Sunday, June 24, 2012

The Starch Solution: Eat the Foods You Love, Regain Your Health, and Lose the Weight for Good!, by John McDougall

If you want to improve your odds of living without the symptoms of chronic disease, presented from a honest, fact and research based, non profit -oriented perspective that is focused only on your health, then read this book.

The punchline is in the title:  humans can optimize their health through a starch -based diet.  For example, rice based (as in many Asian cultures) or root vegetable based (e.g., potato) (as in some Latin American cultures).   So instead of saying:  "don't eat animal proteins for health reasons and here's your unsatisfying salad," Dr. McDougall might say "don't eat animal proteins for health reasons and here's your quite satisfying bowl of rice decorated with an assortment of vegetables."

Throughout the book Dr. McDougall posits a simple question:   is there truth in what we hear about healthy eating from advertisements (like "milk makes bones healthy") or from the USDA (the food pyramid)?   Finding the answer requires wading through an enormous number of research papers published internationally.   Finally, once he identified fact based positions, how could he present this information to the general public who would not be inclined to read medical research papers?    This book is the outcome (with tons of references for those of us who actually like to read the research reports).

Probably most folks would be surprised by the facts, and even more folks wouldn't like the facts because they're not fun.   (Just like smokers who'd rather not hear the facts about smoking and lung cancer, for folks who've spent their lives enjoying cheese products, they'd probably prefer to just not listen to the facts about them.)

Here's a sample (the editorializing tone is more mine than Dr. McDougall's, although I doubt he'd change much):

  • Milk does not "do a body good."   It is really bad for you (unless you're a calf).   As for the calcium scare, you don't need milk (nor supplements) for calcium.  In spite of all the advertising (which also influences our physicians, if like most they are not nutritionists). 

    Calcium is a mineral; it is not generated by the cow.   The cow eats vegetation, and picks up its minerals through its food, which then make their way to its milk.    Bottom line:  the bad that milk does outweighs any good, and calcium isn't an issue if you eat even a small amount of healthy vegetables.

    Why does this seem so unbelievable?   Because the dairy industry spends tens of millions of dollars each year on advertising, which then enters the popular belief system.   Advertising from folks who make a profit on a product should not be assumed to be accurate.   Ask the Marlboro man.

  • The US Department of Agriculture (USDA) publishes the food pyramid (renamed the food plate recently); how could we doubt that the government has our best interests in mind?    The USDA serves the agriculture industry.   Many decades ago, when family farms were a norm in America, they served a large portion of our population.   Today, when agribusiness's massive firms control the bulk of American agricultural production, the USDA leadership (not the helpful employees; our local USDA guys provide excellent assistance to small farmers and ranchers) largely serve big business.  

    You might be surprised that lawsuits filed against the USDA have been won, pointing out the hidden connection between lobbyists and USDA decision makers (or the revolving doors between big business and the USDA appointments).

    Bottom line:  the USDA dietary advice is neither accurate nor helpful.

  • Supplements, from vitamins to flax seed to Omega acids, are largely unnecessary.  But they're profitable.
You can see the many problems that Dr. McDougall faces.   He's trying to use facts to fight the misinformation generated by huge advertising and lobbying budgets.  The medical establishment, either through the profit motive of current practice and pharmacology or through the ignorance of the body of research, is at best disinterested in the topic.   And worst, he's telling us the facts, which aren't particularly fun for folks who've invested a lifetime of enjoyment of cheeseburgers, yogurt, or mac and cheese!

In spite of these obstacles, Dr. McDougall does an excellent job of minimizing the ranting, maximizing the clear and straightforward presentation of facts, and providing impeccable scientific references.

His publisher probably figured out the orienting this book towards weight loss would help sell more copies.  But it is really about extending quality of life without chronic illness.   That's probably why folks like Dr. Caldwell Esselstyn (whose famous work at the Cleveland Clinic includes showing that diet can reverse heart disease) and Dr. Neal Barnard (of the Physicians Committee for Responsible Medicine) are supporters.

I'll diverge to say more about Dr. Esselstyn.  Because while Dr. Barnard does outstanding work, sometimes his association with people who avoid animal products on an ethical basis can cause folks to ignore his strong, research -based and anti -big business efforts.   In contrast, publically Dr. Esselstyn is all and only about providing beneficial, fact based health care to his patients.

Consider his 2010 editorial in The American Journal of Cardiology,106-6, , was titled "Is the Present Therapy for Coronary Artery Disease the Radical Mastectomy of the Twenty-First Century?" It is a scientific attack on the profitable and neo-traditional approach of surgery for heart disease.   The American Journal of Cardiology charges a hefty fee for a reprint, but you can read the article for free, here.   Here are some of his opening paragraphs, footnotes removed, and emphasis mine:

"To fully grasp how so many smart, right-minded people could get it so wrong, it might help to start with a quick review of medical history. Take the radical mastectomy, conceived by William Halsted in the late 19th century. The procedure was intended to remove all cancer cells of the breast, the overlying skin, the underlying muscle, and regional lymph nodes (Figure 1). It was mutilating, permanently disfiguring, and no more effective than less radical, less disfiguring procedures.
Still, because of the prestige and respect Halsted commanded as a teacher of surgeons, his disciples defended and taught the radical mastectomy at the most revered medical colleges. His extreme surgery was perpetuated for almost a century, until challenges by courageous physicians in Europe and America, along with a prospective randomized study by Dr. Bernard Fisher, finally sounded the death knell of this standardized surgical error of the century.
The 21st century analogue to this unfortunate chapter is the interventional and pharmaceutical treatment of coronary artery disease. This approach results in significant mortality, morbidity, and unsustainable expense. Neither the procedures nor the drugs that accompany them treat the cause. Standard care for coronary artery disease is nothing more than palliative. The purveyors of this treatment acknowledge that it is but a stopgap therapy.
And as in the case of the radical mastectomy, there is a far more effective, cost-effective, and sustainable treatment. It’s simple: advocate a lifestyle of plant- based nutrition, make a bold leap toward a world free of heart disease, and lessen our use of scalpels and drugs."

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