For adults under age sixty-five, the easiest way to get B12 is to take at least one 2,500 mcg supplement each week. If you take too much, you merely get expensive pee. Well, not all that expensive: A five-year supply of vitamin B12 can cost less than £13.10 If you’d rather get into the habit of taking it daily, the once-a-day dosing is 250 mcg.11 Note that these doses are specific to cyanocobalamin, the preferred supplemental form of vitamin B12, as there is insufficient evidence to support the efficacy of the other forms, like methylcobalamin.12
As you age, your ability to absorb vitamin B12 may decline.13 For those over sixty-five who eat plant-based diets, the supplementation should probably be increased from at least 2,500 mcg a week (or 250 mcg a day) up to 1,000 mcg of cyanocobalamin each day.14,15
Instead of taking B12 supplements, it’s possible to get sufficient amounts from B12-fortified foods, but you would have to eat three servings a day of foods providing at least 25 percent of the Daily Value (on the Nutrition Facts label),16 with each serving eaten at least four to six hours after the last.17 The only green-light source I’m aware of is B12-fortified nutritional yeast, for which two teaspoons three times a day would suffice. For most people, though, it would probably be cheaper and more convenient to just take a supplement.
My other supplement recommendations in this section can be considered conditional, but getting enough vitamin B12 is absolutely nonnegotiable for those centering their diets around green-light foods.
Vitamin D from Sun or Supplements
I recommend that people unable to get sufficient sun take one 2,000 IU vitamin D3 supplement each day,18 ideally with the largest meal of the day.19
In the northern hemisphere, below approximately 30° latitude (south of Los Angeles, Dallas, or Atlanta), fifteen minutes each day of midday sun on the forearms and face without sunblock should produce sufficient vitamin D for Caucasians under the age of sixty. Those who have darker skin20 or who are older21 may require thirty minutes or more.
Farther north, at 40° latitude (Portland, Chicago, or New York City), the sun’s rays are at such an angle during the months of November through February that vitamin D may not be produced. No matter how long you might sunbathe naked in Times Square on New Year’s Day, you won’t make any vitamin D.22
Above 50° latitude (around London, Berlin, Moscow, and Edmonton, Canada), this “vitamin D winter” may extend for as long as six months of the year.
Vitamin D supplements are therefore recommended for people at higher latitudes during the winter months and year-round for those not getting enough midday sun, regardless of location. This may also apply to those living in smoggy cities, such as Los Angeles or San Diego.23
I do not recommend sunbeds. They can be both ineffective24 and dangerous.25 The lamps emit mostly UVA,26 which increases melanoma skin cancer risk without producing vitamin D.27
Eat Iodine-Rich Foods
Iodine, a mineral essential for thyroid function, is found predominantly in the ocean and in variable amounts in the soils of the world. To ensure everyone was getting enough, table salt was fortified with the mineral starting in the 1920s. So if you do add salt to your food, use iodized salt (not sea salt or “natural” salt, which contains about sixty times less iodine28). Given that sodium is considered the second-leading dietary killer in the world,29 however, iodized salt should be considered a red-light source.
There are two yellow-light sources of iodine: seafood and dairy milk. (Iodine leaches into the milk from iodine-containing antiseptic chemicals used to disinfect the cow’s teats to prevent mastitis.30) The most concentrated green-light source is seaweed, which has the iodine of seafood without the fat-soluble pollutants that build up in the aquatic food chain.
Sea vegetables are the underwater dark-green leafies. I encourage you to experiment with ways to include them in your diet. The recommended daily intake of iodine is 150 mcg, which is what is in about two sheets of nori,31 the seaweed that’s used to make sushi. There are all sorts of seaweed snacks on the market now, but most, if not all of them, seem to have added red-light ingredients. So I buy plain nori and season the sheets myself by brushing them with jarred pickled ginger juice and lightly sprinkling on wasabi powder before recrisping them at 150°C for about five minutes.
Sprinkling just half a teaspoon of the seaweeds arame or dulse onto dishes you’re preparing may also get you your iodine for the day. Dulse is sold as pretty purple flakes you can just shake onto your food. I do caution against hijiki32 (also spelled hiziki), because it has been found to be contaminated with arsenic. I also caution against kelp, which may have too much iodine; just half a teaspoon of kelp could exceed the daily upper limit. For the same reason, you shouldn’t get into a regular habit of eating more than fifteen sheets of nori or more than a tablespoon of arame or dulse a day.33 Too much iodine can cause excessive thyroid gland activity.34
For those who don’t like seaweed, Eden brand’s tinned beans have a tiny amount of kelp added such that iodine levels average between 36.3 mcg per 130-gram serving (great northern beans) to 71.2 mcg (pinto beans).35 Not only are those levels safe—you’d have to eat about twenty tins a day to get too much—but checkmarking my three legume servings a day with Eden’s beans would fulfill your daily iodine requirement.
One last note about iodine: Although people who avoid seafood and dairy products do not appear to have impaired thyroid function,36,37 I would not leave it to chance during pregnancy, where iodine is critical for proper brain development.38 I agree with the American Thyroid Association’s recommendation that all North American pregnant and breast-feeding women receive a prenatal vitamin containing 150 mcg of iodine daily.39
Consider Taking 250 mg of Pollutant-Free (Yeast- or Algae-Derived) Long-Chain Omega-3s Daily
According to two of the most credible nutrition authorities, the World Health Organization and the European Food Safety Authority, you should get at least half a percent of your calories from the short-chain omega-3 ALA.40 That’s easy—the one Daily Dozen tablespoon of ground flaxseeds takes care of that. Your body can then take the short-chain omega-3 from flaxseeds (or chia seeds or walnuts) and elongate it into the long-chain omega-3s EPA and DHA found in fish fat. The question, however, is whether the body can make enough for optimal brain health.41,42 Until we know more, I recommend taking 250 mg of pollutant-free long-chain omega-3s directly.
I don’t recommend fish oil, since even purified (“distilled”) fish oil has been found to be contaminated with considerable amounts of PCBs and other pollutants, so much so that taken as directed, salmon, herring, and tuna oils would exceed the tolerable daily intake of toxicity.43 This may help explain the studies that found adverse effects of fish consumption on cognitive function in both adults and children. But many of those studies either were done downstream of a gold-mining area contaminated with mercury, which is used in the mining process,44 or included people who ate whale meat or fish caught next to chemical plants or toxic spills.45 What about fish you’d just get at a restaurant or supermarket?
An elite group of Floridians (mostly corporate executives) was studied. They ate so much seafood that at least 43 percent exceeded the U.S. Environmental Protection Agency’s safety limit for mercury, and it appeared to have an effect. The researchers found that excessive seafood intake, which they defined as more than around three to four servings per month of such fish as tuna or snapper, elevates mercury levels and appeared to cause cognitive dysfunction. The effect wasn’t large—only about a 5 percent drop in cognitive performance—but “a decrement [in executive function] that no one, let alone a health-conscious and achievement-oriented person, is likely to welcome.”46
Thankfully, you can get the benefits without the risks by getting long-chain omega-3s from algae instead,47 which is where the fish primarily get it from to begin with.48 By cutting out the middle-fish and getting EPA and DHA directly from the source at the bottom of the food chain, you don’t have to worry about pollutant contamination. In fact, the algae us
ed for supplements are just grown in tanks and never even come in contact with the ocean.49 That’s why I recommend a contaminant-free source to get the best of both worlds, omega-3 levels associated with brain preservation50 and minimized exposure to industrial pollutants.
What About . . . ?
All the other vitamins, minerals, and nutrients should be taken care of by the mountains of nutrition you’ll be getting by centering your diet around whole plant foods. And many of those nutrients are ones Americans normally don’t get in sufficient quantity—namely, vitamins A, C, and E and the minerals magnesium and potassium, along with fibre.51 Ninety-three percent of Americans don’t get enough vitamin E. Ninety-seven percent of American adults don’t get enough fibre.52 Ninety-eight percent of American diets are deficient in potassium.53 You, my friend, are going to be the one in a thousand who does it right.
If you have a specific question about some obscure nutrient—like, “What about my molybdenum or menaquinones?”—rather than have me bore everyone else with minutiae, allow me to refer you to the best reference book available on plant-based nutrition by the preeminent dietitians Brenda Davis and Vesanto Melina.54 The authors go into great detail and even have chapters on pregnancy, breast-feeding, and raising bouncing boys and girls.
Vitamin B12-fortified plant-based diets can offer health benefits for all stages of the life cycle.55 Dr. Benjamin Spock, the most esteemed pediatrician of all time, wrote perhaps the bestselling American book of the twentieth century: The Common Sense Book of Baby and Child Care. In the seventh edition, the final one before Dr. Spock died at ninety-four, he advocated children be raised on a plant-based diet with no exposure to meat or dairy products. Dr. Spock had lived long enough to see the beginnings of the childhood obesity epidemic. “Children who grow up getting their nutrition from plant foods,” he wrote, “have a tremendous health advantage and are much less likely to develop health problems as the years go by.”56
Notes
Preface
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3. Ornish D, Scherwitz L, Billings J, et al. Intensive lifestyle changes for reversal of coronary heart disease. Five-year follow-up of the Lifestyle Heart Trial. JAMA. 1998;280:2001–7.
4. Ornish DM, Scherwitz LW, Doody RS, et al. Effects of stress management training and dietary changes in treating ischemic heart disease. JAMA. 1983;249:54–9.
5. Ornish D. Intensive lifestyle changes and health reform. Lancet Oncol. 2009;10(7):638–9.
6. Adams KM, Kohlmeier M, Zeisel SH. Nutrition education in U.S. medical schools: latest update of a national survey. Acad Med. 2010;85(9):1537–42.
7. Jamal A, Dube SR, Malarcher AM, Shaw L, Engstrom MC. Tobacco use screening and counseling during physician office visits among adults. National Ambulatory Medical Care Survey and National Health Interview Survey, United States, 2005–2009. MMWR Morb Mortal Wkly Rep. 2012;61 Suppl:38–45.
Introduction
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18. Mayo Clinic News Network. Nearly 7 in 10 Americans take prescription drugs, Mayo Clinic, Olmsted Medical Center Find. http://newsnetwork.mayoclinic.org/discussion/nearly-7-in-10-americans-take-prescription-drugs-mayo-clinic-olmsted-medical-center-find/. June 19, 2013. Accessed March 31, 2015.
19. Murray CJ, Atkinson C, Bhalla K, et al. The state of US health, 1990–2010: burden of diseases, injuries, and risk factors. JAMA. 2013;310(6):591–608.
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37. Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84(2):289–98.
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