“Hello Dr. Maloof, My name is John, I’m an 28 year old working in San Francisco, California. I’m wondering how and what I can do to become healthier? I don’t eat meat because of the obvious health effects like heart disease, high cholesterol, the bio accumulation of chemicals in the tissues, etc. I exercise and stretch to try and keep my body moving correctly. I do the general health things.. I would love to know what I can do to improve my body from a chemical stand point. Which of my levels are wrong? Which nutrients am I missing? What things can I do to keep my body in peak condition? I found you when a friend was showing me the video of your collaboration with Camille Rowe and your direct scientific approach to helping people become healthier is what I’ve always wanted. If there’s any way you could respond and even just give me some tips that would be amazing. Thank you so much.”

Hi John,

First off, great job for eating a plant based diet and exercising — you already way ahead of most people living in the United States. You asked a bunch of good questions. I’ll give you my very best tips for optimizing your health from a chemical standpoint.

First off, most people aren’t eating 5 servings of produce a day. I recommend doubling that. The Guardian recently reported on a study led by Imperial College London which found that, “Eating up to 800g of fruit and vegetables – equivalent to 10 portions and double the recommended amount in the UK – was associated with a 24% reduced risk of heart disease, a 33% reduced risk of stroke, a 28% reduced risk of cardiovascular disease, a 13% reduced risk of total cancer, and a 31% reduction in premature deaths.” It’s a really high bar that few people have the discipline and commitment to achieve but it will a huge difference for the health of your microbiome. Think about eating fruits and veggies as creating compost for the soil of your intestines. Soil is largely broken down plant matter and bacteria. You want the best fertilizer inside you (e.g. compost) to help your body grow and repair itself. I recommend getting 3 servings of cruciferous vegetables, 3 – 4 servings of brightly colored produce (e.g. like berries, beets, squash), and 3 servings of leafy greens a day. Really, your goal should be to eat the most colorful rainbow you can. Make sure to get some cooked and some raw I recommend going out of your way to shop at local farmers markets for the best quality pesticide free produce. If you go at the end of the day you can often bargain for really good deals.

There are a few labs worth looking at regardless of your age. Which labs you should do will depend on what your insurance will cover and your budget. You could also just go get some basic blood labs from your doctor. For example, hgb a1c to check for blood glucose abnormalities, a NMR lipoprotein analysis with lipid panel to check your cholesterol, hs-crp to look at inflammation, and homocysteine to look at oxidative stress. One concern for vegetarians is that they may not get enough vitamin B12 because it is only found in animal products. Being a vegetarian, you also need to keep a close eye on iron, calcium, zinc, vitamin D, vitamin A, and Omega 3’s. Getting these measured would be expensive. But, at a minimum I would make sure to check your b12 as well as vitamin D levels because if this is low, it can affect your hormones, immunity, and bone density.

If you find yourself stressed out a lot, I would supplement with magnesium I see this deficient in most people. To know about what nutrients you are missing I like this test—the Genova ONE (Optimal Nutritional Evaluation). It’s a lot cheaper if you have insurance. It gives you quite a lot of information on micronutrient deficiencies. It can also tell you if you have any amino acid deficiencies. And, it can let you know if you need more plant based antioxidants. It can also tell you if you need probiotics and digestive enzymes. If this test says you have a high need for these, it’s also a good idea to get a stool study. I wrote this article on Viome which is my new favorite microbiome test.

I would also add that meatless diets are also very much up for debate. Yes, bioaccumulation of chemicals is a concern. But, that’s the result of eating farmed fish or confined animal operation meat. I personally focus on wild game and fish for my main sources of protein but this is not always available or affordable for everyone. Really, you have to listen to your body and if it is telling you that you feel (a) energetic (b) focused and alert (c) satisfied and (d) strong while eating a vegetarian diet, then stick with it. But if at some point in your life you feel a strong craving for meat, you may need to add small amounts back in because usually it’s a sign your body needs something it is not getting from your diet.

In terms of numbers you want to know for your fitness the most important one is VO2 max—which measures maximum oxygen uptake by the body during severe exercise. You want a high VO2 max for optimal health. Use this test for a good approximation. If your VO2 max isn’t high, you need more cardiovascular exercise. I would also add weight lifting to your fitness regimen if you aren’t already doing it. This is super important as it helps you maintain a high metabolism, low body fat percentage and good bone density. If you want to be in peak condition you exercise beyond the national recommendations. That means instead of a half an hour a few days a week you should aim for at least an hour of exercise 5 – 6 days a week. Work your way up to that. Remember, peak fitness benefits come from no more than 90 minutes a day so don’t overtrain and make sure to give yourself some time for recovery between super strenuous workouts.

If you want peak performance you’ll need to develop some special skills that a lot of people lack–and one of those is understanding the role of recovery. For someone 18, your body is probably in pretty darn good condition given how you eat and exercise. But, I see a lot of young people working hard and playing hard and not really giving themselves enough downtime to recover. By recovery I mean: (a) good quality and quantity of sleep and maintaining proper circadian rhythms (that means going to bed at the same time every night and waking up at the same time every morning), (b) the ability to adapt to stress through developing mental fitness and good autonomic nervous system tone through meditation and mindfulness practices and heart rate variability training and (c) spending time with those you love cultivate resilience.

By far, the most valuable tool I have learned to use is mindfulness to help me lengthen the space between perception and reaction. And, hand in hand with mindfulness is the attention to breathing. You can use your breath to change your internal emotional state. This is a superpower that will change your life. Count to 5 as you take a deep inhalation into your abdomen. Then very slowly exhale while pursing your lips. To activate your vagus-nerve mode, aim to reduce the number of breaths from a typical 10-14 per minute to 5-7 per minute. This slow deep breathing will activate your parasympathetic nervous system and allow you to calm yourself down in any stressful situation.

One thing worth investing in is a water purification system. I use a Berkee filter. Drinking enough water is so freaking obvious but it’s still something a lot of people fail to do. But, drinking enough pure water is not something a lot of people think about because we live in a country with access to generally “clean” water. The problem is, our water supplies are often contaminated with pharmaceuticals, pesticides, and other byproducts of industrialization. Making sure you get a half a gallon a day of pure H20 will make a big difference in your health.
I hope this advice helps! Let me know if you have any other questions!