I’m going with ‘milks’, partly for simplicity and partly because it amuses me that this offends some people. Terminology aside, one thing not in question is their unstoppable rise in popularity. Ethical and environmental concerns, dairy allergies and intolerances, and health considerations are all contributing factors here. Anecdotally, I’ve also noticed that friends and family find plant-based milks an appealing option even if they have no intention of going vegan or vegetarian.

The breadth of choice out there is vast, and everyone’s taste buds are slightly different, but beyond this there are some other important considerations and tips that can help guide your choice – especially if you assume or expect plant-based milks to do exactly the same job as dairy milk.

1. Think soya for protein content

Plant based milks do not have the same nutrient profile as cow’s milk. The macro proportions vary quite significantly between each variety, but none match the protein content (approx. 3.5g/100ml) of cow’s milk. The only one that comes close on this front is soya milk (2.5-3g/100ml), so it’s the option that I recommend for most of my athlete and vegan clients for whom protein is an important consideration. Of the other major plant players, oat comes next with about 1-1.5g/100ml, whereas the protein content of almond (0.5g/100ml) and coconut (0.1g/100ml), for example, is negligible.

2. Sweetened or unsweetened?

Most brands come with sweetened or unsweetened varieties. Of course, personal taste preference plays a role here, but beyond that, my recommendation would be based on what type of client you are and when you’ll be having the milk. If you’re a runner or cyclist that struggles to meet the high carbohydrate demands of your training, then the sweetened option can be sensible, especially if you’ll be drinking it during key training windows. However, in the general population, we over-consume sugar, so I would generally recommend the unsweetened option if you find this palatable (I much prefer it).

3. Don’t go organic (but do shake)

This is an important one. Despite the health halo surrounding the organic label, there are times when it is best ignored. Organic foods in the UK cannot be fortified with vitamins and minerals unless such fortification is a legal requirement in that product (which does not apply to plant milks). The vast majority of non-organic plant milks do now contain added vitamins and minerals, making them an incredibly useful source of these micronutrients, especially for those on stricter plant-based diets where risk of deficiencies is much higher and good quality food sources are harder to find. Calcium, vitamin D and vitamin B12 are the most common fortification examples, but the list, helpfully, is starting to grow.

Sub-tip: make sure you always shake the carton before use, as the added ingredients (especially calcium) can otherwise settle at the bottom.

4. Look for iodine

The above tip on fortification brings me neatly on to iodine. Iodine is essential for thyroid hormone production and foetal brain development, but deficiency is common, especially in strict plant-based diets, since dairy and seafood are the most reliable dietary sources. Good plant-based sources are harder to find, with the notable exception of seaweed. However, the iodine content of seaweed varies massively and can also be excessive and lead to toxicity issues. Fortified foods therefore play a key role, and plant-based milks are just starting to recognise this and lead the way. Look for ‘potassium iodate’ or ‘potassium iodide’ on the label.

5. Not all plant-based milks are created (environmentally) equal

The dairy industry is an environmental nightmare, so any switch from cow’s milk to plant-based milk is going to be helpful on this front. However, as with all ethical debates, there are plenty of nuances that should be considered, especially if climate change and the environment in general are your main drivers for steering clear of dairy.

The three key components are greenhouse gas (GHG) emissions, water use, and land use. At a global level, cow’s milk is 3-4 times worse than each of the major plant options for GHG emissions, and 10-20 times worse than plant milks for land use. For water use, there’s much more variability within the plant milk sector, with almond and rice milks requiring 5-10 times the amount of water of oat or soya milk production (but still only half as much as cow’s milk). These are global averages, and numbers will vary from country to country (and climate to climate). Cow’s milk production in the UK, for example, is heavily reliant on rainwater and therefore water use is not a major factor. There are other considerations that I won’t even scratch the surface of here, but if this issue is as important for you as it is for me, do your research!

6. Practical issues and the curdling conundrum

Plant-based milks have some massive practical advantages – not least the fact they can be stored at room temperature before being opened, and keep for far longer than cow’s milk in the fridge after opening.

However…the elephant in the room is the curdling conundrum. Anyone who’s dabbled with plant milks will have experienced this when adding to teas, and especially to coffees. I find it weirdly unpredictable and therefore it often catches me off guard. It doesn’t affect the flavour of the drink, but it’s not nice to look at. I’ve tried doing my research, and it seems it’s a combination of heat and acidity that causes the curdling. There are a few tactics out there such as heating the milk, and / or adding it to the cup first before slowly adding the coffee, but to be honest, the only thing I’ve found consistently reliable on this front is choosing one of the ‘barista’ varieties. If anyone has any tips that I’m missing, though, please let me know!

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If this pandemic has taught us one thing, it is hopefully that we should never take our environment, wildlife, or health for granted. OK, so those are three things really, but nevertheless, they are also the three main reasons that people choose to go plant-based. And unlike Dry January, which, although important, only serves a purpose if it achieves a long-term change in behaviour and an improved relationship with alcohol, the benefits from Veganuary are instant. So even if you do only stick with it for a month, every single meal you eat that does not contain meat or dairy has almost certainly helped the environment and the fight against climate change.

If you’ve read my blogs before, you’ll know that I’m not militant about levels of restriction. In my opinion, every step in the direction of plant-based eating should be encouraged. But, if you are committing to being fully vegan, in January or beyond, you have my absolute respect and admiration.

However, there so many common pitfalls or myths about plant-based approaches that I see among clients, friends and family (and on social media…) and perhaps chief among them is that it is automatically a healthy approach. This is most certainly not the case. Whatever your definition of healthy might be, plant-based diets can very easily be lacking in multiple essential nutrients unless due care is taken. But nothing worth having ever comes easy, and personally, I find it incredibly satisfying working with plant-based clients to overcome these deficiencies. Since veganism is usually driven by strong ethics, hopefully this doesn’t put people off.

I could write a blog about each and every at-risk nutrient (and probably will do at some point), but I thought I’d just use today’s blog to re-introduce the topic, and also mention a few other useful articles that I’ve come across in the past few days.

Firstly, this piece for My Nutriweb on how to be ‘vegan savvy’ is a useful starting point. It discusses the rise in popularity, as well as this idea of a false ‘health halo’ around poorly-balanced vegan diets. It also mentions a few of the at-risk nutrients requiring specific attention, and introduces Azmina Govindji’s concept of ‘nutrient bridges’ as a means to make a vegan diet more ‘savvy’.

Then moving briefly onto sports (sorry, couldn’t resist), I loved this very practical and applied case study of a Gaelic footballer pursuing a vegan diet for ethical reasons. The paper recognises the increased interest in plant-based diets in sport, for health and potentially also performance, but also acknowledges the serious planning this requires, especially at this elite level. Indeed, this athlete’s calcium, iodine, vitamin D and B12 levels were all around his lower limits without supplementation, but there was no compromise in terms of his elite level of body composition or performance. And interestingly, his ethical dedication to veganism seemed to rub off on his teammates. A useful lesson in the power of positive role modelling.

And last but not least is this observational study of the diets of vegan runners. 30 recreational runners – all members of the Vegan Runners Club – had the adequacy of their diets assessed through comparison against recommended levels. The key finding was significant energy deficiency; 80% of athletes had energy intakes insufficient to meet their metabolic needs, and this is certainly something that rings true in many of my clients, due to the naturally high fibre and often low calorie nature of a vegan diet. Besides the impact on health (which is too big a topic to discuss here), this energy deficiency will reduce athletic performance and muscular adaptation from training.

The vegan athletes’ diets were also deficient in protein, vitamin D and selenium, although perhaps surprisingly, adequate for iron, zinc, B12 and calcium – thanks in part to supplementation.

If you were planning to start your plant-based journey in 2021, I sincerely hope that the latest lockdown hasn’t dampened your enthusiasm for doing so. It is one of, if not the most powerful thing you can do as an individual to help the planet. But I also hope that you do it sensibly and with great care and attention. I love working with plant-based clients (whether sporting or otherwise), so please get in touch if you’d like a helping hand!

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I’m happy to report that this drift has continued, and I managed to avoid eating meat for the whole of 2018. Well OK, that is not entirely true, as I had one mishap on the flight back from my own stag do in Porto, when I ate a bread roll with chicken puree which I thought was hummous. Hard to believe that my abstinence was broken, not for a juicy burger or Sunday roast, but a distinctly average airline snack. So anyway, I’ve chosen to overlook that one setback and continue working towards (and thoroughly enjoying) a fully plant based diet. As is tradition, the aforementioned stag do was closely followed by my wedding, and we kept it meat-free there too (see pic above). This was certainly met with a bit of scepticism in the build up, but we made sure that it was vegetarian (and mostly vegan) food done properly – in other words, beautiful to look at, but even more of a delight to eat. The feedback we had from our guests was almost exclusively really positive (you can never please everyone!)

Media coverage of vegan / vegetarian / plant based eating really is everywhere right now, and I genuinely can’t see it disappearing any time soon. The recent  EAT-Lancet report attracted plenty of coverage (and as ever in modern Britain, furious ‘debate’ too). This report was the result of a scientific review process to define a healthy, sustainable diet to support the planet and its growing human population in decades to come. Inevitably, the report recommends huge reductions in meat intake (a tiny 14g of red meat per day, for example), as well as tight restrictions on dairy too.

The report ruffled plenty of feathers and made many people uncomfortable, but the facts are getting harder to ignore with every passing month. Personally, I’m now at a stage where most meals are vegan, but I still eat the occasional portion of sardines or other oily fish, very small amounts of butter and cheese, and eggs that are from truly free-range sources…like the hens in my parents’ garden! I’m still very much of the opinion that the message of plant based eating needs to be spread positively rather than with angry or smug judgement, and that it is absolutely fine for anyone to make slow and steady steps towards achieving it.

The post A meat free year (and the growing evidence base) appeared first on Tom Hollis.

Q2. What about protein?

Protein remains all the rage, and people often worry that a plant based diet might waste away their sculpted muscles, leaving them a weak imitation of their former self. The media is to blame here –  it continues to purvey the myth that protein is endlessly desirable; that more is always better; and that it is a nutritional panacea, removing hunger and giving us all wonderful physiques. With meat and meat products being comfortably the biggest contributors to UK protein intakes (37%) and dairy the third biggest (14%), it’s easy to see how concerns about protein might arise if faced with the prospect of removing animal products from our diet…especially in the context of our misleading media.

But the reality isn’t as dramatic as that. Yes, protein is essential, for growth and repair among other things, but in general we massively overeat it in this country. We have a finite capacity to use the protein that we eat, and any leftover building blocks (amino acids) are split, with the nitrogen containing part converted to urea and flushed down the toilet, and the other half stored – not as muscle, but as fat.

And yes, protein requirements do vary somewhat with life stage and lifestyle, but the general reference nutrient intake (RNI) for protein in 19-50 year olds, for example, is 0.75g / kg body weight / day (roughly 56g per day for a ‘typical’ 75kg man). Bear in mind, then, that the average UK man eats 88g of protein / day, and it’s clear there’s plenty of room to play with.

I am not going to pretend that protein intakes come effortlessly with a plant based diet, but as ever, it just requires a little more thought into meal preparation, at least initially. The key is getting to know and love some good plant protein sources, and including one or two of them at every meal. Some of the classics (and among my favourites) are beans, pulses and grains (e.g. lentils, chickpeas, quinoa), as well as tofu, nuts and seeds. These are therefore all key features of the vegan diet, but even certain cereals and vegetables can be a surprising boost to protein intakes (e.g. rice, broccoli, spinach and kale). An added advantage of most of these plant-based protein sources is that unlike many of their animal equivalents, they are high in fibre and low in salt and saturated fat.

3. Any other nutrients I need to worry about?

Yes, without doubt. A vegan diet will usually be incredibly rich in many vitamins and minerals without even trying, but others will run the risk of deficiency.

Vitamin B12 is essential for our brain and nervous system, as well as red blood cell formation, but unfortunately is abundant in animal foods but scarce in plant foods (besides fortified products).

Calcium, crucial for bone and teeth health and nerve transmission, can be found in vegan foods such as almonds, dried fruit, kale and fortified dairy alternatives, but we all have high calcium requirements, and it’s undoubtedly harder to meet these targets once dairy is out of the equation.

Iron is vital for its oxygen carrying role in our red blood cells, but it’s another one of those nutrients that’s more concentrated (and better absorbed) from its animal sources than plants. That said, it is still available in a wide range of plant foods (e.g. lentils, nuts, seeds and fortified breakfast cereals), so it’s just a case of identifying and prioritising these.

The final nutrients that warrant a mention here are omega-3 fatty acids. Alpha linoleic acid (ALA) is considered ‘essential’ in the diet, because we can’t make it ourselves, although we are able to (albeit inefficiently) convert it to the very useful long-chain omega-3 fatty acids, known as EPA and DHA. EPA and DHA continue to be widely researched, and while we probably don’t yet know the full extent of their physiological roles, there is some consensus that they can reduce inflammation,  which is likely to play a part in their postulated roles in cardiovascular and mental health. Annoyingly, EPA and DHA are not found in many foods, and without oily fish in the diet (mackerel, salmon, sardines etc.), it can be difficult getting enough, which is why government guidance remains for us to eat one portion of oily fish per week. However, the fish don’t actually make their own omega-3s; rather they obtain them from the microalgae in their own diets. So, vegans have the option to cut out the middle man here and supplement their diets with microalgae. Additionally, vegans should be looking to ensure that their diets have plenty of ALA (which, if you remember, can be inefficiently converted to EPA and DHA), such as linseeds or chia seeds.

The bottom line here is that a vegan diet, although generally very nutrient dense, can also leave some gaping holes. These can be somewhat addressed by carefully considered dietary modifications, but I would also recommend a multi-vitamin and mineral supplement that helps fill the gaps. Of course it is better to obtain all nutrients from food rather than pills wherever possible, but I just feel this approach helps remove some of the worry. Unsurprisingly there are now vegan specialist supplements that focus on problem nutrients for a plant based diet. Unlike standard supplements, these would make sure, for example, that the vitamin D was not derived from sheep’s wool, or omega-3s from fish oils, but this level of strictness may or may not be necessary, depending on the individual.

4. What if you only eat good quality meat?

As I mentioned in the first part of this blog, people adopt plant based diets for a number of reasons, with animal welfare and environmental sustainability the most common. So the argument about only eating good quality meat is a very valid one – ‘good quality’ can usually be at least loosely associated with better farming conditions and perhaps (but certainly not always) a better standard of living for the animal. Ultimately though, the animal is still being raised and killed for human consumption, so it depends where your own ethical line is here.

Similarly, if we all just ate good quality meat in much smaller  quantities, then I feel that the sustainability argument would be hugely diluted too. My own opinion is that this is the ideal scenario – where good quality meat and fish is seen as a real treat, to be eaten on special occasions and enjoyed. If everyone had this approach, the future of our planet would instantly be far brighter. The problem is, this is never going to happen, or at least not any time soon. For most people in Britain, hardly a meal, let alone a day, goes past without meat, and this is nothing compared to the likes of the USA. And then the huge, rapidly developing nations of India and China need to be factored in, going through their economic and nutrition transitions simultaneously: a typical trend of increasing wealth and urbanisation linked to a dietary shift from plants to animals, much of it poor quality, processed convenience food. 

Given that a third of the world’s population lives in these two countries alone, I don’t feel that we have the luxury of waiting until everyone adopts the ideal pattern of eating. Instead, I think it has reached the stage where people who are sufficiently motivated need to take one for the team by making serious sacrifices. That said, I don’t think there are rules about how one adopts a plant based diet. Rushing from all to nothing isn’t likely to go well, so I would say it’s perfectly acceptable and natural to do it in stages…but then I would say that, as that’s exactly what I’m doing right now.

5. How do you live without bacon / burgers / cheese etc. etc. etc?

This is definitely something I used to ask vegetarians! Of course, that’s now been flipped and people are asking me those same questions. Unlike some plant eaters, I am not going to pretend that meat is suddenly not delicious. I spent 30+ years of my life eating and loving it, and my tastebuds have certainly not changed overnight. But it’s really not that difficult to live without certain foods. Turning down sizzling countryside bacon and Easter lamb with my family a couple of weeks ago was a challenge, but also a bit of a milestone for me. I think up until that point I’d thought that I would revert back to the ‘good quality meat as a treat’ option at some point, but I don’t think I will now.

If you feel passionately about anything, then you happily make sacrifices for that passion, be that your family, your hobbies, or your diet. Of course, as I have said before, your diet is something to be cherished and enjoyed; it is one of life’s great pleasures and not just a means of getting nutrients. But there’s a lot of enjoyment to be gained from becoming a better, more imaginative cook, while improving your health and the sustainability of the planet at the same time.

The post Veganism and the plant based revolution (part II) appeared first on Tom Hollis.

A: Don’t worry – they’ll tell you

There’s something about vegans that really gets under other people’s skin. They find themselves the butt of jokes for being smug / puny / dull / joyless / awkward / sanctimonious etc etc…and to be perfectly honest, I’ve had times when I’ve thought the same. I used to be more than a little sceptical of veganism (and vegans), thinking it an unnecessarily restrictive lifestyle, and the preserve of preachy individuals who wear shoes made from hemp.

No-one likes being told what to eat (or what not to eat), and we fear change, especially when it comes to something as important as food. Nor do we enjoy having our opinions challenged by uncomfortable truths, so add all of this together, and you get a little hostility.

But vegans have a delicate balancing act to manage. On the one hand, they don’t want to be the stereotype from my punchline at the top (that talks about nothing else), but on the other, they believe in this passionately enough to have made significant sacrifices, so why shouldn’t they share their views, and dispel some myths when, no doubt, challenged? After all, they are just making an ethical choice and a positive difference to animals, the environment, or both.

And like it or not, it’s not going to disappear any time soon. There might be plenty of ‘Veganuarians’ who’ve had their fill of tofu and quietly returned to juicy burgers and bacon butties, but in general, veganism and plant based eating is going to continue to flourish. And rightly so.

Veganism is still too extreme for me, but my own diet has become increasingly plant based over the past year or two, so I’d rule nothing out in the future. My shift started with an enforced meat-free month of volunteering on an eco-construction project in Uruguay (oh god, I’m starting to sound like I wear shoes made from hemp too). I was apprehensive about the prospect, but meals were easy, varied, and delicious, thanks in no small part to a French vegan couple who were resourceful and imaginative cooks. I felt fantastic that month, although of course, my circumstances probably played a huge part too (manual outdoor work in the sun all morning, swimming in the sea every afternoon…), so I won’t fall into the lazy trap of assuming causation.

I returned home to a girlfriend (now my fiancee) who had independently become more impassioned in her vegetarian views and who now is 99.9% vegan (if there is such a thing). I’m not even close to this level – in fact I’m not even a vegetarian as I still eat fish occasionally – but I’m proud to be taking steps in what I feel is the right direction. I am a huge animal lover, and I love the fact that a plant based diet is cheap and (if done well) very nutritious. These are all pretty good reasons to make the change, but for me, sustainability is by far the biggest consideration, and particularly the vast differences in greenhouse gas production and water consumption between animal and plant based diets. In my head, it is a very simple message: if you care about the planet, or are in any way environmentally minded, you should be eating less animal produce and more plants…no matter how uncomfortable that makes you feel.

Whether you go full vegan or just start cutting out meat a couple of days a week, it requires extra thought and creativity in the kitchen to prevent meals becoming repetitive…but this is surely a good thing. I must admit it also helps being a dietitian, as I am aware of and can avoid common nutritional deficiencies and pitfalls of plant based diets. Indeed, as a dietitian, more and more people want to ask me about veganism and plant based diets, so I’ve started to think of the five questions I get asked most frequently (by patients, friends and family), and some useful responses. I’ve just started with question one, below, and will follow up with the other four in a few days.

1. Is a vegan diet good for you?

The easy (and probably quite disappointing) answer here would be to say ‘it depends’, which of course it does. It depends on what sort of vegan diet you have; it depends on what you mean by ‘good for you’; and it depends on any other personal considerations that might affect your requirements.

Most important of these is which type of vegan diet you eat, or plan to eat. I know a fair few vegans who are overweight, and by no means a picture of health. Equally, there are probably a billion or so healthy non-vegans around the world who have a wonderful, balanced diet, so one is not necessarily healthier than the other. ‘Vegan’ does not always equate to ‘healthy’, whether talking about the overall diet or individual foods – you could eat as much sugar, or glug down as much vegetable oil or coconut milk as you want on a vegan diet, but of course that would be a long way from ‘good for you’.

Also important is what is meant by ‘good for you’. Some people might mean ‘help me to lose weight’, others ‘nutritionally complete’, others ‘help prevent cancer’ etc. So when a dietitian is asked if a diet, or even a specific food, is good for you, it can often be a surprisingly difficult question to answer, especially when considering the final mini-point here – individual factors and requirements.

Gender, age, physical activity, health conditions and health goals are just a few of the huge number of factors that might influence someone’s nutrient requirements, and therefore whether a vegan diet might be ‘good’ for them, so it can be really hard to generalise to a population. A very simple example would be a female of menstruating age. She would have iron requirements about 70% higher than a male of the same age, and so might be at greater risk of iron deficiency with a vegan diet, since the restrictions of the diet instantly eliminate some of the richest sources of iron. Add existing anaemia into the mix, for example, and situation is exacerbated.

Having said all of this, I think the short answer is that, yes, in general, a vegan (and certainly a vegetarian) diet would be a healthier option for most people in the UK. A vegan diet is certainly not a magic wand for health, and I’d suggest choosing to adopt it for stronger, ethical reasons rather than, for example, weight loss, but it is likely to be far high in fruit, veg and pulses (and therefore fibre and many micronutrients) and obviously low in processed meat (and therefore saturated fat and salt), all of which are problem areas in the UK diets. An added bonus is the fact it encourages you to be inventive and think more carefully about food and meals – undoubtedly a key factor in the success of any diet.

So please pay me another visit in a few days, when I’ll have written up the reponses to the other four most common questions on veganism and plant based diets. See you then.

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