Doctors For Nutrition

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Culinary Medicine
Where the science of nutrition meets the art of cooking.

Article first published in Vegetarian Living NZ Magazine.

Culinary Medicine is about bringing the kitchen into the heart of health. It’s not just about knowing which foods are good for you, but learning how to prepare, cook and share them, and make healthy eating a joyful part of everyday life. Discover how everyday food choices—made right in your own kitchen—can change your health, mood, and habits for good.[1-3]

In our last article, we explored how small daily habits can protect your heart and overall well-being. In this issue, we go beyond science and get practical with Culinary Medicine, a new way to make healthy eating simple, enjoyable, and lasting.

What is Culinary Medicine?

Culinary Medicine blends nutrition science with practical food skills: planning, cooking, and sharing meals in ways that support everyday health.[1-3] It’s not solely reserved for gourmet chefs or health professionals; it’s an approach anyone can use to help prevent and manage disease through simple, meaningful choices in the kitchen.

At its heart, Culinary Medicine is hands-on. Whether taught in community workshops, integrated into medical training, or practised at home, it brings people together to build confidence and knowledge. Empowering people with real-life skills, transforms healthy eating from an abstract idea into something practical, enjoyable, and achievable every day.

Why Culinary Medicine matters

In Australia and New Zealand, cardiovascular disease is the leading cause of death, claiming one life every 12 and 90 and minutes respectively.[4,15] High blood pressure affects one in three adults, with disproportionately higher rates among Indigenous and Pacific peoples, and type 2 diabetes now affects tens of thousands, with cases rising rapidly among both adults and young people. Many chronic conditions—heart disease, diabetes, obesity—are largely preventable, yet the numbers continue to climb.[4,5]

Most people understand that healthy eating and regular movement are important to prevent the onset of chronic disease. Still the pressures of daily life, ingrained habits, and even limited access to nutritious food often make change difficult. The ripple effects manifest in reduced well-being, increased financial strain, and diminished overall quality of life.

Culinary Medicine provides a practical, evidence-based pathway forward. By teaching everyday cooking skills and helping people reconnect with whole, nourishing foods, it empowers individuals to make sustainable, meaningful shifts that support long-term health.

Culinary Medicine is changing the way doctors support patients

Most doctors receive limited education in nutrition or practical food skills.[6] Even when clinicians understand what constitutes healthy eating, many feel unsure about how to guide patients in making realistic changes.

This gap is slowly beginning to close. Culinary Medicine is increasingly integrated into medical education, giving future health professionals greater confidence, empathy, and practical, real-world skills. When doctors understand not only what to eat but also how to make healthy eating achievable in daily life—and can translate that into meaningful guidance—patients are far more likely to experiment with new foods, cook at home, and maintain healthier habits over time.[1,6]
The proven benefits – what research shows

Culinary Medicine interventions have shown tangible improvements in:

Increased fruit, vegetable, and whole grain intake.[1,2,7]

Improved cooking confidence and meal planning skills.[1,7]

Lowered blood pressure, cholesterol, and HbA1c in diabetes.[8,9]

Enhanced quality of life and mood.[8,9]
The whole food plant-based advantage

Choosing what to eat can be confusing, but evidence continues to highlight the unique health benefits of whole plant foods: vegetables, fruits, legumes, whole grains, nuts, and seeds. These foods are naturally rich in fibre, phytonutrients (including antioxidants), and a diverse range of vitamins and minerals. All of these components have been shown to lower the risk of heart disease, type 2 diabetes, and certain cancers.[8-11]

These beneficial compounds are naturally absent from animal products such as meat and dairy, which contain no dietary fibre and a narrower array of protective nutrients. When we look at the wider body of scientific research, whole plant foods consistently demonstrate positive impacts on health. At the same time, the evidence for animal products ranges from neutral to harmful effects on long-term health.[8,12]

That’s why at Doctors For Nutrition, our approach to Culinary Medicine focuses on maximising whole plant foods and minimising or eliminating animal products and ultra-processed foods, which often lack the components required for optimal health.
What exactly are whole plant foods?

Whole foods look much the same as they did when picked, pulled, or harvested— bananas, kumara, spinach, and brown rice; no ingredient list needed here. In contrast, ultra-processed products bear little resemblance to their origins and often need a back-of-pack explanation.

To keep it simple in the supermarket:

If you can easily tell where it came from, it’s likely a whole food.

If something healthy (like fibre or nutrients) has been removed, or something less healthy (like salt, sugar, or preservatives) added, approach with caution.[13]

Corn on the cob, frozen corn, or canned corn are all close to whole; cornflakes, however, have lost nutrients and gained sugar and salt.[13]

Some processing can improve nutrition, like cooking tomatoes to increase lycopene, making tempeh without losing fibre, or simply freezing berries. The healthiest foods retain the “good stuff” and don’t hide behind lengthy labels.

A few label-reading tips:

In Australia and New Zealand, ingredients are listed in order, with the most abundant first. If sugar or oil is near the top, or “added vitamins” are listed near the end, pause to consider if a less processed version is available.[14]

Key questions:

Can I tell where this came from?

Has anything good been removed?

Has anything not-so-great been added?
Practical tips for everyday healthy eating

Eating well doesn’t have to be complicated or time-consuming. Small, practical strategies can make healthy meals achievable for everyone, no matter how busy life gets. Batch cooking, prepping ingredients ahead, and relying on simple one-pot meals save time, while affordable staples like canned beans, frozen vegetables, and bulk grains keep costs down. Start with easy recipes and build your skills gradually. Remember, every meal prepared at home is a win. Arranging your kitchen so wholesome foods are visible and accessible, keeping pre-chopped veggies and fruit on hand, and making cooking a shared, social activity all help turn healthy choices into lasting habits.
1. Planning & prepping

Prep ahead: Chop vegetables or fruit for easy snacking, and use the “chop & stop” method—chop garlic, onions, or broccoli and rest for 10 minutes before cooking to maximise beneficial cancer-reducing compounds.

Prepare extra veggies: Boost family favourites with more vegetables, legumes, or grains.

Try new ingredients: Experiment with grains and legumes like quinoa, brown rice, and chickpeas.

Keep convenience on hand: Use microwavable, tinned, or frozen beans and vegetables for quick nutrition.

Meal plan: Map out the week ahead to simplify shopping and cooking, reduce stress, and make healthier choices.

2. Cooking

Start simple: Focus on easy recipes that fit your lifestyle and skill level.

Modify family favourites: Add more veggies or lentils to a dish you cook regularly.

Use flavour smartly: Enhance meals with spices, herbs, garlic, and citrus instead of relying on salt, oil, or heavy sauces.

One-pot meals: Stews, stir-fries, or sheet-pan dishes save time and reduce cleanup.

Batch cook meals: Make extra servings to freeze or store for quick, healthy options later.

Mindful experimentation: Make cooking enjoyable by trying new ingredients or plant-based swaps for processed or animal foods.

3. Sharing & social eating

Cook together: Invite family, friends, or whānau to join in the kitchen—mealtime is more enjoyable when it’s social.

Community connections: Organise veggie potlucks, recipe swaps, or family cook-offs. Sharing meals strengthens relationships and reinforces healthy habits.

Respect culture and tradition: Look for ways to add healthy twists to favourite recipes while honouring family and cultural practices.
Take your next step

Culinary Medicine takes the guesswork out of healthy eating, giving anyone the tools to make lasting, positive changes at home. You don’t need to be a chef. Change starts with you, your chopping board, and your kitchen—one simple meal at a time.

Interested in learning more? Sign up for our Culinary Medicine course. The first fully on-demand program of its kind in Australia and New Zealand—created by nutrition experts and medical doctors, made for everyone. Traditionally only taught in medical schools and universities, Culinary Medicine is now accessible to all, with content suitable for health professionals, food industry leaders, and anyone ready to make lasting changes. Immerse yourself in a course that equips you to cook, eat, and live better—no prior experience required.
References

Polak, R., Phillips, E. M., & Nordgren, J. (2019). Culinary medicine: Paving the way to health through our forks. American Journal of Lifestyle Medicine, 13(5), 451–460. https://doi.org/10.1177/1559827619871922

Kumar, N., & Tandon, O. P. (2022). Culinary medicine: A new era of health through the kitchen. J Ghat Health Allied Topics, 8(1), 148–154.
https://www.joghat.org/uploads/2025-vol-8-issue-1-full-text-492.pdf

Storz, M. A., & Hammad, S. (2022). Culinary medicine and healthy ageing: A comprehensive review. Nutrition Research Reviews, 37(1), 179–193. https://doi.org/10.1017/S0954422423000148

Heart Foundation NZ. (n.d.). Statistics. https://www.heartfoundation.org.nz/statistics

Jebari‑Benslaiman, S., Galicia‑García, U., Larrea‑Sebal, A., Olaetxea, J. R., Alloza, I., Vandenbroeck, K., Benito‑Vicente, A., & Martín, C. (2022). Pathophysiology of atherosclerosis. International Journal of Molecular Sciences, 23(6), 3346.
https://doi.org/10.3390/ijms23063346

Aspry, K. E., Van Horn, L., Carson, J. A., Wylie‑Rosett, J., Kushner, R. F., Lichtenstein, A. H., Devries, S., Freeman, A. M., Crawford, A., & Kris‑Etherton, P. (2018). Medical nutrition education, training, and competencies to advance guideline‑based diet counseling by physicians: A science advisory from the American Heart Association. Circulation, 137(23), e821–e841. https://doi.org/10.1161/CIR.0000000000000563

Satija, A., & Hu, F. B. (2018). Plant‑based diets and cardiovascular health. Trends in Cardiovascular Medicine, 28(7), 437–441. https://doi.org/10.1016/j.tcm.2018.02.004

Tuso, P. J., Ismail, M. H., Ha, B. P., & Bartolotto, C. (2013). Nutritional update for physicians: Plant‑based diets. The Permanente Journal, 17(2), 61–66. https://doi.org/10.7812/TPP/12‑085

Medawar, E., Huhn, S., Villringer, A., & Witte, A. V. (2019). The effects of plant‑based diets on the body and the brain: A systematic review. Translational Psychiatry, 9, 226. https://doi.org/10.1038/s41398-019-0552-0

Van Duyn, M. A. S., & Pivonka, E. (2000). Overview of the health benefits of fruit and vegetable consumption for the dietetics professional: Selected literature. Journal of the American Dietetic Association, 100(12), 1511–1521. https://doi.org/10.1016/S0002-8223(00)00420-X

Neuenschwander, M., Ballon, A., Weber, K. S., Norat, T., Aune, D., Schwingshackl, L., & Schlesinger, S. (2019). Role of diet in type 2 diabetes incidence: Umbrella review of meta‑analyses of prospective observational studies. The BMJ, 366, l2368. https://doi.org/10.1136/bmj.l2368

Campbell, T. C., & Campbell, T. M. II. (2017). The China study: The most comprehensive study of nutrition ever conducted and the startling implications for diet, weight loss, and long-term health (Revised & Expanded ed.). BenBella Books

Monteiro, C. A., Cannon, G., Levy, R. B., Moubarac, J.-C., Louzada, M. L. C., Rauber, F., Khandpur, N., Cediel, G., Neri, D., Martinez‑Steele, E., Baraldi, L. G., & Jaime, P. C. (2019). Ultra‑processed foods: What they are and how to identify them. Public Health Nutrition, 22(5), 936–941. https://doi.org/10.1017/S1368980018003762

Health New Zealand / Te Whatu Ora. (2025, July 2). How to read food labels. https://info.health.nz/health-topics/keeping-healthy/eating-well/how-to-read-food-labels

Heart Foundation Australia. (n.d.). Key statistics: Cardiovascular disease. https://www.heartfoundation.org.au/your-heart/evidence-and-statistics/key-stats-cardiovascular-disease
March 1, 2026
Global Lifestyle Medicine Leaders Unite in Istanbul

Doctors For Nutrition (DFN) was proud to be represented at the 3rd Global Lifestyle Medicine Leadership Forum held in Istanbul, Türkiye, from 9–14 February 2026, a landmark gathering of lifestyle medicine leaders from around the world.

CEO Rebecca Stonor attended on behalf of DFN, joining peers from regions including Argentina, Mexico, Germany, Singapore, the UK, the UAE, Indonesia and the USA for several days of strategic dialogue, shared learning and collaboration. Rebecca attended the forum as an invited guest, with all travel costs generously covered by the International Board of Lifestyle Medicine, reflecting IBLM’s commitment to supporting collaboration among leaders from diverse regions.

A global gathering for lifestyle medicine

Hosted by the International Board of Lifestyle Medicine (IBLM) and the Lifestyle Medicine Global Alliance (LMGA), the forum brought together leaders of national lifestyle medicine societies and related organisations to align on vision, strategy and practical implementation. IBLM is the global standard-setting body for lifestyle medicine certification, helping define competencies and credentialing for physicians and other health professionals worldwide.

LMGA unites national lifestyle medicine organisations to advance a shared vision of a world without non-communicable disease, strengthening collaboration, sharing best practices and amplifying the voice of lifestyle medicine on the global stage. Within this context, DFN’s participation ensured that the Australasian perspective on plant-based nutrition and lifestyle medicine was part of the global conversation about transforming healthcare systems.

Lifestyle medicine: meeting a global health crisis

Lifestyle medicine is an evidence-based medical discipline that uses nutrition, physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection as foundational therapeutic tools for the prevention, treatment and even reversal of many chronic diseases. This approach directly targets the root causes of conditions such as type 2 diabetes, cardiovascular disease, obesity and many other non-communicable diseases, which now dominate global morbidity and mortality and drive escalating healthcare costs.

As organisations like IBLM and LMGA highlight, lifestyle medicine is a rapidly growing field that offers affordable, scalable and sustainable solutions to the global epidemic of non-communicable disease, with the potential to reverse much of the chronic disease burden and significantly reduce healthcare spending worldwide. DFN’s work in promoting whole food plant-based nutrition and lifestyle medicine across Australia and New Zealand is closely aligned with this global movement to reorient health systems towards prevention and true health care.

From leadership forum to international symposium

Following the leadership forum, participants travelled together to Biruni University for the 2nd International Symposium of the Turkish Society of Lifestyle Medicine on Friday, 13 February. The full-day symposium provided a platform for leaders in lifestyle medicine from around the world to share their experience in implementing lifestyle medicine in practice within clinics, health systems, and communities.

For DFN, this was an invaluable opportunity to hear real-world case studies, explore barriers and enablers to implementation in different health systems, and contribute insights from the organisation’s work in clinician education and plant-based nutrition advocacy. Participation in both the leadership forum and the Turkish Society of Lifestyle Medicine symposium further strengthens DFN’s ability to bring global best practice back to Australasia and to support health professionals in delivering lifestyle medicine in everyday practice.

Looking ahead for DFN

DFN extends sincere thanks to IBLM for organising this visit and to the Lifestyle Medicine Global Alliance and Turkish Society of Lifestyle Medicine for hosting a thoughtfully designed program that combined structured meetings, shared meals and rich cultural experiences in Istanbul. Insights gained from this week of global collaboration will inform DFN’s ongoing work to equip health professionals with the knowledge and skills to use lifestyle as medicine, advocate for systems change and help build a future where the burden of chronic disease is dramatically reduced. Together, we can achieve our mission of a world free from preventable disease.

Join the lifestyle medicine movement

Health professionals in Australia, New Zealand and the Pacific Islands who are interested in becoming certified in lifestyle medicine can do so through Doctors For Nutrition. Be at the forefront of this movement and enrol now to complete the prerequisites before the exam on 29th November 2026, in Sydney.

February 17, 2026
Love your heart
Proven lifestyle habits for lifelong cardiovascular health.

Article first published in Vegetarian Living NZ Magazine.

Every 12 minutes an Australian loses their life to cardiovascular disease (and every 90 mins for New Zealanders)[1,36], yet up to 80% of these deaths are preventable.[2] The secret to prevention lies not in a pill, but in how we live our lives. From the food on our plates to the quality of our sleep, the habits we develop over our lifetime shape our cardiovascular health – for better, or worse.

In our last article we introduced readers to the six pillars of lifestyle medicine, and their vital role in maintaining wellbeing. Let’s take a closer look at how each pillar impacts heart health, and share simple ways to protect your heart and optimise your cardiovascular health.

What does the term ‘cardiovascular’ mean?

Cardio = heart
Vascular = blood vessels.
Your heart is the central organ of the cardiovascular system which functions like a pump to push blood through your blood vessels (including arteries, veins and capillaries), supplying oxygen and nutrients to all of your cells, nerves, muscles and other organs in your body.

Cardiovascular disease (CVD) describes a group of conditions affecting the heart and blood vessels, including coronary heart disease, heart failure, stroke, and vascular dementia. These conditions all impair blood flow throughout the body.[3]

The primary cause of CVD is atherosclerosis, where fatty deposits called plaque build up inside artery walls. This process begins with damage to arteries, triggered by high blood pressure, high cholesterol, smoking, and other risk factors. Cholesterol and fats become trapped, inducing an immune response resulting in the formation of plaques. Over time, plaque narrows and hardens the arteries, making blood flow difficult. If a blockage occurs or, more commonly, if a plaque ruptures, it can cause a blood clot that blocks circulation, leading to a heart attack or stroke.[4]

High levels of cholesterol play a critical role in the development of CVD. Low-density lipoprotein (LDL) cholesterol carries cholesterol from the liver throughout the body, is primarily implicated in the formation of arterial plaque, and is often given the moniker ‘bad cholesterol’. High-density lipoprotein (HDL) carries cholesterol back to the liver to be processed and ‘flushed’ from the body – hence it is often referred to as ‘good cholesterol’. HDL cholesterol, however, may not protect against CVD as much as once thought, with high levels being linked with increased risk of cardiovascular events.[5,6] Current evidence emphasises focusing on lowering LDL cholesterol and maintaining a healthy balance of lipoproteins rather than simply raising HDL levels. Managing cholesterol levels alongside other risk factors remains essential for protecting heart and blood vessel health.[4,7]
Protect your heart with simple lifestyle modifications

Whole food plant-based eating patterns

The type and amount of fat you consume through your diet are key factors in determining your cholesterol levels. Eating foods high in saturated and trans fats causes the liver to produce more cholesterol, slows its removal from the blood and elevates LDL cholesterol levels. Trans fats are particularly harmful. They raise LDL and lower HDL cholesterol levels, thereby significantly increasing the risk of heart disease.[8.9]

Foods that can raise cholesterol levels due to their saturated fat content:

Eggs (also high in cholesterol)[10,11]

Processed (e.g. ham, sausages, salami) and red meat

Dairy products e.g. cream, cheese, butter, milk, yogurt, and ice cream

Commercially baked goods e.g. pastries, biscuits, cakes, brownies

Deep-fried and takeaway foods, e.g. crisps, hot chips, burgers and pizza

Trans fats occur naturally in small amounts in animal products and can exist in higher amounts in processed foods where they are deliberately added. You can easily spot these in packaged goods as they’ll have “hydrogenated oils” or “partially hydrogenated vegetable oils” listed on the packaging.

While plant-based meat alternatives generally contain less saturated fat than their animal-based counterparts, and can help reduce CVD risk when they replace meat, they can still be a significant source of saturated fat and typically contain more fat than whole plant foods.[12] Reducing saturated and trans-fat intake is key to lowering cholesterol and CVD risk.

Conversely, diets rich in fibre, antioxidants, unsaturated fats, and phytonutrients help reduce cholesterol, blood pressure, vascular inflammation, and tissue-damaging oxidative stress.[13]

→ Aim to incorporate the following heart-healthy foods in your diet daily

Whole grains, e.g. oats, brown rice, quinoa

Legumes, e.g. lentils, beans, chickpeas, peas, edamame. soybeans

Dark leafy greens, e.g. spinach, kale

Cruciferous vegetables, e.g. broccoli, cauliflower, cabbage

Fruit, e.g. berries, apples, citrus, kiwifruit

Nuts and seeds e.g. walnuts, almonds (¼ cup max), flaxseed & chia (1 Tbsp)

Garlic, onions, herbs and spices

Colourful vegetables, e.g. capsicum, beetroot, carrots
A note on blood pressure, sodium & CVD Risk
High blood pressure (hypertension) is another major contributor to CVD in New Zealand and Australia, increasing the risk of heart attack, stroke, heart failure, and kidney disease.[14] In New Zealand, around 1 in 5 adults lives with hypertension, with even higher rates in Māori & Pacific populations.[15,16] The rates in Australia are similar with 1 in 6 adults living with hypertension.{36]

Eating too much sodium causes the body to retain water, increasing blood volume and blood pressure. This, in turn, increases pressure on arterial walls, causing damage and accelerates the development of atherosclerosis. Approximately 75% of the sodium in the diet comes not from the salt shaker but from processed and packaged foods.[17]. Reducing processed food intake and favouring whole foods is the simplest route to cut sodium and reduce cardiovascular disease risk.

Physical activity

Regular physical activity helps your heart work more efficiently, improves blood flow, and supports healthier cholesterol levels.[18] It can also help lower blood pressure and improve how your body uses insulin to manage glucose, both important for protecting heart health.[19,20] Exercise keeps your arteries flexible by increasing the natural production of nitric oxide—a compound made by the vessel walls that helps them relax and widen for better circulation.[21]

On the flip side, sedentary behaviours have wide-ranging adverse impacts on the human body, increasing the risk for hypertension and CVD.

→ Aim for at least 2 ½ hours of moderate-intensity or 1 ¼ hours of vigorous physical activity spread across the week. Bump the time spent active up to 5 and 2 ½ hours, respectively, and enjoy even greater heart health benefits.[22] Try to spread these activities across the week and aim to do muscle-strengthening exercises at least twice a week.

Restorative sleep

Sleep is a critical regulator of cardiovascular health. Getting less than 6 hours of sleep is strongly linked to higher risks of heart disease, stroke and high blood pressure.[23,24] Inadequate sleep disrupts blood pressure regulation, increases stress hormones such as cortisol, and elevates inflammation, all of which can damage blood vessels over time. Even when sleep quantity is adequate, poor sleep timing can also raise risks. Shift workers, for example, experience up to a 26% higher risk of coronary heart disease compared to day workers due to disruption of natural sleep–wake cycles.[25]

Improving sleep can be one of the most powerful ways to protect your heart. If you struggle with persistent insomnia, loud snoring, or daytime sleepiness despite adequate time in bed, it is important to speak with your doctor. Early assessment and treatment can significantly improve long-term heart health.

→ Aim for 7–9 hours of good-quality sleep per night (or 7–8 hours for those over 65).[26] Maintain a regular sleep schedule, create a cool, dark, quiet bedroom, avoid screens close to bedtime, and limit caffeine, and heavy meals in the evening.

Stress management

Chronic stress is insidious. It keeps your cardiovascular system activated, maintains elevated cortisol and adrenaline, promotes inflammation, dysregulates blood pressure, and deteriorates the function of the inner lining of blood vessels (endothelium). Over time, these damaging effects promote hypertension, plaque buildup, and vascular stiffening. Stress can also reduce blood flow to the heart, triggering chest pain, irregular heartbeats, or even heart attacks in vulnerable people—sometimes even in those without prior heart disease.[27,28]

Research indicates that those with high stress hormones have a 63% higher risk of cardiovascular events.[29] So, if stress feels overwhelming, leads to anxiety, sleep disturbance, or persistent low mood, it is important to see your doctor. They can assess underlying health issues, refer you to support services, and connect you with effective therapies. And if you ever notice new, severe, or worrying physical or other symptoms, it’s safest to seek medical help immediately.

→ Aim to adopt regular stress-management practices, e.g. mindfulness, breathing exercises, yoga, meditation, progressive muscle relaxation, and nature walks. Cultivate hobbies, work–life balance, and downtime.

Avoidance of risky substances

Smoking and vaping

An overall downward trend in daily smoking rates among adults in New Zealand and Australia is cause for celebration.[30,37] Tobacco smoke contains numerous toxins that injure the endothelium, increase blood pressure, decrease HDL, promote inflammation, and accelerate plaque formation. [31] While e-cigarettes and vaping are often promoted as alternatives to smoking, they are not risk-free. Growing evidence highlights significant cardiovascular risks associated with their use.[32] Being both tobacco-free and nicotine-free is the ideal option for maintaining a healthy heart.[31}

Alcohol

Alcohol intake raises blood pressure, promotes arrhythmias, increases triglycerides, contributes to weight gain, and can trigger cardiomyopathy (weakening of the heart). Over time, drinking accelerates vascular ageing and increases CVD risk.[33]
Alcohol is a carcinogen, and no level of consumption is safe for health[35].

→ Aim to reduce or quit smoking, vaping or alcohol for optimum cardiovascular health. Seek counselling, social support, and connect with quit programs or addiction services when necessary. These services will help you establish healthier routines and environments that support your long-term wellbeing.

Positive social connections

Studies show that strong, meaningful relationships— with family, friends, whānau, community—buffer stress, offer emotional support, reduce loneliness, and promote healthier behaviours. Conversely, loneliness and social isolation have been shown to increase inflammation, blood pressure, and overall cardiovascular disease risk. One meta-analysis found that social isolation increased heart disease risk by up to 50%[32].

→ Aim to prioritise relationships—schedule regular catch-ups, join community or interest groups, volunteer, lean into family, community and cultural connections. Nurture a support network and reciprocate support.

Interested in learning more?

Sign up for our Tackling Heart Disease course. This online on-demand course designed for anyone living with—or wanting to prevent—cardiovascular disease. Whether you’re dealing with health concerns or simply want to keep your heart strong, this course equips you with the knowledge, tools, and expert guidance to make lasting, positive changes. Developed by expert healthcare practitioners, you’ll gain valuable knowledge and learn practical strategies to support better heart health and longevity.
References

Heart Foundation New Zealand. (n.d.). Statistics. https://www.heartfoundation.org.nz/statistics

World Heart Federation. (n.d.). Prevention. https://world-heart-federation.org/what-we-do/prevention/

American Heart Association. (n.d.). What is cardiovascular disease? https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease

Jebari-Benslaiman, S., Galicia-García, U., Larrea-Sebal, A., Olaetxea, J. R., Alloza, I., Vandenbroeck, K., Benito-Vicente, A., & Martín, C. (2022). Pathophysiology of atherosclerosis. International Journal of Molecular Sciences, 23(6), 3346. https://doi.org/10.3390/ijms23063346 (PMC8954705)

Yelamanchili, D., et al. (2025). HDL-free cholesterol influx into macrophages and transfer: implications for dysfunctional HDL. Journal of Lipid Research. Advance online publication. https://www.sciencedirect.com/science/article/pii/S0022227524002128

Ryu, H.-E., Jung, D. H., Heo, S.-J., Park, B., & Lee, Y. J. (2025). Extremely high HDL cholesterol paradoxically increases the risk of all-cause mortality in non-diabetic males from the Korean population: Korean genome and epidemiology study-health examinees (KoGES-HEXA) cohorts. Frontiers in Medicine, 12, 1534524. https://doi.org/10.3389/fmed.2025.1534524

Wang, X., Li, Y., & Zhang, L. (2024). Dietary patterns and cardiovascular risk: Evidence from a prospective cohort study. Scientific Reports, 14, 80578. https://doi.org/10.1038/s41598-024-80578-w

Harvard Health Publishing. (n.d.). How it’s made: Cholesterol production in your body. https://www.health.harvard.edu/heart-health/how-its-made-cholesterol-production-in-your-body

HEART UK. (n.d.). Saturated fat. https://www.heartuk.org.uk/low-cholesterol-foods/saturated-fat

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Blair, S. N., et al. (2009). Physical fitness and mortality. Journal of the American Medical Association, 301(19), 2024–2030. https://pubmed.ncbi.nlm.nih.gov/19757859/

Lavie, C. J., et al. (2020). Exercise and the cardiovascular system. Progress in Cardiovascular Diseases, 63(6), 763–771. https://pmc.ncbi.nlm.nih.gov/articles/PMC7700832/

Ministry of Health NZ. (n.d.). Be active every day: Physical activity for adults. https://healthed.govt.nz/products/be-active-every-day-physical-activity-for-adults

Luyster, F. S., et al. (2023). Sleep duration and cardiovascular disease risk: Meta-analyses of observational studies. Journal of Clinical Sleep Medicine, 19(4), 11326. https://jcsm.aasm.org/doi/10.5664/jcsm.11326

Banks, S., & Dinges, D. F. (2007). Behavioral and physiological consequences of sleep restriction. In M. H. Kryger, T. Roth, & W. C. Dement (Eds.), Principles and practice of sleep medicine (5th ed.). Elsevier. https://www.ncbi.nlm.nih.gov/books/NBK19961/

Torquati, L., Mielke, G. I., Brown, W. J., & Kolbe-Alexander, T. (2018). Shift work and the risk of cardiovascular disease: A systematic review and meta-analysis including dose–response relationship. Scandinavian Journal of Work, Environment & Health, 44(3), 229–238. https://doi.org/10.5271/sjweh.3700

National Sleep Foundation. (n.d.). How many hours of sleep do you really need? https://www.thensf.org/how-many-hours-of-sleep-do-you-really-need/

Satyjeet, F., Naz, S., Kumar, V., Aung, N. H., Bansari, K., Irfan, S., & Rizwan, A. (2020). Psychological stress as a risk factor for cardiovascular disease: A case-control study. Cureus, 12(10), e10757. https://doi.org/10.7759/cureus.10757

Vaccarino, V., & Bremner, J. D. (2024). Stress and cardiovascular disease: An update. Nature Reviews Cardiology, 21(9), 603–616. https://doi.org/10.1038/s41569-024-01024-y

Tsai, S.-Y., Hsu, J.-Y., Lin, C.-H., Kuo, Y.-C., Chen, C.-H., Chen, H.-Y., Liu, S.-J., & Chien, K.-L. (2024). Association of stress hormones and the risk of cardiovascular diseases: A systematic review and meta-analysis. International Journal of Cardiology: Cardiovascular Risk and Prevention, 23, Article 200305. https://doi.org/10.1016/j.ijcrp.2024.200305

Smokefree NZ. (n.d.). Smoking rates and figures. https://www.smokefree.org.nz/facts/law-policy-and-research/smoking-rates-and-figures

Heart Foundation New Zealand. (2023). Smoking and vaping position statement. https://assets.heartfoundation.org.nz/documents/shop/submissions/smoking-and-vaping-position-statement.pdf

Espinoza-Derout, J., Shao, X. M., Lao, C. J., Hasan, K. M., Rivera, J. C., Jordan, M. C., Echeverria, V., Roos, K. P., & Sinha-Hikim, A. P. (2022). Electronic cigarette use and the risk of cardiovascular diseases. Frontiers in Cardiovascular Medicine, 9, 879726. https://doi.org/10.3389/fcvm.2022.879726

Rehm, J., & Shield, K. D. (2019). Alcohol consumption and cardiovascular disease: Epidemiological evidence. Addiction, 114(9), 1670–1683. https://pubmed.ncbi.nlm.nih.gov/31309639/

American Heart Association Newsroom. (2023, May 3). Social isolation and loneliness increase the risk of death from heart attack, stroke. https://newsroom.heart.org/news/social-isolation-and-loneliness-increase-the-risk-of-death-from-heart-attack-stroke

World Health Organisation (2023, January 4). No level of alcohol consumption is safe for our health.
https://www.who.int/europe/news/item/04-01-2023-no-level-of-alcohol-consumption-is-safe-for-our-health

Heart Foundation Australia. (n.d.). Key statistics: Cardiovascular disease. https://www.heartfoundation.org.au/your-heart/evidence-and-statistics/key-stats-cardiovascular-disease

Nogrady, B. (2024, March 5). Smoking rates in Australia drop below 10%, but vaping increases. BMJ, 384, q559. https://doi.org/10.1136/bmj.q559
February 1, 2026
Plant-powered lunchboxes: 10 easy tips for happy, healthy kids
Healthy lunch boxes can set children up with steady energy, better focus and long-term health by centering lunches on whole plant foods like fruits, vegetables, whole grains, legumes, nuts and seeds.

Dietary guidelines worldwide are increasingly converging on a plant-forward approach that safeguards both human health and the planet’s future. The EAT-Lancet Commission’s Planetary Health Diet exemplifies this shift, advocating for meals dominated by vegetables, fruits, whole grains, legumes, nuts, and minimal animal products to feed a growing global population sustainably while slashing greenhouse gas emissions, land use, and water demands. By packing plant-powered lunch boxes today, parents empower kids not just with vibrant health but also with the tools to thrive on a healthy planet tomorrow, fostering lifelong habits that honour our shared environment.

A whole food plant-based pattern is appropriate and nutritionally adequate for all life stages, including childhood and adolescence.

A whole food plant-based (WFPB) dietary pattern, rich in fruits, vegetables, whole grains, legumes, nuts, and seeds with minimal or no animal products or ultra-processed foods, is nutritionally adequate and supports optimal growth for all life stages, including the critical periods of childhood and adolescence.

Many organisations including Dietitians Australia, the Canadian Paediatric Society, and the British Dietetics Association all affirm that appropriately planned plant-based diets are healthy and nutritionally adequate for all stages of life. For growing kids, nutrient rich WFPB diets fuel steady energy, cognitive function, bone development, and immune health and children who are raised on healthful vegan diets have a reduced risk for heart disease, cancer, obesity, diabetes, and other conditions.
Building a healthy lunch box

Aim to include these elements most days.

Whole grain base: wholemeal or grainy bread, wraps, pasta, brown rice, quinoa or leftover baked potatoes/sweet potatoes.

Protein-rich plants: hummus, bean spreads, lentil dhal, baked beans, tofu strips, tempeh, edamame, or nut/seed butters, where allergy-safe.

Colourful produce: fresh fruit, veggie sticks, cherry tomatoes, salad mixes, roasted veg or corn on the cob.

High-calorie whole foods (for little tummies and active teens): avocado, tahini, nuts and seeds, or seed-based dips, avoiding coconut products due to the high saturated fat content and its impact on cardiovascular health.
Top 10 lunchbox tips for parents

Think “whole plants first”
Base most choices on minimally processed fruits, vegetables, whole grains, legumes, nuts and seeds to maximise nutrient density and fibre.

Pack plenty of plants early in life
Childhood is when arteries can already show atherosclerotic changes, so everyday plant-rich lunches help protect heart health from a young age.

Offer familiar favourites plus one “yet-to-be-liked” food
Combine foods your child already enjoys with a small serve of something new, allowing them to explore with all their senses over multiple exposures.

You choose the ‘what’ and ‘when’; they choose ‘which’ and ‘how much’
Provide regular opportunities and a variety of healthy options, then let kids decide what and how much to eat from what is offered.

Make it fun and positive
Use colourful containers, playful names like “broccoli trees”, shapes, and descriptive language that spark curiosity rather than pressure.

Role model what you pack
Children are more likely to enjoy fruits and vegetables when they regularly see their adults eating and enjoying the same foods.

Stock the pantry for success
What comes home from the shop (or an online order) ends up in lunch boxes; keep processed meats, high-fat animal products and junk foods out of your fridge and pantry.

Rethink dairy, meat and processed meats
Calcium can be readily obtained from plant foods such as greens, beans, tofu, tempeh and fortified soy milk, while processed meats are classified as Group 1 carcinogens and are best avoided.

Plan for energy needs without the junk
Use calorie-dense whole foods like whole grain breads, smoothies, hummus, nut and seed spreads, and avocado to fuel active kids instead of ultra-processed snacks.

Remember key nutrients and supplements
A well-planned plant-based pattern usually meets or exceeds most nutrient needs, still vitamin B12 must be supplemented, and vitamin D should be monitored, with safe sun exposure or a plant-based supplement as needed.
Simple kid-friendly lunchbox ideas

Mini wholemeal wraps with hummus, grated carrot, lettuce and corn; fruit salad; a small container of roasted chickpeas.

Leftover veggie pasta or rice-and-bean salad in a thermos; cucumber and capsicum sticks; a mandarin or berries.

Wholegrain sandwich with mashed beans and avocado; cherry tomatoes; a fig or date and a small handful of nuts or seeds (if permitted).
Find kid-friendly DFN recipes

For practical ideas and step-by-step guidance, explore the free kid-friendly whole food plant-based recipes in the Doctors For Nutrition recipe collection at: www.doctorsfornutrition.org/recipes. Many of these meals and snacks adapt easily to lunch boxes and help children enjoy more fruits, vegetables, whole grains and legumes every day.
January 20, 2026
Live well and stay well
How lifestyle habits can transform your health.

Article first published in Vegetarian Living NZ Magazine.

It’s a concerning fact that chronic disease rates are continuing to rise across Australia and New Zealand. Conditions such as type 2 diabetes, cardiovascular disease, certain cancers, and obesity are placing an increasing burden on individuals, families, and our health system. What if we told you that the most powerful medicine isn’t found in a pill bottle or hospital ward—but in our kitchens, communities, and daily routines?

Enter lifestyle medicine – a growing field that focuses on evidence-based, therapeutic lifestyle interventions to prevent, treat, and even reverse chronic disease. At its core are six pillars: whole food plant-based eating patterns, regular physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connections. Together, these pillars form a holistic framework for vibrant health.

Let’s explore how each of these lifestyle pillars plays a vital role in maintaining your wellbeing—and how simple changes can transform your life.

Whole food plant-based eating patterns

The foundation of lifestyle medicine is a diet based on whole, minimally processed plant foods, including vegetables, fruits, legumes, whole grains, nuts and seeds. Adopting this way of eating isn’t just about preventing illness—it’s about fueling the body with nutrient-dense foods that actively support healing and resilience.[1]

Mounting evidence supports the use of plant-based diets in reducing the risk of a range of noncommunicable diseases that are so prevalent today. The American College of Lifestyle Medicine[2] outlines, for example, that cardiovascular disease—the leading cause of death in New Zealand[3] and worldwide—can not only be prevented but also reversed in some cases through a whole food plant-based diet.

Other New Zealand data reflects the benefits of this way of eating. A 2020 study[4] using New Zealand as a case study examined how the food system contributes to the growing burden of noncommunicable diseases. The review concluded that plant-based diets could be key in lowering this burden, with ‘vegan’ scenarios conferring the greatest health gains and cost savings: 43% more quality-adjusted life years and 45% greater cost savings (NZ$⁢20.2 billion in total) than meeting New Zealand’s dietary guidelines alone.

Physical activity

You don’t have to be an ultramarathoner to reap the benefits of movement. Aotearoa’s physical activity guidelines suggest that 2 ½ hours of moderate-intensity or 1 ¼ hours of vigorous physical activity spread across the week can confer a range of benefits, including reducing the risks of heart disease, obesity, strokes, type 2 diabetes, certain cancers, and depression. Bump the time spent active up to 5 and 2 ½ hours, respectively, and enjoy even greater health benefits.[5]

Aim to sit less and move more by including a variety of physical activities throughout the week. Include moderate activities, such as brisk walking, biking, or dancing; vigorous activities, such as jogging, fast swimming, or playing team sports; and muscle-strengthening exercises, such as push-ups or heavy gardening. Try to spread these activities across the week and aim to do muscle-strengthening exercises at least twice a week.

Movement should feel like a celebration of what your body can do, not a punishment. Set some activity goals, make a start, and build up slowly.

Restorative sleep

We often overlook the importance of sleep, but it’s a crucial pillar of long-term health. The brain remains highly active during sleep, carrying out essential processes that restore both the mind and body. Quality sleep improves learning, memory, and mood. It also enhances motivation for other lifestyle-enhancing behaviours, such as exercise and healthy food choices.

The accumulated effects of disordered sleep are well documented and include cardiovascular disease, hypertension, obesity, metabolic syndrome, diabetes and impaired glucose tolerance, immunosuppression, inflammation, cancer, cognitive impairment, psychiatric disorders such as anxiety and depression, and even premature death.[6]

Building healthy sleep habits starts with lifestyle adjustments. Establish routines such as consistent bedtimes and wake times (adults should aim for 7-9 hours of sleep per night), using the bed exclusively for sleep, and reducing exposure to blue light at least an hour before bedtime. Daytime behaviours are equally important: increasing morning light exposure, taking regular movement breaks throughout the day, limiting caffeine consumption, avoiding late-night snacking and alcohol, and staying well-hydrated all promote sleep readiness. Additionally, integrating other pillars of lifestyle medicine, such as whole food plant-based nutrition, regular physical activity, and stress-management techniques, further supports restorative sleep.

Stress management

Stress is often an unavoidable part of life. Still, when left unmanaged, it can significantly impact both physical and mental health. Chronic stress is linked to a range of health issues, including high blood pressure, depression, and weakened immune function[7]. There is a reciprocal relationship between stress and health—stress can contribute to illness, and poor health can increase stress. This highlights the importance of effective stress management.

Management involves both minimising exposure to stressors where possible and using techniques that help regulate the body’s response to stress. In today’s fast-paced world, there is a growing emphasis on regularly practicing stress-relief strategies to build resilience and support overall wellbeing.

The goal isn’t to eliminate stress entirely, but rather to develop healthier, and more resilient ways of coping with it. As discussed throughout this article, other lifestyle factors such as nutrition, physical activity, sleep, and social connection also play a valuable role in stress reduction. Studies have shown that regular mindfulness practice and other mind-body techniques can reduce inflammatory markers in the body, thereby reducing the risk and improving outcomes for people living with chronic illnesses.[7]

Avoidance of risky substances

Lifestyle medicine emphasises avoiding or eliminating harmful substances like tobacco, vaping products, alcohol, and other drugs. These substances contribute to conditions such as cardiovascular disease, cancer, liver disease, and mental health disorders. In addition to harming the body, substance use often deepens emotional and social struggles—particularly for people dealing with stress or hardship.

Lifestyle medicine practitioners support individuals through evidence-based strategies to reduce or eliminate risky substance use. This includes motivational interviewing, behavioural counselling, social support, and connecting patients with quit programs or addiction services when necessary. This empowers individuals to build healthier routines and environments that support their long-term wellbeing.

Positive social connections

Human beings thrive on meaningful connections with others. Numerous studies confirm that strong social ties are protective against depression, anxiety, heart disease, and even early death[8]. Incorporating connection into our lives doesn’t require having a huge social circle. Meaningful conversations with a few close friends or family members can be enough. Volunteering, joining a social club or group, or spending quality time with loved ones can all reinforce a sense of belonging.

In Māori health models, such as Te Whare Tapa Whā, Taha whānau (family health) is one of the four cornerstones of wellbeing. It is the capacity to belong, care, and share, where individuals are part of wider social systems(9). Lifestyle medicine honours this perspective—recognising that wellness is not just physical, but also deeply social and cultural.

The power of lifestyle medicine lies in the way its principles connect and reinforce one another. A person who eats nourishing food is more likely to sleep well and have the energy to move. Regular movement supports better mental health. Positive relationships can help someone manage stress and avoid risky coping mechanisms. It’s a web of wellbeing—and even small changes can create a ripple effect.

Lifestyle medicine doesn’t promise perfection. It’s not about rigid rules or all-or-nothing thinking. It’s about empowering people with the tools to live healthier and longer lives.

Check out our Daily Lifestyle Habits guide, which includes a checklist to help you incorporate regular lifestyle habits into your daily.
References

Doctors For Nutrition. (n.d.). Why WFPB. https://dfn.azwebsolutions.co.nz/clinicians-students/why-wfpb/

American College of Lifestyle Medicine. (2023, April 18). The benefits of plant‑based nutrition: Treatment and prevention of cardiovascular disease. International Board of Lifestyle Medicine. https://lifestylemedicine.org/articles/benefits-plant-based-nutrition-cardiovascular-disease/

National Heart Foundation of New Zealand. (n.d.). Statistics. https://www.heartfoundation.org.nz/statistics

Drew, J., Cleghorn, C., Macmillan, A., & Mizdrak, A. (2020). Healthy and climate-friendly eating patterns in the New Zealand context. Environmental Health Perspectives, 128(1), 17007. DOI:10.1289/EHP5996

HealthEd. (2025, May). Be active every day – HE2311. https://healthed.govt.nz/products/be-active-every-day-physical-activity-for-adults

American College of Lifestyle Medicine. (2022, August). Sleep and health: A lifestyle medicine approach [PDF]. https://lifestylemedicine.org/wp-content/uploads/2022/08/ACLM-Article-LM-Sleep-and-Health.pdf

American College of Lifestyle Medicine. (2022, February). Lifestyle Medicine and Stress Management. [PDF].
https://lifestylemedicine.org/wp-content/uploads/2022/08/ACLM-Article-LM-Stress-Management.pdf

American College of Lifestyle Medicine. (2022, February). Positive Social Connection: A Key Pillar of Lifestyle Medicine. [PDF].
https://lifestylemedicine.org/wp-content/uploads/2022/08/ACLM-Article-Positive-Social-Connection.pdf

Ministry of Health – Manatū Hauora. (2025, March 20). Te Whare Tapa Whā model of Māori health. New Zealand Ministry of Health. https://www.health.govt.nz/maori-health/maori-health-models/te-whare-tapa- hahttps://www.heartfoundation.org.nz/statistics
January 2, 2026
2025 Year in Review: Advancing Nutrition & Lifestyle Medicine in Australasia
A look back at Doctors For Nutrition’s milestones—spotlighting the landmark Nutrition & Lifestyle Medicine Symposium, new professional courses, international collaborations, and growing momentum in lifestyle medicine education.

Symposium: Highlight event of 2025

The 2025 Nutrition & Lifestyle Medicine Symposium, delivered over two days in Adelaide, was a one-of-a-kind event designed to advance clinical understanding and implementation of lifestyle medicine in practice. Bringing together leading researchers, healthcare professionals, and advocates, the Symposium delved deeply into the latest science on the six pillars of lifestyle medicine. Experts presented actionable strategies to integrate these pillars into healthcare and connected with a dynamic community committed to reducing chronic disease. The event set a powerful agenda for the future of clinical nutrition interventions.

Enjoy a brief recap of the Symposium and learn how you can access the complete recordings for yourself.

The evolution of our team in 2025

2025 was a year of dynamic growth and meaningful transition for the Doctors For Nutrition team. We farewelled our talented Projects Lead, Louisa Chamberlain, as she embarked on the next chapter of her journey, focusing on her health coaching business. At the same time, we were delighted to welcome Amy Leahy as our new Education Lead. A registered nutritionist with a Master of Public Health and experience at Mastering Diabetes, Amy has contributed valuable expertise to the design and delivery of innovative new courses. We also welcomed Dr Elena Schaller, a values-driven science communicator, into the critically important role of Fundraising Officer – strengthening our capacity to expand our impact. Our Marketing & Communications Lead, Karyn Ogier, stepped into the additional role of Projects Lead, overseeing the development and launch of two exciting new initiatives (more on this below). This year also saw the expansion of our Advisory Council, enabling us to draw on an even broader range of experience, knowledge, and credibility as we continue to set the standard in nutrition advocacy and education.

New courses designed to drive better health outcomes

In 2025, DFN proudly launched two new first-of-their-kind professional e-learning courses: Tackling Heart Disease and Culinary Medicine. Designed for clinicians, allied health professionals and health-engaged community members, these courses deliver comprehensive, practical training in preventing and reversing cardiovascular disease, alongside essential culinary skills to support lifestyle-focused prescriptions. Together, they address a core gap in healthcare education and everyday practice across Australia and New Zealand.

We offer free previews of both courses that you can try before you buy. Check them out today by visiting the Tackling Heart Disease and Culinary Medicine pages on our website.

Building healthier futures through our projects

Helping people understand their diet and its impact

In June, we released the 4Leaf Survey, an innovative online dietary assessment tool designed to help individuals understand their eating habits and make meaningful, evidence-based changes. The survey provides users with a personalised snapshot of their diet quality across key areas, highlighting strengths and opportunities for improvement. It also estimates the carbon footprint of their diet, helping users understand the environmental impact of their food choices. By translating complex nutrition and sustainability science into clear, actionable insights, the 4Leaf Survey empowers both the general community and healthcare professionals to take practical steps toward healthier, plant-forward eating patterns while considering their environmental impact. This tool supports DFN’s broader mission to promote nutrition literacy, sustainable lifestyle changes, and climate-conscious food choices.

Fruit & Vegetable Prescription pilot program

In November, DFN launched a Fruit & Vegetable Prescription pilot program in Aotearoa, New Zealand, strengthening its commitment to supporting communities through practical, food-based solutions. Delivered in collaboration with local healthcare and community partners, the pilot provided participants with regular boxes of fresh produce and simple, supportive guidance to help make healthier eating more achievable. By addressing both nutritional knowledge and food accessibility, this pilot represents a significant step toward reducing chronic disease risk and demonstrating the power of food as medicine in real-world settings. While impact outcomes are still being evaluated, early feedback highlights the value of improving access to nutritious food for those who need it most. With continued funding, DFN hopes to expand this initiative into a full community-based education program, reaching more people and fostering long-term, community-led improvements in health and wellbeing.

National events and thought leadership

DFN amplified its message through attendance and presentation at key conventions: the GPCME South in New Zealand and AMSA National Convention in Sydney. Our team led high-impact sessions on plant-based nutrition and lifestyle medicine, engaging hundreds of medical professionals and medical students in evidence-based strategies for practice and patient empowerment.

Media presence and community impact

Vegetarian Living Magazine NZ, featured key articles by DFN, extending our reach and credibility across Australasia. Our board director, Luke Wilson, wrote on behalf of DFN in a HuffPost article dispelling myths around our obsession with protein. I also had numerous interviews with radio stations around Australia promoting our resources and events.

Our popular Food Vitals webinar series continued, with new sessions that critically examined nutrition’s role in heart disease and cancer prevention. The Dine With a Doc events in New Zealand and in Melbourne brought together like-minded communities to foster dialogue and support for plant-based approaches in public health and clinical practice.
Growing our global reach

2025 was a year for exceptional growth for DFN, expanding our community across international borders. Our social media presence surged, engaging a wider audience of healthcare professionals, students, and the public with high-quality science-backed education on plant-based nutrition and lifestyle medicine. Website visits reached new heights as users increasingly accessed free resources, courses, professional position statements, and webinar archives. These tools empowered thousands to enhance their nutrition knowledge and make informed health decisions. This global digital engagement reflects our mission to democratise access to trustworthy, actionable information in preventive health and whole food plant-based care.

During this time, our digital presence continues to thrive:

64,052 active website users explored our resources, with 4Leaf Survey, new courses, and recipe collection leading in popularity – an increase of more than 20,00 visitors on last year!

8,532 newsletter subscribers, each month growing steadily.

22,818 social media followers, with 130 joining monthly to stay connected.
Collaborative projects through partnerships

Another highlight of the year was our partnership with the Educated Choices Program to co-create and release two educational videos: Heart Smart and Unlocking Diabetes. These resources deliver practical, current, and science-backed content for clinicians and the public, supporting dietary empowerment and literacy in chronic disease prevention.

Our strong relationship with the International Board of Lifestyle Medicine has flourished, with growing interest in certification locally in Australia and New Zealand, as lifestyle medicine gains traction globally.

Looking forward

Doctors For Nutrition continues to advocate for whole food plant-based nutrition across healthcare sectors and upholds rigorous standards in lifestyle medicine training and policy. Demand for evidence-based certification and the enhanced integration of nutrition education in medical and allied health curricula are on the rise, thanks to dynamic partnerships and a committed professional community.

2025 has set new benchmarks for impact. We thank our community, collaborators, and supporters for propelling our shared vision: a world free from preventable disease where everyone can thrive and live to their full potential.
December 8, 2025
Nutrition & Lifestyle Medicine Symposium 2025

Doctors For Nutrition was delighted to host Australasia’s only lifestyle medicine symposium with a focus on whole food plant-based nutrition in November 2025.

On Saturday, 8 and Sunday, 9 November 2025, the vibrant city of Adelaide played host to the landmark Nutrition & Lifestyle Medicine Symposium 2025 (NLMS25), proudly presented by Doctors For Nutrition (DFN). Held across two iconic venues—the Adelaide Health and Medical Sciences Building and Inparilla (Wyatt Trust)—the event attracted over 200 delegates, predominantly medical professionals, including GPs, specialists, dietitians, allied health experts, researchers and medical students, alongside community members and thought leaders. Together, they explored the transformative power of whole food plant-based nutrition and lifestyle medicine.

Energetic and engaging two-day experience

The atmosphere was buzzing with enthusiasm as participants eagerly absorbed the latest research and practical tools across the six pillars of lifestyle medicine: whole food plant-based eating, physical activity, restorative sleep, stress management, avoidance of risky substances, and positive social connections.

Saturday’s symposium featured a robust lineup of expert speakers. The program included exclusive keynote presentations by Dr Will Bulsiewicz—renowned gastroenterologist and gut health expert—and Drew Harrisberg, Exercise Physiologist and Diabetes Educator, who shared unique insights exclusively for NLMS25 attendees.

Dr Sam Gartland, a UK-trained GP, shared his inspiring personal journey with multiple sclerosis and presented on integrating lifestyle medicine pillars into clinical practice. Other notable speakers included Stephan Herzog, Executive Director of ABLM & IBLM, who discussed how diet and lifestyle help individuals thrive; Dr Nicole Lee on changing Australians’ relationship with alcohol; Dr Lisa Kennedy offering guidance through perimenopause and menopause; and Dr Kaitlin Harkess led a mindfulness meditation session.

Included in the plenary presentations was a lively panel Q&A comprising Doctors For Nutrition advisory members—Dr Malcolm Mackay, Dr Sam Gartland, Accredited Practising Dietitian Nina Trinquet, and Dr Peter Johnston— who engaged with delegates in thoughtful discussion and knowledge sharing.

Sponsors & exhibitors: A hub of activity and innovation

Thanks to our sponsors and supporters

Doctors For Nutrition warmly thanks all sponsors, exhibitors, and suppliers whose generous support made NLMS25 a meaningful and impactful event. We are especially grateful to our HARVEST Sponsor, Mushroom Health Science Australia, for providing credible nutrition resources about Australian mushrooms. Our SEED Sponsors, the Educated Choices Program and New Leaf SA, provided invaluable support to the event through their commitment to promoting healthier lifestyles.

The exhibitor hall was a hive of activity throughout the event, bustling with engaged attendees exploring innovative plant-based products, resources, and health coaching. Exhibitors reported an engaged and interested audience, with numerous meaningful conversations and connections made across the day.

Key exhibitors included Pure Plant Protein, makers of smooth and nutrient-dense faba bean protein powder; Phyba, innovators in gut-friendly plant protein formulations; Healthy Empire, natural, gut-friendly, and nutrient-rich foods, including smoothie mixes, bliss ball blends, and protein products; Eat Plants for Health, guided by Health Coach, Sarah Radford; and our friends at Doctors for the Environment Australia. Check out our photo gallery of the exhibition space.

These close interactions added tremendous value to the delegate experience showcasing the expanding plant-based and lifestyle medicine markets.

Culinary Medicine workshop: Exceeding all expectations

The optional Culinary Medicine Workshop on Sunday featured DFN’s CEO Rebecca Stonor, cooking alongside Dr Lisa Kennedy and dietitian Nina Trinquet. The workshop was originally planned to welcome 45 attendees, yet the session was so popular that over 60 participants joined—underscoring the high demand for practical, hands-on learning in plant-based cooking. The workshop included preparing and tasting dishes such as scrambled tofu with fresh corn tortillas and a delectable chocolate berry porridge, deepening attendees’ knowledge and culinary skills.

International Board of Lifestyle Medicine Certification exam at NLMS25

As part of the Nutrition & Lifestyle Medicine Symposium 2025, healthcare professionals had the unique opportunity to sit the prestigious International Board of Lifestyle Medicine (IBLM) Certification Exam. This internationally recognised certification distinguishes practitioners as leaders in evidence-based lifestyle medicine—a rapidly growing field focused on preventing, managing, and often reversing chronic disease through the six pillars of lifestyle medicine.

The exam, which was held on Sunday, 9 November, directly following the Culinary Medicine Workshop, is the culmination of rigorous preparation, including comprehensive online and event-based medical education. Successfully becoming an IBLM Diplomate provides healthcare professionals with enhanced credibility, career advancement opportunities, and a powerful network dedicated to transformative patient care.

Learn more about the certification program and how to take the next steps. Register now to leave plenty of time to prepare for the exam in Sydney in November 2026. Stay tuned for details!

Continuing professional development and on-demand learning

The symposium was approved for 5.5 continuing professional development (CPD) hours by the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM), enabling healthcare professionals to enhance their credentials and broaden their clinical expertise.

For those who missed sessions or wish to revisit content, full recordings are available for on-demand access, free one-time-only for Doctors For Nutrition members, or at a fee for non-members, ensuring ongoing learning beyond the live event.

Join us in Sydney in 2026

NLMS25 was a resounding success—a vibrant platform uniting diverse stakeholders in the pursuit of disease prevention, optimal health, and sustainable living. The enthusiasm and learning ignited here will surely ripple through clinical practice, research, policy, and community life across Australasia.

With success behind us, excitement builds for the next Doctors For Nutrition Conference in Sydney in November 2026, as we continue the journey toward a world free from preventable disease where everyone can thrive and live to their full potential.

Together, we look forward to building on this foundation towards even greater impact in future events.

November 15, 2025
A new plate for Australia

How Doctors For Nutrition are advocating for our health and climate revival

With the release of the new Australian Dietary Guidelines in 2026, Doctors For Nutrition is well-positioned to offer the Australian community tools to transition to a whole-food, plant-based diet, thereby improving public health. Guidance on plant-predominant eating patterns, climate and environmental impacts, and practical educational support is expected to be included in the review.

Responding to new guidelines

With the review of the 2013 Australian Dietary Guidelines now underway, Doctors For Nutrition has submitted evidence and actively participated in stakeholder consultations, advocating for stronger recommendations of plant-based proteins and integration of environmental sustainability into national nutrition advice. Our submissions urge updates to food groups, replacing red meat and dairy with nutrient-rich plant-based options, and call for a clearer emphasis on the health and affordability benefits of plant-predominant diets.

A draft of the new Australian Dietary Guidelines is scheduled for release for public consultation in 2025, providing stakeholders, experts, and the broader community with an opportunity to provide input before finalisation. Doctors For Nutrition will participate in this vital process by carefully reviewing the draft and submitting evidence-based feedback, championing recommendations that highlight plant-based eating and environmental sustainability. Our ongoing involvement ensures that robust scientific and health perspectives help shape national dietary advice for all Australians.

Plant-based proteins in global nutrition guidance

Plant-based proteins—legumes, nuts, seeds, and whole grains—are being prioritised in worldwide dietary guidelines due to overwhelming evidence of their health and environmental advantages. The latest US Dietary Guidelines Advisory Committee recommends listing these foods first in the protein group, aligning with global models like the EAT-Lancet Commission’s “Planetary Health Diet.” This shift helps support chronic disease prevention and provides more sustainable options for populations everywhere.

Dietary guidelines worldwide are shifting to incorporate more plant-forward nutrition recommendations, a trend highlighted by a comprehensive global analysis published in Current Developments in Nutrition. The study assessed 95 national dietary guidelines and found that, while a minority (40%) of countries have an explicit position on vegetarian diets, nearly half already mention plant-based alternatives to meat and milk.

More recent guideline updates are responding to scientific evidence and global sustainability goals, encouraging a transition away from animal proteins and toward legumes, nuts, seeds, and whole grains as key sources of nutrition. The tendency to recommend plant-based options is strongest in countries that prioritise environmental efforts, and weakest where animal agriculture remains economically dominant. Expanding dietary guidelines to better include plant-based diets not only supports better health but also substantially reduces premature mortality and greenhouse gas emissions—underscoring the case for nutrition policy reform worldwide.

Climate change:
A dire national challenge

Climate change is imposing catastrophic costs on Australians.

The National Climate Risk Assessment finds that, unless rapid action is taken, severe impacts such as quadrupled extreme heatwaves, skyrocketing heat-related deaths, increased disaster recovery costs, marine heatwave devastation, and extensive coastal flooding will escalate sharply by 2063–2090. Aboriginal and Torres Strait Islander communities face heightened vulnerability, and national productivity may shrink by hundreds of billions due to climate-driven disruptions. Cutting climate pollution from fossil fuels is essential but diet is also key—plant-based eating patterns dramatically lower greenhouse emissions, protecting both people and the planet.

How plant-based diets help

Moving to a plant-based dietary pattern can make a substantial impact on health and sustainability in Australia. Global modelling shows that if everyone shifted toward plant protein sources, greenhouse emissions would fall by up to 17%, a move highlighted as essential for combating climate change in national and international recommendations. Nutritionally, plant-based diets help reduce the risk of heart disease, type 2 diabetes, and certain types of cancer, while also lowering environmental and economic burdens. To learn more about how our food systems contribute to climate change, read our recent article on the topic.

Doctors For Nutrition’s role and resources

Doctors For Nutrition provides extensive educational materials, workshops, webinars, and practical resources to help Australians adopt a plant-based diet. Our programs equip both the public and healthcare professionals with the necessary information and tools to make lasting dietary changes that benefit both human and environmental health. These resources, designed to demystify plant-based eating, provide meal planning support, and empower individuals and communities to take action in line with emerging national guidelines.

Doctors For Nutrition are proud to have submitted high-quality evidence and are invigorated by the opportunity to help shape the new Australian Dietary Guidelines. As the guidelines evolve to reflect the latest science and sustainability imperatives, our educational resources will be critical for ensuring Australians achieve better – and greener – health outcomes for the future.

September 19, 2025
The power of lifestyle medicine: Your pathway to better health

At Doctors For Nutrition, we believe that health is not just about treating symptoms—it’s about empowering you to prevent, manage, and even reverse disease by addressing the root causes. Lifestyle medicine is a practical, evidence-based approach that puts you in control of your health journey, and at its heart lies the transformative potential of whole food plant-based (WFPB) nutrition.

What is lifestyle medicine?

Lifestyle medicine is a holistic approach to healthcare that focuses on modifying daily habits—like nutrition, physical activity, sleep, stress management, and social connections—to prevent and manage chronic diseases. Rather than just masking symptoms, lifestyle medicine targets the underlying causes of conditions such as cardiovascular disease, type 2 diabetes, and certain cancers, helping you achieve true, lasting health.

Lifestyle medicine practitioners focus on evidence-based lifestyle interventions, often working in conjunction with conventional treatments or medications when needed—it’s a complementary, not alternative, approach.

The field is built on six key pillars that work together to support overall wellbeing, with WFPB nutrition being the cornerstone that brings these pillars together.

Incorporating some simple lifestyle changes into your daily life can be both easy and rewarding.

The magic of whole food plant-based nutrition

A WFPB diet is a powerful tool for preventing, managing, and reversing disease. This way of eating is rich in fruits, vegetables, legumes, whole grains, nuts, and seeds, and excludes animal products and heavily processed foods. People who switch to a WFPB diet often report more energy, better mood, clearer skin, and improved overall wellbeing—even within a short time.

Here’s how you can start today

Whole food, plant-based nutrition
Fill your plate with a variety of fruits, vegetables, whole grains, legumes, nuts, and seeds. Start your day with a nourishing bowl of oats topped with berries or start adding beans to your salads for extra fibre and nutrients.

Regular physical activity
Aim for at least 30 minutes of movement most days—this could be a brisk walk, cycling to work or dancing in your living room. Take the stairs instead of the lift or enjoy a family walk after dinner.

Restorative sleep
Prioritise 7–9 hours of quality sleep each night. Create a calming bedtime routine, limit screen time before bed, and keep your bedroom cool and dark for better rest.

Stress management
Incorporate stress-relieving practices into your day, such as mindfulness meditation, deep breathing, or spending time in nature. Even taking 10 deep breaths before meals can help lower stress levels.

Positive social connections
Nurture relationships by sharing meals with loved ones, calling a friend, joining a club, or volunteering in your community. Meaningful connections can boost your mood and support long-term mental health.

Avoidance of risky substances
Join the ‘sober curious’ movement by considering going alcohol-free during the week. Choose sparkling water or herbal tea instead of alcohol. Seek support if you need help reducing alcohol, tobacco or other substances.

By weaving these small, positive habits into your routine, you can make meaningful strides toward preventing and even reversing chronic disease—one day at a time

Why prevention matters

Did you know that up to 80% of chronic diseases can be prevented with healthy lifestyle choices? Conditions like cardiovascular disease, type 2 diabetes, and many cancers often develop over years due to factors like poor diet, inactivity, and unmanaged stress. By making small, sustainable changes—like choosing more whole plant foods, moving your body regularly, and managing stress—you can significantly reduce your risk and boost your quality of life.

Your invitation: The Nutrition and Lifestyle Medicine Symposium, Adelaide 2025

Ready to learn more and connect with a supportive community? We’re excited to invite you to the Nutrition and Lifestyle Medicine Symposium in Adelaide on 8 and 9 November 2025! This event is open to everyone—not just health professionals. Whether you’re just starting your health journey or looking to deepen your knowledge, you’ll find inspiration, practical tips, and the latest science on how lifestyle medicine and plant-based nutrition can transform your life.

GET YOUR TICKET TODAY

You can do this!

Changing habits can feel daunting, but you’re not alone. At Doctors For Nutrition, we’re here to support you every step of the way. By embracing lifestyle medicine—especially whole food plant-based nutrition—you’re investing in a healthier, happier future for yourself and your loved ones. Let’s take the next step together. Join us at the Nutrition & Lifestyle Medicine Symposium 2025 in Adelaide, and discover how small changes can lead to big health rewards. Everyone is welcome!

Are you a healthcare professional interested in treating patients using lifestyle medicine practices?

As the Australasian and Pacific Island representative of the International Board of Lifestyle Medicine, we are proud to offer the certification pathway for physicians and healthcare professionals to gain international recognition as lifestyle medicine practitioners, and become IBLM Diplomates (dipIBLM).

FIND OUT MORE

July 14, 2025
Reflections on a decade with MS
Finding hope, health, and purpose

Ten years ago, on an ordinary Friday afternoon in August 2015, I sat in a neurologist’s office and heard the words that would change my life: “It looks like you have multiple sclerosis.” I’m not sure if she said those exact words to soften the blow, but it didn’t change the fact that they altered the course of my life.

I was 40 years old, a mother to two beautiful young children, busy with life and passionate about my work as a plant scientist. At that moment, fear and uncertainty flooded my thoughts. Would I be able to keep up with my kids? Would I lose my ability to walk them to school, and to work and live the life I’d built?

If you’ve ever been diagnosed with a disease that has the potential to leave you incapacitated and unable to take care of yourself or those around you, a range of emotions can hit you all at once. It’s a moment of profound vulnerability when you realise how unpredictable life can be.

You can go through all of the emotions often felt when someone you love dies because, in a way, it is a type of grief. In that short moment, your future has gone. Yet, even amid the devastation, there is often a flicker of determination—a quiet voice that says, “What can I do to improve my chances?” Guided by a determined pragmatism, I took on the challenge of doing whatever it would take to be well.

What is MS? Understanding the diagnosis

Multiple sclerosis (MS) is a chronic and often unpredictable disease. The immune system mistakenly attacks the protective covering of nerves in the brain and spinal cord, disrupting the flow of information within and between the brain and body. Symptoms develop, ranging from numbness and fatigue to vision loss and, in some cases, pain and significant disability. The course of MS can be relentless, progressing over time and robbing people of their independence.

Searching for answers: What causes MS?

The causes of MS are complex and not fully understood. Genetics play a role, but research shows that environmental factors contribute significantly to the pathology and outcomes of people with MS. Research points to viruses—like Epstein-Barr virus—as potential triggers for the immune system’s misguided attack.

If you or someone you love is facing a debilitating disease like MS, know this: there is hope. You have more power than you think.

However, another piece of the puzzle has become increasingly clear: our modern Western diet and lifestyle also play a role. Research into the role of the gut microbiome shows that people with MS often have dysbiosis, where the diversity and overall balance are disrupted, leading to immune system dysfunction.^1,2 Dysbiosis can be caused by factors such as infections, antibiotic use, dietary changes, or chronic inflammation. But the predominant cause of microbiome dysfunction is due to what we feed it.

The role of diet and lifestyle

The typical Western diet—high in animal protein and saturated fat while being low in fibre—has been shown to fuel inflammation and may contribute to the progression of autoimmune diseases like MS.³ After my diagnosis, I dove into the research, desperate for hope. What I found was both sobering and empowering: while I couldn’t change my genes, I could change what I put on my plate and how I lived each day. Instead of beating myself up for the mistakes of the past, I put one foot, or fork, in front of the other and began to shift the balance toward a healthier way of living.

Changing the course: A whole food plant-based diet

Before my diagnosis, I considered myself to be someone who ate well. Animal products were featured in all of my meals and snacks. I believed, as we all do, that these foods gave me the protein, iron and calcium I thought my body needed. Vegetables and some fruits were included in my meals, but rarely would I have consumed the recommended daily intake. I also never considered how much saturated fat I was eating due to my high dairy and high meat diet. It was no secret that I loved butter!

After reading the science and learning that my diet had likely been disease-promoting, I adopted a whole food plant-based diet that is naturally low in saturated fat. I now fill my plate with colourful fruits, vegetables, whole grains, legumes, nuts, and seeds while avoiding animal products and processed foods. The science is compelling: such a diet can reduce inflammation, support a healthy immune system, improve wellbeing⁴ and may even slow or halt the progression of MS.⁵

I often get asked if I ever go ‘off plan’ and treat myself to a burger or a block of chocolate. However these people don’t understand the nature of the disease. I see the way I eat now as a diet of abundance. I never feel I go without treats or lack delicious things. It’s not that I can’t eat certain foods, but more so that I choose those that benefit my health. Don’t get me wrong; I’m not perfect, but it’s all about progress over perfection and supplying my body with the nutrients it needs to be well.

As a scientist, I understand that anecdotal evidence is the weakest form of proof when it comes to establishing a cause-and-effect relationship. However, my story is not unique. There is a growing body of research indicating that changes in both nutrition and lifestyle can help manage symptoms and may even slow the progression of disease. More than one lifestyle intervention can benefit the other. While there is currently no cure, I believe that if the changes I am making have kept me out of a wheelchair and helped prevent other chronic illnesses, then my efforts have been worthwhile.
Beyond diet: Other powerful lifestyle interventions

Diet is just one piece of the puzzle. Over the past decade, I’ve embraced a range of lifestyle interventions that research shows can benefit people with MS, including:

Regular physical activity: Movement keeps my body strong and my mind clear.

Stress management: Mindfulness meditation helps me stay resilient.

Adequate sleep: Prioritising rest allows my body to heal and recharge.

Vitamin D: Safe sun exposure and supplementation support my health.

Social connection: Staying engaged with loved ones and my community lifts my mood.

It’s not about perfection but about creating a lifestyle that supports healing and hope. The more of these positive changes I adopt, the better I feel—and the more empowered I am.
Ten years later: Living well, sharing hope

A decade after my diagnosis, I am symptom-free and thriving. Not only have I kept up with my children, but I have also watched them grow into remarkable young adults. My work as CEO of Doctors For Nutrition allows me to share the life-changing power of evidence-based dietary and lifestyle interventions with others facing chronic illness, or those who simply want to live well.

For those who have been diagnosed with a debilitating illness like MS, you understand that fear can either stop you in your tracks or motivate you to change. I chose to shift my mindset and completely embrace a ‘new normal’. My family has joined me on this journey, and my children are shining examples of plant-powered teenagers.

Having agency over my health has been transformative. I am living proof that, while MS is a formidable diagnosis, it does not have to define or limit us. By embracing the power of food and lifestyle, along with conventional treatment if required, we can change the course of this disease.

I look back on the past ten years with gratitude and celebrate my MS anniversary. If you or someone you love is facing a debilitating disease like MS, know this: there is hope. You have more power than you think. And you are not alone—I’m here, cheering you on every step of the way.
References

Dunalska, A., Saramak, K., & Szejko, N. (2023). The role of gut microbiome in the pathogenesis of multiple sclerosis and related disorders. Cells, 12(13), 1760. https://doi.org/10.3390/cells12131760

Yoon, H., Gerdes, L. A., Beigel, F., Sun, Y., Kövilein, J., Wang, J., Kuhlmann, T., Flierl-Hecht, A., Haller, D., Hohlfeld, R., Baranzini, S. E., Wekerle, H., & Peters, A. (2025). Multiple sclerosis and gut microbiota: Lachnospiraceae from the ileum of MS twins trigger MS-like disease in germfree transgenic mice—An unbiased functional study. Proceedings of the National Academy of Sciences, 122(18), e2419689122. https://doi.org/10.1073/pnas.2419689122

Swank, R. L., & Goodwin, J. (2003). Review of MS patient survival on a Swank low saturated fat diet. Nutrition, 19(2), 161–162. https://doi.org/10.1016/S0899-9007(02)00851-1

Simpson-Yap, S., Nag, N., Probst, Y., Reece, J. C., Jelinek, G. A., & Neate, S. (2022). Prospective associations of better quality of the diet with improved quality of life over 7.5 years in people with multiple sclerosis. Multiple Sclerosis and Related Disorders, 60, 103710. https://doi.org/10.1016/j.msard.2022.103710

Swank, R. L., & Dugan, B. B. (1990). Effect of low saturated fat diet in early and late cases of multiple sclerosis. The Lancet, 336(8706), 37–39. https://doi.org/10.1016/0140-6736(90)91533-G
June 4, 2025
Plant-based eating doesn’t have to be all or nothing: Cooking demo recap
Making the shift to plant-based eating doesn’t have to be perfect – it just has to begin.

At Doctors For Nutrition, we know how powerful a whole food plant-based (WFPB) diet can be for long-term health. But we also know that for many people, making the switch can feel like too big a jump, especially when they’re cooking for others or are used to more familiar flavours.

That’s why our most recent plant-based cooking demo looked a little different.
Transition-friendly recipes, without the compromise

Inspired by our new course, Make the Switch, we focused this cooking demonstration on easy, plant-based comfort food recipes that offer a more familiar texture and taste – ideal for those just starting out, or trying to get family members on board. These recipes are still oil-free and packed with goodness, but they are designed to feel like a natural step from a typical Western diet.

What we cooked:

Make the Switch Lasagne – a hearty, easy, satisfying dinner the whole family can enjoy

Decadent Chocolate Mousse – a rich, fibre-filled, smooth and entirely plant-based dessert
WATCH COOKING DEMONSTRATION NOW

While this demonstration featured Western-style comfort food, we’ve also responded to feedback requesting more global, culturally diverse plant-based options. Inside our course, we share helpful resources for those seeking non-Western recipes and flavours – because healthy eating should feel relevant and accessible, no matter your cultural background.

Accredited Practising Dietitian Nina Trinquet, one of the experts featured in the course, also joined us for a live Q&A.

Why we’re focusing more on ‘meeting people where they are’

Over time, we’ve received thoughtful feedback from health professionals: while many patients stand to benefit from a whole food plant-based diet, not all are ready to commit to the full transition straight away. Some are simply overwhelmed. Others cook for households that aren’t quite on the same page yet.

We created Make the Switch to respond to that very challenge.

The course is a supportive, flexible starting point for anyone curious about eating more plant-based food without needing to do it all at once. Its focus on real-world meals, batch cooking tips, and habit-building strategies helps people build momentum in a way that works for them.

We also walk participants through how to adapt their favourite meals – whether that means simply veganising a dish, moving it towards a more plant-based version, or taking it all the way to WFPB. No judgment. Just tools and guidance to help them find what works for their lifestyle, right now.

We recognise that many people may choose to include plant-based meat and dairy alternatives along the way. Instead of taking an all-or-nothing stance, we guide participants in how to read labels and compare products, so they can make informed choices that better support their health during the transition.

And the best part? You don’t need to do everything at once to experience benefits. Even small, gradual changes can lead to meaningful improvements in health. That’s the dose-dependent magic of whole plant foods – the more you add, the more your body thanks you.

For our WFPB readers: This might help someone you love

Already eating whole food plant-based yourself? This course was made with your family and friends in mind. We hear from many people who want to help a loved one dip a toe into this way of eating, but aren’t sure how to start those conversations or what to cook that will actually be enjoyed.

Make the Switch is designed to support that journey, with support to reshape familiar favourites into dishes even the sceptics will enjoy, and structured guidance that doesn’t overwhelm.

Tip: You don’t need to be a DFN member to gift someone a membership, which provides access to Make the Switch at 50% off the course price.

It’s a practical way to help a loved one get started on their own terms, and with support.

No judgment. Just tools and guidance to help them find what works for their lifestyle, right now.
April 16, 2025
Embracing a plant-based future: Understanding challenges, creating change

The journey toward a plant-based lifestyle isn’t just about swapping ingredients—it’s about reimagining our relationship with food, health, and the world around us.

While this path presents real challenges, each obstacle we encounter offers unique opportunities for growth and transformation.

Understanding our food choices

The most profound barriers to embracing plant-based eating often lie within our hearts and minds. Many of us are unaware that we carry deep emotional connections to traditional foods that have marked celebrations, comfort, and family gatherings throughout our lives. Rather than viewing these connections as roadblocks, we can use them as inspiration to create new, meaningful food traditions that honour both our heritage and our evolving values.

Beyond the protein myth

When people express concern about plant-based nutrition, protein often takes centre stage. Yet this focus on protein reflects outdated nutritional understanding. A well-planned whole food plant-based diet provides abundant protein through diverse sources like legumes, wholegrains, seeds, tofu and tempeh. While vitamin B12 supplementation remains important, this simple addition supports an otherwise complete nutritional profile.

Our healthcare crisis has reached a tipping point, with younger generations facing unprecedented health challenges.

The conversation around ultra-processed plant-based alternatives deserves nuance. While these foods shouldn’t form the foundation of our diet, they can serve as helpful transition tools when implementing dietary change. More importantly, they represent remarkable innovation in food technology that continues to evolve toward healthier, more sustainable options.

Environmental truth-telling

The environmental impact of our food choices often gets clouded by misleading comparisons. Yes, almond cultivation requires water—but when we examine the full picture, plant-based food production consistently demands fewer resources than animal agriculture. By focusing on seasonal, locally sourced plant foods, we can build sustainable food systems that nourish both people and the planet.

Making plant-based living accessible

The perception that plant-based eating is exclusively for the privileged overlooks the rich history of plant-centred diets across cultures and economic circumstances. Traditional cuisines worldwide showcase the delicious potential of affordable plant foods like beans, grains, and seasonal vegetables. As demand grows, we’re seeing more accessible plant-based options emerge in mainstream markets, making this way of eating inclusive for all.

Healthcare’s necessary evolution

The gap in nutrition education among healthcare providers presents both a challenge and an opportunity for transformation. Organisations like Doctors For Nutrition are pioneering change by equipping medical professionals with evidence-based knowledge about plant-based nutrition. This dietary shift is crucial as we face rising rates of chronic disease and mounting healthcare costs.

Catalysts for change

Three powerful forces are accelerating the plant-based movement:

1. Our healthcare crisis has reached a tipping point, with younger generations facing unprecedented health challenges. Plant-based nutrition offers a practical, affordable, evidence-based solution for preventing, managing and treating many chronic conditions.

2. Climate awareness has evolved from a fringe concern to a mainstream priority. Young people especially recognise the profound link between food choices and environmental impact.

3. Food technology continues to advance, creating more appealing and nutritious plant-based options that make the transition easier for those accustomed to animal products.

The heart of change: Stories that move us

While scientific evidence supports plant-based eating, facts alone rarely drive lasting change. Our hearts often lead the way, guided by compassion for animals, concern for our planet, or personal health experiences. These emotional connections create powerful motivation for sustained change when paired with solid evidence and practical support.

Building a community proves essential for long-term success. Whether through local potlucks, online forums, or cooking classes, sharing our journey provides encouragement, practical tips, and the joy of collective positive change.

Moving forward together

The shift toward plant-based lifestyles represents more than a dietary choice—it’s a movement toward more conscious, compassionate, and sustainable living. While challenges exist, each one presents an opportunity to learn, grow, and create positive change. Through education, community building, and sharing our stories, we can support each other in creating a healthier future for all.

Remember that transformation happens one choice at a time. Every plant-based meal, every shared recipe, and every conversation about conscious eating contributes to broader positive change. Your journey matters, and your choices ripple outward in ways you might never see, but that collectively shape our shared future.

February 11, 2025
Melbourne Potluck Dinner with Prof Kim Williams
A night of connection and inspiration

Last weekend, the Melbourne plant-based community came together for a truly memorable evening hosted by Doctors For Nutrition (DFN) and Plant Powered Melbourne. The exclusive potluck dinner, featuring US-based cardiologist and plant-based advocate Prof Kim Williams, celebrated the power of community, the joy of food, and the life-changing benefits of a whole food plant-based (WFPB) diet.

The evening was a huge success and we had an amazing turnout of DFN supporters, physicians, dietitians, medical students and friends from both Melbourne, and other states of Australia!

A vibrant turnout

The event welcomed a fantastic mix of attendees, including physicians, dietitians, nutritionists, students, and friends from across Melbourne. The enthusiasm and energy in the room were palpable, with like-minded individuals gathering to connect, share, and inspire one another. Events like these highlight the power of community to spark social change from the ground up.

A feast to remember

Guests contributed an array of nourishing and delicious WFPB dishes that showcased the creativity and abundance of plant-based eating. The spread was as diverse as it was delightful, with little left over by the end of the evening—a true testament to the culinary talent in the room!

A thought-provoking discussion

The evening’s highlight was a Q&A session with Prof Kim Williams, facilitated by DFN’s CEO, Rebecca Stonor. Joined by key medical professionals and leaders from Melbourne Lifestyle Medicine, the discussion explored the health benefits of a WFPB diet and its potential to prevent and reverse chronic diseases.

Prof Kim Williams discussed the latest research from the International Journal of Disease Reversal and Prevention along with powerful evidence that a WFPB diet, low in salt, oil and sugar, is one of the most effective strategies we can all use to reduce our risk of developing heart disease.

Dr Heleen Haitjema delivered an inspiring talk on the role of storytelling in driving sustainable change and wellbeing. Her message resonated with many in attendance, emphasising the transformative power of personal health journeys.

… a WFPB diet, low in salt, oil and sugar, is one of the most effective strategies we can all use to reduce our risk of developing heart disease
Join the movement

If you’re inspired to take action, here are some ways to get involved:

Share your story: We’d love to hear from you if you’ve experienced a health transformation through plant-based eating! Submit your story to be featured on our website, with the option to remain anonymous.

Host your own potluck: Bring your loved ones together with our Plant-iful Plates for a Purpose fundraising guide. It’s a fantastic way to share delicious meals while supporting DFN’s mission.

Become a member: DFN memberships are a great way to access resources, support vital initiatives, and join a growing community committed to health and sustainability. Memberships are available for community members, students, concession card holders, and healthcare professionals.

Stay connected

Don’t miss out on future events and opportunities to connect with the DFN community! Subscribe to our emails and follow us on social media for updates.

Thank you to everyone who made this event a resounding success. Together, we’re building a healthier, more compassionate world, one meal at a time. Let’s keep the momentum going!
January 14, 2025
Standing out at the Vegan Festival Adelaide

On the weekend of 7-8 December, Doctors For Nutrition hosted a stall at the world-renowned Vegan Festival Adelaide.

The Vegan Festival is a highlight for the Adelaide vegan community and won the Community Event of the Year at the Citizen of the Year Award Winners 2022 held by the City of Adelaide. The festival attracts a large number of people who eat a standard Australian diet. Historical data collected by organisers indicates around a third of festival goers are either curious about veganism or attending to support a friend. The festival also hosts many people who are vegan for ethical and environmental reasons and may not be aware of the many health benefits of eating a whole food plant-based diet. The diversity of this demographic creates fertile ground for conversations, and the amazing Doctors For Nutrition volunteers took full advantage of this.

Over the course of the weekend, volunteers handed out 367 physical resources, documented 254 conversations, signed up 9 new members, and gained 40 new subscribers. This is a fantastic outcome, and demonstrates the growing interest in eating a plant-based diet for optimal health.

A whole food plant-based diet has completely changed my life.

Conversations at the stall indicated that many people had either not heard of Doctors For Nutrition prior to the festival or had read about the organisation for the first time on the Vegan Festival website. This feedback emphasizes the importance of Doctors For Nutrition having a presence at events not solely focused on plant based nutrition and its benefits, and the impact of using event platforms to showcase the organisation’s work.

Dr Heleen Haijema, Co-founder and Chair of the Board, and Rebecca Stonor, CEO were also in attendance helping to run the stall and conduct informative and engaging cooking demonstrations and talks. These attracted particular attention, with attendees heading straight to the stall for further information after hearing Heleen and Rebecca speak.

Over the weekend, many inspiring conversations were conducted, with one visitor telling volunteers that eating a whole food plant-based diet had completely changed their life. Others commented how amazing it was to see a stall representing an organisation like Doctors For Nutrition at the Vegan Festival.

Doctors For Nutrition will engage with new members and subscribers in the coming weeks to provide additional information and resources.

Doctors For Nutrition also won Best Stall of the festival, with festival organisers drawing attention to the consistent busyness over the weekend, and the team’s dedication to sharing evidence-based information about plant-based nutrition. It was an incredibly successful weekend, leaving volunteers and key staff feeling inspired and energised. Many thanks to all who assisted with the stall, talks, and demonstrations, and we look forward to many more crucial conversations at future events.

January 2, 2025
Doctors For Nutrition 2024: Year In Review
As 2024 draws to a close, we’re excited to reflect on the year that was and share the remarkable milestones the team at Doctors For Nutrition have achieved over the past 12 months.

Leadership transition

This year marked a significant leadership change as Sarah Warner stepped down as CEO to dedicate more time to her family. Sarah has been an integral part of the organisation since the beginning and remains a vital part of our team as Finance and Development Lead. We’re thrilled to have welcomed Rebecca Stonor as our new CEO, ushering in a new chapter for DFN. Rebecca brings a wealth of knowledge in, and lived experience with, whole food plant-based nutrition.

Launching our membership program

A key highlight of the year was the launch of our DFN membership program, offering our community exclusive access to online courses, past webinars, and our Nutrition in Healthcare conference recordings. The membership was launched not only for healthcare professionals, but also for the general community, students and concession card holders, empowering all with the vital knowledge of whole food plant-based nutrition. In just a few months, we’ve welcomed over 100 members, including five gifted memberships to medical students at the AMSA Global Health Conference.
Expanding our digital reach

Over the past six months, our dedicated team has worked hard to ensure a smooth transition to an improved email marketing platform and learning management system for our course delivery, enabling a seamless experience for our supporters.

During this time, our digital presence continues to thrive:

48,232 active website users explored our resources, with the What is WFPB page and recipe collection leading in popularity.

8,520 newsletter subscribers, growing steadily by 63 new signups per month.

21,287 social media followers, with 100 joining monthly to stay connected.

Our valued subscribers were kept abreast of news, views and insights across the plant-based community through our bi-monthly e-newsletter.
Promoting the Lifestyle Medicine Certification in our region

From May 2024, in partnership with the International Board of Lifestyle Medicine (IBLM), DFN was excited to offer the certification pathway for physicians and healthcare professionals in Australia, New Zealand, and the Pacific Islands to become an IBLM Diplomate (dipIBLM).

The alignment between IBLM and Doctors For Nutrition reflects a shared vision of a world free from preventable disease, enabling everyone to thrive and live to their full potential. As exam registrations close for 2024, we anticipate reopening registrations in the new year.

Encouraging the community to optimise health

The new DFN Health Challenge was launched in October to our community. Similar to our Doctors Health Challenge which ran in late 2023, this new offering has been made available to the wider community for enrollment so that they too can experience the life-changing benefits of a whole food plant-based diet. This program has been specifically tailored to Australian and New Zealand audiences, offering practical guidance on how to source healthy, affordable ingredients from local supermarkets.

Our voice in the media

Co-Founder and Chair of the Board, Dr Heleen Haitjema, was invited to participate in a debate on the new Sky News ‘The Jury’ program where she provided her expert opinion on the pressing need to decrease red meat consumption to counteract the damaging environmental and climate consequences of meat production.

Dr Haitjema was also interviewed by the Plantrician Project’s Co-Founder and Board Chair, Dr Scott Stoll, for their long-standing friendship and 13 years of attending their conferences. Dr Haitjema was honoured to be the longest-attending delegate at the International Plant-Based Nutrition Healthcare conference this year in Anaheim.
Empowering health professionals

Our Prescribing Nutrition course continued to transform how healthcare professionals learn about and prescribe whole food plant-based nutrition. Participants’ feedback underscores the course’s life-changing potential:

Of the 123 new enrollees this year:

100% felt more confident discussing plant-based diets with patients.

91% were inspired to make personal dietary changes themselves.

Keeping a close eye on the Australian Dietary Guidelines Review

In February this year, the National Health and Medical Research Council called for expressions of interest for experts to join a sustainability working group as a part of the Australian Dietary Guidelines review process. We shared this communique with our audience and encouraged their participation in the review.

Sustainable diets (accessible, affordable and equitable diets with low environmental impacts) were identified as one of the priority areas during the prioritisation process for the Australian Dietary Guidelines review. Given the shift to adopt sustainable dietary guidelines in many countries worldwide, Australia is well on the way to potentially ensuring a similar change in focus.
Hosting live events and webinars

This year, we hosted four live webinars and two CPD-approved Food Vitals webinars. More than 1000 people signed up, with the majority of attendees being healthcare professionals. Topics ranged from ‘Ageing: the role of nutrition’ with Dr Michael Greger to ’Sustainability and diet’ and ‘Five proven benefits of a plant-based diet for sports performance’ each with a panel of international experts

Advocacy and face-to-face engagement

We connected directly with hundreds of health professionals, medical students and the general community at events like our Dine with a Doc Dinner in Melbourne and Auckland, GPCE in Sydney, and the Vegan Festival Adelaide, distributing over 1,800 resources.

We heard memorable feedback such as “It’s sad that we are not taught this in medical school. We are only taught about prescribing pills” and “Thank you for the work you do, it has been life-changing”, reinforcing the importance of our attendance at these events to share our mission.

Shocked at Dairy Australia’s presence in the primary school curriculum, Dr Heleen Haitjema has written to Ministers for Education across most of Australia, calling for an immediate end to the Discover Dairy education program. Visiting the MUSE Global School in LA gave us insight into how sustainability and plant-based nutrition can be successfully taught in schools, with immeasurable benefits for the community.

Dine with a Doc, Melbourne

Vegan Festival, Adelaide

Vegan Festival, Adelaide

Dine with a Doc, Auckland

Looking ahead

As we prepare for 2025, our team are focused on a variety of projects and campaigns.

We will continue expanding tools and resources to help the community sustainably transition to a whole-food, plant-based diet. We are excited to offer our community new courses and an interactive dietary assessment tool in 2025. Our popular webinars, in-person events, cooking demonstrations, and members-only exclusive activities will be offered throughout the year.

Our team will progress with advocacy projects, including plans to develop educational resources for schools in Australia and New Zealand. We will also position ourselves to respond to the draft Australian Dietary guidelines when they are released.

Thank you to our dedicated community of supporters and team for making this year one to remember. Together, we’re creating a world free from preventable diseases where everyone can thrive and live to their full potential.

Together, we can keep the momentum going!
December 18, 2024
A call to end the ‘Discover Dairy’ program in Australian schools
Let’s prioritise healthier, un-biased, evidence-based nutrition education for our children

Doctors For Nutrition Co-Founder and Chair of the Board, Dr Heleen Haitjema, has written to Ministers for Education across most of Australia, calling for an immediate end to the Discover Dairy education program, which uses resources provided by Dairy Australia, in schools.

Our education system has an obligation to provide students with nutrition information that is unbiased and evidence-based. School curricula should be protected from the influences of industry bodies, such as Dairy Australia, whose interests are commercial in nature. Providing a more health-promoting and science-based approach, and incorporating a range of plant-based alternatives, can effectively cater to students’ diverse dietary needs and preferences, thereby enhancing overall lifelong health and well-being.

Our children deserve access to the most accurate and health-promoting nutritional guidance, and it’s time we re-evaluate the role dairy plays in school education.

A growing body of scientific evidence suggests that dairy may have inherent health risks – from heart disease, certain cancers, allergies, digestive issues, and type 1 diabetes – which is concerning when exposure to dairy foods begins at an early age.

Dairy and bone health

Dietary guidelines have long led people to believe that dairy products are essential for optimum bone health, but the evidence does not support this commonly held belief. High dairy consumption has been related to increased rates of osteoporosis and fractures, [1,2] contradicting the widespread messaging that dairy promotes bone health. A 2005 review in the journal Pediatrics showed that drinking milk has no significant effect on children’s bone health. [3] Similarly, a seven-year follow-up of adolescent girls published in 2012 indicated that neither dairy nor calcium intake made any difference in preventing stress fractures. [4] Weight-bearing exercises and other lifestyle factors are far more important in maintaining lifelong bone health. [5,6]

Dairy and heart health

Heart disease is the number one cause of death in Australia and around the world. Cholesterol and saturated fats contained in dairy products are known to increase the risk of heart disease and stroke. [7,8] Scientific studies have documented that a diet free from dairy, with a shift to plant-based nutrition, together with moderate physical activity, cessation of smoking and stress management, can prevent and even reverse heart disease. [9,10]

Dairy and cancer

Various studies have also linked the consumption of dairy foods to certain types of cancer. Dietary studies indicate that dairy increases the risk of prostate cancer in men [11-13], and breast and ovarian cancers in women [14-18]. In one large study involving 23,000 lactose-intolerant people who avoided milk and dairy products, a lower incidence of lung, breast, and ovarian cancers was found than in their dairy-consuming relatives [19].

Dairy and digestive health

Lactose intolerance, which is the body’s inability to digest the sugars within milk due to a lack of, or inactivity of, the enzyme lactase, is highly prevalent worldwide, leading to the development of gastrointestinal discomfort, including abdominal pain, bloating, and diarrhea. [20] While cow’s milk allergy in children is associated with chronic constipation, other gastrointestinal, skin and respiratory symptoms can also arise. [21-24]

Dairy and type 1 diabetes

Early exposure to the A1 beta-casein protein in cow’s milk has been implicated as a causal trigger in the onset of type 1 diabetes, an autoimmune disease often diagnosed in childhood. A study from Australia and New Zealand also identified an increased risk of type 1 diabetes among children who had consumed dairy in infancy. [25] and a subsequent study involving over 3,000 infants with genetic predisposition for diabetes uncovered that early cow’s milk consumption increased their risk for type 1 diabetes.[26] A report by the American Academy of Pediatrics [27] estimated that avoidance of cow’s milk protein exposure in the first three months of life may reduce the risk of developing diabetes by as much as 30%.

Smarter choices for health: Plant-based options

It is important to emphasise that milk and dairy products are not essential in the diet and may pose certain health risks. A diet rich in whole grains, fruits, vegetables, legumes, and nuts can meet all nutritional needs without the health risks associated with dairy consumption. Plant-based milk alternatives, such as soy, almond, or oat milk, offer a lower-saturated-fat option. Essential nutrients for bone health, including calcium and potassium, can be easily obtained from whole plant foods, while adequate vitamin D can be gained through sunlight exposure or supplements when needed.

At Doctors For Nutrition, we urge State Education Ministers across Australia to advocate for the removal of the Discover Dairy curriculum from schools. It’s time to prioritise children’s health by introducing an inclusive, evidence-based nutrition curriculum that empowers them to build a healthier future.
References

Case-Control Study of Risk Factors for Hip Fractures in the Elderly”. American Journal of Epidemiology. Vol. 139, No. 5, 1994

Feskanich D, Willett WC, Stampfer MJ, Colditz GA. Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. Am J Public Health. 1997 Jun;87(6):992-7. doi: 10.2105/ajph.87.6.992. PMID: 9224182; PMCID: PMC1380936.

Lanou AJ, Berkow SE, Barnard ND. Calcium, dairy products, and bone health in children and young adults: a reevaluation of the evidence. Pediatrics. 2005;115:736-743. doi: 10.1542/peds.2004-0548

Sonneville KR, Gordon CM, Kocher MS, Pierce LM, Ramappa A, Field AE. Vitamin D, calcium, and dairy intakes and stress fractures among female adolescents. Arch Pediatr Adolesc Med. 2012;166:595-600. doi: 10.1001/archpediatrics.2012.5

Hind K, Burrows M. Weight-bearing exercise and bone mineral accrual in children and adolescents: a review of controlled trials. Bone. 2007 Jan;40(1):14-27. doi: 10.1016/j.bone.2006.07.006. Epub 2006 Sep 7. PMID: 16956802.

Gómez-Bruton A, Matute-Llorente Á, González-Agüero A, Casajús JA, Vicente-Rodríguez G. Plyometric exercise and bone health in children and adolescents: a systematic review. World J Pediatr. 2017 Apr;13(2):112-121. doi: 10.1007/s12519-016-0076-0. Epub 2017 Jan 15. PMID: 28101776.

Li Y, Hruby A, Bernstein AM, et al. Saturated fats compared with unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease: a prospective cohort study. J Am Coll Cardiol. 2015;66:1538-1548. doi: 10.1016/j.jacc.2015.07.055

Chen M, Li Y, Sun Q, et al. Dairy fat and risk of cardiovascular disease in 3 cohorts of US adults. Am J Clin Nutr. 2016;104:1209-1217. doi: 10.3945/ ajcn.116.134460

Szeto YT, Kwok TC, Benzie IF. Effects of a long-term vegetarian diet on biomarkers of antioxidants status and cardiovascular disease risk. Nutrition. 2004;20:863-866. doi: 10.1016/j.nut.2004.06.006

Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? Lancet. 1990;336:129-133. doi: 10.1016/0140- 6736(90)91656-U

Qin L, Xu J, Wang P, Tong J, Hoshi K. Milk consumption is a risk factor for prostate cancer in Western countries: evidence from cohort studies. Asia Pac J Clin Nutr. 2007;16:467-476.

Song Y, Chavarro JE, Cao Y, et al. Whole milk intake is associated with prostate cancer-specific mortality among U.S. male physicians. J Nutr. 2013;143:189-196. doi: 10.3945/jn.112.168484

Chan JM, Stampfer MJ, Ma J, Gann PH, Gaziano JM, Giovannucci E. Dairy products, calcium, and prostate cancer risk in the Physicians’ Health Study. Am J Clin Nutr. 2001;74:549-554. doi: 10.1093/ajcn/74.4.549

Kroenke CH, Kwan ML, Sweeney C, Castillo A, Caan BJ. High- and low- fat dairy intake, recurrence, and mortality after breast cancer diagnosis. J Natl Cancer Inst. 2013;105:616-623. doi: 10.1093/jnci/djt027

Cramer DW, Greenberg ER, Titus-Ernstoff L, et al. A case-control study of galactose consumption and metabolism in relation to ovarian cancer. Cancer Epidemiol Biomarkers Prev. 2000;9:95-101.

Larsson SC, Bergkvist L, Wolk A. Milk and lactose intakes and ovarian cancer risk in the Swedish Mammography Cohort. Am J Clin Nutr. 2004;80:1353-1357. doi: 10.1093/ajcn/80.5.1353

Qin B, Moorman PG, Alberg AJ, et al. Dairy, calcium, vitamin D and ovarian cancer risk in African American Women. Br J Cancer. 2016;115:1122-1130. doi: 10.1038/bjc.2016.289

Kushi LH, Mink PJ, Folsom AR, et al. Prospective study of diet and ovarian cancer. Am J Epidemiol. 1999;149:21-31. doi: 10.1093/oxfordjournals.aje. a009723

Ji J, Sundquist J, Sundquist K. Lactose intolerance and risk of lung, breast and ovarian cancers: aetiological clues from a population-based study in Sweden. Br J Cancer. 2015;112:149-152. doi: 10.1038/bjc.2014.544

Catanzaro R, Sciuto M, Marotta F. Lactose intolerance: An update on its pathogenesis, diagnosis, and treatment. Nutr Res. 2021 May;89:23-34. doi: 10.1016/j.nutres.2021.02.003. Epub 2021 Mar 21. PMID: 33887513

Iacono G, Cavataio F, Montalto G, et al. Intolerance of cow’s milk and chronic constipation in children. N Engl J Med. 1998;339:1100-1104. doi: 10.1056/NEJM199810153391602

Dehghani SM, Ahmadpour B, Haghighat M, Kashef S, Imanieh MH, Soleimani M. The role of cow’s milk allergy in pediatric chronic constipation: a randomized clinical trial. Iran J Pediatr. 2012;22:468-474.

Sampson HA. Update on food allergy. J Allergy Clin Immunol. 2004;113:805-819. doi: 10.1016/j.jaci.2004.03.014

Host A. Frequency of cow’s milk allergy in childhood. Ann Allergy Asthma Immunol. 2002;89(6 Suppl 1):33-37. doi: 10.1016/s1081-1206(10)62120- 5

Chia JSJ, McRae JL, Kukuljan S, et al. A1 beta-casein milk protein and other environmental pre-disposing factors for type 1 diabetes. Nutr Diabetes. 2017;7:e274-e281. doi: 10.1038/nutd.2017.16

Kimpimaki T, Erkkola M, Korhonen S, et al. Short-term exclusive breast- feeding predisposes young children with increased genetic risk of type I diabetes to progressive beta-cell autoimmunity. Diabetologia. 2001;44:63-69. doi: 10.1007/s001250051581

Eidelman AI, Schanler RJ. Policy statement: breastfeeding and the use of human milk. From the American Academy of Pediatrics. Pediatrics. 2012;129:827-841. doi: 10.1542/peds.2011-3552x
November 21, 2024
International Plant-Based Nutrition Healthcare Conference 2024

Dr Heleen Haijema, Co-founder and Chair of the Board, and Rebecca Stonor, CEO, were excited to attend the 12th International Plant-Based Nutrition Healthcare Conference in Anaheim, California.

PBNHC 2024 is the USA’s premier medical education conference focused exclusively on scientific research conveying the efficacy of whole food plant-based nutrition. The Plantrician Project has been holding conferences since 2012, to educate medical doctors, clinicians, and other health influencers on the indisputable health benefits of a plant-based diet.

The Australian Contingent

The conference is held annually and attracts a wide range of medical doctors, nurses, students, dietitians, nutritionists, health coaches, and the general public interested in nutrition. With both live and virtual delegates, the conference is open to all those passionate about choosing foods to improve health. Both Heleen and Rebecca funded their trips and conference attendance personally, ensuring that donations to DFN remain dedicated to supporting our core mission and programs.

There were a few familiar faces in the crowd with a small group of Aussies and New Zealanders in attendance! Heleen and Rebecca were reunited with colleagues, old acquaintances, and made some new friends.

At this event, attendees learned from the foremost experts in preventative nutritional medicine about practical applications for empowering patients to use food as the foundation of their health and well-being. Topics ranged from weight loss to water fasting, eye health to mental health, and there was a common thread among all presentations: Eating a plant-based diet is not only about preventing, managing, and often reversing chronic disease but also about longevity and promoting’ health span’.

Dr. Scott Stoll, co-founder of the Plantrician Project, opened the Plenary sessions. He emphasized the importance of offering patients messages of hope rather than resorting to fear after a diagnosis. Patients who maintain hope are more effective at overcoming challenges, reducing anxiety, and gaining a stronger sense of control and well-being. Storytelling in healthcare is another powerful tool, with proven positive effects on health outcomes. Dr. Stoll also highlighted the significance of building community by organising potlucks to foster connection—a key element promoted by DFN through their Plant-iful Plates campaign.

The Plenary presentations went over four days and covered a plethora of medical conditions. Speakers included Dr Joel Fuhrman, recipient of this year’s ‘Plantrician Project Luminary Award’, Dr Brooke Goldner, Dr Alan Goldhammer, and Dr Michael Klaper. Dr Rudrani Banik, an ophthalmologist, highlighted the importance of a nutrient-dense diet, rich in fruits and vegetables, for optimal eye health.

Dr Dean Ornish presented his latest research into halting and reversing the early stages of Alzheimer’s disease with a whole food plant-based diet and other lifestyle interventions. Dr. Ornish explained the unifying theory of chronic diseases, demonstrating that the same lifestyle changes—including adopting a whole-food, plant-based diet—can prevent and even reverse the progression of many chronic conditions. After four days of presentations, it became clear that these diseases share a common root: low-grade chronic inflammation, which leads to the development of chronic illness.

L-R: Rebecca Stonor, Dr Scott Stoll and Dr Heleen Haitjema

Then there was the conference food! Breakfast was included, with steel-cut oats being the staple topped with fresh berries, ground flaxseeds, and nuts. Green smoothies were also on offer! At lunch and dinner, delegates piled their plates high with a buffet of assorted salad vegetables, sauces, spices, and dressings, all carefully chosen for their nutrient density and promotion of optimal nutrition. Soups and warm dishes were served along with cooked whole grains and legumes. The delegates did not go hungry or experience the afternoon sleepiness that comes from the typically heavy, oil-laden, conference food served at many other events.

Attending this conference highlighted the fact that Doctors For Nutrition and the Plantrician Project have been friends for many years. Dr Heleen Haitjema attended their very first conference in 2012, and soon after, she felt compelled to establish a similar charity in Australasia. She has since attended all twelve conferences hosted by the Plantrician Project. Dr Scott Stoll, one of the organisation’s co-founders, publicly thanked her for her long-term and ongoing friendship.

Heleen and Rebecca have returned to Australia with newfound motivation and passion for promoting this vital information in the Southern Hemisphere. To stay informed of upcoming events held throughout Australia and New Zealand by Doctors For Nutrition, subscribe to our mailing list!

October 8, 2024
Start your day right: A plant-based breakfast for health and vitality
Embrace the power of plants at breakfast to set the tone for a day full of energy, focus, and well-being. By choosing a nutritious morning meal, you’re unlocking five amazing benefits that pave the way to a healthier lifestyle—one meal at a time!

Starting your day with a plant-based breakfast is a powerful way to maximise nutrition. Discover five life-changing benefits, each with practical tips you can use immediately.

1. Peak nutrient absorption in the morning

Fuel your morning with maximum nutrient power

Morning is the prime time for your body to absorb and utilise nutrients effectively. After fasting overnight, your body is particularly receptive to the nutrients you provide, making breakfast crucial for setting the tone for your day. Starting your day with a plant-based breakfast is a strategic way to flood your body with essential vitamins, minerals, and antioxidants. This approach not only maximises nutrient intake but also helps reduce the risk of chronic diseases.^[1]

Practical tip: Try a nutrient-packed smoothie or smoothie bowl with dark leafy greens, berries, seeds, and spices.

2. Superior performance without crashes

Feed your brain, fuel your body, and curb cravings

Whether you’re gearing up for a day at the office or tackling a physically demanding job, a plant-based breakfast rich in whole grains, fruits, and vegetables is key to sustaining mental and physical performance throughout the day. Foods high in complex carbohydrates and nitrates—like whole grains and leafy greens—help maintain steady glucose levels, enhance cognitive function, improve blood flow, and reduce fatigue.^[1,4]

A plant-based breakfast can help stabilise your mood and reduce cravings. Foods high in plant-based proteins, such as tofu, support serotonin production, keeping you satisfied and curbing those mid-morning hunger pangs.^[2]

Practical tip: Try a hearty breakfast, something like oats, that supports both brain and body performance. Alternatively a tofu scramble on whole-grain toast topped with leafy greens can provide an extra mood boost.

3. Powerful phytochemicals and antioxidants

Protect your health, one meal at a time

Every meal is an opportunity to protect your health against cancer and other chronic diseases, and breakfast is the perfect place to start. Plant foods are the only sources of phytochemicals and antioxidants—powerful compounds that neutralise harmful substances support cellular repair, and inhibit the growth and spread of cancer cells.^[3] The anti-inflammatory properties of these compounds help reduce aches and pains, particularly for those with autoimmune conditions, and combat inflammation linked to heart disease.^[3] Choosing a nutrient-dense, plant-based breakfast lays a strong foundation for long-term health and vitality.

Practical tip: Add spices like turmeric, cinnamon, and ginger to your morning oats, topped with berries or other fruits, for an extra boost of cancer-fighting, anti-inflammatory goodness.

4. Enhanced digestive health

A healthy gut starts with breakfast

The fibre in a plant-based breakfast is crucial for healthy digestion and maintaining a balanced gut. Morning is a sensitive time for your digestive system, so starting the day with a fibre-rich meal helps regulate bowel movements, supports gut health, and prevents discomfort throughout the day.^[2,3]

Practical tip: All plant-based choices are naturally high in fibre, so you can’t go wrong. Add chia seeds or flaxseeds to your oats for an extra fibre boost, or bake them into a fibre-packed oatmeal bake.

5. Optimal hydration

Hydrate from the inside out

Many plant-based foods, like fruits and vegetables, are naturally high in water, making them perfect for rehydration after a night of fluid loss. Morning hydration helps restore fluid balance, kickstart metabolism, and support cognitive function. It also aids digestion and flushes out toxins, ensuring your body starts the day at its best. Remember, the water content in fruits and vegetables also contributes to your daily fluid intake.

Practical tip: Treat yourself to a green smoothie or hydrating fruit salad made from watermelon, oranges, and strawberries to replenish your fluids and keep your body running smoothly.

We hope these insights have inspired you to see that a plant-based breakfast isn’t just a meal; it’s a foundation for a healthier, more vibrant life. Starting your day with nutrient-packed plant foods can set the tone for everything that follows, from improved energy and focus to better digestion and long-term health benefits.

Ready to take your breakfast to the next level? Visit the Plant Oceans Nutrition website by Martina Brayford to get your FREE Superfood Breakfast Guide, featuring five easy, plant-based recipes and practical tips for a healthy start to your day.

Martina Brayford
Certified Health Educator and Cooking Instructor

Martina Brayford is a Certified Health Educator and Cooking Instructor with the Physicians Committee for Responsible Medicine. She holds a certificate in Plant-Based Nutrition from the T. Colin Campbell Center for Nutrition Studies at Cornell University and studied Food & Nutrition Coaching at Nature Care College in Sydney.

Martina is passionate about using plant-based nutrition to improve health and reduce chronic illness. Through her business, Plant Oceans Nutrition, she promotes plant-based eating in her community in Western Australia. She runs group cooking classes, online programs, and individual coaching sessions, on how the right foods can promote long-term health and vitality.
References

Greger, M. & Stone, G. (2015) How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease

Barnard, N. D. (2019) Dr. Neal Barnard’s Program for Reversing Diabetes

Fuhrman, J. (2011) Eat to Live: The Amazing Nutrient-Rich Program for Fast and Sustained Weight Loss

Barnard, N. D. (2014) Power Foods for the Brain: An Effective 3-Step Plan to Protect Your Mind and Strengthen Your Memory
August 24, 2024
General Practice Conference and Medical Exhibition – Rotorua, New Zealand

Doctors For Nutrition were proud to exhibit at the General Practice Conference and Medical Exhibition (GPCME) in Rotorua, New Zealand.

GPCME 2024 attracted a wide range of general practitioners, nurses, nurse practitioners, practice managers, students, pharmacists and health coaches with a total attendance of over 1,000 delegates. The medical exhibition is a major part of the conference and provided delegates with a wide update in one location.

The conference programme provided a general practice update, with short, sharp and to the point clinical content, including key take home messages to help drive immediate behaviour change.

Thanks to grant funding, DFN staff were able to attend and exhibit at the conference providing us an opportunity to engage with our target audience, promote our advocacy work, distribute resources, build relationships with ally organisations and educate the attendees on the benefits of a whole food, plant-based diet for disease prevention and care.

Many of the delegates we spoke to agreed that plant-based diets, high in fruits, vegetables, whole grains and legumes, can prevent many of the chronic illnesses they see in their practices daily. With the current exponential growth in the use of weight loss medications, one GP from Auckland commented that, “There is no use in talking about weight loss medication if (patients) don’t change their diet.”

The overwhelming response to our message was exceptionally positive. A GP from Wellington commented that, “It’s very exciting to see nutrition being used in medicine.” Another GP from the Bay of Plenty found it sad that they were not taught about nutrition in medical school, “We are only taught about prescribing pills.” One other exhibitor declared that we were “the most exciting exhibit” at the conference.

It’s very exciting to see nutrition being used in medicine.

DFN’s Social Media and Events Lead, Rebecca Stonor, was joined by colleague Karyn Ogier (Marketing & Communications + Education Lead, New Plymouth), and volunteers Dr Luke Wilson (GP, Board Director & New Zealand Ambassadoc) and Dr Catherine Gray (GP and Lifestyle Medicine Practitioner, Shape My Health, Hastings).

The conference was held at the Energy Events Centre in Rotorua. Many doctors were interested in our new Lifestyle Medicine Certification through the International Board of Lifestyle Medicine. One lucky GP from New Plymouth was excited to be the recipient of the recently launched DFN membership. Several GPs also registered for our next Food Vitals webinar on the role of nutrition in managing menopause.

If you’d like to support us to attend more of these conferences and events, please consider a one-off or monthly donation. Help us share the invaluable benefits of whole food plant-based nutrition for disease prevention and reversal with medical professionals!

June 19, 2024
Dine with a Doc – Auckland, 2024

Doctors For Nutrition hosted a sustainability-focussed ‘Dine with a Doc’ dinner with a panel discussion featuring local doctors and sustainability experts.

Panellists from left to right: Dr Mark Craig, Dr Mandy Bergstrom, Ben Eietlberg

The evening was a huge success and we had an amazing turn-out on a cold wintry night of our Auckland-based supporters, physicians, nutritionists, and students! The overwhelming feedback from the evening was that guests now felt like they were a part of a community promoting a plant-based lifestyle.

Our panel discussion centred around how we can ‘inspire sustainable dietary change’ in those around us. This topic included both meanings of the word sustainable – long term change as well as promoting environmental benefits. Physicians and general community members alike all possess the power to lead by example and promote whole food plant-based nutrition for both human and planetary health.

Our two medical doctors on the panel, Dr Mark Craig and Dr Mandy Bergstrom, gave insights as to how this way of eating has benefited the health of their patients and their own lives. Ben Eietlberg clearly highlighted how our food systems have a huge impact on our environment and the future of our planet. Bringing these two factors together, changing to a plant-based diet is the single most important thing we all can do to mitigate climate change.

People watch you. They hear what you say. They watch what you do. If you demonstrate how easy it is to eat a plant-based diet, people are willing to try.

During our Q&A session with the guests, Dr Mark Craig was asked, “Where do you get your protein?” and in reply, said, “Where do you get your fibre?” highlighting the common misconception that plant-based foods do not contain enough protein. Dr Mandy Bergstrom shared her experience of working as an emergency medical doctor and seeing patients suffering chronic diseases related to diet and lifestyle.

Ben Eitelberg, plant-powered ultra trail runner and co-founder of The Lentil Intervention, educated attendees on ‘Planetary boundaries’ and how our food systems have a massive impact on the environment.

When asked how he inspires sustainable change his response was to lead by example. “People watch you. They hear what you say. They watch what you do. If you demonstrate how easy it is to eat a plant-based diet, people are willing to try.”

And then there was the food! Khu Khu Eatery has a reputation for some of the most delicious plant-based, Thai inspired dishes in Auckland. They did not disappoint! It was fresh, tasty and healthy.

During the event we ran a competition to win a one year FREE Doctors For Nutrition membership. Congratulations to Sarah Mortimer from Seed Nutrition.

To stay in the loop about future events, make sure you subscribe to our mailing list and keep an eye on our social media accounts!

June 19, 2024
From guidelines to greener plates: Australia’s necessary dietary shift

Sustainable diets emerge as an area of ‘very high priority’ for the Australian Dietary Guidelines review. DFN welcomes this focus and anticipates a future with more plants on every plate.

As the Australian Dietary Guidelines (ADGs) undergo review, the National Health and Medical Research Council (NHMRC) has placed significant emphasis on exploring sustainable diets, establishing a working group to solely tackle this topic.

But what exactly constitutes a sustainable diet? According to the Food and Agriculture Organization (FAO), it encompasses diets with minimal environmental impact, ensuring food and nutrition security for both current and future generations. These diets prioritise biodiversity and ecosystems, respect cultural diversity, and are accessible and affordable to all. Let’s explore how plant-forward diets align with these principles.

Reduce greenhouse gas emissions

Food contributes to roughly one quarter of global GHG emissions. Livestock – animals raised for meat, dairy, eggs and seafood production – contribute a staggering 31% to this figure, and this is before accounting for additional factors such as land use or supply chain emissions from crop production for animal feed.

A 2016 study led by Marco Springman identified that a global switch to a vegan diet could reduce food-related greenhouse gas emissions by as much as two thirds.

Locally the data shows we are not headed in the right direction when it comes to livestock emissions. The latest Australian GHG emissions quarterly update (Dec 2022) shows that emissions from agriculture have risen as a result of increases in livestock numbers and crop production.

A global switch to a vegan diet could reduce food-related greenhouse gas emissions by as much as two thirds.

Save lives

The same 2016 study also highlighted moving to diets with fewer animal-sourced foods would have major health benefits, up to 8 million lives could be saved globally by 2050. More than half of these avoided deaths would be attributed to red meat consumption and 24–35% due to increased fruit and vegetable consumption.

Not surprisingly Australia ranks among the world’s top meat-consuming countries, with an average annual consumption of 89.6 kg per person in 2019. Australia’s leading health issues, like heart disease, stroke, and diabetes, all have direct links to poor nutrition.

Plant-based diets, including total vegetarian or vegan diets, are recognised in the current Australian Dietary Guidelines as healthy and nutritionally adequate for all stages of life. Nutrient-dense plant-based diets are a central pillar of a healthy lifestyle, helping to prevent many of the chronic conditions that impair quality of life as we age.

Maximise public funds

The Australian Institute of Health and Wellbeing (AIHW) identified ‘overweight and obesity’ as the number one risk factor contributing the highest cost to Australia’s health system, at $4.3billion, not accounting for other costs such as reduced productivity.

Imagine what could be achieved, from a dietary perspective alone, if even a portion of this money was directed to strengthening and building new partnerships with all levels of government, the private sector, community-based organisations, and families to ensure consistent and equitable access to healthy, safe, affordable foods for all.

Prioritising biodiversity

Three quarters of global deforestation is driven by agriculture, beef production is responsible for a whopping 41% of that.

A 2020 WWF report on deforestation identified Australia as the only country in the developed world to appear on the list, clearing for cattle pasture was the primary driver.

Almost 75% of Australia is rangelands, suitable for livestock farming but this does not mean deforestation and land clearing is not rife. 680,688 hectares (the size of Ireland) of woody vegetation were cleared in Queensland alone in 2018-19, mostly for agriculture. Much of this was ‘likely or known’ koala habitat cleared for activity linked to grazing cattle for beef in Queensland alone; they are now endangered.

A brief word on soy; there is no doubt that soy is being grown in harmful ways across the globe but the biggest reason for the surge in its production (it has increased 15 times in the past 50 years), is to feed livestock. More than three-quarters (77%) of global soy is fed to livestock for meat and dairy production.

680,688 hectares (the size of Ireland) of woody vegetation were cleared in Queensland alone in 2018-19, mostly for agriculture.

Easing the household financial strain

Food and non-alcoholic beverages continue to put pressure on Australian households. Local and international studies indicate diets that include more plants provide more cost savings than those heavy in animal products. A simple example is a homemade curry where 500g of lamb is swapped out for chickpeas – this one meal alone could save about $12 for a family of four. The other benefit is the proliferation of many frozen and canned plant-based foods that reduce food waste and are accessible for the majority of Australians.

Australia must take action

The global syndemic of obesity, undernutrition, and climate change affects most people in every country and region worldwide. In high-income countries like Australia, where many of us are in a fortunate position to have choices when it comes to our diet, we have an important role to play.

S hifts to plant foods correlate consistently and robustly with higher overall diet quality for human health. These same shifts are key for planetary health – which underpins all human health – they are a prerequisite to remaining below the 1.5°c warming threshold set by the 2015 Paris Climate Agreement, and securing a safe operating space for humanity.

Doctors For Nutrition praises the NHMRC for addressing the urgent need to promote diets that are healthy and have low environmental impacts. We look forward to seeing sustainability woven through the revised Australian Dietary Guidelines when the final updates are published in 2026.

Have you seen the news?

On Sunday evening 25 February 2024, Dr. Heleen Haitjema, co-founder and board director of DFN, joined a debate on the new Sky News ‘The Jury’ program, and provided her expert opinion on the pressing need to decrease red meat consumption to counteract the damaging environmental and climate consequences of meat production.

Watch the recording here

February 26, 2024
Free yourself from gluten fear

The gluten-free market is booming. Is it time you got on board? Should you be worried about gluten? Article first published in Vegan and Plant Based Living Magazine New Zealand.

Gluten, a protein found in wheat, barley, rye, and potentially oats, is a common ingredient in many foods. It is naturally occurring but can be added to provide flavour and an irresistible texture to tasty foods like bread, pasta, and baked goods. It also acts as a binding agent in processed foods, giving them shape.

Sometimes it may also be lurking in unexpected places, such as herbs, nutritional supplements and even your toothpaste.

Is this very common protein something we need to avoid?

Friend or faux

Globally the gluten-free market is worth more than AU$30 billion and rapidly growing. More and more people are ‘going gluten-free’ for health reasons, convinced that gluten-free products are a healthier choice. However, in reality it may be quite the opposite.

For the small percentage of us (about 1%) diagnosed with coeliac disease, there is no question that a strict gluten-free diet is the only option. Coeliac disease is an autoimmune disorder, not a food allergy, where the immune system mistakenly attacks the lining of the small intestine when gluten is present, leading to damage, inflammation, and nutrient malabsorption. Blood tests and a small bowel biopsy are required to confirm diagnosis.

In addition to coeliac disease, an estimated 3% of us may suffer from non-coeliac gluten sensitivity (NCGS). NCGS can be harder to diagnose because there are no specific biomarkers, and the symptoms overlap with many other gastrointestinal issues. Diagnosis requires a supervised elimination diet.

If you’ve worked with your healthcare professional and ruled out coeliac disease or NCGS but feel better when you go gluten-free, there may be a couple of very good explanations.

Firstly, a large number of foods containing gluten are processed. Think breads, pasta, pizza, cereals and processed meats – the list goes on. Dr Will Bulsiewicz, US-based Gastroenterologist, explains: “That is one of the main reasons people may feel better when they go gluten-free … they are eliminating many ultra-processed foods from their diet”.

Secondly, for a small number of people, the problem isn’t gluten itself but rather fermentable carbohydrates (known as FODMAPs) often found in gluten containing foods, specifically fructans.

For those individuals, fructans are not well-absorbed in the small intestine and can ferment in the large intestine, causing digestive issues. Cutting out gluten-containing foods alone alone will not solve gut issues; it also requires removing other high-fructan-containing foods like watermelon, broccoli, and cashews. Diagnosis and treatment requires working with a registered dietitian to follow a low-FODMAP diet and subsequent reintroduction.

Wholesome variety for happy tummies

For the vast majority of us there is no good reason to remove gluten from our diets; in fact, we are doing ourselves a disservice.

Some gluten-free options can be highly processed, contain less protein, lack fibre and have higher levels of salt and saturated fats, compared to their gluten-containing counterparts.

Some gluten-free options can be highly processed, contain less protein, lack fibre and have higher levels of salt and saturated fats, compared to their gluten-containing counterparts.

The inflammatory effects of gluten are often sighted as a reason people cut it out. This is true for people with coeliac disease but for most of us it’s the opposite – gluten-containing foods, specifically whole grains, have been associated with reducing inflammation.

The power of a variety of whole grains also benefits our heart health. In 2017, a study of over 100,000 participants found that people without coeliac disease who restricted gluten intake had an increased risk of heart disease (one of the leading causes of death in Australia and New Zealand) compared with those with a higher gluten intake. Why? You guessed it, a lower consumption of whole grains.

Moreover, gluten has been shown to act as a prebiotic, feeding the “good” bacteria in our microbiome and keeping the bad guys at bay. For example, a prebiotic carbohydrate derived from wheat bran, stimulates the activity of the probiotic bifidobacteria in our colon. This important probiotic helps digest fibre, prevents infections, and produces compounds, such as B vitamins and healthy fatty acids.

Cost is also a consideration. Gluten-free foods are often more expensive than similar foods containing gluten, sometimes costing twice as much. This can make following a gluten-free diet expensive if you have no medical reason to do so.

The final verdict – seek a proper diagnosis before eliminating gluten. If you think you are one of the small percentage negatively impacted by gluten, it is crucial to be assessed by a health professional before making any dietary changes.

This is undoubtedly one of those times to heed the wise words of your mother and consider, “if everyone else was to jump off a bridge, would you?”.

A diverse diet, filled with a variety of whole grains, supports a healthy heart, reduces inflammation and promotes a thriving gut microbiome. Your body will thank you with every delicious bite.

This article is republished with permission from Vegan & Plant Based Living.

February 2, 2024
Dine with a Doc – Melbourne, 2024

Doctors For Nutrition hosted a ‘Dine with a Doc’ dinner with Prof. Kim Williams, US Cardiologist.

The evening was a huge success and we had an amazing turn-out of DFN supporters, physicians, dietitians, medical students and friends from both Melbourne, and other states of Australia!

Prof Kim Williams launched the event with an insightful and informative presentation, highlighting how diet-related disease, particularly cardiovascular disease, is the biggest killer in the Western world. He then commented on findings of his recent publication ‘What’s on our plate? Healthful vs. Unhealthful Eating Habits of Physicians’, which showed only 4% of physicians were eating a heart-healthy diet and only one of them was vegan.

Williams then invited the audience to comment on Chat GPT’s answers to the question: ‘If plant-based diets are associated with lower death rates and less chronic disease, help sustain the planet and avoid animal cruelty, why are they not widely adopted?’ To view the top 10 AI-generated answers, check out Kim’s slides from the evening.

Prof. Kim Williams is well known for his famous quote: “There are two types of cardiologists, vegans and those who haven’t read the data”. From hearing Prof Kim Williams speak it was clear that there are in fact three types of cardiologists, the third group being those who have read the data but have personal barriers to change!

There are two types of cardiologists, vegans and those who haven’t read the data

A whole food plant-based buffet, full of delicious nutrient-dense dishes, was served and was a great way to complete the evening. People chatted, made connections, and networked over a plate of heart-healthy food!

DFN staff, supporters, and advisory council members then met the following morning to brainstorm future collaborations and how we can raise awareness of whole food plant-based nutrition for preventing and reversing chronic disease so that everyone can thrive and live to their full potential.

To stay in the loop about future events, make sure you subscribe to our mailing list and keep an eye on our social media accounts!

January 17, 2024
Doctors For Nutrition 2023: Year In Review
At the end of another fulfilling year, we evaluate our achievements and look forward to maximising our impact in the exciting year ahead.

In 2023, resilience prevailed amidst national and international challenges, sparking shifts in priorities. Growing environmental concerns, and economic strains fueled a push towards plant-based choices.

Weather-related events such as wide-spread flooding, bush fires and a peak in average temperatures highlighted the need for sustainability. The ongoing cost-of-living crisis prompted many of us to seek out ‘savvy sustenance’: getting back to basics with nourishing and budget-friendly meals. We continued to spend more time at home than ever before, in Australia roughly 40% of us now work remotely, growing interest in healthy home cooking.

Doctors For Nutrition set the tone for 2023 within our own community by hosting Australasia’s only whole food plant-based nutrition conference. We gathered over 250 like-minded people in Melbourne to showcase both the long-established and the latest research on the leading lifestyle factor to influence health outcomes: our diet. The momentum of this cornerstone event continued throughout the year with many conversations and connections growing.

During the rest of year we fast-tracked hundreds of GPs, medical students and health professionals, teaching them how to improve patient outcomes through plant-based nutrition, via our Prescribing Nutrition course.

We continued to inform many thousands of people across the healthcare sector and wider community through educational webinars, resources, mainstream and social media. We also spoke face-to-face with health professionals and medical students.

Finally we wrapped up 2023 with the Doctors Health Challenge — helping health professionals to better understand and assist their patients in implementing lifestyle changes by making those changes themselves!

See details of the year’s achievements in the snapshots below, and read on to discover what’s in store for 2024.

Over 250 delegates, the majority of whom were healthcare professionals, gathered in-person or virtually. Those joining face-to-face gathered in Australia’s cultural capital, Melbourne. The conference ran over two full days and we were joined by 24 local and international experts. Delegates learnt about the role of a whole food plant-based approach to eating in the prevention, management and reversal of numerous chronic disease conditions.

A key focus of the event was providing practical tools and techniques to support delegates in transitioning to a whole food plant-based diet themselves or helping their patients to do so. Interactive sessions facilitated real-time responses to the most popular questions from the crowd.

Outside of the main academic program there were many other opportunities in which to partake: chances to get moving including a mindfulness session, a run and a guided walk.

Explore a brief recap on the academic sessions throughout the two days and learn how you can access the full recordings.
Growing our reach

In 2023 we:

Built our e-list to 7,770 subscribers; gaining an average of 77 new subscribers every month.

Had over 35,000 active users on our website; with our recipe collection and our NIHC23 conference pages proving highly popular.

Provided free resources to our community. There were 2,676 downloads from our website.

Added 9 new plant-friendly clinicians to our website.

Hit 20,000 social follows, an average of 304 new subscribers every month.

Began our new bi-monthly e-newsletter — a newsletter keeping our audience abreast of news, views and insights across the plant-based community.

Continued providing our expert-opinion across a range of magazines, newspapers, radio, podcasts and websites.
Prescribing Nutrition

In 2023 we:

Up-skilled 379 doctors and medical students via a blended learning course.

Helped 100% of our participants feel more confident talking with patients about plant-based diets.

Feedback shows that the course fills an important knowledge gap; rather than turning to medication, they now have another tool in their bag…whole food plant-based nutrition.

Learn more about our free online course for GPs, medical students & health professionals.
Doctors Health Challenge

In 2023 we launched the Doctors Health Challenge. We set out to show GP’s first hand the benefits of whole food plant-based nutrition. Ultimately, we wanted to increase the number of GP’s championing whole food plant-based nutrition in patient care and also teach them how to make a dietary shift, providing the necessary tools to assist their own patients.

The month long challenge included bite-sized lessons on topics such as simple meals and convenience foods for busy professionals through to medication modification that may be required. The challenge also offered an online live cooking demo, online Q&A sessions and a final challenge celebration.
Food Vitals Webinars

In 2023 we hosted 5 Food Vitals Webinars. The topics covered were:

The role of nutrition in women’s hormonal health and polycystic ovarian syndrome (PCOS)

Chronic kidney disease: the role of nutrition

The role of nutrition in acne

Breast cancer: the role of nutrition

Remission of rheumatoid arthritis with nutrition
Face-to-face events

WONCA, Sydney

ASLM, Melbourne

GPCE, Melbourne

AMSA, Gold Coast
Besides hosting our own event we were out and about in the community. In 2023 we reached more than 2,700 health professionals and medical students by collaborating, presenting and exhibiting at 4 health conferences and events:

Australian Medical Students Association (AMSA) National Convention on the Gold Coast

Australian Society of Lifestyle Medicine (ASLM) Conference in Melbourne

WONCA Sydney

General Practice Conference and Exhibition (GPCE) Melbourne

More than 2,600 Doctors For Nutrition resources were distributed to health professionals and medical students, including ‘Plant-based nutrition: A guide for health professionals’, patient handouts and meal plans.

Our team had 820 face-to-face interactions with health professionals and medical students, many of whom were excited to hear about a charity promoting the important role of plant-based nutrition in healthcare.
Fundraising

Doctors For Nutrition is a fully independent charity that relies solely on donations. We are able to deliver all that we do thanks to the generosity of our donors.

A generous donor offered us the opportunity to raise funds by matching up to $50,000 of donations received up until 31 December 2023. We were so grateful to our supporters to helped us raise $47,116. This equated to an impressive $94,231 in matched donations!

In recognition of the importance of future healthcare professionals, Doctors For Nutrition were fortunate to be able to offer five scholarship places to our Nutrition in Healthcare Conference, also made possible by the generosity of our donors.

Medical students who received NIHC Scholarships

The year ahead

Next year we will run the Doctors Health Challenge again, continue with our much-enjoyed Food Vitals Webinars and up-skill more health professionals via our Prescribing Nutrition course.

For the broader community, we also look forward to delivering a series of online cooking demonstrations and are in the midst of developing a new course to help transition to whole food plant-based nutrition for life.

Alongside these projects, we’ll be continuing to strengthen and grow alliances with other organisations and seek impactful opportunities to gain traction for our messages about whole food plant-based nutrition for health — human health and planetary health.

From all of us at Doctors For Nutrition, thank you for accompanying us on our mission. We’re excited about what the future holds, and we’re looking forward to your support.

If you’d like to get involved in supporting our work you can find out more now.
December 20, 2023
Inaugural Doctors Health Challenge

A taste of wellness: healthcare professionals embrace a month of WFPB eating

Throughout November, we ran our FREE Doctors Health Challenge. Over 200 healthcare professionals—who were not following a whole food plant-based eating pattern—signed up to experience the benefits of this way of eating. Guided by doctors and dietitians, this self-paced challenge was designed to help healthcare professionals better understand and assist their patients in implementing lifestyle changes while reaping the health benefits.

In terms of self-reported dietary patterns of our pre-challenge survey respondees, the largest group was Reducetarians (actively reducing their intake of animal products), followed by Omnivores and Pescatarians. Almost 60% of participants had dabbled in trying a whole food plant-based diet at some point.

The challenge was crafted to provide the necessary support and practical guidance for individuals looking to try out a whole food plant-based lifestyle, hoping to help them stick with it if they choose to do so.

Even if participants didn’t fully adopt the lifestyle after the challenge, the trial granted them insight into the experiences of their patients pursuing similar health paths.

The Doctors Health Challenge’s success was also in its transformative impact on participants. The multifaceted approach, including cooking demonstrations, live Q&As, and a self-paced online course system, offered practical guidance and accessible learning avenues.

The suggested food swaps proved invaluable, enabling easy transitions toward plant-centric meals. Modules covering how to choose healthier options at the supermarket as well as when dining out, and how to put together balanced meals without recipes, served as a link between understanding what to do and effectively implementing it.

Trying recommended recipes became a delightful exploration, showcasing the delicious possibilities of whole food plant-based cuisine. Additionally, the guidance on adapting existing family meals helped integrate healthier options into daily routines.

However, what truly resonated with participants was the education about how whole food plant-based eating is a preventive measure against chronic diseases. This knowledge empowered them to make informed choices about their health.

[I joined the challenge] to become healthier and to know firsthand what this is like so I can help my patients overcome any barriers.

– GP, South Australia

Many individuals joined with the goal of enhancing their own and their families’ dietary habits, as well as aiding their patients. With a significant population grappling with lifestyle-induced chronic illnesses like Type 2 diabetes and cardiovascular disease, possessing expertise in a healing dietary approach facilitates more effective conversations about addressing these conditions.

The post-challenge survey revealed a remarkable shift in mindset among the respondees. An overwhelming 90% expressed their intention to incorporate significantly more whole plant foods into their diets, indicating a profound and lasting impact. The combination of practical tools, educational resources, and the enticing appeal of plant-based meals spurred immediate changes and fostered a long-term commitment to healthier eating habits among many healthcare professionals.

Due to the interest and enthusiasm we’ve had, we’re looking to run another version of the challenge in 2024, expanding its reach to a wider audience eager to embrace the benefits of whole food plant-based eating. You can register your interest to keep in the loop about when this will happen.

December 19, 2023
Doctors For Nutrition’s call for change
The House of Representatives Standing Committee on Health, Aged Care, and Sport undertakes an inquiry into diabetes in Australia, with a view to improving policies and supporting all Australians.
The House of Representatives Standing Committee on Health, Aged Care, and Sport (the Committee) has embarked on a critical journey—an inquiry into diabetes in Australia.

Urgent action is needed.

1 in 20 Australians are living with diabetes. This number has increased almost 2.8-fold between 2000 and 2021. This figure is likely to be higher as it is estimated 500,000 people are living with silent, undiagnosed type 2 diabetes.

This inquiry aims to draw conclusions and recommendations based on submissions and evidence, with a focus on:

Understanding the root causes of diabetes

Exploring new evidence-based advances in prevention and management

Evaluating the broader impacts of diabetes on Australia’s health system and economy

Examining interrelated health issues between diabetes and obesity in Australia

Assessing the effectiveness of current Australian Government policies and programs

With a vision for a world free of preventable diseases, DFN commends the Committee’s efforts to improve policies and support systems, ultimately benefiting all Australians.
The crucial role of diet in diabetes prevention

The underlying mechanism of type 2 diabetes, comprising 85% of reported cases, is insulin resistance. Contrary to popular belief, it is not carbohydrates or sugar that cause insulin resistance. Insulin resistance is caused by a build-up of fat inside muscle and liver cells. Fat stored in these cells reduces their sensitivity to insulin, resulting in increased blood glucose levels.

Type 2 diabetes remains largely preventable by maintaining a healthy lifestyle. DFN champions a whole food plant-based (WFPB) eating pattern as the key intervention.

Research has consistently demonstrated the numerous benefits of a WFPB eating pattern for the prevention and reversal of diabetes, including weight loss, improved insulin sensitivity, blood sugar regulation, reduced inflammation, and a lower risk of comorbidities.

Prevention before cure

DFN advocates for the prevention of disease. Our healthcare system is designed to treat illness and is poorly equipped to assist the general population in preventing chronic illness; especially in the case of type 2 diabetes.

Researchers have found that people who followed a vegan diet had a 78% lower risk of developing diabetes, compared to non-vegetarians. We also know that a plant-based diet can improve long-term glucose control and reduce the need for medication.

People who followed a vegan diet had a 78% lower risk of developing diabetes, compared to non-vegetarians.

The cost of diabetes

Considerations of cost must extend beyond the serious financial implications, there is also the profound physical, mental, and emotional toll on those affected, along with their families and broader networks.

The economic cost of diabetes in Australia was $14.6 billion in 2017.

WFPB nutrition not only effectively manages the disease but also offers significant additional advantages, notably its environmental sustainability. In a time when three-quarters of the nation express concerns about climate change, this presents a substantial and encouraging aspect.

Obesity as a risk factor

The interrelatedness between diabetes and obesity is indisputable. Up to 60% of type 2 diabetes diagnoses can be attributed to excess weight or obesity. Plant-based diets result in greater weight loss compared to a non-vegetarian diet.

Calling for effective prevention strategies

DFN suggests that the Australian Dietary Guidelines review, regulation to discourage poor food choices and education must be at the forefront of change.

Our participation in the ‘Inquiry into Diabetes in Australia’ isn’t simply a response—it’s a passionate plea for change. Our submission underlines the potential of nutrition in preventing and managing diabetes, urging a shift toward evidence-based, preventative healthcare policies.

We firmly believe that concerted efforts can transform the landscape of diabetes management for a healthier, more informed future.

Read the full submission (including references).

You can also view Dr. Neal Barnard (MD, FACC, Adjunct Professor of Medicine at the George Washington University School of Medicine in Washington, D.C.) presenting research on nutrition and T2DM during a 2022 Food Vitals webinar.
November 29, 2023
Australasian Society of Lifestyle Medicine Conference 2023: BETTER HEALTH FOR ALL

Doctors For Nutrition were proud sponsors of the Australasian Society of Lifestyle Medicine Conference, LM23. The event offered high-level training for health professionals in the application and implementation of Lifestyle Medicine.

Through practitioner education, awareness, advocacy, and research and development, the Australasian Society of Lifestyle Medicine is transforming healthcare so that lifestyle modification is always considered in the prevention, treatment and management of chronic and lifestyle-related disease.

Lifestyle Medicine addresses the root causes of disease with evidence-based lifestyle behaviours, including exercise, diet, sleep, social connectivity and stress management.

Compared to many medications, it is relatively inexpensive, widely accessible, safe, and free of all but good side effects. As such, it is well placed to improve health outcomes among marginalised and disadvantaged communities.

LM23 BETTER HEALTH FOR ALL was a two-day international conference held at the Pullman Albert Park, Melbourne, Victoria.

Encouraging patients to transition to a whole food plant-based diet is the way of the future.

DFN proudly hosted an exhibit at this two day event, meeting with delegates and sharing our free resources. Advisory council members Dr Juliette Roex and Dr Peter Johnston, APD joined Nina Trinquet, APD and Rebecca Stonor (DFN Social Media and Events Lead), engaging in conversations with healthcare professionals interested in prescribing nutrition.

Many engaged and interested healthcare practitioners, including nurses, health coaches, dietitians, dentists, general practitioners and specialists, were keen to learn about the benefits of whole food plant-based nutrition for disease prevention, management and reversal. They were grateful for our patient handouts, meal planner, shopping list and recipe cards, all of which could make the transition to a plant-based diet easier for their patients.

A GP from NSW agreed wholeheartedly with our vision, stating that “encouraging patients to transition to a whole food plant-based diet is the way of the future”. She currently talks about nutrition to all of her patients and understands that a healthy way of eating can prevent many of the chronic health conditions she sees on a daily basis.

Many doctors walked away excited about joining our Doctors Health Challenge and also encouraged their peers to register!

For more information on how to get involved in lifestyle medicine, visit the ASLM membership page.

September 18, 2023
2023 Australian Dietary Guidelines Review
After a long wait, the review of the 2013 Australian Dietary Guidelines (ADG) has progressed to the next phase — high priority research questions have been announced and the topics look favourable.

During 2021 the National Health and Medical Research Committee (NHMRC), responsible for the ADG review, conducted scoping activities to refine the areas considered for an update.

DFN participated in the scoping phase. The headline topics that were flagged included:
Update the ‘lean meat and alternatives’ food group to recommend plant sources of protein in preference to animal sources

Remove red meat entirely from the current ‘lean meat and alternatives’ food group

Remove milk/yoghurt/cheese and alternatives as a standalone food group

Provide clarity about the health benefits of carbohydrates and starches from whole food sources, in the face of dangerous ‘high fat low carb’ diet trends

Stronger emphasis on the health benefits of plant-based eating patterns

Integration of environmental sustainability considerations into the guidelines, highlighting the co-benefits of plant-based diets for both human and planetary health

Proceed with caution on dietary cholesterol due to evidence on its health risks, especially among hyper-responders

Ensure the new guidelines recognise the proven affordability of plant-predominant diets in comparison to standard Australian diets
‘Very high priority’: plant sources of protein, dietary patterns and sustainability

The NHMRC has prioritised a preliminary list of potential topics, ranked from very-high to low priority. It’s a very positive indication that the majority of topics DFN flagged back in 2021 are up for further exploration.

A literature search and public call for systematic reviews based on these topics is currently underway.
The topics that have been identified as the highest priority are intake/exposure and health outcomes for:

dietary patterns relevant at a population level (a plant-based diet is referenced as one such pattern)

animal vs plant sources of protein (specifically protein intake from plant-based sources vs from animal sources, high vs low intake of plant foods, high vs low intake of animal foods and dairy vs dairy alternatives)

high vs low/no intake of ultra-processed foods

Part of the fact-finding work to narrow down the topics was a survey targeted at all people who use the current ADGs, including those who use them for work (clinicians, researchers, educators, policy makers) or as a personal information source (e.g., consumers). A whooping 33% wanted to see plant-based diets included in the updated guidelines.
33% wanted to see plant-based diets included in the updated guidelines.

The full table of priorities can be viewed on the NHMRC website.

A focus on sustainability

The relationship between dietary patterns and/or food intakes and sustainability outcomes was also identified as a very high priority and will be addressed via a separate process.

The NHMRC acknowledges that there is an increasing population interest in eating sustainably and that the health impacts of some of these diets is not known to them, in some part due to the extensive progression there has been in knowledge since the 2013 ADGs.

One important source of knowledge that the NHMRC is likely to be scrutinising is the 2019 EAT-Lancet Commission on Food, Planet, Health. They brought together 37 world-leading scientists from across the globe to answer the question: Can we feed a future population of 10 billion people a healthy diet within planetary boundaries? The answer was a resounding ‘yes’, through a predominantly whole food plant-based diet. DFN looks forward to seeing the critical need for a shift to plant-based nutrition elevated during the exploration of sustainable diets.

Enriching the evidence base

As part of our submission, DFN supplied multiple systematic reviews addressing the NHMRC criteria. The full list of research submitted can be viewed below.
Citations of papers submitted

Dybvik JS, Svendsen M, Aune D. Vegetarian and vegan diets and the risk of cardiovascular disease, ischemic heart disease and stroke: a systematic review and meta-analysis of prospective cohort studies. Eur J Nutr. 2023 Feb;62(1):51-69. doi: 10.1007/s00394-022-02942-8. Epub 2022 Aug 27. PMID: 36030329; PMCID: PMC9899747.

Zhao Y, Zhan J, Wang Y, Wang D. The Relationship Between Plant-Based Diet and Risk of Digestive System Cancers: A Meta-Analysis Based on 3,059,009 Subjects. Front Public Health. 2022 Jun 3;10:892153. doi: 10.3389/fpubh.2022.892153. PMID: 35719615; PMCID: PMC9204183.

Gan ZH, Cheong HC, Tu YK, Kuo PH. Association between Plant-Based Dietary Patterns and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Nutrients. 2021 Nov 5;13(11):3952. doi: 10.3390/nu13113952. PMID: 34836208; PMCID: PMC8624676.

Jafari S, Hezaveh E, Jalilpiran Y, Jayedi A, Wong A, Safaiyan A, Barzegar A. Plant-based diets and risk of disease mortality: a systematic review and meta-analysis of cohort studies. Crit Rev Food Sci Nutr. 2022;62(28):7760-7772. doi: 10.1080/10408398.2021.1918628. Epub 2021 May 6. PMID: 33951994.

Zheng J, Zhu T, Yang G, Zhao L, Li F, Park YM, Tabung FK, Steck SE, Li X, Wang H. The Isocaloric Substitution of Plant-Based and Animal-Based Protein in Relation to Aging-Related Health Outcomes: A Systematic Review. Nutrients. 2022 Jan 9;14(2):272. doi: 10.3390/nu14020272. PMID: 35057453; PMCID: PMC8781188.

Gibbs J, Gaskin E, Ji C, Miller MA, Cappuccio FP. The effect of plant-based dietary patterns on blood pressure: a systematic review and meta-analysis of controlled intervention trials. J Hypertens. 2021 Jan;39(1):23-37. doi: 10.1097/HJH.0000000000002604. PMID: 33275398.

Kazemi A, Barati-Boldaji R, Soltani S, Mohammadipoor N, Esmaeilinezhad Z, Clark CCT, Babajafari S, Akbarzadeh M. Intake of Various Food Groups and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Adv Nutr. 2021 Jun 1;12(3):809-849. doi: 10.1093/advances/nmaa147. PMID: 33271590; PMCID: PMC8166564.

Schwingshackl L, Schwedhelm C, Hoffmann G, Knüppel S, Laure Preterre A, Iqbal K, Bechthold A, De Henauw S, Michels N, Devleesschauwer B, Boeing H, Schlesinger S. Food groups and risk of colorectal cancer. Int J Cancer. 2018 May 1;142(9):1748-1758. doi: 10.1002/ijc.31198. Epub 2017 Dec 14. PMID: 29210053.

Lee KW, Loh HC, Ching SM, Devaraj NK, Hoo FK. Effects of Vegetarian Diets on Blood Pressure Lowering: A Systematic Review with Meta-Analysis and Trial Sequential Analysis. Nutrients. 2020 May 29;12(6):1604. doi: 10.3390/nu12061604. PMID: 32486102; PMCID: PMC7352826.

Koch CA, Kjeldsen EW, Frikke-Schmidt R. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. Eur Heart J. 2023 Jul 21;44(28):2609-2622. doi: 10.1093/eurheartj/ehad211. PMID: 37226630; PMCID: PMC10361023.

Tomé-Carneiro J, Visioli F. Plant-Based Diets Reduce Blood Pressure: A Systematic Review of Recent Evidence. Curr Hypertens Rep. 2023 Jul;25(7):127-150. doi: 10.1007/s11906-023-01243-7. Epub 2023 May 13. PMID: 37178356; PMCID: PMC10224875.

Jarvis SE, Nguyen M, Malik VS. Association between adherence to plant-based dietary patterns and obesity risk: a systematic review of prospective cohort studies. Appl Physiol Nutr Metab. 2022 Dec 1;47(12):1115-1133. doi: 10.1139/apnm-2022-0059. Epub 2022 Aug 19. PMID: 35985038.

Craddock JC, Neale EP, Peoples GE, Probst YC. Vegetarian-Based Dietary Patterns and their Relation with Inflammatory and Immune Biomarkers: A Systematic Review and Meta-Analysis. Adv Nutr. 2019 May 1;10(3):433-451. doi: 10.1093/advances/nmy103. PMID: 30947338; PMCID: PMC6520040.

Nachvak SM, Moradi S, Anjom-Shoae J, Rahmani J, Nasiri M, Maleki V, Sadeghi O. Soy, Soy Isoflavones, and Protein Intake in Relation to Mortality from All Causes, Cancers, and Cardiovascular Diseases: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. J Acad Nutr Diet. 2019 Sep;119(9):1483-1500.e17. doi: 10.1016/j.jand.2019.04.011. Epub 2019 Jul 2. PMID: 31278047.

Liu Y, Zhu L, Li D, Wang L, Tang H, Zhang C. Stroke risk with vegetarian, low-animal and high-animal diets: A systematic review and meta-analysis. Asia Pac J Clin Nutr. 2022;31(3):422-432. doi: 10.6133/apjcn.202209_31(3).0010. PMID: 36173214.

Fan M, Li Y, Wang C, Mao Z, Zhou W, Zhang L, Yang X, Cui S, Li L. Dietary Protein Consumption and the Risk of Type 2 Diabetes: ADose-Response Meta-Analysis of Prospective Studies. Nutrients. 2019 Nov 15;11(11):2783. doi: 10.3390/nu11112783. PMID: 31731672; PMCID: PMC6893550.

Gao X, Zheng Q, Jiang X, Chen X, Liao Y, Pan Y. The effect of diet quality on the risk of developing gestational diabetes mellitus: A systematic review and meta-analysis. Front Public Health. 2023 Jan 9;10:1062304. doi: 10.3389/fpubh.2022.1062304. PMID: 36699870; PMCID: PMC9868748.

Qi XX, Shen P. Associations of dietary protein intake with all-cause, cardiovascular disease, and cancer mortality: A systematic review and meta-analysis of cohort studies. Nutr Metab Cardiovasc Dis. 2020 Jun 25;30(7):1094-1105. doi: 10.1016/j.numecd.2020.03.008. Epub 2020 Mar 17. PMID: 32451273.

Lambert V, Muñoz SE, Gil C, Román MD. Maternal dietary components in the development of gestational diabetes mellitus: a systematic review of observational studies to timely promotion of health. Nutr J. 2023 Mar 7;22(1):15. doi: 10.1186/s12937-023-00846-9. PMID: 36879315; PMCID: PMC9990275.

Zargarzadeh N, Mousavi SM, Santos HO, Aune D, Hasani-Ranjbar S, Larijani B, Esmaillzadeh A. Legume Consumption and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Adv Nutr. 2023 Jan;14(1):64-76. doi: 10.1016/j.advnut.2022.10.009. Epub 2023 Jan 5. PMID: 36811595; PMCID: PMC10103007.

Raghavan R, Dreibelbis C, Kingshipp BL, Wong YP, Abrams B, Gernand AD, Rasmussen KM, Siega-Riz AM, Stang J, Casavale KO, Spahn JM, Stoody EE. Dietary patterns before and during pregnancy and maternal outcomes: a systematic review. Am J Clin Nutr. 2019 Mar 1;109(Suppl_7):705S-728S. doi: 10.1093/ajcn/nqy216. PMID: 30982868.

Mendes V, Niforou A, Kasdagli MI, Ververis E, Naska A. Intake of legumes and cardiovascular disease: A systematic review and dose-response meta-analysis. Nutr Metab Cardiovasc Dis. 2023 Jan;33(1):22-37. doi: 10.1016/j.numecd.2022.10.006. Epub 2022 Oct 21. PMID: 36411221.

Bhandari B, Liu Z, Lin S, Macniven R, Akombi-Inyang B, Hall J, Feng X, Schutte AE, Xu X. Long-Term Consumption of 10 Food Groups and Cardiovascular Mortality: A Systematic Review and Dose Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr. 2023 Jan;14(1):55-63. doi: 10.1016/j.advnut.2022.10.010. Epub 2022 Dec 22. PMID: 36811594; PMCID: PMC10102997.

Koch CA, Kjeldsen EW, Frikke-Schmidt R. Vegetarian or vegan diets and blood lipids: a meta-analysis of randomized trials. Eur Heart J. 2023 Jul 21;44(28):2609-2622. doi: 10.1093/eurheartj/ehad211. PMID: 37226630; PMCID: PMC10361023.

Benatar JR, Stewart RAH. Cardiometabolic risk factors in vegans; A meta-analysis of observational studies. PLoS One. 2018 Dec 20;13(12):e0209086. doi: 10.1371/journal.pone.0209086. PMID: 30571724; PMCID: PMC6301673.

Quintela BCSF, Carioca AAF, de Oliveira JGR, Fraser SDS, da Silva Junior GB. Dietary patterns and chronic kidney disease outcomes: A systematic review. Nephrology (Carlton). 2021 Jul;26(7):603-612. doi: 10.1111/nep.13883. Epub 2021 Apr 28. PMID: 33864650.

Farvid MS, Sidahmed E, Spence ND, Mante Angua K, Rosner BA, Barnett JB. Consumption of red meat and processed meat and cancer incidence: a systematic review and meta-analysis of prospective studies. Eur J Epidemiol. 2021 Sep;36(9):937-951. doi: 10.1007/s10654-021-00741-9. Epub 2021 Aug 29. PMID: 34455534.

Ahmad Jabri, Ashish Kumar, Elizabeth Verghese, Anas Alameh, Anirudh Kumar, Muhammad Shahzeb Khan, Safi U. Khan, Erin D. Michos, Samir R. Kapadia, Grant W. Reed, Ankur Kalra, Meta-analysis of effect of vegetarian diet on ischemic heart disease and all-cause mortality, American Journal of Preventive CardiologyVolume 7, 2021,100182, ISSN 2666-6677, https://doi.org/10.1016/j.ajpc.2021.100182.

Viguiliouk E, Glenn AJ, Nishi SK, Chiavaroli L, Seider M, Khan T, Bonaccio M, Iacoviello L, Mejia SB, Jenkins DJA, Kendall CWC, Kahleová H, Rahelić D, Salas-Salvadó J, Sievenpiper JL. Associations between Dietary Pulses Alone or with Other Legumes and Cardiometabolic Disease Outcomes: An Umbrella Review and Updated Systematic Review and Meta-analysis of Prospective Cohort Studies. Adv Nutr. 2019 Nov 1;10(Suppl_4):S308-S319. doi: 10.1093/advances/nmz113. PMID: 31728500; PMCID: PMC6855952.
Evidence shows plant-based nutrition is a powerful lifestyle prescription. It can:

Help prevent [1], manage and reverse cardiovascular disease [2,3] and type 2 diabetes [4,5,6].

Prevent obesity [7,8] and promote healthy weight loss [9].

Optimise blood pressure and cholesterol, as effective as medication [7,8].

Reduce medications [9].

Reduce risk of certain cancers including breast [10], prostate [11] and bowel cancer [12].

Improve overall health in areas such as sexual function [13,14], gut microbiome [15], joint inflammation [16,17] and mental well-being [18].
What next?

Identified research will be collated and relevant reviews will be selected, in addition to recognising gaps in the evidence. Selected research will be used to update the guidelines and prioritise gaps where new evidence reviews may be required. A limited number of reviews will be commissioned to fill these gaps.

The timeline for the revised ADGs has been shifted out; they now will be launched in 2025.
Key references

Kim H, Caulfield LE, Garcia‐Larsen V, Steffen LM, Coresh J, Rebholz CM. Plant‐Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All‐Cause Mortality in a General Population of Middle‐Aged Adults. Journal of the American Heart Association. 2019;8(16). doi:10.1161/jaha.119.012865

Ornish D. Intensive Lifestyle Changes for Reversal of Coronary Heart Disease. Journal of the American Heart Association. 1998;280(23):2001. doi:10.1001/jama.280.23.2001

Esselstyn CB Jr, Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? J Fam Pract. 2014;63(7):356-364b. ncbi.nlm.nih.gov/pubmed/25198208.

Qian F, Liu G, Hu FB, Bhupathiraju SN, Sun Q. Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Intern Med. July 2019. doi:10.1001/jamainternmed.2019.2195

Tonstad S, Stewart K, Oda K, Batech M, Herring RP, Fraser GE. Vegetarian diets and incidence of diabetes in the Adventist Health Study-2. Nutr Metab Cardiovasc Dis. 2013;23(4):292-299. doi:10.1016/j.numecd.2011.07.004

Barnard ND, Cohen J, Jenkins DJA, et al. A Low-Fat Vegan Diet Improves Glycemic Control and Cardiovascular Risk Factors in a Randomized Clinical Trial in Individuals With Type 2 Diabetes. Diabetes Care. 2006;29(8):1777-1783. doi:10.2337/dc06-0606

Le LT, Sabaté J. Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts. Nutrients. 2014;6(6):2131-2147. doi:10.3390/nu6062131

Matsumoto S, Beeson WL, Shavlik DJ, et al. Association between vegetarian diets and cardiovascular risk factors in non-Hispanic white participants of the Adventist Health Study-2. J Nutr Sci. 2019;8:e6. doi:10.1017/jns.2019.1

Wright N, Wilson L, Smith M, Duncan B, McHugh P. The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutrition & Diabetes. 2017;7(3):e256-e256. doi:10.1038/nutd.2017.3

Hastert TA, Beresford SAA, Patterson RE, Kristal AR, White E. Adherence to WCRF/AICR cancer prevention recommendations and risk of postmenopausal breast cancer. Cancer Epidemiol Biomarkers Prev. 2013;22(9):1498-1508. doi:10.1158/1055-9965.EPI-13-0210

Ornish D, Weidner G, Fair WR, et al. Intensive lifestyle changes may affect the progression of prostate cancer. J Urol. 2005;174(3):1065-1069; discussion 1069-1070. doi:10.1097/01.ju.0000169487.49018.73

Bouvard V, Loomis D, Guyton KZ, et al. Carcinogenicity of consumption of red and processed meat. Lancet Oncol. 2015;16(16):1599-1600. doi:10.1016/S1470-2045(15)00444-1

La J, Roberts NH, Yafi FA. Diet and Men’s Sexual Health. Sexual Medicine Reviews. 2018;6(1):54-68. doi:10.1016/j.sxmr.2017.07.004

Towe M, La J, El-Khatib F, Roberts N, Yafi FA, Rubin R. Diet and Female Sexual Health. Sexual Medicine Reviews. 2020;8(2):256-264. doi:10.1016/j.sxmr.2019.08.004

David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559-563. doi:10.1038/nature12820

Clinton CM, O’Brien S, Law J, Renier CM, Wendt MR. Whole-foods, plant-based diet alleviates the symptoms of osteoarthritis. Arthritis. 2015;2015:708152. doi:10.1155/2015/708152

McDougall J, Bruce B, Spiller G, Westerdahl J, McDougall M. Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002;8(1):71-75. doi:10.1089/107555302753507195

Blanchflower DG, Oswald AJ, Stewart-Brown S. Is Psychological Well-Being Linked to the Consumption of Fruit and Vegetables? Soc Indic Res. 2013;114(3):785-801. jstor.org/stable/24720280
September 12, 2023
Perimenopause: the changes before the change
Navigating haywire hormones when approaching menopause can be challenging. Thankfully, there are lifestyle interventions that can help smooth the transition.

Article first published in Nourish Magazine.

Women are born with several million potential eggs in the form of ovarian follicles; what we have at birth is all we’ll ever have. As each month of menstruation passes, we are withdrawing from our ovarian reserve. By puberty, a woman’s egg count might be 1 million, at 25, maybe 300,000. Then, at around 35, the decline starts to get a bit steeper, until all eggs have been depleted. As the number of ovarian follicles containing the eggs drop, the production of oestrogen by the ovaries slows right down. Once the numbers drop to a critical level our periods stop. This is menopause.

A woman is said to be menopausal or post-menopausal when she has not had a period or any bleeding for one full year. The average age for menopause is 51 all over the world, ranging between 45 and 55 years of age. The lower oestrogen levels we experience trigger a response in our brain, increasing our follicular stimulating hormone levels. These hormonal changes are thought to cause the symptoms of menopause and perimenopause.

Perimenopause is the stage of life leading up to your last menstrual period. It usually lasts around four years although it may last anywhere from two to eight. The average age of perimenopause is 47 but it can start much earlier. For example, if you are destined to stop your periods around age 46 it may commence as early as in your late 30s. Perimenopause is a time in a woman’s life that is often marked with hormonal fluctuations, especially oestrogen levels.

Haywire Hormones

There are no hormone tests that can reliably diagnose perimenopause because levels can fluctuate widely on a day-to-day basis. Avoid blood, urine, and saliva tests as these are unproven, and of little help. Instead, a detailed medical history is usually all that is needed, while blood tests and pelvic scans might be suggested as individually appropriate. For example, a woman having heavy periods or recent onset of painful periods may have other conditions such as adenomyosis, fibroids, endometriosis, or polyps.

The thing to understand is that symptoms of perimenopause may start long before your periods stop, impacting both mental and physical health.

You may notice mood changes, crowding or skipping of menstrual cycles, erratic periods, heavy periods, hot flushes, worsening of premenstrual symptoms, and reduced libido. Sleep disturbances, loss of confidence, panic attacks, and heightened stress and anxiety are also common. It’s a time when many notice unwanted weight gain that is harder to shift, even though exercise and calorie intake remain the same. The intensity and frequency of symptoms varies for each woman as hormones fluctuate, with some months being completely symptom-free.

Unfortunately, the fact that the most common symptoms associated with menopause may be experienced by women in perimenopause is not often emphasised.

Smoothing the transition

Every aspect of health, at every age and stage of life, benefits from nutrition and lifestyle changes. This is especially true during perimenopause, a phase in our lives where we should start paying attention to our body and our metabolism. It’s also a responsibility-laden time of life when we may tend to neglect ourselves while we are taking care of everyone else!

Perimenopause and menopause affect half the world’s population. Yet, even with so many impacted, when it comes to the benefits of lifestyle modifications, with or without menopausal hormone therapy, there is still a lot of misinformation. There is no doubt that making behaviour and lifestyle changes can go a very long way, both in the short term and longer term, helping us to avoid unnecessary medications or surgery that can be associated with reaching the end of our childbearing years.

… when you sleep better, you tend to stress less, and make better food choices.
There are six pillars of lifestyle medicine that can help us make the transition through this phase of life with as few unpleasant symptoms as possible.

Shifting towards a whole food plant-based diet

Regular physical activity

Restorative sleep

Stress management

Avoidance of risky substances

Positive social connection

Start by improving one aspect of your lifestyle as this tends to cascade to other aspects of your life. For example, when you sleep better, you tend to stress less, and make better food choices. Reducing symptoms such as hot flushes and night sweats as well as improving mood and sleep with simple changes such as ensuring a regular bedtime routine, going for a walk outdoors, or doing a simple daily workout is usually achievable.

My advice to everyone is this: don’t wait until you are 50 to make these lifestyle changes. It’s never too early (or too late) to eat healthily, stress less, move more, sleep better, avoid alcohol and smoking, and build positive social networks to help you live your best life.
The Plant Panacea

Based on what I observe in my patients, the most dramatic positive changes occur when they avoid alcohol and smoking while switching to a colourful, plant-predominant diet. By this I mean adopting a diet packed with whole plant foods, such as antioxidant-rich, nutrient-dense fruits and vegetables that help reduce chronic inflammation. Fibre-rich beans, soy and intact wholegrains, as well as healthy fats from nuts and seeds can all help in reducing menopausal symptoms. Starchy vegetables such as sweet potatoes, potatoes with skin on, mushrooms, and herbs and spices are also excellent health-promoting foods easily included in everyday recipes.

The bottom line is that the same way of eating that helps prevent cancer is also the same one that can help manage perimenopausal symptoms.

As plant foods are naturally lower in calories, maintaining an optimal weight may also be a positive side effect of shifting towards plant-based nutrition. Excess weight is commonly associated with more severe menopausal symptoms (especially hot flushes) as well as an increased risk of many other common conditions we should consider as we age, like heart disease, dementia, and certain cancers.

Minimally processed soy should be enjoyed regularly. Soy is a bean packed with healthy plant oestrogens, fibre, protein, vitamins, and minerals. It is particularly good for lowering the incidence and the intensity of hot flushes.

Interestingly, what and how you ate as a child and young adult has an impact on your later years, including how you deal with perimenopause and menopause.

So, if you are parenting a girl, starting these healthful plant foods early in life will set her up for a smooth transition much later on. It is well documented that all long living, healthy societies around the world base the majority of their diet on whole or minimally processed plant foods. There really are no separate diets for different conditions. The bottom line is that the same way of eating that helps prevent cancer is also the same one that can help manage perimenopausal symptoms.

This article is republished with permission from nourishmagazine.com.au.
August 9, 2023
Leading by example

The tide is turning as we see more doctors recommending lifestyle interventions. Learn about Dr Ethan An’s approach to the nutrition prescription.

Sydney-based GP, Dr Ethan An, personally strictly adheres to whole food plant-based nutrition. How does he translate this into action for his patients, many of whom have not even considered diet change, and is he seeing success? Read our Q&A with this inspirational healthcare professional.

When did your interest in nutrition start?
Growing up, my father was a pharmacist with an interest in nutrition. He made his living from dispensing pharmaceutical products, but he believed that food was the best medicine.

He used to quote excerpts from books on the power of nutrition to prevent and treat heart disease and cancer. He tried to ban processed red meat and refined carbohydrates from the house, with varying degrees of success. This meant I always had the ‘food is medicine’ mantra buried somewhere deep in my consciousness, and didn’t resurface until I was in my late 30s when I started to develop early stage metabolic syndrome in the form of high cholesterol levels, raised fasting glucose, and stage 1 hypertension.

As a doctor, I knew that medications would not fix me, and I embraced a whole foods plant-based diet without hesitation, reversing my condition.

… the medical system is largely geared towards managing chronic disease, rather than addressing the root cause, which often lies in lifestyle factors.

During your medical training, was nutrition given much focus as an important part of preventative health or as a tool to treat patients?
During my studies, the medical school curriculum had an increased focus on prevention and holistic care, a shift away from strict anatomy/physiology/pathology-based courses of the past. Answers to exam questions about treatment options for a given condition always had to start with ‘lifestyle and non-pharmacological interventions’ to get full marks.

Even then, the idea of ‘nutrition as medicine’ did not get much airtime. Medical schools have always taught disease, not health, which is why the medical system is largely geared towards managing chronic disease rather than addressing the root cause, which often lies in lifestyle factors.

How do you encourage patients who are firmly against a diet change?
I find patients with chronic lifestyle-related diseases such as type 2 diabetes, obesity and heart disease often find a doctor focusing on lifestyle and nutrition quite refreshing. They have come to expect a quick renewal of their prescriptions and referrals during their visits.

Most people are receptive to the idea of changing their diet to improve their health. I have had some patients who flat-out reject reducing or eliminating animal products, but I believe that even seemingly unproductive discussions sow a seed in their minds, which may take years to sprout.

Talk us through a ‘success story’ you’ve had.
A patient last year was a middle-aged gentleman with obesity and high total cholesterol, high triglycerides and LDL cholesterol. Like many, he wasn’t keen on statins.

I discussed a plant-based diet with him. He said he would be happy to reduce his meat intake but didn’t think he could go completely plant-based. I gave him a referral for a repeat blood test and advised him to go on a meat-reduced diet and to return after a few months.

He came back exactly 21 days later. He had lost 2.5 kg and dropped his total cholesterol, triglycerides and LDL cholesterol by 24%, 30% and 23%, respectively. When I asked him what had happened, he told me he had implemented a completely plant-based diet. I saw him again just last month, and he has maintained his low lipid levels and has now lost 8 kg.

I find patients with chronic lifestyle-related diseases such as type 2 diabetes, obesity and heart disease often find a doctor focusing on lifestyle and nutrition quite refreshing.

Dr An is available for consultations. He is based in Balgowlah, New South Wales and is also available for telehealth consultations. To find out how to contact Dr An, visit his profile in our Find A Clinician Tool.

June 7, 2023
Foods with benefits
Wholefoods may just save your life, and at the very least, they will deliver a host of health benefits. Here’s what you need to know to get started.

Article first published in Nourish Magazine.

There are many ways to approach a plant-based diet, but from a medical perspective, the gold standard is wholefood plant-based nutrition, often simply called WFPB. This eating pattern includes an abundance of fruits, vegetables, intact wholegrains, legumes, nuts, seeds, herbs, and spices while excluding all animal products, including red and white meat, seafood, eggs, and dairy products. It eliminates fast foods, fried foods, refined and processed foods (including refined flour, oil, and refined sugars), and highly processed foods like chips, lollies, and chocolate – even if they are vegan. Salt, caffeine, alcohol, and artificial sweeteners are also avoided.

We might think of this way of eating as a nutrition prescription for wellness. The evidence-backed benefits of WFPB nutrition include:

Reduced overall mortality (dying from any cause)

Lower risk for many types of cancer

Lower chance of developing type 2 diabetes mellitus

Significantly less cardiovascular disease such as heart attacks or strokes

Lower blood pressure

Lower cholesterol

Healthier body weight.

We might think of this way of eating as a nutrition prescription for wellness.

For those struggling with diet-related chronic disease, switching to a WFPB pattern of eating can often significantly improve, or even reverse the disease process. In fact, a report prepared by the EAT-Lancet Commission, consisting of 37 world-leading scientists, suggested shifting to a plant-based diet could save 11 million lives per year. It’s the number one eating pattern with the potential to save lives!
Cut the calorie counting

Calorie counting and weighing or measuring foods is unnecessary for health, however, if you are transitioning from a refined, calorie-dense standard Western diet to a WFPB nutritional pattern, understanding calorie density in order to thrive is important.

Typically the majority of foods eaten on a WFPB nutritional plan are lower in calorie density, which simply means that larger portions need to be eaten to make up the same amount of calories. For example, one tablespoon of oil (high calorie density) contains 120 calories, whereas you’d need to eat four cups of broccoli (low calorie density) to consume the same calories. Likewise, 85 grams of steak has the same calories as an entire cup of lentils.

As a very general guide, when looking at your average day of eating on a plate, fill half your plate with vegetables and fruits and the other half with whole grains, starchy vegetables (such as potato, sweet potato, pumpkin, and peas), and legumes (such as lentils, beans, and chickpeas). Nuts, seeds, herbs, and spices can be used in smaller quantities for additional flavour and texture.

Switching from more refined and calorie-dense foods to whole plant foods often leads to effortless and hunger-free weight loss. However, if you feel more tired, hungry, or potentially start losing weight you don’t want to, it can be helpful to increase portions of healthy, more calorie-dense plant foods, such as legumes, wholegrains, nuts, and seeds.

Smart switches

Let’s consider the healthiest plant-based alternatives for a few common items you’ll be looking to replace.

Milk

Choose a plant milk with minimal ingredients, ideally containing just the main ingredient and water, free from added sugars, oils, additives, preservatives, or synthetic vitamins and minerals.

Cheese

Blitzing nuts, seeds, or even oats can substitute for parmesan, especially if you add in some herbs and spices. Nut and seed butters, such as cashew or sunflower, can substitute for soft cheeses in recipes when thinned out with water. Just remember, nuts and seeds are high in fat, so be mindful of portion sizes. Homemade hummus, blended beans, and sauces made with potato, carrot, pumpkin, or cauliflower can also make delicious cheese-like sauces.

Ice-cream

Try frozen banana, mango, and other fruit blends to make a sweet dairy-free dessert.

Meat

Some vegetables and fungi can provide the chewy, meat-like texture many people are used to – mushrooms are a great example, especially shredded oyster or king oyster. Beans and other legumes work well to provide the ‘filling-factor’ that meat often contributes to meals. This works perfectly for many family favourites, including bolognese, tacos, and burger patties. Grains such as quinoa, buckwheat, and oats can also be a substitute for minced meat.

Seafood

Artichoke hearts, jackfruit, and banana blossom can provide the ‘flaky’ texture in seafood dishes, while adding a small amount of dried celery, seaweed, lemon, or dill can give the right flavour boost.

Nutrient know-how

You might have questions or even preconceptions about meeting your nutritional needs when switching to a WFPB nutritional pattern. The reality is, calorie for calorie, those eating animal-free diets typically get higher intakes of nearly every nutrient – fibre; vitamins A, C, E, and B; folate; potassium; and minerals like calcium, magnesium, and iron.

Calorie for calorie, those eating animal-free diets typically get higher intakes of nearly every nutrient.

WFPB eating also comes with dramatically less sodium and saturated fat, and no dietary cholesterol. A well-designed plant-based nutritional plan is appropriate for all ages and all stages including children, athletes, the elderly, and during pregnancy. Despite this, common myths remain. Let’s debunk a few.

Protein

Protein is the number one nutrient of concern for many, and typically of the least concern for medical professionals skilled in WFPB nutrition. Plant-based dietary patterns, especially wholefood plant-based dietary patterns, easily contain more than sufficient protein, and also come packed with other health-promoting nutrients. For example, one cup of cooked lentils comes with 22 grams of protein, 2 milligrams of iron, and 18 grams of fibre. On the other hand, a 100 gram serve of beef has a similar amount of protein and iron, zero fibre, and also comes with 12 grams of saturated fat.

The common myth that plant foods need to be combined or complemented to meet protein and amino acid requirements has been long disproven. We can easily meet the requirements needed for optimal health without considering percentages or types of amino acids, protein quality, availability, or digestibility. If you are eating enough calories, you’ll mostly likely get all the protein you need, and well above the recommended daily requirement.

Iron

While iron deficiency and anemia can be a real medical concern, there is no evidence that plant-based nutritional patterns increase the risk for iron deficiency, anemia, or iron store depletion. In fact, many people consuming omnivorous diets still get much of their dietary iron from non-heme iron (or plant-derived iron sources). Too much iron, especially too much heme iron (from animal flesh), actually translates to an increased cancer risk, so the optimal goal is adequate iron, not excess.

Guidelines suggest men and postmenopausal women require approximately 8 milligrams of iron per day, menstruating women require approximately 18 milligrams per day, and pregnant women have the highest requirements at around 27 milligrams per day. To put this in context, a breakfast of one cup of oats, lunch of a baked potato topped with one cup of beans and with leafy greens, dinner of a lentil and kale soup, and a snack of a half cup of raisins and nuts would provide over 30 milligrams of iron. To optimise absorption, consume iron-rich foods with a source of vitamin C, such as citrus, strawberries, capsicums, or tomatoes.

Calcium

Dairy consumption is not associated with stronger bones, despite the high levels of calcium it contains. Only about 30 percent of the calcium listed on the label for cows’ milk will actually be absorbed and used by our bodies, compared to 50 percent of the calcium in a plant food like bok choy.

The recommended daily intake for calcium in most Western countries is 1,000 to 1,300 milligrams per day. However, the World Health Organization recommends a much lower intake of 400 to 500 milligrams, noting that calcium needs increase with increased intakes of animal protein and sodium. Therefore, calcium recommendations in Australia are likely excessive for those enjoying a healthy wholefood plant-based diet. Regardless, there are plenty of nutritious plant sources of calcium to ensure sufficient intake – oranges, almonds, beans, greens, tahini, and chia seeds.

What about supplements?

Besides vitamin B12, there are no specific supplements necessary for those following a WFPB nutritional pattern beyond those recommended for the general population. However, standard nutrients of consideration (such as iron and vitamin D) should be tested and included via supplementation if they cannot be gained through diet and lifestyle alone.

Supplementation with Vitamin B12 (also known as cobalamin) is recommended for people following a plant-based diet. It is required for normal blood function and neurological health, and deficiency can be serious. B12 deficiency is relatively common in the general population, and not just in those following plant-based nutritional patterns. Fortunately, we can all safely maintain adequate B12 levels by supplementing and having our levels checked annually by an MMA blood or urine test (as opposed to a serum vitamin B12 blood test).

Nutritional needs can vary throughout our lifespan, such as during childhood, pregnancy, or later in life. It is always best to discuss nutritional needs and supplementation recommendations with your healthcare provider, regardless of your dietary habits. WFPB nutrition is a simple way of eating that can certainly be delicious and will definitely deliver health benefits. Over time you will be happy to skip the processed foods and head straight for the fresh produce. Give it a try and feel the difference!

This article is republished with permission from nourishmagazine.com.au.
May 23, 2023
Nutrition in Healthcare Conference 2023

Doctors For Nutrition was delighted to once again host Australasia’s only whole food plant-based nutrition conference in February 2023.

Over 250 delegates, the majority of whom were healthcare professionals, gathered in-person or virtually. Those joining face-to-face gathered in Australia’s cultural capital, Melbourne. The conference ran over two full days and we were joined by 24 local and international experts who showcased both the long-established and the latest research on the leading lifestyle factor to influence health outcomes: our diet. Delegates learnt about the role of a whole food plant-based approach to eating in the prevention, management and reversal of numerous chronic disease conditions.

A key focus of the event was providing practical tools and techniques to support delegates in transitioning to a whole food plant-based diet themselves or helping their patients to do so. Interactive sessions facilitated real-time responses to the most popular questions from the crowd.

Outside of the main academic program there were many other opportunities in which to partake: chances to get moving including a mindfulness session, a run and a guided walk. During the conference dinner we were honoured to be joined by Professor Boyd Swinburn to discuss The Global Syndemic. We enjoyed plenty of belly laughs thanks to our entertaining MC Clint Paddison. Our Board-Chair Dr Heleen Haitjema and Dr Ayesha Sherzai also guided us through a cooking class.

Another highlight of the jam-packed weekend was the entirely whole food plant-based menu, keeping our delegates fuelled and supporting the evidence-based philosophy of the conference.

We were pleased to be able to offer health professionals Continuing Professional Development (CPD) credit for NIHC. The conference was approved for CPD hours by the Royal Australian College of General Practitioners (RACGP) and with the Australian College of Rural and Remote Medicine (ACRRM).

In recognition of the importance of future healthcare professionals, Doctors For Nutrition were fortunate to be able to offer five scholarship places, made possible by the generosity of our donors.

        Another fantastic outcome from the conference was that I got to meet like-minded medical students from other universities.

Five university scholarship students joining us at the NIHC

Following is a very brief recap on the academic sessions throughout the two days. If you are interested in accessing the full recordings on-demand head to our ‘on-demand access’ page. CPD hours are available with RACGP and ACRRM, they may also be available for other professional bodies based on self-reporting requirements.

DAY ONE

What is whole food plant-based nutrition and how can I prescribe it?
Dr Renae Thomas

This session kicked-off the conference with an introduction to whole food plant-based (WFPB) nutrition from a clinical perspective. Dr Thomas discussed the nuances (such as salt, oil, and sugar), specifics (inclusions and exclusions), nutrition as a spectrum, and frequently asked questions (such as around protein, calcium, and iron). She provided a foundational overview of the benefits of WFPB nutrition for patients (and health professionals alike)! Following this, Dr Thomas delved into what is often the most challenging component – the practical aspect of how to prescribe nutrition in a clinical setting and specific methods to make this easily accessible, understandable, implementable, and results driven.

Dr Renae Thomas

Preventing Cognitive Decline
Drs Dean and Ayesha Sherzai

Drs Dean and Ayesha Sherzai started off our academic sessions by looking at what we know about our amazing brain, the diseases that affect it, their consequences, and what we can do as a society to reduce their risk and prevalence.

With dementia being the #1 disease in most countries of the world (74.7m people impacted globally) this in-depth session provided hope that we all have the ability to improve our brain health.

They discussed the myths and misunderstandings that relate to Alzheimer’s Disease. As opposed to being purely a genetic disorder, for instance, adherence to a healthy lifestyle can in fact offset the genetic component: genetic risk combined with an unhealthy lifestyle sees risk skyrocket by 360% but, genetic disease combined with a healthy lifestyle reduces risk to less than 30%.

The doctors presented evidence showing that a healthy lifestyle can prevent or reduce the advancement of dementia. Central to this is food which is considered to be most important for the brain’s internal environment protecting from oxidative stress and reducing inflammation.

        Eat a cup of greens and you’ll have an 11 yr younger brain.

Evidence-based weight loss
Dr Michael Greger

Physician, New York Times bestselling author and internationally recognised speaker on nutrition, Dr Michael Greger joined us via treadmill from the US to present on evidence-based weight loss. Dr Greger reiterated that the single most effective long-term weight loss strategy is a whole food plant based diet. He focused on the significance of calorie density and a shift from restriction to concentrating on quality whole foods.

General Practitioner Panel: Turning the tide on type 2 diabetes
Dr Anis Ta’eed, Hollie Waters APD and Dr Gemma Newman

Hollie Waters APD, Dr Gemma Newman, Dr Anis Ta’eed and Clint Paddison

Our experts shared research and experience regarding nutrition and type 2 diabetes mellitus (T2DM), shedding light on the pathophysiology of T2DM, why ketogenic/low-carb diets aren’t appropriate in T2DM, preventing and reversing T2DM and meal planning.

Dr Anis Ta’eed reminded us how critical it is that the underlying cause of T2DM is addressed; it does not need to be inevitable that decline in health, or death, will happen as a consequence of diabetes. Dr Gemma Newman shared information on how to control diabetes, including thoughts on calorie restriction and the use of lower carb diets. Hollie Waters APD provided practical advice on what a well-planned WFPB diet may look like, and shared simple substitutions and tips on meal planning.

Nutrition and Skin Conditions
Dr Niyati Sharma

Dermatologist Dr Niyati Sharma delved into the nutrition link with common skin conditions such as acne, rosacea, psoriasis and others, including urticaria and hidradenitis suppurativa. She provided recommendations for these conditions and explanations of the potential causes. Dr Sharma shared details about the complex interplay between the immune system, the skin microbiome and the environment resulting in a breakdown of the skin barrier. She highlighted that It is just as important for dermatologists to talk about nutrition as it is for a cardiologists.

Dr Niyati Sharma

Nutrition and Indigenous Health
Tracy Hardy APD

Tracy delved into the importance of culturally responsive, trauma integrated care, practice and healing approaches. With so many critical lessons to be learnt from First Nations Peoples of Australia her presentation was invaluable. It was an area of care in which many delegates were seeking more education. Tracy highlighted the Aboriginal holistic wellbeing model and the impact of colonisation. She raised the need to find ways to tackle the systemic disconnect we have with where our food comes from, making it more disposable and adding to our significant food waste problem.

Tracy Hardy APD

Hormone Harmony
Dr Gemma Newman

We were fortunate to have Dr Newman join us on the stage for a second time to speak about the key role that nutrition can play in keeping our hormones in check. She delved into common conditions linked to women’s health including PCOS, fibroids and endometriosis and how lifestyle can improve these problems. Dr Newman explored how various lifestyle measures can impact hormone-related conditions

        All of the pillars of lifestyle medicine apply to PCOS.

Dr Gemma Newman warming-up the crowd with the ‘Gemma wiggle’

DAY TWO

Meat and Gut Health
Dr Alan Desmond

Consultant Gastroenterologist Dr Alan Desmond explained the effect that meat consumption has on the human gut microbiome and reviewed the evidence on the links between meat consumption and many common digestive disorders.

He presented some staggering statistics around the increase in bowel cancer rates locally and reviewed the most up-to-date scientific publications on meat and gut health, explaining the therapeutic potential of a whole-food plant-based diet in helping patients to restore their gastrointestinal health.

Food and the Environment
Dr Peter Johnston APD

Dr Johnston recapped the dire situation we’re currently in from a planetary perspective. He investigated the impact of our food system on the environment and the way forward to optimise human health and environmental sustainability on Earth. Sadly he pointed out that we pay for low-cost animal foods three times: at the checkout, in subsidies (taxes) and in the enormous clean-up cost to our health and environment.

        To deal with the problem of protecting the environment, we first need to know what the problem is.

Dr Peter Johnston

Nutrition and Heart Health
Dr Caldwell Esselstyn

Eminent MD, Dr Caldwell B. Esselstyn, one of the most well-known and respected luminaries in the plant-based healthcare movement, joined us from the US for his greatly anticipated presentation on Nutrition and Heart Health.

Dr Esselstyn discussed how we should treat the cause of coronary artery disease. Rather than drugs and procedures which do not treat the causation of this disease, people who transition totally to plant-based foods may halt and selectively reverse their disease.

        Food and food alone can halt and reverse the effects of coronary artery disease.

A nutritional approach to cardiac rehabilitation
Dr Ahmad Farshid

Delegates enjoyed the inaugural presentation of dietary and outcome data, from cardiologist Dr Ahmad Farshid, for a group of high risk patients using a plant-based diet for treatment and prevention of ischaemic heart disease. Importantly Dr Farshid confirmed that individuals with heart disease will take responsibility for their own health and that they will make sufficient changes to affect their risk factors such as blood pressure, weight and cholesterol.

GP Panel Discussion
Dr Luke Wilson, Dr Alyce Churchill, Dr Sam Gartland, Dr Martyn Williamson, Dr Juliette Roex

A panel of GPs with specialities in different areas discussed a broad range of common questions that arise in the areas of mental health, challenges in primary care with whole food plant-based lifestyle interventions, nutrition and autoimmune conditions and effective patient change communication.

Dr Alyce Churchill (speaking)

Dr Martyn Williamson

Dr Juliette Roex

Dr Luke Wilson

Dr Sam Gartland

WFPB Immersions and Workplace Programs
Dr Malcolm Mackay, Dr Peter Johnston APD, Jenny Cameron

Dr Mackay, Dr Johnston and Jenny shared exactly how they obtain such impressive results with their retreat and group program clients. They explained how they walk with them through the barriers to making change, the strategies for overcoming these and took a dive into the dose-response nature of dietary intervention.

Dr Malcolm Mackay, Jenny Cameron, Dr Peter Johnston

Nutrition and Cancer Panel
Dr Despina Handolias, Dr Alan Desmond, Dr Renae Thomas

Oncologist Dr Handolias presented the cellular pathways of cancer, genetic alterations, nutritional/dietary interventions in oncology, and the main dietary interventions that have been studied. She examined risk reduction in the context of the complexity of cancer. Dr Thomas explored hormonal cancers and known potential risk factors in terms of prevention and relapse prevention, as well as dietary pattern. Dr Desmond returned to the stage for a second time to dive deeper into bowel cancer and the role played by the gut microbiome and diet in bowel cancer risk.

Dr Alan Desmond, Dr Despina Handolias, Dr Renae Thomas

Behaviour Change in a Community Setting
Dr Dean Sherzai

After a robust 2 days exploring the evidence base behind WFPB nutrition, Dr Sherzai detailed a neuroscientific approach to behaviour change in a community setting. He explored: why behaviour change often fails; the roles of different parts of our brain in the change process; and The Habit Loop. He generously shared what has worked for him in their community projects and looked into effective behaviour change approaches.

Dr Dean Sherzai

I never thought it was possible … until we did it
Dr Renae Thomas

It was a perfect high energy wrap-up to the NIHC with an inspiring look at how the landscape has changed in regards to nutrition in the healthcare field through the lens of an Australian Preventive and Lifestyle Medicine Physician who has lived and practised it in the USA since becoming a doctor.

Dr Alan Desmond

Dr Ahmad Farshid

MC Clint Paddison

Prof Boyd Swinburn

Dr Sherzai, Dr Haitjema

Doctors For Nutrition were elated at the positive response to the NIHC. The energy at the venue was electric and everyone of our phenomenal speakers were so generous with their time outside of their sessions. They each gave us so much insight and knowledge into their specialist areas, and, most importantly, provided actionable and practical advice. Our brilliant MC, Clint Paddison, kept the weekend flowing smoothly.

Thanks also goes out to our facilitators who got our minds and bodies moving each morning, our conference organising partner, Think Business Events, our sponsors and exhibitors and the CENTREPIECE team (particularly for the bespoke menu).

Finally an important thanks to our delegates who will take away their knowledge and share it with others!

April 4, 2023
Doctors For Nutrition 2022: Year In Review
As another successful year draws to a close, we review the highlights and look ahead to growing our impact in 2023.

2022 continued to be a challenging year for many; we saw the ongoing repercussions of the global pandemic and frequent devastating weather events. The positive side of these hard times was that making conscious choices, for both ourselves and the planet, remained high on many people’s agenda.

On a climate action front we saw Australia pass the country’s first climate change legislation in more than a decade. May 2022 saw the release of Aotearoa New Zealand’s first Emissions Reduction Plan (ERP), including a Māori ‘climate action platform’. COP27 negotiations in Egypt highlighted it was now crunch time for countries like Australia and New Zealand to step up and take urgent action at home. 8 in 10 Australians are concerned about climate change, seeking ways they can make a meaningful impact.

Fortunately, one way becoming universally acknowledged is turning to a plant-based diet. A recent study conducted by La Trobe University, Griffith University and Queensland University of Technology surveyed more than 3000 Australians about their views on diet and eating habits. 32% of participants said they had reduced their meat consumption in the past 12 months.

Another area that needs focus, and can be addressed through a healthful plant-based diet, is the ever present obesity epidemic. 2 in every 3 adults, and 1 in 4 children are overweight or obese in Australia, these numbers are mirrored in New Zealand. Without a significant improvement in these statistics we will see more chronic diseases and early death, greater vulnerability to infectious diseases and significant increase in health care costs. COVID-19 has shown that people with obesity or chronic diseases get sicker and are more likely to die from infectious diseases.

The urgent need for whole food plant-based nutrition has never been clearer, Doctors For Nutrition continues to strive to make this the norm.

Once again it has been a busy and rewarding year at Doctors For Nutrition. We are humbled by all the supporters and allies who have joined us to champion the power of nutrition to transform healthcare.

We successfully launched an online nutrition training course, well received by the participants who were all general practitioners or medical students. The ‘Prescribing Nutrition’ course was approved as a CPD Activity with the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine.

General Practice Conference and Exhibition Sydney

Australian Society of Lifestyle Medicine Conference

Adelaide Medical Students’ Society O’week Lunch

The team enjoyed being able to attend more face-to-face events again this year and ran a range of events over the course of the year, presenting and exhibiting at 7 health conferences and events across the country.

In August we launched a new website: it includes a distinct portal for health professionals and the general public, a new search functionality and expanded content. After 3 months, the time spent by visitors on the new site was up 56% versus the same period last year.

We also launched the ‘Find a clinician’ tool, a directory connecting the public with plant friendly health professionals. We look forward to the number of health professionals growing exponentially in 2023.

The team has been hard at work preparing for our upcoming conference: Nutrition in Healthcare 2023. This event, being held in Melbourne on 17-19 February 2023, will welcome global leaders in nutrition.

We continued to inform many thousands of people across the healthcare sector and wider community through educational webinars, resources, mainstream and social media.

See further details of the year’s achievements in the snapshots below, and read on to discover what’s in store for 2023.
Growing our reach

In 2022 we:

Built our e-list to over 7,000 subscribers; gaining an average of 85 new subscribers every month.

Had 83,000 unique website page views; over 70% of which occurred following the launch of our new website, with our recipe collection and our NIHC23 conference pages proving highly popular.

Increased our social following to 16,425 across our social channels.

Continued providing our expert-opinion across a range of magazines, newspapers, radio, podcasts and websites.

Continued our regular contributions to Nourish Magazine, Aotearoa Vegan and Plant-Based Living, and NZ Vegetarian Magazine.
Educational events

Online course: Teaching doctors and students how to prescribe nutrition

In 2022 we:

Piloted our new course Prescribing Nutrition in March 2022, then launched as an on-demand offering in November 2022.

491 doctors, medical students and other healthcare professionals have received important knowledge and and practical tools on how to best introduce nutrition to their patients

100% of those who participated said they felt more confident talking with patients about plant-based diets.

70% of survey respondents did not identify as WFPB or vegan before the course commenced, meaning that the majority were not already familiar with plant-based diets and their benefits, including the positive impact on many common chronic diseases. 64% of respondents were inspired by the course to eat either slightly or significantly more whole plant foods, while another 30% were inspired to keep going with the changes they have already made.
Food Vitals Webinars
In 2022 we:

Became an approved CPD Education Provider with the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine.

Ran 4 CPD approved Food Vital Webinars, viewed more than 1280 times.

Topics included: ‘Sustainable and healthy eating patterns’, ‘Type 2 Diabetes: Reversal and Weight Loss’, ‘The role of nutrition in optimising men’s health’, and ‘Recovery from autoimmune conditions’.

More than 50% of webinar registrants had not attended a previous event or webinar hosted by Doctors For Nutrition—demonstrating we are reaching new audiences.

The majority of survey respondents indicated that the webinars had increased their confidence for discussing plant-based nutrition with patients, assessing diet, and making nutrition recommendations.

All the webinar recordings can be accessed freely via our Food Vitals web page.
Face-to-face events

In 2022 we:

Reached over 3000 health professionals and medical students by collaborating, presenting and exhibiting at 7 health conferences and events. This included the:

Adelaide Medical Students’ Society (AMSS) O’week lunch, Adelaide

General Practice Conference and Exhibition: Sydney

Australian Medical Students’ Association (AMSA) Global Health Conference, Melbourne

Australian Society of Lifestyle Medicine Conference, Cairns

Australian Medical Placements Health, Education and Training Chronic Disease Workshop, Adelaide

General Practice Conference and Exhibition: Melbourne

Royal Australian College of General Practitioners GP22 Conference, Melbourne

More than 3000 Doctors For Nutrition resources were distributed to health professionals and medical students, including ‘Plant-based nutrition: A guide for health professionals’, patient handouts and meal plans.

Our team had 550+ face-to-face interactions with health professionals and medical students, many of whom were excited to hear about a charity promoting the important role of plant-based nutrition in healthcare.

Highlights included Dr Heleen Haitjema and Dr Peter Johnston presenting to an audience of medical students at the AMSA Global Health Conference, and supporting the AMSS to ditch their traditional sausage sizzle during O’week and replacing this with a sustainable plant-based lunch.
Fundraising
In 2022:

Ten plant-powered enthusiasts trekked through part of the Larapinta Trail to help raise awareness of whole food plant‑based nutrition:

The walk was led by the World Expeditions team, who prepared delicious whole food plant-based meals and snacks. The group raised $17,187 for Doctors For Nutrition to help continue our nutrition education programs for healthcare professionals.

Larapinta team

Marion Meloni and Dr Heleen Haitjema
EthicalJobs.com.au offered us the opportunity to raise funds by matching up to $7,000 of donations received over the course of a week. Thanks to our generous donors, we exceeded our goal and raised $7,454 — turning that into a total of $14,454!
Agenda 2023

2023 will be a milestone year for us, holding our second Nutrition In Healthcare Conference (NIHC). Welcoming both international and local experts, the conference offers a program rich with evidence-based research and content exploring the relationship between diet and disease. Alongside two full days of academic sessions, the conference will also include a whole food plant-based menu, a social program, networking opportunities and an exhibition space.

Thanks in part to the generous support of the Center For Nutrition Studies, we have been able to offer our Prescribing Nutrition course on-demand. In 2023 we expect to reach 600 more healthcare professionals and medical students.

Other projects in the pipeline include: more educational events, both online and in person; new free web resources for health professionals; a forthcoming collection of whole food plant-based recipes with accompanying meal plan; a health professionals plant-based challenge and, more tools and support for those transitioning to a whole food plant-based diet.

We will also continue to engage with decision-makers across the spectrum of healthcare institutions to highlight the evidence for whole food plant based nutrition, with a key focus on the review of the Australian Dietary Guidelines.

Alongside these projects we’ll be continuing to strengthen and grow alliances with other organisations, and seek impactful opportunities to gain traction for our messages about the science and practice of whole food plant-based nutrition for health.

From all of us at DFN, thank you for accompanying us on our mission. Here’s to a year ahead filled with action towards health and wellbeing through, both now and into the future.

Click here if you’d like to get involved in supporting our work or make a donation. Or if you’d like to meet face-to-face it is not too late to register for NIHC!
December 16, 2022
Is plant-based for you?

Making the transition can seem a little overwhelming, but we’re here to say: plant-based is for everyone! Article first published in Nourish Magazine.

Thinking about making the plant-based transition, but worried it’s not for you? Or maybe you’ve already made the switch, but have questions about sticking with it. Common concerns include meeting nutritional requirements, feeling full enough, and experiencing digestive distress, among other things. These most often come up in the adjustment period and you can rest assured that when choosing to eat wholefood plant-based, you have quite likely chosen the healthiest diet out there.

No need for nutrient FOMO

While some people worry about how they’ll meet their nutritional needs when going plant-based, a varied wholefood plant-based diet provides all the necessary ingredients for optimal health. In fact, plants are some of the most nutrient-dense foods available. Dark leafy greens and legumes are rich in iron, zinc, and calcium. Wholegrains, fruits, and vegetables provide a range of essential vitamins, minerals, and phytochemicals. While beans, lentils, nuts, and seeds are high in protein and dietary fibre. As with any way of eating, it’s important to ensure your diet is well-balanced. Changes in the way we farm and process foods, and a shift in the way we live and spend our time, means some vitamins and minerals may require a little extra attention. Here’s a few to be aware of.

Vitamin B12 – This is an essential vitamin that is important for the maintenance of the nervous system and formation of healthy red blood cells. Plants, fungi, and animals are unable to make this vitamin. Luckily, B12 is made by bacteria so you don’t need animal products to obtain it; it’s easy to meet your needs through supplements and fortified foods.

Vitamin D – This fat-soluble vitamin is produced by our bodies in response to sun exposure. With greater efforts to avoid the damaging effects of UV rays, and more time spent on indoor activities, many people are at risk of vitamin D deficiency. Although some vitamin D can be obtained through your diet, without adequate sun exposure or supplementation, you may be at risk of low levels. Speak to your GP about a blood test to check your levels..

Iron – There is a common misconception that eating a plant-based diet places you at greater risk of low iron levels. This simply isn’t the case – even for non-vegetarians, most iron in the Australian diet comes from plant foods while less than 20 percent of iron intake comes from meat and meat products. Including plenty of wholegrains, legumes, and green leafy vegetables ensures adequate iron intake. Eating these foods with those high in vitamin C enhances absorption, a process that is carefully regulated by our gut. Another benefit of choosing a whole food plant-based diet is that it contains no heme iron – the type of iron found in animal foods – which has been linked to multiple sclerosis and heart disease.

Calcium – By eating a varied plant-based diet, you’ll get all the calcium you need without the added health risks that come with consuming dairy products. Leafy green vegetables, like kale, bok choy, broccoli, and Brussels sprouts, are particularly good sources. Beans, lentils, tofu, tempeh, fortified plant milks, almonds, blackberries, and oranges are also rich in this mineral.

Keeping your fuel tank full

Some people think they may not feel full enough when following a plant-based diet. Rest assured, carbohydrates are the main source of fuel for our body and are preferred by our brain. Including plenty of fruits, vegetables, wholegrains, and beans – naturally rich sources of complex carbohydrates – will ensure you easily meet your daily energy needs. The higher levels of fibre also slow down the digestive process, providing sustained energy throughout the day and keeping you feeling fuller for longer.

Focus on whole plant foods because these retain more of the vitamins and minerals that may be lost with processing. An adequate intake of iron-rich foods will also ensure your energy levels remain high. Remember, good sources include beans, lentils, chickpeas, dark green leafy vegetables, tofu, tempeh, wholegrains, nuts, and seeds.

If your daily routine is demanding, eat regularly throughout the day to stay fuelled up, including carbohydrate-rich foods like oats, potatoes, brown rice, wholemeal pasta, legumes, and fruit. If you are particularly active, it may also be helpful to add an energy-dense snack or two, such as hummus, dried fruit, nuts, or seeds.

Too much, too soon

When starting to eat more plant-based, some people can experience digestive upsets. This doesn’t mean plant-based isn’t for you! The time it takes to adjust to a new way of eating is very individual. It may be helpful to start out slowly, introducing a wider variety and larger quantities of certain foods, over time.

In fact, a wholefood plant-based diet has been shown to improve the health and diversity of our gut microbiota, increasing the number of beneficial bacteria that feed on the abundance of dietary fibres that are naturally present in plant foods. A healthy microbiota, in turn, plays an important role in preventing and treating conditions like heart disease, diabetes, and inflammation associated with autoimmune diseases.

To limit digestive discomfort, enjoy your meals in a relaxed environment, chew food well, and drink plenty of water. Limit caffeinated and carbonated beverages as they may exacerbate bloating and stomach pain. Soak, cook, and rinse legumes well before eating and, finally, consider a gentle exercise regime. Increased blood flow can promote gut motility, and body movement may help you naturally release gas to alleviate bloating.

A healthy microbiota plays an important role in preventing and treating conditions like heart disease, diabetes, and inflammation associated with autoimmune diseases.

What about a healthy social life?

Transitioning to a plant-based diet doesn’t have to mean giving up shared meals or eating out. As more and more people become conscious of the health benefits associated with this way of eating, and the environmental impact of our food choices, plant-based diets have become one of the biggest culinary trends of this decade. Your friends and family may be open to trying new foods with you! And if not, respect their choice and instead let them observe the delicious meals you eat and the positive effects your diet has on your health. You may find they become more interested to try plant-based foods over time.

When it comes to eating out, you’ll be spoilt for choice these days! Most restaurants will offer vegan-friendly options. To keep up your healthy approach, look for plant-based dishes that are likely to be low in fat and full of vegetables, legumes, and wholegrains – or those that could be easily modified to suit. If the meal can only be served with white rice or pasta, don’t be beat yourself up over having to compromise. Just select the best available plant-based option. You can also choose restaurants cuisines that traditionally rely on plant-based wholefoods, such as Indian, Mexican, Ethiopian, Thai, Vietnamese, and Italian.

All-in or slow and steady?

When making changes, some people like to go all-in from the start, while others find a gradual approach more sustainable. Think about other lifestyle changes you have made and what worked best for you then.

If slow and steady is your style, start by adding more legumes, vegetables, and wholegrains to your meals. These foods keep you full and feeling satisfied for longer, so you’ll naturally eat less animal products and processed foods. When items in your fridge or pantry run out, replace them with wholefood plant-based alternatives, like wholemeal pasta in place of white. You can also leave some items off your shopping list entirely, such as refined oils and processed foods with added salt or sugar in their many forms.

When exploring plant-based alternatives, choose carefully if health is your priority. Use the nutrition information panel and ingredient list to identify the best choice. As a general guideline, select those with recognisable wholefood ingredients that contain at least 3 grams of fibre per serve. Keep salt to a minimum – multiply the milligrams of sodium by four and aim to keep this lower than the kilojoules per serving. Also try to stick to products that are low in fat, aiming for those with less than 3 grams per hundred and avoid foods with added sugars. Check the ingredient list for sugar and its many aliases, such as agave, fructose, and dextrose.

Be mindful that a successful dietary change is often a matter of trial and error. Test a variety of products to find the ones you like best and for which application. For example, one plant milk may be great in coffee, but another is better for cooking. Investing in a few key appliances can also make clean eating easier. A pressure cooker, or multi-cooker, significantly cuts cooking time for beans and wholegrains, while a high-speed blender or food processor can be used for making oil-free dressings, sauces, and hummus, as well as raw desserts.

There are many great reasons to adopt a wholefood plant-based diet; but it’s important to identify your ‘why’. Being clear on what spurred your decision will help you navigate any challenges as you make the change. Any big life change can seem overwhelming at first, but allowing time for learning and adjustment each step of the way will help you stick to your goals. Finally, don’t be afraid to ask for help. Consider consulting an accredited dietitian to ensure your new diet meets your individual needs.

This article is republished with permission from nourishmagazine.com.au.

November 7, 2022
A snack for every season

Seasonal eating is something we should all pay attention to. Your health and your back pocket will thank you! First published in Aotearoa Vegan Magazine.

As a self-proclaimed health nut, I have been on a quest for many years to optimise my nutrition, searching for the most nutrient dense foods of superior quality. Therefore, I naturally found myself ‘down the rabbit hole’ of seasonal eating and its relevance to human health. Seasonal eating is consuming the foods within your geographic area that are in peak harvest for that time of year. Here’s an insight into my discoveries.

How seasonality influences our health

Studies show fresh seasonal foods have a higher nutrient profile when compared to foods that have been imported from overseas or outside local perimeters and where ripening agents have been used. For example, studies show broccoli holding higher concentrations of vitamin C during peak season, turnips higher in antioxidants and other phytonutrients, and rosemary higher in antioxidants, alongside enhanced antimicrobial properties.

Commonly used ripening agents forcefully ‘speed up’ or ‘slow down’ the fruit and vegetable ripening process, going against their natural growing tempo. This artificial method may be used in the hope of prolonging stability of the food during transportation, as well as a way to meet the demands of consumers. Some of the agents often used are calcium carbide, ethylene, acetlyne and ethanol. Research suggests that calcium carbide, for example, should not be used due to its potential link to ailments such as poor mental health, neurological pathologies, headaches and sleep disorders.

Imported produce, often travelling from the other side of the globe, may arrive with less bioactive compounds and micronutrients due to variables such as travel conditions, storage and impact of temperature. Foods, including cruciferous vegetables (broccoli, cabbage, brussels sprouts) and cherries, have shown to decrease in antioxidants when stored at cooler temperatures. Although evidence around snap frozen vegetables suggests they retain their nutrient value if stored in the freezer directly after harvesting. The nutrients are then preserved delivering comparable nutritional quality as when freshly picked.

Eat the rainbow

Eating seasonally increases your chances of eating a wider variety of fruits and vegetables, encouraging you to ‘change up’ your produce choices and maybe reach for something you have never tried before! This creates a diverse gut-microbiome, which simply means creating an assortment of the types of ‘good bacteria’ that live in our gastrointestinal tract, optimising our digestive and overall health.

Research conducted on a remote North American demographic by the University of Chicago found our gut bacteria changes from season to season to ‘align’ with the foods we’re meant to be eating at that time of year. Furthermore, a comparative study concluded digestive microbes have drastically declined in variety and abundance within modernised populations when compared to traditional cultures such as the Hadza Hunter-Gatherers of Tanzania.

Learnings from our ancestors

Ancient practices such as ayurvedic medicine in India have named the practice of seasonal eating as ritucharya. The philosophy emphasises that to obtain optimum health and as a

prophylactic measure towards illness, one must eat in accordance with the season. In Australia, First Nations people recognise a connection between indigenous astronomy and seasonal foods. Carefully analysing the astronomical position of the stars provides insight into seasonal changes, notifying them of animal and plant behaviours which indicates what foods to utilise as medicines.

Sourcing your seasonal produce

Every Sunday morning, without fail, you will find me at my local farmers market bright eyed and bushy tailed, reusable mesh vegetable bags in-hand, with ‘seasonal’ snatching at the forefront of my mind. Not only do I know I will be supporting my local farmers, likely drastically reducing my exposure to pesticides, herbicides, and the ripening agents we touched on above, I’ll also be putting myself in a position where seasonal foods are in abundance comparative to mainstream supermarkets.

Another option is growing your own produce at home. It is not only fun and exposes you to nature, but also a fantastic way to encourage a seasonal predominant eating pattern. The foods you grow in your backyard garden or balcony pots are most likely not going to flourish unless you plant produce right for its environment in accordance to the time of year.

Inform yourself of what’s in season. As a general guide I have provided a list below, although where you’re located may influence this guide.

Seasonal gains beyond your personal health

Commercial greenhouses are typically trying to meet consumer demands, providing access to specific types of fruits and vegetables all year round. Unfortunately, they also require a lot of energy to maintain and then transport to their final location. On the other hand, eating seasonal food grown close to home under natural sunlight aligns with sustainable purchasing, reducing detrimental effects consumption has on our planet. We must be mindful that where we purchase our food from can either positively or negatively influence our carbon footprint.

Finally, seasonal eating is favourable to your wallet! Due to the produce being more readily available to suppliers, you will potentially be finding yourself paying less in the months where that food is in season.

Perhaps, there truly is ‘a snack for every season’.

Connect with Celeste at www.thelifestylemedicco.com.au

October 5, 2022
Food and your mood

Can what we eat and drink affect our mental health? You bet it can. Here’s how you can harness the protective power of plants to feel your best. Article first published in Nourish Magazine.

Most of us know that when we are physically unwell or exhausted it can negatively impact our mental health – in the ways we think, cope, and act. And how we feel mentally also influences our physical self-care, such as eating well, moving, and resting. The connectedness of our physical and psychological state is undeniably intertwined and is particularly significant for several mental health conditions, including depression and anxiety disorders. Because our physical health is greatly impacted by our diet, there are some protective actions we can take when it comes to what we eat and drink, which can also be beneficial for mental health.

The gut-brain connection

Our body can influence our psychological state through the gastrointestinal tract, or the gut. Our gut has the wonderful ability to communicate with our brain through the enteric nervous system and with chemical messengers (hormones) such as serotonin. Serotonin is produced by specialised cells within our intestines. Foods rich in tryptophan can help increase your production of serotonin, well-known for its calming effect as it works to reduce anxiety and improve depression. Choosing plant-based sources can simultaneously help you build a healthy gut microbiome and reduce your risk of many chronic diseases.

Our gut bacteria, or microbiome, is also capable of producing gamma-aminobutyric acid, or GABA, another important chemical made in the brain and found in some foods. GABA works to reduce anxiety and improve mood and sleep. We know eating a wide variety of plants helps to promote a healthy gut microbiome, but are there foods of increased benefit? The science says yes! Fermented foods like kimchi, sauerkraut, and soy yoghurt contain GABA and probiotics to nurture your microbiome. Consuming foods rich in glutamate and vitamin B6, the building blocks of GABA, is also beneficial for boosting GABA levels.

The simple act of eating is enough to release dopamine, another feel-good hormone. Unfortunately, high-fat and high-sugar foods are particularly good at causing a dopamine boost. Biologically, this is why a doughnut or ice-cream can feel so much more pleasurable than a less indulgent option. The reasons for this are rooted in human species survival and not longevity or good mental health. High-fat and high-sugar foods are addictive, and breaking the cycle of craving and consumption, termed ‘The Pleasure Trap’ by renowned psychologist and researcher Dr Doug Lisle, is important to gain control over your physical and mental health. Breaking up with these foods might be difficult at first but your taste buds will adapt quickly, your microbiome will improve, and you can continue to enjoy a normal dopamine boost from healthy plant-based foods.

Eating for optimal mental health

Studies have shown that diets rich in neuro-protective vitamins and minerals such as B vitamins, Omega 3 DHA, iron, magnesium, and zinc are beneficial to our brain and mental health. Deficiencies in these various nutrients can affect your brain’s development, learning and memory, as well as increase the risk of feeling irritable, stressed, and fatigued. Fortunately, your nutritional needs can be easily met by eating a wide variety of plants. Here’s where to find these neuro-protective nutrients.

Vitamin B6 – bananas, watermelon, peanut butter, almonds, sweet potatoes, peas, avocados, hemp seeds, chia seeds, beans, chickpeas, prunes, wheat germ, sunflower seeds, pineapple, pumpkin, green beans, pistachios, figs, nutritional yeast, baker’s yeast, garlic, kale.
Vitamin B9 – spinach, beans, lentils, asparagus, lettuce, tomatoes, broccoli, avocados, mangoes, oranges, most whole grains, nutritional yeast, baker’s yeast, basil, peanuts, artichokes, rock melon, walnuts, flaxseeds, sesame seeds, cauliflower, tahini, sunflower seeds, peas, okra, celery.
Vitamin B12 – supplementation is recommended and can easily be found in pharmacies. Also found in some fortified cereals, fortified plant-based milks, and nutritional yeast.
Omega 3 DHA – flaxseeds, chia seeds, hemp seeds, dark leafy greens, seaweed.
Iron – legumes, dark leafy greens, broccoli, nuts, dried fruit, iron-fortified bread and cereals, oats, tofu.
Magnesium – kelp, oats, almonds, cashews, seeds, cacao, dark leafy greens, bananas, sweet potato, whole grains, beans, wild and brown rice.
Zinc – legumes, nuts, seeds, oats, tofu.

Think about what you drink

Hydration also has a significant impact on mental functioning. How much you hydrate, and with what fluids, can impact on your concentration, mood, and anxiety symptoms. It can even affect your sleep. Regularly and adequately hydrating with water and other healthful options, such as herbal tea, can improve your focus, increase your performance, reduce fatigue, and best support your psychological wellbeing.

However, there are some beverages that can negatively affect our mental health. Alcohol and caffeinated drinks are the main culprits. Caffeine acts as a stimulant to our nervous system with enticing effects such as a reduction in fatigue, increased alertness, and improved mental performance. These effects are temporary and have to be weighed up against other well-known side effects, including increased heart rate and blood pressure, increased feelings of anxiety, restlessness, difficulties with sleep, and diuretic effect (the need to urinate more frequently). Good hydration can be an uphill battle if you’ve already had a few coffees by mid-morning.

Then there’s alcohol, which is quite a messy substance for the brain. The anticipation and consumption of alcohol can produce a satisfying but temporary increase in dopamine. However, regular consumption, and in particular alcohol-dependency and withdrawal states, leads to suppression of serotonin and GABA production (our happy hormones and mood improvers mentioned earlier). This can reduce your ability to manage stress, increase anxiety and panic, and result in lower mood. Alcohol is also no friend to your gut microbiome.

The evidence we have to date says that reducing your exposure to alcohol has benefits for your mental and physical health. Adhering to the Australian National Health and Medical Research Guidelines is strongly recommended. They advise quite clearly that no amount of alcohol consumption is risk free and that all healthy and non-pregnant adults should limit their consumption of alcohol to a low-risk quantity of no more than 10 standard drinks per week or 4 on any one day.

The science is clear

Drinking more water, eating a lot more whole plant foods, and consuming less refined products (and yes, I’m afraid this includes caffeine and alcohol too) can give many people a much-desired boost in both their mental and physical health. This is one nutrition prescription that is widely accessible, relatively easy to implement, economical, and comes with a long list of additional health benefits.

If you are struggling with your mental health, it’s also important to talk to your GP, psychiatrist, or psychologist, so that the most appropriate treatment options for you can be considered. Conventional approaches including psychology and medication will be part of the journey to better mental health for many people, and dietary change should be seen as a complementary treatment, not a substitute. With a holistic approach encompassing evidence-based nutritional and lifestyle improvements, there is potential to enhance the effects of other treatments, reduce relapse risk, and build better general health.

Of course, even if you aren’t currently experiencing a mental health issue, it’s beneficial to consume foods that contain neuro-protective nutrients and that promote good gut health, which can affect hormone production and mental health. And this can be as simple as focusing on eating a wide variety of whole plant foods and keeping well hydrated.

This article is republished with permission from nourishmagazine.com.au.

September 5, 2022
Unbreakable bones

Strong bones are important for all ages. While bone health is critical for healthy ageing, it’s the bones you bank today that can protect you from osteoporosis later. Article first published in Nourish Magazine.

Bones play an essential role in the human body – they support movement, protect our vital organs, and store essential nutrients.

Bone is living tissue and undergoes continuous change throughout our lives via a process called remodelling, which is a biological process where older bone tissue is removed and new bone tissue is formed. This process protects our bones from stress failure and is essential in maintaining normal blood calcium levels, important for many critical functions in our body including healthy heart and nerve function. Remodelling is regulated by many factors: our diet, physical activity, hormones, and medications.

Your bone bank account

When it comes to bone health, we often associate it with ageing, although we should be paying attention to our bones much earlier than this. The more bone mass we ‘bank’ in our younger years, the better protected we are from osteoporosis and fractures later in life.

Puberty is often correlated with growing taller, but what isn’t as obvious is the rapid increase in bone mass, reaching its maximum when we are around 25 to 30 years of age. By the time we are in our forties and fifties, we slowly begin to lose bone mass as a normal part of aging. We can, however, take steps to optimise bone health at any age to avoid osteopaenia or osteoporosis later in life.

Osteoporosis is a condition that results in loss of bone strength, making bones more fragile and prone to fractures. Osteopaenia, often referred to as ‘pre-osteoporosis’, is where bone mass is abnormally low, but not to the same extent as osteoporosis.

As a general rule of thumb, bone formation tends to slightly exceed bone breakdown in the first half of our life, contributing to an increase in bone mass during our younger years. In the second half of our life, bone breakdown exceeds bone formation, tipping the balance towards a gradual decrease in bone mass over time. Osteopaenia and osteoporosis occur when bone mass decreases more than what would typically be expected as part of ageing.

Osteoporosis is a common condition in both men and women, although it is more common in women. For women, the drop in oestrogen levels that occurs around menopause upsets the balance of bone remodelling, resulting in increased bone loss. An initial rapid decrease is often experienced, which tends to slow over time. For men, the rapid bone loss phase tends to be delayed, typically commencing in their mid to late sixties. For most of us, bone loss can be significantly slowed through proper nutrition and regular exercise.

For most of us, bone loss can be significantly slowed through proper nutrition and regular exercise.

The best nutrition for strong bones

Let’s get one thing out of the way first. ‘Milk builds strong bones’ is a reductionist way of approaching this important part of human health. Bone health is much more complex than consuming adequate calcium. First, achieving and maintaining excellent bone health is multifactorial: it is a combination of excellent nutrition, regular physical activity, sunlight exposure, and avoiding factors that can be detrimental to bone health where possible. Second, more than adequate dietary calcium levels can be achieved by adopting a diverse wholefood, plant-based diet that excludes dairy. And third, from a purely nutritional perspective, while calcium forms a critical dietary contribution to bone health, there are many other dietary factors that work to either optimise or hinder bone health.

If you already eat a diverse diet rich in whole plant foods while minimising processed foods, you are well-on the way to achieving and maintaining bone health. Let’s explore some important nutritional requirements required for healthy bones.

Calcium

It is well known that calcium is an important nutrient for healthy bones, and over 98 percent of our body’s calcium is held within our bones. Here’s the catch with that pervasive milk marketing: while dairy products contain calcium, they also regularly contain growth factors, lactose sugar, occasional contaminants, and often a significant amount of fat and cholesterol, making them an unfavourable choice for obtaining this nutrient.

As a general rule, the most healthful calcium sources are green leafy vegetables and legumes. Broccoli, Brussels sprouts, kale, and other greens are loaded with highly absorbable calcium and a host of other healthful properties. Exceptions are spinach and chard, which contain a large amount of calcium but hold on to it tenaciously, making it difficult to absorb. You will also find plenty of calcium in legumes including chickpeas, beans, and lentils. Soy products like tofu and soy milk are available fortified with calcium (look out for at least 100mg of added calcium per 100mL). These also contain phytoestrogens, or plant compounds, that have a similar structure to oestrogen and help to reduce excessive bone breakdown.

Magnesium

Approximately 60 percent of this essential mineral is found in bone. Low magnesium intake is associated with a lower bone mass. Beans and greens are magnesium rich, while other great sources are whole grains, nuts and seeds, bananas, and even dark chocolate (80 percent cocoa or more). Stick to a high-quality vegan variety and remember, don’t go crazy, it comes with other additives we are best to minimise.

Vitamin D

The importance of vitamin D for bone health is evident through the range of bone conditions that can be experienced when intake is inadequate, in particular Rickett’s disease and osteomalacia. While vitamin D is often considered a dietary requirement, it is primarily obtained from sunlight, and only small quantities actually come from our food. Vitamin D is crucial in promoting calcium absorption into the bloodstream from the gastrointestinal tract. The best and most efficient way for us to obtain vitamin D is through sunlight exposure. If you can’t obtain adequate sun exposure, then a supplement is recommended.

Vitamin K

Several studies have found low vitamin K intake to be associated with low bone mass and increased risk of fractures. Good sources of vitamin K include dark green leafy vegetables such as spinach and kale. Just one cup of raw spinach will provide more than the recommended daily intake. Other sources include Brussels sprouts, broccoli, cauliflower, and blueberries.

Zinc, Copper, Manganese and Phosphorus

Zinc, copper, and manganese have been shown to play an important role in bone health while phosphorous is necessary to support increases in bone mass, and is predominantly stored with calcium in bones. All of these can be found in abundance in a variety of plant foods: wholegrains, legumes, nuts, seeds, fruits, and vegetables.

The bone thieves

So, we now know eating a variety of whole plant foods is important for supporting strong bones. But there are also factors that can diminishdimmish bone health These are often referred to as the ‘bone thieves’. Here’s what you might want to avoid or limit where possible.

Alcohol

Excessive alcohol consumption is a well-recognised risk factor for decreased bone mass and osteoporosis. Simply put, it has a toxic effect on our bone forming cells.

Medications

Corticosteriods Corticosteroids such as prednisone suppress bone formation, contributing to a decline in bone mass and an increased risk of osteoporosis. Certain anti-seizure medications are associated with Vitamin D deficiency, also negatively affecting bone health. It’s important to remember that medication is frequently necessary. In situations where chronic usage is unavoidable, a proper assessment of bone health should be conducted and bisphosphonate treatment may be considered.

Smoking

There are many reasons to take heed of this message, although you may be interested to know that achieving and maintaining healthy bones is one of them. Smoking creates an imbalance in bone turnover, contributing to lower bone mass and an increased risk of osteoporosis.

Sugar-sweetened drinks and caffeine

Soft drinks are high in phosphates that tend to inhibit calcium absorption. Both soft drinks and sugar-sweetened beverages (especially cola drinks) are associated with increased risk of fractures. Be aware that caffeinated beverages such as coffee are associated with accelerated bone loss. It’s best to keep coffee to a minimum and, ideally, eliminate sugar-sweetened drinks.

Move it or lose it

Physical activity is vital to bone health for all age groups. Weight bearing activities, such as jogging or jumping, in combination with resistance training is recommended. These activities place our bones under mechanical strain, resulting in an increase in bone formation while suppressing bone breakdown. As we age, we are likely to sustain good bone health or experience a slower decline in bone mass if we maintain an exercise regime.

Bone health is a complex, lifelong process. A diverse wholefood, plant-based diet puts you on the right track for maintaining healthy bones. Combine optimal nutrition with regular physical activity and sunlight exposure to maximise your bone mass and minimise your risk of developing osteoporosis. Remember, it is never too late, no matter what life-stage you are in – you can always improve your bone health with these strategies.

This article is republished with permission from nourishmagazine.com.au.

July 1, 2022
DFN successfully upskills doctors on prescribing nutrition
During April, Doctors For Nutrition launched an online course, ‘Prescribing Nutrition’. Read about how this course had a significant impact on more than 300 doctors and medical students.

Why the ‘Prescribing Nutrition’ course is needed

The majority of general practice consultations in Australia exclude nutrition-related counselling; alarming given that poor nutrition is a leading contributor to health loss and early death.

Research conducted in Australia and New Zealand has identified barriers to GPs providing nutrition care that include; perceptions of inadequate skills in nutrition counselling associated with inadequate training, ambiguous attitudes and, differing perceptions about the role of general practitioners in nutrition care.(1)

Our course was developed to address these barriers and equip healthcare professionals in Australasia with confidence and practical tools to support patients with a plant-based dietary shift.

Video lesson within the Prescribing Nutrition course

The launch of ‘Prescribing Nutrition’

During April and May 2022, more than 300 healthcare professionals enrolled in the two intakes of the Prescribing Nutrition course. The first intake was open to medical students, followed by a second intake for medical doctors. The course consisted of blended learning methods – video, text, an interactive assignment and a live workshop with plant based GP facilitators, including breakout sessions to work on a case study together.

The content was delivered by doctors and dietitians with expertise in whole food plant-based nutrition. Lessons covered evidence supporting the benefits of a healthy plant-based diet, how to talk to patients about diet (especially within the time constraints of a typical GP consultation), recommendations for success, communication skills and everyday practical tips. Participants completed a short quiz following each lesson.

Clockwise from top left: Dr Adrian Griscti, Deeni Betar-Young APD, Dr Alyce Churchill, Dr Luke Wilson, Dr Shireen Kassam, Dr Stephanie Dakin, Dr Malcolm Mackay, Emma Strutt APD, Dr Martyn Williamson and Dr Heleen (Roex) Haitjema

The assignment component of the course tasked participants to undertake real life nutrition discussions in consultations with patients, and report back on their experience. This was a great opportunity to put learning into practice, encourage reflection and uncover areas where further development was desired.

Powerful participant feedback

Via completed feedback forms we were pleased to discover that:

After engaging with the mini-course, 100% of the participants were more confident talking with patients about plant-based diets.

On a scale of how likely participants would be to recommend the mini-course to a friend or colleague, the average was 9 out of 10 (where 10 is highly likely and 1 not at all likely).

The mini-course inspired approximately 48% of the participants to make personal dietary changes whereby they intend to eat significantly more whole plant foods.Another 15% intend to eat slightly more whole plant foods and 31% are inspired to continue with the changes they have already made.

Participants reported that the course had delivered an introduction to material that had not been taught during university studies, as well as resources to support them.

I noticed that throughout my medical degree, so far, we have only had 2 hours of nutritional teaching, and it was quite lacklustre. Being able to learn more nutritional medicine has already been beneficial towards my placements and I haven’t even graduated yet. I feel that the more that I learn about nutritional medicine I want to make sure I incorporate it into my future practices because it is vital for the holistic view of a patient’s health. – Medical student, VIC

I have always tried to discuss nutrition with patients in the past, but despite knowing the benefits, and eating plant-based myself I haven’t felt very confident discussing a plant-based diet with patients and tended to give the general and vague advice I was taught in university. Now that I have some useful tools and techniques on how to broach the subject with patients, and especially with the huge amount of informative and practical resources provided in the course, I plan to discuss a plant-based diet a lot more with patients. I feel that I will be able to make a real change in the health of my patients with this increased knowledge. – GP, WA

I really enjoyed this course and learnt a lot (and I have an undergrad in human nutrition!). I appreciated the practical approach and patient-centered advice. – Medical student, QLD

The course opened the eyes of many to the key role that nutrition plays in healthcare and in their future consultations.

Nutrition plays an integral part in the holistic care of a patient’s health. Until this course I had not considered its weight as part of the healthcare conversation. As an aspiring general practitioner, I see nutrition now as something that I want to strive to integrate into the assessment of each patient, as important as the smoking history, and broached as often as blood pressure is measured. – Medical student, VIC

Since doing this course I have been talking about diet in more consultations and I plan to continue to do this. I hope it will mean that I will empower my patients to become in control of their health and not feel reliant on medication. I hope then nutrition will become the first line in my management plan for most patients so that I can then give more patients the chance not to take medication but to try a whole food plant based diet instead. – GP, UK

WFPB nutrition is relevant to all humankind and I would like to discuss this in some form with most patients. I feel more confident in broaching the subject with patients and in ways that will be less judgemental, using a gentle coaching style. I was inspired by the bonus content on the course and have ordered the books that were suggested on communication skills. – Medical doctor (specialist), New Zealand

I thoroughly enjoyed the course and it has been very helpful in making changes to my diet and my families as well as increasing my confidence with advising patients. – Medical doctor (specialist), VIC

Please make this available to all doctors. – Medical doctor (specialist), QLD

Moving forward: help us upskill more doctors to prescribe nutrition

Available spots within the pilot of both the medical students and doctors course filled quickly.

There is no doubt nutrition is a powerful tool that every doctor should have in their toolkit. Our aim is to provide our course far and wide, free of charge and with easy access. Healthcare professionals are in the unique position of being a trusted authority across a broad range of topics, and the ripple effect they can have on their patients, patients’ families and wider communities, is far reaching.

We are able to provide resources like this course to health professionals thanks to the generosity of our donors. Being a fully independent charity that relies solely on donations, every dollar is appreciated.

$100 allows us to provide one free of charge space for the Prescribing Nutrition course. In Australia, on average, a GP sees 114 patients a week. Even if only 80% of the GPs who participate in our mini-course use the skills and resources they have gained to introduce plant-based nutrition at half of their appointments, that $100 donation you make today may equate to more than 400,000 new conversations about the power of whole food plant-based nutrition. If you would like to make a on-off donation, or wish to join others in becoming a monthly donor, please click here.

We have been inundated with queries about the next opening and release of the course to the wider healthcare community, and are delighted to already have more than 100 people on the waiting list.. We anticipate that the next course will be available in the third quarter of 2022. Interested in signing-up? You can join the waitlist here.
Acknowledgements

Doctors For Nutrition extends sincere gratitude to the contributors to ‘Prescribing Nutrition’: Dr Heleen Haitjema, Dr Luke Wilson, Dr Shireen Kassam, Emma Strutt APD, Dr Alyce Churchill, Dr Malcolm Mackay, Dr Adrian Griscti, Dr Stephanie Dakin, Dr Martyn Williamson and Deeni Betar-Young APD.

Key reference
1. Ball LE, Hughes RM, Leveritt MD. Nutrition in general practice: role and workforce preparation expectations of medical educators. Aust J Prim Health. 2010;16(4):304-10. doi: 10.1071/PY10014
June 27, 2022
Hormone harmony

Healthy hormones are a bit of a balancing act, and many common health complaints are caused by imbalances. It may surprise you to learn that what you eat can help or hinder here. Article first published in Nourish Magazine.

Excess oestrogen exposure

In Western countries, girls are starting their periods younger, and women are tending to go through menopause later. This means lifetime exposure to the female sex hormone oestrogen is extended, putting females at increased risk of hormone-dependent cancers.

Oestrogen is vital, however, not in excess. So what can we do about it? Doing what we can to ensure regular bowel movements is a great start. Constipation can make us overexposed to oestrogen. Our body discards excess hormones and products of metabolism through our faeces. When we get blocked up, those waste products seep back into our bodies through the intestinal wall and are re-metabolised, increasing our hormonal exposure.

A high fibre diet is useful for hormonal regulation because it increases the size of your stools and makes them softer, helping to keep you regular. Fibre will also lower cholesterol, keep you feeling full longer, and is important for gut health, which has other knock-on benefits for overall wellbeing. Put simply, fibre is the part of plant foods that your body does not digest. There are many different types of fibre in nature, so to benefit most, you need to include a variety of plant foods: wholegrains, legumes, nuts, seeds, fruits, and vegetables (skin on where possible).

Painful periods

There is a connection between the food you eat and your body’s oestrogen levels. Animal products, processed foods, and added oils increase your levels of oestrogen, in part because they are inflammatory. The more of these foods you consume, the more likely your uterine lining will become abnormally thick. As a result, when it begins to break down during the menstrual cycle, this process creates more prostaglandins. Painful periods are often caused by these hormone-like lipids that make your uterus contract to help get rid of its lining. The higher the levels of prostaglandins, the more severe the cramping.

In addition, eating foods that decrease inflammation in the body can help to tame period pain. Research has shown that a meat-free eating pattern works to decrease inflammation in the body. One study demonstrated that a healthy, plant-based diet significantly reduced the intensity and duration of period pain. The effect of the diet was so powerful that some of the women participating refused to switch back to their regular diet, even though the way the study was designed required this.

Interestingly, there are vitamin D receptors in the womb, and it is thought vitamin D could be helpful to reduce prostaglandins and therefore period pain. Ginger, best known as a calming remedy for an upset stomach, has also proven effective for period pain. In one study, it was shown to be equally effective as two different types of anti-inflammatory painkillers. Curcumin, an active compound in turmeric, also has benefits due to polyphenols, and is recommended this is taken just before your period starts.

To alleviate period pain, try eating lots of fibre-rich foods plus good amounts of turmeric and ginger just before your period starts and throughout, as well as adding a vitamin D supplement if your levels are low. This may provide some big improvements within just a few cycles.

Eating foods that decrease inflammation in the body can help to tame period pain. Research has shown that a meat-free eating pattern works to decrease inflammation in the body.

Polycystic ovarian syndrome

In Australia, polycystic ovarian syndrome (PCOS) affects around one in 10 women of reproductive age and around one in 5 of First Nations women. It is a common cause of fertility difficulties and can also be a risk factor for pre-diabetes, gestational diabetes, and type 2 diabetes. Symptoms include irregular ovulation, erratic periods, weight gain, and acne.

PCOS is a condition fuelled primarily by insulin resistance, and many of the same strategies that apply to diabetes management can also minimise the effects of PCOS. Once again, fibre is king. Foods high in fibre will combat insulin resistance by slowing down the rate of digestion, in turn regulating blood sugar. Processed foods void of nutrients, such as white flour, sugar-sweetened drinks, cakes, and other treats should be minimised. If you are craving something sweet, try reaching for a piece of fibre-packed fruit instead.

Organic, non-GMO soy foods, like tofu and edamame, can improve many aspects of PCOS, including reduced triglycerides, blood sugars, body weight, and insulin levels. Soy also has a high polyphenol content. Polyphenols are a family of plant-based compounds with a wide range of anti-inflammatory and antioxidant capacities. Because chronic, low-grade inflammation is common for PCOS sufferers, this is desirable.

Menopausal matters

Hot flushes, insomnia, sexual dysfunction, vaginal dryness, mood changes, and weight gain are all associated with ‘the change’. But do we have to accept this as a part of life? No. There are many ways to deal with these symptoms, including medical treatments, lifestyle changes, and food choices.

A series of interviews with women in the US, Canada, and Japan, conducted by anthropologist Margaret McGill, brought interesting insights into menopause. One of the most common complaints, hot flushes, was not experienced by women in Japan to the same extent as those in the other countries. In fact, it is so infrequent that they did not even have a word for the phenomenon. The only symptom mentioned, other than the cessation of periods, was shoulder stiffness – and men reported this symptom about as often as women did!

Thinking about the traditional Japanese diet, it is based on rice with relatively little meat and no dairy. The hormonal impact of avoiding dairy hormones could play a part here. Also, the Japanese women were slimmer on average, meaning that the oestrogenic effect of fat cells was also minimised. These women tended to eat a lot of soy, in the form of miso soup, tofu, tempeh, and edamame beans. Soy is a source of complete amino acids, but also phytoestrogens. The isoflavones contained in soy – specifically genistein – have been shown in studies to improve menopausal symptoms and bone mineral density, while reducing the risk of breast, prostate, and colon cancers. Another study that followed Japanese women over time found that those who ate more soy were 68 percent less likely to experience hot flushes than those who did not. However, various studies have had mixed results, and it is likely that overall this may benefit most women, but will not necessarily result in complete elimination of symptoms.

Low sperm count

If you or your partner have been diagnosed with a low sperm count, there are simple steps that can improve quality and quantity. Smoking and drinking are two habits to toss. Also, take the time to consider exposure to hormone-disrupting chemicals. Dioxins and heavy metals, which are especially concentrated in plastic-heated foods, farmed fish, and processed meats, have been associated with reduced sperm quality.

Studies have shown an association between reduced sperm count and saturated fat. If you have already said goodbye to animal products, there are only a few plant foods to be aware of that contain saturated fat, such as coconut, coconut oil, palm oil, and palm kernel oil. While reducing or eliminating these foods, also think about optimising vitamin E, selenium, and Co-enzyme Q10, which may also be helpful for healthy sperm. You can get these from nuts and seeds.

These are only a few of the major conditions that can be mediated by our hormones. It quickly becomes clear there is a common thread to maintaining balance: an eating pattern that avoids animal products, minimises refined or processed foods, and includes an abundance of fibre, antioxidants, phytonutrients, and numerous other health-promoting substances found in whole, plant foods. It’s clear, healthy hormones are connected to a healthy diet.

This article is republished with permission from nourishmagazine.com.au.

June 21, 2022
Fast facts: the ins and outs of fasting

Thinking about giving fasting a try? Here’s what you need to know beforehand. Spoiler alert: there is a way you can eat to enjoy the benefits typically achieved by fasting. Article first published in Nourish Magazine.

Rewinding to just over a decade ago, I had the experience of completing a three-month medical school placement at TrueNorth Health Center in California, under the supervision of internationally renowned physician and nutrition expert Dr Michael Klaper. TrueNorth offers a residential program based on a wholefood, plant-based diet, free from refined salt, oil, and sugar. It is also one of the only places in the world that offers medically supervised water-only fasting. Before undertaking my training at the centre, I knew nothing about fasting and since then, there has been an explosion of interest in this area. If this is something you are considering, here’s what you need to know as a starting point.

What you do eat matters more than any fast

Let’s get something straight before we consider any type of fast. Dr Klaper says, “More important than the fast is the food you eat day after day, month after month, year after year.” And the eating pattern the doctors at TrueNorth recommend before, and especially after a fast, is unanimously a diet of whole plant foods.

More important than the fast is the food you eat day after day, month after month, year after year

In fact, virtually every benefit ascribed to fasting – better metabolic health (improved insulin sensitivity and lower cholesterol), weight loss, lowered risk of cancer, reduced inflammation, and increased longevity – is also a benefit demonstrably experienced by those consuming a plant-based diet with whole and unprocessed foods as the foundation. There are good reasons for this, including that wholefood, plant-based eating is already naturally lower in energy density while still being satiating and nutrient dense. Therefore, to some extent this can mimic the caloric restriction a fast may aim to achieve. This type of eating pattern also excludes animal protein, which we know increases insulin-like growth factor 1 (IGF-1). A reduction in IGF-1 is touted as one of the most important effects of fasting, and some findings even imply that it is the reduction of protein intake that is most important to achieve this effect.

Invariably, people who participate in fasting studies do not all eat a healthy, low-fat, wholefood, plant-based diet. So, these studies don’t necessarily tell us whether fasting can add to the health benefits already gained when you eat this way. Longevity researcher Dr Valter Longo has become world-famous for his fasting trials and one of his most interesting findings is that the people who benefit most from his fasts are those who are the unhealthiest in the first place. While the effects of fasting will vary from individual to individual, you can be certain that any effect is ultimately less important than what you eat day to day on an ongoing basis. Just as you can’t out-exercise an unhealthy diet, you can’t out-fast one either.

Is there any benefit to fasting?

A fast is simply a period of abstaining from food and, in its purest form, would involve consuming only water for a specified time period. We carry fuel reserves that enable us to survive for significant periods of time between meals. About four to six hours after a meal, your body will have either used or stored the energy provided. In the absence of new glucose (energy) from food, your liver starts increasing production of substances called ketones to help keep your brain fuelled. As your body uses more of its stored glucose, it becomes more reliant on ketones, until at some point (usually around 16 hours after the last meal) it can be said to be in ketosis. This means your body is primarily operating on stored fat and ketone bodies.

Ketones signal a switch in your body’s metabolism. While in the ‘fed’ state, your metabolism favours growth and flexibility, whereas a ‘fasted’ state is characterised by an increased defence against stressors and repair of damage. Therefore, temporary forays into the fasted state are thought to slow ageing and be beneficial for health through numerous mechanisms. For example, a cellular cleaning process known as autophagy ramps up, enabling the body to clean out damaged and old cells, ultimately replacing them with newer, healthier ones.

However, there’s something important to understand about this process. It is the regular switching between the fed and fasted states that seems to be most natural and beneficial. Prolonged periods spent in either of these states at the exclusion of the other are likely to be suboptimal (and yes, this includes the keto diet).

Types of fasts you might consider

Because most of us live in an environment of calorie excess where food is available 24/7, we may only ever experience a fast when asleep. And many of the beneficial processes of fasting start up within hours, not days, of us going without food. In recent years, evidence has been mounting around the benefits of either intermittent fasting or an adaptation of periodic fasting that allows food. Let’s look at the most common variations:

The 16/8 Method

This form of intermittent fasting uses time-restricted feeding, where eating is limited to an 8-hour window during the day. For example, if the first meal is at 11 am, the last meal for the day would be finished by 7 pm. While most people achieve this by skipping breakfast, the optimal option metabolically would be to skip dinner instead.

The 5:2 Diet

In this variation of periodic fasting, calories are restricted on two non-adjacent days of the week, where only 800 calories are consumed. On the other five days, you eat as you normally would. This isn’t really an actual fast and is therefore presumably less likely to result in the benefits associated with fasting, depending somewhat on meal timing and composition.

Eat Stop Eat Fasting
This is a type of intermittent fasting that involves not eating for 24 hours, once or twice a week. During the 24-hour fasts, usually between dinner on one day to dinner on the next day, only water is consumed. This should result in at least six to eight hours of ketosis for most people. I would advise against anything more than gentle exercise during this period if you try this.

Fasting Mimicking Diet
This is a restricted-eating program where specific plant-based foods and supplements provided in a pack are consumed for five consecutive days, no more than once a month. On the first day, about 1,100 calories are consumed, dropping to 725 calories on days two through five. While some eating continues during the fasting period, the diet is designed to trick your cells into thinking they aren’t being fed.

To fast or not to fast?

Australian longevity guru Dr David Sinclair suggests “almost any periodic fasting diet that does not result in malnutrition is likely to put your longevity genes to work in ways that will result in a longer, healthier life.” While fasting may benefit many of us, it won’t be right for everyone, depending on personal and medical histories. Those with a history of disordered eating or other risk factors should be particularly cautious. Always consult a health professional who is trained and has experience with fasting if in any doubt. And, because fasting does place a strain upon the body, it is a practice that we are best to ease into – especially females, whose bodies can be more sensitive to changes in energy intake and timing of this.

While fasting may benefit many of us, it won’t be right for everyone.

However, some form of time-restricted eating can be possible and helpful for most of us. If the methods discussed previously seem too extreme for you, you can instead aim to eat within a 12-hour window each day – from ‘sun up to sun down’. Try to have a bigger breakfast and a smaller dinner. Our insulin sensitivity is greatest in the morning, and we are more likely to store calories consumed later in the day, which can also affect our sleep.

For those who’d like to try something closer to a traditional fast, the fasting mimicking diet would be a better option than a water-only fast for most. If you have specific medical issues that you believe would be best addressed by a water-only fast, then medically supervised is the only way to go. Find a reputable and established clinic like the one I trained at, TrueNorth, to support you.

Personally, I tend to keep my eating within a window of 10–12 hours each day. I regularly ‘fast’ one day a week, consuming only water. I might try Dr Longo’s fasting-mimicking diet once or twice a year, though I don’t particularly like the idea of stopping or restricting my exercise, work, and social life to complete it.

After all, there’s something to be said for quality of life! And a whole food, plant-based eating pattern provides the best of both worlds – enjoying loads of healthful whole, plant foods while also reaping numerous benefits not dissimilar to those provided by fasting.

This article is republished with permission from nourishmagazine.com.au.

April 27, 2022
Medical students lead the way by replacing sausages with a plant-based lunch

Future doctors at the Adelaide Medical Students’ Society O’Week celebrations kicked off university life the healthy way.

The Plant B Life and DFN team enjoying O’Week.

Each year, the Adelaide Medical Students’ Society (AMSS) welcomes future doctors to the University of Adelaide with an orientation day (O’Day). Last week, this popular event was held at the Adelaide Health and Medical Sciences building where 150 new students were provided with sun, music and food in a festival atmosphere. The O’Day lunch in the past included a free sausage sizzle. However, this year the AMSS committee decided it was time to make a more sustainable change to the menu.

Acknowledging that processed meats are classified by the World Health Organisation as group one carcinogens and that meat production contributes to climate change, AMSS approached Doctors For Nutrition in the lead-up to O’Week.

We were delighted to support AMSS to offer the crowd a plant-based lunch from Plant B Life. The meal included a protein-packed quinoa salad of broccoli, chickpeas, pumpkin and kale with a tangy mustard dressing. The students were also treated to a delicious bliss ball! The students appreciated the change from another sausage sizzle and devoured the food. Also with sustainability in mind, all of the packaging used by Plant B Life was compostable.

Quinoa salad provided by Plant B Life.

Our Advisory Council members, Dr Juliette Roex (GP Registrar) and Deeni Betar-Young (Accredited Practicing Dietitian), were at the event to engage with the students in discussions around the role of nutrition in healthcare. With poor nutrition being a leading cause of health loss and early death, attendees were interested to learn how they could one day support their patients by educating them on whole food plant-based nutrition. Deeni suggests: “a healthy eating pattern is fundamental for disease prevention and management, and this can be achieved through eating more plants, and focusing on whole foods”.

Advisory Council members, Dr Juliette Roex and Deeni Betar-Young.

When asked if they knew someone with a chronic health condition, many of the students indicated that they had a friend or family member with diabetes. This led to discussions around reversing diabetes, among other lifestyle diseases, with plant-based nutrition.

“A plant-based diet can help to prevent, manage and even reverse type 2 diabetes. Doctors For Nutrition aims to provide GPs and dietitians with this knowledge so that they will begin prescribing nutrition for many chronic illnesses, including diabetes” said Juliette.

“A plant-based diet can help to prevent, manage and even reverse type 2 diabetes.”

All students who attended the O’Week event were given a Doctors For Nutrition ‘Plant-based nutrition and health guide’ as a part of their welcome bag and many collected a nutrition information pack from the stall. These guides and resources are available free to download via the Doctors For Nutrition website.

Plant-based nutrition information provided to O’Week attendees.

We look forward to continuing to support health organisations to show leadership in their events by promoting healthy, environmentally friendly, plant-based food.

Photos by Jacqui Brogan.

March 9, 2022
A doctor’s advice to help kids enjoy more fruit and vegetables

Simple tips to help your kids develop a long-term healthy relationship with what’s on their plate.

As a family medicine doctor, the more I read the latest evidence-based information about feeding our children, the more I realise the importance of giving them the best start in life with a nutrient dense whole food plant-based diet.

Although as a mother of two young plant-powered boys, I also realise how disheartening it can be when you have spent precious time planning, buying and cooking a delicious healthy plant-based meal, only for it to be thrown on the floor.

Doctor’s orders are to not give up, your effort is worthwhile!

Plant-based diets have many advantages, including being lower in saturated fat and cholesterol, while also delivering more fibre, antioxidants, folic acid, vitamins C and E, carotenoids, and a host of other beneficial phytochemicals.

Children eating a plant-based diet are much more likely to be in the healthy weight range. Evidence is clear that childhood obesity strongly correlates with being obese as an adult, illustrating just how important a healthy start in life is.

I hope the following tips are helpful in the daily challenge of feeding fussy, stubborn small people, ultimately increasing your child’s intake of whole foods and developing a long-term healthy relationship with what’s on their plate.

1. You only have control over the ‘when’ and ‘what’, don’t sweat the rest

Meal times can be stressful. When I’m feeling frustrated that my kids won’t eat something I remind myself of the ‘what’, ‘when’, ‘which’ and ‘how much’ rules. As a parent I have control over ‘when’ my child eats and ‘what’ is served. The child’s role is to decide ‘which’ foods they will eat and ‘how much’. You can lead a horse to water but you can’t make them drink and toddlers can be more stubborn than any donkey.

Build a plate for your child that incorporates some healthy foods you know they like and then also offer something new or yet to be liked. The trick is not to panic if they don’t eat much for a meal. They are likely to make up for the calories with healthier foods later in the day so try to avoid offering something else less nutritious.

2. New food is alien and must be analysed

For young children, new foods can be overwhelming. Children use all of their senses to explore foods; how it feels, what it looks like, how it smells, what it sounds like when you poke it. All of this enquiry must first be conducted before it will receive the ‘OK to be eaten’. Therefore it is important we repeatedly give the child the opportunity to analyse the food, often serving it in different forms, so they can become confident to eat it.

3. It is ok to hate brussel sprouts

My kids actually like brussel sprouts but it is ok if your child has some foods they dislike. Heck, we all have some foods we don’t fancy.

4. Make it fun

Look inside for your inner child when you serve food to kids. Remember to be enthusiastic, make food colourful and fun. Kids love choice, so giving them two options can be a winner at our house. I like to use cookie cutters to make vegetables (like cucumber) into fun shapes. Talking positively about food is important.

Try to avoid statements like ‘eat your broccoli, it will make you big and strong’, no one likes to be told what to do especially kids. Instead use descriptive words, such as ‘can you hear how delicious and crunchy this apple sounds when you take a bite’. This makes food sound exciting and catches their curiosity. At our house we call broccoli baby trees and at times we are all dinosaurs eating our broccoli trees (all the while making dinosaur sounds).

5. Which brings me to my next tip, role modeling

Children’s brains are wired to observe and copy adult role models. We learnt this the hard way when our three year old started saying ‘crap!’ every time something upset him. It is super important for your kids to see you eating healthy foods, sit with them at meal times and show them how you eat and enjoy healthy meals. It’s really not fair to have rules for them that don’t apply to you.

6. What you bring home (or order online) is what you and your kids will eat

I often ask parents at my GP clinic what they had for dinner the night before and commonly I hear potato chips and chicken nuggets. Parents often shrug and tell me that’s all their child will eat. I have to remind people that if they are buying chicken nuggets then there is a high chance that their children will eat chicken nuggets. Their children are not the ones in charge of the weekly grocery shop.

7. Make food a family affair

Get kids involved in buying, preparing and cooking healthy foods and they will be much more likely to eat them. Cooking is an essential skill for a healthy life. Make meals a priority, turn off the TV and sit down together as a family at least once a day. For older kids, talk to them about your values and why you choose to eat this way, so they can be better informed to make healthy food choices of their own as they grow older.

It takes a village to raise a child. What you do at home is super important but we also need to support each other and advocate for what is important to us. If this is something you are passionate about, talk to your local school or kindy about the benefits of whole plant foods, get involved in community events, write to your local council about ideas you have.

I want to see our chronic health pandemic improve. I want to preserve our beautiful planet for my children to explore. Change happens from the bottom up, vote with your forks and trolleys and watch your children thrive.

If you have any great whole food, plant based recipes I would love to hear about them, please reach out!

Dr Taisia Cech is a GP who is board certified in lifestyle medicine and holds a certificate in plant-based nutrition. She has a lifestyle clinic, The Healthstyle Doctor, in Nelson, New Zealand, which offers individual and group lifestyle support, both locally and virtually.

Find her at thehealthstyledoctor.com and on social media @thehealthstyledoctor. Taisia has recently contributed to the Doctors For Nutrition recipe collection, available for free.

February 3, 2022
The heart of the matter

Heart disease is an everyone disease. Thankfully, your lifestyle has the power to protect your lifelong health. First published in Nourish Magazine.

The heart is a magnificent pump made of very specialised tissue that, over an average lifetime, beats about 2.5 billion times. For long-term health, we need to look after this vital organ – and it’s never too early to start.

Sadly, heart disease is the number one cause of death in Australia and New Zealand, with more than 50 people dying of this condition in our region every day. While the statistics are eye-watering, the good news is that positive lifestyle changes can help you avoid and, in some cases, even reverse coronary heart disease. Chief among them is adopting a dietary pattern centred on whole plant foods, with every step in this direction offering greater benefits for your heart health.

But am I really at risk?

The process that leads to the development of heart disease starts from a very young age in most of us. So, understanding the risk factors and ailments associated with the disease is an important step to take to prevent yourself, or your loved ones, from becoming a statistic.

Major mechanisms in this process include the build-up of fatty cholesterol-laden plaques in our coronary arteries and the inflammation that develops in the lining of our blood vessels, known as endothelial dysfunction. Heart disease develops when plaque – made of fat, cholesterol, calcium, and other substances in the blood – builds up inside the artery walls, limiting the supply of oxygen-rich blood to the heart muscle.

The plaque inside these inflamed blood vessels can rupture, causing a clot that interrupts blood flow to the heart, and without oxygen, the heart muscle dies leading to a heart attack or sudden cardiac death.

Given modern lifestyles, most of us are at some risk. Who hasn’t had a chat with their doctor about cholesterol by the time our thirties are behind us?

Doesn’t it come down to genetics?

It has been said that we not only inherit our genetic makeup from our ancestors but also the family recipe books and habits. And, in many cases, the latter is more influential in determining our health trajectory than our genes. In fact, through good lifestyle choices, we can actually modify the expression of our genes. This is known as the science of epigenetics.

In the case of heart disease, we can significantly decrease our risk by eating a healthy plant-based diet, which naturally helps us maintain a healthy weight, decrease our LDL (or ‘bad’) cholesterol, dampen endothelial inflammation, decrease our diabetes risk, and support a healthy gut microbiome.

By eating this way, we are following the consistent advice of national health bodies: to eat a diet rich in nutrient-dense whole plant foods; naturally high in fibre, antioxidants, and anti-inflammatory compounds; and one that is low in unhealthy fats, salt, and added sugar.

While we cannot change factors such as our age, sex, and genetics, a healthy lifestyle gives us the best chance at supporting our heart through all stages of life.

Lifelong health is built with lifestyle

A diet based on plentiful whole plant foods is the foundation of good heart health. It is also fundamentally important to keep active, develop good sleep patterns, cultivate healthy ways to manage stress, and nurture positive social connections. These lifestyle interventions not only offer protection against developing heart disease but can even halt and reverse the condition.

By adopting a healthy lifestyle and a wholefood, plant-based diet, we are addressing the root causes of heart disease. The fact that common biological processes underpin virtually all chronic diseases means that your wholefood, plant-based way of eating doesn’t just reduce one risk factor – it has an influence on them all. This is different to using medications, which target specific conditions that are seen as risk factors for heart disease. For example, statins that are prescribed to lower cholesterol or anti-hypertensive medications that are prescribed to treat high blood pressure.

Cultivating a healthy lifestyle helps to circumvent the causes of disease and illness, hopefully avoiding the need to treat the symptoms of disease later.

Yes, there’s proof that plants work

In fact, a low-fat, wholefood, plant-based diet is the only diet that has been shown to halt and reverse heart disease. For example, lifestyle medicine pioneer Dr Dean Ornish is famous for helping Bill Clinton use a vegan diet to reverse heart disease. Dr Ornish also conducted a randomised controlled trial in which patients adopted a low-fat, plant-based diet alongside regular walking, relaxation, and group support.

The study group showed regression of atherosclerosis (arterial plaques) after one year, with further improvement after five years. The study group also experienced a 72 percent reduction in the frequency of chest pain (angina) compared to just 36 percent in the control group receiving standard care, of whom 60 percent needed cholesterol-lowering medication and 20 percent required the placement of a stent.

These kinds of results have been demonstrated in both small and large groups of patients, using a wholefood, plant-based diet alone – even at a population level where we can observe the overwhelming relationship between plant-predominant dietary patterns and the virtual absence of heart disease.

The wholefood approach

It is important to appreciate that a plant-based diet cannot be automatically assumed to be a healthy one. Saturated fat, processed sugars, and excessive salt from any source can negatively affect your health. It’s best to limit or avoid processed or manufactured foods because there are often fats, salt, artificial flavourings, and sugars added to enhance palatability. We also want to limit sources of plant-based saturated fat, such as coconut oil, and calorie-dense foods, such as cakes, burgers, and pizzas.

You can decrease your heart disease risk factors by emphasising simple wholefoods and minimising processed and packaged products. The enormous health benefits of a plant-based dietary pattern are all linked to this lower calorie density, higher nutrient density way of eating. This healthy eating pattern focuses on wholegrains, legumes, starchy and non-starchy vegetables, fruits, herbs, and spices – ingredients that lend themselves to a wide range of delicious dishes in flavours and styles from cuisines around the world.

Obviously, the more that you lean in the plant-based direction, the more the beneficial effect. For people with existing markers of heart disease, it certainly pays to go ‘all in’, with the supervision of a knowledgeable health professional. However, if your aim is to maintain and optimise good health, you may prefer to start small and work towards a more committed wholefood approach as you feel the benefits for yourself.

A healthy lifestyle helps to circumvent the causes of disease and illness

But wait! There’s more

When talking about heart disease here, we’ve been focusing on coronary artery disease, which is caused by narrowing or obstruction of the coronary arteries that supply the heart. However, the same processes that occur in the arteries of the heart also occur elsewhere in the body, manifested in many ways.

For example, blockages and reduced blood supply to the brain are major causes of strokes, cognitive decline, and dementia. Peripheral vessels can also become narrowed or blocked, limiting blood supply elsewhere in the body. This, by the way, is why erectile dysfunction is commonly thought of as a ‘canary in the coal mine’ for heart disease.

Shockingly, cardiovascular diseases as a whole cause nearly one in three deaths in Australia and New Zealand, and an enormous amount of suffering and disability. The powerful flipside is that the same lifestyle changes that prevent and treat coronary heart disease also offer protective and therapeutic benefits for all of these associated vascular diseases.

These lifestyle measures are not only life-enhancing, but often more effective. And it keeps going. They also offer protection from a wide range of other diet-related diseases from diabetes to cancer – bringing only the very best of side effects, from maintaining a healthy weight naturally to enjoying clearer skin and more energy. Pass the plants, please!

6 heart healthy foods

Eating a rainbow of whole and minimally processed plants is a proven way to reduce risk factors for heart disease. Here are just some of our favourites.

Blueberries – rich in antioxidants, helping to decrease inflammation in blood vessel walls.

Tomatoes – rich in the potent antioxidant lycopene, shown to help lower cholesterol and decrease heart disease.

Broccoli – loaded with fibre, antioxidants, and vitamins, helping to guard against calcification of blood vessels.

Green leafy vegetables – provide a natural package of heart-healthy nutrients including vitamins A, C, E, and K.

Beetroot – contains a high concentration of healthy plant-based nitrates that help dilate or open blood vessels, leading to lower blood pressure.

Oats – help lower LDL and total cholesterol while improving insulin response to sugar and supporting a healthy gut microbiome.

This article is republished with permission from nourishmagazine.com.au.

January 31, 2022
Doctors For Nutrition: 2021 in review and outlook for 2022
There is no doubt the last two years have left a profound mark on society. One benefit from this tumultuous period has been a wake-up call for health.

Doctors For Nutrition have been enthused to see the importance of healthy nutrition elevated. Over the course of the year it has been well documented that what we eat can affect our body’s ability to prevent, fight and recover from infections. There has also been broad recognition that human diets are inextricably linked to environmental sustainability. These facts have made the urgency for a shift to healthy plant-based nutrition even more critical.

Over the course of 2021 we have seen the ability for our global community to work together to solve problems. Doctors For Nutrition have seen the same response from our own passionate community who have connected with us at events, shared our educational material and supported us in our advocacy work.

In 2021, we continued to place evidence-based knowledge at the finger-tips of people across the healthcare sector and wider community via educational, events, website resources, policy submissions, mainstream and social media.

Our nutrition and health toolkit for clinicians has gained even more traction as a valuable resource. 4,000+ healthcare practitioners and their patients have downloaded it or received a complimentary copy via mail.

We teamed up with a range of dietitians, doctors and other plant-powered people to curate a set of delicious recipes. To-date more than 21,000 people have perused our collection to find out what’s for dinner.

2,200+ health professionals, students and members of the public took advantage of our exceptional line-up of expert presenters for our Food Vitals Webinar Series.

As part of the inaugural United Nations Food System Summit, we were honored to be joined by 52 experts from a range of healthcare and food-related fields for our Independent Food Systems Dialogue. The conversation focused on national dietary guidelines as a lever to attain a healthier, more sustainable and equitable food system.

Sadly, we farewelled 2 team members, including Catherine Laurence, who was integral to establishing our charity. We were, however, pleased to welcome 2 new team members and 2 new Advisory Council members. We enjoyed ongoing collaboration with our strategic partners and allies, and were grateful to be supported by 120 generous volunteers.

See further details of the year’s achievements in the snapshots below, and read on to discover what’s in store for 2022.
Growing our reach

in 2021 we:

Built our e-list to over 6,000 subscribers, doubling it since last year.

Had 78,000 unique website page views, our new recipe collection proving extremely popular (see more below).

Increased our social following to 16,200 across our social channels (up 22% from last year).

Enjoyed providing our expert-opinion across a range of magazines, newspapers, radio, podcasts and websites.

Continued our regular contributions to Nourish Magazine and New Zealand Vegan and Plant-Based Living.
Educational events

in 2021 we:

Ran 4 Food Vital Webinars, viewed more than 1,150 times. Each interactive session provided the opportunity to learn from our speakers’ extensive nutrition knowledge and clinical experience.
I am a 64 year old GP practising medicine for 40 years. I only came across all the evidence for the benefits of WFPB this year thanks to DFN. I have completely changed my diet in the past 4 months and dropped my cholesterol back into the normal range. I promote WFPB to all my patients.
Reached thousands of healthcare professionals and students this year by collaborating, presenting and attending health conferences and webinars. This included:

The NZ General Practice Conference, Aotearoa’s largest GP conference

The Australian Medical Students’ Association (AMSA) Global Health Conference

The AMSA National Convention

AMSA Rural Health Summit

The Australasian Society of Lifestyle Medicine Diabetes Summit

The General Pathology Conference

Greening the Healthcare Sector Forum

Hungry For Change, a special webinar for medical students on healthy, sustainable diets and how to talk to patients about it.

Held an ‘introduction to plant-based’ webinar as part of No Meat May and led a panel at the Vegan Festival Adelaide, both focused on driving awareness amongst the general public.

Planned to exhibit at the Royal Australian College of General Practitioners’ GP21 Conference, however this was unfortunately cancelled due to Covid-19.
Nutrition resources

in 2021 we:
Continued to share our nutrition and health toolkit. This year 77% of survey respondents who have used these educational resources with their patients reported an increase in the frequency with which they discuss plant-based nutrition, and 71% feel more confident to do so.

Collaborated with plant-based experts to provide 60 recipes with no added oil, very low to no added sodium, and no refined sweeteners. In less than 6 months they have been accessed by 20,000 people. The corresponding dietitian-designed meal plan and shopping list has been downloaded 1,000+ times. Our new eCookbook has been downloaded 350 times in just 5 weeks.
My husband and I used the meal plan and shopping list to begin our whole food plant-based eating. It made the transition much easier and we found all the recipes to be very delicious.
Health policy, guidelines and advocacy

in 2021 we:

Leveraged the opportunity to participate in the Australian Dietary Guidelines review, commencing with the NHMRC scoping survey.

Continued to focus on the importance of the guidelines review by hosting an Independent Food Systems Dialogue. We assembled a group of experts from our region and beyond. They concluded that Australian diets need to significantly increase plant-based and minimally processed foods, with corresponding reductions in animal-sourced and highly processed foods. The detailed feedback from our event was submitted to the United Nations for consideration as part of September’s United Nations Food Systems Summit.

Provided input into a number of Department of Health, United Nations and World Health Organisation documents as part of their consultation process:

National Preventative Health Strategy

UN Decade of Action on Nutrition 2016-2025

WHO fat intake guidelines

National Obesity Strategy

Senate inquiry on food labelling

Added our voice to a number of global and national campaigns, calling for an urgent shift to plant-based diets to combat climate change:

ProVeg Diet Change campaign

Healthy Climate Prescription

Plant-based Treaty

Open Letter to Prime Minister Scott Morrison calling for more ambitious action on climate change to protect health
Some of the DFN team throughout 2021.

What’s coming up in 2022?

Next year we will continue to educate, equip and empower healthcare professionals and their patients about the life-saving benefits of whole food plant-based nutrition.

With your support, we will expand our educational programs, offering webinars, workshops and CPD accredited learning and development courses specifically for healthcare professionals.

Our website will be relaunched to provide a more user-friendly experience for healthcare professionals and their patients, including a searchable database of plant-friendly practitioners.

As the Australian Dietary Guidelines review progresses, we will continue to call for the new guidelines to place a much stronger emphasis on the health benefits of plant-based eating patterns and the risks associated with meat-heavy diets.

Acknowledging the rise in people transitioning to a more plant-focused diet, we look forward to sharing new resources to support this shift.

Already underway is a research project to demonstrate the affordability of a whole food plant-based diet compared to a typical Australian diet, and the significant environmental benefits via emissions modelling. We expect to publish our findings in 2022.

Alongside these projects we’ll be continuing to strengthen and grow alliances with other organisations, and seek impactful opportunities to gain traction for our messages about whole food plant-based nutrition for health—human health and planetary health.

From all of us at DFN, thank you for accompanying us on our mission. Here’s to a year ahead filled with action towards health and well-being, both now and into the future.

If you’d like to get involved in supporting our work you can find out more now.
December 15, 2021
5 best plant-based present ideas: Christmas gifts for the plant-curious to the plant-obsessed

The countdown is on, are you running out of time to find the perfect gift for your loved ones this holiday season? Meaningful, purposeful presents that don’t break the budget are not always the easiest thing to find. Why not consider one of the many fantastic whole food plant-based (WFPB) books that have hit our shelves this year, or fall back on an old favourite? We have reached out to a couple of bookworms on our expert Advisory Council to see what has taken pride of place on their bookshelves. Here is what they read (and loved) this year.

The Plant Power Doctor

Written by Dr. Gemma Newman

The Plant Power Doctor is a lovely, easy to read book that contains so much (referenced) plant-based nutrition information. You can really feel Gemma’s warmth and care when reading it.

The book contains sections on why and how to lead a healthy plant-based life. The sections are in different colours and contain a combination of factual information, recipe templates, real-life stories and some beautifully photographed, easy to prepare recipes.

Written in easy-to-understand language, I can visualise Gemma speak as I read. In the first section she discusses what a whole food plant-based diet is and why it is healthy. She then goes on to discuss other topics such as heart health, diabetes, hormones, healthy gut and longevity. Gemma describes how to change to a whole food plant-based way of eating and then offers some recipe advice.

As a plant-based GP myself, I appreciate the clear language she uses. The book’s format is like a motivating and inspiring consultation. There is something for everyone, from an omnivore looking at dipping their toes into a plant-based diet, through to a long-time vegan who wishes to eat as healthily as possible, through to someone who has eaten whole food plant-based for years.

Review by Dr. Adrian Griscti, Ambassadoc, South Australia

The Proof is in the Plants

Written by Simon Hill

“Longevity, prevention of disease and a beautiful, healthy planet”. I feel that this quote by esteemed gastroenterologist, Dr. Will Bulsiewicz in the forward of, The Proof is in the Plants, neatly summarises what this book is all about.
This is the most informative, up-to-date and fun ‘reference’ book on plant-based dietary patterns that I have read in quite a while. The amount of research that Simon Hill put into writing this book is really phenomenal. It is a book that you can pick up and easily read whether you have an interest in nutrition or whether you have a science-based tertiary degree. It is accessible to everyone who wishes to expand their knowledge base in this area.

As a science nerd, I have enjoyed visiting Google Scholar and reading quite a few of the referenced scientific and clinical studies. The data presented demonstrates the undeniable common thread between dietary patterns and human health.

Apart from the direct health benefits, this book holistically looks at many aspects of a plant-based way of eating including the sustainability of our planet – not just climate change but also the impact of western diet upon rates of zoonotic diseases and degree of deforestation and their impact.

Although the book is jam-packed with information in its 400 or so pages, the layout includes tables, diagrams, highlighted sections and factual summaries, making it a very easy read. It is a book that I will continue to refer to again and again.

By all means read this book from cover to cover, but truly you could open it up at any page and because of the way it is presented you will expand your nutrition knowledge immediately.

Review by Dr. Adrian Griscti, Ambassadoc, South Australia

Whole by Natural Harry

Written by Harriet Birrell

My wife Jenny and I own quite a library of plant-based nutrition books which we regularly loan to family and friends and some of my patients. One book that is not allowed to leave our kitchen bench however, is, Whole by Natural Harry.

All the recipes in this hardcover book are absolutely delicious, easy to make and without a long list of difficult to find ingredients. They are all healthy WFPB dishes, without added oil. Opposite each recipe is a mouth-watering colour photo of the dish.

The book starts with a section with Harry’s tips on cooking plant-based meals. She then presents some of her favourite recipes grouped into different categories. Our dog-eared, food smudged copy of this book opens up at multiple favourite recipes including the ‘Cheesy Zucchini Noodle Bake’ page! Each recipe has a comment from Harry describing her thoughts and feelings about her creation. There is also plenty of space on each page to allow you to make your own comments.

Whole is a beautiful book with a textured cover and pages that feel delightful to hold. The photography is spectacular and accentuates the delicious food. This is a book that would make a well-loved gift – if you can bear to part with it. Our other favourite recipes are ‘Sweet Potato Nachos’, ‘Oaty Seed Loaf’ and …all the rest!

Review by Dr. Adrian Griscti, Ambassadoc, South Australia

The Plant-Based Diet Revolution

Written by Dr Alan Desmond

UK based gastroenterologist Dr Alan Desmond is a close friend of Doctors for Nutrition, having spoken at our inaugural conference in 2019 and continued to share his expertise on all things gut related during subsequent webinars.

His first book provides a carefully thought out and practical introduction to a plant-based diet, with (unsurprisingly if you’re one of almost 65k following him already on Instagram) an emphasis on the latest research on gut health, naturally complemented by some delicious recipes!

The Plant-Based Diet Revolution is succinct and highly visual, with the look and feel of a contemporary cookbook – it’s easily digestible in small bites. Perfect for those who might just want to skim or jump around through different topics and the numerous tips and success stories peppered between, before deciding which of 80 included recipes they’ll try out today. Yet, in its entirety it answers all of the questions anyone curious about a plant-based diet might want to ask.

I’d highly recommend The Plant-Based Diet Revolution for anyone you’d love to encourage to become more plant-based. The beautifully presented recipe section alone, with its simple but attractive recipes with a refreshing UK twist (more familiar to most of us down-under) makes it a great gift to entice even your least plant-forward relatives or friends. Plenty of gluten free and oil free/optional recipes too. Vive la (Plant-Based Diet) Révolution!

Review by Dr. Luke Wilson, Board Director and New Zealand Ambassadoc

Eating Plant-Based; Scientific Answers to Your Nutrition Questions

Written by Dr Shireen Kassam and Dr Zahra Kassam

If you are buying for the friend who loves to be the first at everything, pre-order this new book due out on 20th January 2022. It is written by our very own International Advisor and founder of, Plant-Based Health Professionals UK, Dr Shireen Kassam and her sister Dr Zahra Kassam, founder of Plant-Based Canada.

Eating Plant-Based; Scientific Answers to Your Nutrition Questions, is a Q&A style book that addresses common health-related topics about a plant-based diet. A global transition to a plant-based food system has now become an urgent imperative for both human and planetary health. Even though plant-based diets are associated with some of the best health outcomes and supported by major nutrition and dietetic organisations around the world, myths about the requirement for meat, dairy and eggs persist.

This book is for anyone who would like a deeper understanding of the scientific evidence supporting a plant-based diet and its impact on human health. It is a guide for health professionals who are increasingly meeting people in their practice who have chosen to adopt a plant-based diet. It is for those of you who are already following a plant-based diet and for those who would like to switch to this way of eating but are being put off by family and friends who question your choice and fill your head with doubt. Is it safe to raise children on a plant-based diet? How do you get enough protein? What about calcium? The answers to all these questions are simple and straightforward and this book provides the scientific background to our understanding of plant-based diets.

If you are thinking about making the transition, this book will give you the confidence to do so. If you are already following a plant-based diet, it will help you with advocating and discussing your choice with others in an impartial, evidence-based way. The questions are based around the sisters’ experience of advocating and educating family, health professionals, patients and the public on plant-based diets for the last decade.

If you haven’t had a chance to check-out all these good reads yourself, grab two copies! Not only will you enjoy the read but it will be a lovely way to connect, discussing what you have learnt and comparing recipe notes.

We’d love to hear what plant-based books you’d add to the Santa list this year! Let us know via social media.

November 30, 2021
WFPB: Restrictive or Intuitive?

Is it possible to align a wholefood, plant-based approach with intuitive eating? Absolutely! It’s all about an abundance of healthful food.

Intuitive eating is a concept that’s become increasingly well-known since Evelyn Tribole and Elyse Resch first developed it in the ’90s. These pioneering dietitians founded a movement that provides a valuable counterpoint to unhealthy dieting and weight-loss culture, embracing a non-dieting approach to self-nourishment and care.

By removing food restrictions, the principles of intuitive eating can offer a welcome escape from the ‘black and white’ thinking that often accompanies dieting, fostering a healthier relationship with food. Intuitive eating encourages tuning in with our body’s needs, which can be revolutionary, especially for people who have been trapped in a cycle of yo-yo dieting.

Isn’t plant-based a food restriction?

As long as a plant-based diet is not adopted as a subterfuge for restrictive or disordered eating, it’s absolutely possible to take an intuitive-eating approach. But how does a wholefood, plant-based (WFPB) eating pattern fit in, given that this seeks to exclude highly processed as well as animal-derived foods? Does it go too far and tip us back into a diet mentality?

Although it’s often referred to as the WFPB diet, this way of eating is not like other diets that require a restrictive mindset. Firstly, the goal of a WFPB eating pattern is not weight loss, but health improvement. It will often result in weight loss, but this is a by-product, not the purpose of the lifestyle. The benefits occur without any need for restricting or monitoring dietary intake. In fact, this is actively discouraged.

Instead, a WFPB approach encourages eating to satiety from a rainbow of vibrant whole plant foods that are rich in fibre and phytonutrients and low in calories, while being naturally filling and satisfying.

Secondly, the focus is on what’s included rather than what’s excluded. When you load up on the good stuff, there won’t be any room for processed or animal-derived products. In line with intuitive eating principles, a WFPB way of eating is all about feeling good within ourselves and having a relationship with food that fits with the values of respecting our bodies and honouring our health and wellbeing.

Lastly, it’s also an empowering way for us to take a daily stand for a kinder and fairer world – values of increasing concern for many of us. These are motivations that are both life-affirming and self-affirming, rather than being about restriction or body image.

Intuiting your way to WFPB

Although going fully WFPB is great (with qualified supervision if you’re on medication, given that needs can rapidly change), many people prefer to dip a toe in first and move gradually. This is absolutely fine and very much part of the WFPB philosophy.

The aim is progress not perfection, and any pace that works for you is likely to be self-reinforcing as the benefits make themselves apparent. With that said, there are a number of questions that arise when eating intuitively and WFPB. The first and most obvious is that eating whole or minimally processed plant foods may not feel intuitive at first.

What if I crave junk food?

Processed food and many restaurant foods, especially from the big fast-food chains, are specifically designed to be hyper-palatable, with ‘craveability’ being their holy grail. An entire food industry has been built around tricking our taste buds (and microbiota!) into thinking we want more of what are essentially ‘food-like substances’ – high in added salt, oil, and sugar.

Not only that, but these items are heavily marketed and ever-present in our day-to-day environments. As a result, before we truly tune in to our bodies, we might feel ‘intuitively’ inclined to reach for these types of products. The key here is to come back to your motivations of optimal wellbeing. Seek out and sample healthier wholefood options at a pace that’s right for you and, crucially, give your body a chance to adjust as you try out what will undoubtedly feel unfamiliar (and possibly even boring) at first.

Research suggests that our taste buds take about 12 weeks to adapt to and appreciate new flavours through the fascinating process of neuroadaptation. At the same time, our gut bacteria will also rapidly adjust, influencing our cravings in a healthier direction the more we crowd out the junk with a variety of whole plant foods.

Doesn’t WFPB often lead to weight loss?

A strong theme in intuitive eating is that weight loss should never be the goal. So how does this square with WFPB diet proponents who note that a healthy weight is a protective factor against many chronic diseases and often flag weight optimisation as one of its benefits? Some clarification is needed here.

Intuitive eating doesn’t actually demonise the idea of weight loss where this may be beneficial for an individual’s health, any more than it would where weight gain is needed. The point is that traditional diets don’t work, so weight-related goals are put aside and goals such as healthy living, feeling good, and trusting your body’s cues are prioritised.

In close alignment with this, a WFPB approach isn’t about dieting or weight loss either, rather it’s about attaining and maintaining good health.

What about ‘unconditional permission to eat’?

One of the intuitive eating principles is around giving yourself unconditional permission to eat. Well, if like me you are convinced by the WFPB nutrition science, you no longer consider animal-based or highly processed foods as nourishing food choices, so it’s not about restriction but about what you choose to include based on your convictions. Not only that, but a key aspect of a WFPB diet is that it can be eaten ‘ad libitum’ – with no portion control, calorie counting, or food monitoring – while enjoying the wonderful side effect of better health!

This was powerfully seen in the BROAD study, a highly successful trial in rural New Zealand in a community suffering from high rates of obesity and type 2 diabetes. The participants were guided to follow a traffic light system indicating foods that form part of a healthy WFPB diet and encouraged to have as much of these as they liked. Many of the participants reported that ‘not being hungry’ was a key factor in enabling them to stick to the program. The study results spoke for themselves, with participants’ health markers improving dramatically, including natural reductions in BMI, weight, and cholesterol as well as resulting reductions in medication needs.

What if I don’t feel full and satisfied?

Some people associate WFPB eating with ‘rabbit food’ and worry that they’ll no longer feel full or satisfied if they preference these foods. And this certainly wouldn’t fit with the intuitive eating principles of honouring our hunger, feeling our fullness, and discovering what feels satisfying. Fortunately, tuning in to our hunger cues is crucial when we choose a WFPB way of eating, too.

In fact, because whole plant foods usually have a much lower calorie density than foods in a typical Western diet, we are likely to need bigger portion sizes when eating this way, which may seem counterintuitive at first, especially when we’re culturally conditioned to distrust large servings! Eating to fullness, or satiety, when we consume foods high in fat, means we have already consumed excess energy. By contrast, when we follow a WFPB diet without restrictions on quantity, we feel full without having consumed excess energy.

What’s abundantly clear in the literature is that, whatever your size, changing your diet to include predominantly whole plant foods is likely to induce beneficial changes in your biochemistry. And the rewards come quickly, from reduced inflammation to better immunity and hormonal regulation to a thriving gut microbiome. What better way to reinforce an intuitive approach to eating and a truly healthy relationship with food!

Separating fact from fiction

There are some myths and misconceptions about intuitive eating. Let’s clarify.

Unconditional permission to eat means anything goes, so nutrition doesn’t matter

Not at all! Intuitive eating is all about attuning to your body’s needs and what it calls ‘gentle nutrition’ whereby you make choices that honour your health and what feels good. This results in positive physical and mental health outcomes and an escape from counterproductive cycles of restriction.

Eating intuitively means eating to emotional cues

The intuitive eating principles emphasise coping with our emotions with kindness and specifically counsel against using food to comfort, distract, or numb painful feelings. Instead, they advocate dealing with the source of difficult emotions, recognising that ‘eating for an emotional hunger may only make you feel worse in the long run’.

Weight-related goals are always a sign of disordered eating

False. Intuitive eating principles don’t preclude wanting to achieve or maintain a healthy weight as part of your overall health and wellbeing goals. The point is that achieving a particular body size and shape isn’t the focus.

There is no such thing as a healthy weight

While intuitive eating rejects diet culture, it doesn’t deny the health risks of obesity. What it does do is help people escape cycles of dieting that are known to promote poor body image, guilt, and disordered eating patterns without any lasting weight-loss benefits.

This article is republished with permission from nourishmagazine.com.au.

November 8, 2021
United Nations Food Systems Summit

The United Nations Food Systems Summit was held in September, 2021. The Summit was called to address the critical role food systems play in global challenges such as the double burden of malnutrition (under-nutrition and over-nutrition), climate change, and inequality.

H.E. Amina Mohammed, Deputy Secretary-General of the UN presenting at the Summit

The outcomes of the Summit will deliver progress towards achieving the UN’s 17 Sustainable Development Goals (SDGs), goals that Australia and Aotearoa New Zealand have formally committed to.

Was it the “people’s summit” the world needed?

Over the past 18 months, the Summit brought together global leaders and communities from around the world to collaborate, share best practices, foster innovation, influence local and global agendas and transform the way the world produces, consumes, and thinks about food.

Locally to feed into the Summit process, DFN held an Independent Food Systems Dialogue, uniting experts from a range of healthcare and food-related fields in our region and beyond.

Although the Food Systems Summit was praised by many, it was boycotted by a wide array of scientists, researchers, food producers, advocacy and Indigenous groups. Criticism included the heavy influence of industry interest groups, the inability to address the role and responsibility of the corporate sector in the food systems and a lack of interactive or meaningful participation from grassroots movements, Indigenous peoples, small-scale farmers, and other marginalised populations.

One hotly debated topic was the place of animal source foods in a sustainable food system. ‘Solution clusters’, or thematically organised groups, have been established to bring together a menu of possible actions. The ‘solution cluster’ for sustainable livestock could not reach a unified set of actions for its final proposition, ultimately three separate papers were submitted, rather than one.

Far from wasted effort

Regardless of its shortcomings, the message from the Summit has decisively hit the world stage: clear and radical actions are needed to ensure that our broken global food system can deliver on the triple challenge of health, economic livelihoods, and environmental outcomes.

Three-quarters of the UN member states have submitted a National Pathways document, a commitment to build on existing initiatives and leadership. Initiatives, alliances, coalitions and commitments have also been formed by a breadth of Summit participants. Commitments include: promises to improve Indigenous People’s participation in food systems transformation, addressing malnutrition in adults and children, promoting gender equality, and protecting biodiversity.

Local action

Aotearoa New Zealand Prime Minister, Jacinda Ardern, has committed to elevate the role of the Māori people in the food system and encourage a Māori worldview through every step of the process. This mirrors the view of our keynote speaker at our DFN Independent Food Systems Dialogue, Professor Boyd Swinburn from the University of Auckland, who outlined the nascent Mana Kai policy that draws on Māori concepts around the social and environmental aspects of food, and how these are interrelated.

Australia has not yet submitted any firm commitments in the form of a National Pathways document although the member state dialogues, convened by the Australian Government Department of Agriculture, Water and the Environment earlier this year, did acknowledge that there are important synergies between a healthy diet for people and the planet. The dialogue report noted that key changes required in Australia involve increasing the proportion of healthy plant-based foods in diets, decreasing energy intake and decreasing intake of unhealthy food and drinks.

Australia played a very active role during the course of the Summit in promoting livestock as key to a sustainable food system. Greater emphasis must be placed on ensuring high-income countries like Australia, where protein and calorie excess is the norm, shift towards supporting the consumption of more plant foods. These shifts have been highlighted as a non-negotiable prerequisite to remaining below the 1.5°c warming threshold set by the 2015 Paris Climate Agreement, and necessary to secure a safe operating space for humanity.

The Australian Government has joined the Global Sustainable Livestock Coalition, established as part of the Summit process, alongside the World Farmers’ Organisation, International Livestock Research Institute, International Dairy Federation and others. The coalition has been established to, among other objectives, provide governments, investors, donors, and multilateral institutions, with ‘accurate science-based information about livestock’s role/actions in delivering the SDGs’.

National dietary guidelines for a healthier, more sustainable and equitable food system

The Summit has identified Food Based Dietary Guidelines (FBDGs) as a solution area that needs to be substantially improved and used much more effectively. A 2019 review indicated that 90 countries had FBDGs, yet most had not had their intended effect, including in Australia.

Few countries’ FBDGs consider sustainability issues, such as environmental aspects, food waste, food safety, access, affordability, the important roles of traditional foods, or cultural acceptability. The proposition is that all countries should have FBDGs, based on sound science, tailored to their specific country, and incorporating sustainability as well as health concerns.

The onus is on high-income countries such as Australia to make radical shifts in diet, especially in relation to animal-sourced foods. This requires improvements not only to the content of our current dietary guidelines but also to their implementation. They are an informational instrument that needs to be backed up by a supportive policy environment. FBDGs should be applied in guiding other relevant public policy such as public procurement, hospital and school food, food labelling, fiscal policies, etc.

A page from the Brazilian food guide.

Brazil’s FBDGs are often hailed as world-leading. Notwithstanding, their commitment at the Summit includes implementing dietary guidelines based on scientific evidence, to support public policies in different sectors. These policies will aim to “strengthen consumer information and reinforce agendas that foster healthy diets, in particular, the consumption of fruits and vegetables”. And rightly so. Research has shown that if FBDGs were redesigned and fully adopted, the economic value of reduced mortality is estimated to be US$7.2 trillion to US$8.9 trillion, or equivalent to between 10 and 15 percent of global GDP.

Locally the Australian Dietary Guidelines (ADGs) review is currently underway, led by the National Health and Medical Research Council. They are committed to a transparent, inclusive process that will provide the public and interested parties the opportunity to contribute. The aim is to ensure the revised guidelines use the most relevant, high-quality evidence and are user-friendly.

The revised ADGs can be an important catalyst for change. If the guidelines consider the impacts of diet on our food system and the SDGs, it is more likely that other government portfolios start engaging with them as a lever. We must get them right.

Food systems touch every aspect of human existence, from individual health to the health of our environment and our societies. They have a direct or indirect bearing on all 17 Sustainable Development Goals. Image: United Nations Development Program

Leveraging the momentum

Food systems are one of the most fundamental elements of modern human society, forming complex webs of food producers, supply chains, regulators, markets, and consumers. This complexity may leave us feeling powerless. Has the Summit simply created even more policy inertia, more recommendations that will never see the light of day? What role, if any, do we all have to play in transforming our food system?

Two comments from keynote speakers at the DFN Independent Food Systems Dialogue remind us that we have the power to drive change together.

“The only way we are going to overcome policy inertia is by lifting the voice of civil society and holding the main power brokers to account, that is the government and the food industry.”

Professor Boyd Swinburn

“We have the power as individuals…we must use our fork, our note and even our vote for a better future and a better food system.”

Dr Sandro Demaio, CEO of VicHealth

Keynote presentations from the DFN event are available to watch now.

DFN looks forward to the momentum from the Summit continuing with the upcoming COP26 climate conference and, closer to home, the ongoing review of the ADGs. Like many across Australia, we eagerly wait to learn if Australia will step-up to the calls from other G20 countries and greatly improve our contribution to global climate action.

If you are interested in helping our work to inform the review of the ADGs, please get in touch by email or via our contact form.

If you are interested in helping our work to inform the review of the ADGs, please get in touch by email or via our contact form.

October 7, 2021
Global greenhouse gas emissions from animal-based foods double that of plant-based foods

A new study published last month in the Nature Food Journal, is one of the first to account for net carbon dioxide, methane and nitrous oxide emissions from all sub-sectors related to food production and consumption.

This comprehensive study led by the University of Illinois examined four major sub-sectors for plant and animal-based food emissions associated with food production processes. These were: land-use change, farmland activities, raising livestock and other activities beyond the farm gate, such as transport, from 171 crops and 16 animal products across the globe.

The study found that our food system accounts for 35 percent of all human-made greenhouse gas emissions. Across all regions, emissions equivalent per capita are greatest from the production and consumption of animal based foods. The authors used complex and robust methods of assessment to show very clearly that emissions from production and consumption of plant-foods are around half that of animal based foods, when we take into account the land use requirement, feed, methane production and processing requirements.

The majority of emissions from food production were animal based (57 percent). Only 29 percent of emissions were attributed to the production of plant-based foods. Beef, cow’s milk and pork were the biggest contributors to this tally, with rice being the most greenhouse gas intensive of the plant-foods. The top 10 plant-based foods in terms of emissions equivalents (apart from rice), were all relatively low, when compared to the animal based top 10.

Production and consumption based GHG emissions from plant and animal based food.

Source: Xu X, Sharma P, Shu S, et al research paper

What is of huge concern is that while emission calculations for land use, methane and nitrous oxide are in-line with previous studies, overall emissions calculated in this recent study are much higher than previously estimated by the Food and Agriculture Organization of the United Nations in 2010, and more in line with the upper estimates provided by the IPCC. This really highlights the significance of food based emissions and the urgency of action now required.

The United Nations projects that over the period 2009 to 2050, food production will need to increase by 70 percent to meet increasing food demand…

he United Nations projects that over the period 2009 to 2050, food production will need to increase by 70 percent to meet increasing food demand. Increased food production may accelerate land-use changes for agriculture, resulting in greater greenhouse gas emissions, reduced carbon sequestration and further climate change.

With the exponential rise in food demand in mind, this study once again reinforces the importance of the need for an urgent change in consumption towards more plants, particularly in high meat-eating countries like Australia. Shifting to a whole food plant-based diet not only significantly lowers your personal greenhouse gas emissions, it also improves your health. A win-win for people and planet!

Key reference
Xu X, Sharma P, Shu S, et al. Global greenhouse gas emissions from animal-based foods are twice those of plant-based foods. Nat Food. Published online September 13, 2021:1-9. doi:10.1038/s43016-021-00358-x

October 6, 2021
Simplify and Nutrify

The four fundamentals of healthy eating aren’t complicated at all. Read how easy it can be to nutrify your eating pattern. Article first published in Nourish Magazine.

At last Plant-based eating is catching on at an increasing pace, and for good reasons: personal health, reducing our environmental footprint, and compassion for animals are all powerful motivators. From a health perspective, saying goodbye to animal products is a fantastic step. Even lean, white, or unprocessed meats are laden with saturated fat. Plus, animal products are the only source of dietary cholesterol and contain a host of inflammatory compounds proven to contribute to chronic diseases such as heart disease, diabetes, and common cancers.

By choosing plant foods instead, we give ourselves a tremendous head start in both maintaining and regaining good health through all life stages. But establishing a healthy plant-based dietary pattern can be a challenge, especially when we are used to a standard Western diet, and the lure of convenience foods is ever-present.

So, let’s simplify everything and focus on nutrifying your diet. These fundamentals of healthy eating will help you and your family take advantage of an abundant, life-affirming wholefoods approach to plant-based eating.

Power plate courtesy of Emma Strutt, APD

#1 Wholistic Habits

A wholefood, plant-based way of eating makes vegetables, fruits, whole grains, and legumes the stars of your plate. Keeping these in their pure state or minimally processed retains all their nutrients, taking advantage of your body’s natural mechanisms such as feeling satiated, stabilising blood sugar levels, and promoting healthy gut flora, which has numerous knock-on benefits for your overall health.

A great rule of thumb is to fill half your plate with vegetables and fruits and the other half with whole grains, starchy vegetables (such as potato, sweet potato, pumpkin, and peas), and legumes (such as lentils, beans, and chickpeas). Nuts, seeds, herbs, and spices can be used in smaller quantities for additional flavour and texture.

Like any new undertaking, there’s plenty to learn before eating this way becomes a habit, but the good news is that once you’re on a roll it becomes second nature, so persistence pays off. As you focus more on wholefoods, you’ll notice that your cravings change, too. Your taste buds will adapt, and your gut microbes will no longer respond well to processed, packaged, or animal-based foods. It’s a self-sustaining cycle, and you’ll see the rewards are worth it!

#2 Plan to Plantify

A few meal-planning basics can make including more wholefoods in your diet so much more manageable and enjoyable. A great starting place is to ‘plantify’ some familiar recipes. Perhaps spaghetti bolognese transports you back to your childhood happy place? This is a perfect example of a dish that is even tastier as a plant-based version. Adapting old favourites will help you establish a repertoire of trusted dishes, and there’s no shortage of recipes you can look to for inspiration and guidance.

If you include ‘wholefood, plant-based’ or ‘WFPB’ in your searches, you’ll be well on the way. When planning for the week, consider dishes that can be made in larger quantities so that there is plenty for a couple of dinners or leftovers for work lunches. Freezer-friendly recipes are great candidates for double batches as they can be frozen for another time, making for a ready-to-go nutritious meal whenever you need it. You can even prep up healthy breakfasts such as overnight oats or chia puddings, which are perfect options for making ahead of time.

Once you’ve got your recipes sorted for the week, it’s a great idea to jot down your shopping list before heading to the markets or grocery store. Having a list with you will avert those impulse purchases and ensure you have the right ingredients on hand at home, making it much easier to follow through on your good intentions.

#3 Oil-free cooking

Remember, vegetable oils are not wholefoods, therefore are not recommended as part of a wholefood, plant-based diet. For example, while whole olives and sunflower seeds provide a nutritious package of fibre, amino acids, vitamins, and minerals, extracting just the oil leaves behind the vast majority of these important nutrients. What remains is a concentrated source of liquid fat, shifting our calorie intake away from the healthier, complete foods.

Here’s the good news! You don’t have to give up those caramelised onions or crispy roast potatoes. With a little know-how, there are many ways to cook dishes without oil – and without sacrificing the flavour.

For any kind of pan-frying, water can be used to moisten the pan – just add a little at a time to prevent food sticking. This works so well, you’ll wonder why you ever used oil to begin with. For caramelised onions, the trick is to start by dry frying them before adding water. Add the sliced or diced onions to a hot pan and keep them moving for a couple of minutes, until they start to brown. Then, simply add one tablespoon of water to deglaze the pan, let it evaporate, and repeat while continuing to stir until the onions are soft and brown.

Roasting veggies without oil is just as easy, once you quit that habitual oil drizzle! If you’re concerned about sticking, baking paper or reusable silicone baking sheets work well, although cooking without oil actually makes for easier washing up. Just leave any stuck bits to soak and your dish will wipe clean. For oil-free roast potatoes that are golden on the outside and fluffy in the middle, parboil or steam them before roasting. Moisture is added during this step and, because the potato is cooked part of the way through already, it won’t dry out in the oven. Yum!

#4 Naturally Sweet

Intrinsic sugars, or in other words those that occur naturally in whole fruits and vegetables, come wrapped in a package of healthy nutrients, making them a welcome part of a wholefood, plant-based diet. By contrast, added or refined sugars are best kept to a minimum. In this way, sugars are similar to extracted oils versus the wholefoods the oils are extracted from.

Be aware that there are upwards of 40 types of sugars found in packaged food and drinks. Brown rice syrup, malt syrup, agave syrup, fruit juice concentrate, coconut sugar, date sugar – the list goes on, and most are no more healthful than plain old white sugar!

Ditching added sugar doesn’t mean an end to sweet treats though. For example, in wholefood, plant-based baking a cup of overripe mashed banana can be substituted for a cup of sugar, or you can use unsweetened apple sauce in the same way. In both instances, you’ll just need to reduce the other liquids in the recipe slightly to account for the moisture in the fruit.

If your added sugar intake is moderate, after about one week you’ll find you’ll have more stable energy throughout the day and the cravings will have ceased. Fruits will seem sweeter and more delicious than ever before and, if for example you opt for the occasional piece of dark chocolate, you’ll be amazed by how rich and satisfying it is in small quantities.

If in doubt, go back to basics

It’s often said that healthy eating has become too complicated and, with the masses of information at our fingertips, it is easy to get bogged down and overwhelmed. But, amidst all the claims and counterclaims, there is one simple formula that won’t let you down. Eat ‘wholefoods’ and ‘plant-based’. This is a great guide to sustainable, healthy eating that is abundant in nutrients.

This approach says a big YES to a wide variety of colourful, nutritious foods that lend themselves to limitless dishes, from familiar favourites to any number of cuisines from around the world. Not only that, when we focus on what we’re including rather than what we’re excluding, it’s easy to crowd our plate with health-promoting, wholesome foods, gradually displacing processed and animal-based foods. The added bonus: it’s a lifestyle that offers the freedom to delete that calorie or macro-tracking app and eat up!

This article is republished with permission from nourishmagazine.com.au.

September 15, 2021
The role of national dietary guidelines in attaining a healthy and sustainable food system
The world’s first UN Food Systems Summit, taking place in September 2021, aims to identify bold new actions to meet urgent global health and sustainability goals. To feed into the Summit process, DFN held an Independent Food Systems Dialogue in July focusing on national dietary guidelines as a lever to attain a healthier, more sustainable and equitable food system, both in Australia and globally. Below we share the keynote talks from the dialogue, a link to our feedback report, and a summary of the recommendations made by our expert participants.

Food systems touch every aspect of human existence, from individual health to the health of our environment and our societies. They have a direct or indirect bearing on all 17 Sustainable Development Goals. Image: United Nations Development Program

Why dietary guidelines, and why now?

Well-designed dietary guidelines based on the best available evidence, free from industry influence, have significant potential to influence improved diets. They are an example of a ‘triple-duty action’ that could address multiple aspects of the Global Syndemic of obesity, undernutrition and climate change.

In high-income countries, where protein and calorie excess is the norm, shifts to plant foods correlate consistently and robustly with higher overall diet quality. These same shifts are not only desirable in terms of planetary health – which underpins all human health – but are a prerequisite to remaining below the 1.5°c warming threshold set by the 2015 Paris Climate Agreement, and securing a safe operating space for humanity. Without these shifts, led by the highest-consuming nations such as Australia, the Sustainable Development Goals will inevitably be undermined.

The world’s first UN Food Systems Summit, coming up next month, aims to identify bold new actions to align the food system with the Sustainable Development Goals. To feed into the preparations for the Summit, Doctors For Nutrition convened an Independent Food Systems Summit Dialogue in July. With dietary guidelines being one of the solution areas identified under the Summit’s Action Track on sustainable consumption, and the Australian Dietary Guidelines review underway at present, our aim was to explore the role of national dietary guidelines in attaining a healthier, more sustainable and equitable food system.

DFN brought together experts from a range of sectors to explore how national dietary guidelines can support food systems transformation
DFN’s Food Systems Summit Dialogue

Bringing together experts from a range of healthcare and food-related fields in our region and beyond, we invited participants to explore three key questions around the Australian Dietary Guidelines via focused breakout groups:

What would truly sustainable Australian Dietary Guidelines look like?

What are the existing barriers to implementation of the guidelines and how can we overcome them?

What fresh ideas can we consider to drive multi-sectoral implementation?
The keynote presentations from the event were recorded and are available to watch here, with thanks to our guest speakers, Dr Shireen Kassam, Professor Boyd Swinburn and Dr Sandro Demaio.

The detailed feedback from the dialogue as a whole has been submitted to the Summit convenors via the UN’s official feedback form.
Summary of key messages

The key headline recommendations emerging from the dialogue are summarised below:

Dietary guidelines must integrate sustainability and equity issues into their scope of evidence and resulting recommendations.

Australian diets need to significantly increase plant-based and minimally processed foods, with corresponding reductions in animal-sourced and highly processed foods. Messaging around the guidelines must highlight this.

Guidelines must be culturally responsive, reflecting diverse dietary patterns and cultural wisdom about the relationships between food, health and planet.

Industry interests must not have a seat at the table in the development of dietary guidelines or any other aspects of nutrition and public health policy. Profit motives of harmful interests require vigilance and strong governance.

The Australian Dietary Guidelines should be used to underpin nutrition education, healthy food policies and sustainable agriculture in Australia.

Policy coherence is essential so that the dietary guidelines are not undermined by policies, regulations and programs in other sectors.

Coordination across government, at all levels, is required to support an enabling environment for dietary shift. Sector leaders have a key role but industry efforts need to be further incentivised and codified.

The dietary guidelines need to be supported by an effective implementation plan including education for health professionals, school students and the public.

Monitoring and evaluation is essential to measure progress towards implementation and drive targeted action to identify and fill the identified gaps, leaving nobody behind.
We are grateful to everyone who brought their expertise to contribute to a rich dialogue, resulting in a set of exciting proposals for consideration by the convenors of the Food Systems Summit.

In addition to our keynote speakers, we extend special thanks to the facilitators of the three breakout discussion rooms: Dr Talia Raphaely (consultant, Sustainably Speaking), Dr Peter Johnston (dietitian, Perfect Human Food), and Dr Aletha Ward (public health academic, University of Southern Queensland).

If you are interested in helping our work to inform the review of the Australian Dietary Guidelines, please get in touch via our contact form.
August 11, 2021
AMSA Global Health Conference 2021

We engaged with the new generation of health professionals at the AMSA Global Health Conference 2021 and gained some important insight on what medical students think about the role of nutrition in healthcare.

On 6-7th August more than 250 medical students came together in Perth, Australia for a few inspiring days of learning and fun at the annual AMSA Global Health Conference 2021. Doctors For Nutrition were there to engage with students and raise the importance of nutrition in healthcare.

Conference highlights

With this year’s conference theme ‘Seeds for change’, it was a perfect occasion for DFN to spark interesting conversations with future doctors about a healthcare system that embraces evidence-based nutrition as the first line of defence.

A large number of students visited the DFN stall for information on the benefits of plant-based eating. The DFN team consisted of Nutrition and Research Development Lead, Dr Angela Genoni, Neuroscience PhD Student, Hugo Morandini, and DFN Ambassadoc for Western Australia, Dr Alyce Churchill. Our team was on-hand during the conference, educating the delegates about the important role of nutrition in medical practice and distributing free practical resources.

Dr Angela Genoni said: “Some of the students approaching our stall have already been following vegan or vegetarian lifestyles and were engaging with more in-depth conversations on the benefits of plant-based eating for long-term health.”

“In contrast, we also spoke to a large number of students who confessed that they didn’t know much about nutrition as they were not taught about nutrition in medical school”, added Hugo Morandidi.

On the second day of the conference, Dr Angela Genoni delivered a short talk on ‘The Power of Plants’ where approximately 60 medical students had a chance to learn more about how plant-based nutrition can reduce rates of developing chronic disease.

More than 100 ‘Plant-based nutrition and health,,’ toolkits were distributed to students to assist them in facilitating nutritional advice during patient consultations.

The DFN team agreed that students’ interest in the benefits of plant-based eating was very reassuring. “Students understood very quickly why we needed to be here. It felt we were at the right place at the right time”, explained Hugo Morandini.

The gap in nutrition education

“A plant-based diet is a powerful prescription for good health. Many of the world’s leading killers – from heart disease and type 2 diabetes to certain types of cancer – can be prevented by focusing our diets on plant-based foods”, said Dr Neal Barnard, President of the Physicians Committee for Responsible Medicine and DFN International Advisor.

Yet historically, nutrition education is not a major focus of medical training internationally, including in Australia. According to a 2019 study, medical students receive very little nutrition education during medical school. This educational gap makes it very difficult for medical graduates to provide preventative, evidence-based nutrition advice that could help optimise patients’ long-term health and combat chronic conditions.

Medical students speaking about nutrition

During the conference, the DFN team had a chance to ask medical students what they think about the role of nutrition in medicine. It was encouraging to hear from students like Jana about her views on nutrition: “Nutrition is one of the key ways to prevent non communicable disease’’, she said. She added that she would like to see much more emphasis should be placed on optimising health through lifestyle, especially given how much misinformation is out there.

Closing the gap

Since 2018, Doctors For Nutrition has been on a mission to fill the educational gap in the current healthcare system by providing nutrition information and resources to current and future medical professionals.

Having the opportunity to work with Australian Medical Students’ Association the organiser of the Global Health Conference 2021 in Perth, was an important step in extending DFN reach to the next generation of doctors. It was also an opportunity to strengthen relationships with AMSA who share a vision for promoting evidence-based nutrition approaches in medicine.

In their position statement, AMSA is calling for a medical education system to improve the quality and quantity of nutrition education so graduating medical students are better prepared to provide appropriate nutritional advice in clinical practice.

After a successful event like the AMSA Global Health Conference 2021, the DFN team is looking forward to collaborating with AMSA on future events to highlight the importance of plant-based nutrition education for medical students.

Next steps

Missed this event and want to learn more about the benefits of plant-based nutrition?

The DFN website provides a number of practical educational resources designed for health professionals in clinical practice. You can get a copy of the Plant-based Nutrition and Health Guide and access the Food Vital Webinars to learn more about the benefits of whole food plant-based eating. The DFN recipe collection is also a great place to find inspiration for health-promoting recipes and access practical tips when cooking for nutrition.

Author bio:

Martina Brayford is a Doctors for Nutrition volunteer who is passionate about the importance of plant-based nutrition to improve the quality of people’s lives and reduce chronic illnesses. Martina holds a certificate in Plant-Based Nutrition from the T. Colin Campbell Centre for Nutrition Studies at Cornell University and studied Food & Nutrition Coaching at the Nature Care College in Sydney.

With her Plant Oceans Nutrition website, Martina is on a mission to promote plant-based eating among her community and friends in Western Australia, advocating the power of food as medicine and sharing local knowledge about plant-based produce.

August 8, 2021
NZ’s updated Eating and Activity Guidelines allow for “totally plant-based”
The Ministry of Health of Aotearoa New Zealand has recently announced an update to its national Eating and Activity Guidelines, including a number of meaningful changes that Doctors For Nutrition is encouraged to see.

The Ministry of Health of Aotearoa New Zealand has recently announced an update to its national Eating and Activity Guidelines.[1] While the central ‘Eating and Activity Guidelines Statements’ for adults remain the same and were not reviewed, several meaningful changes have been made that are welcomed by health-promotion charity, Doctors For Nutrition.

1. Kiwis have a new ‘plate model’ with a focus on whole plant foods

The tools used to describe what a healthy eating pattern looks like have changed and the Ministry of Health has created a plant-centric image [2] that looks somewhat similar to Canada’s Food Guide.

This updated image makes it clear that if an adult chooses to eat red meat, chicken or fish, these components should be a small segment of overall food intake.

As the nutritional guidance developed in 2015 was not reviewed, the ‘milk and milk products’ segment remains. However in 2019 the NZ Ministry of Health recommended ‘reducing dairy’ within its ‘Sustainability in the Health Sector’ report [3], so chances are high that the ‘milk and milk products’ segment will be reconsidered in future.

When Canada’s Food Guide was updated in 2019, a strong emphasis was placed on plant-based eating patterns for health and environmental sustainability. Dairy no longer has a stand alone segment, instead becoming a minor part of the ‘protein foods’ segment, alongside a statement to ‘choose protein foods that come from plants more often’.

2. The guidance is “largely plant-based” and explicitly allows for “totally plant-based” eating patterns

Figure 1. Eating and Activity Guidelines image: ‘Choose a Balance of Healthy Food Every Day’

While the flexible guidelines do allow for moderate amounts of animal-based foods (eggs, dairy, poultry, seafood) and small amounts of red meat, it’s now clear that fully plant-based eating patterns are covered by these guidelines too.

Official recommendations are made for plant-forward changes to the eating practices of New Zealand adults, including limiting processed and red meat and increasing consumption of vegetables, fruit, legumes, nuts and seeds.

Will Kiwis get on board with putting this advice into action? Research by Colmar Brunton shows over 1.5 million New Zealanders are already eating less meat and that interest in ‘flexitarianism’ is growing fast. [4]

Despite this progress, there is much work to do to implement equitable policies that ensure all individuals and households have reliable access to healthy, affordable and sustainable food.

Health professionals are making their voice heard on these key issues, including OraTaiao: New Zealand’s Health and Climate Council, an organisation representing over 700 health professionals, who have called for Government Ministers to establish a Tiriti-based food system that is equitable, improves health, and reduces climate pollution. At a regional level, health advocates in Nelson are urging their City Council to adopt C40 Good Food City policies to make it easier for everyone to access healthy, sustainable food.

Table 1. Recommended dietary changes for New Zealand adults, from the 2020 Eating and Activity Guidelines for New Zealand Adults

3. For those that choose to include meat in their diets, the recommended standard serving size for cooked lean meat has decreased to 65g

The new serving size for lean meat applies to cuts including beef, lamb, pork and veal. Further guidance suggests adding legumes to meat dishes to help increase intake of plant foods.

Serving sizes for cooked or canned beans, lentils, chickpeas, or split peas are generous at 1 cup (150g) and the serving size for tofu is 170g.

4. The Guidelines include commentary on the “urgent need to promote diets that are healthy and have low environmental impacts”

For the first time, the eating guidance acknowledges that the current food system is having a negative impact on the environment and the importance of promoting eating patterns that factor in environmental sustainability. This includes considering greenhouse gas emissions, fresh water quality and scarcity, land use, soil health and food waste when recommending eating patterns.

       “Globally, people are increasingly focusing on the way that food is produced and consumed, and the negative impacts the food system is having on the environment. There is an urgent need to promote diets that are healthy and have low environmental impacts.”

– 2020 Eating and Activity Guidelines for New Zealand Adults

Doctors For Nutrition is hopeful that the New Zealand Ministry of Health will follow up this acknowledgement by swiftly reviewing their ‘Eating and Activity Statements’ to more clearly recommend plant-based sustainable eating patterns with reduced meat and dairy.

The Ministry of Health acknowledges the government sector has more work to do to define what constitutes sustainable healthy diets in the New Zealand context. A recent study by researchers at Otago University found that a population shift towards healthy, low-waste plant-based diets could reduce diet-related climate emissions by up to 42%. [5]

The study authors call for immediate action on policies to support this transition, stating “our findings reinforce the message from the recent EAT-Lancet Commission that the global evidence base is sufficiently strong to justify urgent action among policymakers, and that further postponement poses a great risk to society”. [6]

5. Advice has been added for pregnant and breastfeeding women, including statement to “Encourage, support and promote breastfeeding”

It is clear that nutrition is critical during the phases of pregnancy, breastfeeding and infancy and Doctors For Nutrition are pleased to see updates provide guidance for mothers, including advice for vegetarians and vegans. Pregnant and breastfeeding women who follow vegetarian or vegan diets are encouraged to discuss nutrition with their team of health professionals.

The guidelines recommend exclusive breastfeeding until 6 months and continued breastfeeding until two years and beyond, listing a wide range of health benefits for both infant and mother.

       “Breast milk is the ideal food for babies because it provides important nutrition plus antibodies, enzymes, hormones and growth factors that cannot be replicated in commercially produced infant formula. [7] Improving breastfeeding rates in Aotearoa/New Zealand will directly contribute to achieving equity for Māori”

– 2020 Eating and Activity Guidelines for New Zealand Adults

Alongside the health benefits, the guidelines describe breastfeeding is also the most environmentally sustainable option for feeding a baby. [8]

Importantly, it’s also acknowledged that the responsibility for breastfeeding does not lie solely on the mother and that everyone has a role to play in supporting breastfeeding, from partners, family, whānau, friends and health professionals to workplaces, early learning services, health facilities and the wider community. More information on breastfeeding and supporting breastfeeding can be found here.

If you are seeking more information on plant-based pregnancies, retired paediatrican Dr Heleen Haitjema has some reassuring advice.

6. The updated Guidelines acknowledge the wider determinants that influence people’s food and physical activity choices, and ultimately their health.

Age, ethnicity and socioeconomic status shouldn’t be a barrier to healthy nutrition, which is a basic human right. Yet these factors unjustly have a significant influence on both diet and health outcomes. Data from the New Zealand Health Survey shows that while most children live in food secure households, almost one in five children (19%) in New Zealand lived in severely to moderately food-insecure households in 2015/16. [9]

The Eating and Activity Guidelines acknowledge that there are a range of factors that influence dietary choices and many of these are not under individual control.

      “Many different factors contribute to people’s food and physical activity choices, and ultimately their health. These include social, cultural, economic, accessibility, practical and personal factors and it is important to acknowledge that many of them are not under people’s direct control. Differences in these underlying factors contribute significantly to the inequity in relation to diet, physical activity and health in New Zealand.”

– 2020 Eating and Activity Guidelines for New Zealand Adults
The Guidelines also refer to pae ora, the Government’s vision for Māori health. Pae ora is a holistic view of health that sees the elements of mauri ora (healthy individuals), whānau ora (healthy families) and wai ora (healthy environments) as interconnected and mutually reinforcing.

To achieve food security for all whilst improving human health, health equity and environmental wellbeing, leaders must follow the lead of scientists in acknowledging food as an urgent priority. Doctors For Nutrition look forward to Government progress on policies and initiatives that foster pae ora and ensure that all whānau have reliable access to healthy, affordable sustainable kai.

Summary

While the main dietary recommendations were not reviewed and hence remain unchanged, Aotearoa New Zealand’s updated 2020 Eating and Activity Guidelines contain useful additions and may signal further positive changes to come.

There is more clarity that the guidelines describe an eating pattern that is ‘largely plant-based and the new ‘plate model’ helps to communicate this in visual form.

It’s pleasing to see that “totally plant-based” eating patterns are noted to fit within the flexible guidelines.

Serving size recommendations have been updated. For those that choose to eat meat, a standard serve of lean meat is just 65g.

Acknowledgement of the wider determinants of food choices gives hope that national policy action will follow to support everyone to have reliable, equitable access to a nutritious diet.

Endorsement of breastfeeding and its benefits, as well as the need for everyone to play a role in supporting breastfeeding, is a key new update.

Arguably the most significant addition is the inclusion of commentary on environmental sustainability and the “urgent need to promote diets that are healthy and have low environmental impacts”.

This progress and increased clarity is pleasing to see. But in the face of health, equity and environmental crises, revision of the more substantial Eating and Activity Guidelines Statements is urgently needed.

The Australian Government has recently announced that they will provide $2.5 million to the National Health and Medical Research Council to review the 2013 Australian Dietary Guidelines. During this review process, Doctors For Nutrition will call for health equity and environmental sustainability to be key factors in the updated guidance, and a strong emphasis on promoting whole food plant-based eating pattern.
Key references

Ministry of Health. 2020. Eating and Activity Guidelines for New Zealand Adults: Updated 2020. Wellington: Ministry of Health. https://www.health.govt.nz/system/files/documents/publications/eating-activity-guidelines-new-zealand-adults-updated-2020-jul21.pdf

Ministry of Health. 2020. Choose a Balance of Healthy Food Every Day PDF. Wellington: Ministry of Health. https://www.health.govt.nz/system/files/documents/publications/choose-balance-healthy-food-every-day-dec20.pdf

Ministry of Health. 2019. Sustainability and the Health Sector: A guide to getting started. Wellington: Ministry of Health. https://www.health.govt.nz/system/files/documents/publications/sustainability-and-the-health-sector-30jul2019_1.pdf

Food Frontier and Life Health Foods, 2019. Hungry for plant-based: New Zealand consumer insights. Colmar Brunton. https://www.foodfrontier.org/wp-content/uploads/2019/10/Hungry-For-Plant-Based-New-Zealand-Consumer-Insights-Oct-2019.pdf.

Drew J, Cleghorn C, Macmillan A, Mizdrak A. Healthy and Climate-Friendly Eating Patterns in the New Zealand Context. Environ Health Perspect. 2020;128(1):17007. doi:10.1289/EHP5996

Willett W, Rockström J, Loken B, et al. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019;393(10170):447-492. doi:10.1016/S0140-6736(18)31788-4

Davidove M, Dorsey J. 2019. Breastfeeding: A Cornerstone of Healthy Sustainable Diets. Sustainability, 11(18), 4958. doi:10.3390/su11184958

Victora, Cesar G et al. 2016. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, Volume 387, Issue 10017, 475 – 490. https://doi.org/10.1016/S0140-6736(15)01024-7

Ministry of Health. 2019. Household Food Insecurity Among Children: New Zealand Health Survey: Summary of findings. Wellington: Ministry of Health. https://www.health.govt.nz/publication/household-food-insecurity-among-children-new-zealand-health-survey
July 27, 2021
Staying plant strong

Changing your diet can present the odd challenge as your body adjusts to different foods. DFN Board Director and Ambassadoc Dr Luke Wilson explores some common concerns and how to overcome them. Article first published in Nourish Magazine.

Last year, I reached the personal milestone of being fully plant-based for 10 years. I’ve been helping others make this change for almost as long and every year, more and more people from all walks of life are becoming enthusiastic about making the plant-based transition. Whether you’ve made this choice for health, environmental, or ethical reasons (or a combination of all three!), it’s undeniable that going plant-based can throw up the odd hurdle. Let’s better understand some of the most common issues people face, so you can help yourself (or someone you know) stay the course of this positive change.

I have no energy

Plant foods like fruits and (especially) vegetables are less energy dense (lower in calories) than animal products, so we can run into problems if we simply substitute one for the other. Feeling lethargic and low in energy when following a plant-based diet, believe it or not, is almost always because we are simply not eating enough!

Often, this happens when plant-based eaters make well-intentioned efforts to avoid eating too many carbs, but complex carbs are the body’s best source of fuel. Starchy vegetables, whole grains, and beans and legumes contain four, five, and six times more energy respectively than other vegetables and up to twice as much energy as fruit. So, it’s little wonder that our ancestors relied on (minimally processed) staple crops like rice, potatoes, oats, corn, and wheat to provide most of their energy. If you’re feeling low on energy, the best place to start is simply eating more food, emphasising these more concentrated sources of healthy carbohydrates.

I need more protein

Protein is the most overhyped nutrient ever. Because it’s a term often (erroneously) used interchangeably for ‘meat’, our protein intake can become a hot topic of conversation or receive misplaced concern when we reveal we only eat plants. Protein is found in all whole foods and our daily protein requirements are tiny: about 10 percent of our total daily energy intake is optimal for most. If this sounds low, consider that our bodies grow the most and the fastest when we are babies – and the perfect food to fuel that growth is breastmilk, with a whopping 7 percent of energy from protein!

Because almost all plant-based foods provide over 10 percent of energy from protein (except fruit, which is generally about half this), if you are meeting your energy needs from plant-based foods, you are almost certainly getting all the protein you need from it too.

It’s worth noting that although beans and legumes are often seen as the best source of plant-based protein (around 20–30 percent of energy from protein) – and are certainly an excellent choice to include in your diet regularly – there’s no need to consume these in large quantities, or at all if you’d rather not. Even if you just ate corn all day, you would easily get over 150 percent of your daily protein requirements.

While athletes or people who are very physically active may wish to look more closely at their protein intake, most people can simply forget about it. We have an inbuilt drive to eat more when we exercise more (which is why exercise alone isn’t particularly effective if your goal is weight loss) and when we eat more whole, plant-based foods, we automatically get more protein. Problem solved!

It upsets my belly (gas)

In contrast to protein, fibre is likely the most underrated component of our food, and we should be paying more attention to it. Fibre is essential for staving off gut-related disease, but most people who follow the standard Western diet don’t manage to consume the minimum recommended amount. In contrast, the average plant-based eating pattern easily meets or exceeds our fibre requirements. Simply changing from omnivorous eating to fully plant-based will increase your fibre intake over one-and-a-half times.

However, the reason that fibre is so important for our health is also the reason it can give us trouble, especially when we first switch to eating more plants. It feeds the trillions of bacteria that live in our gut, known collectively as the microbiome. When we change to plant-based eating, our gut bacteria suddenly get all the fibre they’ve ever dreamed of. Over time they get used to this, and you’re left with the healthy and happy gut that has been associated with lower risk of everything from heart disease to depression, with better immunity into the bargain. But sometimes the transition can be a little rough, with symptoms like bloating, abdominal pain, and increased gas possible as your microbiome adapts.

Simply changing from omnivorous eating to fully plant-based will increase your fibre intake over one-and-a-half times.

For almost everyone these symptoms ease over time and eventually disappear completely. But if you’ve had issues with gut symptoms in the past, you may want to ease your microbiome into things gradually. Initially limiting foods that are especially high in fibre, such as beans and whole grains, can make a huge difference. You can increase your intake as your gut microbiome adjusts to the increased fibre. If you’re really struggling, you might like to check out 24 The Happy Gut Course online with plant-based gastroenterologist Dr Alan Desmond. Or for a comprehensive book about plant-based gut health, do your microbiome a favour and get a copy of Fibre Fueled by gastroenterologist Dr Will Bulsiewicz.

My hair started to fall out

More commonly, I hear from patients that their hair, skin, or nails seem much healthier since going plant-based. As a doctor I can confirm that a healthy, plant-based eating pattern (along with a B12 supplement and regular, safe sun exposure or a vitamin D supplement) provides absolutely everything your body needs to maintain hair, skin, and nails in optimal condition.

So why do some people report hair loss when they switch? The usual culprit is a medical condition called telogen effluvium, which may sound like an incantation from Harry Potter but is not usually serious. Telogen effluvium is generally triggered by a disturbance to the hair cycle, which itself results from a ‘triggering event’. These events include prolonged periods of stress, hormonal changes, and nutrient deficiencies.

Looking back to ‘I have no energy’, a switch to plant-based eating can cause a sudden and significant decrease in energy intake and/or associated weight loss if you aren’t meeting your calorie needs. It’s this that can in turn trigger hair loss in some people. Again, as with addressing your energy needs, simply increasing the number of starchy vegetables, whole grains, and beans and legumes you’re eating will prevent this issue or resolve it in almost all circumstances. These latter two food groups along with green leafy vegetables are also great plant-based sources of zinc and iron that you could consider increasing if you do notice hair loss. Do keep in mind that because the hair cycle is literally years long, it can take time to notice improvements even once you’re doing all the right things. It’s also worth discussing your concerns with a GP that is plant-based friendly.

There’s too much oestrogen from soy (males)

Before we even get started on this one, I’d like to point out that plant-based eating does not necessitate eating a lot of, or even any, soy products. I’m in favour of a minimally processed and varied approach to eating, so I probably consume soy once a week at most. Gone are the days when the only dairy and meat alternatives were soy-derived or some form of tofu. There’s no need to consume soy at all if you’re plant-based.

But what if we do eat soy regularly? We’ve all heard that soy contains a particularly high amount of phytoestrogens. These are plant substances that have a very similar structure to oestrogen from the body and can bind to oestrogen receptors. While this may sound concerning, the science is clear: there are numerous health benefits related to phytoestrogen consumption for both men and women, and no convincing evidence of any problems.

Men who are worried about the effect of eating plant-based on their hormone levels should be heartened by a recent article published in the World Journal of Urology that showed no association between the plant-based content of diet and serum testosterone levels. Further comfort can be taken from the less scientific but hilariously reassuring self-experiment of Brian Turner, a vegan bodybuilder who consumed about half a kilogram of soy daily for over a month and found his testosterone levels had, if anything, increased.

Even if you experience the odd hurdle as you make the transition, you can be confident that a plant-based diet comes with myriad health benefits and little to worry about.

Even if you experience the odd hurdle as you make the transition, you can be confident that a plant-based diet comes with myriad health benefits and little to worry about. Based on my decade or so of personal and professional experience, following the science, conducting my own research, and helping hundreds of others to shift to plant-based eating, I am convinced that this is the healthiest dietary pattern for humans. Of course, just like any lifestyle change, a little bit of research and planning from the outset will make the transition a lot easier. A varied plant-based eating pattern that emphasises whole, unprocessed foods (and that mandatory B12 supplement!) is a fantastic long-term choice with proven power to add years to your life and life to your years.

This article is republished with permission from nourishmagazine.com.au.

July 6, 2021
FODMAP fact drop
Most people have heard of the low FODMAP diet, but how well do we understand what it can help with and how it should be implemented? DFN’s Queensland Lead Dietitian Emma Strutt APD distills the commonly misunderstood diet, providing the essential information. Article first published in Nourish Magazine.
The low FODMAP diet is a three-phase dietary approach designed by researchers at Monash University, to help those with medically diagnosed irritable bowel syndrome (IBS) better manage their symptoms. Evidence suggests approximately 70–75 percent of people with IBS can experience symptoms from FODMAPs and following a low FODMAP diet can improve symptoms, especially bloating, abdominal pain, and diarrhoea. Some preliminary evidence suggests that limiting FODMAPs may also improve gut-related symptoms in those suffering endometriosis or inflammatory bowel disease, however more research is needed in this space.

What is a FODMAP anyway?

FODMAPs are certain types of carbohydrates that are poorly digested in the small intestine but are rapidly fermented by gut bacteria once they reach the large bowel. FODMAP is an acronym, which stands for:

Fermentable – carbohydrates that are broken down by gut bacteria.

Oligosaccharides – fructans and galactooligosaccharides, found in foods such as legumes, wheat, and onions.

Disaccharides – lactose, found in dairy products.

Monosaccharides – fructose, found in certain fruits and sweeteners such as high-fructose corn syrup.

And – no explanation needed for this one!

Polyols – sorbitol, mannitol, xylitol and maltitol, found in certain fruits, vegetables, and artificial sweeteners.

What’s all the FODMAP fuss about?

FODMAPs generate gas and have an osmotic effect, meaning they draw water into the intestines to help with gut motility, which prevents constipation. While this is all generally part of a healthy functioning digestive system, these processes can result in digestive issues for some people with sensitive guts. However, this doesn’t mean high FODMAP foods are bad for our health.
It’s important you don’t avoid FODMAPs unnecessarily, as many FODMAP-containing foods are a valuable part of a healthy dietary pattern.

In fact, healthy gut bacteria thrive on many high FODMAP foods and the majority of people can include these foods in their diets without any ill consequences. It’s important you don’t avoid FODMAPs unnecessarily, as many FODMAP-containing foods are a valuable part of a healthy dietary pattern. A low FODMAP diet actually reduces the abundance of beneficial bifidobacteria in the gut, and if poorly designed, can also reduce intake of fibre and certain micronutrients like iron and calcium, all of which are very important for our long-term health.

Is the low FODMAP diet right for you?

We need to understand that FODMAPs themselves are not the cause of IBS, so eliminating them won’t cure the condition. Also, the low FODMAP diet was never designed to be a permanent change; rather it is a tool to help people identify which particular foods and FODMAPs trigger their symptoms, allowing them to adopt a more suitable eating pattern in the long term, whereby healthy FODMAP foods are gradually reintroduced, so that the gut can learn to love them. As gastroenterologist Dr Will Bulciewicz likes to say, we can think of this process in a similar way to strength training, where the gut is a muscle that is becoming stronger through careful, incremental increases in intake.

Depending on a person’s baseline diet and lifestyle, other changes such as exercise, altering fibre intake, or reducing treat foods could be a more suitable starting point than a low FODMAP diet. Some people may see improvements in their symptoms simply by including more whole plant foods, eating slowly, managing their stress, or moving more.

Trials have also found interventions like yoga and hypnotherapy to be just as effective as a low FODMAP diet for symptom management. Additionally, it’s worth noting that about 25 percent of IBS sufferers will not see improvements on a low FODMAP diet, so other therapies may need to be considered. When it has been determined that a low FODMAP diet is appropriate, there are three phases to move through:
A two- to six-week elimination phase, where high FODMAP foods are swapped for low FODMAP alternatives.

An eight- to 12-week reintroduction phase, where each FODMAP group is methodically reintroduced to help identify the specific FODMAPs that are causing symptoms and to establish tolerance levels.

Personalisation is less of a phase and more for long-term health and symptom management. Well-tolerated FODMAPs should be included in the diet to promote diversity, while poorly tolerated foods remain restricted, but only to the level that provides symptom relief – the aim is to ease restrictions as much as possible!

Is low FODMAP and plant-based even possible?

At first glance the initial phases of the low FODMAP diet may seem near impossible for plant-based people. Many healthy plant foods will need to be excluded in phase one but with a bit of planning, it is possible to achieve nutritional adequacy while eating this way as a vegan or vegetarian.

A common pitfall is removing too much fibre, which can result in constipation. Similar to a standard plant-based diet, when planning main meals, it’s helpful to include good wholefood sources of carbohydrate and protein, along with a variety of vegetables.
Obtaining an adequate intake of certain micronutrients, such as calcium, iron, and omega-3, when following a plant-based, low FODMAP diet can also be a little challenging, so seeking advice from a dietitian or nutritionist is recommended.

Low FODMAP nutrient know-how

Calcium
Low-oxalate leafy greens, such as kale and rocket
Chia seeds
Tahini Calcium-set firm tofu
Calcium-fortified plant milks, such as almond, cashew, or macadamia. If using soy milk, you will need to choose one made from protein isolates, not the whole beans.

Iron
Pumpkin seeds
Quinoa
Oatmeal
Tempeh
Firm tofu

Omega-3
Flax seeds
Chia seeds
Hemp seeds
Walnuts

Eat as many plants foods as you can

People who consume more than 30 different plant foods per week have far greater microbial diversity, which supports good gut health, so try to include as many different whole plant foods as you can, even in phase one of the low FODMAP diet. It’s a great idea to purchase the Monash University FODMAP Diet app to help guide you in your food choices, as some foods have upper tolerable limits.

For example, small amounts of particular legumes are considered low FODMAP, but it is important to pay attention to serving sizes. Canned legumes have a lower FODMAP content than those cooked at home from dried legumes. This is because the water-soluble FODMAPs leach out of the legumes into the brine, therefore when the legumes are rinsed well before eating, less FODMAPs are consumed.

Some people may still experience reactions to even small servings of legumes, so if this is the case for you, start by incorporating a very small serving, such as half a tablespoon of canned lentils, into a strictly low FODMAP meal. Slowly build on this quantity over a few weeks, while keeping track of symptoms.

While there are many fruits that will need to be avoided initially, there are still plenty of options to choose from. For example, cumquats, dragon fruit, grapes, guava, kiwi fruit (green and gold varieties), mandarins, papaya, and strawberries, to name a few. Low FODMAP varieties should actively be included as they are a good source of both soluble and insoluble fibre, which is important for regular bowel motions. Try to limit yourself to one serve of fruit per meal and aim for two serves per day. Again, check the Monash University FODMAP Diet app, as many other fruits can be included, just in smaller portions.

Rest assured, flavour can still be plentiful when eating low FODMAP – even though cooking without onion and garlic can seem like a tall order. You can still achieve delicious flavours with the use of low FODMAP herbs, spices, and condiments. Fresh herbs will be your best friend, so add basil, coriander, chives, lemon grass, mint, parsley, and rosemary to your meals, where appropriate. Dried herbs and spices such as cinnamon, cumin, paprika, and star anise will also be invaluable. And if you can’t get by without a hint of onion flavour, the green tops of spring onions are okay too. You can also add plenty of flavour with condiments such as mustards, peanut butter, tahini, soy sauce or tamari, capers, olives, tomato paste, nutritional yeast, and most vinegars.

A low FODMAP diet can offer symptom relief for the majority of people suffering from IBS, including vegans and vegetarians, but ultimately variety is key when it comes to a healthy gut microbiome. Remember, a low FODMAP diet can also reduce your intake of beneficial gut bacteria, particularly bifidobacterium species, therefore it’s vital to understand that this dietary regimen is not intended to be a permanent change. The goal should always be to liberate yourself to eat as many plant foods as possible, after doing the necessary detective work to find out your tolerable limits for specific trigger foods.

NOTE: A low FODMAP diet should be trialled under the guidance of a dietitian to avoid nutrient deficiencies, and after obtaining medical advice to establish a correct diagnosis.

This article is republished with permission from nourishmagazine.com.au.
May 20, 2021
A Doctor and a Chef: Healthy plant-based cooking class
Doctors For Nutrition marked the launch of our new recipe collection on 27 April 2021 by holding a free virtual cooking class with chef Adam Guthrie and Dr Andrew Little. Below are all the details, including the replay and links to the recipes that we cooked on the night.

Cooking and eating plant-based meals has a range of benefits for our health and the planet’s. However it can be hard to know what to cook, or how to make healthy food taste good!

Dr Andrew Little and Chef Adam Guthrie are here for one night only to help fast-track your journey to confidence with healthy cooking. Join them for a free ‘curry night’ cooking class where you’ll gain access to two amazing recipes to cook during the session and learn a wide range of simple tips and techniques to try out in the kitchen.

While cooking a plant-based ‘Butter Chicken’ and Thai green curry, your Doctor and Chef hosts, Andrew and Adam, will share:

How to make healthy meals both filling and delicious

Why embracing international flavours will expand your plant-based horizons

Tips to save time and money when shopping and cooking

Favourite everyday and crowd-pleasing meals

Answers to common FAQs about implementing an evidence-based whole food plant-based lifestyle
Watch the recording

Get the recipes

Thai green curry

Plant-based ‘butter chicken’

About the hosts

Chef: Adam Guthrie

Adam Guthrie is a professionally-qualified chef with a certificate in plant based nutrition. He is the plant-based food writer for the national magazines Nourish and EatWell and the founder of the I Feel Good Plant-Based Program. He helps people who want to add more plants to their day for better health.

Doctor: Andrew Little

Dr Andrew Little is an Anaesthetist at the Tweed Base Hospital. Whilst most of his day is spent putting people to sleep for surgery, the rest of his time is devoted to awakening people to the benefits of a plant-based diet.

Help us provide more free events

Doctors For Nutrition is able to offer free educational events thanks to the kind support of donors. We are an independent charity 100% funded by donations. Please give what you can to enable us to keep providing free events like these. Any amount makes a difference and all gifts over $2 are tax-deductible in Australia. Thank you!
April 27, 2021
Cooking for nutrition
DFN’s recipes and dietitian-designed meal plan make it easier for anyone to take a step towards a more energising, sustainable plant-rich eating pattern. DFN’s Lead Qld Dietitian Emma Strutt explains the principles underpinning the collection and shares some handy tips for successful whole food plant-based cooking.

What we choose to cook each week has a significant impact on our health, as well as the health of the people we are cooking for. The good news is that most Australians have a desire to be more adventurous in the kitchen and try out a variety of healthy dishes. [1] If that’s you, you are in the right place.

Our newly-released recipe collection and dietitian-designed meal plan make it easier for anyone to take a step towards a more energising, sustainable plant-rich eating pattern.

What is cooking for nutrition all about?

Choosing more plant-based dishes is the fastest way to experience the benefits of a healthy diet. Many people have discovered this, and cooking plant-based meals is now mainstream, with 42% of Australians reducing or eliminating meat. [2] However it can be daunting for those who are just getting started!

To help streamline the process of learning to create nutritious meals and snacks, Doctors For Nutrition have teamed up with a range of dietitians, doctors and other plant-powered people to curate a set of simple yet delicious recipes.

Why is a resource like this needed?

Poor nutrition is a leading cause of health loss in both Australia and New Zealand. [3,4] Making it simple to find healthy recipes that can be easily, cheaply and quickly prepared is one way to help cut through the stress and confusion of meal planning. While there are many social, environmental and other factors that contribute to poor nutrition (and Doctors For Nutrition is seeking change in many of these areas), one of the most common questions for those wanting to eat more plant-based meals is ‘what do I cook?’.

One of the most common questions for those wanting to eat more plant-based meals is ‘what do I cook?’

Not just any recipes

The recipes in the DFN collection have been specially selected to reflect our healthy eating principles; they are abundant in the nutrient-dense whole plant foods you should aim to eat every day, with minimal amounts of the “sometimes” foods. They are a guaranteed meat, dairy and egg-free zone, with no added oil, very low to no added sodium, and no refined sweeteners.

The recipes are all dietitian-approved, aiming to remove the guesswork involved in people seeking to upgrade their nutrition with the minimum fuss. The accompanying meal plan and tips by dietitian Emily Levy APD provide a guided step-by-step way to get started.
About the DFN recipe collection

Dietitian-approved

Easy to make, with many in the ‘super easy’ category

Reflective of a wide diversity of ethnic cuisines

Quick to make, with prep time usually less than 30 minutes

Inexpensive, and do not require expensive appliances

Made from easy-to-access ingredients

Suited to a range of ‘occasions’ including entertaining, picnics and BBQs

Allergy-friendly, with many suitable people who are gluten-free or nut-free

Easy search and filter options

No long introductory recipe blurbs!

Handy chef’s tips and notes

Downloadable recipe cards to save or print

The collection includes pdf recipe cards for printing or download.
Specific needs

Among the collection, some of the recipes are higher in energy density, such as smoothies and desserts, and dishes containing tofu, nuts or avocado. These are great for growing kids, lean highly-active people, and those wishing to gain weight. However, for people wanting to lose weight, or those with cardiovascular disease or type 2 diabetes it is advised to choose those recipes that contain only the ‘every day’ and ‘as often as you can’ ingredients from the DFN Healthy Eating Guide, or make a few adaptations to reduce the fat content.

As always, individual needs vary, and people who have health concerns or an existing diagnosis should see a dietitian or doctor with nutrition expertise to help develop a personalised plan for their specific needs.

Further tips, hacks and FAQs

Avoiding hidden ‘SOS’

One of the advantages of home cooking and a whole foods focus is that additives are naturally avoided, including salt, oil and sugar (‘SOS’). However, it can be convenient to buy some healthy whole foods in pre-packaged form, such as canned beans. The key here is to look for salt-free cans to avoid hidden sodium.

Healthy plant milks

Plant-based milks are a useful ingredient in a plant-based diet, and are readily available and steadily coming down in price, especially home-brand options from supermarkets. The best options are soy, oat, nut and hemp milks with no added salt, oil or sugar. Coconut and rice milks are high in fat and sugar respectively, so are not recommended.

Washing produce

Produce should always be washed as it can unfortunately be contaminated with sprays, animal waste or by-products that are used as fertilisers or find their way into irrigation water, which brings with it a risk of food poisoning.

Benefits for planet and pocket!

As well as being the most health-promoting way of eating, a plant-based diet is best for the planet. [6] In fact, following eco-friendly practices is generally budget friendly and convenient too. [7] For example, bulk buying pulses, grains, nuts and seeds is highly efficient and cost-effective as well as green. Likewise, keeping the skin on fruit and veg is delicious, non-wasteful and highly nutritious, too! Try unpeeled mashed potato and pumpkin chunks with the skin on: you won’t look back.

To blend or not to blend?

Blended foods such as smoothies or ‘nice cream’ feature in 2-3 recipes as a healthier alternative to ice cream/milkshakes. These are great for kids and athletes, or older people with low appetite. However for those wanting to lose weight, it’s best not to “drink your food”.

Tempeh Breakfast Burrito

With all that said, the best way to get started is not to overthink things, and just get cooking! If mangos are in season, you could try my Mango bean salsa on rice. My other top recommendations are the Plant-powered stew, Yellow split-pea curry, Lentil bolognese and Lemon millet cake.

When you are ready for a full week of healthy plant-based meals, dietitian Emily Levy’s meal plan is a top resource. Download it from the recipes landing page here.

I hope you, your friends, family and colleagues all enjoy these recipes. We would love to see and hear how you get on, so don’t forget to post photos and tag us on social media, or leave a review on the recipe webpage.

Yours in health,
Key references

McCrindle. Australia’s Cooking Landscape. 2017.

Food Frontier and Life Health Foods, 2019. Hungry for plant-based: Australian consumer insights. Colmar Brunton. https://www.foodfrontier.org/wp-content/uploads/2019/10/Hungry-For-Plant-Based-Australian-Consumer-Insights-Oct-2019.pdf.

Australian Bureau of Statistics. aihw.gov.au/reports/burden-of-disease/burden-disease-study-illness-death-2015/contents/summary.

Tobias M. Health Loss in New Zealand 1990-2013: A Report from the New Zealand Burden of Diseases, Injuries and Risk Factors Study. Ministry of Health; 2016. health.govt.nz/publication/health-loss-new-zealand-1990-2013.

Read more about the whole food plant-based approach and why it rejects reductionism at https://dfn.azwebsolutions.co.nz/general-public/what-is-wfpb/

Poore J, Nemecek T. Reducing food’s environmental impacts through producers and consumers. Science. 2018;360(6392):987-992. doi:10.1126/science.aaq0216

Goulding T, Lindberg R, Russell CG. The affordability of a healthy and sustainable diet: an Australian case study. Nutr J. 2020;19(1):109. doi:10.1186/s12937-020-00606-z
April 27, 2021
Growing gains, not pains!

Setting kids and teens up with good nutrition is central to lifelong health. They’ll flourish when nourished with a plant-based diet. First published in Nourish Magazine

If you’re a plant-based parent, it’s only natural to want your children to join you on your health-promoting journey. If this is a recent change for you, they may well protest at having to eat this way. On the other hand, perhaps you’re yet to explore the world of plant-based cuisine but your child decides they want to try a vegetarian or even vegan diet.

Whichever the case, the good news is you can be confident that a wholefood, plant-based diet is the most nutrient-dense way to eat and will give your child a fantastic foundation for good health. In fact, it can put them at a health advantage over their omnivore peers – as long as their diet is varied and is predominantly based on whole plant foods rather than vegan junk foods.

As a parent, you’ll want to ensure that you know how to best meet the needs of their growing bodies, which can be a little different to the needs of adults. Plus, it’s always good to be clued up in preparation for questions and occasional criticisms, usually from well-meaning people who are not nutritionally trained – friends and family, but possibly even your doctor or nurse.

Plant-based diets are healthy for all life stages

Many organisations including Dietitians Australia, the Canadian Paediatric Society, and the British Dietetics Association all agree that appropriately planned plant-based diets are healthy and nutritionally adequate for all stages of life including pregnancy, breastfeeding and early childhood. Nutrition guidelines from around the world also give us similar reassurance.

Plant-based diets have many advantages, including being lower in saturated fat and cholesterol, while also delivering more fibre, antioxidants, folic acid, vitamins C and E, carotenoids, and a host of other beneficial phytochemicals. This may explain why people of all ages who eat plant-based diets have a lower incidence of obesity, heart disease and other vascular diseases, as well as lower rates of diabetes and cancers.

Plant-based diets are lower in saturated fat and cholesterol, while also delivering more fibre, antioxidants, folic acid, vitamins C and E, carotenoids, and a host of other beneficial phytochemicals.

Conversely, we know from published research that atherosclerosis (a narrowing of the arteries that heightens the risk of heart disease and stroke) begins in childhood. It has been shown from autopsies of trauma victims that virtually all children raised on a standard Western diet have signs of heart disease – visible to the naked eye – by age 10! Evidence shows that this heart disease begins in utero, so it is never too early to start improving your own diet. And of course, ensuring your children have the best possible diet as they grow sets them up for better lifelong health.

Let’s dispel a few myths so you can make the right choices for your family.

Don’t growing bones need dairy?

Dairy products are frequently cited as being ‘essential for bone strength’. Yet a recent review by leading Harvard researchers concluded that high consumption of milk may increase the risk of fractures later in life. Graphs of milk consumption versus the incidence of hip fractures (a key marker of bone strength) show that countries with the highest dairy consumption generally have the highest rate of hip fractures. We also know that osteoporosis was once very low in traditional Asian cultures where dairy consumption was rare, although sadly, such benefits have been lost as diets have become increasingly Westernised.

Interestingly, about 65 percent of all humans are actually lactose intolerant, including most people of Asian, African, and Latin American descent. Consuming milk from cows, sheep, and goats is a fairly recent development in terms of our human evolution and has only been practised for around 8,000–10,000 years. We could even consider it quite strange that we wean from our human mothers, then promptly start to breastfeed from another animal!

Acne and asthma are frequent problems for children and removing dairy products is known to reduce or eliminate these conditions. It’s also good to be aware that dairy cheeses contain mild opiates, called casomorphins, and so are mildly addictive. You can help children overcome any cravings with the many plant-based alternatives now available. Better still, there are plenty of easy-to-make, wholefood recipes for the healthiest cheesy fix.

Bone strength comes primarily from weight-bearing exercise, so when it comes to kids and teens, it’s best to keep screen time to a reasonable minimum. Instead, try to encourage sports and other physical activities that they enjoy. Calcium in the diet is also required and can be readily obtained from greens; white, navy and black beans; tofu and tempeh; fortified soy milk; and figs; among other wholefoods.

Calcium can be readily obtained from greens; white, navy and black beans; tofu and tempeh; fortified soy milk; and figs; among other wholefoods.

Healthy bones also require vitamin D, which we make when exposed to sunlight – another reason to get your kids outside playing games or sports. Depending on skin tone (with darker skin needing more sun), around 15 minutes during the middle of the day is generally enough. Supplements are available if sun exposure is less than this and, since vitamin D is a common deficiency population-wide, it’s a good idea for everyone, regardless of diet, to get their levels checked periodically by the family doctor.

Are meat and fish even safe for children?

The World Health Organization has classified processed meats, including bacon, ham, salami, hot dogs, and sausages as Group 1 carcinogens – meaning they have been proven to cause cancer. This puts them in the same category as tobacco, asbestos, and plutonium. You wouldn’t want your children smoking cigarettes, so it stands to reason you wouldn’t want to feed them a proven carcinogen either. Similarly, red meats, such as beef, lamb, and pork, are categorised as Group 2A carcinogens – meaning they probably cause cancer,

Considering seafood, our oceans have been used as an industrial sewer for the past 300 years, so fish and shellfish now contain toxic levels of mercury, PCBs, dioxins, and microplastics. Most of the world’s fisheries are now considered to be overfished or in collapse, and even fish farming is unsustainable. It’s a huge contributor to the problem of antibiotic overuse, which does not result in a healthy ‘product’ for human consumption.

Like most animal foods, eggs have been associated with an increased risk of heart disease, stroke, cancer, and diabetes. In fact, eggs are the leading source of cholesterol in the standard Western diet, and are also packed with saturated fat. They do contain some protein, but per 100 grams, they deliver about the same amount of protein as oats or whole wheat. Nuts, on the other hand, have significantly more protein per 100 grams than eggs. A diet based on whole plant foods with sufficient calories easily meets the protein needs of kids, teens, and adults. Even better, it has been shown that replacing protein from animals with protein from plants gives us all our essential amino acids while significantly reducing our risk of mortality from all causes.

This article is republished with permission from nourishmagazine.com.au.

Updated: 2 February 2026

March 18, 2021
Australian Dietary Guidelines review scoping survey
The review of the Australian Dietary Guidelines is underway, with an initial scoping survey currently seeking input into what should change and what is missing from the current guidelines. Responses are invited from everyone who uses the guidelines whether professionally or personally, so this is an excellent early opportunity to submit your suggestions.

Scoping survey open now

Following on from the 2020 announcement that the Australian Dietary Guidelines are up for review, an initial stakeholder scoping survey is now open, seeking input on how the current guidelines are used and inviting suggestions for topics for consideration in the review.

The current scoping stage is a valuable first chance to suggest high-level topics for the review, with the survey providing space to suggest up to four topics to update and four to consider for inclusion.

The headline topics that DFN is flagging at this scoping stage are as follows:
To update

Update the ‘lean meat and alternatives’ food group to recommend plant sources of protein in preference to animal sources

Remove red meat entirely from the current ‘lean meat and alternatives’ food group

Remove milk yoghurt/cheese and alternatives as a standalone food group

Provide clarity about the health benefits of carbohydrates and starches from whole food sources, in the face of dangerous ‘high fat low carb’ diet trends

To include

Place a stronger emphasis on the health benefits of plant-based eating patterns

Integrate environmental sustainability considerations into the guidelines, highlighting the co-benefits of plant-based diets for both human and planetary health

Proceed with caution on dietary cholesterol due to evidence on its health risks, especially among hyper-responders

Ensure the new guidelines recognise the proven affordability of plant-predominant diets in comparison to standard Australian diets

Have your say

The survey is open to everyone who uses the ADGs, whether as a health professional or on an individual basis to inform their eating, so is an excellent opportunity for our plant-based health community to share our views.

For full details about what is in and out of scope for the survey, see nhmrc.gov.au/health-advice/nutrition/australian-dietary-guidelines-review.

Next steps

Responses to the scoping survey will be collated and published on the NHMRC website in the second half of 2021.

The next major opportunities for input during the review are anticipated to be:

The call for supporting evidence on finalised review topics – expected in the final quarter 2021

Further targeted and public consultation – currently expected in the second quarter 2023

DFN is preparing to have involvement at both of these stages and throughout the process, to champion the importance of whole food plant-based diets for the health of all Australians and to safeguard planetary health into the future.
If you are interested in helping our work to inform the review of the Australian Dietary Guidelines, please get in touch via our contact form.
February 23, 2021
Protein needs are easily met among plant-based eaters

New research led by Doctors For Nutrition’s lead dietitian for NSW, Joel Craddock (APD) of the University of Sydney, highlights protein quality of plant-based dietary patterns, and points to limitations in the commonly-used Digestible Indispensable Amino Acid Score, or ‘DIAAS’.

In recent years, plant-based dietary patterns have been increasing in popularity, with a growing body of literature demonstrating significant associated health benefits, and for athletes, significant improvements in recovery and performance.

Protein intake is often raised as a macronutrient of concern for people following plant-based dietary patterns, particularly athletes; however there is no evidence that, with a wide variety of food intake required, intakes are not achieved easily.

Now, a new review has revealed limitations with the current Food and Agriculture Organisation-endorsed method for determining protein digestibility, the Digestible Indispensable Amino Acid Score (DIAAS).

The DIAAS was principally designed for use in developing nations where protein intake and availability is scarce, however is now often used in Western nations. Emphasising protein quality in the West is typically unproductive, detracting from other truly prevalent nutritional shortcomings (such as fibre). Many of the limitations of the DIAAS are emphasised when used in groups following plant-based dietary patterns.

Protein digestibility among plant-based eaters is underestimated by the current DIAAS methodology.

The DIAAS limits the contribution to overall dietary protein intake made by fruits, vegetables, meat analogs, nuts and seeds. This can be quite significant given those following plant-based dietary patterns consume a much greater quantity when compared to omnivores. This difference can mean true protein digestibility is underestimated.

In addition, assessment of protein digestibility is often made using single, uncooked protein isolates, whereas actual food is consumed cooked and with a variety of components, likely considerably increasing amino acid absorption.

Another more generalised point the research team flags is that the DIAAS has been modelled in animals such as pigs and rats. There are similarities in digestion between these animals and humans, but there are also substantial differences. Protein in these fast-growing animals is generally required for tissue growth, whereas in humans it’s largely required for maintenance.

These factors should be taken into account when assessing protein quality of overall plant-based dietary patterns, especially in individuals where a higher protein intake is recommended, such as in the case of athletes.

The review, published in Current Nutrition Reports in January 2021, is available online at SpringerLink.

Craddock, J.C., Genoni, A., Strutt, E.F. et al. Limitations with the Digestible Indispensable Amino Acid Score (DIAAS) with Special Attention to Plant-Based Diets: a Review. Curr Nutr Rep (2021). https://doi.org/10.1007/s13668-020-00348-8

January 31, 2021
Be smart, B12

If you follow a plant-based diet, vitamin B12 is probably on your radar – and it should be! This is one nutrient you need to supplement. Here’s why. Article by DFN’s Lead Dietitian for South Australia, Deeni Betar-Young APD. First published in Nourish Magazine.

Often flagged as the most important nutrient to be aware of on a plant-based diet, vitamin B12 (also known as cobalamin) is required for normal blood function and neurological health, and deficiency is serious. There are plenty of myths surrounding B12, so let’s learn how to ensure adequate intake. B12 is produced by certain bacteria (not by animals, as some people believe) when in environments containing the mineral cobalt, which makes up part of the structure of vitamin B12. Animal products can be high in B12 because animals obtain it from bacteria in the food (or faeces!) they eat, or are able to synthesise it in their guts.

Historically, traces of soil left on foods grown in nutrient-rich environments and unsanitised drinking water were likely to have been regular sources for early humans. However, this is no longer the case. We now (quite rightly) sanitise our water supply and wash our vegetables thoroughly to avoid ingesting pathogens. Also, in part due to intensive farming practices, soils have been depleted of many nutrients globally. As a result, even farmed animals are commonly given B12 supplements.

Is there B12 in plants?

There have been many claims made about natural plant sources of B12, with certain foods such as seaweed, spirulina, mushrooms, and fermented foods reported to contain it. While some of these foods do in fact contain B12, in most cases this appears to be predominantly in ‘inactive’ forms. These do not fulfil the important functions of ‘active’ forms in the body, and can even block uptake of the active B12! Even where the B12 does appear to be in a form that we can absorb, we’d be hard-pressed to consume enough of that particular food to meet our daily needs. The key message is that none of these foods have been shown to improve the B12 status of humans and therefore cannot be relied upon for adequate B12 intake.

Because B12 is produced by bacteria, some is formed in our bacteria-laden guts (or colons); however, this isn’t able to be absorbed into our bloodstream because B12 absorption occurs higher up in our digestive tract, in the small intestine. As a result, there are only two non-animal food sources of vitamin B12: supplements and fortified plant foods.

Fortified foods are those that have had B12 added to them during processing, like nutritional yeast, certain meat substitutes, and some plant milks. The B12 content of fortified foods can vary considerably between brands and batches.

To obtain and absorb enough vitamin B12 from these foods, they need to be consumed at multiple times over the day and often in quantities that exceed standard serving sizes. For this reason, it’s always preferable to also take a supplement rather than relying solely on fortified foods.

So, are omni diets better?

While there’s no denying animal products do contain B12, we can safely say that this limited benefit is outweighed by the costs. This is because animal products come packaged with certain harmful properties, including known cancer-promoting agents, production of TMAO (a significant causal factor in our number one killer, heart disease), saturated fats that promote insulin resistance, inflammation, and numerous other risks including overall increased mortality. By contrast, wholefood plant-based diets are associated with reduced risks of diabetes, heart disease, many cancers, autoimmune diseases, and much more. Further, animal farming promotes antibiotic-resistant infection risks and the emergence of zoonotic diseases that transfer from animals to humans. So, we can safely say it’s preferable to eat a healthy plant-based diet with a cheap and effective B12 supplement than it is to eat animals!

          It’s preferable to eat a healthy plant-based diet with a cheap and effective B12 supplement than it is to eat animals.

Deficiency isn’t just a vegan problem

People avoiding animal products aren’t the only ones at higher risk of developing a B12 deficiency. As we age, we often become less efficient at absorbing B12 from animal products, which puts anyone over age 50 in the higher risk category. Those with gastrointestinal conditions such as Coeliac disease and Crohn’s are also at higher risk as they may also absorb less B12. There’s also a small percentage of the population with a condition known as ‘pernicious anaemia’, which prevents vitamin B12 from being absorbed. And, particular medications can reduce B12 absorption, namely, proton-pump inhibitors, which are used to manage reflux and Metformin (also called Diaformin), a diabetic drug.

So, what happens when we don’t have enough B12 in our bodies? A deficiency can lead to serious consequences and even death if it isn’t detected and treated early on. In the early stages, it often presents similarly to iron deficiency with fatigue being a common symptom, as well as a loss of appetite and nausea. There are many other ways that a B12 deficiency can show up, including tingling or numbness of hands and feet, mild depression, and diarrhoea. Neurological symptoms are some of the most concerning effects of a prolonged or pronounced B12 deficiency, as they tend to be irreversible and can develop into serious conditions like dementia. Even a mild B12 deficiency can increase risk of dementia, and once a dementia diagnosis paired with a B12 deficiency has been made, supplementing is no longer able to improve cognitive function.

          A deficiency can lead to serious consequences and even death if it isn’t detected and treated early on.

Anyone who displays symptoms of a B12 deficiency or who has had a low B12 reading when last tested, should have their B12 status checked. Those at higher risk of developing a deficiency, including vegans, should have routine testing done, especially if they aren’t following a regular and adequate supplementing regime. It’s particularly important to ensure you have adequate levels while pregnant or breastfeeding, as the B12 status of mum determines that of baby.

The most common test GPs order for this is a serum vitamin B12 test. However, this test isn’t always an accurate indicator of B12 status because it can show ‘false positive’ results, where the level looks to be in the normal range, but the person is actually deficient. To get an accurate B12 status reading, I recommend an MMA (methylmalonic acid) test. MMA is related to B12 metabolism and our levels increase if we become B12 deficient. So, next time you’re due for a B12 test, ask your GP for an MMA blood or urine test rather than a serum vitamin B12 blood test (this may come at an out-of-pocket cost).

Smart supplementation

Supplementation is recommended to start within the first few months of reducing or eliminating animal products from your diet. Our bodies store some B12 in the liver and muscles, so we can usually go a short time without supplementing before signs of a deficiency develop. There are various methods of supplementing – oral (sprays, chewables, or capsules), sublingual (sprays or dissolvable tablets under the tongue), and intramuscular injections. I always recommend an oral supplement as the safest, most effective and practical way to ensure adequate vitamin B12 status.

Injections are equally safe and effective but are less practical for most. Sublingual supplements do not appear to be any more effective at ensuring effective absorption of B12 than oral supplements, and are less well-studied than oral forms.

          The cyanocobalamin form of B12 is extremely reliable.

Most supplements are in the form of either methylcobalamin or cyanocobalamin (which is converted into the body’s usable forms when consumed). Despite the common notion that methylcobalamin is the active form and the most easily absorbed by the body, the best form to take is cyanocobalamin, except in a few special cases. The cyanocobalamin form is the most extensively studied, stable, and effective form for raising and maintaining adequate B12 status, so it is extremely reliable.

Absorption of B12 is complex and only small amounts can be absorbed at a time, so supplement doses are much higher than the recommended daily intake. Either smaller daily doses of B12 may be consumed or much larger doses can be taken on a less frequent basis to maintain adequate B12 status.

In general, healthy vegan adults can ensure adequate intake with a daily supplement of 100–250mcg of B12 in the cyanocobalamin form. Alternatively, a larger weekly dose of 2500mcg can be taken. It’s a good idea to discuss your B12 status and supplementation needs with a qualified health professional to ensure a personalised approach, because absorption can vary between individuals depending on their overall health, life stage, specific conditions, and medications.

My best advice is to find a GP or dietitian who specialises in plant-based diets. You can find listings of these on the Doctors For Nutrition website.

Vitamin B12 is essential for human health and it is important to have a solid plan in place to obtain it when following or considering a plant-based diet. As an Accredited Practising Dietitian who specialises in plant-based nutrition, I firmly believe that everyone can reap the enormous benefits of this healthy, compassionate, and sustainable lifestyle. As part of this, maintaining adequate B12 levels is important and, fortunately, easily achieved through inexpensive supplementation.

This article is republished with permission from nourishmagazine.com.au.

January 18, 2021
DFN wins Change Maker of the Year Award!

Doctors For Nutrition are honoured to have won Change Maker of the year in the inaugural Nourish Vegan Awards, which celebrate the best in plant-based living, as voted by readers of Nourish Magazine.

Back in May we were excited to learn that Doctors For Nutrition had been nominated for the 2020 Change Maker Award. We are now delighted to announce that we have won!

Nourish is Australia’s leading plant-based magazine, and the awards are the first of their kind in Australia. Nominees across a range of categories were shortlisted by experts from the Nourish team, followed by voting by more than 17,000 members of the Nourish community.

Speaking about the win, Doctors For Nutrition’s director and co-founder Dr Heleen Haitjema said:

“It is a thrill for Doctors For Nutrition to have won this award. The articles we contribute to each issue are a fantastic opportunity for our medical and nutrition experts to share actionable evidence-based information on how to thrive on a plant-based diet.

“We are humbled to have received the most votes in the Change Maker category, and thank everyone who voted for us. It is a heartening testament to the growing interest in whole food plant-based nutrition within the community.

“We take our hats off to the other nominees and finalists in our category, all of whom do inspiring work that helps show people both why and how to embrace plant-based living.”

Doctors For Nutrition experts have contributed to every issue of Nourish Magazine since December 2018, reaching a wide audience throughout Australia, New Zealand and internationally. After each issue, DFN’s articles are republished with permission on our blog, where they continue to receive thousands of hits every month.

Past articles by DFN expert contributors can be browsed in our articles section, and many are also published on the Nourish website.

January 15, 2021
DFN’s 2020 year in review and 2021 plans
2020 was an important year where, despite the challenges and disruptions that have touched every corner of the globe, we made some significant strides forward on our shared mission. Below we outline the key achievements of 2020 and preview the year ahead.

Year in review 2020

Despite the enormous collective challenges of 2020, we were privileged to be able to continue our work with focus and determination throughout the year, with our passionate community by our side at every step.

Never before has the need for healthy plant-based diets been clearer, both to address many of the diet-related chronic diseases that make people the most vulnerable to severe COVID-19 outcomes and to reduce the risk of future emerging pathogens by scaling back animal agriculture.

Alongside releasing our new nutrition and health toolkit for clinicians in 2020, we informed many thousands of people across the healthcare sector and wider community through educational events, website resources, policy submissions, mainstream and social media.

We welcomed new team members, nurtured fruitful strategic partnerships, grew our reach, particularly among our target cohorts of health professionals, and saw encouraging growth in our movement and growing awareness of the multiple benefits of plant-based dietary shift, both locally and abroad.

It was a particularly heartening moment when we learnt that DFN had won Nourish magazine’s Changemaker of the Year Award: an honour for our young charity and a testament to the growing appetite for an evidence-based ‘nutrition first’ approach to health.

See further details of the year’s achievements in the snapshots below, and read on to discover what’s in store for 2021.
Growing our reach

In 2020 we:

Built our e-list to over 3,000 subscribers, and 12,500 followers across our social channels, representing significant growth since last year (40% and 25% respectively).

More than tripled our website’s reach in 2020, to 70,000 unique page views.

Published 26 articles on our blog, with a cumulative total of >15,000 views (>14,000 unique).

Launched our Australasian plant-based health professionals Facebook group, which now stands at over 100 active health-professional members.

Reached over 1,300 video viewers this year, who together have watched 207 hours of our educational content, primarily through our Food Vitals series: read more below.

Achieved media coverage across a range of outlets including our first TV news story announcing our new Plant-based nutrition and health resources for health professionals.

Continued to contribute articles on plant-based nutrition to every issue of Nourish magazine, whose readership is continuing to expand in our region and beyond.
Educational events

During 2020 we hosted, co-hosted and presented at a range of events, both online and in-person where possible, aimed at a variety of professional and lay audiences. Highlights:

The Heart of the Matter nutrition in healthcare symposium (Adelaide)

The Pleasure Trap: an evening with Dr Doug Lisle (Canberra)

South Pacific Society of Lifestyle Medicine Conference: Turning the Tide on NCDs (Fiji)

Our Food Vitals webinar series (online)

Adelaide Vegan Festival (Adelaide)

Lifestyle Medicine 2020 (online)

Together, these events enabled us to reach a large number of delegates. Our Adelaide Symposium in February and Food Vitals webinar series together attracted almost 2000 registrants, of whom approximately 60% were healthcare professionals. We were also delighted to have the proceedings from the Adelaide symposium published in the International Journal of Disease Reversal and Prevention.
Plant-based nutrition resources for health professionals

The release of our guide for health professionals and accompanying resources was our milestone project of 2020. Developed with the expertise of our Advisory Council members, the toolkit of resources aims to educate practitioners on the fundamentals of a whole food plant-based eating pattern and its health benefits, and to assist them in promoting this dietary pattern to their patients.

Impact since the toolkit launched in September 2020:

Reach

>400 hard copy guides and toolkits distributed across AU and NZ.

>1800 digital downloads.

Web page aimed at health professionals viewed >3,400 times (>2,500 unique views).

The data we have from orders, downloads and evaluations indicate that around 70% of those who have accessed the resources are from the health sector.

Demographics

The health professionals most frequently accessing the resources are doctors (around 30%) of whom a majority are GPs; dietitians, nutritionists and nurses are next (10% each), with the remainder being from other health professions.

Of the respondents working in the health sector, 93% are in roles where they provide patients with health advice.

Feedback

38% of all respondents to our evaluation questionnaire (n=84 as at 1/1/21) said the proportion of their diet coming from whole plant foods increased as a result of the resources, either significantly or slightly. This rises to 81% when those who already follow a WFPB diet are excluded.
Among health professionals in patient-facing roles:

92% said they will be using one or more DFN resources in their practice on an ongoing basis.

95% strongly agree or agree that ‘the DFN resources have improved my confidence in discussing plant-based nutrition with patients’.

74% agree that ‘the DFN resources improved my confidence in responding to patient queries about plant-based diets’.
Food Vitals webinar series

This webinar series was launched alongside our Plant-based nutrition and health materials as a further free educational offering to explore the role of diet in preventing and treating specific disease processes or optimising health in different population groups.

Self-rated prior knowledge was an average of 6 on a scale of 1-10, therefore meeting a clear need to build on this knowledge.

Impact

Around 90% of all respondents report being inspired to eat more whole plant foods, or to keep going with changes they have already made (around 30% and 60% respectively), with only 10% saying they would not be making changes.

89% of health professionals in patients-facing roles report being more willing and confident to recommend WFPB nutrition within their practice (70% of these significantly; 30% slightly).

All the webinar recordings can be accessed freely via our Food Vitals web page.
Agenda 2021

2021 holds ambitious plans for us as we seek to amplify our message about the benefits of healthy plant-based dietary patterns, with a focus on providing practical tools for health professionals and patients alike to help with their implementation.

Projects in the pipeline include: more educational events, both online and in person; new free web resources for health professionals; a forthcoming collection of whole food plant-based recipes with accompanying meal plan; preparation for our 2022 Nutrition in Healthcare Conference and, excitingly, a new transition guide to support individuals in going plant-based for their health.

We will also continue to engage with decision-makers across the spectrum of healthcare institutions to highlight the evidence for whole food plant based nutrition, with a key focus on the review of Australia’s national dietary guidelines.

Alongside these projects we’ll be continuing to build our foundations, strengthen and grow alliances with other organisations, and seek impactful opportunities to gain traction for our messages about the science and practice of WFPB nutrition for health.

From all of us at DFN, thank you for accompanying us on our mission. Here’s to a year ahead filled with action towards health and wellbeing through, both now and into the future.

Click here if you’d like to get involved in supporting our work.
December 20, 2020
Planning your plant-based holiday feast
Whether you’re an old hand at plant-based eating, cooking for a plant-based family member or wanting to include more whole foods these holidays, we have the menu for you. This holiday feast will impress everyone!

There is no doubt an important part of the Christmas season is enjoying good food with loved ones. This time of year is the perfect opportunity to show them how delicious plant-based eating can be.

Doctors For Nutrition plant-based menu

We have gathered some festive favourites from our expert Advisory Council. Each recipe is easy to prepare and the ingredients are readily available in local shops.
The time for sharing

A completely plant-based menu may raise some common questions from friends and family, such as ‘how do you get enough protein’? Take the time to be prepared, have a read over our mythbusters and information on health conditions so you are equipped with the facts to help you feel more confident when sharing your knowledge.

Remember, this is the season for joy and laughter. When discussing a whole food plant-based diet focus on the many evidence-based positives such as lowering blood-pressure, maintaining a healthy weight, and preventing or even reversing chronic disease, rather than the negatives associated with eating animal-based products.

Give the gift of health

Are you looking for some healthful gift ideas to inspire your loved ones? You could consider:

Gifting them a whole food plant-based home-cooked meal on a day of their choice.

Compiling some of your whole food plant-based ‘go-to’ recipes in a scrapbook, complete with some of your own personal notes and pictures.

Offering them a whole food plant-based shopping experience. Take them to your local farmers markets, introduce them to your favourite seasonal fruit and veg and suggest how it could be used.

Dedicating a donation on behalf of your loved-one to Doctors For Nutrition, including a special message. We are a registered Australian charity with Deductible Gift Recipient status, so donations over $2 are tax deductible.
Encouraging your friends and family to include even a few more high-quality, nutrient-dense plant-based foods in their weekly repertoire is a step in the right direction. You’ll definitely be on the ‘nice list’ this year!

Make sure you tag us on Facebook and Instagram and hashtag #DoctorsForNutrition if you create any of our recipes; we’d love to see your photos!

Download the recipes now.
November 29, 2020
DFN joins health organisations’ call for a healthy, regenerative and just future
Doctors For Nutrition is among 29 health organisations calling on the Australian government to take urgent policy action to address the climate emergency and protect health.

DFN is part of a coalition of health groups led by the Climate and Health Alliance (CAHA) calling for a national climate change response to secure a healthy, regenerative and just future.

Between August and October 2020, we took part in a roundtable series convened by the alliance. Our General Manager, Marion Meloni, joined thought leaders from multiple sectors to engage in a process of futures thinking for a health-centred post-COVID recovery.

This work fed into CAHA’s updated policy roadmap entitled Healthy, Regenerative and Just: Our vision for a better future. Published on 16th November, the document sets out recommendations under eight areas of policy action to tackle the climate and biodiversity crisis, and deliver significant public health, economic and environmental benefits.

These include measures to transform energy, transport, infrastructure and land use systems, including a new sustainable approach to food and agriculture to improve nutrition while safeguarding the environment, achieving cost-savings and reducing the risk of new communicable disease outbreaks.

As CAHA’s Executive Director Fiona Armstrong said, “Right now, in this moment of disruption, we have the opportunity to re-shape our society for a better future.”

Building on CAHA’s 2017 Climate, Health and Wellbeing Framework, the new vision now specifically advocates diets based on plants among its health-promoting and emission reducing initiatives. It also calls for research funding to establish the cost-savings of a plant-based dietary shift.

The new policy roadmap was released along with an open letter to Prime Minister Scott Morrison, calling on him to implement the recommendations as a matter of urgency.

DFN is one of 29 signatories to the CAHA-led open letter to Prime Minister Scott Morrison

Colleagues and friends who support this message are also warmly encouraged to email their local MP calling for action on climate and health using CAHA’s template letter, which can be adapted to maximise impact.

Below, we set out some key facts and references about the health and climate benefits of whole food plant-based diets that our fellow plant-based health advocates may like to refer to when writing to their own MPs
Whole food plant-based dietary shift for healthy people and planet

The pathway to a healthy future requires transitioning to a sustainable food system, starting now. Key to this is a shift to plant-based dietary patterns.

The world’s appetite for animal products, especially in high-income countries like Australia, has exceeded safe limits for greenhouse gas emissions, nutrient flows and biodiversity loss, and urgently needs to be scaled back.

Australia is also facing worsening rates of diet-related disease. The latest findings from the Global Burden of Disease study shows that we are living longer in poor health. Four of the five risk factors associated with the highest number of deaths and reduced healthy life years in Australia are conditions that a whole food plant-based diet has been proven to prevent and alleviate, including high blood pressure, high body-mass index, and high fasting plasma glucose.

Multiple studies confirm the benefits of replacing animal with plant protein: for example, overall mortality risk has been found to decrease by 10% for every 3% energy increment replacement of plant for animal protein.

As noted in the policy roadmap, “land-clearing, has been linked to the rise of zoonotic diseases, such as COVID-19.” Transforming our food system towards plant-based diets has a significant role to play in mitigating this, since the main driver of land-clearing both globally and in Australia is livestock production.

Read more about DFN’s membership of the Climate and Health Alliance and our other advocacy work.

Ask your MP to support a healthy, regenerative and just future via the template letter, and forward us a copy of your email!
Key references

Clark M et al. Global food system emissions could preclude achieving the 1.5° and 2°C climate change targets. Science. 2020;370(6517):705-708. doi:10.1126/science.aba7357

Willett W et al. Food in the Anthropocene: the EAT-Lancet Commission on healthy diets from sustainable food systems. Lancet. 2019;393(10170):447-492. doi:10.1016/S0140-6736(18)31788-4

Henry et al 2019. The role of global dietary transitions for safeguarding biodiversity

Song M et al. Association of animal and plant protein intake with all-cause and cause-specific mortality. JAMA Intern Med. October 1, 2016;176(10): 1453–1463. doi:10.1001/jamainternmed.2016.4182

The Global Burden of Disease 2019. http://www.healthdata.org/gbd/2019

United Nations Global Land Outlook, 2017. https://knowledge.unccd.int/glo/GLO_first_edition
November 24, 2020
Full of beans: toddler nutrition

When it’s time for your toddler’s first foods, you want the very best nutrition for their development. A plant-based approach is a proven recipe for success!

The right nutrition is the best way to set your little one up for lifelong good health, and a vibrant plant-based diet is hands-down the most nutrient-rich way to feed your growing child. As a parent, you may sometimes feel scrutinised – or even criticised – for saying ‘thanks, but no thanks’ to the standard Western diet for your child, but you can be confident in the knowledge that your plant-based choice is backed by an enormous body of evidence.

Many organisations including Dietitians Australia, the Canadian Paediatric Society, and the British Dietetics Association all agree that appropriately planned plant-based diets are healthy and nutritionally adequate for all stages of life including pregnancy, breastfeeding and early childhood. Renowned paediatrician Dr Benjamin Spock also recommended a fully plant-based diet in the final edition of his bestselling book, Baby and Child Care, acknowledging the growing research supporting this.

As a parent, being informed about plant-based nutrition is important as this will provide reassurance that you are doing the best for your child. In my experience, infants raised on plant-based diets grow into healthy, strong adults and typically experience less childhood illness than their peers who are fed a standard Western diet. Let’s look at what you need to know to ensure your tot is full of beans and thriving on good nutrition from birth into childhood.

From birth to first foods

From birth until around six months of age, all your child will need is breast milk, or a suitable plant-based alternative if you are unable to breastfeed. Breast milk is nature’s perfect food! For breastfeeding mums, excluding animal foods reduces toxic residues in breast milk, while eating a vibrant wholefood, plant-based diet provides key nutrients for both mum and baby, from A to Zinc.

A healthy plant-based diet for mum also increases the chances that the baby will enjoy a range of plant foods when it’s time to start on solid foods.

You can start introducing solid foods when your baby can sit in a highchair with good head control. They’ll be able to grab things to put in their mouth and will have started showing an interest in food. For the best start in life, I strongly recommend only offering your child plant-based foods when they are ready to start eating solid foods.

It’s important to avoid any foods that could cause choking, so make sure first foods are soft enough or otherwise are mashed or pureed to eliminate any risk. For new parents, it’s a good idea to complete an infant first aid course to ensure you are aware of the risks and appropriate responses in case something does go wrong.

A taste for healthy

I encourage introducing a wide variety of plant foods to your child, including all types of vegetables and fruits, legumes, whole grains, nuts and seeds (in appropriate forms to avoid choking risks). This is not only good for their nutrition, but also for their gut microbiome and for their future openness to eating a wide range of foods.

As with all ages, foods with added salt, sugar or oil are not advised, and steering clear from the outset means your little one won’t develop a taste for these unhealthy additives. Whole grains are a healthier choice than refined grains and are a good source of iron for your growing tot. You might try oats eaten as porridge, brown rice, well-cooked millet or amaranth, or wholemeal bread – aiming for low sodium in your choices.

When you are introducing new foods, don’t stress about how much is eaten. At this stage, your baby is exploring unfamiliar tastes and textures. They will want to touch, smell, and play with new foods but not necessarily taste or gobble them up them straight away. Start with one new solid food every few days and watch for any signs of allergic reaction. This applies to any solids, whether plant or animal in origin.

If your child rejects the new food, accept this and try introducing it again later. It can take a dozen or more exposures before they are ready to eat something different. Eating should be fun, so there’s no need for power struggles or to otherwise fall into the trap of using unhealthy sweets as a reward. If they reject a food, perhaps show your child that you will eat it yourself. Modelling healthy eating behaviours is so important because children will notice what you eat.

Prevention over cure

Powering your toddler up on a wholefood plant-based diet means you are protecting them from myriad risks associated with the standard Western diet. The standard diet is high in animal and processed foods that are nutrient-poor but high in salt, fat, and refined sugars and starches. Studies have shown that 100 percent of children raised this way have visible signs of heart disease by age 10!

I strongly recommend against feeding your toddler any dairy products. The cows’ milk these products are made from is designed for baby cows, containing powerful hormones that help a small calf grow from 30 kilograms to 300 kilograms in just two years! In human babies, cows’ milk can be the cause of colic and reflux, iron deficiency, constipation, eczema, and rashes. There is some evidence that it may also be a trigger leading to type 1 diabetes in those with genetic susceptibility.

Dairy is strongly linked to the development of chronic disease later in life, including heart disease, many types of cancer, osteoporosis, inflammatory bowel diseases, acne, migraines, and obesity. Soy foods, on the other hand, including soybeans, soy milk, tofu, and tempeh are good foods for toddlers. Evidence shows that soy consumed during childhood can reduce cancer risk in later years by up to 60 percent.

Powering your toddler up on a wholefood plant-based diet means you are protecting them from myriad risks associated with the standard Western diet.

Nutrients that nurture

It is vital that you supplement your plant-based toddler with vitamin B12. I recommend a low-dose chewable B12 supplement or a spray in the cyanocobalamin form, given every other day (you can crush the chewables into

food). It’s time to start supplementing once solid foods start to substantially displace breast milk or fortified formulas. Low B12 levels can be catastrophic in toddlers and adults, so ensure both you and your child have your levels tested once every year.

Iron is important for growing toddlers to enable oxygen transport throughout the body and to support normal growth and cognitive function. Iron-rich foods include iron-fortified wholegrain cereals, leafy greens, beans, lentils, and sprouted whole grains. Vitamin C-rich foods can increase iron absorption up to five-fold, so add citrus, capsicums, berries, brassicas, and tomatoes in abundance! Foods from the onion and garlic family also facilitate iron absorption, so are another good inclusion.

Vitamin D is important for growth and bones. The best way to meet your child’s needs is to make sure they get 20 minutes of sunshine on their forearms and face each day, and longer if your toddler has darker skin. If this isn’t possible, then supplements or fortified foods are a good idea.

To ensure adequate omega-3 fatty acid intake, include dark leafy greens, ground flaxseeds, chia seeds, hemp seeds and walnuts. At the same time, minimise omega-6 rich foods such as oils and processed foods because these impede the conversion of omega-3 fatty acids into the longer forms needed for healthy brain development.

Iodine levels can be a concern in toddlers and adding iodised salt isn’t the best solution due to the sodium it delivers. Seaweeds are a good source of iodine, especially dulse, wakame, and nori (many toddler’s just love an avocado nori roll!). Kelp should be avoided because its iodine content is too high. You may consider an appropriate iodine supplement if iodine intake is a concern.

While breast milk is a major source of calcium before solid foods are introduced, plant foods such as beans and greens are rich in calcium, so be sure to include these in your toddler’s diet.

Making whole plant foods the cornerstone of your diet will provide your body with an array of micronutrients, which all work together to meet your nutritional needs.

Growing good eaters

Toddlers and young children have high energy needs but small stomachs, so aim to offer food every two to three hours. Include energy-dense starchy foods such as whole grains, potatoes, lentils, and beans as well as nutritious plant-foods with a naturally high fat content, such as avocado, nuts, and seeds (always taking care to avoid whole nuts due to choking risk).

Toddlers need to learn to chew solids, but smoothies can be a great way to help them eat their greens and other vegetables and fruits. You can also include dates, flaxseed, hemp or chia seeds, and nuts for an energy-packed meal or snack. Other healthy, satisfying snacks could include hummus with carrot sticks, pieces of cooked potato, pumpkin or broccoli, and wholemeal toast.

If organic foods are affordable and available, these are a good choice for your toddler. However, it’s more important to focus on introducing a range of nutritious plant foods to your child. Setting them up with good eating habits early also sets them up for good health throughout their lifetime. A plant-based diet is wonderfully health promoting for baby… and you!

This article is republished with permission from nourishmagazine.com.au.

Updated: 2 February 2026

November 16, 2020
Clear up carbohydrate confusion to improve diabetes outcomes

Contrary to popular belief, it isn’t carbohydrates or sugar that cause insulin resistance. Dr Chau Tran explains.

Diabetes is the fastest growing chronic condition in Australia. More than 1.2 million Australians are living with known diabetes, while many more remain undiagnosed. Prevalence of diabetes in Australia has tripled over the past 25 years and there is no sign of this slowing.

World Diabetes Day (14 November) is an important awareness raising initiative, which this year focuses on ensuring all health professionals are equipped with the correct knowledge and understanding to support those living with diabetes.

Dr Chau Tran, Endocrinologist and Doctors For Nutrition NSW Ambassadoc, said it isn’t all bad news. Type 2 diabetes, which accounts for 85 per cent of all cases, is largely preventable by maintaining a healthy lifestyle.

“Evidence shows that type 2 diabetes can be prevented or delayed in up to 58 per cent of people by following a healthy eating plan, maintaining a healthy weight and being active. “Sounds simple right? Well, the confusion is rife, particularly when it comes to diet, especially carbohydrates,” Dr Tran said.

“The underlying mechanism of type 2 diabetes is insulin resistance. Contrary to popular belief, it isn’t carbohydrates or sugar that cause insulin resistance. Insulin resistance is caused by a build-up of fat inside muscle and liver cells.

“Studies have shown that high intake of saturated fat, as opposed to monounsaturated and polyunsaturated fats, causes insulin resistance, impairs insulin secretion and is toxic to the cells that produce insulin in the pancreas. Eating greater amounts of saturated fat is also linked to high blood cholesterol levels and an increased risk of heart disease,” he said.

Contrary to popular belief, it isn’t carbohydrates or sugar that cause insulin resistance. Insulin resistance is caused by a build-up of fat inside muscle and liver cells.

– Endocrinologist and DFN Ambassadoc, Dr Chau Tran

These fats are found in animal-based products such as meat, processed meats and dairy foods, many manufactured or packaged foods and a few plant-derived products like palm oil, coconut (flesh, oil, milk and cream) and some margarines.

Dr Tran said: “The foods which should make up the bulk of a healthy diet are whole plant foods such as wholegrains, legumes, fruits and vegetables, which have been shown in studies to be beneficial in both preventing and managing diabetes.

“People, with or without diabetes, should include an abundant diversity of these healthful foods in their diet. The major emphasis should be on reducing intake of foods high in saturated fat and avoiding processed sugars and highly refined carbohydrates.

“A low carbohydrate diet may provide short-term improvements in body weight and blood glucose levels, but there is no strong evidence that a low carbohydrate diet will benefit your health, or even be safe, in the long-term. Healthy weight, excellent glucose control and better overall long-term health outcomes can be sustainably achieved on a diversified whole food plant-based diet,” he said.

“Diabetes is one of the biggest challenges confronting Australia’s healthcare system. We must use events like World Diabetes Day to shine the spotlight on diabetes education, including nutrition education, to empower both patients and health professionals,” he said.

Phone interviews with Endocrinologist Dr Chau Tran available on request.

More information on whole food plant-based nutrition for type 2 diabetes can be found at doctorsfornutrition.org/type-2-diabetes.

November 10, 2020
COVID-19: a tipping point for a change in dietary behaviour

COVID-19 has increased the focus on new opportunities to efficiently manage health outcomes in Australia and Aotearoa New Zealand. We must harness this unique moment in time to fight the pandemic and, more broadly, manage the rising tide of chronic disease.

The pandemic has highlighted the importance of maintaining overall health; in Australia more than 70% of COVID deaths had pre-existing conditions. The value of a healthy, balanced diet, rich in whole foods is more crucial now than ever.

Doctors For Nutrition, a registered health-promotion charity led by medical and dietetic professionals, has launched a toolkit to assist medical professionals in leveraging this opportunity.

Dr Adrian Griscti, a rural GP for over 33 years and Doctors For Nutrition Advisory Council member, welcomes the launch of Doctors For Nutrition ‘Plant-based nutrition and health: A guide for health professionals’.

“We’d all agree that diet is the number one decision you make for your health each day. Health practitioners play an important role in inspiring and supporting people to improve their diet and longer-term quality of life,” he said.

“Although our training often does not include nutrition education, patients still turn to us for advice about healthy eating.

“Unfortunately many GPs simply don’t have enough time during appointments to provide their patients with nutrition advice. Also patients may not realise how vital simple dietary steps can be in improving their ailments. This guide helps to bridge that gap.

Diet is the number one decision you make for your health each day.

“In just 10 minutes, you’ll be informed about the benefits of shifting to a more whole food plant-based eating pattern, how it is linked to reduced rates of chronic disease and the range of positive outcomes for those who adopt these changes. It provides evidence-based guidance on healthy, sustainable eating patterns,” Dr Griscti said.

The guide includes practical tools such as a quick diet survey to find easy areas for improvement. There are also useful support tools for patients such as a 2 page patient handout and dietitian-designed shopping list.

Emma Strutt, Australian Practising Dietitian and Doctors For Nutrition Queensland Lead Dietitian, said the guide has been designed to be very user friendly.

“Even health professionals with limited nutritional knowledge will feel comfortable using and sharing the tools with clients. For instance the shopping-list requires minimal explanation, making it an effective handout that won’t take up too much precious consultation time.

“I believe plant-based nutrition has been one of the most powerful and underutilised interventions in healthcare. This way of eating centres on unprocessed fruits and vegetables, wholegrains and legumes.

Plant-based nutrition has been one of the most powerful and underutilised interventions in healthcare.

“Unfortunately this isn’t the last, or the most severe, pandemic we are likely to experience. By using this global crisis as an accelerator towards healthy, nutritious and sustainable diets, we will improve resilience to future pandemics, reduce rates of chronic disease and help address environmental crises.

“Doctors For Nutrition is providing health professionals an extremely relevant and simple tool to do this,” Emma said.

Free access is available to health professionals and the general public at here.

Interview opportunities with Dr Adrian Griscti and APD Emma Strutt are available on request via phone or on location in Adelaide for Dr Griscti. An Advisory Council member in your area may also be available.

Media contact via email

September 20, 2020
The Cancer Consensus
Is cancer part of a genetic lottery or can prevention really begin on our plate? Dr Renae Thomas explores the role of healthy whole food plant-based nutrition as part of the cancer prevention toolkit. Article first published in Nourish Magazine.

When I was four years old, my father was diagnosed with metastatic cancer. This type of cancer is one that spreads from where it started in the body to other areas. Despite the fear, pain and suffering, thankfully, he has been cancer-free and healthy for 25 years since. I can now reflect on the positives that came out of this challenging time for our family, which ended up being my introduction to nutritional medicine.

I will never forget many of the awful experiences my father went through: the seemingly endless vomiting, the weight loss, losing his hair, and the pallor of his skin. He became a shell of himself from total exhaustion. But equally, I remember more amusing events, such as his lips and hands stained orange from juicing (oh, the noise of that juicer day in, day out!), the playful arguments we had over dinners of pureed vegetables (again!), and – much to the horror of almost everyone at that time – our transition to a plant-based diet. We now cringe at some of the experimental foods we ate back then before veganism became mainstream (homemade, frozen, congealed tofu dessert anyone?).

I will never know for sure whether my father’s lifestyle changes contributed to his cancer recovery, subsequent remission, and relapse prevention. However, he was always very conscious of basing his choices on the best scientific evidence available. The emerging research that continues to be published remains founded on the same principles – that preventing many of the chronic diseases that still plague us today has a strong relationship with nutrition.

What are the chances?

Cancer has become a deep-rooted fear for much of the world’s population. This is not without reason, given cancer is the second leading cause of death globally. Every year, approximately 17.5 million people receive a new diagnosis of cancer, a figure predicted to increase by about 70 percent by the year 2030.

And, it’s not simply a lottery of genetics. The American Institute for Cancer Research estimates that, at most, 10 percent of cancers are secondary to genetic causes and that around 40 percent of cancer cases are preventable. This means about seven million cases of cancer could be prevented every year by optimising controllable cancer risk factors – including nutrition.

It is estimated that one in every three cancers may be directly associated with sub-optimal dietary intake. What we eat represents a multiple-times-per-day environmental exposure that varies greatly between individuals. This is why dietary differences and their relationship to cancer have been extensively studied. Nutrition research has been broadly divided into two categories: dietary exposures related to increased cancer risk and dietary exposures that may have a protective effect against the development of cancer.

One in every three cancers may be directly associated with sub-optimal dietary intake
The bad news first

Nutritional patterns and foods that appear to be related to an increased cancer risk have been identified by observing dietary patterns in populations, conducting experimental human and laboratory studies, and developing theories based on known biological processes. The International Agency for Research on Cancer, a division of the World Health Organization, identifies carcinogenic (cancer-causing) substances, including foods. Those with the strongest evidence are known as class-1, or ‘known’ carcinogens, and class-2, or ‘probable’ carcinogens.

Combined with high-quality, peer- reviewed and published scientific research, much of the evidence we currently have suggests that diets high in animal products and low in plant-based foods increase the risk for cancer development, recurrence, and risk of dying from cancer. This evidence is consistent with results generated by numerous meta-analyses and systematic reviews as well as with large research studies of various populations worldwide. Here is what the research tells us about cancer and animal products.

High intakes of animal protein have been associated with increased risk of cancer mortality. Many of the known class-1 and class-2 carcinogens can become concentrated in animal products, especially those higher in fat. Consumption of these increases exposure to many environmental toxins and pollutants, including pesticides, herbicides, insecticides and heavy metals.

The World Cancer Research Fund states that both unprocessed and processed red meats can increase inflammation and cellular stress, and increase exposure to compounds such as nitrites. For example, every 50 grams of processed meat consumed per day (such as one hotdog or two slices of ham) is associated with an eight percent increase in the risk of dying from cancer.

‘Meat-cooking-related mutagens’ (Heterocyclic Amines and Polycyclic Aromatic Hydrocarbons) are classed as known carcinogens. These are found in well-cooked meat, poultry and fish products, in pan drippings, and in any meat surface that is browned or chargrilled.

Eating seafood and white meats is also associated with increased exposure to many known carcinogens, including heavy metals, added hormones, antibiotics, and plastics.

High intakes of dietary fat and cholesterol are associated with increased risk for cancer. Animal products contribute to much of this in the standard Western diet. Just half an egg, one and a half serves of dairy, and 125 grams of meat, poultry or seafood per day exceeds the maximum recommended intake of dietary cholesterol.

It’s also important to understand that some typically plant-based foods can also increase cancer risk. These include ultra-processed foods, alcohol, carbonated beverages, and excess refined carbohydrates.
Much of the evidence suggests that diets high in animal products and low in plant-based foods increase the risk for cancer development, recurrence, and death
So, what’s the good news?

There are specific foods associated with decreased cancer risk, and the ones with the most consistent evidence are plant- derived. These include wholegrains, legumes, starchy vegetables and tubers, non-starchy vegetables, fruits, nuts, seeds, herbs, spices, and the foods subsequently made from all of these. There is extensive research that supports these foods for not just cancer prevention, but overall human health and diminished risks for both chronic and many acute disease processes.

Let’s look at the benefits of plant foods according to the research.

Plant foods are high in substances known as phytochemicals, which have antioxidant properties that reduce stress on DNA and can protect cells from turning into cancer.

Plant foods are the only source of fibre in human diets, with numerous large studies providing evidence that higher fibre intake is associated with reduced risks for many types of cancer.

Wholegrains contain a vast variety of substances that can be protective against cancer formation, including fibre, vitamins and minerals, healthy plant chemicals, nutritious plant fats, and antioxidants. These can support cell, gene and hormonal functions, while reducing inflammation, cholesterol and cellular stress.

Fruits and vegetables similarly contain many health-promoting compounds, such as fibre and antioxidants, which help protect and detox DNA, cells and enzymes from stress and damage. Cruciferous vegetables (such as broccoli, cauliflower, cabbage and kale) are particularly powerful for cancer prevention.

The anti-cancer properties of nuts and seeds include many compounds that have been found to support healthy cell function and growth, and also suppress many cell functions that may lead to cancer. Nuts and seeds are also high in fibre, vitamins and minerals, anti- inflammatory substances, and healthy fats – many of which have been associated with a decreased cancer risk.

Numerous studies have documented the antioxidant, anti-inflammatory, and immune-boosting effects of herbs and spices. Research suggests they may enhance prevention and treatment of several cancers by supporting healthy cells and DNA, preventing the growth and spread of cancer cells, optimising hormones, and making cancers more responsive to treatments including radiotherapy and chemotherapy.
What we eat matters

The general consensus of all scientific research is that the processes of cancer and its treatment, remission and recurrence are highly complex, with significant interaction between human genes and environmental exposures. Excitingly, there is a growing body of high-quality evidence that suggests cancer risk reduction strategies can lie in the foods we eat each day. While there are no guarantees or absolutes, it does appear that for many (like my dad), a shift towards eating more plants and less animal products can have a protective effect against cancer development.

What we eat can even enhance treatment response, raise the chances of full remission, and help avert the likelihood of cancer recurrence. This information is incredibly empowering for the global fight against cancer. But it gets even better as the science also shows eating more whole plant foods is protective against many other chronic diseases such as type 2 diabetes and cardiovascular disease. Much of this evidence exists on a spectrum, meaning it doesn’t have to be all or nothing. Every step in the right direction can be celebrated, because each healthy choice contributes towards improvements.

What we eat can enhance treatment response, raise the chances of full remission, and help avert the likelihood of cancer recurrence

As a traditionally educated medical doctor, I continue to advocate for appropriate medical evaluation of all cancer patients. Radiology and chemotherapy can be the best option for many people with a cancer diagnosis. However, it’s important to understand that the prevention, treatment, and risk-reduction for recurrence of cancer is multifactorial. There is no harm in at least reviewing the current evidence surrounding cancer and nutrition, and subsequently discussing with your doctor what may be beneficial for you to incorporate into your life. In no way do I suggest a plant-based diet is a substitute for medical care; there are no ‘miracle cures’. However, I am confident that the peer-reviewed scientific research that has fascinated me since childhood shows us nutrition plays a powerful role in health and disease prevention.

It brings me great satisfaction to have a nutrition prescription in my tool kit to help support my patients. This information can be applied in an attainable and sustainable way for those with a diagnosis as much as it can by those who wish to minimise risk. In short, my research and experiences have taught me to eat more plants… and that Dad is always right!

This article is republished with permission from nourishmagazine.com.au.
July 27, 2020
Plant performance
Athletes all over the world are going plant-based, and for good reason. You can hit peak performance with plants. GP and athlete Dr Malcolm Mackay unpacks the benefits of this game-changing lifestyle to support your training, competition and recovery. Article first published in Nourish Magazine.

More and more leading athletes are adopting a whole food, plant-based (WFPB) diet for improved sports performance. The release of the The Game Changers documentary has been a tipping point for interest in WFPB nutrition – a performance-enhancing strategy that is safe, ethical and available to everyone, from leading sportspeople to regular gym users.

As an athlete myself, I have a long-standing interest in sports nutrition. Distance running and a love of snow skiing motivated me to begin my plant-based nutrition journey when I was in medical school, learning about the damage the Western diet was causing to our arteries and other aspects of health. It seemed to work for me, I ran a 2:32 marathon in 1980 and had a couple of first places in my early triathlons. Even now at age 60, I can still run a reasonable half marathon – something I don’t think I would be fit enough to do had I spent decades eating chicken, cheese and oil.

The benefits of WFPB nutrition combined with avoidance of animal products and processed foods, impact the whole cycle of sports performance – training, competition, and recovery. Carbohydrate-rich whole plant foods not only provide optimal fuel while supporting blood flow to muscles during training and competition but also support the critically important recovery phase. These foods counteract the oxidative stress and inflammation caused by intense exercise, resulting in fewer overuse injuries and a shorter recovery time, giving athletes the capacity to do quality training sessions, more often.

Whole plant foods counteract the oxidative stress and inflammation caused by intense exercise, resulting in fewer overuse injuries and a shorter recovery time.
But what about protein?

The focus on protein, and particularly animal protein, is the most persistent myth in sports nutrition. No one who consumes adequate calories from a variety of whole plant foods is likely to suffer reduced performance due to lack of protein.

While the term ‘protein’ is used in common language and some diet guides to describe certain foods, this is misleading. It implies that these foods are composed of protein only and that other foods do not provide any. Dietary guidelines can also add to the confusion by describing a protein group that includes legumes and nuts but not wholegrains, when on a per-calorie basis, wholegrains have the same protein content as nuts. All whole plant foods are a complex ‘package deal’ with varying amounts of protein. Only processed foods like olive oil, coconut oil and sugar contain zero protein. The natural plant protein package also includes an abundance of health-supporting phytonutrients and dietary fibre, which are absent from the animal protein ‘package’. In fact, animal proteins often include health-damaging and inflammatory substances. High protein diets based on animal products are deleterious to health and athletic performance.

While some of the effects are due to the other toxic components of the animal protein ‘package’, the quantity and composition of the protein itself has the following adverse effects on health and athletic performance.

Acid load (reducing tolerance to lactic acid build-up during intense exercise).

Negative calcium balance and bone loss due to acid load.

Kidney stress and long-term damage.

Dehydration and electrolyte depletion.

Insulin resistance (causing reduced muscle glycogen).

Adverse shift in gut microbiome profile.

Adverse impact on cardiovascular function.

The primary nutrition issue for plant-based athletes is consuming enough calories to support their heavy training loads. Failure to thrive on a plant-based diet is usually the result of not eating enough calories. The carbohydrate-rich foods that provide the ideal fuel for athletes – such as oats, brown rice, wholemeal pasta, potatoes and beans – have only half the calorie density of meat, chicken and fish. This means twice the quantity will be required to get the same number of calories. Eliminating vegetable oils (the most calorie dense and nutrient poor food group) further dilutes the calorie density of meals, so athletes need to adapt to eating larger meals and more snacks.
The natural plant protein package includes an abundance of health-supporting phytonutrients and dietary fibre.

Plants contain all the essential amino acids and have an amino acid profile that is more health supporting than that of animal proteins. Athletes do not need to choose higher-protein foods to meet their extra protein needs because they consume more calories than the general population, which means more food and more protein. A typical WFPB diet provides about 12 percent protein, which equates to approximately 1.5 grams of protein per kilogram of bodyweight for a moderately active person, as opposed to an elite athlete. If athletes are (unnecessarily) anxious about getting enough protein on a WFPB diet, this can be increased by consuming more of the higher-protein plants – more legumes, higher-protein grains (e.g. wheat rather than rice), higher-protein tubers (potatoes rather than sweet potatoes) and more protein-rich, low calorie, non-starchy vegetables.

Popular sports nutrition emphasises the importance of consuming protein as soon as possible after exercise but much of the evidence supporting this idea is highly reductionist and may not translate to improvements in performance. It’s true that adequate food intake during the recovery period is important, including the protein that is naturally present in the wholefood, plant-based package. However, after a big workout, it may be better to focus on hydration and phytonutrient-rich plant foods that neutralise inflammation and protect damaged tissues.

Protein supplements are unnecessary and can displace calories that might otherwise have come from nutrient-rich whole plant foods. Inadequate protein intake is only likely to occur in the context of inadequate calorie intake (or on diets built on sugar and oil). Most of us easily meet our protein needs and any additional protein is deaminated in the liver (increasing blood urea levels) and then metabolised to sugar and fat, which is used for energy or stored in the body. Adding protein powder to your meal is like adding sugar – calories without any of the fibre, nutrients and phytonutrients.

It’s simple – eat peas, not pea protein.
Nutrients, when removed from their whole food context and concentrated, can also have unanticipated adverse effects. For example, taking more of one mineral can impair the absorption of other minerals. Animal studies performed in the past suggest that increased intakes of plant protein do not promote cancer and ageing in the same way that animal protein does. Whole plant foods contain the right balance of all the nutrients and phytonutrients that we need for optimal health – we don’t need to try and outsmart nature. The exceptions here are vitamin B12 and vitamin D, which we would get from bacteria and sunshine if we lived in nature, but we don’t these days and supplements may be recommended. Iron supplements can also be appropriate for short-term correction of proven deficiencies.

The proof of plant performance

A WFPB diet can improve sports performance in the following ways.

The high carbohydrate content maximises glycogen stores, which provides fuel for endurance events and long training sessions.

The lower fat content and higher water and fibre content of whole plant foods means they have a lower energy density, making it easier to maintain a lean physique.

It supports optimal cardiovascular health. Arteries remain free of plaque and the improved endothelial (artery lining) health allows arteries to dilate fully, improving blood flow to the heart and muscles.

The nitrates in leafy green vegetables and beets boost nitric oxide production, improving blood flow to muscles and reducing blood pressure.

Blood viscosity and red blood cell stiffness is reduced, boosting capillary blood flow, and delivering more oxygen to where it’s needed.

The antioxidant phytonutrients in whole plant foods neutralise the free radicals that are produced as byproducts of our cellular energy metabolism and protect our cells against exercise-induced damage.

Many phytonutrients in whole plant foods have powerful anti-inflammatory actions. These dampen down sports related tissue inflammation without the harmful side effects of anti-inflammatory pharmaceuticals.

Immune function is improved through the action of whole plant food phytonutrients and the absence of inhibitory effects from animal products and processed food.

WFPB nutrition supports improved mood and energy levels, essential for consistent and goal directed training.

Plant-based athletes can easily meet and exceed their protein requirements by eating adequate calories of whole plant foods, which provide protein in a form that our bodies are designed to process. The WFPB diet also comes with a host of benefits that support holistic health and wellbeing. It’s simple – eat peas, not pea protein.
This article is republished with permission from nourishmagazine.com.au.
July 6, 2020
Ironing out the facts

Many women have low iron stores, but it’s not due to a lack of meat. Dietitian Rhianna Redclift sets out the science on how to maintain optimal levels. Article first published in Nourish Magazine.

There is a misconception that getting enough iron on a plant-based diet is difficult. The reality is, with a little thought, meeting your iron requirements is relatively easy.

Plant foods happen to be abundant in this vital mineral. For example, 100 grams of cashews contain almost twice the amount of iron as 100 grams of cooked beef. When you consider this alone, it’s not hard to see why vegans and vegetarians can often consume more iron than people who choose to eat animal products.

Understanding iron

Iron is an essential mineral found predominantly in our red blood cells. It is essential to transport oxygen from our lungs to all the tissues in our body. We also require iron for energy metabolism, neurological development and hormone synthesis. There are two forms of dietary iron: haem iron and non-haem iron. Non-haem iron is found in plant foods and iron supplements. Haem iron, on the other hand, is found in animal flesh such as red meat, seafood and poultry. Haem iron is more readily absorbed than non-haem iron, which probably contributes to the misconception that plant-based diets do not provide enough iron.

What doesn’t get talked about so much is that an iron overload has been linked to inflammatory conditions such as type 2 diabetes and heart disease, among others. The human body cannot rid itself of excess iron and therefore has evolved to regulate absorption to help prevent this from happening.

Human physiology is very well adapted to consuming iron from plant sources.

However, due to haem iron’s high bioavailability and the fact that it bypasses the body’s finely tuned iron-regulation systems, it is more likely to lead to high iron stores. Non-haem iron on the other hand is carefully balanced based on the body’s need for iron. This clever system is a protective measure for prevention of iron overload and indicates that human physiology is very well adapted to consuming iron from plant sources.

While non-haem iron is regulated by our bodies, it is also less easily absorbed. This is largely due to the influence of other compounds found in plant foods. The key to meeting your iron needs on a plant-based diet is to minimise foods that might impede your absorption and maximise those which can increase it.

The dreaded deficiency

If our consumption of dietary iron is chronically low, our stores become depleted and this decreases our haemoglobin levels. Once our stores are exhausted, this results in iron deficiency anaemia. This condition limits the body’s ability to transport oxygen to our cells, resulting in symptoms such as fatigue, weakness, heart palpitations, shortness of breath, reduced immune function, and hair loss.

Iron deficiency anaemia is one of the most common nutritional deficiencies in the world and affects approximately 25 percent of the population globally – and it is important to note those following a plant-based diet are no more at risk than omnivores. Iron deficiency is more prevalent in young women, largely due to blood loss during menstruation, and, in Australia, women who follow calorie-restricted diets for weight loss are most vulnerable.

While some studies have shown that, compared to omnivores, those following plant-based diets can have iron stores at the lower end of the normal range, in Australia, this does not mean they are at a greater risk of iron deficiency anaemia. In fact, the lower iron stores found in vegetarians and vegans could actually be beneficial given that research has found high iron stores may be associated with an increased probability of chronic diseases such as type 2 diabetes.

Getting enough iron

The Australian Recommended Dietary Intake for iron is eight milligrams for adults and 18 milligrams for women of menstruating age.

Even though vegans and vegetarians tend to consume similar, and often more, iron than omnivores, they still tend to have lower iron stores. This would suggest that those following plant-based diets have higher iron requirements. Based on information provided by the National Health and Medical Research Council and New Zealand Ministry of Health nutrient reference values, those following a plant- based diet may need 1.8 times more iron than omnivores due to the types of iron consumed and their rates of absorption.

However, this guidance is derived from limited research on vegetarian diets. These recommendations were based on a study in which the vegetarian diet was high in iron inhibitors and limited in vitamin C rich fruits and vegetables, which are essential for regulating the uptake of non-haem iron from the gastrointestinal tract.

Until we have clear science on how much more iron vegetarians require, it is important to focus on including plenty of iron-rich foods while also optimising our diet to increase absorption of this important nutrient.

Iron inhibitors

Tea, coffee and wine can all reduce the absorption of iron due to their tannin content, which binds to iron and causes it to be excreted from the body. Because of this, it is recommended we avoid drinking these beverages within an hour of mealtimes.

Additionally, phytates found in many vegetables, legumes and wholegrains can also reduce iron absorption, particularly in those with poor diets. We can all combat this by cooking, soaking, sprouting, leavening, and fermenting our plant foods. These processes can all help to reduce phytate levels.

You could try sprouting some of your legumes, eating tempeh and other fermented foods, and consuming wholegrain bread. It is important to understand that phytates are also powerful antioxidants and may reduce the risk of chronic health diseases and some forms of cancer, so they also play a role in a healthy diet. You don’t want to avoid these compounds altogether, rather consume them as part of a varied diet.

Source: The Australian Food Composition Database

Optimising absorption

Some of the best plant-based sources of iron include legumes, soy products such as tofu and tempeh, nuts, seeds, wholegrains, dried fruits such as figs, leafy green vegetables, oats and fortified wholegrain breakfast cereals. To minimise the effects of phytates on iron absorption, it is important to consume vitamin C rich foods with meals. This can enhance the uptake of iron up to six times in those with low iron stores.

To increase iron absorption, you can try cooking legumes in a tomato-based sauce, include vegetables on your plate such as capsicums, cauliflower and green vegetables, or enjoy half a glass of freshly squeezed orange juice (with the pulp) alongside your meals. Even the citric acid in a squeeze of lemon over your food will help to increase your iron levels.

If you are concerned about your iron intake, discuss this with your doctor and dietitian. If a blood test reveals you are low in iron, you may need to take a supplement to help bring your iron stores back up to the recommended range. There are also certain health conditions and medications that can affect uptake of iron, so this should also be considered. It is a good idea to speak to your medical practitioner before taking any supplements. If supplements are required, your doctor can suggest the appropriate iron supplement that is best for you.

This article is republished with permission from nourishmagazine.com.au.

May 19, 2020
Nutrition in the time of COVID-19
As the world grapples with the novel coronavirus pandemic, Doctors For Nutrition’s Western Australia Lead Nutritionist, Dr Angela Genoni PhD, unpacks the role of nutrition in supporting our immune system.

The novel coronavirus SARS-CoV-2 and its resulting disease, COVID-19, have already touched almost every country on the globe. Many of us have lost jobs, had hours reduced and are being urged or required to stay home in lockdown, unless we work in healthcare or other essential industries.

Things that seemed secure a few short weeks ago are no longer quite so safe; many of us have necessarily been brought back to living simple lives. When we stop to reconsider the basics, it is important to consider the role that good nutrition plays in supporting our immune system.

So, what do we really need to support our immune system? What evidence is there surrounding what we eat and the ability of our immune system to cope with viral or bacterial infections (the latter of which often occur when a person is already fighting a viral disease such as COVID-19)?

Western diets and susceptibility to infection

As stated in the latest United Nations System Standing Committee on Nutrition newsletter, “Unhealthy diets are the leading cause of ill-health. Without dedicated action on nutrition, all forms of malnutrition are likely to increase as a result of the pandemic’s impact on food environments. Financial hardships, reduced physical activity, and altered purchasing patterns favouring products with longer shelf life and often poorer nutrition profiles can lead to higher levels of food insecurity, undernutrition, and overweight/ obesity.”[1]

Here in Australasia, we live in a society where we can purchase whatever food we like at almost any time we wish. Unfortunately, much of this is of animal origin and/or highly processed, making it highly palatable and yet lacking in vital micro and macronutrients. The result is a perverse form of malnutrition where, despite the overabundance of food, people are chronically under-nourished.

The over-abundance of nutritionally-poor food in our Western society is a proven trigger for inflammation that contributes to immune dysfunction and reduced control of infection.[2] This over-abundance also contributes to a prolonged positive energy balance which is one of the primary drivers of obesity.[3,4] Fat cells (adipocytes) release inflammatory substances such as tumour necrosis factor (TNF) and the Interleukins (IL), particularly IL-1 and IL-6, and these inflammatory markers combined with obesity, greatly increases susceptibility to infection.[4]

Dr Angela Genoni PhD

Western style diets, characterised by a high-fat content, are well reported in the scientific literature to alter the colonic microbiome in favour of an undesirable shift to a higher ratio of Firmicutes:Bacteriodetes.[5-7] This is associated with increased gut permeability, an increase in serum lipopolysaccharide (LPS) concentrations, and reductions in bacterial by-products (including short chain fatty acid production), all of which can result in chronic inflammation and decrease the ability to fight infection. This is supported by literature showing obesity to be an independent risk factor for morbidity and mortality following infection with the 2009 H1N1 influenza A virus.[4] Early data from the COVID-19 pandemic indicates the risk of complications from COVID-19 are also increased in patients with a BMI over 25.[8]

Similarly, a modern Western-style diet has been shown to induce significant shifts in our gut microbiome and is strongly associated with weight gain and associated metabolic disorders.[9] Evidence now also shows the gut microbiome exhibits an ability to talk with the lung microbiome, termed the gut-lung axis, which may also influence our ability to

respond to triggers such as viral infections.[10] Diets high in plant-based foods with varieties of dietary fibre types are considered beneficial for host health due to their ability to increase microbial diversity.[11, 12] In addition to the microbial populations, the metabolites produced, such as short chain fatty acids, may provide some protection against inflammatory responses.[13]

We also know that a single meal containing high amounts of salt and saturated fat increase the inflammatory response in those with asthma, irrespective of BMI.[14]

The protective properties of whole food plant-based diets

The ‘why’

The risk factors outlined above make it very prudent to consider what sort of diet we can follow to reduce our risk of inflammation, both after single meals and over the long term. Diets high in dietary fibre (obtained exclusively from plants), are well reported to reduce inflammation.[17, 18] A particular type of dietary fibre, resistant starch, is showing particular promise for reducing gut and systemic inflammatory markers.[19, 20] Resistant starch is found abundantly in foods such as whole grains, legumes and root vegetables. [6] Plant-based diets have also been shown to consistently improve obesity-related inflammatory profiles.[15, 16]

Plant foods also contain many other bioactive substances, such as flavonoids, whose significance we are only beginning to understand, both individually and synergistically, in regulating many biochemical pathways – including inflammation – in the body.[16, 21]

The ‘how’

In these uncertain times, it is relatively easy and cost effective to base your diet around plant foods and gain the health benefits of dietary fibre and bioactive substances. Dried whole grains and legumes are perfect sources of complex carbohydrates, dietary fibre and resistant starch. Generally, these foods are readily available and cost effective, even in our current state of lockdown. Basing your diet on this food group and adding in fruits and vegetables will provide all of your nutritional needs, including protein.*

A simple diet, based on simple foods can also result in significant cost savings in these stressful times.[22] Contrary to popular belief, frozen vegetables are not nutritionally inferior. Often snap-frozen at the point of harvest, in some cases they can contain more nutritional benefit than their fresh counterparts due to being frozen so quickly.[23]

Other protective lifestyle factors

Finally, our immune system is not solely influenced by what we eat. Long-term stress is also well reported to detrimentally impact our immune system.[24] We are all under varying degrees of stress during this crisis and it is vitally important we stop momentarily to put ourselves first and try to relax. We know many people in healthcare and other essential services are working extra hours under high stress, while many others are facing the stress of financial uncertainty. Hard as it may feel, this makes it even more important than ever to find ways to unwind. Now is the ideal time to start a small but sustainable practice of meditation, or just put some music on to relax. We all need the support of friends, loved ones and strangers now more than ever, so again, now is a crucial time to practise kindness and find ways to look after each other, even if those are limited to ‘virtual’ methods.[25]

Similarly, lack of sleep is also undesirable for optimal immune function,[26] so do try to make this a priority. For those who are, of necessity, spending more time at home, the current situation is an opportunity to be kind to your body and catch a bit of extra time in bed.

It may be a little more difficult for many of us to follow our regular exercise routines whilst COVID-19 still dominates our society, with gyms, swimming pools and beaches closed. However, exercise has many benefits for our physical and mental wellbeing, and may also further support our dietary pattern in terms of a healthy gut microbiome.[27] There are many forms of exercise attainable at home at little to no cost and again, it is about finding something small which fits with your lifestyle to start with.

As I like to tell my children, “we get one body and one chance at a long-healthy life. Look after it.”

*Long-term plant-based diets require supplementation with vitamin B-12
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United Nations System Standing Committee on Nutrition. Email, 28 March 2020. Food Environments in the COVID-19 Pandemic: Impacts and positive policy actions to deliver sustainable healthy diets for all

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Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care. 2016;22(7 Suppl):s176-85.

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Clemente JC, Ursell LK, Parfrey LW, Knight R. The impact of the gut microbiota on human health: an integrative view<. Cell. 2012;148(6):1258-70.

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Xu D, He G, Mai K, Zhou H, Xu W, Song F. Postprandial nutrient-sensing and metabolic responses after partial dietary fishmeal replacement by soyabean meal in turbot (Scophthalmus maximus L.). British Journal of Nutrition. 2016;115(3):379-88.

Vinolo MA, Rodrigues HG, Nachbar RT, Curi R. Regulation of inflammation by short chain fatty acids. Nutrients. 2011;3(10):858-76.

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Eichelmann F, Schwingshackl L, Fedirko V, Aleksandrova K. Effect of plant‐based diets on obesity‐related inflammatory profiles: a systematic review and meta‐analysis of intervention trials. Obesity Reviews. 2016;17(11):1067-79.

Liu RH. Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals. The American Journal of Clinical Nutrition. 2003;78(3):517S-20S.

Kim MS, Hwang SS, Park EJ, Bae JW. Strict vegetarian diet improves the risk factors associated with metabolic diseases by modulating gut microbiota and reducing intestinal inflammation. Environmental Microbiology Reports. 2013;5(5):765-75.

Roager HM, Vogt JK, Kristensen M, Hansen LBS, Ibrügger S, Mærkedahl RB, et al. Whole grain-rich diet reduces body weight and systemic low-grade inflammation without inducing major changes of the gut microbiome: a randomised cross-over trial. Gut. 2019;68(1):83-93.

Brouns F, Kettlitz B, Arrigoni E. Resistant starch and “the butyrate revolution”. Trends in Food Science & Technology. 2002;13(8):251-61.

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Bellik Y, Boukraâ L, Alzahrani HA, Bakhotmah BA, Abdellah F, Hammoudi SM, et al. Molecular mechanism underlying anti-inflammatory and anti-allergic activities of phytochemicals: an update. Molecules. 2013;18(1):322-53.

Schuster, R. How to Get People to Stop Eating Meat? Better Alternatives. Haaretz. May 18, 2017

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Ticinesi A, Lauretani F, Tana C, Nouvenne A, Ridolo E, Meschi T. Exercise and immune system as modulators of intestinal microbiome: implications for the gut-muscle axis hypothesis
April 14, 2020
South Pacific Society of Lifestyle Medicine Conference 2020: Turning the tide on NCDs

Dr Luke Wilson reports back from the inaugural South Pacific Society of Lifestyle Medicine conference in March 2020. Luke was among a high-profile speaker lineup – including an opening address by the President of Fiji himself.

Addendum, 9 April 2019: our thoughts are with our Pacific neighbours who are currently dealing with the terrible impacts of Cyclone Harold on top of the COVID-19 crisis. Our hearts go out to all who are affected and we stand in solidarity with our healthcare colleagues working on the frontlines.

SPSLM group photo. Image credit: Pete Navosailagi

Bula! Last month I was in Pacific Harbour, Fiji for the South Pacific Society of Lifestyle Medicine (SPSLM)’s inaugural conference. Around 100 attendees were present from island nations across the Pacific including Papua New Guinea, Solomon Islands, Vanuatu, Tonga, Samoa, Tuvalu, Kiribati and the Cook Islands, and of course Fiji.

I was fortunate to have been offered the opportunity to speak following a chance encounter with Dr Paul Wood, a fellow GP and lifestyle medicine physician in Auckland last year at the Australasian Society’s own conference. When I found out Dr Wood’s recently established Society was planning a conference, and its timing – starting the day after my birthday – of course I offered my services on the spot. Despite having grown up in New Zealand, technically islands in the Pacific too, and our close connections and short distance from our neighbours, this was my first time visiting the Pacific.

Even though it meant a very early morning start for my transfer to the Pearl Resort venue, I was determined to make registration on time. I had a DFN pull up banner I wanted to get a prime spot for, and also a stack of DFN materials to be distributed to delegates.

Delegates posing for social media; DFN booth in background. Credit: Pete Navosailagi

But to be perfectly honest I had an ulterior motive for my motivation to arrive early, and am happy to report it was well worth the effort – I was on time to witness His Excellency the President of Fiji, Major-General Jioji Konrote, opening and addressing the conference. President Konrote called for urgent action to deal with chronic disease in the Pacific. I’m told he is vegetarian, and – perhaps unsurprisingly given his military background – is renowned for his physical prowess, encouraging delegates to ‘run’ rather than ‘walk the talk’.

President Konrote’s opening address. Credit: Pete Navosailagi

President Konrote graced us with his attendance through the welcome address by SPLSM’s own President, Dr Chester Kuma, which I was pleased from the outset emphasised the role of the transition from ‘Garden foods to processed foods’ to address the heavy burden of non-communicable disease (NCD).

The following presentations provided further sobering detail about the impact and prevalence of diet-related NCDs on the Pacific which is regrettably becoming increasingly dire: some Pacific nations have a prevalence of obesity of up to 80%, and while the global average for diabetes prevalence is 10%, several Pacific nations are over 30%.

After posing with us for our official conference photos President Konrote departed with his cavalcade no doubt back to the more mundane realities of political life, or perhaps for a run. Either way, the challenge has been thrown down by Fiji for DFN to secure the Governor General of Australia at least to open our next conference, if Jacinda Ardern is unavailable.

After our first morning tea break, which included tropical fruit that tasted great, no doubt assisted by the fact that it was locally grown and in season (NZ conference caterers, please take note) we returned to the first of several talks from a presenter who was online rather than in person. Associate Professor Darren Morton, speaking to us presumably from New South Wales, discussed how ‘Evidence Based Medicine’ biases physicians against nutrition. He pointed out that objecting to lifestyle medicine approaches solely due to a lack of evidence from randomised controlled trials is equivalent to avoiding using parachutes for the same reason. This was followed by Professor Garry Egger, again remotely, extolling the benefits of shared medical appointments, before a return to in-person presentation with Stephen Penman of the Australasian Society of Lifestyle Medicine providing a thoughtful and courageous presentation on what Lifestyle Medicine is and is not.

After (a plant-based) lunch, presentations included lifestyle factors impacting eye disease, tobacco control in the South Pacific, and a remarkable testimonial from Dr Margaret Cornelius on her own journey to wellness through lifestyle changes (including, naturally, a whole food plant-based diet). After my early start, nerves about my upcoming and still fairly unpractised presentation caught up with me a bit, so I slipped off to check in to my room and prepare myself a bit prior to the all-important Conference Dinner.

Welcome speech SPLSM President, Dr Chester Kuma. Credit: Pete Navosailagi

The star power continued that evening with a dinner address by Dr Jone Hawea of the Pacific Island Food Revolution TV series telling his story. He realised that a new more accessible approach to nutrition education was needed in the Pacific, seeing for example standard public health efforts to combat Coca-Cola’s popularity fail (in fact, in 2018 the soft drink maker tripled its production capacity on the island).

Dinner address by Dr Jone Hawea. Image credit: Pete Navosailagi

He explained what they were up against alluding to Coca-Cola’s response of ‘Putting one of our [rugby] 7s stars on a billboard promoting Coke’. One of his motivations was to restore pride in traditional foods – Dr Hawea said that when he went to the villages, people would apologise for serving him traditional food. The response to Pacific Island Food Revolution suggests that it has gone a long way towards bringing traditional and healthy food choices back into fashion. It has an enthusiastic following on social media and is now shown in 6 countries across the Pacific, as well as in Australia and New Zealand (so give them a ‘like’ on Facebook and check it out!)

Dr Hawea’s presentation was an appropriate introduction for what followed: a buffet of many traditional favourites, I believe some of which were cooked in a lovo (ground oven). This was the first time I tried dalo (taro), and there were also several other delicious offerings including dishes made from native seaweeds and leaves, alongside some tasty representation of Fijian cuisine’s Indian influence too.

The delicious 100% plant-based dinner buffet. Image credit: Pete Navosailagi

There were a couple of talks scheduled the next morning before mine, but I opted to catch up on some rest and do a few last minute run-throughs of the presentation before I was on at 10.55. After apologising for New Zealand’s recent success at the Vancouver 7s tournament, and hoping to appease the largely Fijian audience by informing them I was wearing my Fiji Rugby shirt in solidarity with their national team, I launched into my presentation, ‘Creating a Lifestyle Intervention for Your Community’.

If you’re interested you can get the main points through reading my article on this topic originally written for ASLM. Just as when I wrote that, I hoped to help inspire the attendees to consider having a go at doing their own program, with a few adjustments as appropriate for their community. The talk was well received and going by the feedback I had from attendees indeed several of them were inspired to consider getting started on something of their own. I also emphasised the environmental benefits of the intervention we chose: a whole food plant-based dietary pattern, bolstered by Jono Drew et al.’s recently published NZ-specific data, and acknowledging that this existential threat to humanity let alone our individual health must guide our healthcare practices and recommendations in the future, especially for the sake of the Pacific.

I had the honour of warming the stage for Associate Professor Wayne Dysinger, past President of the American College of Lifestyle Medicine and Chair of both the American and the International Boards of Lifestyle Medicine. In the first of his several presentations at the conference Dr Dysinger detailed how nutrition specifically could be used to effectively and rapidly reverse type 2 diabetes, which as mentioned earlier in the conference is a particular issue in the Pacific. With changes in diet, he explained, it would be possible for Pacific nations to rapidly eliminate the scourge of [type 2] diabetes almost entirely. After lunch, we learned about strategies for enhancing sleep, helping people adopt new habits, and options for further education and qualification in lifestyle medicine.

Left to right: Dr Luke Wilson, Dr Wayne Dysinger, Dr Ross Grant. Image credit: Pete Navosailagi

The day finished on a high note with a fantastic and inspiring presentation on the Complete Health Improvement Program (CHIP) in Fiji and globally. This program is very well researched and has proven efficacy with published outcome data including in New Zealand and Australia, as well as the United States and Europe. The Fiji team have been collecting data for publication too which is eagerly anticipated (perhaps a presentation at next year’s SPSLM?). Dr Alipate Vakamocea told us that the lab pathologists turned up to his CHIP sessions unannounced because they were so surprised by the results of the tests they had been running that they wanted to find out what was happening. There has also been a Fiji-specific cookbook created which will be published soon. Keep an eye on the Fiji CHIP Facebook page to be alerted when this is released.

Presentation by CHIP graduate, Mr Ilaitia Tuinamoala. Image credit: Pete Navosailagi

The highlight however, was another incredible testimonial, this time from Mr Ilaitia Tuinamoala, a CHIP graduate. He explained that before CHIP he was 160kg and his quality of life was really affected by sleep apnoea. He would have difficulty sleeping at night due to snoring, as would his wife, so they slept in different rooms. The need for an extra room meant it was difficult for him to go back to his village, or to stay in hotels. He was falling asleep at his desk at work unknowingly and was worried he would lose his job, and was no longer able to be involved in his church activities due to his health. Since CHIP, his health has improved dramatically and he has gone from a 6XL size to a size M and his waist size has reduced some 20 centimetres, his snoring has disappeared, and his extended family have also enrolled themselves in the program; he has even started a shop selling 100% plant-based foods.

Lectures were interspersed throughout the conference by freestyle Pacific-dance inspired exercise routines to Pacific music (and perhaps slightly more frequently than I would have liked also to Tones & I’s Dance Monkey which seems to be even more popular in Fiji than back home). While I have to admit that my coordination and ability to follow movements has clearly decreased significantly since my kapa haka days, this felt a lot more authentic and natural and enjoyable than the standard conference ‘let’s get up and stretch for 2 minutes since sitting is the new standing’ routine, and I think we all started looking forward to it more and more as the conference progressed and the dance moves became more daring. Notes taken for DFN’s next conference.

One of the invigorating exercise/dance sessions

On Day 3 biochemist Associate Professor Ross Grant returned to spend the better part of an hour destroying the high fat ‘keto diet’ fad, and later on in the day Dr Lillian Kent proceeded to destroy the remaining ghost of the high fat ‘keto diet’ fad with another excellent lecture focussing on the gut microbiome. Dr Kent is also working on a very exciting sounding program to be deployed mostly in rural areas of the Pacific called ‘Live More Abundantly’ which I’m looking forward to hearing more about at future conferences.

Learn more about the dangers of the keto fad here.

Perhaps the highlight of the third and final day however was the presentation from Dr Walter Vermeulen from Samoa on METI, the Matuaileoo Environment Trust Inc. Dr Vermeulen founded the Trust which exists to provide training and promote capacity building to achieve sustainable living in Samoa through self-reliance, particularly of grassroots communities. As a part of this they provide free healthy living seminars at which attendees learn about the importance of nutrition, are shown healthy recipes to cook and prepare, and are also shown the benefits of a whole food plant-based diet to prevent and reverse chronic illness (they have developed a cookbook with recipes in Samoan and English). I was particularly interested to hear about a four village healthy living project they had completed. This involved various community members working together to promote change and a 3 hour health seminar explaining the causes of the non-communicable disease (NCD) and how to reverse them. This approach was highly successful with 123 of 165 of the villagers reversing their NCD, including 32 out of 36 cases of type 2 diabetes. Fittingly, following the final panel discussion about the practical implications of what we had learned, an honorary Fellowship of the SPSLM was presented to Dr Vermulen.

METI healthy living seminar. Image credit: Matuaileoo Environment Trust Inc

Dr Kuma’s closing address challenged us, as we returned to our various countries, to take action and use what we had learned to help our communities, and to talk to government and other organisations to get them on board with a lifestyle medicine approach. My 3 days in Pacific Harbour were most enjoyable and educational. Typical of the Fijian hospitality I experienced, there was a very friendly and relaxed atmosphere and I met many new people who were likewise interested in where I was from and what I was working on, and of course DFN and its work in Australia and New Zealand. What I enjoy most about conferences and is most valuable is the time spent exchanging ideas and stories with others with many of the same aspirations and interests. It’s a chance to connect again with and be amongst your ‘tribe’, and also an opportunity to experience the unique customs, cuisine, culture, and community of the location. I hope this isn’t lost and forgotten in the now inevitable transition to more online offerings. Vinaka Fiji and SPSLM for a wonderful event that I won’t be forgetting anytime soon, I’m thoroughly looking forward to visiting again some day!

Delegates sporting SPSLM polo shirts. Image credit: Pete Navosailagi

“Turning the Tide on NCDs – It Starts with Us” was the theme for the inaugural South Pacific Society of Lifestyle Medicine Conference. The 3-day event in March 2020 explored evidence-based strategies to empower health professionals as “change agents” in helping combat the NCD crisis.

Find out more including details about the next conference via spslm.org/conference, and access a number of free educational resources via the SPSLM website, including selected webinars, available at spslm.org/Webinars.

April 5, 2020
Diets debunked

Fad diets are famous for ‘miracle’ claims that help us eat better and lose weight. We explain why they aren’t the answer to achieving a healthy body weight – or even good health, for that matter! Article first published in Nourish Magazine.

Our bodies don’t like to be starved. Human physiology and our evolutionary development is set up for us to maintain weight. This was once vitally important to ensure survival when food was scarce, but flash forward to today and, at least in wealthy countries, the food landscape is vastly different.

We have thousands of calorie-dense options at our fingertips. It’s no surprise that many Australians struggle to maintain a healthy body weight. Despite new fad diets regularly being touted as the answer to our health woes, they simply don’t work. And it’s important to understand why.

Most importantly, when it comes to achieving a healthy body weight or long-term weight loss, diets rarely work. The greatest downfall of most is over-restriction, which can lead to hunger, cravings and then binges and subsequent feelings of failure. It’s a nasty cycle.

Weight loss is also not as simple as eating less and moving more. There are a lot of complexities at play here, including appetite-influencing hormones, the interplay of genetics, stress levels, our emotional state, eating environments, support networks – even how much we sleep can influence our appetite and body weight.

Let’s take a look at the claims of some of the most popular fad diets and consider how effective they really are.

The ketogenic diet

Originally intended as a regimen to treat epilepsy that doesn’t respond to medication, the ketogenic diet has become one of the most googled dietary trends in the world.

A ketogenic diet (keto for short) is a very low-carbohydrate, high-fat way of eating, which limits total carbohydrate intake to about 20 grams per day. The intention is to achieve a state of ketosis, which causes your muscles and liver to switch their primary fuel source from glucose to fatty acids, as your liver starts to produce ketone bodies to fuel your brain and other organs.

In order to achieve ketosis, it is commonly recommended that a person avoids carbohydrate-rich foods like wholegrains, legumes, starchy vegetables and most fruit, while greatly increasing consumption of fats and oils, certain meat and dairy products, nuts, coconut products and avocado. A small amount of low-carbohydrate veg – such as leafy greens, brassicas, and mushrooms – is allowed.

the scales aren’t always an accurate reflection of what’s going on inside.

Proponents claim that a keto diet can not only assist with weight loss but help manage diabetes as well. But does the science support these claims? Well, in the first few days of eating this way a person can indeed lose a decent amount of weight, but the scales aren’t always an accurate reflection of what’s going on inside.

When carbohydrate intake is restricted, glycogen stores (and therefore water stores) in muscles are reduced, resulting in weight loss but not necessarily fat loss. Most of this water weight will return as soon as a person starts to eat enough carbohydrates again. Additionally, the keto diet as well as other adaptations of a low-carb diet, such as Atkins or the Dukan Diet, are too low in fibre and too high in inflammatory compounds, which can harm the health of your gut microbiome. The short-term weight loss effect of the keto diet simply does not outweigh the long-term risks of eating this way.

Paleo diet

There’s a lot to unpack when it comes to the paleo diet. This diet was popularised by American scientist Dr Loren Cordain, who argued that if we return to our prehistoric roots and eat the foods of our ancestors, we could reduce our ill health and disease rates.

The modern adaptation of the paleo diet recommends roughly 60 percent of calories come from animal products with the remaining 40 percent derived from plants. This diet promotes the intake of meats, eggs, fish and seafood, non-starchy vegetables, tubers, nuts and seeds, coconut and olive oil. Foods to avoid include wholegrains, legumes, dairy products, processed foods and vegetable oils.

There are some positives here.

The elimination of dairy and processed foods coupled with the promotion of wholefoods is a big move in the right direction. However, the heavy focus on meats and the elimination of legumes and grains is not so positive. Additionally, the paleo diet promoted today is a far cry from the diets our ancestors consumed. I don’t know about you, but I certainly haven’t stumbled across any evidence that suggests cavemen consumed processed meats such as bacon and salami or paleo-approved chocolate bars. Also, most plants consumed in the paleolithic era no longer exist and domestication of livestock has greatly reduced the amount of omega-3 fatty acids found in meat today. So, we are actually hard-pressed to accurately replicate a prehistoric diet today.

I certainly haven’t stumbled across any evidence that suggests cavemen consumed processed meats such as bacon and salami or paleo-approved chocolate bars.

Nutritional anthropologists who have analysed paleolithic diets suggest the average fibre intake during this era was between 70–150 grams per day – far more than the average Australian currently consumes. In fact, it would be near impossible to achieve this on a modern paleo diet, given the focus on animal products (which contain no fibre) and the avoidance of legumes and wholegrains.

Conversely, the overall nutrient intake of someone following a healthy plant-based diet might actually come closer to reflecting the micro and macro nutrient intake of our paleolithic ancestors.

Low lectin diet

Lectins are a type of carbohydrate-binding protein that are in all plant foods, and are found in particularly high amounts in raw legumes and wholegrains. Therefore people following a low-lectin diet focus on grass-fed meats, A2 milk, and low-lectin vegetables like leafy greens, cruciferous veggies and sweet potatoes, while eschewing most legumes, wholegrains and nightshade veggies.

Lectins have received much press in recent years, since certain fad diet books tarnished them as ‘anti-nutrients’, falsely claiming they are the ‘real’ cause of autoimmune conditions, inflammation and obesity. This is a perfect example of how a nugget of truth can be stretched beyond recognition. When consumed in their active form, lectins can cause negative side-effects like nausea, vomiting and diarrhoea, and they have also been shown (in animal studies) to interfere with the absorption of certain minerals.

However, it is important to remember that people rarely eat raw legumes or seek to consume uncooked wholegrains!

Cooking and soaking can deactivate most lectins, and our bodies take care of the rest because we produce certain enzymes that can degrade some lectins.

Lectin-rich foods like legumes, wholegrains and nuts have consistently been associated with better health outcomes, including weight loss and reduced risk of cardiovascular disease and diabetes.

In fact, lectins can actually be beneficial, acting as an antioxidant, protecting our cells from free-radical damage. Lectin-rich foods like legumes, wholegrains and nuts have consistently been associated with better health outcomes, including weight loss and reduced risk of cardiovascular disease and diabetes. These foods are also valuable sources of vitamins, minerals, protein, healthy fats and fibre. The benefits of consuming lectin-containing foods far outweigh the hypothesised risks.

Sugar-free diet

The idea behind a sugar-free diet is to eliminate all added sugars and limit foods with naturally occurring sugars, such as fruit and carbohydrate-rich vegetables.

To adhere to this diet, a person will commonly avoid any foods with processed sugar, maple syrup or agave listed as an ingredient, and alcohol. Some even greatly reduce their intake of starchy vegetables like potato, corn and peas, and eliminate most fruits. Although, depending on who you talk to, some fruits are allowed after an initial ‘detox’. This diet tends to be big on coconut oil, meats, nuts and nut butters, allows full-fat dairy products, and promotes the intake of non-starchy vegetable options like greens, brassicas and salad vegetables.

There are some positives here – Australians consume far too many processed foods, so limiting intake of lollies, soft drinks, ice-creams, pastries, desserts and so on will obviously provide health benefits and initially people may also lose weight. However, there is definitely no scientific evidence to support the avoidance of fruits and vegetables because of their naturally occurring sugars. Fruit and veggies come packaged with fibre, water, vitamins and minerals, protein and antioxidants – not just natural sugars.

When it comes to weight management, scientific studies have consistently associated fruit and vegetable consumption with weight loss. When removing these healthy foods from the diet, it is not uncommon for other foods that are less health-promoting to start creeping in.

Carbohydrate-rich wholefoods aren’t the enemy, they are a good source of the energy, fibre and nutrients required for longevity.

A lifestyle that works

Fad diets fail over and over again.

They simply aren’t the answer for achieving a healthy body weight. The way forward is a sensible approach to food and nutrition, filling your plate with whole plant foods while crowding out the unhealthier foods. Eating this way is not a ‘diet’ per se. It’s an evidence-based, sustainable, health-promoting lifestyle. A wholefood plant-based lifestyle also changes your gut microbiota, increasing healthy bacteria, improving insulin sensitivity and protecting against chronic disease.

Focusing on fruits, vegetables, wholegrains, legumes, small amounts of nuts and seeds consistently over time will yield results.

There are now countless studies suggesting a plant-based approach is the optimal choice for our overall health, as well as a achieving healthy body weight.

Focusing on fruits, vegetables, wholegrains, legumes, small amounts of nuts and seeds and doing so consistently over time will yield results. Part of why it works so well is that whole plant foods have a low calorie density, increasing satiety rather than creating the deprivation experienced when trying to adhere to a typical restriction style diet. This bolsters our ability to stick to a healthy eating pattern in the long term – the key to success!

This article is republished with permission from nourishmagazine.com.au.

March 31, 2020
World Kidney Day 2020
World Kidney Day 2020: Plant-based nutrition offers hope for both prevention and treatment of kidney disease.

Maintaining healthy kidneys is often overlooked in the fight against chronic diseases. Yet, chronic kidney disease (CKD) currently affects approximately one in ten adults worldwide and its burden is increasing. By 2040, it is projected to become the fifth most common cause of years of life lost globally. [1]

Without appropriate treatment strategies, CKD progresses to end-stage kidney failure requiring dialysis or transplantation to sustain the individual’s life.In high-income countries like Australia, the cost of dialysis and transplantation on the health care budget is immense, while in low-income countries most people with kidney failure have inadequate, if any, access to such lifesaving treatments.

For these reasons, World Kidney Day this year focuses on the importance of preventative interventions to avert the (a) onset and (b) progression of kidney disease. [1] As a nephrologist, I would argue there is nothing more powerful than optimal plant-based nutrition to help achieve these goals.

Primary prevention of CKD: averting the onset of CKD

The two most common causes of CKD are diabetes and high blood pressure (hypertension), which are together responsible for up to two-thirds of cases. Each of these diseases causes chronic damage to the blood vessels and internal structures of the kidney over time. In fact, up to 30% of people with diabetes will develop CKD within 20 years of their diagnosis. [2] In order to prevent CKD, we must therefore first address these two chronic diseases.

The most common causes of chronic kidney disease are type 2 diabetes and high blood pressure.

Fortunately, there is now established evidence that dietary change is a powerful strategy to treat both diabetes and hypertension, as it addresses their root cause: the highly processed, energy dense, nutrient-poor standard Western diet. Research shows that shifting to a more whole food, plant-based diet can not only prevent but even reverse these conditions.

Type 2 diabetes

Looking at type 2 diabetes first, a recent meta-analysis of 9 prospective studies found a healthy plant-based pattern of eating reduced the risk of developing type 2 diabetes by 30%. [3]. This is almost certainly an underestimate of the true reduction because the studies analysed adjusted for body weight (BMI), which is a mediator of dietary effect. Several controlled trials have also demonstrated reversal of established diabetes with dietary change alone. One such trial compared an unrestricted low-fat fully plant-based diet to a control group on a calorie restricted American Diabetic Association diet. [4] After 22 weeks, a larger proportion of the low-fat plant-based group were able to reduce their glycaemic therapy (43% vs. 26%). In addition, hemoglobin A1c decreased 0.96% in the plant-based group compared to 0.56% in the control. Given the starting mean A1c of 8.0%, this reduction represents substantial improvement in their disease.

Hypertension

Several dietary factors also impact blood pressure and rates of hypertension. Specifically, low sodium, high potassium (e.g. plant intake), low alcohol and weight loss all substantially reduce blood pressure [5], and the combination has been demonstrated in controlled trials to be very effective. [6] For example, amongst those with a systolic blood pressure >150 mmHg, the low-salt DASH diet (rich in fruits, vegetables and whole-grains) compared to a high-salt standard American diet had a mean reduction in systolic blood pressure of 20.8 mmHg. [7] This is more effective than any single drug therapy, without the harmful side effects.

Further benefits

Moving beyond the prevention and treatment of diabetes and hypertension there is even further evidence that a healthy diet helps to prevent CKD. Observational studies have shown a diet encouraging the consumption of plants is inversely associated with the development of CKD [8] and the initiation of dialysis [9], despite statistical adjustment for diabetes, obesity and hypertension. I have explored some of the specific mechanisms through which a plant-based diet improves kidney health further below.

Secondary prevention: slowing CKD progression

Diet is critical in the management of all CKD, irrespective of whether the disease is due to diabetes and hypertension, or other conditions such as auto-immune diseases, polycystic kidneys or malformations from birth. In all cases, a standard Western diet contributes significantly to chronic kidney damage and therefore plays a major role in the progressive worsening of kidney function and the development of end-stage kidney failure.

In all cases, a standard Western diet contributes significantly to chronic kidney damage.

Protein: the plant advantage

One of the most important dietary factors for kidney health is protein intake. From animal studies it has been known for decades that a diet high in protein increases the workload for the kidneys (hyperfiltration). [10] Initially the kidney compensates well, but this extra stress has serious long-term consequences, ultimately resulting in progressive damage. Human studies support this animal research. Observational studies demonstrate a clear linear relationship between protein intake and risk of progression to kidney failure. [11] Furthermore, controlled trials show a low protein diet results in a slower decline in kidney function over time compared to a high protein diet. [12,13,14]

Unfortunately, the standard Western diet typically is very high in animal product derived protein, with average intakes close to two-times the recommended daily requirements (0.6-0.8g per kg of body weight per day). [15] Not only is protein intake on a whole food plant-based diet naturally lower (whilst remaining sufficient), but the proteins also come directly from plant origins. This is important because at least some animal proteins appear to be more detrimental to the kidney than plant proteins. [10] In fact, one study found that replacing just one daily serve of red meat with soy and/or other legumes could reduce the risk of reaching end-stage kidney disease by 50%. [16]

Animal proteins appear to be more detrimental to the kidney than plant proteins

Dietary acid: the facts

Another important aspect of dietary effects on kidney function is acidosis. Every piece of food we eat is made up of acid and base pre-cursors that affect the acid-base balance in our blood. Animal-derived and refined foods are generally net acid-producing, whilst fruits, vegetables and legumes are net alkali-producing. In CKD, the kidney’s ability to maintain normal acid-base balance in the blood becomes impaired and acidosis can develop. Chronic acidosis is not only associated with a loss of bone mass, impaired heart function and increased risk of death, but also contributes to worsening kidney function. [17] It is therefore unsurprising that high dietary acid load (i.e. high consumption of animal foods) has been shown to significantly increase the risk of kidney failure [18] and markers of kidney disease progression. [19]

Tertiary prevention: preventing CKD complications

Lastly, in addition to slowing kidney function decline, a whole food plant-based diet addresses many complications seen in advanced kidney disease such as:

Cardiovascular disease

It is a sad fact that for people with CKD the risk of dying from cardiovascular disease is 20 times greater than the risk of requiring dialysis or transplantation. Plant-based diets are associated with a significantly lower risk of cardiovascular disease in both observational studies [20] and controlled trials. [21,22] A meta-analysis of 6 cohort studies of people with CKD found those eating a healthy dietary pattern (higher intake of plants) was associated with a 27% reduction in overall death. [23]

High phosphate levels

In kidney disease phosphate can build up in the blood and cause harm to bones and blood vessels, leading to an increased risk of death. Whole plant foods help combat this as they contain phytates that bind to dietary phosphate, thereby significantly reducing its gut absorption compared to highly processed and animal foods. [24]

Uremic toxins

Numerous organic solutes, which are normally removed from the blood by the kidney, accumulate in CKD and contribute to various symptoms, heart disease and risk of death. Due to changes in gut bacteria, two of the most well studied toxins, indoxyl sulfate and p-crestyl sulfate, have been found to be approximately 60% lower in vegetarians compared to omnivores. [25]

Summary

If we, as a global society, are to successfully manage the worldwide rising levels of CKD we will need to focus on holistic preventative strategies. Plant-based nutrition is not only an effective tool for primary prevention of kidney disease onset, but it can also play a powerful role in both secondary and tertiary prevention due to its ability to slow disease progression and avert severe complications. This World Kidney Day, I encourage everyone to raise awareness of both kidney disease and this underutilised approach to reduce its increasing impact on society.

Dr Anis Ta’eed, MBBS, FRACP is a consultant nephrologist from Melbourne who is passionate about the benefits of whole food plant-based diets for kidney health as well as for overall chronic disease management.

Dr Ta’eed has been a member of Doctors For Nutrition since attending its inaugural Nutrition in Healthcare conference in February 2019, and has since become one of the charity’s valued expert volunteers, contributing particularly to medical content, including its online topic summary on chronic kidney disease.
Key references

worldkidneyday.org/2020-campaign/2020-wkd-theme/

kidney.org.au/your-kidneys/support/kidney-disease

Qian F, Liu G, Hu F et al. Association between plant-based dietary patterns and risk of type 2 diabetes. JAMA Intern Med 2019 Jul 22. doi: 10.1001/jamainternmed.2019.2195

Barnard ND, Cohen J, Jenkins DJ et al. A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes Care. 2006 Aug;29(8):1777-83.

Appel L. The effects of dietary factors on blood pressure. Cardiol Clin 2017; 35:197-212

Yokoyama Y, Nishimura K, Barnard ND et al. Vegetarian diets and blood pressure: a meta-analysis. JAMA Intern Med. 2014 Apr;174(4):577-87.

Juraschek SP, Miller ER, Weaver CM, Appel LJ. Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure. J Am Coll Cardiol. 2017 December 12; 70(23): 2841–2848

Kim H, Caulfield LE, Garcia-Larsen V et al. Plant-Based Diets and Incident CKD and Kidney Function. Clin J Am Soc Nephrol. 2019; 14:682-691

Smyth A, Griffin M, Yusuf S et al. Diet and Major Renal Outcomes: A Prospective Cohort Study. The NIH-AARP Diet and Health Study. J Ren Nutr. 2016 Sep;26(5):288-98

Kontessis P, Jones S, Dodds R et al. Renal, metabolic and hormonal responses to ingestion of animal and vegetable proteins. Kidney Int. 1990 Jul;38(1):136-44.

Metzger M, Lun Yuan W, Haymann J et al. Association of a low-protein diet with slower progression of CKD. Kidney Int Rep 2018; 3: 105-114

Levey AS, Greene T, Beck GJ et al. Dietary protein restriction and the progression of chronic renal disease: what have all of the results of the MDRD study shown? Modification of Diet in Renal Disease Study group. J Am Soc Nephrol. 1999 Nov;10(11):2426-39.

Nezu U, Kamiyama H, Kondo Y et al. Effect of low-protein diet on kidney function in diabetic nephropathy: meta-analysis of randomised controlled trials. BMJ Open. 2013 May 28;3(5)

Hanh D, Hodson EM, Fouque D. Low protein diets for non-diabetic adults with chronic kidney disease. Cochrane Database Syst Rev. 2018 Oct 4;10:CD001892

Munro HN et al. (1987) Protein nutriture of a group of free-living elderly. Am J Clin Nutr 46: 586–592

Lew QJ, Jafar TH, Koh HW et al. Red Meat Intake and Risk of ESRD. J Am Soc Nephrol. 2017 Jan;28(1):304-312

Dobre M, Yang W, Chen J et al. Association of serum bicarbonate with risk of renal and cardiovascular outcomes in CKD: a report from the Chronic Renal Insufficiency Cohort (CRIC) study. Am J Kidney Dis. 2013 Oct;62(4):670-8

Banerjee T, Crews DC, Wesson DE et al. High dietary acid load predicts ESRD among adults with CKD. J Am Soc Nephrol 2015; 26:1693-1700

Goraya N, Simoni J, Jo CH, Wesson DE. A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate. Clin J Am Soc Nephrol. 2013 Mar;8(3):371-81

Kim H, Caulfield LE, Garcia-Larsen V, Steffen LM, Coresh J, Rebholz CM. Plant-Based Diets Are Associated With a Lower Risk of Incident Cardiovascular Disease, Cardiovascular Disease Mortality, and All-Cause Mortality in a General Population of Middle-Aged Adults. J Am Heart Assoc. 2019;8(16):e012865.

Ornish D1, Scherwitz LW, Billings JH et al. Intensive lifestyle changes for reversal of coronary heart disease. JAMA. 1998 Dec 16;280(23):2001-7

de Lorgeril M1, Salen P, Martin JL et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation. 1999 Feb 16;99(6):779-85.

Kelly JT, Palmer SC, Wai NS et al. Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies. Clin J Am Soc Nephrol 2017; 12:272-279

Kalantar-Zadeh K, Gutekunst L, Mehrotra R et al. Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clin J Am Soc Nephrol. 2010 Mar;5(3):519-30

Patel KP, Luo FJ, Plummer NS et al. The production of p-cresol sulfate and indoxyl sulfate in vegetarians versus omnivores. Clin J Am Soc Nephrol. 2012 Jun;7(6):982-8
March 12, 2020
US psychologist Dr Doug Lisle shares insights about ‘the Pleasure Trap’

On 19 February 2020, an audience in Canberra heard from prominent US evolutionary psychologist Doug Lisle PhD about the ‘Pleasure Trap’ that locks people in to unhealthy habits, and how we can overcome this hidden force – with supporting presentations by Doctors For Nutrition.

Doug Lisle PhD presenting in Canberra, February 202

Why do we struggle to make healthy choices? This is the question that acclaimed psychologist Doug Lisle PhD explored in his keynote talk in Canberra last Wednesday night.

A thought leader in evolutionary theory and human psychology, Dr Lisle has observed that the root cause of weight gain and other self-destructive behaviours can be attributed to a psychological phenomenon known as ‘the pleasure trap’.

A crowd of 140 turned out in Canberra to hear about the pleasure trap and how to escape it. According to Dr Lisle, losing weight is both the number one personal goal and the biggest single cause of psychological angst amongst people living in the developed world. The pleasure trap explains the dopamine-based brain reward systems that predispose us to seek calorie-dense food, and other experiences that improve our chances of survival and reproduction.

The empowering message is that, as soon as we start to transition from highly-processed, nutrient-poor foods, we begin to restore the biological processes that naturally keep us running at maximum efficiency and vitality.

The event was put on by Canberra Weekly and supported by Doctors For Nutrition

Once you are free of addicting foods you will begin to appreciate the subtle pleasures that fruits, vegetables, beans, and intact whole grains provide – Dr Doug Lisle, PhD

In support of the keynote talk, Dr Lisle’s colleague, psychologist Jennifer Howk PhD, shared her own inspiring story from addiction to junk food and alcohol to living a healthy lifestyle, free from addiction.

Representatives from Doctors For Nutrition opened the evening with introductory talks on the powerful role of plant-based nutrition in addressing obesity and other chronic lifestyle-related conditions. General Manager Marion Meloni provided an overview about the charity’s mission, vision and activities, followed by GP Dr Stephanie Dakin who walked through some of the key evidence on preventative nutrition, in particular the benefits of a whole food plant-based diet for people who struggle with their weight. Dr Dakin contrasted this with diets such as keto and Atkins that may result in short-term weight loss but have proven health risks over the longer term.

Slide from Dr Stephanie Dakin’s presentation: a whole food plant-based diet is proven to sustain long-term weight loss

An audience Q&A session brought up a range of topics, such as the importance of eating minimally-processed plant-based foods, the dangers of fad diets, and how we can make changes step by step to allow our taste buds and dopamine response to re-sensitise to healthy food supportive of health and wellbeing.

One of the attendees on the night said she has been unsure what to expect but had found the event eye-opening. “It’s refreshing to receive non-blaming insights about why weight-gain happens alongside practical advice on how to implement a plant-based diet to sustain an optimum BMI and overall health”, she said.

The event was hosted by Nick Samaras from The Canberra Weekly, and supported by Doctors For Nutrition. The original event listing can be accessed here.

About the presenters

Doug Lisle PhD

Since completing his PhD in clinical psychology at the University of Virginia, Dr Lisle’s decorated career has seen him work as a lecturer in psychology at Stanford University, and as a forensic psychologist in both the Texas and California criminal justice systems. Today, Dr Lisle is the psychologist for the McDougall Wellness Program in Santa Rosa, California. Read more.

Jen Howk PhD

Dr Howk is an author, researcher, and interdisciplinary social scientist. She earned her BA with honours from the University of Washington in Seattle and completed her MA and PhD in political science at Harvard University. Dr Howk’s graduate work and ongoing research explore questions at the intersection of social vulnerability, resilience, and wellbeing. Read more.

Marion Meloni

Marion Meloni is a management consultant by background, with experience in the healthcare sector and a special interest in whole food plant-based nutrition. She was previously CEO of Doctors For Nutrition.

Dr Stephanie Dakin

Dr Stephanie Dakin is a GP based in Canberra and serves as DFN’s Ambassadoc for the Australian Capital Territory. Providing evidence-based nutrition and lifestyle advice is a cornerstone of her clinical work. Full bio.

Learn more about the pleasure trap

Lisle, DJ & Goldhamer, A (2006) The pleasure trap: mastering the hidden force that undermines health & happiness. Summertown, Tenn.: Healthy Living Publications

The pleasure trap TEDx talk: Douglas Lisle at TEDx Fremont (17-minute video)

February 25, 2020
First Peoples’ food wisdom
For more than sixty thousand years, Aboriginal peoples used their own practices of healthcare and healing, enjoying excellent health that was largely free from the burden of modern diseases. Doctors For Nutrition’s Northern Territory Ambassadoc Dr Amanda Robinson shares the value and wisdom of Aboriginal and Torres Strait Islander peoples’ ways of understanding life, healing, food systems and management of ecosystems. Article first published in Nourish Magazine, January 2020.

Image credit: nourish magazine

My Aboriginal name is ‘Lungarrma’, which means north wind. The north wind that blows from the Wessel Islands in the Northern Territory is believed to be a healing wind and is embodied in the dances and songs of the Yolgnu people of the region. I have a deep love for my culture and a desire to improve the health and wellbeing of Aboriginal people. This has also influenced my personal journey. Through a whole food plant-based diet, I have not only turned my own health around but also changed the lifestyle trajectory of my family, a shift that will serve them throughout their lives.

I believe incorporating long-standing Aboriginal philosophies of holistic health with a modern whole food plant-based diet has the potential to improve the physical, mental and spiritual wellbeing of all Australians.

Let’s explore some of the wisdom of Australia’s First Nations people.

Aboriginal and Torres Strait Islander peoples have always valued connection to country. Communities once lived sustainably and in balance with the land, which was both a source of physical sustenance and spirituality. It is now accepted that Aboriginal people were much more than basic hunter-gatherers as was previously assumed. Their deep respect and understanding of the land was demonstrated through the management of resources, including hunting and gathering, traditional burning, sowing and storing of plants, baking, aquaculture and other farming-style practices. It is through such activities that Aboriginal people were able to create food systems that were sustainable over tens of thousands of years. At the heart of this knowledge was a whole-of-life view of health and a fundamental belief in the interconnectedness of Aboriginal people to the land and the wider universe.

In his excellent book Dark Emu, Black Seeds: Agriculture or Accident, Bruce Pascoe documents that Aboriginal people were consummate agriculturalists, cultivating and domesticating native crops that were perfectly adapted to local temperatures, pest and environmental pressures. These practices provided both nutritionally rich food and traditional medicines, perfect for supporting the health of the people during different seasons. Enjoying a wide variety of fruits, seeds, and vegetables, traditional bush tucker could include anything from the nectar from the bottle brush flower, kilipi (bush bananas), to a crunchy red bush apple. Many traditional foods can still be enjoyed today and as the knowledge of Aboriginal food wisdom increases, so does the popularity of these healthy foods. As a result, they are becoming more accessible and are even being used as feature ingredients in fine dining restaurants.
Powerful Plants

As an essential feature of most Indigenous diets around the globe, fruits and vegetables played an important role in optimising health and providing medicine. Some native Australian foods are still available today.

Murnong

The murnong or yam daisy is a perennial herb with an edible root that can be eaten raw or cooked. It has a radish-like texture with a unique, sweet coconutty flavour. This was once a major source of food for Aboriginal people, who farmed the vegetable before European animal agriculture decimated crops. Murnong is easily digestible, causes no spike in blood sugar, and is believed to be eight times as nutritious as a standard potato.

Kakadu plum

The gubinge or Kakadu plum has the highest percentage of vitamin C of any fruit in the world. Also known as gumbi gumbi or bush apricot, it is found throughout the drier areas of Australia and is perhaps the most versatile of Aboriginal medicines. It was used in a significant number of traditional medicinal applications, from the treatment of coughs and colds to eczema. This fruit boasts an array of benefits including being an antipruritic, antiviral, detoxifier, blood pressure regulator and immune system booster. It was also traditionally used for treating various cancers, digestive disorders, fatigue and even mental illnesses. While the fruit and its seeds are well-known for having medicinal properties, it is the leaves that are the most potent. These can be used as a tea or tonic, or dried and used in capsules, creams or salves.

Quandong

Commonly known as a wild peach, quandong is a sweet and tangy fruit that was traditionally used for both food and medicine. It is high in antioxidants, folate, magnesium, iron and calcium, and also has twice as much vitamin C as an orange. Aboriginal people crushed the quandong kernel into a paste because it was also an effective cure for toothache.

Strawberry gum

A variety of eucalyptus, the strawberry gum or forestberry has high antioxidant activity. This little native gem also has antifungal and antibiotic properties as well as the ability to help balance the microflora of the gut. The leaves have a fruity flavour that Aboriginal people enjoyed chewing but can also be used as an herbal tea or dried spice. It works especially well with fruits to bring out berry flavours.

Boab

Boab leaves and baby boabs contain large amounts of iron, calcium, vitamin C, vitamin A and potassium. This unique looking tree is currently being researched for its potential to treat iron deficiency anaemia. Research suggests the iron content of a boab leaf is 26 milligrams per 100 grams. It is clear to see why this is of interest when compared to spinach, which has only about 2.7 milligrams per 100 grams.

Grains and seeds

The seeds of native millet and kangaroo grass make for nutritious, gluten-free flours when milled. Australia also has its own ancient grains, which are grown in the crocodile infested wetlands of the Northern Territory. Native rices, such as Oryza rufipogon and O. meridionalis, are high in protein and overall nutrition as well as being drought and pest resistant. As a result, this hardy food has been touted as a grain that could feed the world.

Embracing Bush Foods

Including some traditional Aboriginal foods into your diet as part of a whole food plant-based approach to wellbeing is a way to enhance health, encourage sustainable foods, and support local Aboriginal industries. Plus, you’ll get to explore new and unique tastes! Many of these foods are available from online stores such as bushfoodshop.com.au. Here’s some ideas you may like to consider:

Plant a quandong tree in your backyard instead of an apple tree or swap out dried apricots for some dried quandong

Make strawberry gum kombucha or ice cream and enjoy the delicious fruity undertones with shades of cinnamon, strawberry and passionfruit

Explore some of the dried or powdered native foods that you can add to your daily smoothie or use to make tea

Try some ancient native grains in your plant-based bowl of goodness for an added boost of protein

Spice up your next feast with some bush tomatoes

Swap out your standard spices with your very own combination of native herbs and spices

Replace salt for some saltbush leaf, which is also a great way to get a boost of calcium, magnesium and zinc

For something a little more adventurous, try a bit of foraging. Take off your shoes, get grounded and explore your local land; you may be surprised what native foods are growing in your neighbourhood!

Ancient Wisdom for Modern Problems

Traditional Aboriginal food systems incorporated complex connectivity to the land that supported both the environment and the health of the people for over sixty thousand years. This is in stark contrast to our current systems that have been shown to be destructive to the environment and also the common modern diet, which is wreaking havoc on our health. Diabetes, heart disease, allergies and obesity are often the consequences of high-fat, high-sodium, nutrient-poor foods that are highly processed, causing inflammation and damage to the body.

The EAT-Lancet Commission report on sustainable food systems states, “Because much of the world population is inadequately nourished and many environmental systems and processes are pushed beyond safe boundaries by food production, a global transformation of the food system is urgently needed”. Perhaps it is time we turn our attention to the wisdom of our First Peoples to help solve these problems.

Aboriginal people recognise health as a multi-dimensional concept that embraces all aspects of existence, including living in harmony with the natural world and the whole community. It is an ancient value system that can provide a fresh perspective on human and environmental wellbeing.

The tremendous value and wisdom of Aboriginal and Torres Strait Islander peoples’ ways of understanding life, healing, food systems and management of ecosystems could significantly enhance our current knowledge and shift our understanding of what it means to be ‘well’. While there is still a need for quality research in these areas, we could all benefit by embracing ancient practices that have the potential to heal the land and improve our holistic health and wellbeing.
This article is republished with permission from nourishmagazine.com.au.
February 10, 2020
The Heart of the Matter – Adelaide Nutrition in Healthcare Symposium
Adelaide Nutrition in Healthcare Symposium with international keynote speaker, Dr Kim Williams (USA) and local experts.

On Sunday 2 February 2020, DFN held a Nutrition Symposium in Adelaide, welcoming over 200 healthcare practitioners and members of the public to explore the role of nutrition in cardiovascular health.

The full-day event entitled The Heart of the Matter: why we have a cardiovascular disease crisis and how we can eat our way back to health featured presentations by cardiologist Dr Kim Williams (USA), alongside a lineup of local healthcare professionals, medical students and an athletes’ panel.

Delicious whole food plant-based catering was on offer giving delegates a taste of nutritious vibrant ‘food as medicine’, and the day closed with an optional free screening of The Game Changers.

Thanks to generous donors, scholarships were awarded to nine local healthcare students who were delighted to grow their knowledge and networks in the field of preventative nutrition.

We also submitted the proceedings from the symposium to the International Journal of Disease Reversal and Prevention, which was published in January 2021.

Dr Kim Williams

Recap video

With thanks to Inbound Creative.

Symposium proceedings

The full article is available online by creating a free account at ijdrp.org

Symposium sessions

Nutrition and Heart Disease: the Heart of the Matter

Dr Kim Williams (USA), MD, MACC, FAHA, MASNC, FESC

Cardiologist, Rush University Medical Center, Chicago USA • Doctors For Nutrition International Advisor

Dr Williams’ presentation on nutrition and heart disease took delegates on a deep dive into the evidence.

First touching on the prevalence of cardiovascular disease, he went on to explore the key risk factors and the lifestyle interventions that have been proven effective in both treatment and prevention – chief amongst them, the adoption of a whole food plant-based eating pattern.

In turn, Dr Williams unpacked the evidence about dietary interventions to address obesity, diabetes, hypertension and hyperlipidemia, which are key to promoting and, in many cases, restoring cardiovascular health.

He also highlighted where associated co-benefits of plant-based diets have been established, for example in achieving better emotional wellbeing among those diagnosed with type 2 diabetes.

Nutrition in Medical Schools Q&A Panel

Panel moderated by Dr Kim Williams with medical students Sylvia Gralak and Lucy Brown, and Flinders Medical Center RMO, Dr Juliette Roex

Dr Williams facilitated a lively discussion, in which the panelists explained why they became interested in the role of nutrition in healthcare, and their future career goals. All share a strong commitment to integrating nutrition science into their practice in order to offer true health care as opposed to the prevailing ‘sick care’ model.

The importance of planetary health as a pre-requisite to human health was also emphasised, with Sylvia explaining the potential for plant based diets to not only improve our health significantly but also protect the environment.

All three panelists can attest to the lack of nutrition education in medical schools, something that Sylvia and Lucy are looking to address through their work with the Healthy Communities team at the Australian Medical Students’ Association. This was the topic of their presentation that followed the panel Q&A.

Enhancing Nutrition Education for Medical Students

Australian Medical Students Association representatives

Sylvia Gralak and Lucy Brown, medical students at the University of Adelaide

Sylvia Gralak
Sylvia is a final year medical student at the University of Adelaide. She is the current National Officer for Public Health and Code Green Project Officer with the Australian Medical Students’ Association.

Lucy Brown
Lucy is currently undertaking her third year of the MBBS medical program at the University of Adelaide. Lucy is also part of the Australian Medical Students’ Association Healthy Communities team.

Sylvia and Lucy presented the initial results of the Nutrition in Australian Medical Schools Survey, a project launched in 2019 by the AMSA Healthy Communities team.

After running through the key elements of the survey, they shared the preliminary results. The central finding is that Australian medical students are interested in and motivated to provide nutritional counselling to patients, but do not currently feel equipped to implement this into their future practice.

In light of these findings, AMSA Healthy Communities have mapped out a number of advocacy and education pillars to help progress the integration of nutrition in Australian medical schools.
A Healthy Heart from the Start

Dr Heleen Roex-Haitjema & Dr Juliette Roex

Dr Heleen Roex-Haitjema, MD (non-practising paediatrician) • Co-founder and Chair of Doctors For Nutrition

Dr Juliette Roex, MBBS (Resident Medical Officer) • Lead Student Advisor for DFN

Dr Roex-Haitjema and her daughter Dr Juliette Roex’s presentation set out the importance of healthy food choices from the earliest stages of life

Some of the key references from the presentation:

Strong JP, Malcom GT, McMahan CA, et al. Prevalence and Extent of Atherosclerosis in Adolescents and Young Adults: Implications for Prevention From the Pathobiological Determinants of Atherosclerosis in Youth Study. JAMA. 1999;281(8):727–735

J. P. Strong, H. C. McGill. The pediatric aspects of atherosclerosis. J Atheroscler Res 1969 9(3):251-265

Vogel RA, Corretti MC, Plotnick GD. Effect of a single high-fat meal on endothelial function in healthy subjects. Am J Cardiol. 1997 Feb 1;79(3):350-4
Science vs Confusion

Dr Heleen Roex-Haitjema, MD

Paediatrician (non practising) • Doctors For Nutrition Co-founder and Chair

Dr Roex-Haitjema’s presentation explored the area of interpreting research studies, with the aim of ensuring the strength of the evidence is prioritised in the ultimate conclusions reached by fellow practitioners, policy makers, and the general public.

With the growing role of industry-funded studies and commercial partnerships permeating the research and public health promotion sphere, Dr Roex-Haitjema also highlighted how to be aware of any third-party influences or potential bias when seeking to evaluate health claims.
Ask us Anything about Nutrition Panel Q&A

Deeni Beetar-Young, APD
Dr Adrian Griscti, MBBS, FACRRM, FASLM
Panel Q&A moderated by Dr Heleen Roex-Haitjema

Dr Adrian Griscti is DFN’s South Australia Ambassadoc and Deeni Betar-Young APD is South Australia Lead Dietitian for DFN

This wide-ranging Q&A covered a number of nutrition topics including:

Key nutrients such as vitamin B12, iron and iodine

Whole food plant-based diets for different stages of life and health conditions

Tips on how to bring up/discuss diet with patients
An Apple a Day Keeps the Cardiologist Away

Dr Adrian Griscti, MBBS, FACRRM, FASLM

General Practitioner, Barossa Valley • Doctors For Nutrition Ambassadoc for South Australia

From decades at the front line of rural community medicine, Dr Griscti shared how patients and their doctors can measurably reduce cardiovascular risk factors with the help of some affordable and simple lifestyle and diet upgrades. He also provided some illustrative anonymised case studies and shared the results of his own cardiovascular health turnaround.

The key takeaway from Dr Griscti’s session was that cardiovascular disease risk factors share many common underlying biological causes, mechanisms and disease pathways which can be significantly improved with a whole food plant-based diet.

Some of the resources and references mentioned in Dr Griscti’s session:
National Vascular Disease Prevention Alliance: Absolute cardiovascular disease risk management – Quick reference guide for health professionals

Australian absolute cardiovascular disease risk calculator: cvdcheck.org.au/calculator

Wright, N., Wilson, L., Smith, M. et al. 2017. The BROAD study: A randomised controlled trial using a whole food plant-based diet in the community for obesity, ischaemic heart disease or diabetes. Nutr & Diabetes 7, e256.

Ref: McMacken, M. and Shah, S., 2017. A plant-based diet for the prevention and
treatment of type 2 diabetes. Journal of geriatric cardiology: JGC, 14(5), p.342.
Athletes’ Panel

Plant-powered Athletes’ Panel Q&A

Panelists:

Kate Abraham (New York and Berlin marathons participant)

Izzi Batt-Doyle (Distance runner, NCAA 10km Bronze, 2017 and 2019 Australian representative at the World University Games, BA Psych (Hons) Mindfulness & Nutrition)

Ben Loaker (cyclist, personal trainer)

Samuel Mussared (pro bodybuilder, coach)

Moderator: Damian Espinase (ultra-runner)

In the lead-up to a complimentary screening of The Game Changers documentary, this Q&A provided perspectives from athletes all of whom use a plant-based approach to eating for optimal athletic results, recovery and overall health.
Photo Gallery

The full event photo album can be found here.

Media

Plant Proof Podcast: interview with Dr Kim Williams

Release date: 30 Jan

Plant Based News article about the Symposium

Published: 30 Jan

A full-length audio conversation between Dr Kim Williams and Simon Hill of the Plant Proof Podcast, recorded in the run up to the Symposium, covering a wealth of detail on cardiovascular disease risk factors and the evidence on nutritional interventions. Resource links included.

News article by DFN’s co-founder Lucy Stegley, quoting from Dr Kim Williams and other Symposium presenters, with background about the content and objectives of the event.

DFN video interview with Dr Kim Williams

In this interview, filmed in Adelaide on the day of the Symposium, Dr Williams shares his experience of appearing in The Game Changers, explains his own transition to a plant-based diet, outlines his key concerns about ketogenic diets, and highlights the importance of nutrition education within the medical profession. With thanks to Inbound Creative for videography and editing.

Delegate feedback

The symposium has received positive feedback from delegates, including those within the healthcare sector and laypeople. The wordcloud below shows the most frequently-occurring words and phrases in praise of the event.

Our scholarship recipients emphasised the educational value they gained from the symposium. Below is a selection of their comments:

It was inspiring to hear from doctors who are currently practising the way I would like to in future, in addition to furthering my passion and interest in this area of medicine. – Medical student, University of Adelaide

I am interested in lifestyle-based interventions for people with depression and chronic illness … it is a privilege to learn more about the role of nutrition/lifestyle in disease prevention, and to hear the experts share their clinical experiences. – Health Psychology student, University of Adelaide

As a newly studying Nursing student I hope to be able to educate and aid individuals in fighting health conditions exacerbated by a ‘western diet’ which is what the Symposium speakers are doing. – Nursing student, University of Adelaide

Four of the Symposium scholarship recipients

Acknowledgements

This event would not have been possible without the assistance of numerous individuals, organisations and institutions. With warm thanks to:

Our presenters

• Dr Kim Williams • Dr Heleen Roex-Haitjema • Dr Juliette Roex • Dr Adrian Griscti • Deeni Betar-Young APD • Sylvia Gralak • Lucy Brown • Kate Abraham • Izzi Batt-Doyle • Ben Loaker • Samuel Ryland Mussared • Damian Espinase

Our event and scholarship donors

Our venue and venue host

The University of Adelaide Associate Professor Hubertus Jersmann

Our creatives

Ben Adlington and Josh Jarvis from Inbound Creative for filming the event
Jacqui Rose from Jacqui Brogan: Photography . Film . Graphic Design

Our event caterers

Plant B Life
Francesco’s Cicchetti
Wicked Coffee

Our media and promotional partners

Nourish Magazine Australia
Plant Based News
ABC Radio Adelaide
Climate and Health Alliance
International Journal of Disease Reversal and Prevention
Food For Life by Physicians Committee for Responsible Medicine

Our feature film

The Game Changers

Our booth holders

Australian Plant Based Medical Students’ group
Doctors for the Environment Australia
Plant Powered Adelaide
Nourish Food & Wellness

Our ticketing partner

Humanitix

Our scholarship recipient attendees and all of our delegates
February 5, 2020
Media release: What role does nutrition play in cardiovascular disease?

For immediate release
Attention: health, medical, lifestyle editor
Issued: 30 January 2020

At a Symposium in Adelaide this weekend, eminent US cardiologist Dr Kim Williams and local healthcare experts will explain how dietary choices can influence the primary underlying cause of death for Australians.

Photo credit – Dave Allocca

“The spectre of heart attack and accompanying disease states and disability need not haunt us,” says Dr Williams.

“Evidence shows that these are largely conditions of lifestyle and therefore predominantly preventable and even reversible.”

Dr Kim Williams will be joined by South Australian healthcare practitioners, including Barossa Valley general practitioner Dr Adrian Griscti and Australian Practicing Dietitian Deeni Betar-Young who will reveal the reality behind the disheartening statistics and empower attendees from all walks of life with the science and skills to improve their cardiovascular and overall health.

Dr Williams is part of the Advisory Council team for the Australian registered health-promotion charity, Doctors For Nutrition. He is also Chief of Cardiology at Rush University Medical Centre in Chicago and a past President of the American College of Cardiology. Most recently, he starred in the wildly successful documentary The Game Changers, executive produced by the likes of James Cameron, Arnold Schwarznegger and Novak Djokovik.

Registered health promotion charity Doctors For Nutrition (DFN) are the hosts of the Symposium. Co-founder and qualified paediatrician, Dr Heleen Haitjema MD says DFN is committed to sharing sound and independent guidance on the role of nutrition in chronic disease. From presenting at nearly 100 events such as hospital ‘grand rounds’, community classes and conferences around Australia and internationally, Dr Haitjema knows first-hand about the glaring gap in education levels across the medical community when it comes to best-practice nutrition prescriptions.

Dr Haitjema emphasises that “doctors are not to blame” for their lack of nutrition science knowledge as the vast majority “get their information just like everyone else – through the media.” She laments that despite having three doctors across two generations in her immediate family, they “were not taught” about this vital component of healthcare in their medical degrees. Doctors For Nutrition aim to redress that imbalance by integrating science-based evidence into the institutions and policies responsible for the prevention and treatment of disease.

Attendees will get to directly experience food as medicine with nutritious whole food plant-based catering provided at the event by local Adelaide businesses Plant B Life and Francesco’s Cichetti.

Presentations will be followed by a plant-based athletes’ panel featuring South Australian amateur and pro runners, a cyclist, bodybuilder and personal trainer. A free screening of the The Game Changers caps off a day filled with a healthy dose of nutrition education and inspiration. All welcome.

Ends

For Further Information & Comment

Dr Kim Williams Doctors For Nutrition International Advisory Council team member by email

Dr Heleen Haitjema Doctors For Nutrition Co-founder, Executive Director, Medical Liaison by email

doctorsfornutrition.org

Download a PDF version of this media release with further links and resources here.

January 30, 2020
Level up

A regular health check is important even when you eat a healthy diet. Blood tests can be a helpful tool in achieving and maintaining peak health. GP Dr Adrian Griscti gives a rundown of the bloodwork to get done as part of a regular checkup. Article first published in Nourish Magazine.

Blood transports oxygen and nutrients to our tissues and organs, carries cells and antibodies to fight infections, removes waste from our cells, and helps regulate our body temperature among other things.

Whether we are looking to maintain or regain health, testing levels of different components of our blood may help us understand where we can make improvements to support us in feeling well.

After extensive research, which included reading The China Study my wife Jenny and I decided to adopt a whole food plant-based diet to improve our health. We later became fully vegan for ethical and environmental reasons. Our initial aim for transitioning to a plant-based lifestyle was to minimise our risk of developing chronic diseases. However, we also found it helped us live a vibrant lifestyle with countless delicious food options.

I choose to have periodic blood tests to objectively assess whether my preventative health strategies, including diet, are helping me achieve good health and wellbeing. This not only gives me reassurance that I am eating an optimal diet but also provides evidence as well. A great indicator of my own health improvement is my total cholesterol, which has dropped from 6.1mmol/L prior to changing my diet to 3.7mmol/L today.

There is no routine set of blood tests to suit everyone – a personalised approach is best.

Blood tests can be undertaken either diagnostically in response to a symptom or as a screening tool to check your health status, even when you well. The types and frequency of the blood tests your doctor orders will depend on your health, stage of life, family history, lifestyle and previous results. There is no routine set of blood tests to suit everyone – a personalised approach is best. So, it’s important to discuss your health goals, current lifestyle, and dietary patterns with your doctor so they can order the most appropriate blood tests for you.

Common blood tests

Let’s get an understanding of some commonly performed blood tests and what these tell us about our health.

Complete Blood Picture

This test measures the quantity, size, shape and, to a degree, function of your red blood cells, white blood cells and platelets. Low haemoglobin (the oxygen-carrying component of a red blood cell) is an indicator of anaemia, often associated with tiredness and pallor. White blood cells are the body’s protectors, working to safeguard you against infectious diseases and inflammation. An abnormal white cell count can indicate how well our immune system is responding to infection or inflammation. Platelets are blood cells that help your body form clots to stop bleeding. Unexplained bruising may result from a low platelet count.

Multiple Biochemical Analysis

This test offers a snapshot into how your kidney and liver are functioning. These organs are critical to many processes involving digestion and detoxification. This test also provides a glimpse into your blood sugar (which is the body’s main source of energy), uric acid (an indicator for gout) and electrolyte (or salt) balance.

Haemoglobin A1C

This test measures the amount of glucose that binds to a part of the haemoglobin molecule over the preceding three months, and is a way of measuring how sugar-coated your blood cells are, so to speak. We use this test in the diagnosis and management of pre-diabetes and diabetes.

Lipid Profile

This test looks at some of the fats in your blood circulation, in particular cholesterol and triglyceride levels. Although these molecules are important in the manufacture of your natural steroid hormones, if your levels are higher than normal this can contribute to hardening of the arteries, premature heart disease and certain types of dementia. In Australia, the recommended guideline for total cholesterol is below 5.5; however, for prevention, under 4 is better. LDL Cholesterol is usually referred to as the ‘bad’ cholesterol, and we should aim to have this below 2mmol/L. HDL Cholesterol on the other hand is referred to as the ‘good’ cholesterol because it removes the excess LDL cholesterol from your blood. However, if there is no excess LDL, you don’t need much HDL to counter this. Conversely, if your LDL is unfavourable, high levels of HDL will not protect from heart disease.

Vitamin B12

Vitamin B12 is necessary for normal red blood cell formation, tissue and cell repair, nerve health, and DNA synthesis. A B12 deficiency can lead to permanent nervous system problems. This is a particularly useful test for anyone following a plant-based diet, people over 50 years old, and those on medications that can affect the absorption of vitamin B12, such as Metformin (a medication for type 2 diabetes) and proton pump inhibitors (medications for gastro-oesophageal reflux). Because Vitamin B12 is made by a microorganism found in soil and water which is then consumed by animals, it is effectively only found in food of animal origin. However, owing to modern farming practices, even the animals are supplemented these days to provide animal products with necessary levels. People who follow an exclusively plant-based diet have simply cut out the middleman, so are advised to take a regular vitamin B12 supplement.

High Sensitivity – C Reactive Protein

This is a protein produced by the body when blood-vessel walls are inflamed. It is one of a number of biomarkers of cardiovascular disease risk.

Thyroid Function Tests

This measures how well your thyroid gland is working. The thyroid is one of the determinants of your metabolic rate, and testing reveals if it is underactive or overactive. Some of the symptoms of an underactive thyroid include excessive tiredness, depression, weight gain and constipation while an overactive thyroid can result in menstrual irregularity, anxiety and weight loss.

Iron Studies

These are a group of tests that help assess the iron stores in your body and how effective they are. This will give you an indication of whether you have either a deficiency or overload of iron. This is a particularly useful test for women of menstrual age and for anyone investigating causes of tiredness, lethargy or shortness of breath.

Essential Fatty Acid Profile

This is a less commonly performed test which can be useful for those of us eating an exclusively plant-based diet. This test measures the levels of individual Essential Fatty Acids (EFAs) and the all-important ratio of Omega 3 to Omega 6 EFAs. Omega 3 EFAs tend to be more anti-inflammatory than Omega 6 EFAs. We need to ingest EFAs because our body is unable to make them. A well planned whole food plant based diet will assist you reach a desirablel Omega 3 to Omega 6 ratio of approximately 1 to 4.

Optimising your health markers

By no means is the list of bloods tests mentioned here an exhaustive list of those that can be used to monitor your individual health. It is important to discuss your specific needs with your healthcare provider. Although, in Australia, most blood tests are covered by health insurance (whether government or private), some may incur an out of pocket expense.

Once you receive your blood test results, you can improve your health markers by focusing on the pillars of good health – adequate sleep, management of stress, appropriate exercise, and a healthy diet – I recommend a whole food plant-based diet.

Aim to eat foods as close to how they grow in nature and include the colours of the rainbow every day to ensure you get a range of antioxidant compounds. Choosing water as your regular drink, while avoiding alcohol and minimising caffeinated drinks. I also suggest a safe and appropriate amount of sun exposure to help maintain adequate levels of vitamin D.

As well as improving the biomarkers in our blood, every positive step you take towards a healthy lifestyle can help prevent, manage or even reverse many chronic diseases. The highlight of my professional work is seeing patients use this information to transform their health – the smile on the face of a person who has reversed Type 2 Diabetes is priceless!

This article is republished with permission from nourishmagazine.com.au.

January 9, 2020
Doctors For Nutrition year end wrap-up and outlook to 2020

As 2019 draws to a close, we review the highlights from our first full year of operation, give a huge shout out to the amazing supporters and partners who are so central to our mission, and look ahead to growing our impact to the next level in 2020 and beyond.

2019 in review

It’s been a busy and rewarding year at DFN and we are grateful to all the supporters and allies who have joined us to champion the proven power of nutrition to transform healthcare.

Since achieving registration as a health promotion charity with tax deductible DGR status in late 2018, we have been putting down roots to build our capacity as an organisation and attract the resources we need to power our mission. With this, we have established a dedicated team of board members, staff, advisors and volunteers, undertaken a range of projects and created an exciting program for the coming year.

We’ve put the whole food plant-based health agenda on the map in our region with the first ever Australasian Nutrition in Healthcare Conference, hosted and appeared at a wide range of other events including our first Dine With A Doc professional development forum, released our full website, grown our team, lobbied for institutional and policy change through a range of channels, built fruitful alliances with a number of healthcare organisations and influential experts, expanded our social media reach, achieved coverage of our message via print, radio, video and podcast outlets, and embarked on some exciting projects and campaigns for 2020 and beyond.

NIHC 2019 highlights

What’s coming up in 2020?

We’ll be continuing to engage actively in institutional advocacy, community outreach and practitioner education as part of our core mission. To bolster these efforts, our major projects for 2020 include:⁠ ⁠

🍎 Developing and disseminating a whole food plant-based nutrition overview guide and webinar for health professionals⁠.

🍎 Collaborating with key partners on creating a plant-based nutrition education module for medical students⁠.

🍎 Undertaking a comprehensive public health and economic analysis of a population shift towards a diet based on whole plant foods⁠. ⁠ ⁠ ⁠

We’ll also be planning for our next Australasian Nutrition in Healthcare Conference, coming up in Melbourne in February 2021, holding a range of other educational events both within the healthcare sector and the community at large, continuing to grow our Speakers’ Bureau, expanding our media reach, adding to our library of free online resources and harnessing the expertise and enthusiasm of our growing networks to bring our message into the mainstream.

From all of us at Doctors For Nutrition, thank you for powering our mission. We sincerely appreciate your continued support as we build a better future for healthcare – now and for generations to come.

If you’re not yet part of our family of supporters, please join us! Donations to Doctors For Nutrition are tax-deductible, and create the base we need to create and implement our future plans.

And, if you’re looking for a meaningful gift, you can make a donation in honour of a loved one: just fill in their name on our donation form and we will email you a personalised certificate that you can present to them.

December 18, 2019
Plant Powered Families
Following a plant-based lifestyle is pretty easy these days, but what about bringing your family along for the ride too? Three parents from the Doctors For Nutrition team with plant-powered kids of various ages share what they love about sharing the lifestyle, what has challenged them, and what they love to eat together. Article first published in Nourish Magazine.

The Craddock family

Joel is husband to Samantha and father to Arlo, age four, and Vali, age one. He also has qualifications in dietetics, science, fitness and education, and is completing a doctorate degree exploring plant-based dietary patterns and their relationship with immune function and the inflammatory response.

Words: Joel Craddock

In my work as a dietitian, I see a constant stream of research that shows the harmful effects both animal-based and refined food products have on human health. I’ve been immersed in nutrition research for almost eight years now, and it has become apparent to me that eating in line with whole food plant-based principles is the ideal way to get – and stay – healthy. As a dad, I suppose it’s only natural that I want my young family to reap the rewards of this lifestyle too. I really could not imagine raising my family any way other than plant-based.

However, we weren’t always plant-based and there have been some bumps in the road as we adapted to a new way of eating. Surprisingly, my wife Samantha and I did not find knowing what to cook, tracking down obscure ingredients, or trying to get enough of a specific nutrient the hardest part. Rather, we were most challenged when it came to the kids eating with extended family or friends.

Joel and Samantha Craddock with their boys

Understandably, not everyone fully appreciates the value of a whole food plant-based diet (yet!). So when the boys go to someone else’s house to be minded, they are almost always ‘treated’ to foods that are high in sugar, salt and/or oil. While the acute health effects of this may be negligible for the boys, it’s the behavioural consequences that we end up dealing with back at home that troubles us. Getting the kids to eat broccoli or carrots after these kinds of ‘treat foods’ is almost impossible.

Taste buds are trainable, so it’s important to consistently provide healthy options with minimal refined sugar, salt and oil to keep the cravings at bay. We’ve certainly experienced that the sugar addiction is real and can come on quickly! To get around this issue, we’ve become more organised when getting the boys looked after. When our kids are cared for by other family members, we pack all their food and snacks in advance. This has been an effective strategy that takes the stress out of it for everyone. We’ve found gentle ways to educate our own parents and siblings by sharing resources and having non-judgemental chats, while being mindful not to harp on about food choices all the time.

Another challenge has been kids’ birthday parties where lollies, sugary drinks, animal products, and cake are served in abundance. It can be difficult explaining our lifestyle choices to other busy parents who are just trying to get through their child’s special day. Even though most people have at least heard of the benefits of a plant-based or vegan diet these days, some parents still seem to feel that our boys are missing out. Samantha and I try to shrug off any criticisms we may get without getting into debates because we’re confident we’re creating important healthy foundations for our family. For events, we usually bring a healthier alternative in lieu of the typical refined party products. Our homemade chocolate date balls and other naturally sweetened treats are enjoyed and help keep the kids happily snacking away among the minefield of traditional temptations!

We’re really content with our decision to raise our boys on whole plant foods as we can see the positive effects – they are simply thriving! Both boys have tracked above the 90th percentile for weight and height and have typically hit all their other developmental milestones early. When they do get sick, they shake it off pretty quickly. They are simply beaming with energy and vibrance.

Recipe: Lentil veggie bolognese

This is a staple meal in our household and a family favourite. It’s crammed with whole food plant-based nutrition. Plus, it’s so cheap and easy to make!

Serves 4-6
INGREDIENTS

1 Onion

4 Cloves garlic

Water (for frying)

2 cans No/low salt diced tomatoes

2 cans Lentils, drained and rinsed

1 cup Mushrooms, chopped

1 Carrot, chopped

1 tsp Italian herbs

1 cup Broccoli, chopped

1 cup Zucchini, chopped

1 tsp Balsamic vinegar

1 tbsp Soy sauce (or tamari)

1 tsp Onion powder

500g Wholegrain pasta
METHOD

Finely dice the onion and garlic.

In a large saucepan, fry the onion and garlic in a little water (about 1 tbsp), stirring often. Add another tbsp when the water has evaporated.

Add the remaining ingredients (except the pasta) and leave to simmer until the vegetables are soft, about 15–20 minutes.

Meanwhile, cook the wholegrain pasta.

Once the vegetable sauce has cooked through and softened, blend with a stick blender. We do this to disguise the chunky vegetables from our 4-year-old, but it’s not essential.

Serve garnished with nutritional yeast, chilli flakes or whatever else floats your bolognese boat!
The Little family

Andrew is a husband, father and anaesthetic registrar with degrees in exercise science, physiotherapy, and medicine/surgery. Both Andrew and his wife Sarah follow vegan diets and are raising their son Harrison on a plant-based diet.

Words: Dr Andrew Little

Dr Andrew Little with his son Harrison and wife Sarah

I specifically remember saying to my friends in medical school that I could never date a vegetarian because I liked eating meat so much. Well, not only did I end up marrying a vegan, but I became one myself. And now, my wife Sarah and I are raising our first child, Harrison, on a plant-based diet. He is 15 months old and thriving.

Our decision to raise our little boy on a plant-based diet led to some challenging discussions with friends, family and colleagues. Dairy and meat are marketed as ‘a vital component of our diet’ and as a formerly devoted carnivore, I know firsthand how this food culture is ingrained in us from a young age. Believe it or not, even my medical training barely touched on the impact of food on health. It was only after taking a personal interest in the effects of diet on the environment, the animals and on human health, that Sarah and I felt the only rational choice was to bring up Harrison on a plant-based diet. However, we didn’t make this decision lightly and we did – and continue to do – thorough research into plant-based diets to ensure all Harrison’s needs are met.

Like all parents, we want the best possible life for our child. So, I was determined to understand our options and find answers for any outstanding questions we had. I searched the latest peer-reviewed studies and delved into the published nutritional data on plant-based diets. Also, calling on my daily practice as an anaesthetist, with physiology being my specialty, I am confident the physical design of the human body strongly points towards our ideal diet being heavily plant-based. Even our default psychological tendency is to love animals as they are – not lust after eating them. Just pop a rabbit and an apple next to a toddler and see which they reach out to cuddle and which they try to nibble on!

My wife was already convinced that a plant-based approach was the healthy way to raise Harrison since she had been vegan for some time. However, I found myself more cautious about his growth and development – to the point that I was a bit fanatical about measuring his growth parameters. But, it turned out I had nothing to worry about. Harrison has been consistently well above average on the growth charts. He is currently in the 85th percentile for height, 70th percentile for weight and his head circumference is literally 1.5cm bigger than the 99th percentile! To top it all off, he was leaps ahead of his other milestones: crawling at 7 months, walking by 10 months and now at 15 months, has at least 10 words that he can associate consistently. Harrison has continued to flourish on a plant-based diet, never having consumed animal protein in his life, not even as a developing foetus.

Both my and Sarah’s favourite part of parenting Harrison is by far witnessing the joy he gets from life. We are both filled with happiness to see the way the world delights him. Not only do we have a very healthy and happy boy who enjoys exploring the world around him, but we also feel good knowing that this is a sustainable lifestyle for our beautiful planet and his generation.

Both my and Sarah’s favourite part of parenting Harrison is by far witnessing the joy he gets from life.

Recipe: Brekkie bruschetta

We love to start the day at our house with this brekkie bruschetta made with fresh produce from our local farmer’s market. Simply get the amounts of each ingredient you need to feed your family. We also serve this with a delicious berry smoothie on the side!
INGREDIENTS

Roma tomatoes

Avocado

Red onion

Fresh basil leaves

Fresh mint leaves

Balsamic glaze (or any rich balsamic vinegar)

Whole meal, whole grain bread (or gluten-free substitute)

Freshly squeezed lemon or lime juice

Light sprinkle of sea salt and pepper (optional)

METHOD

Finely dice the tomatoes, avocado and red onion into a bowl to create your bruschetta mix.

Roughly chop the fresh basil and mint and combine with the bruschetta mix.
Squeeze the fresh lemon (or lime) juice and gently stir through.

Toast the bread as desired and then add the bruschetta mix on top.

Pour a dash of balsamic glaze over each slice and enjoy!
The Davies family

Andrew, an intensive care physician at a public hospital, and Claire, a registered nurse and pastoral carer at a private hospital, are parents to Bridget, age 14, and Emma, age 12. Their family adopted a plant-based diet after Andrew experienced burnout and had to take a year’s break from clinical medicine.

Words: Dr Andrew Davies

The Davies family

Our family transitioned to a whole food plant-based (WFPB) diet five years ago. This change in our lifestyle was sparked by the amazing health transformation we witnessed in one of our relatives. Claire’s octogenarian aunt, Dulcie, was told by her cardiologist that medications were her only option for the severe episodes of chest pain she was experiencing daily due to advanced heart disease. Her GP gave her a copy of Dr Caldwell Esselstyn’s book How to Prevent and Reverse Heart Disease and within three weeks of adopting the low fat WFPB diet recommended in this book, Dulcie’s chest pain had disappeared. As healthcare professionals who were previously not sufficiently aware of the power of food to positively influence chronic disease – we were inspired to start paying more attention to our own diets too!

We gradually shifted towards plant-based eating over about 12 months, beginning as pesco-vegetarian before dropping the seafood and moving to vegetarian. After watching the documentary Forks Over Knives (a film I highly recommend), we decided it was time to eradicate eggs and dairy and go fully plant-based.

Initially my health and wellbeing improved exponentially; however, a few years later I began to struggle with my fitness and lost six kilograms in weight unexpectedly.

It turned out I had low iron and haemoglobin levels, and investigating my symptoms further led to a diagnosis of Coeliac disease. So, avoiding foods that contain gluten became another important factor in my dietary choices.

When we first embarked on overhauling our diets as a family, we decided it was best to allow our children (then aged nine and seven) to make their own choices about the pace of change they were comfortable with. However, while they were at home, there would be far fewer animal products in the pantry. Our eldest daughter, Bridget, connected with the philosophy of compassion towards animals as she observed the choices we made as parents and watched the documentaries and podcasts we educated ourselves with. She asked to no longer eat meat, eggs and dairy.

Our youngest, Emma, had been a picky eater since infancy, and chose to continue to eat mostly meat, fish, brown rice, pasta and potatoes as she had never enjoyed the taste or texture of fruit and vegetables. However, she later decided to drop meat from her diet due to her values about animal cruelty. Then a year ago, Emma was found to also have Coeliac disease. Having since removed gluten, she is now gradually starting to eat more vegetables. She will sometimes request eggs or fish, which we allow her mostly to satisfy ourselves that her diet remains diverse, given her overall fruit and vegetable intake remains low during an important period of growth and development.

Having two Coeliacs in the family might sound like a pain when it comes to catering for everyone at mealtimes, but we keep it simple by using rice, potato, sweet potato or gluten-free pasta as the foundation for most meals. Eating out at restaurants initially seemed scary, however, many establishments offer vegan and gluten-free options these days, so it hasn’t been a worry. We have found it helpful to alert organisers of school camps or parties about our girls’ dietary requirements ahead of time. While there are almost always vegetarians at these events, plant-based and especially gluten free plant-based food is less common. Bringing our own food can be the easiest solution – and a way to inspire other families to consider the fabulous taste (and health benefits) of plant foods.
Some benefits we’ve noticed are that we seem to get sick with colds and flus far less than other families and our general activity levels have increased as we feel more energised.

We are all healthy and happy, and find it generally easy to stick to our food choices for school and work lunches by preparing everything at home in advance. Some benefits we’ve noticed are that we seem to get sick with colds and flus far less than other families and our general activity levels have increased as we feel more energised. We’ve also observed that plant- based eating has helped us to sleep better and to be more mindful and compassionate to ourselves and others. As parents, what delights us the most is how our daughters have both been emboldened by this lifestyle to become strong and informed advocates for the environment.

Recipe: Taco dinner

This colourful meal is one of our favourites. It wins hearts (and tastes) and caters for everyone’s appetite. Just put it all on the table and watch your family light up at the fresh food in front of them. The elements of this dish can be used in multiple ways – from tacos to burrito bowls, salads to dinner sides.

WHITE BEANS IN TOMATO SAUCE

1 Onion, finely chopped

2 Cloves of garlic, crushed

1 Medium carrot, chopped

2 Sticks of celery, chopped

2 cans White beans, rinsed and drained (we use lima beans, but any will do)

1 tbsp Tomato paste

1 tsp Sweet paprika

1 can Chopped tomatoes

Water, as needed

2 Bay leaves

Salt and pepper to taste

MEXICAN SPICED RICE

4 cups Cooked rice

3 tsp Ground cumin

2 tsp Garlic powder

1 tsp Onion powder

2 tsp Paprika

2 tsp Dried oregano

Pinch chilli powder (optional)

Water, as needed

CASHEW SOUR CREAM

1 cup Soaked cashews, rinsed and drained (either overnight or for 30 minutes in boiling water)

1 Lemon, juiced

1 tsp Salt

1 cup Water

Chives, finely sliced as garnish (optional)

TO SERVE

Avocado, mashed

Ripe tomatoes, chopped

Lettuce, finely sliced

Chilli sauce (optional)

Tacos shells or whole grain tortillas
METHOD

Make the beans. In a heavy based casserole dish, fry the onion and garlic in 2 tsp of water or vegetable stock. When translucent, add the carrot and celery and cook on a medium heat for about 5 more minutes. Add tomato paste and sweet paprika and stir in, then add tin of tomatoes. Add just enough water to cover the beans, then add the bay leaves and simmer for 20 minutes. Season to taste.

Make the rice. Place the spices in a hot pan and stir frequently until fragrant. Add rice and stir until combined and heated through. Add add 1⁄4 cup of water, just enough to make it a bit sticky and moist.

Make the sour cream. Mix all ingredients in a high-speed blender until smooth, adding more water if necessary to achieve the sour cream consistency of your dreams.

Place everything on the table with avocado, tomatoes, lettuce, taco shells or tortillas.
This article is republished with permission from nourishmagazine.com.au.
December 9, 2019
Recovering from Multiple Sclerosis with dietary and lifestyle changes
Dr Sam Gartland is a GP based in Ballina NSW. In 2008 he was diagnosed with relapsing-remitting MS. Through evidence-based lifestyle changes, including a whole food plant-based diet, Sam has achieved a full recovery, and is now an active advocate for these approaches to be at the centre of MS patient care.

What is Multiple Sclerosis?

MS is considered to be an autoimmune, degenerative and progressive disease of the central nervous system (brain and spinal cord). The resulting symptoms can manifest throughout the body, including motor impairments from weakness and spasms to paraplegia, optic neuritis, bladder and bowel dysfunction, as well as intense fatigue and cognitive decline over time.

MS is the commonest disabling disease of young adults affecting 25,607 people in Australia – an increase of around 20% between 2010-2017.[1]

It is a devastating disease with a large number (up to 58%) unable to retain employment following diagnosis [2] and 75% ceasing work within 10 years of diagnosis.[3]
Nurture before nature

Studies of identical twins have demonstrated that genes contribute 25% to the risk of developing MS. [4] The stronger the genetic background risk the earlier the onset of MS. [5] Of importance to PwMS (People with MS) and their treating doctors is the finding that genetics has little role to play in disease progression and outcomes in MS.

The largest genetic study of PwMS, The International MS Genetics Consortium study, looked at the genome of 9772 PwMS and found, “no evidence for genetic associations with clinical course, severity of disease or month of birth, and no evidence of interaction with gender…”[6]

The largest meta-analysis of established MS genetic risk variants and disease severity found no effect of genes on clinical outcomes over the longer term (10 + years).[7]

A smaller (n=127) study did show an up to 30% effect of genes on disease progression in the first 5 years of the disease.[8]

Healthy versus damaged nerve myelin
It is clear that environmental and lifestyle factors are the main drivers of MS. Fortunately there is a lot known about these risk factors. The known environmental and lifestyle factors include:

A Western diet high in saturated fats and low in Omega 3s [9, 10]

Cow’s milk exposure [11, 12]

Viral infections (EBV, HHV) [13]

Low Vitamin D and sunlight exposure [14, 15]

Smoking [16, 17, 18]

Stress [19, 20, 21, 22]

Shift work [23, 24, 25]

Therefore, just as with other modern chronic conditions, any comprehensive treatment program has to address these modifiable risk factors.
It is clear that environmental and lifestyle factors are the main drivers of MS.
The lifestyle prescription

In 1948 the Neurologist Prof Roy Swank recognised the association between animal fat consumption and the incidence of MS. This prompted him to set up a remarkable 34 year study that investigated the effect of a low saturated fat diet in MS. Publishing his work in The Lancet in 1990 he demonstrated that those that adhered to this diet (regardless of disability at the beginning of this study) stabilised the disease with little or no progression of disability and survived for the duration of the study. Those that didn’t keep to the dietary changes significantly deteriorated with the majority being dead at the end of the study.[26, 27]

Little was made of this study until the work of Professor George Jelinek, a Professor in Emergency Medicine. He developed MS himself and went back through the literature to develop a comprehensive lifestyle intervention program to manage MS. In 1999 he developed the “Overcoming MS Program” (OMS).[28]

This approach advocates:

Adopting a plant-based diet that avoids dairy and altered fats (allowing seafood if desired)

Supplementing with flaxseed

Maintaining a Vitamin D level at 150-225nmol/L

Meditation

Regular exercise

Smoking cessation

Those following this program demonstrate significant improvements within 1 year: improved mental health 12%, physical health 19%, and overall quality of life 11%. [29] These changes are sustained and increase over a 5-year period with improvements in: mental health 23%, physical health 18%, and quality of life 20%.[30]
Since this time there has been an abundance of data supporting the steps that Professor Jelinek has advocated. For example, the HOLISM study surveyed over 2500 PwMS in 57 countries and found that those following the steps of the OMS program had better health outcomes: Less disability, fewer relapses[31], better quality of life[32], and less incidence of depression[33] and fatigue.[34]

Exercise has also been well documented to improve quality of life and function[35] and immunological markers in PwMS.[36] A new RCT showed that resistance training can have a neuro-regenerative effect with increases in cortical thickness.[37]

The nutrition connection

While more dietary studies are needed, the existing evidence has shown a consistent link between saturated animal fat intake and MS.[38-43] Observational studies have additionally found that PwMS had lower antioxidant blood levels than people without MS, indicating that eating a plant-based diet high in antioxidants may also be protective against MS.[44]

So far, there has been one pilot RCT of a plant-based diet in PwMS that ran for 1 year. This did not demonstrate significant improvements on disease activity or MRI, which aligns with Swank’s findings that it takes up to 5 years to achieve disease stability. However, patients in the pilot did experience improvements in fatigue, BMI and metabolic biomarkers, which represents a significant improvement in quality of life.[45]

Further long-term RCTs are needed to develop our understanding of the diet/MS connection, but what we know so far strongly indicates that whole food plant-based diets are effective for both prevention and mitigation of MS.

Having experienced my own recovery journey, I am committed to advocating for healthy diet and lifestyle: this includes updating medical training and putting lifestyle and diet research at the forefront of MS research.

Healthy diet and lifestyle must be at the forefront of our approach to preventing and treating MS, with whole food plant-based nutrition as a central pillar.

The take-home message

The understanding of the causes and (non-drug) treatment interventions for MS has increased greatly. PwMS and their treating health professionals now have a large and congruent evidence base on which to plan their treatment. The tertiary prevention of MS must include comprehensive lifestyle changes to optimise outcomes. This has finally been recognised by Neurologists. The January 2018 editorial of the Journal Neurology declared:

“encouraging a healthy lifestyle (healthy eating, a normal weight, routine physical activity or exercise, and avoiding smoking) should be a fundamental message we give to all newly diagnosed patients with MS.”[46]
Useful links

overcomingms.org

gawler.org/retreats-and-services/overcoming-multiple-sclerosis

mspgh.unimelb.edu.au/research-groups/centre-for-epidemiology-and-biostatistics-research/neuroepidemiology

abc.net.au/news/2017-03-15/multiple-sclerosis-doctors-back-unconventional-treatment/8355786

wholefoodsplantbasedhealth.com.au/medical-conditions/auto-immune-diseases/multiple-sclerosis

codebluedoc.com
Key references

MS Research Australia (2017). Health Economic Impact of Multiple Sclerosis in Australia in 2017.

van der Hiele K, van Gorp D, Ruimschotel R, Kamminga N, Visser L, Middelkoop H. Work Participation and Executive Abilities in Patients with Relapsing-Remitting Multiple Sclerosis. PloS one 2015; 10(6): e0129228-e.

Coyne KS, Boscoe AN, Currie BM, Landrian AS, Wandstrat TL. Understanding Drivers of Employment Changes in a Multiple Sclerosis Population. Int J MS Care 2015; 17(5): 245-52.

Parnell GP, Booth DR. The Multiple Sclerosis (MS) Genetic Risk Factors Indicate both Acquired and Innate Immune Cell Subsets Contribute to MS Pathogenesis and Identify Novel Therapeutic Opportunities. Front Immunol 2017; 8: 425-.

Briggs F, Davis M. Multiple sclerosis genetic risk burden confers earlier onset. (S49.001). Neurology 2019; 92(15 Supplement): S49.001.

Sawcer S, Hellenthal G, Pirinen M, et al. Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis. Nature 2011; 476(7359): 214-9

George MF, Briggs FB, Shao X, et al. Multiple sclerosis risk loci and disease severity in 7,125 individuals from 10 studies. Neurol Genet 2016; 2(4): e87.

Pan G, Simpson S, Jr., van der Mei I, et al. Role of genetic susceptibility variants in predicting clinical course in multiple sclerosis: a cohort study. Journal of neurology, neurosurgery, and psychiatry 2016; 87(11): 1204-11.

Riccio P, Rossano R. Nutrition facts in multiple sclerosis. ASN Neuro 2015; 7(1).

Hoare S, Lithander F, van der Mei I, Ponsonby AL, Lucas R. Higher intake of omega-3 polyunsaturated fatty acids is associated with a decreased risk of a first clinical diagnosis of central nervous system demyelination: Results from the Ausimmune Study. Multiple sclerosis (Houndmills, Basingstoke, England) 2016; 22(7): 884-92.

Malosse D, Perron H, Sasco A, Seigneurin JM. Correlation between milk and dairy product consumption and multiple sclerosis prevalence: a worldwide study. Neuroepidemiology 1992; 11(4-6): 304-12.

Winer S, Astsaturov I, Cheung RK, et al. T cells of multiple sclerosis patients target a common environmental peptide that causes encephalitis in mice. J Immunol 2001; 166(7): 4751-6.

Virtanen JO, Jacobson S. Viruses and multiple sclerosis. CNS & neurological disorders drug targets 2012; 11(5): 528-44.

Tremlett H, Zhu F, Ascherio A, Munger KL. Sun exposure over the life course and associations with multiple sclerosis. Neurology 2018; 90(14): e1191-e9.

Derakhshandi H, Etemadifar M, Feizi A, et al. Preventive effect of vitamin D3 supplementation on conversion of optic neuritis to clinically definite multiple sclerosis: a double blind, randomized, placebo-controlled pilot clinical trial. Acta Neurol Belg 2013; 113(3): 257-63.

Rosso M, Chitnis T. Association Between Cigarette Smoking and Multiple Sclerosis: A Review. JAMA Neurol 2019.

Poorolajal J, Bahrami M, Karami M, Hooshmand E. Effect of smoking on multiple sclerosis: a meta-analysis. Journal of Public Health 2016; 39(2): 312-20.

Hedström AK, Hillert J, Olsson T, Alfredsson L. Smoking and multiple sclerosis susceptibility. European Journal of Epidemiology 2013; 28(11): 867-74.

Mohr DC, Hart SL, Julian L, Cox D, Pelletier D. Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis. BMJ (Clinical research ed) 2004; 328(7442): 731.

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About the author

Dr Sam Gartland is a GP based at The Clinic, East Ballina. He was diagnosed with relapsing-remitting MS in 2008. In January 2009 he attended an Overcoming MS program run by Professor George Jelinek at the Gawler foundation. By following this program he managed to return to work full time and has remained relapse free. The lesions on his MRI scan resolved and he now feels in the best shape of his life. His recovery is in line with the published results of the OMS program. His story and others can be found in the book, Recovering from MS – real life stories of hope and inspiration. Sam has been involved with Doctors For Nutrition since attending the inaugural Nutrition in Healthcare Conference in 2019. Connect with Sam via his website drsamgartland.com.
November 29, 2019
The plant prescription

These days we have access to thousands of valuable pharmaceutical compounds packaged in tablets, powders, creams, injections and various other potions. However, are we neglecting some of the most ancient and powerful pillars of health in favour of popping pills? Doctors For Nutrition’s Hannah O’Malley (BPharm) digs in. Article first published in Nourish Magazine, October 2019.

Image credit: nourish magazine

It’s no secret that nutrition has been used as medicine for millennia. From Hippocrates in the third century BCE to Esselstyn today, medical physicians have promoted the power of food, and plants in particular. Yet these days we are far more likely to walk away from a doctor’s clinic or pharmacy with a bag full of pills than a prescription for fresh produce. However, the tide is turning and more clinicians are recognising the powerful role of lifestyle medicine when it comes to preventing, treating and even reversing disease. Nutrition, of course, does not replace drugs in every circumstance, but its role as a key part of the health equation is overlooked far too often.

More clinicians are recognising the powerful role of lifestyle medicine when it comes to preventing, treating and even reversing disease.

As a pharmacist, I see dozens of patients every day with conditions that could be helped through simple yet powerful plant-based food choices. I’m pleased to say the pharmacy I work at is beginning to place more emphasis on lifestyle, now offering free healthy recipe cards to patients and even selling cans of lentils and jackfruit alongside medications. While a pharmacist is generally the health professional people see most often, if a condition is severe or persistent, then seeking advice from a doctor is certainly recommended. It’s also best to talk to your doctor before any significant lifestyle changes if you have health conditions or are on medications.

Let’s explore some common problems people consult pharmacists about and consider lifestyle prescriptions to help avoid and manage these so you can spend more time feeling your best.

Fatigue

Tiredness, insomnia and lack of energy are common complaints for pharmacists to hear. Many people are seeking supplements to gain an energy boost, but to determine what will be most effective it is important to look at the cause of fatigue rather than just the symptoms being experienced. Overwhelming exhaustion can be attributed to anaemia, inability to get adequate sleep, nutritional deficiencies, low thyroid levels, sleep apnoea, depression, stress and other factors. A range of pharmaceuticals may be prescribed depending on the individual case, including supplements, zopiclone, levothyroxine and antidepressants.

Lifestyle prescription
A whole food plant-based diet including a range of vegetables, fruit, whole grains and legumes will maximise nutrition and help to prevent deficiencies. It’s important to make sure you eat a large enough quantity of food as whole plant foods are generally lower in caloric density. This eating pattern also excludes processed foods, which is beneficial as these may exacerbate fatigue due to the erratic blood glucose levels they can cause. You can give yourself the best chance of a good night’s sleep by minimising caffeine, avoiding alcohol and limiting pre-sleep screen time. Taking steps to remove avoidable stresses and build a supportive network of friends, family and community are also key factors that shouldn’t be underestimated.

Acne

As your largest and most visible organ, skin plays a huge role in your wellbeing. It is also prone to irritating and sometimes painful health conditions, which can seriously impact your confidence. Acne vulgaris is the most common skin disease in Western countries, affecting the vast majority of adolescents and many adults. Hormones, genetics, stress, diet and other factors play a role in the development of this condition. Usually, pharmaceutical therapies include antibacterial creams, antibiotics or tablets that regulate cell growth, such as isotretinoin.

Lifestyle prescription
It is reported that frequent dairy consumption may be a leading factor in the link between diet and acne, and rates of the condition are far lower in areas where dairy is not typically consumed. Many people find that a low-fat eating pattern helps reduce the number and severity of acne spots. Therefore, avoiding processed oils (including olive and coconut oil), choosing plant-based milk alternatives, and using nutritional yeast instead of dairy cheese are steps worth considering and could help pave the way to clearer skin.

Image credit: nourish magazine

Constipation

We struggle to do ‘number twos’ when our bowel movements become too hard or dry. Constipation can be uncomfortable and even painful, and may lead to more complicated issues like haemorrhoids, irritable bowel syndrome, obstruction or perforation. Common pharmaceutical therapies include fibre supplements, osmotic laxatives (that draw more water into the bowel), and stimulating laxatives.

Lifestyle prescription
Fibre in its natural form is essential for keeping us regular, so eating lots of vegetables, fruit, legumes and whole grains will reduce the risk of constipation. A study using the 2011–2012 National Nutrition and Physical Activity Survey reported that over 80 per cent of Australian adults did not meet the suggested dietary target of fibre, which also contributes to reducing the risk of chronic disease.

Staying well hydrated is also crucial and most people should aim to drink at least six to eight glasses of water per day, and more if exercising. Being active for at least 30 minutes per day is also important for healthy bowel function.

Osteoarthritis

As we age, the protective cartilage on the ends of our bones wears away. For some people, this may lead to painful, inflamed areas where the bones rub against each other. Arthritis can lead to chronic pain, which is often managed by medication and sometimes results in surgeries to replace the joints. Common pharmaceuticals used for osteoarthritis include paracetamol, ibuprofen, diclofenac and naproxen.

Lifestyle prescription
Losing excess weight can ease the load through weight bearing joints such as hips and knees, often giving significant relief of pain, and a whole food plant-based diet is a proven way to achieve this. Turmeric may also offer relief for those suffering with osteoarthritis. A meta-analysis of studies using turmeric extract found reductions in pain score with effects comparable to certain anti-inflammatory medications, but without gastric side effects. Note that all herbal supplements should be used with caution and it’s important to notify your healthcare provider of any supplements you’re taking, including turmeric and curcumin.

Weight Management

Statistics show nearly two in every three Australians are overweight or obese, and it’s a similar story in New Zealand. It can be hard to resist the unhealthy foods that are advertised and discounted almost everywhere we look. And on the whole, we are consuming more processed foods and animal products than ever. Dieting is common, particularly among females, and meal replacement shakes or bars are popular items in some pharmacies. The medication Orlistat was also invented to support weight loss by reducing absorption of fat, but people commonly report side effects of nausea and faecal incontinence – not fun! These shakes, bars and medications are not an optimal (or long term) solution for healthy weight management.

Lifestyle prescription
A great recipe for weight management is to eat fewer processed foods (including refined oils and spreads) and prioritise more whole plant foods which are naturally lower in calories. The New Zealand BROAD Study encouraged people to adopt a low fat, whole food plant-based diet. Over six months, the average weight loss for participants was almost 12kg! Another study involving over 60,000 people found that the less animal products eaten (and more plants consumed), the lower the average Body Mass Index (BMI) of participants. Those eating a vegan diet were the only group that had an average BMI within the healthy range.

So, as you can see, plenty of plants each day can help keep the pharmaceuticals at bay! Unsurprisingly, the same dietary pattern that is likely to help prevent and manage many of Western society’s major chronic diseases, is the same one that helps with more minor health conditions too. Processed foods and animal-based foods may lead to a certain level of chronic inflammation in the body compared to whole plant foods, and this can underlie many chronic diseases.

Try to centre your meals on vegetables, fruit, whole grains and legumes (with some nuts, seeds and seaweed in the mix). And if you follow a plant-based diet, make sure you take a vitamin B12 supplement. While eating this way may initially sound challenging, any small steps towards more whole plant foods are a positive move! You’ll discover there are thousands of recipes to explore and new ingredients to try that are scrumptious and filling! You can find more information at nutritionfacts.org for specific health issues.

Medicines have a vital role to play, but we need to bring the emphasis back to healthy nutrition and lifestyle so you can take more control of your health.

Each person’s situation is different and you should consult your health practitioner before making major changes to your diet or lifestyle, particularly if you have a significant medical condition or take prescription medications. We all still get sick sometimes and may well benefit from medicines. When you do experience symptoms of a minor ailment, or something more serious, make sure you discuss it with your pharmacist or doctor to get the right advice. Medicines have a vital role to play, but we need to bring the emphasis back to healthy nutrition and lifestyle so you can take more control of your health.

This article is republished with permission from nourishmagazine.com.au.

November 29, 2019
Are plant-based pregnancies safe?

Dr Heleen Haitjema explains how a well-planned plant-based diet from pre-conception onwards sets your child up for a long and healthy life. Article first published in Nourish Magazine.

A healthy start

All parents want to provide their children with the best possible start in life, and pre-conception is the ideal time to establish health-giving conditions for a pregnancy. Spoiler alert: a plant-based pregnancy can be just as safe as any other and can be an even healthier start for bubs.

Parents-to-be who follow (or are considering following) a plant-based diet may sometimes feel uncertain about their decision, and particularly when it comes to ensuring a healthy pregnancy and baby. This sense of trepidation can be intensified by well-meaning family, friends and even physicians who may question this choice. As a paediatrician and a mother of three, I’d like to clear up some of the confusion so you can make an informed decision for you and your soon-to-be bundle of joy.

Science supports a plant-based approach

Most concerns usually stem from questions about whether you’re getting enough of this nutrient or that nutrient and, with the growing volume of reputable evidence-based resources available now, it’s never been easier to do your own research. Some background reading combined with support from a suitably-qualified healthcare professional can enable those considering starting – or growing – their family to feel confident that following a healthy plant-based lifestyle is safe for both mother and baby. The good news is you have the best available nutrition science on your side!

Many organisations including Dietitians Australia, the Canadian Paediatric Society, and the British Dietetics Association all agree that appropriately planned plant-based diets are healthy and nutritionally adequate for all stages of life including pregnancy, breastfeeding and early childhood. The official Australian Dietary Guidelines have also endorsed healthy vegan diets since 2013. This should immediately put to rest all the common misconceptions about animal products being necessary to supply sufficient iron, calcium, protein and so on. And, as more studies are conducted, it becomes ever clearer that diseases related to lifestyle choices respond very favourably to a switch to a whole food plant-based (WFPB) diet and this also applies to pregnancy.

The good news is you have the best available nutrition science on your side!

A caution for traditional diets

What might be shocking for people who follow a traditional diet is that the beginnings of heart disease can be detectable in a baby’s arteries even while still in the womb. Fatty streaks in the aorta of a foetus can be attributed to high cholesterol levels in the mother’s blood. Solid scientific studies have however demonstrated that a WFPB diet can prevent and even reverse heart disease in most cases. For many people, the same applies to the global epidemic of type 2 diabetes, autoimmune diseases and many other chronic conditions. So, rather than questioning whether animal products are necessary during pregnancy, let’s for a moment turn the concern on its head and instead ask the question: How safe is a diet based on animal products during pregnancy?

Many complications in pregnancy are linked to lifestyle diseases where animal products are a major contributing factor. For example, pre-eclampsia is linked with hypertension, a lifestyle disease prevalent in societies with a typical Western diet high in animal-based and processed foods. A study has shown that pre-eclampsia (where pregnant women can develop high blood pressure, fluid retention, and protein in the urine) occurred only once in 775 pregnancies in subjects who avoided animal-based foods. For comparison, in Australia where the typical Western diet is the norm, the prevalence of this condition is around 1 in 33 pregnancies. Pre-eclampsia can lead to eclampsia, a complication that involves damage to other organ systems such as the kidneys, and can be life threatening for mother and child.

Gestational diabetes is also closely linked to eating animal fat, red meat, eggs, cholesterol, as well as to low fibre intake. Remember, cholesterol is found exclusively in animal products and they do not contain any dietary fibre. A well-designed study from 2015 compared omnivores, different kinds of vegetarians and vegans. It showed that the more plant-based people were eating, the less obesity occurred and therefore the less risk of gestational diabetes. It is important to note that obesity also decreases fertility and increases the risk for many complications during pregnancy and delivery.

Are supplements necessary?

The standard advice for pregnant women in Australia, regardless of diet, is to take a supplement with the particular vitamins and minerals that are important for the developing baby. For women who choose to forgo this supplement, there are some nutrients that need attention to ensure adequate intake.

First of all, let’s talk about vitamin B12. This essential nutrient should be supplemented by anyone following a plant-based diet, whether pregnant or not. It might surprise you to learn that this is not because animal products are the only source of B12. In fact, vitamin B12 is made by soil-bacteria and thanks to modern sanitisation, we no longer reliably ingest it through our food or water. Even animals on modern farms have their feed supplemented with vitamin B12! So, eating a plant-based diet and taking a supplement is actually a more direct way to meet your needs. The vital takeaway here is that people following plant-based diets should ensure consistent, adequate B12 levels through supplementation. The recommended dosage is either 250 micrograms every day, 1000 micrograms twice a week, or 2500 micrograms once a week. Dosage is not linear due to the way it is metabolised. Be aware that the typical pregnancy supplement provided in Australia has only 2.6 micrograms per tablet, so an additional B12 supplement is required.

Iodine intake also requires special care during pregnancy and lactation. Low iodine levels can cause congenital hypothyroidism. This means that the baby is born with a condition where the level of thyroid hormone is too low. If left untreated this can lead to developmental and growth problems. The recommended daily intake of iodine is 150 micrograms for adults, 220 micrograms during pregnancy, and 270 micrograms while breastfeeding. Seaweed is a good source of iodine, especially dulse, wakame and nori. I recommend avoiding kelp (also known as kombu) as its iodine levels are too high, and also hajiki, which is high in arsenic. With regular consumption of seaweed, tablet-based iodine supplementation can be lowered.

Vitamin D is crucial for many metabolic processes in the body. The most natural way to get this essential vitamin is through direct exposure to sunlight. Also, plenty of plant-based milks, cereals and tofu products are fortified with vitamin D. I recommend having your vitamin D levels tested before deciding if you need to supplement.

Omega-3 fatty acids are important in the development and maintenance of the brain, retina, and cell membranes. Good sources of omega-3 include ground flaxseeds, chia seeds and walnuts. Those following a whole-food approach can ensure a good ratio of omega-3 to omega-6 by avoiding added oils and processed foods which are high in omega-6, and not going overboard in their consumption of nuts, seeds, avocado, olives and other high-fat whole foods. However, for pregnant and breastfeeding mothers who do not stick closely to a low-fat WFPB diet, I advise taking a low-dose (around 250 milligrams) DHA+EPA supplement.

Certain key nutrients require special care during pregnancy and lactation.

The foundation of a healthy life

It wasn’t until my own children were out of high school that my husband Alphonse (an obstetrician/gynaecologist) and I stumbled upon information about the health benefits of a WFPB diet. What a shock it was to discover that there was such an easy, affordable and safe way to treat so many chronic diseases! Why had we not been taught about dietary interventions in medical school? In fact, our daughter Juliette had less than two hours of lectures about diet in her entire medical degree, and nothing about the benefits of a plant-based approach. This is a major shortfall in our local and global education system I hope can be changed through the work of organisations such as Doctors for Nutrition. I passionately believe everyone has the right to be informed about nutrition and its far-reaching consequences for our health. My whole family made the switch to a plant-based lifestyle over 8 years ago after learning about the vital role of diet in health. We’ve delved into most of the research over this time and the science consistently confirms that we made a sound choice.

Families and parents can be reassured that a WFPB diet is a healthy foundation for both mothers and children, and fathers too for that matter! As a paediatrician, I believe this way of eating is preferable during pre-conception and pregnancy, and then for all stages of life from childhood right up until a ripe old age!

This article is republished with permission from nourishmagazine.com.au.

Updated: 2 February 2026

October 23, 2019
World Food Day 2019: plant-based diet shift vital to solving nutrition crisis

Doctors For Nutrition welcomes the theme of this year’s World Food Day and its clear message: that putting plants back at the centre of our plates is essential to ensuring healthy, sustainable diets are accessible to all – now and for generations to come.

Current food systems are failing

Our current food systems are failing to ensure food security and healthy nutrition for all. Food systems are also contributing to climate change and environmental degradation – and without a healthy planet we cannot sustain a healthy population.

Image: fao.org/world-food-day

Urgent action is needed to address all forms of malnutrition

In its recent report on food security and nutrition, the UN warned that the number of undernourished people in the world is increasing. More than 820 million people do not have enough to eat, but at the same time, rates of overweight and obesity continue to increase in all regions.

An unhealthy diet is the leading risk factor for deaths from noncommunicable diseases, including heart disease, diabetes and several common cancers. Health problems linked to obesity are costing national health budgets up to US$2 trillion per year.

World Food Day 2019

The UN’s World Food Day – marked annually on 16 October – emphasises that achieving Zero Hunger is not only about addressing hunger, but also nourishing people, while nurturing the planet.

This year’s slogan is “Our actions are our future. Healthy diets for a #ZeroHunger world”, and the extensive World Food Day website is packed with tips and resources on how we can be part of the solution.

Its guidance on diet choices is a key part of this, and the message is clear: we need to move away from processed foods and excessive consumption of meat, and put plants front and centre:

Eat plenty of fresh, ripe and seasonal vegetables and fruits daily and add more legumes, nuts and whole grains to your diet. Legumes and nuts are great sources of plant-based protein. What’s more, legumes can be cheaper than animal proteins. They’re also kinder on our planet.

DFN co-founder Dr Heleen Haitjema welcomes this message and encourages fellow healthcare professionals, policy makers and the general public to take the guidance to heart. “The best way we can nurture both personal and planetary health is by de-emphasising animal products in our diets and shifting to a whole food plant-based eating pattern”.

October 16, 2019
Highlights from the 2019 International Plant-Based Nutrition Healthcare Conference

Words by Dr Malcolm Mackay, Jenny Cameron and Dr Heleen Haitjema.

From September 22-25, one of the world’s leading medical conferences on plant-based nutrition took place in Oakland, California: The Seventh International Plant-Based Nutrition Healthcare Conference (PBNHC).

Several of the Doctors For Nutrition team attended, including Dr Heleen Haitjema, Dr Juliette Roex, Dr Andrew Davies, Peter Johnston PhD, Dr Malcolm Mackay and Jenny Cameron, as well as international Advisory Council members Dr Scott Stoll (co-founder of the PBNHC) and Dr Neal Barnard.

Some of the Australian contingent, including the authors of this post, Dr Heleen (Roex) Haitjema (third from left), Jenny Cameron (middle) and Dr Malcolm Mackay (third from right). Image credit: pbnhc.com

It was DFN co-founder Dr Heleen Haitjema’s seventh year of attending the conference. She recommends it unreservedly: “the speakers, the topics, the science, the organisation, and not unimportantly the exceptional whole food plant-based catering covering all meals across the four days.”

It was also Dr Malcolm Mackay’s seventh year at the conference. Malcolm says attending this conference every year is invaluable to his medical practice and his role in providing plant-based nutrition education. It’s not just the great information from the conference presenters, it’s also the sharing of ideas and experience with other delegates who are bringing nutrition into healthcare.

“Every year I return from this conference with a renewed passion to work harder and smarter to empower people to transform their health with whole food plant-based nutrition”.

It is a tough job narrowing down the highlights, but here are key takeaways from some of the most outstanding sessions.

The Power of the Plate: The Science of Regeneration and Sustainability – Dr Scott Stoll

Dr Stoll opened the event with a presentation describing how everything is interconnected between humans, animals and plants. Our food choices have a huge impact on health and beyond. We know that moving away from animal agriculture will have a huge benefit for our environment. Restoring soil quality should also be a priority to optimise the nutrition contained in food. Dr Stoll explained how we should aim to achieve the levels of healthy microorganisms and nutrients that once were seen decades ago, before the widespread use of pesticides and herbicides.

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Cardiovascular Disease Prevention and Reversal: The Esselstyn Program – Dr Caldwell Esselstyn and Ann Esselstyn

Key take home messages from this energetic pre-conference workshop were that patients need to understand the endothelium (the inner lining of our blood vessels) and nitric oxide (a powerful vasodilator formed from nitrates in certain foods). We should avoid eating anything that damages endothelial health, such as animal based foods and processed foods – including oil. The best foods for protecting and enhancing the endothelium are green leafy vegetables. For patients with heart disease, Dr Essylstyn recommends that eating green leafy vegetables, not drinking these, 6 times per day.

Further core principles of Esselsyn’s nutrition are: no animal products; absolutely, definitely no oil; no caffeinated coffee; no sugar; low salt and no avocado or nuts apart from a small quantity of flaxseed meal or chia seeds. The foods to include are grains, legumes, vegetables and fruit. He only recommends restricting fruit when triglycerides are elevated. In Dr Esselstyn’s experience if patients adhere perfectly to his diet their heart disease goes into long term remission even if their LDL cholesterol does not reach the ‘heart attack proof’ target of less than 2.0mmol/L. An antioxidant rich whole food plant-based diet reduces the stickiness of the blood and stabilises plaque so that patients may not need to continue taking aspirin after a year or so on the program.

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The Hidden Connections: Tendon Health and Nutrition – Dr Jimmy Conway

When Jimmy suffered a heart attack nearly a decade ago and discovered Esselstyn’s Prevent and Reverse Heart Disease book, he turned his life around with a whole food plant-based diet. Not only did he reverse his own heart disease, but he also experienced pain relief from old sporting injuries. This led him to dive deep into the scientific literature to see if there was a link between tendon pain and nutrition. What he found led him to conclude that rotator cuff tears are the equivalent of a heart attack of the shoulder. The same risk factors for heart disease apply to rotator cuff tears. As with heart disease there are multiple mechanisms through which nutrition can damage or enhance tissues. e.g. Advanced Glycation End products (AGEs – from meat and processed foods) are toxic to rotator cuff tendon cells. He talked about the mechanisms of injury and repair and found nitric oxide to be important for tendon healing. Just like Dr Esselstyn recommends for reversing heart disease, nitrate rich foods are important for recovery from injury. Healthy blood vessels means healthy tendons and a healthy heart.

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Plant-Based vs. Omnivore For Gut Health: The effect of a low-FODMAP diet on the microbiome when treating SIBO/IBS – Dr Angie Sadeghi

The lecture on gut microbiome and small intestine bacterial overgrowth/irritable bowel syndrome (SIBO/IBS) was of particular interest to DFN Ambassador Dr Malcolm Mackay, as he frequently sees patients with bloating and other gut symptoms. We learnt that fibre is an essential macronutrient for the gut and that high fat diets adversely alter the gut microbiome leading to damage to the gut barrier and inflammation. Fibre and carbohydrates support a community of good gut microbes that produce health supporting short chain fatty acids.

The first step in treating SIBO is to stop all dairy foods and investigate for the underlying causes such as coeliac disease or hypothyroidism. Low FODMAP diets are a band aid solution and restrict the very foods that support a diverse gut microbiome – these diets were never intended to be long term. Dr Sadeghi recommends first eliminating animal products, alcohol, sugar, refined oil and environmental toxins. She then uses a ‘reverse elimination diet’, adding back a diversity of whole plant foods, starting with those that are least likely to cause symptoms – starchy fruits and vegetables (e.g. bananas, plantains, root vegetables, squash). All food is either cooked or frozen first (freezing breaks up the fibre) even if it is to be blended into a soup or a smoothie. People switching from a standard American diet (SAD) diet can expect rapid improvements but progress can be slow for people who have lost microbial diversity by following restrictive diets for long periods of time.

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Overcoming Insulin Resistance: Keys to Restoring Insulin Sensitivity – Cyrus Khambatta PhD

Dr Khabata’s expertise in diabetes comes from his experience as both a patient and a practitioner. After being diagnosed with type 1 diabetes, he went on to earn a PhD in Nutritional Biochemistry, which he now channels into helping thousands of people master their diabetes. His session described the steps in the development of insulin resistance, including the literature documenting the rise of insulin resistance in people living with type 1 diabetes. He explored the mechanisms by which dietary and lifestyle choices impact cellular insulin sensitivity, showing how a low fat whole food plant-based diet and exercise interventions can be used to reduce total insulin requirements and potential long term complications for people with a diagnosis of either type 1 or type 2 diabetes.

In the case of type 2 diabetes, Cyrus explained that a high fat diet is the cause of insulin resistance because fat deposits end up in places where they don’t belong, such as muscle, liver and pancreas cells. The high fat content in these cells lowers their sensitivity to insulin, known as insulin resistance. The cause of the disease is thus high dietary fat, not high blood sugar, which is a presenting symptom. A whole food plant-based diet will also benefit patients with type 1 diabetes in lowering their insulin requirements, although these patients will stay dependent on external administration of insulin, while many type 2 diabetes patients manage to come off their medications entirely. He noted that the effect of insulin resistance on type 1 and 1.5 diabetes is often not appreciated by health professionals when they recommend a high fat diet, explaining how people eating a ketogenic diet can give themselves ‘double diabetes’, i.e. the autoimmune form plus insulin resistance.

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Nutrition, Cognition and Dementia – Drs Ayesha and Dean Sherzai

Husband and wife neurologists Dean and Ayesha Sherzai are co-directors of the Alzheimer’s Prevention Program at Loma Linda University Medical Center, which is situated in one of the Blue Zones of the world. ‘Team Sherzai’ as they are known, talked about dementia, highlighting the factors that increase risk and the healthy lifestyle behaviours that are protective, stating that nutrition is the most important factor in brain health. The process of dementia starts decades before it is diagnosed, and everything we do will move us towards or away from the precipice of dementia. For Alzheimer’s disease, prevention is the new treatment. Doctors For Nutrition are excited to host Team Sherzai at their 2nd International Australasian Nutrition in Healthcare Conference in February 2021.

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Nutritional Foundations for Paediatric Populations: Growing Healthier Children – Dr Jackie Busse

Dr Andrew Davies described this session as “the single best plant-based talk I’ve ever heard – Jackie is full of knowledge and enthusiasm.” Paediatrician Dr Busse presented an evidence based case for how children thrive on a plant-based diet. Essentially, children are just small humans when it comes to their nutritional needs. However, they do need about 75% more calories per kilogram of weight for growth and to compensate for higher physical activity levels. This allows for a higher fat content of their diets compared to adults, which can easily be reached by adding in higher fat whole plant foods, such as avocados, nuts, seeds and soy products. One of the most common problems doctors see in children in the general population is constipation, which can be treated by adopting a naturally fibre-rich whole food plant-based diet.

Follow Dr Busse

2019 Plantrician Project Luminary Award Ceremony

Dr Neal Barnard MD, was honoured with this year’s prestigious Plantrician Project Luminary Award. Dr Stoll presented the award, describing Dr Barnard’s “invaluable scientific contribution through scholarly research; pioneering work in public policy that continues to shape numerous national initiatives and key legislative decisions; selfless leadership and compassionate service; and the creative development of practical resources that have transformed people around the world.” It was followed by an entertaining conversation between these two pioneering doctors on the topic of “What years of experience shows about the power of plants for human health.”

Follow Dr Barnard

Doctors For Nutrition highly recommends this outstanding conference to all, whether you are a medical doctor, other healthcare professional, or just interested in the science of healthy nutrition. Visit the PBNHC website for the photo and video gallery, and upcoming announcements about the next conference.

October 11, 2019
World Mental Health Day: Diet plays a key role for mental health

For immediate release
Attention: health, medical, lifestyle editor
Issued: 9 October 2019

A diet high in fats, sugars, junk foods and processed meats is contributing to the current general malaise in the community and a high incidence of poor mental health, according to Doctors For Nutrition.

Depressive disorders affect more than 300 million people around the world, and are associated with unemployment, poor physical health, impaired social functioning, and, in its most severe forms, suicide.

One in five Australians aged 16-85 experience a mental illness in any year and the prevalence is the same in New Zealand. According to the The Royal Australian College of General Practitioners, mental health concerns are the single most common reason people visit their GP.

Numerous studies have linked physical health with mental health. Essentially, the healthier we are, the higher likelihood we have of experiencing a greater sense of overall wellbeing.

Health-promotion charity, Doctors For Nutrition, report there is mounting evidence indicating that a whole food plant-based diet can improve people’s mental and physical health. In the process, this can help address the gap in life expectancy for people with poor mental health, which is currently a shocking 10-20 years, with lifestyle diseases a major cause.

“Nutrition interventions are an important tool that we need to utilise in caring for some of society’s most vulnerable people,” says DFN spokesperson Dr Alyce Churchill.

This can practically translate to, for example, a breakfast full of nutrient-packed ingredients such as rolled oats, fruit, seeds, and soy milk. Health-wise, this recipe wins hands down over a meal based on bacon – a processed carcinogenic meat – and eggs, which are high in artery-clogging cholesterol.

All animal products contain arachidonic acid, an inflammatory compound known to contribute to brain changes, which may adversely affect mood. Excessive intake of foods high in arachidonic acid, such as chicken and eggs, can ultimately make us chronically sick, with evidence associating high levels of arachidonic acid in the bloodstream with a greater incidence of suicidal risk and major depressive episodes.

A wholefood eating pattern centred on fruits, vegetables, grains and legumes can lift our mood and protect us from depression. Too much processed food may conversely put our mental health at risk.

The most recent research gathered from 16 randomised controlled trials found dietary interventions hold promise as a novel treatment and prevention avenue for reducing symptoms of depression across the population. DFN are excited about the emerging research into the gut-brain connection via the intestinal microbiome and the potential for enhancing mental wellbeing through a diet high in fibre-rich fruit and veg.

Whilst there are many underlying factors contributing to mental health and wellbeing, it is clear that nutrition is of critical importance.

Ends

For Further Information & Comment

Dr Alyce Churchill is available for comment on +61 400 721 812 or by email.

Dr Luke Wilson is available for comment on +64 27 651 1551 or by email.

Dr Heleen Haitjema is available for comment on +31 83 44 66 52 or by email.

doctorsfornutrition.org

Download a PDF version of this media release here.

October 9, 2019
Wellington health professionals ready to transform health through nutrition

DFN’s Hannah O’Malley (BPharm) and GP Dr Luke Wilson presented to 50 clinical colleagues at a recent professional workshop, in collaboration with the Pharmaceutical Society of New Zealand.

A Food Odyssey

Dr Wilson began the presentation by taking attendees on a ‘Food Odyssey’, exploring how human dietary patterns have changed through history, arriving at where we are now, and how we can get to a better place. Dr Wilson then presented the Gisborne BROAD study (of which he was a co-lead), and used a range of evidence to explain the powerful benefits of plant-based nutrition.

Dispensing Lifestyle Medicine

Pharmacist Hannah O’Malley asked the audience, “If you had access to a pill that could significantly reduce the risk of heart disease, obesity, diabetes and bowel cancer, without any side effects, would you recommend it?”. She went on to present on ‘Practical Ways To Dispense Lifestyle Medicine’, where time and again, the evidence has shown that whole food plant-based eating does just that.

Feedback from the event corroborates what we already know: that a lack of nutrition awareness is common in the health profession but that there is a great appetite to fill this knowledge gap. As one attendee put it: “I have really been impacted by the realisation that poor diet and nutrition is the leading cause of so many health conditions. Will certainly be improving my current diet.”

>90% would recommend or highly recommend the workshop to other health professionals

Many members of the audience came away inspired to start incorporating their learning in their personal and professional lives. “I am going to use this info starting NOW – in my own lifestyle and then when I’ve learnt more, will share with others.” Several have committed to undertaking further professional development in nutrition as a result, with one calling the workshop “truly life changing”.

Handouts, references and further resources

Links to further educational resources are provided on our website here.

Please also browse our information on the impact of nutrition on many common health conditions and stay tuned for further resources and guidance that are in the pipeline.

We are always open to delivering similar workshops to health professionals around New Zealand and Australia. Enquire here.

October 3, 2019
New Zealanders flock to learn about Plant-Based Lifestyle

A crowd of over 100 attended the recent Picton Food Frontiers event to learn why The Lancet medical journal and other international groups are calling for a Great Food Transformation towards healthy and sustainable plant-based diets.

Locals packed into the newly opened Picton Library to enjoy nutritious plant-based nibbles, hear from three expert presenters and take part in a panel Q&A. The event was co-hosted by The Better Base and local author, James Wilson.

Dr Luke Wilson, Director of Doctors For Nutrition, was the first speaker. Attendees were guided through ‘A Food Odyssey’; looking at where we are now, how we got here and solutions for transforming health. Dr Wilson stressed that while there is a role for individual efforts, “high level changes are needed, regionally and nationally.”

Sustainability was the next topic of the night with Dr Mike Joy, Victoria University ecologist, presenting on the Future of Food. Dr Joy described the immense ecological challenges faced in New Zealand and explained that what we eat has a huge impact on the environment. His message was clear: a significant shift towards production of plant-based food is needed.

Picton author James Wilson was the final speaker, discussing how he adopted a whole food plant-based diet in his sixties for health reasons and never looked back. His recent book, Plant Paradigm, discusses the rationale for eating plants and provides answers to many commonly asked questions.

From left to right: Dr Mike Joy, Hannah O’Malley, James Wilson and Dr Luke Wilson

The event MC, Doctors For Nutrition Advisory Council member and pharmacist Hannah O’Malley, then facilitated a panel discussion.

The audience called for similar events to be held all around New Zealand to raise awareness of the importance of healthy, sustainable plant-based diets.

September 10, 2019
Media release: Prostate deaths can be reduced

For immediate release
Attention: health, medical, lifestyle editor
Issued: 2 September 2019

The high numbers of Australian men dying from prostate cancer could be significantly reduced with a plant-based diet, according to a leading group of doctors.

About 3,500 Australian men die of prostate cancer each year. It is the most common cancer among men.

About 3,500 Australian men die of prostate cancer each year. It is the most common cancer among men.

The incidence of prostate cancer in Australia is one of the highest in the world. Nearly one-in-two men have a risk of getting some form of cancer in their lifetime. More men die of prostate cancer than women die of breast cancer.

There’s strong evidence to suggest diet plays a key role in the prevention of prostate cancer. Doctors For Nutrition recommend a whole food plant-based diet to have the best chance of avoiding prostate cancer.

Recent work by Dr Dean Ornish* involving men with early stage prostate cancer who followed a low fat plant-based diet (in addition to other lifestyle changes) demonstrated a significant reduction in prostate specific antigen (PSA) levels after one year, and none progressed to requiring conventional treatment in this time.

Excitingly, Dr Ornish has also shown that over 450 prostate cancer promoting genes in these men were switched off, and almost 50 cancer fighting genes were turned on by the lifestyle changes. Their blood was almost eight times more effective at fighting the growth of prostate cancer cells than those who did not make the changes.

A nutrition prescription that will help in the fight against prostate cancer emphasises unprocessed fruits, vegetables, whole grains, and beans and legumes. This way of eating avoids meats, dairy products, and eggs and minimises refined and processed foods.

A low fat whole food plant-based eating pattern can also help to prevent heart disease, the leading killer of men in Australia, say Doctors For Nutrition.

Ends

For Further Information & Comment

Dr Malcolm Mackay is available for comment here
Dr Heleen Haitjema is available for comment on 0432 994 909 or via email

doctorsfornutrition.org/prostate-cancer

*Dean Ornish MD, a clinical Professor of Medicine at the University of California, has directed clinical research through the Preventive Medicine Research Institute demonstrating the changes in diet and lifestyle can slow, stop or even reverse the progression of early-stage prostate cancer.

Download a PDF version of this media release here.

September 2, 2019
Media release: Plant-based meals must be a focus in Australian hospitals and aged care facilities

For immediate release
Attention: health, medical, lifestyle editor
Issued: 26 August 2019

The Victorian government’s initiative to improve the taste, enjoyment and health of food available in hospitals and aged care facilities provides a unique opportunity to improve health outcomes for patients, staff and visitors alike.

The Victorian government’s audit provides a unique opportunity

The Victorian government’s initiative to improve the taste, enjoyment and health of food available in hospitals and aged care facilities provides a unique opportunity to improve health outcomes for patients, staff and visitors as well, according to Dr Heleen Haitjema, Director of Doctors for Nutrition.

The health promotion charity Doctors For Nutrition has welcomed the proposed audit which will result in new nutrition standards.

“Hospitals are an ideal place to introduce people to an evidence-based plant-based diet, which can significantly lower the risk of cardiovascular disease, diabetes, obesity, colorectal cancer and other chronic conditions. This eating pattern is also healthier for the planet, which is a fundamental prerequisite to human health,” said Dr Heleen Haitjema.

The Australian Medical Association’s latest position statement on nutrition states that ‘hospitals and other residential health care facilities should provide access to healthy foods, including plant-based meals and meals that are low in fat, sodium and added sugars, as well as no and low sugar beverages’ in order to improve the health of patients, staff and visitors.

“It is vital that health institutions offer nutritious plant-based meal options and eliminate processed meats from all menus,” Dr Haitjema said.

Processed meats are a group one carcinogen and are inappropriate to be served in a healthcare setting according to the World Health Organisation.

Ends

For Further Information & Comment

Dr Heleen Haitjema is available for comment on 0432 994 909 or via email.

Download a PDF version of this media release here.

August 26, 2019
Media release: New Heart Foundation Nutrition Guidelines should promote plant-based diets

For immediate release
Attention: health, medical, lifestyle editor
Issued: 22 August 2019

The healthiest diet for our heart, and indeed human and environmental health more widely, is a whole food plant-based diet.

The healthiest diet for our heart, and indeed human and environmental health more widely, is a whole food plant-based diet

Doctors For Nutrition were pleased to see that new nutritional guidance from The Heart Foundation promotes eating more plant foods including fruit, vegetables and wholegrains. They also encourage reducing processed meat and highly processed junk foods.

However, in failing to promote a whole food plant-based diet, the guidelines missed an opportunity to reduce rates of heart disease and save thousands of Australian lives.

The move to endorse unflavoured full-fat milk, yogurt and cheese, and lift the limit on the number of eggs that can be eaten per week, will put our communities at greater risk of disease and death. Full fat dairy products and eggs are high in saturated fat and cholesterol. Evidence shows that as dietary saturated fat and cholesterol increases, so does our risk of heart disease.

The Heart Foundation have themselves acknowledged, “research tells us that a plant-based diet can be beneficial in lowering bad LDL cholesterol, it can help people maintain a healthy weight and blood pressure and can reduce the risk of diabetes, heart disease and many other health problems.” Research by doctors Dean Ornish and Caldwell Esselstyn also demonstrates that a whole food plant-based diet can reverse advanced heart disease.

Doctors For Nutrition calls on the Heart Foundation to amend their guidance to clearly promote the safest diet for individuals wanting to prevent or manage heart disease: one heavily emphasising whole plant foods and discouraging high-fat and animal-based foods. Our organisation would welcome the opportunity to work with The Heart Foundation to achieve the best evidence-based guidance to protect against our number one killer.

Ends.

For Further Information & Comment

Dr Heleen Haitjema is available for comment on 0432 994 909 or via email.

doctorsfornutrition.org/cardiovascular-disease

Download a PDF version of this media release here.

August 22, 2019
Media release: NZ Ministry of Health is right to urge reduced meat and dairy in hospitals

For immediate release
Attention: health, medical, lifestyle editor
Issued: 9 August 2019

The New Zealand Climate & Health Council and health promotion charity Doctors for Nutrition strongly support the new Sustainability and the Health Sector guidance announced last week as it will result in a much healthier population.

“People and the planet will both be healthier if we shift towards a plant-based diet, and cut back on meat and dairy, as recommended,” according to Dr Alex Macmillan, Co-convenor of OraTaiao: The NZ Climate and Health Council.

“The recommendations will help prevent some of New Zealand’s biggest killers including obesity, heart disease, diabetes and bowel cancer. Taking a prevention approach by addressing diets means huge savings for the health sector which can then be used for better treatment, including for cancer patients.”

The American Academy of Nutrition and Dietetics agrees that people who eat a plant-based diet are at reduced risk of many diseases.

All of the international research supports the new guidelines, including the recent EAT-Lancet Commission, which calls for an urgent ‘Great Food Transformation’.

Doctors For Nutrition Lead Nutrition Advisor for NZ and Canadian Registered Dietitian, Anna DeMello, is working at the University of Otago and researching sustainable, healthy diets.

“Alongside health benefits, we see a stepwise reduction in diet-related climate pollution as our diet becomes increasingly plant-based. Public institutions can play a leading role in addressing the climate emergency, including implementing sustainable food policies and procurement practices”, Anna explains.

According to the World Health Organisation, processed meats are group one carcinogens (meaning they cause cancer) and are unsuitable to be served by health organisations to patients or staff.

Alcoholic beverages and tobacco smoking are also group one carcinogens, which is why these are also not appropriate to consume in health organisations.

Australian doctor Renae Thomas, who is currently working at one of the most progressive hospitals in the world, Loma Linda University Medical Center in California, believes the new guidelines will lead to a healthier population.

Dr Thomas has challenged Dietitians NZ, who are worried about cutting back on meat and dairy in hospitals, and who receive funding and sponsorship from both the meat and dairy industries.

“Plant-based meals are appropriate for people at all stages of life, including while in hospital. The Loma Linda University Hospital is completely vegetarian with a menu endorsed by dietitians and has the best hospital rating in the region. Their menu provides an adequate amount of protein, iron, B vitamins, and fibre with less cholesterol and saturated fat. The diet thus reduces risk of heart disease, diabetes, hypertension, colon cancer, and obesity.”

“The need for high calories and protein in hospital can easily be addressed with plant-based options including protein drinks like smoothies and other fortified plant-based milks, legumes and beans, grain-based meals, nuts and seeds,” said Dr Thomas.

“Providing vegetarian and plant-based nutrition in a hospital provides an opportunity to educate patients on optimal nutrition when well planned and under the guidance of hospital registered dietitians.”

Leading medical journal, The Lancet, highlights food as the single strongest lever to optimise human health and environmental sustainability on Earth. “The nature and scale of the response to climate change will be the determining factor in shaping the health of nations for centuries to come.”

OraTaiao and Doctors For Nutrition strongly endorse the ‘Sustainability and the Health Sector’ report and consider that once recommendations are implemented, New Zealand could become innovative world leaders in promoting healthy, sustainable diets.

Ends.

For Further Information & Comment

Dr Luke Wilson, Doctors For Nutrition Director and GP, is available for comment on 027 651 1551 or via email.

Dr Renae Thomas, Senior Resident at Loma Linda University Health, is available for comment via email.

Dr Alex Macmillan, OraTaiao Co-convenor and Senior Lecturer in Environmental Health, is available for comment via email.

Dr Heleen Haitjema, Doctors For Nutrition co-founder and Director, is available for comment on 0432 994 909 or via email.

Download a PDF version of this media release here.

About OraTaiao

OraTaiao has over 500 health professional members calling for urgent, fair climate action – with real health gains now and for our future. Their call to action on climate change has been signed by 14 of the country’s leading health professional bodies, representing over 60,000 health professionals.

About Doctors For Nutrition

Doctors For Nutrition is a health promotion charity led by medical and dietetic professionals dedicated to putting evidence-based nutrition at the heart of healthcare.

August 9, 2019
Red and processed meat: fact and fiction
There was a collective sigh of relief from the bulk of the population when a re-examination of scientific studies recently concluded people could continue to eat red and processed meat.

The fact that the review did not find eating red or processed meat was safe did not seem to matter. The widely-reported message was that, although the science showed eating meat was harmful, it was only a little bit harmful, and not enough for people to worry about.

The article which captured the world’s attention contradicts well-established advice to cut down on red and processed meat, which for a long time has been associated with cardiovascular disease, several cancers, and other chronic lifestyle diseases such as type 2 diabetes.

A 14-member team from the Annals of Internal Science – a journal run by the American College of Physicians – reviewed past studies that fit their criteria. One of the reviews looked at people’s attitudes about eating meat. Predictably, it found that omnivores are reluctant to give it up, even if they know their health is at risk. These results were factored into the guidelines, essentially saying that since people don’t want to give up meat, they don’t need to.

Interestingly, three of the panel members dissented from the conclusions and advice from this latest review.

Industry ties

Everyone involved with the research signed a disclosure form that they did not have any conflicts of interest to report during the past three years, a standard set by the International Committee of Medical Journal Editors.

The New York Times has since reported that Bradley Johnston, an epidemiologist at Dalhousie University in Canada, who co-led the endeavour behind the new recommendations, has previously received funding from the International Life Sciences Institute (ISLI) in 2016 for a study which argued that warnings to cut sugar were based on weak evidence. As the ILSI study fell just outside the 3 year timeline, Johnston did not make this disclosure.

ISLI is a corporate-funded nonprofit organisation claiming to conduct “science for the public good.” However, investigations by academics, journalists and public interest researchers show that it is a lobby group that protects the interests of the food industry, not public health.

A report from the World Health Organisation in 2000 found that ILSI was used by certain tobacco companies to thwart tobacco control policies.

Getting clear on the facts

Many organisations have been critical of the latest recommendations from the Annals of Internal Medicine and have expressed grave concerns about the potential for damage to public understanding, and public health.

The Physicians Committee for Responsible Medicine called the results misrepresentations and said that there’s abundant evidence linking red and processed meat to heart disease and increased risk of premature death. It found the findings a major disservice to public health, and called on the journal to issue a public retraction.

The American Heart Association called the conclusions of the study questionable.

Dr. Frank Hu, the chair of the nutrition department at the Harvard T.H. Chan School of Public Health, said he was stunned when he realised that Dr Johnston was both the leader of the meat study and the same researcher who led the industry-funded review that attacked guidelines advising people to eat less sugar. He notes that the tool he employed in his meat and sugar studies could be misused to discredit all sorts of well-established public health warnings, like the link between secondhand smoke and heart disease, air pollution and health problems, physical inactivity and chronic disease, and trans fats and heart disease.

Summary
In detail

Excellent rebuttals have been provided by several members of our Advisory Council:

Dr Scott Stoll

Dr Neal Barnard

Dr Shireen Kassam

We also commend the commentary from the following other experts and organisations:

Dr Dean Ornish

Dr T Colin Campbell

True Health Initiative

Food Revolution Network
There is understandable confusion among the public and healthcare professionals alike, given the daily deluge of confusing and contradictory reports about diet. To help address this, DFN continues to develop evidence based information for healthcare professionals and the general public.
August 5, 2019
Immunity boost

DFN’s Queensland Lead Dietitian Emma Strutt APD explains why what we eat can have a profound effect on our immune systems. Article first published in Nourish Magazine.

Winter is upon us and we are spending more time indoors. This is the time when cold and flu viruses circulate and attempt to invade unsuspecting victims. What we eat – or don’t eat – can have a profound effect on our immune systems.

If you become deficient in certain micronutrients, including vitamins A, C and E as well as iron, zinc and selenium, your immune function can be impaired, increasing the likelihood of getting sick. When you eat a good variety from each of the core food groups – vegetables, fruits, whole grains and legumes, with the occasional brazil nut thrown into the mix – you should be covered on the nutrient front. While no diet should be seen as a panacea, healthy eating centred around whole plant foods can certainly help boost your immune system. My top five tips will help you further build your best immune system.

Look after your gut and it will look after you

The human microbiome is certainly a hot topic at the moment, and with good reason. Your gut microbiota is made up of trillions of microbial organisms. In fact, we have more bacteria cells in and on us than we do human cells! We now know that our gut bugs have a profound effect on overall health and immunity, and about two thirds of our immune system is distributed around our gut. To keep your microbiota happy and diverse you need to feed it the right stuff, and your gut loves fibre. Aim to eat at least 30g of fibre each day, ideally more.

         Research suggests that people who have the highest intake of fruits, vegetables, whole grains and legumes also have higher bacterial gene counts, which has been associated with improved immune function as well as lower body weight, less inflammation and reduced risk for certain chronic diseases.

Research suggests that people who have the highest intake of fruits, vegetables, whole grains and legumes also have higher bacterial gene counts, which has been associated with improved immune function as well as lower body weight, less inflammation and reduced risk for certain chronic diseases. Certain types of fibre – known as prebiotics – enhance the growth of beneficial bacteria. Prebiotic foods include legumes, onion, garlic, leek, asparagus, artichoke and oats as well as cooked and cooled starches like potatoes, wholegrain pasta and rice. So pasta and potato salads are a great option, especially when paired with dressings made with whole ingredients rather than refined oils. Adding small amounts of fermented foods to your diet, such as tempeh, miso or water kefir may also help the growth of good gut bacteria, as many fermented foods naturally contain beneficial bacteria called probiotics.

Eat a rainbow every day

To really optimise your diet and enhance immunity, focus on eating a variety of foods of all colours. This helps to maximise your intake of phytochemicals, antioxidants, vitamins and minerals. The pigments that give food its beautiful, bright colours also provide us with protective components. The benefits of each colour group are all slightly different too. For example, orange vegetables such as sweet potato and carrot contain beta-carotene, which is a precursor to vitamin A that supports the immune system. Red foods like tomatoes and watermelons contain lycopene, an antioxidant that protects against cell damage. Dark green leafy vegetables, including kale, spinach and rocket are packed with folate and vitamin C, which maintain healthy cells and protect against infection. Blue and purple plants such as berries and grapes are bursting with anthocyanins, a group of antioxidants that have mild antibacterial effects. And I have to give a special mention to kiwi fruit! Gold kiwi fruit has been shown to reduce the incidence, severity and even duration of upper respiratory tract infections, sore throats and head congestion.

         The pigments that give food its beautiful, bright colours also provide us with protective components.

Keep your diet low in fat

If you eat a plant-based diet centred around whole foods, your fat intake will generally be lower than that of the average person. And that’s a good thing! Intervention studies have shown lower fat diets, or those where fat is less than 30% of total calories, can increase the activity of a type of white blood cell that plays a major role in ridding the body of virally infected cells, and even tumour cells. Some fat in the diet is important. However, if you are adding fats to your meal, opt for whole foods such as olives, avocados, nuts and seeds in place of processed oils and spreads.

Include mushrooms and nutritional yeast

Mushrooms and nutritional yeast are as delicious as they are nutritious. Both fungi and yeasts contain compounds called beta glucans, which show great promise for keeping the immune system healthy. Although more robust research is needed, numerous studies have suggested that certain mushroom compounds have immuno-modulatory effects and can enhance natural killer cell activity (cells that fight infected cells). Nutritional yeast, also known as savoury yeast, can also help maintain the body’s defences against pathogens. It is similar to bakers yeast but undergoes a heating and drying process that deactivates it. Just one spoonful a day can reduce the occurrence of the common cold by about 25%. It also boosts the immune system, has an anti-inflammatory effect, helps counter the negative impact of stress on the body, and provides good amounts of B vitamins and protein. You’ll find the cheesy, nutty flavour perfect for dairy-free cooking.

Stress less

The body’s stress response – commonly referred to as ‘fight or flight’ – is a natural process we undergo when our body is preparing to either confront or avoid a threat, whether perceived or real. Problems arise when this response is continually evoked by less critical, day-to-day stressors such as job, money or relationship challenges. Chronic stress can have a number of detrimental effects on your health and wellbeing, including suppression of your immune system and an increased susceptibility to colds and flu. While we can’t avoid all stress in our lives, nor should we aim to, developing healthy ways to mitigate stress is important. Relaxation techniques such as meditation and yoga can help lessen your body’s stress response, as can moderate amounts of physical activity. A healthy diet can also be of benefit by boosting our mood and thereby decreasing stress. A study involving over 12,000 Australians found a direct relationship between happiness and the amount of fruit and vegetables consumed. According to this study, to achieve optimal mood lift, the magic number of fruits and vegetables appeared to be eight or more serves per day.

         A study involving over 12,000 Australians found a direct relationship between happiness and the amount of fruit and vegetables consumed.

I am often asked what plant foods are the absolute best for warding off colds and flu. And the simple answer is: the foods you are actually going to eat and enjoy! So you don’t like Brussels sprouts? You gag at the thought of grapefruit? Well, you don’t have to eat them. Just keep your diet varied and centred around whole plant foods and you’re well on your way to building a healthy immune system. Whole foods have thousands of active compounds that help your immune system protect you against infection. Focus on fuelling your body with what it needs and this will give you the best shot at keeping all your systems healthy and happy.

This article is republished with permission from nourishmagazine.com.au.

July 17, 2019
Media release: Australasian doctors agree with EAT-Lancet: plant-based diet shift is vital

For immediate release
Attention: health, medical, lifestyle editor
Issued: 9 April 2019

The recently-established health promotion charity Doctors For Nutrition welcomes the 2019 release of the EAT-Lancet Commission on Food, Planet, Health.

This major report is a partnership between the global non-profit EAT Foundation and one of the world’s leading medical journals, in collaboration with nutrition, health, sustainability and policy researchers. The report outlines how to achieve healthy and sustainable eating patterns for an estimated global population of 10 billion people by 2050, and is the product of three years of work by nearly 40 international experts.

According to the Commission, unhealthy diets are the leading risk factor for disease worldwide and, “pose a greater risk to morbidity and mortality than does unsafe sex, and alcohol, drug, and tobacco use combined.” The current global food system, say the authors, is among the largest drivers of climate change, environmental degradation, and transgression of planetary boundaries. It will be impossible to meet the UN Sustainable Development Goals or the Paris Climate Agreement without a radical global transformation of our food system, according to this report.

The current global food system is among the largest drivers of climate change, environmental degradation, and transgression of planetary boundaries.

The Commission’s Planetary Health Diet stresses the importance of consuming a much greater quantity of whole, plant-based foods (vegetables, fruits, legumes, whole grains, nuts and seeds), and reducing the consumption of animal products. Among its recommendations, it highlight the need to reduce global consumption of both red meat and refined sugar by more than 50%, mainly by lowering intake in wealthier countries.

The ‘Planetary Health Diet’ emphasises whole, plant-based foods and reduced consumption of animal products

The targets and recommendations provided within the EAT-Lancet report lay out a pathway for the necessary global shift toward a plant-based eating pattern, and Doctors For Nutrition supports this substantial effort. This week, the 23rd International Union for Health Promotion and Education (IUHPE) World Conference on Health Promotion is taking place in Rotorua, bringing together hundreds of participants with a passion for health promotion, advocacy, and policy development.

With a theme of ‘Promoting Planetary Health and Sustainable Development for All’, findings from the EAT-Lancet report are front and centre for both presenters and delegates.

Doctors For Nutrition’s Lead Nutritionist for the New Zealand region, Anna deMello, is presenting on the topic of Resilience enhancement via population-level uptake of plant-based eating patterns. Jono Drew, 5th year medical student and DFN affiliate in NZ, is also presenting the results of his Bachelor of Medical Sciences honours thesis, which modelled the climate impacts of various eating patterns in the NZ context and showcases the benefits of plant-based eating patterns for both personal and planetary health.

Ends.

For Further Information & Comment

Dr Heleen Haitjema is available for comment on 0432 994 909 or via email

doctorsfornutrition.org

Download a PDF version of this media release here.

View Doctors For Nutrition’s Position Statement on the EAT-Lancet Report here.

April 9, 2019
Media release: Leading plant-based nutrition experts to address NZ health symposiums

For immediate release
Attention: health, medical, lifestyle editor
Issued: 15 February 2019

Two of the world’s leading plant-based nutrition experts will address symposiums in Wellington and Auckland next week following a major new conference in Melbourne this weekend.

Keynote speakers, Dr Neal Barnard of the Physicians Committee for Responsible Medicine (left) and Dr Scott Stoll of the Plantrician Project (right)

US based physicians Dr Neal Barnard and Dr Scott Stoll are coming to New Zealand at the invitation of the recently formed Australasian non-profit organisation Doctors For Nutrition (DFN) and will speak in Wellington on Tuesday night (February 19) and in Auckland on Wednesday night (February 20).

Their NZ appearances will follow the inaugural DFN Australasian Nutrition in Healthcare Conference in Melbourne this weekend. In addition to presentations by over 20 healthcare professionals, the Melbourne conference also features the premiere of the new documentary, Diet Fiction. Tickets to the Australian conference have already sold out.

The Wellington event will feature the New Zealand premiere of Code Blue. This inspiring documentary follows the journey of US physician Dr Saray Stancic from a multiple sclerosis diagnosis to wellness through the implementation of plant-based nutrition and lifestyle changes.

The Auckland event will also include presentations from Australian pediatrician Dr Heleen Haitjema (co-founder of DFN), medical doctor Juliette Roex and local general practitioner Dr Mark Craig.

New Zealand DFN ambassadors, Dr Luke Wilson (GP, Wellington) and Anna deMello (Canadian-registered Dietitian, Dunedin), say the events come as something of a watershed moment for thousands of New Zealanders now showing increasing interest in the health and environmental benefits of plant-based eating.

They note that last month’s EAT-Lancet Commission report on healthy and sustainable eating patterns, along with findings from a recent Colmar Brunton Better Futures report, suggest that 1 in 10 New Zealanders are now identifying as vegetarian or mostly meat-free. This growing adoption of plant-centric eating patterns points to important changes in both attitudes and practice among the population.

Dr Wilson says that DFN’s mission is to “grow awareness about the benefits of whole food plant-based nutrition among the general public, healthcare professionals and within health institutions through education, outreach and research.”

DFN are also hosting the New Zealand premiere of Diet Fiction on February 28 in Auckland with special guest speakers – including the US film-maker Michal Siewierski and executive producer Peter Eastwood (NZ).

Ends

For Further Information & Comment

Please feel encouraged to get in touch should you require any further information about any of these events or to request a press pass.

Dr Barnard, Dr Stoll and other presenters will be available for interview and/or comments should this be desired. High resolution photos also available.

Dr Luke Wilson MBChB, BA, MSc is available on +64 27 651 155 or by email.

Speaker Backgrounds

Dr Neal Barnard, MD

Dr Barnard established the Physicians Committee for Responsible Medicine (PCRM) in 1985, and the Barnard Medical Center in 2016. He works with patients with diabetes, obesity, and other chronic conditions, having published numerous clinical research studies.

He has written over 20 books for lay audiences, most recently including The Cheese Trap and The Vegan Starter Kit. He has appeared in numerous documentaries, including Super Size Me and What the Health, and television shows, including The Daily Show and The Ellen Degeneres Show.

Dr Scott Stoll, MD

Dr Stoll is co-founder and Board Chairman of The Plantrician Project. He is also co-founder of the annual International Plant-Based Nutrition Healthcare Conference which enters its seventh year in 2019 and is attended by 1,000 physicians and allied health professionals.

Dr Stoll specialises in regenerative medicine and is a board-certified specialist in Physical Medicine and Rehabilitation. As a member of the 1994 United States Olympic Bobsled Team, he is well suited for his additional roles as a team physician at Lehigh University, the United States Bobsled and Skeleton Federation, and advising physician serving professional and Olympic athletes.

Download a PDF version of this media release here.

February 15, 2019
Can a plant-based diet help Australians live longer?

The Australian Medical Association laments that many medical students are “graduating with significant gaps in their knowledge of nutrition and related health problems, adding to the nation’s health bill from chronic disease.” Hot on the heels of the recent EAT-Lancet Commission on Food, Planet, Health, twenty leading healthcare practitioners from across the world are converging in Melbourne this weekend to discuss the role nutrition can play in promoting healthier, longer lives for their patients – and their colleagues.

The keynote speaker at the inaugural Australasian Nutrition in Healthcare Conference (NIHC2019) is US physician Dr Neal Barnard MD. With over 30 years of research behind him, Dr Barnard is one of the foremost experts on the subject of plant-based nutrition for the prevention and reversal of chronic conditions such as diabetes, cardiovascular disease, autoimmune diseases and obesity.

Founder and President of the non-profit organisation Physicians Committee for Responsible Medicine, Dr Barnard has led numerous peer-reviewed studies, written more than twenty books and been interviewed for numerous TV and film productions including The Dr Oz Show, Super Size Me and What The Health. Barnard also features in the two Southern Hemisphere documentary film premieres being screened as part of the NIHC2019 – code blue and Diet Fiction.

Dr Barnard will present alongside other medical doctors, registered dietitians, allied healthcare professionals and patient case studies on the latest science about the leading lifestyle factor to influence health outcomes: our diets. From UK gastroenterologist and gut health expert Dr Alan Desmond, to local Australian general practitioners and many other specialties in between – each presenter has been convinced by the growing body of peer-reviewed evidence that points to what we eat as being a significant contributor to our health outcomes. The message they are coming together to share at this sold out event is that a whole food plant-based eating pattern is the key to reducing our chances of succumbing to chronic diseases at all stages of life.

Doctors For Nutrition hopes to bring light to the emerging movement towards utilising plant-based nutrition in the frontline of best-practice preventative medicine.

Some of the other leading presenters at the NIHC2019 are Dr Scott Stoll, former Olympian and co-founder of the US non-profit organisation The Plantrician Project; Dr Renae Thomas, an Australian lifestyle medicine practitioner currently based in North America’s only Blue Zone – Loma Linda, California; and New Zealand general practitioner Dr Luke Wilson, co-author of the BROAD Study – a community-based lifestyle intervention which established impressive weight loss and associated health benefits without calorie restriction.

Australia faces a growing epidemic of chronic non-communicable diseases. This proliferation of ill health has doctors and the general population alike beginning to look more critically at what’s on their plates. Can our collective menus predominantly take the blame and ultimately provide the solution to our expanding waistlines and hospital waiting lists? Doctors For Nutrition – the new Australian registered health-promotion charity hosting the NIHC – hopes to bring light to the emerging movement towards utilising plant-based nutrition in the frontline of best-practice preventative medicine.

“A plant-based diet is a powerful prescription for good health. Many of the world’s leading killers – from heart disease and type 2 diabetes to certain types of cancer – can be prevented by focusing our diets on plant-based foods. I’m looking forward to joining some of the world’s top nutrition experts at the Australasian Nutrition in Healthcare Conference in discussing the latest research in this exciting field.” – Dr Neal Barnard, MD

Conference Snapshot

Australasian Nutrition in Healthcare Conference: Melbourne Docklands, 15-17 February 2019. This event is now over. Learn about our most recent Nutrition in Healthcare Conference 2023.

Code Blue trailer: Watch HERE | Diet Fiction trailer: Watch HERE

February 14, 2019
‘Eat Whole Foods, Mostly Plant-Based’: What Does This Actually Mean?
DFN Board member Dr Luke Wilson digs into the importance of eating whole plant-based foods in the Australasian Society of Lifestyle Medicine blog.

This simple, yet effective mantra is derived from Michael Pollan’s best-selling book In Defence of Food (the original quote being ‘Eat food, not too much, mostly plants’). If you haven’t read that book, then the ‘Eat food’ part of the statement is a little confusing. Isn’t everything that we eat food? The idea is that much of what is eaten today is very different to what even our great-grandparents would have recognised as food.

The reason for this is processing. When a food is minimally processed, it is considered to be a ‘whole’ food. I say minimally processed, rather than unprocessed, because there is very little available to us today that has not had some degree of processing, and processing in of itself is not necessarily a bad thing. A ‘whole’ food can also be described as ‘food as grown’. How close is it to something you could pluck from a tree, pick from a bush, or pull from the earth?

         How close is it to something you could pluck from a tree, pick from a bush, or pull from the earth?

Let’s take an apple, for example. The most ‘whole’ would be if you were to pick a ripe apple from your own tree. This way it’s fresh, likely organic, and entirely unprocessed. Now most of us don’t have our own trees, so the best we can get is an apple from our local supermarket. This is still an excellent choice, but if we wanted to split hairs then we could talk about how ripe the apple was when it was picked, whether it was grown organically, how it had been washed, and whether it had been stored in cooled atmosphere storage before it reached you. Certainly none of these things would be particularly significant, but you can see that it’s not quite the same as homegrown or buying from a farmer’s market.

Real processing begins when the apple is peeled, cubed, and becomes apple pie filling. If we process it a bit further again, making sure it’s all mashed up and smooth, and perhaps add a little sugar then it becomes applesauce. Still not bad, especially if it’s sugar-free, but you can see that what started out as an apple is looking less and less like something we would have encountered often before we had machines and technology to do a lot of the work for us! Pressing the apples and removing everything except their natural juice is about as processed as it gets (although we could process apple juice further to make apple syrup), so while again this isn’t necessarily a ‘bad’ choice, you can see that most of what makes the apple an apple has been removed. Apple juice is clearly not a ‘whole’ food.

Eating more whole foods is important for at least three reasons

Firstly, as you might have guessed, these foods are the most nutritious for us. This is because they retain the nutrients that came naturally in the food. Secondly, these foods are closer to what our body’s natural mechanisms are used to. For example, the sugars in the ‘whole’ apple are packaged together with fibre, which helps our body keep the level of sugar in our bloodstream stable. If we remove the fibre by juicing the apple then our body responds quite differently, and struggles to keep our blood sugar levels steady. A whole apple is also a lot more satiating than apple sauce, which is in turn more satiating than apple juice. This is a really important point when it comes to keeping a healthy weight. Usually the parts of foods removed by processing (fibre and water) are the same that enable us to feel ‘full’, which means the more whole your food is, the harder it is to overeat. Finally, eating whole foods allows you to minimise the amount of substances added to food that aren’t great for keeping you looking and feeling your best, like salt, sugar, and oils, and other extras like additives and preservatives. While most of us no longer keep salt shakers on the table, it may surprise you to learn that 70% of the salt we eat comes from processed foods. In Australia and New Zealand most of our salt intake actually comes from bread, which you might not even have thought of as a processed food (until now).

Clearly, asking yourself how ‘whole’ a food is, is very helpful for choosing the healthiest foods. So how about ‘mostly plant-based’?

A plant-based food is simply a food of plant rather than animal origin. Essentially this incorporates five food groups: vegetables, fruits, grains, beans and legumes, and nuts and seeds. As you were reading that list you were probably nodding your head, because almost certainly you have heard about the health benefits of foods in all of these categories, and you know already that you should be eating more of them. Perhaps you even feel you’re getting your fair share already! However, very few of us are actually eating ‘mostly’ plants. You may have heard advice to aim for 5 servings of fruits and vegetables a day, and be feeling you’re doing pretty well by getting thereabouts most days (in fact, the most recent Australian Dietary Guidelines recommend consuming at least 5 serves of vegetables and legumes, and at least 2 serves of fruit a day: less than 4% of the population reach the first goal and not quite a third meet the second3! New Zealand recommends at least 3 serves of vegetables, and at least 2 serves of fruit: 64% meet the first goal and just 57% the second). Interestingly though, the more servings we eat the better we seem to do. Recently researchers demonstrated that while ‘5 a day’ is good, ’10 a day’ is much better!

         While ‘5 a day’ is good, ’10 a day’ is much better!

In fact, there doesn’t seem to be an upper limit when it comes to plant-based foods. Areas called The Blue Zones were first identified by National Geographic in 2005. These are the locations that are the home to the healthiest and longest living peoples on the planet: Okinawa, Japan; Nicoya Peninsula, Costa Rica; Ikaria, Greece; Sardinia, Italy; and Loma Linda, California. One thing they all have in common is a diet that is primarily plant-based. On average, meat is eaten about 5 times a month, portion sizes are about the size of a pack of cards. The Okinawans, for example get almost 70% of their energy for the day from sweet potatoes! While the Japanese are renowned for their consumption of fish and seafood, the Okinawans actually get only 1% of their energy from fish, compared to 6% from legumes, including soy and other beans. Something else you might be wondering is how a population in California, of all places, is right amongst this rather exotic sounding bunch and punching well above their weight when it comes to health and longevity. In fact, the inhabitants of Loma Linda will live on average 10 years longer than the average American, and are 10 times more likely to live to 100. Well, not at all coincidentally, this area is home to a large population of Seventh Day Adventists, and a plant-based diet is part of their belief system.

Why are plant-based foods so good for us?

Well, they simply pack more of a nutritional punch. They are full of a vast array of nutrients and compounds, many that are likely to still be discovered, that can do all sorts of amazing things for our body. Antioxidants are a prime example. Consider that even iceberg lettuce contains more antioxidants than any commonly consumed animal product, and that on average, plant foods have 64 times more antioxidant power than animal products. That’s just one example, but if you want to learn more about what plant-based foods can do for you then check out Dr Michael Greger’s (Fellow of the American College of Lifestyle Medicine) excellent but rather morbidly titled How Not to Die.

If plants are so good for us, is there ever a time when ‘only’ plants beats ‘mostly’ plants?

Interestingly it appears so. The Blue Zones provide a great example of people who are extraordinarily healthy and long-lived through eating mostly plant foods most of the time. However, medical pioneers and researchers Dr Dean Ornish and Dr Caldwell Esselstyn have demonstrated that at least for patients with heart disease, ‘only’ plants is the safest option. Both have demonstrated reversal of atherosclerosis with a diet that eschews animal products entirely and focuses on whole plant-based foods that are low in fat. If you have a personal or family history of cardiovascular disease especially, then Dr Esselstyn’s Prevent and Reverse Heart Disease is a must read.

         Swapping in just one entirely plant-based meal each day, and increasing the quantity and variety of other whole plant-based foods at other mealtimes is a great way to start.
So, whole foods, mostly plants!

For your best health ever, simply ask yourself two questions when it comes to choosing a food, choosing more that check both boxes:

Is it from a plant?

How close is it to something plucked from a tree, picked from a bush, or pulled from the earth?

Eating more whole, plant-based foods doesn’t at all mean you’re going to be confined to a bland and monotonous regimen of fruit and vegetables. Nor does it mean you’re going to need to fork out to enjoy tempeh, hemp seeds, or kale smoothies. Nowadays there’s recipes for everything from pizza to burgers to cakes and cookies that can help you to maximise your intake of foods that are mostly whole and mostly plant-based. Swapping in just one entirely plant-based meal each day, and increasing the quantity and variety of other whole plant-based foods at other mealtimes is a great way to start, and you’ll soon notice the benefits in how you look and feel!
Read the full referenced article at Lifestyle Medicine Australia.
November 9, 2018
Type 2 diabetes and nutrition

The relationship between diabetes and nutrition is often oversimplified and equated with an excess of ‘sugar’ or glucose in the diet, by clinicians and laypeople alike. Unfortunately, this widely held belief and the resulting dietary choices are contributing to the current epidemic of type 2 diabetes and poor outcomes for patients with diabetes.

Certainly, both types of diabetes are defined by an excess of glucose in the blood. However, the amount of glucose in our blood depends mostly on our body’s ability to use the glucose we consume, with availability and sensitivity to insulin being the critical factor. Excitingly, by revising our own and our patients’ nutritional approach to diabetes, we can ‘reverse’ most cases of type 2 diabetes, and help those with type 1 diabetes dramatically reduce their insulin use and risk of complications and chronic disease.

It is clear that the Western diet plays a key role in our current epidemic of type 2 diabetes.

This diet is characterised by high fat consumption, high protein consumption (both largely from animal sources), and a moderate intake of carbohydrate (largely from refined sources, especially sugar and flour). For example, the average diet in Australia and New Zealand is approximately 32% energy from fat, 17% protein, and 46% carbohydrate. As we see populations that have traditionally consumed a diet considerably higher in carbohydrate, but lower in fat and protein move towards the Western dietary pattern, a dramatic corresponding increase in type 2 diabetes occurs.

In China in 1980 less than 1% of the population had type 2 diabetes. At this stage, the Chinese diet had just begun to shift towards Westernisation. In 1970 for example, the Chinese diet was approximately 8% energy from fat, 10% protein, and 83% carbohydrate. By 2011, this had ‘Westernised’ to 32% fat, 13% protein, and 54% carbohydrate. It has been estimated that 11.6% of the Chinese population now have diabetes and 50.1% have prediabetes.

Across the Pacific in the United States, the Native American Pima people of Arizona are thought to have perhaps the highest prevalence of type 2 diabetes in the world: about 50% of all Pima over the age of 35 are affected. Their diet is similar in both total energy and macronutrient composition to that of the general population in the US, with approximately 35% energy from fat, 15% protein, and 47% carbohydrate. Intriguingly, the Pima of Mexico, who are very closely related genetically, have a substantially lower prevalence of type 2 diabetes at 13.4%. Their diet is more traditional and ‘…remarkable for the low percentage of calories derived from fat…’ at approximately 26% fat, 11% protein, and 62% carbohydrate.

While Westernisation of diet is also accompanied by increased food availability and substantially reduced physical activity, increases in rates of type 2 diabetes trend with increased fat intake, not an increased carbohydrate intake.

While Westernisation of diet is also accompanied by increased food availability and substantially reduced physical activity, increases in rates of type 2 diabetes trend with increased fat intake, not an increased carbohydrate intake. Even refined sugar, often blamed for the diabetes epidemic, seems to have little role in its aetiology besides as a source of additional energy. Furthermore, the idea that refined sugar is hazardous for glycemic control in people with type 2 diabetes is not supported by research. In one study, glucose control actually improved on a higher sugar diet, where participants were supplemented with 60g of fructose per day in place of complex carbohydrates, despite no changes in body weight10! Of course, there are plenty of other reasons why we should all minimise or avoid refined sugar, but at the very least from the above examples we can conclude it is possible to eat a diet that is very high in carbohydrate, perhaps even refined carbohydrate, compared to current diets in Australia and New Zealand without developing type 2 diabetes. If the high fat intake of the Western diet is instead implicated, why might this be the case?

It is now well known that body mass index and type 2 diabetes are closely related.

The risk essentially increases linearly as BMI increases, and weight gain after age 18 is a major determinant of risk. While it is often assumed that refined sugar and carbohydrate are the major contributors to excess energy intake in Western society, again this idea is not supported by research. A recent UK study found that compared to those with normal BMI, obese participants had a 14.6%, 13.8%, 9.5% and 4.7% higher intake from fat, protein, starch and sugar, respectively. In fact, it was concluded that because the proportion of fat in the diet, rather than sugar, was higher among overweight and obese individuals, focusing public health messages on sugar may mislead on the need to reduce fat and overall energy consumption.

Unsurprisingly then, type 2 diabetes can be effectively treated by weight loss.

A recent and exciting finding was that intensive weight management in a primary care setting resulted in remission of diabetes in 46% of participants. Remission varied with the weight loss achieved, increasing from 7% of participants who maintained 0-5kg of weight loss to 86% of those who lost 15kg or more. Unfortunately, the intervention was indeed ‘intensive’, replacing all food with a mere 825-853kcal a day of a high carbohydrate, low fat formula for between 3-5 months…

Read the full referenced article at l ifestylemedicine.org.au/content/type-2-diabetes-and-nutrition.

November 8, 2018
Creating a lifestyle intervention for your community

Dr Luke Wilson describes the key ingredients of a successful community-based lifestyle intervention, drawn from his experience as co-creator of the groundbreaking BROAD Study.

About 4 years ago, a colleague of mine and I embarked upon an ambitious project. We created a novel community-based lifestyle intervention for a group of 33 people in Gisborne, New Zealand (population: 36,600) with either a BMI of 25 or higher with type 2 diabetes, ischaemic heart disease, hypertension, or hypercholesterolaemia, or a BMI of 30 or higher. During our experience working on the wards at Gisborne Hospital we had seen the damage that chronic disease was inflicting upon this small, semi-rural community.

In our last year of medical school, we had both interned in Santa Rosa, California alongside lifestyle medicine pioneers including Dr John McDougall at the McDougall Program and Dr Michael Klaper at the True North Health Center. So we already knew that a move towards plant-based nutrition would prove extraordinarily effective in treating patients with these conditions, now it was just a matter of putting this knowledge into action.

Gisborne is the region with New Zealand’s highest rates of socioeconomic deprivation, obesity and type 2 diabetes. For myself, a major motivation for the project was to sow the seeds for a transformative change within a community that really needed it, and I feel that this was the greatest achievement of the program and its participants.

My second hope for the project was that it might inspire you, as a fellow lifestyle medicine practitioner or advocate, to establish similar projects within your own community. Given this could be established in Gisborne, New Zealand, largely just through the combined efforts of two recently graduated doctors, it can surely be achieved almost anywhere by just about anyone!

I have chosen a few aspects you might find worthy of consideration when designing your own intervention:

1. Select people who are motivated to change

I highly recommend screening and considering ‘stage of change’ when selecting participants. Most will be familiar with the Prochaska and DiClemente Transtheoretical Model, which describes six ‘health of change’. We measured ‘readiness for change’: participants were asked to rate their agreement with three statements: ‘Something has to change’, ‘Something has to change now’, and ‘I have to change now’. Essentially our intention was to identify whether a participant was in the ‘Preparation’ stage and ready to take action. As it turned out, likely because participants were invited to participate, then required to complete several rather extensive forms and an in-person interview, these ratings may have been somewhat redundant. Nonetheless, almost without exception eventual participants rated all 3 of these statements ‘strongly agree’ or ‘agree’.

As lifestyle medicine practitioners we know that there are multiple factors that influence ability and motivation to make lifestyle changes, and to maintain these. Our interventions are a limited resource, so considering which individuals are most likely to benefit and succeed makes sense. In research, this does compromise ‘external validity’. But in the real world, this helps us get the most ‘bang for our buck’.

Recently, a participant from our initial group even established Gisborne’s first cafe with a whole foods, plant-based focus.

Taking on a group of highly motivated and energised participants, who are more likely to succeed, results in the generation of a number of advocates and role models for your intervention. These success stories can sweep the less motivated within their families and community into action through their enthusiasm, and also increase the likelihood of further investment and participation. In Gisborne, former participants have volunteered as mentors, been employed in further projects, and funding has ultimately been secured from local trusts . Recently, a participant from our initial group even established Gisborne’s first (perhaps even Australasia’s first?) cafe with a whole foods, plant-based focus. Success breeds success.

2. Be aware of benefits that motivate

There was a lot more interest among the participants than I anticipated in short term benefits and outcomes, and I now believe these are the primary motivator for most people. While as health professionals, we often focus on changes in indicators of long term outcomes (e.g. risk factors for chronic disease) most of us are naturally short-term focussed. Participants were ecstatic about how good they were looking and feeling. As Dean Ornish explains, the ‘joy of living’ is a very powerful motivator.

That said, the most popular lecture I created was entitled ‘Know Your Numbers’. It explained what health-related ‘numbers’ meant: weight and ‘ideal weight’, cholesterol, blood sugar and HbA1c, BMI, and blood pressure. Following this session, participants were much more interested in their results, and they became something they could use to track their own progress. This also has applications in the context of medical practice generally. Taking the time to explain to patients the significance of risk factors and providing the information so they can track them themselves is likely to increase patient activation, which itself has been associated with improved health outcomes.

The power of this intervention, as opposed to a less disruptive dietary shift, is that participants obtain immediate results. This provides immediate evidence that their changes are working and therefore worthwhile persevering with.

Our intervention shifted participants to a whole foods, plant-based diet. This is the intervention we had observed being so transformative for patients in Santa Rosa, and that had already been used so effectively by Dean Ornish and Caldwell Esselstyn. The power of this intervention, as opposed to a less disruptive dietary shift, is that participants obtain immediate results. This provides immediate evidence that their changes are working and therefore worthwhile persevering with. It also means they rapidly begin receiving highly reinforcing unsolicited positive feedback from friends and family, who notice changes in appearance, energy levels, and mood.

3. Involve and engage your community

By partnering with different groups in the community we provided additional support for the participants which made their environment more conducive to continuing with the lifestyle changes they had been prescribed. We also generated interest in the program in the wider community, and many of these changes would make it easier for people who were not involved in the study to make healthier food choices too.

Read the full referenced article at lifestylemedicine.org.au/content/creating-a-lifestyle-intervention-for-your-community and visit the BROAD Study web page at thebroadstudy.com.

May 25, 2018