the schools anymore so we’re you know we’re we’re working on things and we’re seeing changes I you know when I first arrived nobody walked anywhere because walking showed you were too poor to afford a 25 cent taxi and and so people just didn’t walk and now people walking in the mornings there’s walkathons all the time and you know the restaurants have diabetes wellness approved men you know menu options and the stores are having way more produce than they used to and they’re carrying little some of them have little health sections now where they sell flax seeds and steel cut oats and things like that so we’re really seeing some very encouraging changes it’s quite wonderful yeah so to me number one is you need the foundation of your diet to be whole plant foods and that is critical and so what do I mean by that I mean you want ten servings of vegetables and fruits you want two or three servings of legumes you want to make sure you’ve got a serving of nuts and seeds or to like at least one of nuts one of seeds and make sure there’s an omega-3 rich source you if you’re eating grains are a little bit optional depending on your caloric needs but you want them to be mainly intact you want lots of herbs and spices because they’re loaded with phytochemicals and antioxidants so that’s number one whole plant foods number two you want to make sure that you’re getting up in terms of the amount of fiber you’re eating so so and you do that just by eating that that number of whole plant foods and the the number one source of fiber of course is beans and so including some legumes is a really really good idea the average person’s eating 15 grams 20 grams at most of fiber a day we probably need more in the range of at least 35 to 50 for optimal health Paleolithic people ate 70 to 150 grams of fiber a day so that that’s number two number three is be very picky about your sources of carbohydrates carbohydrates you you not only do you want to make sure you’re not consuming refined carbohydrates so when we say refined carbohydrates we’re talking about both complex and simple carbohydrates simple carbohydrates being sugars so soda pop and and candy and white sugar and brown sugar and honey and all all concentrated sweeteners and and refined well honey wouldn’t be refined but generally sugars that are concentrated even agave syrup and and then on the complex carbohydrates the refined complex carbohydrates are the white flour products the white rice products so thus the the concentrated starches and both of those are consistently associated with increased disease risk increased risk of overweight and obesity you can’t stop eating them and they’re addictive I and so and and and so we just need to get rid of those foods as much as is possible and and then the next thing is a lot of people will say well you know whole grains are fine so I eat all whole wheat bread and I eat you know puffed rice and I eat my flaked organic chem lakes or whatever and people also need to understand that there’s a hierarchy within the whole grain world and I I created this sort of hierarchy of whole grains to help people understand that just because it’s a whole grain doesn’t mean it’s not highly processed okay so you can take and make whole grain flour but then you’re making you know that muffins or cupcakes or whatever with the whole grain flour you’ve still added a bunch of fat and sugar and salt and you know what we you know what we do when we make foods out of flour is add things to make it taste good and so in the whole grain hierarchy at the top of the hierarchy is intact whole grains then would be next would be cut whole grains like steel cut oats then next on the hierarchy would be rolled whole grains like rolled oats then next would be the grant reddit whole grains then ground then flaked then puffed at the bottom and when you the puffing process is you know you put a green under you know so much pressure that you puff it well as you go down the hierarchy you digest and absorb these things faster you increase the surface area so it increases your blood glucose more you decrease the nutritional value because you’re exposing the food to air and just just all of these processing techniques and so we want to as much as possible stay higher on that on that whole grain hierarchy so that’s number three is the carbon carbide it’s number four is with protein it stick to plant as much as is possible and again you want to be sticking mainly to beans lentils peas these intact sort of legumes that have all the fiber and phytochemicals and all of that and choosing less often the more highly processed options now there’s a lot of controversy about soy so I’ll just say I haven’t said anything about so I’ll say a few words about soy to me the acid test is to look at the healthiest longest-lived populations on the planet two populations the Okinawans and the seventh-day adventists that are blue zone populations include soy as a dietary staple the Okinawans consuming two servings a day and the Adventists consuming I’m not sure they haven’t quantified it but soy is a part of their regular daily diet and so if it is a staple in the longest-lived people’s it’s probably not poison so but what people need to understand is that we want to be choosing I would choose organic and I would choose soy that’s less processed so edamame soybeans and and tofu or tempeh is not super highly processed rather than this this sort of veggie meats which are more highly processed which I’m not saying you can never include but should be less often and so you know plant-based protein foods have huge advantages over animal-based protein foods and I won’t get into that too much but just know and I think you’ve heard it probably from

1. Fuhrman quite a lot there’s so many problems with meat in comparison to

legumes I have a kind of a list where of them side by side and there’s so many advantages to legume and if we look at mortality this Studies on mortality show that even the tiniest bit of legume consumption 2/3 of an ounce a day decreases mortality by 7 to 8 percent whereas with meat it’s the exact opposite meat increases mortality consistent across the board so so that’s number for protein number five we’d be talking about fat and again get your fat from Whole Foods and and you know rather than I look at oils to me oils are to the fat world as sugars are to the carbohydrate world you know with carbohydrates when people get their carbohydrates from Whole Foods they’re at no increased risk of disease they’re at a decreased risk of disease and it’s the same with fat so I think that with fats we want to get them mainly from Whole Foods nuts seeds avocados and these kinds of of higher fat foods rather than from oils which are highly refined foods and and so that and making sure we have that source of omega-3 we need two to four grams a day we would get that from eating a tablespoon of flax seeds we would get that a ground flax seeds because you’re not going to absorb it from intact flax seeds a couple of tablespoons of hemp seeds a tablespoon and a half of chia seeds you know an ounce of walnuts would provide that so that’s you know and with fats you want to you know absolutely eliminate trans fats you want to minimize saturated fats so maybe five six percent of calories is what the American Heart Association and the American College of Cardiology suggest the only people that are in that realm are vegans so that’s bottom line it’s not hard to be in that range on a vegan diet and we want to avoid damaged fats so fats that are heated to high temperatures and also even storing nuts and seeds we want to store nuts and seeds in their fridge or refrigerator so what I do when I buy nuts or seeds is so I get you know my five kilos or ten pounds of walnuts or pumpkin seeds or whatever I always buy them in volume the first thing I do is soak soak them for you know overnight or for a few hours whatever it is dehydrate them in the dehydrator and then I put them in little containers and freeze them I take them out as I need them and that’s that’s how I deal with nuts and seeds and so I think that was number 5 number six would be to to minimize exposure to environmental contaminants so we’re wanting to minimize our exposure to persistent organic pollutants like dioxins and all of these pollutants that that you know move up the food chain and and mercury and and the heavy metals and and you know all of these agro chemicals pesticides and herbicides and and and growth you know growth regulators and all of these things so how do we do that with two ways eat lower on the food chain and eat organic so it’s really as simple as that next on the list would be to really reduce our the toxic compounds that are formed from cooking and so we’re talking about heterocyclic amines and polycyclic aromatic hydrocarbons and advanced glycation end-products and an acrylamide and all of these compounds which are potentially a neurotoxic carcinogenic you know and so we just need to be aware of those and so how do we deal with that don’t eat fried foods just don’t eat them don’t you know don’t fry with oil you keep if possible keep oils out of cooking as much as possible I think you know just not using them and and then storing foods properly so that the nuts and seeds in the fridge and freezer and so forth and I think that was number seven or eight around there anyway and then the next on the list to me would be to maximize phytochemicals and antioxidants and that means just eating the widest variety and the most colorful foods you can within each category so in fruits and vegetables i io e say at least three green to red or two red to purple blue to orange yellow you know and a few even the white beige family with the onions and garlic and so forth and so you want the whole range of the rainbow but you want the variety and not just in fruits and vegetables think about it when you’re choosing beans more of the red and black beans more of the e and grains you know black rice or red rice or red or black quinoa instead of always choosing the brown for example and and so and and just the variety as well so you don’t want to be eating six apples a day as your as your fruits you want to be including some berries and some citrus fruits and and and it’s the same in in all categories you want to be varying up your your choices and then and and I’m not sure if I’m missing any but the last one that I would say would be just don’t overeat do not overeat I the Japanese with the Harry Hatch abou thing eat till your 80% full is a really good plan it’s so hard to do in such an obesogenic environment where we have such you know foods that we can’t resist all around us and people are offering and that’s how we show love and it’s how we commune with our families and it’s so difficult it’s so difficult and so we just need to be really conscious of you know not just the type of food we eat but the quantity of food so if we’re eating a large volume it’s we want to eat a large volume of salad not a large volume of garbage food and and just you know and not the other thing that to me is really important is not drinking sugar that’s one of the best things you can do for weight control because people who are leaner have a have a much lower risk of any chronic disease and a greater longevity so that’s very very important so those are kind of the that I would say the top ten if I did ten I’m not spread to nine or ten but anyway the the top and and then I’ll leave you with my you know sort of final thought and that is that you know we we have such power in our personal example it’s it’s incredible people you know nobody I think we don’t get through to anybody by spitting in their face we need in order to move people we need to connect with them and love them and cherish the wonderful things that they’re doing and then share our example of good health but also share delicious wonderful food with a really generous heart and and I think that’s the the most important thing we can do to help other people shift rather than you know waving a finger at them or telling them they’re they’re idiots or any of that it doesn’t bring us together we we need to be connecting with people with respect and and with love and that means sharing it means sharing food and it means just being generous so that’s what I’m thinkin if some is all about it’s about compassion it’s about wanting to make this world a more beautiful place more ethical place and and it begins with how we treat our neighbors so I’ll leave you with that and thank you so much [Music] you [Music]