Friday, December 2, 2016

How Not to Die, by Michael Greger

This is a terrific book, albeit at times a bit overwhelming. Dr. Greger's gig is medical research into the potential to improve health and /or reduce disease through nutrition. His website, is a phenomenal resource with brief and amusing videos that summarize research on a variety of topics.

This book summarizes years of research and review into two sections: how to minimize your risk of a variety of diseases, and how to adjust your lifestyle to maximize health and minimize risk.

To be clear, Dr. Greger, like a few other medical leaders (I'm thinking folks like Dr. Alan Goldhamer, Dr. John McDougall, Dr. Caldwell Esselstyn, Dr. Dean Ornish), is disruptive, pushing the current medical norms to recognize the potential of nutrition on disease.

Dr. Greger quotes Dean Ornish on this: "[he] realized reimbursement is a much more powerful determinant of medical practice than research."

Fighting consensus thinking doesn't make these folks wack-jobs: think about the history of medicine. I'll give you a couple of examples just in case you're skeptical:
In the 1700s, one woman in six died of fever after childbirth. That's a lot of dead moms. In 1795, Alexander Gordon said the fevers were infectious and could be cured. Consensus thinking said he was a fool. In 1843, Oliver Wendell Holmes said similar, with evidence. Ignored. Most disturbing, in 1849, Ignatz Semmelweiss showed that sanitation (physicians dipping their hands in a disinfectant between the autopsy room and the delivery room) eliminated puerperal fever entirely. You'd think that was heroic. The consensus said he was mad, not to mention a Jew, and fired him from his job. (He died in an insane asylum.)  It took until the start of the 20th century (Dr. Lister was presumably a better politician) for doctors to accept this information. There are plenty of other examples, like pellagra. But you get the idea. Just because something is "normative" in medicine doesn't mean it is best for the patients.
Of course, just because something is fringe doesn't make it good either: the key is evidence based analysis, where one accounts for motives (e.g., was a study funded by an industry with billions at stake?) and quality (e.g., was the study well run?). This is precisely Dr. Greger's specialty.

In part two of his book, Dr. Greger presents his "daily dozen:"  beans, berries, other fruits, cruciferous vegetables, greens, other vegetables, flax seeds, nuts, spices, whole grains, beverages, and exercise.

Really though, this section is a bit much. I might just not be ready to run my daily menu through a checklist.

One other complaint about Dr. Greger's work: he tends towards reduction-ism. As T. Colin Campbell points out, current research gets so engaged looking for the magic chemical (that a pharmaceutical firm can market at profit) that it forgets the holistic nature of unprocessed plant based foods. To this end, Dr. Campbell points out that researchers might notice that apples seem like healthy eating.  They notice there's vitamin A in an apple.  So they look at the health effects of vitamin A, with a goal of making a vitamin A pill that will provide the healthy effects.  Presumably without the hassle of eating the apple.  But, unfortunately, all sorts of systems get in the way of this working out the way a pill lover might like.

All in all though, this is worth reading. If nothing else, for the preface and introductory chapter.

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