Nutrient Density with Dr. Sarah Ballantyne: Rational Wellness Podcast 366

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Dr. Sarah Ballantyne discusses Nutrient Density with Dr. Ben Weitz.

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Podcast Highlights

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Dr. Sarah Ballantyne was previously known as the PaleoMom and is the best selling author of five books, including her new book, Nutrivore: The Radical New Science for Getting the Nutrients You Need from the Food You Eat.  In this book, Sarah creates educational resources to help people improve their day-to-day diet and lifestyle choices, empowered and informed by the most current evidence-based scientific research. With Nutrivore, Dr. Sarah has created a positive and inclusive approach to dietary guidance, based in science and devoid of dogma, using nutrient density and sufficiency as its basic principles: Nourishment, not judgment. Her new website is Nutrivore.com.

Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure.  Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

 

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Podcast Transcript

Dr. Weitz: Hi this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates and to learn more, check out my website, drweitz.com. Thanks for joining me and let’s jump into the podcast. Hello, Rational Wellness Podcasters.

I’m excited today that we’ll be speaking with Dr. Sarah Ballantyne about her new best selling book, Nutrivore. Nutrivore’s subtitle is the radical new science for getting the nutrients you need from the food you eat.  In this book, Dr. Sarah creates educational resources to help people improve their day to day diet and lifestyle choices, empowered and informed by the most current evidence based scientific research. With [00:01:00] Nutrivore, Dr. Sarah has created a positive and inclusive approach to dietary guidance based in science.  And this is the Rational Wellness podcast, so we love science and devoid of dogma, using nutrient density and sufficiency as its basic principles. Nourishment, not judgment. While there’s a lot of great valuable information in this book, one thing that I found particularly helpful was the Valuable Vitamins Cheat Sheet, which we can refer to.  Dr. Ballantyne, thank you so much for joining us.

Dr. Ballantyne: Oh, thank you so much for having me.

Dr. Weitz: You say Nutrivore in your book is not a diet, however, you were previously known as the Paleo Mom, so in this book, your description of a healthy diet in this book sounds more like a Mediterranean diet, so, it sounds like you changed your [00:02:00] approach, did you have to file divorce papers from the paleo community?

Dr. Ballantyne: I’m, I’m pretty sure it’s still enough through legal action that I’m not allowed to say anything. No, in all seriousness, you know, I think, my transition from Paleo to Nutrivore has been a very iterative process. I can’t say that there was one moment where I went, Oh, I think I’m wrong about some things.  I think this entire community is wrong about some things. I think there is a more diverse diet that we can be embracing that actually will be more health promoting, but also, have better coverage in terms of supplying all of the nutrients that our bodies need. It really, the research started, I think it was 2014 or 2015, I started doing, researching for a book on the gut microbiome, that still has not been published, but it was that research of really trying to understand how different foods impact the composition of the bacterial community that lives in our guts. That was the beginning of me going, oh wait a minute, legumes are really phenomenally health promoting. They’re the most nutrient dense, starchy foods. They have vitamins and minerals that, make them very valuable. They’re really great sources of polyphenols, and I don’t think we think of legumes as, being particularly great sources of polyphenols.  And the more that I did this research, the more I really questioned a lot of the dietary dogma that I had bought into.  And as the research and reading the science really, like, opened up my eyes, I started to realize that I had some disordered eating patterns that I had learned through the Paleo community as well.  So I had this personal journey behind the scenes of addressing my own food fears and expanding my own diet as I was undergoing this professional journey right out in the open for everyone to see as I kept going, excuse me, I think, I think maybe we’re wrong about lentils. I think maybe we’re wrong about corn.  I think maybe we’re wrong about oats. And the, the more foods that I, that are not considered paleo, that I really started to, like, change my mind on, the more it became obvious that it was time for me to move on, and, and build something new, and that’s what Nutrivore is.  

Dr. Weitz: So, you have a chapter in, or a section in your book where you talk about the myth of plant toxins, and, you know, one of the big knocks against legumes and lentils, things like that, are that, and this is a argument that paleo advocates often utilize, that lectins, that these foods like legumes contain lectins and phytates and what are called anti-nutrients or plant toxins and these are one of the main reasons why we want to avoid grains and beans.

Dr. Ballantyne: Yeah, so I actually this is, there was a huge conversation behind the scenes with my editor and the team at Simon Schuster about this chapter. So chapter 10 is a myth busting chapter and it kind of has something for everybody in there because it also talks about, whether or not, right, the myths about animal foods being bad for us, which is not true.  There’s a lot of seafood myths that I bust, a lot of myths about food quality, talking about, you know, olive oil and, organic foods as well.  It was really important to me to include a section on plant toxins, because that was the world that I used to, to, those were the circles I used to be in. And I had sort of learned that way of thinking from very prominent scientists names that we’re all familiar with if, if we’ve heard about Lectins and Phytates and Oxalates.

Dr. Weitz:  We might call this the anti-Gundry section.

Dr. Ballantyne: That could be. And as you dig into the science, I mean there’s, there’s a couple of different layers here. So the first layer is that yes, like sometimes the isolated compound in a food, like in, in a lab, it, in, when scientists are validating these compounds, they’re looking at them for potential use in pharmaceutical industries, typically where these scientific studies come from.  And I used to do this type of research. So like, I’m very, very familiar with how these experiments are designed and the different types of techniques that are used. So you take this, this compound that’s isolated from something. And you, first of all, you put it on some cells, and you see like, what do those cells do?  Does it change the proteins those cells are making, right? Like, that’s a really interesting way to understand that compound. Does it have use in a pharmaceutical industry somehow? And then the next kind of step you do to understand what this compound does is you, use it in animal models. So for example, there are some specific, plant toxins [00:07:00] that in animal models of colitis, when you administer just that one compound, you get increased inflammation.  That sounds really scary. That is not, that scientific study is not there to tell us to not eat the whole food. It’s there to help understand whether or not there’s pharmaceutical applications for that one specific compound in the food. And so we need to be understanding those studies within that bigger picture of how does the whole food, because a food is thousands of different chemical compounds, you know, maybe dozens of different nutrients. How does the whole food affect our entire biology?  Because every food will have something that you could isolate and concentrate and put in some, you know, high doses in an animal and go, okay, here’s a negative impact to one biological system. That is actually where a lot of pharmaceutical discovery has, has come from. A lot of cancer drugs come from exactly that process, [00:08:00] but that doesn’t help us understand the whole food.

And so my, my realization of this sort of logical fallacy of like, just because a food has a compound in it that is harmful to one biological system or one specific circumstance, we can’t judge the whole food based on that compound. And that was one of my main, um you know, uncomfortable realizations that I had been thinking about nutritional sciences in this way that is incorrect. And that really drove me to go back to the research and go, okay, so now let’s actually look at studies showing, like looking at whole legumes and not just looking at phytohemagglutinin as a, as an isolated compound. Let’s see how, in animal models, in humans, in intervention studies, where you give a group of humans and you have them eat more legumes.  Let’s look at these studies. And what you see is. the fiber types, the polyphenols, the very high legumes are the the most nutrient dense starchy foods on [00:09:00] average. They’re very rich in vitamins including folate which is one of the most common nutrient shortfalls in the standard American diet. So legumes tend to be some of our best food sources of folate.  Very very mineral rich. You start to see that the that all of the benefit we’re getting from those nutrients, the way that that fiber impacts the gut microbiome, all of that constellation of beneficial effects that we’re getting from eating the whole food completely suppress any potential negative impact from that one compound that in isolation is not great for us.

We’re not eating that compound in isolation, we’re eating the whole legume. And so that is a major sort of difference in how I have changed my view of research. Another big thing that really shifted for me over the last seven or eight years is putting more value in meta analyses. Now, a scientist will always say, right, that the most rigorous scientific [00:10:00] evidence is meta analyses, systematic reviews, umbrella reviews, right?  Like these are the studies, that pool together data for many, many, many studies. So they have a bigger data set. So they have more statistical power, and they incorporate a step of evaluating studies for bias. And so they, they actually have a step for evaluating a study’s quality before they incorporate the data into their giant data set.  And then they typically include a, now let’s also look at all of these, animal model studies, cell culture studies that help explain why this is the average effect we’re seeing. And that is another change that I’ve really made over the last, you know, several years in how I am understanding food is instead of looking at that one study that used phytohemagglutinin in an animal model of colitis, right, and showed increased inflammation.  I’m looking at the systematic reviews that look at all of the different [00:11:00] intervention studies where they take a group of people and have them eat more legumes and then measure various health outcomes, look at it, reducing risk of cardiovascular disease, type 2 diabetes, how it can cause weight loss in people with overweight or obesity how it can reduce risk of certain types of cancer, like looking at that big, big picture in these huge studies that are pooling together data from 20, 30, 300 different studies.  So they have really, really high statistical power. So it’s also a more rigorous approach, and one that really values scientific consensus. And so I included that in Chapter 10 because, I know my followers have kind of watched this whole journey, right? They’ve, they’ve seen all the little bits and pieces as I start to piece this together and really question a lot of the diet dogma that I held to be true.  But it’s also there for the, for the people who are not following that closely to help them understand my transition to a permissive dietary [00:12:00] structure where we can make room in a healthy diet for any food.

Dr. Weitz: That’s great. I generally agree with your overall dietary approach. However, when it comes to the research, it continues to be problematic.  And even if you’re looking at meta analyses, unfortunately, most of the dietary studies are not randomized controlled trials where they give people certain foods and they’re basically just asking people to fill out these food frequency questionnaires, which are so inaccurate. And that makes it difficult, I think, to talk about the real science when it comes to food.  You can’t just take a group of people and just give them, make sure they’re eating legumes, you know.

Dr. Ballantyne: So let’s drill down on that because I think, you know, your point of large perspective studies is really important. Like, I think that is a really important thing to sort of explain to your listeners here.  So perspective studies, or they can be retrospective too, [00:13:00] but these are the studies where we take, I don’t know, 20,000 people and we follow them for 10 years, right? Things like, these are things like, the NHANES study, Framingham, right? There’s these huge, huge cohort studies.

Dr. Weitz: Right, but none of these are control trials where you’re actually giving them food.  So you really have no idea what they’re eating. And then they’re filling out these food frequency questionnaires, sometimes asking them, what did you eat in the last month?  Sometimes in the last year?  And, you know, the recall is so sketchy.

Dr. Ballantyne: Absolutely. So different cohorts have different levels of, sort of trust in their diet recalls.  So for example, the NHANES cohort, their diet recalls are what did you eat over the last two days? And they take that as various snapshots over time. So that is considered a dataset that is much more reliable in terms of, like, actually reflecting what people eat, but also, Our memory is fallible.  We do not want to admit to eating certain things when we’re [00:14:00] being given a survey. And all of those studies are correlative, right? So they tell us that there may be an association, but we have no way of knowing from those types of studies if that association is causative. Did that group of people have lower cardiovascular disease risk because they eat fewer legumes or more legumes, or is it because of this constellation of factors, because that’s the other thing that we see in these types of studies is something called healthy user bias.

So this is where somebody who is eating more plant foods, less, I mean this is a big problem in all of the studies showing that red meat is problematic. It’s a big problem. It’s like a classic example of healthy user bias because red meat has been demonized for so long that people who don’t eat very much red meat tend to eat more fruits and vegetables, they tend to be more active, they tend to also have higher socioeconomic status, so they have social determinants of health working in their favor.  They tend to be female, who also we just get less cardiovascular disease.  And so it’s really hard when you have a lot of different things stacking in these correlative studies to be able to separate out, okay, but how much of this is that these people are eating more legumes? And how much of it is all of the other things that go along with that person who eats more legumes?

And that is, This is absolutely a challenge in nutritional sciences research, and one of the reasons why I never only rely on prospective studies in my interpretation of nutritional sciences. So fortunately for us, we are getting more randomized control. They’re not blind, because you can’t blind somebody from the diet they’re eating, typically.  There’s a few studies where they’ll be like, here’s a muffin and you don’t know if that’s the muffin that has the extra fiber in it or not, right? There are some studies that they can figure out blind, but overall diet studies, we can’t, but we are getting more studies where they take one group of people and say, keep doing what you’re doing, and they take another group of people and they have them work with a dietitian, they work with a, you know, work with a health coach, and they have a dietary structure for [00:16:00] them to follow.

And we’re getting more and more of those studies that we can then go, okay, so we have the intervention study that reinforces what we see in this big observational one that can’t establish causality. And then we can also look at The nutrient difference in, in what these people are eating and look at what we know about how those nutrients impact these biological systems and make a strong case for that being the causal mechanism here as well.  So it is very much about, yes, I absolutely agree that not putting too much weight into an observational study because it cannot establish causality. But taking that as our indication that here’s something to drill down further on understanding healthy user bias and, and how that impacts statistical analyses, but also then we can start layering on, other, other evidence.  And I think we do have a Fortunately, a growing body of intervention clinical trials, randomized but not blind, as well as animal [00:17:00] models that can help to drill down on the biochemical mechanisms behind the benefits.

Dr. Weitz: And let’s get back to the scientific information that you’re adding to our body of knowledge, which is the nutrient density of foods.  So tell us why higher nutrient density is so important and then how do we measure it?

Dr. Ballantyne: Yeah. So, I think that the background piece of information here is that most people’s diets fall short of actually supplying us with even the daily values of all of the essential nutrients, which, 

Dr. Weitz:  Which we know are very, very under, you know, very limited and most people would benefit from having more than the RDA.

Dr. Ballantyne: Absolutely correct. So, so we’re falling short of the RDA. Okay. And there’s some indication that the RDAs are still maybe not optimized, right? Like, they really need to be thought of as a minimum for most nutrients. I think they’re probably in the range for some. And [00:18:00] so there’s four essential nutrients for which 90 percent of Americans are not hitting the daily value, ever.  There’s ten essential nutrients for which half don’t of Americans are more or not hitting the daily value. But even when you, there’s a lot of different studies that will analyze diets that either look at meal plans from, you know, cookbooks or whatever, or they’ll look at people following that diet and look at what they’re actually eating.  And they’ll analyze the diets for nutrients and show that even people who are following diets anticipating that those are healthier ways to eat. Uh, each diet has a collection of nutrients that are a lot harder to get. And so there is a proportion of people who are not meeting the daily values of those nutrients.  And, I mean, government dietary guidelines aren’t off the hook here either. Even the dietary guidelines for Americans has a collection of about five nutrients that people aren’t getting enough of even if you follow the guidelines perfectly. So this is kind of a thing that is across dietary guidelines.

Dr. Weitz: Not to mention that there’s thousands of phytonutrients for which we have no guidelines at all and nobody has aren’t even calculated.

Dr. Ballantyne: Ew, I’m so glad you brought that up. I mean, we have, there’s like 10 ish thousand phytonutrients of which we really understand a few hundred. We know the more of them we consume, the healthier we are on average.  We know the biochemical mechanisms, there are very strong antioxidants, they tend to be anti inflammatory. Different phytonutrients localize in different areas of the body, they interact with different pathways, so they have a wide range of different benefits. So, we want. to be consuming a wide range of phytonutrients.  And there’s no daily value for phytonutrients. There’s probably enough data to actually establish one for polyphenols, but that hasn’t been done because we don’t get daily values for non essential nutrients. But I think you and I are on the same page that maybe phytonutrients could be labeled as essential just because they’re so important.

So we are, we’re in a situation where even people who are really intentional about their [00:20:00] food choices because We don’t learn this, right? We don’t learn in school, but also in dietary templates. When you are picking up a diet book at the store, you’re typically learning about what to not eat or how to measure the things that you eat.  You’re typically not learning about nutrients and what they do in the body and which foods contain what nutrients and how to choose foods from different groups so that you’re getting the full range of nutrients that your body needs. And that is what I am building with Nutrivore. And so that includes identifying nutrient dense foods and focusing on them because we’re trying to fill that gap.

So typically, our intake of these nutrients is high enough that we don’t have a disease of malnutrition, right? We don’t have scurvy. We’re getting enough vitamin C to not have scurvy, but we’re still falling short of hitting our daily value and vitamin C is definitely an example of a nutrient for which we Getting a lot higher than the daily value has been shown to have a lot of benefits for, for various situations.  [00:21:00] So, we’re in that weird ray of like, okay, it’s not so low that we’re like, I’m really, really sick, but not getting enough vitamin C is increasing risk of mental health challenges, increasing risk of cardiovascular disease. It’s having a negative impact on our health. So the best way to fill not just that vitamin C gap, but all of the different gaps that we have is identifying nutrient dense foods and being intentional about adding them to our diets.  So that is again, one of the tools that I am creating in my book, A Nutrivore.

Dr. Weitz: I’m curious as to how you come up with this, nutrient density score, for example, are all nutrients equal weighted? Are some more important than others, you know, how, how much is considered a good amount?

Dr. Ballantyne: Oh, I, that’s okay.  I’m going to nerd out about nutrient density calculation math with you. I think you, we’ve got [00:22:00] another three hours, I hope. So, I created something called the Nutrivore score, which is a measurement of nutrient density, which is scientifically defined. This is the consensus definition as total nutrients per calorie.  The definition of nutrient density, like it, Nutrient density calculations have an interesting history. So a nutrient dense food, that term was first coined in the 70s and it was defined as any food with a substantial amount of nutrients per serving. Substantial was not like specified any more than that.  You’re like, what does that mean? And so, I was someone who was alive in the 70s, 80s, and 90s. I remember labels and how that was like the beginning of like the health aura and the like healthification of labels but not the product, right? That led to a lot of challenges. And what ended up happening in the 70s, 80s and 90s was the demonization of foods as bad because they had high [00:23:00] fat content, like avocados, nuts and seeds, right?  These foods that we now recognize are really like important heart healthy fats. Those foods got demonized for having high fat content. But a sugary fruit punch could say a good source of vitamin C on the label if it had 10 percent of the daily value per glass. And so in the early 2000s, that definition was updated to significant amounts of nutrients per calorie.  Because we were in a situation, we’re still at a situation, where there’s no shortage of calories in the food supply, but there is a shortage of nutrients in the food supply. So we need to understand how to get more nutrients per calorie, not more servings of foods. And at the same time, scientists are working on different nutrient density scores.  So there’s a few dozen of them that have been created over time, none of which have been adopted by any institute or agency. My initial intention when I was first building the Nutrivore website and working on the the early foundational content.  In preparation for writing the book was I’m going to go through all this research and figure out which one’s the [00:24:00] closest to being ready for prime time, which one is almost there.  And I’m just going to use whichever is the best one in the science. I spent three months reading every single nutrient profiling paper out there. And I kept hitting, well, why are you guys doing that? I kept hitting these moments where I was like, That makes no sense. So, couple of the challenges, and you identified a few right in the question.  So, one of the biggest like, like pitfalls that I see happening in nutrient profiling right now is scientists are trying to figure out which nutrients to include in the calculation so that the score at the end aligns with the healthy eating index, which is a measurement of how well someone’s diet follows the USDA dietary guidelines for Americans.

Uh, it’s kind of like retrofitting the score for the guidelines that already exist. I think that’s the opposite of the right way to go about it. I think we should be figuring out how to understand the food and then seeing what that tells us about maybe some edits to the next day. The guidelines are [00:25:00] updated every five years.  It would not be a big deal to edit them again and go, hey, now we know these foods are more nutritionally important, right? That, that’s, there’s, that should be something that can happen. And then there’s this idea of like penalizing foods for containing things like added sugars or sodium or saturated fats or cholesterol.  And then there’s this idea of, like weighting certain nutrients. That’s all kind of happening right now in the scientific literature. So like the Food Compass is sort of well known because it keeps making the news for having such a high score for Lucky Charms cereal. It is not ready for primetime either, although I think it’s probably the most interesting out of the ones that are in development right now.

Dr. Weitz: We have to look at who’s funding all this food science.

Dr. Ballantyne: They’re weighting food attributes, they call them, in a way that is a very like plant based diet lean. And the fact of the matter is you don’t need to weigh certain nutrients more [00:26:00] heavily than others to get to the end of plants have lots of nutrients per calorie.  Like that’s, that’s an easy conclusion. All of these different scores come up with that result. That’s not something you need to put in the math, but that’s what a lot of the direct to consumer, right? That’s what Furman’s ANDI score does as well. It doesn’t include nutrients that are mostly found in animal foods but it includes a lot of nutrients that are only found in plant foods.  And you end up with a system that makes animal foods look terrible and plant foods look great. So with that being, my starting place, like that’s okay. This is, this is the field of science. What that, this is what I have to work with here. I, I, it was a really obvious like algorithmic choice for me.

So the Nutrivore score is algorithmically identical to something called the Nutri Rich Foods Index. So it’s simply a sum of amount of nutrient divided by daily value of nutrient, and then that sum is divided by the energy density of the food. There’s no weighting certain [00:27:00] nutrients more heavily than others.  I think you end up in a situation where you, you bias foods when you start doing that. And also, you could take the approach of, I’m going to weight the nutrients that people are more likely to be deficient in. more in this, like, I’m gonna, like, let’s say it’s like folate, vitamin E, vitamin A, vitamin D. I’m going to give those more weight.  Magnesium, vitamin D. Magnesium, vitamin C. But, you know what happens when you do that and you create an entire system on that, is you overcompensate, right? So people start choosing those foods because they have these higher scores and now they’re missing out on the nutrients that are not given as much weight in the calculation.

So that just felt like that the future proofing of the score is to not actually give these nutrients more weight, but to include as many different nutrients as I have enough data that makes sense to. So the Nutrivore score includes 33 nutrients in the calculation and weight them all equally and make sure that I have representation in these [00:28:00] nutrients of nutrients that are inherent to plant foods, that those are the only source, but also nutrients that are inherent to animal foods, that that’s the only source, so that we’re not automatically putting in a plant based diet bias into the score, and then do all of the math blind, and then just see what it tells me.

And so the NutriScore doesn’t, like, all the nutrients are weighted the same. There’s no, it’s really too complex of a system to be able to do corrections for competitive binding or nutrient synergy because it has to do with everything you eat at a meal and not just what’s in one food, like, as soon as you put salad dressing on your salad, you’re going to absorb more vitamin K and beta carotene, it’s way, it’s, it’s way too complex, and it doesn’t really tell us about the food.  So it’s just a very simple calculation. And it’s the context of like how much is nutrient is versus how much we need. It’s the daily value. Thank you. Yes, the daily values might be an underestimate, but in terms of the math, that doesn’t really matter, because what it is doing is it is basically saying, [00:29:00] this thing we need 100, 100 milligrams of so 200 milligrams in this food is amazing, right?

That’s so great. This thing we need 10 nanograms of, I don’t think there’s anything that’s measured in nanograms, 10 micrograms of, okay, so we’re gonna, we’re gonna, you know, basically it’s, it’s a way of correcting for how much we need. So it doesn’t really matter that they’re, they might be a little bit off.

It’s ballpark is, is good enough in that math. Uh, and then yeah. And then there’s no normalization. There’s no weighing for different food groups, which some of these scores do. They’ll just say, okay, we’ll give the top food in every, in every group. We’ll get a hundred. So then all of a sudden you’re making, you’re making like kale look the same as like whole wheat bread because they’re the tops in their groups, which is, I think also silly.  So it just keeps it very, very simple. It’s a straight up calculation. Yeah. The thing that’s special about it is how much data is in the calculation and that’s why it gives us such a complete picture of the nutrient density of foods.

Dr. Weitz: I make a prediction you’re probably not going to get a huge grant from [00:30:00] Kellogg’s for your program.

Dr. Ballantyne: No, but you know what, a grant would be a grant. Would it be a grant? As long, as long as I can maintain my independence. Yeah, no chance, chances, chances are good. Uh, the Kellogg’s cereal tends, tends not to, even fortified tends, tends not to have Amazing nutrients. 

Dr. Weitz: You know that whole fortification thing, it’s interesting.  There’s an example of where you’re weighting certain nutrients and how we think we’re making people healthier. Just take iodine as an example. So we had all these millions of people suffering from goiter because they had low iodine. And so we add iodine fortification by adding it to the salt and we have this huge decrease in the number of people with goiter.  And we have this huge increase in the number of people with autoimmune thyroid Hashimoto’s. So, you know, it’s being applauded for years now as this great example of how fortification is so beneficial, but [00:31:00] we just traded one disease for another.

Dr. Ballantyne: I mean, potentially, as somebody with Hashimoto’s thyroiditis very, very personal one there.

Dr. Weitz: You can put me in that camp too. 

Dr. Ballantyne: Yeah, I know. It’s like worst initiation ritual ever to get into that club, right? But, but yeah, I think, you know, that’s, so fortification is fascinating to me. Let’s go on this tangent. Because, because, you know, it really has very limited success stories. So even if you, even if you bought into that very simple narrative of we got a 74 percent reduction in, in goiter.  And even if you wanted to say Hashimoto’s thyroiditis is much more complex than iodine excess. And so let’s, let’s not count that as, as like coming off of the success story. I think there’s a lot of nuance here and probably Of course. 

Dr. Weitz: Yeah. I was oversimplifying for sure.

Dr. Ballantyne: And then we’ve got iron fortification, and that has caused, if I remember correctly, it’s like 30 or 40 percent reduction in iron deficiency anemia, [00:32:00] and then folic acid fortification has pretty, like, impressively reduced risk of neural tube defects.  Those are the three success stories of fortification, right? So we’ve got three success stories, we fortify with a lot more nutrients than just those three, right? Like pretty much all the B vitamins except B12 are in a fortification. Okay, well not B7 either. All of the, the, the B vitamins that we were known about in the 40s.  And then we’ve got vitamin D, but not, not in that many. That’s mostly in, dairy products that are geared at kids and not as much in dairy products that are geared as adults. I think it’s, it’s, It’s kind of surprising how little of an effect fortification has had on, well, no effect, on like the really big You know, health conditions that are a major burden on society that can completely take away your quality of life, that have really high morbidity and [00:33:00] mortality rates, right?  Like cardiovascular disease and type 2 diabetes and cancer. You can’t see a signal from fortification reflected in those health outcomes, nor can you from multivitamins. Which is fascinating to me, and it really to me reinforces the importance of getting at least most of our nutrients from whole foods.

Not that I’m anti supplement, there’s definitely a time and a place. Like, I take so much vitamin D to keep my levels normal, right? Like, I’m definitely not anti supplement, but I think that if you think of fortification as a supplement, right? It’s the same forms that are in a multivitamin, generally. It really, you see the value of a food first approach and then, you know, individualized supplementation as a second layer rather than supplementing the entire food supply.

Dr. Weitz: Right. So, since you’ve been calculating the nutrient density of so many foods, tell us about some of the biggest surprises that you’ve discovered, which [00:34:00] you talk about in your book.

Dr. Ballantyne: Yeah, there have been,

Dr. Weitz: by the way, warning, warning, … Sarah is about to bust some of the food myths and functional medicine practitioners are not going to be happy.

Dr. Ballantyne: Yes. Uh, thank you for the, like rolling out the, what is the opposite of the red carpet for the answer to this question. So I think the, there’ve been a lot of surprises now, my take a sort of high level view to this question before I share like the most nutrient dense food, which nobody would have ever guessed in a million years.  I think the best way to use the Nutrivore score is to identify simple swaps or additions in a meal that don’t take away from like your enjoyment of the meal, but will add a lot of nutrition to the meal. So like a really easy example would be like if you’re making a pasta dish, like swapping out regular pasta for whole grain pasta will add some nutrients, but then if you swap that out for like a lentil or chickpea based pasta, so you’re [00:35:00] gonna, you’re gonna double your nutrient density going from like plain whole wheat, you’re going to about quadruple it going up to like a lentil or chickpea based pasta.

And that’s all you did. But then maybe you also identified a simple addition and you added some sliced mushrooms to your sauce or some basil or some garlic. Probably added a lot of flavor to the sauce as well, but then you added a lot of nutrition and Your pasta dish is probably just as great. So, as a practical tool, I think that’s the best way to use the Nutri Force score.  My favorite, like, nerding out surprise moments, are the foods that have reputations for being nutritionally pointless, that get a redemption arc, that through the Nutri Force score calculation, my favorite example of this is iceberg lettuce, which has more nutrients per calorie than celery, or, which we put up on this pedestal.  or Cucumber or Artichoke. It actually has slightly more nutrients per calorie than Sockeye Salmon. 

Dr. Weitz: Does celery juice cure all ails?

Dr. Ballantyne: Waiting for the scientific study to show that one. So far, [00:36:00] so far so far lacking. Although celery does have some really interesting polyphenols, but you’re getting that from celery in any form, it doesn’t have to be juiced.  So that’s my favorite way to use the Nutri Score. Is to kind of say, like, look at the value of iceberg lettuce, look at the value of watermelon or potatoes. Like, foods that people kind of love to dunk on. But there’s also been a lot of, you know, Just like, who, okay, who could have known that the single most nutrient dense food was canned clam liquid?  Like, that is not something, if you had told me, like, here’s, here’s your data set of 8, 000 foods, guess, what, what are you gonna guess? And I would have guessed liver, maybe, Or maybe like a Leafy Green, like Watercress, and Watercress and Liver are both, like, way up there. But the single most nutrient dense food is canned clam liquid.  And here’s how the math works out. Like, here’s, here’s how that happens. I feel like that needs, because I do not want to start a drinking clam juice story. Trend That is not what we’re trying to do here. . I wanna say why we’re run clam

Dr. Weitz: juice in every [00:37:00] grocery store. .

Dr. Ballantyne: I mean, if you are going to incorporate, make sure to go up on totally paper

Dr. Weitz: and clam juice.

Dr. Ballantyne: Clam juice. Empty, empty shelves. Make sure to look for a low sodium option if this is something that you want to incorporate. You don’t have to, though. I think that’s the other liberating thing about the new, the 

Dr. Weitz: What the hell is clam juice anyway?

Dr. Ballantyne: So it is literally the liquid that, like, clams are cooked in.  So, so you can either get it from, like, it is the liquid when you drain a can of clams, or you can buy it separately because it’s used as an ingredient in linguine with clam sauce in clam chowder. It’s used as a cocktail ingredient. So it has some like traditional like food uses as well. But yeah, it is the liquid that clams are cooked in typically pressure cooked in.

Dr. Weitz: So there is some I think you should change the name to clam broth. It’ll sell like crazy.

Dr. Ballantyne: Yes. Clam juice does kind of sound like you squeezed the clams. That’s, I’m pretty sure there’s no squeezing [00:38:00] step. It’s just Heating them in liquid, then doing something really cool with the clams, and then selling the liquid because it has a lot of flavor.  Clam Bisque, I mean, I guess you could think of it as, yeah, but it’s unseasoned. So, there’s a lot of nutrients that are in the clams that ends up, you know, that are water soluble that end up in the liquid. So the reason why canned clam liquid or clam juice is the top most nutrient dense food, and this is true for all of the most nutrient dense foods, it’s very very low energy density.  So when you divide by a very small number, you get a much bigger number. So a food that has a very low energy density So canned clam liquid is five calories per cup. When you have something that’s that low energy density, it doesn’t have to have a ton of nutrition to have high nutrients per calorie.  So remember, nutrient density is nutrients per calorie, not per serving or per hundred grams. So, when you have something that’s super low energy density, doesn’t need to have a ton of nutrition. And canned clam liquid, [00:39:00] has some impressive nutrition. It has 500 percent of the daily value of vitamin B12 in a one cup serving, like, which is just huge.  And it also has some potassium, some other minerals, it’s, you know, it’s got some other B vitamins, it’s got some protein. So it has an impressive amount of nutrition. for that five calories. That’s how the math works out for it to be the top. But is it going to contribute the most, like, nutrients to your diet?

No, that’s going to be a food like the actual clams, right, or oysters, or liver, or those like really nutrient dense leafy greens like kale and watercress and rainbow chard. Those are all the foods that are going to contribute a lot more to your diet. like absolute nutrition, which is why I never recommend only using the NutriVerse score to choose our foods, that we, it’s fascinating, it tells us a lot about a food, but it’s not the only information that we want to be considering when we’re putting together our plates, because then we’re going to end up with a diet where we’re just eating, Clam juice and watercress all day and that’s not going to be [00:40:00] nutritionally beneficial.  But other foods that have that like really low energy density that end up with really high NutriVore scores are not as alarming as clam juice. Like coffee is way up there. You know, it’s, it’s one of the top most nutrient dense foods because it’s packed with polyphenols, actually has some B vitamins as well.  but also one or two calories per cup. A lot of leafy greens make the cut. Same, same thing, right? Not very high nutrient density, but for each calorie, tons of nutrition.

Dr. Weitz: Interesting. You also break the myth about healthy fats and you state in your book, that healthier fats include olive oil.  Avocado oil, which most functional medicine practitioners agree with, and soybean oil, canola oil, corn oil, and sunflower oil, which many in the functional medicine community do not agree with.

Dr. Ballantyne: Yeah, this was [00:41:00] one of I want you to just imagine me coming from a place where I was very anti vegetable oils in the past and really reading in the science and falling down this rabbit hole of scientific studies for a few weeks, because I had such a hard time wrapping my head around this.  So I, I want to, like, like, I want to preface my answer to this question by, yep, I, my inner child had a temper tantrum as I was reading these studies. I had a really hard time. Being open to this research. It was, it was really challenging, and, and it’s because We’ve got such a strong mechanism in place for understanding high omega 6 polyunsaturated fats in relation to omega 3 polyunsaturated fats and how those should be inflammatory, right?

We, we just have such a wealth of scientific evidence showing that, These fats in the cell membrane are used as substrate and what, which one you have will [00:42:00] determine which you know, paracrine and autocrine signaling molecules are made. We know that if omega 6 is there, we get inflammatory signals.

We know if omega 3 is there, we get either anti inflammatory or anti inflammatory. Only mildly inflammatory signals. Like, we have, we have it all mapped out. We know, we know all the biochemical mechanisms. And yet, when you give humans canola oil, or corn oil, or soybean oil, not only does it lower their cardiovascular disease risk factors, like, like, seeing lower serum cholesterol, is only exciting if you also see lower cardiovascular disease risk, which we do.

We see lower all cause mortality, a general indicator of health and longevity. And, what’s fascinating is studies that have actually compared canola oil head to head with olive oil intervention trials have shown They’re both equally as good for cardiovascular disease risk, and they work through different mechanisms, so actually, we would be, we would be best off if we were incorporating [00:43:00] both into our diets, which is mind blowing, because it tells us that there is some regulation of these paracrine and autocrine signaling molecules beyond substrate bioavailability.

but we don’t know what it is. And that is, fascinating. This is definitely a, science has really shifted in the last five years. We’ve got now a really good body of scientific evidence showing benefits to vegetable oils. I still put olive oil on a pedestal. I still think olive oil is, is the king of oils.

You just can’t, you just can’t, like the polyphenols, the triterpenes, it’s got so much good stuff in it. You, you really can’t, I don’t, I don’t think you can beat olive oil, but it shows that these more affordable. oil options are beneficial. Not as good as olive oil, but for somebody on a budget, you know, still beneficial.

And I think what’s, what’s so important in following that science is, again, right, the difference between how we understood it when it was in animal models, [00:44:00] and cell culture models, versus now how we understand it in humans, and the fact that it reveals an important something different in our biochemistry that we still need to understand, but we’ve got these intervention trials that make the result very, very clear.

Dr. Weitz: I just want to apologize to the listeners for this gardener who’s right outside my window who seems like he’s never gonna stop with his lawn blower or whatever it is. So I wanted to push back just a little bit because I do think that a percentage of these studies that have shown that there’s a decreased cardiovascular risk with soybean oil and some of these other polyunsaturated oils is because they’re comparing saturated fat with substituting a soybean oil or something like that and That’s not necessarily substituting an omega 6 versus omega 3 or, you [00:45:00] know, an overall different type of, you know, there aren’t too many studies that, you mentioned one, but there aren’t too many studies that are really comparing olive oil versus soybean oil.  uh, saturated fats versus polyunsaturated fats and the polyunsaturated fats having some benefit potentially.

Dr. Ballantyne: Yes, I, so I think that’s a great point. So I think, the, the broader point is when we switch to something, right, There’s two parts of the equation. There is whether or not the thing we’re now eating, what its health effects are, and what is the thing that we swapped it out for.  Right. So absolutely correct. The studies that show benefits to vegetable oils are the studies that show swapping out butter or margarine for vegetable oils. So swapping out a saturated fat, whether that’s a natural saturated fat or a man made saturated fat, which what fully hydrogenated vegetable oils and margarine are.

For an [00:46:00] unsaturated fat. I still think that’s very fascinating and I still think that it makes a strong case for benefits of vegetable oil, but there are now more, more studies that are comparing vegetables to olive oil. There’s one that I cite in the book that compared If I remember correctly, it compared, olive oil, corn oil, sunflower oil, and I think canola was in there, and it looked at all cause mortality, again, sort of a broad indicator of health and longevity.

And, I think, like, nobody is surprised, it showed olive oil, right, high oleic uh, acid, right, a omega 9, a monounsaturated fatty acid, extremely rigorously shown to reduce cardiovascular disease risk, right? So, it showed olive oil was, was, was the king, was definitely beneficial but then it showed still reductions in all cause mortality from other vegetable oils and increases in all cause mortality from margarine and butter.

So your [00:47:00] zero was not having these things, right? And I think, I think there is a good enough body of scientific literature, for example, showing in humans that we don’t see vegetable oil consumption increasing C reactive protein or TNF Tumor Necrosis Factor Alpha, or Interleukin 6, like these markers of inflammation.

I think there is enough information to say solidly, again, olive oil, avocado oil, I don’t think you could compete with them because those monounsaturated fats are so beneficial. But I think we can take a step back for sure from saying that vegetable oils are problematic. I don’t, science does not support saying that they’re increasing cardiovascular disease risk or that they’re inflammatory.

Dr. Weitz: Just to play devil’s advocate one more time, I hope you don’t mind, is, there was the Minnesota study, which was one of the few dietary studies where they actually had people staying at this mental institution and they were able to control everything they ate so they know accurately what they really ate.  And it turns out that when they [00:48:00] substituted, omega 6 oils for saturated fats, While there was a potential reduction in cardiovascular disease, all cause mortality actually increased in those eating the vegetable oils, and the conclusion seemed to be that there was an increase in cancer, which people attributed to some sort of increase in inflammation.

Dr. Ballantyne: I, I’d be very interested, I’m not super familiar with that study, so I, I don’t. 

Dr. Weitz: Remember the studies in the 60s, and the Minnesota was. Oh, the Minnesota starvation. Published, and they went. It was the Minnesota

Dr. Ballantyne: starvation experiment, was also part of it.

Dr. Weitz: I don’t know. This was like in a mental institution and they hadn’t published it.  And then just like in the last, I don’t know, 10, 15 years, they published it. And so.

Dr. Ballantyne: Yeah. I mean, I I don’t want to, to speculate on the quality of that study, having not, not read it. I, my, my, my little alarm bells go up as soon as you say the data was published 30 or 40 years later, because we don’t actually know what the methodology [00:49:00] was in that case.  The people who probably, We’re taking, right, taking notes on that data may no longer be with us. So I do have little like my little skeptic are dark up, but I don’t want to comment because I’m, I’m not familiar. That’s

Dr. Weitz: okay. Since, since you’re breaking myths, you also said something about olive oil, which I think people need to hear.  I talked to so many people who are like, I won’t cook with olive oil because it’s, it’s going to become rancid. It’s going to be damaged by the heat. Can you explain what the deal is and is it okay to fry my eggs in olive oil?

Dr. Ballantyne: It is absolutely fine to cook with olive oil. They’ve done studies where they sit, they heat olive oil for like 24 hours and measure how much of the fats get oxidized in that time and show olive oil is actually incredibly heat stable.  The higher the quality of olive oil, typically the better, even though it has a lower smoking point. So we do want to be aware of smoking points when we’re cooking with something like olive oil. So can

Dr. Weitz: you explain the difference between smoke point [00:50:00] and is it burning and heat stability? Okay.

Dr. Ballantyne: Yeah. So I’m going to try.  This, this is, I’m going to try. There, we’re getting into some really interesting physics phenomenon here. So, what is making a high quality olive oil have a lower smoke point, which is the temperature at which it will start to smoke is 

Dr. Weitz: And people automatically assume that means that the oil’s getting damaged.

Dr. Ballantyne: Yes, it kind of, so it is sort of. So it doesn’t necessarily mean oxidation of fat, so there’s other things in the olive oil that are starting to burn. So it is some, but it is other compounds, and these are compounds that are taken out in the refinement process in a regular olive oil. That’s why a refined olive oil has a longer shelf life and has a higher smoke point.  So it’s more like these other compounds are there that they can start to burn at a lower temperature and then that can trigger a bit of a downstream [00:51:00] chemical reaction for making some of the fats oxidize. So if you heat an oil to smoke, point. If it’s really smoking, like if I’m in my kitchen, if I overheated the pan, I didn’t realize it, if I’m putting the smoke, if I put the oil in and it smokes a little bit, I’m going to take the pan off the heat, I’m going to throw something in it, food, not water, don’t, don’t, not water, food in it to cool it down real fast, I’m not going to worry about it.  If I throw it in and it is like, smoke detector, like I need to throw on the fan over the range because it is smoking that much, I’m gonna toss that, I’m not gonna, like that is now going to have a lot of oxidized fat in it, and it can happen quite quickly.

Dr. Weitz: Right.

Dr. Ballantyne: So, that being said, If you’re staying below smoke point, which most cooking applications will be like, like olive oil hat, depending on the quality of olive oil, it’s going to have a smoke point in the like 360 to 410 range.

Yeah.

Dr. Weitz: I’ve seen 375, 350. [00:52:00] Yeah.

Dr. Ballantyne: Most like baking is getting to like a hundred and sixty like anything in the oven, right? That your actual functional temperature is not as high Like your surface temperature on the food is not as high as the oven temperature, right? That’s because that’s that’s how cooking works. 

Dr. Weitz: Wait, wait, wait, wait.  I don’t think most people understand that So, so if you bake vegetables in the oven and you put the temperature at 375, the food’s not at 375

Dr. Ballantyne: Not yet. Yeah, it takes, so the food, so think about the heat transfer. Okay. So your food starts off, let’s say at room temperature. Okay. So it’s, it’s, it’s starting off at, I don’t know, 70 degrees.

Dr. Weitz: Right.

Dr. Ballantyne: You rub some oil on it, some, some seasoning, you put that in the oven at 375. Let’s say the smoke point of your oil is 375, right? So you’re right at that that line. You are, until you’re at a point where the food is starting to burn, you are not at a point where that oil is going to be hitting the smoke point because the food [00:53:00] has, it’s like a heat sink, right?  So it’s absorbing the heat, from the rest of the oven, but the temperature of the food, where that oil is, isn’t coming up to the temperature of the oven yet, until, right, until you’re, it’s starting to burn, but in that like, nice phase of like, I’ve got a little browning, a little roasting, it’s very, very delicious, you haven’t hit the smoke point of the oil.

Okay. If you pull the pan out. Things are starting to burn. You pull the pan out and you can see smoke coming from the pan. You overdid it. So typically for me, if I’m roasting vegetables, I actually typically do them at 375, but I’m using an olive oil that’s going to have a smoke point more in the 400 to 410 range.

So like I never, I’m not risking it, by having the oven temperature higher than the smoke point. But like this is why you can bake with olive oil, right? Like baked goods, the internal temperature typically is getting up to 160 is typically where a baked muffin or, you know, a cake or something is, is done.

So most of the time, even on your pan, [00:54:00] The temperatures that you’re cooking with in your pan are probably more likely in the 300 range than in the 400 range. Again, unless you’re overheating the pan, which can happen. So these fats are absolutely fine to cook with. It is the vitamin E and the polyphenols are helping to prevent oxidation, but also just those monounsaturated fats are more heat stable than a lot of other, a lot of other oils.  So absolutely fine to cook with. But if, if you, if you whoopsie, and we all whoopsie, it’s fine. Like that is a normal I’m cooking at home experience, and you’re getting a lot of smoke, off of that oil, I, I would recommend tossing it and starting over.

Dr. Weitz: Okay, so you can cook with olive oil, you can bake with olive oil, but just keep the temperatures down below the smoke point.  So if your olive oil has a smoke point of 400 or 375, you know, then don’t roast at 450, roast at 350 or something like that. And with the pan, if you’re making eggs or something on a pan, just don’t [00:55:00] put it up to the highest heat and just watch to make sure that the oil’s not.

Dr. Ballantyne: Most pans don’t like that either, right?  Like most Most of your pans aren’t even as like, I mostly cook on stainless steel. My stainless steel pans don’t want to be cooked, like heated up on, on maximum heat either, like they’re going to warp. So it’s, it’s good for the oil and good for your cookware.

Dr. Weitz: So does higher nutrient density of your food correlate with better health outcomes and or longevity?

Dr. Ballantyne: Yes, so, what we know is that people who get more, have a more nutritious diet, who have fewer nutrient shortfalls, who are, like, eating more of these nutrient dense foods, eating, right, eating more vegetables, eating more fruit, eating more seafood, like these foods that are very nutrient dense, they have reduced risk of heart disease, all cause mortality, cardiovascular disease, type 2 diabetes, cancer, Alzheimer’s disease, osteoporosis you know, like a list goes on and on and on. Do we have studies looking at people [00:56:00] following Nutrivor yet to be able to say that? Not yet. Not yet. But Nutrivor is very much built on the scientific consensus around the importance of nutrients and the overall eating patterns that are shown in a wealth of studies to support long term human health.

Dr. Weitz: You state in your book that being overweight is not necessarily associated with being unhealthy and that you can be overweight, or obese and still be metabolically healthy. Isn’t it the case that in the U. S. Very few people are actually metabolically healthy. In fact, one study published in 2018 found that only 12 percent of Americans were actually metabolically healthy.

Dr. Ballantyne: Uh, yes. So there’s a little bit of a difference in how, like, how metabolically healthy is defined. So the study that said that only 12 percent of people are metabolically healthy used a like more rigorous definition. There’s been other studies that, you know, basically it’s like how [00:57:00] many health markers have to be normal to be called metabolically healthy and how many are allowed to be abnormal, before we start calling you, metabolically abnormal.  Uh, so it’s like do you say zero markers, one marker, or two markers? And that’s, that’s kind of how it’s searched for hard to compared the actual stats in some of these studies because they’re using a slightly different definition. So, in one study that I quote in the book, it showed that basically about half of overweight people are metabolically healthy.

About a quarter of normal weight people are metabolically abnormal. We can’t directly compare that to the 12 percent study because they’re using a definite, a different definition. So, of like how many of these markers and which markers exactly we’re looking at. So it makes it a little bit tough, tough to, to do a direct comparison there.

I think the, rather than getting like into the weeds of the actual number because of that challenge with how it’s defined in different studies, I think the more important thing is to take that step back and say, look at this number of overweight and obese people. It’s about a third of [00:58:00] obese people, about half of overweight people who you know, have normal blood pressure, normal serum triglycerides, normal CRP, normal fasting insulin and glucose, normal A1c, like, they are the example of people who are not experiencing metabolic health detriment.

And when you, regardless of how you define, like, how rigorously you define metabolically normal versus abnormal, The, the, when you start to striate these populations based on other things other than BMI and you look at, for example, physical activity is, physical activity is the strongest indicator. So people who are physically active regardless of their weight have a vastly higher percent chance of being metabolically healthy and people who are inactive regardless of their weight have a vastly higher chance of having metabolic abnormalities.

Other factors that are influenced. are things like diet quality how much sleep we’re getting, right social determinants of, [00:59:00] of health. Uh, so that’s reflected in things like socioeconomic status and race and ethnicity. So it’s complex. And I think that because, because we have these large population studies showing, you know, 50 percent of overweight people are metabolically healthy.

Again, regardless of these differences and how different studies define it. The, I think the take home from there is these other things like physical activity, like diet quality are where the focus needs to be, right? We also see that most people regain weight when they lose it, right? That weight loss diets are not sustainable.

I’ve gone through this experience myself, having lost substantial amounts of weight three times in my life. Uh, hopefully third time’s the charm. We’ll see. It’s, it’s such a I think anybody who’s gone through it, so I can say from my own personal experience, the science backs this up, but this is my own experience.[01:00:00]

My health has not correlated very much, very well with my weight. So I have had very, very good health at moments in time where I have been heavier. And I have had very, very poor health at moments in time when I have been lighter and vice versa, right? Like, but the correlation is not really, you can’t really, you can’t really line it up.

But I can line up how my health has. related to my stress levels and I can line up how my health is related to my activity levels and my overall average diet quality. And so what I want to do with Mutivore is create that focus on the health habits that somebody who is obese, those are health habits that typically will lead to, to weight loss.

Maybe not for everyone. The great thing is it will lead to health independent of weight loss. So I’m trying to, create something that’s weight inclusive, that is certainly compatible with weight loss goals. You can definitely apply a NutriVer philosophy to [01:01:00] an energy deficit. Like that is absolutely something that you can do.

And actually I would recommend it because the less the gain, the harder it is to get all of the nutrients that we need. So the more that nutrient density focus is actually important. But I don’t want. The benefits of a healthy diet to feel unobtainable for somebody just because they haven’t had success on a weight loss plan in the past.  And by shifting that focus to the things that actually matter for long term health, independent of weight, that’s what I’m hoping to achieve is improving people’s health. And it’ll be, you know, individual whether or not that goes along with weight loss.

Dr. Weitz: Right, and you’re also trying to shift the focus away from all these restrictive diets and, you know, in the functional medicine world we constantly have discussions about, you know, which is the best diet, the vegan, the carnivore, you gotta avoid food BODMAPs, you gotta avoid lectins, Oxalates, Histamines, [01:02:00] on and on and on and people are constantly, oh I don’t know if I should eat that food because it might create oxalate and you know it it just gets kind of crazy end up with uh people on very very restrictive diets and that’s not healthy.

Dr. Ballantyne: I agree completely. And I think it’s not, I mean, there’s two challenges with restrictive diets. First is the fewer foods you eat, the harder it is to actually meet your nutritional needs from those foods. So that is kind of goes against the, the NutriVer philosophy. But the second one is we’ve got psychology research dating back to the nineties showing that restrictive diets lead to disordered eating patterns, emotional eating, weight regain cycles.

It’s, it’s when you define a diet based on the things you’re missing. and that you are depriving yourself of. It doesn’t set us up psychologically to sustain that diet. So on Nutrivore, we really talk about sustainable nutrition. So how do we increase diet quality, but without depriving us of our favorite foods?

Other than for medical reasons, that’s obviously a separate, that’s obviously a separate thing over [01:03:00] there. But how do we intentionally make room for what I call quality of life foods in order to sustain that overall higher quality diet? So that is a large part of the discussion in the first part of the book.

Dr. Weitz: Yeah, I feel like you’re in some ways carrying forward kind of the Part of the philosophy of Dr. Jeffrey Bland, who I used to, every year, go to his lecture he would give. I used to listen to his audiotapes, and when everybody was engaged in all these diet wars, and they still are, of course, he’s always talked about emphasizing the quality of the food and not just, you know, how much fat and how much carbs, and we’ve got to look at the quality, and, and that’s what this is sort of getting to.  Let me, let me ask you one more question and we’ll wrap. You mentioned 12 foundational food families in your book, which are the categories of foods with the most nutrient density. So I thought this would be a good way to kind of sum, sum up this discussion. [01:04:00]

Dr. Ballantyne: Yes, so the 12 foundational food families are all of the foods that have something unique to offer us nutritionally, that have a really like solid foundation of scientific studies showing us health benefits of the nutrients those foods contain.  It doesn’t mean we have to eat all of them. So, for example, one of them is seafood, and if you’re allergic to seafood, or you can’t access it because it’s not affordable to you, like, it’s, it is, none of those foods are a absolute 100 percent must, but they are the foods that help, expedite the goal of getting all of the nutrients our bodies need from the foods we eat, which is our bodies.  the goal of Nutrivore. So they are the foods that make achieving that the easiest. And when we prioritize, I, I lay out serving targets per day or per week, depending on what food we’re talking about of these 12 foundational food families in the book. That adds up to like a third to maybe half of our, of our food intake, depending on, on, on what you’re choosing.

It is a small portion of the overall diet, but when we do that, that gets us most of the way to [01:05:00] achieving our, our nutrition. goals, you know, our daily values of everything across the board. So they are very much about achieving that goal efficiently so that we have the most room for rounding out with whatever other foods we want.  So the 12 foundational food families are, I will just list them vegetables in general, root vegetables, leafy vegetables, cruciferous vegetables, mushrooms, alliums, that’s the onion family, fruit in general, berries and citrus fruit, seafood I already mentioned, legumes, and nuts and seeds.

Dr. Weitz: That’s great. This is just an aside.  I just recently became acquainted with one of the downsides of eating fruits, which is, for some reason, in the last couple of weeks, our house has become inundated with fruit flies.

Dr. Ballantyne: Oh, I have, I have two suggestions for you. Oh, really? Wow. Yes, let’s, great, perfect, perfect question to wrap up on. So, So I will say, you can buy these little, they’re like yellow look at like fruit fly traps or, gnat traps [01:06:00] on Amazon or wherever.  They’re these little pieces of yellow sticky, they’ve got some kind of coating on it that attracts insects. So in my house they’ll also, Find the occasional mosquito that makes its way in. I got rid of fungus gnats on one of my plants from them. And then I was like, what if I put this close to the bananas?  What will that do to the fruit flies? Oh look, it catches them. So that is the lowest, lowest effort one. But the free option is get a like old plastic, like a plastic water bottle, something like that. Stab some holes in the side so that there’s a way in, but the great thing about stabbing it, I use like a metal, like skewer for meat to stab, stab a ring of holes around the outside.

And then I stick, you can either use a string to like put a little bit of banana, it works really well. But a little bit of fruit either on a string that is like then tied with the cap. So it’s dangling down. or you can use like a bamboo skewer or something like that to put it in [01:07:00] so that you’ve got a little bit of fruit towards the top.

So the rotting fruit in there is going to be slightly higher than the holes. And then put like a half inch of water at the bottom with a drop of dish soap. So fruit flies are amazing at getting in. They’re not very good at getting out. They gorge themselves on the fruit and then they drop into the soapy water and drown.  And it is a fun project to do with kids. Definitely, highly recommend. Uh, careful with the stabbing things, because sometimes kids get a little excited by that. And it works, and it works, I definitely, it’s the, it works better than the sticky stuff. But then you do have that. And then when you’re ready, I just put, tape over the holes and throw the whole thing out.

Dr. Weitz: Oh, cool. That’s great. So tell our listeners how they can get a hold of the book and find out more about you, Ann. I’d

Dr. Ballantyne: love to. Thank you. Uh, so the book is called Nutrivore, The Radical New Science for Getting the Nutrients You Need from the Food You Eat. It’s available from just about any online bookseller and lots of local bookstores.  You can also request it at your local library if they don’t already have a copy. My website is neutrovore. com and that’s where like all of the really academic deep dive articles that are like the supporting evidence for everything in the book. Uh, that’s where all of those live and on social media, on TikTok, YouTube, Facebook, Instagram, threads, and Pinterest.  I’m at Dr. Sarah Ballantyne.

Dr. Weitz: That’s great. Thank you so much.

Dr. Ballantyne: Thank you.

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Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy. Listening to the Rational Wellness Podcast, I would appreciate it if you could go to Apple Podcasts or Spotify and give us a 5 star ratings and review.  If you would like to work with me personally to help you improve your health, I do accept a limited number of new patients per month for a functional medicine consultation. Some of the areas I specialize in include helping patients with specific health issues like gut problems. [01:09:00] neurodegenerative conditions, autoimmune diseases, cardiometabolic conditions, or for an executive health screen, and to help you promote longevity.  and take a deeper dive into some of those factors that can lead to chronic diseases along the way. Please call my Santa Monica White Sports Chiropractic and Nutrition office at 310 395 3111 and we’ll set you up for a new consultation for functional medicine. And I look forward to speaking to everybody next week.