Living with Diabetes

Get healthy through the Holiday Season

The Holiday Season – Thanksgiving, Advent and Hanukkah – is just around the corner. Supermarkets have already been selling gingerbread, cinnamon stars, and other sweet allurements for weeks, and the Christmas markets with their aroma of freshly roasted almonds and mulled wine are nearing. Sweet, fatty and carbohydrate-rich foods tempt us everywhere and are supposed to get us through the cold, dark season with pleasure – a great challenge for those who want to keep their body shape or do not want to overstress it, but also especially for those people who should not mindlessly feast for health reasons.

Every Holiday Season diabetics, who should keep an eye on their blood sugar and insulin levels, face this challenge.

With a few tricks and a bit of planning, however, the Holiday Season can be fully enjoyed even with a diagnosis of “diabetes”.

Enjoyment is welcome – it’s the quantity that matters

For everyone – but for diabetics especially – the following is true: “The dose makes the poison.“

When snacking on sweets such as special holiday cake or pie, cookies and the like, enjoying the holiday menu and alcohol, it is important to watch the quantity or switch to tasty, healthier alternatives from the start.

When baking cakes or cookies, it is easy to reduce the amount of sugar and fat without forfeit the taste.

Carbohydrate-rich side dishes such as pasta, dumplings, rice, etc. are also a must on festive days. However, it is worth using these sparingly and preferring a larger portion of vegetables such as red cabbage, root vegetables, or lettuce. Gravy and sauces for roasts can also be thickened excellently with pureed vegetables or rye bread – therefore we can forgo processed starch as well as fatty sauces can be skipped.

In order to maintain a healthy body and metabolism, it is worthwhile to rely on light meals such as protein with vegetables or salad in the evening and to avoid a dessert. This keeps the rise in blood sugar moderate and allows the body to rest adequately overnight.

Alternative enjoyment

For example, instead of a cake, you can prepare a baked apple with raisins and cinnamon. You can easily avoid sugar and fat in this way, and at the same time increase the intake of fiber. Sautéed pears with goat cheese, for example, are also a perfect low-sugar dessert.

Instead of the usual Holiday Treats made with white flour, you can bake cookies made from oatmeal and sweeten them with pureed apple. Pralines made from nuts, dates and cocoa powder also offer wonderful alternatives without fat, white flour and refined sugar. 

Sugarcoated, roasted almonds for example can be wonderfully replaced by roasted chestnuts, which bring their very own sweetness.

Exercise lowers blood sugar

Even if the dark, cold season invites you to cuddle up on the sofa and so many suitable excuses against physical activities are quickly found, you should still incorporate exercise into your everyday life and especially during the holidays. A long walk with friends and family should definitely be a valuable activity following feasting or sitting for long periods of time. This not only burns more calories, but also lowers blood sugar.

Caution with alcohol

For most people, alcoholic beverages such as mulled wine, hot caipirinha as well as (sparkling) wine are part of a felicitous and, cozy Holiday Season. But alcohol also affects blood sugar levels. The extent to which it causes blood sugar to rise however cannot be said in general terms and varies greatly from person to person. Therefore, it is advisable to use alcoholic beverages as sparingly as possible and to measure blood sugar levels more often.

With this in mind, we wish you a joyous and healthy Holiday Season!

All Calories Are Not Created Equal

Many people follow the guideline if you “want to lose weight, [you] must ingest fewer calories”. In doing so, they trust the calorie specifications on the food label.

At first glance, this seems logical. The body needs a certain amount of energy to maintain, for example, heartbeat, respiration, digestion, and so on. If there is too little fuel to accomplish the tasks, the body falls back on its fat reserves.

A lower calorie intake should therefore melt away the pounds on your hips – but unfortunately it’s not quite that simple.

What is a calorie?

The calorie is a physical unit for energy, work and heat. More than 150 years ago, researchers determined the amount of energy contained in bread, meat, fish or fruit. To do so, they burnt a certain amount of the corresponding food in a steel cylinder (calorimeter bomb) surrounded by water. This combustion process generated heat which heated the surrounding water. This data was meticulously recorded and used to derive how high the energy or caloric value of the various foods was and this was defined as a calorie or kilocalorie.

“A calorie is consequently the amount of energy required to heat one gram of water by 1 °C” – or 1 kilocalorie (kcal) is exactly the amount of heat/energy density required to heat 1 kg of water by 1 °C (from 22 °C to 23 °C). If a slice of pizza has 245 kcal, this means that the energy stored in it is sufficient to heat 245 l of water by one degree Celsius.

Therefore, one might think that it doesn’t matter for body weight whether one consumes a whole apple or drinks the same amount as apple juice instead. However, while the daily consumption of apples is healthy and provides the body with plenty of vital and dietary fiber, the corresponding amount of apple juice contributes in the long run to the metabolism becoming unbalanced, since in particular the abundant sugar enters the blood quickly and unregulated, thus negatively affecting the insulin level.

Scientists are largely in agreement that it does make a difference where the calories come from, in what form, and probably even at what time of day they are ingested. This is because the type and processing of food determine how our digestive tract and the billions of microorganisms that make their home in it utilize the food.

Preparation and consistency influence calories

Scientists have discovered that food does not release its calories to us one to one. For example, the body has to expend a lot of energy to break down and digest raw vegetables or high-fiber foods. If, on the other hand, the vegetables or whole grain products are cooked, the fiber and complex carbohydrates contained are broken down in such a way that the digestive system does not have to expend as much energy. This implies cooked foods provide more calories than raw foods. The longer a food is cooked or processed, the more the structure of the food changes.

Cell walls break down, nutrients are broken down and are more quickly and easily available to the body.

Janet Novotny, a nutritionist at the U.S. Department of Agriculture, and her colleagues have also demonstrated this very impressively using almonds as an example. The usable calorie content of almonds eaten raw was 20 percent lower than that of the same amount of almond paste. When almond paste was consumed, the full calorie count came into play.

Just to save calories, however, you still shouldn’t switch to a raw food-only diet because it can lead to an undersupply of nutrients and digestive problems. A healthy mix of raw foods and gently prepared foods provides optimal nutrition for the body while still being low in calories.

How much the body absorbs from a food also depends on its consistency. A wholegrain bread with butter and a “Milchschnitte” (a cake based treat with a ‘milky’ filling) are both rated at around 300 kilocalories per 100 grams. The fact that more calories are nevertheless absorbed from the soft children’s snack and that its “caloric value” is ultimately higher can be explained by the fact that the body has to expend more energy when digesting the wholegrain bread with complex carbohydrates.

Japanese researchers have demonstrated this effect in an experiment with rats: for 22 weeks, they fed one group of the animals the usual grain diet. A second group of rats was fed food with the same number of calories but processed food that required significantly less chewing. The result was that the rats with the “soft food” were obese after the experimental period, while the others were not.

Calories – hunger and satiety

It’s one thing to meet your energy needs. But it’s quite another thing to feel full and satiated in the process. Calories are not nutrients. We can mathematically ingest the appropriate amount of energy, but still remain hungry because our food contains few nutrients.

Even carbohydrates and proteins, which both provide 4 kcal per gram, do not have an identical physiological effect on the body.

Short-chain carbohydrates such as glucose enter the blood quickly, causing blood sugar and insulin levels to skyrocket. The hormone insulin encourages the body’s cells to rapidly absorb sugar from the blood. Once this happens, insulin levels promptly drop – which in turn triggers hunger. While 100 kilocalories from a low-sugar apple are filling, the juice drinker quickly feels hungry again and the desire to eat something, despite the same amount of energy ingested, due to the higher sugar intake.

Protein, on the other hand, leads to long-lasting satiety. In the stomach, proteins are broken down into amino acids, which enter the small intestine and stimulate the hormone production of cholecystokinin, peptide YY and glucagon-like peptide1. These pass into the blood and transmit the signal of satiety to the brain. At the same time, insulin levels remain stable after the consumption of protein-rich meals and cravings are prevented. It is also interesting to note – as studies have confirmed – that almost one third of the calories consumed in the form of protein are burnt off again directly when the proteins are digested.

Metabolic Balance does not count calories!

Instead of paying attention to the number of calories, it makes more sense to look at the quality of the food. Metabolic Balance therefore recommends unprocessed foods that are as close as possible to there natural state. High-quality cold-pressed oils should not be avoided under any circumstances, despite their high energy content. After all, fat is not only an energy carrier, but also indispensable for many metabolic processes in the body. Fish, meat, vegetables, fruit, legumes, mushrooms, nuts or dairy products with a natural fat content provide not only energy but also plenty of fiber, complex carbohydrates and protein, which are jointly responsible for maintaining the body’s functions and have a high satiety value. Thus, they help maintain weight or facilitate weight loss without having to count calories.

Meals composed of fat, protein and fiber-rich vegetables – as recommended by the Metabolic Balance nutrition plans – have a positive effect on blood sugar levels.

At the same time, a nutrition according to Metabolic Balance ensures a balanced vitamin and mineral account so that all nutrients can be optimally metabolized. Now at the latest, “all calories are not created equal” – after all, it makes a clear difference to the body whether 300 kcal are consumed in the form of fruit, vegetables and nuts or 300 kcal from foods that are less rich in vital substances, such as potato chips and sweets, which provide hardly any vital substances and make it more difficult for the body to function.

Sources:

  1. Oka, K., Sakuarae, A., Fujise, T., Yoshimatsu, H.,Sakata T, et al. (2003). Food texture differences affect energy metabolism in rats. J Dent Res, 82: 491–494. doi: 10.1177/154405910308200617.
  2. Trivedi, Bijal (2009). The Calorie Delusion: Why food labels are wrong (darin u. a. Interview Geoffrey Livesey), New Scientist. (15 July 2009)
  3. Flores-Mateo, G., Rojas-Rueda, D., Basora, J., Ros, E. & Salas-Salvadó, J. (2013). Nut intake and adiposity: meta-analysis of clinical trials. Am J Clin Nutr, June 2013, 97: 1346-1355. First published online April 17, 2013. doi:10.3945/ajcn.111.031484.

Sugar vs. Low-calorie Alternatives

A calorie-conscious diet is important to many people today. Especially sugar is a red rag for many and so you can find more and more sugar substitutes and sweeteners such as aspartame, saccharin, succralose, mannitol, sorbitol and many more in various foods.

These artificial sugar alternatives are not only used in confectionery. They are also contained in many processed products, beverages and so-called ‘light’ products. Sweeteners usually have a very low or even no calorie content, whereas sugar substitutes, with about 40% of the calorie count, are only reduced in calories compared to household sugar.

Consumers are often easily misled on this topic. Reduced-calorie products are usually understood as “healthy” and are therefore preferentially purchased and consumed. However, the consequences of excessive consumption of the sweeteners or sugar substitutes contained in them can be devastating for the body.

1. Food Cravings

Research has shown that sweeteners like saccharin lead to constant feelings of hunger. This is because when saccharin is ingested, the body believes it needs to metabolize sugar. But since there is no real sugar to metabolize for energy, the organism reacts with feelings of hunger.

In stock-breeding, saccharin is used as an appetite-stimulating fattening agent. In the human organism, its intake has a similar effect.[1]

The consequence of sweetener consumption can lead to eating more and the body is supplied with more energy than it needs. Thus, by consuming light products, more calories are often absorbed than would be the case if the same product containing conventional sugar were consumed.

2. Disturbance of the Intestinal Flora

Products sweetened with sweeteners often contain the statement that “excessive consumption may have a laxative effect”. One of the reasons for this is that the artificial substances can disturb the intestinal flora. Studies published by the German Medical Journal confirm that sweeteners negatively change the intestinal flora.[2] The intake of sweeteners causes bacteria to multiply, which can metabolize more dietary fiber. This produces short-chain fatty acids, which enter the bloodstream via the intestinal cells and – when there is no energy demand – are stored in fat cells.

Artificially produced sweeteners cannot be metabolized by the human organism. Their consumption contributes to the fact that the composition of the intestinal flora is changed. In the long run, this unbalances the metabolism. Weight gain, high blood pressure and other ailments can be promoted.

Metabolic Balance deliberately avoids the use of sugar and any kind of sugar substitutes. The body can cover its sugar requirements with fruit and vegetables. Sugar substitutes and sweeteners, which are produced with high technological input or exclusively artificially in the laboratory, have no place in a healthy and balanced diet, which consists mainly of unprocessed and natural foods.

The clear recommendation is to stay clear of light products and all foods enriched with sugar substitutes.

It is best to reduce sugar altogether. However, if you don’t want to give up cakes or desserts completely, you should definitely prepare them from scratch. By doing so the sugar content can be significantly reduced or the natural sweetness of fruits (e. g. dates) can be used.


[1] Bürkle, Silvia et al. (2015): „Ernährung macht’s möglich – Stress ade“, p. 59

[2] Süßstoffe: Studie belegt Störung von Darmflora und Glukosestoffwechsel https://www.aerzteblatt.de/nachrichten/60139/Suessstoffe-Studie-belegt-Stoerung-von-Darmflora-und-Glukosestoffwechsel

The Intestine and its Inhabitants

The intestine is an important part of the digestive system – it transports the food bolus, absorbs nutrients and water, produces vitamins and short-chain fatty acids, and removes indigestible food components. With a length of about eight meters, a surface area of up to 400 square meters and a diameter of only a few centimeters, it is the main transport artery from the food supply in the supermarket to the bloodstream.

With our food, we not only absorb vital nutrients that enter the bloodstream via the intestine, but also many foreign substances and pathogens. A healthy intestine that is equipped with a good intestinal flora and whose intestinal wall barrier is intact can catch, destroy and excrete toxins and pathogenic germs in advance, so that they no longer pose a risk to the body.

Unfortunately, the “interior equipment” of the intestine is massively disturbed by today’s modern nutrition and lifestyle. Often the intestinal mucosa is damaged, e. g. by nutrition low in fiber and too much sugar or by abundant additives that are added in large quantities to many processed foods. It is estimated that about 8 kilograms (17.6 lbs) of preservatives pass through the intestine over the course of an adult life. This is unfavorable, since the preservatives do their job in the intestine just as they do as an additive in food: They destroy bacteria and do not distinguish between disease-causing or health-promoting intestinal bacteria.

The intestinal mucosa as a border post

Nutrients and water are supposed to reach the body from the intestine. However, this does not apply to undigested food components, toxins and pollutants. Therefore, the intestinal mucosa must form an effective barrier. Normally, the cells in the intestine are located close together and the intercellular spaces are sealed with a kind of “Velcro” tape, i. e. membrane protein complexes, the so-called „tight junctions“. In addition, the intestinal mucosa is supported by a variety of different intestinal bacteria, which settle on the intestinal mucosa like a “thick fluffy carpet”, creating an impermeable barrier to blood circulation.

The tight junctions can be opened to allow larger molecules and larger quantities of water to pass through.

Disruptive factors such as stress, medications, alcohol, pathogenic germs and various additives can alter the intestinal flora and damage the intestinal mucosa. The pathogenic bacteria primarily benefit from a changed intestinal flora, because they can adapt very quickly to the changed environment and multiply accordingly quickly. As a result, inflammation of the intestinal mucosa may occur and the intestinal epithelium gradually becomes permeable (leaky gut syndrome) to allergens, pollutants and pathogens that harm the body. Allergies, diabetes mellitus type 2, skin diseases and fungal infections are also associated with a damaged and altered intestinal flora.

Food for the intestinal cells

Lactobacilli (lactic acid bacteria) and bifidobacteria, which settle sufficiently in the intestine, can protect and strengthen the intestinal mucosa. Studies have impressively demonstrated that lactobacilli can repair defects caused by harmful bacteria.

The broadest possible bacterial colonization in the intestine is therefore more than desirable. This ensures that the intestine is well supplied and the intestinal cells are optimally nourished. The intestinal cells receive all vital nutrients directly from the intestinal content. The intestinal content can be partially metabolized by some intestinal bacteria from the group of lactobacilli and bifidobacteria, forming short-chain fatty acids. Short-chain fatty acids provide energy, stimulate intestinal peristalsis and the circulation of the intestinal wall. Particular attention is paid to butyric acid, which promotes the metabolism of the intestinal mucosa and the growth of blood vessels in the intestinal wall. It also has anti-inflammatory and anticancerogenic effects.

Propionic acid and acetic acid play an important role in gluco- and lipogenesis. Furthermore, propionic acid supports the glucose balance in addition to building up the intestinal flora. It throttles the release of glucose and stimulates the pancreas to produce insulin. At the same time, the sensitivity of the body cells to insulin is increased.

It is therefore beneficial if sufficient lactobacilli and bifidobacteria colonize the intestine. With a nutrition rich in fiber, especially vegetables, legumes, whole grains and fruits, the bacterial population can be increased. But just as important are foods that provide probiotic bacterial strains, which are mainly found in fermented foods such as sauerkraut, yoghurt, kefir, buttermilk and many more.

Intestinal bacteria against obesity

Obesity is still mostly induced by high calorie food intake and lack of exercise. However, numerous studies have shown now that there is also a significant difference between normal and obese people with regard to the composition of the intestinal microbiome. Thus, the two bacterial strains Bacteroidetes and Firmicutes occur in different populations – in normal-weight individuals, in the majority, Bacteroidetes strains were detected, while Firmicutes predominated in overweight individuals. The higher the percentage of Bacteroidetes, the lower the body weight was.

Currently, scientists are increasingly interested in the significance of the bacterial species Prevotella and Bacteroides in connection with the clinical picture of obesity and the corresponding nutritional recommendations. In studies, subjects were divided into different enterotypes depending on which bacterial species dominated – Prevotella or Bacteroides. They were able to show that this classification had a decisive influence on dietary success. If Prevotella dominated, the subjects responded successfully to a nutrition characterized by abundant dietary fiber, especially fiber from whole grain products. If the bacterial strain Bacteroides had the upper hand, then this nutrition was less successful. Instead, a nutrition that promoted bifidobacteria, i.e. foods rich in inulin (parsnips, Jerusalem artichokes, leeks, salsify, and many others), was better able to positively influence metabolism and support weight loss.

Conclusion

Our intestine and its functionality has an immense influence on our health and well-being. For this reason, it is important to do everything possible to maintain intestinal health and take good care of the intestinal inhabitants. This is best achieved with a nutrition that is above all varied and rich in fiber and vital substances (vegetables, herbs, whole grains, legumes) and largely avoids processed foods and products. With a colorful mixture of these foods, as they are also compiled in the Metabolic Balance nutrition plan, the health-promoting intestinal bacteria receive plenty of nourishment and the opportunity to settle diligently in the intestine. In addition, high-quality fats (cold-pressed vegetable oils) and proteins (sea fish, nuts, dairy products, eggs) should not be missing. While fats support the energy production of intestinal cells, proteins (amino acids) are important components for building and repairing damaged intestinal cells.

The Metabolic Balance nutrition plan takes all these criteria into account. Nevertheless, it may well be that participants with long-standing intestinal problems need support at the beginning of the nutritional change due to a very weakened intestinal flora. In this case, pre- and probiotics can be very useful and good.  But – “Keep your eyes open when shopping” – many of these pre- and probiotics contain, in addition to a variety of bacterial strains, plenty of additives, which in turn cancel out the positive effect of the bacterial strains and have an unfavorable effect on the intestinal flora.

For example, Metabolic Basics Probiotics B.26 is recommended. With 26 bacterial strains (100 billion germs) and 24 herbal, spice and fruit extracts, it offers a high concentration and bacterial diversity. At the same time, the herbal and spice extracts have an anti-inflammatory effect on the intestine and facilitate the settlement of important intestinal bacteria in the intestine.

Source:

  1. Yu Q et al. Lactobacillus protects the integrity of intestinal epithelial barrier damaged by pathogenic bacteria. Front Cell Infect Mircobiol. 5:26.
    Doi: 103389/fcimb.2015.00026.
  2. Schumacher B. “Störungen im Darm machen krank“. Ärzte Zeitung 2014 Oct 10; 03:05.
  3. Wehkamp J, Götz M, Herrlinger K, Steurer W, Stange E „Chronisch entzündliche Darmerkrankungen“; Deutsches Ärzteblatt 2016 Feb 5; 113/5
  4. Fischer S. „Genom, Proteom und Mikrobiom – Ein mikrobiologischer Blick in den menschlichen Organismus. Die Naturheilkunde 5/2015
  5. Francesco Asnica et. Al: Microbiome connections with host metabolism and habitual diet from 1098 deeply phenotyped individuals; Nature Medicine (2021; DOI: 10.1038/s41591-020-01183-8)
  6. Christensen L., Roager H. m., astrup a., Hjorth m. f. (2018): microbial enterotypes in personalized nutri-tion and obesity management. am J Clin nutr 108 (4): 645–651
  7. Hjorth m. f., Roager H. m., Larsen T. m., Poulsen S. K.,Licht T. R. Bahl m. I., Zohar Y., astrup a. (2018): Pre-treatment microbial Prevotella-to-Bacteroides ratio, determines body fat loss success during a 6-month randomized controlled diet intervention. Int J Obes 42 (3): 580–583

Plant-Based Alternatives to Cow’s Milk

Oat milk, spelt drink, rice drink, almond milk, hemp milk, etc. – the supermarket shelves are full of plant-based alternatives to classic cow’s milk.

In the Metabolic Balance nutrition plans, you will only find soy milk alongside animal-based varieties such as cow’s, sheep’s and goat’s milk. Why is that? Has Metabolic Balance missed the trend and is sticking to long-established, obsolete opinions? Isn’t it possible to add another plant-based alternative to the nutrition plan and replace the classic cow’s milk and the well-known soy milk? The clear answer is: “No, it isn’t.”

Assuming that cow’s milk can simply be “replaced” by a plant-based variant is wrong from the start. A vegetal drink might be a refreshing soft drink, but it can never be a full and adequate substitute for cow’s milk. Cereal or nut drinks mainly consist of water – approx. 90% – so their nutrient content is not comparable to that of the original cereal grain or nut, but is far below that.

Cow’s milk, on the other hand, serves as the calves’ only food for weeks and provides all the nutrients to help calves grow into handsome cows. And this does not work with plant-based alternatives, which do not only lack important vitamins but above all high-quality proteins that the body can easily metabolize.

It is therefore not surprising that, according to a U.S. study, milk made from cereal products is not suitable for infant nutrition and cannot be considered a wholesome, adequate baby food, as it lacks proteins, vitamins and minerals that are vital for a child’s development. https://academic.oup.com/ajcn/article/106/2/597/4557638

But nuts are rich in valuable fatty acids and B vitamins, and oats have a lot of dietary fiber and minerals?!

Yes, that’s correct. From a nutritional point of view, the source products of alternative milk drinks in their unprocessed state often have a variety of valuable vitamins, proteins, fats, minerals and/or fiber. This is absolutely true. But if you look at the processing steps of the various milk types, it quickly becomes clear that the end product no longer has the same properties as the unprocessed basic product. 

Production

The alternative types of milk are usually produced with the help of extensive technological processing. The grains/nuts are crushed, mixed with water and then boiled. Enzymes are added to the resulting pulp that, among other things, break down the starch and thus trigger the fermentation process, which takes several hours and then results in a watery pulp which is finally sieved and filtered. This liquid usually does not look like milk, as it is quite clear. In order to obtain the desired whitish color of milk, certain vegetable oils are added, which form an emulsion with the liquid and thus create the typical color of milk.

The soy milk production process is similar to that described above. The soybeans are first soaked in water, then ground, boiled and filtered. However, no enzymes or edible oils are added there. In some cases, the resulting soy milk, like cow’s milk, is finally pasteurized and homogenized.

The nutrient content of the various plant-based drinks varies extremely. However, most of them have only a very small amount of protein. In addition, the biological value is not very high, i.e. only a fraction of the protein can be converted into the body’s own protein. Due to the extreme processing and exposure to heat and mechanics, many of the valuable ingredients such as vitamins, minerals and fiber have been lost.

The industry knows what to do, of course, and adds various additives such as calcium, magnesium, zinc, omega-3 fatty acids and the like to many milk drinks. Even if the additives seem “sensible” and healthy at first glance, appearances are deceptive: such additives are often far less easily absorbed than the natural nutrients in cow’s milk.

Conclusion by Metabolic Balance

Due to the numerous additives in plant-based milk alternatives and their low protein and nutrient content, most of those alternatives cannot be used as a substitute for cow’s milk.

Soy milk, however, takes a special position in this respect, as far fewer chemicals are required for its production than for the other milk alternatives. In addition, soy milk contains about 3-4% protein, which is relatively high compared to other milk alternatives. Of course, there are also justified objections against soy milk, such as genetic manipulation, the clearing of rainforests or the high concentration of allergens, as well as a possible hormonal effect on the organism. Nevertheless, from a nutritional point of view, soy milk appears to be a suitable food to replace cow’s milk at least to some extent.

If you are not comfortable with the idea of cow’s milk and/or soy milk, don’t worry; Metabolic Balance offers a variety of different breakfast options so that you can be happy, full and well supplied with all the important nutrients even without milk or milk alternatives.