Karina Inkster: You're listening to the No-Bullsh!t Vegan Podcast, episode 154. Dr. Leigh Ettinger is on the show to discuss the benefits of the plant-based diet in several contexts, including paediatric obesity and endurance cycling.

Hey, welcome to the show. I'm Karina, your go-to no BS vegan fitness and nutrition coach. Thanks so much for tuning in today. If you haven't yet checked out our collection of awesome and free vegan resources, including a vegan-specific portion guide, protein calculator, eBooks, restaurant guides, and more, head to karinainkster.com/resources. That's karinainkster.com/resources.

I'm honoured to have Dr. Leigh Ettinger join me on the show today. Dr. Ettinger has been a medical doctor since 1998, but did not learn about the plant-based diet until 2014. He made changes in his own eating and quickly saw the benefits. He's earned a certificate in plant-based nutrition from eCornell, and is now board certified in obesity medicine. He enjoys helping families successfully change course to a plant-strong path for their health, for the animals, for social justice, and for the environment. Leigh's favourite vegan meal is oatmeal, and that's something we discuss in greater detail in our conversation. 

Hi, Leigh. Thank you so much for coming on the show and speaking with me today.

Dr. Leigh Ettinger: Hi, Karina. Thanks for having me.

Karina Inkster: Let's start with a little background story. So I'd love to hear about how you came to veganism, and how you came to do what you do career-wise.

Dr. Leigh Ettinger: Okay, sure.

Karina Inkster: I know it's kind of a loaded question, but a couple of points would be awesome.

Dr. Leigh Ettinger: How much time do we have? So I'm a doctor, and I've been a doctor since 1998. I didn't learn about actually the plant-based diet first until 2014. I enjoy cycling, and I was watching my cycling videos on YouTube, and a video from Durianrider came up. Do you know Durianrider?

Karina Inkster: Yes. Yeah, for sure.

Dr. Leigh Ettinger: So yeah, really, a funny video came up, I was watching it, and it was stuff cyclists say. It was all these inside jokes about cycling, and I thought it was very good, and I wanted to see what other comedy kind of content he had about cycling. And I'm looking, and the next video I watch, he's talking about a banana, that he says that when you're going out on your bike ride... And I'm an avid cyclist, I've been an avid cyclist for a long time, so he was saying, "When you are going out on a bike ride, take the brown spotty banana, that's the banana that's full of sugar, to give you energy on the ride. If you take a yellow banana and eat the yellow banana, that's very starchy, not very sugary. You're not going to get the energy from that banana until you're sitting on the couch after the ride."

So I had never really thought about that. I'd always grab the yellow banana. So I started taking the brown spotty bananas, and getting the sugar for my riding. And then looked at more content, and it turns out that he's vegan, and he's talking about the animals, and he is talking about the environment, and he's talking about how he eats in order to fuel cycling, and I'm like, "Hmm, let me try it out." Initially, it was for very selfish reasons, that I just wanted to bike faster. I was looking for legal and ethical ways to improve my cycling, and so started to make some changes in my diet, and then started also to look at the more scientific literature at the books by... I first found Dr. McDougall, and The Starch Solution, books by Esselstein, and videos by Dr. Esselstein, and Dr. Campbell, and really started to embrace this way of eating. And saw some changes pretty quickly in my own health and my cycling. And then learning more about animal welfare, and environmental issues really helped it stick for me.

Karina Inkster: Interesting. So how did the vegan piece and the doctor piece collide? So your website is drherbivore.com. I love that name and the URL by the way. But how did those two things come together? Veganism came later in this trajectory, and now you've combined them.

Dr. Leigh Ettinger: Yeah, so I was working as a paediatric nephrologist, so I was taking care of kids with kidney disease in a major medical center in Northern New Jersey. And local paediatricians would refer me patients with high blood pressure, 'cause in the paediatric age group, high blood pressure can often be a sign of kidney disease. So we're working with families, I rule out kidney disease, and heart disease, and hormone disease, and really start to look at their diet and lifestyle, and be sitting there with a child with a large body mass index, with family history of diabetes, and hypertension, and obesity, and started to talk to them about dietary changes that I was learning about.

My own blood pressure lowered when I went plant-based and was really having some good success, actually getting kids off of medicine, the blood pressure medicines, or not having to start blood pressure medicines. And it was interesting and very satisfying to me, because when I would prescribe medicines for someone's blood pressure, no one really would say thank you, they'd be like, "Oh, how long do I have to take this? Do I have to take this for the rest of my life, or..." However, when I would show someone the dietary and lifestyle changes that would help them reduce their blood pressure, they'd come back, and be able to stop their medicines, and they'd be like, "Thank you." That's when they were very appreciative. So that was very professionally satisfying for me to have that feedback from the families, that I was giving them the tools to go ahead and lead healthier lives.

So I got the eCornell certificate in plant-based nutrition and also helping my patients lose weight with a plant-based diet. I got board certified in obesity medicine. My hospital had a paediatric weight management practice clinic, and another kind of program, an evening program, for families that were struggling with weight issues. So I joined that, and working with the dieticians there, and the other experts trying to help families with paediatric obesity, which was a big problem in Northern New Jersey, as well as elsewhere.

And then the pandemic hit, and my hospital quickly pivoted to telemedicine, and so I was doing the paediatric kidney disease, and the paediatric obesity online like this, and decided that I can take the parts of my practice that I enjoy, and really reach out across the whole state, reach out to more families. The families are really enjoying it, it's very convenient for them. They don't have to drive to the doctor, they don't have to sit in the waiting room, and perhaps be exposed to other infectious diseases.

So I decided in the spring/summer of 2021 to leave, and founded the Dr. Herbivore practice, which is a telehealth practice, licensed in New York and New Jersey, trying to help families that want to embrace the plant-based diet. So kind of a dual aspect of families that are already looking to raise their child vegan or vegetarian, and kind of want to make sure they do it. They talk to the paediatrician, the paediatrician says, "Oh, you have to have milk." Or, "Where do you get your protein?"

So I want to be a resource to those families who maybe can't get the information from their own paediatrician. So I have evidence-based information, they can work with me on telehealth. And then also with families that are struggling with obesity, I think the plant-based diet is great for helping people lose weight. I lost 20 pounds myself going plant-based, and have seen it really benefit a lot of people. So the second aspect of the practice is to help families that are struggling with paediatric obesity, adopt a more plant-based diet, plant-strong diet, and get healthier, improve wellness. Not necessarily focusing on the scale, but to improve wellness, and lowering risk factors for 

health problems associated with obesity.

So I chose the name Dr. Herbivore, because when I was trying to do all this in the hospital setting, I'd bring up the plant-based diet, and honestly, a lot of families were initially turned off by it, they're like, "Well, what are you talking about?" And, "My paediatrician says I need to drink milk." It just was such a surprise and such a shock to some families. Other families were like, "Oh, yeah, we are starting to hear about that." Or, "Oh, we have a vegan in our family." 

Certainly, if there were any kind of background I could work with, that was helpful, but some families were initially turned off by that. So I wanted to name my practice as some kind of indication that that's what you are getting, this Dr. Herbivore, so that you would know you would be getting, if you're working with me, a more plant-forward, a plant-strong way of eating.

Karina Inkster: Wow. Well, thank you for that. That makes complete sense. It's like expectation management before your patients start working with you. That's genius.

Dr. Leigh Ettinger: Yes, yes. Very good.

Karina Inkster: Yep.

Dr. Leigh Ettinger: Thank you.

Karina Inkster: That's awesome. Yeah, very cool. Thank you for sharing. And so I have many thoughts going through my brain right now around what you said about how folks at the hospital seem to already be on the plant-based diet, on the plant-based train somewhere, like, "Oh yeah, I've heard about that." Or, "Oh, yeah, I have a family member who's into it." But it seems like there was a lot of resistance there, and I would assume that having something like Dr. Herbivore now, you're finding folks who are specifically looking for the services that you offer, versus just bringing up plant-based eating randomly to patients at a hospital, right?

Dr. Leigh Ettinger: Right, exactly. I was trying to feel out one family, and the mom was sitting there scowling at me, and I was a little bit off-put by that. So I actually called her up a few days later - this was a child I was seeing for high blood pressure - kind of feeling out if they would be interested in learning more about the plant-based diet. And so I called her up a few days later, I was like, "Oh, did you have any questions about what we were talking about?" And she was like, "You vegetarians, you're in a cult, and you can do whatever you want, but don't try to force your views on my family." So I was like, "Okay, well, thanks a lot. Still happy to help with hypertension in other ways, but thank you for letting me know." And never-

Karina Inkster: Oh my goodness.

Dr. Leigh Ettinger: Saw them again. But yeah, certainly it does help with expectations.

Karina Inkster: Absolutely. So I want to ask about some specific nutrients, and general things that parents might be concerned about when it comes to plant-based kids. First of all though, you're working in paediatric obesity, so what are some of the specific benefits of the plant-based diet in this world? And then we'll branch out a little bit after that and just talk about children's nutrition in general.

Dr. Leigh Ettinger: I really like the plant-based diet, because it is so clear as to what you're eating and what you're not eating. So many of the diet messages these days for weight loss are portion control, or moderation, or eating a balanced diet. And those are very vague concepts for people, and what might mean moderation for one person doesn't mean the same for another. You could have a guy say, "Oh, I only drink a soda once a month. I'm practicing moderation." Another guy says, "Oh, I'm only drinking a soda once a day. I'm practicing moderation." Or once a week. And they're all right, but they're also all wrong. So the clear thing about plant-based with eating is that you're eating the plants and not the animals. It's really not debatable, and it's a very clear message.

I mean, it's a little bit harder these days. So I went plant-based in 2014, and since then, there's been a very big industry developed around plant-based junk food. And so it's a little bit harder to use that fine line as a key indicator of what's healthy and what's not healthy, but in general, the whole foods and the plants are going to be what's healthier. So I like that message that it is so clear. And the other message that I like is that it really doesn't require the feeling of being deprived, in that you can fill up on these whole plants, you can fill up on these high-fibre, high-water content foods, that can really satisfy our mind's hunger. And that we've been wandering this planet for hundreds of thousands of years looking for food, and it's only in the last 100 years that just calories are so easily accessible, and so the reward centres of our brain are still tuned to seeking out calories. So that can make it hard when there's calories all around to not eat them.

Our brain thinks that it's doing the right thing by eating all these calories to prepare for any upcoming shortage of calories, but that shortage isn't coming. So our brain thinks it's doing the right thing, but it's become problematic to eat all these calories. But if you can fill up the stomach with these high-fibre, high-water content foods that are low calorie, then the brain can be satisfied, and say, "Okay, I'm full, I don't need to go hunting for more calories." So that can be very reassuring to the brain, and help with this way of eating.

And then the other thing that I like about it is that when we're working with someone, working with the family, we really, really don't have to focus on the diet or on the scale, we can talk about other things that might be important to the child or the family that can help support their decision to eat this way. For example, a lot of the kids today are worried about the environment, for example. I had a young lady who was cleaning up her parks on the weekend, local parks, and I said, "Well, it's great that you're acting locally, but let's think globally about how our food choices affect our carbon footprint, and resource use, and wastage." And so working with her, again, we don't have to be talking about what's happening on the scale, we could talk a bit about how the plant-based diet, plant-based eating is more environmentally friendly, or animal welfare, which is another important issue for a lot of people.

My own daughters were in elementary school when my family transitioned to a plant-based diet, and just in talking to them, they're like, "Oh, we don't have to eat the cute animals? That's great, good for this way of eating.” And it was kind of easy for them. And again, not having to talk about weight. They don't have it, they didn't have it, and they don't have a weight issue, but for someone who does, just focusing on perhaps the animal welfare if that's important to them, then all the better.

Karina Inkster: Right. I love that. We're, in our practice with nutrition and fitness, all about not focusing on the scale, and non-scale wins. And I mean, sure, some folks have fat loss as a goal, but if we're not focusing on that as the only reason someone's looking at their diet, or the only reason someone's going to start training. It's kind of a side benefit to other things. And what you just mentioned about the environment, and ethics, and animal agriculture in general are generally things that keep people vegan long-term, whereas just a quick fix weightloss like, "Let me go vegan for 30 days, and see if I can lose 10 pounds,” generally doesn't last. It's not going to turn someone into a lifelong vegan, nine times out of 10.

So I like the focus on things other than weight, even though there are some health things, and maybe some weight things too to work on. It doesn't have to be the focus, it doesn't have to be the obsession, and the reason that we're doing this. So I really like that. I appreciate the branching out from the weight outlook.

Dr. Leigh Ettinger: Right. And also the teams that are really plugged into social media. It's nice to find resources, whether it's a documentary, or an influencer that they're interested in, or music, or athlete, or a political person, someone out there who they can aspire to, or follow that can help, rather than me sitting there saying, "Oh, you need to lower your blood pressure to reduce your risk of a heart attack in 40 years." That's a very abstract concept for a teenager, but if we can like, "Oh, let's look at what Billie Eilish is posting about these days." She's a very outspoken vegan. So things like that are more present for the teenager who, developmentally, is more thinking about the here and now.

Karina Inkster: That's a great point. Man, you have to be so plugged into what all the kids are watching, and listening to. I have no idea. I feel really old when it comes to that stuff.

Dr. Leigh Ettinger: Yeah, it's constantly changing too.

Karina Inkster: Good point, yeah. So there's some parents who are concerned about feeding their children, especially young ones, a fully plant-based diet, even if they're plant-based themselves. Sometimes people decide to start a family, they have a kid, and they're like, "Oh, well, we're vegan. Should the kid be vegan?" So what are some things that you tell folks generally on a more zoomed-out scale when they're concerned about things like nutrient deficiencies, or the never-ending protein question. When there's some concern either from parents themselves, or from family members, who see that a kid is growing up vegan, what are some things that you point them toward, or tell them to alleviate some of these concerns?

Dr. Leigh Ettinger: Right. I'm really a big fan of the Cronometer program, which is a free online program where you can plug in a food diary for the day, and it gives an analysis of the macronutrients, the calories, and 82 micronutrients. And so it's really nice to go over that with a family, and actually, they're often surprised as to how much extra stuff the kids are getting on the standard American diet, or even a well-planned plant-based diet. It gives you a percentage of the essential amino acids, the nine amino acids that we need, that we can't make ourselves. And without much fuss, people are getting 150%, 200% of the essential amino acids they need each day.

So that can be very reassuring. There's a very nice kind of colour-coded handout or printout from the screen that it's nice to show families and reassure them, so that when grandparents or a paediatrician is questioning their choices, it's nice to say, "Well, look, we know that Junior is getting 200% of these essential amino acids. He's going to do just fine with this way of eating." So that's a way I handle the protein question, with facts and data.

Karina Inkster: That's a great point. I think a lot of folks can probably use that, even just without thinking about children just themselves, like, "Where am I at with amino acids, and overall calories, and fibre?" Which is huge.

Dr. Leigh Ettinger: Yes.

Karina Inkster: Most of the population, isn't it 97% of the American population? Is deficient in fibre technically? So I mean, that would be a useful exercise.

Dr. Leigh Ettinger: I'm happy to say I'm in the top 3% of The U.S. population for fibre.

Karina Inkster: Excellent.

Dr. Leigh Ettinger: A plus.

Karina Inkster: A plus. Me too. I'm in Canada, but I think that stat probably is all across North America.

Dr. Leigh Ettinger: Yeah, yeah. Everyone's so worried about protein, but fibre's the real superfood that we need to be getting more of; that's the deficiency that's running rampant in the country.

Karina Inkster: Absolutely. So what about hypertension? You've mentioned this a couple of times, patients, children even, coming in with either markers, or already having hypertension. What are some of the specific benefits of eating vegan for hypertension?

Dr. Leigh Ettinger: I'd see children with already heart changes from high blood pressure. So the heart is a muscle, and part of the evaluation when I would meet someone with high blood pressure is to get an echocardiogram, a picture of the heart. So those numbers that you see on the cuff is the heart kind of lifting weights, and when the heart is pushing those high numbers all day and all night for months or years, like your arm will get bigger when you're lifting heavy weights, your heart muscle will get bigger. You want your arm muscles to be big, or maybe not, but you want a nice muscular body, but you don't want a very muscular heart. A thickened heart muscle needs more oxygen, needs more nutrients, and has been shown to be a risk factor for an early heart attack. So you don't want that thickened heart muscle. And I was seeing that in some kids with high blood pressure, they had already had high enough blood pressure for long enough that their heart was changing.

Karina Inkster: Wow.

Dr. Leigh Ettinger: So what are the benefits of the plant-based diet? So there's a lot of studies in the adult literature about the benefits of the plant-based diet. Mostly it's that it's a low-sodium diet. So you can think that farm animals, the herbivores that are on the farm get salt lick because the plants that they're eating don't have enough salt, there's just not a lot of sodium in plants, and so the herbivores get a salt lick. In the wild, they might lick rocks, or dry riverbeds. So when you're eating plants, you're just automatically getting a very low-sodium diet. The carnivores don't need a salt lick, 'cause eating the herbivores, they're eating the muscle of the plant-eating animal, where the salt has been stored.

And so if a human is eating meat, then they're getting the meat that the herbivore gathered, and it's automatically a higher salt diet. And then not even including all the processed meats, and the processed foods that add even more sodium. So when you're going and switching to a plant-based diet, it's really already a very low salt diet, and it's been known since the 1830s that sodium will raise blood pressure. And we're eating so much salt on the standard American diet, that there have been studies that show that lowering the salt improves your longevity, improves your cardiovascular system, improves your heart attack risk. So just eating plant-based, eating more like an herbivore automatically gets you a lower sodium diet, which is associated with better heart health.

Karina Inkster: This is of course, assuming you're not just sitting around eating chips all day, which are vegan?

Dr. Leigh Ettinger: Yeah, that's right. We hope that it's not the junk food vegan that is eating all the that sodium in the processed foods. So more whole plants, fruits, vegetables, legumes, starches, whole grains, those are the kind of salt-free foods that can really lower your salt intake over the course of the day. Loading up on highly processed foods is not going to give you that same benefit.

Karina Inkster: Right. Not that there's anything inherently wrong with chips for example, but if that's all you're eating, and you're trying to affect change, from a health perspective, probably not the greatest setup there. So what about athletic performance? A lot of people are going into plant-based eating specifically for athletic performance.

Dr. Leigh Ettinger: Yeah, can I just go back to the chips?

Karina Inkster: Sure, yeah.

Dr. Leigh Ettinger: In that it's not just the chips and the soups, cereal, breakfast cereal, has a tremendous amount of sodium. That's the nice thing of the Cronometer app, is that it can really tell you about where all the hidden sources of sodium are. So you can just about assume that whenever you're opening a package of just about anything, you're getting a big load of sodium, a big salt bolus into your body. It's a preservative, it's a flavour, and it's really everywhere in our standard American diet, or even, as you pointed out, the standard vegan diet, if you're eating a lot of the processed foods. So just be wary of the salt, is what I say. Now do you want to talk about if you have any questions about that, or you want to talk about athleticism? I'm happy to move on.

Karina Inkster: Yeah, yeah, let's talk about that. So we had a huge influx of new clients around the time The Game Changers documentary came out, and so a lot of folks nowadays are making the change to either a more plant-based diet, or an exclusively plant-based diet, specifically for athletic performance.

So it's something I think about. I went vegan 20 years ago for just ethical reasons, but since then, it's evolved to the environment, and personal health, and also athletic performance. But as a cyclist, you've probably noticed performance changes, performance benefits. So what's the deal with the plant-based diet, and how it supports endurance athletes like yourself?

Dr. Leigh Ettinger: Yes. I was thrilled about The Game Changers, especially as a cyclist. There's a cyclist featured in that movie, so I was all cheering for that. But it really helps endurance athletes like cyclists and runners. One thing that I noticed was just improved recovery, that after a long and difficult challenging bike ride, I'd be ready to go again the next day, and that just increases my enjoyment of the sport. But also I've been able to show and document on Strava. Are you familiar with Strava?

Karina Inkster: Yes, I'm on Strava. I log my swims on there.

Dr. Leigh Ettinger: Oh, nice. Yeah, so it's really nice that with Strava, I've been able to see improvements in my own cycling. And it's actually funny, I talked about this in another interview on YouTube, some of the cycling benefits, and it was an hour interview, and in the comments section, people were criticizing this thing or that thing I would say about nutrition, but no one disparaged my cycling. So that would've really hurt my feelings if they did that. But I can share with you the improvements that I saw with my own cycling. It's such a great high-carbohydrate diet, that you just feel like you have energy each and every day, and I think that's really good to feel energized by all the complex carbohydrates that we eat. So one benefit that I noticed was that I did a four-mile uphill last summer that I had done in when I was 43. So I just turned 50 last summer, and my 50-year-old self beat my 43-year-old self by two minutes on a 21-minute climb.

Karina Inkster: Wow.

Dr. Leigh Ettinger: And so that's a 10% improvement. Yeah, and at the same weight, it's not like I had lost a whole bunch of weight and was able to go faster - I was at the same weight. So that just goes to show that my cardiovascular system improved, my muscular system improved, and Lance Armstrong is famous for saying that the doping that he did gave him a 10% improvement in his cycling performance. They say that plant-based is the new doping. I can show that it gave me, over seven years of eating this way and training, a 10% improvement in my performance over that 20-minute climb uphill. And if I had done doping, I could have gotten that 10% improvement maybe in a few months or a year, but plant-based and consistency got me improvement over seven years. So that was very satisfying.

Then another thing that I did last summer was a six-day bike trip in the Pyrenees. So these are the mountains that are used in the Tour de France, and I was able to enjoy six fun days going over the same mountains that they use as routes in the Tour de France. And I really wanted to challenge myself on a climb called the Col d'Ichere, which features frequently in the Tour de France. It wasn't in last year's Tour de France, but it's going to be in this year's Tour de France. One of the bicycling magazines rated it as one of the top 30 challenging climbs in the world. And I wanted to go up that hill, that nine-mile uphill as fast as possible. I really wanted to challenge myself as a 50-year-old. And I'm really happy to say that I went up in an hour and 13 minutes, and for my age group, among the 50-year-olds, Strava's been going on since 2009, so comparing myself to all the other 50-year-olds who went up since then, I placed around 700th out of 10,000 people.

Karina Inkster: Wow.

Dr. Leigh Ettinger: So in the top percentiles compared to all these other people. And that really felt good. That was my season goal, I really wanted to go hard, and I just totally went as hard as I could. If it's abstract to think about biking up a mountain, what I did was, I kept my average heart rate, I look back, my average heart rate for the hour and 13 minutes was 160, so that's 85% of my maximum heart rate. And so for listeners out there who can't think about biking a mountain, just think about maintaining a heart rate at 85% of your maximum for an hour and 13 minutes. That's what it took.

And I really think that I credit the plant-based diet for allowing me to train, and allowing me to do that extreme effort as a 50-year-old. So that felt really great, and it was an amazing experience. I saw a rainbow when I was on it. Actually going up that mountain, we went out of this mist, and looking down, there was a rainbow, and I saw a llama. There was just a random llama. But it was just a magical kind of experience while my legs are burning, my heart rate was burning, my lungs are burning just for an hour and 13 minutes, and it was very magical, almost spiritual experience, getting to the top, and looking down over the Pyrenees. So I credit and thank the plant-based diet for making that possible.

Karina Inkster: That's incredible. Kicking your 43-year-old self's ass at the age of 50 is pretty impressive.

Dr. Leigh Ettinger: Yeah, yeah. That was cool. That felt good. Thank you, plant-based diet.

Karina Inkster: Yay. Thank you, plant-based diet. Yeah, so there's some research now into why this might be the case. I think there's a lot of antioxidants in the plant-based diet. We're not eating as many pro-inflammatory ingredients as folks do when they eat animal products. What else, if anything, is the magic sauce in the vegan diet? It's not just the fact that we're not eating dairy, I think there's things inherent in plants that might be helping us when it comes to athletic performance.

Dr. Leigh Ettinger: Right. All the phytonutrients, and the antioxidants, polyphenols, all the vitamins and minerals, just so nutritionally great way of eating. I take a vitamin B12 supplement, and a vitamin D supplement in the winter. Everyone probably should in this hemisphere. But that's all I really need, is that, and my plants. So it's really very complete. Cycling makes you so hungry, any kind of endurance sport that just makes you so hungry, that just filling up on the plants gives me everything that my body needs to fuel those adventures. That's what cycling is really, a great adventure.

Karina Inkster: That's an awesome way of looking at it. That's how I see my swimming, except unfortunately, the open-water season here on the West Coast is so short. The water is about 50 degrees at all times, so it has to be warm enough outside to be worth it. And I wear a full wetsuit of course, but I kind of see it as an adventure. It does make me extremely hungry as well, so I need to make sure that I'm fuelling before and refuelling after. But you're more of an endurance athlete, I lift weights mostly and then swim, but not insanely long distances. But your overall calories for the day must be pretty high, especially if you're training for something.

Dr. Leigh Ettinger: It's funny to look at the Strava, which gives an estimate of your calorie expenditure, and seeing that I did a ride and burned 3,000 calories, 4,000 calories, that's a good reason why I'm so hungry sometimes. But that's always a surprise. Actually, in the cycling community, there was a challenge, people were trying to burn... This was especially during COVID, people were looking for things to do, they were challenging themselves to burn 10,000 calories on a bike ride.

Karina Inkster: Oh dear.

Dr. Leigh Ettinger: That was a goal. Yeah, I never tried that, but the people that were doing it online, you have to go all day, and into the night pretty hard to reach that kind of target. I don't recommend it. But that's just kind of the extreme things that people were doing to keep themselves entertained or challenged during COVID. Actually, I enjoy open-water swimming too. I was doing some events like open-water swims and aqua vélos. Have you heard of aqua vélos?

Karina Inkster: Are those races with biking, like cycling and swimming?

Dr. Leigh Ettinger: Yeah, it's like a triathlete event, but I've had five-foot surgeries, I have a fused joint in my foot.

Karina Inkster: Oh yikes!

Dr. Leigh Ettinger: So I can't run. They would have a category where I would start with the triathletes, do the swim, and then the bike, and then my finish line was the end of the bike leg. So I was doing a few of those until COVID, then the pool shut down, and I wasn't able to swim anymore. And I moved also away from any kind of pool that I could train in. But I do miss the swimming, I do enjoy the swimming, it's so clearing just to be in the pool, in the water, and not have any distractions.

Karina Inkster: Absolutely. I don't meditate, but I swim. So that's my mental health practice, especially outside.

Dr. Leigh Ettinger: Yeah, yeah. I don't understand, there are people that buy these devices that they can listen to music or podcasts while they're swimming, and I'm like, "No, no, no, I swim to get away from the electronics."

Karina Inkster: Right, exactly.

Dr. Leigh Ettinger: "I don't want that distraction." But there's something very zen about swimming, just trying to find the most rhythmical, kind of smoothest path through the water, with the least effort. It's a nice full-body experience, and I do miss it.

Karina Inkster: Absolutely, yeah. Yeah. Well, it's one of the reasons my husband and I moved to where we live now from Vancouver. We live on the Sunshine Coast of BC, 'cause so easy access to the ocean, and we have 32 lakes within a 20-minute drive of our house, so you can just jump in, just beautiful water to swim in.

Dr. Leigh Ettinger: Nice.

Karina Inkster: So I think it would be a deal-breaker for me if I didn't have a pool, and didn't have bodies of water to swim in.

Dr. Leigh Ettinger: Right, right.

Karina Inkster: So that factored into the decision to live where we do.

Dr. Leigh Ettinger: Right. I moved to a place with not as good swimming, or no swimming, but incredible cycling around here. And my wife is also plant-based, also a vegan, and she's really into rock climbing. So we’ve got beautiful world-famous rock climbing. I'm in the Shawangunks, which is a... If you ask climbers, they'll know about the Shawangunk Mountain Range for rock climbing. So she's doing her rock climbing, and I'm doing my cycling, and we're enjoying the nature here.

Karina Inkster: That's brilliant. So what are some of the programs that you offer? I know you have telehealth for folks in specific areas, and then there's also online courses that anyone can take. So maybe you can tell our listeners a little bit more about those options.

Dr. Leigh Ettinger: Thank you. Yeah, I enjoy working with families in New York and New Jersey, where I'm licensed as a medical doctor. But for families that are outside of those states, I do have e-courses, because I want to help more people. I want to reach out. These e-courses are part of the programs that when I'm working with a family, they get access to, but also for other families who are looking to fine-tune their plant-based experience. So I have three of them. One of them is how to transition the family to plant-based eating. So how to make changes in the family, why to make changes in the family, and also specifically things to work on with an elementary school kid, how to talk to your teenager, adolescent. So I'm bringing in the different age groups. And most importantly, how to stick to the plant-based diet. So there are strategies, and ways to think about the plant-based eating in the long-term, so that you can maintain this way of eating for your health goals, or your ethical goals, your environmental goals. That's really important.

So there's that course. I have a course specifically for paediatric obesity. So how to use the plant-based diet for your family, the how's and why's of reducing calorie intake. Well, again, without having to count anything, it's just mostly crowding out the higher calorie processed foods with the lower calorie, higher fibre, higher water content plants, but strategies to make that happen for a child.

And then a third course, which is how to really nourish a plant-based child. And this is for the families that are concerned about this, or that macro or micronutrient. It really goes over those nutrients, and where they can be obtained on the plant-based diet. And also, there's a tutorial in there on how to use the Cronometer. There's just a few tutorials online about how to use the Cronometer. There’s one on using it as a plant-based diet, but there's none for plant-based children. So I just really wanted to give families the tools so that they can do the course, spend a few hours watching the videos, and doing the reading material, and then have these skills to go ahead and continue to do the plant-based diet and thrive on the plant-based diet. So that's all that's in these courses.

Karina Inkster: Brilliant. And those are all available on your website, drherbivore.com?

Dr. Leigh Ettinger: Yes. There's a pull-down tab that will take you to the e-courses, and you can learn more about them. There's previews, and see what... There's other content and order them there.

Karina Inkster: Brilliant. I have one more question that I almost forgot about, but it's going back to what you said originally about your journey to what you do now as a career, and moving away from the hospital setting that you were in. And it was this whole concept of telling folks that you're vegan, and then getting pushback, which happens still with health professionals all the time, not just patients, doctors, dieticians, all these folks, who actually are not educated in plant-based nutrition, and have preconceived notions about how it works or how it doesn't work.

Anyway, so I still feel like there's a lot of work to be done in the medical field in general when it comes to the vegan diet. So what are some things that you, as a health professional, as a medical professional, are doing or could do? And what are some things that we, as the general public, fitness coaches or not, can do to move those concepts in a more plant-based direction? So right now, there's small things. Certain hospitals are now offering vegan meals, and generally, I think veganism is more mainstream than it was even eight years ago, but you've experienced it yourself, there's still a lot of inaccurate information, lots of myths, especially in the medical world. So what are some things that we can all do? Any thoughts on moving this needle in the right direction?

Dr. Leigh Ettinger: Yeah, I've been trying. So since 2017, I've been giving talks to doctors at Grand Rounds. So Grand Rounds is a program in - every hospital has it for the different departments, paediatrics, surgery, things like that. So maybe once a week they'll have either... The whole department get together for either administrative work, or have an expert speaker come in. So since 2017, I've been giving paediatric Grand Rounds around New York and New Jersey about the plant-based diet for kids, whether that is specifically for hypertension, or for obesity, or just how to make sure that a family that is raising a plant-based child, that you, as the paediatrician, or a paediatric nurse practitioner, are meeting their needs. So instead of bugging them about protein, make sure that they're getting their B12, things like that.

So really want to give them an appreciation for the plant-based diet, so that they can work more expertly with the families in their practice who may be asking questions, or considering, or even totally plant-based already, and I want to help support the paediatrician. So I've been doing that a lot, especially around New York City. You've heard of Mayor Eric Adams?

Karina Inkster: Don't know if I have.

Dr. Leigh Ettinger: Oh, you've got to look into Mayor Eric Adams. So he's been a mayor, I guess for two years now, but he had very severe type two diabetes. He was starting to lose his vision from his blood sugar. And he went plant-based, and lost a lot of weight, improved his vision, got off medicines, and became a big advocate of the plant-based diet, and then became mayor, and he's made a strong push in New York City to-

Karina Inkster: It's ringing a bell.

Dr. Leigh Ettinger: Yeah, this is really... He's trying to be a model for other cities. So he's doing things like, in the New York Hospital systems, the default meals are now plant-based. You have to actually ask for meat to appear on... You have to insist for meat to appear on your tray as an inpatient in New York City hospitals. He's introduced Vegan Fridays for the schools. So they were having meatless Mondays, but now he has vegan Fridays, so that school cafeteria lunches on Fridays are now vegan. He's doing work in the prison system, also getting the prisoners healthier meals. So he is doing all this great work. So that was actually kind of my lead in to approach these hospitals in and around New York City, saying, "Hey, Mayor Adams is making all these changes. Your families might have questions. I'm an expert on this, let me come talk to your paediatricians, your residents in training, your community paediatricians." So that's been a great lead in for me.

But that's really what I'm trying to do, is help these doctors that are... We didn't really learn about it in medical school. We didn't learn about nutrition in medical school. And I'm not blaming anyone, just saying that it's time to start to get more exposure to this way of eating, so that it can be, instead of dismissed, or disparaged in the paediatrician's office, that the paediatricians at least can help support families who've made this decision. So that's been my side mission. My side gig is giving these paediatric Grand Rounds. And talking to community groups also about the plant-based diet that have questions.

Karina Inkster: That's brilliant. Well, I'm glad I asked, 'cause I had no idea you did that. That's very cool. Side gig, very important, educating fellow medical professionals.

Dr. Leigh Ettinger: Yeah.

Karina Inkster: So what about us non-medical professionals? What are some things that we can do in the vegan world when it comes to just furthering the message, or getting the idea out there, that it actually benefits the general population in a lot of different ways?

Dr. Leigh Ettinger: I'd like to plug a community, that online community that I'm a moderator for. It's called Whole Communities. It's established by Dr. Campbell at the Center for Nutrition Studies, and it's a community that's about a year and a half old, and it's like a Facebook group except, A, there's no advertisements, and B, there's no trolls. And so it's a nice online community where people are coming together to help each other. This is not a place for people, say, looking for recipes. We don't talk about recipes. Everyone's pretty much firmly plant-based. And they want to talk about communities. It's called Whole Communities. How to bring the plant-based message to communities, and spread the message. And people will either post questions, or post commentaries, or post articles. I'm honoured to be a moderator of this group, and it's a nice place to meet, and gather, and figure out ways to spread the vegan message.

Karina Inkster: Wow, that's brilliant. So how do I join? It sounds amazing.

Dr. Leigh Ettinger: Yeah, if you search for Whole Communities, I can give you the link afterwards, you can put it in the show notes. But there's a little application that you can fill out, and then come join us in Whole Communities and we can continue the conversation as to how to help bring plant-based to your community.

Karina Inkster: Brilliant. Well, thanks so much for speaking with me, Leigh. Any closing thoughts for our listeners as we're finishing up here?

Dr. Leigh Ettinger: No, thank you very much. Except on your... You always ask your guests what their favourite vegan meal is. I didn't get to ask what my favourite meal is. Can I share?

Karina Inkster: Ah, yes, you can. I saw it on your guest form, but I did not mention it. Yes, do share.

Dr. Leigh Ettinger: It's oatmeal. So I had a moment of thoughts, you survey your guests, and I've noticed you asked this to other guests, and so I had a moment to think about it. I eat oatmeal every day, so that's got to be up on the list. So a nice bowl of oatmeal to start my day is my favourite meal. With maybe blueberries, or cranberries, some brown sugar, some chia, or hemp seeds, or things like that. Keep it interesting with overnight oats. I was disappointed that you didn't ask me what my favourite vegan meal is. So I'll have to say, in conclusion, that my favourite meal is oatmeal.

Karina Inkster: Aw.

Dr. Leigh Ettinger: That's okay. Yeah.

Karina Inkster: Sorry about that. I have oatmeal every single morning. It's probably been about maybe 25 years. So I'm with you on the oatmeal, for sure. Yeah, I always mention it before I introduce a guest, so it's good to know, good to know. But so great to speak with you, Leigh. Thanks so much for coming on the show.

Dr. Leigh Ettinger: Thank you, Karina. This has been fun.

Karina Inkster:Leigh, thank you again for taking the time to speak with me. Make sure you check out our show notes at nobullshitvegan.com/154. Thanks so much for tuning in.