Wednesday, April 16, 2014

Spicy Thai Cabbage Salad

Recently the word “superfood” has entered into the lexicons of Americans. (I have to give credit to my friend Julie for helping to popularize it.) However, the way we apply the term to foods has been ad-hoc and inconsistent, at best. Typically, we use the term for exotic and expensive sounding foods such as acai, goji berries, sea-buckthorn and the like. Depending who you talk to, you might also hear kale and quinoa described in such glowing terms. However, rarely will more generalize foods, such as iceberg lettuce be described as “super,” even if it is a health promoting food. Another food that is often ignored, but certainly deserves more attention, and is clearly entitled to the entry of the exclusive membership of "superfoods" is cabbage.


Considering how much attention kale has been getting recently, it is surprising that it’s superfood cousin, cabbage, has been left on the sidelines. Perhaps cabbage needs it's own Ryan Gosling meme

This is especially surprising considering there are over 400 articles on cabbage and the role it can play in cancer prevention and treatment. According to one study done on cancer cells in a petri dish, cabbage was one of the best vegetables for cancer prevention displaying the ability to kill multiple types of tumor cells (in part, thanks to the high amount of sinigrin an antioxidant found in cabbage); cabbage has also been shown to lower cholesterol in multiple studies, and red cabbage was awarded the “best bang for your buck” by Dr. Greger because of the high concentration of antioxidants, vitamins, and minerals as well as because of red cabbage's low price point. On top of all of this, cabbage is incredibly versatile, and can be added to just about any dish and prepared in nearly anyway!



This Spicy Thai Cabbage Salad is the perfect way to get more superfoods into your life!

Serves 3-4: 
For the salad:
1 ½ cups green or savoy cabbage, shredded
1 ½ cups purple cabbage, shredded
1 cup carrot, shredded
1 cup zucchini, shredded
3 stalks celery (optional)
1 large handful fresh basil, chopped
1 tablespoon fresh cilantro, chopped
½ cup peanuts or cashews (leave out if making a nut-free version)
Fresh or dried mint to taste

For the dressing:
2 tablespoons lemon juice
2 tablespoons apple cider vinegar
¼ cup Liquid Aminos or low sodium soy sauce
¼ cup vegetable broth mixed with ground flax seed (see: oil replacement guide)
2 tablespoons pure maple syrup
2 cloves garlic
1 inch piece of ginger, peeled
1 ½ tablespoons curry powder
1 teaspoon chili powder
1 teaspoon hemp seeds
The dressing will keep for about one week in the refrigerator. 



In a large bowl, combine all of the salad ingredients and toss to mix thoroughly.

In a high-speed blender, combine all of the dressing ingredients and blend until smooth. Pour over the tossed salad ingredients, mix well, and enjoy. 

D. Boivin, et. allAntiproliferative and antioxidant activities of common vegetables: A comparative study,” Food Chem., 112(2): 374-380, 2009.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Tuesday, April 1, 2014

Cooking without Oil

A while ago, I presented two research pieces on oils in general and one specifically on coconut oil. Not only are oils highly processed and bad for your arteries, but oil has around 4,000 calores per pound, making it the most calorie dense but nutrient-poor item in the American diet. Since my earlier postings, several people have asked, “well then, how do you cook?” Here are a few tips.




First, when buying pans, it’s best to buy heavier stainless steel or cast iron cookware. While any type of cookware will work, these higher grade metals are less likely to burn.

Dressings and Sauces:
·         My biggest suggestion is to become accustomed to using vinegars – particularly on salads. These are highly alkalizing and health promoting foods that taste great and can be found everywhere.
o   Try apple cider vinegar, balsamic, red and white wine but also look for flavored infused vinegars. I’ve had some delicious fig and berry infused vinegars. Even chocolate! I’ll be honest, pomegranate vinegar is gross.
·         To re-create creamier sauces or dressings replace the oil with blended silken tofu. I find 1 – 2 tablespoons does the trick.
·         You can also add ground flaxseed or chia seeds to hot water. Start using the same amount of water as you normally would use oil. Slowly add the ground seeds to the water and mix well until the water starts to almost gel and thicken. White chia seeds help make the most appetizing dressing color.
·         White beans or cashews are other great options for creating creamier sauces. Use the same amount of white beans as you normally use oil. If using cashews (always get the raw if you can,) I typically soak the cashews for at least 1 hours before – longer is better. I normally will do 1 part cashews and 1 part old fashioned oats. This creates a delicious creamy blend and helps cut the total fat from the cashews.

To sauté or Stir-fry:
·         Simply replace the oil you would normally use with either water or vegetable broth. First heat the pan and then add your food, add a small amount of water or broth as needed –note you will need less than you are expecting. Depending what you’re making, you can also try juices as well. Be sure to stir often.
·         Several vegetables such as mushrooms or onions contain enough liquid which will release while cooking. Heat the pan first and then cook at a slightly lower temperature for several minutes to caramelize onions or brown mushrooms. Stir constantly.

Baking:
·          To replace oil or margarine in baking, try using non-sweetened applesauce as a substitute for cookies, cakes, and other sweet baked goods (check out our Peanut Butter and Oat Cookies, the Quinoa and Chocolate Chip Cookies, or Engine 2’s Banana Oatmeal Peanut Butter Cookies.)
·         Mashed or pureed tofu can replace oil in other (non-sweet) baked goods.
·         Ground Flaxseed can also be an excellent sub for oil as well as for eggs (mix 1 tbsp ground flax with 3 tbsp water to create an egg replacer). For baking, use 3 parts flaxseed for every part oil or fat you are replacing. This can cause baked goods to brown more quickly so keep an eye on your dish.
·         Parchment paper is a game changer. It’s safe to cook on and makes clean up a breeze!

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Saturday, March 15, 2014

Mung Beans and Sprouting Guide

Sprouting is an ancient technique that has been used on all sorts of beans, legumes, and various seeds as a way to increase their nutrition profile, digestibility, and flavor. Over the winter I’ve become addicted to sprouted mung beans (sometimes called ming beans) but this process can be repeated with any other legumes including lentils and chickpeas (which are other favorites).

While you can buy sprouts from most grocers today, they are far cheaper when you sprout them yourself. Besides being relatively cheap, especially when compared to the huge amount of nutrients sprouted legumes offer, they can also be a nice way to add fresh, raw produce to your diet year around.  Adding sprouts is an easy way to make any meal look a little more exotic and fancy.  




One study published a few years ago examined food consumption in five different regions of the world and found that legumes intake was the most important factor associated with longer lifespan. The study found an 8% reduction in risk of overall mortality for every 20 grams of legumes consumed. 

As legumes, mung bean sprouts are an incredible source of nutrients. Besides being anti-inflammatory, they offer an excellent amino acid profile and are 20% calories from protein which is remarkably high (sigh, and yes, they are a complete protein, just like all whole foods!) They also are high in vitamin C and vitamin K, which is essential for the process of blood clotting. Vitamin K also helps regulates bone mineralization and helps maintain bone density. Mung beans are an excellent source of riboflavin, folate, iron, and manganese. They are also packed with Omega 3 and Omega 6 fatty acids as well as other micronutrients.




Besides being an all-around nutritional all-star, mung beans are incredibly easy to sprout taking an average of only 3 days before becoming edible. Once sprouted, mung beans have a tasty, fresh nutty flavor and offer a delicate crunch when added to a dish.

Once sprouted, you can keep mung beans in a sealed jar in the refrigerator for up to 5 weeks, although once you taste them, I'd be surprised if they last more than a few days!    




How to sprout legumes:

1. Take the desired amount (yield is approximately 2:1 so 1 cup of dry mung beans will be roughly 2 cups sprouted) and rinse them until the water runs clean.

     2. Then place the beans in either a bowl or jar and fill with cold filtered water. Add about 2-3 times the amount of water as there are beans. IE: 1 cup beans needs 2-3 cups water

     3.   Let soak overnight (8 – 12 hours)

     4. After soaking the beans, drain them and rinse them again with cold water.

    5. Place the beans in either an empty bowl or jar and set to the side. Store them in room temperature that isn’t directly hit by sunlight, but that does get some light.

   6. The next morning (day 2) the beans should be starting to open. Rinse once more in cold water and then return to the jar or bowl.
   
   7. By day three you should see little tails coming out of the body of the bean. You can either enjoy them this way, or let those little tails grow for another day for a softer sprout. Both are delicious. Rinse one final time, and then enjoy by adding to both raw and cooked meals.




   They’re great on salads, pastas, tossed in soups or pretty much any other dish! I just tossed some on top of my Green Mac N' Cheese

Darmadi-Blackberry, M. Wahlqvist et al. "Legumes: The Most Important Dietary Predictor of Survival in older people of Different Ethnicities," Asia Pacific Journal of Clinical Nutrition. 2004, 217-20.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Friday, February 28, 2014

The Holistic Heart Book Review and Giveaway

Last month Dr. Joel Kahn offered a great guest post about where people can find reliable information about health and nutrition (I swear his very kind comment about my site was completely unsolicited!) However today I’m reviewing his new work and Dr. Kahn also agreed to send a copy of his book to a lucky winner so be sure to enter below!



Joel K. Kahn, M.D. The Holistic Heart Book: A Preventive Cardiologist’s Guide to Halt Heart Disease Now. A Reader’s Digest Book, 2013.

Since the early 90s when Dean Ornish, M.D. and Caldwell Esselstyn, M.D. first published their respective works proving that heart disease is not only caused by, but can also be reversed through lifestyle changes and diet, there has been a fury of research on the topic. Despite this, heart disease continues to be America’s number one killer, taking nearly 600,000 lives every single year. Dr. Joel Kahn, a preventative cardiologist and Clinical Professor of Medicine at Wayne State University School of Medicine has recently published his own heart health manifesto, which neatly ties the best research on heart disease into one easy to read and very informative book. It is no exaggeration to say, this book can literally change your life.

In clear and precise language Dr. Kahn explains how complex the heart really is, comparing it to the brain, as the heart has its own neurons, hormones, and electrical field. Dr. Kahn’s work is broken down into two sections. The first section reviews the most current research on heart disease.

Unlike Dr. Esselstyn’s Prevent and Reverse Heart Disease which focuses exclusively on diet and heart health, Dr. Kahn’s book takes a different approach and demonstrates that it takes a healthy body to have a healthy heart. For instance, the thyroid gland, which sits about a foot above the heart, can have a profound impact on heart health. Roughly 2% of Americans have an overactive thyroid, and another 5% have an underactive thyroid (hyperthyroidism and hypothyroidism). The disturbance caused by these hormonal imbalances can both greatly affect the heart in negative ways. In this section, Dr. Kahn also demonstrates the importance of healthy arteries and further complicates our understanding of HDL – basically it’s not as simply as calling it “good cholesterol.”

In the second part of the book, Dr. Kahn offers over 70 “prescriptions” that he often writes for his patients. However, these prescriptions are a far cry from the one your doctor would typically write you. Instead, this is where the book truly becomes “holistic,” although I mean that in best possible light. Backing everything up with citations to peer-reviewed articles, (and admitting when the evidence on certain topics is still weak - such as grounding). These prescriptions range all over the place, from eating your greens, to changing your cleaning supplies and deodorant, to practicing yoga (vitamin Y, as Dr. Kahn puts it).  



Surprisingly, (and perhaps slightly controversial) Dr. Kahn highly recommends several different vitamins and supplements. While he is very careful about which ones he actually recommends, he suggests discussing these with your primary doctor before adding any supplements to your regimen. Besides claiming that the research on the benefits of supplements is strong, he has also seen many of his patients thrive when they start including some supplements and vitamins. One in particular is CoQ10 – Coenzyme Q 10, which is a powerful antioxidant made by the body, helps assist cells to produce energy. Around the age of 40, our body’s production of this antioxidant begins to slow, and Dr. Kahn recommends it to many of his patients. (note: there was not a citation on this supplement)

While all of this could be overwhelming, Dr. Kahn recommends that people start slow, picking just a few of his prescriptions out to try for a few weeks before adding more to the routine. He writes that the goal is to incorporate as many as possible without adding additional stress to our lives. In fact, reducing stress is one of his main goals!

It needs to be added that Dr. Kahn considers himself an ethical vegan. That said, while he promotes and encourages a complete plant-based lifestyle, he is far less dogmatic than some of the other authors on this topic. In fact, in his book, he includes some pointers for those simply looking to make wiser choices when it comes to animal products.


This book stands out when compared to the other works on this topic, both for its easy-to-follow writing style as well as for its holistic approach. If you are looking for practical and easy-to-incorporate advice to help protect your heart look no further. The added benefit is all of the advice will help improve your overall health, not just your heart. As Dr. Kahn says, it takes a healthy body to have a healthy heart. 

I got to meet Dr. Kahn and his wife Karen at the NYC Veg Fest!

GIVEAWAY
Here are the rules. First, the winner needs to live in the United States (sorry international readers, no disrespect). The contest will end on March 15th at midnight. To enter, you must be a subscribed reader to BYOL. To increase your chances of winning leave a comment on this post. You will also gain a point if you "like" Bring Your Own Lentils facebook page. 

Also be sure to find Dr. Kahn on facebook. He is always post interesting articles on health and fitness

a Rafflecopter giveaway
As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Saturday, February 15, 2014

Sharping the Saw by Joel Kahn, M.D. Preventative Cardiologist

Today I have a really special post to share with you all. Joel Kahn, M.D. has written a special guest post for BYOL today on how and where a preventative cardiologist gets their information about health and nutrition. The advice he shares below is sound and can be a great resource to anyone regardless of their interest in nutrition. Dr. Kahn and I have been connected online for the past year, and being nearly done with his book, which I can’t recommend enough, I am greatly looking forward to meeting Dr. Kahn in person at the New York City Veg Fest.

Dr. Kahn is one of the nation’s most renowned interpreventional cardiologists. Having practiced invasive, interventional, and preventative cardiology since 1990, Dr. Kahn has years of clinical and research experience. He is a regular contributor for MindBodyGreen, Readers Digest magazine, and the recent author of The Holistic Heart Book.   



Sharpening the saw: How a teacher gets training:

I am excited to write a guest piece for BYOL and am looking forward to speaking at the NYC Vegetarian Food Festival March 1.  I am a cardiologist trained at the University of Michigan long ago (graduated summa cum laude due in part to my vegetarian diet!) and practicing in Detroit all these years. I do heart catheterizations, place stents, run to emergency rooms, see office patients, and answer a zillion calls and emails a day.

Long ago I chose a vegetarian lifestyle and then the big V over a decade ago. No burger, no cheese, no fish etc.  I have been on billboards across Detroit in my doctor coat announcing “Beat heart disease, diabetes and cancer, Go Vegan” and speak regularly on TV, radio and lectures on the health, environmental and ethical reasons that plant based lifestyles are the best and only choice for the future.

Increasingly I am looked upon to have the answers to tough question, tricky critics, anti-vegan blogsites, Paleo promoters and so on. So how does the teacher stay ahead of the rest and have as many answers as possible?  As Stephen Covey wrote in the Seven Habits of Highly Effective People, how do I sharpen my own saw to be able to cut more effectively?  Can these help you stay on top of trends in nutrition, animal rights and related topics?

One resource I used that may appeal to some readers was to formally go back to school. I chose a program in integrative cardiology offered at www.a4m.org in conjunction with the University of South Florida School of Medicine.  These year long curriculum of both online and classroom lectures is open to both physicians and others interested in an advanced training in many areas of health and wellness and offers the advantage of a university affiliation if so selected. Other resources for formal education can be found at www.functionalmedicine.org, www.abihm.org, and www.acam.org.   For those interested predominantly in nutrition, online programs offered at www.integrativenutrition.com, www.ecornell.com, and www.aryuvedicnutrition.com are available.

Not everyone has the time or interest to pursue these formal courses and still there are options, including ones I use, to stay current and engaged in the fast paced world of nutrition and health.  First on the list is to sign up for the daily emails from Dr. Michael Greger at www.nutritionfacts.org.   Dr. Greger is in Washington, D.C. and has been producing short and high quality videos on YouTube for several years.  There is no charge to receive his daily email and the number of videos exceeds 1,000.  Dr. Greger does very thorough research of the medical literature and all his videos are backed by multiple references drawn from the medical literature. He reviews about 14,000 articles on nutrition yearly and finds hidden gems. He presents the topics in vivid and clear formats and adds his special humor and slight sarcasm to provide a constant stream of enjoyable material. I watch his videos daily and often search his site for information. He produces one video a year that is an overview of a topic that lasts an hour and it has always been a highlight that I share liberally on social media. Sign up now if you have not.


Another site that will challenge and educate you is www.plantpositive.com. This site is shrouded in more mystery as the author is anonymous. I have emailed with him and he is a graduate student who chooses to keep his identity hidden.  He produces You Tubes which are free and last form about 8 to 30 minutes.  There are easily over 150 such videos so there are literally hours and hours of information.  Like Dr. Greger, this site relies heavily on medical references and not just opinion.  Plant Positive has taken the task of responding to Paleolithic blogger and authors, cholesterol confusionists, and all lovers of animal saturated fats.  There is a group of these people that are polished, practiced and vicious in their defense of eating animals for health. I listen and relisten regularly to these videos.  They provide a detailed analysis of the writings of Loren Cordain, Gary Taubes and others and identify false statements, distorted references, and logic fallacies on a regular basis.  This faction is not to be taken lightly and several physicians with best selling books promoting diets that are variations of Atkin’s ketogenic and pro-atherogenic venues are constantly confusing the public about the health risks of animal products.  I encourage you to jump into this site but be prepared for some of the topics to be very detailed and challenging.

My good friend Dr. Neal Barnard founded www.pcrm.org about 25 years ago. Trained as a psychiatrist, Dr. Barnard shifted to animal rights and plant based nutrition and set up this organization which does research, advocates for ethical treatment of animals, sues institutions fraudulently promoting unhealthy programs, and writes regular blogs that are shared on social media.  I learn so much from Dr. Barnard and am sure you will too.

A friend I have not yet met but hope to is Dr. John McDougall at www.drmcdougall.com.  Dr. McDougall worked in Hawaii decades ago and observed how the health of native Japanese started to deteriorate when they moved to Hawaii and starting to consume Western foods.  He established a clinic that promoted plant based diets rich in complex carbohydrates and whole grains and has treated tens of thousand of patients or more with these diets.  He regularly writes blogs, publishes book, and produces teaching videos and I have found these very helpful.

Another resource I bring to you is www.mindbodygreen.com. This site established in 2011 has grown at a meteoric speed and now 15 million or more visits occur monthly.  I began writing a weekly column for them a year ago and have contributed over 50 blogs on health and nutrition.  The authors are diverse and occasional blogs promoted non-vegan diets.  I respond to these vigorously for the often erroneous data they present.  Yoga, recipes, and life coaching are frequent other categories. 


And finally, www.bringyourownlentils.com.  This site is simply fun, diverse and of high quality. I am proud to be contributing and look forward to meeting you on March 1. Come say hello.  I will be talking about 10 Holistic Heart Tips and my new book The Holistic Heart Book www.holisticheart.com will be available.  

You can learn more at my website www.drjoelkahn.com or on Twitter at @drjkahn.  Ciao!

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Monday, February 3, 2014

Oil-Free Ethiopian – Plant-Strong Niter Kibbeh and Misir Wett

If I’ve ever contributed something positive and original to the healthy, vegan lifestyle, I truly believe this is it! My friend Abby first turned me on to Ethiopian food almost two years ago. Since then I’ve fallen in love with its unique flavor combinations and the fun that comes along with eating with your hands.



While eating vegan at an Ethiopian restaurant isn’t really a challenge, eating healthy, plant based vegan can be, as essentially all of their food is cooked in a spiced-oil known as niter kibbeh.

When another friend of mine offered to lend me an old Vegan Ethiopian Cooking Zine (remember those?) called Papa Tofu Loves Ethiopian, I decided I would try and create a healthier alternative to niter kibbeh. (Note, Papa Tofu is currently working on a full-scale cookbook, watch out for it, because it is going to be amazing.)



Learning a great deal from reading through the opening of the zine and Papa Tofu’s recipes, I went to work and am now happy to share with you my results which I believe upholds the integrity of the complex flavors associated with this food - without the harmful side effects associated with a high-oil meal.

If you’ve never had Ethiopian, their traditional cuisine is similar to Indian in the sense that it is best to think of each dish as a side, and as such, a complete meal is comprised of several different components. These components are typically served on one large platter and shared between a group of friends or family. True Ethiopian dishes needs to be accompanied by injera – a soft and supple sour pancake-like bread made of teff grain – that is used in place of utensils (Injera over Knives, anyone?) The food is eaten with your hands by ripping small pieces of injera off and then using that to scoop up the various dishes on your platter. That said, this lentil-based dish is delicious on its own as well.

Because Papa Tofu is working on a cookbook, I’m only going to share my recipe for Plant-Strong niter kibbeh and Misir Wett (a delicious red lentil dish sometimes spelled wot or wat) but feel free to search around the internet to find other delicious recipes like Fassolia, Shiro Wett, and my favorite, Gomen. (Whenever I make Ethiopian I typically make 3-5 of these dishes and I buy injera from a local Ethiopian bakery in Harlem, but you can also buy it from any Ethiopian restaurant or try making it yourself).



Ethiopian cuisine is not difficult to make; however, because there are often several components to a single meal, be prepared to use several different pots and pans! You’ll also want to make sure you have a nice large container of vegetable broth before you start and it will be helpful if you either buy or make your own Berbere (Burr-burr-ee) spice blend ahead of time. Most stores sell a relatively mild pre-mixed berbere blend, so if you prefer some heat, make your own. I also find it helpful to dice a few red onions, and mince several cloves of garlic and ginger before starting anything else.

Now let’s make some plant-strong niter kibbeh



Plant-Strong Niter Kibbeh (keeps up to 3 days in the fridge)
1 ½ cups of vegetable broth
¼ of a ripe avocado (this replaces the fat of the oil)
¼ cup chopped red onion
2 tablespoons minced garlic (or more to taste)
1 tablespoon minced ginger
½ teaspoon turmeric
½ teaspoon fenugreek
½ teaspoon ground cardamom
½ teaspoon ground cinnamon
6 whole cloves or ¼ teaspoon ground clove
¼ teaspoon ground flax seed (optional)
Pinch of nutmeg

(This recipe makes just shy of 2 cups – enough for an entire Ethiopian meal comprised of several different recipes – with a little bit left over)

In a high powered blender or food processor, add all of the ingredients and blend until completely smooth. If you are using a Vitamix or similar blender, continue blending the ingredients until steam begins to rise out of the lid. If you are using a lower powered blender, transfer the blended sauce into a small sauce pan and bring to a low simmer and then let cool.



Misir Wett

1 ½ cups dry red lentils
3 cups of vegetable broth or water (to cook lentils in)
1 cup of vegetable broth (for sautéing)
1 medium red onion – finely diced
3-4 cloves of minced garlic
2-3 tablespoons no-salt tomato paste or 1-2 medium tomatoes
3 tablespoons niter kibbeh
1-2 tablespoons of Berbere spice
1 tablespoon sweet paprika
1 teaspoon cumin
1 teaspoon coriander
1teaspoon cinnamon

Start by soaking, washing and cooking your red lentils as you normally would. Then place them into a large pot with 3 cups of vegetable broth and cook as you normally would until the lentils are very soft – roughly 25-30 minutes. Once done, drain off any extra liquid.

Right before the lentils are done cooking, heat a pan and add two to three tablespoons of niter kibbeh. Saute the onions and garlic until the onions become translucent. At this point, add the tomato, berbere, and other spices. Mix well and sauté for another 2-3 minutes. Now add 1 cup of vegetable broth and bring to low simmer. (Note: If you want a smoother gravy, you can blend all of these ingredients) Now add the lentils and another tablespoon of niter kibbeh and a tiny bit of vegetable broth and sauté for a an additional 10 -15 minutes.

Note, once finished cooking you can add lightly blend or food process all of this for more of a dipping sauce. 
Serve over an injera lined platter and top with fresh cracked black pepper. 

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.

Wednesday, January 15, 2014

Iron Deficiency and Anemia

Recently a good friend of mine told me that she was diagnosed with anemia. She has been vegan for as long as I have known her (at least five years) and is the first vegan I’ve met who actually had a mineral deficiency of any kind. While I can’t go into specifics, I do know she follows a mostly health promoting lifestyle. Besides generally eating well she is also an accomplished Ironman athlete. Some of the symptoms she felt included general fatigue and dizziness but other signs of anemia include: pale skin, rapid heart beat, shortness of breath during exercise, headaches, insomnia, and muscle cramps. 

She reached out to me for a little advice and happy to oblige I started doing a little more in-depth research. This is what I found.

The main function of iron in our body is to create hemoglobin, which helps facilitate red blood cell health. An adequate iron level is of paramount importance as it ensures the cells are able to deliver oxygen-rich blood throughout the body. Iron also plays a role in building blood proteins needed for food metabolism, digestion, and proper circulation.



First, while my friend is anemic, meaning she does not have enough iron in her system, having too much iron is equally dangerous – watch for a fuller post on this subject in the future. While it is relativity rare to be diagnosed, iron toxicity typically occurs in those who eat meat. This is because of the type or “quality” of iron in animal vs. plant foods. People obtain iron from either eating plants or from eating animals that have been fed plants. It is then absorbed into their bodies through the upper gastrointestional tract. Plant foods contain what is known as non-heme iron. Animal foods contain non-heme iron but also has whats known as heme iron or “blood iron.” Traditionally, we our told that heme iron is more easily absorbed by our bodies and therefore of a higher quality, but that view is starting to be questioned as excess iron has increasingly been linked to Alzheimer’s disease, a double digit increased risk in colorectal cancer, type II diabetes, and coronary heart disease. Heme iron intake has also been associated with increased risk of stroke, gestational diabetes, gallstones, and cancers of the prostate, lung, stomach and kidneys, among others.   

Our bodies are remarkable. Because the human body doesn't have a mechanism to rid itself of excess iron, we evolved a way to regulate its absorption. When our bodies have sufficient storage levels of iron approximately 5% percent of the iron present in food is absorbed, when a person is iron deficient, then the amount absorbed from the foods eaten can increase by as much as 20%. However, studies have found that the body has a much more difficult time regulating the absorption of heme iron, making iron toxicity or iron overload much more possible.

Now, back to the original topic of anemia. I want to stress that it is very possible to become anemic on any type of diet. Vegetarian’s levels of Hemoglobin, which reflects the amount of iron in the blood, are comparable to those in people who eat flesh. In a review by Craig McPherson, M.D., he stated that while iron stores may be lower in vegetarians, there is no reported increase in incidence of iron deficiency anemia. In fact, iron reduction has been shown not only to decrease the risk of getting various types of cancer by 35%, but anemia has actually been found less frequently overall in those who eat a strict vegetable based diet than those on the Standard American Diet – this is potentially caused by the consumption of large amounts of dairy which bind and inhibit the body from absorbing iron.

Back in July when I had my blood tested, my hemoglobin levels were found to be in the ideal range so I don’t overly concern myself with iron (Hemoglobin A1C: 5.1 which also puts me at a lower risk of diabetes). That said many plant foods that I regularly consume are high in iron. Dark leafy greens and dried beans are perhaps the best sources of non-heme iron. Not only is kale, collards, and spinach all high in iron but they also contain vitamin C, which helps the absorption of non-heme, and are overall, healthy for everyone to consume. In fact, per 100 calories, cooked spinach has more than 15x the amount of iron than a steak! Soybeans, lentils, tofu are also all excellent sources - and all higher in iron than steak per 100 calories-and are accessible and affordable.



However, sometimes just eating foods high in iron won’t be enough, as my friend recently found out. The good news is just because she was diagnosed as being anemic, doesn’t mean she needs to turn to meat. Nor does it necessarily mean she should start gulping iron supplements. Dr. Michael Greger of nutritonfacts.org suggests that those who are diagnosed with anemia talk with their physician about first trying to get their blood hemogloblin levels up through diet alone, because a recent study found an increase in oxidative stress in the body.

Luckily, there are many things we can do to help encourage our bodies to absorb non-heme iron found in our food.

As I mentioned above, vitamin c rich foods helps our bodies absorb non-heme iron. While dark leafy greens have both iron and vitamin c, if you are eating a food that is lower in vitamin C such as chickpeas, it is best if you include a food higher in vitamin c with it such as bell pepper, citrus fruits, broccoli ect. It’s also not a bad idea to avoid taking in tea or coffee as both can block iron absorption.

Another slick trick to help improve the bioavailability of non-heme iron is to prepare your dish with foods such as garlic and onion. The allium family of vegetables foods have phytonutrients that help promote iron absorption. Also steaming your dark leafy greens before eating them can also help improve your bodies iron absorption.

While cooking with cast iron has also been shown to increase the amount of iron content in foods, our bodies are less able to manage the absorption of that type of iron - making it less than ideal for those already with healthy storages of iron.
 
Below is a chart of plant foods high in iron:
Food                       Amount            Iron (mg)
Soybeans, cooked         1 cup                  8.8
Lentils, cooked             1 cup                  6.6
Spinach, cooked           1 cup                  6.4
Tofu                             4 oz                     4.7
Chickpeas, cooked       1 cup                   4.7
Swiss Chard, cooked    1 cup                   4.0
White Potato                1 large                3.2
Quinoa, cooked            1 cup                  2.8
Pumpkin Seeds             1 cup                  2.1
Raisins                          ½ cup                 1.6
Kale, cooked                1 cup                  1.2
Broccoli, cooked          1 cup                  1.1

Source: USDA Nutrient Database for Standard Reference.


Further reading:
Brazier, Brendan, Thrive: The Vegan Nutrition Guide to Optimal Performance in Sports and Life. 2007.

Cook, J.D. “Adaption in Iron Metabolism.” Journal of American Journal of Clinical Nutrition. February, 1990

Stankiewicz, J. and S. D. Brass. “Role of iron in neurotoxicity: A cause for concern in the elderly?” Current Opinon of Clinical Nutrition and Metabolic Care, 2009. 

McDougall, Craig, M.D. “Letter to the Editor: Plant Based Diets Are Not Nutritionally Deficient.” The Permanente Journal. Spring; 17. 

 “The McDougall Newsletter.” Vol 12, Issue 8. The Asian Paradox: End of the Line for Low Carb Diets? Literature Review

Hunt, JR. “Bioavailablitliy of iron, zinc, and other trace minerals from vegetarian diets.” American Journal of Clinical Nutrition. Sept 2003; 78. 

Pulde, Alona, M.D. and Matthew Lederman, M.D. Keep it Simple, Keep it Whole: Your Guide to Optimum Health. 2009.

As always the information presented in this blog is for educational purposes only. It should not be considered as specific medical, nutritional, lifestyle, or other health-related advice.