Lorraine T Sakaguchi, President, VSH

I'd like to introduce the Vesanto Melina.

Vesanto Melina

Thank you. Okay, thanks everyone. This is about meeting all your nutritional needs and I've been a dietitian since 1965. That's a lot of years. I don't know, 59 or 69 or something. And I've seen the evolution of nutrition all this time. What we're going to be looking at today is some key nutrients, protein, essential fatty acids, four minerals, vitamins D and B12, food guides summarizing it, and a bit about remission of type 2 diabetes as an example. So what I find, I've been vegan for 33 years. So I've seen a real evolution, and there's certainly been an evolution in myself. I used to think that vegan was like the way to go. It was perfect, and it would bring everybody to better health. And what I'm seeing lately is that we have to get it right to be vegan. Like we have to, there's a few things to tweak. Sometimes people go vegan just for animal rights reasons. And I've even been involved in a court case once for a child that had vitamin D deficiency. And we really need to address some of these nutrients quite carefully. So people can go vegetarian or vegan for ethical reasons, but not quite get the health aspect. So plant-based is a broader way of seeing things. and usually addressed for health reasons. I was lead author of the American Dietetics Position Paper on vegetarian nutrition. And what we're realizing with time is that it does have to be well-planned to work. Like any diet has to be well-planned. You know very well that the standard American diet is getting people into all kinds of chronic diseases, but we have to address the issues with the vegan pattern. So we find that there are nutrient deficiencies in all the different dietary patterns, and it would be good the more we get this on a broader basis, done very, very well. The nutrients that we have to address when we're going plant-based are EPA and DHA, the long-chain omega-3s, vitamins D and B12, and calcium, iodine, and for women, iron and zinc. With the meat-based diets, you also have a set of nutrients that are deficient. Vitamin D ends up being on that list, and calcium. But you'll see that there's a different pattern beyond the vitamin D and calcium. What we find is that when people go plant-based, there's different ways of looking at it. And now we've got summaries that are related to health. plant-based diet index. And that's when you choose a really healthy plant-based pattern. And the unhealthy plant-based diet includes the unhealthy plant foods and animal products. So what unhealthy plant foods are there? What would people be eating with that? Potato chips. Gotcha. What else? French fries. French fries. Oreos. Yeah, you can get vegan Oreos now. And pop. Pop, like 25% of calories in many, many diets come from pop. Sweets, desserts, just all kinds of foods like that. And what we're finding is that when we look at the major chronic diseases, if you look at, these are some studies from all sorts of different countries, US, China, Korea, and they're done in different countries. The plant-based dietary index, when you've got basically a lot of whole plant foods, you drop your risk of these chronic diseases just across the board. A long time ago, I thought, yeah, vegan, we drop our risk of chronic disease, but it is a healthful pattern that drops the risk. And you'll see it's going down this whole set here of chronic diseases. The healthful plant-based diet drops the risk even more. And the unhealthful plant-based diet, in contrast, can raise your risk. So it's important to be addressing this. And I'll tell you, I'm 83, I'll be 84 next month, and I'm planning to be 118, and I want a whole bunch of you to be there. We'll have another talk that year, and we'll get together. Because I can see a lot of you are, you've been persevering in this pattern, and it can be a wonderful pattern, but we really want to succeed. And the research is coming out thick and fast about many of these areas. My dad was a cancer research and diabetes research professor, and my mom was a preschool teacher who liked kids cooking. So that's how I got interested in the whole thing, but we sure didn't know very much a long time ago. Like we're really learning quickly. So these are the ones we're going to look at now. So protein, how many people here have been asked by their friends or people wondering, where do you get your protein? Put your hand up if you've had that question come, because it's really hilarious. You have somebody put two hands up, been asked this, where do you get your protein? And it is one that we really need to address. And of course, we know that the biggest, largest muscled animals have, you know, they living, they're herbivores. It isn't a big problem for we humans to do it either. Here's a couple of them. This Mimal Delgado was vegetarian since birth and vegan for the last 11 years. And Jahina Malik was vegan since birth. So, you know, we do see people in all kinds of sports, every or you can imagine that they are doing very, very well. And you can look at these websites in the sport that you're particularly interested in, and you'll see some leaders that are winning races and doing all kinds of things. So we need about 10% to 15% of our calories for protein. So where do you think we get it? So what we find is that with the veggie meats, for example, and I, I did some work, I actually did a cookbook with Yves, Yves Veggie Cuisine. They're, they're really constructed to be very much the pattern of meat, except of course they don't have the saturated fat. They don't have the new 5G that's linked to cancer. They don't lead to TMAO with linked to heart disease, but the veggie meats are very, very similar in other ways. The soybeans are also a really good choice. And the legumes, those are really something I rely on a lot. And seeds, mushrooms and green vegetables also are very high. And grains actually provide about half the world's protein, just under 50%. I've trekked in Nepal and the people carrying Nepaps, they were living on millet and spinach and they were carrying everything for us. And even starchy vegetables have some. You'll notice some of the protein powders are from potato protein now. It's good to get the protein powders that are our mix if you use us. Nuts are a bit lower than seeds. The only group that's really kind of low is the fruits. But they have, of course, other very positive qualities with their protective phytochemicals. This is an interesting one, how much protein we need. And we need about one and a half grams per kilo when we're babies, but it drops to 0.8 grams per kilogram healthy body weight when we're older. And so this is one of the changing things that works out. So if you're 126 pounds, pounds, you need about 46 grams a day. If you're 154 pounds, you need about 56 grams a day. But as we get older, we're finding that we do need more protein. We don't absorb it as well. We don't digest it quite efficiently. So the American system and the Canadian haven't adjusted their ratings for seniors. But they have in all kinds of other parts of the world. So they make a higher recommended intake. And I think this is really helpful and important. If you want to figure out your own protein intake, you take your healthy weight in pounds, divide it up by 2.2 to get your kilograms. and then have about one gram per kilogram healthy body weight. So if a person was way overweight, they wouldn't use that, the other extra fat cells. They don't need as much protein, but you'd use your healthy body weight as an ideal. And it isn't that hard to get that, but it does take thinking about it and making sure. So what we find when we look at the diets of different countries is that, remember, some of our goals a few pages back were about 46 to 84 grams for protein. And we find that overall, our averages are certainly within that range, but that does mean some people are falling a bit short. I put pictures here of some restaurants in Paris. I have a sister living in Paris, and so we get to go there. And she told me the other day that even in Paris, they're going more plant-based. They're going more vegan in Paris. So that was encouraging. And I do find, I have the, you know, you read the news and it can be kind of discouraging, but I find that when we travel, we go to different places, it's very encouraging the kind of people we meet that are thinking about the environment, their health, animal issues. It's really heartwarming. We don't have a separate RDA, that's the Recommended Dietary Allowance, for seniors in the U.S., but... consensus is building that we should be at least 1 to 1.2 grams per kilogram when we're older. And this will help us maintain our muscle. You do have to keep exercising, though, while you do it. But there have been quite a few research studies now that show that when we do this and we do the, whether it's weight bearing, walking, and so on, we will have better walking speed, leg and hand grip, and better balance. The protein powders can help some people, like if you're, if you have a smoothie in the morning and it's mostly fruit, it's good to put some protein powder in that if you're trying to boost your protein. And the protein powders to get are the ones that don't have a lot of extra junk in. Some of them, you know, of course, when you go to a natural food store, it's a big row of whey protein, but they're really good soy pea blends like including potato protein that are quite helpful and not with a lot of extra things added to them. So here's an example of how to get 75 grams of protein a day without any added protein powders. So we've got our breakfast of cereal, choosing soy milk, which has much higher protein than, say, oat milk or rice milk, hemp hearts, a little sprinkle of those, and perhaps some flax seeds for omega-3s. Then my typical lunch is always salad and either beans or tofu. And you could have some toast with hummus on it at some point. And then you could have a yam or sweet potato. That's good for your eyes, the orange. and black beans or something like that, avocado, broccoli, and maybe a dessert of chia pudding made with soy milk. So that's the kind of, I mean, it isn't really hard to do, but you see there's not a lot of room for junk food in that. So the typical protein in selected foods, you see the veggie meats and the tofu and the soybeans are right out there. By the way, when I look at diets, if any of you are not entirely vegan, I find that in a health perspective, some of the near-vegan diets are... as healthful when we're looking at the research. They're not quite as good from an environmental perspective or the animal issues perspective. Well, not nearly as good, but they are turning out to be okay from a health perspective. Then if we look at the other foods, we find all the lentils, the peanut butter, which is a legume, the hemp seeds, the whole grains, nuts, all these can be protein contributors too. The leucine is a branch chain amino acid that's good for muscle building. And I've really been focusing on this. You know, I'm planning to be 118. I really have to, you know, make a good plan for it. And so, you know, I've been interested in these, you know, how to do that. So, like, I make sure I go to the gym every day and do a couple of yoga classes and some weight-bearing exercise classes, things for seniors, you know, not really hard. It's not like ultra marathons, but just do some of that. And Cam and I go for walks every day and do a few other little exercises. And that really makes a big difference for keeping your protein and your muscles. You know, Robert Cheek, have you ever had him come? He's a muscle builder. Somebody nodded, nodded, we know him. Anyway, he's a person that writes books on sports medicine and bodybuilding, very good books. And I phoned him one day and said, what do you have for lunch? And here was his lunch. You know, it's got some tofu, some beans in it. Just all together, it worked out perfectly for the leucine level. One of our books that just got to #1 on Amazon is Plant-Powered Protein. And here's some examples for getting higher protein intakes. Granola can, you know, a lot of granola that you buy at the store has a lot of fat and sugar in it. But if you bake it with some extra seeds, these are recipes from that. Plant Protein book, you can get a lot of protein. Then I mentioned my lunches are typically salad and marinated tofu cubes. And that was a cute recipe. I live in Vancouver cohousing. One of my neighbors said, I don't want you to talk to me about vegan. So I didn't. I restrained myself. But after a while, she had a stroke and then She came up with the best recipe for marinated tofu when you put it in the pot. It was really fun that she did that. It's just got tamari and rice vinegar, a bit of toasted sesame oil, ginger, garlic, and I have it in the fridge all the time marinating, put it in the air fryer. Then the peanut edamame salad, and then the double chocolate surprise cookies are good because they have black beans in them. That keeps them in the freezer so don't eat them all right away. A wide variety of the meta-analyses and the really big studies have shown that soy and pea protein are as effective as animal protein in the way that you find muscle and strength. So if you want to boost protein intake, I think it really makes sense to have at least one protein-rich soy source at every meal. Some people just have toast and peanut butter. Peanuts are a legume. That can work well. It can be really, really easy. You could have some, for kids, it's good to have some of these lower fiber choices and choosing the kind of meal that you want. Our Kick Diabetes Cook, by the way, is used by New York hospitals. next nutrient we're looking at after protein is omega-3 fatty acids. And this one, there's been quite a lot of interesting research. In our earlier books, we were saying, hey, just eat seeds, hemp, chia, ground, flax, walnuts, greens. Have you heard of that? Get your omega-3s. What we're finding now is that our ability to convert these into the long-chain omega-3s is really quite limited. We don't do it very well. We thought we did, 10, 15 years ago, but it turns out we don't that well. It also turns out, these are why people eat fish, these long chain omega-3s. But it turns out the fish aren't even getting very many. There's fish farms and fish aren't fed very much of the omega-3s. They get their omega-3s by having microalgae, by consuming microalgae. And so we can actually bypass the fish and go right to the microalgae sources. We can have the EPA and DHA supplements. Now, this isn't an official recommendation yet, but in some countries it is. And I think it can really help because these are important parts of your brain and they're also in the cell membranes around all your different cells. So how much? Well, it's really... We don't have good research on that. And it probably varies from one person to another. So there's a company called Omega Quant. I think it's in Dakota or somewhere. And you can write to omegaquant.com, get them to send you a little kit, and you do a blood, just prick your finger, get it, send it in a blood sample, and they'll tell what your level is. So I've been having right now about just over a thousand milligrams a day of DHA and EPA. But this is really new areas of research that we're not very clear on. But if we want to get old and have our brain still working really well, I think it's a real key. And it surprises me sometimes when sometimes people get older and they think their body can run, but they're not putting in the right fuel. It really makes a difference to do that. Next iron, has anybody here been anemic or someone in your family? Yeah, I see a few hands go up, mostly women, of course. This is a very important, of course, for the oxygen and CO2 transport, but it's also used for immune function, enzymes, thyroid, amino acid metabolism, really, really important. And it's surprising how much we need, like little teeny babies. need more than men and women, seniors. Women of childbearing age, women who menstruate have relatively high intakes, but the little wee people, they need a lot. It's surprising. What we find our intakes are, remember I've put what the recommended are, women of the childbearing age 18 and women and men, women over 51 and all men, need eight. And you can see that the vegans are doing relatively well here. There was some very poorly done old research that said vegans need a whole lot more iron intake, like 1.8 times as much, and that was very poorly done research. We don't need that high levels, but we do get more than people on other diets. Even when people are eating meat with blood in it, they don't get as much as vegans do. So iron deficiency in childhood is the most common nutrition deficiency in preschoolers, all those little kids, and they can have real health problems if they don't get enough iron. And one of the interesting things is, I don't know how many people have grandchildren here, Yeah, and some have children. So those little guys, the iron-rich cereals have really been a godsend for them. They can provide the 11 milligrams they need quite easily. Some advertising that comes from the meat industry says meat is the answer, but it actually isn't an easy way to get the iron. And it's, of course, linked with all these risk of chronic diseases later on in life, not right away, but later on. So a baby, for example, would need six beef quarter pounders to get the RTA. It's amazing. And that you can get it from, you know, this small amount of the iron fortified infant cereals. So I've even had little kids that were, you know, past the baby stage. but it just helped to mix it in with their cereal, that kind of thing. It was tricky to do that. So you can get it from 1/3 of a cup of fortified infant cereal or from some tofu. But you see, as soon as we start moving into the whole foods, it's more than these little guys will eat quite easily. For iron, what you want is the legumes, the grains, whole grains, the seeds and nuts, vegetables, and then there are a few other things. I know I've found some people get coal when they don't have enough iron, and we've kept a jar of raisins on the counter, and just somebody could grab a few raisins, and that seemed to stave off the coal. And then blackstrap molasses, that's where when they do the sugar cane refining, the minerals go into the molasses. So legumes are really, really good iron sources. You absorb more if you need more, and it's dissolved into pasta sauce quite easily. That's a good way to kind of sneak in legumes for some people and cooking cast iron. These are some things when people first go vegetarian, I know I did this, I was going vegetarian in the 70s. and, you know, eating more spanakopita’s with cheese and grilled cheese sandwiches and stuff. But it's better to do some different kind of replacements. For example, you could use toast and peanut butter instead of the grilled cheese sandwich or tofu in a sandwich or a lasagna. There's cashew cheeses, which actually are pretty good. They have some protein, they have some zinc and dairy. On the other hand, it's low in iron. It actually blocks iron absorption. And legumes are excellent iron sources. And cashews have both iron and zinc. So you can really feel encouraged. I know the cheeses that used to come out were pretty poor nutritionally, but there's some really good ones out there now, the non-dairy cheeses. And you're having that event in a little while. And you can boost your iron intake with absorption. enhancers. So if you've got red pepper in your stir fry or orange juice or some orange with your scrambled tofu or your peanut butter sandwich or something like that. So all of these things will help absorb iron. And then some things can block iron absorption. If you have tea with meals, mostly it's fine to have tea with meals, but if your iron was a bit dodgy, you could avoid doing that. If you have a zinc supplement, it can block iron absorption. And dairy products, as I mentioned. Zinc is another one, interesting one. Now, why do they think we need zinc? It's not so famous as some of the nutrients, but it does a lot of stuff. It's like the busiest mineral I can think of. It's involved with immune function, wound healing, skin repair, growth reproduction, activity of just hundreds of enzymes, cell signaling. And one of the things as you get older, if you are losing your sense of taste, this can be related to low zinc. I know I sometimes can't taste very well. One of my neighbors says, you don't taste good. You lose your sense of smell too. You don't smell good. Yeah. So if our zinc intakes are low, the legumes and whole grains have them. But when you cook or soak or sprout, you'll increase your zinc intake and absorption. So these are sometimes kind of borderline, but they're just another reason that we really want to be including things like the cashews, the legumes. So the intakes of kind of borderline for some people on plant-based diets. It's the same kind of picture, the legumes, the nuts and seeds, the grains, the vegetables and fruits. And you see the animal products are right in the same ballpark. although there's many more of the plant foods. So what you want to do, again, is have zinc-rich foods, and that's the whole grains, the legumes, the seeds. You know, make sure you're cooking. Sometimes people sprout and so on. And it's good to have snacks that are nutritious, like instead of a bag of potato chips, having a handful of cashews or some hummus on toast, that kind of thing. iodine now this is another really interesting one so I was trekking in Nepal I forget when it was, I think it was the 90s and in 1993 and I was uh I came by this woman that had a goiter and what happens with when we're low in iodine our thyroid gland just grows bigger and bigger and bigger trying to trap all the iodine it can. And so many people in certain regions of the world were getting iodine deficiency. And Nepal was one. Also the appellations. And it can have tragic consequences. People were having, if they went through pregnancy and they were low in iodine, they could end up with a child that was called a cretin. It affected the mental development, some of the body shape. So what happened in 1990 was it, 1924, So it was just over 100 years ago, they decided to iodize salt. And it just fixed it. It just fixed it like that. We didn't end up having those problems, which was a real blessing. So, and in Nepal, for example, now, iodized salt is commonly used. It's very inexpensive. Around the world, they've really fixed some of those iodide problems. We need just a tiny little bit there's about 150 micrograms just a sec yeah for adults 150 micrograms and there is an upper limit so you don't want to take huge amounts of iodine pills because they get problems if you got too much the way to get it is you can use cheap old iodized salt so like a dollar to a box You can use nori, you can use dulse. Carrot powder is a bit tricky because it's so concentrated. But it's not in some of these cooking salts, sea salts, Himalayan salt, pink salt. It's not, they don't have iodine. So it's added to cheap old iodized salt and you just eat it like 3/8 of a teaspoon a day, tiny, tiny amount. The last mineral is calcium. And of course, it's in our bones and teeth, but it's used in a lot of other areas in our blood. Very important things, muscle relaxation, nerve cell transmission, just really key. So you've got to have your calcium in your blood at the right level. No question about it. If you don't, your body will just get it out of your bones. So this can work quite well. Do you think cow's milk is necessary? You've seen ads saying it is. I see some people shaking their heads, you're right. So each mammal makes milk for their offspring. And if a calf was allowed to wean, or nurse until it was weaned at 6 to 10 months, which of course they're not, because they're removed and the milk goes to humans, but the calf would weigh 400 to 700 pounds in that short of time. Like this is fattening stuff. You know, you can really gain weight. But no milk requires this, no species requires the milk of another species. And in pre-agricultural times, people still got a lot of calcium just from all kinds of plant foods. So the non-dairy sources have advantages that they don't have the saturated fat or the cholesterol, and they have all kinds of other nutrient advantages. So calcium-rich plant foods are in every single food group, every food group. They're in vegetables, these particular ones, including molasses, which was from sugar cane, yeah, and the fortified orange juice, but also oranges and figs. There's also Hispanic people would always make their tortillas with calcium salts, and some of them that you buy are really good in calcium. Sesame seeds or tahini dressing and almonds. The black and white beans and also the tofu, tofu set with calcium, just check the label, and then lots of different non-dairy milks. So every food group can give calcium. We don't need a milk group. And actually Canada has stopped having a milk group. The US still has that, but it's been changing in many, many countries. And so if you look at the bioavailability, Dairy products, you get about 25 to 40% and same with tofu. But the greens, how many people eat lots of greens here? Lots, I think. And some grow. We've got some good horticulture people here too. These are really, really good sources of calcium. And the juice can be fortified with calcium. Legumes are pretty good and sweet potatoes. So they've got the vitamin A for preventing natural degeneration and cataracts, but they also have the calcium. The only ones that are low, even though they have calcium, are spinach and beet greens and Swiss chard. They have calcium, but it's bound up with oxalate and we don't get it out so easily. Same with Rivar. So how much do we need? About 1,000 or 1,200 when you're older. And I'm finding, I have clients both in my office, which is in Vancouver, or online, and I find a lot of times people aren't needing the recommended intakes for calcium. Well, we saw that for plant-based, but we also saw it for just all kinds of diets of short calcium. And so it can really help to have a slight calcium supplement, not too much, just a bit. So a systematic review showed that vegetarians, these people would be eating, drinking milk and having cheese, have a 25% higher risk of hip fractures, and vegans have a 75% higher risk of hip fractures. So these are in some big studies worldwide. North America wasn't actually doing so badly. But they were in many, many parts of the world. So why would this be happening? What do you think? Not eating the leafy greens as much? Yeah? Eating more dairy? Eating more dairy. Well, the dairy is okay for this one. Or you could have fortified soy milk. Vitamin D? Yeah, vitamin D helps us absorb, retain calcium, dope pee it out, keep it in your bones. So some of the reasons that we vegans don't have so much, and I bet some of you may have low bone density. It's really important, and you can improve this a lot. We have less body weight. There's a lot of slim, elegant people here. We don't have quite the big body weight that can help you maintain calcium. Now you don't want to go that route, but it does make a difference. And when we're walking, we should do a little bit of, you don't get as much calcium retention in your bones. by swimming as you do by walking. You need that little tiny bit of an impact. You don't have to stomp. Our calcium intake is a bit low. And we found though, for at least at 525 milligrams a day, our bone health is better. It's lower, like somebody said, vitamin D, lower vitamin B12, lower protein. That's another part of bone. And we don't use as much hormone replacement therapy. So you can really tweak your habits so that you get better, ensure strong bones, meet the recommended intakes. Vegetables and fruits actually help a lot too. And of course, you see our lifestyles, how they've gone in the direction of not supporting strong bones. We want weight-bearing exercise at least six to seven times a week. When we choose meals, look at the label and see if it's fortified. I know that in the court case I did, the expert witnessing, they were using cashew milk and they didn't put vitamin D in it. And so this poor little kid ended up not getting vitamin D. And they thought they were doing something good, whole foods, but sometimes the processed foods can be a real help. Like we thought that with the iron fortified cereals for little kids. So a few processed foods are actually a good idea, it turns out. Tofu made with calcium. Oh, and this is from, she's a professor at your local university. I got a few of the notes from her paper. It's quite an interesting one. Two servings of non-dairy milk could help. or you could use some of these greens. And you can top it up with supplements. And what you want to do with that, it's interesting, you don't want like a thousand milligram supplement or even a 500. It's better to get little ones and have them two times in the day because you absorb it better. Vitamin D, of course, is for bones. and immune system, it also can help us reduce or prevent our risk of Crohn's, Ms. rheumatoid arthritis, stroke, and cardiovascular disease, and help insulin production. So we used to think of vitamin D for bones, but it turns out even to help us with cognitive function. Vitamin D is sneaking in a lot of places and doing good things for us. So the amounts we need are based on really old research that's just on bones. Again, we're really not sure how much an individual needs. And of course, our bodies can produce vitamin D if we're exposed to the sunlight. But a lot of people are low. And one of the papers I have over there is about low vitamin D in guess what state? Hawaii, you're right. But it was surprising to me. This state is a sunny state. There's very low vitamin D in a few people. So why would that be? You think? We don't go outside. We don't go outside. New sunscreen. That's right. What else? Skin tone. Skin tone. Yeah, people who have very dark skin need more. Another one, this is an older study I saw about Honolulu. Skateboarders were low in vitamin D, about half of them. And it was probably because of smog. because the sun's out there, but some of the rays are being blocked. So it was really interesting to see this. So how do we figure out whether our vitamin D is at an optimal level? There are serum vitamin D lab tests. I know where I live, I have to... pay specially for it. But of course, I've been really interested because I want to know that I have strong bones, all the way through. And so I've paid for serum vitamin D tests and found out I was a low absorber and probably got worse as I got older. So anyway, I've paid to have my vitamin D tests. And so, surprisingly, what we used to say in our books was that the serum vitamin D would be low if you were in vitamin D winter. You know, northern latitudes, like Vancouver, of course. You know, it rains a lot in the winter, it's cloudy, parts of Canada. And then some of the research said if it's above 35 to 37 degrees north, but Even Honolulu is turning out to have some low vitamin D statistics. So it's all these things that you mentioned not going out. And I think some cultures don't want to expose their skin. They don't want to get, you know, dark suntans or, you know, have darker skin. You know, it's just been really changing. So it's quite interesting. So it's well worth getting your vitamin D checked. So they suggest for adults, the official recommendation is low, like 800 international units around that level. This is, I wouldn't recommend you do this, but I found I had to go to 9,000 international units to get to an optimal serum vitamin D. And my co-author, Brenda Davis, is way lower, like 2,000. So it really varies individually. It's probably to do with absorption or who knows what. But anyway, it's worth checking, you know, to get a lab test, see what your serum vitamin D is. The D3 is good. There's plant-based versions of that. I think this is the last nutrient we're doing is B12. And that has all kinds of important jobs, like converting into energy, DNA synthesis, red blood cells, your cells will get bigger, but they won't divide properly, the sheaths around nerves. and remove homocysteine. Vegans who don't supplement, but I bet everybody here does supplement with B12. I'm seeing lots of nods here. It's really important. And it's not from meat, it's from microorganisms. But those microorganisms are in animal products. They're just contaminants in there. So it's suggested that everybody over 50 should get B12 from fortified food or supplements. And there's two kinds, cyanocobalamin and methyl cobalamin. Cyanocobalamin has a teeny bit of cyanide in it, but there's cyanide in all kinds of ordinary foods. So it's the scrunchiest amount. And that seems the kind, most research is done on cyanocobalamin. Methyl cobalamin is okay too, but they don't know as much about exactly how much you need. So the recommended intakes are for most adults, 50 to 100. And we're always talking to Michael Greger about how much should we say, because we don't have good research on this yet. So we have little arguments about B12. And you'll find different opinions, but here's what we're saying right now, including him, because we were in a very lively area of research with nutrition. And so for seniors, we want probably 50 to 1,000 micrograms a day, which is a teeny, teeny, teeny scrunchy amount. This food guide is very helpful as a general guide. It shows your food for the day. And if people are wanting to lose weight, they maybe use less of the grains, but otherwise, you can see that it's got quadrants almost, and vegetables, fruits, seeds and nuts, and legumes, as well as the grains. And then it includes the other essentials. And you can find this on plant-poweredprotein.com food guide if you want to have a look at it. It's also in two of our books. But it also shows the calcium-rich foods in the center. So some food guides around the world have stopped using a dairy group and are including, because we get calcium really easily from the different foods in the different food groups. For example, oranges and figs or fortified orange juice. will have calcium. The tortillas that Mexican people have always used were fortified with calcium salts. Tahini and almonds are good calcium sources, and the nuts and seeds. And with the legumes, they're very rich if you have, for example, tofu set with calcium, black or white beans, the fortified soy milks, and the Vegetables can be terrific sources of calcium. We went through some of that, which ones were particularly good, but it's the kale, the broccoli, the bok choy. Now, what really helps tremendously is to eat mostly whole foods. They have lots of fiber, and I think sometimes people just don't recognize that every cell of your body is a product of what you eat, whether it's your skin or your bones, they're all made of these different foods. And when you eat a lot of very processed foods and the high fat foods, you’re just not providing the nourishment that we need for ideal health. Now, this one, I think her name's Monica Espilbeck. She's working at the cancer center here, dietitian. Anyway, she wrote a really good paper. Anyway, just about phytochemicals are just all the beautiful colors in plants. And they do all kinds of stuff. And we don't even have official recommendations for them. But this is why we're saying, eat really colorful foods, go down those aisles in the supermarket and pick gorgeous things. These are some other ones, carotenoids, that help, for example, your eye, but also your prostate cancer risk. isothiocyanates, all the cruciferous vegetables, broccoli and all that stuff, anti-inflammatory, anti-cancer, and lignan seeds. So you can see why we're suggesting that plant food guide. And then add in a few supplements. Consider B12, D, iodine, omega-3s, calcium. And for these, these are how we can Lower our risk, or even if you've got a chronic disease, put it into remission in a lot of cases. I got to work with Dean Ornish a long time ago when they were turning around heart disease. Brenda Davis and I both got to go to Berkeley and do that. It's no longer controversial, for example, with type 2 diabetes that can be put into remission. And so the lab tests for three months and you're considered in remission. So what we want protectively is just all these nutrients that we've been talking about, and we make a healthy gut microbat in the process. What we urge is, you know, there've been sort of anti-carb relations. lobbies from different groups or the paleo people saying don't eat carbs. Well, carbs are really important. They run your brain. We need carbs. There's an absolute requirement. But we want them from high fiber, whole plant foods. Carbohydrates are only in plant foods, and we really need them from all this little pile that she's looking at here. What you want to avoid is the added refined sugars. Like sugar was even taken out of whole foods. It was taken out of beets, taken out of sugar cane, extracted. And some people's diets, a lot of people's diets are like 25% sugars in pops, that kind of thing. So we want to avoid that and minimize the refined carbs. both sugars and starches. Now, eating a few of those isn't a bad thing, but we sure don't want to rely on them. We want to go for more of the whole foods. Legumes are kind of a... fun and interesting. Legumes, another word is pulses, used in Britain. There is another description of beans, peas, lentils here. The studies show that they're linked with lower percentages of body fat. A lot of the legumes only have 3% calories from fat, very, very low fat, but they deliver plenty of protein, great fiber, and they have all these minerals as well. So there are common features in the blue zones where people consistently live to over 100. One of the studies showed that the statistically significant indicator of longevity was, for people 70 and over, was eating beans, peas, and lentils on a regular basis. For breakfast, somebody might have, I mean, you might think, do I have to sit down to a big bowl of beans at breakfast? Give me a break. A simple, simple way to do it is just to have peanut butter on your whole grain toast. It's really easy. I know people who do that, you know, they just want a quick breakfast, be done with it, and that's it. It's healthy. Some people do have beans on toast. You can have tofu, scrambled tofu, and put some veggies in it. There are bean burritos, salad dosas, and you can also have soy milk or soy yogurt in cereals, smoothies, or chia pudding. So those are simple ways to have legumes at breakfast. So we do recommend that people eat them like three times a day. And lunch and supper, well, that's pretty easy. We're used to all the lentil soups. I will often cook them up and put them in these little glass containers. Don't use plastic so much anymore or avoid it, but use the ones that can be microwaved, put a whole pile in the freezer. We can have beans in our salads. We can have falafels when we go to the mall. We can have lentils or tofu in our lasagna, different lovely ways to make tofu. And of course, there's all kinds of burgers and veggie meats, some that are very whole foodsy and some that are high protein and more processed, but there's quite a range and can be used in kebabs, great for get-togethers. And snacks is a really important one too. It's good for people to, for example, take hummus if they're going to an event and they don't know what would work, you know, for them to eat, other than just standing by the potato chips. And you can have chickpeas, green peas, Actually, the vegan society in Honolulu has lots of people that grow, the vegetarian society or vegan society, lots of people that grow plant foods. And it's kind of fun to see all the different things that people grow. You can have marinated tofu. That's one of my favorites is a snack. And you can have bars or muffins or so on that do have some legume or bean or protein component. And even desserts, for example, the chia pudding, it's lovely. Use a fortified non-dairy milk or black bean brownies. Those bliss balls are delicious. They've got lime in them. And double chocolate surprise cookies, the surprise is black beans. And carrot spice cookies, those are both from plant-powered protein. So in our Kick Diabetes cookbook, we did wonderful recipes that didn't have any added oil and no added sugar, and they still tasted good. We've got this little taste panel that makes sure that everything is like a five-star recipe, but it's still a healthy one. So the health benefits of legumes do support this healthy gut microbiota. They support our digestive health. They reduce risk of GI diseases such as cancer, GI cancer, but other digestive problems. They help us lower our risk of cardiovascular disease and stroke. They stabilize our blood sugar. I find this really, really helpful because my family has a lot of alcoholics, actually, very creative people, but we have trouble keeping our blood glucose stable. And I find the beans are really, really helpful, especially like having little cubes of marinated tofu or hummus or bean soups. just for snacks or for meals. They really help me stabilize my blood sugar and keep my brain working properly. So, of course, they improve satiety. They help when we want to lose weight. They're low in fat, as I mentioned, many of the beans. And they also deliver all these iron, zinc, sometimes calcium in many of them, B vitamins, and other nutrients. So they're very, very valuable. To make it easy, curry in a hurry is a really good one. You just cook up some lentils and add some curry paste and some onion, cook up some onion. These tofu fingers or cubes, I do all the time. Got some in my fridge every single minute. So just marinating in a little mix of tamari and ginger and garlic and a bit of rice vinegar and optionally toasted sesame oil and just stick them in the air fryer for 11 minutes and they're ready. And so those are like my potato chips for keeping my protein. And I just want to be strong. And if that's a goal of yours too, to have lots of protein through the day, but have it whole foods-y, then Easy Peasy Chili was just a simple chili recipe. And then a big bowl can be quite elegant for having company, having a kind of elegant spread, or you can eat that way for just yourself with little bowls in the fridge of all these things that you just haul out when you want a pretty meal. But you can see you get all the colors there, so all those protective phytochemicals that we were talking about. So CNN says, eating this food may be a reason why people live to 100, the magical beans, beans, and you'll end up with a healthy gut microbiota. And the American College of Lifestyle Medicine is a really good group. You've got a few practitioners here in Hawaii that are on this wavelength now, which is very, very good. Reducing body fat stores is a good idea. There's different ways to lose weight, different ways. I found cutting out evening snacks can really help. And this is a really good paper that just came out within the last few months on the environment, the Eat Lancet Commission. And when you craft your diet this way, you end up with better health, That's Climate Change, A Kinder World, and these are our books. And that's Brenda Davis, who was here last year, just over a year ago, and her son Corey. He's a government agrologist and environmentalist. We have one book that we just sent in to the publisher, Plant Powered Seniors, and we're all seniors that did it. Brenda just turned, I think, 67, and the doctor that we're working with is 72, and I'm 83. that we're all fully fledged seniors. So thank you very much.

Lorraine T Sakaguchi, President, VSH

Mahalo Vesanto Melina for this wonderful talk and to all of you for coming tonight. Really appreciate your being here in spite of all this weather. And stay safe until we see you again. Mahalo. Aloha.