Brenda Davis, RD – Nourishing Plant-based Children From Birth Through Adolescence

Poor Diet Is The #1 Cause Of Death In America And Globally

Uh now uh let's get started I am really excited about sharing uh this presentation with you because it is a presentation that um that is near and dear to my heart uh about um nourishing plant-based children from birth through adolescence and I have to tell you that my writing partner of the book nourish uh RMA Dr RMA Shaw and myself really saw a hole in the literature there there really wasn't anything that covered thoroughly um plant-based families and so what I'm doing with you today is.

To provide for you uh this um you know a lot of the information that we provide in this book and I I hope that it will be of value to you and your family uh so a quick outline uh we're going to start by talking a little bit about why plant-base we'll talk about the safety and adequacy of plant-based diets for children four Core Concepts of uh feeding children then we'll look at considerations at various stages of growth so infants uh toddlers uh children and teens.

And then we'll wrap up by by discussing some of the potential nutrition shortfalls and how you avoid those so let's start with why plant-based well the answer is very simple plant-based is healthy sustainable and Humane and so we're going to dive a little more deeply into each of these aspects of plant-based nutrition for children so first looking at uh the uh aspect of uh healthy so when it comes to nutrition and health we know um that the food we eat is so critical to our well-being.

It is necessary for optimal growth and development of children of course food we all know is our fuel but what fewer people recognize is it's also the raw materials that we need to build and repair every cell of our body the link between diet and disease is a very strong p nutrition is linked to 70% of deaths globally 90% of type 2 diabetes 80% of heart disease and about 30 to 70% of cancers and it is the number one poor diet is the number one cause.

Of death in America and globally so you can see here from the US burden of disease collaborations it's at the very top of the chart and among consumers there is tremendous confusion and controversy about what diet really is best for human health but the good news is that among a medical professionals among um nutrition experts among the leading health organizations on the planet there is tremendous agreement and whether we're looking at you know National dietary guidelines World Health Organization guidelines um nutrition uh organizations uh Pediatric.

And medical organizations universities uh what we see consistently is there is Broad consensus on dietary risk factors we know overc consumption of calories increases risk of disease we know low intake of high-fiber plant Foods increases risk of disease like fruits and vegetables legumes whole grains nuts and seeds we need to be increasing our intake of these things High intakes of foods with added fat sugar and salt increase risk of disease high intake of refined carbohydrates of sweet beverages of red and processed meat of deep fried.

And fast foods on these issues there is no debate and in a nutshell what we're saying is we need to be eating mostly whole plant Foods we need to minimize our intakes of Highly refined foods and animal products and to me the acid test is just simply to look at the healthiest longest lived people on the planet and of course we're talking about the people of the blue zones people from lalinda the NOA Peninsula and Costa Rica Sardinia Italy iara Greece okanawa Japan people in the.

Blue zones have extended healthy lifespan and some lifestyle practices are unique to each Blue Zone some are shared by two or more blue zones as you can see in this Vin diagram but there are certain lifestyle practices that are common to every single Blue Zone and these are that they have very strong families they're socially engaged they do Conant moderate physical activity they tend not to smoke and where diet is concerned there's two factors they all eat plant-based diets and they all consume legumes as a.

Dietary staple there are so many advantages to health uh uh Health advantages to plant-based diets they improve mortality and Longevity they reduce overweight and obesity plant-based diets are associated with lower rates of heart disease type 2 diabetes cancer hypertension non-alcoholic fatty liver disease cataracts gastrointestinal disorders and gout uh to name H a few experts consistently agree that the dietary patterns that are best for human health maximize whole plant foods and minimize highly processed foods and animal products but some people would say we're.

Doing What We Can To Minimize The Risk

Talking about children here do we have to think think about chronic diseases during childhood and the answer is actually yes while ensuring optimal growth and development is the number one priority in childhood we do need to do what we can to minimize the risk of Lifestyle induced disease during childhood and of course Beyond if we look at overweight and obesity in children approximately 20% of America of American children are and teens are obese in the 1970s it was 5% 70 to 80% of adolescents that are.

Obese will remain obese in adulthood childhood obesity is associated with a laundry list of adverse Health consequences from metabolic disorders to cardiovascular disease type 2 diabetes liver disorders sleep apnea lung disorders menstrual disorders and what we know I'm sorry this um chart somehow disappeared on this computer but what we know is is consistently plant-based eaters have lower rates of of overweight and obesity and in fact in the Adventist house study too they were a pure vegetarians or vegans were the only dietary category that were within.

The healthy um uh weight Zone and so we consistently see the the leanest bodies among plant-based e ERS when we think of heart disease atherosclerosis actually begins really early in life fatty streaks are found in the ordera of children younger than three years of age and by age 10 nearly all kids have fatty streaks and fatty streaks are very typically present in the coronary arteries of people in their 20s we consistently see less heart disease among plant-based eaters and and perhaps the most profound of of.

The studies was the Adventist Health study to uh showing almost half the rates of of vegan uh heart disease in vegan men compared to similar healthc conscious omnivorous men but we do have a recent metaanalysis showing about a 25% reduced risk of incidence and mortality from es schema heart disease among vegetarians and vegans compared to omnivores and again type 2 diabetes it used to be rare in children 20 or 30 years years ago uh rates are absolutely escalating in this age group today and we see.

Cases in children um as young as eight years of age and sometimes even younger complications appear earlier of course in these children and and tend to be more severe um and the risk factors are of course overweight and obesity um moms with gestational diabetes uh their children are at higher risk certain ethnic groups are higher are at higher risk like native American children uh black children Hispanic children and children with a family history of diabetes what we know is there's less type 2 diabetes among plant-based.

Eaters uh than among uh and again my um my my Graphics have disappeared um basically we see rates of about 133% in American adults we see rates in healthc conscious um uh 7th Day Advent of close to 8% in the omnivores and and that number goes down to about 3.2% in vegetarians and then 2.9% among the vegans in this category uh in terms of cancer cancer rates have been rising steadily over the last several decades in the US and globally with the largest increases reported in.

Infants uh according to the National Cancer Institute overall cancer rates have increased 27% uh since 1975 in children under 19 years of age and again we see less cancer among plant-based eaters compared to similar health-conscious meat eaters cancer rates were in Epic Oxford 11% lower among vegetarians or lacto oval vegetarians 19% lower among vegans and in the Adventist Health study 2 8% lower among lacto vegetarians and 16 percent lower among vegans and if we look at the Cancer uh the diet uh recommendations uh for cancer.

Prevention from the world cancer research fund and the American Institute of cancer research what we see is is a a recommendation to eat a diet rich in whole grains vegetables fruits and beans uh to limit consumption of fast foods and other processed foods high in fat starches or sugars to um uh uh limit consumption of sweet beverages to limit alcohol consumption and of course to limit consumption of red and processed meat and in fact the world the wh or the World Health organization's International Agency for.

Research on cancer I think it was in 2015 uh declared process meat a group one carcinogen in the same category as Asbestos and tobacco and red meat a group 2A or probable carcinogen in the same category as DDT and glyphosate and then of course you know we have to ask ourselves why are we feeding children um you know in school programs in hospitals uh hot dogs and hem sandwiches it doesn't make a lot of sense so when it comes to what diet is best for health.

I think um the answer was articulated beautifully by Dr Katz Dr David Katz in this quote the evidence is strong consistent and compelling that a diet of predominantly or even exclusively whole plant foods can promote Health selectively treat and reverse disease and confer comparable benefit to the planet what we should be eating then for disease reversal and health promotion for the sake of people in the planet alike is clear enough welcomed by some clearly inconvenient to others the truth is that we should all be eating.

Plant predominant diets moving on to um the sustainable uh.

14%-18% Of All Greenhouse Gases

Issue and and what we know is in terms of sustainability some diets are preferable to others when we look at the environmental impacts of animal agriculture about 14 to 18% of all greenhouse gases more than all forms of transportation combined um are due to animal agriculture uh it animal agriculture is the leading cause of rainforest destruction species Extinction ocean dead zones and water pollution it's responsible for 91% of the destruction of the Amazon and animal agriculture occupies 40% of the Earth's habit habitable land mass if.

We look at the habitable land used for food production both animal and plant we're using at present about 50% % of the Earth's habitable land and about 40% uh of um 80% of that is for animal agriculture if everybody ate the way they do in the UK that would be 95% of the land required to produce food for everyone on the planet if everyone ate the US diet it would be 138% we would need about 1.4 Planet Earths to sustain the population if everybody ate a.

Vegan diet it would be 12% uh an article from the proceedings of National Academy of Sciences in 2016 stated that by 2050 greenhouse gas emissions would be reduced by 29% if we all followed the global dietary guidelines to eat more fruits and vegetables Less meat sugar and calories and 70% if we all ate a vegan diet their recommendation a global shift towards a plant-based diet if we look at the amount of land required to feed an omnivore we would need about two football fields for one.

Person per year for people eating plant-based two football fields would feed about 14 people you know we are wasting valuable food after cows arrive at a feed lot they consume 12 pounds of food to gain enough weight to produce just one pound of beef 50% of the world's grains go towards feeding livestock while close to a billion people go hungry every day if we look at the carbon footprint of our food what we see becomes a sort of self-evident uh if you look at the carbon.

Footprint of of a grazing beef uh it's about 60 they produce about 60 kilograms of carbon dioxide equivalent per kilogram of food uh for lamb it's 24 for cheese 21 coffee 17 prawns 12 P pork seven poultry uh six eggs 4.5 and then we go down into the plant Foods you're looking at between about3 for nuts 04 for root vegetables 04 for for a lot of fruits 0.9 for beans and lentils one for corn 1.4 for grains uh four for Rice you can see if if.

We're eating on the lower end of the of of the spectrum and we're eating plant Foods our carbon footprint is dramatically reduced and simple changes can make a big impact even if the world just ate 15% Less meat it would be like taking 240 million cars off the road each year the eat Lancet commission uh from 2019 asked this important question can we feed a future population of 10 billion people within the healthy planetary uh within healthy planetary uh boundaries and the the answer is absolutely.

Food is the single strongest lever to optimize human health and environmental sustainability on earth a Dietrich in plant-based foods and which fewer animal food with fewer animal Foods confers both improved health and environmental uh benefits I love this quote by Jonathan H saffron for he said changing how we eat will not be enough on its own to save the planet but we cannot save the planet without changing how we eat and that brings us to the third piece of the why plant-based which is plant-based is.

More Humane Animal centered diets hurt animals and in my opinion it makes absolutely no sense to cause pain suffering and death of other living beings if it's unnecessary there was a uh poll by the American Society for Prevention of Cruelty to animals and in this poll 94% of Americans agreed that animals should not suffer but the reality is very different 10 billion land animals are slaughtered for food every year in America an estimated 99% are raised in factory farms or Kos confined animal feeding operations Dr.

Albert schwitzer the uh 1952 winner of the Nobel Prize said the time is coming when people will be amazed that the human race existed so long before it recognized that thoughtless injury to life is incompatible with real ethics ethics in its unqualified form is extended responsibility to everything that has life I think Dr schwitzer would be very disa appointed uh to see where we're at in 2021 and uh there was an opinion piece in the New York Times uh called the end of meat is here.

One can only hope and in this uh article Again by J Jonathan saffr for uh he States our hand has been reaching for the door knob for the last few years co9 has kicked the door open on the other side is not something new but something that calls from the past a world in which farmers were not myths tortured bodies were not food and the planet was not the bill at the end of the meal one meal in front of the other it's time to cross.

The threshold on the other side is home being plant-based isn't about personal Purity it's not about moral superiority it's about making a conscious choice voice to widen your circle of compassion it is about recognizing the consequences of our food choices Beyond ourselves by getting our nutrition from Plants we all win and that brings us to um the the second part of this presentation on the safety and adequacy of plant-based diets for children the question a lot of.

Are Plant Based Diets Safe For Infants And Children?

People ask is our plant-based diet safe for infants and children and parents wonder will my children's growth and development be adversely affected will my family meet their nutritional requirements if we're eating plant-based and the answer is that we have many studies don't done over many decades to show that plant-based diets are safe for children I recall some of the big classic studies that came out in the late 80s the British uh vegan children's study that found that children rear to be vegan can grow up to.

Be normal children and this at the time was a bit of a revelation the farm study from 1989 with over 400 children uh the Seventh Day Adventist children study from 1990 and then we have a systematic uh review of vegetarian diets in 2017 and the vichi study from Germany in 2019 and the findings were really can really be summarized as this lacto ovo vegetarian children grow at least as well as omnivorous children vegan children also grow normally although their growth may be a little slower during.

The toddler years uh and some people ask about the negative findings and in fact there were some negative findings in the 70s and 80s that were reports from the uh reporting adverse effect effects of plant-based diets from communities that used extremely highly restrictive diets and and uh homemade uh milks that were grossly inadequate um but since then uh we have a very different uh food world and nutritious and fortified and wonderful plant foods are very widely available and we don't see these kinds of adverse outcomes.

Very often anymore when people are including balanced diets and I think uh one of the most um useful comprehensive uh uh report that we have that we can share with Physicians that we can share with our health care providers is the position of the Academy of nutrition and dietetics on vegetarian diets from 2016 and they state that it is the position of the American Academy of nutrition and dietetics that appropriately planned vegetarian diets including vegetarian or total um including total vegetarian or vegan diets are healthful.

Nutritionally adequate and may provide health benefits in the prevention and treatment of certain diseases well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle including pregnancy lactation infancy childhood adolescence and for athletes and of course people sometimes get concerned about these words appropriately planned and well planned and wonder if they have to have a calculator in hand and get quite nervous about that but the reality is all diets for children regard less of dietary pattern need to be appropriately planned and it's.

Not rocket science it's actually fairly simple you know it's it's I I always find it funny that in our society we consider a um you know a school lunch like this to be well planned and quite appropriate but we raise our eyebrows when we see um a a a lunch that looks like this that's completely plant-based I think maybe we need to examine our definitions of well plan uh there are many uh advantages associated with plant-based diets for children and these advantages were outlined in the.

Position statement from the America from The Academy of of nutrition and dietetics um these diets plant-based diets are generally higher in quality which means there are more fruits and vegetables there are more you know there's more fiber there's less fat and so on so they are associated with higher intakes of fruits and vegetables and associated nutrients with lower intakes of sweets and salty snacks with lower intakes of total unsaturated fat and all those are very good things and of course lower risk of obesity as well.

So to summarize in terms of adequacy to ensure an ad to ensure adequate plant-based diets we want to choose quality foods we want to ensure sufficient quantity enough calories for children and we want to include plenty of variety within the mix there are really four Core Concepts of of uh feeding children the first is that we need to promote optimal growth development and well-being and a variety of dietary patterns including well-planned plant-based diets can adequately support the growth and development of children all diets for children.

Must must provide adequate calories and nutrients number two is to prevent immediate childhood health concerns the diet needs to prevent conditions of poor nutrition like iron deficiency anemia Dental carries over or under nutrition this means providing a variety of nutrient-dense foods fortified foods and supplements when they're indicated number three is we need to establish eating habits that support Health throughout life and minimize the risk of chronic diseases so eating patterns established in childhood profoundly impact food choices in adulthood plant-based diets tend to have higher diet.

Quality scores and plant-based children have healthier body weights they eat more fruits and veggies they eat more fibers fewer snacks all of those things we just mentioned and number four this is a really important one nurture children's natural ability to eat intuitively and with Joy or to listen to their bodies hunger cues and to eat with joy as parents we can encourage um you know listening to our bodies and and Li and having a lifelong relationship with food by honoring our child's appetite and we'll talk.

About the division of responsibility for feeding keeping experiences around food positive and pleasant exploring food together avoiding food rewards and punishments and Ellen Sader is one of the leading um uh experts on on child feeding and and she says the secret of feeding a healthy family is to love good food trust yourself and share that love and trust with your child when the joy goes out of eating nutrition suffers and the division of responsibility is this there is leadership for parents and autonomy for children and.

Leadership means that as parents we are responsible for the what the when and the where of feeding our children are responsible for how much they eat and even whether they eat at all and in terms of leadership that means that we might say well we're having pasta broccoli beans and fruit at 6 o'clock at the kitchen table and our children then determine how much of that they will eat the dues of chill of feeding children are have family meals they are vitally important be a positive.

Role model offer healthy choices encourage physical activity don't encourage dieting uh don't do the um sort of negative weight talk or teasing and avoid Express excessive screen time The Guiding principles are patience Adventure and curiosity and fun so let's move on to looking at considerations at various stages of growth so there are a number of uh developmental stages during childhood of course beginning with.

Developmental Food Management For Infants

Infancy and in early infancy we're just talking about feeding on demand period and that is of course we'll talk more about the specifics of that for o older babies uh they're transitioning to table Foods you don't want to get pushy and you do want to take no for an answer when the child says they don't want anymore for toddlers this is children from 1 to three years of age this is the peak of neophobia they they become uh often rather picky eaters for schoolage children they.

Need continued support and structure but again you want to avoid pushing cheerleading shaming bribing all of those things and in adolescence family meals are especially critical and they will be developed in food management skills of their own so let's start with infants from0 to 12 months of age and we'll start by talking a little bit about the best milks for baby and uh of course I there there is no controversy about this whatsoever human breast milk is best for human infants as other mammals milk is.

Best for their offspring exclusive of breastfeeding is recommended for the first six months of life and you want to be continuing for as long as it benefits you and your baby normal natural hum human weaning is two to four years and I know that seems uh a lot for people um but that is natural human weaning and and if you can continue for two three or four years the benefits you Pro provide your child are really quite extens ensive there are multiple advant advantages both for.

Baby and for mother and we do have studies that have compared the breast milk of vegetarians with the breast milk of omnivores and compared to the breast milk of nonvegetarians the breast milk of well-nourished uh vegetarians contains about the same level of macro and micronutrients it does however contain smaller amounts of omega-3 fatty acids and it also contains far fewer environmental contaminants especially among vegans which is a huge advantage to your child so what are safe alternatives to breast milk for people that cannot or choose.

Not to breastfeed the only acceptable substitute for breast milk in the baby's first year of life is um is commercial infant formula of course if you're on unable to breastfeed there is the option of acquiring human breast milk from a milk bank for example uh but this is very expensive so the only other alternative uh to breast melt is is human is commercial infant formula and for lacto oval vegetarians what most um authorities like the American Academy of Pediatrics will recommend is cow-based formula and they'll.

Recommend soy based formula for vegans or for babies that can't cons cow mil but often people wonder is soy formula safe and the answer is um there there have been studies comparing infants fed breast milk cow's milk formula and soy formula and this particular study looked at all three groups and they all had normal range for brain development and cognitive function the breastfed babies outscored the the milkfed baby the cow's milkfed babies and the soy formula babies slightly but the milk fed and soy uh fed.

Babies did not differ uh significantly at all and and just so you know there actually are a number of companies right now that are in the process of of developing uh nonoy vegan formulas and they're based on things like almonds and Grains and so forth uh so those should be available in the next year I would I would uh expect the American Academy of Pediatrics also weighs in saying isoflavones and soy formula do not adversely affect human development reproduction or endocrine uh function so what about.

Homemade formula well homemade formulas uh are not appropriate for infants severe malnutrition in infants uh have been traced to homemade formula on a number of occasions and when I mentioned uh the communities that that had children who died or failed to thrive on vegan diet diets uh they were almost always traced back to homemade in Formula that provided very few calories and grossly inadequate nutrition so this is not something to fool around with in addition for infants up to 12 months breast milk or formula must.

Not be replaced with cow's milk goats milk soy milk almond milk or any other um type of milk so let's move on to complimentary feeding when should we start baby on solid food well we want to start solids around 6 months of age when a baby shows signs of Readiness uh some people say well why not earlier why not at three or four uh months of age well the baby's actually not developmentally ready it's not he's not he or she is not physiologically ready they're in.

Other words they can't swallow Foods they don't have the digestive system to manage um uh solid foods and the greatest immune protection uh comes from breast milk and it occurs when baby is exclusively uh breastfed so why not later uh some people think well may if it's good to wait six months maybe it's better to wait eight or nine but by six months of age babies need the additional calories and the additional iron provided by solids this is a really critical period for um adapting to.

Various tastes and textures and if you miss this critical period often what happens is the baby won't want um foods with different textures and they can become very fussy eaters so the first foods should be iron-rich foods and and so iron rich infant uh cereals uh mixed with breast milk or formula would be a reasonable Choice well cooked or Blended mashed tofu lentils or beans would also be a reasonable Choice and then of course because babies are developmentally ready for solids at 6 months you can.

Also start vegetables and fruits and Grains and nut and Seed Butters and creams and I know this is this is a a surprise for some people uh we used to tell parents to wait uh for at least a year or more if if there was a history of allergy to wait two or three years before introducing uh nuts and seeds in the form of Butters and creams and uh you know this um new thinking now is that we should not delay the introduction of potential allergens.

Um and we should be introducing them actually very early and uh with medical support for infants at very high risk uh but but what we found uh what research has found especially where uh peanuts are concerned is that early introduction of peanut protein will actually dramatically reduce our risk of allergy and children so this is this is something to be uh very aware of so what kinds of texture are appropriate well a six-month-old baby can safely um handle a variety of textures and usually you'll start.

With a A puree food at the very beginning and then very quickly um you know to a a lumpy or mashed or finely chopped uh kind of texture soft finger foods are also appropriate for for babies once they've you know started the solid foods there are a number of baby food no no there are several foods that are not considered safe for babies unpasteurized Dairy cow's milk processed meat honey raw Sprouts danger with the honey and Sprouts it's danger of bacterial contaminations sugar sweetened beverages um.

Fruit juices uh foods with added sugars to Age Two actually protein powders and any foods that present choking hazards like hard round or sticky foods and then we also want to limit commercial rice products because these products have been found to be quite high in ARs snic and and of course babies with the tiny little bodies uh this is not a good thing so you really don't want to be uh uh providing a lot of commercial rice products and uh something that people should be aware.

Of is babies milk is still the main source of calories for the for six to eight month olds it will still be providing providing about 80% of their calories by 9 to 12 months it's about 50% and at 1 to 2 years it's about 30% % of their calories and there's a lot of uh debate about whether uh we should be doing this baby Le weaning versus spoon spoon feeding and baby lead weaning is just allowing babies to feed themselves and not actually spoon feeding them.

And it does allow baby uh greater control of their food intake and they can stop eating when they're full and so on um babies in in baby lead weaning are just given food on their tray and encouraged to explore it and eat whatever they can get into their mou independently I I feel that a compromise may be uh a reasonable especially for slower growing babies providing more iron and calorically dense foods on a spoon can help to ensure adequate intakes and so so for these you.

Know baby cereals and you know the pureed Foods whatever to be giving them on a spoon and then giving giving babies these you know sort of finger foods and other foods that they can actually pick up and and consume seems a very reasonable compromise what about supplements well breastfed babies need Vitamin D about 10 micrograms uh up to 12 months of Age and and the American Academy of Pediatrics actually recommends a milligram of kilogram per kilogram of iron beginning from four months until recommended intakes are.

Met by solid foods but this is actually a little bit controversial um uh a lot of pediatric organizations around the world don't believe that necessary so this one's a a bit of a judgment call here um I would suggest uh you know discussing it with your with your um health care provider for formula fed babies you don't need to use any uh uh supplements at all if iron fortified formula is used um moving on to toddlers from 1 to.

Developmental Food Management For Toddlers

Three years of age um feeding guidelines you want to avoid distractions at this stage you want to keep the atmosphere Pleasant you want to limit the meal duration don't be you know stretching meals out to an hour or something uh 15 20 minutes is more than enough for most uh young children you want to be providing three meals a day plus snacks with water in between encouraging self- feeding at this stage and continue to introduce new foods if a baby rejects a food or a toddler.

Rejects the food don't worry just introduce it again often it'll take up to 10 to 15 exposures before a food is actually accepted so don't give up uh the appropriate Foods you want to focus on healthy family foods with a variety of flavors textures and colors you want to minimize processed foods with added fat and or with added uh salt and sugar at this stage and ensuring adequate calories means providing regular meals and snacks feeding sufficient but not excessive fiber you don't want to be putting.

Concentrated fiber like wheat brand on your children's food uh you want to include grains and starchy vegetables and legumes at or tofu at most meals so they're more calorically dense foods you want to include fat uh sources with each meal and and when we talk about fat low it's really important to recognize that very lowfat diets are inappropriate for toddlers they should be getting about 40% of their calories from fat at age 1 and that would slowly be reduced to about 30% by age three so.

You can see it's it's a fairly high-fat diet you don't want to restrict high-fat Whole Foods like avocados to tofu nut and Seed Butters and creams and you can use concentrated fats and oils but if you do do so judiciously because they can crowd out foods that provide iron and zinc and calcium and all the other essential nutrients it's best for most of the fat to be coming from Whole Foods now when we talk about milk for toddlers this is an important one because starting at.

About one year of age full fat fortified soy milk can be introduced soy milk has about the same amount of protein as cow's milk and more iron so that's a benefit of soy milk but soy milk has less fat than 2% cows milk so it's important that other fat sources are included toddler formulas can also be an option for toddlers with feeding difficulties or with poor dietary intakes but they are definitely not necessary for most healthy children we need to mention uh some milks are are.

Probably um you know less uh desirable at this stage shall we say fortified uh almond coconut O Rice hemp milks really do provide insufficient uh protein to serve as a primary milk for toddlers they provide a a gram per cup uh rice milk should be completely avoided for children under five due to its arsonic content and other beverages apart from their milk uh you want to select water as the main beverage avoid all sugar sweetened Beverages and if you do decide to provide a little fresh.

Squeez juice limit it to not more than 4 ounces a day whole fruits and I'm talking about fruit juice here whole fruits are better choices vegetable juice I would say is just fine uh how how much sugar and salt uh well the um chronic disease risk reduction cut off is uh 1,200 milligrams for toddlers for salt um many kids meals at fast food establishments exceed this limit in one meal uh for sugar the American Heart Association recommends no added sugar for toddlers up to the age.

Of two and no more than six teaspoons per day for children over the age of two and you know a little sugar like maple syrup or something in a healthy muffin or a cookie that you're making homemade is not the issue the issue really is processed foods and you need to be aware uh one serving of you know one processed food or a soda or something like that can easily contain 10 to 12 teaspoons of sugar so we just need to be aware of that um.

This is our plant-based food guide from nourish and and what you'll see is that uh it's a plate with half of the plate being fruits and vegetables uh and nearly a quarter of the plate as grains and starches and then the rest being legumes nuts and seeds and then we have this little plate above which are the add-ons that are the things you might not get enough of even if you eat according to the recommendations of the plate and that would be um vitamin B12 vitamin.

D iodine and possibly EPA and DHA so what you want to do is you want to provide a variety of foods from each food group during the day it's best to include foods from at least three or four of the five food groups at each meal and include foods from at least two of the food groups at snack times and I being a Canadian I I'm really proud of um the new food guide that Canada has Health Canada I think has now become a global leader.

In in nutrition National nutrition policy with the new food guide and what you can see here is that the food guide is is half the plate is fruits and vegetables a quarter of the plate is grains and a quarter of the plate is protein rich foods but they make a very strong recommendation that that you should be choosing plant uh protein foods most often and when they list your choices for protein foods they begin with all the plant choices as opposed to the animal choices you.

Can see there are no longer four food groups where meat and dairy are two out of the four food groups um Dairy has not been entirely excluded it's in with the protein foods but it no longer has a category of its own so this is really quite a progressive uh plant-based plate uh what about supplements for toddlers uh we would recommend 600 IUS of vitamin D a day a vitamin B12 10 micrograms a day or 250 micrograms twice a week iodine 90 micrograms a day EPA.

And DHA 70 milligrams a day and this is still controversial it's optional but I I think it's it's a reasonable choice and U multivitamin is optional as well liquid supplements are recommended at this stage so moving on to Children and.

Developmental Food Management For Children

Adolescents uh we want to nurture a healthy relationship with food at this age it's really important engage children in food selection at the market and grocery store cook with your kids kids love to pour and stir and chop and shake and blend and all of those things grow a garden with your kids and if you can't grow a garden because you don't have a yard grow herbs grow Sprouts have a little a couple of um you know um containers of tomatoes and cucumbers on your balcony.

Do what you can make family meals a priority keep the atmosphere positive and fun you want to instill Healthy Habits by including a variety of wholesome minimally processed foods avoid short order cooking limit highly processed fast foods and fried foods avoid sugar Sweeten Beverages and do not be overly restrictive occasional treats are okay and um you know the the you want to make healthy versions of popular favorites when you can cookies muffins bars popsicles ice cream sparkling drinks you can do all of that in a.

Healthy way you want to limit exposure to less healthful choices such as candy and salty snacks but don't absolutely forbid them being overly restrictive can res result in food obsessions and an unhealthy relationship with food and there are lots of challenges for children and and uh older children and teens as well and the concerns about overweight underweight Eating Disorders uh become magnified at this stage um often children of this stage especially teens will skip breakfast or other meals and as parents there are a lot we.

Can do to help them to avoid doing that um you know they don't always make healthy choices outside of the home so that's another uh consideration um and um you know there are uh adjustments required for athletes as well and uh for for um adolescents acne can be an issue in going plant-based can can be very helpful in that regard and for teens and adolescents family meals matter uh family meals have more this is a uh from um from experts on on this particular topic but.

The findings are that family meals have more to do with positive adolescent outcomes than socioeconomic status family structure after school activities tutors Church any of those things family me uh meals are hugely important they help children perform better in school they help them to eat more healthfully they make kids and parents happier they provide an opportunity to share values and build family traditions and um maybe most importantly they help you to stay stay connected with your children uh supplements for children and and teens again vitamin.

D vitamin B12 iodine EPA and DHA and an optional multivite uh which uh again these supplements can be of course in in chewable form or for adolescents they can be in swallowed form um and um so finally we will uh wrap up by talking about avoiding nutrition shortfalls and we will look briefly at at protein Omega-3s iron zinc calcium vitamin D vitamin B12 and iodine so we'll begin with protein can children get enough protein without animal products and the answer is absolutely even the largest mammals.

On the planet can get enough protein from plants and if we look at how much protein um is re recommended the RDA at various life stages you can see that for very young infants it's about 1.5 grams per kilogram um and they're 2.2 pounds in a kilogram so um and that begins to decline As you move towards adolescence so by age 1 to three it's 1.05 grams per kilogram and by the teen years it's 85 grams per kilogram and for adults it's 08 so you can.

See the difference there and then in terms of the actual amount of protein based on a sort of a reference body weight for each category uh it's about 13 grams for a 1 to three year old child and a 19 for a 4 to eighty old going up to around the 50 for for teens a little more for the boys and the girls now there is uh there there is no separate uh RDA for plant-based eaters but some experts do suggest that we increase uh the.

Amount of protein a little bit to to make up for the reduced digestibility of protein in plant foods and so many experts recommend an increase of somewhere between 10 and 30% and you can see for younger children um you know between one and eight years of age it would be 20 to 30% and for older children it might be closer to 10 to 15 and again if you look at um the the how much that is in terms of grams a day um it would be.

About 17 grams for a 1 to three year old and about 23 grams for a 4 to eighty old now a smaller increase of maybe 10% or no increase at all would be required for children who regularly include soy milk tofu veggie Meats nut and Seed Butters and other low fiber foods in their diet because it's fiber that interferes with the absorption of that protein and then lacto overo vegetarian children who regularly consu consume eggs and dairy product would not need to increase uh their protein.

Intake either so then the question comes up how much do the children actually consume well we actually have a a study that looks at and takes in toddlers and that's the vichi study I mentioned earlier from Germany and um they looked at 430 children who were uh toddlers one to three years of age and the average protein intakes in these children was 2.7 milligrams per kilogram per day for the omn Wars uh 2.3 milligrams per kilogram per day for the lactoval vegetarians and 2.4 milligrams per.

Kilogram per day for the vegans and if you recall the RDA is 1.05 grams per kilogram per day uh for this age category so every single category uh whether vegan lactoval vegetarian or omnivore uh these children are were all consuming at least double the protein that was recommended and you can see why when you look at the protein in in Foods recall that toddlers need 13 grams uh per day uh if we look at even the highest fiber vegan diets we might increase that to 17.

Grams per day but you can see here that half a cup of soybeans a qu cup of tofu 2 ounces of Veggie Meats a half a cup of lentils provide somewhere around the 10 to 15 grams of protein which is a very similar amount that you would find in meat poultry or in 2 ounces of meat poultry or fish uh you get about somewhere around 7 to n grams from you know half a cup of other legumes a cup of soy milk a couple of tablespoons.

Of hemp seeds which is very similar to what you would get from a cup of cow's milk or an egg or a half an ounce of cheese and then of course all the other plant foods provide some protein uh with um you know grains and nuts and seeds being being fairly substantial sources uh plant-based eaters generally get plenty of protein unless they don't get enough calories so so people who um have anorexia nervosa um you know or are very ill may not get enough calories and.

Then if they eat nutritionally inadequate diets that are low in protein a high fat high sugar junk food diets or uh fruitarian diets where they're not consuming nuts and seeds and and um legumes and vegetables and so forth uh ensuring sufficient intakes means including at least one protein Rich choice at each meal like tofu Tempe adami or other soy Foods beans lentils or split peas veggie Meats Satan seeds nuts and including a protein Rich choice at snack time can help and selecting a milk uh with.

Uh protein like soy milk or pea milk or for lactoval vegetarian uh children uh cow's milk will help to meet protein requirements uh omega-3 uh fatty acids the big question here is don't kids need fish for omega-3 fatty acids and the answer is not necessarily Omega-3s also come from plants they come from land plants like flax seeds chia seeds hemp seeds walnuts they come from soy and from greens um but they also come from sea plants and that's where you find the long chain omega-3 zpa.

And DHA so they come from microe and microe uh is not something that we buy in a package and eat as a food it it's usually we culture the microalgae and extract the EPA and DHA and we purchase it in the form of supplements either liquid supplements or um you know or um uh uh some mixed to supplements and then macro LG or seaweed also provides a little bit but it's EPA only and its fairly small amount so from birth to 12 months we get sufficient.

Omega-3s in breast milk there will be higher levels if the mother consumes a direct source of EPA and DHA so if she's consuming a microe based uh supplement um and of course um if the child sufficient the child will get sufficient if they're consuming formula fortified with DHA as well and so you can see um the US uh adequate intakes um in children 1 to three years of age you're looking at about7 grams of alphin enic acid per day but if the child doesn't get any.

EPA and DHA I would double that to 1.4 so they have enough of the raw materials to convert the Ala or the plant omega-3 into the longchain omega-3 zpa and DHA and so if they do get EPA and DHA I would suggest about 70 milligrams per day and then you can see children four to 8y old uh eight years old you would look at either uh 1.8 um uh grams of of of ala or uh and or 0. n grams of ala Plus 90 grams of.

EPA DHA so you can do one or the other you can either do the middle column for ala or you can do the US dietary guidelines for AA which assumes some intake of EPA and DHA so you could do that plus some uh supplemental EPA and DHA and so you can see for for 9 to 13 year olds you're looking at about 100 milligrams of epad DHA or about two grams of of ala and and for older children it's it's closer to two to three grams.

Of ala or you know around the 110 for for girls and 160 for boys for for the uh EPA DHA so if you're looking at you know one um milligram of or 1.4 1. five to two or three um grams of uh of ala per day for children how much do you get in food well you get about 2.6 in an ounce of walnuts 2.5 in a tablespoon of Chia uh 1.6 in a tablespoon of ground flax one in a tablespoon of hemp and about 0.1.

Or less than 0.1 in a cup of greens about half the fat and greens is actually omega-3 but they're so low in fat that you have to eat a lot of them to get enough so boost Omega-3s will incorporate ala Rich seeds like ground flax Chia and hemp seeds and walnuts or their Butters creams oils into the daily diet and consider adding an EPA DHA supplement uh vitamin B12 how much do we need well we need about a a microgram.

How Much Vitamin B12 Do Kids Need?

for for toddlers going up to about 2.4 micrograms for for children 14 plus which is the same as it is for adults but there’s lot of controversy about these amounts or these recommendations um it it uh it’s appears as though we probably need a little bit more and I would suggest probably about double what is recommended to be to get optimal amounts um a lot of people ask well are plant-based eaters at higher risk and they are plant foods are not reliable B12 sources unless they’re fortified even foods commonly thought to be reliable sources organic veget vable seaweed fermented foods and mushrooms really should not be relied on as sources of B12 I know that chlorella has some uh usable B12 but at this point in time it’s better to rely on a B12 supplement or fortified Foods uh as they’re they’re simply more reliable uh sources and in terms of stores uh in an adult stores can last two to three years or more in h but in in um in uh babies uh that’s not the case breastfed babies born to B12 deficient mothers can develop B12 deficiency within months or even weeks of of birth uh we need to be sure of vitamin B12 breastfed babies require a B12 supplement if the mother does not include consistent reliable B12 sources in her diet a formula contains uh a vitamin B12 so formula fed babies there’s no concern but once breastfeeding slows or stops infants must be provided with an alternative source of vitamin B12 either in the form of supplement or or fortified foods but preferably um more reliable is uh the supplement choice so what are the symptoms of deficiency well we see regression of Developmental skills we see something called hypotonia which is poor muscle tone vomiting diarrhea lethargy failure to thrive tumors Twi or Tremors twitches and uh uh brain damage and and the brain damage one um unfortunately can be irreversible if this goes on long enough so this is not something to fool around with for sure so what are reliable B12 sources well the most reliable is supplements uh second would be B12 fortified foods and you certainly can do a combination of those two things uh and then for you know lacto oo or plant predominant eaters animal products can be used as well as B12 sources uh so much B12 well we’re looking at uh for infants uh if if we’re supplementing it’s about 5 micrograms per day uh and then for older children toddlers it’s about 10 4 to8 years old 25 and then 9 to 13 years old uh 50 and 14 years plus 100 micrograms now some will say 50 micrograms is enough and there is some evidence to suggest that uh this is enough um but if if if we do the math on absorption rates based on the information we have 100 micrograms is is super safe so that’s why I went for 100 micrograms these are uh recommendations that will really ensure uh adequate levels uh liquid drops or sprays are suggested for children up to three years of age and chewable can be used thereafter but of course liquid uh supplements are always better absorbed uh moving on to iron uh the US RDA is a little bit shocking when it it comes to iron you can see for children up to one year of age um uh it’s 11 milligrams from 7 to 12 months and for a male adult it’s 8 milligrams so you can see they need more iron than an adult men uh and and for one to three year olds it’s seven for 48 year olds it’s 10 milligrams uh there are a number of factors that can increase the risk of iron deficiency uh number one being premature birth or low birth weight so uh we tend to put down iron stores in that last trimester of uh pregnancy and and if the baby’s born early they will not have the iron stores that would be expected and almost always they need iron supplementation a early introduction to cow’s milk before one year of age is probably the biggest cause of iron deficiency in full-term infants uh cow’s milk should not be fed to infants under a year of age um and the use of unfortified infant formula can can contribute the late introduction of solid foods over six months of age is also a factor uh for children and teens drinking too much milk over 24 ounces per day of cow’s mouth between the ages of one and five is a big um risk factor for iron deficiency insufficient dietary sources lead exposure uh certain health conditions chronic infections heavy menstrual bleeding um sorry can all be uh significant contributors to iron deficiency so how do we maximize iron status of of children well we want to number one moderate the intake of iron absorption Inhibitors Phat polyphenolic compounds and the main source here is is um you know things like wheat brand putting these concentrated uh fiber sources on food uh children don’t usually drink tea so that’s not uh a big issue there uh we want to boost our intake this is a big issue for children of iron absorption enhancers so for example uh if a child’s eating lentils or or some you know iron-rich food you want to make sure at the same meal they’re having some vitamin C rich food so it could be you know citrus fruit it could be something like um red peppers or other vegetables um and and other iron absorption enhancers are vitamin C carotenoid rich foods and alien vegetables like garlic and onions uh we want to replace meat with legums rather than Dairy so one of the big mistakes that people who are shifting to a plant-based diet often make is they just switch out meat they switch out you know the meat for um cheese pizza or or macaroni and cheese or all of these cheese uh Laden foods that they’re familiar with and dairy is um is actually a poor source of iron and it actually inhibits the absorption of iron so when people do that uh it it encourages iron deficiency so you want to replace meat with with iron-rich plant foods like leggings um uh to to help ensure iron status is is maintained and select iron rich foods um within uh each food group as well and uh and and that means you know in in the nutton seed group for example pumpkin seeds cashews are reasonable sources within the group uh you know um white beans and black beans are are good sources lentils are an excellent source of iron so just getting familiar with the sources of iron is really helpful and then in terms of iron um uh supplements as I mentioned the AAP suggests this a milligram per kilogram from four months until uh solid foods but that’s controversial and premature infants uh requiring often 2 milligrams per kilogram uh so that is something to be uh aware of and do children need iron supplements uh well normally iron is tested at about a year of age and and so you kind of go from there supplement if indicated and and if you do use a multivitamin you may want to select one with iron if your child’s iron levels are are a little bit on the on the edge uh zinc is another nutrient that we need to be uh aware of zinc absorption can be significantly lower from plant Foods especially if the plant foods are high in Fates so we don’t have any separate recommendations for vegetarians but just to be aware that absorption may be lower so we may need as much as 50% more so if we look at the RDA this is something to that that I find very interesting so for a one to threey Old they need about three milligrams of zinc per day but their upper limit for a 7 to 12month old they need uh three milligrams a day as well but their upper limit is 5 milligrams and the upper limit for a 1 to threey old is seven um uh milligrams so the difference between the RDA or the recommended intake and the upper limit the the the level at which adverse consequences can occur if you have more than that uh it’s very very small window so you have to but you don’t want to be um providing massive amounts of of zinc that’s for sure uh and then you can see the amounts required for older children and the upper limits are a little bit more generous with upper children their bodies can handle a little bit more so there are number of factors that that increase risk for inadequate intakes and again it’s exclusive breastfeeding Beyond six months very high phate intakes uh picky eating uh highly refined diets because of course when you refine a whole grain into a white flour product um one of the nutrients nutrients you lose in the process is zinc as you lose most other minerals as well uh so this is something to be aware of overly restrictive diets can be low in zinc uh kids with eating disorders may not get enough zinc and children with gastrointestinal malabsorption issues may not get enough zinc like children with celiac disease for example so how do we boost zinc well limit the the intake of very high phate foods like wheat brand and use food preparation techniques to reduce Fates and that means soaking and sprouting and and and um uh uh cooking and roasting and and yeasting Breads and all of those things help to break down Fates Fates are just the storage form of phosphorus in Foods so it just it just breaks them down we want to ensure sufficient calories include regular nutritious snacks especially for small children use if you do use a multi you can use a multi with zinc it usually has a very appropriate level and include zinc rich foods at each meal which you know you’re talking about mainly um legumes not and seeds are the big uh zinc sources in the in plant-based diets calcium is often a concern the uh recommended intakes are super high in North America relative to the rest of the world uh 700 milligrams for 1 to three year olds 1,000 for 48y olds 1300 for 9 to 18 year olds this is a lot uh it’s it’s almost double what it is in some other countries just just so you’re aware of that uh calcium intakes in plant-based children well lactoval vegetarian children consume as much or more calcium than non-vegetarians but vegan children are 100% plant-based children often do fall below the RDA for calcium the American RDA for calcium uh so can children actually get um you know can they meet the RDA without dairy and the answer is absolutely they can by including sufficient calcium-rich plant foods and some calcium fortified Foods if they need a little boost being aware of factors that can impact calcium absorption uh is also really important so what are the calcium-rich plant Foods you know when you think about our food guides and and not in Canada anymore but in the states and in most other countries dairy products are the foods that are highlighted as calcium rich foods and not a lot of other foods are are included in that category and so it’s important just to become familiar with the calcium rich foods and so it’s the dark the low oxalate dark greens and and tofu that’s made with calcium and the Fortified non-dairy milks and beans and Tahini and and even black strap or black strap molasses and and some of the nuts and seeds um chia seeds are actually a really good source as well so there are a number of sources and one of the things that makes it way easier to meet the American rdas and Canadian rdas is to select calcium fortified non-dairy milks and other foods with added calcium it’s so much easier to provide a little four to eight-year-old child with a th000 milligrams of calcium if you’re including one or two servings of of fortified non-dairy milk and day because they have about you know 300 milligrams per cup so you’ve got 3 to 600 milligrams right there uh so uh if we look at this is just a child menu with a with a th000 milligrams of calcium to show you what it might look like and and here you have oatmeal and berries uh one serving of fortified non-dairy milk or a cup of non-dairy milk uh a tablespoon of Chia seeds a small whole grain muffin peanut butter and banana wrap uh veggies and cashew uh dip uh you know a smoothie made with the milk black beans quinoa broccoli uh chocolate pudding made with a fortified nony milk and you’ve got a th milligrams so that it’s pretty uh simple to do uh you want to be very aware of factors that can inhibit or or enhance calcium absorption and things that can have a negative impact or excessive oxalates or Phat excessive sodium can cause you to actually urinate out calcium high acid load alcohol which isn’t a concern except it can be for adolescence uh caffeine again can be for adolescence and uh positive impact of course vitamin D you need Vitamin D to absorb calcium other factors affecting calcium absorption uh the amount of calcium consumed at one time so absorption efficiency decreases as calcium intake increases uh which means that if you consume U you know 500 milligrams in one meal you’ll absorb less then if you took that 500 milligrams and spaced it five times throughout the day you would end up absorbing more so age and Stage um U makes a difference too calcium absorption is actually as high as 60% in infants and young children it’s only about 15 to 20% during adulthood except for pregnancy when it’s higher so children do absorb more calcium than adults and then we want to consider calcium bioavailability uh the dairy industry likes to say that the only bioavailable calcium is in dairy products but that’s not quite true we absorb about 32 or so percent of the calcium from dairy we absorb about the same from tofu made with calcium we absorb a little bit less from soy milk but not a tremendous amount less it’s somewhere around the 25 uh percent or so a little bit less from sweet potatoes and from leggings as well uh but we absorb the most calcium from low oxalate greens like broccoli kale Chinese Greens turnup Greens mustard greens we absorb some 40 to 60 or even 70% in some cases of these of the calcium from these Foods however we don’t absorb a lot of calcium uh from spinach beak greens and swiss chard these sort of very high oxalate greens because the you know the calcium is bound to oxalates and it’s not available for absorption and so um these we might get 5% or so of the calcium from uh so we really just can’t rely on them as good calcium sources uh finally iodine uh iodine insufficiency um is uh is an issue for some children and severe severe deficiency results in cognitive impairment is the number one cause of preventable brain damage in the world which is a little bit shocking but it’s true mild deficiency in pregnant women um and infants can lower IQ by 10 to 15 points adversely affecting learning ability so we just really need to be aware of where our iodine is coming from and making sure there’s a source uh the risk is definitely higher in vegans because um the you know key sources in omnivorous diets are are things like um fish and and and milk and eggs and things like that so iodine the iodine RDA um is is uh about um 130 micrograms for 7 to 12 month old uh children 12-month-old children it’s about 90 for 1 to eighty old children and then 120 for 9 to 13 and 150 as it is in adults for for 14 plus it’s higher in pregnancy and lactation as well uh the food sources the richest sources as I mentioned are seaweed dairy products Fish seafood eggs and eyye salt um seaweed can easily exceed the upper limit this is an extremely concentrated food in Japan um seaweed is regularly consumed as part of the traditional diet it’s not in North America some vegans include it but they don’t always and so if you’re if you’re not including seaweed then the only significant Source I mean you can get little bits from fruits and vegetables and so forth but the the key Source then becomes iodized salt and of course many vegans prefer not to use iodized salt and so then it really can be an issue so how do we boost intake well if you’re using salt I would suggest we should be using iodized salt or iodized sea salt you can get some decent salts that are iodized if you’re not um especially if you’re not consuming seaweed uh you can include another thing you can do is include controlled amounts of seaweed particularly if you’re not consuming Seafood Dairy and eggs which is of course uh the case for vegans um and then use a supplement um a multivitamin or iodine drops as a as another option so in summary um well-designed plant-based diets are safe and appropriate for growing children and we are actually more likely to meet children’s nutritional needs with a thoughtfully planned plant-based diet than we are by feeding them a typical Western diet but the most compelling reasons for shifting to a plant-based diet are the benefits Beyond personal health the benefits for future generations to all life on Earth and to our planet uh itself and the information that I talked about today is all provided in much greater detail in uh the book nourish which was just released in November of 2020 and uh with that I will um finish my presentation and of course I I um must mention my other uh books uh becoming uh vegan uh and becoming um raw as well as as guide books um for families so Brenda thank you that was truly truly amazing and I know I can hear a collective audio gasp saying yes that was worth the wait really tremendous thank you so much well thank you so much I really appreciate it and I’m sorry again for the technical difficulties and uh rushing through a little bit but I hope that some of the information that was provided will be of value to uh the people that were able to join us well I I I know it was and with that um we’re going to go ahead and start our our live Q&A session with you now if that’s okay absolutely great great and so um I think everybody uh is aware but just in case you’re not what we’re going to ask everybody to do now is on your Zoom control tab at the bottom of your Zoom screen you’ll see a tab that says reactions uh some people have it in their participants tab but most people have it in their reactions tab you can click on raise hand and if you go ahead and click on raise hand we will see your hand raised and we will take your questions in the order in which we receive them uh as we do that we’ll go ahead and ask you to unmute each time and so um with that I already start to I’m starting to see a couple of hands coming in already which is great and keep them coming everybody we’d love to have as many questions as we can take for Brenda I know she wants to help you all out as well so with that I’m going to open this up to Sophia who has waited patiently Sophia thank you so much and go ahead with your question for Brenda hi Brenda thank you so much thank you so much for your generous guidance and uh I wonder if I can ask you a question that is not related only to Children yeah thank you I am vegan and I’m doing intermittent fasting to improve my poor digestion but I keep losing weight is there a way to fast and keep my weight intact at the same um I would say you know the big thing is that is that uh how long are is your intermittent fast how long are you doing it for and then how big is your window of time to eat during the day and then we have to look at that window and try to figure out how to get more calories in that window so how long are you uh are you fasting every day like doing um a Tim restricted feeding where you stop eating and then you start again the next day at a certain time uh I fast um nearly every day about 16 um hours 14 to 16 hours fasting and it helped me a lot for my stomach problem but still have poor digestion so I’m keeping on working on it okay so are um are you eating three three meals your in your window okay most of time sorry most of time two meals and a smoothie because I cannot digest easily food so okay so two meals plus a smoothie is okay uh we should be able to I mean the the thing is is you we have to figure out how to get your calories up so in becoming vegan comprehensive addition there’s an entire chapter on your um weight for underweight individuals but what I would say is is boost the calories in your smoothie so uh in your smoothie add hemp seeds maybe a/4 cup of hemp seeds add uh you add H concentrated calories add avocado add you know make sure that you’ve got some fat in the form of nuts and seeds use um a a good fortified non-dairy milk like a like um fortified soy milk with lots of of um calories and so you’re getting a more energy dense smoothie and then in your other meals um make sure that you have adequate fat so uh because that’s more calorically dense and you have adequate starchy Foods in those meals and legumes and so um for example if you’re having um you know a salad uh for example as one meal you want to make sure you’ve got an excellent protein Source an excellent carbohydrate source so you’ve adding grains adding legumes adding starchy vegetables and then pour on top very generously a very fat Laden dressing which would and it doesn’t have to be with oils at all it can be with you know when I make my dressings I might put in cashews and hemp seeds and you know so nuts and seeds you want to get those calories from Whole Foods as much as possible or avocados uh to to try to get as many calories in and if you’re going super lowfat it’s hard to get a calorically dense meal because the foods have a greater volume for less calories and that’s one wonderful for people who are trying to lose weight but for people who are trying to gain weight or not lose any more weight uh they need more energy dense foods and the most energy dense foods or calorie dense foods are nuts and seeds and avocados and these more fat rich foods thank you Brenda um we’re gonna move on now to somebody with the initials DF DF if you’d go ahead and unmute yourself please thank you so much thank you Branda you are amazing I’ve been following your work for many years thank you thank you I thank you I have a couple of uh questions um I have been plan-based for some time uh but my work uh white blood cell count is lower than the than the normal range uh I think the normal range is like four and it’s like three Min is like 3.8 or 3.9 it’s been like this for a couple of years uh but I don’t I don’t think have any clinical symptoms of not feeling well um so I’m just wondering whether this is healthy this is okay my second question is uh when we when it comes to metabolic health or managing weight do we need to differentiate between like brown ose tissue white ose tissue and visceral fat I know visceral fat is not it’s not a good thing but I was reading a little bit on like brown adapost tissue and white adapost tissue I just wonder whether you can um enlighten me on this thank you okay the first question um remind me Ben uh it was about um oh the white cell count right uh you know I’ve I’ve heard so many vegans say that their white sell counts are a little bit lower and and and in in reality it’s really quite normal for our white cell counts to be a little bit lower and I’m I’m not I you know I’m I’m not a physician and I I don’t I haven’t done a lot of research on this particular topic but my guess just a sort of Common Sense guess would be that we need a little bit fewer white cells when we have less to fight so um it it seems to make a sense people do not seem to be adversely affected or have adverse Health uh adverse Health outcomes because of these slightly lower levels slightly below you know you have to say what are we basing normal on and basing normal on omnivore and so vegans the the whole systems can be slightly different than that of an omnivore and so I I would say uh relax don’t worry about it this is very very common among vegans and very normal among vegans and the second the Brown versus white adapost tissue well um I you know again it seems if you have higher levels of brown adapost tissue you burn calories more effectively it helps you with um your metabolism but again I definitely not my area of expertise and I think physical activity is is uh super important adequate rest is super important but yes there’s definitely a difference between the metabolic outcomes of people that tend to have higher levels of of brown fat versus white fat Brenda thank you and up next we have Rita Rita go ahead with your question please oh actually we just want to make sure you’re unmuted first okay perfect thank you hi Brenda it’s good you too one second okay um it’s good to see you here and I just have a question for you actually because my brother just sent me uh you know one of the thing which is say is too much vitamin B12 Hazard us for the health now we know that it does prevent the alimer is but to what extent because there was a study done in jamama network and that was uh I think the open scientist was led by the Jose Flores Guero and the stepen Becker in the University of groning gun in the Netherland and they are saying that if there are no underlying causes then you should not really take it but everybody has underlying causes they are not only dealing with one item so it all depends upon how publ read this message so what input do you have well you know there are not a lot of studies that have showed adverse outcomes from consuming uh vitamin B12 on a daily basis a even a reasonable amount because you only absorb maybe 0.5 to 1% of what you consume if you’re consuming over 500 micrograms I mean the only adverse outcomes that have really you know are are very significant are some people who are taking large amount on a daily basis do end up having some skin issues like acne for example and for those people you know they might want to reduce the amount they’re having have smaller amounts or you eat more of the Fortified Foods as opposed to the supplements um but generally oh and I should say uh Rita is a colleague a very esteemed colleague and it’s really nice to have you uh with us Rita and it’s nice to be able to say hi to you as well but um I in my opinion um the potential adverse outcomes uh for vegans especially who uh are not consuming sufficient uh B12 are far Graver than any risks of taking a a regular supplement if you have skin issues you might have to modify a bit but generally what we see is we see in a number of studies um that those that have low levels of B12 end up boosting their homosysteine and homosysteine is an independent risk factor for cardiovascular disease for birth defects for cognitive impairment for all of those things and so and in order to um you know keep uh homosysteine down you need to be getting a reasonable amount of B12 and there’re you know plant foods are not reliable sources so we have to be taking it in one form or of another E either from fortified Foods or supplements and so I would say um you don’t not like vitamin D where some individuals can’t seem to normalize their vitamin D even at two or 3,000 IUS a day they need to go to four or five um but for for B12 that is you do not need to be doing huge megga does um you know having um you know a moderate intake on a daily basis H is is in my view has been shown demonstrated over many decades to be a a safe thing to do and and and so for for for vegans I think that that is just um you know not something to worry about Brenda thank you and up next we have patiently waiting Renee hi Renee if you’d go ahead and unmute yourself hi thank youa um I have a question about EPA DHA and iron um I take Dr Ferman supplement as you had on your screen for the EPA and DHA and also I eat a lot of FL and chia Walnut um and also for iron I do all the things to enhance the absorption but my levels are still not optimal for both of those I’m wondering what is there are there some people that just don’t absorb it due to genetic reasons or is there something else I should be doing so can you I’m sorry I just missed one little part so for iron your levels are low they’re low uhuh and I eat the iron rich foods I eat all the ways that you teach about and um do the things to optimize it such as the vitamin C and um those things too okay and and then your EPA and DHA are they’re in the mid-range they’re not yeah they’re not optimal okay I mean I H so so um with iron um there there are a number of things that you can do to try to increase iron a little bit more and and intake but if that doesn’t work then you may want to be doing a supplement you know with like a multivite with iron or a or an iron um like fair you know like a um a liquid iron supplement uh a couple times a week there are lots of different things you can try but in terms of diet uh one of the things that can make a big difference is to I’m not sure I mean I’d have to look at your intake at every meal and all of that but but one of the things that I I do is um when I cook my grains for breakfast so if I’m cooking whatever grain you know oat Groats or or camoo berries or whatever I actually uh cook them with with very small lentils to boost the iron very significantly in the breakfast meal um and uh because iron is are iron is much more concentrated in lentils than it is in grains for example and so even when you’re making grains to go with a a Buddha bowl or or something like that if you cook in with the the grain some lentils you can get a boost of of um you know quite a number of milligrams each day of of um you know of iron and then and then of course you’re doing the making sure you’ve got a good source of vitamin C with that meal as well um you know for small children one of the things that I I’ve suggested and some people aren’t too keen on it but but iron infant infant ser uh is iron enriched and for children that tend to be low even older children when you mix a little bit of infant cereal into let’s say you’re making muffins or pancakes into the batter that boosts iron tremendously and can turn iron deficiency around for children that are kind of sensitive to having uh the supplements a lot of people are sensitive to iron supplements so that’s that’s an issue for lots of people but um yeah I mean you you just have to play around until you can get your levels and again you know the the levels for example of fertin um I it’s all based on omnivores and so vegans tend to have lower levels of serum fertin and this is not necessarily a bad thing if you’re within a reasonably healthy range uh because uh high levels of of serum fertin are associated with increased risk of a number of chronic diseases because having a lot of free iron in the blood can end up acting as a prooxidant especially from in meat eaters that are eating a lot of heem iron um but so so just be aware of that that your your fair if your hemoglobin hematocrite are normal um don’t worry about a slightly low serum fertin um and then in terms of uh the epad DHA I mean all you can do really is is to do what you can to enhance the conversion ala and to take the EPA and DHA directly which you’re doing and if your levels are still subpar you may want to look at just taking a little bit more and I’ve seen for people that are looking at I mean there’s a lot of question about the the accuracy of the current measurements for Omega-3s um so that’s you know it’s still we’re still in early stages of developing those kinds of resources but but or those kinds of tests and so we we don’t know for sure they’re absolutely uh accurate but I’ve known people who who um you know were taking two or 300 milligrams EPA and DHA a day who had to increase to somewhere six to 800 to get a day to get their levels in that range that they wanted to be so so that just takes a little bit of you know playing around with it Brenda thank you um this is amazing all this value that you’re adding for all of us thank you so much for doing this Q&A session and I want to remind everybody uh that we’re only able to take questions if you come on and raise your hand so we’re not taking questions from the chat box or anything like that so just want to make sure everybody knows that come on and raise your hand and we’ll make sure we we do our best to get to you in the time we have allotted and so with that Brenda we have Michelle who’s uh been waiting patiently Michelle thank you so much for unmuting and what’s your question for Brenda thank you um Brenda it’s a it’s amazing to uh to see you again uh I’m I’m a huge fan um I have a question about probiotics for children um so I am a practicing nutritionist and I’m wondering what you think um when you’re dealing with the child that has um withstood prolonged and repeated antibiotic use and they’ve got a very very depleted microbiome um about the efficacy of probiotics and um the child will not uh tolerate or is not interested whatsoever fermented foods of any kind um I’ve noticed that the research seems to be um fairly um unsupportive of probiotics in terms of e efficacy that it can be a supporting player but I wondering you look at this research so much more extensively than anyone I know uh what have you found um in that regard in terms of the effectiveness of probiotics um to help that situation because I think focusing on food seems to be the most effective thing that I found absolutely and I think you’re right your spot on Michelle uh the the evidence is still a little shaky on on whether or not probiotics how effective they are and and there’s a lot of research showing that uh they that they can be effective if they are very carefully selected and and uh so there’s certain certain you know bacteria that that uh are are very specific to certain types of conditions and situations that you need to be supplying um uh in the you know in this in the supplement form so and and that I definitely don’t have the expertise in that regard but uh but there are some really good uh uh books there there’s one by um Alan Desmond and another of course fiber fueled and that that go through some of this in reasonable uh detail but the other thing is I think you’re absolutely right that the most critical factor is providing you know the gut microbiome with um sufficient prebiotics and and prebiotics are simply the food for the bacteria and you need to have uh sufficient prebiotics in in food and and and then slowly the gut microbiome will start to rebuild itself uh in a positive direction um and so prebiotics um you know it all plant foods contain prebiotics uh prebiotics are just different types of fiber and one of the most important things is the diversity of the prebiotics so you want to be including fiber rich uh a wide variety of fiber rich foods for for optimal uh results but I in the situation that you’re talking about I based on what I’ve seen over the years I would still think that a really high quality probiotic U you know probiotic supplement could be a reasonable Choice as well Brenda thank you and up next we have I believe Arty if I’m saying that correctly Arty if you’d go ahead and unmute yourself hi Brenda thank you very much for your talk hi um sorry my she going oh okay um I just want to thank you very much because um you’ve been one of the biggest influences um in my practice I work as a family medicine doctor and uh in terms of how I’ve changed things and approach my patients you’ve I I basically follow everything you advise and pass it on to my patients and I’ve seen great benefits so I really want to thank you for that well already thank you that that means the world to me I I just so appreciate you sharing that and and I feel so honored so thank you so much well no thank you so my question was to um extend towards kids so I’m mainly my specialist area is type two diabetes but I’m mainly seeing adults as a family medicine doctor I do see kids as well though um so the question was about sort of the typical plant-based uh plate that we use for adults uh I I saw your your picture up for the the one that you use for kids as well and it looks very similar um but in terms of limiting fat content uh I do limit it to a certain degree that you know they allowed a small proportion of uh fats that are high in omega-3 like whether it’s walnuts or cheese seeds or flax seeds um but in kids that are very young because over here I’m in I practice in Dubai and over here we have a huge epidemic of obesity type 2 diabetes um in in Fairly young children to be honest um and it’s it’s quite sad to see but um in terms of sort of limiting fat proportion I I’m not entirely completely confident to limit it as much as I would in adults so I don’t what are your thoughts on that um you know it’s a really unfortunate to see what’s happening in the Middle East um with uh overweight obesity and chronic disease it’s just escalating and and it’s sad to see it among children uh particularly and um I you know my feeling if if you look you know it’s so interesting if you look at the blue zones because what you see is you see the owans eating about 10% of calories from fat uh and then you see the the people from from icara Grease eating 50% of calories from fat and and in my experience um uh the health consequences have far less to do with the relative percentages of macronutrients just so long as you’re within a reasonable amount for protein and carbohydrate and fat they have less to do with the relative percentages of those macronutrients than the sources of those macronutrients so when fat comes from nuts and seeds and avocados and Whole Foods uh they are con it it is consistently protective to health when protein comes from plant foods like legumes and and you know all of the plant foods you can think of it is consistently protective to health when carbohydrates you know carbohydrates are often so you know so Mal maligned or whatever you you would call it they’ve been blacklisted in so many people’s books but it’s carbohydrates are are not a at all when they’re unrefined they are actually protective to health it’s when we strip everything of value away from them that they cause problems so in in an unrefined or whole food form none of those macronutrients are an issue and so to me the important thing with children is to be providing them with a wide variety of whole plant foods that are excellent sources of fiber that are not overly processed and so these children who we see overweight and obesity in you know the goal to me is not to take fat out of the diet the goal is to take garbage out of the diet it’s to take the highly processed foods out if they’re plant-based that’s wonderful if they’re not you want to be getting rid of or at least minimizing intake of of animal products especially the processed animal products the fast foods fried foods processed Meats so on um and and and those are the goals uh those are you know getting rid of Highly processed foods is the biggest issue uh in in uh for for children who are uh overeating children don’t usually overeat things like beans and whole grains and vegetables and fruits and when they’re getting these healthy foods it you know which I talked a little bit about in the presentation why it’s so important to have that division of responsibility so that children aren’t that we’re not shoving Foods down their throat and we we say when they say no we respect that when they’re full and to help them to learn to you know really honor their bodies in terms of when they’re feeling full and when they’re hungry and and so these are all very important and and well we may not want to be necessarily pouring oil over their food if they’re overweight because it’s so concentrated in calories we definitely don’t want to be withholding uh higher fat whole plant Foods because they need fat fat is you know it’s it’s part of the the um cell membrane of every cell in the body and it affects the fluidity and shape and flexibility of those cells and what they can let in and out and it affects our brain function our brain cells it’s a really important macronutrient as is protein as is carbohydrate and so we we don’t want to look at f as the sort of the evil villain where obesity is concerned overeating is the evil villain and what causes overeating is when we mess up our appetite control center by eating these foods that are infused with fat and sugar and salt that are concentrated sources of those things that mess up our ability to know when to stop eating and and so that to me over eating happens when we’re eating those kinds of heavily processed foods that are designed to hit that um Bliss point in in individuals where you just can’t stop eating like potato chips those kinds of things are really hard to stop eating and so it’s best to not have them in the home it’s not you know it it’s not something that you say well you never never eat but but that you’re 95 % of the time what you’re eating from one meal to the next excludes uh these these really highly processed foods and so yeah I mean children still need probably you know depending on the age uh like I said age one it’s about 40% of calories from fat by age three it’s about 30% and for older children usually we look at 25 to 30% of calories from fat being very appropriate um even in those cases thank you Brenda we have up next and I I hope I’m pronouncing your name correctly I’m going to give it a try uh leel uh if you would go ahead and unmute yourself hi hi hi hi it is leel thank you very much hi brard it’s such an honor to meet you you too I have three questions if you’re able to ask them the the first one is on the the brown fat that someone brought up um is it possible to get your body to to produce more Brown fat uh yes I I um have you know not uh certainly not my key area of expertise but I have seen where it is possible to increase uh Brown fat and people do do all sorts of uh things to try to do that but I think um you know and I don’t I actually even know how much diet can influence that exercise exposure to cold sleep all of those things play a role but you know what after this um after this conference I’m going to do some a little more research into Brown fat and then um KP you didn’t mention CP but for for iodine is kelp a good source wellp if you’re not g to use fortified salt yeah so kelp is super concentrated and iodine so concentrated that about a 16th of a te teaspoon provides 150 micrograms so that is like a pinch it’s a very very small amount so the danger here is the the for adults the uh RDA is 150 micrograms the upper limit is 1,00 micrograms uh you would hit that with what a half a teaspoon or something of kelp powder uh so just to be very very aware of uh of the amount you’re using so if you’re using the you know the seaweed KP versus most people just use the CP powder that you sprinkle on Foods just be very aware of the amount you’re using especially for a child because again the upper limit for iodine for children is not very high uh it’s you know really um it would be exceeded very very rapidly if you’re using cow powder in excess so it’s just a pinch so you just want to you know learn exactly how much you get from the C powder and then make sure you’re not exceeding the upper limit uh but it’s a very concentrated source so it could be a you know quite useful and is there a situation with thyroid that you should avoid CP or or iodine because they I’ve heard different I don’t know they theories or but but recent information that you should avoid iodine if you have thyroid issues well no um it depends I mean if you have um Hashimoto disease then caution is definitely warranted but for a lot of people who have hypothyroid um it’s triggered by a lack of iodine if you don’t iodine is necessary for the manufacturing of um thyroid hormones and if you don’t get enough iodine you don’t produce the thyroid hormones that you need uh so it really important to get enough iodine although you don’t want to necessarily over you know you don’t want to be over the upper limit for sure um but but iodine is really critical for people with most people with hypothyroid disease Brenda thank you and up next we have Laura Laura if you’d go ahead and unmute yourself please and we thank everybody by the way for keeping your your questions direct and brief for uh Brenda it’s really fantastic so thank you Laura go ahead Laura H are you there she’s unmuted but we’re not [Music] hearing you know you know what Laura I Laura I’m so sorry we’re gonna we’re actually gonna mute you we’re having a hard time hearing you um but what we’ll do is we’re just we’re just gonna try you back one more time in a minute let’s move on to and I hope I’m pronouncing this correctly joa if we can have you uned can you hear [Music] me hello hi yes can you hear me we can thank you okay hi Brena hi everybody I just I’m we’re mixing okay I think you’re good now thank you okay so first question is like do you maybe recommend like um iodine in pregnancy and also um uh probiotics in the pregnancy I’m sorry probiotics yes and iodine iodine definitely um iodine is absolutely critical during pregnancy because well you need about 220 micrograms during pregnancy 290 I believe during lactation and um if you don’t get sufficient iodine in pregnancy uh your child can be born with a very severe cognitive impairment and and uh so you iodine is critical to brain uh development so you absolutely need to get iodine and and and it is an issue um if you’re not using IIs salt you just need to what you can do is to choose a prenatal supplement that includes iodine which to me is probably the easiest way to make sure that you’re getting enough iodine and some of the other nutrients that are pretty critical during pregnancy as well um so one of the other nutrient that you might want to consider looking for in in a prenatal supplement is choline so both of those but iodine definitely you want to hit your RDA for iodine when you’re pregnant and then um the second question was about probiotics during pregnancy and again I don’t think it’s necessary um if you’re eating uh a lot of Prebiotic iotics uh you should and and you can not only eat prebiotics you can eat probiotics as well in the form of fermented foods um you know if you’re consuming some I use a cashew almond fermented yogurt a naturally fermented sometimes I make my own H sauerkraut there are lots of fermented foods uh you know you can do your own fermented cheeses and things like that too or or purchase them so great Brenda thank you and um Laura we’re g to try you one more time Laura H let’s try to unmute you hopefully you’re you’re it’ll work this time Laura are you there yeah I’m here can you hear me yes we can thank you okay I’m gonna talk fast because it might not stay um I was trying to ask about um I’ve had kidney stones show up a few times now in my CT scans and um um I found out about oxalates and been trying to not have high oxalates but it cuts out like every food and um I wanted to know what you thought about that because it ends up being like almost nothing I can eat between that and my allergies and the second question related is that online and even in the you know legitimate places everybody has different opinions about how much oxalates food has it’s not even consistent at all so then that makes it even harder that’s a question yeah one of the the thing that is kind of one of the things that is nice to know is that vegans actually have a significantly lower risk of kidney stones com even though they eat more oxalates they have a lower risk of kidney stones compared to non-vegetarians um generally a high meat diet is is not good in terms of kidney stones so so you’re you know having a plant-based diet is a good step making sure you’ve got a lot of uh you know organic acids and citric acid and so on can also be helpful uh drinking a lot of water is absolutely critical um but yes uh there are people who are very sensitive to uh oxalates and so one of the things that you you know one of the places that I would go uh that I feel is really reliable in terms of of the information on oxalates is um uh uh Jack Norris’s website vegan Outreach uh.org um he has um just amazing an amazing um um you know uh um a section on oxalates and and it’s just very very well done uh so I would go there to vegan health.org and for others uh the his B12 section uh information on soy all of those things are just very detailed and and very well done so that’s a just an exceptional resource um so definitely I would do that and then you know just be be picky about which greens you’re using and and definitely if you’re making smoothies avoid any oxalate Rich greens I’m sure you know all of that uh certainly spinach is you know really high on the top of the list so green Swiss chard they’re all up there so uh uh yeah and above and beyond that just make sure you’re getting your liquid uh water water water Brenda thank you we have uh David coming up next David if you’d unmute your audio please great thank you can you hear me you can thanks David hi hi Brenda by the way I have one of your older books oh yes and you know I have two new uh diabetes books I don’t have diabetes but I just I have it I bought it years ago I’m sorry okay th this is one of the new ones it’s called Kick diabetes Essentials and uh and then I have the kick diabetes cookbook as well so yeah defeating diabetes I think I did in 2013 so yeah it’s a great book I um just wanted to share but I’ve been following I’ve listened to a lot of your lectures over the years and you know so I’ve been plan based about three years full time 100% now but I do have a question I recently and I obviously I feel great I’m younger but I did it because you know I wanted the long-term effects of it but I do have a question so um I’ve been eating a B12 only about 500 MCG every other day or so I’ve also been supplementing with a little bit of nutritional yeast but I it wasn’t anything I was overdoing but recently I went to my doctor to get a health check and he decided to uh check my B12 and I had over 14 close to like 1500 um which was above the range of normal so I wanted to find out what do you recommend my personal doctor is not a plant-based doctor so he didn’t have a solution for me um but what’s what’s like a good amount to eat so that I’m not over the limit because that kind of got me nervous especially the fact that I read of the side effect so yeah so David I would suggest that it depends on how much nutritional yeast and if you’re having any other fortified foods like fortified non-dairy milks you may be getting plenty from your diet you don’t need any supplement at all um but if your diet is is sort of spotty in in B12 what what I think uh I would suggest you do is just uh for now um I I would for now not take the supplement for a while until you have your B12 tested again and see what it’s out at just with your your fortified food like nutritional yeast and then if if it starts to if it you know starts to get to a a more normal level then you might want to just start with like a thousand micrograms once a week and see where that takes you uh and and just sort of monitor your B12 to see see what you know what’s a good place for you obviously 500 micrograms every second day was too much for you uh it it’s not really that excessive for people who are 65 plus we usually suggest a thousand micrograms a day and for for other adults we usually suggest a th000 micrograms twice a week uh so the amount you were taking wasn’t Ridiculous by any stretch but for some reason your your levels are are really high so it’s coming from somewhere uh and and so I would just I would just cut out the supplements for now test again and then you know once your numbers start getting into a more normal range then you know just try a once a week uh thousand microgram Brenda thank you we have now uh Denise Denise if you’d go ahead and unmute yourself we have uh room for your question for Brenda as well just double checking now there we go hi Denise hi there thank you I love this opportunity to speak to Brenda I teach uh older people plant-based eating in Tucson Arizona and I love sharing your work I love your hierarchy of grains slide and all you do but my question for you and I have followed you know what you’ve said on this but just hoping maybe you could give me a little more specific guideline to help people is the calcium question and so you know when I even for myself when I was trying to figure out how to make sure I get enough calcium from Plants I drink milk I get about 300 milligrams in one 8 o glass but then you know in terms of the greens and the beans so you know I saw how collar was high on on a calcium but then I read that it’s like moderate with oxalates and so I’m trying to compare is it the Collard or the kale and how I mix that up and then I do eat beans you know but it says like some beans are better than other beans and I I guess I just wish I could have you know a a little bit of a of a just like a a you know a guide like you know if I drink advise other the people I teach you know you could have a glass of soy milk and if you eat this many cups of raw greens or cook greens and then of course it’s difference between raw and cook so if you were able to just share a tiny bit more on that I it would be helpful yeah oh that’s that’s actually a really good idea um it it it it sounds like um um just a little chart that would be ideal where and you know we actually have in in becoming vegan we have this little center of the plate that’s calcium rich foods and says you know pick six um six to eight of all of these different foods throughout the day and it shows you exactly how much of the beans and the and the and and the low oxalate greens and the figs and the almonds and the you know Chia seedss are another one all of those different foods that that could be um you know reasonable sources of calcium and so your your milk would count as two because it’s a half a cup W so we’re looking at foods that would give you about 150 micrograms per serving and so you’re wanting about six of those or eight of those or something like that so but I could see a chart might be really fun um but basically the the biggest thing to remember is is that if you’re eating a diet where you’re including that 300 milligrams of of calcium in your in your fortified uh milk and you’re eating a varied plant-based diet and you’re including low oxalate greens and a little bit of tofu and a little bit you know just a variety of things you’re going to be getting around five or 600 milligrams of calcium in your plant Foods plus your 300 you’re there uh it’s I think you may even be overthinking it so so by including one or one and a half or two servings of that fortified non-er milk and then just eating a varied healthy varied uh plant-based diet uh you’re good to go and and I wouldn’t worry about it much beyond that there’s an article that everybody should read that I think is very interesting called milk and health uh by Walter Willet and David lewig and it’s free online uh and it uh it really looks at the evidence um um for for you know the link between milk and health and IT addresses a lot of the calcium issues as well and and it’s just basically stating that we know um uh maybe a lot more in some ways and a lot less in other ways about the link between calcium and health and uh yes we want to get close to the RDA plant-based eaters may need a little bit less than animal who people who are eating a really acidic diet for example but overall we want to be somewhere in the ballpark of you know 7 to a, milligrams and if you’re older you might want to be closer to that thousand or 1200 which is recommended um but essentially um it’s it’s not uh as difficult as what many people imagine it to be and so just do do get familiar with the lower oxalate greens and the other foods that can provide calcium the seeds that are good sources of calcium the nuts that are good so basically it’s almonds tahini chia seeds that are the best um you know in the nuts and seeds and then in the in the the um uh beans the legum family um black turtle beans Navy beans nor Great Northern beans white beans those kinds of beans are are good sources and then in the you know in the the fruit and vegetables of course it’s the greens and and uh figs are a reasonable source and so going through the food groups selecting your most concentrated sources and then just having that Variety in your diet uh just gets you there so I think you’re you’re you probably have to worry a lot less about it than than you might be imagining Brenda thank you so much uh just just incredible this is all we have time for at this point um you you’ve been incredibly gracious with your time uh especially Bel all this this Q&A session after a wonderful lecture and I know again on behalf of our entire audience um thank you thank you from the bottom of our hearts it’s been so useful well thank you so much ben it was such fun to see you again and thank you everyone for your patience again and uh so glad you uh you’re still here so enjoy the rest of this amazing conference thank you Brenda great to be with you again we’re so glad come back with us each time it’s it’s just just perfect thank you thank you [Music]