Picky eater in the family? video captions

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- Hello, everyone.

Welcome back to Conversations with Dr. Aw.

I'm Dr. Aw, I'm your Chief Medical Officer at OMERS and Oxford.

Thanks so much for taking the time to tune in.

We've got another great session with Alex Bhathal, a registered dietician who has become our go-to expert on all things nutrition.

So welcome back, Alex.

- Thanks, James, it's great to be here.

- Yeah, nice to see ya.

So today we thought we would talk about something topical, climate change.

So as we see the news, it almost seems like on a regular basis, there's floods, there's overheating, there's heat waves, there's forest fires, there's health effects.

And, you know, with this plethora of information online and lots of people trying to come up with their own theories of how we save the planet, actually, you know, the medical community and the nutrition community has actually been looking at how to eat for sustainable planet, or how do you eat for a healthy planet.

So we thought today, it'd be interesting to say, "Gosh, how could we create habits on a daily basis in our own lives, as we're now reintegrating into society, whether we're going back to work or kids are going back to school."

"Are there ways that we can do things to eat for a healthy planet?"

And so with that, I like to, you know, hand it over to Alex and maybe you could give it a sort of an overview on the kinds of maybe questions or thoughts that come up when you have an opportunity to talk about this with your patients in your clinical practice.

Is this something that you lead with or something that organically kinda happens?

- Ooh, that's a good question.

So I think either, you know, really is the answer.

It can come up either way, but more and more, especially in the last year I've had clients bringing this up to me as something that they want to incorporate into their healthy eating habits.

So whether it's reducing waste or reducing consumption of animal products, and how do they do that in a sustainable manner?

So a couple years ago, I will say at The EAT-Lancet Commission on food planet and health, actually brought together 37 different scientists from across the world to tackle this question, right?

So can we feed our growing population, and they're projecting 10 billion people, a healthy diet that's sustainable?

So we can sustain it within planetary boundaries.

And just to kind of paraphrase the authors, this is the scale of the problem that we're dealing with.

So, unhealthy diets actually pose a greater risk to human health than unsafe sex, alcohol, drug, and tobacco use combined.

So there's that, which is surprising actually, I think, when we frame it in that way.

And global food production is actually the single largest driver of environmental degradation.

So food is very much, you know, intertwined with planetary health and individual health.

So going back to that question, can we do it?

The answer is yes.

(Alex laughing)

Luckily, so, phew!

But it's going to take some changes in the way we produce food, and then on the individual level, of course, the way we eat.

- So that's great.

That's interesting about the scientific panel in terms of their recommendations.

So what are the kinds of tips that you give patients when you see them, when they say,

"Hey, gosh, it sounds great."

It's purposeful, but from a practical point of view, you know, where do I begin?

- Yeah.

So very broadly, there are two things we can work towards.

So the first is actually doubling on average, our consumption of fruits, vegetables, nuts, legumes, so beans and lentils, and then actually reducing by half our consumption of refined sugars and meats.

So, James, we've talked a lot about different eating patterns and diets in the past.

I'm just curious, does that remind you of any we've talked about recently?

- Absolutely.

It sounds like a pretty healthy plant-based Mediterranean type diet.

- Exactly, yeah, absolutely.

So it's very much like the Mediterranean eating pattern, the MIND diet.

And so it's really, I think encouraging about this report that they put out is that those are two eating patterns that are very strongly associated with good physical health in the long term.

Good, you know, mental health and brain health.

And then it's nice to know that yeah, we can actually do this and it's healthy for the planet as well.

Okay, so you asked how do we do that?

(Alex laughing)

Practically?

That's the big question because the what, you know, when we're reading a report like this, the what is easy, it's the how that's really the hard part.

So for many of my clients, I suggest basically a two-step process.

So first you wanna audit yourself, okay?

Grab a little notebook, and over the course of a few days, or maybe a week, just jot down every time you have a fruit, maybe every time you have a vegetable, some whole grains, whatever it is that you're focusing on, particularly.

And I think it's helpful to take it one step at a time.

So you might not want to audit for all of these things all at once.

That'll give you a sense of what your usual intake is.

And then you have your target of trying to double it or in the case of sugars or meats, trying to half it.

So step one is just figuring out what am I actually eating?

Step two is experimenting.

So this is where you get to have a little bit of fun.

If you're heading back to the office, as many of us are, you might consider brown bagging your lunch.

This is really gonna give you the most control.

If you go that route, you want to really think of ways to make healthy eating easier, trying to reduce friction around it.

How can you make it the simple choice, right?

I had a client recently with a very, I think, ingenious approach to this.

So she was trying to increase her consumption of fruit.

And what she ended up doing was actually moving her fruit bowl next to her coffee maker on the counter.

So we know that when we're trying to establish new habits, cues are important and we need them to be very visual and very timely.

And so it was kinda cool about this experiment that she set up for herself, was she paired it with a habit that was already in place.

You know, she'd get up in the morning, go into her kitchen, first thing she did, turn on the coffee maker.

And then she made it easy, right?

So she had her coffee, she'd grab a piece of fruit, out the door she goes.

It didn't require any prep.

And she was careful to, you know, buy fruit that she actually liked.

I think we've got to like what we're eating.

And that worked really nicely.

What we had tried prior to that was actually preparing, you know, chopping up fruits and putting them in Ziploc baggies.

And that sounded like a great idea, but in reality, when things got busy or something came up, it just didn't get done.

So there was a lot of friction.

And so this early morning, you know, fruit bowl by the coffee maker works really well.

So that's my example of, you know, one way you can experiment with different ways of increasing fruits and vegetables.

If you're not a brown bag lunch person that's okay too, you can get a little bit
strategic with your ordering at restaurants.

So this might be something as simple as, you know, doubling up the beans in your burrito, or getting a vegetable on the side, maybe trying a vegetarian restaurant in your area that looks really good.

These might sound like small things, and maybe they are, but they're exactly the kind of things that these experts are referring to when they talk about the changes that are going to have the greatest impact on our health and the health of our planet in the long run.

- That's great.

I like the idea about cueing and habit forming because in terms of the world of behavioral change, I remember things like for weight loss, you know, you only eat of a dessert plate or always have a glass of water whenever you do this.

So I love that idea about healthy, sustainable eating, linked to a habit or a cue to make it easy.

- Yeah.

- What about fish? Do you have a comment about fish?

I know there are some Netflix documentaries that were going around about, I think it's called Seaspiracy or something, but just about the farmed fish.

Do you have any opinions on where you get your fish?

How much fish?

'Cause I know it's always a good source of omegas, and it's a healthy food, but is that something we have to consider in terms of where we get the fish?

- Yeah, so sustainability in the fisheries.

Oh gosh, it's such a complicated topic.

I'm definitely not gonna do it justice today.

But there are organizations, watchdog organizations that you can look for, for more sustainable fishing practices.

I haven't seen Seaspiracy, I'll be honest with you.

So I'll have to check it out.

But fish is included in this report as something of sort of moderate emphasis, right?

So maybe once a week, that kinda thing.

A little bit of fish is helpful we know for brain health.

We know there are some types of fish farming and types of fishing that are more sustainable than others.

I can't say exactly which ones right now, because it is so really honestly complicated that you sort of need these third-party watchdog groups to come in and do the auditing for you.

But yeah, so probably a little bit, but you wouldn't, I think for sustainability, wanna be having fish every night, for example.

And from a health perspective that could raise some concerns as well.

- Great, what about, and maybe you touched on it already a little bit, but food waste, you know, the expiry dates, does it really mean we have to throw the food out or when they say it's best before, and any tips for folks about how to shop and plan for minimizing food waste?

- Yeah, yeah.

So, you're absolutely right.

So best before dates typically refer to the, when the food is at its highest quality for enjoyment, it's not necessarily a food safety cutoff date.

So your food can still be good and can still be consumed, you know, probably beyond these dates, as long as it looks okay and it smells okay.

For reducing food waste, there's a lot in this report that speaks to the production side.

But you know, on the personal level, there are things we can do as well.

Having a plan goes a really long way, so we know that people who do a little bit of meal planning, which is really something as simple as, you know, maybe picking three or four entrees for the week, shopping for those ingredients.

Generally they're gonna be wasting less than the folks who shop sporadically or who maybe have a standard grocery shop, but they don't really know what they're gonna be making until the day of, or the night of.

What is also very helpful for many clients are having these kinda backup meals, plan B meals that you can throw leftovers into.

So a few examples might be a stir fry, right?

You can use leftover meats, you could use tofu, you could use any leftover vegetables, stuffed peppers work really well for this.

You can even mix in grains that you might have leftover.

You know, maybe a little bit of fried rice, if you have leftover rice from a meal that you had earlier this week.

So having some kind of backup meals, plan B meals can be really helpful for cutting down on food waste.

And I will add that usually that requires shopping your pantry and shopping your fridge before deciding to order out or shop for more food.

So that's kinda step one, just take a look at what you have and think, is there anything I could make from what I already have on hand?

- Great, super.

I like that shopping your pantry and shopping your fridge first.

What about shopping in your backyard for those that are lucky enough to have a garden?

I know for this pandemic, a lot of people, myself, you know, my wife's a big gardener, so we kind of got into it and she did this vegetable garden and it was great because instead of going to the grocery store, you just go in the backyard, pick some stuff.

So, any tips on the urban gardens or home gardens in terms of that contributing to the mission of a healthy planet.

- Yeah, I mean, it doesn't get much more local than your backyard, right?

So, that's wonderful.

And I think too, just speaking from experience, we have a small vegetable garden as well that we just started this year.

It's been wonderful because, we try and do this in my own house.

So shopping our pantry, shopping our fridge.

And sometimes we are out of things and like "Jeez, you know what would be really good in this pasta is like some roasted tomatoes."

And we're like, "Oh, we have tomatoes in the backyard."

So we just go pick a few and roast them ourselves.

So it cuts down on that extra trip to the grocery store.

So, you know, I think even if you have a small balcony, a lot of people live in condos these days, even if you can only grow a few things, it's that incremental effect, right?

So, as an individual, it might seem very small, but if we get, you know, 10%, 20% of the population doing this, it actually has a significant effect on the transportation of food and the greenhouse gas emissions that we're reducing as a result.

- Great, excellent.

Maybe one last question.

Started playing with my mute because I have some workers in my house, so they've been kind of noisy.

(James laughing)

So I apologize for the in and out.

And like any future trends, like, do you have any crystal ball views from your peers?

Like are you seeing other kinds of trends that might be happening as more people, maybe particularly the younger generation, the gen Zs and folks that are more aware of their environment, would things might be changing in terms of nutrition?

- As it relates to climate change or?

- Yeah, climate change.

Do you think it's, you know, food security is going to.

I mean, it's a broad question and maybe not a fair question, but it just made me think
about from your viewpoint, what you're reading and what you're hearing from your colleagues.

Is any trends that you're seeing in terms of responsible eating, do you see this, you know, continuing or changing?

- So I think one of the fastest growing trends that we're seeing is the adoption of, you know, we call it plant-based eating, but there's more vegetarian eating, more vegan eating.

So vegan being no animal products included in a person's diet. So those seem to be on the rise.

What does EAT-Lancet report showed is that what we call flexitarian eating can be just as, if not in some circumstances, more sustainable.

So, I think this trend that we're seeing is a shift towards fewer animal products being consumed, more plant-based products at sort of every level, if that makes sense.

So there's sort of different ways of and different degrees of implementing that.

So I would think that's probably the biggest trend I'm seeing in nutrition.

This is probably not directly related to food, but it is coming up more and more, and that's around reducing packaging waste.

So plastic waste with packaging is a concern that I'm hearing more and more from clients.

Also a great reason to start a garden, right?

It's not gonna come wrapped in plastic.

And so I think what we're gonna see in the supermarkets are companies taking note of this and finding ways to package in materials that are compostable, that are low waste or that are even zero waste.

- Well, thank you so much, Alex, again for great conversations and great tips.

I love that word flexitarian, that's one that I'm not as familiar with.

So I think that's a nice model of eating for the future, eating healthy.

The other great thing is eating responsibly for the planet, also is good for your body in terms of medical benefits, in terms of plant-based diet, Mediterranean style MIND died.

So there's a lot of good reasons to follow these protocols.

And I think you've shared some great tips about how to make it practical.

So thanks again, everybody, for tuning in, and hopefully you can incorporate some of these tips in terms of your habits on a day to day and have great tasting food that's healthy, that's good for your planet, your neighbors, and for sustainability.

So thanks again, Alex, and thank you all for tuning in and we'll see you next time.

Stay well.