In this episode, we discuss:
- The EAT-Lancet planetary health diet, including why and how it was created and the concept of a “planetary health diet”
- What micronutrients are lacking in the EAT-Lancet diet and why it matters
- How mainstream media has received the EAT-Lancet diet
- Why discussions on nutrient density are so complex, including the synergistic relationships between some necessary nutrients
- How phytic acid affects the bioavailability of key nutrients like iron, zinc, and calcium
- Ways to increase nutrient density while following the EAT-Lancet guidelines
- The problem of outdated and non-standardized recommended daily allowances of nutrients
- How EAT-Lancet researchers have responded to criticisms of their guidelines
- Ty Beal’s recommendations on what makes a healthy diet
- “Estimated micronutrient shortfalls of the EAT–Lancet planetary health diet” by Ty Beal, Flaminia Ortenzi, and Jessica Fanzo
- “Milk and Health” by Walter C. Willett and David S. Ludwig
- “Perspective: Proposed Harmonized Nutrient Reference Values for Populations” by Lindsay H. Allen, Alicia L. Carriquiry, and Suzanne P. Murphy
- “Priority Micronutrient Density in Foods” by Ty Beal and Flaminia Ortenzi
- “Friend or Foe? The Role of Animal-Source Foods in Healthy and Environmentally Sustainable Diets” by Ty Beal, Christopher D. Gardner, Mario Herrero, Lora L. Iannotti, Lutz Merbold, Stella Nordhagen, and Anne Mottet
- Global Alliance for Improved Nutrition website
- Follow Ty Beal on Twitter @TyRBeal and on LinkedIn
- Learn more about the Adapt Naturals Core Plus bundle, or take our quiz to see which individual products best suit your needs
- If you’d like to ask a question for Chris to answer in a future episode, submit it here
- Follow Chris on Twitter, Instagram, or Facebook
- Get your free LMNT Recharge Sample Pack when you purchase any LMNT product at Kresser.co/lmnt
- Visit Paleovalley.com/Chris and use the code KRESSER15 to get 15% off your order
- Visit Insidetracker.com/chriskresser and get 20% off everything in the store
Hey, everybody. Chris Kresser here. Welcome to another episode of Revolution Health Radio. Many of you have probably heard of the EAT-Lancet planetary health diet. This made a big splash when this paper was published. The idea was the researchers tried to come up with a diet that is good for individual humans and good for the planet, and is sustainable over time. But it turns out that this diet approach that they proposed, which was heavily plant-based [with] lots of grains and legumes and very few animal products, fell short of some critical micronutrients that most people don’t get enough of already and could potentially deepen and exacerbate those micronutrient deficiencies.
So I invited Ty Beal on the show to discuss this. Ty is a global nutrition scientist, he’s a research advisor on the knowledge leadership team at [the] Global Alliance for Improved Nutrition or GAIN, where he generates evidence to guide programs and mobilize knowledge related to global nutrition and food systems, and he has a PhD from UC Davis, where he was [a] National Science Foundation Graduate Research Fellow. And he and his colleagues published a critique of the EAT-Lancet planetary health diet and highlighted what the micronutrient deficiencies would be if you were to follow that diet and why that is a problem in a world where those nutrient deficiencies are already prevalent, not only in the developing world, but even in rich industrialized countries like the [United States] and Canada. So in this show, I dig into the paper that Ty just published. We talk about what the planetary health diet is, which micronutrients are lacking, and what can be done, if anything, to shore that up. [We discuss] what Ty’s recommendations would be for a truly nutrient-dense and nutritionally sustainable diet for most of us. And we talk a little bit about some of the responses that he’s had from his paper from the authors of the EAT-Lancet planetary health diet, like Walter Willett, and also David Katz.
This was a fascinating discussion. And if you’ve been listening to this show for any length of time, [you know that] I’m really passionate about nutrient deficiency and nutrient density and how we can improve our micronutrient status and why that is the rising tide that lifts all boats and can help us achieve almost all of our health goals, at least to some extent. So this was a really important interview for me and a really important topic. I hope you enjoy it as much as I did. Let’s dive in.
Chris Kresser: Ty Beal, welcome back on the show. [It’s a] pleasure to have you.
Ty Beal: Thanks for having me, Chris.
Chris Kresser: So I think a lot of people have heard of the EAT-Lancet planetary health diet from this show, listeners of this show, or people who followed my work or yours. But for those [who] are completely unfamiliar with this concept, why don’t you just start by defining what that is?
Ty Beal: Sure. So a planetary health diet in the context of the EAT-Lancet report was really trying to design a diet that can meet the needs of a human, the global human population, now and in the future, as well as stay within planetary boundaries. So a way to think of that is like a healthy and sustainable diet.
Chris Kresser: Healthy for us, healthy for the planet. That’s the promise, right?
Ty Beal: Exactly.
Chris Kresser: And what would you say about how this diet has been received overall in the mainstream media, and just from what you’ve seen on Twitter and social media, and the kind of general reception of EAT-Lancet?
Ty Beal: Yeah, I think there’s sort of two camps. I think it’s highly praised by a lot of media as sort of the solution that we need to be working toward, especially by environmentalists, I would say. And there’s also been a fair amount of pushback, certainly on social media, as well. A little bit less so on mainstream media. But social media has been full of people pushing back on the limits on animal-sourced foods, questioning the nutrient adequacy of the diet. So we really see some polarized responses to the report.
Chris Kresser: So I recently had Ridge Shinn and Lynne Pledger on [the show] to talk about more of the ecological, environmental, and sustainability aspects of an animal-based diet and why animals might actually be necessary in our food system and ecosystem. So I’m going to not focus on that in this conversation, especially because you have published a paper that is specifically about some concerns that you have about the micronutrients lacking in the planetary health diet. And this is an interest that you and I both share overall, nutrient status and nutrient density and the importance of that for our health and well-being. And you’ve done a lot of phenomenal work on this subject before. For listeners who haven’t heard my previous interviews with Ty, you should definitely check those out. Because we talk[ed] about another paper that I think was from March of about a year ago, right Ty? March 2022, the Frontiers in Nutrition paper?
Ty Beal: Yeah, exactly. That was last year [at the] same time.
Chris Kresser: Last year, where you and your colleagues published the nutrient density ratings of foods. And I believe it was the first paper to take bioavailability fully into account. And from that, we learned how important animal foods can be in the diet from a nutrient-density perspective. So tell us a little bit about the EAT-Lancet planetary health diet from a micronutrient perspective and what some of the concerns that you have are.
Ty Beal: Sure, so I’ll just start by saying I was actually asked by an editor of a journal about the adequacy because they had some concerns, and I think some people had reached out to them. So there, it was not just me who was sort of questioning the adequacy. I think there were some others. But really, I think for me, I have done enough work on modeling global diets, nutrient density, nutrient adequacy, as well as actual deficiencies in people when you look at their levels of these biomarkers in the body. So I had concern because I knew the lower you get with animal-sourced foods, the more challenging it can be to meet your needs, especially for nutrients like iron and zinc, which exist in plant-sourced foods, but they’re quite a bit less bioavailable. And there are some questions on the EAT-Lancet diet, which we don’t have to get into the debate about how protective that is of non-communicable disease, but it’s a minimally processed plant-based diet. I don’t have a lot of concerns there. It’s really more on the adequacy side, where it’s very high in whole grains and legumes, which, if minimally processed, can be part of healthy diets. But it’s concerning because they’re very high in phytate. And I don’t think, maybe, many people don’t realize this. But it was sort of off the charts of phytate in terms of how we look at recommended intakes for zinc, for example, where you have these categories of unrefined diet, which would be about 1200 milligrams of phytate. There’s a lower bioavailability of zinc. This affects iron, as well. But what we saw is that, wow, the phytate on this diet is actually closer to 2000 and even close to 2500 milligrams. So its impact on bioavailability really isn’t well understood.
Chris Kresser: So can I just interrupt there for the listeners who are not aware of what phytate, also known as phytic acid, [is?] Can you tell folks a little bit about why that’s a concern from a micronutrient perspective?
Ty Beal: Yeah, so phytate binds to minerals like iron, zinc, [and] calcium, and it really inhibits their absorption. So the higher the phytate in the diet, the lower the bioavailability of those minerals. And so that’s why, in particular, I was concerned about recognizing that when you have a lot of phytate in the diet, you actually have to consume a lot more iron and zinc. And many people don’t realize that, right? It’s just, oh, you just have a set amount of iron that you need and a set amount of zinc. But it actually depends on what your total diet is and the bioavailability. And the other factor, which I didn’t mention, is that heme iron is really much more bioavailable. And heme iron is only found in animal-sourced foods. So you have this sort of difference in the bioavailability from the type of iron and the amount of phytate and other antinutrients that can prevent that absorption or hinder the absorption.
Chris Kresser: Yeah, so this is something that I wrote about in my first book, The Paleo Cure, way back in 2013, 10 years ago now. And my belief has always been that whole grains and legumes, especially when they’re properly prepared, as some of the traditional methods of preparing grains and legumes, which most cultures did prior to the Industrial Revolution and still do, like soaking them with some acidic substance like yogurt, kefir, or lemon juice, can break down some of the phytic acid. And there’s been some interesting research on this, and [the process] makes the nutrients more bioavailable. But I think it’s pretty safe to say that in many situations, grains and legumes are being consumed without those traditional methods of preparation in our culture today [and] in most places in the modern industrial world. So if you’re building your entire food pyramid, if you will, your entire diet around these foods—which can be okay in moderation—but if they’re replacing other more nutrient-dense food, that’s where the problem and the concern comes in. Would you agree with that?
Ty Beal: Yeah, I think it’s a question of balance. And like you said, most people are not preparing their grains and legumes. And we know that because we’re using food composition data from foods in the form that they’re typically consumed, right? So in their typically consumed form, they have a certain amount of phytate. Now we know, of course, like you said, you can ferment, you can germinate, you can soak grains, legumes, seeds, etcetera, to reduce phytate. But that’s not being done in the majority of these foods around the world.
Chris Kresser: Yeah, I mean, I’ve tried to get patients to do this for many years. And I would say just a small handful actually would do it. And it’s a lot of work, and that might actually fit in with a more traditional lifestyle, where there [are] shared resources and people are doing those kinds of things together, and it’s just part of a normal daily routine. But it’s not really built into the modern way of living for most people.
Ty Beal: Yeah, I agree with that. But I have seen more and more products, at least in the [United States], [made from] a sprouted grain. For example, sprouted quinoa. I see that commonly sprouted oatmeal. Even Costco has these products, at least the sprouted oatmeal.
Chris Kresser: That’s true.
Ty Beal: So I think there could be a movement toward that. I think that’s one potential way to improve the bioavailability, and I certainly think it’s worth pursuing. I’ve also seen sprouted lentils and mung beans, [and] things like that. But I think you’re right that most consumers are not going to be purchasing those products at this point.
Chris Kresser: Yeah, we’re talking about a very small minority, but I’m glad you brought that up because particularly health food stores like Whole Foods, natural grocers, and even like you said, in Costco and some other more mainstream stores, you can find some sprouted varieties, and they are a much better choice from a nutrient density perspective. So you mentioned zinc and iron as two of the main nutrients of concern because they’re minerals that are bound by phytate. Are there other nutrients that you’re concerned about on the planetary health diet?
Ty Beal: Yeah, in this recent study, we also found shortfalls for calcium and vitamin B12. Now, they weren’t as large as for iron and zinc. But I do think there’s a concern there, especially when you think of populations consuming low amounts of animal-sourced foods.
Chris Kresser: And why do you think it is that this was—was this quantified in the paper that was published on planetary health diet? I mean, the whole premise was a diet that’s healthy for humans and healthy for the planet. So was it that they didn’t take micronutrient density into account as one of the health factors? Or was it that they weren’t considering bioavailability and the impact of phytate? In other words, is your concern just a lack of the amount of that nutrient on paper like the [Recommended Dietary Allowance] (RDA) or [the] presence of phytic acid that interfere with the absorption of those nutrients? Or both?
Ty Beal: I think it’s a combination. So the lead author was Walter Willett. I think he’s probably the world’s leading expert on nutrition or nutrition epidemiology. And his perspective is that the recommended nutrient intakes are not really appropriate. You should either use nutrient density per calorie because people need different energy requirements. They’re not necessarily applicable because he’s looking at the health outcomes of these intakes of different levels. So, I sort of disagree. But I think his point is just that there’s a disagreement about how much of these nutrients we need. And I think a big one for [him], he and David Ludwig published a review in the New England Journal of Medicine on calcium. And that suggests that people don’t need as much calcium as is suggested in the recommended nutrient intakes. Now, I’m sort of agnostic to that, whatever. But I’ve worked with micronutrients enough to know that the data, it all kind of suggests the same thing. The food supply data say there’s not high enough nutrient density in the food supply. The dietary intake data when we survey people, what did you eat in the last 24 hours, there’s not enough micronutrients in their diet. And the biomarkers, when you actually measure in people’s bodies, there are widespread micronutrient deficiencies.
So for me, I think it’s a pretty significant burden worldwide. And I think the question then can become, well, what is the real health burden from this? What’s the morbidity and mortality? And that’s, I think, a reasonable debate. But for me, it’s an important issue to focus on. I think, when you look at the original adequacy assessment for the EAT-Lancet planetary health diet, the other issue is that it used different recommended nutrient intakes that were dated. So they weren’t the latest evidence. And we also had an update in 2020, where there was a paper out by Lindsay Allen and others that said, let’s try to agree on a harmonized set of recommended nutrient intakes. Because if you look into nutrient intakes, many countries or regions of the world have different recommendations. So you have the EFSA in Europe, the European Food Safety Authority, you have the Institute of Medicine in the [United States], and then you have others in other countries, and many of them are saying different things, [with] different justifications. I think I would acknowledge there is some uncertainty around what levels of these nutrients we should consume. But I think you would probably agree with this: many of these are not necessarily based on optimal consumption. So even if you do meet the target for a nutrient, it may actually be beneficial to consume above that for many different reasons. Now, I think you can see an argument on the other side where people say, well, there’s also a risk of consuming too much. People may say that about iron, and I’ve heard that. So I think there [are] some things that are open to debate, but from my perspective, we looked at things as objectively as we could, trying to use the latest evidence on bioavailability, trying to be pretty fair. We assumed a 10 percent bioavailability of iron on the EAT-Lancet diet, which I think is pretty generous considering how much phytate is in there. But there are some animal-sourced foods, and there’s quite a bit of vitamin C. So we wanted to be fair, and we still find shortfalls. So I think it comes down to probably the biggest factor is a disagreement about what are the recommended intakes? And that I think there’s some disagreement about.
Chris Kresser: Yeah, I want to linger here for a little bit because I’m very concerned with the idea of downwardly revising the recommended nutrient intakes, rather than increasing them, which I think is what the majority of research suggests we should be doing. There are so many reasons for this. One of the problems I see is that there’s a lot of research in different areas that points to the need for increasing, I think, in many cases, the recommended intake of these nutrients. But there isn’t a central sort of source like to your point of harmonized recommendations that’s pulling all of these different lines of evidence together. So an example would be, we know that chronic disease affects nutrient needs in two ways: it increases the demand for nutrients because chronic disease is a stressor on the body, and it decreases, in many cases, the absorption of nutrients. For example, we know that people with obesity and metabolic issues convert less sunlight into vitamin D in response to sun exposure than someone who’s lean and metabolically healthy. And we also know that they absorb less vitamin D from both food and supplements such that if you look at the scientific research, you can see that the recommended dose for maintaining adequate serum vitamin D levels for someone who’s obese with metabolic disease is often 5 to 10,000 IU, versus maybe 1000 to 2000 IU for someone who doesn’t have those conditions.
We also have an increase in environmental toxins that bind to minerals and other nutrients and interfere with their absorption; there’s a lot of papers on that. We have an increasingly industrial food system where food is shipped for 3000 or 4000 miles before it’s consumed, and it’s losing nutritional value throughout that journey in that process. And then we have the presence of antinutrients, like you’ve mentioned with phytic acid, but there are others that can interfere with nutrient absorption such that the if you were to just look at diet surveys and the amount of nutrients that people are consuming on paper, you know better than anyone that that’s not the ultimate amount that we’re actually absorbing and using. And as a clinician who has literally tested every single person who’s walked through my door for 15 years for nutrient status, I can honestly say that there’s been only a small handful of people who didn’t have at least one and not multiple nutrient deficiencies, as evidenced by their biomarkers and their food intake, assessing their food intake with something like Cronometer or a similar tool. And these are people who are highly—my patients are not the average population. They’re people who are highly motivated; they’ve typically been listening to blogs and podcasts like mine for a long time. They’re not eating a Standard American Diet. They’re shopping at health food stores and eating a relatively good diet, and it’s still an issue for those people.
So I get really nervous when I hear the idea that we don’t have to worry about [nutrient density] and maybe we need fewer nutrients than the RDA has established. Especially because, in many cases, the RDA has not been updated for 20 or even 30 years. And the formula for the RDA is often based on things like average body weight, and average body weight has gone up hugely in the past 25 or 30 years alone. So yeah, I’m just curious about your take on that. Because this is really your area of expertise and study. And you see, you’re aware of all these different lines of evidence and different factors that affect nutrient density.
Ty Beal: Yeah, Chris, I think you’re absolutely right about all of that. I fully agree. And I don’t have any question that the risk of inadequacy is much higher than any risk of harm from excess nutrient intake. I mean, [if] you look at the data, [the] nutrient density of our diets is not great. And [if] you look back to traditional cultures or our ancestors, they had much higher nutrient densities than we consume now. And there are other concerns. Climate change. As more carbon comes into the atmosphere, there’s actually going to be a reduction in the iron and zinc and other minerals in our crops. So the very crops that are going to be supplying these plant-rich diets, grains, staple foods, there’s going to be less iron and zinc and protein in these foods. So we have to pay attention to this. We need to increase the nutrient density of foods. I fully agree about that. So I think that the concern about or the question maybe of, well, what exactly do people need? What do we need to avoid the specific effects of some disease from a deficiency? That’s a different question than what’s optimal. And you talked about vitamin D. We looked at the prevalence of vitamin D deficiency using a very low bar of the 25 OHD. And that’s not optimal, right? I think there is a case where 50 or higher would be optimal when you look at other markers, right? And we’re just looking at sort of this very low bar, and we find widespread deficiency.
So I think I am concerned, just as you are. You mentioned your patients. Well, we looked at people in the [United States], the [United Kingdom], all around the world, and we found, this is a study that came out last fall, we found actually very high prevalence of deficiency all over the place. Worldwide, two in three women aged 15 to 49 had at least one micronutrient deficiency, and that wasn’t even looking at all of the nutrients. There are 25 essential micronutrients, [and] we were looking at three or four. Some countries, in India and Cameroon, Côte d’Ivoire, others, it’s nine in 10 women. So it’s not a small issue. Even in the [United States], over 20 percent of women in that age group are deficient in iron. In the [United Kingdom], it’s similar, and also in the [United Kingdom], you see folate and vitamin D deficiency around 20 percent. So, I agree. I think this is an underappreciated issue, and it’s something that requires attention.
Chris Kresser: Yeah, and again, even those deficiency statistics are using benchmarks [that] might be out of date or too low, right? So I mean, an example that I’ve used recently is with magnesium. The current RDA for magnesium is 320 for women and 420 for men, but those RDAs were last published in 1997 using average body weights of 133 pounds for women and 166 pounds for men. But today, the average body weight is 169 pounds for women, and 196 pounds for men. And some researchers published a study in 2021, where they recalculated the RDA for magnesium to reflect that increased average body weight in the U.S. population. And they came up with a new adjusted RDA for women of 467 to 534 milligrams per day. That’s a huge difference. That goes from 320 to up to 534; that’s 200 milligrams per day more that a woman would need, and the male level was 575 to almost 660. So again, another 200-point increase. Then you look— (crosstalk)
Ty Beal: But Chris, we just consume an extra 1000 calories to keep you— (crosstalk)
Chris Kresser: To compensate.
Ty Beal: To compensate, right?
Chris Kresser: Yeah, but the problem is, as you well know, those extra 1000 calories of cheese doodles and Big Gulps and highly processed and refined foods don’t contain any nutrients to speak of. So the average intake of magnesium for U.S. adults is currently 340 to 344 milligrams for men and 256 to 273 milligrams for women. So women are already falling short of the inadequate RDA that was published in 1997. But if we were to use these updated RDAs based on the actual current average body weights today, the typical person is falling short 200 to 300 milligrams per day less magnesium. So, that’s just one example. There [are] papers that suggest the RDA for [vitamin] B12 should be 300 to 500 percent higher in order to reliably avoid signs and symptoms of B12 deficiency. There [have] been arguments that the RDA for vitamin D, which is currently only 600 IU/d, should be at least 1000 IU/d, if not higher. The Linus Pauling Institute has argued that the RDA for vitamin C should be increased by 200 percent. So, there [are] other things I want to talk about, but I just couldn’t let that go because you and I, I think, both know too much to be able to accept the proposition that, hey, the RDAs are not only fine, [but] maybe they’re too high, and we should just be satisfied with people not even meeting the RDA. I think that’s a really dangerous argument.
Planetary health diets like EAT-Lancet offer dietary guidelines that supposedly support human health while providing the greatest protection to the environment. But the nutrient needs of the global population are complex, and diets like these that favor plant-based foods fall short. Global nutrition scientist Ty Beal joins this episode of Revolution Health Radio to discuss why and how we can do better. #chriskresser #nutrientdensity #diet
Ty Beal: Yeah. And I think another point to highlight is that the recommended intakes used from the original EAT-Lancet adequacy were from 1973. So they were far more data than what you’re referring to. Which, of course, yes, many of the latest recommendations are still based on evidence that is quite dated. Yeah.
Chris Kresser: Okay, there’s one more point I have to make, and then I promise I’ll let this go. But it is the topic of the podcast. We’re not too far off on a tangent. And I’m curious if you ever see, if like about this, because I haven’t seen any studies that look at this. And it seems mind-bogglingly complex to do so, but also very important, which is the concept of nutrient synergy. So we know that nutrients aren’t just isolated from each other in our bodies. They have complex and often synergistic relationships. We were just talking about magnesium, [so] let’s use that as an example. That’s required for the absorption and activation of vitamin D. So even if someone is getting enough vitamin D on paper through diet or sunlight or supplements, if they are falling short on magnesium, then they will effectively present with a vitamin D deficiency, even though their intake of vitamin D is sufficient.
Copper is similar; it’s required for the absorption of iron. So if someone is copper deficient, even if they’re getting enough iron, they can be iron deficient and even anemic. And I’ve seen that over and over in my practice, particularly with women who were not responding to iron supplementation or increasing iron in their diet; they were still anemic. We would test their copper, find that they were low, give them copper, and all of a sudden, their iron levels would go up. [Vitamin] K2 regulates calcium metabolism. So if you’re getting plenty of calcium, but not enough [vitamin] K2, that calcium can end up in the soft tissues, like blood vessels and kidneys, and not get into the bones, teeth, and hard tissues where you want it. So to me, that’s another big factor. Because on paper, if someone’s getting enough of certain individual nutrients, if they’re low in other nutrients that are required for the biotransformation and activation of those nutrients, then they’re still going to have a problem. And I’m not aware of any studies on nutrient sufficiency that even attempt to deal with that, given the complexity.
Ty Beal: It’s a great point, Chris. And I think it’s another case for why we should aim to consume most of our nutrients through whole foods. I think there’s a lot of reasons why, but that’s another one. And at the very least, be very mindful when we think about, which maybe we’ll discuss, we think about other strategies like fortification or supplementation to really consider the synergistic effect of these nutrients.
Chris Kresser: Yeah, absolutely. Okay, so what, in your mind, can be done to—if you were to design a planetary health diet, let’s put it a different way., How would it be different [from] what they’ve proposed?
Ty Beal: I don’t want the responsibility of trying to design a planetary health diet.
Chris Kresser: Yeah, that’s a big task.
Ty Beal: Also, nobody’s going to say their [recommended] diet and have everybody agree with you, right? People are going to criticize for all different reasons. So I’ll sort of stay clear on the planetary side because like you said, you talked about that. I think it’s reasonable to push back on some of the modeling of the EAT-Lancet to say, look, maybe we can produce more animal-sourced foods in a holistic way using circular diverse agroecosystems and produce more than what they propose. But I won’t go there because that’s a whole topic in itself. I will say there are many different approaches that we could use to design a diet that is nutrient adequate and healthy. And I will also just say for the EAT-Lancet diet, it was not proposing that everybody should consume this exact same diet. They do have ranges, and they did want to say there’s flexibility here. But I think we need to aim for higher nutrient density. So that would be one suggestion. And I think the way to do that [would] be to increase some of the types of animal-sourced foods that are most nutrient-dense. Of course, being organ meats, being very nutrient-dense shellfish, especially bivalves. And in general, the diet would benefit from some increase in animal-sourced foods.
The current diet has about 14 percent of calories from animal-sourced foods. So I mean, not thinking about the sort of environmental impact, just solely on nutrient adequacy, I think increasing that is [an] easy way to increase the nutrient adequacy because plant-sourced foods and animal-sourced foods have complementary nutrient profiles. And the lower you go in either food group, you have increased risk for trying to meet your nutrient needs. Now, I think listeners may be saying, “Well, I can meet my nutrient needs on a vegan diet,” or “I can meet it on a carnivore diet; I don’t have any issues.” What I’m thinking about is at the population level, it’s very difficult for most people to meet their nutrient needs. So what we need to do when we’re thinking of public health is to promote diets that are very protective of those concerns. Increasing nutrient density in general. The other aspect that I think we already discussed is to reduce the amount of phytate. Now, phytate can have benefits. And I’ve heard arguments for why you don’t want to reduce phytate too much. There can be health-protective effects of some phytate. So I think it’s more about moderation, though. I don’t think we need 2000, 2500 milligrams of phytate in our diet to have any benefits. And we know that that really hinders the bioavailability [of nutrients].
So whether that’s reduced through the processing or consuming [of] foods. There’s a bit of a variation between different types of legumes, nuts, seeds, and whole grains that are higher or lower in phytate. So choosing ones that are lower in phytate, I think, can be a benefit. And there’s also breeding strategies. There’s a strategy called biofortification, where it actually allows agronomists to change the nutrient content of the crops to adjust the amount of phytate. Again, you don’t want to reduce, you don’t want to take it all out. But you can actually do that in the breeding process. And that is being done more and more, and I think that’s a good strategy. There are other strategies, and I think it would be not efficient and not effective to only pursue dietary change, or to try to have everybody in the whole world consume a perfectly healthy diet. Because we know that there are many barriers to people having access to all of these diverse foods. We think about affordability as a big one. And animal-sourced foods are generally more expensive. Not always, but they’re often more expensive. So there [are] some challenges with affordability and people having access to safe foods or having access to refrigeration to store foods, right? Fruits and vegetables are actually not always accessible in many low- and middle-income countries. So when you think about worldwide, the issues around access and whatnot, I think we have to consider all sorts of different strategies that we can use.
Another one of those is fortification. So staple foods like, you can use grains; [they] can be whole grains, oils, whatnot. Salt is fortified with iron; it could be fortified with other nutrients, as well. I think we need to work on fortification in a smart way really as a safety net for when we can’t have, when populations can’t consume all of their nutrient requirements through foods, we can make up for that in fortification. And I know the caveat, like you said, adding a few nutrients is not making up for the diverse food matrix of foods that contain lots of these nutrients in synergistic ways. But it can really help fill nutrient gaps for people. And it can be done in cost-effective ways and with minimal environmental impact. So I think we need to pursue that. And I mentioned biofortification. This is really, I think, something that we need to pursue in terms of scaling up so that the food that we consume, the crops that we consume, are as dense as they can be in nutrients. When we started breeding crops in the agricultural revolution to really increase yields to increase sugar and starch, it had a negative effect on the nutrient density of those foods. And now we are starting to pay attention to that. I think we need to scale up the breeding of crops. Now this can be something as simple as using an orange-flesh sweet potato compared to a white-flesh sweet potato, which the dominant varieties of sweet potato, for example, in Africa are actually white-flesh. So there are already efforts in place to work on developing varieties that contain orange-flesh sweet potato. They’re higher in vitamin A, they’re higher in folate, and that can make a real difference, especially if those can be scaled up.
And the fourth thing I would do is focus on supplementation when needed. And that’s providing concentrated nutrients either consumed through a pill or through a powder, or even in lipid-based nutrient supplements. These can be really helpful for populations with increased needs. So [for] pregnant [and] lactating women, young children, they can be consumed, where you add them to food. And really, those are effective ways of increasing nutrients, but they all have limitations. There can be side effects with supplements. You don’t want excess, for example, iron, obviously, which can happen in a supplement form. But I think all of these strategies are important. And the reason is because no single strategy can be enough to make sure the whole population in the world can actually get the nutrients they need. So I think we have to be smart and try to do as much as we can to provide access to all of the populations who may not have access to diets that ultimately would provide all of the nutrients required through the inherent or intrinsic nutrient density in the foods themselves.
Chris Kresser: That’s really fascinating. And I agree with all of that. I think there’s a lot we can do to shore up our nutrient status, even in our existing food system. And a lot of the conversations I’ve had with you before, and also with people [who] are working on this more from a food production perspective, regenerative agriculture and farming, which will produce much more nutrient-dense foods, and making changes to the food system overall, is going to be a big help. And I also appreciate the distinction you made between what’s possible on an individual level and what is likely on a population-wide basis, which is what public health is concerned with. And this comes up in research studies, as well. If you do a study on a particular dietary approach and the compliance is horrible, then in that study, the results will often be presented as a failure. And you might have an individual say, well, what happened to those five people [who] were able to stick with that diet for two years? Well, they actually had pretty good results. So yes, from an individual perspective, it’s possible, and likely certain even, that results will vary from person to person. But when you’re talking about what is a good general recommendation to make on a population-wide basis, you have to take into consideration people’s typical behavior, unless you have some magic wand that is going to somehow change that behavior when you introduce your recommendation. Because that’s just the reality of the situation.
Ty Beal: Yeah, you’re absolutely right. And behavior change is hard. And it’s not easy to change the demand for foods. People want certain foods because they’re desirable for many different reasons. I think, to your point, we looked at what, based on the current diets when you look at the food supply, so all the foods available for consumption [in] a country at the national level, based on existing diets, so what people are currently eating, we really see that when animal-sourced foods get below 30 percent of the calorie supply, you start to see a lot more micronutrient inadequacies. And that’s just pretty clear. And to your point about what people are actually going to consume when they have choices, when they have enough money to buy what they want to buy, we have to consider these factors. Not everybody’s just going to buy the most nutrient-dense foods possible, right? So it’s an important consideration. I think you were correct to say that there’s a big difference between the public health recommendations and what may be possible for an individual who’s very health conscious, who listens to health podcasts and reads about it and makes sure that their diet is top-notch.
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Chris Kresser: I know when you published this paper that was raising some concerns about the EAT-Lancet planetary health diet, not surprisingly, the authors of that paper probably didn’t agree with some of your assessments. I think Walter Willett is submitting a letter to the editor, and David Katz published a LinkedIn article with some objections. I’m just curious what those were and how you would respond to their response.
Ty Beal: Yeah, so I’ll say first off that I had been discussing with Walter as I was creating this analysis; we sent a draft of the paper before we even submitted it. And he provided feedback. So it’s been friendly. I really actually admire the ability of Walter Willett and David Katz to engage in really constructive, respectful dialogue. So we have some differences. But really, it’s not like we are worlds apart. And I think it’s really important to highlight that. These types of discussions are really important and essential for science. I think the media and social media aim to polarize these issues, and I think there’s actually more in common than there is that we disagree on. But yes, there are some disagreements. And I think, in the letter, which Walter sent to me, he’s going to submit, I think there [are] valid points, and we’re going to respond, and I think we’ll have a lot of agreement about that. But ultimately, I think there’s still some disagreement about, like you mentioned, what are the recommended intakes? And what should we be aiming for with these diets? And I think it’s important [that] whatever diet we promote, I want it to be nutrient adequate, and I don’t want to take a lot of risk on that because I see how widespread deficiencies are. So I think that’s just something that I would want to maintain and be able to advocate for throughout this process.
Chris Kresser: Yeah, I couldn’t agree more. I wish there were more venues and forums for these kinds of respectful and informed discussions. I won’t even necessarily say debate. I mean, it could be a debate; it could be a discussion. I recently listened to a discussion about the future of [artificial intelligence] (AI) and the impact of AI between Stuart Russell, who literally wrote the textbook on AI, and then I can’t remember the name of the second. His first name was Gary; I can’t remember his last name. And it was [in a] completely different context, of course, AI versus health and nutrition. But I was struck by just how valuable it was to hear two experts [who] really respected each other and listened to one another while they were talking and actually took in what the other person was saying. And in one case, we sort of listened to one of the experts change his mind in real time, based on what he was hearing from the other person in the discussion. And my main takeaway from that was, wow, why doesn’t this ever happen in the world of nutrition? It seems like there’s just so much more vitriol and polarization and name calling and ad hominem arguments. And almost to the point of a religious debate or discussion where it just starts to go beyond even just the data and the facts and turn into more of a belief or agenda-driven thing. So I hope that we can have more examples like this of people just really working together to find a solution that’s in everyone’s best interest.
Ty Beal: I hope so, too. And I will say there are a lot of healthy discussions going on behind the scenes. I know, because I’ve been a part of many discussions where it is productive, it is constructive, [and] it is respectful. And I don’t think the public is seeing those, right? Because those are happening over email, [and] that’s happening in comments, in paper revisions to meetings. I’m on papers all the time with many of the EAT-Lancet authors, for example. And we have some disagreements, some discussions, [and] some debates. That’s good, that’s healthy, [and] that’s important. And I think the more we can have scientists with different perspectives work together, the work that is going to be produced is going to be much more balanced because we all have biases; we all need to have them challenged and checked in a respectful way because we learn from them. I’ve changed my position to writing papers.
Another researcher who I really respect is Christopher Gardner, who wrote a paper recently on animal-sourced foods, and he’s been on a mostly plant-based diet for decades, and we have some different views, but I was sort of impressed by the fact that we could really agree about most things and recognize that there are different approaches; there are many different approaches to a healthy diet. Some of the biggest things to address we can agree upon like, let’s really address these ultra-processed foods or the junk foods, and try to have a more wholesome, minimally processed diet. So I think probably, it looks, because on social media and other public forums, there is just, I think, an incentive to be critical or polarizing. But there is quite a bit that goes on among scientists in these discussions. I think what people will also see is that there are these formal processes of writing a letter to the editor and then having the authors respond. I think that’s helpful, too. But we just need a lot more of this type of, I think, productive discussion between scientists.
Chris Kresser: [I] 100 percent agree with that. So what are you working on next? Can you tell us, or do you have to kill us afterward?
Ty Beal: No. So really, my organization, GAIN, works on trying to do programs and interventions to change the food system, the food environment, so that people can access healthy foods. So I’m working on some projects to really help guide those programs and also try to quantify nutrition more accurately, more appropriately in environmental impact assessments. So that’s another topic I’m interested in. You can sort of see the mini studies that looked at, what are the greenhouse gas emissions of each food that’s produced, right? And I think that there is a more holistic way to look at that. Part of that is through looking at the food more in terms than just kilograms, or calories, or whatnot. So we’re working on some efforts to try to quantify that in, I think, more holistic ways. And ultimately, I’m open to any projects that I can be a part of that [and] help advance my agenda of trying to improve access to healthy diets for everybody. So yeah, I won’t go into all the details. But I really, really enjoy working with people who are trying to be constructive and productive, as opposed to debating to try to win an argument. And those are the projects that I’m pursuing and working on now.
Chris Kresser: What a relief. That sounds like much more fun than the alternative. And I definitely applaud the work you’re doing. I think it’s really important. As you know, I think that nutrient deficiency and nutrient density issues have become primary for me. After 15 years of treating patients and training thousands of healthcare practitioners in 50 countries worldwide and seeing lab results from all over the world, and my research on these topics, I’ve become convinced that addressing nutrient deficiency and aiming for increasing nutrient density of every bite of food that we put into our mouth is the rising tide that can lift all boats. It’s not to say that it’s a panacea and that that’s going to solve all of our health problems. That’s, of course, ridiculous. But I think it’s one of the few things that we can do that we know will have a positive impact on just about every health condition that we suffer from at this point. Whether you’re looking at heart disease, or metabolic dysfunction, or depression, or dementia, and Alzheimer’s [disease] or hormone imbalances, all of those are characterized by some degree of nutrient deficiency. And, unlike big, gnarly issues, at least in the industrialized world, like environmental toxins and the global food system and things like that, increasing nutrient status is relatively low-hanging fruit. I mean, the work you do worldwide, that’s a tougher goal in developing countries, particularly, I imagine. But in the West, in the wealthier industrialized countries, it seems to me that just even some small steps toward increasing the nutrient density of diet[s] could go a very long way in improving people’s health. So this has become sort of a legacy issue for me because it doesn’t require seeing a Functional Medicine clinician one-on-one and paying thousands of dollars for that and for lab testing. It doesn’t require anything fancy, really. It just requires a more nutrient-dense diet and in some cases, maybe some well-targeted supplements, and that can make an enormous difference in individual health and in public health.
Ty Beal: I find that so striking, Chris, that in working in the context of the [United States], I know you work with other patients. But in the [United States] where obesity and other noncommunicable diseases are very high, you still see a significant role for addressing micronutrient deficiencies. And I think that’s an important takeaway because that’s not the narrative you hear in many public health messages, right? You don’t hear, we should be concerned with nutrient adequacy and nutrient deficiencies in the [United States] or other high-income countries. But I don’t think that’s true. I think it’s clear from the data that there really are some important gaps, and it affects not just undernutrition, but the relationship with other noncommunicable diseases, like you pointed out.
Chris Kresser: Great. Well, thank you so much, Ty, for joining us again. I know you’re pretty active on Twitter. Is that the best place for people to follow you and stay up to date with your work?
Ty Beal: Yep. I post the latest things I’m working on on Twitter. My handle is Ty R Beal. It’s T-y-R-B-e-a-l. So please check it out, and I’ll be happy to engage there as long as it’s respectful.
Chris Kresser: Yeah, exactly. No hating, please. Then, the other piece of that, of course, is personal ad hominem attacks are not very persuasive, right? If you want to argue with something that has been published in the literature, publish something yourself or make a constructive argument using data that [are] actually supportable rather than just slinging mud and calling names, which is not very persuasive at all, for those of us [who] are paying attention. So again, thanks for your work, Ty. Thanks, everybody, for listening. Send your questions to ChrisKresser.com/podcastquestion, and we’ll talk to you next time.
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