Plant-Based Nutrition From Birth Through The Senior Years – Brenda Davis, R.D.

Deciphering Truth from Myth in Nutrition

Thank you so much there we go I think we're good okay as mentioned my presentation today is called getting it right plant-based nutrition from birth through the senior years so it's a lot to cover and certainly we won't be covering every single aspect but I'm going to give you I I hope a pretty good overview so we'll be talking first about the safety and adequacy of plant-based diets and and when I say plant-based we'll be looking mostly at vegan and vegetarian diets specifically and then we'll.

Talk about some of the nutrients of Interest the nutrients that people are are asking questions about a lot so we'll look at protein iron zinc calcium and vitamin D12 omega-3 fatty acids and iodine and they'll then we'll conclude with a very short uh sort of segment called what to eat that is a real practical piece and and we'll finish up with that so first let's take a look at the safety and adequacy of plant-based diets I want to begin by telling you in the 1970s when.

I went to University this was before I was actually vegan uh I I learned a couple of things about uh plant-based or especially vegan and vegetarian nutrition one of my professors was Zach sabry who wrote a book called nutris4 and that was the text for one of our for one of our programs and in this book it says adults and only adults can safely remove meat but nothing more from their diets and an interpretation is adults can be lacto-ovo vegetarian they can't be vegan and people.

Other than athletes like children and teens can't can't even be vegetarian it's not safe so that's what we learned in University and then our introductory nutrition textbook prior to 1975 vegetarians were were and included in a chapter called food baptism and Crockery and then after 1975 they actually changed the title to Alternative food patterns so so uh um you know updated on the spectrum of exceptions a little bit um but you can imagine so this we're talking about 40 years ago uh it was um we.

You know basically all I can say is we've come a long way thank goodness the number one evidence-based resource globally has actually been this uh a piece from the um uh the Academy of nutrition and dietetics on uh it's actually their position statement on nutrition on vegetarian diets and uh they stayed in this position that uh that appropriately planned vegetarian diets including total vegetarian or vegan diets are helpful 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 and this is this is uh the sad news the position statement recently expired and I actually checked into this and it doesn't look like we will have a replacement for this type of position paper and the reason is is that the academy is Shifting to a more targeted position papers that use an Evidence analysis process and and so they're taking targeted questions uh right now they're.

Assembly an expert panel for a systematic review on vegetarian dietary patterns and health outcomes so it won't be the comprehensive reviews that the old positions were which to me is is disappointing um but nonetheless we will probably have a number of different reviews or or position statements that do look at various aspects of of vegetarian and plant-based diets in the meantime the 2016 paper is actually a really good resource it's a reliable summary of the literature and it is still used and respected around the world.

There is another expert review and the lead author on this was actually one of the authors on the 2016 position paper at Winston Craig and and so this paper is actually also very useful it's it's called the safe and effective use of plant-based diets with guidelines for health professionals so that's one you can certainly provide to health professionals if you need this kind of document so how do plant-based diets fare in terms of nutrient content and diet quality so what I want to do because there's.

So much information here is just give you a brief glimpse of the last decade of research so we'll actually look at research that compares a different nutrient intakes and diet quality of people that are consuming either vegan diets and we use a V for vegan diets lacto-ovo vegetarian diets which are represented by an Lov or non-vegetarian diets which are Envy so here's a here's our brief summary and and what I did was rather than go by year I went by the number of participants in the.

Study so the first study we'll talk about is one that that has over 90 000 participants was done in 2017 in France and in this study the lack of vegetarians and vegans have the best macronutrient composition and diet quality vegans have the highest fiber Antiques and the lowest intakes of saturated fat sugary drinks and refined Foods vegans also have the higher highest intake intakes for 12 micronutrients however they did fall short on calcium and b12 all dietary groups were low in their intakes of vitamin D.

The second is a study from Riso that's a reason that's a an Adventist Health study over 70 000 participants in this study and in in this particular uh Adventist Health study to uh the vegans have the highest intakes of fiber vitamin C iron potassium and magnesium there were actually no nutritional shortfalls in any of the dietary groups except for vitamin D which was low in all dietary groups uh the next study is as an Epica Oxford study from the UK over 30 000 individuals and in.

This study the vegans again had the highest intakes of fiber vitamin C vitamin E folate magnesium iron and copper vegans have the greatest cardio metabolic benefits but 85 percent of the vegans in this study were low in B12 and iodine uh the next study is one from Belgium and it was almost 1500 participants and in this study the vegans scored the highest and the non-vegans scored the lowest for the healthy eating index and the Mediterranean diet score so these are actually diet quality scores and so.

This is pretty significant vegans have the lowest intakes of total and saturated fat sodium and sodium and the highest intake of fiber vegans had about half the rates of overweight and about a quarter the rates of obesity compared to a non-vegetarians and then we have a study out of Denmark over 1300 uh individuals and in this study vegans came closer to the Nordic nutrition recommendations than non-vegetarians vegans met nutrient needs except for vitamin D iodine and selenium women also surprisingly had a low intake of vitamin.

A which is not commonly seen uh the next study was one from Germany 258 so we're looking at a smaller number of participants uh but 258 participants beacons have the lowest intakes of calories total and saturated fat cholesterol and sugar vegans have the highest intakes of fiber vitamins a c e k folate magnesium and iron however they did fall short of recommended intakes for B12 vitamin D calcium and zinc uh the next was a study from Switzerland or just over 200 individuals and in this study.

All dietary patterns were nutritionally sound vegan intakes of B12 vitamin D calcium and zinc were below however the RDA B12 status was good though as vegans were using B12 supplements and then a study out of Germany with just 72 individuals vegans in this study had the highest intakes of fiber folate and vitamins a B1 B6 c e and K there were no differences in vitamin B12 vitamin D or iron status of the individuals in this study however the vegans did have reduced iodine status and then.

The last study that we'll look at is one from Finland 41 individuals and the vegans had more favorable fatty acid profiles they had higher fiber and phytochemical intakes however they did fall short on B12 vitamin D iodine and selenium so in summary well-planned vegan diets whether they're plant-based plant exclusive or Omniverse well I should say well-planned diet whether plant-based plant exclusive or omnivorous can meet nutritional requirements vegans generally have the highest intakes of folate vitamin cke iron potassium magnesium and copper the nutrients that most commonly.

Fall short are B12 calcium vitamin D iodine and zinc so reliable sources of these nutrients need to be provided overall vegans have the highest diet quality scores and the highest quality diets at the lowest intakes of total unsaturated fat the lowest intakes of sugar-fried foods sodium highly processed foods and the highest intakes that I hope I said the lowest intakes of total unsaturated fat and so on and the highest intakes of fiber phytochem vegetables fruits leggings whole grains nuts and seeds the it's I think important.

For people to recognize that just because a dietary pattern falls short of the RDA doesn't mean that's unusual all dietary patterns have you know uh will fall short of the RDA for certain nutrients governments have actually attempted to fill the Gap by implementing nutrition education programs and fortifying food so adding iodine to Salt adding vitamins A and D to milk adding B vitamins and iron to grains for example expanding nutrition education to include plant-based diets and fortifying plant-based Staples like non-dairy milks and plant-based proteins can.

Also help to fill the gap for plant-based eaters these practices are actually more common in North America than Europe which explains some of the differences between the results in North America and the results in Europe so the next question that often comes up is our plant-based diet safe and adequate to support the growth and development of infants and children and we have you know relatively limited findings but about 30 years plus of findings and the findings that were you know to to look at them you.

Know sort of as a totality of the evidence lacto-ovo vegetarian children grow at least as well as omnivorous children actually there was a study in the Adventist Health um you know various studies that showed the lack of a vegetarian children actually were taller and bigger than omnivorous children so they certainly grow as well vegan children grow normally although growth may be slower especially during the toddler years they do tend to be a little bit smaller and lighter the most recent studies we have come out of.

Germany and these are the becci studies they're two on Toddlers and two on youths and over 400 children were were examined per cohort and they included vegans lactose vegetarian uh children and omnivores they examine nutrient intakes nutritional status and growth and there were no significant differences in energy intake or growth among the different dietary groups all groups were well nourished although they were below reference intakes for calcium and vitamin D with the vegans having the lowest intakes for those nutrients however vegans have the highest intakes.

Of fiber vitamin B1 B6 vitamin C E K folate iron potassium and magnesium and.

Solving the Protein Puzzle in Plant-Based Diets

They have the lowest intakes of sugar and saturated fat the author's conclusion was that vegetarian including vegan diets and meat recommended intakes during childhood and Adolescence there was a Polish study that brought a lot of press from 2021 this study um looked at 187 5 to 10 year old children consuming either vegan vegetarian or omnivorous diets the vegan diets were associated with a heart a healthier cardio metabolic risk profile lower fat Mass lower blood cholesterol lower fasting glucose levels the intakes of sugar and saturated fat.

Were lower the intakes of fiber were higher but vegan diets were associated with lower intakes of calcium vitamin D and b12 the B12 deficiency was only in unsupplemented diets vegan children were however slightly smaller and they had reduced bone density although their bone density was still within the normal reference range there was a Canadian study from 2022 with almost 9 000 children that found that those who eat vegetarian including vegan diets had similar measures of growth and nutrition compared to those who eat meat vegetarian children.

Had higher odds however of being underweight according to the lead author a plant-based dietary program pattern is recognized as a healthy eating pattern due to increased intake of fruits vegetables fiber whole grains and reduced saturated fat vegetarian diets appear to be appropriate for most children the take home message for Pediatric plant-based diets is that vegan and vegetarian diets are safe and adequate when they're appropriately planned we need to ensure sufficient calories and micronutrients including reliable sources of B12 calcium and vitamin D we want to avoid.

Overly restrictive regimes and provide fortified Foods or supplements as they're needed we have to remember that infancy in early childhood are stages of life when adequate growth and development are the top nutritional priorities plant-based diets can be less energy dense like all diets for infants and toddlers they need to be designed to ensure adequate calories and nutrition the bottom line is all diets for children regardless of dietary pattern need to be appropriately planned to ensure nutrient needs are met and this just you know to prove.

A point which lunch tray is more appropriately planned you know people assume that an omnivorous diet is going to be somehow Superior to a plant-based diet for children when in fact it really is the other way around plant-based diets provide far more nutrient dense they're more far more nutrient dense they provide more of the essential nutrients we need generally and they're they're more conducive to lifelong good health when we think of the sad diet or the standard American diet over a third of children eat fast.

Food on any given day in in the United States close to 70 percent of calories come from highly processed foods fewer than one in ten children meet recommended intakes for fruits and vegetables this is a pollen and and so we really need to consider all of this about 50 percent of American Children and adolescents are either overweight or obese the reality about vegetarian and vegan diets is their higher quality diets they're associated with higher intakes of fruits vegetables and Associated nutrients they're lower in in sweet.

And salty snacks they're lower in total and saturated fat and they reduce the risk of obesity in children and if we look at overweight and and obesity among vegetarians and vegans you know two of the big studies that have compared people eating a variety of dietary patterns are the Epic Oxford study and the Adventist Health study too and if you look at the BMI or the body mass index um that that the individuals who participated in these studies uh uh have you can see so what.

I want to show you is this this yellow region is what we consider to be a healthy BMI which is essentially between mean you know 18.5 and and and 24.9 uh and what you can see is everyone in all dietary groups of these health conscious individuals and epic Oxford were within the healthy BMI range but the vegans were the leanest of all uh categories and then in the Adventist Health study too the vegans were the only uh group that fell within the healthy BMI range the.

Lack of a vegetarians The Fish Eaters and the meat eaters were all above they were all either well they were all in the overweight category obesity is above 30. so what we need to recognize however is some vegetarian and vegan diets are more healthful than others you know when you think about this uh snack that this little girl is eating it's a hundred percent vegan snack it doesn't mean it's good for you ensuring adequacy in a diet involves providing high quality food ensuring a sufficient quantity.

Of food having a wide variety of foods in the diet and adding in fortified Foods or nutritional supplements when they are indicated so let's move on to look at some of the nutrients of interest in plant-based diets protein iron zinc calcium and b12 calcium and vitamin D B12 Omega-3s and iodine I did Cover protein in my last lecture but I decided to cover it again here for those of you that are just catching this lecture so starting with protein I think this is my favorite protein.

Cartoon of all times this little rodent is asking this big muscular gorilla no meat at all are you sure you're getting enough protein and the reality is is anyone who's plant-based has been asked the question where are you getting your protein or where do you get your protein but the reality of course is even the largest mammals on the planet managed to get enough protein from Plants to build huge muscles so puny people probably can't do we're so small by comparison there are many many Afflicted.

Body Builders and healthy individuals who manage getting enough protein purely from plants so the big question to ask is how much protein do we actually need well the RDA for protein is generally stated in terms of grams per kilogram per day an infant needing 1.5 or so during early infancy 1.2 during later infancy children need about one toddler's about 1.05 and older children about 0.95 teens about 0.85 adults about 0.8 grams per kilogram body weight and for those of you that aren't as familiar with kilograms.

A pound um or a kilogram is 2.2 pounds and then for pregnancy and lactation it's a little higher 1.1 during pregnancy 1.3 during lactation so what does that mean in terms of grams per day well the RDA in grams per day refers or applies only to a specific reference body weight which you see in the red uh numbers on on the left hand side here and and so you have to adjust this number for individuals because everybody has a bit different body weight but these reference.

Body weights for reference body weights you would be looking at about 13 grams for a toddler about 19 for a 48 year old about 34 for a 9 to 13 year old and then somewhere between about 46 and 56 for for teens and adults about 71 per pregnant and lactating women you need more or more for athletes and I'm not talking about you know people that do like I do an hour of exercise a day I'm talking about competitive athletes athletes so there there is no.

Separate RDA for them but uh 1.2 to 2 grams of protein per kilogram of body weight per day are generally recommended by you know Health authorities and and uh um you know in position statements and so on depending on the individual's training uh it is has been suggested that we may need more for seniors so there's no separate RDA for seniors in North America although protein digestibility and synthesis are reduced some countries actually do have a separate RDA like Australia for example has a separate RDA.

For seniors but consensus is building that a consumption of 1 to 1.3 grams per kilogram per day reduces age-related muscle loss achieving this level of intake uh can be challenging because energy needs are typically reduced in this population so they eat less but they need more protein so it's it's a little bit more challenging if you do the math so you take an athlete or senior who needs 1.2 grams of protein per kilogram body weight that that person weighs 75 kilos or 165 pounds they would.

Require about 90 grams of protein per day well for an athlete who consumes 3 000 calories that wouldn't amount to about 12 percent of his calories from Protein that's really easy to achieve on almost any diet um for a senior eating 1800 calories per day that would amount to 20 calories from protein and that is more difficult to achieve on a plant-based diet so what we're saying here is we probably need to focus a little bit more on ensuring that we've got a decent source of.

Protein in each meal uh for seniors we possibly may need more for people who are eating truly Whole Food plant-based diets so fiber in plant cell walls reduces protein digestibility so for those eating very high fiber oil food plant-based diet some experts recommend an increase of 30 for toddlers 20 for children four to eight fifteen percent for children nine plus and teens and ten percent for adults this is not necessary for people who regularly eat lower fiber foods like plant-based meat Alternatives tofu soy milk peanut.

Butter those kinds of foods or for lactose vegetarian people who regularly include Dairy and AIDS in their diet if we look at protein digestibility protein digestibility can be increased by reducing anti-nutritional factors such as trypsin Inhibitors and lectins by soaking sprouting fermenting and cooking Foods uh break it but we can reduce or increase protein digestibility by breaking down fiber by grinding blending making a smoothie other food processing techniques that reduce particle size thereby freeing up the protein to be absorbed and by removing or reducing fiber.

Through refining which of course isn't our best option from a nutritional uh perspective so if you look at the actual digestibility of food you can see that these lower fiber foods or foods that have had the particles broken down we absorb we we digest about 92 to 96 of the protein so that's things like you know white uh flour bread soy protein isolate peanut butter tofu or even whole wheat flour or bread um that's not that much different from what we would absorb from from animal.

Omega-3s: Making the Right Choices

Products that have no fiber at all like beef or milk or eggs of course we do absorb a little bit less from higher fiber whole uh plant foods like oatmeal I have 86 lentils at 84 most other leggings somewhere between 72 and 89 of the protein being digested so if we you know consider these additions for Whole Food plant based eaters we would be increasing you know the grams of protein per kilogram body weight you can see in the various groups uh a little you know.

By the the amount uh recommended the 30 20 15 and 10 and so we we would be looking at you know close to 1.4 for toddlers a little over the one for for children close to one for teens and close to 0.9 for adults and about 1.2 for pregnancy 1.4 for for lactation and what that means in terms of grams a day is we're looking at around close to the 20 grams for young children around the 40 for for older children at around the 50 to.

60 for for teens and adults and and around 78 for pregnant and lactating women so average requirements uh for protein are 46 grams a day for women 56 for men if we add 10 it would be 50 grams for women 62 for men so it's it's still not a terribly high amount of protein so for what's what are actual intakes well in in uh let's see seven or eight studies two four six seven studies here uh you can see that average intakes in me in this.

Is health conscious individuals most of these studies are looking at health conscious individuals 92 grams a day on average um and and for for vegetarian 76 and for vegan 72. so you can see they're all uh you know have a pretty pretty a good amount above that sort of RDA so what about intakes and toddlers well veggie looked at that they looked at 430 one to three year old children average intakes were 2.7 grams per kilogram per day for all omnivores 2.3 for lacto OVO 2.4.

For vegans and the RDA is 1.05 grams per kilogram per day so they were all well beyond double the RDA so not much of a problem uh achieving uh needs what about older children well again the vet Youth Study looked at 401 6 to 18 year olds their average intakes were were 1.36 for omnivores 1.14 for lacto oval and 1.16 for vegans the RDA is 0.85 2.95 grams per kilogram per day so again above uh the RDA so you know if you look at and you.

Can see why if you start to look at the protein content of selected Foods so we get about 15 to 30 grams of protein in a cup of soybeans or three ounces of Veggie need or a cup a half a cup of tofu or a cup of lentils or other legumes that's about the same as what we get from three ounces of meat poultry or fish we get some you know 6 to 13 in you know quarter cup of hemp seeds a cup of you know.

Cooked grains like spelled wheat or kamu to a quarter cup of pumpkin seeds um you know and then all of the other foods like nuts and soy milk and quinoa and so forth um this isn't much different than what you'd get from a couple of eggs or a cup of milk or an ounce of cheese plant-based eaters generally get enough protein unless they get insufficient calories they have Eating Disorders illnesses or or they just don't get enough food this is not that common in North America.

Most people don't have a problem getting enough calories second is their diets are just very poorly balanced or poorly planned they're high fat High sugars junk food diets like you know soda and french fries tea and toast diets and some fruitarian diets may not make the cut either because fruits tend to be a little lower in protein uh or they fail to meet their increased needs like seniors with low energy intakes or poor appetite pregnant women with morning sickness they may not get enough protein many.

People say but isn't plant protein inferior to animal protein the reality is the concern you know the concern here is that plant protein is incomplete or they're missing one or more of the nine essential amino acids and the truth is all whole plant foods contain all nine essential amino acids essential amino acids are essential because animals don't make them they're made by plants so it makes no sense to think we can't get them from Plants it's where they come from so that's you know the bottom.

Line sometimes the amount of Lysine leucine or methionine may be low in a single food per gram of protein in that food this could be a you know an issue if we only ate one food but we don't we eat a variety of foods and I think it's really important when we're talking about you know the the sort of quality of protein plant versus animals so animal protein to recognize that protein quality is is not just about essential amino acids it's about how well that that.

Protein sustains Health throughout life plant protein reduces risk of more mortality and disease animal protein increases risk of mortality and disease and and it's also about you know to me uh how uh you know a plant a protein Source will support the health of the planet as well so these are issues that you know need to be considered uh as I said all the essential amino acids are named by plants so we get them directly by eating plants or indirectly biting animals that eat do we.

Need to complement proteins to ensure sufficient essential amino acids and we've known since the 80s that we don't need to do that but somehow uh it's it's something that people just can't can't seem to get over so it's not necessary to complement protein if we eat enough protein and calories all we need to do is eat a variety of plant Foods over the course of the day and include some lysine leucine-rich choices like legumes as part of the mix we can boost intake of protein by.

Including at least one protein-rich choice at each meal like beans lentils split peas tofu tempeh edamame or other soy foods that you need to put so inclined seitan seeds nuts we can also include especially for children I think this is quite relevant and for seniors some lower fiber choices in the mix like tofu soy milk peanut butter seitan and then selecting when we select if we're using commercial uh non-dairy milks to select melts with higher protein like soy or female for example moving on to iron.

How much iron do we need well this is the Shocker infants the RDA for infant 7 to 12 months of age is 11 milligrams a day it's eight milligrams for an adult man okay so that's more iron than what an adult man needs for an infant children 1 to 13 years of age at seven to ten depending on age uh and then for teens it's 11 for males 15 for females who are menstruating of course and then 18 for women because they lose uh iron each.

Month during pregnancy and lactation it's 27 during pregnancy and only nine during lactation because they're not generally menstruating the upper limit for iron is 44 children and 45 for teens and adults so this is important to know because we don't want to overdo iron either do vegetarians need more iron will The Institute of medicine recommends although it's not a separate RDA they recommend 1.8 times greater intakes for vegetarians but this is to me a really controversial figure it was based on one test diet that maximized.

Iron absorption Inhibitors and minimized iron absorption enhancers it's not reflective of typical plant-based diets well needs may be slightly higher 1.8 times to me is an overestimate for most individuals eating a varied plant-based diet so what are actual iron intakes well this is a bit of a surprise to most people but if you compare non-vegetarians lack of vegetarians and vegans you'll see that non-vegetarians actually have lower intakes than either lack of OVO vegetarians or vegans with vegans generally having the highest intakes what about in toddlers.

And youth same story non-vegetarians around the six milligrams a day lack to oval around the seven and vegans around the nine so a little bit higher intakes in in vegans however there are two forms of iron in food heme iron which is found mainly in meat poultry and fish 40 to 70 percent of the iron in meat is heme iron it's about 15 to 35 bioavailable and intake is associated however with metabolic syndrome heart disease colorectal cancer and colorectal cancer and it's a bit of a.

Pro-oxidant in the body so it's you know it's definitely more bioavailable but that doesn't make it necessarily a good thing non-heme Iron by contrast is found in both plants and meat it's only one to twenty three percent bioavailable but that depends on physiological iron requirements so absorption and iron deficient individuals can actually be 10 times higher than it is in Iron replete individuals vegetarians who generally don't have a higher risk for iron deficiency except possibly administrating women however we do have lower serum ferritin or iron.

Stores lower iron stores that are within the normal range don't affect how a person feels or you know and and and do not appear to be a disadvantage when the diets replenishing iron losses and hemoglobin hematocrit are normal it actually may turn out to be an advantage as higher serum ferritin tends to be associated with increased risk of some chronic diseases however iron deficiency is the most common nutritional deficiency in infancy in childhood with the greatest risk being in preschoolers and if a preschooler has low.

Iron over time it can impact cognitive and motor function which can persist Beyond childhood and it can also impair their immune function so what are the factors that would increase risk of iron deficiency in in infants and children well in infants uh premature birth or low birth weight is a big uh red flag for increased uh a risk of iron deficiency um early introduction to cow's milk uh dramatically increases risk use of unfortified infant formula late introduction to solid foods more than six months of age.

And in children and teens drinking too much cow's milk over 24 ounces a day in those ages one to five years insufficient dietary sources lead exposure health conditions chronic infections or heavy menstrual bleeding and uh if we look at recommendations for or or iron for infants the addition of iron rich and iron enriched foods should begin by six months of age providing 11 milligrams of iron for a 7 to 12 month old infant is challenging without iron fortified Foods or supplements is red meat the answer.

Uh which you know uh we see you know we see this in um infant feeding recommendations all the time they're often a suggestion to you know begin red meat early to avoid the risk of iron deficiency and this is not the answer at all red meat is higher is high in total and saturated fat it contains a lot of pro-inflammatory compounds and intake is associated with increased risk of of cancer of heart disease of diabetes and of other chronic diseases and this is what a lot.

Of people don't realize it would be impossible for a baby to eat enough red meat to meet the RDA 100 grams or three and a half ounces of lean roast beef has 1.37 milligrams of iron so a baby would have to eat 28 ounces of lean beef to meet the RDA of 11 milligrams so how much iron is in in foods that might be appropriate for infants well to meet that 11 milligram recommendation you would need to the baby would need to eat six tablespoons of.

Fortified infant cereal 13 tablespoons of tofu 27 tablespoons of lentils and just so you know there's 16 tablespoons in a cup uh 52 tablespoons of strained infant chicken or 79 tablespoons of infant strained beef because just interesting to know that do infants need iron supplements well breastfed infants do need iron supplements if they're premature so one to three milligrams per kilogram for the first year is what's generally recommended full term infants the American Academy of Pediatrics recommends a milligram per kilogram beginning from four to six.

Months of age or until um recommended intake is is met with solid foods the Canadian Pediatric Society recommends exclusive breastfeeding for the first six months they believe that you'll get enough iron from that but you need to ensure sufficient iron in solid foods thereafter and and they don't necessarily recommend an iron supplement unless it's indicated formula fed infants just need to the parents need to choose iron 45 formula so ensuring sufficient iron and plant-based diets means selecting iron-rich foods from within each food group and and.

In the legumes group lentils chickpeas and other beans in tofu are great sources in the grains the the um pseudograins tend to be a little higher in Iron like amaranth and and quinoa tap is fairly high as well uh wheat sorghum fortified grains nuts and seeds seeds are a little more concentrated iron in Iron than most nuts but in the nut category cashews pine nuts almonds and Brazil nuts are good choices in the vegetable category peas string beans and leafy greens are good choices and in.

The fruits prune juice and dried fruits and other foods that do provide iron are fortified meat analogues and black strap molasses number two is we want to want to moderate our intake of iron absorption inhibitor and phytate um are are one thing that we need to be aware of and these are most concentrated in in bran especially wheat bran so you don't want to be sprinkling wheat Brown on your food for example and and we just need to be conscious of the amount of.

Unlocking the Power of Whole Grains

phytates in you know um uh whole grains that are unleavened especially we can reduce phytates with leavening and soaking and sprouting and and all of these uh techniques but if we’re using flatbreads uh they’re they’re a little higher in in phytates and when they’re the dietary staple and with little else we sometimes do see uh problems there polyphenolic compounds from tea and and for both phytates and polyphenolic compounds if we eat these with meals we can reduce iron absorption by about 50 to 90 from that meal so if you’re drinking teas that are rich in polyphenolics like black or green teas even other some of the herbal teas we want to separate the tea from the meal by at least an hour uh zinc can can impair uh iron absorption as well calcium and dairy products interfere with calcium absorption too we also want to boost intake of the iron absorption enhancers so the most you know known one is is foods that are rich in vitamin C and organic acids like citrus fruits and strawberries and all sorts of fruits and vegetables allium vegetables like onions and garlic beta-carotene rich foods like carrots and some spices like pepper turmeric and ginger can actually enhance iron absorption as well and then we want to replace meat with legumes rather than Dairy a lot of people when they’re first making the transition to a more plant-based diet we’ll end up eating more dairy products you know lasagna with cheese and macaroni and cheese and pizza with cheese and so forth we don’t want to be doing that because Dairy is low in iron meat is high in iron so you’re swapping a high iron food for low iron food and dairy actually inhibits the absorption of iron so it’s a double whammy so we don’t want to do that we want to choose legumes legumes provide iron in a form that is absorbed as we need it without being a pro-oxidant and we can even cook and cast iron to further boost iron content moving on to zinc zinc is a nutrient that’s necessary for a new function wound healing growth and reproduction and the activity of hundreds of enzymes it’s important for cell signaling and cell division building proteins and DNA recommended intakes you can see only three milligrams for toddlers five for older children eight for nine to 13 year olds nine for teens 14 females 11 for males 14 years of of age and over 11 for pregnancy 12 for lactation and sorry that eight was for 9 to 13 year olds plus adult women 19 years of age and older and needs can be up to 50 higher in those eating high fiber high five take plant-based diets there are homeostatic mechanisms that appear to help people adjust to lower intakes over time which means that it helps people to absorb more so this this you know can certainly um uh can occur now if we look at actual zinc intakes it’s not quite the same as iron what we see is non-vegetarians tend to have the highest at around you know 11 or 12 milligrams lacto oval vegetarians around you know 10 to 12 and vegans you know generally around 11 although epic Oxford was a little a little uh lower uh what about in in toddlers and youth well it was interesting they were all pretty close omnivores had about five milligrams per day lacto OVO vegetarians just below five and vegans at about five milligrams per day they were all fairly low to be honest so zinc deficiency what we see with moderate zinc deficiency is impaired immune function loss of appetite hair loss diarrhea and with more severe deficiencies stunted growth in children delayed sexual maturation impotence uh hypogonadism eye and skin lesions so it’s you know it’s fairly serious stuff we need to pay attention to zinc especially during the growing years factors that increase risk are inadequate intakes and poor zinc absorption and we see inadequate intakes in poor quality diets so again highly processed or junk food diets diets that don’t have a lot of variety we see it in in you know kids that are picky eaters we see it with late introduction to solid foods and we see it in in adults and teens who are consuming excess alcohol we see it with insufficient calories restrictive diets poverty eating disorders and illnesses as well and then in terms of poor zinc absorption of Hi-Fi tape diet and emphasis on high phytaking foods like wheat bran and unleavened breads a failure to employ techniques that reduce phytates like soaking sprouting fermenting leavening and of course we see it with reduced absorption ability people that have uh gastrointestinal diseases or malabsorption syndromes liver disease renal disease diabetes cancer can have a reduced absorption ability so how do we boost zinc well we we want to include Zac rich foods at each meal we want to limit the use of very high phytate foods like wheat brand use food preparation techniques that reduce phytase and ensure sufficient calories including regular nutritious snacks for small children especially so what foods contain zinc well foods that contain at least two milligrams per serving are in red things like azuki beans and tofu pumpkin seeds chia seeds oatmeal and compare you can see that compared to the amount in beef at 3.5 and then foods that are in purple like the cashews and the wheat sprouts and kamut uh are are somewhere between 1.5 and 2 and then we get um some zinc from other legumes other nuts and seeds a little bit from fruits and vegetables as well but not so much avocados being a little bit of an exception at 1.3 for a medium-sized avocado zinc supplements are they needed well too much zinc can impair copper and iron status reduce immune function cause nausea vomiting stomach pain and headaches and and the upper limit for zinc for adults it’s like 45 milligrams so it’s not very high a single nutrient supplements are just not advised unless they’re medically indicated which means you’ve got uh you know a um a zinc deficiency that that’s that’s been identified most multivitamin mineral supplements can provide safe levels of zinc and can provide a boost for those with low intakes and actually can be a value for uh for children uh moving on to calcium uh the big question we often get asked where calcium is concerned is isn’t cow’s milk necessary and the answer is no it’s not necessary every mammal produces a milk that’s designed specifically for their offspring no species requires the milk of another species for their survival in fact in my opinion it would defy rationality to assume that any animal would require the milk of another animal for its survival it just doesn’t make sense if we look at pre-agricultural populations humans average a thousand to 1500 milligrams of calcium per day without a single drop of cow’s milk where did they get it they got it mainly from plants calcium-rich plant Foods offer impressive advantages over Dairy it’s low in saturated fat cholesterol straw free they’re rich sources of fiber and antioxidants and phytochemicals and vitamin C K and folate magnesium potassium Boron and so you know plant foods can be a really wonderful source of calcium if you’re choosing uh correctly so how much do we need well the recommended dietary allowance are the RDA is actually quite high in North America it’s a little lower in a lot of the European countries um but it’s 700 milligrams a day for one to three year olds a thousand for 48 year olds and 1300 or 9 to 18 year olds it’s a thousand for adults for females nine to fifty and for males 19 or sorry nine 19 to 15 for males 19 to 70 and it’s 1200 for women over 50 and men over

70. so how much are people actually consuming well looking at you know uh

the these Six studies that provided calcium average calcium intakes but we’re looking at close to 900 milligrams a day and in Western countries um for vegans over a thousand or 1068 for lactoba vegetarians and and about the same for omnivores so vegans definitely having slightly lower intakes but intakes that are actually higher than a lot of people might imagine them to be intakes in toddlers and youth in the veggie were actually pretty dismal omnivores just over the the 400 lacto OVO around the 400 vegans closer to 300. this is definitely lower than what most experts would would recommend so how do vegans and vegetarian vegetarian people do in terms of their bone health well the Epica Oxford study was a little concerning um there have been a lot of studies that have reported somewhat reduced bone density and increased fracture rates among vegans compared to omnivores but the 2020 study the Epic Oxford study looked at um about 55 000 individuals and they found that um the the risk for total fractures was

Iron: The Forgotten Nutrient

Almost one and a half times increased and in in vegans compared to to omnivores and this means about 20 more hip fractures for every thousand people over 10 years for vegans the higher risk however was only observed in vegans with a BMI under 22.5 so vegans who had more you know sort of muscle mass and body weight had had lower uh risk or no greater risk than omnivores um the the increased risk was actually mainly for post-menopausal women it wasn't so much for men so why.

Did we see increased risk well vegans have lower body mass index so the the vegans are thinner they they have a BMI averaging 22.1 compared to 24.5 for the uh for the omnivores they'd lower in this study they had lower calcium intakes 591 milligrams versus over a thousand for the omnivores uh they didn't look at Vitamin D but other epic Oxford studies show significantly lower intakes of vitamin D they had lower protein intakes about 13.3 percent of calories versus 17 for the omnivores and they used.

A lot less hormone replacement therapy which which actually in can increase bone density so there there are a number of reasons why they may have had a higher risk but I can tell you from personal experience uh this is um you know I'm 64 years old I have a family history of osteoporosis I had my bone density done after 20 years vegan so I was about 50 years of age when I had it done and I haven't had it done since well I should get it.

Done again um but my lumbar spine bone mineral density was two and a half standard day of deviations above the young adult mean my bone mineral density of my right femur was two standard deviations above the young adult mean and just so you know osteop osteopenia is 1.2.5 1 to 2.5 standard deviations below the young adult I mean an osteoporosis is two greater than 2.5 standard deviations below the uh young adult means when I went in to get my results from my doctor his jaw he.

He opened my file in his jaw draw he said your bone density is so high that we had to put an arrow at the top of the chart because we couldn't plot it he said I don't know what you're doing but just keep doing it he had ordered my bone mineral density because he was concerned because I had been vegan for for many years and I was a slim white female with a family history of osteoporosis so and I can tell you I'm quite sure why.

I I have strong bones it's because I I eat a very good diet I make sure I get enough calcium and vitamin D and other nutrients that go towards building strong bones but I'm physically active and that's the key when you're physically active and you're you're telling your body to stay your bones to stay strong so and yes that's me doing the handstand there um strong vegan bones are really about meeting the rdas for calcium ensuring reliable sources of vitamin D which help with calcium absorption.

Including some calcium vitamin D fortified Foods if if we can't get there eating a lot of vegetables and fruits at least nine servings a day designing the diet to ensure optimal intakes of other bone building nutrients light like potassium and magnesium and vitamin K and all of those things and we want to get weight-bearing exercise and I aim for at least 60 Minutes six or seven times a week actually seven times a week generally so that's you know what we should be doing when we you.

Know we live in a fairly sedentary Society I sit at a desk a lot of the time I need to fit exercise in uh it's just so important so how do we get enough calcium without dairy well we want to eat sufficient calcium-rich plant foods like low oxalate greens uh tofu made with calcium chia seeds almonds figs you know beans like Black beans and Great Northern beans and we can use a little bit of tahini blackstrap molasses things like that um the big question I can.

Remember back in the 90s when the dairy industry in Canada claimed that sure there's they had an ad in in magazines that said sure you can get calcium from plant foods but it's not bioavailable and um and that of course is not true um we absorb from dairy products about 34 some you know 32 to 34 of the calcium that's in that food we absorb about the same amount of calcium from tofu made with calcium and from soy milk possibly a little bit less from soy.

Milk in the 25 to 32 percent range we absorb a little bit less from most legumes just over the 20 and sweet potatoes but we absorb actually significantly more from low oxalate greens somewhere in the neighborhood of 40 to 70 percent from broccoli and kale and Chinese greens and turnip greens and mustard greens the these foods are also our sources of vitamin K and potassium all sorts of nutrients that you know move us towards building stronger bones so they're an exceptional source of calcium however we.

Don't get as much calcium from greens that are high in oxalate even though looking on in a chart of calcium content of food they look like they're really high up but because they're so high and oscillates the oxalate bind to calcium making it unavailable for absorption we only get about five percent of the calcium from spinach eat greens and swiss chard and from rhubarb as well the other thing number two that we can do is to select calcium fortified non-dairy milks and other foods with added.

Calcium if we have a hard time getting to where we need to be calcium fortified melts provide about three to 450 milligrams of calcium per cup tofu made with calcium provides about one to three hundred milligrams per half cup you just need to read the label one to two servings of non-dairy milk along with other calcium-rich plant food choices will typically get us easily to the RDA whether you're an adult or a child we want to be aware of factors that inhibit calcium absorption the things.

That have a negative impact are excessive oxalates or phytates excessive sodium a high acid load alcohol and caffeine positive impact of course vitamin D and fruits and vegetables as well other factors affecting calcium absorption are the amount of calcium consumed so absorption efficiency decreases as calcium consumption at a wheel increases so if you eat your entire thousand milligrams of calcium at one meal you'll absorb far less than if you distribute that thousand milligrams over three meals for example age and life stage matter too calcium absorption.

Is as high as 60 percent in infants and young children absorption decreases to 15 to 20 percent during adulthood except during pregnancy when it goes up again looking very briefly at vitamin D vitamin D needing the RDA is an issue for everyone but many studies suggest the risk is higher among vegans because we have fewer dietary sources most people don't make enough vitamin D from Sunshine exposure and people that live in the North like I do I live in Canada we don't make Vitamin D from.

Sunshine between about October to March or April so it's a long time to go without making vitamin D from Sun and our ability to produce vitamin D from Sunshine depends on the latitude that we're at the time of year the time of day the cloud cover our age our body weight our skin color our skin exposure all of those things can make a big difference the RDA for vitamin D is 400 IUS for for infants 0 to 12 months and 600 for everyone else from 1.

To 70 years of age and 800 for those over 70 uh uh years of age so food sources for for everyone um you know food sources are mushrooms that are grown in UV light eggs fish liver fortified foods like non-dairy and dairy milks and cereals so you can see for for people that are eating Whole Food plant-based diets they're not eating um many if any fortified Foods there's not a lot of sources they need to rely on sunlight if they don't get enough sunlight then they.

Need a supplement so supplements 400 IUS is recommended for all infants to Age Two 600 is often suggested for children a thousand to two thousand is often suggested for adults with higher intakes possibly needed for seniors vitamin D3 raises serum levels to a little bit greater it's death than D2 and maintains higher levels longer than D2 plant-based D3 however from lichen is widely available so it's not an issue moving on to vitamin B12 vitamin B12 the RDA is close to one microgram for young children it's.

Close to uh two for older children and for for um everyone 14 years of age and older it's actually 2.4 and it's getting closer to three micrograms per during pregnancy adaptation 2.6 and 2.8 plant Foods actually come up sort on B12 so B12 is an issue for plant eaters plant foods are just not reliable sources unless they're fortified even foods that are commonly thought to be reliable sources like organic vegetables seaweed fermented foods and mushrooms should not at this point be relied on as sole sources.

Of vitamin B12 and just you know to to to give you uh you know a little bit of the reason why um you know seaweed for example um the the B12 and seaweed when the seaweed is dried is often the active B12 is converted to inactive forms of B12 so it's not as usable in that in that respect fermented foods well it depends on how dirty the containers are how much.

Essential Nutrients: Focus on Zinc

Bacteria are in the containers when the foods are being fermented mushrooms again and are they growing on human manure or what are they grown on you know it that will make a difference for their B12 content and so at this point these just are not consistent reliable sources uh vitamin B12 Stores May last two to three years or more in adults however breastfed babies born to be 12 deficient mothers can develop B12 deficiency within months or even weeks of birth in some cases causing irreversible brain.

Damage this is something that just simply should never happen uh pregnant and lactating women need to make sure they have a reliable source and we need we need to make sure we have reliable sources throughout life deficiency symptoms include megaloblastic anemia which is um you know all of the symptoms like weakness and fatigue and all of that it can cause eventually nerve and brain damage gastrointestinal disturbances and elevated homocysteine which can increase risk of cardiovascular disease there is a higher risk for seniors in developed countries.

Six percent of people 60 plus are B12 deficient uh and this is you know very significant this isn't just uh vegans or vegetarians this is everyone B12 deficiency increases the risk of dementia and Alzheimer's 10 to 30 percent of individuals over 30 have a diminished ability to cleave the B12 off the protein it's bound to in animal products due to lower gastric acid and reduced enzyme production The Institute of medicine actually recommends that everyone who's over 50 relies on supplements or fortified foods for their B12.

And not on animal products in their later years or 50 plus years we don't want to mess with B12 vegans vegetarians and everyone 50 plus needs to ensure reliable sources daily to monitor B12 staff and to monitor B12 status so what are reliable sources well certainly supplements are reliable sources B12 fortified foods like non-dairy melts and animal products for those under 50 who are eating animal products who are eating a sort of a predominantly plant-based diet it so how much should we be getting from supplements.

Well you can see the RDA here at you know a couple micrograms a day the recommended doses are 5 to 10 micrograms for toddlers about 25 micrograms this is a daily dose for four to eight year olds and then possibly 25 to 50 for for 9 to 13 year olds and and around the 50 for adults possibly 100 micrograms for those 65 plus many people are recommending 500 to 1000 micrograms a day during pregnancy and lactation 50 to 100 micrograms uh is is adequate as well.

If we're just dosing two or three times a week we're looking at you know about a thousand micrograms a day um and and it's this is not recommended for seniors actually um it's recommended that they do daily B12 so what form is bass cyano versus methyl uh and adenosyl cobalamin and this is the great debate among many practitioners in the sort of plant-based world with some of our um you know very respected voices saying we need to rely on cyano uh and and others saying it.

Should be methyl and cyano is the synthetic form of B12 that contains a molecule of cyanide however the amounts are less than what would be consumed in common foods like flax fresh apple juice apricots those kinds of things this is the most stable and least expensive form so if we're looking at providing it uh you know in Foods or to the global population that's not as well off cyanocobalamin makes a lot of sense it's safe for most people but there's a caution for people with inherited.

Disorders of B12 metabolism smokers and those with kidney disease for those people it's probably better to rely on on methyl and adenoscele these are the natural forms of B12 they are a little bit less stable but they're better retained once they're absorbed some experts suggest because they're less stable that we aim for a thousand micrograms a day um and some experts suggest taking both methyl and adenoscele for best results and and so I think that makes sense because they have you know can be used slightly.

Differently in the body and and that sort of would help to cover all your bases I think you can do either I'm you know lean towards the natural forms myself uh generally uh but I I think that um either can be can be quite suitable omega-3 fatty acids is fish necessary in the diet and the answer is no omega-3 fatty acids are present in plenty of other Foods they're present in land plants like Chia flax and hemp seeds and walnuts and the Ahi flower and the.

Accum seed oils which you know aren't very common foods so not going to be relied on they're also present in Greens although greens are very low in fat so you'd have to eat a lot to get enough they're also present in sea plants microalgae in the form of supplements and macro algae which only provides EPA other prevent they're present in eggs which is only DHA not EPA so do vegetarians and vegans get enough homemade well our intakes are of ala are generally similar to or higher.

Than omnivores of EPA and DHA um they we generally have negligible intakes and vegans unless we take microalgae supplements it's low in vegetarians with eggs providing you know moderate amounts what about our status well plasma levels of ala are similar to that of omnivores DHA and EPA about 30 percent lower in lack of OVO and about 40 to 70 percent lower in vegans so what about conversion of ala to EPA because technically ala can be converted to EPA and DHA but since vegans essentially and since.

Vegans essentially consume no no EPA or DHA from the diet they rely on endogenous conversion unless they're taking the supplements and most humans conversion is fairly inefficient averaging about five to eight percent it is higher in young women there was a study showing conversion to EPA and to DPA and DHA uh being about 30 percent in young women because their bodies are prepared for pregnancy of course and but for men it was it was a lot lower than that uh so there are four I have.

Four tips for optimizing omega-3 fatty acid status number one be aware of factors that depress conversion of ala to EPA and DHA and the non-diet factors are genetics uh you know we can genetically have less capacity to convert gender men tend to be less efficient than women age uh infants especially preterm infants have less capacity to convert and seniors have less capacity uh smoking and chronic diseases like diabetes metabolic syndrome and hypertension and impair conversion as well and then we have a number of diet factors.

The first being high intakes of omega-6 fatty acids so if we're eating a lot of omega-6 relative to omega-3 this can depress conversion up to probably 40 to 60 percent um and and this you know we'll talk about the solution to that but it's pretty simple inadequate nutrition insufficient protein lack of vitamin mineral cofactors like zinc magnesium niacin Paradox same vitamin C trans fatty acids and alcohol and very high fat diets actually can depress conversion as well uh number two is to ensure sufficient alpha linolenic.

Acid and for you know if you look at the the recommended intakes uh they you know range from 0.7 for toddlers to you know 1.6 for for adult males and and 0.7 in females to 1.1 in adults um what I recommend is for people who are consuming no EPA and DHA that we double those intakes to uh 1.4 uh to 3.2 grams uh per per day uh and uh so 1.4 during during the uh the toddler years in 3.2 for adults and for teens and for.

Women it would be uh 2.2 grams uh during adulthood per day and a little higher during pregnancy and lactation uh plant sources of Omega-3 well we get about 2.6 uh grams in um an ounce of walnuts we get about one in a tablespoon of Chia seeds one in a tablespoon of ground flax seeds I'm sorry a 2.5 in a tablespoon of Chia seeds 1.6 in a tablespoon of ground flax one in a tablespoon of hemp seeds and less than 0.1 in a cup of greens so.

If we're aiming for you know 2.2 to 3.2 we'd have to eat 20 or 30 cups of greens at least to get enough we'd need to eat two or three tablespoons of of hemp seeds and you know just over a tablespoon of ground flax or tablespoon of Chia seeds or an ounce of walnuts we want to moderate our intake of omega-6s.

Iodine: An Overlooked Essential Nutrient

If they're excessive so increasing omega-3 fatty acids is the most important way to balance C-section fit so we want to focus more on increasing the Omega-3s than decreasing omega-6s but in some cases it can be helpful to moderate omega-6 intakes especially when intakes are very high and we can do that just by you know if we're using oils and cooking for example not choosing omega-6 Rich oils like safflower and grape seed and sunflower and corn and soy and cotton seed and sesame oil instead we would.

Choose you know an avocado or an olive oil for example um and and then or we might use an omega-3 ripped oil for salad like flax or ham and we might you know just moderate our intake slightly of of omega-6 Rich Whole Foods but I that's something that you would definitely worry a lot less about like pumpkin and sunflower and sesame seeds and then you want to consider direct sources of long chain omega-3 fatty acids who might benefit from supplementation well certainly those with increased needs.

Like pregnant and breastfeeding women those who may not convert efficiently like people with diabetes metabolic syndrome hypertension people that have traditionally consumed a lot of fish possibly seniors possibly everyone we don't know and that's the reality is we're not sure if if everyone would benefit from it or if by providing it for children they would convert less I generally recommend that I think at this stage based on what we know it's a good idea to supplement with EPA and DHA probably you know two or three.

Hundred milligrams per day for adults a little less for children so in typical suggested intakes as I mentioned one uh 70 to 120 milligrams for children two to three hundred uh for adults three to five hundred for pregnant and lactating women people with a diagnosed deficiency may need more like 800 to a thousand milligrams per day and finally iodine iodine is a nutrient that we need to have on our radar on our radar severe iodine deficiency results in cognitive impairment and it is the number one.

Cause of preventable brain damage in the world mild deficiency in pregnant women and infants can lower IQ in their offspring by 10 to 15 points adversely affecting their learning ability um so how do vegans and vegetarians do well vegans are at increased risk of poor iodine state is generally based on the studies we have lacto-ovo vegetarians are at lower risk than vegans um because iodine is present in in dairy products and it's not present because there's some magic about it we use iodine to disinfect the.

Teeth of cows so the iodine gets into the milk that way uh and those living in countries with a high prevalence of deficiency are especially vulnerable because the iodine in soil varies pretty dramatically in different in different nations and so some countries other some places in Europe for example that there's just not much iodine in the soil so people have a higher risk of deficiency and um you know if you look at the RDA it's it's 150 micrograms um for for adults uh and and it's.

A little higher 220 in pregnancy 290 in lactation it's it's 90 to 120 during childhood but it's 110 to 130 for infants which is really uh high and it means it needs to be coming from breast milk so breastfeeding mums need to make sure they have a source the upper limit is is is not that high so for one to three-year-old their RDA is 90. their upper limit is 200. for four to eight year old it's 300 for 9 to 13 and 600 for an adult.

It's 1100 micrograms of of iodine so it's it's you know it's not a big window between the RDA and the uh and the upper limit especially for uh young children so food sources iodized salt sea vegetables efficiency food milk eggs and plant plants grown in iodine rich soil bread it's in the Dual conditioners um so how do we get 150 micrograms a half a teaspoon of iodized salt a sixteenth of a teaspoon of kelp powder two sheets of nori uh the the big sheets of nori.

A half a teaspoon of Dulce granules a cup and a half of milk six large eggs six ounces of fish just to give you an idea of the relative amounts that you would require of these Foods so certainly for those that are are trying to minimize salt intake uh the uh see seawood can be a a source the problem is is that it's quite variable among various Seafoods and the other thing is it's so highly concentrated we have to be careful to not exceed the upper.

Limit so if you get 150 from a sixteenth of a teaspoon of kelp 1 8 of a teaspoon exceeds the upper limit for a small child so we just need to be very conscious of that we we need to recognize that oh and it's six slices of bread so so how do we boost intakes if we're using salt we can select an iodized salt or iodized sea salt include appropriate amounts of seaweed use a supplement or multivitamin or iodine drops if we're so inclined so the.

Last part of my presentation which I can zip through pretty quickly is what to eat so it's this is not a diet of decoration by any stretch of the imagination this is beautiful colorful Foods and one of the places that we can start is by looking at a food guide and looking at the amounts of foods within each food group that would be appropriate to be consuming and this is the the vegan plate from becoming vegan in the plant powered protein books this is the plant-based.

Plate from nourish and so and this is Canada's food guide which if you have if you're not aware of Canada's food guide um dairy products in Canada's food guide no longer have a designated group they are they haven't been excluded from the food guide but they are just included as one among many choices in the protein group as you can see half the prep plate is fruits and vegetables a quarter of the plate is whole grain foods or you know grain foods but they say choose.

Whole grains and then protein foods which includes meat and poultry and tofu and nuts and seeds and legumes and so forth but what's really interesting is consumers are encouraged to choose plant protein sources every day and to choose them more often than animal-based protein foods which is really quite amazing we want to eat most you need to remember that every single cell of your body is a product of what goes into your mouth so we need to be carefully choosing Whole Foods as opposed to uh.

Refined Foods in our diets we want to make whole plant Foods the foundation of the diet choosing nine or more servings of vegetables and fruits a day and a half a cup raw or a cup of or a half a cup of raw cooked or a cup of raw leafy vegetables is considered one serving I know I CH I consume probably 12 to 14 servings a day and I'm sure many of you do as well you want to go for color and variety you want every.

Color of the rainbow to be represented and I'm really funny about this when I'm making a salad I want to get every color I want the purple blue the green the yellow the orange the red and some variations if I can find a watermelon radish with that bright pink color it's just the greater the variety and and color the more phytochemicals that you're consuming in antioxidants and all of those powerful Foods you want three servings of leggings a day and it doesn't mean it's three you.

Know um bowls of beans it's it could be scrambled tofu it could be a cup of soy milk it could be some peanut butter on bread uh it could be some hummus but you want to be including some of these Foods at pretty much every meal and having at least one serving as whole legumes every day either beans or lentils is really key you want to select whole grains mostly intact and bury your intake of grains with your energy needs so people that are trying to.

Lose weight may go very low on their intake of grains and they may focus more on vegetables and fruit uh fruits and legumes as their Staples and consume very little of these Foods people who are athletes may need 10 or 12 servings a day to meet their you know their caloric requirements so it really varies with individuals you know and and it's really important to get rid of the refined grains but we also need to recognize that all whole grains are not created equal a granola.

Bar isn't the same as a bowl of oatmeal a box of flaked cereal like wheat flakes does not equal a wheat berry salad for example there is a hierarchy of whole grains and that hierarchy begins with intact whole grains in intact whole grains we're talking about you know grains pretty much as they're picked off the plant you just remove the outer husk like barley and Oak roots and quinoa and and Camus berries and these kinds of things these are these are foods with you know nothing.

Has been added nothing's been taken away everything's there and and as you go down the list then you you cut those grains and then you and then you roll the grains and then you you may Shred the grains and then and then and grind the grains and as you go down the list further you flake the grains and then you pop the grains and as you go down this whole grain hierarchy they're all made with whole grains but as you go down the hierarchy you're increasing.

The surface area of the food you're increasing the rate at which it will be absorbed into the bloodstream you're increasing destruction of nutrients and and valuable components like phytochemicals so as you stick closer to the top top of the hierarchy I mean the best you could do would be sprouting these whole grains because then you're actually enhancing its nutrition profile instead of degrading the nutrition profile so many people think if if they buy something with whole grain on the box or the bag that's all they.

Need to worry about and that's not we want to be eating these Foods as close to as grown as possible uh nuts and seeds we want at least a serving of day a day and you're again your intake would depend on your energy needs and and and whether or not you're you know you're you're on a limited uh diet because you're trying to reverse disease for example um but at least to serving a day because this is your source of Omega-3s you want to when it.

Comes to nuts and seeds go for a variety in Omega-3s so Omega-3s again you're talking Chia flax hemp seeds walnuts um but what a lot of people don't realize is different nuts and seeds feature different nutrients like the the richest sources of vitamin E are almonds and sunflower seeds the richest sources of calcium in the in the nut and Seed world are almonds chia seeds poppy seeds and sesame seeds the best sources of iron and zinc are cashews and and seeds potassium almonds pistachios and pumpkin.

Seeds magnesium Brazil nuts chia seeds pumpkin seeds sesame seeds manganese hazelnuts and pecans selenium Brazil nuts and so you get my point you just want to include variety for that reason and you want to sprinkle a generous amounts of herbs and spices over your Foods these are the foods that have perhaps the most uh the greatest amounts of phytochemicals and antioxidants per gram uh and they can be quite powerful like turmeric for example is it you know powerful antioxidant anti-inflammatory compound and so um just including.

A variety in in your.

Plant-based Diet and Bone Health

Meals is a really good idea and and one of the the things that we can do is to use more ethnic foods in in Asia for example you know they use a lot of turmeric and they use a lot of uh um you know things like garam masala which is a mix of seasonings cumin like black cumin and other cumins that are are really powerful promoters of health and you can even add you know cinnamon and Nutmeg and cloves and things like that to your breakfast.

Bowls and and you can you know use ginger and garlic and and these kinds of foods with a more of an Asian Flair and and so just uh including a wide variety is a key we want to absolutely minimize highly processed foods even if they have a label of vegan or vegetarian or whatever processed foods are processed foods and we want to minimize their intake these are foods without its fat sugar and salt generally not the healthiest choices so we just want to get rid of.

Them we want to choose organic when we can and you know growing Foods in your own garden is really wonderful um but purchasing organic foods is is a really good choice and then we need to ensure reliable sources of all essential nutrients some nutrients can pull through it and we want to make sure we get reliable sources B12 vitamin D iodine and Omega-3s and and if we need supplements especially B12 we need to take them and I think one of the last points I want to.

Make is is parents we need to teach our children and and it is you know our eating patterns are established in childhood and they profoundly impact food choices during adulthood in providing children with nutritious whole plant Foods is a gift that really and truly lasts a lifetime I I you know I I put a lot of emphasis on fruits and vegetables and whole grains and beans and lentils and all of those Foods when my kids were little and they still love those foods and they're they're.

Um you know really important parts of their diet but I just I want to finish with a bit of a story because um when my I can uh you know I have lots of stories about my kids shocking people with what they would eat but I can remember my daughter when she was nine years old walking up the stairs uh from from you know to getting ready for bed and she said Mom can I have a bad time snack and I said sure honey and she.

Said well what can I have I said well take a look in the fridge and see what you find she found a a bunch of fresh spinach and she said oh Mom we have spinach can I cook the spinach and I said Sharon she cooked the spinach and with fresh garlic she got out the garlic chopped the garlic put it in and it was sitting on her plate and she you know chalked up a lemon and and as my six-year-old son's walking up the stairs she's.

Squeezing the lemon on her uh spinach and he looks at her and he says huh is that spinach and she said yes and and he said well well is there any more and she said oh sorry I just ate I'm eating the last back and he burst into tears and I thought who would believe a six-year-old's crying because he can't get any spinach so I said quickly oh we have broccoli we okay and that was it you know and but it's it's often your reaction to.

A food how you treat food what you teach children how you how they you know come along with you to the farmer's market and get to pick the different things growing the foods doing all of those things that instills a love for healthy foods and that is so so important in summary well-designed plant-based diets are the highest quality diets they are nutritionally adequate at every stage of the life cycle and these are some of my books which you may be familiar with and with that I'll.

Say thank you very much and I'll stop my share and take questions all right so thank you so much Brenda for that that very comprehensive presentation though that was great you're very you're very welcome so uh we're gonna go ahead and begin our live q a session and actually just before we do that so you showed your books but where can people get your books major bookstores are available company uh so yeah they're they're pretty widely available okay and how about um people finding you on.

Social media well I am I you know what I would love if anybody would ever want to help me with becoming good at social media but probably I'm most active on Facebook and there's a there's actually a group called the work of Brenda Davis and uh that is a discussion group and and then I have a a basic Facebook Brenda Davis um you know you'll see me there I I'm I I haven't learned to do Instagram even though I have an Instagram account I never go.

There so I need to learn how to do that okay great and um just for our viewers we were just showing um on the screen um that you could actually get your book through our website as well oh wonderful and if you buy it through our website I believe it's Amazon that ultimately is the Bookseller but we'll get a small little portion to help support what we do here at the Village wonderful oh that's the best idea of all all right well I I appreciate that.

So um for the for the sake of the audience um I just want to go over a couple of things things for the uh for the Q a we don't take questions directly from chat what we do is we take questions by raising your hand if you're not familiar with how to do that SEC at the button second from the right is called reactions you'll click on that and then you'll select raise hand and then if I call on you I'll unmute you and ask you.

To state where you're from and to ask your question and then we just ask that questions are brief and on topic and um I have uh again a couple questions that I want to ask you as well so um such as you know so from your work with uh with people with diabetes uh what what foods cause people to have an increase in their blood sugar and what what foods cause them to uh to be able to decrease their blood sugar um you know a lot.

Of people ask this question think that it's really specific Foods uh it is overeating that causes problems with blood sugar and and overeating the worst foods to overeat are refined foods and processed meat those are the worst foods to overeat and any animal products can be problematic but but processed foods refine foods without any fiber those are the foods to be really concerned about but overeating that leads to overweight and obesity can cause fatty liver and cause fat to accumulate even in your pancreas and that.

Literally drives insulin resistance inflam you know anything that causes inflammation oxidative stress dysbiosis uh lipotoxicity all of those things which you know are caused from these highly processed crappy diets can can induce insulin resistance and problems with your blood sugar thank you and um you know we hear a lot of talk in the plant-based World about reversing diabetes through through a plant-based diet can all type 2 diabetes be cured with diet and lifestyle or are some people unable to to lower their blood sugar unable to.

Reverse their their insulin resistance and how and how is it possible to fix any sort of issues with the pancreas the pancreas you know the beta cells producing the the insulin in the first place yeah so this is a a very interesting question now I first of all will say that there are some people with type 2 diabetes that will never be able to completely reverse their disease but there is virtually no one that cannot improve their prognosis and reduce their requirement for medication and and.

And and Insulin we can all do that and so improving the diet there I would say a small percentage of people and it's mainly people who've had diabetes for a very long time that have done a lot of damage to their pancreas that we don't always get and see complete reversal although I've worked with people who have been diabetic for 20 or more years and had complete reversal so it is possible and and it depends on how hardcore you go with your diet so the the.

More sort of Whole Food higher raw um you know little bit this will come as a bit of a shock but sometimes you know focusing not so much on the on the whole grains and and starchy vegetables but more on the leggings and non-starchy vegetables getting sort of a lower caloric intake to reduce that you know what they want to do is re reverse lipotoxicity that takes weight loss and when you reverse lipotoxicity you reverse insulin resistance you want to promote a healthy gut microbiome so.

You want more fiber in your diet you want to reduce inflammation you want to reduce oxidative stress when you do all of those things you start to turn things around and it's not always super fast it can take time but it's faster than what most people would imagine it would be I think now you talked a little bit about how do you you know sort of get your beta cells functioning uh if if you know they're they're not functioning properly well sometimes beta cells there's some.

Studies that suggest that beta cells just go to sleep when when they're you know when there's so much fat being stored in the pancreas and so on that they can actually wake up again in some cases not all cases but in some cases beta cells can reawaken and and we've seen this so so certainly you want to get your diet as clean as it can be you want to reach a healthy body weight you want to be physically active one of the best things we did.

In the Marshall Islands for our um you know for our participants with me get them moving.

Vitamin D: The Sunshine Vitamin

After every meal no sitting after you eat after you eat you move your body that allows your body to you know just use the energy you've eaten so much more efficiently and so that's that's just absolutely critical great um so question um one more question before I I open up to the audience so we just had Pamela popper on before you and um she was talking about vitamin D and our obsession with getting you know our vitamin D levels high in the blood but there's no.

Real research that shows that doing so has an impact on on health and that um that it may be that there's a reverse causation with regard to like when you see somebody is sick and they've got a low D and maybe because they got you know because they're sick that their D went down um are there are there is there any sort of research that you see that goes beyond just showing you know um getting D high in your blood but actually shows you um endpoints.

In health and and life expectancy with regard to raising D levels well probably the most comprehensive uh uh study that I've ever or report that I've ever seen which is over 50 pages what was from Michael holick and and certainly I think there's evidence to show that having vitamin D in you know a specific range the NIH and their health professionals information fact sheet provides their recommended healthy ranges and and to be honest with you I I've actually seen a lot of individuals who are eating.

Vegan get their levels tested and they're they're not just not within that healthy range they are dismal they're they're you know so low it's concerning and and you know part of the issue is there's just not a lot of natural sources of vitamin D in a plant-based diet now some people live in you know Florida or Southern California or Hawaii or whatever and they they may have pretty good access to sunlight year round I don't and so I you know I I need to have um.

A a better you know a certainly a supplement uh especially during the months when I don't get Sunshine but I I think that my in my view the evidence is uh strong enough that I I don't know that we have to even measure our levels to be honest unless you haven't been doing anything for a long time I think what people just need to do is make sure there's a source or take a supplement to to make sure they're getting a source of vitamin D I.

Don't think it's worth risking to be honest uh I think that uh vitamin D you know vegans have a higher incidence of osteoporosis and osteopenia and vitamin D is protective for that it's somewhat protective against colon cancer and some other things so it I I just think it makes sense to to be to be needing at least the RDA for vitamin D and and people have a hard time doing that without a supplement in many cases no in all cases but in many cases thank you.

All right so Rita where are you from what's your question uh this is Rita bhatija from Long Island hi Brenda hi Rita a fellow dietitian beautiful job beautiful job thank you so much uh any thoughts on the digestive enzyme to absorb more protein on on taking digestive enzymes to absorb more proteins yes interesting question I am I I actually don't think it's necessary for most people I think we produce plenty of digestive enzymes people as they get older may be producing somewhat less and I think.

It's an individual thing so for people that that really are uh struggling and possibly for some seniors uh then to me it may actually make sense to try that route um but I'm I haven't seen good studies looking at people taking these enzymes versus those that don't so I think generally we don't have good evidence have you seen uh studies Rita oh well I really haven't looked into the studies but this is as a rule that since the absorption the lowest was 74 you know one.

Of the green group I thought that taking that would definitely will be helpful yeah well it just depends because a lot of times the the protein is is bound in in the food with the fiber and it just goes right through and out the feces and so having more digestive enzymes may help if you're lacking if your production is low but for most people they're producing enough but they're still not going to manage to be able to break down the food well enough it's like nuts.

And seeds they were showing that you know the the calories in nuts and seeds are overestimated because you lose about 25 in your feces because you just don't chew them well enough to break it down so that you can actually extract uh those calories and that happens for all full foods thank you you're welcome okay so can can somebody be overweight and healthy oh such a such a a a good question um what I would say is I think that when you're overweight you're producing more.

Cytokines more inflammatory compounds especially so so really it depends on where your fat is stored so if you're storing a lot of visceral fat in and around your vital organs that obesity or.

Why B12 is a Non-Negotiable Nutrient

Overweight is is far worse than if you're storing it subcutaneously near the surface of your skin but in my view carrying excess fat on your body especially to the level of overweight or obesity uh it it it it increases the it increases insulin resistance it increases inflammatory um uh compound production and it's not ideal there are huge variations in the health of different overweight individuals so some overweight individuals who are eating a really healthy diet they're just eating too much food for their requirements um may.

Actually do very well they they may be physically active they may be getting all the nutrients they need they may be needing a ton of antioxidants they may be fighting that inflammation with all the good things they're bringing in and they may achieve very reasonable Health even though they're overweight compared to an individuals who's overweight who's eating a sad diet there's no comparison we can't lump people who are overweight all in the same category because that's just not fair there there are many people who are.

Eating Whole Food plant-based diet who are carrying excess body fat and some of them are genetically programmed to store calories and they you know you could take 2 two individuals who are eating the exact same diet where the same height and you would think they need the same number of calories at one will be you know underweight and the other will be overweight because of their genetic differences and it's not fair there are some people that are just metabolically efficient and I I I have a.

Friend who's you know not much different in height she's about an inch shorter than me and and she needs probably 500 at least calories a day more than I do she weighs a hundred pounds soaking wet I mean it's just you know it's just not fair but I'm more metabolically efficient than she is and so all we'll eat our salad and then I'll have made some little treats or something for dessert I'll have one and she'll have four and she'll still be skinnier than I am.

And so I think that's something to recognize that sometimes we think well it's our fault we're just oh overweight but but it we're genetically Pro human beings are genetically programmed to store calories and and we have differences in that genetic you know I mean the one advantage that these people would have that we who use calories efficiently have is we'd survive famine way better than they would but unfortunately we live in a society of abundance and there's food everywhere all the time and so it's not.

Easy to you know the average that what 70 percent of Americans are overweight or obese so it's it's it's more unusual to be normal weight than it is to be overweight because we live in an obesogenic environment and so I think it's just important to recognize that and so for someone to achieve a healthy body weight they have to work pretty hard on it and be physically active and not overeat and you know I I have my trick so you know I'm I I make sure.

I eat my just three meals a day I don't eat snacks or at least very rarely do I don't eat after supper I have a good amount of time you know 14 hour kind of fast each night I make my meals you know really relying on vegetables and fruits and with my beans and then a smaller portion of the more carbohydrate concentrated Foods smaller portions of nuts and seeds and and that's how I maintain my weight and I'm very Physically Active I do you know an.

Hour apart before I did this lecture I did an hour of uh spin class uh and so you know I'm I'm very committed to my fitness and so that's not that easy uh for for often when P especially depending on your lifestyle right so I hope that answers the question yes and Brenda our next speaker is going to be a little bit delayed do you mind staying on for a little bit not at all I'm very happy to do that all right good so you started.

Talking about what you eat can you tell us what you eat for lunch and dinner oh only I can even add in breakfast if you like two get one free so yeah so my breakfast is a bowl and my breakfast bowl it consists of whole grains like camo berries and Oak Groats and quinoa with some lentils thrown in and I throw in very small brown lentils that so I get that added fiber and protein into that that bowl and then into that I add either I.

Like something creamy so either be an unsweetened yogurt uh or it'll be a chia pudding that is just homemade you know stock and then uh on that well in that bowl I have fruit and so this morning I had a mango a peach and some blueberries those were my fruits and my bowl oh and a half a banana so I mean this is a big bowl this is not a little bowl and then on that I have a seed mix that I store in the freezer.

That's chia seeds black seeds hemp seeds pumpkin seeds all of that stuff and some chopped up Brazil nuts and that gets sprinkled on top and then on top of that I love something crunchy on top so on top of that I have a dehydrated raw granola that I just love so I do this granola thing and that goes on top and then I use a non-dairy milk and I tend to use soy milk because it's higher in protein and it's you know nicely fortified I sometimes.

Make a homemade uh almond hemp seed milk so.

The Senior Perspective: B12 and Aging

I'll do that as well then lunch is almost always like 90 percent of no 99 of the time is a giant salad so it's a huge huge plater bowl of salad with every color of the rainbow and then I always include a source of protein so it will either be little cubes of baked tofu or it'll be Bean or both sometimes I make a mix of some sort of whole grain and lentil or something like that that'll go on top and then uh so there's uh.

You know the project and then there's some sort of carbohydrate so it'll be quinoa or or steamed sweet potatoes or something so it's a really complete meal and then I often put a little bit of fruit because I like to have you know Apple pieces or berries or mangoes or something like that on it and then I put some seeds so dehydrated sunflower pumpkin seeds and then my my dressing is usually a hemp seed dressing uh with tahini and hemp seeds and and then that goes.

On top maybe a little balsamic vinegar on top of that and that's my lunch I always have an orange after lunch that's my little dessert if you will because it helps with the absorption of everything and so that and then dinner well it just depends what season it is what you know but it will often be something like a you know one of my favorite dinners is a bowl again you know start with a grain or sweet potato and then steamed vegetables and then some sort.

Of beans or whatever with some nice spicy peanut sauce or something on top but other favorite meals are stews and soups with you know some sort of salad that it go with them um I love um you know these uh um uh collared wraps and you know there's all that kind of stuff as well uh and and I and sometimes they do very traditional meals like a lentil nut loaf with you know potatoes and and two or three vegetables and I make a mushroom gravy and.

That kind of stuff so yeah that's how I eat if anyone doubts that you know so you know you can you can't eat a plant-based diet and love what you eat I think you've just disproved that I love what I eat I can tell I can tell so um all right let me let me get one more question and I think we actually may be ready so let me get one more question I want to confirm that in the background so I'm just gonna um go.

To uh Laura where are you from and what is your question hang on am I off am I muted no you're good you can speak we hear you okay okay California and I am is how absorbable is the calcium from almonds and then also what is there any tea that wouldn't interfere with calcium absorption like maybe hibiscus or some other tea that you can drink with a meal yeah so too uh really really good questions uh the first question um uh to do with calcium and.

Almonds in the absorption I believe it's about 21 percent however what I do with my almonds is I soak them for a good day as so can and and and then I dehydrate them and that soaking is going to increase the bioavailability of the minerals so and and I don't think I've ever seen a study that has assessed the bioavailability of the soaked nuts versus the you know the the raw unsoaked nuts but I am positive it would be better uh and I absolutely love just.

Eating the soaked nuts sometimes I just soak them and put them in the fridge like that it's almost got a kind of coconutty feel um but but soaking and dehydrating is a good way to further improve so almonds are considered you know the calcium is considered sort of moderately bioavailable from almonds just like sesame seeds I guess you assessments is probably even a little lower um and then the second question with regards to T I would actually have to look it up look up the the.

Amounts of polyethanol compounds and all the herbal teas so definitely black tea and green tea are high and you wouldn't want to include those but there are a number of herbal teas that that would be quite and actually I could even um but just do a search low polyphenolic herbal teas and you'll come up with a number of of um of options because there's so many herbal teas uh well probably [Music] only anyway uh but just do that search and you'll you'll you'll come up with.

Some good ones let's see 10 oh no what teas are low in polyphenols there I go um yeah they're just showing their their all high they're not they're just.

Your Health is Individual: The Power of Baseline Testing

looking at green teas and all of that but oh there’s a there’s an article on polyphenol content of all of the different teas so you can definitely find some good articles that way great well Brenda thank you so much for your time and all the information that you shared with us and your enthusiasm is very contagious so oh thank you and and can I just answer one other I just saw something come up in the chat that’s important some some folks are thinking they might need to start taking a thousand micrograms of B12 a day because of what I said and I think before you do that get your B12 levels tested because some people do fine on 500 I myself am

64. and I um you know I eat some fortified foods and I use nutritional

yeast so I only take the 12 twice a week and and so if you’re using some fortified foods like that you may not need to take it every day even as a senior but but if you get your levels tested and know your Baseline that’ll be really helpful my writing partner besant is 81 and her level she discovered was actually really hot so she she actually pulled back a little bit so it’s really a little bit individual right and if we could unmute the audience please so they can all thank you and and thank you thank you that’s so nice thank you that’s a really nice fuzzy feeling so thank you so much thank you [Music]