Fish: The Untold Story


By Robyn Chuter

  • Fish consumption has been linked in epidemiological research to a higher risk of breast cancer and heart disease.
  • Fish is the major dietary source of exposure to persistent organic pollutants which are linked to diverse health issues including impaired immune function, liver damage and Parkinson’s disease.
  • In most people, fish consumption is the major source of mercury exposure. Mercury is a neurotoxin linked with anxiety, attention deficit, and dementia.
  • Antibiotics and antibiotic-resistant bacteria are found in farmed fish, as they are in other intensively-reared animals.

When I counsel clients seeking weight loss, disease prevention or reversal, improved mood – and anything else they want to fix – to cut down on or entirely eliminate their animal product consumption, most can accept pretty easily that the great weight of scientific evidence supports this advice.

But then the question always comes up: “What about fish? Isn’t fish good for me?”

In the past I used to recommend moderate fish and seafood consumption for those who still wanted to include some animal foods in their diet, figuring it was safer than chicken or meat.

I no longer give that advice, and here’s why:

Over the years, numerous large, well-designed studies have indicated that fish consumption poses significant risks to health. But none of these studies have received widespread coverage in the popular media, which constantly pushes the line that fish is heart-healthy, an excellent source of omega 3 fats, and a good source of lean protein.

What risks were found? Well, how about a roughly 50% higher risk of breast cancer in women who eat the most fish, compared to women who eat little or no fish (1)?

Or a 2-fold higher risk of heart attack and a 2.9-fold higher risk of cardiovascular death in men with a high intake of nonfatty freshwater fish (2)?

Or a 30% higher risk of coronary death in Finnish male smokers with the highest intake of omega-3 fatty acids from fish (3)?

What’s in fish that makes it a health risk?

1) Persistent organic pollutants (POPs):

The world’s oceans are now brimming with toxic chemicals such as PCBs, dioxins and dieldrin. Some of these are no longer in use (such as PCBs and dieldrin, whose prodution was banned in 2001 because of their adverse health effects), yet they remain in our environment because they strongly resist biodegradation.

They get into the ocean either through direct discharge from factories, or by contaminating ground water or river water that eventually ends up in the ocean. There they are absorbed by phytoplankton, which are eaten by zooplankton, which are eaten by tiny fish, which are eaten by bigger fish, and so on and on, up the food chain.

These contaminants are fat-soluble, so they concentrate in the fatty tissues of the animals that eat them, and biomagnify (reach higher and higher concentrations in animals) at every step up the food chain.

Humans are at the top of the food chain, so every time we eat fish, we’re copping the full load of contaminants that that fish has accumulated over its lifetime.

So what’s the problem with that?

PCBs (polychlorinated biphenyls) are endocrine (hormone) disrupters that cause liver damage; interfere with normal sexual development within the womb, impair immune function, motor skills and short-term memory in babies whose mothers ate fish high in PCBs; and increase the risk of liver, biliary tract and breast cancer (4).

Dioxins also cause liver damage, are endocrine disrupters and probable carcinogens (cancer-causing agents). They adversely affect metabolism of haem (the oxygen-carrying protein in red blood cells), serum lipid levels, sperm count and motility, and the function of the thyroid gland and immune system, and may cause diabetes (5).

European researchers concluded that

“… if the recommended LC n-3 PUFAs [long chain polyunsaturated fatty acid – i.e. DHA and EPA] intake would be based on fish consumption as the only extra source, the majority of the study population would exceed the proposed health based guidance values for dioxins and dioxin-like substances.” (6)

Dieldrin is linked with the development of Parkinson’s disease, breast cancer, and immune, reproductive, and nervous system damage. Male babies born to women who were exposed to dieldrin during pregnancy have a higher risk of undescended testes (7).


Farmed_vs_wild_salmon_contaminantsThe chart at left shows levels of some POP contaminants found in wild-caught (green bars) and farmed (red bars) salmon (8). As you can see, farmed salmon has higher levels of all of these contaminants than wild salmon.

However, exposure to any amount of these contaminants is risky, particularly as there is no research on the combined effects of these chemicals. Toxicology tests only investigate the effects of one chemical at a time, but many toxic substances have a synergistic effect – that is, exposure to very small amounts of multiple chemicals may cause just as much harm as a large exposure to just one chemical, especially if those small exposures are repeated on a regular basis… such as eating a can of salmon several times per week.

As the researchers who produced the chart concluded,

“Risk analysis indicates that consumption of farmed Atlantic salmon may pose health risks that detract from the beneficial effects of fish consumption” (8).

2) Mercury:

All fish and seafood contain methylmercury, and most of the mercury load in most people’s bodies comes from fish consumption, not amalgam fillings or thiomersal, the mercury-containing preservative used in many vaccines (9, 10).

Mercury is linked with infertility, neurological and mental disorders (including anxiety, attention deficit, and dementia), high blood pressure and endocrine disorders; and mercury levels are also strongly correlated with the risk of heart attack (11, 12, 13, 14, 15).

Mercury levels vary from one fish species to another, with large fish such as shark, swordfish and king mackerel being the most polluted.

But as with the POPs, persistent low-level exposure is just as dangerous as occasional high exposure, because mercury takes months to eliminate from the human body, and if more is ingested before previous doses are eliminated, then it starts to accumulate – particularly in the brain and kidneys.

3) Antibiotic residues and antibiotic-resistant strains of bacteria:

Like other factory-farmed animals, farmed fish are routinely given antibiotics to prevent infectious diseases from spreading like wildfire through the densely-stocked pens. Residues of these antibiotics contaminate not only the flesh of the farmed fish, but also wild fish and shellfish living in or travelling through the vicinity of the fish farm (16).

Use of antibiotics has been linked to a higher risk of breast cancer (17) and prostate cancer (18); chronic low-level intake of antibiotics through the food supply may also be a risk factor for cancer.

Antibiotic-resistant strains of bacteria including E. coli, Salmonella, and Serratia species bacteria cause food poisoning, respiratory diseases and urinary tract infections.

Furthermore, antibiotic-resistant bacteria can transfer the genes that confer their antibiotic resistance to other bacteria – including ones living in your body, making these formerly harmless bacteria capable of causing serious disease for which there may be no effective treatment (16).

The bottom line is, it is simply not worth exposing yourself to the serious, even life-threatening hazards posed by POPs, mercury and antibiotic-resistant bacteria, when every nutrient that fish contains, can be obtained from other, safer food sources that offer a range of beneficial nutrients.

The short-chain omega 3 fat alpha-linolenic acid (ALA) occurs in abundance in flaxseeds (also known as linseeds), chia, hemp seed, walnuts, pepitas (pumpkin seeds) and green leafy vegetables. ALA can be converted into the long-chain omega 3s EPA and DHA, which occur in fish, although the efficiency of this conversion varies from person to person. The good fats in these foods come packaged up with cancer-fighting lignans, fibre, and powerful antioxidants, none of which occur in fish.

If you want to safely boost your intake of ready-formed DHA and EPA, you can take a supplement derived from algae. As a matter of fact, that’s where fish get their long chain omega 3 fats. The algae are grown in controlled conditions, ensuring they are free of mercury, POPs and other contaminants. There are many vegan-friendly algal DHA and EPA supplements available, including Opti3, Nuique Omega 3 and Source Naturals Vegan Omega 3s.


Vegan White Chocolate Pistachio Bark


This white chocolate treat is so versatile that you can add almost anything to it. Wrap it in a cellophane bag for a beautiful handmade gift

By Cassie Heneghan

Makes 1 slab


300g vegan white chocolate

1 cup pistachios, roasted, roughly chopped

2 tbsp pink confetti sprinkles

1. Line a baking tray with canola oil spray and baking paper and set aside.

2. Place the chocolate into a heat proof bowl and into the microwave for 1 minute. Stir and place back into the microwave for a further 30 seconds and stir again. Repeat at 30 second intervals if chocolate isn’t melted.

3. Pour the chocolate onto the prepared tray and spread out evenly using a pallet knife. Sprinkle with pistachios and sprinkles and allow to set, approximately 30 minutes.

4. Break into pieces and place into cellophane bags or air tight containers.


Should you get a flu vaccine this winter?


By Robyn Chuter

  • The Cochrane Collaboration is an international, independent, not-for-profit organisation which assesses the published literature (and unpublished trials, when available) to establish a reliable evidence base for the practice of medicine.
  • Separate Cochrane Reviews on flu vaccination for children, healthy adults, the elderly, and health care workers caring for institutionalised elderly people, have concluded that they offer little protection against the flu, and don’t reduce the rate of complications, hospitalisation or worker or student absenteeism.
  • Furthermore, getting the flu vaccine doesn’t prevent the transmission of the influenza virus to other people, so it’s of no benefit for ‘herd immunity’.
  • The researchers found an alarming absence of safety studies in children under two.
  • The researchers were disturbed by the amount of misrepresentation, manipulation of data and outright fraud that they found in drug industry-sponsored trials of flu vaccines.

Winter is finally upon us here in the southern hemisphere, and many of my clients have been asking me about flu vaccination. Fortunately, I don’t have to sift through the scientific literature all by myself to come up with advice on this matter; I can simply quote the findings of the Cochrane Collaboration on influenza vaccination.

For those of you not familiar with the Cochrane Collaboration, it is an international, not-for-profit organisation comprised of independent researchers – that is, they do not receive any funding from commercial sources, instead relying on international government agencies and charitable donations (commercial organisations such as pharmaceutical companies are specifically prohibited from making donations, under the Cochrane Collaboration’s Policy Manual).

The role of the Cochrane Collaboration is to establish an evidence base for health and medical care, by assessing the published literature (and unpublished trials, when available) to determine whether interventions such as surgery, medical drugs and nutritional supplements are effective at treating particular conditions. The work of the Cochrane Collaboration, which is published in Cochrane Reviews, is “internationally recognised as the benchmark for high quality information about the effectiveness of health care.”

So what is the Cochrane Collaboration’s verdict on flu vaccination? Separate Cochrane Reviews have been published on influenza vaccination in:

  • Children,
  • Healthy adults,
  • The elderly, and
  • Health care workers caring for institutionalised elderly people.

In every case, the reviewers concluded that the task of accurately assessing the effectiveness of flu vaccination was made next to impossible by the fact that the studies published by pharmaceutical companies were marred by poor methodological quality, multiple types of bias and in some cases, outright deceit:

“This review includes trials funded by industry. An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry-funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favourable to the vaccines. The review showed that reliable evidence on influenza vaccines is thin but there is evidence of widespread manipulation of conclusions and spurious notoriety of the studies.”

Vaccines for preventing influenza in healthy children

Here is a summary of the key points in each Cochrane Review (quotation marks indicate a direct quote from the review; points without quotation marks are my paraphrases):

  • “Inactivated vaccines in children aged two years or younger are not significantly more efficacious than placebo” – in other words, injecting your child with saline solution would protect them from the flu about as well as a flu vaccine [N.B. all seasonal flu vaccines used in Australia – Fluarix, Fluvax and Vaxigrip/Vaxigrip Junior – are inactivated].
  • “Twenty-eight children over the age of six need to be vaccinated to prevent one case of influenza (infection and symptoms).”
  • Flu vaccination does not prevent the transmission of influenza to others.
  • There is no reliable evidence that giving kids flu shots reduces their number of sickness-related school absences.
  • Flu vaccination does not reduce the rate of lower respiratory tract disease (e.g. pneumonia), drug prescriptions, or middle ear infections (or their consequences or socioeconomic impact).
  • 47% of children given a placebo instead of a vaccine developed an upper respiratory tract infection during the follow-up period, compared to 53-70% of vaccinated children.
  • “One specific brand of monovalent pandemic vaccine is associated with cataplexy [a sudden and transient episode of muscle weakness accompanied by full conscious awareness] and narcolepsy [a chronic neurological disorder inhibiting the brain’s ability to regulate sleep-wake cycles] in children and there is sparse evidence of serious harms (such as febrile convulsions) in specific situations.”
  • “The main problem we encountered in interpreting studies… was that of high risk of bias: all included studies were poorly reported and contained either contradictions between data in figures, tables and text, or reported implausible events or showed evidence of reporting bias of one sort or another” – in other words, the authors of studies conducted by drug companies fudged data, left out important data, or just made stuff up to make the vaccine look good.
  • Studies reporting that flu vaccination was effective are far more likely to be published than those reporting that it wasn’t; and studies finding that flu vaccines harmed children are far less likely to be published (and therefore don’t come to the attention of doctors or vaccine policy makers).
  • Flu vaccines are not adequately tested for safety before being released onto the market: “This is the case of the 2010 TIV by CSL Ltd used mainly in Australia. One child in every 110, aged below five, vaccinated with the CSL vaccine had a febrile seizure. Australia suspended its use. These episodes highlight the insufficient regulatory attention to potential harms from influenza vaccines in children, as the registration trials for the CSL vaccine had been carried out on 162 children aged up to three years (Collignon 2010).”
  • “It was surprising to find only one study of inactivated vaccine in children under two years, given current recommendations to vaccinate healthy children from six months of age in the USA, Canada, parts of Europe and Australia. If immunisation in children is to be recommended as a public health policy, large-scale studies assessing important outcomes, and directly comparing vaccine types are urgently required.”
  • That single safety study of inactivated flu vaccine on children under 2 was conducted over 30 years ago (which means the test was done using a different vaccine than those used currently, since seasonal flu vaccines change annually depending on which flu strains are circulating) and in only 35 children! So much for governments’ and doctors’ reassurances that vaccines are safe – how can you possibly know if you haven’t tested them?
  • The report’s authors were clearly concerned that vaccine manufacturers are not disclosing adverse reactions to flu vaccines that occur during clinical trials, as they stated: “Further safety data should also be collected or made available of the safety of vaccines in children, particularly inactivated vaccine in younger children. There is an immediate need to standardise safety outcome data… Honest and full disclosure of all safety data to researchers is also a priority.”
  • And in summary: “National policies for the vaccination of healthy young children are based on very little reliable evidence… Decision makers’ attention to the vaccination of very young children is not supported by the evidence summarised in our review. Although there is a growing body of evidence showing the impact of influenza on hospitalisations and deaths of children, at present we could find no convincing evidence that vaccines can reduce mortality [death], hospital admissions, serious complications or community transmission of influenza.”

(Summarised from the Cochrane Review ‘Vaccines for preventing influenza in healthy children’.)


Vaccines for preventing influenza in healthy adults

  • “In the relatively uncommon circumstance of vaccine matching the viral circulating strain and high circulation, 4% of unvaccinated people versus 1% of vaccinated people developed influenza symptoms … The corresponding figures for poor vaccine matching [the more common situation] were 2% and 1%.”
  • “… under ideal conditions (vaccine completely matching circulating viral configuration) 33 healthy adults need to be vaccinated to avoid one set of influenza symptoms. In average conditions (partially matching vaccine) 100 people need to be vaccinated to avoid one set of influenza symptoms.”
  • Flu vaccines reduce the risk of total “clinical” seasonal influenza (i.e. influenza-like illness) symptoms by “around 1%… the effect appears minimal. This is remarkable as healthy adults are the population in which inactivated vaccines perform best.”
  • There was no difference in working days lost to the flu, hospital admissions or flu complication rates – including the risk of pneumonia – between those who received flu shots and those who didn’t.
  • 1.6 additional cases of Guillain-Barré Syndrome (a major neurological condition leading to paralysis) occur for every million flu vaccines administered.
  • The harms inflicted by flu vaccines are poorly understood because of inadequate research and documentation of adverse effects.
  • The situation may be even worse than this report indicates, since “Fifteen of the 36 trials were funded by vaccine companies and four had no funding declaration. Our results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favorable to their products and some of the evidence comes from trials carried out in ideal viral circulation and matching conditions and because the harms evidence base is limited.”
  • “No RCTs [randomised controlled trials] assessing vaccination in pregnant women were found. The only evidence available comes from observational studies with modest methodological quality. On this basis, vaccination shows very limited effects: NNV [number needed to vaccinate in order to prevent one case] 92 (95% CI 63 to 201) against ILI [influenza-like illness] in pregnant women and NNV 27 (95% CI 18 to 185) against laboratory-confirmed influenza in newborns from vaccinated women.
  • In summary: “The results of this review seem to discourage the utilisation of vaccination against influenza in healthy adults as a routine public health measure. As healthy adults have a low risk of complications due to respiratory disease, the use of the vaccine may be only advised as an individual protection measure against symptoms in specific cases.”

(Summarised from the Cochrane Reviews ‘Vaccines for preventing influenza in healthy adults’ and the 2014 update to that review.)


Vaccines for preventing influenza in the elderly

  • “Due to the poor quality of the available evidence, any conclusions regarding the effects of influenza vaccines for people aged 65 years or older cannot be drawn.”
  • “Our findings show that according to reliable evidence, the effectiveness of trivalent inactivated influenza vaccines in elderly individuals is modest, irrespective of setting, outcome, population and study design. Our estimates are consistently below those usually quoted for economic modelling or decision making” – that is, the benefits of flu vaccination in this age group are not sufficient to justify the cost of a vaccination program.

(Summarised from the Cochrane Review ‘Vaccines for preventing influenza in the elderly‘.)


Influenza vaccination for healthcare workers who work with the elderly

  • “No effect was shown for specific outcomes: laboratory-proven influenza, pneumonia and death from pneumonia. An effect was shown for the non-specific outcomes of ILI [influenza-like illness], GP consultations for ILI and all-cause mortality in individuals ≥ 60. These non-specific outcomes are difficult to interpret because ILI includes many pathogens, and winter influenza contributes < 10% to all-cause mortality [dying from any cause] in individuals ≥ 60. The key interest is preventing laboratory-proven influenza in individuals ≥ 60, pneumonia and deaths from pneumonia, and we cannot draw such conclusions.”
  • The studies analysed for this review “are at high risk of bias” because most of them were funded by pharmaceutical companies.
  • And in summary: “We conclude that there is no evidence that vaccinating healthcare workers prevents laboratory-proven influenza, pneumonia, and death from pneumonia in elderly residents in long-term care facilities. Other interventions such as hand washing, masks, early detection of influenza with nasal swabs, anti-virals, quarantine, restricting visitors and asking healthcare workers with an influenza-like illness not to attend work might protect individuals over 60 in long-term care facilities and high quality randomised controlled trials testing combinations of these interventions are needed.”

(Summarised from the Cochrane Review ‘Influenza vaccination for healthcare workers who work with the elderly’.)

Let me reiterate here that the Cochrane Collaboration is not a bunch of dope-smoking, hemp sandal-wearing ‘alternative medicine’ types; it is the most authoritative institution in the world when it comes to providing an evidence base for medical care.

So when multiple Cochrane reviews point out that manufacturer-sponsored flu vaccine trials are biased and of poor methodological quality and even taking this into account, they still don’t show any advantage for getting a flu vaccine, you can take that to the bank!

If your doctor is keen for you to have a flu vaccine this year, ask if he or she has read the Cochrane reviews on the subject, and if so, what special circumstances apply in your case that might override the Cochrane recommendations.

If there are none, and yet your doctor is still insistent that you should have the vaccine, you’re well within your rights to ask why.

Better yet, find another doctor.

Read my article on how to minimise your risk of flu.


Caloric density – the key to weight-loss success!


By Robyn Chuter

  • Caloric density expresses the energy (i.e. kilojoules/calories) per gram of foods.
  • Most whole, unrefined plant foods have low caloric density.
  • People tend to eat the same weight of food each day, regardless of its energy density.
  • Stacking your diet with low caloric density foods allows you to lose weight without counting calories or reducing portion size.


One of the most magical things about a diet based on unrefined plant foods is that it facilitates almost effortless weight loss. The scientific principle behind this magic trick is caloric density.

So what’s caloric density? It’s simply a measurement of the calories/kilojoules per gram of a particular food.

Foods with a high water and fibre content, but a low fat content, have low caloric density. They provide fewer calories per serving, meaning that you can have bigger servings, or more servings, without taking in excessive calories. Giving foods with low caloric density centre stage on your plate is the most effective long-term weight management strategy there is.

Interestingly, researchers have found that people tend to eat the same weight of food each day regardless of the composition of the diet, so choosing foods that have fewer calories per gram is obviously going to lead to lower calorie intake, and therefore weight loss.

Here is the caloric density of some representative foods:


Get the picture? Vegetables, fruits and legumes have very low caloric density, so you can eat as much of them as you like without fear of exceeding your calorie needs. Fortunately, these foods are also high in nutrient per calorie density… but that’s a post for another day.


Chocolate Pecan and Smoked Salt Vegan Cookies


These cookies are the perfect treat for yourself or when you have unexpected guests. Keep them in an air tight container and you can enjoy them for up to two weeks – if they last! Make extra dough and keep in the refrigerator for instant cookies for up to 2 months.

By Cassie Heneghan

1 tbsp ground flaxseed meal
2 tbsp water
125g nuttelex
½ cup brown sugar
½ cup caster sugar
1 tsp maple syrup
1 ¼ cup self raising flour
½ tsp baking powder
250g dark chocolate chips
85g pecans, roughly chopped
smoked sea salt for topping

1. Preheat a fan forced oven to 160C and line a two baking trays with canola oil spray and baking paper.

2. In a bowl, combine flaxseed meal and water and allow to stand for 5 minutes.

3. Using an electric mixer, cream the nuttelex, sugars and maple syrup for 60 seconds on a medium speed.

4. Add the flaxseed and whisk for a further 30 seconds on a medium speed.

5. Add the flour, baking powder, chocolate and pecans and stir until combined. Measure out 2 teaspoon sized balls and sprinkle with a small pinch of smoked sea salt. Place onto the baking tray, 6cm apart and then into the oven to bake for approximately 10 minutes or until golden brown.


Vegan Colcannon


By Cassie Heneghan

Colcannon is the ultimate budget comfort food and part of my Irish heritage. Grab yourself a large white cabbage and leave a wedge to make some apple coleslaw.

Makes 4 serves

60g nuttelex
1 brown onion, thinly sliced
2 cloves garlic, minced
800g potatoes, peeled, diced
¼ cup coconut cream
2 tbsp vegan mayonnaise
2 tsp flaked salt
2 tbsp mint leaves, roughly chopped
2 spring onions, thinly sliced

1. Place the potatoes into a large pot and cover with cold water. Simmer over a medium heat until just cooked through. Drain, place back into the pot and set aside.

2. In a frypan, heat the nuttelex and saute the onion and garlic until golden brown. Place into the pot with the potatoes along with the coconut cream, mayonnaise, salt, mint and spring onions and mash using a potato masher.


5 reasons to think twice before taking calcium pills


By Robyn Chuter

  • Calcium supplements are frequently recommended to postmenopausal women.
  • Calcium supplements raise the risk of kidney stones, heart attack and acute abdominal conditions.
  • Elderly people who take a calcium supplement have a higher risk of death.
  • Taking calcium supplements does not reduce the risk of bone fractures, and neither does eating a high-calcium diet.

Calcium supplements are widely promoted in popular media, and routinely prescribed by both medical doctors and naturopaths to postmenopausal women, particularly those who have been diagnosed with low bone density. Many vegans consume calcium supplements and/or calcium-fortified foods because they worry that their dietary intake of calcium may be inadequate.

Because calcium is a mineral found abundantly in our food supply, it has long been assumed that raising calcium intake, through either higher intake of dairy products fortified foods or supplementation, is at worst harmless, and at best beneficial to our bones.

But an editorial published in the medical journal Heart pulls together multiple strands of evidence which strongly indicate that both those assumptions are false.

Here are some disturbing facts on calcium supplements:

#1. Calcium supplementation raises the risk of renal calculi (kidney stones) by about 20%.

The pain caused by kidney stones is so excruciating, it is often described as one of the strongest pain sensations humans can experience – and the closest men (who comprise 80% of kidney stone cases) ever get to the pain of childbirth!

Taking calcium supplements was found to raise the risk of kidney stones by 20% in the Nurses’ Health Study (1) and by 17% in the Women’s Health Initiative trial (2).

#2. Calcium supplements substantially raise your risk of heart attack.

A metanalysis of 15 randomised, placebo-controlled trials of calcium supplementation, involving over 20 000 patients aged 40+ who were followed up for a year or more, found that patients allocated to calcium supplementation had around a 30% greater risk of suffering a heart attack (3).

Patients with renal failure (who are often given calcium supplements to lower their blood phosphate level) are at even higher risk: calcium pills dramatically accelerate coronary-artery calcification, contributing to the very high cardiovascular death rate in this population (4, 5, 6).


#3. Taking calcium supplements nearly doubles your risk of admission to hospital with an acute abdominal condition.

A review of adverse events from 7 randomised clinical trials of calcium supplementation, found that taking calcium supplements caused a plethora of gastrointestinal complaints. Constipation, excessive abdominal cramping, bloating, severe diarrhoea or abdominal pain, upper gastrointestinal events and gastrointestinal disease were over 40% more likely to afflict people taking calcium pills than those taking placebo

Most worryingly, those on calcium pills were 92% more likely to require hospitalisation for an acute gastrointestinal condition (7).

#4. Elderly people have a higher risk of dying when they take calcium supplements.

A randomised, controlled trial conducted on 602 elderly, frail Australians found that those given 600 mg of calcium per day plus daily sunshine exposure, had a 47% increase in total mortality and a 76% increase in cardiovascular mortality compared to those receiving sunshine exposure alone (8).

#5. Taking calcium supplements does NOT reduce fracture risk.

This is the real kicker. The aggressive marketing activities of calcium pill manufacturers have managed to persuade almost the entire populace – including the vast majority of doctors – that raising calcium intake is the most important step we can take to lower the risk of bone fractures. Yet the authors of the Heart article point out that

“the anti-fracture effects of calcium are modest, having been demonstrated in only two studies of calcium plus vitamin D, and suggested to be of the order of about 10% reduction, in meta-analyses” (9).

And by contrast, several trials have found that higher calcium intake either has no effect on the risk of suffering a bone fracture risk, or actually increases it!

For example, an 18 year prospective analysis involving 72 337 postmenopausal women found that neither total calcium intake nor dairy product intake had any protective effect against bone fractures, while vitamin D intake was strongly protective (10).

The Women’s Health Initiative study referenced above (2) found that although

“calcium with vitamin D supplementation resulted in a small but significant improvement in hip bone density, [it] did not significantly reduce hip fracture.”

And a study of 61 433 Swedish women, who were followed up for 19 years, found that those with the highest intake of calcium had a 19% higher risk of suffering a fracture (11).

There are proven, safe and effective ways to build your bone health and decrease fracture risk, without the scary side-effects of calcium supplements! To find out more, read my article The top 5 tips for building strong, healthy bones.


The B12 issue

  • Vitamin B12 is made by bacteria that live in soil and water, and are ingested by animals.
  • Deficiency causes serious consequences including anaemia, depression and elevated homocysteine.
  • Vegans, older people and those taking acid-suppressing medication should either take B12 supplements routinely or get a blood test for serum B12 every year.
  • Vitamin B12 injections are unnecessary; oral supplementation, especially with sublingual sprays or lozenges, is as effective, and possibly more effective, than injections.

However, vitamin B12 deficiency is very common in the general population; the Framingham Offspring Study found that, of the almost 3000 people tested, 39% had vitamin B12 levels below the desirable range. Interestingly, meat intake was not found to correlate with higher B12 levels in this study.

The prevalence of deficient or suboptimal B12 levels is highest in the elderly (very few of whom are vegetarian or vegan!!!), so it is clearly not a problem confined to those eating plant-based diets.

The fact is, vitamin B12 is made by bacteria – either living on the roots of plants, in the guts of animals or in water – and it only occurs in animal-derived foods as a product of bacterial activity.

If we drank water out of ponds, pulled vegetables out of the ground and ate them dirt and all, and generally weren’t so scrupulous with our food hygiene, we would all receive a perfectly adequate amount of vitamin B12 each day (along with a hefty dose of intestinal parasites, which our ancient ancestors were plagued with, and pathogenic bacteria). But chlorination of town water supplies kills B12-producing bacteria along with the nasty ones, and our vegies reach us in a scrubbed state, so we have very little exposure to these natural sources of B12.

Anyone adopting a plant-based diet should ask their GP for a serum B12 test every year unless they’re taking a supplement on a regular basis. Up until recently, the serum vitamin B12 test (which has a reference range so wide you can drive a Mack through it) was the only one you could get from most doctors unless you offered to sleep with them ;-). This resulted in many people with serum levels in the lower end of the reference range being reassured that their vitamin B12 level was ‘normal’, when in fact they were showing early signs of B12 deficiency such as increased red blood cell size.


Fortunately, recent changes to testing procedures mean that if your serum B12 is in the lower end of the reference range, your blood sample will automatically be tested for ‘active’ B12 (holotranscobalamin), which is a much more accurate indicator of your B12 status.

If you’re over 50, you should also have an annual B12 blood test regardless of your dietary practices, because our ability to absorb B12 declines with age due to a condition called ‘atrophic gastritis’, which reduces stomach acid production.

You should also get tested each year if you’re on acid-suppressing medications such as Nexium, Prilosec, Zantac or Tagamet, which increase the risk of B12 deficiency. Better yet, make the right changes to your diet and get off acid suppressing medication, which also increases the risk of Streptococcus pneumoniae-associated pneumonia, hip fracture and other non-fragility fractures and polyps in the stomach that can turn cancerous.

I’m often asked by my clients whether supplemental vitamin B12 is derived from animal products, and whether the supplements are ‘natural’.

Here are the facts: All B12 supplements are made by bacteria which are purpose-grown on a cobalt-enriched medium in a laboratory. The B12 produced from this process is just as natural as the bacterial B12 found in flesh, dairy and eggs – that is, it’s made in the same way (i.e. by bacteria), and has exactly the same chemical structure, as vitamin B12 that you would get by eating the flesh or eggs from an animal.

The best B12 supplement is a sublingual (under the tongue) spray or lozenge. The vitamin B12 in these preparations is absorbed through the mucous membranes under the tongue, by passive diffusion. This sublingual absorption bypasses the numerous biochemical processes that take place in the gastrointestinal tract, which is a huge advantage for people with impaired absorption due to advancing age or gastrointestinal problems.

Oral vitamin B12 supplements, in sufficient doses, have been shown to be just as effective as B12 injections, even for people suffering from pernicious anaemia (a condition in which secretion of intrinsic factor, which is necessary for B12 absorption in the gut, is impaired). So there’s no need for B12 injections, which can be painful, are potentially dangerous in patients who are taking anticoagulants such as warfarin, and require a visit to a doctor or nurse, which adds inconvenience and extra cost.

A dose of 500 mcg of B12 2-3 times per week is sufficient for most adults to maintain good levels of vitamin B12; children require proportionately less depending on body weight. If a blood test has established that you have a B12 deficiency, take 500 mcg daily for 2 months, then repeat the blood test.

Although the science is not 100% clear on this, I lean toward using a methylcobalamin spray rather than cyanocobalamin, as cyanocobalamin has to be converted into methylcobalamin in your body anyway in order to be used, and methylcobalamin may be better retained in the body once absorbed than cyanocobalamin. Methylcobalamin is only available in Australia in injection form, but you can order methylcobalamin sprays for personal use only (i.e not for retail sale) from overseas.

I get mine from iHerb, which has a huge range of products, and fast, cheap shipping. If you haven’t already set up an account with iHerb, you can do so in seconds flat, and then use the discount code UTE208 at checkout to get $5-10 off your first order.

Just one word of warning: high dose vitamin B12 supplements have been reported to cause or aggravate cystic acne. I recommend choosing a supplement that contains 500 mcg or less of vitamin B12 to minimise this risk.

The bottom line: ensure your B12 level is sitting pretty by using a B12 supplement, then relax and enjoy your yummy, healthy plant-based food. (Or eat dirt if you’d rather get intestinal parasites along with your B12…)


Zucchini and Green Bean Vegan Salad


A filling and fresh raw option that is a great quick lunch or a dinner side. Add some nuts or vermicelli noodles to bulk it out

Makes 2 serves

2 x zucchinis
100g green beans, top and tailed, halved
2 tbsp shallots, roots removed, thinly sliced
1 long red chilli, thinly sliced
1 tbsp coriander leaves

1 tbsp rice bran oil
1 tbsp rice wine vinegar
1 tsp salt
1 ½ tsp brown sugar
2 tbsp lemon juice
1 clove garlic, peeled, minced

1. Slice the zucchini lengthways using a very thin slicing blade on a food processor or a madolin. Toss together with the green beans, shallots, chilli and coriander.

2. To make the dressing, place all ingredients into a jar with a sealed lid and shake until the sugar has dissolved. Pour over the salad and serve immediately.


Vegan Chickpea and Potato Curry


This curry is a great idea for a dinner a dinner party canapé. Pappadums take the place of rice in this dish and make it much easier to eat. The varied textures make for a well balanced Indian dish!

Makes 4 serves


2 tablespoons peanut oil
2 teaspoons yellow mustard seeds
420g can chickpeas, drained, rinsed
1 cup sweet potato, 1cm cubed
1 cup potato, 1cm cubed
100ml coconut milk
250ml vegetable stock
1 birds eye chilli, thinly sliced
2 teaspoons salt
1 packet pappadums (approx 30)
½ cup mango chutney (thick)
1 bunch coriander, thoroughly washed

Curry Paste
1 small brown onion, diced
2 cloves garlic, minced
2cm piece ginger, peeled
1 teaspoon coriander seeds
1 teaspoon cumin seeds
1 teaspoon ground turmeric
½ teaspoon garam masala
2 tbsp peanut oil
1 tbsp water
50g almond meal

1. Using a heavy based saucepan, heat the oil over a low heat and add the mustard seeds. Allow to pop away for approximately 1 minute.

2. To make the curry paste, place all ingredients into a food processor or mini chopper and blend until smooth and consistent. Scoop curry paste out into the saucepan and stir for approximately 5 minutes using a wooden spoon so that the paste doesn’t catch on the base of the pot.

3. Add the chickpeas, sweet potato, potato, coconut milk, stock, chilli and salt and allow to simmer over a low heat for 30 minutes. Set aside to cool for 10 minutes.

4. Prepare pappadums according to suppliers instructions.

5. Add a tablespoon of curry to each pappadum and top with 1 teaspoon of mango chutney and a sprinkle of coriander.