Tag Archives: book review

Book Review: “Gorilla Mindset” by Mike Cernovich

Posted on June 11, 2016 | Comments Off on Book Review: “Gorilla Mindset” by Mike Cernovich

 

Gorilla-Mindset-book

Lawyer, blogger, and Tweetmaster Mike Cernovich has a new book, Gorilla Mindset: How to dominate and unleash the animal inside you to live a life of health, wealth, and freedom. Per Amazon.com’s rating system, I give it four stars (I like it).

♦  ♦  ♦

I’m an internal medicine specialist. For years, I’ve been struggling with how to convince my patients to exercise regularly and lose excess weight permanently. Why? So they’ll be healthier and live longer. Everyone wants to do that, right? But so few do. Because it’s hard to change lifelong habits to achieve a goal that may be years away. To make the change, you need the right mindset. Yes, it starts in your head.

The old mindset is: “I’ve been fat and lazy for years. I’ll always be fat and lazy. I’ve tried and failed a dozen times to change my lifestyle, and will fail every time.”

What’s the necessary new mindset? “I can do this. I’m not a brainless automaton without free will. I can see that discipline and sacrifice today will pay priceless dividends down the road. I don’t have to be fat just because everyone in my family is. I can overcome temptation. I’m not going to spend time with losers that bring me down. I’ll make new friends, people who live like me and support me. I will not be brainwashed by advertisers and food manufacturers who are only concerned about their profit, not my life. I have a plan for my life, and being fat and lazy aren’t in it.”

I wish I could download and install that into my patients’ brains!

Who created this?

Who created this?

I read this book hoping to pick up some new tips that would help me with my patients that need that mindset shift. And the author did not disappoint. I also ran across several techniques that I already use in my diet books, such as visualization.

Mike Cernovich’s methods include self-talk, posture improvement, mindfulness, focus, visualization, framing, and others. They will help with mindset re-set. The book is a fill-in-the-blank workbook, so buy your own copy and get to work.

The book is explicitly aimed at men. I would say the target demographic age is 16 to 40. The mind-bending methods should work for those over 40. It’s for men wanting more out of life, to rise above the hoi polloi, and willing to do the work.

It’s not a “weight loss book” per se; see the subtitle for details. However, Mr. Cernovich lost weight from 260 to 180 lb (118 to 81 kg). So he knows the struggle. He says, “…it’s almost impossible to maintain high levels of health while eating a diet high in processed foods.” I agree.

I particularly liked the chapter on money and livelihood. Young men need this information. The book is chock full of avuncular advice, so needed these days when too many boys grow up without a masculine role model. (Women, think long and hard about your children before you frivorce your husband.)

A little of the advice herein is California hippy-dippy woo, but it shouldn’t hurt you and may help, even if it doesn’t appeal to me. I’m convinced the author firmly believes in his recommendations and follows his own advice. I’m skeptical about some of the nutritional supplement advice, too; I’d check with P.D. Mangan for his thoughts.

The author hopes Gorilla Mindset becomes a perennial classic. He’s not quite there yet with this edition. He needs a chapter addressing sex/girls/women. Also, many young men need help on how to find a life purpose that motivates them. This isn’t enough: “If you feel unfilled [sic], stop doing whatever it is you’re doing. Try something else. Walk the streets until you’re exhausted. Repeat this every day. When you finally see what you want, your life will change.” My teenage daughter recently took an online occupational aptitude test that really helped give her some direction. My son is next; his interests are superficial and all over the map. Of course, aptitude is nothing without deep interest or passion. Another issue for the next edition: What about God and centuries-old religions?

A watershed moment in the Mike’s adolescence was when his father asked him, “When are you going to get serious?”

I ask you the same.

Steve Parker, M.D.

PS: If you think this review has too many words with vowels, you should see my books. They’re full of ’em.

 

Comments Off on Book Review: “Gorilla Mindset” by Mike Cernovich

Posted in Book Review

Tagged , ,

Book Review: The South Asian Health Solution: A Culturally Tailored Guide to Lose Fat, Increase Energy, Avoid Disease

Posted on September 24, 2015 | Comments Off on Book Review: The South Asian Health Solution: A Culturally Tailored Guide to Lose Fat, Increase Energy, Avoid Disease
Indian woman cooking chapati

Indian woman cooking chapati

Here’s my review of The South Asian Health Solution: A culturally tailored guide to lose fat, increase energy, avoid disease by Ronesh Sinha, published in 2014.

♦   ♦   ♦

Dr. Sinha practices internal medicine in southern California (Silicon Valley) and has a large dose of South Asians in his clinic. “South Asia” usually encompasses India, Pakistan, Nepal, Bangladesh, Bhutan, Sri Lanka and Maldives. It is home to one fifth of the world’s population. This book pertains mostly to Indians, which is Dr. Sinha’s ethnicity. I live in the Pheonix, AZ, area and we have a fair number of Indian engineers and physicians.

WHY DO SOUTH ASIANS NEED THEIR OWN SPECIAL HEALTH GUIDE?

Because Dr. Sinha says they have unique genetic and cultural issues that predispose them to type 2 diabetes, abdominal obesity, coronary artery disease, high blood pressure, and adverse cholesterol numbers. For example, compared to natives who stay in their home countries, South Asian immigrants to the West have 3–4 times higher prevalence of diabetes, he says. Dr Sinha has a program that he’s convinced will prevent or forestall these medical problems in South Asians.

Dr. Sinha says South Asians eat too many carbohydrates and are too sedentary. Especially those who have moved to the West (e.g., US, UK, Europe, Canada). He notes that the core of the typical South Asian diet is flat breads, lentils, rice, fried crispy snacks (with heart-poisoning trans fats), culminating in 150–200 daily grams of carbohydrate more than he sees in other ethnics in California. Western fast foods, sodas, and sweets compound the problem.

He says “most South Asians are skinny-fat,” meaning skinny legs and arms but with a fat belly from visceral fat. This is also called sarcopenic obesity. The usual “healthy” body mass index (BMI) numbers don’t apply to Asians. The World Health Organisation classifies Asians as underweight if BMI is 18.4 or less, healthy at BMI of 18.5 to 13, overweight at BMI 23.1 to 25, and obese if BMi is over 25. These numbers are lower than those used for non-Asian populations.

Another issue in his South Asian patient population is vitamin D deficiency related to their dark skin (hence, less vitamin D production) and too much time indoors. He says vitamin D deficiency promotes inflammation and insulin resistance. More on this below.

Some South Asians have a K121Q gene mutation that causes insulin resistance, which in turn can cause disease. And whether it’s genetic or not (but I think it is), he says South Asians tend to have higher Lp(a) [aka lipoprotein(a)], which causes early and aggressive coronary artery disease. They also tend to have small dense LDL, leading to a lower-than-expected total cholesterol level which may be deceptively low.

Sinha notes a strong vegetarian preference in Indians but spends almost no time discussing it. From the book, I can’t tell if Indian vegetarians are lacto-ovo-vegetarians, pescetarians, or vegans. The author is not a vegetarian.

Gadi Sagar temple on Gadisar Lake, Jaisalmer, Rajasthan, India

Gadi Sagar temple on Gadisar Lake, Jaisalmer, Rajasthan, India

 

SINHA’S GRAND UNIFICATION THEORY OF DISEASE CAUSATION

So, South Asians, at least in the West, have a high-carb diet, are too sedentary, and have genetic tendencies to heart disease and diabetes. How do these factors cause disease? It’s all tied together with insulin resistance. Insulin is the main hormone that keeps our blood sugar from rising too high after we digest a meal. Insulin drives blood sugar into our body cells to be used as energy or stored as fat or glycogen. If our tissues have insulin resistance, blood sugar levels rise. As a compensatory effort, our pancreas excretes more insulin in to the blood stream than would normally be the case. Whether or not that eventually lowers blood sugar levels, the higher insulin levels themselves can cause toxicity. For example, higher insulin levels raise blood pressure, which damages the cells lining the insides of our arteries, leading to chronic inflammation and atherosclerosis (hardening of the arteries). Some of the arterial damage is mediated through small dense LDL cholesterols (aka type B LDL), which is promoted by high insulin levels (hyperinsulinemia). Insulin resistance also results in a defective and overactive immune system, which further promotes chronic inflammation. This inflammation is “…the root cause of almost every imaginable chronic disease…from heart attacks and strokes to Alzheimers Disease.”

Anyway, this is Dr. Sinha’s hypothesis, and there is some scientific evidence to support it. Sinha says that the concept of insulin resistance “weaves together virtually every chronic ailment currently afflicting South Asians.” That may be a bit hyperbolic: He carves out no exceptions for arthritis, asthma, eczema, migraines, glaucoma, macular degeneration, hearing loss, erectile dysfunction, hepatitis C, prostate enlargement, toenail fungus, or male-pattern baldness.

Dr. Sinha’s Grand Unification Theory of Disease Causation has some support among physicians and scientists, but is by no means universally accepted among them. As for myself, I think he’s over-simplifying (for his readership’s sake?) and getting a bit ahead of the science.

Most clinicians aren’t testing directly for insulin resistance. What are the indirect clues? Belly fat, low HDL cholesterol, high trigylcerides, high blood pressure, prediabetes, and type 2 diabetes. These are components of the metabolic syndrome. Not everybody with one or more of these factors has insulin resistance but many do.

WHAT’S HIS PROGRAM?

If Sinha is correct, the South Asian Health Solution is a “low-insulin lifestyle” achieved through carbohydrate-reduced eating, exercise, and avoidance or resolution of belly fat. These help improve all components of the aforementioned metabolic syndrome. The backbone of the plan is carbohydrate restriction. For low-carb eating, avoid wheat bread and Indian flat breads (e.g., chapatis, naans, parathas, puris, phulkas), aloo (primarily potatoes and starchy vegetables), rice and other grains, beans, and sugar. Keep track of your net carbohydrates (he likes FitnessPal.com, which includes South Asian foods).

If you need to burn off body fat, limit carbs to 50–100 grams/day (digestible or net carbs, I assume). Aim for 100–150 grams/day to maintain health and weight loss.

You might be able to add “safe starches” later: white rice, potatoes. To replace your Indian flat breads, learn how to make them with substitutes for wheat flour: coconut flour or almond flour (no skins) or almond meal (skin included). Recipe on page 347. Rice alternatives are cauliflower “rice,” shredded cabbage, broccoli slaw, chopped broccoli, and chopped carrots.

He likes ghee, extra virgin olive oil, coconut oil, and butter. Avoid high omega-6 fatty acid consumption, as in vegetable oils. Of course, avoid trans fats. Good fats are saturated, monousaturated, and omega-3s.

He provides a few low-carb recipes, surprisingly without specific carb counts: chapatis, microwave bread, cauliflower pizza, coconut cauliflower rice, shredded cabbage sabji, gajar halwa (carrot pudding), and coconut ladoo.

Dr. Sinha doesn’t provide a comprehensive meal plan. He trusts his California South Asians to figure out how and what to eat. They’re smarter than average (he never says that, but that’s been my experience with South Asians in my world).

Dr. Sinha is also a huge proponent of exercise. He’ll tell you about squats, lunges, planks, burpees, yoga, and Tabata intervals. He agrees with me and Franziska Spritzler that “physical activity is the most effective fountain of youth available.”

Steve Parker, M.D., Conquer Diabetes and Prediabetes

Taking a rest from the fountain of youth

 

I skipped some of the chapters due to lack of time and interest: women’s issues (e.g., pregnancy, polycystic ovary syndrome, post-partum depression, osteoporosis), childhood, fatigue and stress management, and anti-aging.

MISCELLANEOUS TIDBITS

  • He likes high-sensitivity CRP testing.
  • His metabolic goals for South Asians are: 1) keep waist circumference under 35 inches (90 cm) in men, under 31 inches (80 cm) in women, 2) keep triglycerides under 100 mg/dl (1.13 mmol/l), 3) keep HDL cholesterol over 40 mg/dl (1.03 mmol/l) for men, and above 50 mg/dl (1.29 mmol/l) for women, 4) keep systolic blood pressure 120 or less, and diastolic pressure 80 or less, 5) keep fasting blood sugar under 100 mg/dl (5.6 mmol/l) and hemoglobin A1c under 5.7%, and 6) keep hs-CRP under 1.0 mg/dl.
  • He says HDL cholesterol helps reduce insulin resistance via apoprotein A-1 (apo A-1), which increases glucose uptake by cells.
  • He likes to follow the triglyceride/HDL ratio. If under 3, it means low risk of insulin resistance being present.
  • He likes to follow total cholesterol/HDL cholesterol ratio: ideal is under 3.5.
  • Statins are way over-used.
  • Ignore total cholesterol level by itself.
  • Stress control and sleep are important.
  • The author had some metabolic syndrome components: high triglycerides, low HDL cholesterol, and type B LDL (small, dense particles).
  • He dislikes the usual-recommended low-fat, low-cholesterol diet.
  • 4 tbsp (60 ml) of extra virgin olive oil daily seems to lower blood pressure.
  • Magnesium supplementation may lower blood pressure.
  • The liver stores about 100 grams of glycogen and muscles store 300–500 grams.
  • Vanaspati is a “cheap ghee substitute” made from vegetable oil and widely used in Indian restaurants and many Indian processed foods. Avoid it since it’s a source of trans fats.
  • Aloo sabji is a potato dish.
  • Traditional Indian herbs/spices include turmeric, cardamon, ginger, and cilantro.
  • Find an Indian medication guide at http://www.medguideindia.com/show_brand.php.
  • Coconut milk is a traditional fat in India.
  • Curry, curry, curry.
  • http://www.pamforg/southasian.
  • http://southasiahealthsolutions.org.
  • Non-alcoholic steatohepatitis (NASH) is quite common in South Asians, seemingly linked to visceral (abdominal) obesity and insulin resistance related to carbohydrates.
  • The book has no specific focus on diabetes.

THUMBS UP OR DOWN?

Overall, I like many of Dr. Sinha’s ideas. They seem to be supported by his experience with his own patients. I trust him. I bet many South Asians and non-Asians eating the Standard American Diet would see improved health by following his low-carb, physically active program.

Steve Parker, M.D.

 

Comments Off on Book Review: The South Asian Health Solution: A Culturally Tailored Guide to Lose Fat, Increase Energy, Avoid Disease

Posted in Book Review

Tagged , , , , ,

Book Review: “Stop the Clock: The Optimal Anti-Aging Strategy”

Posted on August 31, 2015 | Comments Off on Book Review: “Stop the Clock: The Optimal Anti-Aging Strategy”
dementia, memory loss, Mediterranean diet, low-carb diet, glycemic index, dementia memory loss

“I wish we could have read PD Mangan’s book thirty years ago!”

I read P.D. Mangan’s 2015 book, Stop the Clock: The Optimal Anti-Aging Strategy. I give it five stars in Amazon’s rating system. High recommended.

♦   ♦   ♦

I approached this book with trepidation. I like PD Mangan even though I’ve never met him. We’ve interacted on Twitter and at our blogs. You can tell from his blogging that he’s very intelligent. I don’t know his educational background but wouldn’t be surprised if he has a doctorate degree. My apprehension about the book is that I was concerned it would be brimming with malarkey and scams. Fortunately, that’s not the case at all.

Twin studies have established that 25% of longevity is genetic. That leaves a lot of lifestyle factors for us to manipulate.

I’m not familiar with the anti-aging scientific literature and don’t expect it will ever be something I’ll spend much time on. But it’s an important topic. I’ll listen to what other smart analysts—like Mr. Mangan—have to say about it.

It’s quite difficult to do rigorous testing of anti-aging strategies on free-living humans. So the best studies we have were done with worms, rodents, and monkeys; the findings may or may not apply to us. For example, long-term calorie restriction—about 30% below expected energy needs—is known to prolong life span in certain worms and rodents, with mixed results in rhesus monkeys. It’s the rare person who would follow such a low-calorie diet for years as an experiment. I doubt I would do it even if proven to give me an extra five years of life. I like to eat.

There are several prominent theories of how and why animals age. The author thinks the major factors are:

  1. oxidative stress
  2. inflammation
  3. a decline in autophagy (perhaps most important)

An effective anti-aging program should address these issues.

In the anti-aging chapter of his book, The South Asian Health Solution, internist Ronesh Sinha says that “Lifestyle practices that reduce excess inflammation in the body will help delay the aging process.” Dr. Sinha is a huge exercise advocate and low-carb diet proponent.

Mr. Mangan makes a convincing argument that a good way to forestall aging is to apply hormetic stress. Hormesis is a phenomenon whereby a beneficial effect (e.g., improved health, stress tolerance, growth, or longevity) results from exposure to low doses of an agent or activity that is otherwise toxic or lethal when given at higher doses.

Needs a bit more hormetic stress

Needs a bit more hormetic stress

In case you’re not familiar with hormesis, here’s a major example. Lack of regular exercise leads is linked to premature death from heart disease and cancer. Starting and maintaining an exercise program leads to greater resistance to injury and disease and longer life span. On the other hand, too much exercise is harmful to health and longevity. We see that in professional athletes and excessive marathon runners. Something about exercise—in the right amount—enhances the body’s intrinsic repair mechanisms. That’s the hormetic effect of exercise; one mechanism is by turning on autophagy.

Autophagy is the body’s natural process for breaking down and removing or recycling worn-out cellular structures. This wearing-out occurs daily and at all ages.

If you’re thinking Mr. Mangan recommends exercise as an anti-aging strategy, you’re exactly right. Especially resistance training and high intensity training. His specific recommendations are perfectly in line with what I tell my patients.

Calorie restriction is another form of hormesis; the body reacts by up-regulating stress defense mechanisms. As a substitute for calorie restriction, the author recommends intermittent fasting. Intermittent fasting increases insulin sensitivity, which leads to enhanced autophagy. Fasting seems perfectly reasonable if you think about it, which very few do. Many of us eat every three or four hours while awake, whether a meal or a snack. If you think about it, that’s not a pattern that would be supported by evolution. In the Paleolithic era, we often must have gone 12–16 hours or even several days without food. Hominins without the resiliency to do that would have died off and not passed their genes down to us.

Steve Parker MD, Advanced Mediterranean DIet

Naturally low-carb Caprese salad: mozzarella cheese, tomatoes, basil, extra virgin olive oil

Another anti-aging trick is a low-carb diet, defined as under 130 grams/day, or under 20% of total calories. It may work via insulin signaling and weight control.

Glutathione within our cells is a tripeptide antioxidant critical for clearing harmful reactive oxygen species (free radicals). We need adequate glutathione to prevent or slow aging. Cysteine is the peptide that tends to limit our body’s production of glutathione. We increase our cysteine supply either through autophagy (which recycles protein peptides) or diet. Dietary sources of cysteine are proteins, especially from animal sources. Whey protein supplements and over-the-counter n-acetyl cysteine are other sources. Fasting is another trick that increases cysteine availability via autophagic recyling.

I don’t recall the author ever mentioning it, but if you hope to maximize longevity, don’t smoke. Even if it has hormetic effects. Maybe that goes without saying in 2015.

When I read a book like this, I always run across tidbits of information that I want to remember. Here are some:

  • those of us in the top third of muscular strength have a 40% lower risk of cancer (NB: you increase your strength through resistance training not aerobics)
  • exercise helps prevent cognitive decline and dementia, at least partially via enhanced autophagy
  • exercise increases brain volume (in preparing to do this review I learned that our brains after age 65 lose 7 cubic centimeters of volume yearly)
  • optimal BMI may be 20 or 21, not the 18.5-25 you’ll see elsewhere (higher BMI due to muscle mass rather than fat should not be a problem)
  • Scientist Cynthia Kenyon: “Sugar is the new tobacco.” (in terms of aging)
  • phytochemicals (from plants, by definition) activate AMPK, a cellular energy sensor that improves stress defense mechanisms and increases metabolic efficiency
  • curcumin (from the spice turmeric) activates AMPK
  • coffee promotes autophagy
  • he does not favor HGH supplementation
  • in the author’s style of intermittent fasting, you’re not reducing overall calorie intake, just bunching your calories together over a shorter time frame (e.g., all 2,500 calories over 6-8 hours instead of spread over 24)
  • mouse studies suggest that intermittent fasting could reduce risk of Alzheimer’s disease and Parkinsons disease
  • consider phytochemical supplements: curcumin, resveratrol, green tea extract
  • calorie-restriction mimetics include resveratrol, curcumin, nicotinamide, EGCG, and hydroxycitrate
  • supplemental resveratrol at 150 mg/day improved memory and cognition in humans

The author provides very specific anti-aging recommendations that could be followed by just about anyone. Read the book for details. Scientists are working feverishly to develop more effective anti-aging techniques. I look forward to a second edition of this book in three to five years.

Steve Parker, M.D.

PS: People with certain medical conditions, such as diabetics taking drugs that can cause hypoglycemia, should not do intermittent fasting without the blessing of their personal physician. If you have any question about your ability to fast safely, check with your doctor.

PPS: If you need to lose weight on a low-carb diet, consider my Advanced Mediterranean Diet or Ketogenic Mediterranean Diet.

Comments Off on Book Review: “Stop the Clock: The Optimal Anti-Aging Strategy”

Posted in Book Review, Longevity

Tagged , , , , , , , , , , , , , , , ,

Book Review: Zest for Life – The Mediterranean Anti-Cancer Diet

Posted on January 10, 2014 | Comments Off on Book Review: Zest for Life – The Mediterranean Anti-Cancer Diet

51VBKOWQ3dL._SX258_PJlook-inside-v2,TopRight,1,0_SH20_BO1,204,203,200_.jpg

A couple years ago I read and reviewed Zest For Life: The Mediterranean Anti-Cancer Diet, by Conner Middelmann-Whitney, published in 2011. I guess I forget to pull and re-post my review off my old Advanced Mediterranean Diet blog. Per Amazon.com’s rating system, I give it five stars (I love it). Here it is.

 ♦   ♦   ♦

The lifetime risk of developing invasive cancer in the U.S. is four in ten: a little higher for men, a little lower for women.  Those are scary odds.  Cancer is second only to heart disease as a cause of death in western societies.  The Mediterranean diet has a well established track record of protecting against cancers of the prostate, colon/rectum, uterus, and breast.  Preliminary data suggest protection against melanoma and stomach cancer, too.  I’m not aware of any other way of eating that can make similar claims.

So it makes great sense to spread the word on how to eat Mediterranean-style, to lower your risk of developing cancer.  Such is the goal of Zest For Life’s author.  The Mediterranean diet is mostly, although by no means exclusively, plant-based.  It encourages consumption of natural, minimally processed, locally grown foods.  Generally, it’s rich in vegetables, fruits, legumes, olive oil, whole grains, red wine, and nuts. It’s low to moderate in meat, chicken, fish, eggs, and dairy products (mostly cheese and yogurt).

Note that one of the four longevity hot spots featured in Dan Buettner’s Blue Zones was Mediterranean: Sardinia.  All four Blue Zones were characterized by plant-based diets of minimally processed, locally grown foods. (I argue that Okinawa and the Nicoya Peninsula dwellers ate little meat simply due to economic factors.)

Proper diet won’t prevent all cancer, but perhaps 10-20% of common cancer cases, such as prostate, breast, colorectal, and uterine cancer.  A natural, nutrient-rich, mostly plant-based diet seems to bolster our defenses against cancer.

Ms. Middelmann-Whitney is no wacko claiming you can cure your cancer with the right diet modifications.  She writes, “…I do not advocate food as a cancer treatment once the disease has declared itself….”

She never brings it up herself, but I detect a streak of paleo diet advocacy in her.  Several of her references are from Loren Cordain, one of the gurus of the modern paleo diet movement.

She also mentions the ideas of Michael Pollan very favorably.

She’s not as high on whole grains as most of the other current nutrition writers.  She points out that, calorie for calorie, whole grains are not as nutrient-rich as vegetables and fruits.  Speaking of which, she notes that veggies generally have more nutrients than fruits. Furthermore, she says, grain-based flours probably contribute to overweight and obesity. She suggests that many people eat too many grains and would benefit by substituting more nutrient-rich foods, such as veggies and fruits.

Some interesting things I learned were 1) the 10 most dangerous foods to eat while driving, 2) the significance of organized religion in limiting meat consumption in some Mediterranean regions, 3) we probably eat too many omega-6 fatty acids, moving the omega-6/omega-3 ratio away from the ideal of 2:1 or 3:1 (another paleo diet principle), 4) one reason nitrites are added to processed meats is to create a pleasing red color (they impair bacterial growth, too), 5) fresh herbs are better added towards the end of cooking, whereas dried herbs can be added earlier, 6) 57% of calories in western societies are largely “empty calories:” refined sugar, flour, and industrially processed vegetable oils, and 7) refined sugar consumption in the U.S. was 11 lb (5 kg) in the 1830s, rising to 155 lb (70 kg) by 2000.

Any problems with the book? Only relatively minor ones. The font size is a bit small for me; if that worries you, get the Kindle edition and choose your size.  She mentions that omega-6 and omega-3 fatty acids are “essential” fats. I bet she meant to say specifically that linolenic and linoleic fatty acids are essential (our bodies can’t make them); linolenic happens to be an omega-3, linoleic is an omega-6.  Reference #8 in chapter three is missing.  She states that red and processed meats cause cancer (the studies are inconclusive).  I’m not sure that cooking in or with polyunsaturated plant oils causes formation of free radicals that we need to worry about.

As would be expected, the author and I don’t see eye to eye on everything.  For example, she worries about bisphenol-A, pesticide residue, saturated fat, excessive red meat consumption, and strongly prefers pastured beef and free-range chickens and eggs.  I don’t worry much.  She also subscribes to the “precautionary principle.”

The author shares over 150 recipes to get you started on your road to cancer prevention.  I easily found 15 I want to try.  She covers all the bases on shopping for food, cooking, outfitting a basic kitchen, dining out, shopping on a strict budget, etc.  Highly practical for beginning cooks.  Numerous scientific references are listed for you skeptics.

I recommend this book to all adults, particularly for those with a strong family history of cancer.  But following the author’s recommendations would do more than lower your risk of cancer.  You’d likely have a longer lifespan, lose some excess fat weight,  and lower your risk of type 2 diabetes, dementia, heart disease, stroke, and vision loss from macular degeneration.  Particularly compared to the standard American diet.

Steve Parker, M.D.

Disclosure: The author arranged a free copy of the book for me, otherwise I recieved nothing of value for writing this review.

Comments Off on Book Review: Zest for Life – The Mediterranean Anti-Cancer Diet

Posted in Diet Reviews

Tagged , , , ,

Book Review: The Heart Healthy Lifestyle – The Prevention and Treatment of Type 2 Diabetes, by Sean Preuss

Posted on November 22, 2013 | Comments Off on Book Review: The Heart Healthy Lifestyle – The Prevention and Treatment of Type 2 Diabetes, by Sean Preuss

I recently finished an ebook, The Heart Healthy Lifestyle: The Prevention and Treatment of Type 2 Diabetes by Sean Preuss, published in 2013. Per Amazon.com’s rating system, I give it five stars (I love it).

♦   ♦   ♦

This is an invaluable resource for 1) anyone recently diagnosed with type 2 diabetes or prediabetes, 2) those who aren’t responding well to their current therapeutic regimen, and 3) type 2 diabetics who want to reduce their drug use.

Strength Training Helps Get Excess Blood Sugar Out of Circulation

Strength Training Helps Get Excess Blood Sugar Out of Circulation

Mr. Preuss is a fitness trainer who has worked with many type 2 diabetics. He demonstrates great familiarity with the issues diabetics face on a daily basis. His science-based recommendations are familiar to me since I reviewed many of his references at on of my other blogs, Diabetic Mediterranean Diet.

Like me, Mr. Preuss recognizes the primacy of lifestyle modification over drug therapy for type 2 diabetes, as long as drugs can safely be avoided or postponed. The main lifestyle factors are diet and exercise. Too many physicians don’t spend enough time on these, preferring instead to whip out the prescription pad and say, “Here ya go. I’ll see you in three months.”

I have gradually come to realize that most of my sedentary type 2 diabetes patients need to start a work-out program in a gym where they can get some personal attention. That’s Mr. Preuss’s opinion, too. The clearly explained strength training program he recommends utilizes machines most commonly found in a gym, although some home gyms will have them also. His regimen is easily done in 15-20 minute sessions two or three times a week.

He also recommends aerobic activity, such as walking at least several days a week. He recommends a minimum of 113 minutes a week of low intensity aerobic work, citing evidence that it’s more effective than higher intensity effort for improving insulin sensitivity.

I don’t recall specific mention of High Intensity Interval Training. HIIT holds great promise for delivering the benefits of aerobic exercise in only a quarter of the time devoted to lower intensity aerobics. It may be that it just hasn’t been studied in type 2 diabetics yet.

I was glad to see all of Mr. Preuss’s scientific references involved humans, particularly those with type 2 diabetes. No mouse studies here!

Another strength of the book is that Sean tells you how to use psychological tricks to make the necessary lifestyle changes.

The author notes that vinegar can help control blood sugars. He suggests, if you can tolerate it, drinking straight (undiluted) red wine vinegar or apple cider vinegar – 2 tbsp at bedtime or before carbohydrate consumption. I’ve heard rumors that this could be harmful to teeth, so I’d do some research or ask my dentist before drinking straight vinegar regularly. For all I know, it could be perfectly harmless. If you have a definitive answer, please share in the comments section below.

I read a pertinent vinegar study out of the University of Arizona from 2010 and reviewed it at one of my blogs. The most effective dose of vinegar was 10 g (about two teaspoons or 10 ml) of 5% acetic acid vinegar (either Heinz apple cider vinegar or Star Fine Foods raspberry vinegar).  This equates to two tablespoons of vinaigrette dressing (two parts oil/1 part vinegar) as might be used on a salad.  The study authors also say that “…two teaspoons of vinegar could be consumed palatably in hot tea with lemon at mealtime.”

The diet advice herein focuses on replacement of a portion of carbohydrates with proteins, healthy oils, and vegetables.

I highly recommend this book. And sign up for Mr. Preuss’s related tweets at @HeartHealthyTw.

Steve Parker, M.D.

Disclosure: Mr. Preuss gave me a free copy of the book, otherwise I have received no monetary compensation for this review. I met him once, about two years ago.

Comments Off on Book Review: The Heart Healthy Lifestyle – The Prevention and Treatment of Type 2 Diabetes, by Sean Preuss

Posted in Diabetes, Exercise

Tagged , , , , ,

Book Review: The Oldways 4-Week Mediterranean Diet Menu Plan

Posted on December 5, 2012 | Comments Off on Book Review: The Oldways 4-Week Mediterranean Diet Menu Plan

67618_10151198435353246_1768152938_n

I’ve been an admirer of Oldways for many years. They tirelessly advocate for a way of eating that demonstrably lengthens lifespan while reducing rates of heart disease, stroke, cancer, diabetes, and dementia. Especially when compared to the standard American diet.

I’m very pleased to see Oldways present a four-week plan that helps the average person incorporate Mediterranean diet principles into daily life. These recipes are simple, practical, and delicious. No need for exotic ingredients or culinary classes!

Get started soon. You won’t regret it.

Steve Parker, M.D.

Disclosure: Olways provided me with a free pre-publication review copy of the book.

Comments Off on Book Review: The Oldways 4-Week Mediterranean Diet Menu Plan

Posted in Diet Reviews, Recipes

Tagged , ,

Book Review: The Smarter Science of Slim

Posted on October 12, 2012 | Comments Off on Book Review: The Smarter Science of Slim

Earlier this year, I  reviewed  The Smarter Science of Slim, by Jonathan Bailor and published in 2012.  The review is at my defunct Advanced Mediterranean Diet blog, so I moved it here.  Per Amazon.com’s rating system, I give it four stars (”I like it”).  Evelyn at The Carb Sane Asylum has some different ideas about the book at her blog.

♦   ♦   ♦

Mr. Bailor’s weight-management diet avoids grains, most dairy, oils, refined starches, added sugars, starchy veggies, corn, white potatoes.  You eat meat, chicken, eggs, some fruit, nuts, seeds, and copious low-starch vegetables.  No limit on food if you eat the right items.

Is the Energy Balance Equation valid?

It’s high-fiber, high-protein, moderate-fat, moderate-carb (1/3 of calories from carbohydrate,  1/3 from protein, 1/3 from fat).  He considers it Paleo (Stone Age) eating even though he allows moderate legumes and dairy (fat-free or low-fat cottage cheese and plain Greek yogurt).

Will it lead to weight lose? Quite probably in a majority of followers, especially those eating the standard, low-quality American diet.  When it works, it’s because you’ve cut out the fattening carbohydrates so ubiquitous in Western societies.  The protein and fiber will help with satiety.  Is it a safe eating plan?  Yes.

(For those with diabetes needing to lose weight, I prefer a lower carbohydrate content in the diet, something like Conquer Diabetes and Prediabetes: The Low-Carb Mediterranean Diet.  For non-diabetics, is Smarter Science better than my Advanced Mediterranean Diet 2nd Edition?  Of course not, silly!)

I don’t recall any recipes or specific meal plans.  You put your own meals together following his guidelines.

Our major points of agreement:

  • Exercise isn’t terribly helpful as a weight-loss technique for most folks.
  • We’re overweight because we eat too many starches and sweets.
  • Natural, minimally processed foods are healthier than man-made highly refined items.
  • No need to emphasize “organic” /grass-fed beef/free-range chicken.
  • We don’t do enough high-quality exercise.

I have a few problems with the book:

  • It says we’re eating less.  U.S. caloric consumption over the last several decades has increased by about 150 cals (630 kJ) a day for men and 300 cals (1260 kJ) for women.  The author seems to contradict himself at one point by favorably quoting Hilda Bruch’s writing that “…overeating is observed with great regularity” in the obese.
  • Scary graphs showing increasing instances of heart disease and diabetes over time aren’t helpful because they ignore population growth.  The population-adjusted diabetes rate is indeed increasing whereas heart disease rates are decreasing.
  • It says the Calories In/Calories Out theory of overweight has been proven wrong.  This is by no means true.  It just hasn’t helped us much to reverse the overweight epidemic.  Sure, it’s often said that if you just cut a daily tablespoon of butter out of your diet, you’d lose 11 lb (5 kg) in a year, all other things being equal.  Problem is, all other things are never equal.  In reality, we replace the butter with something else, or we’re slightly less active.  So weight doesn’t change or we gain a little.
  • It says the “eat less, exercise more” mantra has been proven wrong as a weight loss method.  Not really.  See above.  And watch an episode of TV’s “The Biggest Loser.”  Exercise can burn off fat tissue.  The problem is that we tend to overeat within the next 12 hours, replacing the fat we just burned. I agree with the author that “eat less, exercise more” is extremely hard to do, which is the reason it so often fails over the long run.  As Mr. Bailor writes elsewhere: “Hard to do” plus “do not want to do” generally equals “it’s not happening.”  Mr. Bailor would say the reason it ultimately fails is because of a metabolic clog or dysregulation.
  • He says there’s no relationship between energy (calorie) consumption and overweight.  Not true.  Need references?  Google these: PMID 15516193, PMID 17878287, PMID 14762332.  The author puts too much faith in self-reports of food intake, which are notoriously inaccurate.  And obese folks under-report consumption more than others (this is not to say they’re lying).
  • Mr. Bailor’s assessments too often rely on rat and mice studies.
  • By page 59, I had found five text sentences that didn’t match up well with the numeric bibiographic references (e.g., pages 48, 50, 59).
  • S. Boyd Eaton is thrice referred to as S. Boyd.
  • How did he miss the research on high intensity interval training by Tabata and colleagues in 1996?  Gibala is mentioned often but he wasn’t the pioneer.
  • Several diagrams throughout the book didn’t print well (not the author’s fault, of course).
  • In several spots, the author implies that HIS specific eating and exercise program has been tested in research settings.  It hasn’t.

Mr. Bailor’s exercise prescription is the most exciting part of the book for me.  His review of the literature indicates you can gain the weight-management and health benefits of exercise with just 10 or 20 minutes a week.  NOT the hour a day recommended by so many public heath authorities.  And he tells you how to do the exercises without a gym membership or expensive equipment.  That 20 minutes is exhausting and not fun.  You have fun in all the hours you saved.  If this pans out, we’re on the cusp of a fitness revolution.  Gym owners won’t be happy.  Sounds too good to be true, doesn’t it?

One component of the exercise program is high intensity interval training (HIIT), which I’m recently convinced is better than hours per week of low-intensity “cardio” like jogging. Better in terms of both fitness and weight management.

The resistance training part of the program focuses on low repetitions with high resistance, especially eccentric slow muscle contraction.  This is probably similar to programs recommended by Doug McGuff. John Little, Chris Highcock, and Skyler Tanner.  I’m no authority on this but I’m trying to learn.  By this point in the book, I was tired of looking up his cited references (76 pages!).  I just don’t know if this resistance training style is the way to go or not.  I’ll probably have to just try it on myself.

I admire Mr. Bailor’s effort to digest and condense decades of nutrition and exercise research.  He succeeds to a large degree.

Steve Parker, M.D.

Comments Off on Book Review: The Smarter Science of Slim

Posted in Diet Reviews

Tagged , , , ,

Book Review: The Blue Zones

Posted on May 14, 2012 | 1 comment

Here’s my review of The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest, a 2008 book by Dan Buettner. I give the book four stars on Amazon.com’s five-star system (“I like it”).

The publisher donated three copies of The Blue Zones as give-aways, which I gave away to my blog readers.

♦ ♦ ♦

The lifestyle principles advocated in The Blue Zones would indeed help the average person in the developed world live a longer and healthier life. The book is a much-needed antidote to rampant longevity quackery. Dan Buettner’s idea behind the book was “discovering the world’s best practices in health and longevity and putting them to work in our lives.” He succeeds.

Mr. Buettner assembled a multidisciplinary team of advisors and researchers to help him with a very difficult subject. Do people living to 100, scattered over several continents, share any characteristics? Do those commonalities lead to health and longevity?

They studied four longevity hot spots (Blue Zones):

  • Okinawa islands (Japan)
  • Barbagia region of Sardinia (an island off the Italian mainland)
  • Loma Linda, California (a large cluster of Seventh Day Adventists)
  • the Nicoya Peninsula (Costa Rica).

Research focused on people who lived to be 100.

Until recently, two of the Blue Zones—the Nicoyan Peninsula and Sardinia—were quite isolated, with relatively little influence from the outside world.

Mr. Buettner et al identify nine key traits that are associated with longevity and health in these cultures. Of course, association is not causation, which Mr. Buettner readily admits. He draws more conclusions from the data than would many (most?) longevity scientists. Scientists can wait for more data, but the rest of us have to decide and act based on what we know today. Here are the “Power Nine”:

  1. regular low-intensity physical activity
  2. hari hachi bu (eat until only 80% full—from Okinawa)
  3. eat more plants and less meat than typical Western cultures
  4. judicious alcohol, favoring dark red wine
  5. have a clear purpose for being alive (a reason to get up in the morning, that makes a difference)
  6. keep stress under control
  7. participate in a spiritual community
  8. make family a priority
  9. be part of a tribe (social support system) that “shares Blue Zone values”

Of these, I would say the available research best supports numbers 1, 4, 7, 8, and the social support system.

I doubt that hari hachi bu (eat until you’re only 80% full) will work for us in the U.S. It’s never been tested rigorously. The idea is to avoid obesity.

The author believes that average lifespan could be increased by a decade via compliance with the Power Nine. And these would be good, relatively healthy years. Not an extra 10 years living in a nursing home.

Appropriately and early on, Mr. Buettner addresses the issue of genetics by mentioning a single study of Danish twins that convinces him longevity is only 25% deterimined by genetic heritage. Environment and lifestyle choices determine the other 75%. I believe he underestimates the effect of genetics.

Over half the population of the Nicoya Peninsula Blue Zone are of Chorotega Indian descent, not from Spanish Conquistadores. Would a Danish twin study have much to say about Chorotega Indians’ longevity? We don’t know, but I’m skeptical. Also, the Sardinians and Okinawans would seem to have centuries of a degree of inbreeding, too, according to Buettner’s own documentation.

Do the Adventists tend to marry and breed with each other (like Mormons), thereby concentrating longevity genes? You won’t find the question addressed in the book.

Because I think genetics plays a larger role in longevity than 25%, I’d estimate that the healthy lifestyle choices in this book might prolong life by six or seven years instead of 10. But I’m splitting hairs. I don’t have any better evidence than Mr. Buettner, just a hunch plus years of experience treating diseased and dying patients.

These four Blue Zones do share a mostly plant-based diet of natural foods with minimal processing. Two of the populations—the Okinawans and Costa Ricans—didn’t seem to have any choice. Heavy meat consumption just wasn’t an option available to them. Rather than promoting a low-meat plant-based diet, it might be more accurate to conclude that “you don’t have to eat a lot of meat, chicken, or fish to live a long healthy life.”

In other words, it may not matter how much meat you eat as long as you eat the healthy optimal level of fruits, vegetables, and whole grains. It’s a critical difference not addressed in this book except among the Adventists.

Even if you could live an extra two years as a vegan, I’m sure many people would choose to eat meat anyway. By the way, this book conflates vegan, lacto-vegetarian, lacto-ovo vegetarian, near-vegetarian, and vegetarian into one: vegetarian. They are not necessarily the same. It’s a common problem when considering the health aspects of vegetarianism.

By the same token, plenty of my patients have told me they don’t like any kind of exercise and they won’t do it, even if it would give them an extra two years of life. What many don’t realize is that from a functional standpoint, regular exercise makes their bodies perform as if they were ten years younger. There’s a huge difference between the ages of 80 and 70 in terms of functional abilities.

Why read the book now that you have the Power Nine? To convince you to change your unhealthy ways, and indispensible instruction on how to do so.

Steve Parker, M.D.

Disclosure: The publisher’s representative did not pay me for this review, nor ask for a favorable review. They offered me a review copy and three give-aways, and I accepted. I figure the cost of the books to the publisher was $16 USD total.

1 Comment

Posted in Diet Reviews, Longevity

Tagged , ,

Book Review: Why We Get Fat

Posted on April 26, 2012 | Comments Off on Book Review: Why We Get Fat

Gary Taubes’ latest book is Why We Get Fat: And What To Do About It. I give it five stars per Amazon.com’s ranking system (I love it).

♦ ♦ ♦

At the start of my medical career over two decades ago, many of my overweight patients were convinced they had a hormone problem causing it. I carefully explained that’s rarely the case. As it turns out, I may have been wrong. And the hormone is insulin.

Mr. Taubes wrote this long-awaited book for two reasons: 1) to make the ideas in his 2007 masterpiece (Good Calories, Bad Calories) more accessible to the public, and 2) to speed up the process of changing conventional wisdom on overweight. GCBC was the equivalent of a college-level course on nutrition, genetics, history, politics, science, physiology, and biochemistry. Many nutrition science geeks loved it while recognizing it was too difficult for the average person to digest.

Paradigm Shift

The author hopes to convince us that “We don’t get fat because we overeat; we overeat because we’re getting fat.” We need to think of obesity as a disorder of excess fat accumulation, then ask why the fat tissue isn’t regulated properly. A limited number of hormones and enzymes regulate fat storage; what’s the problem with them?

Mr. Taubes makes a great effort convince you the old “energy balance equation” doesn’t apply to fat storage. You remember the equation: eat too many calories and you get fat, or fail to burn up enough calories with metabolism and exercise, and you get fat. To lose fat, eat less and exercise more. He prefers to call it the “calories-in/calories-out” theory. He admits it has at least a little validity. Problem is, the theory seems to have an awfully high failure rate when applied to weight management over the long run. We’ve operated under that theory for the last half century, but keep getting fatter and fatter. So the theory must be wrong on the face of it, right? Is there a better one?

So, Why DO We Get Fat?

Here is Taubes’s explanation. The hormone in charge of fat strorage is insulin; it works to make us fatter, building fat tissue. If you’ve got too much fat, you must have too much insulin action. And what drives insulin secretion from your pancreas? Dietary carbohydrates, especially refined carbs such as sugars, flour, cereal grains, starchy vegetables (e.g., corn, beans, rice, potatoes), liquid carbs. These are the “fattening carbs.” Dozens of enzymes and hormones are at play either depositing fat into tissue, or mobilizing the fat to be used as energy. It’s an active process going on continously. Any regulatory derangement that favors fat accumulation will CAUSE gluttony (overeating) or sloth (inactivity). So it’s not your fault.

What To Do About It

Cut back on carb consumption to lower your fat-producing insulin levels, and you turn fat accumulation into fat mobilization.

Before you write off Taubes as a fly-by-night crackpot, be aware that he’s received three Science-in-Society Journalism Awards from the National Association of Science Writers. He’s a respected, professional science writer. Having read two of his books, it’s clear to me he’s very intelligent. If he’s got a hidden agenda, it’s well hidden.

One example illustrates how hormones control growth of tissues, including fat tissue. Consider the transformation of a skinny 11-year-old girl into a voluptuous woman of 18. Various hormones make her grow and accumulate fat in the places we now see curves. The hormones make her eat more, and they control the final product. The girl has no choice. Same with our adult fat tissue, but with different hormones. If some derangement is making us grow fatter, it’s going to make us more sedentary (so more energy can be diverted to fat tissue) or make us overeat, or both. We can’t fight it. At not least very well, as you can readily appreciate if look at the people around you at any American shopping mall.

This’N’That

Taubes’s writing is clear and persuasive. He doesn’t beat you over the head with his conclusions. He lays out a logical series of facts and potential connections and explanations, helping you eventually see things his way. If insulin controls fat storage by building and maintaining fat tissue, and if carboydrates drive insulin secretion, then the way to reduce overweight and obesity is carbohydrate-restricted eating, especially avoiding the fattening carbohydrates. I’m sure that’s true for many folks, perhaps even a majority.

If you’re overweight and skeptical about this approach, you could try out a very-low-carb diet for a couple weeks or a month at little expense and risk (but not zero risk). If Mr. Taubes and I are right, there’s a good chance you’ll lose weight. At the back of the book is a university-affiliated low-carb eating plan.

If cutting carb consumption is so critical for long-term weight control, why is it that so many different diets—with no focus on carb restriction—seem to work, if only for the short run? Taubes suggests it’s because nearly all diets reduce carb consumption to some degree, including the fattening carbs. If you reduce your total daily calories by 500, for example, many of those calories will be from carbs. Simply deciding to “eat healthy” works for some people: stopping soda pop, candy bars, cookies, desserts, beer, etc. That cuts a lot of fattening carbs right there.

Losing excess weight or controlling weight by avoiding carbohydrates was the conventional wisdom prior to 1960, as documented by Mr. Taubes. Low-carb diets for obesity date back almost 200 years. The author attributes many of his ideas to German internist Gustav von Bergmann (1908).

Taubes discusses the Paleolithic diet, mentioning that the average paleo diet derived about a third of total calories from carbohdyrates (compared to the standard American diet’s 55% of calories from carb). My prior literature review found 40-45% of paleo diet calories from carbohydrate. I’m not sure who’s right.

Minor Bone of Contention RE: Coronary Heart Disease

Mr. Taubes provides numerous scientific references to back his assertions. I checked out one in particular because it didn’t sound right. Some background first.

Reducing our total fat and saturated fat consumption over the last 40 years was supposed to lower our LDL cholesterol, thereby reducing the burden of coronary heart disease, which causes heart attacks. Instead, we’ve experienced the obesity epidemic as those fats were replaced by carbohydrates. Taubes mentions a 2009 medical journal article by Kuklina et al, in which Taubes says Kuklina points out the number of heart attacks has not decreased as we’ve made these diet changes. Kuklina et al don’t say that. In fact, age-standardized heart attack rates have decreased in the U.S. during the last decade.

Furthermore, autopsy data document a reduced prevalence of anatomic coronary heart disease in people aged 20-59 from 1979 to 1994, but no change in prevalence for those over 60. The incidence of coronary heart disease decreased in the U.S. from 1971 to 1998 (the latest reliable data). Death rates from heart disease and stroke have been decreasing steadily over the last 40 years in the U.S.; coronary heart disease death rates are down by 50%. I do agree with Taubes that we shouldn’t credit those improvements to reduced total and saturated fat consumption. [Reduced trans fat consumption may play a role, but that’s off-topic.]

I think Mr. Taubes would like to believe that coronary artery disease is either more severe or unchanged in the last few decades because of low-fat, high-carb eating. That would fit nicely with some of his theories, but it’s not the case. Coronary artery disease is better now thanks to a variety of factors, but probably not diet (setting aside the trans-fat issue).

Going Forward

Low-carb dieting was vilified over the last half century partly out of concern that the accompanying high fat consumption would cause premature heart attacks, strokes, and death. We know now that total dietary fat and saturated fat have little to do with coronary heart disease and atherosclerosis (hardening of the arteries), which sets the stage for a resurgence of low-carb eating.

I advocate Mediterranean-style eating as the healthiest, in general. It’s linked with prolonged life and lower risk of heart disease, stroke, dementia, diabetes, and cancer. On the other hand, obesity is a strong risk factor for premature death and development of heart disease, stroke, diabetes, and cancer. If consistent low-carb eating cures the obesity, is it healthier than the Mediterranean diet? Maybe so. Would a combination of low-carb and Mediterranean be better? Maybe so. I’m certain Mr. Taubes would welcome a decades-long interventional study comparing low-carb with the Mediterranean diet. But that’s probably not going to happen in our lifetimes.

Gary Taubes rejects the calories-in/calories-out theory of overweight that hasn’t done a very good job for us over the last 40 years. Taubes’s alternative ideas deserve serious consideration.

Steve Parker, M.D.

References:

Coronary heart disease autopsy data: American Journal of Medicine, 110 (2001): 267-273.

Reduced heart attacks: Circulation, 12 (2010): 1,322-1,328.

Reduced incidence of coronary heart disease: www.UpToDate.com, topic: “Epidemiology of Coronary Heart Disease,” accessed December 11, 2010.

Death rates for coronary heart disease: Journal of the American Medical Association, 294 (2005): 1,255-1,259.

Disclosure: I don’t know Gary Taubes. I requested from the publisher and received a free advance review copy of the book. Otherwise I received nothing of value for this review.

Disclaimer: All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status. Always consult your personal physician before making any dietary or exercise changes.

Update April 22, 2013:

As mentioned above, WWGF was based on Taubes’ 2007 book, Good Calories, Bad Calories. You may be interested in a highly critical review of GCBC by Seth at The Science of Nutrition.

Comments Off on Book Review: Why We Get Fat

Posted in Diet Reviews, Overweight & Obesity

Tagged , ,

Book Review: The New Sonoma Diet

Posted on April 14, 2012 | 1 comment

Last year I read The New Sonoma Diet: Trimmer Waist, More Energy in Just 10 Days, by Dr. Connie Guttersen, RD, PhD, published in 2010. Per Amazon.com’s rating system, I give it four stars (I like it).

♦ ♦ ♦

The New Sonoma weight-loss method works because it counteracts the major cause of overweight—excessive consumption of sugars and refined starches—through portion control. This Mediterranean-style program is likely to reap the major health benefits of the traditional Mediterranean diet: longer life and less chronic disease (heart attacks, strokes, high blood pressure, diabetes, dementia, and cancer).

The New Sonoma Diet: Trimmer Waist, More Energy in Just 10 DaysMost of the food recommendations herein are consistent with Monica Reinagel’s wonderful new book, Nutrition Diva’s Secrets for a Healthy Diet: What to Eat, What to Avoid, and What to Stop Worrying About. On Sonoma, you’ll eat natural, minimally processed, whole foods.

The primary improvements over the 2005 version of Sonoma are the time-saving and budget-saving strategies. The recipes are easier and quicker. I didn’t try any, but they sound yummy. Dr. Guttersen also exands the “Power Foods” from 10 to 12, adding beans and citrus fruit. I’m glad to see the author addressed many of my criticisms of her great 2005 book. I do miss the old refrigerator-ready pull-out depicting the subdivided plates.

Here’s a brief summary for those unfamiliar with Sonoma. There are three Waves. Wave 1 lasts 10 days and is supposed to break your addiction to sugar and refined flour. Wave 2 lasts until your weight-loss goal is reached, and provides more calories, wine if desired, and more variety. Wave 3 is the lifelong maintenance phase: more fruit and veggies, plus occasional sugary desserts, potatoes, and refined flour. Portion size is controlled either by following her exact recipes or through her plate method. Breakfast fits on a 7″ plate (or 2-cup bowl), while lunch and dinner are on 9″ plates, subdivided into various food groups such as proteins, grains, or veggies. Optional recipes are provided for Wave 1 and the first two weeks of Wave 2.

As in 2005, Dr. Guttersen doesn’t reveal how many calories you’ll be eating. My estimate for Wave 3 is 2000 a day. Less for the earlier Waves.

You’ll find indispensible information on shopping and food preparation. Keeping a food journal is rightfully promoted in certain circumstances. I like the discussion of psychological issues, mindful eating, dining out tips, and weight-loss stalls. The mindful eating portion reminded me of Evelyn Tribole’s Intuitive Eating: A Revolutionary Program That Works and Intuitive Eating: A Practical Guide to Make Peace with Food, Free Yourself from Chronic Dieting, Reach Your Natural Weight.

The author makes a few claims that are either wrong or poorly supported by the scientific literature. Examples include: 1) beans are linked to longer life and reduced heart disease risk, 2) grapes are almost as good as wine for heart protection, 3) the health benefits of spinach “border on the miraculous,” and spinach helps prevent inflammatory conditions such as arthritis and asthma, 4) whole grains prevent stroke, gastrointestinal cancer, and diabetes, 5) adding salt and butter for flavor is unhealthy, 6) medicinal qualities of herbs and spices are well documented, 7) saturated fats “are found exclusively in highly processed food products,” 8) you’ll break a lifetime craving for sugary sweets in Wave 1, 9) 64 ounces of water a day is ideal, 10) exercise significanlty helps most people with weight loss, 11) low-carb eating cannot be maintained because it’s unhealthy and unsatisfying, and 12) saturated fats raise the risk of heart disease.

Much of the book reads like an infomercial; at times I even wondered if it was ghost-written by a marketing professional. The author is unflaggingly optimistic. The testimonials would have more credibility if attributed to full names, not just “Betty” or “Bill.” She overstates the health benefits of the individual Power Foods, which are all plant-derived. I’d like to see cold-water fatty fish on the list.

Dr. Guttersen has great faith in observational studies linking specific foods to health outcomes; I have much less faith. Such studies are far from proof that specific foods CAUSE the outcome. They’re just associations, such as swimsuit sales being linked to warm weather. Warm weather doesn’t cause folks to buy swimsuits; the desire to swim does.

Speaking of associations, a multitude of observational studies link whole grain consumption with 20-25% lower risk of heart disease. We may never have proof of cause and effect because the appropriate study is so difficult. Sonoma recommends two whole grain servings a day, which is the heart-healthy “dose” supported by science.

The author’s discussion of exercise is improved over 2005’s, but is still minimal. Why not refer readers to respected Internet resources? We agree that exercise can help with weight-loss stalls and long-term maintenance of weight loss.

Overall, this is one of the healthiest weight-loss programs available. The average person won’t go wrong with Sonoma. In fact, Sonoma-style eating may be the healthiest of all for the normal-weight general public, with the exception of its avoiding saturated and total fat.

Steve Parker, M.D.

1 Comment

Posted in Diet Reviews

Tagged , ,