Vegan Nutrition: What Does the Science Say?

[UltraVid id=163 ]This program is brought to you by the vegetarian Society of Hawaii a nonprofit organization dedicated to sharing with the community the many benefits of a vegetarian diet free monthly meetings include vegetarian experts and locally and on the mainland quick and easy cooking demonstrations and healthful and delicious food samples members enjoy an informative portal e-newsletter social activities and discounted mini vegetarian friendly restaurants and health food stores for an application call nine four four eight three four four that’s nine four four eight three four four or visit our website at WWE sh org VSH org we’d like to let you know that the vegetarian society of hawaii will be celebrating its 20th anniversary during the coming year from a handful of pioneering founders back in nineteen ninety two becoming one of the largest vegetarian organizations in the nation we’ve continued to promote health animal rights and protection of the environment by means of vegetarian education we hope you enjoy this evenings lecture and we hope that everyone will take a look at our free literature table if you’re not a member we’d like to encourage you to join tonight the discounts you’ll get from the vegetarian friendly restaurants and natural food store is down such as down to earth will more than pay for your membership and you’ll receive an informative newsletter as well your membership dues and donations including any you may have made tonight as you came in and thank you very much for that help to make possible events like this and you’ll also be helping to promote a healthful and compassionate lifestyle for people in Hawaii and throughout the world the refreshments tonight are courtesy of down-to-earth natural foods we hope you’ll stay after the talk and enjoy some of these delicious vegan refreshments tonight’s lecture is being video taped for broadcast on the V SH weekly TV series vegetarian on Oahu the program airs on Thursdays at 6 p.m. on llo channel 52 we also welcome you to view many of our previous lectures online at our website vs hor RG where you’ll find a wealth of information and resources tonight’s lecture will be added to the website soon it is now time for a special guest we’re delighted to have with us tonight Jack Norris Rd mr. Norris co-founded vegan outreach in 1993 and is currently the president vegan outreach produces the booklet why vegan among many others and has distributed over 10 million copies to date Jack runs vegan outreaches adopt a college program which has directly handed a vegan outreach brochure to over 3 million students since its started in the fall of 2003 Jack is a registered dietitian he earned a Bachelor of Science degree in nutrition and dietetics from the life in university in Marietta Georgia and 2000 and performed a Dietetic internship at Georgia State University in 2002 2001 jack is the author of vitamin b12 are you getting it staying healthy on plant-based diets and other health articles found at vegan health org and Jack NARS are decom this evening mr. Norris will present vegan nutrition what does the science say please welcome Jack Norris [Applause] then thank you very much Lorraine thank you to the Hawaiian vegetarian society for having me here I’ve only been to ye one other time and it’s just really amazing it’s hard to believe people get to live here year-round I was also invited by the northern Michigan vegetarian society to speak this weekend and I I think I chose wisely okay so my talk tonight is what does the science say before I get into it too much I want to say a few things about vegan outreach this is our website vegan outreach org and we have a free weekly e-newsletter that comes out every Wednesday if you’re interested in signing up for it you can just click right here if you go to our website and it gives a lot of updates on what’s happening in the vegan world so please do that if you’re interested what vegan outreach is most known for is our pamphlet why vegan which we distribute and we also have a few other booklets that are very similar to it but have a slightly different tone and we deliver as lorraine mentioned we hand them out to college students in the last couple years we’ve been giving handing about five hundred thousand to college students every semester at over 500 colleges normally I asked them to pass out this and this booklet a meaningful life I don’t know if everyone got one but if you didn’t please grab one at the table over there if you’re interested it’s about the vegan outreach philosophy of activism and veganism and that sort of thing and gives you tips on how to deal with family and friends if you’re having problems with them what you can do to help animals if you’re interested we also have an expanded version of this pamphlet by written by my co-founder of vegan outreach Matt ball along with Bruce Friedrich of People for the Ethical Treatment of Animals and this book is just $10 on our website if you’re interested a lot of people have that have read it said that it has really helped them deal with family and friends again and activism finally I have this guide to cruelty free eating which I has in it article called staying healthy on plant-based diets it follows along with my talk to a large extent and it lists all the nutrition recommendations I’m going to give with one small exception which I will point out when I get to it so you don’t need to write anything down so what I want to do is examine the role of vegetarian diets and preventing chronic disease as it’s been measured in studies looking directly at vegetarians and in review the nutritional concerns of vegan diets especially but also to some extent at lacto-ovo vegetarian diets so the way that we have a lot of information about lacto-ovo vegetarians and vegans is through five large cohort studies that have been performed on them and a cohort study means that you get a group of people together generally healthy people with different diets and then you follow them over time you measure the diet every few years that they’re eating to make sure they’re still eating the same diet and then you see what sort of disease incidences they have and then compare them to each other and that’s really I think the one of the best ways anyway we have to determine what a vegetarian diet actually does for you and what it doesn’t a number of these studies were finished around the year 2000 and before but right now epic Oxford and Adventist Health – these two bottoms studies are currently ongoing up through this study Oxford vegetarian there were only a total of 760 vegans studied but epic Oxford has 2,000 and Adventist too has 3,000 and that’s going to be a lot more helpful in getting information about vegans than what we have had so far the first bit of information that we got on vegetarian mortality was in 1999 there was a meta-analysis released looking at the combined results of the top four or was it five studies I had shown on the previous slide and it showed that vegetarians had 24 percent less heart disease and regular meat-eaters it also showed that vegans had 26 percent less heart disease than regular meat-eaters in other words people we meet more than one times a week one time a week but that finding was not statistically significant meaning that it could have been due to random chance but it was a trend very similar to the larger group of vegetarians so there’s I think good reason to think that it was a fairly accurate view of a vegan diet but we will find out soon when more research comes out on vegan diets the vegetarians had the same rates of cancer and total mortality as the non vegetarians which was a somewhat disappointing result that’s into some instant that to be possible due to just not having enough people or following them for long enough time because it takes a great deal a very high number of people to find statistically significant results for cancer it’s just a lot less common than heart disease what they did in these studies though is they perform what’s called standardized mortality rates in which they compared the overall population which was all the vegetarians all the vegans all the meat-eaters to the greater population what happens often is it healthier people volunteer for studies and in this case they found out that this was true that the the people in these studies overall had only half the rate of mortality and that is deaths before the age of 90 then the greater population so these were very healthy people and so the vegetarians having the same rates of cancer that was compared to people with somewhat low rates of cancer now the Adventist Health Study and one reason that it seventh-day Adventists are studied is that they promote vegetarianism to their members and a large proportion of them are vegetarian and I think more recently are becoming vegan and the good thing about it is that they have very low rates of smoking and alcohol consumption so you can kind of weed out that variable more easily and see what difference is the diet making because they have such similar lifestyles and not just the drinking and smoking but in other ways also we found that the vegetarian women live two-and-a-half years longer and the vegetarian men lived three years longer among these Adventists hypertension and diabetes was 50% less for the vegetarians and rheumatoid arthritis was 25% less now I’m going to talk a little bit about disease markers and these studies are cross-sectional which means that it was just a slice in time at what these vegetarians cholesterol levels were in other words they didn’t follow people over time to see what happened in their cholesterol levels but in any case what I did was I took all the studies from 1980 through 2003 and I did this back in 2003 it measured vegans cholesterol levels and I averaged them all out in V is non vegetarians the number here is how many were these are people who eat no meat except for fish these are lacto-ovo vegetarians and we found that the vegans had a cholesterol level of 160 compared to 185 and then 202 for the non-vegetarian so they’re doing vegans obviously or having having a much lower level of cholesterol and the big difference was in the LDL cholesterol LDL is the bad cholesterol and the HDL is thought to be good cholesterol and the 50 you want a higher HDL and the vegans had a lower but what’s most important is the total cholesterol ratio to HDL on you sub t and that was 3.14 the vegans vs. 3.7 for the non vegetarians which was a good finding so there’s nothing to worry about that the vegans had a lower HDL cholesterol the vegans also had a lower triglyceride level which was an interesting finding because if you listen to a lot of the people that promote low carbohydrate diets they say that low-carb oh that high carbohydrate diets raise triglyceride levels and in some controlled studies that is true but among free living vegans we can see that it actually isn’t so one only one study has looked at the percentage of vegans with high blood pressure compared to other groups and it found that for men only 6% of the vegans had high blood pressure versus 15% for the non vegetarians and the women had a similar finding with 8% vs. 12% so that was a good finding that was statistically significant in the last few years anyway there’s been two large studies done on body mass index body mass index is a measurement of weight in relation to height and it gives you an estimate of whether someone is too heavy or not but it can be influenced by someone who’s very muscular which could throw off the results but generally that hasn’t been a problem for these studies it all averages out what has been traditionally thought is that a BMI between 20 and 25 is the most healthy a BMI above of 25 to 30 is considered overweight and then over 30 is considered obese and more recently there’s been a theory that maybe people with a BMI below 22.5 and then especially below 20 that may not be a good thing necessarily because of their lower fat free mass in the past we’ve always known that people with BM is less than 20 had higher rates of mortality but it was always thought to be due to undiagnosed disease and smoking related diseases that were not found upon entry into these studies but they’re actually finding that as they they measure for these variables the finding doesn’t go away so and the reason I bring that up is it I think in the vegan movement we often have an idea that there’s no way to get too thin I mean there’s course you can get extremely extremely to thin that that we would agree is not good but generally there’s no way to and I think that maybe we need to rethink that a bit and see if maybe I think especially maybe a little bit higher protein might help increase the fat free mass of some vegans so that we’re not too thin but these are I think somewhat preliminary findings it’s been studied a lot but it takes a lot of studies to really find conclusive evidence of these things anyway the vegan BMI and this Venice hall study – is right in the middle of what’s considered healthy and the non-vegetarian was in the overweight range and the lacto-vegetarian was actually in the over eight weight range as well which is the first time I’d ever seen that in a study but that’s the most recent findings and then this other one the the other largest study in recent years was epic Oxford in 2003 and they had a similar finding with the vegans right in the middle of a healthy BMI and the non vegetarians on average significantly higher they’re not overweight in this case okay then there was one cross-sectional study that has looked at type-2 rates of type 2 diabetes and vegans and this was a very good finding and not a surprising one at all but it was the first time it was actually measured I think we fought for years at a vegan diet has been a way to prevent type 2 diabetes and there have been studies by PCRM treating people with type 2 diabetes with a vegan diet that have been very effective but it hasn’t been looked at in terms of preventive this was just released this year and they found that they actually broke it down and even further diet groups and normal so we’ve got the vegan lacto-ovo fish eaters and then semi vegetarians which are people who eat meat more than once a month but less than once a week and then the non vegetarians eat meat weekly or more I have two findings up here the first one the top ratio was when they adjusted for the body mass index and when they did that they found that vegans had 50% as much type 2 diabetes as non vegetarians but I don’t think I think it was good that they did that adjustment but I think a more accurate adjustment of what the vegan diet can do for you is the adjustment for without the BMI because the vegan diet probably does influence body mass index so if you if you take out the adjustment for the BMI the vegans had only 30% of the type 2 diabetes as non vegetarians basically vegans have very low rates of type 2 diabetes and the cross-sectional study it’ll be interesting to see if we we find that when following vegans over time as well which I won’t be surprised if we do I certainly hope so okay so in terms of looking at cancer there have been a number of studies that have compared rates of lacto-ovo vegetarians to meat-eaters and just recently in 2009 epic the the epic Oxford study released a findings about vegetarians which included vegans and lacto-ovo vegetarians compared to people who only eat fish I’m sorry people who don’t eat meat except for fish compared to regular meat-eaters and they found that the vegetarians and the fish eaters had about 80 percent of the the overall cancer rates as the regular meat-eaters although you can’t say that they had necessarily lower rates than meat-eaters be since fish is meat and the fish eaters also had low rates the top part was that other three other studies have compared all cancer rather than breaking it down into separate types of cancer in vegetarians compared to meat-eaters and they found no difference and the results as for prostate cancer one study has found lower rates and vegetarians three studies have found no difference between the two diet groups in colorectal cancer it was lower in vegetarians in one study and another study it was lower in people who’ve been vegetarian for more than 20 years but no different for current vegetarians and then in three other studies that were no difference there were no studies that showed higher rates of colorectal cancer for vegetarians okay for breast cancer there were five studies that have shown no difference and one study has shown higher rates of breast cancer it was not it did not adjust for having no children and women who have not had children are at a higher risk for breast cancer so that could be part of the reason that this was found and also vegetarians tend to have less children than non-vegetarians so that could explain some of it and the finding was barely significant so I don’t think it’s anything to worry about at all and certainly five studies have not found a difference lung cancer there’s been seven studies that have looked at it and there’s been no difference and then there have been other studies that have looked at it’s smaller less common types of cancer and they’ve been there just hasn’t been enough really to report here so to sum up what I’ve just been talking about in the words of the American Dietetic Association that just released another position paper on vegetarian diets in 2009 they are the most mainstream nutrition body in the United States and possibly the world and they and you know endorse to some extent they don’t tell people that they should go vegetarian but they certainly have a positive position on it and they say that a vegetarian diet can help prevent disease as this top paragraph says and then they say that a well-planned vegetarian diet including a vegan diet are appropriate for individuals during all stages of the lifecycle including pregnancy lactation infancy childhood and adolescence as well as for athletes so if people tell you that you can’t be vegetarian and I still hear that pretty frequently you can point to the American Dietetic Association x’ position okay so now I’m going to talk about some of the nutritional concerns of vegans and lacto-ovo vegetarians in this case of its vitamin b12 is the most important one and it is mostly for vegans although some lacto-ovo vegetarians don’t have the greatest vitamin b12 levels anyone who eats the few animal products you eat the more important vitamin b12 becomes so it’s not just for people who are strictly vegan ok so plant foods do not naturally contain vitamin b12 and that’s why it’s an issue for vegans and there are two types of b12 deficiency one is what I call overt b12 deficiency and that is when you develop your b12 levels get extremely low you develop nerve and blood problems you’ll get a macrocytic anemia you can start developing tingling in your fingers and toes and if you don’t catch it and do something about it you can become it can lead to death actually eventually can often be caught once you have tingling in the fingers and toes it can be reversed and there will be no permanent damage but the longer you let it go the more likely it is to cause permanent damage so it’s not something to mess with and I will get more into it in a second about how to prevent any problems then the other type of vitamin b12 deficiency which we’ve just started learning about in this decade the year 2000 is when these papers started coming out that have shown that vegans have had high levels of homocysteine homless cysteine is thought to be toxic to nerves and blood vessels and it is a byproduct of methionine metabolism which is an amino acid that’s it found commonly in proteins what happens is that if you don’t have enough b12 your body can’t get rid of the homocysteine and high levels of homocysteine have been linked to heart disease stroke Alzheimer’s disease and early death now I don’t think that it is well it has not been conclusively proven that homicidal IED but they all pretty much show the same thing these are vegans who do not supplement for the most part and you can see that the vegan b12 levels are all lower than the NAM than the vegetarians and non-vegetarians now that’s nothing surprising at all we’ve always known that the vegans who don’t supplement are gonna have lower b12 levels but if you look at home with cysteine levels in these same people you will see that the vegans have much higher homocysteine levels whereas the lacto-ovo vegetarians have have the next highest and the non vegetarians have the lowest now a home is cysteine level above 10 to 15 is where you start getting associated with this disease I mentioned earlier and then above 15 is really where there is a concern here is a study in 1998 in which people were supplementing with vitamin b12 and the vegans and here is a study from 98 where the vegans were taking vitamin b12 in a study from 99 where the vegans were taking vitamin b12 and you can see that their homocysteine levels are very well within the healthy range which is like 4 to 8 4 is extremely low it’s pretty I don’t it’s pretty hard to get lower than 4 so all you have to do is take vitamin b12 and your homocysteine levels should be fine okay so there’s a number of myths about what foods contain vitamin b12 and the reason that these miss exists to some extent some some of it is just people making things up but another thing is that the way that you measure vitamin b12 and animal products is using a measure that’s appropriate for animal products because animal products contain mostly active vitamin b12 but there are a lot of molecules that are very similar to vitamin b12 that are not active for humans and these measurements cannot discern between them very well and so what happens is that the companies use these crude methods to to measure their plant products and what they are often finding and many times is inactive vitamin b12 analogs but they still promote their food is having vitamin b12 because it’s it’s like there’s no regulation telling them they can’t do it some of the things that cannot be relied upon blue-green algae which include spirulina and super blue-green algae which is distributed by cell tech multi-level marketing company you may have heard of it I’m not sure and then seaweeds like nori and chlorella they cannot be relied on for vitamin b12 fermented foods like tempeh now in some countries tempeh starter may be contaminated with vitamin b12 producing bacteria and that is how b12 is made by bacteria but the temp the starter for tempeh does not require those bacteria so it’s also very easy to have tempeh without such bacterial bacteria and so if there is vitamin b12 in any tempeh it’s from contamination now none of the tempeh is in the US have ever found any inactive or active vitamin b12 analogues and tempeh but in some foreign countries they have found some at least vitamin b12 analogues so they’ve never really been tested to determine tested accurately to determine whether they were active or inactive brewers yeast and unfortified nutritional yeast they do not they cannot be relied upon for vitamin b12 fortified nutritionally scan organic foods in intestinal bacteria also can’t be relied upon okay so here’s my suggestions for vitamin b12 either take 3 to 5 micrograms a day from fortified foods in at least two servings per day your body can only absorb so much b12 at once in small amounts such as three to five micrograms once you get into a little bit higher amounts like 10 to 100 micrograms you can take just one a day or a thousand micrograms twice a week to dwell is another way to get enough vitamin b12 and so that there’s basically two ways that your body absorbs b12 one is through a system where proteins pick up the b12 and they transport it for you into your bloodstream and then there’s another way of just overwhelming your cell membranes with vitamin b12 and some of it just passively gets through into your blood and that’s why you can get it from such large doses okay so the next thing is omega-3 fatty acids so there are short chain Omega 3s and long chain Omega 3s and the plant omega-3s which are which is called ala or alpha linolenic acid found in flax seeds walnuts can all nm seeds and chia and a few other other foods that are not as common they need to be converted into longer chain omega-3s by your body in order to become the EPA and DHA that you find in fish the fish get it from seaweed and so you can also get EPA and DHA from seaweed and in like the last year and a half I think there is a company now that is has a has a vegan EPA on the market and there has been vegan DHA supplements for quite a number of years now and that are made from seaweed what these omega-3s do is they reduce inflammation blood clotting and cholesterol levels and DHA in particular prevents depression or another way to say that is if you get too low in DHA you could become depressed the problem unfortunately is that your body has to convert them and some people’s bodies do to convert them very efficiently okay so then one other thing about conversion is that DHA can be converted into EPA and so because of this I’ve changed my recommendations recently and since that guy do cruelty-free eating was put out to suggest that vegans should probably take a DHA supplement on a somewhat regular basis just to make sure you’re getting it and the older you get the less efficient your body is at converting these so it’s more important for older people probably to do this I’m going to get a little into that a little bit more in a second but the other there’s another side to this coin of omega-3s and that is omega sixes and I’m sorry this chart is somewhat complicated but I will just want to show it because it illustrates why it’s important to reduce omega-6 fatty acids and omega-6 fatty acids are very common in plant oils like I just talked about what plants have omega-3s and they were fairly obscure plant foods that people are knocking a whole lot of picks up for walnuts but omega sixes are found in just about all plant oils and vegans tend to get very high amounts of omega-6 a good ratio of omega-3 to omega-6 is one to four and vegans tend to be above 1 to 10 on all the way to 1 to 15 in some studies now the reason that this is a problem is that the same enzyme that converts the the short chain omega-3 to the long-chain omega-3s is the same enzyme that converts short chain omega-6 is to long chain Omega sixes and up here is the Magus threes getting converted and down here is the mega mega sixes and this is the enzyme doing it and if you overwhelm this enzyme with omega-6 then it can’t convert the omega-3 so it’s important that vegans reduce their intake of omega sixes as well as increase their intake of omega-3s so these are my recommendations for omega-3s as 2 to 300 milligrams of DHA per day I don’t think it’s necessary to do that every single day or to be the evidence isn’t overwhelming that vegans must do this every day but I think it’s a good idea to do so then avoid omega-6 which is corn soy safflower sunflower anything called vegetable oil as well as sesame oil instead use olive peanut avocado or canola oil which are low in omega-6 is only cook canola oil under low heat for short periods because he does damage omega-3s the good thing about canola is and I know there’s some bad things about it iron mentally but the good thing about is it’s high in monounsaturated fats and it’s also hot it also has a large amount of omega-3 so you’re it’s low in omega 6 and high in omega 3’s as well as flat flaxseed is very low omega 6 as well so then I recommend if you’re taking DHA each day or regularly I recommend you still try to get half a gram of uncooked alpha-linolenic acid into your diet daily by doing one of the following here eating some walnuts only three-halves of walnuts is enough for to get this amount a quarter teaspoon of flaxseed oil a teaspoon of canola oil or a teaspoon of ground flax seeds not to be hard to do but you have to make a point of doing it so vitamin D is not much of a problem in most if you live in Hawaii probably because I imagine most people get out in the Sun and you can always the Sun is always strong here and so all you have to do is get on the Sun for 10 or 15 minutes a day without sunscreen on because sunscreen blocks vitamin D production and if you do that you will get plenty of vitamin D now just in case I just want to inform people if if you don’t live in Hawaii what you need to do because vitamin D deficiency is pretty common on the US mainland a high percentage recent research has shown that a high percentage of people have mild vitamin D deficiency and those diseases are linked with a lot of autoimmune disease and other diseases that you can see listed so because of that I recommend that if you do not get in the Sun every day 10 to 15 minutes if you have light skin 20 minutes if you have dark skin 30 minutes if you’re elderly because elderly people do not convert vitamin D very well and their skin without sunscreen then you should take a thousand international units of vitamin D to vitamin D to is vegan vitamin d3 is not unfortunately this amount of vitamin D does require supplements it cannot you there’s no multivitamin that has that much vitamin D and there’s no fortified food and what country life makes a very cheap common supplement that you can get in in most health food stores a vitamin d2 now I’ve met a lot of vegans that have had problems such as the ones I listed before like just bones hurt and pain and fatigue and a lot being about for that I’ve worked with and after getting either’s in the Sun usually this taking supplements they have felt tremendously better and have felt that they were cured of whatever was was happening to them so it can be a problem for vegans and so that’s why I think I make a big point to making sure people know about it salar da for is only 200 international units and that’s way less than 1000 i recommended and there is a large number of vitamin d researchers that think the RDA should be increased though that is somewhat controversial and i guess we’ll see the next time they update the RDA for vitamin d whether they’re going to increase it or not and there is a controversy about whether vitamin d2 is effective this study kind of indicates that it is in that four of the five vegans in finland who took vitae just five micrograms a day of vitamin B d2 which I think was the 200 international units so much lower than what I was recommending if they took it for 11 months and they had an increase in their lower back bone density of course they were in Finland has a very little Sun and so they were probably needing it somewhat pretty badly the other thing is that vitamin d2 doesn’t last in your system as long as vitamin d3 so you have to take it regularly you can’t just take a lot for a few days and expect it to do much for you unless you’re getting Sun ok so calcium is another issue especially for vegans here are some things that can help prevent osteoporosis weight-bearing exercise throughout your lifetime having a heavier body weight is actually reduces your risk for osteoporosis adequate calcium vitamin D vitamin K protein potassium magnesium and boron adequate estrogen levels especially for women that can be important for some vegetarian and vegans because if women get such low fat if they very very low fat diets and start not having enough fat to produce enough estrogen they could be putting themselves at risk for osteoporosis in factors that can contribute to osteoporosis high sodium and caffeine intake smoking too little protein and a sedentary lifestyle now if you notice I said too little protein not too much protein and that in in the vegan health nutrition circles for many years we’ve promoted the idea that osteoporosis is not a disease of calcium not enough calcium intake it’s a disease of too much animal protein intake so there’s been that’s been a very controversial position it hasn’t been very controversial on the vegan among vegan nutritionists I mean I’ve always had a problem with it but and there’s been a few others that have had that have as well but for the most part all the popular books and that sort of thing promote this idea and so I wanted to just talk about quickly a 2000 alysus that just came out that looked it looked at many many studies that cat bone protein intake and bone health including bone mineral density and fracture rates I’m going to just talk about the fracture rates in the seven cohort studies because I think that’s the most important information but all the rest of the information was pretty similar and I’m not going to necessarily go over every single one the the moral of the story is that they they’ve looked at they’ve combined the data from seven cohort studies and they found that well they don’t really combine all the data into one group of data but they looked at it all and compared it and tried to measure out what was going on and anyway one study found that just one study found that is animal protein intake went up that fracture rates went up the rest of the studies either showed no difference on and one showed that the risk went down in any case the the meta-analysis the authors ended up their paper saying overall the weight of evidence shows that the effect of dietary protein on the skeleton appears to be favorable to a small extent or at least is not detrimental now these are with these are amounts recommended amounts of protein an average amounts of intake they’re not like four times the RDA which some people could take if they’re really really loading up on protein and so that might be a problem if they take that much protein in but generally the idea is that has did has been promoted is it if you eat a lot of protein your body excretes a lot of calcium and studies have shown that to be the case but you also absorb more calcium when you eat more protein and that could counteract it and in studies that have looked at what’s called hormone which is if it’s elevated it often means that your bone is being you is excreting calcium to help your blood maintaining the right calcium balance those studies have been I would say on the side of protein not causing osteoporosis but they were short term clinical studies or laboratory tests so that is the latest information on that and now something that backs that up to some extent is a what I think is the most important study that has come out on vegans and bone bones and that was a 2007 paper on bone fractures from epoch Oxford and they followed a thousand vegans and 10,000 lacto-ovo vegetarians and meat eaters for over four five years and they found that vegans had a 30% higher fracture rate than meat-eaters now when they adjusted it for most of the variables that tend to influence fractures they found that vegans had 30% higher rate but then when they adjusted for calcium intake as well they found that vegans did not have a higher rate so what they found out when they test teased out the data was that among the vegans who got 525 milligrams of calcium a day or more the vegans had the same fracture rates but of the of the vegans who got less they had higher rates and only 55% of the vegans had calcium intakes that high whereas 95 percent of the people in the other groups other diet groups did so this was a pretty well it was a disappointing finding an important one in my opinion and there’s been nothing to counteract there’s been no other study that have followed has followed vegans now if one other study came out and it when it contradicted this and I think that maybe this wouldn’t we shouldn’t take this quite as seriously but until there’s other evidence it seems to me very important that vegans make sure they get at least five hundred twenty-five milligrams of calcium a day at the very least but I would recommend shooting for at least 700 and the RDA is about a thousand for most adults well it is a thousand for most adults then for people who are I think it’s about 50 it’s goes up to 1,300 you know we’ve often said vegans don’t need to worry about calcium because animal protein is what causes osteoporosis that does not seem to the case for the data we have so far the good thing is it there is a lot of calcium and especially on leafy greens which also contain vitamin K which helps protect bones the thing about that though is that you actually do have to eat the greens to get the calcium out of them so if you think that you’re getting the calcium from greens make sure you eat them and also note that the calcium in spinach Swiss chard and beet greens although those foods do have high amounts of calcium they’re not well absorbed because they bind with oxalates and get excreted and also note that the calcium and other leafy greens are absorbed about the same as cow’s milk and soy milk at about 25 to 30 percent of the calcium the US DRI the DRI has replaced the RDA for many nutrients and actually the RDA is considered a DRI right now so the DRI is really the term people should be using but it hasn’t really caught on so much it’s a thousand milligrams for 19 to 50 year olds begin to try to get 700 and I suggest three options one is 3 servings of greens which is a cup and a half of cooked or how many however much raw would equal a cup and a half if it wasn’t if it was cooked so I think it’s usually about 3 to 4 cups of raw greens or or 1 an 8 ounce glass of fortified soy milk or orange juice or 3 to 500 a 3 to 500 milligram supplement each day if you do one of these 3 things your calcium intake is a vegan should be higher than well you know definitely higher than 525 most soy milks now are fortified with vitamin as vitamin B vitamin D and vitamin b12 so you can get it easily from soy milk if you’re interested in drinking soy milk iodine is a more of a problem for people who do not live near the ocean so once again people in Hawaii are vegans and Hawaii probably don’t have to worry too much about iodine it’s needed for a healthy thyroid and if vegans are low in iodine and they eat soy especially soy can counteract iodine and so if you don’t have enough iodine you might find that it a problem if your if you’re eating a lot of soy now if you eat if you regularly iodized salt then you shouldn’t be having a problem with iodine but I don’t recommend that you start eating iodized salt in order to get it also people eat seaweed a lot of sea we also getting iodine in the seaweed if you don’t need seaweed then I would recommend an iodine supplement unless you live in why you might not need to worry about it but in any case what what the deal is with iodine and food is it really depends what how much iodine is in the soil and so food grown in soil near the ocean is going to be higher in iodine so if you live in Hawaii and you eat most of your food I don’t know shipped in from the mainland or something like that then you might not be getting it and it most multivitamins have iodine plenty of it and so if you take one regularly you just check to make sure it does otherwise you can get a bottle of kelp pills very cheap like for five to seven dollars and they can last you at least a year and just take one every few days that’s what I do is just every few days I just take one it’s not nothing you have to worry too much about iron is an interesting issue for vegan diets because vegans tend to have as high or higher iron intakes than non-vegetarians however plant iron is not absorbed as well as iron from meat vitamin C significantly aids an IR absorption though it must be eaten at the same meal to increase the iron absorption the vitamin C forms a chili with the iron that allows you to absorb it good sources of vitamin C besides orange juice is potatoes broccoli cauliflower and many fruit juices are now fortified with vitamin C if you are having if you do happen to have iron deficiency anemia I recommend seeing it if you think you have it I recommend seeing a doctor to see if you really do that can save you a lot of time worrying about is something that’s not there but if you’re having a stubborn case of iron absorption that does not respond to iron supplements or vitamin C then l-lysine is an amino acid that also helps in iron absorption so there’s more details at vegan health org articles slash iron if you just go to vegan health org you can just look at it will be a link to iron and so if this is any sort of issue for you I have a lot of information there about it okay so vitamin E it’s pretty easy to get on a vegan diet except you have to make the effort to make sure you’re doing it item a is made from beta carotene and for men for women at seven hundred men is nine hundred and as you can see you can easily get it from a cup of carrot juice many times IRA you can probably get it from well less you know less than half a cup of carrot juice a day and these other foods have it as well so just make sure your what I do is I keep some carrot juice on the refrigerator and I drink at least a quarter of a cup a day make sure I’m getting enough vitamin A vegetarians do not need to combine protein sources at each meal to get a complete protein because your body stores amino acids that you eat throughout the day and uses them as necessary however I do think it’s good to include legumes like two to three times a day because they are the highest source of protein on vegan diets and that will help you reach make sure that you get enough protein vegan athletes have slightly different needs possibly and I have a number of articles at vegan health org if you’re interested in what vegan athletes need it is possible for vegans to not meet protein needs and I like to bring this up because there’s also an idea in vegan nutrition circles that say that they’re you know I’ve heard people who promote a vegan diets say that there’s no one in the US that is suffering from protein deficiency and that is simply not true in any case here are the ways that vegans might not meet protein needs if you’re not eating enough calories for one thing such as in these these problems anorexia depression dieting you have any of these issues you should definitely try to make sure you’re eating a higher percentage of protein then you normally would if most of the junk food you eat is junk food then you’re not going to be getting enough protein unless it’s very high protein junk food which these days you can actually get quite a bit of high protein vegan junk food but if it’s french fries and soda then you need to worry about it of course you shouldn’t be eating like that anyway but I know vegans who have eaten like that and they gets often get colds and things like that and part of it could be just not having a protein to fight off infections okay so then if you don’t think the protein is important such as some fruitarian diets or some raw foods diets not all by any means but in some or if you avoid legumes so you don’t like to eat them or for some reason then you need to think about how you’re going to get protein in other ways and often soy foods are an easy way to do it okay so now I’m going to move on to soy I get the by far the most questions I get OH when people email me is about soy at least half of I get is about soy so I want to touch on that and this is the last big issue I’m going to touch on sewing the thyroid as I mentioned earlier if you don’t have enough iodine soit could become a problem but studies have shown that if you do have enough iodine then soy does is not a problem so that kind of sums it up pretty quickly okay so in breast cancer that has been a lot more controversial over the years just recently we’ve been getting better information about rates of breast cancer for people eat different amounts of soy so the question is some people say that soy could prevent breast cancer some people say so it could cause breast cancer and that’s because soy has things called isoflavones which are considered to be plant estrogens and what they do is they can attach to estrogen receptors on your cells and then they they do not make the the cell respond as strongly as if it was a normal molecule of estrogen but it has a weak estrogen effect now some people think that this could dull dull the regular estrogen and some people think it could increase the problem if you have a lot of soy and then some breast cancer is actually estrogen positive estrogen receptor-positive which means that estrogen is actually causing the cancer to grow and so particularly for women with those type of cancers it’s been an issue about whether soy is harmful or helpful in 2006 meta-analysis was published looking at the 17 studies it had looked at soy and breast cancer and followed women over time and they found it women with the highest high intake had slightly lower risk of breast cancer and the largest intake was only one serving per day which is a lot less than what many vegans eat which I would guess is probably closer to two or three servings a day but in 2009 the shanghai women’s health study just released results and they found it among pre mental premenopausal women three servings per day of soy was actually protective so these women reading a lot more soy so they were able to figure out what what that was doing and in fact these women with at three servings a day they had about half the risk of the women in the lowest soy group and this finding was highly significant so it seemed to be a I think it’s a convincing finding and then I just just a couple days ago they released more results from that Shanghai woman’s study and they found that women with estrogen positive breast cancer were also not so I was not a problem for them as well they teased out that part of the study four studies have looked at breast tissue biopsies with of women who eat a lot of isoflavones compared to those who don’t and found no difference from higher isoflavone intake and then two studies have looked at women’s survival after breast cancer diagnosis in women who made different amounts of soy and found that there was no reduced survival from soy after a breast cancer diagnosis so it really seems that soy is not a problem for breast cancer at least that’s evidence we have have so far ok soy and dementia in 1999 you might have heard of this since it came out of Hawaii tofu was linked with lower cognitive function now this caused a big kerfuffle I would say in the vegan community because we didn’t know what was going on with that and I know that dr. Harris took samples from soy from tofu products and found higher levels of aluminum that then were healthy I don’t know if that was the cause or not but in any case this was one finding here’s some other findings 2008 an Indonesian study found tofu linked to slightly worse memory but they found tempeh linked to slightly better memory and then the authors in the study go on to state that the tofu and Indonesia uses formaldehyde for processing which is very damaging to the nerve to the brain so that could be the reason and likely is and I looked this up because that sounded so bizarre and I did find articles on the Internet of people trying to get the government of Indonesia to stop doing this and so it does appear to be really true which I didn’t necessarily doubt it when it was the author’s put it in their in their paper but it does seem pretty crazy other studies of links way to better cognitive function and a study of seventh-day adventists many of whom have consumed soy foods their whole lives showed lower dementia and old age than the general population so it seems like as a whole soy probably doesn’t have a bad effect on dementia unless you’re eating formaldehyde with it so okay so other soy issues that may be protective against heart disease it seems that the proteins in soy are are less likely to promote the production of the bad cholesterol LDL cholesterol so that can be one of the reasons why protects against heart disease as well as you know being substitute for for meat in the diet prostate cancer osteoporosis and menopausal symptoms may be soy may protect against tempeh is a particularly good source of absorbable zinc some vegan diets are low and zinc and so that’s a good way to get it of course people have soy allergies and if you have this soy allergy you will want to avoid soy and I like to point out some people do feel better eating soy foods other people feel worse eating soy foods possibly due to allergy or intolerance it just really depends and I also want to point out that you don’t need soy to be vegan the vegan movement does not hinge on soy there were not many soy foods many years ago when Bill Harris first became vegan right in 1964 certainly not the amount of soy products there are now you can find so many of and we could go back to not using soy for so much stuff if necessary but it doesn’t really seem like there is a reason for that and two to three servings a day at least for them the data we have now seems to be safe on vegan health.org I have a page of real vegan children these are children whose mothers were vegan when they were pregnant and vegan during breastfeeding and then these kids have been vegan their whole lives and so you can go look at look at them to see real true life stories of kids who were formed completely by plants and know that it’s healthy and a lot a lot of people unfortunately I mean a lot of people while out leafletting for vegan outreach that say that they’ve stopped being vegan because they got pregnant and I think in some cases you know they get a lot of pressure from their family and friends and even doctors to to stop being vegan so if you know anyone that’s getting pregnant and is is worried about that send them to this page and there’s also another page giving recommendations of course pregnant women okay so if you’re transitioning to a vegan diet here’s what I suggest ins I have four people one is to base your meals around one of each of these foods legumes which are of course dried beans peanuts peas lentils and soy foods grains fruit and yellow and green vegetables and nuts so if you have some of that in each of your meals you should be doing pretty good it should be satisfying and healthy eat plenty of unprocessed foods and if you have a high metabolism and find that you can’t keep up your weight on a vegan diet then think about eating some processed foods like oils pastas and like drinks like smoothies if you want any information I go into more detail about all the things I’ve talked about if you can believe there’s more details on all this stuff than when I went over at vegan health org and you can email me through that site and then I have a blog at Jack Norris Rd com that anytime I change anything of any of any importance on vegan health org I send out a post to everyone that’s subscribed letting them know about the research that just came out so please feel free to subscribe to that and that’s all and if you have questions feel free to ask them thank you yes heed the question what do I think that people living in Hawaii vegans living in Hawaii need to supplement vitamin D no I don’t think that if unless you don’t go in the Sun without sunscreen ever hey I mean you need to do it 10 to 15 minutes every at least every other day if you don’t do that then yes you should use it supplement vitamin D but I you know it’s really easy to do that here it seems to me but if you have a job where you just can’t get outside your body does store extra amounts of vitamin D so if you’re out if you’re out a lot in the Sun on the weekends and your son and your skin actually gets red from the Sun then you probably have enough to last you through the week okay the question was I recommended 30 minutes of Sun for for older people and he said that his dermatologist would not recommend that because of skin cancer obviously I you you know the general recommendations are go to just short of getting your skin red so I think that that’s what you should go by what if you know because people are very different people with dark skin are going to need longer amounts and some people can be in the Sun a lot longer and other people can’t so yeah I am that’s what I would recommend and it hasn’t it is a tough situation and that’s I think why there’s so much vitamin D deficiency these days is because people play on Suns sunscreen to prevent skin cancer which is seems to be a good thing as a reasonable thing to do Jim did you were you next I think okay Jim said that he seen reports that 80 to 90 percent of cancer is due to lifestyle and this studies that I showed don’t seem to correlate to that now smoking is a big part of that smoking is linked to many forms of cancer not just lung cancer so once you take in and when we look at those people the the rates of smoking were very low and they adjusted for smoking so basically they took smoking out of that equation so that right there is going to be a lot of it then alcohol could be alcohol could be a reason for some of the cancer as well that they’ve adjusted tried to adjust out and and really high sodium diets can cause stomach cancer and so those have been I don’t know actually I don’t I don’t know that they adjusted out for that but I’m guessing that those populations that people ate about the same amount of sodium they weren’t eating large amounts like in some countries so you know I have a paper on linked to on vegan health org under an article called it’s like cancer and vegetarianism and it talks about all the the foods that have been linked to cancer and what amount of evidence there is for them and it’s done by the researchers that do epic along with a few others and a couple of those guys are vegans so they’re definitely not just biased against vegans in that group of people and and so you know the estimates 80 to 90 percent of cancer is lifestyle you know that could could also to be chemicals in the environment and things like that not necessarily only food and it could be that vegans do have much lower rates of cancer like I was talking about vegetarians here because they just haven’t been enough vegan studied I mean my hope is it vegans will have much lower rates of cancer when that when those results start coming out and then we’ll know more but right now we just don’t know we can only guess what might be the case question was could the funding sources of these studies influence the results and then the next question was what about societies that have been vegetarian for many generations so the first part most of the studies i’ve referenced I don’t think that there’s any bias going on because like I said there are a couple vegans involved in a great number of those studies and in the other ones like you the studies list to who sponsors them they’re supposed to list it at the end and so you can see if the National Dairy Council is who funded it and so if that’s a case I’m not gonna you know I would I would note that and point it out and in noting that I talked about tonight was it it was that the case where a major source was the meat industry or the dairy industry now there may be some researchers that have certain you know biases and things like that and they tried they try to take that out in ways of the reports but my my impression is that what I’ve presented tonight you know there may be some soy industry funding for some of the soy studies I talked about but other than that I think it’s all been pretty people doing the best science that they can now in terms of societies that have been vegetarian I’ve there have not been studies following societies that are vegetarian and weeding out the vile the vegetarians do against the non vegetarians so there just isn’t data on that you can look at societies that have lower rates of animal product consumption and see how they compare to groups of people that have that have less rates of animal product consumption and it does seem to be that the countries with lower animal product consumption have lower rates of many of the chronic diseases but what I was looking at actual vegetarians and comparing them with non vegetarians and that to me is telling more telling about the vintage actual diet versus what else might be going on in those countries in other words they may have different many different things many different lifestyle factors or genetic factors I hope that answers the question I’ve never seen a database that included iodine in I mean almost every not every but almost every nutritional database actually takes the info from the USDA because it’s such a big body and they update it regularly so in fact you may know more about the USDA database and I do because I know you’ve you’ve done a lot with it on your own but I don’t know of anything that lists iodine levels I’m afraid there are estimates about seaweed that I’ve found alright thank you very much Thanks [Applause] thanks very much jack for such a really illuminating talk I think we’ve all learned a lot and thanks to all of you two for coming tonight we invite you to come out to the courtyard now and get some really great refreshments from down to earth thank you all again and Happy Holidays this program is brought to you by the vegetarian Society of Hawaii a nonprofit organization dedicated to sharing with the community the many benefits of a vegetarian diet free monthly meetings include vegetarian experts and locally and on the mainland quick and easy cooking demonstrations and helpful and delicious food samples members enjoy an informative quarterly newsletter social activities and discounts at many vegetarian friendly restaurants and health food stores for an application call nine four four eight three four four that’s nine four four eight three four four or visit our web site at WWDC org VSH you

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