 Welcome to Healthy Planet, the show for people who care about their health and the health of our planet on the ThinkTech Live Streaming Network series. I'm your host, Dr. Grace O'Neill. Joining me today is Dr. Michael Clapper, physician, speaker and educator. Today we're gonna talk about vegan nutrition and the nutrition education for medical students. So let's get into it. Tell us about your program, Dr. Clapper, moving medicine forward. Well, moving medicine forward was developed in response to a screaming, crying need that you and I, in most positions these days, at least many of them are painfully aware of, and that's this gaping black hole in our medical education called nutrition about the effect, learning about the effect of our patient's diet on these diseases they're bringing to us, the obesity and high blood pressure and diabetes and clot arteries. It seems we're looking everywhere on genetic causes, environmental causes, and we're just looking at what their patients are running through their bloodstream every four hours, which is really the reason they come sit in front of us overweight hypertensive diabetic and inflamed. And so I wish someone had told me in medical school that one, the major diseases that we're gonna replay putting most of our time and energy into the diabetes and high blood pressure session are reversible diseases. Now, no one ever told me that, that these are lifetime diseases they'll be on blood pressure medications forever, once on insulin, always on insulin. This is what I was told. No one told me these diseases will go away with a healthy diet. In second, nobody told me that a diet based on whole plant foods is the natural diet of us plant eating hominids. And when we change from the Western diet filled with meat and dairy and oils and sugars and processed foods and go to that lovely whole food plant based diet, the soups and salads and seen vegetables and Asian curries and stir fries, et cetera. That fuel mixture runs so well through our body that we see these remarkable changes within weeks of adopting a diet on whole plant foods. The obesity begins to melt away and the arteries begin to relax and the high blood pressure starts to come down and the sore joints stop hurting so much. The psoriasis skin starts to clear, the migraine headaches get better, the as medical won't stop wheezing so much. And they turn into normal healthy people right before our eyes. It's the most exciting transition one could wish for your patients and all of the medicine. And yet no one's telling the medical students this. I wish someone had told me this when I was a first year med student. So in response, I started giving a lecture across North America, including Hawaii, called what I wish I learned in medical school about nutrition, where we go through the science about why a plant-based diet will reverse these diseases that are largely caused by the standard Western diet. I mean, we give them scientific understanding and we give them enough confidence to start talking about this with their professors. And my lectures are directed towards the young medical students, the first, second, third, fourth year med students before pharmacosclerosis sets into their brains and they think that drugs and surgery are the only treatment. You know, I tell them before you order another $500 set of blood tests and another $1,000 scan, you ask your patient what they ate yesterday. And if it's full of buffalo wings and burgers and fast foods, that's why they're sitting in front of you, doctor. Send them to the plant-based dietitian, let her do the plant-based counseling. You see the patient back in a month and see if they're not leaner and healthier. Those ailments invariably will be. So we want to get this message across. They say, once you look behind the curtain, they can't pretend you don't know what's behind the curtain. You know, you can't unring the bell. So I'm trying to plant this message in the head as many medical students as possible, but also the dental students and nursing students and pharmacy students. They all are dealing with people with nutrition-based diseases. And so through our nutrition, through our Moving Medicine Forward Initiative, I was traveling around and people are interested can go to my website, drclapper.com and click on Moving Medicine Forward as you're seeing in the graphic and you'll learn what exactly we're doing. And if people would like to make tax-deductible donations, they would certainly be welcome because we have hired a dietitian, Heather Borders, who will do the follow-up in my lectures. In other words, I don't want my lecture for the students to be a one-time drive-by event because if you don't keep the interest up as the weeks go by, the interest fades away. So Heather will follow up after a week or two after my first lecture and ask the students who invited me and what do you need to keep nutrition on the front burner here? Do you need a Q&A with Dr. Clapper every few weeks? Do you want to do plant-based journal club where you talk about plant-based cases from the medical industry? You want to talk about clinical cases, what works and what didn't for the plant-based medicine. Do you want to, let's show films. Let's bring in guest speakers. You want to have Dean Orner should address this one. Whatever you need, let's keep the fire going here. So it becomes a thing, plant-based medicine reversing disease. 10 years ago, no one knew what the microbiome was but now the science brought it to our attention, the media took hold of it and now everybody knows what the microbiome is. Well, we want to do the same thing with the concept disease reversal through plant-based nutrition. So the students start asking their professors about it. The professors talk about, oh yeah, high blood pressure. Yeah, I heard you can reverse that with plant-based nutrition. High blood pressure diabetes. Yeah, I heard you can reverse that with plant-based nutrition. We want those words coming out of the mouths of the professors and the students till it becomes a thing. Yes, of course, the public understands it and the doctors understand it. So this is the thrust of moving medicine forward is to usher in a new generation of nutritionally aware young doctors but it also has dentists, pharmacists, nurses, et cetera as to increase nutritional awareness among the healing professions. And if so, then I can retire in Hawaii knowing that medicine's on the right course and people are getting the best care possible. So I think some people that they may want to go plant-based but they might be concerned about nutrient deficiencies. They're kind of want to segue into our other topic about nutrient deficiencies. Are there any kind of nutrient deficiencies that people who have been on a plant-based diet would be more likely to get than people who are eating meats and vice versa? Important question, of course. And the granddaddy of all questions we get when we talk about a diet-based and pretty much exclusively on whole plant foods is where you're gonna get your protein as if meat is the only source of protein. But, you know, ask any gorilla, ask any elephant, any buffalo, any giraffe. These are all vegetarian animals. They grow thousands of pounds of powerful muscle on plant-based foods because the amino acids, the proteins, vitamins, minerals are in the plants. That's where all the nutrients come from. So the main nutrients, the calories from the carbohydrates of the starches and grains, that's not a problem on a plant-based diet. The protein isn't a problem. If you eat 2,000 calories of whole plant foods you are guaranteed of getting 50, 60 grams of high-grade protein. And especially if you include the, especially protein-rich foods, the legumes, lentils, beans, peaches, pees, have a scoop of those every day and some soup or stew, you're guaranteed to meet your protein needs. And it's just a matter of vitamins and minerals. They're all in the plant foods as well. But there is one nutrient, vitamin B12. It's found in nature, in stream water and in soils. And when we were living earth-connected lives and pulling roots and tubers out of the ground and eating them, we would get B12 that way. When we were drinking out of streams we would get B12 that way when we were connected to the earth like the other animals are. B12 deficiency wasn't an issue but welcome to the 21st century. Nobody's eating on washed vegetables and no one's drinking out of streams. And due to modern sanitation, the bargain we've made for clean water is that the natural B12 sources have disappeared from the plant-eaters diet. And so for that reason, if you're gonna be 100% plant-based, two, three times a week have something with vitamin B12 in it. You can take a B12 supplement, they leave tiny little tablets and sprays you can put under your tongue. But nowadays they're fortifying the soy milks and the veggie burgers with B12. It's easy to get up B12. Just have something with B12 in it three times a week. The only other one is iodine for our thyroid gland to make thyroid hormone. If you're not eating fish, you need to get some iodine somewhere. It's in the soils and healthy soils have iodine that gets taken out by the plants, especially root vegetables and green vegetables. But commercial grown vegetables are we don't treat the soils very kindly and the iodine can be leached out. And I think some of the fatigue that people report on a plant-based diet is really subclinical hypothyroidism from iodine deficiency. And so I tell them at least three times a week put a pinch of iodized salt on your veggies or have a helping of sea vegetables like wakame or arame or sprinkle some dulls powder on your salad there or if you're taking a vegan multivitre and make sure it's got 150 micrograms of iodine in it. So it's not terribly hard to cover your iodine needs but they shouldn't be neglected. Those are the two main ones, B12 and iodine that you need to focus on. Now vitamin D, of course, it's not a vitamin, it's really a hormone that our skin makes. And when we used to live earth-connected lives and all spent all day out in the sun, there was plenty of vitamin D being made in our skin. But now we become so phobic of the sun these days that nobody goes out without sure sleeves and sunscreen. And so very little sunlight's falling on human skin there. And so there's a lot of vitamin D deficiency. So I tell folks get your vitamin D level check and take as much supplemental vitamin D as you need to keep your value between 40 and 70 nanograms per milliliter. And that usually comes down to like 2000 international units a day in a multivitre. And that's about it. If you otherwise eat lots of greeny yellow vegetables, lots of whole grains and lots of legumes, you'll turn into a healthy human being. And that's the most important thing. You'll have a healthy human being with normal blood pressure, normal blood sugar without sore joints with clear skin. You, in short, you stay out of the clutches of people like you and me. And I think, oh, leave your life, eat healthy and go live a wonderful life here. Don't be a professional medical patient, do you have it? Not a traditional power. How about omega-3s? Yes, that's an issue. And now, omega-3s are these long-chain fatty acids. And we eat omega-3s in nuts and seeds, so walnuts, brown flax seeds, chia seeds. Have an omega-3 fat called linolyne gas, and it's 18 carbon atoms long. We need to lengthen those in our tissues to 20 carbon atoms, which is EPA, and 22 carbon atoms, which is DHA. There are people who say that we can't do that efficiently. I'm not so sure about that, because those are based on blood tests of levels in red cells. But the chain elongation happens inside our brain cells and inside cells throughout the body. And we're not really measuring that. And I haven't seen great evidence that taking these DHA supplements really does reduce the risk of anything, dementia, cancer, et cetera. But some people get disturbed by the low numbers in their blood tests. And if they want to take some algae-derived DHA a few times a week, there's probably no harm in it. But I do have concerns about taking it every day. Are we not backing up the metabolism of DHA in our cells here? There's evidence that we might be doing that. And when you give a guy with normal testicle function, you give him testosterone. You can raise his testosterone level. But it has resulted testicle shrink, and he loses ability to produce his own testosterone. Well, I have concern that we might be doing a similar thing in our own cells with by taking a DHA, that might not we be creating a dependency on it. Like they give someone thyroid hormone when they don't really need it. Their own thyroid gland shuts down its production. Only we'd be doing that. That's what's keeping me from recommending DHA supplements for everybody. I don't really know what we're doing in those cells with those supplements. So eat your greens. There's DHA there. Eat your ground flax seeds and walnuts. And if you want to take the DHA supplement, 250 milligrams a couple times a week, I wouldn't be taking that every day. How about other micronutrients like selenium? Do you think anything else should be tested if a person is plant-based? Well, very perceptive question. Selenium is a mineral in the soils. It gets taken up by certain nuts and seeds, radishes, I believe, have it. But classically, Brazil nuts are very rich in selenium. And your thyroid gland needs selenium so we can get on with its chemistry of putting that iodine into the hormone molecules, et cetera. And so yes, we have a jar of Brazil nuts in our fridge. And all of that pop three or four of them every week and chew them up just for my selenium level. If you can get your nutrients out of food, that's better than getting it out of pills because it comes with all the other cofactors and vitamins and lignans and all sorts of things that activate these nutrients. Rather than when you take a specific isolated nutrient, then it doesn't have the natural power, if you will, of the nutrients that are furnished by food. But it's better than nothing. It's better than running into a solid selenium deficiency, iron deficiency, iodine deficiency. But when you're taking these micronutrients, remember, more is not better because there is selenium toxicity. There's iodine toxicity. Just stay within the recommended amounts there. They said Brazil nuts a week was plenty. So we do have some questions from the audience. There's one question, what would be a good ferritin level? I guess some people, some vegans, I'll say some vegans do become anemic, but a lot of people they were anemic to begin with even before they became vegan. And I think as far as I understand, Dr. Clapper, as many meat eaters as vegan people are anemic, so being anemic is not special to being vegan as people might perceive, right? Absolutely. Most cases of anemia, including iron deficiency anemia, happen in people who eat red meat. That's not the, it's not a red meat deficiency. Now, many people with low ferritin levels are consuming dairy products, milk and meat and product cheese made from them. Why is that a concern? Two reasons. There are things in other molecules in dairy products that can block the uptake of iron. So even though there might be iron in the salad that you ate with the cheese, it you may not be able to absorb it due to the blocking molecules in the dairy. And also the many people, especially children. Oh, and because the dairy products these days are made from cows that are all pregnant if the dairy didn't used to be that way, but now the cows are pregnant and they're still pulling milk off these large pregnant bovine, so the milk's full of estrogen. And as a result, women who eat lots of dairy are consuming lots of astrone, estradiol, astral, and their uteruses can get big and they develop these tumors called fibroids and they bleed extra heavy every month. And that's where their anemia is coming from. It's the dairy, it doesn't have any periods, causing the blood loss, causing anemia, and they blame the poor, oh, we gotta eat more red meat. No, you don't, you need to eat less dairy. Look at how you lost. Stop the dairy all together there. So those are ways that the dairy can contribute to the low ferritin levels. And finally, low ferritin levels aren't necessarily a terrible thing. As long as you've got plenty of hemoglobin in your blood, there is a thing called iron overload and then our red meat eating he-men find out the hard way that the iron that's in meat, you can't keep it out of the body. The body, if the body has plenty of iron on board, the intestinal lining can keep plant iron from coming in if there's too much on board already. But heme iron in red meat, boy, that just barges in and settles in the tissues and you wind up with this situation of iron overload that opens the door to everything from strokes to stomach cancers. So more iron is not better. And so when I see a low-ish ferritin, I'm not terribly upset about that, as long as there heme is well over 12 grams, et cetera. So don't worry about it, but if you're really buying, if your ferritin is four and you're having heavy periods, do get that checked out. And first of all, stop the dairy for sure, but low ferritin of itself is not necessarily a bad thing. And then there was a question about choline. Choline seems to be fairly low in vegan foods. How can we get enough choline? Do we need enough choline, I suppose? I was under the impression that choline wasn't necessarily, but I don't know, can you tell us about choline? Right, choline is an organic molecule that you need a small amounts of. It's a whole grains you have choline. There's soy is a good choline source and you don't need much of it. If you eat too much choline and it's found in eggs, if you eat too much choline, you will spawn microbes in your gut that will turn that choline into trimethylamine. So what? Well, your liver then turns that trimethamine into trimethylamine oxide. And this is a molecule from hell. This drives cholesterol into the artery walls. It prevents HDL from removing that cholesterol. So too much choline drives TMAO production, which is not a good thing. So you have some soy products, you have some edamame, some tambourine, tofu a couple of times a week, and along with some whole grains and other legumes, and you'll meet your coli easily. It's nothing that you have to go overboard on for sure. And then another question, what would you suggest to relieve a pinch nerve if you don't want to take a commercial pain reliever? That's a good question. Yes, and you as an emergency physician, I'm sure you'll deal with some of the great... I mean, I think that you could try like probably massage, heat pack, physical therapy, sometimes acupuncture works. There's not a lot of evidence. I mean, a lot of it might be placebo, but it might work for you. So why not try? You could go to a chiropractor if you didn't want to take a commercial pain reliever. Those could be some other things. And they have this thing. It's called capsaicin cream. And sometimes that can be healthy as, you know, I mean, it's not harmful. It's just like hot chili pepper or kind of stuff. You rub on your stuff and it can relieve pain. So if you didn't want to take any medications or say that would be something about you. Yeah, well answered. And also these pinch nerves, I mean, you can hear it in the name. It's a mechanical issue actually. A nerve is getting compressed because some bony structure is compressed again. And these are usually the vertebrae in the neck or in the low back. And it has to do with how we're using our bodies. When we're little babies, we don't have pinched nerves and little kids running around, they don't have pinched nerves by and large. But as the years go by and we don't drink enough water and the disc between our vertebrae starts to flatten down and the vertebrae move together, the openings where the nerves come out to go down the arms and legs can become narrowed and pinched. And the disc can rupture and push on the disc roots, the nerve roots themselves. So get a good diagnosis. Gotta have your doctor order an MRI of whatever is your neck, your lumbar spine, whatever it is. And see where the pinching is happening and what could be done. Are there specific exercises? Sometimes injections in that area, just changing the or may use time for a standing desk. Maybe it's time to take, you know, swimming actually get into yoga and open up those spaces and try and decompress as best you can. So guess if you can get a mechanical diagnosis, find out exactly what is pinching, what nerve and what specific maneuvers could you do to leave the compression there. Sometimes your neurosurgery has to go in and open things up a little bit there but that's the last resort. See if you can do it just naturally by opening up spaces through exercising. So another thing I did wanna ask you and I know you've spoken about it before in your lectures. Some people complain once they go on a vegan diet they don't feel good or as good as they were when they were eating meat before. And I'm wondering what could be the cause of that? I think some of it might be attributed to like bloating for more fiber and what can people do for that? And you know, they might be missing something that they were getting from the meat, I'm not sure but can you comment as to that and how some of that? Do you have a question? Such important because as many people who go back to eating meat again, I didn't feel great on a vegan diet. And there's two things. You mentioned the bloating and just general energy level goes down. We will pick up the bloating in a second here. My theory as far as why people can after a few months on a vegan diet don't feel like they have the energy that they used to or shouldn't have. I think the story goes like this. And it starts like so many things when we're little babies, six months of age. The baby is nursing at the mother's breast and with all the love in the mother's heart your mother didn't know, my mother didn't know, nobody knew but because our parents wanted the best thing for the children at age six months that jar baby lamb and baby chicken, baby turkey baby food is open. And from that time on, three times a day animal flesh is slathered on that baby's intestinal tract and gets it to the bloodstream week after week, month after month, all through infancy, through toddler years, through childhood, through adolescence, puberty, through their teen years, their 20s, their 30s. You eat animal flesh three times a day for 30 years since infancy. And you're going to change the genetics in that body. First of all, if you're eating a meat-based diet then every few hours, three times a day, a flood of muscle-based nutrients, carnitine, creatine, fragments of myeloid blood through the tissues. We can, our own bodies can make these molecules but if they're coming in preformed, your genes and hey, there are plenty of carnitine around a lot of creatine, we don't need to make our own here. And so especially the child down regulates their own production of these molecules, which is okay as long as it keeps coming in on a regular basis in the food. But then after 20, 30 years of that and their own decreased production of those other own nutrients, they go vegan, they read a book or see a film, oh, that's it for me. All those animal-based preformed nutrients, the myoglobin and carnitine, creatine, they're gone. Now the person's body got to synthesize it all on your own. Many, most people can gear up their metabolism and their genetic mechanisms and their enzymes to make these molecules. But a significant portion, 10, 20% or more, it may take months for them to come up with their own the synthesis of these molecules and during that time they draw down on their own supplies of these energy-based nutrients and they don't feel so great and then they eat some meat and all those preformed muscle nutrients flow through their tissues. Oh, I feel great, vegan, vegan, I'm a carnivore. Oh, but what have we observed? This is not natural human physiology. This is an acquired dependency produced by feeding a human infant animal flesh three times a day since infancy. You can create a dependency on animal muscle, but that's not normal. No other primate does that. No gorilla does that, no bonobo does that. And no one else does new human beings who raise their children as vegan since birth. I'm old enough now, I've seen two generations of vegan kids grow up into strong, healthy, smart, beautiful, reproductive people. They don't have meat cravings. They don't, their mouth doesn't water when they walk past the barbecue. This is, they were spared this entrainment into flesh eating. So that's what I think is happening. So what should these people do? It may be some people, as disgusting as it might be, they may need to take some time in transitioning to a complete vegan diet. They may need to eat some animal flesh once a week for a few months as a medicinal treatment here to keep that crash from happening. And you spread out the time in between them so as every six weeks and then every two months and slowly taper off. So it takes you a year or two, so what? It is better than eating meat three times a day. I'd rather eat it three times a month. And so a long, slow taper might be necessary. The bloating, everybody has it to some extent. Dr. Krapra, I'm sorry, we're out of time. We're at the bottom of the hour. We're about to wrap it up, but I'll have to have you on again because there's no more questions that we're getting into. So anyway. But we've been bloating. Yeah, this is Healthy Planet on the Think Tech Livestreaming Network series. We've been talking with Dr. Michael Krapra. Thank you all for being here and thanks to Michael, our broadcast engineer and the rest of the crew at Think Tech for hosting our show. And thanks to you, our listeners for listening. I'll see you on July 6th for more of the Healthy Planet on Think Tech, the show for people who care about their health and the health of our planet. Our next show will be featuring Tyrone Monteri, president of Protect and Preserve Hawaii. We will be talking about native Hawaiian plants. If you have ideas for the show, please contact me at Healthy Planet Think Tech at gmail.com. I got my website at GraysonHawaii.com for more information on my projects, including future show guests. I'm Dr. Grayson Neal, aloha every. Thank you so much for watching Think Tech Hawaii. If you like what we do, please like us and click the subscribe button on YouTube and the follow button on Vimeo. You can also follow us on Facebook, Instagram, Twitter and LinkedIn and donate to us at thinktechhawaii.com. Mahalo.