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FAQs

What is the ‘best’ diet?
There is a lot of confusion historically about nutrition – propagated by the media and food companies and even health professionals ourselves. What’s best? Low fat, low carb, high carb, vegan, paleo, keto? What everyone agrees on is the benefits of vegetables and fruits. Everyone agrees on having whole foods, and unprocessed foods – and most agree that it’s best to limit or avoid processed meats, dairy, sugary cakes, sweets, fizzy sugary drinks, white flour and white bread. If people can reduce all this from their diet and eat as many vegetables as possible then that is a great start.

The pharmaceutical industry, the meat and dairy industry, the egg industry and government guidelines based on agricultural profit have all had an impact on diet guidelines over the years, and this has created conflicting and biased evidence designed to confuse us into inaction. People when confused will just keep eating what they always have, and say ‘everything in moderation.’ But this is clearly untrue. We don’t advise smokers to smoke in moderation. It’s the same with sugary drinks and processed meats. Why feed your child a hot dog or a chicken nugget when you would never dream of giving them a packet of cigarettes? According to The World Health Organisation, processed meats are a class 1 carcinogen – a known cause of cancer.

How to cut through the confusion? Fortunately, Dr David Katz, one of the founders of the American College of Lifestyle Medicine, got the world’s most eminent nutrition scientists from around the world together to create a general consensus they could all agree on as part of his ‘True Health Initiative’. There was much they agreed on – that a diet rich in vegetables, fruits, beans, nuts, seeds, whole grains and water remains the cornerstone to health. If you look at a paleo plate and a whole food plant based plate, they will have far more in common with each other than they would with the plate of someone eating the average Western diet.

What does the science say?
Although it is impossible to distil the essence of the nutritional research into an easy answer, it is interesting to note that Researcher Kevin Hall wanted to answer the question of which style of weight loss is most effective. He conducted a study at the NIH, and gathered low carb and low fat dieters in a lab to control what and how much they ate, then he tracked their fat loss in the lab in a so called ‘metabolic ward study’ – he found that there was no advantage to a low carb diet for fat loss, and in fact if anything, it seemed more likely to result in loss of muscle mass.

A study published in the British Journal of Nutrition in 2012 showed that a low carb high protein high fat diet had a negative impact on how responsive our peripheral arteries are – how well they swell and shrink – which increases cardiovascular risk over time. (Merino J, Kones R et al. Negative Effects of a low carbohydrate, high protein, high fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk. British Journal of Nutrition 2012)

The only study to directly compare the coronary arteries of patients on a healthy low carb diet vs a healthy high carb diet showed significantly reduced coronary blood flow with the low carb diet. (Fleming RM The Effect of High Protein diets on Coronary Blood Flow. The Journal of Vascular Diseases October 2000)

Another study showed that around one third of low fat dieters have rises in their cholesterol despite weight loss – this is important as usually weight loss by any means will reduce cholesterol levels – even TB, alcoholism or chemotherapy could cause lowered cholesterol due to the unhealthy weight loss people experience. On top of that, recent data published from NHANES suggests that reducing carbohydrate consumption in the form of fruits, vegetables, grains and pulses could even shorten lifespan. (European Society of Cardiology. “Low carbohydrate diets are unsafe and should be avoided, study suggests.” ScienceDaily, 28 August 2018.) Participants in the NHANES study had an average age of 48 years, and 51% were women, 49% men. They were divided into quartiles based on the usual percentage of carbohydrates in their diet. The risks of all-cause and cause-specific death rose with each fall in carbohydrate intake, and remained significant after adjusting for all available factors. influenced the association.

The researchers also examined the link between all-cause death and low carbohydrate diets for obese (body mass index [BMI] 30 kg/m2 or greater) and non-obese (BMI under 30 kg/m2) participants in two age groups (55 years and older versus under 55) and found that the link was strongest in the non-obese older participants. Professor Banach, who led the study, noted that animal protein, and specifically red and processed meat, has already been linked with an increased risk of cancer. He said: “The reduced intake of fibre and fruits and increased intake of animal protein, cholesterol, and saturated fat with these diets may play a role. Differences in minerals, vitamins and phytochemicals might also be involved.”

He concluded: “Our study highlights an unfavourable association between low carbohydrate diets and total and cause-specific death, based on individual data and pooled results of previous studies. The findings suggest that low carbohydrate diets are unsafe and should not be recommended.”

Let us consider what kind of dietary patterns seem to promote heart health? After all, heart disease still remains our biggest killer. The only way of eating which has been proven to reverse coronary artery blockages within weeks (by comparing angiography before and after the diet change) is the whole food plant based approach. The Lifestyle Heart Trial findings were published in the Lancet in 1990, and impressive results with dietary intervention alone was achieved through the work of Dr Caldwell Esselstyn, and were also replicated most recently in the Mount Abu Heart Trial. No other dietary pattern has been able to replicate these findings. Considering that heart disease is our number one killer, it seems sensible for a mostly whole food plant based diet to be the recommended choice until new evidence is found to suggest otherwise.

https://youtu.be/cVL-ld4TfRk

How do I feed my family a plant based diet?
The good news is that the American Dietetic Association and the British Dietetic Association both agree that well planned plant based diets can sustain healthy living in all age groups – and may also provide benefits for prevention of diseases. Which diseases might they be referring to? Heart disease and cancer – our biggest killers in the Western world. The BDA has also recently launched their Blue Dot Campaign, highlighting the importance of dieticians being able to offer plant based diet advice to people of all ages and incomes so as to consider the environmental impact of the food we eat.
Why is a more plant based diet so important for children?
Because childhood obesity is on the rise, and we know that obesity is closely linked to increased risk of heart disease, cancer and all causes of mortality. Plant based diets are also associated with reduced risk of chronic respiratory disorders, allergies and recurrent infections in childhood – so not only are you improving their health for today, but also giving them the best chance of reducing disease risk in the future as well.
Recommended resources
  • Raising a Vegan Child – My learning modules made for Plant Based News, in conjunction with The Physicians Committee for Responsible Medicine, guiding pregnant mums and parents to be on how to give vegan children the very best start in life.
  • Nutrition for kids – Great online resources from The Physicians Committee specifically for children
  • Eating well: vegan infants and under-5s – An easy to follow PDF guide with photos of food plates for your toddler and under 5-year old.

Podcasts on the topics of pregnancy and plant based nutrition for children:

Recommended books with kids in mind:


The Help Yourself Cookbook for Kids
by Ruby Roth

Disease-Proof Your Child: Feeding Kids Right
by Joel Fuhrman

The Happy Pear: Recipes for Happiness
by David & Stephen Flynn

How do we eat a plant-based diet?

Where to start

If you are curious and want to consider some diet changes, well done! You are starting some amazing health benefits to nurture your body. How you go about this exciting journey will often depend on what you like to eat right now. Modifying certain favourite foods is a good place to start. For example, a chicken curry could become a chickpea curry, a beef Bolognese a lentil Bolognese, a Mexican chilli could be a three-bean chilli. Slowly experimenting with new flavours and ideas so that it can become a new voyage of discovery and fun – without the pressure – is often a good place to start!

Perhaps starting with breakfast, then changing 2 or 3 meals during the week, then increasing the following week by another 2-3 meals, until pretty soon you have 4 or 5 good rotating meal ideas that replace your old habits. Some people prefer to just dive in head first, and take an all or nothing approach. Just do whatever works best for you. If you change to a completely whole food plant based diet straight away you are likely to reap the benefits more quickly, usually within around two to three weeks. However, if it is a very new way of eating, your gut bacteria will not yet have caught up and so you may notice some initial bloating or flatulence as your gut bugs begin to adjust and respond to your healthy diet change.

Recipes and cookbooks

If you are thinking of making a start with plant based eating but you’re unsure where to begin, I’d recommend these cookbooks to ease you into the transition:


So Vegan in 5
by Roxy Pope & Ben Pook 

BOSH!
by Henry Firth & Ian Theasby

If you are aiming for the healthiest plant based diet because you have active disease such as heart disease or inflammatory arthritis, I like to suggest whole food plant based no oil recipe books. Added fats are of course important – from essential fatty acids and whole foods such as nuts, seeds, avocadoes and olives. But oils are otherwise processed foods, and sunflower oil in particular can have negative effects on the lining of the blood vessel wall. There are some great no oil salad dressing recipes online, and when you are making a dish which requires frying onions, garlic, herbs or spices, water frying in a small amount of water instead is very effective at minimising unnecessary oils.

Check out these websites for your starter kits and recipe ideas:

21-Day Vegan Kickstart

Plant-Based Primer: The Beginner’s Guide to a Plant-Based Diet

Plant Proof

Check out these fantastic recipe books:


Deliciously Ella Every Day
by Ella Woodward

The China Study Quick & Easy Cookbook
by Del Sroufe

Forks Over Knives
by Del Sroufe

The How Not To Die Cookbook
by Dr Michael Greger

The No Meat Athlete Cookbook
by Matt Frazier and Stepfanie Romine
Mental health and nutrition – can food help me?

Mental health is complex. Low mood, anxiety, OCD, PTSD and disorders such as bipolar or schizophrenia are serious disorders for which we should all seek professional help and guidance. Does this mean you have no say in the course of these diseases? Absolutely not. Just as a seed needs nutrient rich soil, sunlight, and rain to flourish, we too need connection, purpose, meaning, sleep, exercise and nutrition to help us on our path to wellbeing. Food and mood are definitely connected. For more information on how nutrition can play a role in mental health, listen to this podcast interview between myself and Fitness Blogger, Model and Dancer Bianca Taylor.

Other books I’d recommend on your path to wellbeing include:

Reasons to Stay Alive
by Matt Haig

The Stress Solution
by Dr Rangan Chatterjee

The Power of Now
by Eckhart Tolle

References

1 in 4 adults have mental health issue in any given year.

Being happy is associated with lower mortality rates

Less likely to catch a cold or flu if you are happ

Brand new study – Feb 2019
Firth J, Marx W, Dash S, et al. The effects of dietary improvement on symptoms of depression and anxiety: a meta-analysis of randomized controlled trials. Psychosom Med. Published online February 5, 2019.
Healthful diets reduce depressive symptoms, according to a meta-analysis published in Psychosomatic Medicine. Researchers reviewed 16 studies that reported effects of healthful dietary interventions on depression and anxiety. Diets that reduced the intake of fatty foods, such as processed meats, and increased fruit and vegetable consumption led to significantly decreased symptoms of depression, compared with control diets. Increased intake of fiber, minerals, and vitamins from plant-based foods may improve pathways related to depression, including inflammation and oxidative stress.
Involved nearly 46 000 people.

Being vegetarian associated with happier mood, despite low intake of long chain fatty acids – adventists

Arachidonic acid as an inflammatory contributor to low mood. Increased suicide risk in pregnancy with high omega six levels.

High sources of arachidonic acid in food according to the NIH includes chicken eggs beef pork and fish.

Restriction of meat, fish and chicken improves mood RCT on 39 people

What about a larger group?
A RCT on nearly 300 people in a workplace environment for an insurance company across 10 cities where once a week half were told about healthy whole food plant based diets. Significant improvements in depression, anxiety and productivity. They also had improved bodyweight, lipid levels and glycaemic control.

Eating vegetables can cut the odds of developing depression by up to 62%, according to a population based study from Taiwan.

Tryptophan is a precursor for serotonin but when you have a high protein diet it doesn’t seem to correlate with high serotonin levels. This is thought to be because of amino acids in high protein foods crowd out the tryptophan for access to the brain. This study on high carb or low carb breakfasts seems to increase the bioavailability of tryptophan which is a serotonin precursor as well as tyrosine which is a dopamine precursor.

This study was a randomised controlled trials following 106 overweight or obese participants for a year. They had equivalent weight loss and cognitive function with high carb or low carb approaches to weight loss but the low fat diet participants had much less anxiety depression and overall better mood state.

This study showed that premenstrual women suffering from PMS crave carbohydrate rich food, Perhaps because it increases tryptophan levels. However, reaching for the ice cream over the sweet potatoes will unfortunately also increase risk of overall inflammation, and cramping…

Coffee seems protective, artificial sweeteners and fizzy drinks are associated with higher rates of depression and anxiety.

Aspartame effects in rats – Lower seizure threshold

Severe reactions to aspartame in people vulnerable to mental illness.

Crossover trail showing increased irritability and depression in adults having well under the daily recommended limits for aspartame.

Avoiding fizzy drinks and coffee sweeteners seems easy enough, but these substances are present in more than 6000 products, including mints, chewing gums, cereals, jams and jellies, juice drinks, deserts, nutritional bars and yoghurts. Another reason to stay in the fruit and vegetable oil at the supermarket.

Nationwide American study measure the level of carotenoid phytonutrients in peoples blood streams. These phytonutrients include some of the yellow, orange, and red antioxidant pigments found in citrus fruits, sweet potatoes and green leafy vegetables. People with higher levels of these nutrients had a lower risk of depression, and there was a dose response relationship observed.

Study following people over time, showing that low dietary folate intake may increase risk of severe depression by as much as threefold.

Same benefits are not experienced with supplements, and in fact in some cases adverse effects are found.

SMILES TRIAL
Three month RCT using nutrition as a tool for remission of depression. People were asked to undertake a modified Mediterranean diet consisting of six servings of vegetables and three servings of fruit a day as well as 5 to 8 servings of whole-grain‘s and a serving of nuts and Olive Oyl a day. They were also advised to have two or three servings of dairy a day and 2 to 4 servings of meat a week.
After three months of third of those in the diary went into remission from the depression and 8% of those in the social support group.

High homocysteine levels are associated with inflammation and blood vessels as well as risk of depression. It is an amino acid that needs B12, B6 and folate to break it down. If you are deficient in any one of these it can be raised.

Study showing rate homocysteine levels in Taiwanese adolescents with depression.

Arthritis

If you suffer from inflammatory arthritis I would strongly recommend you check out this online programme to help you relieve your symptoms and reduce your inflammatory markers. This can be done alongside any treatment you may be receiving from your rheumatologist and should not be thought of as a replacement, but rather an augmentation of medical therapy from which to reduce need for medications if possible.

Paddison Program

This incredible cook book is full of easy to make, Paddison programme compliant whole food plant based no oil recipies for the whole family to enjoy!


A Kitchen Fairytale: Healing with food
by Iida van der Byl Knoefel

Here is a useful page highlighting how to reduce the pain of osteoarthritis:

Reduce Arthritis Pain with a Plant-Based Diet

Do you want to be a plant based athlete?
Check out this website for some amazing bespoke fitness and nutrition plans:
Vegan Fitness

If you want to hear one of the founders talk about his journey to discovering the power of plants:
Watch on youtube

Or listen to some hugely inspiring content from Rich and his incredible guests:
RichRoll.com

Books:


The No Meat Athlete Cookbook
by Matt Frazier and Stepfanie Romine

Finding Ultra
by Rich Roll
Reference Books

The How Not To Die Cookbook
by Dr Michael Greger

The vast majority of premature deaths can be prevented through simple changes in diet and lifestyle. In How Not to Die, Dr. Michael Greger, the internationally-recognized lecturer, physician, and founder of NutritionFacts.org, examines the fifteen top causes of death in America—heart disease, various cancers, diabetes, Parkinson’s, high blood pressure, and more—and explains how nutritional and lifestyle interventions can sometimes trump prescription pills and other pharmaceutical and surgical approaches, freeing us to live healthier lives.


Proteinaholic
by Garth Davis M.D.

“An acclaimed surgeon specializing in weight loss delivers a paradigm-shifting examination of the diet and health industry’s focus on protein, explaining why it is detrimental to our health, and can prevent us from losing weight.

Whether you are seeing a doctor, nutritionist, or a trainer, all of them advise to eat more protein. Foods, drinks, and supplements are loaded with extra protein. Many people use protein for weight control, to gain or lose pounds, while others believe it gives them more energy and is essential for a longer, healthier life. Now, Dr. Garth Davis, an expert in weight loss asks, “Is all this protein making us healthier?”

Is a Plant Based Diet Beneficial in Pregnancy?

Absolutely!

First of all – congratulations! If you’re reading this, chances are you’re about to undergo nature’s most miraculous journey – from womanhood to motherhood. Creating new life within yourself and feeling your baby grow is one of life’s greatest gifts. Everyone’s circumstances are different – your baby may be dearly longed for or a complete surprise – which may bring with it uncertainty or maybe even anxiety – but you are all here for the purpose of helping your baby grow, and helping yourself have a happy and healthy pregnancy – and that’s what I’m here to help you with. Although a plant based pregnancy is likely to confer advantages for health of mum and baby, this does not give us a free pass to chow down on vegan ice cream, cookies and cakes – pregnancy cravings aside! But it should be reassuring to know that a well-planned vegan diet has been deemed suitable for all stages of life – and this page is aimed at really optimising your pregnancy health, rather than a comprehensive list of dos and don’ts.

When you know you are pregnant, you must tell your family doctor, and get your maternity healthcare arranged. You will need to discuss your medical history and if you have any pre-existing medical conditions you must ask your own doctor for advice – this educational content cannot replace the input of your own medical professional.

For more information on this please listen to these podcasts:

and watch this Plant Based News series on Vegan Pregnancy:

Am I eating for two?

Calorie needs increase only modestly during pregnancy. According to the Academy of Nutrition and Dietetics, it works out to about 340 extra calories per day in the second trimester and about 450 extra calories during the third. But your nutrient needs will increase during pregnancy – you will require more calcium, more protein, and more folic acid, even though your calorie needs increase only a little. Therefore it makes sense to limit empty calories found in white bread, pastries and sweets and maximise instead on fruit, veggies, pulses and whole grains.

Protein
Pregnant women should aim for about 70 grams of protein per day during the second and third trimesters. It’s easy to meet this requirement by eating a variety of plant-based foods, including beans, lentils, quinoa, tempeh, tofu, whole grains, and vegetables.
A day’s menu could include oatmeal/porridge with fruit, walnuts, and chia seeds for breakfast; lentil soup and a hummus sandwich for lunch; a brown rice, almond, and chickpea bowl for dinner; and a slice of whole-wheat bread with peanut butter for a snack.

Calcium
You don’t need dairy for calcium, as I’m sure many of you know. Just as every other species on the planet doesn’t need to drink the breastmilk of another. Calcium for the healthy development of your baby can be found in abundance in kale, bok choy, lettuce, cabbage, figs, sesame seeds, tahini, almonds, almond butter, chia seeds, beans, edamame, tofu and fortified plant milks.

Include plenty of calcium-rich plant-based foods in your diet, like tofu, dark green leafy vegetables, beans, figs, sunflower seeds, tahini, almond butter, and calcium-fortified soy milk, cereals, and juices.

Vitamin D
The natural source of vitamin D is sunlight. If you do not get regular sunlight, vitamin D is also available in vitamins and in fortified foods. Many brands of cereal and plant milks are fortified with vitamin D. I’d still suggest a supplement. This is because many of us sit at a desk most of the day, work indoors or live in a place where it is impossible to get enough sun. Some of us are also genetically less able to make this important hormone efficiently despite getting a decent tan! For that reason, we should all consider vitamin D supplementation. In the UK, it is now recommended that every breast-fed baby take a vitamin D supplement of 400iu a day, and everybody over the age of 4 years old should take a supplement of 10 micrograms per day, including pregnant and breastfeeding women. I often tell my patients to take between 15-25mcg daily (or 1000iu), which is often a good dose to maintain their Vitamin D levels, and breast-feeding women will need more, around 2000iu a day.

Vitamin B12
Vitamin B12 is found in all standard multivitamins and in prenatal vitamins. A whole food plant based diet is abundant in nutrients, and this way of eating contains far more nutrients per calorie than any other. But Vitamin B12 is made by soil microbes, so it is the only vitamin lacking, because we wash our fruits and vegetables of their soil, we grow them with pesticides which strip the soil of beneficial microbes, and we have treated water. We can’t get it from soil residues and untreated water like cows, gorillas and all other plant eating animals do. Which I am grateful for as I would rather avoid water-borne disease such as cholera! So what’s the best plant based source? B12 is in fortified foods like marmite, nutritional yeast, cereals and nut milks, but as we need 1-2 mcg daily and it is essential for development of your baby’s nervous system and brain it’s always worth taking a supplement.

Iron
Many women get low in iron during pregnancy – this is in part because blood volume increases by around 50% so there is a dilutional effect. But iron needs are still double what they would normally be (27mg from 15mg). So make sure you are eating plenty of leafy greens like kale, spinach, rocket, and other salad leaves with a rich source of vitamin C to aid absorption. You can get Vitamin C from kiwi fruit, berries and currants, fresh oranges, grapefruit, broccoli, cabbage, peas, blackcurrants, strawberries.

Some people still end up unable to meet their iron requirements and will need a supplement temporarily. Don’t neglect to check this and make sure you are getting enough as it can affect baby’s birth weight and can cause pre-term delivery if you are anaemic. If you do need an iron supplement, make sure you drink plenty of water and get your fibre from fruits and veggies to help prevent constipation! Take your supplement in between meals (especially those containing legumes like lentils and green beans) and not with tea or coffee, so that you can boost your absorption of the iron.

Iodine
The thing you never thought of, right? Iodine is the forgotten element which is essential in the human body for the production of thyroid hormones. Our bodies cannot make it, so we need to make sure we get it in our diet. Thyroid hormone also has a function in normal growth and mental development in babies and children. As iodine is required for the normal production of thyroid hormone, a deficiency can result in a goitre and hypothyroidism, or an under-active thyroid. The generalised symptoms of this include tiredness, weight gain, dry skin and hair, mental slowness and intolerance to the cold. When a developing baby is deprived of iodine, it can result in Congenital Hypothyroidism, which simply means hypothyroidism that you are born with. Unfortunately, the result of this is serious, as it can cause mental retardation and growth problems.

Vegan sources of iodine are sea vegetables like kelp and nori sheets that you use to make sushi. It is also found in some other vegetables, but because the iodine content will depend on the soil content, it varies depending on where you live and is difficult to predict. Current recommendations for daily iodine doses are 150mcg for adults, and 250mcg for pregnant and breastfeeding women. The most reliable way to know you have enough is with a supplement, particularly if you are pregnant or breastfeeding. Selenium is important too, so we can absorb just the right amount of iodine. Great plant based sources include brazil nuts, mushrooms, beans and sunflower seeds.

How can I eat enough when I’m feeling so sick?
Eating small regular meals throughout the day may help. Keeping some whole grain crackers or ginger biscuits by the bed and nibbling them before you rise may stem the nausea too. Soups and cooked veggies may be easier to tolerate than raw veg and salads. Ginger tea may also help, or nibbling on crystallised ginger or ginger biscuits. Keep your fluids up to avoid dehydration and sparkling water may help too…
What about exercise?
Pregnancy is one of the most amazing and most difficult things your body will go through. Your heart has to work harder to pump the extra blood through the extra body weight you will have. As your baby grows, your muscles have to hold up your spine, which can put a lot of strain on your back and your hip joints. If you can, make sure you optimize your core strength before pregnancy, focusing on abs, spine, back, glutes and balance exercises.

When it comes to exercise, do what you can, whenever you can, so you can keep your body strong and healthy. Try not to get down on yourself for the days that you choose to nap instead. Love your changing body the way you love the baby growing inside you.

Mental Health
Make sure you are mindful of supporting your mental and emotional health as well. This is so important, as studies show trauma or low mood in pregnancy can directly impact your baby later in life. Sometimes we cannot control certain events or circumstances in our lives, but what we do have control over is our reaction to these events. We can also control what we tell ourselves these events mean for us, or how we are going to learn from them.

Yoga, meditation, pregnancy support groups, close friends, a supportive spouse, a close family network, a community you belong to – these things all help us to cultivate a more positive framework from which to view the world. You could attend classes like yoga, meditation, and even dance. You could join an online forum if you cannot travel or have no local friends, you could join a pre-natal class or NCT group to get to know others about to embark upon this incredible journey with you. Even just downloading a smart phone meditation app like Calm, HeadSpace or Insight Timer, and doing a meditation exercise twice daily for 10 minutes – is likely to be a huge help over the course of your pregnancy, and for after baby is born too. If you think you might be depressed, consult with your doctor for extra support.

Just after giving birth…

Your body will have a huge amount to deal with during childbirth and in the weeks afterwards. There is a reason the time after birth used to be called the ‘confinement’ period and many cultures have a variation on this – you will need to build up your body’s nutrients like never before – to heal the wounds of childbirth or a caesarean, to have the energy to care for your baby (and any other children/responsibilities you have) and to provide a food source for your new baby. Your hormonal changes will affect your mood, as well as potential sleep deprivation and some women have pain while initiating breastfeeding too. Nutrition is key – to boost mood and resilience for you, and to help boost your baby’s immune system and gut microbiome.

Don’t be tempted to eat junk foods to satisfy your new appetite! A good tip is to start off every day with a green smoothie using kale or spinach and the fruits you enjoy to make sure you have the nutrients and water your body needs. Drink lots of water to help avoid dehydration (and boost your milk supply) and this will also keep your bowels moving. In the early days just prioritise feeding baby, hugging him and getting lots of rest – there’ll always be tidying up to do and exercise can wait for a while…

Should I breastfeed?

You’ve heard it all before, but I’ll say it again. Breastmilk is amazing. You make it especially for them, and its antibody and nutrient density changes based on what your baby needs, each and every time they feed. The foremilk is more watery and thirst quenching, the hind milk has a higher fat content to help fill baby up – so making sure they completely drain one side before starting feeding on the other is important to stop them from feeling hungry so soon. Special receptors at the areola (around the nipple) send signals to let your body know exactly what antibodies your baby needs, you make them and pass them through your milk, until such time as they can make their own. When babies start to ‘cluster feed’ which can often happen at around the times of growth spurts, don’t worry that you are not producing enough for her, she is doing this to stimulate further production, and most milk production occurs in the early hours of the morning, which can impact your sleep but is biologically normal.

Feeding your baby breast milk only until they are around six months old will help you protect them from illness and infection. Babies who aren’t breastfed are more likely to get diarrhoea, vomiting and respiratory infections. But the benefits of breastfeeding last for far longer than six months, and the WHO suggests to breast feed for as long as you can up to the age of 2! I didn’t manage it for quite that long! But whatever you can manage will give your baby a great benefit. Milk contains HMOs (Human milk oligosaccharides) that provide NO nutrition to the baby, but instead feed their microbes. This substance is not for your baby – but for the billions of beneficial bugs that need to grow in the gut for optimal health. There are 100 or more different HMOs needed to help your baby thrive! For mothers, breastfeeding decreases the risk of breast cancer and it may also offer some protection against ovarian cancer. Breast milk can continue to be given alongside an increasingly varied diet once your baby is introduced to solid foods.

Babies from birth to one year of age who are being breastfed are advised to be given a daily supplement containing 8.5 to 10 micrograms (mcg) of vitamin D.

What about cracked nipples and mastitis?

I’ve been there, and some women suffer so badly that I want to mention it here, because finding ways to get through these challenges will be so important to you, both for your health, your baby’s health and of course the animals if you are vegan and want to avoid cow’s milk based formula. Initial discomfort is to be expected perhaps, but if it is painful, please do see a breast-feeding advisor as soon as possible – an abnormal latch can cause such chaffing that cracks can begin after just one or two feeds, which then makes the healing process harder because breastfeeding with cracked nipples is a bit like wearing shoes which cause blisters, but to not be able to take them off! Ensure the nipple is all the way to the back of baby’s mouth, so the baby sucks the areola, not the nipple itself. Waiting for your baby’s feeding reflex before latching is key so their mouth is as wide as possible. Watch a video on YouTube to show you how it’s done, but the steps are:

  • Bring your baby close to your body so they don’t need to stretch to reach your breast
  • Check your baby’s head and body are in a straight line facing the same way
  • Move your baby’s nose to your nipple so they can reach and get the breast underneath your nipple
  • Support your baby’s neck, shoulders and back, BUT make sure their head is free to move
  • Watch your baby tilt their head back and open their mouth wide
  • If your baby’s mouth doesn’t open, encourage it by gently rubbing your nipple against their upper lip and moving away until they open wide
  • Bring your baby to your breast
  • To latch on correctly, your baby’s tongue and lower lip should make contact with your breast first

If you feel this isn’t happening, again go to a clinic –in the UK these are free and available widely, as I imagine they are in other countries too. Your baby could also be tongue tied which can prevent a good latch, so it’s another reason to seek advice if feeding is painful. Once you have cracked nipples there are a few things you can do to help – many women try lanolin, a waxy, yellow substance derived from wool. It is applied to the nipple, and acts as a skin barrier promoting moist wound healing to prevent scabbing. But if you are vegan, you may want to avoid it, so alternatives are to use hind milk (simply rub a little into the sore skin after each feed) or unrefined coconut oil, which is anti-bacterial, anti-fungal and can remove excess dead skin cells from the skin’s surface. You won’t need to clean your nipple before your baby’s next feed. There are other plant based soothing nipple balms, just take a look online.

Another thing to help temporarily would be to give your nipples a break with a nipple shield (now pleased don’t be confused and go into a pharmacy asking for nipple clamps, which is what my sister did when I asked her to go and get some shields for me!!). Another option would be to express milk for a while with a breast pump, and feed your baby with a bottle. If you are committed to breast feeding I would recommend investing in a good breast pump. Initially it is important to get your baby latching on the breast well, but once a good feeding pattern is established, using expressed milk via bottle will ease nipple discomfort and give you a little bit more freedom. If you have to return to work a pump is also a good investment so you can stock pile frozen breast milk which lasts in the back of freezer for up to a year. If you have no problems breastfeeding and are producing extra milk, you could also look into milk donation programmes for premature babies in special care baby units or for vegan mums who cannot breastfeed.

Mastitis

Again, I mention this here because breastfeeding will be very important to many vegan mummies, so I want you to be able to know what to expect. Mastitis is usually the result of a blocked milk duct that hasn’t cleared. Some of the milk behind the blocked duct can be forced into nearby breast tissue, causing inflammation and pain, with or without infection.

Early symptoms of mastitis can make you feel as if you are getting the flu. You may begin to get shivers and aches. The breast will be sore like it is with a blocked duct, only worse. It is usually red and swollen, hot and painful. The skin may be shiny and there may be red streaks. You will feel ill. It is common for the ill feeling to come on very quickly.

Start treatment as soon as you feel a lump or sore spot in your breast. Drain the affected breast with baby’s feeding. This is not the time to stop or to wean. More than anything else, your breasts need to be kept as empty as possible. Your baby’s sucking is the best way to do this. The milk is quite safe for your baby to drink, even if you have had to start antibiotics. Feed more often than usual, starting each feed on the sore breast. Let your baby suck long enough on this side to make sure that it is being drained well. However, take care not to let the other breast become too full, as it may cause a similar problem in that breast. Help the breast to ’empty’ or drain more easily by making sure your bra is very loose or take it off, relax your body and shoulders while you feed to help your milk flow, which also includes breathing nice deep breaths – music may also help.

Change feeding positions – try to choose positions that allow the milk to flow downhill to your baby. For instance, feeding while lying on your left side might help a blockage on the right side of either breast. If the blockage is under the nipple, raise the breast with your hand while you feed. If this doesn’t work, another option is to feed ‘on all fours’ kneeling over your baby. Gently massage the breast by stroking toward the nipple while your baby feeds. Express milk to ’empty’ the breast if your baby won’t suck. If you have mastitis, your milk may taste salty. This won’t harm your baby, but may cause him to refuse the breast. But don’t over express as this could further stimulate milk production and worsen engorgement. Using COLD packs on the affected breast can help reduce swelling and relieve pain, and using WARMTH just before a feed for up to a few minutes, can help trigger your let-down to help clear the blockage and may relieve pain.

Make sure you rest – stay in bed if you can, or at least put your feet up for most of the day. If you do go to bed, take your baby, supplies for changing nappies and your own food and drinks with you, so you don’t have to keep getting up. But if you are not improving over 24-48 hours you must seek help, as antibiotics may be needed to prevent a breast abscess.

Now most potential challenges are dealt with – go forth and enjoy!

What about formula?

You must do what you need to do to keep your baby well and thriving. So I want to start by saying there is no judgement here on which milk to give your baby and why. The Vegan first steps nutrition guide says no soy milk under 6 months, and not as main milk drink under 1, because of the sugars that replace lactose. It also advises against rice milks because of arsenic content. I spoke to paediatrician Dr Miriam Martinez-Biarge about this, and she explained that the formula milks based on rice protein are perfectly safe. Premiriz is made in France, is organic and 100% vegan (even the vitamin D3 is vegan) and does not have palm oil. When asked what her preferred recommendation is for a cow’s milk formula alternative, she often recommends soy formulas for babies under 6 months. She said; ‘They have been used for more than 100 years, and there is evidence that they do not cause any harm in the short or long term.’

Safety of soya-based infant formulas in children

She also said ‘my clinical experience with soya formula has always been very positive; I’m in contact with several families that are using it and babies tolerate it very well (they also seem to like it) and their growth & development is perfectly fine’. When asked if there were any circumstances under which soy milk should not be used, she advised against soy based formula for a baby with congenital hypothyroidism, because soya may affect levothyroxine absorption. Apart from this, and preterm babies while they are in the NICU, she advises soy milk is a great alternative to cow’s milk, assuming your baby is not allergic.

Rice formula includes only isolated and then hydrolysed rice protein, but not the whole grain, so do not contain arsenic. The rest of the ingredients come from other sources. Dr Martinez-Biarge said; ‘A couple of years ago I asked one of the companies that produce this formula in Europe about this and they sent me the analysis they make periodically that includes levels of arsenic and other contaminants and pesticides. The EU regulation on formula milks for infants is quite strict about this.’

So, there are options for mums looking to avoid cow’s milk formula, and milk donation schemes are also a possibility, depending on your budget and where you live.

MYTHBUSTING

You may be plant based and face a barrage of questions from loved ones or people who just don’t get it. Have no fear, just watch my myth busting talk or listen to this podcast which covers the basic questions and concerns people often have around a vegan lifestyle and the associated benefits:

WATCH

LISTEN

Health

How can Plant Based Diets improve my heart health?

WATCH - The modern day epidemics of heart disease and diabetes

What is heart disease?
Cardiovascular means heart and blood vessels. Heart disease is a general term for diseases of the blood vessels. This includes disease in vessels of the heart (which can be narrowed in angina, causing chest pain, or completely blocked in the case of a heart attack) in vessels of the brain (a blockage of vessels here can cause a TIA or a stroke, as well as dementia) or in the peripheral blood vessels (blockages causing impotence, or peripheral vascular disease, causing pain on walking, ulcers, or even gangrene). In reality, any vessel anywhere in the body can begin to stiffen, narrow and block – which is really the underlying problem in heart disease.
Why does this happen?
Atherosclerosis is the reason for symptoms of heart disease. Atheromas, or plaques, build up in blood vessels, and it is these plaques that can narrow the blood vessels and eventually block them. They are made of cholesterol and other fatty substances, white blood cells (which attach themselves to these plaques in an attempt to dissolve them), calcium deposits, and fibrin (which clots the blood and can lead to further blockage of the vessel). If a plaque tears, the blood supply to the artery can be blocked, or in severe cases the blood vessel can even rip open (in the case of a ruptured aneurysm or a dissection, which tends to occur in plaque weakened blood vessels).

On a cellular level, it is dietary fat that causes this clogging of blood vessels. Studies show that a high fat diet reduces the ability of the arteries in the hands and feet to swell and constrict (1), and the only study to directly compare the arteries of the heart in those eating a heathy low carb high protein diet to a healthy high carbohydrate diet, showed reduced blood flow to the heart of the low carb eaters. (2) When scientists want to do experiments on monkeys, to see how diet changes affect animals that are the most genetically similar to humans, they cause atherosclerosis in their blood vessels by giving them a high cholesterol diet. In fact, several monkey studies have been performed which have shown reversal of atherosclerotic plaques with a whole food plant based diet (3). Monkeys are genetically most similar to humans and what were they made to eat? Well, apart from the odd bug, they eat plants, and a lot of them. I know we are not monkeys, but neither are we mice (the most common human proxy in scientific experiments that we rely on to understand drug safety before human trials). Neither are we fruit flies, or yeast cells. But interestingly, the same cellular ageing pathways occur in all of us. And these pathways are dramatically shortened (thereby reducing life span) by eating processed sugars (not fruit as people mistakenly think) and by eating leucine (a protein building block or amino acid most concentrated in animal protein).

So how do we stop it?

There is a well-known researcher by the name of Dr Michael Greger who has collated study evidence on the benefits of whole food-plant based eating for prevention and treatment of heart disease and heart failure. His book ‘How not to Die’ is a New York Times Bestseller and his website www.nutritionfacts.org gets many thousands of visitors each day.

Why the passion? His elderly grandmother was sent home with heart failure to die. She was told by doctors she would not live much longer and there was nothing more that could be done. She tried a unique change of lifestyle that enabled her to survive a few more weeks, which turned into a few more months, which turned into a few more years…. Incredibly she lived another 20 years to see her grandchildren grow up, and her grandson Michael Greger go to medical school. This is one personal story of many that show the long-lasting benefits of this way of eating. She followed the diet programme of Nathan Pritikin, who was one of the first to show that a whole foods plant based could reverse heart disease, and his results were replicated in larger trials by Dr Dean Ornish and Dr Caldwell Esselstyn. This approach has now been shown to reverse disease in thousands of people. A whole food plant based diet cleans out the blockages in blood vessels more effectively than stenting, while also improving blood pressure and diabetes risk too.

How do we do it?
It depends on what you like to eat. Modifying certain favourite foods is a good place to start. For example, a chicken curry could become a chickpea curry, a beef Bolognese a lentil Bolognese, a Mexican chilli could be a three-bean chilli. Slowly experimenting with new flavours and ideas so that it can become a new voyage of discovery and fun, without the pressure. Perhaps starting with breakfast, then changing 2 or 3 meals during the week, then increasing the following week by another 2-3 meals, until pretty soon you have 4 or 5 good rotating meal ideas that replace your old habits. Some people prefer to just dive in head first, and take an all or nothing approach. Just do whatever works best for you. If you change to a completely whole food plant based diet straight away you are likely to reap the benefits more quickly, but if it is a very new way of eating, your gut bacteria will not yet have caught up and so you may notice some initial bloating as your gut bugs begin to adjust and respond well to your healthy diet change.

I’d strongly recommend this book if you have heart disease and are ready to reap the benefits of plant based nutrition:

Prevent and Reverse Heart Disease
by Caldwell B. Esselstyn

Based on the ground breaking results of his twenty-year nutritional study, Prevent and Reverse Heart Disease by Dr. Caldwell Esselstyn illustrates that a plant-based, oil-free diet can not only prevent the progression of heart disease but can also reverse its effects. Dr. Esselstyn is an internationally known surgeon, researcher and former clinician at the Cleveland Clinic and a featured expert in the acclaimed documentary Forks Over Knives. Prevent and Reverse Heart Disease has helped thousands across the US, and is the book behind Bill Clinton’s life-changing plant based diet.

Any tips on Supplements?

Yes!

Oral Vitamin B12 spray is essential. B12 is a vitamin made by microbes in the soil (hence the reason it is in animal muscle, as they have eaten soil, drank untreated water, or eaten corn feed with B12 supplement within it). Even those who eat a lot of meat and eggs will often be B12 deficient after 50 years old, as their stomach can have problems absorbing it. Also taking indigestion or diabetes drugs can reduce absorption of vitamin B12. I like the bio-available form methylcobalamin, which can be bought online from the usual outlets.

I also recommend everyone takes a Vitamin D supplement – 1000-2000units daily assuming you are not already deficient.

EPA/DHA supplements are useful. These are the purest form of Omega three fatty acids on the planet. Made from algae (where fish get it from too) it means you can optimise heart health without having to eat fish (and the heavy metals and toxins within them, unfortunately the seas are so polluted it is almost impossible to avoid this now).

FLAX seeds – these are a super food. 1-2 tablespoons of milled flax every day will drop your blood pressure and boost heart health. Mix into your morning porridge, sprinkle in a salad or main meal, even bake with it (1 tablespoon in 3 of water can replace one egg in baking).

What else can I do to improve my health?

It’s not just about what you eat, but WHEN you eat.
Time Restricted Eating has been shown in many studies to improve lifespan and reduce disease. This is because our digestive enzymes and bacteria have a night and day circadian rhythm, which means we are most effective at digesting when we eat in the middle of the day. Letting your gut lining heal and recover between the work of digestion also boosts the immune system. Aim to consume all your food and drink within a 12-hour window, and every fortnight or so reduce that to an 8-hour window for a few days.
Sleep is essential

If you fall asleep within 20 minutes of going to bed, or go back to sleep within 20 minutes of waking during the night, you are on track with your sleep! Otherwise it needs serious attention. Lack of sleep worsens heart disease, make you fatter, biologically older and more at risk of diabetes. It also makes you less able to be positive and productive. Eight hours is best. How to get back to good sleep?

Aim to go to bed 10 minutes earlier than you normally would for several nights in a row, until you get to a good natural rhythm of bedtime. The key is consistency. 10pm is ideal, but follow your natural pattern to aim for earlier, or later – but no later than 11pm. If you find yourself awake for more than 20 minutes, get out of your room and go somewhere else – perhaps to read. Do not eat or look at your mobile phone! This will help change your sleep associations – so that you associate feeling sleepy with your bed, rather than restlessness.

No caffeine past midday, and never use alcohol as a sleep aid. It disrupts your body’s natural rhythms and means you cannot achieve truly restorative sleep.

Sync yourself with the sun. Go for a brief walk in daylight as soon as you wake, and at least within the first two hours. This will set you up for good melatonin production (our sleep hormone) later in the day.

Keep the lights low and no electronic devices for at least an hour before you go to sleep, or consider buying blue light blocking glasses. I was given a pair by Henshaw Eyewear – if you like them they have created a 15% off discount code for you – PLANTPOWER.

Sleep in a very dark room or wear an eye mask.

If you would like to read more on the vital importance of sleep in our lives, check out:


Why We Sleep
by Matthew Walke
Move
Whatever you are able to do, aim to gradually increase the amount you move your body throughout the day to improve heart health. This isn’t about burning calories so much as helping your body carry you comfortably throughout life – making steady progress. Walk, take stairs, join a gym, practice yoga (which is a good way of using our body for resistance training) or buy some low impact kettlebells and do some workout videos at home. Get outside, walk on the grass – really anything to get you out of a chair and into health!

I like this 4 minute ‘nitric oxide’ activation workout – anyone can do it regardless of fitness level and you don’t need fancy clothes or a gym membership to get started:

https://www.youtube.com/watch?v=PwJCJToQmps

Unwind

Our mental and spiritual health is linked strongly to our physical health – we must look after our mind and soul to allow the body to reap the benefits. This can take a number of guises and again, it depends on you.
Suggestions include:
Enjoy a family pet.
Connect with loved ones.
Eat a family meal.
Nurture a friendship.
Take up a long-lost hobby
Practice meditation – Calm, Headspace and Insight Timer are all excellent smart phone apps for beginners to help with this. Make sure you set these up before bed so you don’t have to look at blue light from the phone prior to sleep.
Take up Yoga
Count your blessings – a gratitude journal can help with this – buy a note book and write things you are thankful for within. It’s amazing how good this can make you feel.
Be of Service – this can be any number of things and again depends on you – join a community group, help a loved one, lend your expertise to someone, regularly surprise a stranger with a random act of kindness…

Aim to truly incorporate these tips into your daily life and you will reap the benefits. This is about forming new habits that will change you, change the expression of your genes, change your gut bacteria, change your outlook and ultimately, give you the tools to achieve the life of vitality you deserve!

How can I use diet to Improve my Diabetes?

What is diabetes?

Type 1 diabetes is a condition where the body stops making its insulin. This is because the cells where insulin is made (pancreatic Beta-cells) have been destroyed – usually by the body’s immune system. Why is this important? Well, insulin is a hormone with lots of uses, but its main role is in transporting glucose from the blood into the cells of our body. When the body is no longer able to use insulin to transport glucose, fatty acids or proteins – it shuts down fast. Without insulin injections, Type 1 diabetics would not be able to survive very long. With diet changes, Type 1 diabetics can reduce their insulin needs and increase their longevity.

Type 2 diabetes is different. It is caused primarily by insulin resistance – the pancreas initially makes enough insulin, but the cells no longer respond to it very well, and so glucose is trapped in the bloodstream instead of being used for energy. Over time, many type 2 diabetics find their tired pancreas is worn out from going into overdrive for a number of years, trying to make more insulin (responding to high blood sugars) and eventually stops working properly – this is why diabetes often progresses over time, and in some people ultimately results in needing insulin. Most type 2 diabetics do not end up needing insulin, and can improve their glucose sensitivity or their pancreatic overload through diet changes, or use medications to improve their blood sugar levels. Amazingly, with diet changes, it is possible to reverse these changes, and take back your health.

Why does insulin resistance happen?

Insulin resistance starts in the muscle cells and the liver cells. This is what ultimately causes Type 2 Diabetes often many years after the process has begun. Normally glucose can go into the muscle cells to power them, and the liver cells for energy and for storage as glycogen. The brain also uses glucose as its main fuel. But remember glucose cannot get there by itself – it needs insulin to ‘give permission’ for it to enter into the cells. Insulin acts like a key in the lock. It attaches to receptors on the cell membrane, which opens little channels in the cell to let glucose in. But for some people this process isn’t working. They have plenty of insulin, glucose is attaching to it, but it is like a key that isn’t opening the lock. The lock is jammed. How? Tiny fat particles build up inside the cells – intra-myocellular lipid – they disrupt the signalling for the insulin keys and prevent them from being able to attach to the receptors properly. The result? Glucose is stuck in the bloodstream, causing toxicity to your blood vessels and your nerves. If you are insulin resistant and your cells are filled with fat, sugars that you eat will make your blood sugars rise very high. You will then blame the banana you just ate for your blood sugar rise, not the chicken salad you ate before it.

This can happen to anyone at any age. Researchers using MR spectroscopy scanning can show muscles and liver cells building up this fat sometimes many years before you notice a problem. Scientists can use these scans to predict insulin resistance, metabolic syndrome, pre-diabetes, polycystic ovaries, gestational diabetes and type 2 diabetes.

How do we clean up the jammed lock?

Reducing or eliminating animal fats and minimising vegetable oils will dissipate the fat inside the cells. It’s that simple. It usually only takes a matter of days for your pancreas to wake up, your cell receptors to work again and for your glucose sensitivity to rise. This will cause a dramatic drop in circulating blood sugar, which will mean reducing your oral medications if you are on them, and with insulin dependent type 2 diabetics, incredibly they can often come off insulin entirely.

I’ve heard low-carb diets help…

Many people around the diet adopt a low carbohydrate diet to try to lose weight and improve their diabetes. The benefits of high fat low carb eating patterns are well known for weight loss, reducing cholesterol in some, and improving average blood sugars. The main reason for this is that they reduce the carbohydrate load that your pancreas has to deal with. The loss of the sugar spike means that less insulin is produced. People get lower blood glucose, they start losing weight and they reduce their circulating insulin. They are happy that they feel better, and their diabetes blood tests are looking better, which reinforces this way of eating. But this is not a long-term strategy for health. Glucose is a bit like petrol for the body. A low carb diet is a like a rag in the petrol tank stopping you from putting in fuel – the car will run well for a while but you can eventually drive into problems.

Carbohydrates are usually half or more of the average person’s diet – if you take out these foods (from unhealthy snacks, but also from rice, fruit, beans, pasta and bread) chances are you will lose weight as a net effect of reducing caloric intake. And what are you replacing these foods with? If you make up for it with meat and cheese, you won’t lose any weight. Studies show that the only low carb eaters who lose weight are the ones who are reducing their overall intake of calories.

More worrisome is what happens in the blood though – if you lose weight (however you do it) typically your cholesterol will drop too. Not necessarily with a low carb diet – about a third of people eating this way actually have a rise in their lipid profiles. A study published in the British Journal of Nutrition in 2012 showed that a low carbohydrate high protein and high-fat diet STIFFENED peripheral arteries eg made the small blood vessels less responsive, and less able to swell and constrict, which increased risk of heart disease – high blood pressure, heart attacks and stroke. Similarly, the only study to directly compare the coronary arteries of patients on a healthy low carb diet vs a healthy high carb diet showed significantly reduced blood flow to the heart (the coronary arteries) with the low carb diet.

Mortality risk in low carb dieters (focusing on animal sources of protein over plant proteins) is also shown to be higher in the long term – heart disease and cancers being the main causes.

What about the ketogenic diet?

This is also a very low carb diet – with a maximum of 30g carbs a day, less than 10% of total calories. The good news for health is that it prohibits processed junk food, refined sugars and refined flour BUT it also prohibits whole grains, beans, lentils, peas, and rice – not so easy. Ketogenic dieters tend to eat meat, dairy, oil and fish, green veg, nuts, seeds and very limited fruits – mainly berries.

How does ketosis work for weight loss? We can burn fuel from glucose and from fat. Our brain uses glucose as its primary fuel, and can use ketones made in the liver via fat metabolism if needs be in times of starvation. Using ketones from fat for fuel also allows the pancreas to make less insulin – this can achieve a flat-line blood glucose profile and greatly reduce need for oral meds and insulin. Plus rapid weight loss, and reduced average blood sugars. But we are not designed to live in ketosis very long.

The PROBLEM is that a ketogenic diet could INCREASE RISK of chronic disease and premature death. Although it’s possible to eat a vegan ketogenic diet, (and this may provide some of the longevity benefits seen with studies on intermittent fasting), generally people on a ketosis diet do choose animal products over vegetable, and often the low carb keto diet by default turns into high fat and high(er) animal protein diet. There are many studies showing a link between eating more animal protein and increased mortality following a heart attack (NHANES and Levine, Cellular Metabolism), and showing that animal proteins are linked to cellular ageing too. There are also many studies showing ketosis causes adverse effects – including atherosclerosis, as there are a fairly large group of children with intractable epilepsy who had to maintain true ketosis long term, and developed early atherosclerotic plaques. Other risks include:

Immediate constipation, bad breath, rashes, brain fog and flu like symptoms.

Longer term… well — the list is too long and ends with death – five scientific papers have reported deaths as an adverse effect from long-term ketogenic diets.

If you want to treat the underlying cause of insulin resistance and inflammation in your body, rather than masking it, you can do this with a whole food plant based diet.

So how do we begin to reverse diabetes once it has started?

A whole foods plant based lifestyle means foods rich in fruits and vegetables, legumes and while grains of all varieties:

What does this mean?

  • Fruit – think of the colours of the rainbow – apples, pears, oranges, grapefruits, mandarins, lemons, limes, nectarines, apricots, tomatoes, peaches, plums, bananas, mangoes, kiwis, watermelon, galia melon, passionfruits and more…
  • Berries – organic and/or frozen to include blueberries, strawberries, blackberries, cranberries, grapes (yes, grapes!) and more exotic berries such as acai and goji.
  • Vegetables – all colours and types – think asparagus, sweet potatoes, yams, potatoes, onions, garlic, aubergines, courgettes
  • Greens – (salad every day, such as lettice, spinach, collard greens, as well as celery
  • Cruciferous vegetables every day like broccoli, or kale, or cauliflower, or sprouts, or all of the above!,
  • seeds (especially flax and chia seeds), sprinkled on hot meals, or over salads,
  • porridge oats (can put your seeds in porridge),
  • soy milk or nut milks,
  • whole grains – including brown rice, wholemeal wraps, brown wholemeal bread and wholemeal pasta. Many people initially respond well to reducing the gluten content of their food. This will involve things like rye bread, lentil flour penne, brown rice flour pasta, buckwheat noodles, brown rice, gluten free oats – all these items are available in most large supermarkets and are gluten free.
  • nuts of all varieties (not salted), especially walnuts, brazil nuts and almonds
  • Legumes: beans including reduced sugar and salt baked beans, kidney beans, black beans, haricot beans, butter beans, broad beans, edamame and every variety in between, green peas, green beans tofu, lentils and chick peas.
  • Herbs and Spices: cumin, coriander, basil, chilli, smoked paprika, turmeric, cinnamon, mixed spice
  • Yummy condiments: nutritional yeast (to add depth of flavour and vitamin B12 to ‘cheesy sauces’ mirin (like soy sauce), vanilla extract, truffle powder or sauce, liquid smoke.
Any tips on Supplements?

B12
Oral Vitamin B12 spray is essential if you are not eating animal products. B12 is a vitamin made by microbes in the soil. This is the reason it is in cow, pig and chicken meat, as they have eaten soil, drank untreated water, or eaten corn with B12 supplement added to it. Even people who eat a lot of meat and eggs will often be B12 deficient after the age of 50, as their stomach can have problems absorbing it. Also taking indigestion or diabetes drugs can reduce absorption of vitamin B12. So it’s a good idea to supplement, especially for diabetics.

Vitamin D
As most of us are deficient in this – as a rule of thumb you are able to make enough vitamin D through sunlight exposure if your shadow is shorter than your body. If you have no shadow or it is very long, chances are you are not making vitamin D. I’d recommend at least 1000u a day in those who have normal levels, and 2000u a day if you have a tendency to run low. If you are already deficient you could need higher doses.

Algae oil
EPA/DHA supplements are useful. These are the purest form of Omega three fatty acids on the planet. Made from algae (where fish get it from too) it means you can optimise heart health without having to eat fish or take cod liver oil (and so avoid the heavy metals and toxins within them, unfortunately the seas are so polluted it is almost impossible to avoid this now).

FLAX seeds – these are a super food. 1-2 tablespoons of milled flax every day will drop your blood pressure and boost heart health. Mix into your morning porridge, sprinkle in a salad or main meal, even bake with it (1 tablespoon in 3 of water can replace one egg in baking).

Further tips
Drink two cups of hibiscus tea a day to lower blood pressure too.

Aim to avoid mouthwash. Some studies show this practice of stripping your mouth of beneficial bacteria is actually associated with high blood pressure and diabetes. This is thought to be because bacteria in our saliva usually help to release nitrous oxide from vegetable foods we eat to open up our blood vessels, killing them off means this first stage of digestion is no longer possible.

Aim to truly incorporate these tips into your daily life and you will reap the benefits. This is about forming new habits that will change you, change the expression of your genes, change your gut bacteria, change your outlook and ultimately, give you the tools to achieve the life of vitality you deserve!

Diabetes Further Reading
If you want to read a book on how your Diabetes can be better managed or potentially in the case of type 2, reversed, check out these books and online resources:

Mastering Diabetes – My friends Robbie and Cyrus are both living with Type ! Diabetes. Cyrus did his doctorate on the topic of insulin resistance and together, they have built and incredible and educational platform to help people living with all types of diabetes to thrive and feel their absolute best through a personal training programme.

I would also recommend these books:


Reversing Diabetes
by Dr Neal Barnard M.D.

The End of Diabetes
by Joel Fuhrman
References

1. Merino J, Kones R et al. Negative effects of a low carbohydrate, high protein, high-fat diet on small peripheral artery reactivity in patients with increased cardiovascular risk. British Journal of nutrition 2012
2. Fleming RM The Effect of high protein diets on Coronary Blood Flow. The Journal of Vascular Diseases October 2000
3. Roden M, Price TB et al Mechanism of three fatty acid induced insulin resistance in humans. Journal of clinical investigation 1996; 97 (12): 2859–65.
4. Roden M, Krssak M et al. Rapid impairment of skeletal muscle glucose transport/phosphorylation by free fatty acids in humans. Diabetes 1999;48(2):358-64
5. Santomauro AT, Boden G et al. Overnight lowering of free fatty acids with Acipimox improves insulin resistance and glucose tolerance in obese diabetic and non-diabetic subjects. Diabetes. 1999; 48 (9): 1836–41.
6. Lee S, Boesch C et al. Effects of an overnight intravenous lipid infusion on intramyocellular lipid content and insulin sensitivity in African – American versus Caucasian adolescents. Metab Clin Exp. 2013; 62 (3): 417–23.

Ketogenic diet and atherosclerotic plaques

Imperial College Research
L M Goff, J D Bell, P W So, A Dornhorst, G S Frost. Veganism and its relationship with insulin resistance and intramyocellular lipid. Eur J Clin Nutr. 2005 Feb;59(2):291-8 (cited in https://nutritionfacts.org/video/lipotoxicity-how-saturated-fat-raises-blood-sugar/)
24 vegans, 25 omnivores

Fat causing insulin resistance on a cellular level

Statistically significant higher insulin sensitivity in vegans
J Gojda, J Patkova, M Jacek, J Potockova, J Trnka, P Kraml, M Andel. Higher insulin sensitivity in vegans is not associated with higher mitochondrial density. Eur J Clin Nutr. 2013 Dec;67(12):1310-5

S Tonstad, K Stewart, K Oda, M Batech, R P Herring, G E Fraser. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutr Metab Cardiovasc Dis. 2013 Apr;23(4):292-9

Tzoulaki et al BMJ 2009 Risk of mortality with sulphonyueas

Increased IGF1 and cancer risk

Walter Kempner managed to show reversal of diabetic retinopathy on a high carb diet – rice/fruit
W Kempner, R L Peschel, C Schlayer. Effect of rice diet on diabetes mellitus associated with vascular disease. Postgrad Med. 1958 Oct;24(4):359-71

High Nutrient Density Diet
D M Dunaief, J Fuhrman, J L Dunaief, G Ying. Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density (HND) diet. Open Journal of Preventive Medicine Vol.2, No.3, 364-371 (2012)
13 diabetics – reduction over a mean of 7 months from HbA1c 8.2 > 5.8, and after most medications were dropped.

J W Anderson, K Ward. High-carbohydrate, high-fiber diets for insulin-treated men with diabetes mellitus. Am J Clin Nutr. 1979 Nov;32(11):2312-21
Injectable insulin reduction in 20 diabetic men who ate a calorie dense whole food plant based diet, vs control diet following conventional diabetic diet.

Study suggests that plant-based diets, especially when rich in high-quality plant foods, are associated with substantially lower risk of developing T2D. This supports current recommendations to shift to diets rich in healthy plant foods, with lower intake of less healthy plant and animal foods.

A plant-based diet for the prevention and treatment of type 2 diabetes

Taiwanese study of vegetarians vs omnivores – half the risk of diabetes. In the sample size no vegans had diabetes. Vegetarians had higher intakes of carbohydrates, fiber, calcium, magnesium, total and non-heme iron, folate, vitamin A, and lower intakes of saturated fat, cholesterol, and vitamin B12.

Microbiome studies
Klimenko NS, Tyakht AV, Popenko AS, et al. Microbiome responses to an uncontrolled short-term diet intervention in the Frame of the Citizen Science Project. Nutrients. Published online May 8, 2018.
A diet rich in fruits, vegetables, and other high-fiber, plant-based foods improves gut bacteria diversity within two weeks, according to research published in Nutrients. Researchers assessed gut bacteria composition in 248 participants over a two-week dietary intervention that increased fiber intake. Those who consumed more fruits, vegetables, and grains improved gut bacterial diversity when compared to participants who did not change their diet. High-fiber diets increase bacteria associated with anti-inflammatory compounds linked to improved glucose tolerance and metabolism.

Mouthwash and blood pressure

Mouth wash and diabetes

Why is climate change linked to human health?

Why is it so bad?

The truth is, our meat obsession is killing us, and the chances of our children’s healthy future on this beautiful planet. Something has to be done fast – we face a ticking clock globally and we are unable to turn back time.

Why is it so bad? People have been eating meat for thousands of years! Well, yes. But not this much. Heart disease, strokes and many forms of cancer have existed for centuries, and were much more common in the gentrified populations who had a ‘richer diet’ – but these diseases have since skyrocketed among people on traditionally more humble diets. In India and China many people who thrived on a vegetarian diet are now developing cancers and diabetes at unprecedented rates. The explosion of consumption of refined sugar, refined flour and excess animal products is a toxic time bomb of obesity and cancer. Plant based eaters tend to be thinner, and have lower cholesterol and blood pressure levels – surrogate markers of future diseases. They have a reduced risk of heart disease, type 2 diabetes and especially colorectal, breast and prostate cancers. Foods such as fruits, vegetables, nuts, seeds, whole grains, beans and lentils, are the cornerstone of health, and the World Cancer Research Fund suggests that these are the foods most likely to protect us from cancer.

More recently, The Lancet highlighted the detrimental effects of meat consumption on human and environmental health. The EAT-Lancet Commission’s Report represents the consensus opinion of over 30 world leading scientists and nutrition experts across the globe. This panel of experts had a tough remit: to provide evidence-based dietary targets for all humans. This includes the 820 million people who do not have enough food, the 2.1 billion who are overweight or obese and everyone else in between. The consensus was overwhelmingly clear- the most sustainable way forward was to adopt a more plant based diet.

The vast majority of antibiotics are given to farm animals, kept in cramped conditions, to reduce the risk of otherwise inevitable infections. This is the biggest driver of the crisis of antibiotic resistance. The antibiotics they are fed, and that we then eat through their meat, are disrupting our own delicate internal ecosystems and will affect how we respond to antibiotics. Soon we face the inability to perform routine caesarean sections because of the risk of infection. According to the World Health Organisation, between 2030 and 2050 climate change is predicted to cause around 250 000 additional deaths a year from malnutrition, diarrhoea, malaria and heat stress.

We can see from this that the environmental impacts are really just as much of a public health concern. The UN IPCC report suggests we have 11 years within which to attempt to avoid the 2C temperature rise that would render us within a tipping point of no return. Fish stocks are depleted by 90%, and silage from industrial scale pig and cow farms are destroying ocean ecosystems.

it is worth pointing out the medical problems that people can face a direct result of the animal agriculture industry. People do not want to work in abattoirs. A report in Trade Magazine Farmers Weekly has revealed that 10 000 positions are unfilled. There is a high rate of PTSD amongst abattoir workers, a higher rate of penile cancer, and a higher rate of domestic violence, drug abuse and alcohol abuse in these communities. The Health and safety executive said the injury rates of workers in the slaughter industry was very concerning. In 6 years, 800 workers suffered serious injuries, 78 required amputations and 4 died while at work. Animals are often slaughtered by some of society’s most vulnerable humans. This has to stop. And we have the technology now to make this happen – plant based ‘meat’ burgers, lab cultured meats, myriad meat replacements. We have no excuses.

Stephen Hawking predicted in just 100 years our species would have to find a new planet to inhabit because we will have made this one uninhabitable. As species extinction and land mass degradation continue unabated, now is the time to act to end this travesty – before it really is too late.

The evidence

Last Summer a ground breaking study was published in Science which took 5 years to complete. The initial aim was to identify how to make animal agriculture sustainable in the future – over 40 000 farms were analysed in nearly 120 countries – and what was the verdit? It is not possible to farm and eat animals in a sustainable way. One year into the study, the lead author decided to begin a plant based diet, because of the preliminary results of their findings.

A report in Nature journal published in October 2018 also warned that a massive reduction in the quantity of meat being eaten, as well as huge changes to farming techniques, are essential to guarantee our planet’s future ability to support humanity. The analysis, which examines future population projections across the planet and the impact of current farming techniques, warns rapid change is vital as global warming causes pronounced impacts on food production.

For more on a healthy plant based diet from an environmental point of view in the UK, check out this really informative document as part of the British Dietetic Society’s One Blue Dot Campaign

A document referred to as EAT Lancet has also recently been published. 

It took 37 experts from 16 countries two years to put together, and it suggests how our food choices could improve our health and survival on this planet. The report states that ‘civilization is in crisis. We can no longer feed our population a healthy diet while balancing planetary resources. For the first time in 200 000 years of human history, we are severely out of synchronization with the planet and nature. This crisis is accelerating, stretching Earth to its limits, and threatening human and other species’ sustained existence.” It also states “the dominant diets that the world has been producing and eating for the past 50 years are no longer nutritionally optimal, are a major contributor to climate change, and are accelerating erosion of natural biodiversity.” So how do we feed 10 billion people by 2050? The diet stipulates that most of a person’s daily intake should be coming from plants, especially whole grains, fruits and vegetables, legumes, and nuts. The researchers’ aim was to feed more people while:

  • minimising greenhouse gas emissions
  • preventing any species going extinct
  • having no expansion of farmland, and
  • preserving water

However, just changing diets is nowhere near enough. To make the numbers add up, it also requires a halving of food waste and an increase in the amount of food produced on current farmland.

Healthy eating guidelines

If you would like more specific and detailed advice on healthy eating guidelines that are not environmentally focussed, but have health as the primary goal, check out the Canadian food guidelines released in 2019. The Canadian government assembled at team to create a document recommending healthy food choices and guidelines for its citizens. Here is an easy pictorial representation of its guidance:

The guideline recommends that:
1) Healthy eating is more than the food you eat,
2) Be mindful of your eating habits,
3) Cook more often,
4) Enjoy your food,
5) Eat meals with others,
6) Use food labels,
6) Limit foods high in sodium, sugars or saturated fat, and
7) Be aware of food marketing.

For more information, click here.

If we all went vegan, how would the farming industry survive?
Our farmers are agricultural superheroes – won’t it be wonderful to be able to support local farmers in growing foods that can make us thrive as well as boosting the natural environment that we need to survive? At last, making healthy foods affordable again? This is possible with the right training and subsidies to bring back no till conservation agriculture to our once fertile soil. If we support local farmers and regenerative agriculture we will have nutrient rich foods that are once more available to all.

The answer has to come from a massive shift in how we produce food. Teaching farmers to return to no-till regenerative farming practices will allow for increased crop yield over time, and offer genuine long-term answers for our economy and our health. We need to support our farmers to return to techniques which allow nutrients and the framework for soil regeneration back into the food chain, which will allow them to provide affordable organic fruits and vegetables and crops grown in soil that has not been soaked in pesticides or ripped apart by industrial sized ploughs. How to do this as a consumer? Grow your own fruit and vegetables at home if possible. Buy local, buy seasonal and buy organic. Support local organic formers through organic vegetable box deliveries to your door. This will be beneficial for your family’s health, and will tip the balance of industry in favour of organic practices.

I spoke with Professor Amir Kassam on this topic, he specialises in Agriculture, Policy and Development at the University of Reading. He explained that ‘livestock are included in farming primarily to make money because of the high demand for meat and dairy.

Some people argue that ruminant animals are needed for recycling nutrients in soil but, biomass in the form of fodder crops or pastures or crop residues can be recycled without having to push the biomass through animal intestines. Just leaving the biomass on the ground surface leads to compost formation, decomposition and incorporation of the biomass into the soil by earthworms. But to encourage earthworms to live in agricultural soils requires that the soil is undisturbed by tilling.

Tillage agriculture, which is the dominant form of agriculture, is a net emitter of greenhouse gases (carbon dioxide, methane and nitrous oxide) and it does not sequester carbon because the mechanical soil disturbance decomposes the soil organic matter quickly. It also destroys soil life which is required to turn biomass into humus in the soil and eventually sequester it.

Organic matter in the soil comes from plant roots and from above ground plant biomass material being returned to the soil. If the grass is grazed by animals, there is a loss of biomass because animals remove it and while some of it is returned as manure, it still needs to be mixed into the soil and turned into humus and eventually into stable sequestered carbon. None of this has anything to do with livestock. Of the biomass eaten or grazed by animals, most of it is turned into meat but in the process greenhouse gases are released. Also, for 100 calories eaten, only 10-12 calories are produced.

Why is it important to make changes to no till conservation agriculture? Because the soil quality is now so poor, we obtain less nutrients in the foods that we grow, and the soil is so depleted that whenever it rains, top soil is immediately washed away, leaching into the seas around the UK, and providing even further depletion of soil for growing our own food. It’s a vicious cycle.

The answer?

Conservation agriculture techniques to minimize mechanical soil disturbance (no-till seeding/planting and weeding, and minimum soil disturbance with harvesting); provide permanent maintenance of soil mulch cover; and diversify crop rotation systems.

Why is this so important?

Minimising soil disturbance helps to reduce the decomposition of roots, earthworms and microorganisms. More organic matter is integrated into the soil because crop waste is left on the ground as mulch and earthworms incorporate it into the soil over time. In fact, earthworms will mix the biomass with soil and add to it nitrogen which comes from the nitrogen-fixing bacteria which live inside the gut of the earthworm and produce worm casts rich in organic matter, which are like fertilizers. Left over crop matter is also turned into compost by bacteria which gets incorporated into the soil as humus. This allows an amazing structural network to flourish called mycorrhizae fungus. Unlike in the tilled soil where there is hardly any mycorrhizae or earthworms. Mycorrhizae have a symbiotic relationship with plant roots and soil because they absorb carbon into their own mycelia and grow into a thick network, connecting all the plants, like an Internet, through which they communicate. This allows sequestered carbon can stay in undisturbed soils for a very long time. The proteins contained in the walls of these fungal networks (mycorrhizae) are amazingly important because they form stable soil – they act as a cementing agent to build soil structure and porosity so that water can be retained like a sponge, the soil is aerated and the top soil does not erode away.

None of the above process need the help of any livestock, and if they were present they would reduce the amount of biomass being returned into the soil to be sequestered.

In Conservation Agriculture systems, sown wheat and pulses are part of the cropping systems and the byproducts do not have to be grazed but instead returns to the soil by leaving it on the ground as mulch. Livestock is not needed to graze the fodder as earthworms will do the job. in Conservation Agriculture, cropping systems are diversified which means that root systems of different crops can explore the full depth of the soil, integrating soil organic matter and carbon deeper into the soil.

If you want to read more about this fascinating topic, read the reports below or follow the work of Farmers Footprint and Dr Zac Bush.

https://farmersfootprint.us

Grazed and Confused report: Pg32 onwards assesses the claim about livestock and sequestration and basically debunks it.

Anything Cows Can Do, Elk Can Do Better