Q:
Can you recommend any vegan food sources of DHA? I’d like to try food before supplements. 


A:
This is a great question I was recently asked by a vegan client. Getting adequate essential fatty acids (EFAs) is extremely important for everyone, but especially for vegetarians and vegans, and especially if they are trying to fall pregnant, are pregnant or breastfeeding.

We all need EFAs for healthy brain, eye and nervous system function (and development in the case of pregnant mamas), and to keep our immune systems humming along nicely.

The two essential omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are most available in fatty fish like salmon, sardines and mackerel. You can also get these EFAs from fish oil. The fish themselves get it by eating phytoplankton, which themselves subsist on microalgae.

Since vegans don't eat fish, getting enough DHA can be tricky. This is especially true for pregnant and breastfeeding vegan mamas. ​

Read on for my extended answer to this question. If you're short on time, scroll to the bottom of the article for my short answer!

I work with a lot of yoginis and yogis, alternative lifestyle leaders, animal rights activists, and environmentally conscious folks. I also work in the field of disordered eating.

​So naturally I often find myself in the situation where I'm chatting with somebody who is very keen to heal their troubled relationship with food... but they don't want to budge on their vegan ideals. 
 
This person may have been through the psychological hell that is a full blown eating disorder...

... OR they may fall into the spectrum of disordered eating on the end of the continuum that wouldn't be classified as a clinical eating disorder, but disordered eating and disordered body image - an issue that faces a significant number of women in Australia.
 
OFTEN, they've experienced both.
 
The big question here is, "If I'm actively recovering from a clinical eating disorder - or any other form of disordered eating - can I be vegan and still get better?"

Tonnes of clients ask me what "I think" about dairy. With the paleo movement at its zenith, the anti-dairy mania couldn't be higher - but it's an equal and opposite, inevitable reaction to the "got milk?" attitude of recent decades, where anyone who didn't drink milk was made to think their bones would crumble like feta the second they hit 60.

As a yoga-loving, natural therapy-studying, Accredited Practising Dietitian with 8 years of formal scientific training I find myself in an interesting position.

We need between 1000 and 1200 milligrams of calcium per day for healthy bones. Before you think "I'm not vegan, I'll be right," know that many Australians are deficient in calcium, so plenty of omnivores aren’t getting enough, either. No matter what your diet, you need to make sure to include two or three servings of calcium-rich foods in each meal, and you’ll be able to hit that target for bone health.

The Australian Guidelines to Healthy Eating suggest consuming 2.5 - 4 serves of milk, yoghurt, cheese and/or alternatives (mostly reduced fat) per day, depending on your age, gender and whether or not you're pregnant or lactating. In short, dairy (or alternatives) is an essential part of every Australian's diet - according to the AGHE guidelines anyway.

My dietetic training heightened the urge to ensure everyone gets enough dairy (or alternatives) into their diet to ensure an adequate intake of calcium and other minerals, and stop their poor little bones from snapping in half. Whether that actually happens if you don't get adequate dairy is another story altogether, and one I'll save for later :)

On the flip side, being a yogi into healthy, sustainable, wholefood based living has exposed me to two camps - the "drink milk as long as it's raw" camp and the "dairy is the devil" camp.

So what do I think of dairy? My opinion is based on what I've learnt from scientific studies (either supporting or denigrating dairy), what I've seen in practice, and my own personal experience (i.e. my 7 years as a vegetarian and 2 years as a vegan).

Here it is: I don't think dairy is inherently "bad" or "good' - I think that for some people it's a health food, and for others it brings disease.

There are a few ways to spot “magic bullet” diets. Those approaches to eating with huge herds of followers declaring that “everyone should eat this way to be the healthiest they can be.” Here’s how to spot them:

1. "It cures everything"

Enthusiasts of the diet/superfood/ingredient claim it cures everything - from chronic diseases, to skin conditions, and even psychological or stress-related disorders.

According to one top Paleo diet website, “eating like this is ideal for maintaining a healthy metabolism and reducing inflammation within the body. It’s good for body composition, energy levels, sleep quality, mental attitude and quality of life.  It helps eliminate sugar cravings and re-establishes a healthy relationship with food.  It also works to minimise your risk for a whole host of lifestyle diseases and conditions, like diabetes, heart attack, stroke and autoimmune.” That’s quite an extensive list!


2. "There's scientific evidence"

There is often scientific evidence to back up these diets. Some of it is super solid, and some of it is anything but. Many paleo studies are extremely short term, and there are very few studies done on the benefits of a 100% raw food diet.

The funny thing about scientific evidence is that if you look hard enough, you can find evidence for whichever argument you decide to take, whether it's paleo or the exact opposite – a high carbohydrate, low to no animal protein, plant-based vegan approach.

The work of Colin Campbell and Cardwell Esselstyn exemplifies the many benefits of such a diet. And their studies are probably the most comprehensive and scientifically valid of the lot. It still doesn't make them perfect and fail-proof, however. I've seen people on a vegan diet suffer, the same way I've seen paleo people and raw foodists suffer. Not everyone does well on a 100% vegan diet, the same way not everyone suits a high animal protein diet.


3. "It's how we were meant to eat."

The flyer at a paleo cafe I enjoy attending says the paleo diet "avoids dairy, grains, legumes, added sugars and preservatives, which our bodies were not designed to digest.”

Really? What about the traditional cultures who adapted to digesting lactose and have lived for centuries eating cultured raw milk products, like the Abkhasians of Russia? Or the myriad traditional cultures who eat legumes and grains on a daily basis - Indians with rice and dahl, or native central americans with maize and beans? You could hardly argue that these guys are unhealthy.

The same applies with hard core raw foodists and vegans. "We weren't meant to eat cooked food." "We don't have the correct length digestive tract or teeth to digest meat." While it's easy to find some form of evidence for some of these statements, they are still sweeping statements - they simply don't work for EVERYone.

If you've found yourself feeling disappointed or like a failure after being paleo/raw/vegan for a while and having it go pear-shaped... don't worry. Here's 5 ways you can find a way of eating that works for YOU.


1. Clarify your motives.

Why do you want to go vegan/raw/paleo? Is it to lose weight/fit into your old jeans/get clear skin? If so, look a little deeper. WHY do you want to lose weight/have better skin? The deeper reason for embarking upon any health endeavour is often to feel more confident, to feel more satisfied, to have a more rich and meaningful life. But feeling good is not only dependent on diet.

You need to look at all aspects of your life in order to feel good - and that includes your emotional landscape, exercise and other habits, attitudes, values, beliefs. It involves assessing your job satisfaction, family dynamics, relationships, and lifestyle.

Want to be wholistic? Then look at the whole picture. Diet is important, but it's only one piece of a much larger whole.


2. Practice intuitive eating.

It's ok if you eat a salad, ditch refined sugars, or eat a vegan meal - as long as it's truly what you feel like.

The only reliable authority, in the end, is your own body. We need to learn how to trust our bodies again, and how to listen to the messages it is sending us about diet. The simple tools of tuning into our bodies and fully experiencing each bite of food have the power to resolve most questions about food choices and diet.

Rather than adopt a diet, you could try a more intuitive way of eating that is highly personalised to your needs, food preferences, lifestyle, and experiences.

A truly instinctive approach to nutrition aligns joyful, nurturing eating with the authentic needs of body and soul. It doesn't include eating raw salads in winter when you are dying for a hot pumpkin soup.


3. Take the best from the diet, and make it your own.

The paleo and raw movements get a big tick for their push towards real foods. Veganism gets a tick for the emphasis on plant-based foods, which most people need more of. We would be better off eating real foods. That means foods that we grow, hunt or pick. Foods that are unmodified and come from nature.

When possible, we should aim for the most nutrient dense foods, because that’s why we eat, to nourish! Not to accomplish some idealised macronutrient ratio. Take the good from these diets, then break the other rules. Don't become a slave to rules and extremism. That brings me to the next point...


4. Avoid extremism

As much as we collectively rant about the benefits of moderation, people will always tend to be extremist when approaching a topic as complex and transitional as nutrition, in an attempt to simplify and make sense of it all.

Unfortunately that desire for "the be all answer" contributes to the hype around "magic bullet" foods or diets. You don't have to go 100% paleo, raw or vegan in order to gain more energy, and be healthier. You may only need to add a few more vegetables to your diet, or reduce your intake of refined sugars and processed foods. People have a hard time grasping moderation as the key, but moderation really is golden.


5. Ditch the labels

Some days I'm "vegan." In Summer in Thailand, I went three months on a raw vegan diet, without even noticing it. In winter in Australia, I eat eggs and the occasional fish. I may have a paleo lunch and on the same day have a non-paleo dinner with roast potatoes and ancient grains. These ways of eating can work when they are slotted in to fit your lifestyle, your day, your mood, your climate, your genetic heritage, and your season.

When these seemingly healthy diets fail is when we try to fit ourselves to the diet, with its theoretical rules and blanket recommendations.

Don't be a raw foodist for the sake of being able to say "I'm 100% raw." That's not very flexible and unless you live in a treehouse in Thailand all Summer running up mountains and practising yoga for 6 hours a day (as I once did), it probably won't work perfectly in the long term.

Ditch the labels and do what works for you. And that may change on a seasonal, daily or hourly basis.

Who wants to live to 100?

Who wants to look 25 forever?

If you've been brought up or conditioned to any extent by mass western culture, you may find your answers to those questions a little bit contradictory!

The western world is obsessed with youth, yet most of us want to live forever. Which implies ageing.

Our cultural impetus is on remaining youthful looking at any cost but at the same time, wanting to extend our life span for as long as possible -  it's a really weird mix.

Whilst I was in India earlier this year, I was astounded and pleasantly surprised to see billboards with elderly female politicians, activists and even moviestars - complete with jowls, pigmentation spots, double chins and droopy eyelids. How refreshing! You never see this kind of thing in Australia.

Of course there is a reverence for youthful beauty in India, but it doesn't totally predominante the media's portrayal (and therefore, the people's acceptance) of women. It got me thinking - if I had to choose between the two, would I rather live to 100, or look 25 forever? Obviously one is possible naturally, the other is somewhat possible via unnatural, expensive and painful means. So having a low tolerance to pain and no progress to date in my plastic surgery funds savings account, I guess I'll go for living until 100! (And just enjoy being 27 while I'm at that actual age).

The nutritionist in me then asked the inevitable question: what should we eat to live to a healthy 100, rather than the decrepit centenarian on life support and a plethora of medications that fuels the fear of ageing? And possibly even retain into advanced age, a degree of sexiness, aliveness, vivacity and pep? (I realise that using that word reveals a distinct lack of pep).

To answer this, we need to distinguish between life span and health span.

It's curious that in the west there is an emphasis on extending life span, rather than health span. According to United Nations estimates, Australia has the fourth-highest male life expectancy in the world (79 years) and the third-highest female life expectancy (84 years).

Big woop!

Many of us have spent time in nursing homes or seen grandparents battle with multiple chronic diseases for years leading up to their deaths. Life span seems more an indicator of how accessible modern medicine and pharmaceuticals are than how healthy a people are overall.

Life span is measured in years, but a longer life doesn't necessarily mean a healthier life. For many people in the western world, optimal health is reached between ages 20-30, after which pre-disease states start to set in and health deteriorates over the next few decades - asthma or allergies in your 20's, adrenal fatigue and PCOS in your 30's, pre-diabetes or diabetes in your 40's, high blood pressure in your 50's and so on. Check out any national health statistics for cancer, heart disease, diabetes and other chronic diseases - and the ever-younger ages people are developing these conditions - and you'll see that we have succeeded in extending our lifespans, only to spend more of our lives dying slowly.

Despite its amazing advances in treating acute health crises, modern medicine has been less successful in treating chronic disease, prolonging life span but not the proportion of life spent in an optimally healthy state. Our hospitals and nursing homes are filled with people "living" to ever increasing ages, but rather than dying late in life, people are spending more time starting to die early in life, and spending much of it in a suboptimal state of health.

Health span on the other hand, is the capacity for people to live vitality-filled, healthy lives until very late in life. According to John Robbins in his fantastic book, Healthy at 100,tThe Okinawans of Japan, Abkhasians of the Caucasus, Vilcabambans of Ecuador and the Hunzas of Pakistan are the longest-living peoples on the planet, but they also maintain incredibly high levels of health until very late in life.

So how do they do it? Sure, they exercise far more, have a respect and adulation for elders, find joy in their work and don't have a word for retirement in their vocabularies; all of this contributes to their comparitively long and vitality-filled lives. But from a purely dietary perspective, the traditional diets of these long-lived cultures are remarkably similar:

* The percentage of their diets that come from plant foods is between 90% (Abkhasians of Soviet regions) and 99% (Vilcabambans of Ecuador and the Hunzas)

* Their consumption of salt is low, and consumption of refined sugar and processed food is nil. Yep, not a smidgen of crap.

* Their overall daily calorie intake (adult males) is 1800 to 1900. In Australia, where lifestyles are far more sedentary, the average man consumes 2650 calories a day.

* In these diets, percent of calories from protein ranges from 10 percent to 15 percent, from fat it's 15-20% and from carbohydrates it's 65-74%. Mind boggling to the average westerner, who has been told to up the protein and cut the carbs in order to lose weight! The U.S. Department of Health and Human Services recommends a daily macronutrient ratio of 10 percent to 35 percent protein, 20 percent to 35 percent fat and 45 percent to 65 percent carbohydrates.

I'm not saying we should emulate exactly the macronutrient ratios of these cultures, in the same way I don't expect we should all live in mud houses and run up mountains for 6 hours a day. These are simply points to think about and experiment with in your diet, rather than replicate exactly. And it doesn't have to complicated. In the words of Michael Pollan, "Eat real food. Mostly plants. Not too much."