Dr. Matthew Nagra, ND
2657 Commercial Dr. V5N 4C3 Vancouver, BC, Canada

Great new randomized crossover trial out of PCRM. They pitted a Mediterranean diet against a low fat vegan diet and found that the vegan diet led to greater reductions in cardiovascular markers like LDL and total cholesterol, as well as greater weight loss (including visceral fat), while the Mediterranean diet may have led to a slightly larger reduction in blood pressure. https://www.tandfonline.com//full/10/07315724.2020.1869625

This recent study was picked up by a lot of outlets to suggest that vegan diets are inadequate for children, but I am honestly perplexed as to how anyone comes to that conclusion. The researchers recruited 40 Finnish children (~3.5 years old) who followed vegan, vegetarian, or omnivorous diets. The 6 vegans had been vegan since birth. They measured nutrient intake/status and a variety of metabolites in each child. Overall, the children consumed the same amount of calori...es and fat but, compared to omnivores, vegans consumed less protein, saturated fat and cholesterol, and more polyunsaturated fat, fibre, folate, zinc and iron, with no differences in vitamin A and D intake. In addition, all the vegans supplemented vit D and most supplemented B12 and iodine, while most omnivores/vegetarians supplemented D and a smaller portion supplemented B12/iodine. Despite lower protein intake in vegans, there were no significant differences in BMI, height, or upper arm circumference, but there were differences in blood amino acid levels with vegans having lower amounts of some amino acids and higher amounts of others. Contrary to sensational headlines, vegan kids were not at higher risk of vitamin A or D deficiency, although they had lower serum levels. Additionally, the researchers did not use the gold standard measurement for vit A status due to limited blood samples. There were no differences in zinc, ferritin or iodine status between meat eaters and vegans, and the meat eaters had significantly lower folate levels. Where the vegans really shined was with their cholesterol levels, indicating significant protection against cardiovascular disease compared to meat eaters. The vegans also may have had higher carnitine levels, which is humorous given the focus placed on the necessity of high carnitine foods by carnivore proponents. The vegans, however, had lower DHA levels, so an algae-based omega-3 supplement may be a consideration, although the authors note that vegan children have not been shown to suffer from health issues typically ascribed to low DHA status. All in all, this pilot study suggests that a vegan diet can be nutritionally adequate for children. See more

In my last 3 posts, I have (hopefully) squashed any concerns around the adequacy of plant-based protein when compared to animal protein. In fact, there may actually be strong reasons to choose plant protein over animal protein for our overall health. In 2020 alone there was no shortage of publications assessing the impact of animal and plant-based proteins on health outcomes and the results echo the research of past decades. The first prospective cohort study by Chen eva...luated protein intake and disease risk in 7786 participants and found that replacing just 5% of carbohydrate calories with animal protein resulted in a striking 20% increase in risk of all-cause mortality (death from all causes). That really throws a wrench into many low-carbers’ arguments. Another prospective cohort by Huang, this time involving over 400,000 participants, found that replacing 3% of animal protein with plant protein reduced all-cause mortality by 10%, but they went further and looked at specific sources of animal protein. Replacing 3% of either red meat protein, dairy protein, or egg protein with plant protein resulted in significantly lower risk of all-cause mortality in both men and women, and replacing white meat protein resulted in lower risk in women as well. Of course, these are just specific populations, what about the totality of the evidence? The first publication by Chen also included a meta-analysis of 11 prospective cohorts (over 350,000 participants) and they found that those consuming the most animal protein had a 9% higher risk of dying from cardiovascular disease (CVD) and those consuming the most plant protein had a 7% lower risk of all-cause mortality. Additionally, another meta-analysis that included 31 prospective cohorts (over 700,000 participants) found that those consuming the most plant protein had an 8% lower risk of all-cause mortality and a 12% lower risk of dying from CVD. To sum up, the evidence does not support the choice of animal protein over plant protein for athletic endeavours, but does strongly suggest that making the switch from animal to plant protein can increase your chances of living a long and healthy life. Refs See more

Have you ever heard that low cholesterol is harmful, and can even increase risk of death? Dr. Gil Carvalho does an excellent job explaining this phenomenon and how many misrepresent these statistics to claim that low cholesterol itself causes health issues. Spoiler alert: low LDL and/or total cholesterol is a very good thing. https://www.youtube.com/watch?v=CxX51n2Z0vc&t=2s

Animal protein proponents often point to acute muscle protein synthesis (MPS) to make an argument for animal protein being superior to plant proteins. This is a short term boost in muscle production that happens after meals, and it is true that animal protein typically result in more MPS than plant proteins. However, MPS is a debatable marker for muscle growth, at least in novice lifters, and the difference diminishes when the leucine content of plant and animal protein is ma...tched. Leucine is important for stimulating MPS, and the point at which there is no further benefit is ~2.5g. For reference, just 1 cup of tofu can provide ~2g of leucine, so it wouldn’t be hard to meet the threshold. I must also mention that recent research on a mycoprotein (fungal protein that is found in vegan Quorn products) results in equivalent or better MPS than animal protein. Another claim that’s made is that animal protein raises blood amino acid levels more than plant proteins, but the very study that is typically cited clearly states that there is evidence of a rapid rise in blood levels with plant protein, but the proteins were simply used up quicker than animal proteins, which gives the illusion of lower serum levels. It helps if we actually read the studies What we’ve discussed thus far is considered mechanistic speculation. The real question is whether or not animal protein leads to greater muscle gains than plant protein. The answer to that is NO. We have a meta-analysis of soy protein, and several studies involving pea or rice protein directly comparing them to what would be considered high quality animal proteins that result in NO DIFFERENCE in muscle mass or athletic performance. We only see a difference when there is less total protein, but if you consume the same amount of protein overall, it doesn’t matter if it comes from animals or plants. This is the final nail in the coffin for the animal protein superiority argument. Of course, optimal protein intake for resistance training is 1.6g/kg of bodyweight, where there is no further benefit above that, so total amount of protein, not the source, may be a point of focus for strength gains. References

There are very few misconceptions in the nutrition space that are as widespread as this one. It’s rare that I go a day without seeing an instagram post suggesting that eating grains will inevitably lead to inflammation and type 2 diabetes. While I’ll certainly tackle inflammation at some point, let’s dive into the diabetes claim. It is true that some studies looking at total carbohydrate or grain consumption may find that higher intakes lead to higher type 2 diabetes ris...k, but that tells us nothing about the quality of the carbohydrates or grains that are being consumed. It is crucial to separate out whole grains from refined grains since they have very different nutrient profiles, fibre content, and impact on our health. When this is done, whole grain consumption is consistently shown to reduce type 2 diabetes risk. This year, a comprehensive publication involving data from 3 prospective cohorts, totaling nearly 200,000 participants found that those consuming the most whole grains had a 29% lower risk of type 2 diabetes compared to those consuming the least. Upon further analysis they found that those consuming more whole grain cereal or whole wheat bread daily significantly lowered risk, while just 2 or more servings of oatmeal, brown rice, bran, or wheat germ lowered risk. A 2017 meta-analysis found that 1 to 3 servings of whole grains per day resulted in the greatest reduction in type 2 diabetes risk of all food groups! To further support my earlier comments about quality, a 2013 meta-analysis found that 3 servings of whole grains per day reduces type 2 diabetes risk by 32%, while 1 serving of white rice per day increased risk by 23%. Brown rice, on the other hand, reduced risk by 13% with only a serving per day! In the end, there is no reason to fear that whole grain consumption will lead to blood sugar dysregulation, insulin resistance, or type 2 diabetes. In fact, the exact opposite is true, as is evidenced by the entirety of the scientific literature. References in the comments See more

The Global Burden of Disease Study (GBD) is the largest, most comprehensive worldwide study on death and disease risk factors ever conducted. It examines health trends from 1990 to present and further breaks down the data by location. According to GBD, poor diets are responsible for more annual deaths than anything else. In 2017, diet was responsible for 10.9 million deaths, or 22% of all adult deaths, while tobacco was associated with 8 million deaths. The majority of t...he diet-related deaths were, unsurprisingly, due to cardiovascular disease. Within diet, the researchers further determined the impacts of specific food groups and additives. They found that the number 1 dietary risk factor for death was too much sodium, followed by low whole grain intake and low fruit intake. Sodium, of course, can raise blood pressure and increase stroke and stomach cancer risk, while whole grains and fruit have been shown to reduce the risk of a variety of conditions. These were eventually followed by high red meat, processed meat, sugar-sweetened beverage, and trans fat intake, as expected. So what can we take from all of this? Improved nutrition could have a profound impact on health outcomes worldwide, and since low intake of healthy foods (whole grains and fruit) are responsible for even more deaths than high intake of many less healthy foods, it’s important to place focus on which foods we should emphasize in our diets, rather than only looking at those that we should limit. Reference in the comments See more

Have you ever heard that beans are toxic because they contain lectins? This is an idea that has been propagated by a few individuals in the nutrition space, but most famously by Dr. Gundry in his book, @theplantparadox. The idea is that lectins are poisonous for humans and can cause inflammation, weight gain, or worse. It is true that certain types of lectins, like those in red kidney beans, can be poisonous when eaten raw, leading to gastroenteritis, but fortunately we co...ok them. Just 15 minutes of boiling is all that is needed to completely eliminate all traces of lectins. Of course, we cook them far longer than that until they’re soft, which would ensure that the lectins are long gone by the time the beans reach your stomach. In addition, many lectins are completely non-toxic, like those found in tomatoes, lentils, chickpeas, and peas. In fact, certain lectins may have anti-cancer properties, although more research is needed. The most dangerous aspect of the lectin fear mongering is that it leads people to consume less legumes. If you weren’t aware, legume consumption is the strongest dietary predictor of survival in older adults and is a staple across the longest living populations on Earth! Legume consumption should absolutely be promoted, not feared. Hopefully this information helps you see past the claims made in The Plant Paradox, but I’ll go further and demonstrate just how terrible the information in the book is. The very first claim made in the entire book is Eating shellfish and egg yolks dramatically reduces total cholesterol. By fact checking reference number 1, you will see that the study in question didn’t focus on egg consumption at all, and the study participants actually REDUCED egg consumption, along with meat and dairy, resulting in lower cholesterol levels. Not only was the claim in the book incorrect, but it was the exact opposite of what the study actually found. The level of dishonesty is astonishing, and it doesn’t end there. Dr. T Colin Campbell of @nutritionstudies did an excellent rebuttal of many of the claims made in the book, so I suggest you visit nutritionstudies.org for more. References See more

October is breast cancer awareness month, and I have seen some fantastic posts by @plantbasedgutdoc and @theplantbasedmd discussing the condition, but I would like to bring awareness to a specific subset of breast cancer sufferers that often goes without mention: men! Male breast cancer is rare, only accounting for less than 1% of all breast cancers, affecting ~230 men in Canada per year, and killing ~55. Due to the rare nature breast cancer in men, it is not something that i...s routinely screened for, nor is it something men will be on the lookout for. For this reason, it is often discovered after it has spread, which can result in a worse prognosis, so I’d like to discuss some risk factors and symptoms to keep an eye out for. Risk factors for male breast cancer include: Family history BRCA gene mutation Radiation exposure Liver cirrhosis Excessive alcohol consumption Obesity Gynecomastia (breast growth) Estrogen treatment Undescended or removed testes Signs and symptoms include: Nipple discharge Crusting of the nipple Inverted nipple Pain/swelling of breast tissue A lump in an armpit An non-healing ulcer/sore on breast tissue If caught and treated early, there is a high survival rate, so if you do ever experience any of the symptoms above, I suggest going for a visit to your healthcare provider for a checkup as soon as possible. *Info from the Canadian Cancer Society See more

While I certainly advocate for whole foods and believe there are more nutritious sources of fats, such as nuts, seeds, and avocados; vegetable/seed oils seem to have been unfairly demonized, especially when compared to animal fats. The primary claim I hear is that vegetable oils, specifically those high in omega-6 fats, are highly inflammatory. Now let’s take a look at the validity of that statement. The primary omega-6 found in most vegetable oils is linoleic acid (LA),... which is actually anti-inflammatory! The fear is that LA can be converted into arachidonic acid, which is inflammatory. However, multiple randomized controlled trials that fed participants high amounts of LA have not found that it increases inflammation. Furthermore, increased consumption of LA does not seem to lead to increased levels of arachidonic acid. Our bodies are smart enough not to create excessive amounts of the inflammatory fat! Conversely, I should note that animal foods can be significant sources of arachidonic acid, especially poultry and eggs. Interestingly, higher intakes of LA actually reduce risk of type 2 diabetes and mortality from all-causes, cardiovascular disease, and cancer. In fact, those genetically predisposed to higher LA levels, have a lower risk of heart disease! Aside from focusing on specific fatty acids, what about vegetable fats as a whole? Well, a very recent meta-analysis found that higher intakes of plant oils resulted in significant reductions in inflammation. Furthermore, data from 3 large prospective cohorts demonstrated that replacing just 5% of calories from dairy fats with vegetable fats may reduce cardiovascular disease risk by 10%! This evidence clearly shows that the concerns around vegetable oils and inflammation are unfounded, and that vegetable oils are far more heart healthy than animal fats. That being said, these statements do not apply to tropical oils like coconut or palm oils, because those are high in saturated fat and can raise heart disease risk. References in the comments See more

The debate around the causes of heart disease is still quite rampant, with many people rejecting the consensus that LDL-cholesterol is causal in the development of heart disease. Instead, they believe that inflammation is the main cause and that elevated LDL isn’t an issue if inflammation is kept low. Fortunately, we have data that may help settle this debate. On the one hand, inflammation has been shown to decrease arterial function and potentially lead to damage of the... endothelial lining of our arteries, which could theoretically contribute to heart disease. That being said, these hypotheses do not tell us if inflammation actually translates into higher rates of disease. Prospective cohort trials, where individuals are followed for many years, have found an association between higher levels of inflammation and higher heart disease risk. However, genetic trials that specifically look at people who are genetically predisposed to different levels of inflammation (based on C-reactive protein levels) have not found an association. These studies, known as mendelian randomization experiments, are of far greater quality and are able to assess whether or not the association is causal because they practically eliminate the potential for confounding variables. Since the results are different from the prospective studies, it leads me to believe that the associations between inflammation and heart disease are not causal (ie. a poorer diet can lead to both higher levels of inflammation AND higher heart disease risk). Lastly, a 2017 trial found that LDL lowering reduced the risk of cardiac events to a similar extent regardless of whether inflammation was high or low. This indicates that LDL-cholesterol is absolutely a greater concern. In addition, genetic studies have shown that lower LDL levels significantly reduce heart disease risk, indicating a causal relationship, unlike what we see with inflammation. Long story short, while inflammation certainly isn’t a good thing, it definitely does not overtake LDL-cholesterol as the primary risk factor for heart disease. References See more

Dr. Danielle Belardo, MD recently debated plant-based vs paleo diets for cardiovascular health at the American College of Cardiology conference and did an excellent job for the plant-based side. You can watch it here: https://www.youtube.com/watch?v=Ez1J-5nA11k

The @bluezones are 5 areas of the world where people live exceptionally long and healthy lives. In fact, the Blue Zones may have some of the highest concentrations of centenarians (people who live to be 100) in the world! The 5 Blue Zones are: Ikaria, Greece; Okinawa, Japan; Sardinia, Italy; Nicoya, Costa Rica; and Loma Linda, California. The question then becomes, what is the key to their success? There are 9 factors, that are common amongst the Blue Zones, that ar...e likely responsible for their health and longevity. They are as follows: Physical activity Life purpose Stress management Spirituality/religion Social support Family structure Low to no alcohol consumption Moderate caloric intake Plant-based dietary patterns While plant-based nutrition certainly plays a significant role, let’s not forget about all the other areas that the Blue Zones are excelling in, which may further contribute to their success. See more

I'm sharing my favourite green smoothie recipe! I hope you enjoy it! https://drmatthewnagra.com/recipe-green-mango-smoothie/

This is an excellent video by NutritionFacts.org evaluating the concerns that are often raised regarding soy and their phytoestrogens. https://youtu.be/O00qLS4bMc8

My friends, Dan Sheanne Moskaluk, have amazing stories to share! Sheanne was clinically obese and Dan was suffering from stage 4 kidney cancer, but they are now healthier and happier than ever! Watch this new interview with Hench Herbivore to learn more about their stories and feel inspired. https://www.youtube.com/watch?v=tqfb7-2SNSk

I find the idea of the modern paleo diet a bit odd since there was never just one paleo diet. Depending on where in the world we look, our paleo anscestors would have had completely different diets. Fossilized feces show us that some early humans were eating upwards of 100g of fibre per day! Thats far more than even most of todays vegans, which is quite the feat since fibre is only found in plants. What modern paleo dieters often overlook is the massive degree to which plan...ts may have been a part of their diets and how their diets will have varied drastically depending on location. That being said, we do have research on the modern paleo diet. One concerning study placed 43 healthy people on a paleo diet while partaking in CrossFit training for 10 weeks. They ate as much as they wanted and had their blood taken before and after. They had an average 7lb weight loss with a significant loss of body fat, while raising their total and LDL-cholesterol, and decreasing their HDL-cholesterol. This is concerning because weight loss is a powerful tool for lowering LDL. The fact that they lost weight and their LDL went up is a very bad sign for heart health. These unfavourable changes seem to be driven by the high saturated fat and cholesterol intake from the paleo diet compared to their pre-study diets. Previous trials that demonstrated benefit from a paleo diet are typically comparing the paleo diet to a less healthy baseline diet. The benefits can almost entirely be chalked up to lower saturated fat and cholesterol intake, and higher fibre intake. In other words, the benefits are predominantly driven by lower animal fat and higher plant consumption. Of course, these benefits dont compare to a whole foods, plant-based diet. Lastly, even Loren Cordain, one of the fathers of the paleo movement, co-authored a paper highlighting that our hunter-gatherer ancestors ate low saturated fat diets and had very low LDL-cholesterol levels. This would be explained by the fact that plants played a significant part in their diets and the wild animals they hunted would have been far lower in saturated fat than what is eaten today. References in the comment See more

While the idea of whole foods is certainly a good framework to base one’s diet on, that doesn’t mean that all processed foods are automatically unhealthy. There are plenty that offer great nutrition and certain health benefits. Here are just a few of my favourites: Vinegar consumption has been shown to improve blood sugar control and may lower cholesterol levels, specifically in people with diabetes! I personally love adding some vinegar to my salads for the added flav...our and health benefits. Nutritional yeast is every vegan’s favourite and it comes with some great nutrition as well! Just 2 tablespoons can provide 8g of protein and, if it’s fortified, it may provide a wide variety of B vitamins, including vitamin B12. One of my favourite ways to use it is by adding both vinegar and nutritional yeast to popcorn for a healthy snack! Soy milk is the most nutritious of all plant milks and provides 7g of protein and 30% of an average adult’s daily calcium needs in an 8oz glass! Tofu, which is also somewhat processed, may provide even more nutrition than soy milk. On top of nutrition, soy products may help significantly reduce breast cancer risk, prostate cancer risk, and cardiovascular disease risk amongst other health benefits. As you can see, whole foods are great and all, but they certainly aren’t the law. The fact that something is processed does not mean it can’t also be healthful. References in the comments : @rosslynmaria See more

You may find it surprising that Hong Kong has one of the highest life expectancies in the world while also being amongst the highest per-capita meat consumers. This is a stat that carnivores love to point to as evidence for the ‘healthfulness’ of a high meat diet. So what’s really going on here? Recent data suggests that HK residents are consuming 664g of meat per day, which is nearly 2 12oz steaks per day! However, we must note that this stark increase in meat consumpti...on occurred fairly recently. If we look at beef consumption, for example, the large spike happened between the mid-2000s and now. This is a relatively new change and chronic illness can take several decades to develop. Furthermore, research on HK centenarians (people who live to 100) found that close to half of them don’t even eat meat on a daily basis while nearly all of them eat fruits and vegetables daily. This is a far cry from the current average consumption. HK residents have previously scored very high on a Mediterranean Diet score, even beating out Greek populations! This indicates a very plant-focused diet. Interestingly, however, the younger HK population, and especially men, did not score as well as the older population, which may help explain what is going on today. It’s plausible that younger people are consuming massive amounts of meat, while the older, healthy population is eating more traditionally. This leads me to believe that we will see increases in disease and mortality rates in the coming decades if Hong Kong keeps up their meat consumption. In fact, we’re already seeing it! The colorectal cancer rates in Hong Kong are 50% higher than Hungary’s, the country with the HIGHEST rates in the world! Furthermore, Hong Kong has double the rates of the USA! So no, meat consumption is not responsible for Hong Kong’s longevity. If they keep it up, it very well may lead to higher disease and death rates and the longevity they are experiencing today is likely a result of a plant-focused diet, economic development, social conditions, and environmental factors that lend themselves to health and longevity, such as an abundance of public parks. Refs See more

The low carb movement seems to go away and return under a different banner every 5 or so years. There was Atkins, South beach, Paleo, and now Keto. One thing these diets all have in common, besides being low in carbohydrates, is that they heavily rely on animal products. This may be why low carb diets are typically associated with higher mortality rates. In fact, higher animal protein and animal fat consumption are individually associated with higher disease and mortality rat...es compared to plant proteins/fats. So what about low carb, plant-based diets? There is a diet pattern known as the Eco-Atkins diet, which is actually low carb and plant-based. Canadian researcher, David Jenkins, published a great study in 2014 comparing a strictly plant-based Eco-Atkins diet to a higher carb, lower fat vegetarian diet, and the results are quite impressive. The Eco-Atkins diet was primarily focused on foods such as seitan, soy, nuts, vegetables, and fruit. By the end, the Eco-Atkins group saw greater reductions in their 10-year heart disease risk, primarily driven by improvements in their lipid profiles. However, it is important to note that we see equally impressive results from diets higher in carbohydrates from whole plant foods, such as whole grains and legumes, which I have discussed at length in previous posts. It is for this reason that I do not believe we need to be focusing on macronutrient ratios for overall health. It’s far more important to focus on getting as much of your nutrition from whole plant foods as you can, and eating in whichever macronutrient ratio feels best for you. References in the comments See more

Yesterday, Anthony Grisé and I debated the topic of LDL-cholesterol, saturated fat, and cardiovascular disease. He argued that LDL-cholesterol doesnt cause heart disease from the side of a meat-only diet, while I argued that it absolutely does cause heart disease, and that saturated fat and cholesterol consumption increase risk by increasing LDL-c. Thanks to Anthony for the discussion, and thanks to Matt Madore, BSc for helping me prep for the debate. Watch the video here: https://youtu.be/NAGVDoxe6J4

Last year a UK nutriitonist, Emma Derbyshire, published an opinion piece and stated that vegans may be at high risk of choline deficiency, which caught a lot of attention. If you dont know, choline is a nutrient our bodies produce, but is also essential, meaning we must get some in our diet. It plays a critical role in brain and liver health and may be especially important during pregnancy. True deficiencies can lead to dementia, muscle damage, non-alcoholic fatty liv...er disease, and more. How much do we need? There are major discrepancies between recommendations with some organizations recommending as low as 400mg/day and others suggesting 550mg. Its important to note that these numbers are based on very little data since choline intake is not something that has been adequately studied. The true requirement is likely between about 150mg and 400mg since the offspring of pregnant women consuming 400mg/day did not further benefit from additional intake. Of course, Emma didnt touch on this in her write-up, likely since she has ties to the animal agriculture industry and animal products are touted as high choline sources. That being said, plant foods can absolutely provide choline! Half a cup of uncooked lentils, chickpeas, or soybeans contain nearly 100mg of choline, while split peas contain far more! Quinoa, brussel sprouts, and broccoli can also provide a fair amount. That being said, it is unlikely that most vegans are meeting recommendations of 550mg (men) or 425mg (women), but neither are nonvegetarians! According the NHANES data, US children, women, and men consume about 250mg, 300mg, and 400mg of choline respectively, yet deficiency is very rare. Furthermore, if vegans did have higher rates of deficiency, we would expect higher rates of Alzheimers, cardiovascular disease, and liver disease, but we actually see quite the opposite. Unfortunately nobody knows exactly how much choline we need in our diet, but it seems unlikely that someone consuming a balanced plant-based diet would be truly deficient, and the concerns around choline may just be another attempt by the animal agriculture industry to stir up controversy. References See more

If you have seen the State-of-the-Art review on saturated fats and health that was published in the Journal of the American College of Cardiology last month, you may be second guessing the dietary guidelines that suggest limiting this controversial nutrient. Fortunately, my friend Matt Madore BSc, sets the record straight in this article that was just published on Medium. He provides a point-by-point commentary on the claims that were made by the review authors and dives in...to the individual references to display how they misrepresented the findings of their own citations. If you have been one of the health professionals who were praising the review, I believe this is required reading, as it showcases how the claims dont stand up upon scrutiny, and we must base our dietary recommendations on the overall preponderance of the evidence. If you are simply interested in learning how nutrition science can be misrepresented to come to false conclusions, this is also a great read for you. It was my pleasure to help put this together and I want to send a big thank you to Dr. David Katz, MD and Plant Proof for helping to get this published. https://medium.com//study-sows-confusion-about-saturated-f See more

A constant source of debate since the explosion of foods like @beyondmeat, seems to be whether or not plant-based mock meats are healthier than the real deal. One common argument is that mock meats can contain up to 20 ingredients, while a steak is just 1 ingredient; however, I tackled that argument in my previous post about the Beyond burger. Recently, data has been published comparing the healthfulness of real and mock meats, so lets dive in. The study in question ...is known as the SWAP-MEAT study. This was a randomized crossover trial where the only changes in the participants diets were 2 or more servings of either plant-based or animal meats per day for 8 weeks with the mock meats being provided by @beyondmeat. They found, with such a small overall change in diet for a relatively short amount of time, an 11 point drop in LDL-cholesterol levels, which would reduce cardiovascular disease risk and was largely driven by the reduction in saturated fat intake. On top of that, plant based meats contain fibre and are devoid of cholesterol, which would further support the claim that theyre a superior option from a cardiovascular perspective. Lastly, the plant-based groups in the study also saw a slight decrease in weight compared to the meat groups. This evidence suggests that not only do these mock meats have a substantially lower environmental impact while being the more ethical choice, but they seem to also be more heart healthy compared to meat. Although, theyre certainly no match for beans or tofu. References in the comments See more

I was pleasantly surprised to see such a massive outlet like VegNews use my commentary on Miley Cyruss latest Joe Rogan podcast appearance. You can read about it here: https://vegnews.com//miley-cyrus-reveals-she-is-no-longer-

It was a pleasure being a part of this interview series, which launches TOMORROW! Click the link below to sign up and gain access to all this wonderful content. http://healthintentionally.co/mattnagra

I was recently fortunate enough to sit down and interview Dr. Michael Greger (virtually)! We cover topics including the benefits of plant-based nutrition for people of ALL ages, the controversy around saturated fat and cholesterol, heart disease reversal, and more! Let me know what you think and if you learned anything! See Dr. Gregers work at NutritionFacts.org!... Reed Mangels Book on Vegan Pregnancies (mentioned in the interview): https://www.amazon.ca/Your-Complete-Vegan-Preg//1507210191 #plantbased #drgreger #nutritionfacts

In case you still have concerns about the adequacy of plant-based proteins, or if youre unsure what good sources are, please see this recent article I wrote for Plant Based on a Budget where I dive into plant vs animal protein debate! https://plantbasedonabudget.com/plant-based-protein/

In my previous post I discussed the link between dairy consumption and prostate cancer, but there may be another reason to choose soy milk instead! Those who consume more soy products, including tofu and soy milk, demonstrate an approximately 30% reduction in prostate cancer risk in both Asian and American populations. Furthermore, Seventh Day Adventists who consume soy milk daily may have a staggering 70% reduction in prostate cancer risk compared to those who avoid it.... However, I should note that the reduced risk may not apply to fermented soy foods. One potential mechanism by which soy reduces risk is by the phytoestrogens in soy binding to specialized estrogen receptors in the prostate, which may help prevent the replication and invasion of cancer cells or even trigger cell death if the cell begins progressing towards cancer. Soy doesnt only reduce risk, however. Soy may actually help slow cancer progression in those who already have the condition, which was demonstrated in a study that had participants drink 3 cups of soy milk per day for a year. Soy is a criminally misunderstood food, as I have discussed at length in previous posts. Not only does it not have a negative impact on our hormones, but may actually reduce the risk of several of our leading killers, including cardiovascular disease, breast cancer, and evidently, prostate cancer. References in the comments See more

Prostate cancer is the second most common cancer in men behind lung cancer, and is the fourth most common cancer overall! By the end of 2020, it is estimated that 23,300 men will be diagnosed in Canada and 4200 will lose their lives to the disease, representing 10% of all cancer deaths in men. Fortunately, we do have some control over our prostate cancer risk through our dietary choices, and in this post I will focus on dairy. A large 2018 review tackled the subject of d...airy and cancer by evaluating all the data for dairy consumption and various cancers. They found that the link between dairy consumption and prostate cancer was the strongest link between dairy and ANY form of cancer! The data was remarkably consistent with regard to total dairy consumption and higher prostate cancer risk. Of the specific dairy foods, milk was most associated with a higher risk. There are several theories behind how dairy contributes to prostate cancer, with one of them being through exogenous estrogen exposure, which can be quite high given that dairy cows are milked throughout pregnancy. Another plausible mechanism is the very high calcium content. Dairy calcium intake has been shown to increase risk and calcium supplements themselves may increase the risk of fatal prostate cancer. The proposed reason for this is because high calcium intake can suppress vitamin D levels and vitamin D may act on prostate cells to help prevent growth and alteration. Lastly, these processes may begin early in life. Daily milk consumption in adolescence may increase the risk of advanced prostate cancer by 3.2x compared to those who drink milk less than daily. With all this information, it is evident that prostate cancer risk is just another reason to @switch4good and #DitchDairy. References in the comments See more

This is an excellent clip from Plant Based News and Dr. Garth Davis discussing some of the reasons for the success of the Blue Zones, some of the longest living populations on Earth. https://www.youtube.com/watch?v=FSfjwu2h5lQ

I was recently interviewed by Danika Koopmans, who is organizing the Revitalize Your Health Summit, involving 21 plant-based nutrition advocates including myself. Topics include: chronic illness, improved energy, weight loss, creating healthy habits, and more! To sign up for access to all the interviews beginning Sept 1st, please visit the link below. https://healthintentionally.co/mattnagra

If you haven't seen Dr. Michael Greger of NutritionFacts.org's "How Not To Diet" presentation, Plant Based News has just published a video of the full presentation. I highly recommend giving it a watch! https://www.youtube.com/watch?v=FT7TY88GC7A

The new Canadian adult obesity clinical practice guidelines were just released this week and theyre fantastic! They discuss the impact of weight stigma on health outcomes and how practitioners can best serve their patients struggling with obesity. They emphasize the importance of identifying the root cause and treating that cause through a holistic approach, including nutrition, physical activity, cognitive behavioural therapy, pharmaceuticals, and surgery when needed. This is such an important topic and the shift in focus away from the number on the scale, towards overall health and well-being is much needed. https://www.cmaj.ca/content/192/31/E875

Gluten-free is everywhere these days! I have even seen trail mix (naturally gluten-free) being labeled as gluten-free It seems that gluten-free has become a marketing tool. That being said, is there science supporting the trend? Gluten is a protein predominantly found in wheat, barley, and rye, and can negatively impact people with Celiac disease, an autoimmune condition that results in an immune response to gluten in the small intestine. This condition can be life thr...eatening, and those with Celiac disease should absolutely avoid gluten! Fortunately, it only affects, at most, 1.4% of the global population and less than 1% of Western populations. Another condition, non-celiac gluten sensitivity, can cause unwanted reactions to gluten, but is not life-threatening, and typically affects the gut. There is a misconception that this condition is exceedingly common, when the best available estimates place it between 0.5 to 6% of the population, and likely on the lower end of that, although theres no reliable test to confirm a diagnosis. So why do so many people avoid it? First, think about where most people get gluten. Bread and pastries! Its important to note that gluten isnt the only component of bread either. Wheat is a significant source of fructans, which are chains of sugars that may cause symptoms. In fact, when people who believe they have gluten sensitivity are given either snack bars containing gluten, fructans, or a placebo, they react more to fructans, NOT gluten! This may also explain why sensitive individuals do better on sourdough, since its lower in fructans. So to answer my earlier question, people may be avoiding it because they think itll harm their health, or because they truly feel better, but they may be avoiding the wrong component! After all, gluten-containing whole grains, such as rye berries are incredibly healthful, and those who adopt gluten-free diets may actually have a higher risk of type 2 diabetes! This makes sense, since both whole grains and fibre intake are associated with lower risk. Let me know below if gluten is something you avoid and why you avoid it! References in the comments See more

One comment that really grinds my gears is that plant-based diets take a lot of planning in order to do them healthfully. My question is, what diet doesnt require planning if the goal is to be healthy? Does eating meat just guarantee health? Is there no difference between a diet centered on McDonalds and one centered on whole foods? Its a double standard and I believe its largely due to inherent biases that many people hold against a plant-based lifestyle. Of course, th...e main claim is that plant-based diets are deficient. The interesting point is that we typically do not die of deficiencies in the Western world. Instead its diseases of excess that are killing us! Too much saturated fat, sugar, animal protein, and refined grains are doing the damage. That being said, lets take a look at how nutrition stacks up between diets. I could review countless dietary intake studies, but will focus on the latest research that measured nutrient intake and actual blood levels of many nutrients in average vegans and omnivores. They found that the vegans consumed less protein (although they had enough!), half the saturated fat, twice the beneficial polyunsaturated fats, more sugar, and more than double the fibre (omnivores didnt even meet recommendations). Note that they consumed more sugar, so this wasnt a special health-conscious group. For micronutrients, vegans consumed more than enough calcium, twice the iron, similar zinc, far more potassium, twice the vitamin E, far more vitamin C and folate, and far less vitamin B12. On blood tests, they found no difference in iron and iodine deficiencies between groups (although both groups need more iodine), vegans had higher rates of zinc deficiency because higher consumption may be necessary from plants, omnivores had more vitamin C deficiency and exceedingly high rates of folate deficiency, while vegans, surprisingly, did not have higher B12 deficiency rates, likely due to supplementation and fortification. Evidently, plant-based eaters have better overall nutrition, but should take extra care with zinc, iodine, and the few supplements I mentioned in my previous post for optimal results. Reference in comments See more

While plant-based diets can be extremely healthful and reduce risk of many non-communicable diseases, there are a few supplements to consider when adopting an exclusively or predominantly plant-based diet. First up is vitamin B12! Ive discussed the importance of this nutrient before, but for a quick recap, a deficiency can lead to anemia, nerve damage, and even dementia-like symptoms. Fortunately, it is added to a lot of plant-based foods, like plant milks, but I suggest ...taking a supplement because deficiency is not worth the risk and fortified foods generally arent a reliable enough source. There are various forms and cyanocobalamin is the most shelf stable and requires the lowest dose, but its best to discuss forms and dosage with your healthcare provider. The 2nd is vitamin D3. In places like Vancouver, where we do not get adequate sun exposure year round, its a necessary supplement for everybody on every diet. It is added to certain foods as well, but typically not in the amounts we want. Standard recommendations suggest 1000IU/day, but many experts believe dosing higher at 2000IU is ideal. Again, that can be discussed with your doctor. There is controversy around the need for omega-3 supplementation. The primary reason to supplement is that it may help preserve long-term brain function, and may be especially important during pregnancy and lactation. We do convert short-chain omega-3s (ALA) from flax/walnuts into the long-chain DHA, but the data is currently mixed on the efficiency of conversion and levels in vegans/vegetarians, which you can test for yourself. Fortunately, algae-based supplements are widely available. Lastly, iodine is an important nutrient that doesnt get enough attention. It is key for thyroid function and risk of deficiency is high in those avoiding iodized salt or sea vegetables. I get mine from sea veggies, but if seaweed isnt your thing, you may want to consider a supplement. The RDI is 150mcg/day for most adults. While Ive written about each of these individually in the past, I hope this post helps as a quick reference, and you can go back to my previous posts to learn more! References in the comments See more

Ive discussed the controversial topic of eggs and cardiovascular disease previously, but an updated meta-analysis was published last month and warrants further discussion. The researchers used data from 66 randomized controlled trials with 3,185 participants to assess the impact of egg consumption on cardiovascular risk factors. They found that egg consumption can significantly increase total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and other lipids. Tot...al cholesterol, more specifically LDL-cholesterol, has been determined to cause heart disease. HDL, on the other hand, used to be thought to reduce risk, but further research has shown that it does not. These changes in lipids, within just 12 weeks of higher egg consumption, certainly do raise disease risk. Whats more interesting is that they found a dose-response. So the more you eat, the higher these values get. For LDL-cholesterol, this relationship was non-linear, which means the risk didnt go up in a straight line. This agrees with what we know about how eating cholesterol affects our blood levels. Theres a plateau, so those who eat more cholesterol to begin with will see less of an effect. This is why many studies wont find an association between egg consumption and heart disease, since many populations already eat a fair amount of cholesterol and the increases in egg consumption are usually fairly small. This paper found greater increases in LDL in healthier people, who are likely consuming less overall cholesterol and junk at baseline, and found larger increases in LDL in studies that used higher amounts of egg consumption. Similarly, a large 2019 study found a dose-response relationship between egg/cholesterol intake and both cardiovascular disease and all-cause mortality. Hopefully you now have a better idea of how studies can come to various conclusions for egg consumption and how it likely has a greater impact on those of us who eat healthier diets to begin with. Just make sure to replace eggs with something healthier like beans to reap all the benefits. References in the comments See more

In case you didn't know, Dr. Michael Greger of NutritionFacts.org does monthly Q&As on YouTube and Facebook, which are fantastic! Always entertaining and educational. Here is his Q&A from this morning!

HDL, or good cholesterol, was once thought to be protective against cardiovascular disease, but that may now be an outdated idea. The reason it was believed to be protective is because those with higher levels tend to have lower rates of heart disease, but it turns out that HDL can just be a marker for a healthier diet in the general population. We now know that those with genetically higher levels ARE NOT protected against cardiovascular disease, and drugs that increase... HDL do not protect against CVD. LDL, or bad cholesterol, on the other hand, can cause heart disease since those with genetically higher levels are at increased risk, and medications or dietary therapies that lower LDL protect against CVD. When adopting a lower fat, plant-based diet, HDL and LDL levels can both come down, which is a good thing with respect to LDL, but some individuals can become concerned with lower HDL levels. However, lifestyle changes can also influence the types of HDL particles we have, and lower saturated fat (typically found in animals) and higher polyunsaturated fat consumption may lead to more potent anti-inflammatory properties in HDL particles, which Ive even heard being called Super HDL! So its the function of the HDL that matters, not the amount. For all these reasons, HDL levels dont seem to be much of a concern, and far more attention should be placed on lowering LDL to protect against cardiovascular disease. References in the comments See more

One of my most popular posts was about iron and plant-based diets, but one thing I didnt discuss was the concept of iron inhibitors, which are foods and drinks that can decrease iron absorption. Certain compounds, known as tannins and polyphenols, can bind to iron in our digestive tract and prevent absorption. These compounds are often found in very healthy foods, but should be consumed away from iron-rich foods or iron supplements, by about an hour, to maximize absorptio...n. They include coffee, tea, cocoa, and grapes. High calcium intake can also reduce iron absorption, so it may be best to consume calcium fortified plant-based milks separated from iron-rich foods to maximize absorption, although the long-term studies of high calcium intake on iron status show that the impact may be minimal. Lastly, certain high iron plant foods may contain considerable amounts of oxalates, which can bind the iron and prevent absorption. The primary oxalate containing greens are spinach, swiss chard, and beet greens. This means that, while spinach is often touted as a high iron food, we dont actually absorb much of the iron! To decrease oxalate content, however, we can boil the greens, but I tend to opt for lower oxalate greens like kale instead. Did you know that certain foods could decrease iron absorption? Let me know below References in the comments See more

It is amazing to me to see how many of my patients have tried to limit their fruit intake as a means of reducing their overall sugar consumption. This is the issue with taking a reductionist view of nutrition and only focusing on specific nutrients (sugar, protein, etc) rather than the context that they are consumed in. > Fruit comes packed with fibre, vitamins and minerals, and DOES NOT worsen blood sugar control. In fact, the fibre and phytonutrients help slow the abso...rption of sugar into the bloodstream, which is why both bananas and dates are actually low on the glycemic index and medium on the glycemic load scale. The info that really seems to shock people is that fruit consumption REDUCES type 2 diabetes risk! Multiple meta-analyses that assess the bulk of the research on the topic all find significant reductions in T2 diabetes risk with higher fruit consumption, with berries being the best individual fruits. We need to stop fearing such healthful foods! Especially when we now know the primary driver of insulin resistance is saturated fat (see my previous post on diabetes). There are even a couple trials on very high fruit intake. An older trial had 17 people eat 20 servings of fruit per day, equating to roughly the amount of fructose (sugar) you would find in about 7 cans of pop, and found no negative effects (and possible benefits) for body weight, blood pressure, insulin, and lipid levels after 12 to 24 weeks. Another more recent trial had individuals consume a very high fruit diet while also increasing vegetable consumption, and they saw a large decrease in their LDL cholesterol, while the only reported adverse effect was really large bowel movements. So lets stop demonizing such a healthy food and encourage greater consumption. After all, low fruit intake is the 3rd leading dietary risk factor for premature death... References in the comments See more

A very interesting article was just published discussing the current understanding of chronic illness and raises some interesting ethical questions regarding treatment recommendations, specifically nutrition. The article highlights some staggering statistics that display the burden that chronic diseases place on the healthcare system. Currently, more than 85% of US healthcare costs are due to chronic conditions and in 2020 157 million Americans are expected to live with ...at least one chronic condition! As Ive discussed previously, nutrition plays a major role in the prevention, and in some cases, reversal of many of these diseases. In the article, the authors primarily discuss cardiovascular disease and diabetes, which account for the number 1 and number 7 killers in America, which is similar to what we see in Canada. Non-insulin-dependant type 2 diabetes, specifically, can be reversed with a plant-based diet and no diet has produced as impressive of results for cardiovascular disease as we see with a plant-based diet. Given this information, the authors conclude that not advocating for plant-based nutrition is unethical. They describe it as withholding potentially life-saving information from those struggling with a variety of chronic conditions. We cannot ensure that our patients will adopt this eating pattern, but they deserve to know its an option. Whether we follow our own advice or not is our prerogative, but our heart disease patients should know that a plant-based diet is the most effective means of improving their health, and if they decide a Mediterranean diet is more achievable, then its their decision. Too many doctors withhold this information on the basis of its too difficult for patients to follow, which removes our patients autonomy in the decision making process and is unacceptable. Food for thought. Reference: Storz, MA. Will the plant-based movement redefine physicians understanding of chronic disease? The New Bioethics. 2020. : @sam_eats_plants See more

In my last post I discussed how collagen is just a protein and that there likely isnt anything special about it. Now Ill target some other claims made about collagen supplements. First, there is little to no evidence suggesting that it helps with leaky gut, heart health, or hair/nail/teeth strength. Where there seems to be research is with joint and skin health. Numerous short-term trials on collagen for joint pain show that it can improve symptoms of arthritis, as evide...nced by a 2018 meta-analysis. However, this is compared to a placebo, not another protein, so it doesnt tell us if theres anything unique about collagen, or if protein supplementation alone can help. Funny enough, research on milk protein also seems to improve joint discomfort and soy protein can improve arthritis symptoms and cartilage health even more than milk protein, particularly in men. We dont have direct comparisons between collagen and soy protein; however, soy protein may reduce inflammation, while collagen has no impact on inflammation and actually doesnt lead to more collagen production in our bones. The argument for collagen is really falling apart here We see the same picture with the research on skin health. Collagen does seem to produce some benefit, but it could just come down to providing the building blocks for our bodies. I am not aware of any research comparing collagen to other proteins, but I did find some research showing that soy phytoestrogens can improve skin and help with bone remodeling. It would be interesting to compare soy to collagen, since you could get the soy protein and phytoestrogens in one package! Lets see if someone conducts that study in the future. In the end, it doesnt look like collagen is worth the hype. There are also possible side effects such as gut symptoms, rash, and headache, which are rarely mentioned, as well as theoretical heavy metal contamination. What we do know, however, is that adequate protein and vitamin C can help with collagen production, so why not start with the basics (nutrition) and save on the extra costs? References in the comments See more

Collagen is a very large protein that is made up of 3 chains of over 1000 amino acids each, and is a part of many body structures, including skin, hair, and bones. We can only absorb individual amino acids or small chains of amino acids called peptides, so our digestive tract breaks down proteins into smaller pieces for absorption. We then use these amino acids to make the proteins we need, one of which is collagen. It stands to reason that the benefits seen with collagen sup...plements come down to providing the body with these building blocks. One of the more recent claims for collagen is that it can help with body composition. Since collagen is a protein, it would be expected to help with muscle building, and we have research on this subject. 2 separate studies, one with men and one with women, split the participants into collagen and placebo groups while doing resistance training for 12 weeks. All groups saw improvements in muscle mass and fat loss, but the collagen groups did better than the placebo groups. The issue with these studies is that they tells us NOTHING about collagen specifically. It just shows us that exercising with added protein can help boost muscle gain and promote fat loss, which we already know... What they should do is compare collagen to another protein to prove that theres something special about collagen. Fortunately, while not looking specifically at muscle gain, researchers have compared the impact of a standard protein powder against collagen on body composition and found that collagen actually did slightly worse. When compared against nothing (placebo) collagen shines, but when compared to an actual competitor, it fails. As you can see, its very easy to design studies that make collagen look good. Collagen proponents also talk about how collagen is a good source of 3 specific amino acids: glycine, proline, and hydroxyproline; however, you can also get these in abundance from foods like alfalfa, legumes, soy, and nuts/seeds. Now youve got an understanding of what collagen is and how the research is conducted to produce good results, Ill discuss some of the claims for skin and joint health next. References below See more

For most of my life my favourite dessert has been ice cream! I believe I have finally perfected a super simple, creamy, and tasty homemade ice cream recipe. Check it out and let me know what you think! https://drmatthewnagra.com/recipe-strawberry-nice-cream/

I recently had an opportunity to chat with the Plant Trainers about the most common myths associated with plant based diets. You can listen to the podcast here: https://www.planttrainers.com/nutrition-myth-busting-with-/

Im not usually one to use the term superfood, but I may need to make an exception for flaxseeds. Not only is flax a great source of omega-3 fatty acids, fibre, and various minerals, but it may have multiple clinical benefits as well! A 2019 meta-analysis that combined 62 trials on flax and cholesterol found that flax consumption resulted in an overall reduction in total and LDL (bad) cholesterol of over 5mg/dL and 4mg/dL respectively; however, more than half of the include...d studies used flax oil. The oil has NO fibre! Fibre, along with the lignans and omega-3s, can contribute to cholesterol lowering, suggesting that ground flaxseeds may be the best option because it includes the fibre and grinding the seeds increases absorption of the omega-3 fatty acids compared to whole flaxseeds. Only 6 of the trials actually used ground flaxseeds, and the majority of them had greater overall effects than suggested by the meta-analysis. I would love to see a trial comparing the various methods of flax consumption and assessing their impact on cholesterol, but based on what we know it seems that ground flax may be the way to go to maximize the cholesterol-lowering benefits! Beyond cholesterol lowering, multiple meta-analyses have demonstrated that flax can help reduce inflammation in the body, with longer-term consumption resulting in greater decreases. In addition, flax can also help reduce blood pressure, specifically with powdered or ground flaxseeds, but not so much with flax oil. Lastly, flaxseeds also seem to improve blood sugar control and possibly improve insulin sensitivity with long term consumption. Is there anything flax cant do?! I love adding a tablespoon or two of ground flax to my oatmeal or smoothies in the morning to ensure Im receiving these benefits. How do you choose to add flax to your diet? References in the comments

I am loving NutritionFacts.org's current video series on Pandemics! Here's today's video highlighting the importance of public safety measures. https://youtu.be/Sy_odMx_tV8

In case youve missed it, the American Cancer Society recently released their new guidelines for diet and physical activity for cancer prevention. Within the guidelines, they suggest avoiding or limiting red and processed meat, sugar sweetened beverages, and processed foods in general, while emphasizing the importance of fruits, vegetables, whole grains, and legumes! This is a huge step forward, so lets hope the USDA guidelines follow suit.... For all the details: https://www.cancer.org//acs-guidelines-nut/guidelines.html

Carbohydrates are often blamed for the current obesity epidemic, but the real issue may be that were just eating more of EVERYTHING. It turns out that Americans daily caloric intake increased from 2054 calories in 1970 to 2501 calories in 2010 according to the USDA with both flour products and fatty/oil products seeing the largest increases. Clearly the issue isnt an either-or. Where low carb proponents really get it wrong is with the theoretical conversion of ca...rbs to fat. Theres a process in the liver called de novo lipogenesis where carbs are directly converted to fat; however, the amount of carbs converted may be very small. Experiments have been done where participants are fed an excess of 50% of their total daily calories and their fat production from carbohydrates is measured. The overfeeding groups consumed more than 100 additional grams of carbohydrates (in the form of sugar) than the control group, which resulted in just 3.7-6.2g of fat production per day compared to 0.7-4.5g in the control group. This is far from any meaningful conversion of carbs to fat. One of the reasons we dont produce much fat through de novo lipogenesis is because its a very inefficient process. By converting carbs to fat, our body needs to actually burn some calories! Evolutionarily, that wouldnt be very beneficial since food scarcity, not abundance as we have today, would have been more of a concern. What actually seems to happen when we overeat carbohydrates, is that theyre preferentially used as fuel and the fat we ate throughout the day is more likely to be stored as fat. So at the end of the day, it really does come down overall calorie balance. I want to be clear: this post isnt about promoting calorie counting, low fat diets, or anything of the sort, but rather to combat the carbophobia that is so prevalent in our society. I am an advocate for eating an abundance of whole plant foods in whichever macronutrient combination feels right for you. References in the comments See more

Everyone knows spending time in nature is a healthy habit, but less is understood about why, or to what extent, it benefits us. One issue is that the research into this area is largely comprised of small studies that use different frameworks for establishing the effectiveness of nature time. However, if we do look at some of the larger studies to date, we can start to get an idea of the benefits. A 2019 meta-analysis of 25 studies that compared mindfulness practices that... took place in nature to practices conducted elsewhere, found that natural settings had greater benefits on psychological and physical conditions. Similarly, a 2010 systematic review, which also assessed 25 studies, found that walking or running in natural environments, instead of a treadmill or a built environment, elicited greater benefits for overall well-being, specifically emotional well-being. A 2018 review aimed to answer some of the questions of how nature time improves our health, and they found that spending time in nature may lower our cortisol (stress hormone) levels, while also improving heart rate, and blood pressure. An Australian study also found that nature time could help drop blood pressure and the researchers advocate for 30 minutes of nature time or more per week, which could reduce the prevalence of high blood pressure in their population by an estimated 9%! While theres still a lot that is not understood about the mechanisms at play, besides the obvious benefits of increased physical activity and sunlight exposure, there are hypotheses that some of the benefits are due to the inhalation of various natural chemicals; one group of which are called phytoncides, which may boost certain aspects of the human immune system. This is a fascinating area of research that I hope gets expanded on in the years to come. Have you spent some time in nature this week? References in the comments See more

Sometimes the term plant-based describes a plant-only or vegan diet, while others believe the paleo diet can also be classified as plant-based. This is the case when someone uses the term to describe a plate that is filled mostly with plants. This definition of plant-based definitely comes with some problems. You could fill your plate with iceberg lettuce and top it off with chicken breast while calling the meal plant-based even though most of the nutrition would be... coming from chicken. Diets can be defined by mass, volume, or servings, but I believe the most useful definition is by calories. For example, the Okinawan diet, which derives 96% of its calories from plants, is described as plant-based while including small amounts of animal products on occasion. Similarly, the plant-based diet used in @deanornishmds research on heart disease was almost entirely made of plants, but did include skim milk and fish oil. When anyone is discussing the research on a plant-based diet, they are almost always talking about a diet that derives the vast majority or all of its calories from plants (think Okinawan or strictly whole foods, plant-based diet). Occasionally the Mediterranean diet, or similar diet patterns, are referred to as plant-based, and while they do tend to derive the bulk of their calories from plants, the Med diet is so well established that any research actually discussing it will refer to it as the Mediterranean diet, not a broader term like plant-based. Every type of criteria for the term has its pros and cons, but in my experience, when advocates are discussing the benefits of a plant-based diet, they are usually referring to a diet that gets 90-100% of its calories from whole plant foods, with 85% being the lowest evidence-based figure Ive seen, and the highest percentages (95+%) being used for chronic disease treatment. To give you some perspective, for the average person that would be the equivalent of eating one skinless chicken breast every 3 days and the rest of your diet being composed of ONLY plants! Comment and let me know how you define plant-based References in the comments : @nikitavizniak See more

I cannot overstate the importance of physical activity for maintaining or improving our mental health. Surprisingly, this is actually an area that has been fairly well researched. A 2016 meta-analysis that looked at 23 randomized controlled trials assessing the benefits of aerobic and nonaerobic exercise for depression is quite enlightening. Compared to controls who either underwent no treatment, placebo treatment, medication, psychotherapy, or alternative treatments, th...e exercisers had a moderate to large reduction in depressive symptoms! If we look deeper at the results, we find that exercise resulted in significant improvements compared to no intervention or usual care. When compared to psychotherapy or antidepressant medications, the researchers did not find a significant difference, which actually demonstrates just how effective exercise can be! Lastly, they also compared a combination of exercise and antidepressant medications to medications alone, and found a moderate, but not statistically significant benefit. Ultimately, the researchers conclude that exercise is a viable alternative or adjunct to antidepressant therapy. A 2018 meta-analysis that looked specifically at aerobic exercise had similar results, but did find a statistically significant benefit compared to antidepressant medications, usual care, and psychotherapy, although I suspect that wouldnt be the case for severe depression. While each study defined their exercise treatment slightly differently, most required approximately 30 minutes of activity, 3x/week. Depression isnt the only condition that exercise seems to benefit. Another meta-analysis on exercise and anxiety, assessed 15 studies and came to the conclusion that exercise is an effective treatment for raised anxiety compared to people who are currently on a waitlist for treatment, and they found that high intensity exercise was better than low intensity. Is exercise a part of your self-care regime? If not, are you going to try to include it? Comment and let me know! References in the comments See more

I am surprised by how many vegans I come across that dont supplement vitamin B12. I believe it is absolutely crucial to supplement. A deficiency can lead to anemia or neurological issues, such as dementia, so it is not worth the risk! Those who consume ruminant animals (eg. cows) can get B12 from them because the bacteria in their guts can produce it. However, you may be shocked to learn that 55% of B12 production is sold to the feed sector! This is because other animal...s, such as pigs and chickens, are often supplemented with B12 since their feed isnt a reliable source and most dont get to roam in B12-rich environments as they would in nature. So many meat eaters may actually be taking a supplement via the animals they eat! I should also note that B12 deficiency is not a vegan-specific issue. While a vegan diet may decrease B12 intake, some research indicates that up to 39% of American adults have suboptimal B12 status where symptoms of deficiency could be experienced, while more recent data suggests 6% of those over age 60 are deficient and closer to 20% have marginal levels, which is why the Institute of Medicine recommends that EVERYONE supplement after age 50 because we may absorb less as we age. Interestingly, the difference between vegan and nonvegetarian deficiency rates may be shrinking, largely due to the increase in supplementation and fortification of vegan foods, such as plant milks. Ive heard some vegans argue that theres enough B12 on unwashed organic produce because of the bacteria on the food, but there simply is not sufficient evidence to back that claim and its downright dangerous if given as advice. Once again, vegans MUST supplement and nonvegetarians should consider testing to see if theyd benefit as well. It isnt worth the risk of relying solely on food sources. B12 supplements are quite cheap compared to other supplements and are very widely available. For dosing recommendations, I suggest visiting @nutrition_facts_org and speaking with your healthcare provider. References in the comments See more

CLINIC RE-OPENING! After months of the COVID-19 lockdown, we at Tonume Integrated Health are finally re-opening our doors on Tuesday, May 19th, in accordance with our Provincial Health Officers guidelines. For full details of the precautionary measures we are taking, please visit this link: https://www.tonume.com/tonume-covid-19-restart-plan Since we will be doing our best to stagger our patient visits and reducing hours, I have had to make some changes to my personal hours.... My hours for the remainder of May are as follows: Monday: 2:30-8:30PM (Phone/Online consultations only) Tuesday: 11:00AM-3:00PM (In-clinic) Wednesday: 11:00AM-6:00PM (In-clinic) Thursday: 11:00AM-4:00PM (Phone/Online consultations only) Friday: Closed Saturday: 11:00AM-6:00PM (In-clinic) Sunday: Closed These appointments are bookable online at the link below, or if you would like to book a phone/online visit during my in-clinic hours, that can be done by phoning the clinic at (604) 428-1399 or emailing [email protected]. I know this has been a challenging time for everyone, and the situation is rapidly evolving; however, please know that I am here to help. I am currently accepting new patients, so lets work together and strive toward reaching your personal health goals. Booking link: https://tonume.janeapp.com/#/staff_member/70