Dr. Greger Fan Questions Supplementing with EPA and DHA

Let me guess, you’re either plant-based or vegan, you follow Dr. Greger’s videos, and you’ve been taking (or considered taking) an EPA + DHA supplement, because Dr. Greger said so.

I have the greatest respect for the folks at NutritionFacts.org. Also, in good scientific spirit, this is my question to you: Have you looked more deeply into the studies Dr. Greger relies on for this specific recommendation? I have, and based on looking more closely, EPA + DHA supplements still have unproven necessity and safety. Let me develop.


Table of contents

  1. Some Basics
  2. What’s wrong with Dr. Greger’s recommendation to take an EPA + DHA supplement?
  3. Less is more – Understanding Omega-6 vs. Omega-3 metabolic pathways
  4. But do these simple dietary modifications provide enough EPA and DHA?
  5. Conclusions
  6. APPENDIX: Admiration, even well-deserved, can cloud critical thinking

Some Basics

Omega-3 fatty acids are important for health. The parent form of it, alpha-linolenic acid, (ALA) is an essential fatty acid, we must get that one from our food. The human body, depending on lifestyle and other factors, converts ALA more or less efficiently into other omega-3s: EPA, then DHA.

The omega you don’t need more of is omega-6. The parent form, linoleic acid (LA), is also essential but widely over-consumed, and is found typically in high-fat plant foods (vegetable oils, nuts and seeds, etc…). Both ALA and LA are found in every unprocessed plant food, in various amounts and ratios.


What’s wrong with Dr. Greger’s recommendation to take an EPA + DHA supplement?

Dr. Greger’s argument in favour of DHA for all vegans relies on one interventional study linking EPA+DHA intake with health benefits: slight improvement at a cognitive test + what’s interpreted as physically improved brain structure and lower grey matter loss. The supplement was fish oil (EPA + DHA), in high doses (per day: 1320 mg EPA + 880 mg DHA).

Any major flaws? Yes, many. The study published in 2013 was done on:

  • Healthy people? Unfortunately, no. Intentionally selected overweight people 25<BMI<30 with – not surprisingly – blood work that’s really not great (hypertension, borderline high cholesterol by the overly-lenient current official standards, etc.).
  • The general public? No. Seniors only (age 50-75).
  • People eating a healthy plant-based diet? No, people who often eat fish.
  • Identical groups? No, the experimental group (the ones taking the supplement) exercised more.
  • Was their diet well-controlled to ensure both groups ate the exact same food, and that the benefit comes only from the supplement? Again, no. The fish intake was measured only 3 one-off times in 26 weeks. Fish intake is also reported by frequency instead of by quantities of EPA/DHA content.
  • Was the intake of plant-based omega-3 from food recorded? No.

So yes, it is a double-blind, placebo-controlled study, and also serves a perfect example of how this “gold standard” can be far from enough. The design of the study matters as well. Here it is rather poor. More importantly this study really says nothing about vegans and people eating a low-fat whole food plant-based (WFPB) diet.

Moreover, and ironically: While the study uses 880 mg DHA per day, Dr. Greger himself reports that a similar dose (800 mg DHA) is dangerous, based on a study showing that in pregnant (omnivorous) women this DHA dose leads to having children with learning difficulties.

“In a study in which women were given a whopping 800 mg of DHA a day during pregnancy, infant girls exposed to the higher-dose DHA in the womb had lower language scores and were more likely to have delayed language development than girls from women in the control group.”

I am aware that Dr. Greger recommends much less than that toxic dose (250 mg of mixed EPA and DHA), but why is he resting his case on a study so poorly designed and using a toxic dose? Mystery.

Part of that mystery was unveiled since. That study actually isn’t the source of inspiration of his recommendation, although it may seem like it is. Dr. Greger’s recommendation for EPA or DHA precedes this 2013 study. Back in 2008 he was already advocating for DHA,  based on pregnancy/child cognition/child vision studies on omnivores. I looked into them, they display generally poorly controlled/documented diets and outcomes of questionable relevance.

His observation in another 2008 video, that “people who don’t eat animals (…) have very low levels of long-chain omega 3s”, and subsequent recommendation to supplement, is based on a study on high-fat vegans. Their diet was comprised of ~33% fat by % of total calories, in short a very high-fat and high-omega-6 diet, not a healthy low-fat, whole-food plant based one. In the section that follows I’ll explain why a low fat content in the diet matters to synthesize EPA and DHA from ALA.

Again, I have great respect for Dr. Greger and the NutritionFacts.org team of researchers.  Simply, at this point in time, the evidence to support necessity and safety of this supplementation regime is weak, and irrelevant to vegans or people on low-fat whole food plant-based (WFPB) nutrition.


Less is more – Understanding Omega-6 vs. Omega-3 metabolic pathways

Modern diets contain an excess of omega-6, typically from vegetable oils and excessive consumption of high-fat plant foods (nuts, avocados, etc…), and animal products. This interferes with our ability to convert ALA into EPA and DHA. Why? Because omega-6 conversions “steal” the enzymes that omega-3s need to convert ALA into EPA and DHA, and also the enzymes for the latter to be utilised.

Some enzymes in this process have a preference for converting omega-3s, but overwhelmed by a crowd of omega-6s (like in the average vegan or non-vegan diet) they process omega-6s. Also, the omega-3 conversions take more steps, which gives omega-3 an extra handicap in the competition against omega-6. Finally, these enzymes have nutrient “co-factors”, meaning that they need all sorts of nutrients to function well. Hence the importance of unprocessed diets, which are more nutrient-dense and less prone to nutrient deficiencies and the subsequent enzyme dysfunctions.

Cutting down our fat consumption, starting with oils and processed foods, and eating more of a low-fat, whole food plant-based (WFPB) diet does a number of good things with omega-3s:

  • reduces drastically omega-6s intake => omega-3s have less competition => more omega-3 converted and used
  • increases the intake of omega-3s (healthy fats like omega-3s, just like protein, are everywhere in low-fat, unprocessed plant foods)
  • increases the nutrient intake => the enzymes rely on those nutrients (co-factors) to convert ALA omega-3s into EPA and DHA.
  • For reasons unrelated to omega-3s, you’ll feel energetic, loose the extra pounds, and prevent or reverse illness. You wouldn’t read this article and wouldn’t have an interest in supplements if you didn’t to some extent value you health, would you?

Do these simple dietary modifications provide enough EPA and DHA?

This has already been discussed here by rockstar nutritionist Jeff Novick in this article (UPDATE: unfortunately the article was removed after I recently pointed out to Jeff that only a few lines of that old article had obsolete data. I’ll update with Jeff Novick’s analysis on omega-3 whenever I find it elsewhere, or with his updated article, whichever comes first. For now read this.)

Long story short, two scenarios:

A) If you eat a well-planned whole food plant-based (WFPB) diet:

  • We’re assuming your diet is low in fat (~10% of total calories), oil-free, varied, and you’re generally healthy and seldom drink alcohol (yep, alcohol affects omega-3 metabolism).
  • You should be fine and achieve similar excellent overall and brain health , just like the many WFPB populations documented throughout the world.
  • This diet should provide enough ALA to meet the Adequate Intake (AI): 1.1g/day for women and 1.6g for men  as set originally by the U.S. National Academy of Sciences; average Western body sizes. (I log my food very occasionally only for educational purposes, my omega-3 intakes as ALA always meets and exceeds the AI).
  • Enough DHA and EPA should be formed by conversion of ALA under those ideal conditions (low-fat, high-nutrient diet).
  • The studies saying that humans poorly convert ALA, or finding low serum levels in vegans are based on people eating unhealthy diets, typically a high-fat diet (>28–40% of energy as fat). There is a case for omega-3 studies done on people eating a WFPB diet, to reveal conversion rates, and perhaps point to optimal levels of ALA in the diet by looking at health outcomes of various intakes instead of comparing blood levels with fish-eaters. Realistically, we won’t see that data anytime soon…
  • To be on the extra-safe side, you can have (if you deem necessary) 1 or 2 Tbsp (tablespoons) of ground flaxseed daily.
    Note: Time, heat, and exposure to air make these healthy fats oxidise and turn into harmful fats. It can’t harm to blend a new batch as frequently as conveniently possible (we do weekly) and keep it in a closed container in the fridge. Although walnuts and chia seeds are also high in omega-3, I stick to using and advocating flaxseed because:

    • Walnuts are most often bought unshelled, prone to oxidation (going rancid), easily overeaten (health-wise counter-productive), and more expensive.
    • Chia seeds are most often eaten whole (they should be ground for any omega-3 benefit), and are more expensive.
    • Flaxseed conveniently has a thick shell that prevents oxidation until you grind on demand, has the highest content of omega-3, comes with other health benefits (high fiber content, plays a role in preventing/reversing prostate cancer with lignans, reduces blood pressure, etc.), and is the cheapest. Who wins? Flaxseed of course!

B) If you’re currently eating more of a “junk food” type of vegan/plant-based diet (processed foods, using oil/margarines, high-fat, etc) and/or consume alcohol frequently:

  • The odds are your diet is deficient in omega-3s, all of them.
  • Even if you were to have ground flaxseeds (high in ALA) or an omega-3 supplement (ALA, not EPA+DHA), you’d likely very poorly convert it to EPA and DHA because of the high-fat, processed and in some cases alcohol-abusing nature of the diet.
  • You might benefit from some sort of EPA+DHA omega-3 supplementation. Everybody agrees that evidence on benefits and risks is still not clear at this point.
  • An EPA+DHA supplement will, at best, only limit in a minor way the damage of this lifestyle.
  • Consider going at least oil-free/low-fat, and preferably also whole food plant-based.

Conclusions

While the West is pondering about EPA and DHA supplementation or not for vegans, in a short-sighted manner and based on reductionist studies, epidemiology has long demonstrated that quasi-fully plant-based societies that refrain from aquatic animals (fish, etc) have thrived, i.e. unmatched excellent health at all stages of life + long healthspan. This should be the reference, not fish-eaters with fish fat running in their blood. The low-fat WFPB societies achieved unmatched health with zero effort put into omega-3 supplementation, and without foods high in omega-3s like ground flaxseed, walnuts or ground chia seeds.

Additionally, before considering a supplement, it must in my view tick ALL these boxes:

  1. proven necessary (confers health benefits, prevents illness, essential nutrient not found in our diet)
  2. proven safe for long-term use
  3. proven irreplaceable: the active ingredient cannot realistically/practically be obtained in sufficient/safe amounts by dietary means within a plant-based diet.

At this point, nothing suggests EPA and DHA pass those tests.

A low-fat WFPB diet is what vegans should consider as a first line of action if they are concerned with their omega-3 status and the consequences it might have on overall health (including neurological/mental/cognitive).

The omega-3 talk among healthy “whole foodies” is at best one of fine-tuning and optimisation, not a matter or life, death or illness – at all. If you are consuming a low-fat, WFPB diet, with ground flaxseed, the precious time of a healthy person is best spent spreading health and helping other people know about WFPB, rather than worrying about any other nutrients than B12, and the nutrients deficient/unavailable in whatever soil your food grows.

This article was focused on assessing the grounds of Dr. Greger’s recommendation and offering an alternative. If you want to find out more details/debate about the relevance or not of EPA/DHA in a vegan or whole-food plant-based diet, Dietician Dominic Marro has written an excellent article below. It notably compiles the positions of notorious WFPB advocates and plant-based doctors:
Do You Need to Supplement With EPA and DHA If You Follow a Whole Food Plant-Based Lifestyle?

Disclaimer: There may be health conditions where omega-3s are poorly absorbed or poorly converted. In those cases the position shared here might not apply, but only concerns healthy individuals.


APPENDIX: Admiration, even well-deserved, can cloud critical thinking

It’s no surprise to anyone that Dr. Greger from Nutritionfacts.org is looked up to in the vegan and plant-based communities; Dr. Greger (learn the spelling folks, “reger” is symmetrical if that helps 😉 ) and his team of ~19 researchers, whom I would like to salute and acknowledge for a change). The NutritionFacts.org team has compiled countless highly educational videos on various aspects of health and nutrition. So it’s no wonder people having learned so much from them hold Dr. Greger and his team in high regard, he’s become a bit of a nutrition research God.

Like with all veneration, the downside of such admiration is that it clouds reason, and leads to something I jokingly coin as:

Gregerscepticopenia: The lack of healthy scepticism, commonly found in a Dr. Greger admirer, towards a view or position held by Dr. Greger.

Dr. Greger is a media. A media literally means an inter-media-ry, in this case between followers and the published science, itself a media between us readers and (when done honestly) a reality scientists observed through experiments they carried out and documented. Thankfully, in good scientific spirit, the website shares the sources so everybody can look into them. And if you do look into them, sometimes, especially when the supporting evidence is weak or preliminary, you’ll have good reasons to disagree with Dr. Greger’s positions, assumptions, interpretations, conclusions, practical advice.

Even true heroes have their flaws. Even the most genuinely truth-oriented people deserve some healthy scepticism, because humans are humans. Such scepticism is good because it would spot unwitting mistakes and get them corrected, raise the standards of scientific practice, and also because you might not agree with someone’s conclusions/convictions when looking at the same raw data.

Let’s all try to break out from the culture of “following” people, and instead be actors of truth-seeking. Let’s try to make a habit to question things even from our heroes, by going to the source of information and judging for ourselves.

Cow’s Milk – Is a “maybe taller” child worth cancer, obesity or premature puberty?

 

The study “Association between noncow milk beverage consumption and childhood height” has been the source of all sorts of sensational headlines from how cow’s milk is a great health food for kids, to perpetuating the dusty old myth that either breastfeeding or plant-based nutrition is unhealthy…

Human breast milk is nature’s most perfect human baby food, and every health authority urges everyone to eat more plant foods. Yet here we are, having to rest a case for the poorly-known triviality that these are the necessary and healthiest ways to feed children, and that the milk from a cow is perfect health food…only for her own calf – certainly not for humans.

What did the study actually find?

Could it be true that kids on cow’s milk grow taller?

Could it be that kids that are breastfed or fed a balanced plant-based diet are the ones that grow normally and that babies and people fed calf food have abnormal growths?

Do minor differences in height even matter? Shouldn’t we look at effects on overall health instead before we advise to eat/drink something?

What’s the untold story? How does dairy affect the actual health of children and of humans of all ages?

Summary of findings

  • Observational studies on their own [especially on homogeneous populations] provide weak evidence and do not prove causality.
  • The study shows no evidence that the final adults are taller.
  • The study did not control for protein intake nor calories, which is a major flaw given the known effects of protein on growth.
  • Other studies done on height and cow milk consumption find different results.
  • Faster growth ≠ health
  • Official recommendations recognise well-planned plant-based or vegan diet as healthful, nutritionally adequate, providing an advantage to prevent and treat certain diseases, and is suitable for all stages of life, including pregnancy, breastfeeding, infancy and childhood.
  • Do we really need to rest a case for breastfeeding? (that’s “noncow” milk too). Babies failing to breastfeed enough (human mother’s milk) are at put at high risks of serious health complications.
  • Cow’s milk is perfect calf food, not human food, and particularly not weaned-off-human food. As a result, dairy causes a range of health complications from chronic illness, to auto-immune disease and more.
  • Cow’s milk contains over 60 hormones (hormonal disruptors) from a large bovine.
  • Cows grow 4 times faster than humans, everything in the hormones and much higher protein content of cow’s milk (compared to human milk) is designed to make a calf double size in 47 days, as opposed to 180 days in humans.
  • Increased growth in children also comes with premature puberty and faster ageing, and higher risks of obesity and type-2 diabetes.
  • The increased growth factors in humans from dairy is associated with increased cancer risk.
  • Protein excess is also associated with higher cancer incidence.

Review of articles on dairy, child development, human height, necessary nutrition, and adverse health effects of dairy/animal protein.



Topic: Criticism of the study and gap between headlines and actual study

“For each daily cup of non-cow’s milk consumed, children were 0.16 inch shorter. By age three, those who drank three cups of non-cow’s milk per day were about 0.6 inches shorter than children who drank an equivalent amount of cow’s milk, but this finding wasn’t statistically significant.

Since cross-sectional studies look at relationships only at a single point in time, they are generally weak types of evidence. And this particular study provided no additional information about the diets of these children. It also didn’t differentiate among types of non-cow’s milk. These are two crucial factors, especially because the researchers suggested that the differences in height may have been due to differences in protein intake.”

Source:
Dr. Ginny Kisch Messina, MPH, RD
http://www.theveganrd.com/2017/06/cows-milk-plant-milks-and-growth-in-children.html


Topic: “How essential is mother’s milk?”

Human infants deprived of the advantages of human breast milk have:1

  • Two to four times the risk of sudden infant death syndrome (crib death),
  • More than 60 times the risk of pneumonia in the first three months of life,2
  • Ten times the risk of hospitalization during their first year
  • Reduced intelligence as measured by IQ score
  • Behavioral and speech difficulties
  • An increased chance of suffering from infections, asthma, eczema, type I diabetes, and cancer (lymphoma and leukemia) in early life
  • A greater risk of heart disease, obesity, diabetes, multiple sclerosis, food allergies, ulcerative colitis, and Crohn’s disease later in life”

Source:
Dr. John McDougall, author of the best-seller “The Starch Solution”, on the nutrition (starch-based low-fat) that has helped thousands of his patients and readers to reverse the chronic illnesses and various diseases of modern society.
Source: http://www.nealhendrickson.com/mcdougall/030400pudairyproductsfalsepromises.htm



Topic: Undesirable effects of artificially increasing growth rates with animal protein

“Increasing body growth may be useful for farm animal production and growing children faster, but it also means growing cancer cells faster, improving conditions for heart disease and speeding up ageing—each of which has been documented. Growing young girls more rapidly means earlier sexual maturation, higher circulating levels of estrogen and, eventually, elevated breast cancer risk.”

My laboratory in a long series of studies conducted over more than two decades showed that the growth of experimental cancer is markedly stimulated by the consumption of animal-based casein, the main protein of cow’s milk. This occurs in part because this animal source protein stimulates the production of the same growth hormone that spurs childhood growth.”

By Dr. T. Colin Campbell
Co-Author of The China Study
Professor Emeritus of Nutritional Biochemistry at Cornell University
http://nutritionstudies.org/mystique-of-protein-implications/


Topic: The part of the story you’re not being told whenever increased growth is bragged about

Consumption of animal products increases the levels of insulin-like growth factor-1 in your body.  However, modern dairy technology has made dairy products an even more potent source of this growth stimulant.  Since 1985, U.S. dairy farmers have been allowed to inject cows with recombinant bovine growth hormone (rbGH), a genetically engineered bovine growth hormone that increases milk production. RbGH treatment produces an increase in IGF-1 in cow’s milk [53,54].  IGF-1 is not destroyed by pasteurization.53   The overall effect is that milk seems to raise IGF-1 levels in people more than any other component of our diet [55].

The direct evidence of the effects of cow’s milk on IGF-1 levels in people has been provided by the dairy industry’s own efforts. Two recent studies, one on adolescent girls and the other on postmenopausal women, showed increasing milk consumption actually raises plasma levels of IGF-1 in the person’s body by an average of 10% [56,57]. Their take on this is, “this is a beneficial effect” because IGF-1 stimulates bone growth.  But, the actual lasting consequences should deliver the final deathblow to dairy products: IGF-1 promotes the growth of cancer.  This growth promoter has been strongly linked to the development of cancer of the breast, prostate, lung, and colon. [58]  Excess IGF-1 stimulates cell proliferation and inhibits cell death – two activities you definitely don’t want when cancer cells are involved [58] ”

Source:
Dr. John McDougall
https://www.drmcdougall.com/misc/2003nl/may/dairyanddisease.htm



Topic: What nutrition is really necessary and best for health?

“In the days before this was discovered, nutritionists, professionals and parents worried that a diet low in dairy products and meats might bring about malnutrition, especially in regard to calcium, protein, and the growth needs of children. But careful studies have shown that if diets are planned sensibly, as all diets should be, protein, calcium, and growth needs will be well covered by a diet of varied whole grains, legumes, vegetables and fruits. (A much greater danger is that of heart disease, stroke, and cancer, when children learn to love an animal-based diet and want it for the rest of their lives.)
What’s the answer? The overall aim in early childhood should be to steer away from an animal-based diet and favor a largely plant-based one, so the child will become used to foods at an adaptable age.”

By Benjamin Spock, MD – Pediatrician
Author of best-seller “Baby and Child Care”
http://nutritionstudies.org/why-parents-should-keep-children-meat-and-dairy-free/



Topic: Position of American Dietetic Association, Dieticians of Canada, and New Zealand Ministry of Health on well-planned vegan nutrition.

POSITION STATEMENT: Vegetarian diets [including vegan]

“It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases.
Well-planned vegetarian diets are appropriate for individuals during all stages of the lifecycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.”

Source: Position of the American Dietetic Association: Vegetarian Diets

Abstract: https://www.ncbi.nlm.nih.gov/pubmed/19562864?level=1
Full-text: http://www.vrg.org/nutrition/2009_ADA_position_paper.pdf

Ministry of Health NZ (Search “vegan” in each guideline documents): http://www.health.govt.nz/our-work/eating-and-activity-guidelines/current-food-and-nutrition-guidelines


Topic: Do you know how many hormones in cow’s milk disturb human hormones?

“each glass of cow’s milk contains nearly 60 different hormones and growth factors, the observations of Dr. Northrup and others who treat the condition [PMS] shouldn’t be surprising.[6]”

By Joe Keon, Wellness Consultant
http://nutritionstudies.org/milk-the-elixir-weve-been-sold/
Article cited:
Hormones and Growth Factors in Milk, published in Endocrine Reviews
https://www.researchgate.net/publication/15080486_Hormones_and_Growth_Factors_in_Milk


The Basic Problem: Wrong Mammal [original title]

Female mammals by definition secrete milk to fully nourish their young offspring. The nutrient content is specific for the growth requirements of each species. In general, the faster the young offspring grows, the higher the concentration of protein, calcium, and other nutrients in the mammal’s milk. Human babies double in size in six months (180 days), and to support this slow development human breast milk is low in protein (1.2 grams per 100 grams of milk). Cow’s milk, however, has almost three times the protein concentration in order to support a growth rate four times as great (47 days to double in size). Rat pups double in size in just 4.5 days and that rapid growth requires a protein concentration almost 10 times greater than that for human babies.

When a human child is fed cow’s milk, designed for four times their natural growth rate, they become over-nourished. This means they get too many calories and too much fat, promoting obesity. It also means they get too much protein, which raises growth hormone levels. One consequence of accelerated growth is precocious puberty. Girls become women at 12 instead of 16. Boys mature earlier, too.

In reverse, for a moment, consider the consequences of feeding a calf human breast milk. The baby cow would fail to thrive on a food with one-fourth the concentration of vital nutrients required to support its faster growth. (You might be charged with farm animal abuse if you did this, so don’t.) However, the disease-producing consequences of feeding the wrong species milk to children is rarely considered as harmful; rather this practice is universally thought of as “necessary, proper, and the best of all nutrition.”

Source:
By Dr. McDougall
Source: https://www.drmcdougall.com/misc/2016nl/oct/chocolatemilk.htm


Topic: On comparing what’s comparable & How to assess healthy growth in infants and children using charts

“Several studies have been reported showing that the growth of vegan children is slower than that of non-vegans (see 7-9). Studies such as these are often cited as evidence that vegan diets are inherently unhealthy. However, when the studies are examined more closely, we find that they are often based on vegans who have very low calorie or very limited diets (only fruit and nuts for example). In addition, many vegan infants are breastfed. Babies who are breastfed tend to gain weight more slowly before their first birthday than do bottle-fed babies. Up until a few years ago, vegetarians whose babies were breastfed were justly suspicious of growth charts. Before 2006, growth charts for infants were mainly based on the growth of babies fed infant formula. Growth charts based on formula-fed infants may make it seem that breastfed infants are not growing well. In 2006, the World Health Organization (WHO) released growth charts that were based on the growth of breastfed infants (10). These growth charts, which show what normal growth should look like, are called the WHO growth charts and should be used to assess growth of children less than 2 years of age. Older children are monitored with growth charts from the Centers for Disease Control (CDC) (10).

An additional question that must be asked is, “What is a normal growth rate?” Growth rate is assessed by comparing changes in a child’s height, weight, and head circumference to rates of growth that have been established by measuring large numbers of apparently healthy children. Once your child’s height and weight are measured, the measurements are compared to growth curves – graphs that show growth patterns of children by age. There is no single perfect growth rate. Instead, growth charts are set up using percentiles. If your child’s height is at the 50th percentile, that means that 50% of children of that age are taller and 50% are shorter. Similarly, a weight at the 25th percentile means 25% of children weigh less and 75% weigh more at the same age.

While some studies show that vegan children are at a lower percentile of weight and height than are other children of a similar age, a recent study shows that vegan children can have growth rates which do not differ from those of omnivorous children of the same age (11). A wide range of growth percentiles are considered “normal.” A child at the 10th percentile for weight or the 95th percentile for height is still considered to be within the healthy range. You don’t get extra points for higher or lower percentiles. However, if your baby or young child is below the 2nd or above the 98th percentile for weight or head circumference (or below the 2nd percentile for length), your health care provider will try to find out why this is and if intervention is needed.”

by Reed Mangels, PhD, Registered Dietician
https://www.vrg.org/nutshell/kids.php


Topic: Growing faster does not mean growing taller, and the health hazard it comes with

“Some studies suggest that the growth of vegetarian children is more gradual than that of non-vegetarians—in other words, vegetarian children grow a bit more slowly at first, but they catch up later on. Final heights and weights for vegetarian children are comparable to those of meat-eating children. Interestingly, breast-fed babies also grow more slowly than bottle-fed babies. Somewhat less rapid growth during the early years is thought to decrease disease risk later in life.”

Read more of this article and find out about early puberty risks, IQ and habit forming and later chronic illness here:

Source:
Physician’s Committee for Responsible Medicine
http://www.pcrm.org/health/diets/vegdiets/vegetarian-diets-for-children-right-from-the-start


For more information (in a short video format) on the effects of dairy on health, check as well the Dairy video series on nutritionfacts.org.


Conclusion

This study is essentially inconclusive regarding height and cow milk consumption. Like most scientific studies taken alone, it is also terribly reductionist, by focusing on only one number (height) at one specific time in the life cycle (early childhood). The study and news headlines fail to take into consideration overall effects that dairy has on not just children but all humans at any age, let alone the harmful effects of dairy in general, besides health.

For that reason, dairy should never be given a green light as a health food just because there is a possibility that it would be good for one and only one thing. Given the health irrelevance of minor differences in height at one stage of growth, and the numerous harmful effects of dairy on overall human & child health, I hope readers will understand why it is irresponsible and unethical to recommend cow’s milk consumption to children or humans at any age.

It won’t be the first time popular media sensationalised the results of a study published in a science journal, sadly at the detriment of public health and more.

It is however the opportunity to witness in real time how easily these headlines mislead the public, and the opportunity to re-inform the mislead public about the adverse effects of dairy on health.

To remain focused on health, this article intentionally did not cover the unnecessary environmental/global warming damage caused by any type of dairy farming, nor did it explore the ethics of affecting the lives of millions of cows and calves whose secretions and flesh and are officially unnecessary for human nutrition. In the spirit of always looking at the big picture, I encourage the readers to explore those to improve your awareness and practice of consumer responsibility.

As hinted by the health authorities mentioned above, dairy is unnecessary. Given the destructive effects of its production and consumption, this is an opportunity to do something incredibly positive: leave all dairy for the calves it is biologically meant for, and let (or help) dairy farmers flip the universal harm of dairying on its head by transitioning to the radically new careers which hopefully will generate more universal benefit.

To end on lighter note, here’s the lovely Dr. Klaper commenting on cow’s milk and dairy in the context of nutrition:

Oil-free Plant Milks in New Zealand

Last updated: 18 April 2017


This list includes plants milk that:

  • contain no oil
  • Additionally: contain no coconut products (because typically from extracted high-fat cream) and no lecithin (which is a pure extracted fat).
  • are suitable for vegans (no ingredients of animal origin)
    Note: I’ve only formally checked the suitability for vegans for Vitasoy so far, only (too) quickly the other brands. Double-check in doubt.

It is relevant for people following a low-fat (incl. oil-free) whole-food plant-based diet.


Table of contents
PART 1 – Oil-free vegan plant milks (soy, oat, almond, rice, macademia)
PART 2 – List of Confirmed Non-Suitable Plant Milks
TODO


PART 1 – Oil-free vegan plant milks

OIL-FREE SOY MILKS

OIL-FREE OAT MILKS

OIL-FREE ALMOND MILKS

OIL-FREE RICE MILK

None at the moment.

OIL-FREE MACADEMIA MILK

PART 2 – List of Confirmed Non-Suitable Plant Milks

Vitasoy Soy Milk Original: contains oil
Vitasoy Almond Milk Original: contains lecithin
Vitasoy Almond Milk Unsweetened: contains lecithin.
Vitasoy Rice Milk Long Life: Contains oil.
Vitasoy Rice Milk High Protein Long Life: Contains oil.

Macro Organic Soy Milk: contains oil
Macro Organic Rice Milk: contains oil

Signature Range Rice Milk Organic: contains oil
Signature Range Organic Soy Milk: contains oil

 

Pure Harvest Soy Unsweetened Malt-Free: contains oil
Pure Harvest Soy No Added Cane Sugar Original : contains oil
Pure Harvest Soy Unsweetened: contains oil
Pure Harvest Oat Unsweetened: contains oil
Pure Harvest Rice Unsweetened: contains oil

Sanitarium So Good Soymilk Unsweetened: contains oil
Sanitarium So Good Soymilk Regular: contains oil
Sanitarium So Good Soymilk Lite: contains oil + mono and di-glycerides (471)
Sanitarium So Good Essential Enriched Soy Milk: contains oil + mono and di-glycerides (471)
Sanitarium So Good Soy Milk Vanilla Bliss: contains oil
Sanitarium So Good Almond Milk Unsweetened: Contains lecithin.
Sanitarium So Good Almond Milk Original: contains lecithin
Sanitarium So Good Almond Milk Vanilla: contains lecithin

Blue Diamond Almond Breeze Original: contains lecithin
Blue Diamond Almond Breeze Chocolate: contains lecithin
Blue Diamond Almond Breeze Barista: contains oil and lecithin
Blue Diamond Almond Breeze (Unsweetened) : contains lecithin
Blue Diamond Almond Breeze Unsweetened Cashew: contains lecithin
Blue Diamond Almond Breeze Unsweetened Vanilla: contains lecithin

Pam’s Regular Soy Milk: contains oil
Pam’s Regular Soy Milk Lite: contains oil
Pam’s Almond Milk Original: contains lecithin (322)
Pam’s Almond Milk Unsweetened: contains lecithin (322)

Australia’s Own Organic Soy Milk: contains oil
Australia’s Own Organic Rice Milk: contains oil
Australia’s Own Organic Almond Milk: contains oil

Imagine Rice Dream Rice Milk Original Enriched: contains oil

Freedom Foods Original Whole Bean Soy Milk: contains oil.
Freedom Foods Extra Milky Soy Milk: contains oil.
Freedom Foods Rice Milk: contains oil.

TODO (plant milks to be checked)

  • Vitasoy Café for Barista Almonds (waiting for reply from Vitasoy)

What milks have I forgotten? => Please share in comments.

Whole-Food Plant-Based Potlucks – Requirements & FAQ

This is for WFPB potlucks in Wellington, New Zealand, organized by Whole-Food Plant-Based Kiwis.

What should I bring?

If you’re not familiar with low-fat, whole-food plant-based (WFPB) eating, and/or never attended the potlucks before, just pick a recipe here and stick to the instructions, it will be perfect 😉

What kind of food do you consider “healthy”?

We advocate the use of low-fat, whole plant foods (unrefined, unextracted, minimally processed plant foods), with a particular emphasis on:
oil-free and generally low in fat, even whole-food fat (like too many nuts, avocado, etc)
• using sweetness from whole sweet foods (like dried fruit, etc) instead of extracted sugars
• and flavour from whole foods and spices etc. instead of salt* or artificial flavouring.

* Note: All dishes are expected to be salt-free so that those on salt-free diets can enjoy them. HOWEVER, although salt reduction is encouraged, it is not the highest priority and you will not be expected to eat salt-free. We will provide a salt-shaker so everyone can enjoy the food at the salt level that suits them personally.

What is this way of eating based on?

Evidence-based clinical research/practice has shown that this specific type of nutrition prevents/halts/reverses cardiovascular disease, type-2 diabetes, hypertension, significantly reduces the risk for cancer, other degenerative diseases and a long list of diseases typical of the modern Western diet, which is typically  high in animal products, in fat and processed foods.

More info here:
http://wholefoodsplantbasedhealth.com.au/

I want to make my own recipe: How do I make it WFPB-compliant?

Not sure what food in your pantry is compliant? How to do without oil? How to add sweetness to your dish using whole foods? what to replace salt with? Worry not!

Here’s a practical guide to whole-food alternatives to processed foods:
http://www.youcefbanouni.com/1230/is-this-a-whole-food-a-list-of-whole-food-health-promoting-alternatives/

Note: This can sometimes be overwhelming, especially for people used to processed foods and just starting their transition to whole plant foods, or to cooking at all. So if you want to make it simple for yourself for now as you learn, just pick a recipe here, keep to the instructions and it will be perfect 😉


Must I be vegan, plant-based or WFPB to attend?

It’s a common fear, in practice almost 100% of the people that have been showing up to the potlucks are in the process of a transition to WFPB.

You or your friends do not need to be plant-based nor vegan nor already super healthy to attend. Only the food is expected to be.

It’s important for us to make everyone feel welcomed, and maintain a supportive environment for people at every stage of their transition to whole-food plant-based nutrition.

If you are not sure what foods are vegan and which are not, see the Recipe section for 100%-compliant recipes.

What gear do I need?

Your own plates and cutlery, we kindly encourage not using disposables nor recyclables to avoid generating unnecessary waste/recycling.
Water
Blankets to put on the grass.
• And in case you’re new to New Zealand: a good sunscreen or a large hat and long sleeves!
• Optional: If you have board games or fun things to play in a group, bring just in case. We do like a bit of play on a full stomach 🙂

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More recipes

100% compliant recipes, just keep to the instructions:
http://www.youcefbanouni.com/1492/list-of-low-fat-wfpb-sos-free-recipes/


 

Almost all below are low-fat, 100% whole-food, plant-based, SOS-free (free from sugar, oil, salt) but you may need to “unprocess” or “wholefoodise” some.

Online:
http://www.youcefbanouni.com/wfpb/
https://plantzst.com/indexes/recipe-library/
http://www.straightupfood.com/blog/
Healthy Living with Chef AJ (occasionally high-fat)
http://foodytv.com/healthy-living-chef-aj/

Books:
Unprocessed (Chef AJ)
The Health Promoting Cookbook (Alan Goldhamer)
Bravo Cookbook (Ramses Bravo)
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Can I come and not bring food?

If you want to come to enjoy the food with us but for whatever reason won’t be able to prepare anything, you can come and enjoy the food provided a few conditions:

  • a 10$ contribution that will be given to charity
  • that you let us know at least 2 days before the potluck date, so that we can make sure to bring enough food for everyone.

Who organizes and why?

My name is Youcef Banouni. I run the Whole-Food Plant-Based Kiwis group on a Facebook, a non-profit support group for people seeking to eat in a way that sustainably prevents, stops, and often reverses many diseases of modern Western society.

I have questions!

Read the FAQ first (this article) but if it still doesn’t answer your questions, you’re more than welcome to get in touch with the event organiser.

Calcium Requirements for Vegans Found Lower based on WHO Data

MAIN FINDINGS

Based on data from the WHO (World Health Organization), the Recommended Daily Intake (RDI)* of calcium for adults on a fully plant-based diet is 660 mg/day, not 1,000 mg/day as suggested by official recommendations (U.S. & Western Europe) intended for people consuming the Standard Western Diet.
For the (minority of) vegans consuming salt-free diets, the RDI is even lower, at 480mg/day.

Animal protein and sodium (salt) deeply influence calcium losses and calcium balance.

Besides putting unnecessary pressure on calcium intakes, the current official RDI of 1,000mg calcium/day is misguiding people on plant-based diets (even more so with lower salt intakes) to observe calcium intakes that may lead to the typical adverse effects of calcium excess.

Vegans and vegan/plant-based information websites are invited to verify the calculations presented here, and if they agree with the demonstration, update their information to this new RDI of 660mg/day. It is time to quit perpetuating an RDI intended for people consuming 60g+ of animal protein per day.

* Disclaimer: The RDI proposed in the present article is calculated using WHO’s calcium model which accounts for animal protein and sodium. Unfortunately, it is not an official recommendation as it should be. These numbers are not endorsed (yet?) by the WHO nor the FAO.

 

PART 1  – DEMONSTRATION

INTRODUCTION

Many vegans are aware that there are some nutritional precautions they must take, which are specific to their dietary lifestyle. Typically, it is important for everybody in our sanitized world – but in particular for vegans – to take a vitamin B12 supplement or B12-fortified.

However, in the transition to a plant-based diet, it is common for people to bring with them (and perpetuate) a number of carnist nutritional myths, or concerns that are by no means exclusive to plant-based diets. Besides B12, other nutrients of common concern are:  protein, iron, omega-3, or calcium.
It’s important to study evidence and demystify these topics, relieve unnecessary concerns, and help refocus attention where it should really be as far as plant-based health is concerned.

Today, I will cover the one of the least covered of these subjects: Calcium requirements in the context of plant-based nutrition.

To my current knowledge, there exists no calcium RDI formulated anywhere specifically for people on plant-based diets. Yet, the World Health Organization has offered them to us, on a very slightly veiled golden platter, since 1997. How was  something this big ignored and never implemented? It is a mystery to me. Hopefully this article helps correct this.

This is how it started.

 

THE CHALLENGE OF MEETING THE STANDARD WESTERN DIET’S RDI WITH WHOLE PLANT FOODS

Meeting the calcium RDI of 1,00o mg is fairly easy when relying on transformed soy products and/or fortified foods and beverages. As you can see below, as little as 150 g/day of a very common type of tofu would easily meet the RDI of 1000 mg/day, and various combinations might as well.


Per 100g (WARNING: these values may vary, most drastically in transformed and fortified products):
Traditional soy products: Edamame: 63 mg; Tempeh: 96 mg; tofu made only with calcium sulfate: 683 mg; tofu made with nigari and calcium sulfate: 282 mg; silken tofu: 31 mg;
Plant milks: Pacific® fortified oat milk: 146 mg; low-calcium soy milk : 42 mg; Other fortified plant milks: wide range;
Legumes: lentils: 19 mg; chickpeas: 49 mg; black beans: 27 mg;
Other starch/carbs sources: sweet potato: 38 mg; potato: 5 mg; brown rice: 10 mg; whole-wheat pasta: 13 mg; rolled oats: 52 mg.
Green leafy vegetables: raw kale: 150 mg; amaranth leaves: 209 mg; bok choi: 96 mg; mustard greens: 118 mg;
Fruits (per 1 medium piece): orange: 52 mg; apple: 11 mg; bananas: 6 mg;
Fungi: shiitake: 3 mg; white mushroom: 6 mg; oyster mushroom: 3 mg;


Both calcium-fortified foods or transformed soy products rely on calcium salts. Adding calcium salts to whole plant foods is a form of indirect calcium supplementation.

The real challenge appears when for whatever reason you either don’t or seldom eat them, or eat them in small amounts only.

When relying exclusively on unprocessed plant foods – which excludes fortified/processed foods mentioned earlier – it is still possible to meet 1,000 mg. It would however require carefully combining high-calcium foods.

Example of a high-calcium plant-based sample menu (to be completed with other foods to meet caloric needs) using only unprocessed, non-fortified, whole plant foods:
1 cup rolled oats, 2.5 cups of cooked amaranth leaves, 2 large oranges, 2 cups chickpeas.
Total calories: 1160 kcal;
Calcium content: 1038 mg (based on Cronometer/USDA database)

In practice, very few people on plant-based diets, including whole-food plant-based, eat anything like this artificially high-calcium diet.

So, quite naturally, some questions come to mind:

  • Why is the calcium RDI so ridiculously high?!
  • Is there something about a plant-based diet that should reduce the amount calcium we need?
  • Conversely, is there something about the Standard Western Diet that makes the calcium RDI abnormally high?
  • How did mostly plant-based populations throughout the world manage to grow bones and age healthfully on diets with no tofu, no fortification, and likely at far less than 1000 mg of calcium/day?

Answer: They weren’t given health objectives based on observing a majority of overweight and obese people eating the Standard Western Diet.

 

METHOD & RESOURCES FOR DEMONSTRATION

The demonstration below is intentionally done in a detailed, step-by-step manner, and to some extent using slightly less academic language. This is so that anyone wondering where these numbers came from can follow and run the calculations for themselves as verification. I used nothing more than high-school level maths.

Unless stated otherwise, all the calculations are based on the data presented in the WHO (World Health Organization) document “Vitamin and mineral requirements in human nutrition, Second edition” which is free to download. The images below are captured from this document.

The WHO report above supports one of the highest and most conservative RDIs for calcium: that for the U.S.A. and parts of Western Europe.

 

DETAILS OF CAPITAL IMPORTANCE: EFFECT OF ANIMAL PROTEIN AND SODIUM ON CALCIUM BALANCE

According to this report, several factors influence the calcium needs. I learned that animal protein and sodium (= mainly salt) intake play an absolutely major role in the calcium RDIs because both dramatically increase calcium loss.

Ok, so accounting for urine and sweat losses (which includes hair and nails) calcium balance happens either at 840, 600, or 450 mg of calcium per day, depending on different scenarios of low-[animal] protein and/or low-salt.

That is huge! You wouldn’t thinks RDIs would vary so much based on dietary lifestyle.

That really struck me!
I immediately wondered what about no animal protein? Or no salt like we do at home?
What calcium intakes correspond to these?

So I went searching for the numbers on the relationships between sodium/calcium and between animal protein/calcium.

 

IN NUMBERS, HOW DOES SODIUM AND ANIMAL PROTEIN INCREASE CALCIUM EXCRETION?

Effect of animal protein on calcium excretion

Page 79:

Comments:
1 g of protein reduces absorbed calcium by 1 mg
“Low-protein” on the graph meant 20g of animal protein/day.
Cutting further that 20g lowers the straight line of excretion by “20g points” on the vertical axis.

Effect of sodium on calcium excretion

(…)

(…)

For someone who has no salt nor high-sodium foods (i.e.: voluntary SOS-free dietary lifestyles, or very low sodium diets for medical reasons such as kidney diseases) the daily intake is somewhere around 100mg sodium/day (from my personal rough estimations). ~100mg is is negligible compared to 3.45g. To simplify the calculations, we will round that up that to zero sodium.

“Low sodium” on the graph meant 50mmol of sodium (1.15 g sodium, ~3 g salt) which in passing, is below the current limit of 1.5g (sodium) set by the American Heart Association.

100 mmol of sodium takes out 40g of calcium, so 50 mmol takes out 20 mg. Going from “low sodium” to salt-free cuts that 50 mmol of sodium from the diet, which lowers the straight line of excretion by “20 mg points” on the vertical axis.

Total of “no sodium” + “no animal protein” : 20 mg + 20 mg = 40 mg, a reduction in excretion by exactly as much as the previous jumps.

If you’re plant-based with an average salt intake in Western Diets (~9g salt/day in the U.S., NZ, etc.), you’re looking at this:


Now the million dollar question is…what are these “?” values, precisely?
I never liked graphic resolutions of equations because it’s imprecise in a number of ways. So let’s see if we can find some equations. This is where it starts requiring high-school level mathematics. But don’t worry, we will use an online calculator to solve this.

 

EQUATIONS FOR CALCIUM ABSORPTION AND CALCIUM EXCRETION vs. CALCIUM INTAKE


Here they are:
Ca_absorbed = 174 log(Ca_intake) – 909 (note: the log here is a natural log)
Ca_excreted = 0.078.Ca_intake + 137 (note: urine losses only)
Ca_excreted = 0.078.Ca_intake + 197 (note: inclusive of +60mg of “skin” losses – see section 4.4.4 – Insensible losses)

Using x for calcium intake (horizontal axis) and y for calcium absorbed or excreted (vertical axis) the equations are:

For calcium absorption:
y = 174 log(x) – 909

For calcium excretion, we have different scenarios:

Scenarios with animal protein

Average [animal] protein (60g/day) + average sodium (3.45 g sodium/day ~ 8.6 g salt/day) :
y = 0.078 x + 197
Calcium balance equation:
absorption = excretion
174 log(x) – 909  = 0.078x + 197

Low [animal] protein  OR Low sodium => decrease of excreted calcium by 40mg
We take the calcium excretion equation above and remove 40mg:
y = 0.078 x + 197 – 40 which is the same as:
 y = 0.078 x + 157
Calcium balance equation:
174 log(x) – 909  = 0.078x + 157

Low [animal] protein AND Low sodium => further 40mg not excreted
y = 0.078 x + 117
Calcium balance equation:
174 log(x) – 909  = 0.078x + 117

Scenarios with plant-based diets

No [animal] protein AND average sodium=> further 20mg not excreted compared to same with low animal protein
y = 0.078 x + 137
Calcium balance equation:
174 log(x) – 909  = 0.078x + 137

No [animal] protein AND No salt => further 60mg not excreted because no salt: 40 mg for low-sodium + 20 mg for the further elimination of salt.
y = 0.078 x + 77
Calcium balance equation:
174 log(x) – 909  = 0.078x + 77

SOLVING THE EQUATIONS

Throw that into a solver to get the x value (calcium intake) at equilibrium. I could have done that with a scientific calculator, or using the Matlab software, but so that everyone can check for themselves, I used a public, free-of-charge solver: WolframAlpha. Click on the above equations to see them being solved.

Below is the solving of the calcium balance equation for average animal protein and average sodium just to check if we got things right:


Why did we take the lowest solution of the two ? Because any solution above 2,000 mg is not a valid solution because the absorption curve  is valid only from 0 to 2,000 mg.

So it gives me ~840 for the first equation. It’s no surprise, that’s the value in the WHO document, found with the same equations. We’re finding the same result, that’s a good start!

Now, what about “no animal protein”? or that + salt-free?

Scroll up and click on the equations above to see the calcium intakes at equilibrium, it’s the lowest of the two values among the solutions Wolfam finds.

CUSTOMISED CALCIUM INTAKES AT EQUILIBRIUM (OR EAR)

The calcium intakes at calcium balance are the following. They’re basically the solutions to the equations listed in the previous section. Note that by definition these values are the EARs (Estimated Average Intakes). This means the intakes below will meet the needs of 50% of the total population.

Scenarios with animal protein

Average [animal] protein (60 g) + average sodium (3.45 g sodium/day ~ 8.6 g salt/day):
Ca_intake = 840 mg;

Low [animal] protein (20 g) OR Low sodium (1.15 g/day ~3 g salt/day):
Ca_intake = 599 mg;

Low [animal] protein (20 g) AND Low sodium (1.15 g/day ~3 g salt/day):
Ca_intake = 444 mg;

Scenarios with plant-based diets

No [animal] protein AND Average sodium (3.45 g sodium/day ~ 8.6 g salt/day):
Ca_intake = 514 mg !

No [animal] protein AND No Salt
Ca_intake = 336 mg !!!

These intakes would cover the needs of only 50% of people in the respective populations.
How much calcium to meet the needs of almost all the respective populations though? In other words,  what are the RDIs?
That’s what we’re going to find out now.

 

CUSTOMISED CALCIUM RDI VALUES BY DIETARY LIFESTYLE

This is how you get an RDI (Recommended Daily Intake) from the EAR (Estimated Average Requirement) we just calculated.

Page 2:

Do we have the value of the “standard deviation” somewhere ?

Searching, and…Yes we do! The full equation for calcium absorption  had “± 71 (SD)” at the end. Now is the time to use that standard deviation.

Following the above method to determine RDI (which is the same as RNI) from the EARs we get:

SD = 71
2 × SD = 142

RDIs = EAR + 142

Scenarios with animal protein

Average [animal] protein + average sodium (3.45 g sodium/day ~ 8.6 g salt/day):
Calcium RDI = 840 + 142 = 982 mg/day.
With no surprise, that is very close to the official RDI of 1,000 mg.
Official RDI are often rounded up to number easy to remember.

Low [animal] protein (20 g)  OR Low sodium (1.15 g/day ~3 g salt/day):
Calcium RDI = 599 + 142 = 741 mg/day

Low [animal] protein (20 g) AND Low sodium (1.15 g/day ~3 g salt/day):
Calcium RDI = 444 + 142 = 586 mg/day

Scenarios with plant-based diets

No [animal] protein AND average sodium (3.45 g sodium/day ~ 8.6 g salt/day)
Calcium RDI = 514 + 142 = 656 mg/day (~660 mg)

No [animal] protein AND No salt
Calcium RDI = 336 + 142 = 478 mg/day (~480 mg)

 

COMPARISON WITH PUBLISHED SCIENCE ON CALCIUM BALANCE IN PLANT BASED-DIETS

The above calculations based on official WHO models for calcium requirements matches a number of others studies and articles on the lower calcium needs in plant-based nutrition:

  1. October 2007: Calcium Requirements Much Lower Than Previously Estimated, by Dr McDougall.
    In this article Dr. McDougall suggests intakes around 500mg/day are sufficient.
    cites:
    Calcium requirements: new estimations for men and women by cross-sectional statistical analyses of calcium balance data from metabolic studies.
    This study examined calcium balance, sweat losses were ignored because considered negligible after measuring them.
  2. June 2016: Long-Term Low Intake of Dietary Calcium and Fracture Risk in Older Adults With Plant-Based Diet: A Longitudinal Study From the China Health and Nutrition Survey
    This study on lifelong senior vegans in China finds the lowest rates of bone fracture happen in a range of calcium roughly from 250mg – 650 mg all genders considers.
  3. December 2014: How to Get Calcium Without Dairy, by Dr. Thomas Campbell.
    Quote: ” if all of your calories are coming from whole plant foods, including plenty of fruits, greens, beans and other vegetables, you don’t need to think twice about calcium requirements or do any fancy math or milligram counting. You’ll be fine.”
    cites:
    Appleby P, Roddam A, Allen N, Key T. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr 2007;61:1400-6.
    Note: This study suggested that vegans with intake below ~500 mg/day had more bone fractures than carnists. However, in a critique of this study, Dr. McDougall observed that the vegans were younger, healthier (lower BMI) and far more physically active. Although the study tried to adjust for that, “vegans had no hip fractures, compared to 30 in the meat eaters, 9 in the fish eaters, and 14 in the vegetarians (dairy)”. He adds:
    “The observation that the fractures were of the wrist, arm, and ankle, and not the hip, to me, means the fractures were due to trauma caused by physical activity and not due to weakened bones.”

 

CONCLUSION

The WHO/FAO matches with the most conservative and highest calcium RDIs in the world: U.S.A & Western Europe.

Using this model and applying it to plant-based diets and low-sodium diets yielded surprisingly low calcium RDIs. The plant-based calcium RDIs are more easily achievable with little to no thought put into nutrition, provided:

  • a well-planned mostly unprocessed diet (more nutrient-dense, from whole foods) even on its own,
  • and/or a particularly low sodium intake
  • and/or calcium-fortified foods.

This is consistent with observations/suggestions from previous research on calcium intake and health in plant-based populations.

 

Acknowledgements

I would like to thank one of the people I view as a role model and mentor, the lovely, brilliant and generous Jenny Cameron. Jenny pointed me towards the calcium chapter of the WHO publication when I asked if any official recommendation suggested lower nutrient requirements for people on plant-only nutrition. Now, I and hopefully many other plant-based folks, have a clearer idea what exactly these requirements are – at least according to one of the most official and publicly recognized institutions that publish dietary health guidelines: the World Health Organization (WHO).

PART 2 – DISCUSSION

(still in the process of writing – table of contents below)

RDI-related questions

• What is an RDI worth anyway?
• Factors affecting absorption
• Shouldn’t the RDI depend on body size too?
• Menopausal women (& “Ageing” men)
• Infants, Children & Adolescents

A concern about calcium excess

• Is it harmful to consume 1,000 mg calcium on a plant-based diet?

Improving calcium balance and bone health

• Reducing/cutting animal protein vs. increasing calcium
• Salt Reduction: An additional strategy for osteoporosis & bone fracture prevention?
• Is it relevant for vegans to reduce salt intake?

• Open Questions

Vegan Buttermilk Couscous (Moroccan Saykouk)

Saykook is a very simple and satisfying Moroccan dish. Traditionally it is made with fermented milk (leben) which is basically a plain liquid yogurt. Here I propose a plant-based version of this dish I’ve always loved. I like it even more now 🙂

Note: I do care to post only WFPB recipes. The yogurt here is not a whole food. So I’m posting this exceptional deviation from a conservative WFPB line-up of recipes. I will be looking forward to making a whole-food yogurt and update this recipe 🙂

Vegan Saykouk (Moroccan Yogurt Couscous)
 
Prep time
Total time
 
Saykouk is a popular summer dish served in Moroccan cuisine. Here is at last and at least, a vegan version while I work to upgrade this to a low-fat whole-food plant-based version.
Author:
Recipe type: low-fat, whole-food, plant-based, sos-free
Cuisine: Moroccan
Serves: 2 large meals
Ingredients
  • 6 cups of steamed wholemeal couscous (For now, check online how to properly steam couscous, I may post a recipe at some point)
  • 500 mL unsweetened plain soy yogurt (I’m yet to try tempeh yogurt for a more whole-food version)
  • 200 mL water
  • Sourness to taste: 2 Tbsp to 8 tsp lemon juice juice or blended whole lemon equivalent (I like sour so for me it’s 8).
Instructions
  1. Blend the soy yogurt with water and lemon, this is to make the yogurt smooth because it tends to clot.
  2. In a container, pour the steamed couscous. If it is still very hot let it cool first.
  3. Add the soy yogurt/water blend, the lime juice, and mix thoroughly until uniform.
  4. Cover and save in the fridge.
  5. Serve cold. Ideal lunch soon a hot day.
Notes
Because the couscous will absorb a lot of the soy yogurt, feel free to pour more soy yogurt just before serving if you like your dishes to be more saucy.
If you don't want to lemon taste in it, trying leaving the covered dish at room temperature for a while, the lactic fermentation should make the dish more sour, as it is supposed to be.

 

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[Recipe] Garam Masala Spice

Ok, I absolutely love Garam Masala! It’s hasn’t always been that way.

There’s a couple reasons why I make this spice mix at home now as opposed to buying it ready-made:

  • The commercial ones are far too hot for me which completely spoils this amazing spice mix.
  • The commercial ones don’t always taste good, the recipes vary.
  • And toasted spices go rancid/change taste overtime, so by home-making you get better flavour. The commercial ones are almost always ground, and a long time ago.

So let’s get toasting!

[Recipe] Garam Masala Spice
 
Prep time
Cook time
Total time
 
Author:
Recipe type: low-fat, whole-food, plant-based
Cuisine: South Asian, Indian
Ingredients
  • 1 Tbsp coriander seeds
  • 1 Tbsp cumin seeds
  • 1 Tbsp poppy seeds
  • 1 tsp peppercorns
  • 1 small stick of cinnamon (2-inch or small finger size) OR 1 tbsp ground cinnamon. (x 3 if you're using the weaker-flavoured Ceylon cinnamon)
  • 3 green cardamom pods
  • 8 cloves
  • 1 dried red chilli (or chilli powder added to the roasting pan towards the end of roasting to prevent it from burning)
Instructions
When toasting spices, you always want to add the spices in the order of the heaviest/bulkiest to the smallest/thinest.
  1. If you're using cinnamon sticks, set a pan/pot on medium and toast until it starts to be dark brown and fragrant. If using cinnamon powder, we'll add it at the end.
  2. Reduce the heat to between low and medium.
  3. Add the cardamom, dried chili,and the cloves. Toast for a few more minuts. Keep stirring.
  4. Add the peppercorns, toast another minute or two. Keep stirring.
  5. Reduce the heat to low/low-ish.
  6. Add the Coriander seeds, toast for another 1 minute. Keep stirring.
  7. Add the cumin seeds, toast for another 1 minute. Keep stirring.
  8. Add the poppy seeds toast for another 1 minute. Keep stirring.
  9. If using cinnamon powder, this is the time to add it. Toast for another 1 minute. Keep stirring.
  10. Off the heat. Empty the pan in a dry bowl. Let cool a few minutes and grind.
Notes
Toasted spices go rancid. So prepare only in small batches, use fresh, keep the leftover in the sealed container in the fridge and use within 1 month.

This is what you get in the end. Bliss!

Chana Masala (Chickpea Curry)

Chana Masala

Chana Masala (Chickpea curry)
 
Prep time
Cook time
Total time
 
I started off with Hema's recipe but found it far too hot and corianderish (seed) for my personal taste. Also simplified greatly the roasting processes. I'm very happy with this recipe now. My ethnically/gastronomically-Indian partner just told me it tasted amazing, and exactly like that Chana Masala we had at that restaurant where we both thought was the best-tasting we've ever had so far in the healthy-food category. So I think my improving this recipe is over and it's time to share it with you 🙂 You'll need to make a trip to the local Indian/Asian shop to do full justice to any Indian cooking including this dish. These are the must-have Indian spices you'll only find in any Indian shops : asofetida & amchur (which is green/unripe mango powder). The rest is usually commonly found even in supermarkets.
Author:
Recipe type: low-fat, whole-food, plant-based
Cuisine: South Asian
Serves: 4~6 adult meals if served with rice
Ingredients
  • 3 cups dried chickpeas, soaked overnight
  • 3 large onions finely chopped
  • 220g of salt-free or low-salt tomato paste concentrate OR 1kg of grated tomatoes (to be reduced later)
  • A few stalks of fresh coriander (5 g)
WHOLE SPICES FOR ROASTING
  • 3 small sticks cinnamon (finger-sized or two inches)
  • 6 cardamom pods
  • 6 bay leaves
  • 1 Tbsp cumin seeds
OTHER SPICES
  • ¼th tsp asafoetida
  • 1 tsp grated ginger, densely packed
  • 1½ tsp turmeric
  • 1½ tsp cayenne (OR 1 fresh hot chilli halved lengthwise)
  • 1½ tsp unripe mango powder (look/ask for amchur in any Indian/South Asian shop, do not replace with mango!)
  • 2 Tbsp Garam Masala (or Make your own)
Instructions
  1. Put the soaked chickpeas to cook for 1h30 on medium heat in a regular pot (without a lid) or ~20 minutes in a pressure cooker. Do not stir them. They should be very soft and melt in the mouth when you press them with your tongue. Don't put too much water, ideally you wouldn't need to strain them later.
  2. Put some brown rice to cook as well to go with the Chana Masala later.
  3. Chop the coriander finely.
  4. Prepare the Garam Masala.
  5. Cut the onions finely. To save time, I use a mandoline to slice them, and a chopper (or a knife). Set aside.
  6. If you're using fresh tomatoes, grate them now to a purée. Set aside.
  7. Grate the ginger
  8. On low to medium heat, roast the spices "for roasting" for a few minutes. To prevent burning the the small/thin spices/herbs, put the biggest items first until roasted, then add the the smaller ones, so in this order: Cinnamon, cardamom, then bay leaves & cumin. Stir well, whenever it starts being fragrant and slightly smoking, add the onion immediately.
  9. Set the heat to the maximum and keep stirring the onions "dry". They will give off a lot of steam and start caramelizing.
  10. When the bottom of your pot starts being brown, reduce the heat to medium.
  11. Add either the grated tomatoes, or the tomato paste + ~1 litre of water.
  12. Add the "other spices" and the coriander, stir well and let cook for ~20 minutes. Stir now and then to prevent sticking at the bottom. Turn off the heat when the sauce is rather thick.
  13. Mix gently with the chickpeas. Enjoy!
Notes
Garnish with fresh coriander and slices of purple onion.
Serve either on rice or as a side with chapati (Indian wholemeal flatbread).