Hello, everyone. Thank you so much for inviting me to take part in this fifth conference on vegetarian nutrition. I'm speaking to you from Vancouver, Canada, and I'm very grateful for the help of three people there. One is Dr. Eric Slievich, a physician with a focus on vegetarian and vegan nutrition. One is Marley Winkler, who translated our nutrition books into Portuguese, did a wonderful job. This is an earlier book. And 1/3 is our host, Thaissa Navalar. Whereas decades ago, there was concern about the adequacy of plant-based diet, The current position paper of the Academy of Nutrition and Dietetics states that appropriately planned vegetarian, including vegan diets, are healthful, nutritionally adequate for all ages and for athletes. This paper goes on to state how powerful these plant-based diets are in both preventing and reversing the major chronic diseases that are our killers. I'm the lead author of this 11-page paper, co-authored with two other experts in the field, and you can see and download it from my website, nutrispeak.com. Here is my co-author of 28 years and 14 books, including the one you have in Portuguese, Brenda Davis, at age 60. and I'm 79 right now. In our writing and speaking, we focus on optimal nutrition. In fact, one of my own goals is to have many, many of us fit as seniors and at ages well over 100. And the research looks very promising. But what do we need to know in order to create a plant-based diet for outstanding health? throughout our life. The nutrients that we'll look at here in this presentation are vitamin B12, vitamin D, calcium, omega-3 fatty acids, and the combination of protein, iron, and zinc that typically come in the same foods, and iodine. We'll begin with vitamin B12. which actually comes from microorganisms. There's no other original source. This is a very complex molecule, as you can see here. It has cobalt in the center. And we humans can't make this molecule, nor can other animals, nor can plants, just microorganisms. And even when it's present in animal products, it comes from microorganisms. Same thing in supplements and fortified foods. Microorganisms are the original source. We on plant-based diets need the supplement or fortified food source to get our reliable vitamin B12. And also everyone over the age of 50, regardless of diet, meat eaters, users of dairy, eggs, many cannot cleave vitamin B12 from its balanced state in animal products. And so the official recommendations are that everyone over the age of 50 use supplements or fortified foods to get their vitamin B12. So how are South Americans doing with vitamin B12? Well, there's one paper from Argentina, showing that 91% of Argentinian vegans consumed less than the recommended index of B12. This was a paper by Gillie. What about Brazilians? Well, we don't have a recent paper on that. However, the estimate is that 40% of the general population is B12 deficient, and 50% of vegans are B12 deficient. So it's really important that people get this right. Well, why is B12 so important? It's essential for, first of all, the synthesis of normal red blood cells. Red blood cells to reproduce, get bigger and bigger and bigger, and then divide. Without B12, they can't do that. And so they stay as large red blood cells that can't do their function properly. It's also required for the synthesis of DNA, our genetic material. It's needed for the maintenance of myelin sheaths that surround our nerve fibers, very important role. And it's required for the metabolism of the energy-giving nutrients. So you can imagine without it, we don't do too well. and for the conversion of a toxic substance called homocysteine into something we actually require called methionine. What happens if we don't have enough B12? Well, first of all, because of the large ineffective blood cells, we become weak, fatigued, irritable, and depressed. The nerve damage is very important in the long term. You begin with numbness and tingling in the fingers and toes, difficulty with balance and walking, memory loss, confusion, and even eventually psychosis. There are also gastrointestinal disturbances, and the high homocysteine can lead to increased risk of heart disease. So here we have this wonderful plant-based diet that is so helpful. supportive, and lack of B12 undermines it. And there's premature death. Also, birth defects can occur. We can store vitamin B12 for very long, for years, two or three years. And so the results don't show up very fast. Adults can recycle their B12 for two or three years. However, infants do not have these stores yet. So it's in infant formula, but breastfed babies can develop deficiency very quickly and become apathetic, irritable, very weak, within weeks of birth, and even more severe brain damage and tragic outcomes. So what we have is a very, very healthy overall diet is undermined if we don't have B12. So, plant foods, can they provide any B12? There is some in the soil, but clean plant foods are not reliable sources of B12. Foods that have sometimes been mistakenly referred to as B12 sources, like organic vegetables or seaweed, or fermented food or mushrooms, they can't be relied on as B12 sources. So if you have any questions about your own status, you can simply get a lab test and have your B12 assessed or your MMA, which is Methylmalonic Acid. And there's a physician, Dr. Eric Slivic, his website is shown here. and any family physician can do this as well. So for people over the age of 50, because aging reduces our gastric acidity and the enzymes that can cleave B12 from the protein where it's bound in animal products, you don't get B12 from animal products. So on any diet, the Institute of Medicine recommends B12 supplements or fortified foods for everyone over 50 because we really don't know who is managing that cleaving process and who isn't. How much B12 do we need? Well, the easiest thing to do, that's what a lot of people do, is to take a supplement of 500 micrograms twice a week. An example is shown here. Or you can take 1,000 micrograms twice a week. Another alternative is to take a multivitamin mineral supplement that has either anywhere from 5 to 100 micrograms per day. It's a tiny, tiny amount like the dot at the end of a sentence. It's really small. So that will do the trick. And because of our rather unusual ways of absorbing B12. Several complex mechanisms. These ranges in amounts seem rather broad, but that's how it works. And the third alternative is to take fortified foods and take these three times a day. It could be nutritional yeast. In Brazil, they're coming into the market, some veggie meats that have B12. And if you're interested in how much B12 for various ages, you can see the website veganhealth.org. Those on plant-based diets who use B12 supplements or fortified foods typically have excellent intakes and status. So it's very, very easily resolved. Next, vitamin D. And here we're talking very sunny country and we know that vitamin D is produced when you have some sun rays on our skin. However, despite being a sunny country, about 45% of Brazilians have insufficient vitamin D and 28% have even less and are actually deficient. as shown by blood levels. Why would this be in such a sunny country? I put the reference for that here. Well, the factors that limit our vitamin D synthesis are, first of all, despite it being so sunny outside, many people get little sun exposure. You might, for example, go from the house into the garage, drive to work, go into a parkade, and walk into the building without sun exposure at all. And we only need 10 minutes to half an hour on the skin per day of kind of 10 in the morning to two or three in the afternoon. But that typically doesn't happen for a lot of people. People may use sunscreen, put it on right away. They can be covered by clothing, even though they're outdoors. so there's no skin exposure. There's air pollution. Surprisingly, even in sunny cities like Honolulu, Los Angeles, San Diego, Sao Paulo, or Rio, there can be air pollution that blocks the ultraviolet B rays that lead to our production of vitamin D. A person with dark-colored skin has melanin that predicts from sunburns, but it also limits vitamin D production, so more exposure to the skin is needed. And the two other factors that are important are advancing age. As we get older, our ability to produce vitamin D decreases. And another factor that can limit vitamin D production is overweight. And this is a serious factor as well. So why is vitamin D so important? Well, we've known for years that it really helps with our bones, to keep our bones strong. It helps us absorb calcium from the GI tract and put it into our bones and not allow it to leave in the urine, like to retain it. But we're finding more recently that vitamin D has a tremendous role in preventing disease. Many diseases in chronic conditions, including cancer and COVID, it's protective against these. It helps us to grow and mature cells. We need it for our immune system function, for our neuromuscular system, and blood pressure regulation and insulin production. So it's really used throughout the body. And one of the, oh, here's one of your vegan athletes on the beach, Marcel. We find that vitamin D is a bit of a mystery right now. How much do we need? The official recommendations are that we need somewhere from 400 to 800 international units. And that's based on bone, our needs for bone health. But many experts suggest significantly more, 1,000 up to 4,000 international units or even more per day for optimal health. And so you will find a lot of opinions out there. And you can get your blood levels checked to see if you're in the optimal range for vitamin D status. And in Brazil, you can now select four to five non-dairy milks. They're just coming into the markets. Many big companies have found that people are switching more to plant milks and starting to fortify them. with not only vitamin D, but also with calcium. And this can be a good way to get calcium and to get vitamin D. Although with vitamin D levels, you'll probably need a supplement as well. How much calcium do we need? Well, it varies through life, but it's quite significant even from the early, early years. We need 700 milligrams when we're little toddlers, and up to the teen years, when bones are growing quickly and we're growing at a great rate, we need 1,300 milligrams per day. Then it drops a bit through the adult years, but for seniors, it rises again, and that's to help us maintain our bone mass into our old age. Now, dairy websites and ads will indicate that what you need for calcium is cow's milk, but in fact, we can get calcium from a lot of different foods, and in fact, from the various food groups. You can meet your calcium needs quite well without any dairy products at all. So first here we see the greens. There's bok choy, kale, Napa cabbage, this long green one, and broccoli. And these are all excellent, well-absorbed sources of calcium. Not shown here are spinach and beet greens because the calcium is blocked by oxalates, the absorption. So oxalate holds on to the calcium and doesn't let you absorb it, even though it's in the spinach and in the big greens. Some other foods are several fruits. Oranges have calcium, and so do figs. And there is calcium-fortified orange juice available in juices. Then if we move into the seeds and nuts, we find that almonds have calcium, and of course, almond milk when it's fortified has even more, and sesame seeds or sesame tahini. So if we start building our diet around these whole foods, instead of using extracted foods like sugars and oils and so on, we'll end up getting a lot of different minerals, including calcium. And one that's kind of fun is blackstrap molasses. When sugar is refined from sugar cane, The minerals that were in this sugarcane plant are concentrated into blackstrap molasses, and we'd want to get organic blackstrap molasses so we don't get pesticides, but it can be a terrific source of calcium and of iron. And finally here, this is a big favorite in Brazil, is beans. So your country's been very, very good at creating wonderful dishes centered on black beans, white beans, pinto beans, lots of different ones. And also calcium set tofu is a terrific calcium source. So how do we meet our calcium needs and maintain bone health through life? How will you do it? So think yourself what foods you include to make sure you get enough calcium and also, what regular exercises do you do to maintain bone density and strong bones? For lifelong bone health, we want to meet the recommended intakes for calcium and vitamin D, include some fortified foods, and our overall diet, including fruits and vegetables, is very healthy for bones. Then we also want some weight-bearing exercise. It could be things like gardening, as shown in the last slide, and it could be exercise where you get a little bit of an impact, like walking or running, and it could be lifting weights. And we want exercise to occur optimally 60 minutes, six or seven times a week. Next, for protein, iron, and zinc, which often come together in the same foods. Well, surprisingly, in many developed countries, our nutritional problems tend to be overweight, too many calories, too much food. But for most developed countries, the nutrient that's low is iron, and this is in Brazil as well. So some Brazilians are low in their hemoglobin levels. A solution for this is to eat beans, and you'll get plenty of iron that way, and you'll also get plenty of protein and zinc. Some of the protein, iron, and zinc-rich foods are shown here, and they're in a variety of different food groups. So first of all, the legumes, the beans, peas, lentils, the chickpeas, the tofu, the soybeans, These are just little powerhouses of protein and of iron and of zinc for your immune system. Keep your blood rich in hemoglobin. Also, whole grains, quinoa that's grown in South America, and also iron-fortified flour, which is coming in, and iron-fortified grains, particularly for babies, those are a very good start, and amaranth. Then seeds or nuts, all sorts of seeds, pine nuts, Brazil nuts, cashews, almonds, and some of the vegetables, particularly green things like peas, green beans, green leafy vegetables, and fruits, dried fruits like raisins. We often keep a jar of raisins on the counter and just have a few as we go by as a snack that can raise your blood sugar, give you some iron. And the fortified veggie meats that are starting to appear. Often these things are in transition diets when people are moving towards plant-based, but they can be helps in terms of the fortification that's added like B12 and iron and so on. And black strap molasses, which I mentioned before. Here we see some of the wonderful Brazilian beans that are used, white, black, pinto, habas, fava, and broad beans, different names used in different countries, and some of the wonderful dishes that are used. And marinated tofu can be part of fajitas. They're just a wonderful combination that can be used at meals throughout the day without any meat included, and giving you tremendous sources of protein, iron, and zinc. And even for breakfast, you can have empanadas that have black or white beans or lentils. You can have in your coffee, fortified non-dairy milks that are made from soybeans or nuts or seeds. Soy, by the way, it has been one of the most controversial foods, I think because it set up a kind of threat to the meat industry. but it actually has been proven to be a superbly healthful food. And regular soy intake in children and teens can set the stage for lifetime reduced risk of breast cancer for girls and reduced risk of prostate cancer for boys. Next nutrient we're looking at is omega-3 fatty acids. And here we aim for about 2 to 4 grams per day. And some of the foods that are grown here in Brazil are chia seeds and flax seeds. In other parts of the world, walnuts can be good sources. And in Canada where I am, hemp seeds are wonderful omega-3s. So you just need a little bit, like a spoonful per day, and say of chia seeds or ground flax seeds. and that'll provide your omega-3s. And from these, we can create long-chain omega-3s in our body. Sometimes people eat fish to get those long-chain omega-3s called DHA, but do we need to do that? Definitely not. In fact, microalgae, not fish, are the actual DHA producers. So in fact, fish get their DHA, from microalgae. They're not the real producers of DHA. They get it down the food chain from the microalgae, and we can simply cut out the middle fish and go directly to the source and get DHA from microalgae. How much DHA do we need? Well, in fact, it's not essential in our diets. We don't require that on plant-based diets, we need DHA. And we can create it in our own bodies. But it's possibly beneficial during pregnancy and lactation. It may help with brain development in those early years. The suggested intakes are at least 200, maybe in the range of 2 to 300 milligrams of vegan DHA, two or three times a week or daily. And because it's not required, we don't know exactly how much, but 200 to twice a week should be fine. Next nutrient is iodine. And why is iodine important? It is an essential component of thyroid hormones, which are produced in the thyroid area near the throat, base of the throat. These hormones are necessary for energy metabolism. In a deficiency, you can get hypothyroidism, very low energy, and you can get a goiter, the thyroid grows in this area. You can get fibrocystic breast disease, or during pregnancy, adequate iodine is absolutely crucial as it is critical to normal brain development of the infant. The recommended intakes are very small, 150 micrograms a day for an adult, and in pregnancy and lactation, the amounts are increased about twice as much during lactation. Iodide salt has been available for more than 60 years and has pretty well eliminated iodide deficiency for most of the country. Interestingly, Brazil can have either too little iodine or too much in some cases. And we need some iodine, but not too much. The recommended intake is 150 micrograms a day, as I said, but the upper limit is 1100 micrograms a day, and that can be toxic. Thyroid function can be compromised by consuming too little or too much iodine. This is checked by thyroid tests. So good iodine sources to make sure you're getting enough amounts that can provide you 150 microgram are 1/2 a teaspoon of iodized salt, that would be one way, nori, those sheets that adults and children would like to eat or on sushi, dulse granules, half a teaspoon, and kelp can be a source. It's a tiny little amount, a 16th of a teaspoon. So often if people are relying on kelp, they have a quarter teaspoon twice a week, but you can get too much quite easily, and people have sometimes done that. And if you're relying on a multivitamin mineral supplement, check that it does have iodine, if that's what you were wanting to be your source, because not all of the supplements do. That was the end of the nutrients. I wanted to mention a good website that you might enjoy and appreciate. It's called happycow.net. And if you're going to different restaurants in an area where you live, want to explore what's vegan and nearby, or if you're traveling, happycow.net is quite fun. You can put in the city that you're interested in and you can also put in, there are some filters. You can have vegan restaurants as your choice. You could have vegan and vegetarian restaurants. Or you can have veg-friendly restaurants. Say you're going out for dinner with a group and some people are vegan and some are non-vegetarian and want a menu choice that'll fill the bill. And you can also set a filter for how many miles away from where you are. So it's quite a good website and there's certainly a lot of veg-friendly and vegan restaurants in Brazil. Next, food guides. I'm finding, as I watch the changes around the world, that many countries' food guides are getting more plant-friendly. Here's Canada's, for example, which has been published for the last two years. And you'll notice that there's no meat group and no dairy group. In fact, half the plate is vegetables and fruit, 1/4 is grains, and they prefer whole grains, And then there's a protein group. And that protein group does include meat and dairy products, but there are small amounts shown in the picture. And there's significant amounts of the beans, the tofu, the seeds, the nuts. And the beverage suggested is water. In our books, Becoming Vegan Express Edition, and comprehensive edition, we have also a food guide that can be a really helpful guide so that you get all the nutrients you need. And it has also, it's modeled of the food guides of different countries. And it has, again, the vegetables and fruits taking up half, the grains, and it has the legumes, the beans, peas, lentils, and it also has nuts and seeds for omega-3 fatty acids. And mentions vitamin B12 and D. And you can see this on the website, becomingvegan.ca. You can see exactly what this is. And it's also, of course, in our books. All over the world, environmentalists are encouraging the shift towards plant-based alternatives. It's a really amazing evolution. As one example, the brand Hurra posted this giant billboard in central Madrid reading, one hamburger pollutes more than your car. They were immediately sued by the Spanish meat industry, but they won in court, and that company can continue with its environmental activism. Adopting A plant-based diet is definitely ecologically sustainable. And you'll find that in the position paper that I mentioned at the beginning. With this single step, you help to preserve the fragile life support systems on this planet. Adopting A plant-based diet is ethically justified as well. There's no diet that better reduces the pain, the suffering, and the death in animals. So it's a win-win-win. It's also a big win for health because we have more and more data showing that our disease risk for the chronic diseases is reduced when we shift to a plant-based diet. My summary for this talk is eat beans, take B12, and check out what are your sources of calcium, vitamin D, omega-3s, and iodine. The material that we've covered is in our books, which I co-authored with dietitian Brendan Davis. And she's spoken at some of these conferences, and will again next year, I think. And our Becoming series is Becoming Vegan, the Express Edition, comprehensive edition. There's also Becoming Raw. This early book in Portuguese, which Marley Winkliffe translated, Thanks Marley, and the Kick Diabetes Cookbook has a number of recipes that don't include any sugar or oils or fats added to the recipes, but they're really tasty recipes. They're very good. I'd like to thank all of you for what you are doing to keep yourself in good health and to make this place, this planet, kinder and more sustainable. So thank you.