Well, if you're looking at the dietary pattern as a whole, I mean, we see reductions in the risks of type two diabetes, cardiovascular disease, certain forms of cancer, particularly gut related cancers.

Weight loss is a big one as well. But if you're looking specifically at the, like protein data, we do have data looking at the reduction in cardiovascular risk, total mortality, which is you can kind of think of it like premature death.

Basically, it's the risk of dying during the period that the study was conducted. So if it's done over ten years, it'd be during that period we see reductions in colorectal cancer risk.

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Welcome to another episode of Real Integrative Medicine. I'm doctor Jordan Robertson. I am so excited to have this conversation today because I hope that you can see the modeling of mind changing that is about to happen over the course of the next, like 30 to 40 minutes here.

As you know, as a longtime listener, or even if you're new, I'm quite a proponent of healthy metabolism building muscle mass. We talk about muscle and protein and nutritional requirements often.

And through a huge portion of my career, I have had the I'm going to use the word belief now, but at the time we maybe thought it was a fact that animal based protein was superior to plant based protein.

And I spent a lot of the last year and a half or so trying to change my own mind about this particular topic by paying attention to some of the bigger speakers in this space and people that are willing to hold up the evidence.

And not just beliefs about a plant based protein and how influential it can be, not just for our health, but also for the environment. So I am so fortunate to be joined by Doctor Matthew Niagara today, who is a natural think.

Doctor Matthew, thank you so much for joining me on the show today. Thanks for having me on and being open to chatting about this. I would love for you to give us a little bit of background, because I feel like I see you everywhere right now, which I think is amazing.

Your your message in the clarity at which you speak, the ability for you to dispel myth in the online space is completely admirable. And so I'd love for you to walk us through how you got to this spot in your career.

You know, what your background is and what your real kind of mission is in your work? Yeah, I mean, I think my interest in nutrition or what ultimately led to me going into this field started really in my mid-teens.

I had a personal trainer when I was about 15. I played soccer my whole life, but at the time I was also playing football. I was also playing hockey. I was doing martial arts like a little bit everything, and so I was training with him and I had struggled.

Despite all of those activities. I always struggled with my weight and I had like pretty bad asthma when I was younger and he really pushed more of a plant based approach to nutrition.

And, you know, for the longest time I didn't really take him seriously. I was a 15 year old boy. I mean, he would take that seriously. But, you know, one one day he wanted me to record what I ate, do a food diary for a couple, a couple weeks.

And that was the point where I was like, oh, man, he's going to see my diet. It's so bad. It's, you know, it's completely kind of the opposite of what he preaches.

And so I was like, for a couple weeks here, I'm going to eat, quote unquote clean just to sort of impress him. And so for those couple of weeks, I cut out dairy, I lowered my meat intake, I ate a lot more fruits and veggies doing smoothies, things like that.

I stopped having the sodas regularly. I stopped having, you know, your other classic kind of ultra processed foods, potato chips and whatnot. And I started feeling better. I was losing weight.

My skin was clearing up, I was breathing easier. And that's what first sort of sparked the interest in nutrition, thinking that, oh, maybe there is actually something here.

Maybe what we eat is important. And then, you know, fast forward a couple of years. When I was in university, I started to slip the other way. I started to, you know, eat a lot of the cafeteria food.

I was drinking with my friends on the weekends and that sort of thing, and I just wasn't feeling as good. And I realized that, you know, I felt a lot better when I was eating more plant based and ultimately decided one day in February, actually, almost 14 years to the day now, now that I think of it, I thought, you know, 100% I'm going all in 100% plant based and have been ever since.

And I just continued to learn. I took nutrition in my undergrad as an elective. I obviously through the natural path medical training, there was nutrition.

And then I've self studied a lot just by surrounding myself with individuals, actual researchers who conduct a lot of a lot of the research. We talk about.

I've been fortunate enough to connect with many of them, and I just surround myself with people who I continuously learn from. And it leads me to, you know, try to dispel a lot of the misinformation that's out there and things that maybe at one point I believed in myself, and I know family members have believed in and ultimately can cause real harm.

I think that's like the big issue with a lot of the misinformation out there around nutrition. I'll quote another doctor, I, looked up to when I was younger who would always say, it's not like flat earthers, you know, no one's going to go sailing off the edge, you know, and harm themselves that way.

Whereas with nutrition, like there are real consequences to promoting a lot of the sort of harmful messaging out there. So I'm just trying to do my best to clear that up.

I love that, and I do think, you know, there's so much emotion in the way that people talk about nutrition. People identify with particular nutritional patterns.

It's very belief based. A lot of the decisions that people make, and I will say that I think that that has maybe in in my past, even deterred me from having conversations about any dietary pattern.

Right, because it seemed like it was more about like, you know, are you a good person and you eat this way or you can you you have the willpower to eat this way.

It became a little bit more about like belief and morality. And I would maybe even say that I've thrown plant based nutrition into that camp where I wasn't willing to look at carnivore or, you know, plant based nutrition, and for the same reasons.

But I think, you know, one of the things that I want us to accomplish in this discussion today is like a to figure out where does the research actually sit right now?

Because something I've struggled with, with looking at plant based research, is that quite often, patients enrolled in trials on plant based nutrition have like low dietary intake on enrollment.

And so the people we're looking at maybe are under fueling or are not eating enough protein. And then we're studying them and saying, see, their their their diet is terrible.

I would love for you to comment a little bit on where you think some of the misinformation on plant based nutrition even stems from, like where why have we been slow to look at this as a as a viable nutritional pattern?

I think one of the biggest things is just the personal biases. So like everybody eats. So everybody tends to have an opinion on it, at least with, you know, what they enjoy at the very least if not getting into the actual like health effects.

Now, if you really enjoy certain ways of eating and you've done it your whole life and something new is presented to you, or like a new idea, there can be hesitation in adopting that.

And that extends beyond nutrition as well. But obviously nutrition is just a it's it's a common one because we do eat every day. So I think that's a part of it.

There are also industry or industry related, we'll say misinformation campaigns. There's actually a pretty big one bashing beyond Meat in particular, that, was just written about, I'm trying to remember, which was it, New York Times?

It might have been there. There's a really good sort of exposé on that. And and there are actual campaigns that are going out there and trying to downplay or potential benefits of plant foods, or even bashing them and saying they're harmful.

And so you have the sort of financial incentives there. And then on an individual basis, we just want to believe certain things or want to enjoy certain things.

So if you tell somebody that bacon's good for them and you know they'll be jumping for joy, tell someone broccoli is good for them and it's a little bit of a harder sell.

So I think that's a part of it. But I think it can also go a lot deeper and get a lot more complicated, because there are several different avenues by which our views can be influenced or our beliefs can be influenced.

Yeah, it's crazy to me. And I always thought that, like whoever was in charge of the like, soy smear campaign around breast cancer risk, I'm like, really?

Like, we think that this legume is like the sole cause of breast cancer. Like whoever was in charge of that PR campaign did obviously like a very good job.

But I was reading about that Beyond Meat. Oh, I'm going to stick with this smear campaign term because I think it's funny, recently. And I was surprised right, by like, because you kind of assume that, you know, that meat.

I don't know if big meat is paying attention really that much to what's happening with another food product. And yet it appears it would appear so, right that there it was, making enough of an impact on people's nutritional choices that it warranted some kind of like, you know, politicized response from from industry.

Yeah. And and what was really, I think a really good comment made by the CEO, Ethan Brown of BP. I mean, he like, at first didn't think that this campaign or we'll call it a smear campaign was going to do much like it wasn't clear that it was going to have the impact it did.

But then like, it worked, it actually did work. And, you know, they were able to sort of spin this message of, well, it's processed, it's unnatural. And it's like so easy to accept that I find from like, like let's say you're someone without any real nutrition training or very deep knowledge in the subject matter.

It's very easy to hold on to that idea of, oh, it's process. It's made of a bunch of stuff. Therefore it's not not good for us. But the reality is, depending on what those components are, it can be good for us.

And depending on what you're comparing it to, it can be good to us or good for us. And when we compare it directly to, to the meats that they are meant to replace or designed to replace, we actually do see that they improve cardiometabolic risk factors, and so they are likely better for us.

Does that mean that they're as good for us as a can of beans? Maybe not, but but that's not really the way that they're used. Typically. Yeah. It's interesting. I saw this recently.

Someone was that had posted something on LinkedIn that was bashing a particular protein bar and saying, oh, it's got, you know, these sugar alcohols in it, and it's got this in it and this in it and this in it.

Like completely missing the point that the purpose of the bar was to replace maybe someone's fast food choice. Right? Like we're not we're never saying that your protein bar is intended to replace like a salad and a protein source at dinner.

It's intended to replace fast food, but that idea of replacement effect is so hard for people to imagine in nutrition, and how influential it is that when something's taking up space in your diet, it's actually squeezing out something else.

And so not only are we talking about the benefit of the thing, we're talking about the benefit of the absence of the other thing that you were going to eat if you didn't eat this thing and that that actually the delta on those two things is partly what creates sort of the we'll call it, you know, the healthier choice and air quotes, not just the food itself.

And so I find that so fascinating because I'm seeing it often that we're, you know, labeling things as being processed or bad or packaged, but the intent of it in the diet is perhaps to replace something that you know, is not neutral, right?

It's something that actually has been shown to cause some harm in nutrition. And so the replacement of it, even if it's something that comes out of a box, is actually kind of like like it's science, the science doing good for our nutrition.

Yeah. And like the good. Yeah. In food like nutrition is a zero sum game. So you're you are always unless you're literally adding calories or removing calories eating less, you're always replacing something.

And when we look at just ultra processed foods as a whole, let's just take that category. They're so different. You can have sugary beverages, you can have donuts, you can have whole wheat bread, which is on the healthier side.

You can have these plant based meats. You can have sausages like those are all clearly different. And you should not expect them all to impact your health in the exact same way.

And health is a spectrum when it comes to food. So you'll have certain foods over here. We'll say the fruits, veggies, whole grains, etc. you'll have some stuff maybe a little closer to the middle.

We'll say refined grains usually are placed kind of in the middle of that. And then you'll have things like the processed meats and sugary beverages on the far side of not being good for you.

So yeah, so food when it comes to health, is on a spectrum, and you always have to look at what it's being compared to. So can we talk about just the completeness of plant based proteins and maybe where, you know, I'll call it it's maybe a bit like bro research to say that plant based proteins aren't aren't complete.

But I certainly have been I have uttered that phrase and used that word. You know, years ago, working with patients. Can we just talk about that a little bit and where some of those concerns around, like protein completeness comes from and whether or not that's something that we actually need to worry about.

Yeah. So there's there's sort of different ways that complete or incomplete protein are defined. The one that, we'll say the, the true like scientific definition is that it's a protein that's completely missing one of the nine essential amino acids.

So there's 20 of them. Nine of them are essential meaning we have to consume them. Our bodies don't produce them. And so all plants actually do contain all nine essential amino acids.

So there is no plant food that's completely missing one. The only food that I'm aware of that is actually missing one is collagen or its derivative, gelatin, which is an animal food.

Funny enough, it's missing tryptophan, which is one of the essential amino acids. Now, what is important though, and I think how the term incomplete is typically used at least online, is they're they're describing a protein that sure, it has all the essential amino acids, but one of the amino acids might be present in like lower amounts.

So if you were to just eat that food and barely meet your protein needs, you might end up low. And one, maybe two of those amino acids. The thing is, we don't eat just one food.

Even if you're eating a like strictly plant based diet, you're probably eating whole grains, beans, fruits, veggies, not seeds, etc. you're not just relying on a single food.

So if you only ate grains and you barely met your protein needs, you might be low in lysine. But beans and lentils and and whatnot have much more lysine.

And so they would compensate. And you don't have to eat them at every single meal together either. It's just throughout the day. As long as you're getting certain foods at breakfast, others at lunch and others at dinner, they'll they'll mix and match throughout the day.

It's it's not a big deal. So this idea that we have to be concerned about the completeness of plant proteins, really it's not it's a non-issue, I would say if as long as you're eating a somewhat varied diet.

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I hope you sign up and you'll enjoy it. And then and let's talk just about protein quantity then. So I think that that's a really great way to put it.

And you're right that like we get stuck on the micro rather than like backing up and saying, well, does this actually matter in the grand scheme of things?

When we look at it in someone's like total nutritional intake and total diet, but how how easy or hard is it for people to meet like their actual protein requirements, especially as we've seen, you know, needs in certain populations start to creep up in terms of grams per kilo per day.

How do we do that from a, from a plant based perspective, without leaving somebody with a bit of a gap in their total number of grams? Yeah. So that's a good question.

The biggest concern, I guess, with swapping to say, a plant based diet from an animal based diet, I don't know, I would say biggest concern, but one of the concerns is that you're replacing high protein animal foods like meat or certain dairy products with low protein options, like if you were to replace beef with rice, you're significantly lowering your protein intake, but you're laughing at it because it's kind of ridiculous.

But but like that sort of a swap. Or if you replace beef with like salads, yeah, that's not going to do it. But if you replace let's take a typical 80%, 80% lean beef and swap it with tofu.

If you eat the same amount of calories, you get actually about the same amount of protein. Now you have to eat a little bit more of the tofu because it's less calories per per bite.

Essentially, it's lower in density, but per calorie they have the same amount of protein. Now, if you take something like Saturn, which is a wheat based protein, it's actually higher in protein than that beef.

It's about as high as extra lean beef, like a 95% lean beef. You take TVP textured vegetable protein, which is typically made from soy, but a lot of the fat's been removed, and it's more of a concentrated protein.

Same thing. It's about the same protein content as extra lean beef. You replace dairy milk with soy milk, you get roughly the same or even more protein.

You replace eggs with tofu, you get more protein. So it's just about swapping out those animal foods for other high protein plant foods, rather than, again, going to like rice or veggies.

Obviously, you want to eat those foods as well, or at least on the veggies, but you just want to make sure that those swaps of the animal foods are for those more suitable alternatives like the tofu, lentils, Satan, etc..

Okay, I love that answer. And that's helpful because even as someone who, you know, for me to like, quickly hit my protein requirements, I mean, I would have to it's protein powder also because I just can't do it through a food only, which would be an easy swap to a plant based protein powder, even though they don't taste quite as good.

But you're right. Like, it's and it's interesting because it's actually then comes down to like I'll say maybe like your cultural tendencies in food if you've not grown up with some of these options, like we do tend to eat similarly to the way that we were raised, how do you help people overcome some of those challenges of making changes to their nutrition pattern when we're so set in our ways, and this isn't something that we do with ease, because the way I listen to those answers, I'm like, I don't cook with any of those things.

Like it was quite an overhaul for me to do it. But I'm curious what your advice is for people and how you practically navigate that change in their nutrition.

Yeah, I do that almost day in, day out and in clinical practice. And I do want to mention that, yes, protein powder is a fantastic option as well, obviously as a convenient way to get more protein in.

But when it comes to swapping out certain foods or tweaking someone's diet, oftentimes I review, say, a patient's diet and I'll see, well, what are the things that we can easily swap and we might not overhaul everything right away.

We might start with a few things. Right. But we'll we'll take steps. So if somebody let's say for dinner, they love pastas, they're having pastas regularly. And maybe they do it with meat sauce.

And that's where some of the protein is coming in. Well, instead of the ground beef in there, you could replace it with either a plant based ground beef, which would be very similar, or lentils in the sauce.

Or one of my favorites is actually just swap out the noodles. You can do a tomato sauce, but swap out the noodles for like a lentil pasta, so you're making essentially the same food depending on your preferences as far as like texture, taste, etc.

maybe you want to do the ground beef with like regular wheat noodles. Or maybe you like the lentil noodles and you'll go that route. But that's a pretty simple swap.

If somebody is typically doing sandwiches with sliced turkey or ham or whatever sandwich meats, you can replace that with sliced tofu, like a smoked tofu or something is usually really good.

It's already pre flavored and and all you have to do is slice it up. That might be an easy option. I often for breakfast I'll throw a little bit of protein powder in my oatmeal to bump up the the protein content too.

Or you know, depending on what they're doing, we might find ways to tweak little things. So, I, I try to work with in what they're already doing. So it's not a huge learning curve, right?

If you can just swap out a couple little things and start there, that can be beneficial. When it comes to heart health, we see that even small swaps of animal protein for plant protein, especially if the animal protein is from red meat, can lead to significant benefits for cardiovascular mortality.

Total mortality like in the NIH AARP study, swapping out just 3% of calories from animal protein. So, for reference, in a typical 2000 calorie diet, that's like the a meat, a slice of meat about the size of a deck of cards.

So just swapping out that little per day with plant protein sources led to significant improvements in risk. And so it doesn't have to be all or nothing either.

These these little steps can be beneficial. I was literally just about to ask you that question. I feel like we were in the same train of thought. I was like, what is that threshold of change that we see?

Like a clinically relevant change in someone's risk profile? But it sounds like it's not very much. Yeah. It's not. And again, that depends on what you replace it with.

So if we look at like meat and your like red meat will say you're replacing it with refined grains and there might be a little benefit or not much at all.

But that's not the type of swap we're talking about. If you swap it out specifically for like plant protein sources. We have studies looking at beans in particular.

We have studies looking at the swap for even like nuts in particular. Not that they're necessarily the highest in protein. We see substantial benefits with a pretty small swap.

So yeah, it doesn't have to be huge, just roughly a serving a day and can do the trick. I feel like that's such important information, right. Especially because food is part of people's identity and culture and the way that they celebrate with each other.

And yet they maybe have this, like this goal of being healthy. The you know, that, I guess I'll call it the hurdle of, of identifying as plant based or going 100% plant based, maybe, is reason enough for them to never look at that as a possible solution.

Right. It's like, you know, do you go all in or bust? Right. But this idea that, like, even a very small change actually produces a significant outcome that's hard.

And nutrition. Right. Like we don't it's it's difficult for us to see clinically meaningful change because it's projected like decades from now. Right.

Broccoli today. You don't feel any better today, unfortunately. But otherwise we wouldn't have to do so much coaching around nutrition. But these are changes that happen over time.

And when patients are staring down a lifetime of change, then sometimes that can be enough for them to never start, right? Like, well, I'm never going to only eat tofu.

So I guess I never better try. That's like such an accessible change or amount of change for someone to make to actually see significant benefit. What other benefits like can you just share with the audience what what benefits do we expect when people make that change to more plant based diet or plant inclusive diet?

Well, if you're looking at the dietary pattern as a whole, I mean, we see reductions in the risk of type two diabetes, cardiovascular disease, certain forms of cancer are particularly gut related cancers.

Weight loss is a big one as well. But if you're looking specifically at the like protein data, we do have data looking at the reduction in cardiovascular risk, total mortality, which is you can kind of think of it like premature death.

Basically, it's the risk of dying during the period that the study was conducted. So if it's done over ten years would be during that period. We see reductions in colorectal cancer risk, I believe specifically with replacement of legumes or nuts.

I'd have to double check the particular study on that, but I'm pretty sure it was those two. And so there are a lot of benefits, but these are largely looking at the long term benefits, like you said, like these aren't things that you're going to notice overnight.

Now there are some things that you might notice quickly, particularly certain markers on blood tests. We actually have a number of studies where red meat is replaced with plant protein sources.

Actually, even white meat is replaced with plant protein sources. And we see improvements in like LDL cholesterol levels. We might see a little bit of weight loss over the course of like 8 to 12 weeks, depending on the study.

So that's rather quick. But these aren't the things that are going to be like super tangible in the way that you just feel other than yeah, a little bit of weight loss maybe.

But but in that period of time it's usually not substantial. That is something that builds over a longer period of time. Can we can we just talk about the carnivore diet for a minute?

Sure. Almost half there. Yeah. There's like, was that coughing or was that swearing. Yeah. Yeah I almost I, I just don't even know how to have like how to tackle this conversation at this point.

And I, I feel like I personally have just taken to like not even wanting to talk about it because it's so bizarre to me that we are willing to have this much cognitive dissonance around nutrition literature in favor of this.

I'm not even going to call it nutrition pattern. It's just it's just bizarre. But I'm curious, like what what your thoughts are and how you handle this conversation with.

And maybe it's not just this diet, but all of the brand, like all of the new sort of like fad based restrictive diets that are villainized, plant based food.

I'm curious how you navigate that or what your words of wisdom is for our audience, because I think I'm sure they're tired of me talking about it. I mean, it's it's just completely contrary to what we have, you know, good evidence for.

It's usually appealing to tradition or appealing to nature, where they're looking at like, well, for millions of years we ate a lot of meat. And and even that like that depends on your location, like where you look in the world, diets were really different, but also who cares?

They live to be like 20 or 30. Like it's not a it's not exactly something to shoot for. And I think that is actually one of the really important points is that when it comes to, you know, evolution, as I like to talk about it, you know, this diet is what led us to to survive.

That might even be true as far as meat consumption. Like it might have been a good source of calories, you know, a dense source of calories for people who are living in scarcity.

But in order to reproduce, pass your genes on and to, you know, survive as a species, you just have to make it to the age that you can reproduce, which is in like your teens.

It really doesn't. You don't have to make it very long. And it tells us nothing about the long term, like cardiovascular risk profile of an 80 year old or 90 year old.

And so it's really just storytelling at that point. The other thing they do really well, the people in the space, is they really hold up anecdotes, so they'll find an individual story of someone who lost a bunch of weight, felt better, maybe their skin improved or something, and they'll try to push that as reason to adopt the diet.

But like, you can find anecdotes for anything. You can find numerous centenarians, people who lived to be 100 plus who smoked every day. You can find Mark Cobb, a researcher from Kansas who did the Twinkie diet, to prove to his students that you can lose weight on any diet.

And guess what? He lost weight and he felt better. And his markers actually improved, largely because of the weight loss. But we wouldn't push a Twinkie diet as being healthy. So it's it's there.

They're kind of throwing out the whole scientific method and the evidence hierarchy and, and just creating this narrative around individual stories or historical, I guess stories, if you want to call them that, even though they aren't true most of the time.

So I would say, like, look, if someone's saying that like, vegetables are bad for you or whatever, it's just a huge red flag. And I know it's really hard for a lot of people to navigate sort of the scientific literature, and I don't expect people to be able to do that.

But yeah, if you have somebody who's completely going against the consensus view, the nutrition guidelines, and let's be clear, like they're a little things in the guidelines, I might change myself if I had the ability to, but to flip them completely on their head, there's just no good basis for doing that.

Yeah, I love that. Well, it's really well put and I love that you brought up the like, you know, it doesn't take us very long in our age to start to be able to reproduce and pass on our genes.

I think that's first of all, hilarious, but also like quite a good reminder that, you know, people's aspirations are usually like longevity and we'll maybe even use the term health span at this point.

And yet we have no research that that dietary pattern improves either of those two things in probably like evidence to the contrary, right, that you probably die sooner if you follow that dietary pattern.

I think when it's appealing to people as people that maybe have, you know, are contrarian or have that like sort of conspiracy theory approach to their health and wellness, they don't want the government to tell them what to do, you know?

Which is why I'm always thinking, like, I'm pretty sure the government doesn't want you to die of cardiovascular disease. It's like they they're trying to keep you alive.

Yeah, yeah. But here's here's the thing with that is they don't even accept that lightly. They they often say, oh, I won't do it because, you know, the government wants us to eat more plants or whatever.

They are not consistent at all. The government also says we shouldn't smoke. The government also tells us we should exercise however many hours a week.

You know, there's a lot of things that they actually agree with. So why are they picking and choosing? Like, really, they should be smoking a pack a day and sitting on their butts all day.

If it's, you know, if they want to go against government recommendation. Yeah, exactly. So so they aren't even consistent with that. And that's actually how I try to tackle a lot of the carnivore stuff or kind of animal based stuff online is I find the inconsistencies in their arguments because they're usually very clear as far as where, where they're being inconsistent or, or cherry picking.

And I just point that out. And I think that's something that a lot of people can grasp is a sort of hypocrisy. So a great example would be, I made a video about like, Anthony Chafee and Ken Barry, who are two, carnivores, where they're both saying like, Anthony.

Jaffe says, if your studies like just to the, the, to the video or to the interviewer and says, like, I don't care about your studies, basically when people bring up research.

And then Cadbury said something similar about how he just doesn't care about research, and then I clips or I switch to clips of them citing research because they think it supports their view.

So it's really just picking and choosing like, oh, hey, this, this one sounds good for me. I'm going to cite this study, but otherwise screw studies. They're all trash.

And so when you present that to an audience, I think it's a lot more clear to see, oh, there's actually a double standard here. And they aren't consistent.

You don't even have to go into the details of the individual studies to see like, oh, they're they're kind of full of it. And so I think that's an effective approach is to sort of showcase where they're inconsistent because like I said, I just don't think everybody has the necessary, domain knowledge to understand, like study methodology and why this study is better than that study and so on.

Which is how we ultimately formulate our views in the, the health space and how guidelines are created and so on. But it's just not as it's not as quick and easy to kind of go through.

And where, in your opinion, has the PR campaign around plant based nutrition gone wrong? Like, do you see any room for improvement there for how we talk about plant based nutrition?

That actually would help make it more accessible to the, I'll say, the average person or someone maybe who their help where their health isn't their hobby, but they do want to improve their overall health.

See, I actually don't think it's as bad as as it's kind of made out to be. If you look at trends in like veganism or, not even strict veganism, but like plant based foods, like, sure, there might be ebbs and flows, but it never completely takes like it's one of those things.

Like it exploded after the Game Changers in 2019 for sure. That was the biggest spike. And then it sort of plateaued and it might go down a little bit, up a little bit.

If you look at like Google Trends, for example, or if you look at surveys on percentage of the population is vegan, it's generally the same or higher over time.

So I don't think it's terrible. But when it comes to the online space and sort of the the algorithms on social media, they've definitely pushed the opposite message.

And I think that's where it's problematic and how I, try to get my message out there and some other people I know is rather than just trying to promote, say, plant based eating, we do so in the context of showcasing clips of of, say, viral videos promoting opposite message and then responding to them.

And I find that that helps take off a little bit more. I think we need to be a little more aggressive in sort of responding or challenging the other side.

I think that's probably how we get our message out there more. But I also don't think that the, you know, PR campaign, if you want to call it that, is so bad that that the movement has died.

I don't think it's anything like that. It just it hasn't grown a ton in the past couple of years, like it did again in, you know, 2019, 2020. Yeah. And I hope that like this, you know conversations like this and conversations that are like maybe if you want to be like plant based curious right.

Versus imagining that you need to go all in. And I think even when I think about my own personal bias around we'll use veganism as a term, is that it was like, well, if I, unless I was going to like also throw out my converse, then I wasn't allowed to participate.

Right. Like there has been, you know, eras of plant based nutrition that where it's extended and meant more than just around your protein source. And I think that those some of those kinds of narratives maybe make it less accessible for the average person to understand the health benefits of the food.

It almost became more than just about the food. And then I think with like the growing knowledge around protein and people wanting to increase their protein, but they're going to do it like in their same dietary pattern, right?

Rather than learning about a new dietary pattern, I think that there's a cool opportunity here for us to start to talk about plant based nutrition. Now that we know more about protein quality and protein quantity and how to help, I'll call it the average person eat more plant based protein and meat.

All those numbers with the replacement of some of their animal based protein. I think there's a really neat opportunity here, but even my own personal bias was that the protein quality's not as good, and I have to eat more grams per gram, you know, than I would if I just eat chicken.

I don't know how to cook it. Or, you know, maybe the the options that I have are really limited, and I've had to undo a lot of that and say, well, look like if cardiovascular disease and cancer are our number one and two killers and slight modifications to people's protein intake, actually dramatically reduce those risks.

Like, I have to change my nutrition, not just open up the conversation for more people to think about changing theirs. Yeah, and I would say that there is also a separation, as you're kind of mentioning, between like veganism and plant based eating like veganism does extend beyond diet.

It's a it's an ethical stance. So yeah, it extends to, you know, clothing and, you know, circuses and like all that stuff as far as, you know, using animals.

But as far as like the nutrition side and what we can do to improve health while also doing something that's better than the alternative for, for, say, the environment and so on.

Yeah. Swapping to more plant based options, plant based protein sources over animal protein sources is a great step, but it doesn't have to be necessarily tied to veganism.

Like I'm vegan myself. It'd be great if everybody was. I have no problem saying that, but I can also set that aside when talking about the nutrition specifically.

Like, do I think that if someone were to eat a 90% plant based diet, that they'd really be harming themselves relative to 100% plant based diet? Not really.

Unless that 10% happened to just be made of butter and red meat. Maybe you know, but but like, but there are ways to do it that I think could be really healthy.

So I think they're, they're separate issues altogether. And I don't think that, that it has the dietary choices have to necessarily be tied. Or let me rephrase, choosing plant protein sources, at least to some degree over animal protein sources, has to be tied to veganism.

It doesn't have to be. Those are two separate things. Yeah. And I think that that's such a great and important distinction, because then we can just think about the numbers and the math and the like.

You know, that replacement of fact and the percent risk reduction that you can have in your in your health with making a dietary change versus thinking of it as an identity change.

So I think that's much harder for people to do. Last question, because we do often talk and and we've talked mostly about protein. But, you know, there there is the possibility for other nutrient deficiencies with a plant based diet, whether it's B12 or omega threes.

How do you how do you navigate that part of nutrition. And the other piece I always, you know, get concerned about is just calories in people that, you know, I'll say irresponsibly go plant based without thinking about that replacement effect and that they can't replace their steak with, you know, with broccoli and have the same calorie intake.

What do you recommend from a practical perspective of how people avoid some of those other, you gonna call them pitfalls? But I don't mean that in a bad way.

Like just potential gaps in the plant based diet. How do you recommend that people navigate that? Yeah. So I think it's really important to understand that all dietary patterns have certain pros and cons.

So like there was a really good systematic review actually two of them now by author new fangirl I think I'm totally butchering the name, but anyways, two of them that came out in the last few years, one on adults and one looking at kids and adolescents, and you see that certain nutrients like magnesium, fiber, folate, they tend to be lower in omnivores and they may be lacking.

But if you look at the plant based vegan specifically population, they tend to consume a lot more of those. But then B12 becomes a concern a vitamin D, maybe a concern, a zinc, maybe a concern. There's certain nutrients.

So it just it doesn't mean that there is all of a sudden a lot more to focus on. It's just different what you need to focus on. Like, I think we can all agree that if you're eating and omnivorous diet, you should probably be trying to focus on some fiber rich foods as well.

And they're not just sort of the standard American fare. So there are a few that are really important to consider. B12, obviously. Now, yes, you can rely on fortified foods to get enough B12.

I tend to suggest that everybody who's eating even a predominantly plant based diet, just take a supplement. It's like the cheapest supplement in the world, B12.

You can get a big bottle that lasts for like a year for like 15 bucks. It, you know, it's not worth, messing around over, vitamin D, depending on where you live.

And that applies to all dietary patterns, not just vegans. So whether you're a meat eater or not, if you're living in a place like I do in Vancouver, yeah, it's something that a lot of people could consider just because we don't get a ton of really warm sunshine year round.

Calcium is potentially a concern if you're getting rid of dairy and not consuming fortified foods. So if you're swapping out your milk for plant based fortified milks, fine.

Probably not an issue. But if you're not consuming those, you don't like them or whatever, well, then I would generally suggest maybe considering a low to moderate dose supplement there to cover needs.

And obviously that can be discussed with your health care provider, who could review your diet more in detail and see kind of what your, what your overall intake is and like.

Those are some of the ones that stick out the most. Iron doesn't actually tend to be as big of a concern as it's made out to be, simply because even meat eaters get most of their iron from plant sources, like plant sources tend to be higher in iron than meat.

Just the bio availability is different. And so, it might be that the overall amount compensates for the lower bioavailability because we don't see significant differences in iron deficiency rates between populations.

We just know that for women of reproductive age, it's a problem regardless of diet. And so, you know, that's something that might need to be supplemented in certain cases.

And that would be determined on a case by case basis with blood testing and whatnot. So I mean, those are some of the the nutrients that I guess come to mind just just off top of my head there.

But when it comes to calories, I think you're right. That can be a concern. If someone swapping out the animal foods for salads, you need to focus, especially if you're active or if you're a growing child.

Obviously that would be up to the parents, but in those contexts, it is really important to make sure you're having calorie dense foods. So using oils potentially for cooking things like nuts and seeds or nut butters are really good sources.

Tofu is excellent. Make sure you're having like whole grains with meals. Those can be good sources of calories. So you want to center meals around these more protein dense and calorie dense foods.

And then yes, have your veggies and everything with it. But don't make that the main dish per se. And so, you know, one thing that I've suggested for, for especially parents who are feeding their kids is if you look at like the Canadian Food Guide, where it has like a quarter grains, quarter protein foods, they call it, and then half the plate is veggies.

I say swap that a little bit, make it more like the veggies are sort of a quarter, and then the rest is filled out by the higher calorie foods. And so there's different ways to to focus on the calorie intake.

But I do think it's a really important point. I love that I really appreciate this conversation. Matthew, you you have I love listening to people who've thought a lot about their topic and have thought a lot about the the research and then how to frame it for the average person to understand these very like complicated concepts with in real life examples or great analogies, great examples and metaphors, because it makes the information so much more accessible to the average person.

But also for our clinician listeners, it helps give them some language to use with their patients that will help them be able to share this message. Right?

Rather than feeling like they're like sheepishly trying to get people to change some of their protein sources and then having to, like, frustratingly go up, you know, toe to toe against some of the work, say, the carnivore stuff.

It gives them some, like verbiage, right from someone who's like deep in it and has spent, you know, a significant amount of time understanding the literature.

I think you've done such a great job of explaining it for our audience about what the benefits are. You know, some of those maybe myths or past myths that were changing our mind on and I'm changing my mind on, and also the potential benefits of making some of these changes.

Share with our audience before I let you go. Like, how can people follow and find you? Do you have any lasting or final words for our audience? And how?

Yeah, how can they learn more about you and what you do? Yeah. Thanks for having me. Of course, and for chatting on this topic. It's definitely a topic I'm passionate about.

And as far as following me, I mean, I have a website doctor, Matthew niagara.com where I upload some like blogs or I'll link all podcasts I'm in like this one.

Also, I'm on all the social media platforms at Doctor Matthew Niagara. So Dr. Dot Matthew Niagara. I'm most active on Instagram as far as like commenting and replying and stuff like that, but but I post up to all of them and, and I actually have a few papers recently that were published.

One was last summer in the Canadian Journal of Cardiology on plant based meat alternatives. And then two recent ones, one was on the lack or near lack of of retinol, vitamin K2, creatine and carnitine in plant based diets.

And then another one on the applicability of the Messi dietary pattern to like modern carnivore diets, because a lot of them tend to cite the Messi tribes as evidence for a carnivore diet.

So those are published in nutrients and in curious, the journals, respectively. So those are linked on my socials as well. And yeah, I think that's really it.

As far as like words of advice, honestly, I say the same thing all the time, but I just think nutrition actually can be pretty simple. So I usually recommend like, you know, you don't need to get bogged down in like, is it okay to blend my bananas with my blueberries?

Or is broccoli or broccolini healthier like it was? Don't don't worry about those things. Really. At the end of the day, if you're eating a variety of fiber rich foods and you're focusing on mostly plant protein sources, like you're doing pretty well.

That that's really the the foundation. And then, yeah, you can get into the nitty gritty on low, finer details. But the return on investment there is going to be pretty small relative to the overall picture.

Amazing. And we'll post links to all of those social platforms so that people can get in touch with you. I think you're an awesome follow on social media.

You're definitely drowning out the noise and other less evidence based platforms and people. And so I'm really grateful for the work that you've done in our profession.

So thanks for being here. Thank you. Thank you for tuning in to Doctor Talks. We hope today's episode has enlightened and inspired you on your path to optimal health.

Each day is a new opportunity to make choices that empower your well-being. For more insights and strategies, subscribe to our podcast and visit our website w WW dot doctor Talksport.com.

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Debunking Protein Myths: The Truth About Plant-Based Diets

Jordan Robertson, ND

Matthew Nagra, ND

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