Vitamin B12 Recommendations

Vitamin B12 Recommendations on a Plant-Based Diet

A plant-based diet has been shown time and time again to be the most health-promoting, disease-fighting, and nutrient-dense way of eating possible. Emphasizing a wide range of vegetables (especially leafy green varieties), fruits, whole grains, legumes, nuts, seeds, herbs, and spices makes it simple to achieve nutrient needs while avoiding chronic overnutrition. Guides such as the Plant-Based Food Guide Pyramid and Plate, 6 Daily 3’s, and Notable Nutrient Chart help with the high level view of what exactly a day-in-the-plant-based-life may look like. As does this post of Everything You Need to Know About A Plant-Based Diet in Less Than 500 Words and Sample Meal Plans Made Simple + Hundreds of Recipes.

One nutrient that likely will fall short on a plant-based diet is cobalamin, commonly referred to as vitamin B12. B12 is produced by microorganisms, bacteria, fungi, and algae, but not by animals or plants. B12 is found in animal products because they concentrate the nutrient after ingesting these microorganisms along with their food in their flesh, organs, and byproducts (e.g. eggs and dairy). Also, ruminant animals (such as cows, sheep, and goats) have bacteria in their rumen that produce vitamin B12.

In a vegan diet, vitamin B12 may be found in fortified plant milks, cereals, and other foods, such as nutritional yeast. However, if vegans are not conscientious about taking in the recommended dietary allowance (RDA), there could be harmful health consequences. Deficiency can result in potentially irreversible neurological disorders, gastrointestinal problems, and megaloblastic anemia. B12 deficiency is not unique to vegans who do not supplement. Deficiency is also a concern with aging, medication use, and gastrointestinal issues. So much so that it has been recommended that all adults over the age of 60 years supplement to avoid deficiency.

Interestingly, the body is able to store B12 for upwards of even ten years. To further complicate this, signs and symptoms for deficiency are either not noticeable or simply very subtle. So, if B12 is not being taken in at adequate levels or if there are absorption problems, deficiency will eventually ensue. Because blood tests for B12 levels can be skewed by other variables, irreversible damage may occur before a deficiency is detected.

RDA’s for vitamin B12 across the lifespan can be found in detail here. For non-pregnant adults, aged 14 and above, the RDA is 2.4 micrograms per day. To ensure this is absorbed (in a healthy individual, barring any possible inhibitors), higher doses are recommended.

B12

 

The bottom line is that it seems the best way to supplement to maximize absorption and maintain optimal blood levels of B12 is for vegan adults (as well as non-vegan adults over the age of 60) should consider supplementing with these doses of vitamin B12:

  • 50 µg twice a day OR
  • 150 µg once a day OR
  • 2,500 µg once a week

High doses of B12 are safe and there isn’t a tolerable upper limit that has been established. It is best to undergo testing regularly and adjust the dose as necessary.

 

The post Vitamin B12 Recommendations appeared first on Plant Based Dietitian.

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How to Protect Our Telomeres with Diet

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In my video, Does Meditation Affect Cellular Aging?, I discussed how stress reduction through meditation might be able to lengthen telomeres, the protective caps at the tips of our chromosomes that tend to deplete as we age.

What about exercise? We can't always change our situation in life, but we can always go out for a walk. London researchers studied 2,400 twins, and those who exercised more may have pumped up their telomeres along with their muscles. Apparently it doesn't take much either. The "heavy" exercise group was only averaging about a half-hour a day.

These were mostly folks in their 40's, but does it still work in your 50's? Yes. A study out of South Korea found that people in their 50's who work out three hours a week had longer telomeres.

In my video, Telomeres: Cap It All Off with Diet, you can see the telomere lengths of young healthy regular folk controls at around age 20, and then at age 50. As we'd expect, the older subjects' telomeres were significantly shorter. What about athletes? The young athletes started out in the same boat, with nice, long, young, healthy telomeres capping all their chromosomes. The older athletes, in contrast to the controls, appeared to still have the chromosomes of 20-year-olds. But these were marathon runners, triathletes running 50 miles a week for 35 years.

What was it about the Ornish intervention that so powerfully protected telomeres after just three months? We saw that stress management seems to help, but what about diet and exercise? Was it the plant-based diet, was it the walking 30 minutes a day, or was it just because of the weight loss? In 2013 a study was published that can help us anser just that question.

The researchers took about 400 women and randomized them into four groups: a portion-controlled diet group, an exercise group, a portion controlled diet and exercise group, and a control group for a full year. In the video, you can see a comparison of the length of each group's telomeres. After a year of doing nothing, there was essentially no change in the control group, which is what we'd expect. The exercise group was 45 minutes of moderate-to-vigorous exercise like jogging. After a year of that, they did no better. What about just weight loss? Nothing. The same thing for exercise and weight loss, no significant change either.

So as long as we're eating the same diet, it doesn't appear to matter how small our portions are, or how much weight we lose, or how hard we exercise. After a year, the subjects saw no benefit. On the other hand, the Ornish group on the plant-based diet, who lost the same amount of weight after just three months and exercised less than half as hard, saw significant telomere protection.

It wasn't the weight loss or the exercise: it was the food.

What aspects of a plant-based diet make it so protective? Studies have associated more vegetables and fruit, and less butter, with longer telomeres. From the latest review, foods high in fiber and vitamins are strongly related to longer telomeres. However, the key may be avoiding saturated fat. Swapping just 1% of saturated fat calories in our diet for anything else can add nearly a whole year of aging's worth of length onto our telomeres.

Saturated fats like palmitic acid, the primary saturated fat in salmon, and found in meat, eggs, and dairy in general, can be toxic to cells. This has been demonstrated in heart cells, bone marrow cells, pancreatic cells, and brain cells. The toxic effects on cell death rates happen right around what you'd see in the blood stream of people who eat a lot of animal products. It may not be the saturated fat itself, however, as saturated fat may just be a marker for the increased oxidative stress and inflammation associated with those foods.

With this link to saturated fat, it's no wonder that lifelong low cholesterol levels have been related to longer telomeres and a smaller proportion of short telomeres--in other words, markers of slower biological aging. In fact, there's a rare congenital birth defect called progeria syndrome, where children age 8-10 times faster than normal. It seems associated with a particular inability to handle animal fats.

The good news is that "despite past accumulated injury leading to shorter telomere lengths, current healthy behaviors might help to decrease a person's risk of some of the potential consequences like heart disease." Eating more fruit and vegetables and less meat, and having more support from friends and family, attenuate the association between shorter telomeres and the ravages of aging.

To summarize: inflammation, oxidation, damage and dysfunction are constantly hacking away at our telomeres. At the same time, our antioxidant defenses, healthy diet, exercise and stress reduction are constantly rebuilding them.


I've asked this diet versus exercise question in a few other contexts. See:

Though dietary change appears more impactful, I'm a big fan of walking. See Longer Life Within Walking Distance and for my personal favorite exercise, Standing Up for Your Health.

For more on the role saturated fat may play in disease, see, for example, my videos Heart Disease Starts in Childhood and Treating Multiple Sclerosis with the Swank MS Diet.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: AJC ajcann.wordpress.com / Flickr

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Phytates in Beans: Anti-Nutrient or Anti-Cancer?

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In my videos, Phytates in the Prevention of Cancer and Phytates for Rehabilitating Cancer Cells, I described how phytates in beans may be the reason why legumes are so successful in preventing cancer and re-educating cancer cells. What about phytates for the treatment of cancer?

Colorectal cancer is the second leading cause of cancer death in the United States. It arises from "adenomatous polyps," meaning that colon cancer starts out as a benign little bump called a polyp and then grows into cancer that can eventually spread to other organs and kill. So the National Cancer Institute funded the Polyp Prevention Trial, highlighted in my video, Phytates for the Treatment of Cancer, to determine the effects of a high-fiber, high fruit and vegetable, low-fat diet.

Researchers found no significant associations between polyp formation and overall change in fruit and vegetable consumption. However, those with the greatest increase in bean intake only had about a third of the odds of advanced polyps popping up. It could have been the fiber in the beans, but there's lots of fiber in fruits and vegetables, too. So it may have been the phytate.

If the tumors develop from polyps, they still need to spread. Tumor growth, invasion, and metastasis are multistep processes that include cell proliferation, digestion through the surrounding tissue, and migration through barrier membranes to reach the bloodstream so the tumor can establish new proliferating colonies of cancer cells. A critical event in tumor cell invasion is the first step: the tunneling through the surrounding matrix. To do this, the cancer cells use a set of enzymes called matrix metalloproteinases. This is where phytates might come in. We've known that phytates inhibit cancer cell migration in vitro, and now perhaps we know why. Phytates help block the ability of cancer cells to produce the tumor invasion enzyme in the first place (at least for human colon and breast cancer cells).

So what happens if you give phytates to breast cancer patients? Although a few case studies where phytates were given in combination with chemotherapy clearly showed encouraging data, organized, controlled, randomized clinical studies were never done--until now. Fourteen women with invasive breast cancer were divided randomly into two groups. One group got extra phytates; the other got placebo. At the end of six months, the phytate group had a better quality of life, significantly more functionality, fewer symptoms from the chemo, and did not get the drop in immune cells and platelets chemo patients normally experience.

What are the potential side effects of phytates? Less heart disease, less diabetes, and fewer kidney stones.

Because cancer development is such an extended process--it can take decades to grow--we need cancer preventive agents that we can take long-term. Phytates, which naturally occur in beans, grains, nuts, and seeds, seem to fit the bill.

In the past, there were concerns that the intake of foods high in phytates might reduce the bioavailability of dietary minerals, but recent studies demonstrate that this co-called "anti-nutrient" effect can be manifested only when large quantities of phytates are consumed in combination with a nutrient poor diet. For example, there used to be a concern that phytate consumption might lead to calcium deficiency, which then led to weakened bones, but researchers discovered that the opposite was true, that phytates actually protect against osteoporosis (See Phytates for the Prevention of Osteoporosis). In essence, phytates have many characteristics of a vitamin, contrary to the established and, unfortunately, still existing dogma among nutritionists regarding its 'anti-nutrient' role.

As one paper in the International Journal of Food Science & Technology suggests:

"Given the numerous health benefits, phytates participation in important intracellular biochemical pathways, normal physiological presence in our cells, tissues, plasma, urine, etc., the levels of which fluctuate with intake, epidemiological correlates of phytate deficiency with disease and reversal of those conditions by adequate intake, and safety - all strongly suggest for phytates inclusion as an essential nutrient, perhaps a vitamin."

The paper concludes that inclusion of phytates in our diet for prevention and therapy of various ailments, cancer in particular, is warranted.

More on preventing tumor invasion and metastasis in:

Other foods that can help stop the progression of precancerous lesions (like the adenomatous polyps) are profiled in Strawberries versus Esophageal Cancer and Black Raspberries versus Oral Cancer.

There's a substance in mushrooms that's also another "essential" nutrient candidate. See Ergothioneine: A New Vitamin?

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: The Ewan / Flickr

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4 More Reasons to Love Veggies and 8 Ways to Bring Them On!

Why: 1. Vegetables are the least calorically-dense foods on the planet. Typically, they range between 14 calories per 100 grams (as in iceberg lettuce) to 86 calories per 100 grams (as in a sweet potato). This is versus the most calorie-dense foods like nuts, which have about 500-600 calories per 100 grams, and oils, which …

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5 Ways To Enhance Nutrient Absorption

1. Use the magic of synergy by combining certain foods together (as seen in this graphic). Vitamin C-rich foods help absorb iron, so eat them together. Some ways to do so are to have a green salad with bell peppers or citrus dressing, drink a green smoothie with some fruit, or make hummus with beans …

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Best Nutrition Bang for Your Buck

 

 

 

 

 

 

 

 

Best Nutrition Bang For Your Buck

When measured on a cost per serving, cost per weight, or cost per nutrition basis, fruits and vegetables beat out meat and junk food:

Most Americans don’t even meet the watered down Federal dietary recommendations. Some have suggested this is because healthy foods are more expensive, but is that true? It depends on how you measure the price.

For over a century the value of food has been measured cost per calorie. If you were a brickmaker in Massachusetts in 1894, you may have needed more than 8000 calories a day. The emphasis was therefore on cheap calories. So while beans and sugar both cost the same back then--5 cents a pound--table sugar beat out beans for fuel value.

Of course food offers much more than just calories, but they can be excused for their ignorance, since vitamins and minerals hadn’t even been discovered yet. Even to this day, though, when the cost of foods are related to their nutritive value, the value they’re talking about is cheap calories. When you rank foods like that, then indeed junk food and meat is cheaper per calorie than fruits and vegetables, but that doesn’t take serving size into account. If you measure foods in cost per serving or cost per pound fruits and vegetables are actually cheaper (see the graphs in my 3-min video Eating Healthy on a Budget). For all metrics except the price of food calories, the USDA researchers found that healthy foods cost less than less healthy foods.

Most importantly, though, which is going to have the most nutrition? In the graphs in Eating Healthy on a Budget I show the average nutrient density of fruits, vegetables, refined grains, meats, milk, and empty calorie foods. Turns out that while junk food may be 4 times cheaper than vegetables, there’s 20 times less nutrition. For meat, we’d be spending 3 times more to get 16 times less.

Conclusion: “Educational messages focusing on a complete diet should consider the role of food costs and provide specific recommendations for increasing nutrient-dense foods by replacing some of the meat with lower-cost nutrient-dense foods…Modifying traditional mixed dishes to incorporate more beans/legumes and less meat may be a cost-effective way to improve diet quality.” That’s good advice for everyone, not just low-income populations.

In my video, Eating Healthy on a Budget, I also show what 100 calories of cheese, candy, chicken, chips, bread, oil, fruits or vegetables looks like.  Which hundred calories do you think would fill you up more? I explore the calorie density of other foods in my video Diet vs. Exercise for Weight Loss.

I have some other videos along the same vein:

Hasn’t the nutrition of our crops declined over the decades though? Or is that just supplement manufacturer propaganda? Find out in my video Crop Nutrient Decline. And if you want to strive to maximize the nutrient density of your diet, check out Calculate Your Healthy Eating Score.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

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Best Dried Fruit For Cholesterol

When I saw there was a paper entitled “Daily Dried Apples Versus Daily Dried Plums: Impact on Cardiovascular Disease Risk Factors in Postmenopausal Women,” the first thing I thought was well, was the study funded by the U.S. Apple Association or the International Prune Association? Turns out neither. Just our taxpayer dollars hard at work. Great! So what did they find?

One hundred and sixty older women were randomly assigned to a dried apple group or a dried plum group and followed for a year. A dozen dried apple rings a day or about 8 prunes. As you can see in my 3-min video Dried Apples, Dates, Figs or Prunes for Cholesterol?, within 3 months the apple group experienced a significant drop in cholesterol that stayed down throughout the rest of the study, but no cholesterol benefit in the prune group. Both dried fruit regimens lowered c-reactive protein levels about the same, though dried plums may cause a quicker decrease in inflammation, whereas dried apples may result in a greater decrease overall.

Prunes may not help our cholesterol, but they may improve the health of our skin—see Beauty Is More Than Skin Deep. That’s of course in addition to their customary regularity role, something I address in Prunes vs. Metamucil vs. Vegan Diet.

Twelve apple rings is equivalent to eating about 2 apples a day. They think that the cholesterol-lowering properties of apples may be due to their unique pectin fiber composition, which may increase fecal excretion of bile. Or there may be cholesterol-lowering phytonutrients unique to the apples. Either way, this supports the extraordinary findings detailed in my previous video Dried Apples Versus Cholesterol.

What about dried figs? The California Fig Board did not want to be left out. They put people on 14 figs a day (that’s a lot of figs!) for 5 weeks and… nothing. Daily consumption of figs did not appear to reduce bad (LDL) cholesterol.

Finally, what about dates? Another recent study tested 4 or 5 dates a day for a month and again nothing. The dates did tend to bring down triglyceride levels, though, which is surprising given their sugar content. Studies of the glycemic index of dates found them to have a surprisingly mild effect on blood sugar levels. In Dried Apples, Dates, Figs or Prunes for Cholesterol? I show graphs comparing the blood sugar effects of straight sugar water versus that same amount of sugar, but in date form. More on the sugar content of dates in Are Dates Good For You?, a recipe in Healthy Pumpkin Pie, and my favorite source for dates here.

Dates beat out other common fruits in terms of containing more vitamins and minerals. They’ve even been touted as the “richest source of dietary minerals,” but because they’re dried they have about 5 times more calories than fresh fruits. Thus, in terms of nutrient density, they’re really quite comparable to other fruits. Apples, however, clearly have others beat when it comes to lowering cholesterol.

More on dried fruit can be found in:

Those with asthma may want to choose dried fruits without the preservative sulfur dioxide.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: storebukkebruse / Flickr

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Eggs vs. Cigarettes in Atherosclerosis


study in the journal Atherosclerosis found that eating just 3 eggs or more a week was associated with a significant increase in artery-clogging plaque buildup in people’s carotid arteries going to their brain, a strong predictor of stroke, heart attack, and death.  If you check out my 3-min video Eggs vs. Cigarettes in Atherosclerosis you’ll see they found an exponential increase in arterial plaque buildup for smokers and egg-eaters. Those that ate the most eggs had as much as two-thirds the risk of those that smoked the most, the equivalent of a pack-a-day habit for 40 years or more.

This did not go over easy with the egg industry.

As revealed in a series of internal memos about this group of researchers retrieved through the Freedom of Information Act, the American Egg Board discussed the “wisdom of making industry responses when the public knows there is a vested interest…” So the Executive Director of the Egg Board’s “Egg Nutrition Center” proposed they contact “some of our ‘friends’ in the science community” to have an “objective, external source author the response.”

“If you do so,” the Egg Board wrote to one of their “friends” at Yale, “we’ll certainly compensate you…” But the prominent Yale physician refused to “participate in an overtly antagonistic letter” given his friendship with one of the co-authors of the eggs and atherosclerosis review.

If you can’t find someone with credentials to counter the science, why not just make one up? Check out Eggs vs. Cigarettes in Atherosclerosis to see this story’s bizarre twist involving an attempt to discredit the egg & smoking study with a hacked email account.

This is the same prestigious research team that wrote the landmark review upon which I based my videos Egg Cholesterol in the Diet and Avoiding Cholesterol Is a No Brainer.

More on eggs in:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day

Image credit: REL Waldman   / Flickr

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