Is a plant-based diet complete? Dr. Conor Kerley PhD, BSc, H. Dip, MINDI

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1 Is a plant-based diet complete? Dr. Conor Kerley PhD, BSc, H. Dip, MINDI

2 For the socialites Twitter Facebook

3 Conor Kerley PhD, BSc, H. Dip, MINDI Graduated from Trinity College, Dublin in Human Nutrition and Dietetics in 2010 PhD with the UCD School of Medicine and Medical Sciences Worked at many hospitals and universities An active member of several professional societies, including the INDI, Nutrition Society, Irish BP Council Lecturer in DIT Content manager at T. Colin Campbell Center for Nutrition Studies

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12 Insufficient micronutrient intake has short term and long term implications for disease risk E.g. immune function is adversely affected by poor intakes of nearly every essential vitamin and mineral 1

13 Inadequate micronutrient intake: Short term Long term Increased risk of infection Increased risk of heart disease Increased risk of cancer

14 Nutrients and plant based nutrition

15 Talk outline 1. Components not found in plant foods 2. Nutrients of concern on plant based diets 3. Nutrients of abundance on plant based diets

16 Components not found in plant foods

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18 Cholesterol Vitamin A Vitamin D 3 Vitamin B12

19 Cholesterol

20 Essential to humans Cholesterol Human cell walls and some hormones made of cholesterol! e.g. testosterone estrogens vitamin D

21 Cholesterol Found in every single animal based food Not found in any plant based food

22 Cholesterol Made by our liver à no dietary need!!! Dietary cholesterol may be unhealthy!

23 Vitamin A

24 Vitamin A Important for: Bone growth, Cell division & differentiation, Immunity

25 Vitamin A Deficiency Total or night blindness à Very rare in the developed world! May: increase infection risk; decrease growth rate; slow bone development; àvery rare in the developed world!

26 Vitamin A

27 β-carotene

28 Too much vitamin A!? Impairs the effect of vitamin D 1 Consumption of moderate amounts of retinol may cause bone toxicity 2 In developed countries, vitamin A toxicity is much more common than vitamin A deficiency 3

29 Too much vitamin A!? Impairs the effect of vitamin D 1 Consumption of moderate amounts of retinol may cause bone toxicity 2 In developed countries, vitamin A toxicity is much more common than vitamin A deficiency 3 Excess vitamin A increases mortality by 16% 4

30 Vitamin A toxicity Reduced bone mineral density; Birth defects, Liver abnormalities, Central nervous system disorders à pregnant women shouldn t eat liver!

31 Can t get too much β-carotene!

32 Vitamin D

33 Vitamin D Maintenance of normal blood levels of calcium and phosphorus; Promotes bone mineralization; Regulates cell growth & differentiation, Immune function

34 D 2 vs. D 3 Vitamin D 2 (Ergocalciferol) n Made commercially by irradiating & purifying ergosterol extracted from yeast n UV irradiated mushrooms Less effective than D Vitamin D 3 (cholecalciferol) n Produced in the skin on exposure to UVB radiation from sunlight n Animal foods/certain supplements Substantially more potent than D 2 11,12 Less bioavailabiltiy, poorer stability & shorter duration of action 9,10

35 2500 Vitamin D Sources Swiss cheese (28g) Beef liver Whole egg Fortified cereal Fortified margarine Fortified milk Tinned sardines Cooked mackerel Cooked salmon RDA Supplement

36 Vitamin D Sources

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38 Kerley s Rule! Shadow must be shorter than your body for vitamin D production! conorkerley@gmail.com

39 Kerley s Rule! Shadow must be shorter than your body for vitamin D production! conorkerley@gmail.com

40 In Winter No sun in Ireland/UK etc. = no vitamin D production Can be a good idea to supplement e.g. 1,000iu vitamin D per day

41 Vitamin B12

42 Vitamin B12 Blood formation Neurologic function

43 Vitamin B12 Not made by humans or plants or animals! Made by micro-organisms found in soil or intestines including human intestines!

44 Vegans & vegetarians USA UK 60% 13 52% 14 Had B12 deficiency

45 Vitamin B12 No reliable natural plant source of vitamin B12! Need to ensure a steady supply Regularly eat foods fortified with B12 e.g. soy, cereal etc. Supplement on a daily or weekly basis

46 Other nutrients of concern on plant based diets

47 Other nutrients of concern in plant based diets Calcium Iodine Iron Zinc N-3 fatty acids Protein

48 Calcium

49 Component of teeth and bones; Blood vessel, Muscle function, Nerve function

50 Calcium Green veg: broccoli, bok choy, kale, collard greens Beans soybeans, chickpeas, pinto beans Sesame seeds Tofu Oranges, berries, apricots, figs, dates Fortified plant milks, cereals etc.

51 Calcium Compared to those eating an omnivorous diet there is Some evidence: that those eating plant based diets need less calcium those eating plant based diets have healthy bones

52 Bone health

53 Iodine

54 Iodine Component of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) Helps regulates metabolism

55 Iodine deficiency Mental retardation, goiter, cretinism, Too much & too little iodine affect thyroid function and metabolism

56 Iodine Found in the sea! à Grown in or near the sea contains iodine: Seaweed Iodine salt Kelp supplements * Iodine supplements (esp pregnancy)

57 Iron

58 Iron Heme proteins Component of enzymes necessary for metabolism

59 Iron deficiency à iron deficiency anaemia à physical and mental fatigue

60 Heme iron Non heme iron

61 Heme iron Non heme iron

62 Iron No route for excretion once absorbed

63 Some meat eating populations may have iron stores far in excess of those needed for health 15 Among elderly participants in the Framingham Heart Study, 13% had high iron stores, while approximately 3% were iron deficiency 16! à higher risk of heart disease, cancer & diabetes 16

64 Iron High heme intake is associated with increased risk of several cancers, including colorectal cancer, pancreatic cancer and lung cancer 17

65 Iron High heme intake is associated with increased risk of several cancers, including colorectal cancer, pancreatic cancer and lung cancer. Likewise, the evidence for increased risks of type-2 diabetes and coronary heart disease associated with high heme intake is compelling 17

66 Iron Lower absorption of iron from plant based foods may be one reason why those on a plant based diets have health advantages!

67 Zinc Component of enzymes Anti oxidant Deficiency: Growth retardation, Hair loss, diarrhea, impotence, eye and skin lesions, loss of appetite, delayed wound healing

68 Zinc Beans, Grains, Nuts, Seeds

69 Those with or at risk of iron or zinc deficiency Phytates are present in some plant foods & can inhibit absorption minerals Vitamin C increases absorption Avoidance of tea, coffee with foods Garlic & onion can increase of absorption from plant foods

70 Essential fatty acids

71 Humans can make fat from any calorie source! 2 essential fatty acids cannot be made in the body and must be eaten These 2 fatty acids: linolenic and linoleic acids are used to build specialized fats called omega 3 & omega 6

72 Omega 3 and omega 6 fatty acids are important! à normal functioning of all tissues of the body Deficiencies cause: Liver & kidney abnormalities Blood changes decreased immune function, Depression, skin changes Adequate intake of the essential fatty acids results in numerous health benefits: Less: heart disease, cancer, autoimmune disease

73 Short vs. long chain essential fatty acids

74 Omega 6 Leafy vegetables, Seeds, Nuts, Grains, Vegetable oils Flaxseed, Chia seeds, Omega 3 Hemp seeds, Walnut, Wheat germ, Soybean

75 Long chain fatty acid Only short chain fatty acids are present in plant foods, Humans can make long chain fatty acids! But... The rate varies and is unpredictable à vegans commonly have lower circulating levels of long chain fatty acids than non-vegans

76 Omega 3 Ensure a regular supply of essential fatty acids Consider supplementing: Algae based DHA & EPA Some seaweeds

77 Protein!

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79 Protein Important for: Growth and repair of tissue including muscle & bone Immune system

80 Protein

81 There are 20 amino acids 11 non-essential amino acids 9 essential amino acids

82 Protein In general: Vegetable In general: Animal Incomplete or low quality protein Complete or high quality protein 1 or more amino acid is lower than others Contains contain all essential amino acids in equal amounts

83 Protein combining? Example: Grains lack 1 amino acid (lysine) Beans lack 1 amino acid (methionine) à Combine grains & brans at meals to provide complete protein!?

84 Plant protein can meet requirements when a variety of plant foods is consumed and energy needs are met. Research indicates that an assortment of plant foods eaten over the course of a day can provide all essential amino acids and ensure adequate nitrogen retention and use in healthy adults thus complementary proteins do not need to be consumed at the same meal

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88 Nutrients of abundance on plant based diets

89 Phytochemicals Antioxidants (e.g. Vitamin C, Vitamin E) Fiber Potassium Magnesium Folate (natural form of folic acid) Nitrate

90 Phytochemicals Nonvitamin, nonmineral antioxidants responsible for the majority of antioxidant effects 18 Populations eating greater amounts of phytochemical containing foods (eg, fruits, vegetables, whole grains) have a significantly lower: heart disease cancer, diabetes High blood pressure arthritis Early death 19-21

91 Antioxidants

92 Oxidation

93 The antioxidant content of foods varies several thousand-fold Diets comprised mainly of animal based foods are low in antioxidants Diets based mainly on a variety of plant-based foods are antioxidant rich, due to the thousands of bioactive antioxidant phytochemicals found in plants

94 Fiber

95 Roughage provides bulk in the intestines Keeps you fuller for longer Maintain steady blood sugar levels Decreases cholesterol levels Feeds intestinal bacteria

96 If you pass small stools, you have to have large hospitals

97 Where do we find fiber?

98 Fiber Found in no animal foods Food in all plant foods!

99 Potassium crucial to heart function plays a key role muscle contraction important for normal digestive and muscular function

100 Potassium 2% of US adults met recommendations for potassium

101 Sources of potassium Beans, Leafy green veg, Potatoes, Squash, Avocados, Mushrooms, Bananas

102 Magnesium Helps to maintain normal nerve function, Helps to maintain normal muscle function, Supports the immune system Aids bone strength

103 Sources of magnesium Whole grain Leafy green veg Legumes Nuts

104 Folate (folic acid) Heart heart Blood health Nervous system health

105 Folate in foods Folate per 100g Folic acid supplement Pepper Leaks Spinach Asparagus Avocado Chick peas Peanuts Sunflower seeds

106 Dietary nitrate Only found in some vegetables Inside the body converts to a gas Decreases blood pressure Increase blood flow e.g. to brain Increases exercise tolerance

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108 Should I take supplements?

109 As much as possible nutrients should be eaten as food not swallowed as supplements!

110 The China Study P. 227

111 Exceptions Vitamin B12 Vitamin D 3 Long chain fatty acids e.g. DHA

112 Plant based with care Pregnant Breast-feeding Babies Adolescents Elderly

113 Pregnancy

114 Eating for 2!?

115 Eating for 2!?

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117 Extra Calories Nutrients?

118 Pregnancy Folic acid (folate) Iron Calcium B12 Iodine Vitamin D Consider omega-3

119 Yes! Pregnancy: extra nutrients?

120 Pregnancy Folic acid (folate) Iron Calcium B12 Iodine Vitamin D Consider omega-3 *Of concern for all pregnancies!

121 Pregnancy Growing baby gets most nourishment from mum through the umbilical cord So Mam usually suffers before baby But

122 Pregnancy Growing baby gets moist nourishment from mum through the umbilical cord So Mam usually suffers before baby But If mum is lacking in any vitamins and nutrients her baby might lack them too.

123 Eat or avoid? Pregnancy: nuts

124 Pregnancy: nuts Eat or avoid?

125 Older adults Exercise Fiber Protein (legumes, nuts, seeds, soy, tofu etc.) B12 Iron Calcium Vitamin D *Of concern for all older adults!

126 Tips Consider small, regular meals If struggling with appetite, weight add extra nuts/seeds/tofu Consider using refined carbs are opposed to higher fiber carbs

127 It is the position of the Academy of Nutrition and Dietetics that appropriately planned vegetarian, including vegan, diets are healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of certain diseases.

128 These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes.

129 Plant-based diets are more environmentally sustainable than diets rich in animal products because they use fewer natural resources and are associated with much less environmental damage.

130 Vegetarians and vegans are at reduced risk of certain health conditions, including ischemic heart disease, type 2 diabetes, hypertension, certain types of cancer, and obesity.

131 Summary Enjoy a wide variety of whole plant foods Focus on: Veg Fruit Legumes Whole grains Add some nuts & seeds Always ensure a steady & reliable course of vitamin B12 Consider omega 3, vitamin D & iodine

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134 Before you make any major lifestyle changes speak to a healthcare professional!

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