Nutrient Based Eating with Dr. Sarah Ballantyne (Part 1) [Ep. 129]

0:13 Welcome to eat well. Well, the podcast for busy women who want to lose weight without constantly counting, tracking, or stressing over every bite. I'm Lisa Salsbury, a certified health weight loss and life coach, and most importantly, a recovered chronic dieter here. You'll learn to listen to your body and uncover the reasons you're reaching for food. When you're not truly hungry, freeing you to focus on a healthier, more fulfilling approach to eating.

1:53 back to the eat well, think well, live well podcast. I am so delighted to have Dr. Sarah Ballantine here with us today. She is a PhD and the founder of NutriVore. com and the New York Times bestselling author of NutriVore, the radical new science of getting the nutrients you need from the food you eat. She creates tons of educational resources for people to help improve their day to day diet and lifestyle choices. And I'm going to stop reading the bio because I just want to say All you need to know is this book is now required reading for my clients. Like it is so good. It is so good. So, um, Dr. Sarah, welcome.

2:33 Welcome to the show. And if there's anything in your bio you want to add to please, please do and introduce yourself. Oh, I mean, thank you so much for having me. Um, I don't know if there's anything to add. Uh, I'm a huge nerd. That is, that is, uh, will become evident very shortly. Uh, I'm a huge nerd of the, uh, nutritional sciences variety. Um, that's the only thing I would add. Perfect. I know you're an avid hiker as well. I see you on Instagram hiking and doing videos for us in the morning. So, um, where do you live that you can hike you around? I live in North Georgia.

3:13 But I grew up in the Pacific Northwest, actually the West coast of Canada, where, um, if you don't go out when it's raining, you don't leave the house for six months of the year. And so I am just an all weather outdoorsy person. The, the key to being an all weather outdoorsy person is just having the right gear. It's like layers and knowing when you need to stay dry. And, uh, I actually really love it. Like especially really, really cold. Mornings or rainy mornings because in Georgia, I would say the average person is a fair weather outdoorsy person, not an all weather outdoorsy person. So I get the entire miles and miles and miles of trail system all to myself. If, um, if the weather's even slightly off, 80 degrees and sunny, so I, I love it.

3:58 I actually value my rainy day walks even more than my sunny day walks. Perfect. I love it. All right. Well, let's jump into talking about nutrients. So fun, right? I mean, I, I think so. I could talk about nutrients day, every day, um, actually I do talk about nutrients all day, every day, um, uh, but that's where my, Uh, life fulfillment comes from. So, I feel like. My, my, my top level is nutrients are the most fundamental component of nutrition, right? Like, nutrition, nourishment, nutrients, they all have the same purpose. Latin root, right?

4:39 They, they all, it's, it's all, it's nourishing us, right? Nutrients are the raw materials that our bodies need to do everything that our bodies do. They're the things that go into all the chemical reactions of life. There's 49 essential nutrients. Hundreds of others that are technically non essential, but extremely important for supporting overall health. And yet, diet culture teaches us, Oh, we just need to count this one thing. Or, cut out this one group of foods. Um, right? Or, right? There's this one thing that we're gonna obse Calories or carb grams or whatever, right? We're gonna obsess over this one thing. Or we're gonna cut out all of these things.

5:21 It's really to obsess over one thing still. And at no point do we actually learn, unless you seek a career in, as like a nutritionist or a registered dietitian, do we learn the basics of nutritional sciences, right? If you think about how much do we know about math? well, you said in your book, like what if high school students Took the same amount of, of nutrition studies as they did math or a language. Like why isn't nutrition studies, one of the sciences offered along with biology and physics, I, uh, so my oldest is about to graduate. Um, and my youngest is a ninth grader and their, their nutrition that they get is a one week unit in the middle of their health course, which is a half class, right?

6:11 So like health is half and PE is half. They have to take that once over their entire high school degree. And basically all they learn is my plate. So, um, Like, they don't, they don't learn about, they kind of learn this, like, this is junk food, right? They learn a moralization of foods through this. This is junk food. These are the four things you put in your plate and what you pour in your glass, right? Very, like, too basic to actually be useful. And it actually, I think, makes us more susceptible to diet culture, right? I think, um, does here in California. They make in that unit in health, they make them count calories and do a full food journal for a week.

6:54 And I told my girls not to do it. I was like, we're not doing that. We're not, you're not at 16 or 14, whenever they took that, you're not going to count calories. And it was, I mean, what, one of my daughters came home and she was like, you would have died mom. It was like, welcome to having an eating disorder in that class because of the way they were talking about calories. And so, yeah, high school students don't, don't get it and they don't get enough. And so that's why, you know, Books like yours are so valuable to, I mean, to high school students, as well as to, you know, any age we can improve at any age. And that's one of the things I bookmarked in your book, was that if you started on a more nutrient dense diet in your 20s, you added like 13 years of life.

7:37 But if you start in your 60s, You still add eight years. And if you start in your eighties, still, what is it? 3. 4 years, 3. 4 years. Like it's never too late to make a difference. So of course we want our kids to know these things, but in, in our learning them, most of my listeners are in their thirties, forties, and fifties. And so they do have teenagers at home. It's time to start teaching them and focusing on the nutrients and, I bookmarked several statistics, but. One that's really incredible is there's four essential nutrients for which 90 percent or more of people don't get enough of and 10 essential nutrients for which half or more people do not get enough of.

8:22 Like we're literally just not eating enough nutrients and is anyone like, does anyone get it? I'm sure there's, I'm sure there's somebody out there. Um, I, I mean the thing is it's like statistically no, right? So, um, the top most common nutrient shortfall is vitamin D, and approximately 100 percent of people don't get enough dietary vitamin D. Now vitamin D we can kind of put into its own little box because it is the only essential nutrient that we don't have to get from our diet. We can get it. Hypothetically make enough in our skin in response to sunlight if we spend enough time outdoors, um, but, uh, unsunscreened skin.

9:05 so, uh, using sunscreen will diminish the amount of vitamin D production, but it won't block it completely. So let's call it safe sun exposure. So either like uh, non sunblocked skin for a short enough period of time that we're not going to burn, because sunburns, still really are bad or a longer period of time using sunscreen will still make vitamin D in that. Um, so like how much, what latitude you're at, what time of year it is, what the cloud cover is, uh, how much melanin is in your skin, right? How much skin. is exposed are all like factors that go into how much vitamin D we're producing. But the fact that we spend more time indoors than we, on average, than we ever have in human history.

9:49 is the main contributor to the low vitamin D levels that are so rampant. So different studies estimate this differently, but something like 75 percent of Americans are deficient or insufficient in vitamin D. So, Those are all the people who could benefit from consuming more vitamin D and or discovering how amazing nature is, um, ideally, ideally both or taking a supplement, right? So I think part of the challenges here, there's always like is an undercurrent whenever we talk about nutrition is we've got systemic challenges to overcome in addition to an educational barrier, in addition to all of the like misinformation that we're taught through, through diet culture, right?

10:40 In addition to competing in terms of palatability between whole foods and ultra processed. foods, like there's, there's layers of challenge here. And one of those challenges is access, right? One of those challenges is just how our modern lives are structured, um, how affordable, uh, you know, nutrient dense foods are or inaffordable they can be. And so with vitamin D specifically, we've got like that additional barrier, which is a lot of people have work schedules that don't allow them to To spend time outside or they don't live in an area where they have easy access to nature Or they don't live in an area where it's safe to go for a walk in their neighborhood in the afternoon, right?

11:24 So we've got a lot of or they don't have they don't have the mobility to go for a walk, right? Like there's there's lots of challenges. when I have time for a walk, it's after dinner and it's dark. Yeah, I, so, uh, a good three months of the year, my walks start in the dark and I watch the sunrise. Um, so I go, you know, first thing in the morning after breakfast before I start work. Um, that's because I have a very high energy dog and she, she's a great dog when she's tired. So, um, that is my first task of the day after coffee is to tire out my dog. but I've really like structured my life around carving out that that time. but just as a like additional, as we're talking about vitamin D, like I always feel like there's so many layers to the vitamin D conversation and that's obviously one of them.

12:09 But the next most common nutrient shortfall is potassium. 97. 8 percent of Americans don't get enough dietary potassium and that's eating patterns. That is completely so that there's no like handful of foods that have so much potassium that if you just eat those foods every day, you'll get enough potassium. Potassium is a harder nutrient to get in the food supply. So we've got a lot of foods that have 10 ish percent of the daily value of potassium per serving, right? Like a potato has 14%, a banana has 8%, a carrot Yeah, bananas aren't like the powerhouse that, that we all, everyone's like, Oh, bananas for potassium. Like, I mean, they're good, but they're not great.

12:51 you want to eat six bananas a day, sure. that, that gets you halfway to your potassium goals. Um, Yeah. they're not, I mean, they're great. Bananas are a nutritious food. Um, but they're not the key to getting enough potassium. It's kind of like you need to eat bananas and parsnips and canned tuna. And yogurt and carrots and, uh, some canned bamboo in your stir fry, right? Like there's, you kind of have to like layer all of the potassium rich foods in order to get enough potassium. And you'll see like a lot of them are root vegetables. So, uh, potatoes, sweet potatoes, carrots, parsnips, winter squash.

13:32 And then we get, like, a layer out of, like, select other fruits and vegetables, right? It's like avocados, like, apricots are okay. Dried apricots are a particularly good source, but only because how a serving is defined. So a serving for dried apricots. is defined as half a cup, but that's really like two cups almost. So it's more like two servings of apricots. Yeah. I mean, um, I, I would call that a good time. I love, I love apricots and their effects, but, but, uh, that's not a good time for everyone. so, you know, raisins are the same, right? They're a good source of potassium, but in part because of how a serving is defined for dried fruit. For some dried fruit, the fresh equivalent is more than a serving.

14:13 So when you see something like raisins or like raisins or dried apricots on a, you know, good source of list, but you don't see grapes or fresh apricots. It's, that's an artifact of, of serving definitions. So, for, for potassium, it's just a harder food to get. And it's a harder food to get because Uh, the average vegetable consumption for Americans is 1. 6 servings per day and where most science is at makes a case for five servings per day as a target for supporting long term health. So it's just that it's that mismatch between how we eat on average and where the science points to as being the eating patterns that help us reach our short term health goals but also protect our long term health and the difference is Nutrient intake, right?

15:03 The difference is, 98 percent of people not getting enough potassium versus if we could change even just the vegetable servings, that, that statistic would look very, very different. I felt like most of the takeaway from the book was produce, generally. You know, fruits and vegetables, that's really the powerhouse of a lot of these nutrients. So, what happens though when we don't get enough? Like, what's the danger? Because there's a little bit like, oh my gosh, like, I was a little overwhelmed with how many, like, how many things I'm not eating. And. I cook from scratch on the daily, you know, and I'm like, Oh my gosh.

15:43 And then I'm thinking, well, what's going to happen? Like what, what would happen if I don't do this? So we're talking about nutrient insufficiency, right? Dietary shortfall of nutrients. And I think what's so insidious about nutrient insufficiency is there can be absolutely no signs. No symptoms whatsoever. So we're talking about this weird gray in between deficiency. Regular dietary intake of an essential nutrient so low that it causes the disease of malnutrition. like scurvy from not getting enough vitamin C.

16:24 Um, so somewhere between that level and the, the daily value, right? The recommended dietary intake. So how much our bodies actually need. So for vitamin C as an example, it only takes 10 milligrams of vitamin C per day to prevent scurvy, but the recommended dietary intake for adult females is 75 milligrams. And for adult males is 90 milligrams. So insufficiency is that that space in between 10 milligrams and 75 or 90 milligrams. Every nutrient kind of has a similar kind of gray range where it's not enough to meet what our bodies need to function optimally, but it's enough to prevent deficiency, right?

17:05 So it's enough to prevent a disease of malnutrition. So what happens in that weird gray? is it puts like strain on the biological systems that need those nutrients. So we think of nutrients as like the raw materials that go into the chemical reactions of life. If you don't have the right raw materials for a chemical reaction that say the cardiovascular system relies upon, a couple of different things can happen, right? So, um, we can shift to a different biochemical pathway that's maybe not quite as good. We might get a biochemical like by product produced, right? That's maybe toxic or inflammatory, or we might not produce as much of the product as we actually need.

17:47 So all of the ways that our bodies kind of accommodate a lack of resources, it's all strain, it's all wear and tear. It's like driving a car with, with plenty of gas, right? We've got all the calories we need, we put all the energy into the car, but we don't have very much oil or brake fluid. Right? So it's like these other things that the engine needs to run that we're going to be able to go out to the grocery store and be fine, right? We're going to be able to do that those couple of trips. But over time, that's going to cause wear and tear on the engine, right? It's going to eventually cause the engine to seize, right? And it's potentially going to interact with other things. So in health. Or those other things would be genetics and epigenetics, our lifestyle, our health related behaviors, like whether or not we smoke or drink, social determinants of health.

18:35 In the car it might be, uh, how cold it is outside, or whether or not there's salt on the road, right? Or if it's 120 degrees in the desert, right? These other things that put wear and tear on an engine. And eventually those things all interact to cause the engine to, to break down or cause us to get into an accident, right? Like it's something else that was going to Right? Be, uh, the development of chronic illness or the increased susceptibility to infection. So it's not a one to one. So a disease of malnutrition is directly caused by the low intake of that one essential nutrient. Insufficiency, it's a collection of insufficiencies that interact with all of these other inputs to our health that collectively increase our risk for chronic disease.

19:19 But they increase our risk of every chronic disease other than heritable. genetic diseases, right? Um, and even some of those still have interactions with, with nutrient intake in terms of the symptomology. So it is collectively increasing our risk without necessarily outward signs now, right? We can still do that quick trip out to the grocery store and the engine sounds fine. So we might not have any signs or we might have really amorphous symptoms. symptoms, right? Things that are really easy to just like, uh, explain away as, Yeah. well, I'm stressed. I didn't sleep well last night. So I might have headaches, fatigue, brain fog, um, just poor mood, low resiliency to stress.

20:02 Uh, we might have joint pain. Maybe our muscles don't recover very quickly after a workout, right? Like we, we might have just like a lack of, of motivation, right? It's like all of these things can be signs of nutrient insufficiencies and, and still not one to one, still not like fatigue is always B vitamins or iron, right? There's many, many, uh, nutrients that can, when we don't get enough, cause fatigue as a, as a symptom, but rather it's this like collection of, eh, I just don't feel great, right? Um, or I have no obvious signs, but over time, years and decades, those nutrient shortfalls increase the risk of a serious health problem, right?

20:47 Something that's eroding quality of life that maybe makes It so that we can't work, um, that maybe, uh, causes, right, a large amount of medical bills or, or causes us to need a prescription. And it's not that new, like, it's not that improving nutrition is a guarantee because there are other things that are affecting our risk, right? There's, Genetics and social determinants of health and environmental exposures and lifestyle. But it is a really clear point of intervention, right? It is a really obvious place where we can tweak our day to day choices and dramatically change our risks of health problems in the future. It's not, it's not going to be 100%, but maybe it's 50%, maybe it's 80%, right? Depending on what we're talking about, depending on the nutritional changes we're making, it can be a really substantial impact, It feels to me kind of like an insurance policy for that marginal decade, that last decade that we live, which we don't know when that decade begins, but typically speaking it typically it's the worst.

21:45 Our health. In America, especially, um, just because that's where I know this, the studies from the decline in our health span is so dramatic. We, we do this like dramatic fall off of health. Whereas we want to make our health span match our lifespan Peter Atiyah talks about that, like squaring off the curve so that we live as healthy as we can. And I feel like this is the insurance policy for that. And It is so hard, really, to make changes right now, when, I mean, I'm 49, and I'm like, I'm doing things today that I hope pay off when I'm 89.

22:28 It's a, it's a long term goal. Like, you think generally long term goals are like, oh, what's my 5 year plan, or my, like, no, we're talking, like, what is your 50 year plan? I've decided I'm just going to start adding in like one thing every once in a while. I'm just going to start adding in one thing so that I'm not trying to overhaul, uh, because I mean, I still, like, I still consider my diet pretty healthy, but I'm like, okay, I'm not eating beans. And so I planned something with beans. Like, each week, and I'm like, once per week, I was eat I mean, we're eating beans, maybe two or three times, uh, a winter, and like, never in the summer. And so, I can plan beans once per week, and not have have that be a huge issue.

23:10 So, I'm trying just anyway, that's just kind of a side note of just kind of like, trying to slowly Okay. Um, because I think one of the really toxic messages we get from diet culture is like, perfect or bust, right? So we get this idea that like, it only counts if you do it perfectly and you need to uh, go from zero to 100 seconds with diet changes, right? Like You go on a diet, right? You just, you, you rip off the bandaid, you jump in You have a last meal on Sunday night, it's like, last supper, and then Monday morning, we're like, we're all in. And then again on Tuesday morning because I only made it to 3 p. m. on Monday, right? like, um, and so, you know, here's the thing is, or there's two things here.

23:54 So first of all, when we're talking about Transcribed long term health outcomes, right? So we're talking about our risk of chronic disease as we age. We're talking about the things that are going to make, uh, like, I'm hoping as an 89 year old that I'm still hiking four miles with my dog every morning, right? And I can come home and lure myself onto the toilet seat with my dog. without handlebars or help, right? Like, that's, I would love, uh, and then I can call my, hopefully, uh, grandkids or great grandkids at that time and have a really fascinating conversation about, like, some cool thing that I learned, right? Like, this is, this, these are my hopes for, for my older years, right? Is that all of the things that give my life joy and fulfillment now are still the major parts of my life at, at 89.

24:41 So what matters, if I'm thinking about those long term health outcomes, is not how I eat today. I could have a perfect day, how, I don't, I would argue a perfect day doesn't exist, but let's just say it did. I eat perfectly today. That means not at all. Uh, nothing. That is completely irrelevant for what my health is going to be in 50, 40, 50 years. What matters is how I eat on average over the next years and decades. So, if I'm going to Tackle change in. such a way that I'm doing the yo yo. I'm doing the on again, off again diet rollercoaster. I'm great for two or three months, but I'm white knuckling it, right? And then I hit that moment of disinhibition where I'm at a birthday party, I have cake, right?

25:26 This thing, I broke my rule. Um, and then all of my health behaviors unravel. My average eating pattern When I am engaging with, with restrictive dieting, I'm engaging with the, the diet rollercoaster, my average diet quality is pretty low. Even if I spend two months perfect, I'm going to spend two months or more, really, really not perfect. Right? So I actually want to tackle change in a way that is building lifelong healthy habits, right? Thinking about long term eating habits. eating patterns, not about seeking perfection today. I want to do whatever change is going to be the easiest change for me to build consistency with so I can get a win, so I can build off of that win and get that next win, right?

26:10 And get that next success. So it's actually really important to figure out what is the, like, what is the way that I get to that end point? However long it takes, if it takes five years, if it takes 10 years, right? However long I get to that point whereby my overall eating patterns are really high quality, how do I get there in a way that I'm, I'm setting myself up for success? So one thing there is like necessarily not engaging in restriction. The other thing there is like taking it step by step, right? So what is, what is this one change that I can make today? Which brings me to the other piece of this, right? The science says every little better choice counts. Right, so we get about the same improvement in all cause mortality, which is an indirect way of measuring overall health and longevity.

26:56 that scientists use to like figure out whether or not something is good or bad for us overall. We get the same reduction in all cause mortality going from zero servings of vegetables per day To one serving per day as we get from going to from one to four, right? So those, sometimes those first steps, those, well, it's, it's diminishing returns, right? So like, I'm getting more of these nutrients that were really important as I get, you know, going from, from zero to, you know, a quarter of these nutrients is a really big deal for all my biological systems that need these nutrients going from a quarter to a half is like, It's still great, but it's just not quite as great as going from 0 to 25, right? So it's just like, we get slightly diminishing returns.

27:37 This happens in biology all the time, right? We can just get these, like, exponential decay curves and U shaped curves where, like, we have this happy medium range where our bodies are like, Yay, this is the amount of all of this that I want. But we have this in nutrition over and over and over again, that the, that one first change going from zero vegetables to one serving is so beneficial. Like, yes, we still want to get up to five, like, that is still the goal. But if the, like, the starting point, It's, it's great to just work on Mm-hmm that that's a, that's a really important habit to build. And that habit, building that into a habit then gives us a baseline to build the next habit.

28:19 So we, we do get. a huge benefit, right? so there's some studies that look at, one or two servings of legumes per week. compared to one or two per month and still show like that's a huge health benefit, right? So every, every little to get to one or two per week. Yeah. Um, I mean, four per week is better. Sure. But like every, every little, every little step is an important step, right? It's important for both the habit formation piece of it, but we're also going to get like, Dividends. We're going to get our health returns back on on That effort. So it's okay to say what's what is my one thing. What is my one thing that I'm going to work on?

28:59 Um, I think it's really important, you know, like, in my book. And my, you know, content on social media, on my website, I try to lay out where the science is at in terms of, um, the most important eating patterns to help us reach our short term health goals and support our long term health. There's no timeline. Like, as you said, right, if we adopt a healthier diet at age 60, we still add, on average, 8 years to our life. That's a huge benefit. That's such a huge benefit. Yeah. I mean, And that doesn't mean wait until you're 60. Would you want to make that very, very clear that doesn't mean, wait until you're 60.

29:40 Um, but it, it just shows us that it's much more important to set ourselves up to have long term success than it is to try to rush into it and set ourselves up to engage in diet mentality and that yo yo again. Yeah. so. While we're like getting there while we're like, okay, I'm just going to get up to one this week or, you know, I'm going to add in one new fruit or one new vegetable. why do you want to get the, like, okay, what I'm trying to get at is could we use supplements in the meantime? And why is it important to get our nutrients from food as opposed to supplements?

30:21 When would like, I just want you to speak a little bit about supplements because I can, I can feel people just saying like, well, I take a multivitamin. I mean, I guess the, the short answer is we could Take supplements. I'm not anti supplement. I am pro judicious and informed use of supplements. And the thing is with multivitamins as like nutritional insurance, which is how they're marketed to us and have been for nearly a hundred years, um, is the science shows, um, they don't work, right? The science shows, there's no health signal. from a multivitamin. At least not in the big, like the biggies, right? The big things that we would track, like all cause mortality, cardiovascular disease incidence or mortality, or cancer incidence or mortality.

31:07 There's some like niche health outcomes that we can look at, right? Like B complex vitamins can slow age related cognitive decline, right? We already talked about Some people need to supplement with vitamin D. if they can't get, uh, sun exposure, right? And it's really hard to get your vitamin D levels up from food sources alone. I'm a vitamin D supplemental person, uh, and I hike outside, uh, four miles every morning, right? So like some people just need it and it's okay. but, uh, you would expect. That if a multivitamin was really working as nutritional insurance, that you would see the signal in cardiovascular disease, in cancer, in all cause mortality. And we don't. We have many different clinical trials, so much so that there's many different systematic reviews and meta analyses, which are our highest quality scientific evidence, that just show nothing.

31:59 bupkis, no, no measurable benefit from a multivitamin. And in fact, a couple of times where maybe a multivitamin could potentially be harmful, I don't want to scare people away from a multivitamin, but high calcium intake, um, so like over, the recommended dietary allowance, like over like 300 milligrams of calcium from supplements does start to tick up increased risk for kidney stones. And there is a little bit of a signal in some meta analyses in cancer incidents, but that's a more studies required to understand if that's a real effect or not. So overall, as long as you're not overdoing calcium from a multivitamin.

32:43 Multivitamins not, not going to do any harm, but it's if our choices to, Especially because multivitamins, I mean, you can still get the cheap ones, but the ones that were sold online are getting more and more expensive, right? So if you're looking at that 300 a month multivitamin supplement sold by your favorite wellness influencer or 300 more to spend a month on whole foods. The science says when we get those nutrients from foods, we do get the expected health benefit. When we get those nutrients from a multivitamin, we don't. What's fascinating is there's not a really good answer for why. Like, well, why doesn't a multivitamin work if I know if I get those nutrients from the ones that are marketed as like, these are food based.

33:27 Like I've seen those, you know, like, um, food based supplements, or I don't know what they call them, but you know what sure, and they, make you think that they're not like synthetic. they might be better. They haven't been studied. I mean, that's the other thing is there's a lot of, like, really fancy, Supplements like really small supplement companies making claims that they can't back up with scientific studies, right? So like, Uh, is one of those greens powders that's supposed to have 100 percent of everything that you need for the day, is that going to be as good as your five servings of vegetables? I can't tell you. I don't think so. Probably not. But I don't have a scientific study to point to to say yay or nay and neither do the companies making those claims.

34:12 So, um, so there's a look, there's some good. Explanations that are it's probably a combination of the things so we know, especially when our multivitamins or tablets that those are very poorly dissolved in our digestive tract, they dissolve too far down the chain that a lot of the opportunity for nutrient absorption has been missed. Right? So like the receptors for bringing those nutrients into the body were higher up. And now that the nutrients are actually liberated from the tablet, there's no receptors down there and it just goes out the other If they even dissolve at all. Like if you want to hear like a kind of a gross anecdote. Let's do it. We're gonna talk about poop now. This is good. We're friends.

34:52 We're officially friends. Yeah. Oh, a wastewater engineer and when he was young and like early on in his career, now he like owns his own, you know, engineering firm and is the big boss. And what, when he was, when he was a wee baby engineer, he had to do site visits. And so he's like, you know, what's in the tanks. This is what floats in the tanks, condoms, And vitamins. That's what I see the most of. That's what, and it's not because people are flushing their vitamins. We're just pooping them out, like, undigested. Yeah, so, don't, if you're, if you are gonna see if a vitamin can help you feel better, for sure, no tablets, because those will just, Get, honestly, just pass right through.

35:42 Yeah, definitely capsule form. Uh, if you do want to take a multivitamin, um, so some of the other possible explanations besides the, um, it just, it just took the, the, the long way through. um, as opposed to the shorter way of just dumping them down the toilet. other possible explanations is it might just, just might not be enough, right? The way that most multivitamins are formulated, it might not be making up enough difference to, to see that, that signal. Um, probably why vitamin D works, because you can get a pretty high dose of vitamin D. Because I have seen my blood levels of vitamin D come up with supplementation. Yes, well also the standard protocol, now not every doctor is going to do this, but the standard protocol is to retest your vitamin D levels, right?

36:27 So some doctors, my doctor, when we were first getting my vitamin D in range, retested every three months and now, uh, I test about every six months. other doctors will just test once a year when you get your annual blood work yet, but there will be a follow up at which point they'll say, well are you taking your vitamin D? Because your levels are still low. Right? And then you'll, you'll go, yeah, no, I'm taking how much you said. And they'll say, okay, we'll double it. Right? So like there will be some kind of follow up where your dose is adjusted and depending on your doctor, it might be, you know, Like, more frequent follow up and, uh, more intentional dosing and with some doctors it might be a little bit more of an afterthought. But we do kind of have this like standard protocol of testing vitamin D levels and figuring out an individualized dose per person.

37:13 Thanks That can range anywhere from 400 IU per day. 2000 is more typical for people with deficiency up to 10, 000 IU per day, right? Like that is the kind of range of, of what people need to get their vitamin D levels. in check, whereas we don't, we don't even have tests for every other nutrient, right? We don't have, you can't take your serum potassium and think that that's measuring the potassium levels in your body. All that's measuring is how well your kidneys are functioning, right? So, uh, because your kidneys control how much potassium's in your blood. Um, you can have low potassium in your blood from low intake of potassium, but low intake of potassium in your blood is more likely.

37:56 a measurement of kidney shenanigans than it is of potassium intake. So we don't even have tests for every nutrient. A lot of the tests that we do have are only done under very specific circumstances, right? Like you're anemic and taking this iron supplement hasn't worked, therefore now we'll test for the other types of anemia, right? Like then we're going to measure your folate, your, you know, vitamin B12 levels, right? And then see if it's a different type of anemia than iron deficiency anemia. so one of the, the challenges here is we don't, other than for vitamin D, we don't have, protocols for figuring out how much somebody needs of specific nutrients.

38:39 It's just all, there's like a standard amount that's put into a capsular tablet and that's what's given. The other thing is there's lots of nutrients that aren't formulated into multivitamins. Right, so like 95 percent of people don't get enough dietary fiber uh, which is a technically non essential nutrient, so it's not, it's not in my statistic of four essential nutrients for which 90 percent or more of Americans don't get enough of from their diet, but there's no fiber in vitamins, typically, right? Um, even a greens supplement, you might get a gram, and I'm like, I cannot choke it down. Like, it's so, fiber supplements are, I've tried several, and I'm like, nope, no, I cannot. The, the other, I mean, to, to the other thing about fiber supplements is it's a little bit like a, a, a fiber monocrop for our gut bacteria.

39:29 So, um, we have certain gut bacteria that do not care. Um, they, they'll eat whatever we eat. They're fine. You know, there's one called, uh, bacteroides. Oh, It's like, Theta, Zeta, Omicron, or something like that. That's not it, but it's just like a bunch of Greek letters that are just like, put together in a word. Um, and that bacteria, it doesn't care. it will live no matter what we feed it. And then we've got all these other like, really, you know. picky eaters of gut bacteria that are really important species, like a lot of, um, the bifidobacterium, uh, that are, like, some of the most important probiotics that we want to grow in our gut.

40:11 They're like, I only eat this one type of fiber. So, like, they're like, they're super picky. Um, and then we've got, right, like, so a normal, like, healthy human gut microbiome would have Like 500 to 1500 different species of bacteria. About 30 or 40 of them are like the multitaskers and the rest are picky eaters. Um, and some of, like, some of them, they don't even want to eat what we eat. They want to eat other bacteria's poop. It's called bacteria cross feeding. And so they don't eat, they don't like, we have to feed the picky eater, the thing so that the other picky eater can eat the picky eater's, metabolic byproducts. So, so, so that, that community requires us to eat a diversity of fiber types, um, which means not just like your cellulose and your hemicellulose and your lignin and your titan and right, like your beta glucans, it means all like there's hundreds of different types of cellulose, right?

41:07 So like, right. It means the small differences that we get when we get our fiber from whole food. So if you take a fiber supplement, right, there's only a few, right, that there, it's probably psyllium husk or it's, uh, inulin fiber, or it's like resistant starch, right? Like it's really only those, those things. It's one type of fiber for like, maybe there's another 50 bacteria that'll like that type of fiber, but what about the few hundred others? that wanted the sweet potato or the broccoli or the apple, right? Like there's the, the way that we get those small differences in fiber type that feed the individual species of bacteria is by getting our fiber from whole foods. So that doesn't mean there's always a time and a place for supplements, right?

41:50 If you're talking about, you know, kids with, sensory processing disorder or autism spectrum and, um, have really, really strong sensory aversions. Uh, they're going to need fiber in order to regulate, gastric motility in order to not have chronic constipation. Like that's a different, that's a different situation, right? This is where we talk about the informed injudicious use of, of supplements. But for the average person, it is vastly superior to get our fiber from whole foods than it is to get it from a supplement. Well, that's good because I'm about to throw that fiber supplement away because I've tried. So I just have permission now. I'm just going to toss that. But that reminds me too, in your book, you talk about getting, um, a certain number of species per week.

42:32 And I was actually, I remember I was on a walk when I was listening to it and I, I paused it and I started counting on my fingers. I'm like, okay, what have I had this far? And I was trying to count and like, I got to do this with paper and pencil, but that that's kind of different than you also have like 12 nutritionally distinct food families. And I wasn't sure like how those, how those relate. And like, so tell us about like getting the species, because that's going to point towards also the, the different fiber. but then there's also, you have distinct food families, nutritionally distinct. So there's actually three overlapping concepts here. So one is like, eat the rainbow. One is your, like, I call them Nutrivore foundational foods, but they're like specific food families that have something unique to offer us nutritionally.

43:18 And then one is high dietary diversity. And it's, I think, really helpful to have all of them on your radar, but they don't necessarily all need to be a focus, uh, right? Like we can, we can break, we can break this up into our baby steps again. So, high dietary diversity literally just refers to eating a lot of different whole foods, right? So it's just a diet that has a wide representation of different types of foods. in it. My favorite study that measured this, was from 2022. They followed nearly half a million people living in nine European countries for an average of 10 years. And they measured dietary diversity using something called dietary species richness. So it was the number of different species of plant or animal represented in the diet.

44:04 over the course of a year. So the other studies measure dietary diversity other ways. They look at per day, or per week, or per month, or they'll do like a, a weird way of like counting food groups instead of counting individual foods. Like there's lots of. different ways of getting at this question. But what this study showed was that the people who consumed 81 or more different species of foods over the course of a full year had a 38 percent reduced risk of all cause mortality compared to the people who consumed 48 or fewer. 38%, so that's uh, roughly almost four years of additional health span and lifespan on average. Like, we can roughly translate a 10 percent reduction in all cause mortality to an extra year of life.

44:47 but that's a bigger impact than any food. So, like, any, any, like, meeting a You know, like, that, that highest level of intake of a health promoting food, your highest are going to be, like, vegetables and nuts and seeds. So those are in your, like, 25 to 30 percent reduction in all cause mortality range. So 38 percent is higher magnitude. And there's a couple of reasons for that. So one is diversity of food equals diversity of nutrients. Right? Diversity of fiber types. Just eating a bunch of different foods reduces the chances of having a really important nutrient shortfall in an essential nutrient. The other thing, though, is it protects us from overdoing something that is harmful in large quantities.

45:30 Right? So ideally, we wouldn't get more than 10 percent of our calories from added sugar. We wouldn't get more than 10 percent of our calories from saturated fat. We don't want to get more than like five ish grams or four and a half ish grams of sodium per day. There's additives and preservatives that in moderation are absolutely fine, they're health neutral, but we don't want to exceed the acceptable dietary intake levels of those. So, uh, when we have a diversity of foods, we're also protected from overdoing something that might be harmful in, to our health in large quantities. So, dietary diversity is so important. Yes. ask a question here real quick. On the species, that's everything from like a carrot, an orange, and chicken, right?

46:11 So it, it counts, it's not just produce we're talking about, but whereas like milk, like yogurt, and cheese, and cottage cheese, would that be one species? Technically in this study. So not only that, like broccoli and kale are the same species. So like even that would have been, yeah. So like half of the cruciferous vegetables we consume are all the same species, Brassica, Olassies. CA? that's really too bad for my counting. Yes. Okay. So technically this study looked at species, but when we're implementing, we're not just implementing the, the insight from this one study, we're implementing the insight from the field.

46:52 So when we look at the field as a whole, we see that every little thing counts, right? So you can absolutely count your broccoli and kale. You can count your orange carrots, your purple carrots, and your yellow carrots, and your bag of rainbow carrots. You can count your different varieties of, of apples. You can count your chicken thigh and your chicken breast. So from a, I'm just trying to figure out how to have a diverse diet. Every, every little, little bit, every, every tiny bit counts. And okay, so then the other thing is this study showed that total dietary diversity mattered. It that was not like a signal from just vegetables, right? It wasn't that. Dietary diversity of vegetables mattered and that because they were looking at total dietary diversity.

47:33 They saw that signal. They were basically saying no, it's across the board. It matters across all food groups. There are other studies that just look at diversity of like plant foods. There was a study out of the human gut project. Published in 2016 or 18, few years ago, um, that showed that the people who consumed 30 or more different plant foods per week had substantially healthier gut microbiomes than people who consumed 10 or fewer, but they didn't look at all of the steps in between. So, like, where is the actual cusp? Is it 22? Is it 28? Is it actually 30? I can't, I can't tell you based on, on that study. So, if we look at the field as a whole, I think we can make a really strong case for 30 to 35 different foods per week, but that is subject to change.

48:19 We need more science to really say, like, what is the threshold here? But that also means, if you count up, that is exactly the activity that I recommend people do when they're, like, working on dietary diversity. Just count up everything that you ate last week. See where you're starting at. Is it 15? Awesome. Let's add two things next week. Let's, um, let's try a different type of apple, right? Or, um, a different, you know, there's so many different citrus fruits this time of year. Let's just try, let's just swap out something like that, right? Do something that's why I like the the one like by the year because right now my Satsuma mandarins on my tree are ripe and I have been weighing them actually because I was like, I wonder what my crop is this year because it's been kind of a a small tree and growing.

49:03 And, um, turns out I realized I'm like the only one that eats them because citrus gives my husband heartburn and my daughter says they're too soft. They were fine the first day I picked them. Now they're too soft. So I have eaten roughly 20 pounds of mandarins in the last month. Those are the best citrus. they are like unequivocally. it's the only time they grow here. It's, they're a different variety that we grow here in Northern California than what you can get in the, like, they're not like those cuties. Those are yummy, but like, this is a different one. No, but a Satsuma Mandarin. Chef's kiss. So, it's like this month, like, I get satsuma mandarins this month and a half, like, sometimes six weeks, very short lived, and then not for the rest of the year.

49:43 And so, like, the rest of the year, I eat, you know, apples and grapes, and then in the summer, I'm like, all the melons. and all the peaches and the nectarines and so I like that like for the year because I'm very much a seasonal eater because it's how I grew up and I do have the opportunity to grow some of my own food and I do have access here to local farms and produce and things. And so, um, which I know everyone doesn't have that option, but just eating seasonally, I, I like thinking of like that for the year because that helps me realize, like, I do have a lot more variety than I think if I just, like, think about more than just this week. Well, and I think that that's the other way to interpret this body of scientific literature is the benefits of eating seasonally, right?

50:31 And the benefits of, of that shift and eating, you know, when we're eating seasonally, we tend to be eating more locally grown produce, which there's not a ton of nutrition data for me to point to. So. It's probably more nutrient dense, but probably not by a huge meaningful amount. But when you're talking about every little bit counting, like, why not? Um, so, that's one concept, right? It's dietary diversity. The other related concept is eat the rainbow. Um, so there are five color families that we divide. Um, we can divide, actually, we can put all plant foods in here. It's mainly going to be fruits and vegetables, because, like, There's not a whole lot of color among like legumes or nuts and seeds and whole grains.

51:12 but those can count, uh, if, if we want to, but it's red, orange and yellow, green, blue and purple and white and brown. And the reason why we divide it into those color families is that the, that's how we can like categorize the phytonutrients that are giving the food. fruits and vegetables and other plant foods. They're distinctive colors. So we have certain patterns that tend to make something red or tend to make something orange to yellow or tend to make something blue to purple. And so those groups of phytonutrients, act differently in our body, Right. So we have different health benefits from different Collections of phytonutrients. So when we are eating the rainbow, we're getting all five color families.

51:53 We have more like health benefit from doing that. That is independently beneficial above and beyond eating enough fruits and vegetables. So that's kind of a way of getting at dietary diversity, but you could have a diverse diet and not be getting all five colors of the rainbow. But you could be also getting all five colors of the rainbow and getting that from five different foods and not having a diverse diet. Right. So we kind of want to have both of those ideas in mind. And then that's where Nutra4 foundational foods kind of also plug in. So these are the 12 food families that each have something unique to offer us nutritionally or are like that's the collection of nutrients they have that we can technically get from other foods, but the way that these foods have them together and in high amounts, it expedites the process of meeting our nutritional needs from the foods we eat, which is the whole point of NutriVore.

52:43 So those food families, right, they're not, They're not non negotiable. We can absolutely negotiate them if there's a food family that you hate or are allergic to or doesn't align with a dietary template that you really love, uh, that's Okay. But what they do in that case is identify the need for either like really conscientiously looking for where else am I going to get those nutrients and maybe supplementation strategy, right? So one of the nutrients of our foundational foods is seafood, fish and shellfish. The main nutrient Uh, that seafood is giving us that kind of elevates it to foundational food status. There, it's, seafood is like double to quintuple the nutrient density of most typical meats that you would get in the grocery store.

53:27 And double to triple the nutrient density of, of most plant proteins. So like seafood is just crazy nutrient dense. About equal to organ meat in terms of its nutrient density. But the main thing that's like, aha, that's, it gets a, it gets to be a foundational food is the long chain omega 3 fats, DHA and EPA, which are crazy important for neurological health, cardiovascular health, and immune health, right, and if something's Good. for those, they're good for everything, right, because we can't have the health of our digestive system if we don't have immune health, or neurological health or cardiovascular health, right? And so, um, if you are, say, allergic to fish and shellfish, they are two of the top eight allergens after all, what that being a foundational food means for you is you need to go, okay, what is the thing that I'm not getting because I'm not eating this food?

54:17 Can I get this from anywhere else? So you can get some from, like, sea vegetables, so, you know, maybe eating the seaweed salad more frequently. There's a few, like, purslane, uh, is a vegetable that is, uh, you need to grow it yourself, but it does have, uh, some omega 3s in it, right? So, like, finding those other, uh, Food sources here and there that have some, or you go, okay, I need a supplement strategy. In this case. It would be algal oil Would be your your vegan long chain omega 3 fat non allergen that you could consume, right? so the foundational foods have something each unique to offer us, right? So in vegetables, we've got five vegetable families that all have something special.

55:01 So cruciferous vegetables, the cabbage family, have a class of phytonutrients called glucosinolates. That we can't get from any other food, that are particularly important for reducing risk of cardiovascular disease and cancer. They're some of our most cancer preventive compounds we can get from our diet. Alliums, the onion family, have a class of phytonutrients called thiosulfonates. Uh, thiosulfonates are also, uh, protective against cancer and cardiovascular disease in ways that are complementary to glucosinolate. So ideally we would get both. We can't get thiosulfonates from any other food family. We've got, um, mushrooms, which have so many different things. that are unique. Um, but the coolest thing they have is an amino acid called ergothionine, which is, not used to make protein in our body, but it has lots of other things that it does.

55:44 And it's a very strong antioxidant and produces risk of All of the diseases associated with aging, uh, so much so it has been nicknamed by scientists the longevity vitamin. Uh, extremely hard to get ergothioneine from, from other foods. Um, then we get root vegetables and leafy vegetables. They each basically, it's because of the types of fiber they have. Leafy vegetables also are our best food sources of vitamin K. So those are just five out of the 12 foundational food families, but I use them as an example because of, of the conversation of dietary diversity and eat the rainbow, because you could be eating the rainbow and missing out on cruciferous vegetables, you could have a diverse diet and be missing out on alliums, right? So the idea is like, it's three different ways of thinking about it.

56:26 food choice in terms of like having more coverage of nutrients, right? Like that is the goal of all three of those eating patterns. And ideally they'd sort of all, all three of them would be on our radar, right? All three of them would be something we're kind of thinking about. I want to make sure I'm getting my 12 foundational food coverage. I want to make sure I'm getting my eat the rainbow coverage. I want to make sure I'm getting my dietary diversity coverage. Emphasizing again, we don't need to go from 0 to 100 in 0. 6 seconds. And because it is a lot to think about, I have created tools for keeping track. Um, and for like, uh, nutrient targets. So, um, I have something called the Nutri4 Weekly Serving Matrix. It is in my book. Uh, so if you get my book, it is, it is in there, and it's got all of these different things in it, like as a, as a checklist, so really, really easy to keep track, but then you've also got all of the whys behind each part, and I also have a digital product on my website, um, called, also called the Nutrivore Weekly Serving Matrix, if you would prefer that, and if you want to just, like, dip your toes, um, I have a, one of the free guides that you get when you sign up for my weekly newsletter, is called Nutriore Foundational Foods.

57:30 So it is just like lists of those 12 food families, how much of them we want to aim to eat per day or per week, and example foods. and you can find that at Nutrivore.com/join. So I've, I've tried to, I know it's a lot to keep track of. I know it can be overwhelming. So I've tried to create different resources to make that part easy because again, the goal is lifelong healthy habits, not uh, I'm setting myself up to, to yo yo. We want to get off. No more yo yo. Yo yo Okay. This has been so amazing. So informative. I'm just like sitting here staring like, yes, keep talking. That's so good. I'm going to put all of your links, all of those links for the things you just talked about in the show notes, obviously the link to your book as well.

58:13 Again, I highly recommend it. And she's a delay. Also, she reads the book herself. So if you, like the audio, I, I love audio books. So I listened to those a lot. Dr. Sarah and I have realized we just have so much to talk about. Bonus, we are going to do another episode next week, so tune in for that and we will see you next week.