Meet the family doctor who went vegan!
I am excited for you to read this article. In summary, it's about how what we consume affects our health.
Dr. Ashwani Garg has kindly shared how he decided the type of medicine that he wanted to specialise in, the events that led to his discovery of veganism, why he went vegan and the amazingness that followed. This shift in thinking and diet had an impact which he hadn't envisaged. For me, the best part of all of this, is that he has no regrets, and he uses his direct experiences to help so many people attain a better quality of life.
Can you tell me a bit about yourself before you became a family doctor?
I finished medical school in 1999 at Northwestern University, and my family practice residency in 2002 at Hinsdale Seventh Day Adventist Hospital. I decided to go into family medicine because I was interested in all aspects of medicine. As I went through the different rotations in medical school, I couldn't see myself focusing on one specialty or limiting myself to seeing only adults, or only children, because I enjoyed seeing all patients. I benefited from getting to know them and found it so rewarding to help them prevent various illnesses. The rotations I enjoyed the most included pediatrics as well as internal medicine, and I enjoyed seeing patients both in the office and hospital. I started out in emergency medicine at various hospitals, seeing patients with very serious conditions or advanced stages of specific illnesses. After which, I treated patients who had endured heart attacks, strokes, and injuries. This did not focus on prevention, but rather cure or management, which is not what I wanted to do.
When did you start eating vegan and what prompted this change?
I thought I was a healthy semi-vegetarian. I ate delicious vegetarian Indian and Asian foods, which didn't contain a lot of oil, and occasionally ate fish and chicken. I used to drink soya milk instead of dairy milk, but I would occasional have small quantities of dairy yogurt and cheese.
I went to Bangkok for my wife's cousin's wedding, and to be safe, I only ordered vegan meals on the flights, and throughout the trip, I only ate vegetarian Thai food, which also happened to be vegan.
It was my first week of being vegan, although it was almost by accident. This was at the end of 2012, after which I happened to come across a documentary on CNN, "Last Heart Attack with Dr. Sanjay Gupta" and "Forks over Knives." I realised that shifting to a completely vegan diet would result in many health benefits.
At around the same time I had my blood drawn in preparation for a life insurance physical, because I wanted to purchase life insurance before the age of 40, and while the results were not bad, they were not completely optimal either! I was borderline for some conditions.
I went to PCRM (Physicians Committee for Responsible Medicine), downloaded some resources, and decided to start off the New Year (2013) by shifting to a vegan diet. Within 3 weeks I was completely vegan, shunning all the occasional fish and chicken, cheese and yogurt, eating a mostly raw type diet. I saw my health and energy levels immediately improve.
At the same time, I got the motivation to start going to the gym every day, and I lost a lot of weight, which was good for me!
I had my blood drawn again and the lab results had become optimal. My blood pressure (BP) had reduced and my weight was at the ideal Body Mass Index (BMI).
Shifting to a vegan diet was not so difficult, because I took the vegan foods I already liked, and made them my full time goal. I was already buying soya milk instead of dairy milk, so I didn't need to make any changes there. I also tried new recipes, and I stopped using using cooking oil, which is encouraged by PCRM's and Forks over Knives. I watched videos on YouTube by influential people like T. Colin Campbell, Dr. John McDougall, Dr. Joel Fuhrman, Dr. Neal Barnard, Dr. Esselstyn, and Rip Esselstyn, whilst using the treadmill. I also checked out all the popular plant based books by the same authors.
My patients started noticing the changes and asked me how I was making it happen. Some of them started following what I was doing, as they were impressed with the results.
After a few months, I started looking into the animal welfare side of the diet, and learned about the cruelty involved in the egg and dairy industries from movies like Vegucated. This motivated me to stick to being vegan.
If any, what connections did you make between health and veganism?
I feel that health and veganism are intimately connected in many ways. First of all, the digestive system is cured. With all that fiber from a whole food plant based diet, the following conditions reduce or disappear:-
hemorrhoids
heartburn
asthma
aches and pains
inflammatory joint pains
migraines
headaches
digestion issues
Swapping processed foods and those with chemicals, to wholesome fresh fruits and vegetables makes a big difference too.
Then you have the compassionate side of veganism. I learned eventually to let go of my anger and adopt compassion. I started doing yoga and meditation which also helped a lot. Taking a deep breath when I see and hear things I don't like, helps me witness it instead of getting wound up.
As a Doctor, I see so many people suffer while they continue to consume unhealthy foods. I have learned to take a deep breath and remind myself that I'm doing the best I can, I'm informing patients about adopting healthy behaviors, but I can't make anyone change, apart from me.
What are the main concerns that you hear about vegan diets and health? As a Doctor, how would you remedy them?
The main concern everyone has is "how do you get your protein?" and I myself struggled with this in the beginning. I was so concerned about protein, that I was consuming plant based protein shakes every day. However, I soon learned that ALL foods contain protein, and that protein requirements are much less than we think. The body needs roughly 0.8gm/kg of body weight of protein, which for a person weighing 70kg would be 56grams, or 224 Calories worth. Between the beans, broccoli, soya milk, tofu, nuts and seeds, I got so much protein that I realised I didn't need a supplement at all. A balanced diet is all it takes.
Other concerns include iron and calcium, which are easily obtained from wholesome plant foods. Therefore, I would be concerned if someone adopted a vegan junk food diet, or for that matter, a junk food diet of any kind!
Other concerns people have are Vitamin B12. This is easy to address. We only need to take 2500mcg once a week, and that goes for everyone, not just vegans.
For Vitamin D3, we need roughly 5000 units once a week, and some people need to supplement DHA or Omega-3, which is about 200mg per day.
The myth that so many people seem to believe, is that a vegan diet is incomplete. I would say that this is not true at all. As long as you follow guidelines shared by for example, PCRM; we'll be fine! PCRM recommends creating a balanced diet using the four food groups, which are:-
fruits
vegetables
whole grains and
beans
I suggest only eating processed, vegan "junk" food rarely. Less than 1 or 2 times a week if possible, whilst making the remainder of what you eat, fresh and natural. Also, don't forget to include nuts and seeds as part of your meal. For example, if you have a soup you may make a creamy base from some peeled almonds or cashews, or garnish your salad with some walnuts or sunflower seeds.
Remember that 97% of people get enough protein, but only 3% of people get enough fiber, and only 1 in 20 people eat the minimal recommended amount of fruit and veg.
Besides PCRM, other great resources include:-
The Vegetarian Resource Group for nutrition advice.
"The End of Heart Disease" by Dr. Joel Fuhrman which definitely offers the latest greatest nutrition advice
What are benefits or concerns for vegan children?
In all the vegan families that I see as patients, the vegan children have been very healthy. This is possibly because their families are over-cautious and as a result, their kids consume more fruits and veg than other kids! They usually get healthy fats from avocados, nut butters, and olives, incorporate beans in recipes such as Hummus, and eat all wholemeal bread and grains. So they are fit and healthy.
I usually suggest that vegans drink soya milk as it is the most nutritious and it has been tested for the longest period of time. My own children now only drink soya milk.
Why do you advocate supplementing a healthy diet with plant milk?
The reason for supplementing a healthy diet with plant milk, is that fibrous foods can often fill the stomach before the child has consumed enough calories, and the liquid plant milk offers a way to get some nutrients (including Vitamins, D, B12, Calcium) which they are usually fortified with.
The resources I mentioned above offer great guidance for raising vegan children too. In addition to them, there's a great book by Dr. Joel Fuhrman called "Disease Proof your Child".
For children the most important way to get them to eat healthy is to get them involved in the cooking process. One amazing thing I saw is the effect of reading and acting out the book "Stone Soup." The children read it and then brought in their own vegetables, made it in school and most of them ate it! When children get involved in the cooking process, they are more likely to eat the food. Ruby Roth has a brand new cookbook geared towards children.
Do you know of other health professionals who advocate a vegan diet and if so, can you tell me why?
There are many health professionals who advocate a "whole food plant based" vegan diet, including the famous Dr. Joel Fuhrman, Dr. Neal Barnard, (founder of PCRM), Dr. Esselstyn, Dr. John McDougall, Dr. Garth Davis, Dr. Joel Kahn, and many other doctors. There is a medical centre that has opened up in Washington, D.C. by PCRM, dedicated to support individuals to improve health and prevent poor health.
These doctors, (and others), have advocated a vegan diet, and many have personal experiences which resulted in being healed, and huge improvements in their health. They also share stories from patients who have experienced wonders that have not been seen with any available drug treatments.
Happy Herbivore have created an international directory of plant based doctors. The Plantrician Project has done the same.
There are many vegan dietitians do online consultations. Four that come to mind are Julieanna Hever, Ginny Messina, Jack Norris, Jeff Novick and Brenda Davis. Many health coaches now advocate a vegan diet and while they may not have the medical credentials, they offer a different practical perspective on veganism.
Is there any scientific proof that a vegan diet is better for us?
There are countless scientific studies that show the benefits of going vegan.
to find studies on cardiology, go to http://www.dresselstyn.com/site/articles-studies/
for diabetes, go to http://www.pcrm.org/health/diabetes-resources/research-linking-diet-and-diabetes,
for health generally, visit http://www.thepermanentejournal.org/issues/2013/spring/5117-nutrition.html and http://www.cfp.ca/content/58/9/917.full
For Seventh Day Adventist Health studies comparing vegan, vegetarian, pescatarian diets, go to http://publichealth.llu.edu/adventist-health-studies/findings/findings-ahs-2 It offers a long-term follow up of the various groups. The results showed that only the vegan group maintained a healthy, normal weight, while the average weight of all the other groups was over what it should be.
As far as scientific studies go, they need to be interpreted with an abundance of caution.
First, find out who is funding the study - is it funded by the egg board, or the dairy council? If so, it is likely to be strongly biased in favour of those products
Second of all, how many people were studied, and what is the magnitude of the benefit - were there confounding factors?
That's why, whenever I am looking for references for scientific studies, I also go to Dr. Greger's website Nutritionfacts.org where he reviews all the latest research about nutrition on a daily basis, and does so while on his treadmill all day! What an amazing man! The videos are in an easy to watch format with great graphics and references.
Looks can be deceiving
Lastly, I want to say a little about the effects of being mostly vegetarian and what happened when I was fully vegan.
Many people underestimate how much meat and dairy they take in. While their actual weight and size may not look like much, the caloric content can be very high. For example, 1/2 cup of cheese may not look like much, but it is actually 228 calories, with 3/4 of those calories coming from fat. On the other hand, 3 apples will have a similar amount of calories, however they will take up much more space on a plate. This might result in people eating fewer apples and therefore they'll consume less calories.
When people go completely vegan, it makes a big positive difference, because all these foods that cause visible and invisible negative effects, are off the plate! If you fill the plate with vegetables, fruit, beans and whole grains exclusively, they will filter out the blood sugar, cholesterol, and toxins from your body much more efficiently. Just like I would not advise someone to smoke 1 cigarette a day, I would also not advise them to consume a small amount of animal products on a daily basis. Being semi-vegetarian makes one's diet incomplete, and it's harder to hit all the targets of fruit and veg servings that way.
Why I think meat and dairy is toxic
One more topic I want to discuss is that I never realised how toxic meat and dairy are because this information is often hidden.
There is a connection between animal welfare and our own health. When animals are unhappy, overweight, and fed toxic waste (to fatten them up), they will be sick and this will make us unwell too!
Johns Hopkins University studied chickens and they found many banned pharmaceuticals including up to 10 different kinds of antibiotics, and this doesn't include the many other drug residues that were present, including tylenol, benadryl, prozac, and arsenic!
When you are eating meat and dairy, you are not only eating the products of cruelty and suffering, but you are eating animals that are fed, bred, and drugged to be fat. I believe that this may contribute to humans becoming overweight and developing cancer growths.
With so many antibiotics, you would expect meat and dairy to be bacteria free, however, resistant bacteria are not eradicated, and even though the animals may be well cooked, the dead bacteria will not be removed! That is why there is a benefit to cutting out meat, dairy and eggs completely. All it takes is a small amount of a these toxins or poisons to enter our bodies, and our health will be effected!
Hormones
Many animal products, including milk, eggs and meat are labelled as "hormone free" however this is completely false, because even though the animals may not have been injected with hormones, they are genetically bred to be massive in size, and therefore produce unnatural amounts of hormones. For further information on this, search "chicken from 50 years ago vs. now" and you'll see pictures of how they've been modified in size. These animal hormones persist and have effects on the humans who consume them. This patly explains early puberty, childhood obesity, and male children growing breast tissue.
My first recommendation is to cut out meat and milk products completely.
In one study, they found hormonal effects from the consumption of one serving of organic dairy milk.
Vitamins and veganism
Vitamin B12
Vitamin B12 is normally found in the soil, but because most food is now clean and washed before we buy it, there isn't enough soil bacteria to produce vitamin B12.
Vegan B12 tablets can be obtained easily. One of the companies that is certified vegan is DEVA.
Taking 1000-2500 micrograms once a week, or in a daily multivitamin formula, is all that's needed.
Plant milk is usually fortified with B12, so most vegans will not become deficient, even without a supplement, if they consume 2 servings of plant milk per day.
Vitamin D3
Vitamin D3 is a vitamin which people in colder climates tend to lack. It is not specific to diet.
Vitamin D is synthesized from sunlight on your skin. The dose that most people need is 400-800 IU daily, or 2500-5000 IU once a week. Some people require more, and others none.
Again, plant milk is usually fortified, so if one consumes 2 servings/day there is no need for a supplement unless they have a low level of it.
Vitamin D2
Vitamin D2 is usually of plant origin, whereas supplements vitamin D3 is usually sourced from sheep's wool. However, vegan options are available. I usually buy mine from DEVA, which is very inexpensive.
Docosahexaenoic acid
Docosahexaenoic acid, also known as DHA, is a fatty acid that can be lacking in vegans and meat eaters alike. The precursor to DHA is ALA and is found in flax seed, chia, walnuts, as well as beans and whole grains. Soy products are very high in Omega-3 fats.
Too much refined oils including the so-called "healthy ones" like olive oil, block the conversion of ALA to DHA because of Omega-6 fat.
Seaweed and algae are a source of DHA, and vegans can find suitable supplements in this way.
Opti3Omega is available in the UK and Vitacost in can be found in the US. They both make vegan DHA.
Those who are not efficient in making DHA include those with chronic diseases, the elderly, or diabetics. I do recommend DHA in pregnancy.
Prenatal vitamins contain folic acid, which can have some harmful effects. However vegans who eat plenty of greens (or foliage, from which, the word folic is derived) do not need folic acid. A good prenatal supplement has been created by Dr. Joel Fuhrman. It is reasonably priced and he created it specifically for vegans. It is called Gentle Prenatal Formula, and combines iron, vitamin B12, and D3 in just the right amounts for a healthy vegan pregnancy.
Related content
A nutritionist's view on common questions about going vegan
Resources showing how diet effects our health, the environment and animals
Need more protein? Try That Protein
All the vegan supplements you could need under one roof
Information about B12
A nutritionists guide to going vegan
Opti3Omega
“Collectively the media; the meat, oil, and dairy industries; most prominent chefs and cookbook authors; and our own government are not presenting accurate advice about the healthiest way to eat.”