Episode 60: How to Raise Healthy Plant-Based Kids with Pediatrician Dr. Rikin Patel

How safe and healthful is a plant-based diet for children?

In this episode of the Plant-Based Canada Podcast we are joined by Dr. Rikin Patel to chat about raising kids following a plant-strong dietary pattern.

Dr. Rikin Patel is a consultant pediatrician and Assistant Professor in the Department of Pediatrics at the University of Toronto. He completed his pediatric residency at Memorial University of Newfoundland, and prior to medical school he completed a Masters in Health Policy Planning and Finance from the London School of Economics and the London School of Hygiene and Tropical Medicine. Currently, Dr. Patel works for the Scarborough Health Network and is a founding member of Markham Kids Clinic. He recently completed the Plant Based Certificate program through the T Colin Campbell Center for Nutrition Studies at Cornell University.  He is passionate about promoting a culture of wellness and resilience within physician and trainee communities through medical improv, meditation and plant-based nutrition. Dr. Patel has worked with numerous families and is passionate and confident in giving children and their families the best fuel for their wellbeing to maximize their potential. He is a certified yoga instructor and teaches Shaolin Kung Fu at the Waterloo Kung Fu Academy with over 30 years of experience

Also, stay tuned for more initiatives from Dr. Patel, as he is currently in the process of opening a new virtual clinic in the Greater Toronto Area (GTA) called Reset Pediatric Lifestyle Medicine that aims at treating and reversing chronic diseases among children using lifestyle-based interventions.

In this episode we discuss:

• Being a plant-strong Pediatrician at a Kids Clinic
• The safety & nutrition of plant-strong dietary patterns for children
• Micronutrients of interest
• Macronutrients of interest
• Milk alternatives
• Recommendations for different ages or stages of growth 
• Myths & misconceptions

Episode Resources:

Ellyn Satter: https://www.ellynsatterinstitute.org/

E. Satter Resources: https://www.ellynsatterinstitute.org/product-category/books-videos/

Plant-based milk alternatives in child nutrition: https://pubmed.ncbi.nlm.nih.gov/37048365/ 

Safety of vegetarian diets for children: https://pubmed.ncbi.nlm.nih.gov/37242126/ 

Dr. Rikin Patel´s Socials

Website: https://www.resetpediatrics.com/ 
Instagram: @dr.rikinpatel.

Plant-Based Canada’s Socials:

Instagram  (@plantbasedcanadaorg)

Facebook (Plant-Based Canada, https://m.facebook.com/plantbasedcanadaorg/)

Website  (https://www.plantbasedcanada.org/)

Thank you for tuning in! Make sure to subscribe to the Plant-Based Canada Podcast so you get notified when new episodes are published. 

This episode was hosted by Stephanie Nishi RD, PhD.

Transcript

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SPEAKER_00 0:04

Welcome to the Plant-Based Canada podcast. Join us as we talk to experts to explore plant-based practices and how our food choices impact our health and the environment. We sit down with doctors, dietitians, athletes in various fields to break down the evidence behind a whole foods plant-based diet and discuss the practical steps we can take in the effort to shift towards a healthier lifestyle. My name is Stephanie Nishi, and today I'm joined by Dr. Rick and Patel to chat about child health. Dr. Rick and Patel is a consultant pediatrician and assistant professor in the Department of Pediatrics at the University of Toronto. He completed his pediatric residency at Memorial University of Newfoundland, and prior to medical school, he completed a master's in health policy, planning and finance from the London School of Economics and the London School of Hygiene and Tropical Medicine. Currently, Dr. Patel works for the Scarborough Health Network and is the founding member of the Markham Kids Clinic. He recently completed the plant-based certificate program through the T. Collin Campbell Center for Nutrition Studies at Cornell University. He is passionate about promoting a culture of wellness and resilience within physician and trainee communities through medical improv, meditation, and plant-based nutrition.

unknown 1:25

Dr.

SPEAKER_00 1:25

Patel has worked with numerous families and is passionate and confident in giving children and their families the best fuel for their well-being to maximize their potential. Also, thank you for more initiatives from Dr. Patel, as he is currently in the process of opening a new virtual clinic in the Greater Channel area called Reset Pediatric Lifestyle Medicine that aims at treating and reversing chronic diseases among children using lifestyle-based intervention. Dr. Patel, thank you so much for joining the Plant-Base Canada podcast today.

SPEAKER_01 2:01

Thank you so much, Steph, for having me on. It's a real honor to be here.

SPEAKER_00 2:06

I'm so looking forward to our discussion today and to jump right into things. I was wondering if you could tell us a little bit more about how plant-based practices became a part of your personal andor professional life.

SPEAKER_01 2:20

Yeah, great. Thank you. So the idea of a plant strong diet was an idea that was introduced to me by my mother, and she's been a lifelong lacto-vegetarian. And 40 years ago, when if if your last name is Patel and you have your roots in the west part of India, it's very much embedded in their culture. And while times have have changed, it's still a very strong part of the culture. So that was really where the seeds were planted in terms of a plant-based diet. Now, I grew up still because of growing up on this side of the world. My family wanted to give me all the options. And obviously, there's different societal and peer pressures. So I grew up, in fact, uh eating meat and animal protein. And so really it was after I was inspired after my undergrad, I went to the London School of Economics and the London School of Hygiene to do a master's in health policy. And it was there that I met a group of friends who were very uh seriously practicing yoga and all the lifestyle practices that come along with it. So it was really the moral and ethical reasons uh for going plant-based that really inspired me because it was foundational to deepening my practice of yoga. And that's really what inspired me in in 2005 to really make the switch. Now, for me, along the way, I see plant-based uh transitioning to a plant-based diet as a journey, and it's something that's refined over time over the last 18 years. But the more and more that I've been reading into the research and the science, and it's become so clear on so many health benefits that it's really reaffirmed and also uh bolstered my decision to continue this way and improve my diet. So there's again so much science now there to support what uh many people do as part of their regular culture.

SPEAKER_00 4:26

And my understanding, you brought these personal lifestyle practices and findings from evidence into your professional life. And I was wondering if you can tell us a little bit more about your work as a founding member of the Markham Kids Clinic and in general your work as a pediatrician and the types of patients you see.

SPEAKER_01 4:45

So for me, talking about a plant-strong diet has been because of my own transition. It's been something I've been talking about to patients. I can remember going back to medical school just after I took to this way of life. And for me, I knew that there were uh plenty of health benefits, and I was regularly trying to talk about it, especially with when you're in medical school, you see uh many adults have with chronic conditions that you know that can be improved with uh dietary adjustments. So it definitely started, I would say the roots uh started back then. And in residency, I I remember being that resident that always took more time with families and teenagers and patients to talk about uh a plant-strong diet, introducing more fiber into their diet and how it could improve um their health. And so now as a pediatrician, it's it's pretty much just become like a second, you know, a second language for me that comes quite naturally. Uh, right now at the Scarborough Health Network, I work as one of the staff pediatricians. And in addition to doing call, having a pediatric clinic, and uh working in the NICU, I also am part of the team that works on the uh Hops Clinic, which is a lifestyle intervention clinic focused on uh children with obesity. And that's really, really satisfying and rewarding because there in that type of clinic, we actively get to talk about uh nutrition and other lifestyle interventions uh with this population because it is focused on lifestyle uh and not on medicine because of the stage in life that they're at. And we know that there's when we approach it from a multidisciplinary perspective with my other colleagues, that we can have tremendous uh benefits and gains. And then, as you mentioned at the Markham Kiss Clinic, that was a clinic that I had founded with a couple of partners a few years ago. I've been doing uh primary care pediatrics there for the last five years, and now I'm moving into a different role, uh, just focusing on consultation uh for pediatrics at that clinic.

SPEAKER_00 7:08

In looking into this topic that we're talking about today, one of the things that came up a lot and potentially is the question: is it safe to raise a child on a vegan or vegetarian or plant-strong dietary pattern?

SPEAKER_01 7:24

Great question. And as you have mentioned, one that comes up very commonly. A couple of years ago, I was on I was asked by uh plant-based food festival to specifically comment on uh plant-based diets from a pediatric perspective. And uh that was at the KW Veg Festival for uh those maybe looking at that talk that's online. But what I want to start out by saying is absolutely uh you can completely raise a child on a uh vegan, vegetarian, or plant-based diet without any concerns. It has been uh reiterated and reaffirmed by the American Academy of Pediatrics, the Canadian Pediatric Society, the Academy of Nutrition and Dietetics in the US, as well as now the Canada food guidelines also uh are moving towards more of a plant-strong diet. So definitely it's uh absolutely feasible, it's healthy. I think one couple of uh important details to point out is that in any of the recommendations that were made by any of these organizations and their positions, they always use the words well planned and giving attention to uh specific nutritional components. And I think this is very important because it's easy just to take it as a black and white yes or no. But it's it's yes, with uh, again, that intentionality, that attention, and that detail that also is really important to executing this in a in a healthy way.

SPEAKER_00 9:03

And we'll get into questions about what does it mean to be well planned a little bit later in this episode. But first, I want to delve into this question a little bit more, just because there were some aspects that were brought up, questioning about developmental potential concerns, whether that be physical or neurological growth concerns. And this is in relation to specific nutrients. So I was wondering if there are, when looking at the specific nutrient level, there have been some that have been noted to be of interest, specifically some of the micronutrients like the B vitamins, especially vitamin B12, vitamin D and calcium, iron and zinc. Uh, why or perhaps why not are these nutrients considered to be important or of concern for children if they are following a plant-strong dietary pattern?

SPEAKER_01 9:54

So I will what I'll do is it maybe I'll start with some of the uh pediatric concerns that come up and then I'll tie it to the specific nutrients. So, first of all, it's important to know that these micronutrients that you mentioned are for especially I can I can target, for example, iron, uh B12, uh, omega-3. These three very specifically are critical in the formation of uh brain growth, development, nervous tissue, uh, the eyes. And so again, these three nutrients specifically come up in that uh with regards to the importance of the development of these areas, and the way sometimes they may show up uh in clinically for us is uh they could, if these are deficient, they could show up as poor growth, uh delayed milestones, regression in milestones. And so this is the way we may we may see it, but again, this is why because uh just going back to this, you know, specific nutrients. If we started with, let's say, for example, iron is a is a common uh micronutrient that's talked about, if you can get enough while on a on a plant-strong diet, and absolutely you can. And what it's and and this is because now so many foods are iron fortified, such as cereals, grains, uh beans. But one thing that's important to remember with iron is that the from from plant sources, it's a non-heme iron. And so it's important that it for it to be uh better absorbed, it be converted into a heme iron, and that's done through a cofactor such as vitamin C, which will make that transition. So, again, the way that looks like the what that looks like in our diet is that let's say you're having some chili, that you have your chili with uh beans or legumes with tomato and bell peppers that are your source of vitamin C that will help make that iron more uh readily absorbed in the gut. So, again, that's one example in iron. Uh, with B12, as we mentioned, B12 is typically found in animal sources. And we uh it's important because as we mentioned, uh regarding to growth, but specifically our nervous system and our brain development, uh it's important to always seek out sources of B12 that are all that are fortified in foods. Uh now cereals are fortified, juices are fortified, unsweetened, soy milk, tofu, tempeh are all fortified with B12. And again, this is very important. And if again, if there's a concern, you can there is always the option of a B12 supplement. And so that is uh in the area of B12 in case we're not getting any sort of animal products. And then finally, as I mentioned, omega-3, very important for eye brain uh nervous system development. It also helps reduce inflammation, but typically again found in uh seafood, eggs, and unless we're having large amounts of algae or you know, sea vegetables, we need to uh take it in through the uh precursor of linolinic acid, and that's typically found in uh uh flaxseed oil, walnuts, soy products. And this is this precursor is then converted into our long-chain omega-3 feed fatty acids that our our nervous system needs for for growth. So again, that is the you know, in terms of our overall development and brain growth, I would target these three uh nutrient levels as particularly important.

SPEAKER_00 13:49

You mentioned one of the aspects of a macronutrient omega-3 fatty acids, which are part of the category of fats. And within macronutrients, we also have carbohydrates and proteins. And protein in particular appears to come up in conversation when it comes to plant-strong dietary patterns. Can you speak to this and how it relates to dietary intakes of children?

SPEAKER_01 14:13

For sure. So it's important to know that with protein, first of all, you can get more than adequate amount of protein in a plant-strong diet. And it's really what usually is misunderstood is that uh plant protein, it does have lower digestibility than an animal protein. And so you require more protein uh intake than those who are have uh animal-based diets. But again, the take-home message for protein is that it's very important to have a variety of plant-based proteins to be eaten that complement each other. Uh, we get protein in lentils, uh, whole grain bread, uh, pumpkin seeds, a variety of nuts and nuts butters. And I think very important point to also bring up is that usually uh there's, you know, studies have been done that have shown that that animal protein-based diets actually contain levels far beyond then the daily requirements. And and that has been shown to be increased the prevalence of heart disease, obesity, diabetes. And so it's important to know that our body can only handle so much protein. And typically, what people are having in the normal standard Canadian or uh American diet is it's much more than is needed. And what that leads to is uh the body working extra hard, specifically the kidneys, to keep excreting because you have this positive nitrogen balance, which then also has its uh uh negative impacts on the body. So, again, uh just to uh reiterate that absolutely you there is um the protein myth in a plant-based diet is completely uh has been dispelled. Uh you can get more than your share. And again, uh variety is important. Uh, and if you're unsure, please talk to always a uh uh a health professional, dietitian, or a physician aware of these diets to see how you could get more of that there. But again, no problems at all, and uh more than adequate intake available in a plant-based diet.

SPEAKER_00 16:30

So it sounds like you can get a variety of the various micro and macronutrients that your body needs. Are there any other nutrients that we haven't touched on that could be of concern or maybe related to possible nutrient deficiencies or have been associated with poor health outcomes? And how may they be addressed if there are them?

SPEAKER_01 16:53

Yeah, thank you. So I again there's so many micronutrients that we could discuss. I think what I'll do is I'll take the opportunity to discuss um one that has come up more so in the discussion. And it uh they're all related, but for example, calcium and and zinc, from a calcium perspective, most people think that they need to have, let's say, uh dairy in their diet, for example, to get enough uh calcium. And and that's definitely not the case because we have there our greens are full of high, high in calcium, broccoli, leafy greens, you know, things like Chinese cabbage and bok choi. And uh they're in fact more highly bioavailable, which means they have, you know, they're they're easier to absorb. You know, one fun fact I always like to remember is that sweet potatoes contain 60, you know, 68 milligrams of calcium. It's not something we, you know, would always think about has high calcium. But again, uh an important part to remember with calcium is that to absorb calcium, you also need uh adequate vitamin D levels. And again, with vitamin D, uh with people who are on a strict plant-based diet with no animal protein, uh, it is important to have vitamin D supplementation, although vitamin D is is readily found now uh in that's fortified in in many uh different foods. But again, if uh if we're not getting foods that are fortified with vitamin D, and the fact that uh in at least in Canada and some parts of the United States, there's long winter, so we're not getting that natural production of vitamin D through sunshine. We may uh likely, I I always say it's a good idea to uh have a supplement of vitamin D. I'm quite liberal about it because uh they've even shown um, you know, in adults, even higher levels of vitamin D have been shown to be benefit, have various health benefits. So, again, uh calcium and vitamin D is one uh micronutrient to address. The second that I wanted to address that has come up um quite often is zinc. So uh one thing to remember is that with in a plant-strong diet, there is a higher risk for having uh reduced zinc, and that's and that's because it's found in lower amounts in plant foods compared to animal products, and they're also less bioavailable, so they're they're less able to be absorbed, and that is because um a lot of foods with zinc are also rich in in phytates. Now you might wonder what a phytate is. Uh, I didn't know what it was for a long time. Phytates are they basically serve as like a storage form of phosphorus in, let's say, legumes, nut seeds, grains, and and typically what happens is they pass through our digestion tract uh and they're unabsorbed because humans, we don't have that enzyme to to break it down. And so what happens though is as it goes through our gut, it also can can bind uh different micronutrients zinc, iron, calcium, magnesium, and so they can in fact reduce our absorption of these micronutrients in the digestive tract. So, and and the re again going back to what zinc is involved with, zinc is really important in our body. It uh not only impacts our our development and our linear growth, it's involved in our immune system function, our wound healing, uh, it's involved in the sexual organ development in in severe cases if it is low. And uh so we it's it's very important. One thing to remember with zinc is that we don't often hear about zinc deficiency, and that's because in in the developed world, we we tend to it's it's quite rare unless you have a genet genetic disorder for uh zinc malabsorption. But even mild deficiency, it's much more prevalent than people realize, right? And so some just common foods to think about that are rich in zinc, hemp and pumpkin seeds, uh different legumes like azuki beans, white beans, mung, uh, whole grains, even nuts such as almond and peanut butter are less so, but also have it. And then I always uh mention to my families that uh just easy way to increase zinc absorption in your body is uh I always talk about three things. You soak, you sprout, and you ferment. And if you just remember these three things uh and and forget everything else, uh that would be a great takeaway in terms of how to increase your zinc uh levels because what this does is it actually breaks down and reduces the phytate level so you can more easily absorb zinc. So yeah, I wanted to just highlight those uh other micronutrients that will come up usually in the discussion of a plant based diet.

SPEAKER_00 21:56

Thanks for that, especially bringing it to the real world practical. Steps that we can take are the real foods that we can be consuming to obtain these nutrients and on the lines of real foods. Traditionally or typically milks have been a common component of a child's dietary intake, especially in North America. But with alternative milk products coming out onto the market or if they have been on the market for a while, what are your thoughts on these, especially for different stages of infant and or child development?

SPEAKER_01 22:32

Right. So we do have, you know, I'll I always start the discussion with families that uh that breast milk is always the uh favored choice uh for uh infants, especially under the age of one. And in terms of milk alternatives, the the only one that's recommended by uh nutrition associations as well as the American and Canadian Pediatrics Association is uh soy milk, right? And the reason why that's the case, I usually always typically show my patients uh a graph related to this because it's really important to know the distribution of calories, fat, you know, carbohydrate, and protein. But soy milk is the only of the different nut milk, such as almond, coconut, you know, cashew, all these different ones. It's the only one that has the most similar protein content to cow's milk. And uh it also has uh similar, it also has uh lower fat content.

SPEAKER_00 23:39

Sounds like in comparison to cow's milk, so why milk has similar protein levels, similar or lower amounts of fat, and the carbohydrate or sugar amount to if you do the natural versus the sweetened versions, um, you can have a more comparable outcome. And so therefore you get the nutrient profile without missing out on specific nutrients of concern, and it's often enriched with vitamin D and sometimes vitamin B12 as well.

SPEAKER_01 24:08

Yeah, they're both uh enriched with vitamin D and B12, which is the one we recommend and typically unsweetened. And even now, there's we're making a push in Canada to have Health Canada recommend uh soy milk as early as 12 months, and that's because while we know that it may have somewhat lower calories to uh and fat to cow's milk, that can be made up in other ways through other fats, but it does provide advantage for several other nutrients, such as iron. And we do know that there's a much lower saturated fat content in uh soy milk, which is also a huge advantage. So, again, typically, while the Canadian guidelines would just reference soy milk as a as a recommendation for above two, I generally encourage it now, even after the age of one, if uh parents want to uh wean off uh breastfeeding and they can move straight to soy milk.

SPEAKER_00 25:07

Thank you very much for providing that comparison and putting it all into perspective. Now, I want to go back to something that you mentioned a little bit earlier, and that was in regards to having a well-planned dietary intake. So putting it all together, how may one go about planning a well-balanced or well-planned plant-strong diet for children?

SPEAKER_01 25:29

It's a big question, but I think what we can what we can look to kind of uh hone in on is that for different stages of our childhood, it's important to uh also note that there's different requirements. And I'll just give you a like a one example. But for uh when when kids are less than three years old, if you're looking to formulate a plant uh focused or strong diet, it's really important to know uh a simple fact that because of the uh increased uh fat requirements, so 35% of the calories of the diet in kids who are less than three should be coming from fat. And and knowing this, then we would plan around it because there would be a slightly higher emphasis on on fat in the diet, which wouldn't be the case after you know they they cross the age of three, because typically after they they move beyond three, then the you know, fat requirement reduces to 10, 15 percent or sorry, to 25 percent. And then pretty much as in childhood and teen years, it's it's similar to adults at about 10 to 15 percent. So I think that's a that's a just an example of just knowing what age and stage you're at and how to cater accordingly. Uh, and that can always be done with the help of a of a health uh professional. I think that's also really important as we're transitioning through. And again, uh the reason why acknowledging these differences are really important is because you know, the greatest amount of growth is happening in that first year of life more than any other time in our in our childhood. But then really the next, you know, really big growth spurt after the first, I would say, you know, one to two years of life, then becomes in puberty. And then our calorie requirements also increase then. Right. So again, it's just uh I'm I'm putting these out there to again establish that based on where we where we are in terms of our age, it's also important to take that in consideration when making a well-balanced uh diet. But it what's what I wanted to at least let our our listeners know is that if you're having a well-planned and well well-balanced diet, uh, unless one is concerned about kids who may be like very severely like picky uh diet, you don't necessarily need, you know, any, for example, like multivitamin, except for what people commonly take are vitamin D and B12. That's one important consideration to keep in mind. And that uh I think it's important just to make sure that we're always focusing on variety. It's uh I think so much of the establishing a diet comes when the parents uh I would I would say parents determine the culture of of food in a home and the the habits they want to instill in their kids. So I always go back to Ellen Satter's uh in her book, this idea of the division of responsibility or duties, where the parents decide when and and what to eat, but then the children, if they if they decide to eat, they'll just they'll actually choose the specific choice and how much to eat. And so that really puts the onus on the parents to really try to make the best, the the healthiest choices possible in terms of what the choices are, uh, but the children ultimately being the ones who choose. And then in addition to that, uh establishing a positive uh environment for children, I feel is very important. Again, this is very much in the control of parents in terms of the types of food are served, you know, what is brought into the home, uh, for example, uh food environment that is, you know, minimized or devoid totally of screens, because again, the that tone for the food culture in the home to be gatekeepers are set by the parents. And so, again, allowing knowing what comes in the home is really important and having control of that. And the reason why the focusing on the home setting is so important because we know that when children are outside of the home, that there are going to be things that they're gonna be exposed to that we may that we may not necessarily have control over. So I know it again, it may it sound intense by controlling what comes in, but if we do that, then there's a little there's flexibility for you know what happens at school or birthday parties or play dates, right? Because I always try to remind parents of the be flexible rule of 80-20 that if you're striving to eat really healthy 80% of the time, then uh we have 20% of wiggle room and you can incorporate other foods that aren't um the ideal choices, but they're reserved for special occasion celebrations and times when you may be outside of the house. So again, there's always a place, uh time and a place for treats. And I found that suppression just doesn't work in the long run. So we just need to work on a balance.

SPEAKER_00 30:42

I really like that focus on the balance and not being potentially hard on ourselves if we are parents, if it's not always 100% considered the fruits and vegetables or the ideal quote-unquote dietary intake because it's there's life and other factors come into play. Now, coming from the parent's perspective, what are some of the reasons to possibly follow a plant-strong dietary pattern starting in childhood or to introduce this type of dietary pattern to a child?

SPEAKER_01 31:18

Great question. So a lot of our the research that we have for that we derive for making decisions about a plant-focused diet still stem from a lot of our adult research and data. But we clearly know that uh children who are more plant-focused in terms of their diet, they have uh lower BMIs and a reduced risk for obesity. Um, again, we know that when it's done carefully, there are absolutely no concerns at all with uh growth and uh development. We also know that kids are at our less risk for type 2 diabetes. The some other health considerations uh to consider is uh reduced risk for high cholesterol and heart disease, which have its roots uh in childhoods as young as three years old. We know that fatty trees can start to develop uh within children's arteries. And now there's uh a growing amount of research that's looking into plant-focused diets that really help reduce the flaring of atopic conditions such as eczema and asthma. So, again, we have uh a lot of uh we have a growing amount of research. There's still more to be done. And we we do know that in our pediatric populations, with uh when it comes to the specific research, we're still limited by our design limitations and our sample sizes. But we do know that again, these are all very good reasons. And there are other conditions that we can uh discuss later on that a plant-based diet will also help to address and improve. But these are just some starting uh points to consider for families uh when they're considering a plant-based diet that starts in childhood.

SPEAKER_00 33:10

So if parents are potentially considering this, or you're in your practice, you're meeting with the family for a first time, or maybe you've met with them for a few times um prior, how do plant-strong or plant-focused practices come into the discussion with parents and their families?

SPEAKER_01 33:30

Yeah, thank you. So in my office practice where I would see patients right from birth, I really start to bring it into the discussion very actively when kids uh are uh pretty much at two years old. And that's where I always take the opportunity to discuss the Canada Health Food Guidelines with every family that I come into contact with. And I always explain that there are three major changes that have occurred in the family or sorry, in the Canada food health guidelines. And one is that uh milk has now been replaced by water, so there's a much more focus on having water in the diet and that milk is not necessary. Two is that the now the plate is much more focused, 50% of it is focused on uh fiber, so more uh vegetables and fruit. And the third big change has been the removal of meat as a food group, and now a focus on a variety of uh protein sources. So I always like to start the discussion at that age, because as you can imagine, most parents they're not familiar with those things, and it it really kind of plants the seeds for us then considering their own diet. And and I always try to, when I'm uh in this conversation looking at the benefit, the health benefits for the kids, I always uh try to frame the discussion as an opportunity for the entire family to improve their health, make better choices, and that we shouldn't, we should never we should never single out uh the the the children, and that as parents, if we can uh model the changes, that they become very easy for the kids to adopt. So I always try to bring in that aspect of the whole family uh improving, and that when the parents also make changes, this modeling has uh has such a strong impact. In fact, we know that you know, for families that are looking to figure out you know what would make the biggest difference in their child's eating behaviors, whether it be like pick picky or restrictive or whatever it may be. And and they've looked at does it is it the is it a matter of like color, shape, texture, so many different things they've looked at, but they found uh very clearly that in fact it's the most important factor on the child's uh dietary preferences is what the parents model. And again, I I really appreciate that point and always bring that up. And and whenever I do, it it's something that always lands very uh genuinely with parents. They appreciate the honest conversation, they always it it gives them the opportunity to reflect on themselves. And we, you know, we all know that if we want to see the change in others, that you know, starting with ourselves is is the best place to start. From there, usually going on if uh parents are interested, we love to establish uh some some SMART goals on how uh families can engage and make their changes more practical.

SPEAKER_00 36:35

That sounds fantastic. And just to clarify, when you say SMART goals, that's referring to specific, measurable, attainable, realistic, and time-specific.

SPEAKER_01 36:46

That is it. You got them all.

SPEAKER_00 36:48

Okay, it's been a while. I really liked how you spoke about role modeling because I think this also ties back to the work by Ellen Slater where she was talking about for if a child is a picky eater, if they see their parent or an older individual or somebody that they spend time with eating a certain food, they're potentially more likely to try it themselves and in other situations as well. So I really like how you brought that up.

SPEAKER_01 37:15

Yeah, I think that repetition is really a key point that I always bring up with families trying to uh introduce and shape uh the diet of the children today, that not to get discouraged, you know, repetition is the key. And if we are are failing, that it's okay. Um, you know, and if we make mistakes, it's also okay. None of us, nobody's perfect, but that consistency and that repetition is really um the hallmark and kind of the foundational principle of leading towards successful changes and and shaping our child's palette in the long term.

SPEAKER_00 37:56

We're gonna shift gears just a little bit. And I know you mentioned or touched on some of this a little bit earlier, but I was wondering, are there any other common myths or misinformation or misconceptions that you would really like to address or make sure that they don't uh persist?

SPEAKER_01 38:15

So there are definitely different misconceptions that might be out there of a plant-based diet, but one that I will just choose to address uh today, and is one that's been, I would say, around for a long time, is that there that a plant-based vegan or vegetarian diet uh is causes an eating disorder. I think this one is uh very prominently still uh thought to be the case. And and and for those that may not know, there was a huge uh spike in in uh teenagers with uh uh uh disordered eating that presented to our hospitals um at the start of the pandemic and and was really fairly consistent almost throughout the pandemic. And I what I wanted to just at least address here is that there is evidence that people with um eating disorders report being more uh vegetarian, vegan, or plant-based than the rest of the population. But it's important to note that this is that this doesn't, while this kind of connection is there, it doesn't mean that uh it in fact this type of diet causes an eating disorder, but that there may be uh a relationship. And so the important, really, really important point that I wanted to come across here is that anytime children, teenagers start cutting out uh certain foods in their diet and become overly preoccupied with foods uh that they're eating, um, you know, there is always a risk of disorder eating and/or an eating disorder. But the real key that I wanted to bring out here is that it's really important um to be able to understand the motivation that's going towards a plant-focused diet. Uh, there are a variety of um of signs, recognizable signs that may point more towards that, okay, this is more than just a uh a diet change and that this could be disordered eating and being able to recognize those signs. I think it's important uh in uh with this um in this idea that we're we're trying to get the appropriate nutritional advice from either physicians, dietitians who uh will will know more of the science behind um proper nutritional eating because in this area there's so much uh misinformation in social media when it comes to uh the condition of eating disorders and uh plant or vegetarian focused eating. So again, trying to get uh seek counsel and advice from uh healthcare practitioners, I can't stress enough how vital it is. And I think it's also important just to uh let um everyone know that you can, in fact, still go through an eating disorder recovery or weight recovery process with the help of professionals on a uh plant-focused diet. And although we acknowledge that sometimes these uh these uh professions aren't easy to find, uh it still can be done.

SPEAKER_00 41:34

Thank you for sharing that. I feel like that's such an important message. And with anything that we discuss here on the podcast, we do encourage individuals to seek their own individual health guidance and consultation, whether they're making a change or if they observe changes in themselves or family members as well. So thank you for bringing that up. So on that note, I'm just aware of the time and I want to change gears to a more happier topic, and that is where can people find out more about you and your work?

SPEAKER_01 42:15

Oh, thanks for asking. So currently, as I I mentioned earlier, I still am I am working as a general pediatrician at the Scarborough Health Network, and uh families who want to see me will always just need a referral to the centenary pediatric clinic where I'm still working there on a weekly basis. Uh at the Markham Kids Clinic, we'll all I'm also accepting referrals uh there also. So those are two locations where people can see me in person, but I'm really, really excited to let uh the public know that uh because uh plant-based eating, but not just that, in the in the kind of greater umbrella of lifestyle medicine, where which plant-based eating falls under, I'm looking to launch a pediatric-focused lifestyle medicine clinic. And for those that may not know, lifestyle medicine uh to me it is, I feel I see it as being kind of a wave of the future for healthcare delivery because it's uh very holistic. Six principles of lifestyle medicine uh include uh a focus on plant-based eating, um, healthy restorative sleep, uh physical activity, our connections and our relationships, uh, stress management and resilience, um, having practices for that, and then avoiding uh risky substances and focusing on self control. So these are the six pillars of lifestyle medicine. And very soon uh people will be able to find our uh offering online, hopefully in the next uh couple of months. And that will hopefully be convenient to people because we are looking to start online as an online virtual offering with our multidisciplinary team, which will have dietitians, social workers, coaches, and also a physical activity component. And so this really excites me because I'm hoping that this will be an offering that will be well received. And I know that there's so much potential because not only are we trying to address physical conditions that we mentioned before, such as obesity, heart-related problems such as high cholesterol and atopic conditions such as asthma, but we're also hoping to uh bring a lifestyle approach to people with uh behavior challenges, uh mental health conditions such as anxiety and depression. So again, this is uh something that really, really excites me to talk about because there's so many uh elements and and I and while plant-based nutrition falls uh as like a very essential principle, it's nice to be able to look at the the lifestyle medicine as an entire offering where we're looking at not only just what people are eating, but other aspects of their life in trying to restore health and really uh bring to your child their their best health to maximize their potential.

SPEAKER_00 45:36

That is very exciting, especially it's it sounds to me like you're looking at the big picture of things and how to provide an overall high quality of life to the individuals that you're working with. Thank you for letting us know. And if you have any further information about that, where listeners can check out, um please feel free to share and I'll add them to the show notes.

SPEAKER_01 46:00

Great. Yeah, I'll I'll share all definitely all the social media platforms that are that are out there. And uh yeah, right now I am seeing uh patients uh all throughout, uh have the ability to see patients all throughout Ontario.

SPEAKER_00 46:13

That's fantastic. Now we're already coming to a close. I can't believe it. So I was wondering if you had a take-home message or final thoughts that you would like listeners to leave this episode with.

SPEAKER_01 46:28

Yeah, so I wanted to just uh, you know, thank you for having me today. And I think one thing is important uh in this journey of improving our diet and improving our lifestyle. It one thing that I I'd like to bring and at least share with the families is that everyone, each of us are on our own journeys, and and really myself and the team members I work with are really here to help uh you and your children take the next step on your journey. Uh, it's sometimes easy to get caught up in kind of setting a high standard, but for me, I really try my best to come to where the family's at and try to encourage them to take that next step. And uh it's really, you know, as healthcare providers who deal with children, we have such a privilege in being allowed into the inner corners of the lives of families through their children, and there's such a big opportunity for us to make a positive change, to shift the trajectory of society. I also just wanted to acknowledge to families listening today that it's uh it's an overwhelming challenge that parents face in raising children. I've been talking about this with my other physician colleagues, and uh there's uh there's so much pressure from mass media, social media. Uh, you know, there's such a strong, I would say, crippling effect of screen time and all the exposure that comes as a result. And so I I wanted to acknowledge that there's an important uh there is uh there are challenges and and they are real, but again, with uh with that challenge, we also have an incredible opportunity and a great responsibility. And and to all the families and parents that are listening, uh, really we we have such a great opportunity to be the change we want to see in our kids and and our children really serve as a as a mirror uh for us to look at and see how we want to become better ourselves.

SPEAKER_00 48:33

Thank you so much for those wise words. Dr. Patel, thank you for joining the Plant Based Canada podcast. And I just want to acknowledge your dedication to sharing information, especially because you offered to do this interview following an overnight shift. So your dedication is very inspirational. So thank you so much for taking this time.

SPEAKER_01 48:55

Yeah, and I really appreciate Steph what you're doing with Plant Based Canada and the entire team. It's uh it's a small team, but you guys are having such a huge impact, and I just really appreciate everything you're doing and really looking forward to working more together in the future.

SPEAKER_00 49:14

This episode was hosted by myself, Stephanie Nietzsche, and Clayton Samantovich is our audio engineer. This podcast featured royalty-free music from freestyle.com. A very special thanks to our guest, Dr. Patel, for speaking with us and sharing his insights. And of course, thank you for listening. If you enjoy our podcast, please consider supporting the show. You can do this by clicking on the link at the bottom of the show notes. The Plant Based Canada podcast is an initiative of the group PlantBased Canada, which aims to educate health professionals and the public on the evidence behind plant-based whole food nutrition for individual and planetary health. To learn more about the show, visit our website at www.plantbased canada.org and stay up to date by following us on Instagram, YouTube, and Facebook at Plantbase Canada ORG. Until next time.