nutritionwonderland

Category: Book Reviews

  • Why the SOLE Food Movement is Failing

    Why the SOLE Food Movement is Failing

    friend of mine sent me an article from a publication called Zocalo that reviews American Terroir: Savoring the Flavors of Our Woods, Waters, and Fields by Rowan Jacobsen.

    A good book but it only makes things harder

    I’m not going to review this title (you can read the one from the Zocalo here) nor am I going to pick on Jacobsen. I’m sure his book is an interesting take on terroir foods as he calls them, picking up where Pollan’s Botany of Desire left off. What I am going to do is explain why I think this book represents another step backwards in gaining wider acceptance of SOLE foods.

    The Issue

    You may not even know what SOLE food stands for (its Sustainable, Organic, Local and Ethical Food) but that’s not even the problem. See, in the US and most of the developed world now, we have crushing obesity and diabetes epidemics going on. The latest obesity numbers released by the CDC should give everyone pause: the US obesity rate is over 30% now, with some states climbing to almost 35%. Stop and take that in for a moment. Just about every third person in the US is now more than 30 pounds over their ideal weight.

    In the face of this monumental health crisis, related directly to food, a group of young, mostly urban dwelling Americans has taken it upon themselves to do something about it and change the food system. This fractious group is composed of some well-meaning professors, chefs, environmental activists, food writers, farmers and maybe even a nutrition blogger or two.  As with any movement, it has many sides. Unfortunately, the side that usually shows with the food movement is one of striking elitism, often so detached from why this issue exists in the first place that I’m often surprised at the amount of progress that has been made.

    Now, I don’t mean to pick on Jacobsen or the reviewer Christine C. Chen; this Zocalo piece is just one I have read out of literally hundreds that strike this exact same chord of elitism that needs to be addressed. The tone these articles create is similar to commenting on how nice the paint on the Titanic looks as the ship was sinking. I think it would instructive to take a look at the people on the ship for a change.

    How Elitism is Counterproductive to Better Food

    Say you live in Indiana, are supporting a family of four, your spouse is a nurse and you work construction. You’ve had a couple brushes with unemployment but for the most part you are making ends meet. Both of you are in your mid-40s and easily twenty pounds overweight, prime candidates for slipping into the obese category. Now, you notice your kids are following in your footsteps, heavier than they should be. You start investigating bringing different foods into their both of your diets. (This is a large part of America, by the way.)

    You hear about this organic, local food thing from a neighbor and are interested in how it might help your family. You start poking around online and this is what you read (from the Zocalo piece):

    As with so many other things in the gastronomic galaxy, the English-speaking world adopted the term [terrior] from the French, who had more than just geography and geology in mind when they coined it. Terroir, from the Latin for “earth,” signifies more than “a taste of place.” It also conveys “a partnership between person, plant, and environment to bring something unique into the world.” Terroir is more than just the soil in which the grapes are grown or the village which lends its name to a wine; it’s the fullest, most concentrated expression of a person’s interaction with the land on which he or she lives.

    “Huh? What language is that in?” you might think. So you look around some more. This is from the New York Times 10.10.10 Food Issue this Sunday. Here is Michael Pollan describing a 36 Hour Dinner Party (seriously):

    The idea is to make the most efficient use of precious firewood and to keep the heat (and the danger) of the cook fire some distance from everybody’s homes. But what appeals to me about the tradition is how the communal oven also becomes a focus for social life (“focus” is Latin for “hearth”), a place to gather and gossip and escape the solitude of cooking at home. Shared meals have always been about community, about what happens among family and friends — even enemies — when they gather around a table to eat; but once upon a time, before every family had its own kitchen in which Mom labored more or less alone, cooking was itself a social activity, one that fostered community and conversation around the chopping board or cook fire long before the meal was served.

    I could post other essays here but the point is already apparent: if you are that guy from Indiana, this party is not yours. The conversation is about becoming one with the soils around you and throwing 36 hour dinner parties of locally sourced food in Napa valley, not about feeding a family of four on a limited budget. Never is any of the food featured in these articles sourced from a grocery store, the one place the majority of the country buys its food.

    The priorities of the agenda-setting side of the food movement are so out of step with what people facing these crippling chronic diseases need to hear that the two never even intersect. And, on the oft chance the foodie elite run into the middle class working family, the message is so distant that is might as well not even have been spoken.

    In short, local food is a message divorced from its audience.

    How Do You Fix This?

    The issue facing a broad adoption of the locally sourced, organic foods is mostly related to supply chains and cost, not a deeper understanding of man’s connection to the soil. While having an appreciation for where our food comes from matters, what is far more important is reform of the agricultural subsidies that have created this situation. Further, we need to create more efficient markets that lower the price of these foods. You’ll hear these discussions but much more infrequently (see James McWilliams at the Atlantic, he picks up on some of this).

    Instead, when you read these locavores your options seem to be: start a large garden, inherit some money and go on a food quest to get in touch with the earth, throw a 36 hour dinner party or potentially go ‘woofing’ on organic farms. At times it would appear as if the local food movement would like most American to revert back into becoming subsistence farmers, living off the land as did our ancestry hundreds of years ago.

    That’s not an option and it shouldn’t have to be. The real issue comes back to money: SOLE food needs to come down in price. That can happen with greater volume and subsidy reform, not 36 hour dinner parties. It will be hard work to get the country back to eating nutritiously again which is why it it is so foolish to drag food into the culture wars by constantly enforcing the idea that eating well is something only rich people can do. It seems there is no better symbol of something that ties everyone together. Maybe it’s time for the food movement to appreciate this fact.

  • Book Review: The Fluoride Deception by Christopher Bryson

    Book Review: The Fluoride Deception by Christopher Bryson

    “Pain in the abdomen. Splitting Headache. Nausea and vomiting. Choking and couldn’t get their breath. Coughing up blood.” Phone calls like these broke the dawn of a fall day in the mill town of Donora, Pennsylvania back in October, 1948. Already two had died and another 18 were soon to follow. The death toll would have been far higher if not for a couple brave firemen filling oxygen tents as quickly as they could. Still, no one was quite sure what was going on. Only later would it be discovered that the thick smog covering this Appalachian valley was due to a severe temperature inversion. Its killer characteristic? Fluoride.

    The Fluoride Deception’s Cover

    Few public health issues in American history have riled people quite like fluoride. Its story is replete with famous figures in American history, dramatic tales from the Manhattan Project, corporate cover-ups, redacted research, shattered careers of those that spoke against it’s use and the tragedy at Donora in 1948. The tide that binds all these accounts together is a fascinating book called, “The Fluoride Deception” by Christopher Bryson. His work paints a picture with enough intrigue to be nominated for an Oscar but remains deftly aware of itself long enough to stay away from hyperbole – most of the time at least.

    Fluoride, The Way Low Down

    The Fluoride Deception by Christopher Bryson

    Bryson takes his readers on an exhaustive journey of the molecule through the eyes of those that have known it first hand. We learn the perils of researching the subject from carefully placed protagonists like scientist Dr. Phyllis Mullenix, whose entire career was derailed by publishing information about fluoride’s neurotoxic effect at disturbingly low concentrations [1], and Kah Eli Roholm, a Danish pioneer in the research of fluoride’s effects and publisher of the groundbreaking work, Fluorine Intoxication [2], back in 1937. Shady, villain-like characters named Dr. Harold Carpenter Hodge and Dr. Robert A. Kehoe act as provocateurs in the background, silently pushing a pro-fluoride agenda with their work – at the behest of the Department of Defense’s Manhattan Project and major fluoride users like US Steel and Alcoa.

    Intrigue is definitely a current running through the text – and it helps readability. Bryson works hard at establishing the links between the industrial uses of fluoride and its eventual role in water fluoridation. His case is circumstantially strong as the middle of the book describes the legal wrangling mill workers would endure to get compensation from corporations using fluorides industrially in the workplace. But what comes away as the most surprising aspect of his account is how the type of fluoride used in water fluoridation is actually just fluosilicic acid, a toxic byproduct of aluminum smelting and other heavy industrial processes. It becomes clear here that the waste is being dumped into the water supply in lieu of having to dispose of it in some other way.

    Given most people’s proclivity for considering fluoride as a beneficial tooth decay reducer, his evidence is both striking and damning. You can reserve judgment temporarily against toothpaste, as it uses sodium fluoride as its preferred molecular combination – not fluosilicic acid, but still take a moment with the thought of people using the water supply as a dumping ground. For just for this insight alone, you would be remiss not to pick up the title. However, for those of you with a scientific nose, it is the moment just after you make the connection between water fluoridation and fluoride’s industrial uses that will both haunt and fascinate you as the book continues. It will also be the moment after which this book’s value to the discussion notably decreases.

    Crying for More, Crying for Less

    Once you wrap your head around the arguments Bryson is making in the book, it starts to fit the vicious battle some people wage against water fluoridation. For the most part, the battle against fluoride is mostly a cold war, although the occasional community, like Southampton in the UK recently, will organize itself in protest of water fluoridation. Frankly, it’s amazing more hasn’t been said here in the US about its use, although there is certainly an underground resistance to its use, spearheaded by the Fluoride Action Network.

    Part of the reason for mass acceptance of fluoridation has been the glowing endorsements given to it by the American Dental Association and the CDC, with the CDC calling water fluoridation ‘one of the ten greatest public health victories of the 20th century‘. The FDA even allows bottled water products that use fluoride to market health benefits from its use.

    Dr. Frederick McKay, the first person to make the connection between fluoride and cavities

    This evolved agency view comes from a series of observations by Dr. Frederick McKay throughout the early 1900s that showed areas in the Western US, where calcium fluoride levels in the water are naturally higher, exhibited stained teeth with far less decay than areas with less fluoride in the water [3]. Landmark studies corroborated these views, especially the 1945 study involving the first test case in Grand Rapids, Michigan that showed adding sodium fluoride to water resulted in up to 54% fewer cavities [4].

    All of this early science on the subject was an issue Bryson mostly avoids, to the book’s detriment. In fact, the way the science is presented is confusing. Fluorides are brought up haphazardly and never fully explained. What are chemical differences between fluoride (the ionized molecule), fluorine (the element), fluoride salts (the compound found in toothpaste), calcium fluoride (naturally found in water) and fluosilicic acid (the waste product often added to fluoridate water)? Given the science we have on fluoride’s neurotoxic effects, could it play a role in the autism epidemic? How does this relate to ADHD, Alzheimer’s, MS – or any neurological disorder for that matter? Fluoride ions have an affinity for calcium in bones, how does fluoridation relate to osteoporosis? The audience desperately needs these type of answers but we never get them.

    What we need is a more nuanced dialogue about the role of fluoride in the body, not less. Bryson should have embraced the controversy a bit more here and explained these different avenues of thinking instead of simply leaving the science of his opposition out of the text. It severely detracts from what this book could be.

    Science Developing Further, Disturbing Conclusions*

    Fluoride science has evolved further since this work was published back in 2006. There are now epidemiological studies examining the role of fluoride and bone fractures, with mixed results in low exposures (like the 1ppm rates CDC aims for in US public water system fluoridation) but more conclusive, damaging results in slightly high 2-4ppm window [5]. It’s still unknown which ethic groups could be most at risk from bone fractures though. More disturbing has been the development of studies that confirm fluoride (along with arsenic) has serious effects on the brain [6, 7, 8], lowering IQ in SE asian children. Again, these effects are seen in the higher 2-4ppm samples of fluoride, rather than the 1ppm exposures most Americans are seeing, but any time a substance causes neurological damage further study should be considered mandatory.

    Advancing from this epidemiological base, one Chinese study group has recently isolated fluoride’s neurotoxic target as the hippocampus in the brain [9, 10], giving future researchers a tangible ‘fluoride pathogenesis’ to work with here. The hippocampus governs many of the higher cerebral functions of humans like memory storage and spatial orientation; any damage to it could cause a number of different, severe neurological issues – similar to the epidemiological observations showing impacts to IQ from SE Asia.

    Even before this new evidence was published, the EPA and the National Academy of Sciences have been reexamining the data surrounding water fluoridation since 2006 . The EPA sets a maximum contaminant level (MCL) and a secondary maximum contaminant level (SMCL) for all water contaminants; effectively the MCL is the ceiling and SMCL is the least amount allowed. For fluoride that range has long been 2-4 mg/L in drinking water but the National Academy agreed that skeletal issues were found from fluoride exposures at levels as low as 1.5 mg/L, nearing the CDC’s water fluoridation targets of 1ppm.

    *We would like to note that 1ppm is equivalent to 1mg/L and they are often used interchangeably in the research. It should also be noted the National Academy mentioned they choose not to examine fluoridation’s effects at .7 – 1.2 mg/L – the CDC’s target range – for reasons that go unmentioned but could easily be implied. Further, all figures here are per liter fluoride exposures that downplay the actual fluoride exposures many people will be exposed if they follow the Institute of Medicine’s (IOM) 3.7L/day water intake recommendation. Taken together, the average CDC fluoridated water range exposure (.95mg/L) multiplied by IOM’s average daily water intake (3.7L) would give the average American 3.515 mg worth of daily fluoride exposure – a figure that falls in the National Academy’s range for concern for skeletal problems and the recent IQ-reducing fluoride exposures from the Chinese study group mentioned above.

    Moving Through the Fog

    We gave you an overview of science surrounding fluoride here because it is complex – and evolving – but the fact Bryson remained silent on the matter, only pounding the conspiratorial angles of this drama, strikes us as foolish. While that makes for a juicy read, storming Alcoa for reparations will not help well-meaning scientists establish fluoride’s true toxicity. Echoing Bryson’s sentiments, we do agree that the industry connections are important to understanding the depths of this story. The fact CDC, FDA and ADA all remain in lockstep behind water fluoridation, even in the face of this new science, is disturbing. And for all we know, the avoidance of fluoride science could have been an editorial decision on his part or his publishing company but, with such charged subject matter, that was an exceedingly poor choice. We just wish he had done more to further the conversation, just as we wished Food Inc. had extended the sustainable agriculture dialogue in a meaningful way (it did not).

    You could easily question Bryson’s objectivity when you read the book but you shouldn’t. Large passages pull from Bryson’s muckraking journalism background and you can almost feel the resentment he has towards those that have fluoridated our water. But he keeps himself in check very well. This stance creates a tone that is both a strength and weakness for Bryson. If you gravitate towards social justice issues, you will soak up this book’s charged approach; the more scientifically minded amongst you might find his angles off putting and his lack of science infuriating. We were somewhere in the middle, we found ourselves enjoying his style but longing for a more exhaustive scientific review somewhere in the text.

    In general, Bryson does a masterful job of weaving political intrigue into an exceedingly readable text considering the subject matter. He creates a story with genuine heroes and villains you may find yourself thinking about long after you put the title down. Experts will surely find fault with Bryson’s work, especially on the scientific front, but if your only exposure to fluoride is the cursory knowledge of its presence in your toothpaste or water, you would be wise to visit this text. We recommend it.

    Additional Resources:

    CDC’s List of New Fluoridated Water Supply Communities (aiming for 75% coverage by 2010):

  • Book Review: FoodSmart: Understanding Nutrition in the 21st Century

    Book Review: FoodSmart: Understanding Nutrition in the 21st Century

    FoodSmart Quickfacts

    FoodSmart: Understanding Nutrition in the 21st Century is a brand new book from award-winning author Diana Hunter that is designed to help navigate the complex world of nutrition. It explains basics like terminology and types of food with ease and, yet, is still able to present the various sides of much more complex topics like of GMOs (Genetically Modified Organisms) and what it means to be “organic” to a nutrition newbie. All and all, it’s not a bad book, especially if you’re just starting out in the world of nutrition and want a strong understanding of what is being talked about by everyone else. You will definitely learn a lot if you read this book, as it is jam packed with information that every nutritionally conscious consumer should know.

    Walk Before You Run

    For me though, this book had its ups and downs. On the positive side, it is chocked full of information, with as much knowledge on each page as an encyclopedia. But that’s also one of the book’s downfalls – it often reads like one, too, but lacks the handy tabs and user-friendly organizational format that encyclopedias have. It seems poorly organized at times (like explaining what “organic” is long after chapter upon chapter has already used the term), and over-structured at others (like pages and pages of pros and cons of different foods, which is just impossible to sit down and read through).

    The book does have many good qualities. For example, Hunter does an excellent job of going over the entire process of food production, from farm to store, explaining the different agencies involved, what they do, and why they do it. Her explanation of nutrition labeling, too, is excellent, and will make even those with no prior knowledge understand what phrases like “lite” actually mean. I wish some of these chapters were near the front instead of hidden at the end. Some of the best parts of this book were pushed to the back when they should have been up front. If you want my advice, read Chapters 1, 6, 7, 10, 12, 3 and 8 in that order first, then the rest of the chapters as you wish.

    The FoodSmart Cover

    Perhaps my biggest pet peeve was the attempt to give “good choices” while really not helping the casual nutritional consumer at all. The entire 30 page chapter on “conquering the confusion” which is supposed to provide guidelines for what to pick out in the grocery store could easily be replaced with the sentence “Always eat 100% organic or the closest you can get to it.”

    Let’s be honest – even the most basic nutritionally-minded consumer assumes that already, and either does eat all organic or can’t afford to. It’s not until much later that she even mentions which foods might be more important than others to eat organically (like those with more pesticide use) or what it really means to be “100% organic” versus “organic” versus “made from organic ingredients.” And that’s not even considering that organic may not always be the best option (I’ll promise to explain myself on that in another post).

    For me, the book shouldn’t have tried to act like a guide and just presented the facts. It would have been much better if Chapter 2 were completely removed. Leave out the “which to choose” (especially when there is no real advice given) and just present the detailed pros and cons of foods like in Chapter 4, though preferably much later in the book after explaining more of the basics (like what the different food types are, what “organic” is, and explaining nutritional labels). The addition of too much “what to pick” kind of thinking, especially early on, clouded the book’s goal of providing “clarity about the many aspects of food and bring to the table an understanding of nutritional research.”

    On the Upside…

    That’s not to say that it’s a bad book. One of the best parts of the book, in my opinion, was its clear and thorough explanation of why it’s not so easy to just say “this is good and this is bad” when it comes to nutrition. Diana Hunter explains exactly why there is so much variation in scientific studies on nutrition, why science doesn’t always give a clear answer even to a simple question, but yet why nutritional research is still very important. Sometimes it is just so hard to explain why two good scientists can get two different answers to nutritional questions, and she details the dilemma perfectly.

    The simple truth is that our bodies are complex and a lot of variables are in play, far too many for any experiment to control. As easy as it might sound to say “is X good for you,” the scientific answer is complicated and includes questions like ‘how often,’ ‘how much,’ ‘if produced by who,’ ‘if you eat Y with it,’ and so on, with each different permutation potentially giving a different answer. And, as I explained, she did do an excellent job of detailing the basics of nutrition and nutritional labeling.

    If your goal is to dive head first into the world of nutrition, this book has what you want. You will learn all the terminology you need to really start understanding some of the more complex nutritional articles out there as well as what all those symbols on packages in the store are really telling you. But if you just want to know what to buy when you go to the grocery store, you’re going to feel overwhelmed and still feel like you’re not sure what to get. It’s not a user-friendly nutritional guide for the masses, and it isn’t going to give you easy choices (except for ‘eat organic‘), nor should it be thought of as one. The book’s best quality is that it gives you the information to start making decisions for yourself, not just follow a step-by-step guide of what to eat.

  • Book Review: The Botany of Desire by Michael Pollan

    Book Review: The Botany of Desire by Michael Pollan

    Book Review: The Botany Of Desire

    Quick Facts on The Botany of Desire

    When looking for books about nutrition and eating, it’s hard not to stumble up Michael Pollan’s The Omnivore’s Dilemma and In Defense of Food. But this is not a review of those books. While both interesting and worth the a read by anyone nutrition-conscious, it is one of Michael Pollan’s other books that is one of the best books I’ve ever read, and simply I cannot bring myself to discuss In Defense of Food or Omnivore’s Dilemma when there is a more stunning work to be mentioned. Published in 2001, The Botany of Desire: A Plant’s-Eye View of the World is . It looks at the interplay between humans and plants. It’s not a nutritional guide, it’s an exploration of our own nature and, more importantly, the plants that exploit it.

    Yes, I said the plants that exploit us. Think about it this way. When we describe how a plant produces nectar so that a bumblebee will lands, drink the nectar from the flower, and in the process pollinates it, we look at is as a master manipulation of the plant. The plant has somehow taken advantage of the bee’s hunt for food to sexually reproduce. In The Botany of Desire, Pollan asks one simple question that leads to an incredible new world view of plants: “What existential difference is there between the human being’s role in this (or any) garden and the bumblebee’s?”

    Like Bees to a Flower

    The book centers around four plants that have excelled at exploiting our desires: Tulips, Potatoes, Apples and Cannibus. Each has succeeded spectacularly by appealing to a different desire of ours: tulips satisfy our desire for beauty, potatoes, for control, apples for sweetness, and cannibus for intoxication. By doing so, they have become four of the most widespread and readily recognizable plants in the world.

    Just think about the millions of tulips that travel around the world to end up a fixture of the suburban landscape, or the feeling of superiority we get from our complete domination of the potato in modern agriculture. Think of Johnny Appleseed, who spread a plant that evolved in Asia across the United States, leading to our current culture where 55 million tonnes of apples are grown worldwide every year, with a value of about $10 billion. Or, think of cannibus, better known as Marijuana: people literally risk their lives and kill for a weed. How can we look at these plants and think that they are anything but evolutionary masterminds?

    In general, we tend to give more credit to the wild species around us, as if they’ve achieved some feat that domesticated species have fallen short of by being unique, special and rare. But Pollan challenges this mental separation we make. What is truly the aim of a species in a broader sense – to be admired for its uniqueness, or to spread its habitat globally? The four plants he talks about have come to be grown on almost every continent in unbelievable quantities, and they have done it by producing compounds and characteristics that we find appealing. Is it really any different than producing nectar for a bee?

    The Book… and More!

    It’s a 304 page masterpiece clearly driven by Pollan’s own love for gardening and plants. Every chapter is packed with amazing information, hilarious anecdotes, and brilliant writing that makes it difficult to put down. It is sure to reshape the way you look at the plants around you, whether they be on our lawn or your plate.

    Botany of Desire Cover

    But, I’d be lying if I said I chose this moment to share this book with you randomly. In truth, there is another reason I wanted to tell you about this book today. I want to give you enough time to read the book before October 28th. Why then? Because PBS has decided to do a documentary centered around this book.

    The two hour feature will explore visually many of the amazing spectacles that Pollan talks about, from the potato fields Idaho to the apple forests of Kazakhstan. It will take us inside the bustling tulip markets in Amsterdam, which deal in the billion dollar flower industry, to the highly controversial medical marijuana plants in America. It follows the natural history of the four plants that have so exquisitely linked themselves in our cultures, and will compliment the book with fascinating images that you have probably never seen before.

    I highly recommend grabbing the book now, giving it a quick read, then catching the PBS documentary on October 28th! After all, the book is always better, but the movie is sure to be engrossing, entertaining, and eye-opening, too.

  • Book Review: Mindless Eating by Brian Wansink

    Book Review: Mindless Eating by Brian Wansink

    pon searching for research for my last article about the social aspects of eating, I stumbled upon a book with a very intriguing title. It’s called “Mindless Eating: Why We Eat More Than We Think“, and is written by a nutritional scientist by the name of Brian Wansink. He studies the psychology of eating, and has spent his career trying to understand the hidden cues that determine what and how much we eat.

    Mindless Eating Quick Facts

    It seemed like an intriguing concept: studying the little changes that make us “mindlessly” eat. And at under 300 pages, it is a quick easy read. It promised to show “why you may nor realize how much you’re eating, what you’re eating – or why you’re even eating at all” – a tall order for a short, pop-psych book. I figured if it even half delivered on that promise, it would be an interesting read, so I sat down and dove in. Here’s my thoughts on the book.

    One Word: Whoa

    This book is simply great. Amazon.com readers have given it the stellar rating of 4 1/2 stars, and I agree. It’s easy to read, completely intelligible, yet delves into the hard science behind psychological nutrition studies. I’m extremely impressed with how fluidly the author explains the science and the meaning of it. You don’t have to have a PhD to understand the research that has been done and what it found. And that’s a good thing, considering how unique and mindblowing the research is that he talks about.

    Does food with a brand name taste better? Yes, actually. Does the size of your plate change how much you eat? Um, yeah, it does. Do you change how you eat based on how others eat? Yep. Do you presume that there’s no way you fall into the same silly traps as everyone else? Yes, and yet you do.

    The key point that Wansink makes, in my opinion, is that no matter how smart you are, how much you think about food, or how carefully you think you make your decisions – you, too, mindlessly eat. We might acknowledge that others could be tricked, but not us. That is what makes mindless eating so dangerous. We are almost never aware that it is happening to us,” Wansink writes. He’s done studies using students who have just taken a 90 minute class on the subject, intelligent groups of people, experts in a particular profession, and even the very scientists who do the research themselves! All of them mindlessly eat and drink. No one is immune to these small, pervasive influences.

    However, that’s no reason to get all upset. Sure, give us a short, wide glass and we’ll drink more than if given a tall skinny one. We’ll eat more from a big package than a little one. But that means you have a way of changing your diet and your eating and drinking habits – just get taller glasses and eat from smaller packages. Throughout the book he gives simple tips that, if followed, allow you to eat and drink 100 less calories a day. 100 calories. That’s it. While it seems slight, it’s what he calls the ‘mindless margin’ – the amount you won’t notice you’re not eating.

    Food For Thought

    The Cover

    As I’ve told you before, your body reacts strongly to what it thinks is starvation – aka a sudden drop in food intake. It doesn’t really matter if you were eating too much before anyhow, your body freaks out and fights against our attempts at weight loss. I’ve warned of the physiological side effects of serious calorie cutting and crash dieting. It’s no surprise that Wansink, too, berates this behavior. The key to successful weight maintenance, he claims, is instead to shed pounds slowly by seemingly not changing a thing. To mindlessly lose weight instead of mindlessly gain it.

    And it makes sense, too. If you cut 100-200 calories out a day you’ll be able to drop about a pound a month without even trying. You’ll get slimmer without feeling deprived or frustrated. He suggests picking 3 changes and trying them for one month, tracking daily how you do. You don’t have to be perfect, but the daily, written reminder will help you get on track and follow your goals. After all, it only takes a month to change a habit – 28 days, according to scientists. So if you can make it the first month you’re much more likely to be able to continue it past that.

    Just imagine how great you would feel if you do that and eat a little healthier, too.

    I think that just about everyone I know can benefit from reading this book. As Wansink writes:

    “We may not be able to outlaw every drive-through restaurant or tax every pint of ice cream in our community, but we can re-engineer our personal food environment to help us and our families eat better.” While we may not be able to change all of the ways we mindlessly eat, we can change a few of them, and that’s enough to have a marked impact on our day to day lives. And in doing that, “we turn the food in our life from being a temptation or a regret to something we guiltlessly enjoy.”

    After all, as Wansink concludes, “The best diet is the one you don’t know you’re on.” I agree.

  • Book Review: Safe Food by Marion Nestle

    Book Review: Safe Food by Marion Nestle

    What if this latest peanut-salmonella outbreak in 2009 was completely preventable?  What if the procedures to prevent it were already in place?  Even worse, what if we didn’t even have a food safety system at all?

    NOTE: This article is the 2nd part of a series about Food Safety in the United States. You may want to read the first part to better understand this article:

    Part 1: Food Safety – A Recent History

    After reading Marion Nestle’s Safe Food, you will see the world of irony and contradiction finds a comfortable home in food safety.  Or should we say, a lack of food safety.  For it becomes painfully obvious in Nestle’s work that, in fact, we do not have a food safety system in the United States and a wide array of interests are actively working to keep it that way.

    Going Down to Get Up

    But before Nestle’s takes us down that dark road, we are introduced to this dysfunctional world very quickly with the story of how Starlink genetically modified corn made its appearance throughout the food supply in countries with bans on GMO crops.

    Quick Facts about this Title

    Her treatment of the subject acts as an interesting twist on the typical introductions you generally see with non-fiction books.  We meet all the players, agencies and of course trickery in a haphazard fashion, instead of having it all methodically laid out.  The method is good – because if you are thirsty for facts, it prepares you for the coming Thanksgiving-like feast.  An avalanche of professional observations and research accompanies every point in this book.  For better or worse.

    This style immediately establishes credibility and you will not find yourself asking whether or not the author is qualified to speak on the subject.  With a Ph.D. in molecular biology form UC Berkeley, a spot on the FDA’s Food Advisory Committee and Science Board and the USDA/DHHS Dietary Guidelines Advisory Committee, Marion Nestle does not really need a formal introduction to remind the reader she knows what’s going on – her prose does the job for her.

    And it’s Nestle prose that sets up an interesting dichotomy around which the entire book spins.  She breaks the world of food safety into two what we would call observational positions:

    • Science Based – ‘Benefits and Costs’
    • Value Based – ‘Fear and Dread ‘

    As she explains throughout the later parts of the book, parties involved with actually making food safe tend to view the situation in a purely scientific sense – ie, the benefits of GMO far outweigh the risks – whereas consumers in the general public use value based judgements – ie, the fear of what GMO could be outweigh the benefits.

    One of her central tenets is that the food makers need to satisfy the public’s value based concerns with the same perniciousness they purportedly apply to the science side of the equation – if we want to feel as if we have a safe food supply.  She claims this would go a long way to assuaging many people’s fears – an slightly provocative argument that would be a radical departure from how risks are currently evaluated.

    After the three – yes three – introductions, we get that the book contains two prominent sections and smaller rejoinder about pathogens, GMO crops and food terrorism, respectively.  But before you think she adopts such a staid format to the detriment of the book, keep in mind how explosive and controversial the subject matter she is dealing with really is.  Billions of dollars are the scale agribusiness operates on and Nestle handles each topic with the proper respect.

    After you find Nestle’s rhythm – which admittedly is not the easiest thing to do – the structure of the book fades away and you won’t find yourself burdened by it.  Other heavy lifting, however, is mandatory.

    Novel Concepts, Descriptive Means

    The cover…

    The book’s first section rips right into the meat of the issue, literally.  We get a first-hand account of the history of efforts and interventions that have been tried to implement a known protocol for ‘pathogen reduction’ called HAACP.  You’ll get a real sense of how much resistance there is on the part of industry to implementing these new controls.  Particularly disheartening was the section dealing with the government’s efforts to test ground beef for e.coli immediately before the Jack-in-the-Box outbreak of the early 90s.  From Page 77:

    “On October 14, the day before the rule for ground meat was to take effect, the federal court in Austin, Texas, issued an injunction that blocked the labeling plan, saying that the Jack in the Box outbreak was insufficient to justify ‘any departure from the normal rule-making procedures.’  Industry groups hailed the injunction as ‘a victory of fairness over bureaucracy.’  That very week, however, three children in Texas died from eating ground meat contaminated with E. coli O157:H7…”

    Similar tales of false starts and questionable means plague the history of food safety and Nestle pulls the curtains back in a fashion that is even and balanced.  You get the sense throughout her work that she, as an educator and public health advocate, is indeed enraged – even disgusted with the ways in which the system works but she never belies herself into a sycophant-like rage.  Instead, Nestle beautifully walks the tight-rope, delivering an objective review of the facts – a rare event in the charged world of food.

    GMO as Savior or Satan?

    Nowhere is this sensibility more pronounced than in the second part of her book, where she covers GMO crops.  Nestle gives her audience a good background on the issue and again dives into the core of the issue.  This time she focuses on the disconnect between researchers who better understand the mechanics of biotech foods and the consumers – reintroducing her dichotomy of science and value based arguments.  Particularly good is her chapter covering the ‘Politics of Consumer Concern’ – where she feels more comfortable in giving her opinion on the issues.  From Page 225:

    “What seems more surprising [about the food industry] is how much the industry’s unyielding opposition to labeling damages its own cause.  If public trust is the key to successful marketing, biotechnology companies should freely disclose their methods, economic goals, and products.”

    While she does give opinion, her treatment of the subject is really great because it, again, is able to show an objective view of the facts.  Sure, Nestle peppers her texts with her observations and opinions but she gives a fair shake to an industry she is usually in direct opposition to.

    The conclusion of the text is an applied section about how the politics of food safety play into bio-terrorism.  The section has a real strapped-on type feeling, especially considering how closely this book was published to the 9/11 attacks on the World Trade Center, mere blocks from her NYU teaching post.  Still, the section comes off as half-baked, possibly a move suggested by publishers to include a terrorism-related topic to move a few more copies in the wake of 9/11.

    Take the Good with the Bad

    Nestle covers all subjects thoroughly, at times too thoroughly.  Often complex analysis of super specific issues creates a significant hurdle to understanding the issues for most people outside of the world of nutrition and health.  You are constantly reminded as a reader that Ms. Nestle is a first and foremost an academic.  Her brilliance is frequently on display but so are her verbose explanations.

    It’s not that any concept she includes is particularly challenging in and of itself but taken together with the enormity of her topics, the political nature of the issue and the alphabet soup of acronyms you’ll find, Safe Food makes for a challenging read.  Observe a paragraph here where Nestle tries to explain the difficulties in determining food allergies (from page 173):

    “The widespread use of soy proteins – transgenic or not – in foods such as infant formulas, meat extenders, baked goods, and dairy replacements might be expected to increase the prevalence of soy allergies, but the increase would be difficult to detect unless it affected large numbers of people.  Worse, because methods to diagnose food allergies are unavailable or imprecise, the allergenic potential of most genetically modified foods is uncertain, unpredictable, and not easily tested.”

    Any reader of Nestle’s previous books would quickly recognize her academic style – and have formed their own opinion no doubt – but new readers should be warned.  Nestle expects her audience to come to this book with a significant background on the topic.  If upon hearing ‘GMO’ you are reminded of failed automakers or little green men from Mars, you might want to look elsewhere for a book.

    (Re)visit This Work

    But also realize this book’s high barrier of entry is also what makes it so good.  The more you read it, the more you know you are dealing with one of, if not THE, authority on the subject.  Yes, the prose bends towards the tone of an academic journal at times but if you want to understand the world of food safety, this is the book.

    The exceptional insight into every dimension of this crisis, the balanced view from both sides of each issue and her ability to educate – even entertain – at times, makes this a great read for anybody with a background in health or food.  Therefore, we highly recommend Safe Food as it provides both acumen into the most pressing issues related to food safety as well as a detailed context for understanding the issues (purchase this work on Amazon to support Nutrition Wonderland).

  • Book Review: The Cholesterol Myths by Uffe Ravnskov, MD

    Book Review: The Cholesterol Myths by Uffe Ravnskov, MD

    A recent study from the New England Journal of Medicine showed that the death rate from heart disease has fallen by over 50% during the period from 1980-2000.  The authors concluded that the dramatic drop can be equally attributed to medical advancements in treatment and better management of heart disease risk factors, respectively.

    Cholesterol Myths in Detail

    While this large decline is great news, the heart disease situation remains more mixed than it first appears.  Of the roughly 340,000 deaths avoided since 1980, only about 82,000, or 24%, can be attributed to cholesterol management (using the now standard IMPACT statistical model (pdf)), despite the relentless National Cholesterol Education Program that was begun in 1985 at the behest of the NHLBI.  More worrisome, another large study states that 70% of the decline in deaths came in people that still have heart disease.  Other doctors also point out that any drop in heart disease deaths does not mean there is a drop in new cases of heart disease.

    Translation: we still have a lot of work to do.

    Closer to the “Truth”

    The perception of reality can mean different things to different people.  To some, those numbers above mark an unbelievable success – a triumph of science over nature.  To other researchers, those same numbers reveal troubling contradictions about the actual causes of the disease.

    And that’s where the questions started for Uffe Ravnskov, MD.

    Does cholesterol cause heart disease or do they merely have an association with each other?  How do HDL and LDL relate?  What role do high fat foods really play?  What if all of those studies about cholesterol were wrong?

     

    The Heart Disease Decline since 1950

    Dr. Ravnskov, a founding member of  the International Network of Cholesterol Skeptics, takes all those positions and goes even further in his book, “The Cholesterol Myths” published by NewTrends Publishing.  One part detective mystery, one part conspiracy theory, Ravnskov tears through piles of medical studies digging towards the “truth.”  His thesis is rather simple: cholesterol does not cause heart disease.  We put emphasis on the word cause for good reason: Ravnskov’s entire argument hangs on tearing apart the correlation-versus-causation dichotomy.  For the most part, he succeeds but at a cost to his text.

    A Myth Unraveled?

    The Book

    Ravnskov lays out his attack into a series of myths he wants to dispel for readers.  Some myths are bold like “High-fat foods cause heart disease” while others are down right incendiary, especially when he claims to bust the myth that “the cholesterol campaign is based on good science.”  Putting down the entire research community is good way to get attention and attention he received.   This book was publicly burned on Finnish television upon publication.  So much for reasoned debate.

    Once you get past the burnings, you will see this work is undeniably strong on laying out a solid foundation in science for those who aren’t so inclined.  Ravnskov meticulously breaks down the correlation-versus-causation argument in a way that lends itself to being understood.  You will definitely understand the difference between the two, even if you only manage to make it twenty pages into the text.

    Cholesterol Myths really shines when it sticks to deeply interpreting studies findings within the scientific paradigm Ravnskov sets up.  His work goes to great lengths to uncover shoddy science in some of the landmark cholesterol-heart disease studies.  In some cases, Ravnskov uncovers pure gold for his readers.  Case in point, one of Ravnskov’s first myths deals with a study examining the Masai people, an indigenous people who did not consume a western diet, for a diet-heart disease connection.  From Page 36 [emphasis added my own]:

    “Professor Mann studied a much greater number of hearts and aortas from Masai individuals of all ages and found that the coronary vessels of the Masai were just as atherosclerotic as those of US citizens, perhaps even moreso.  But severe sclerotic changes [in Masai], so-called raise lesions, were rare; the sclerotic changes in the Masai were situated inside the vessel walls, leaving the inner surface of the vessels smooth.  And in the 50 hearts he studied there was no evidence that myocardial infarction has occurred in any of them.”

    Moments like this really let Ravnskov’s investigatory skills shine; he masterfully dissects the cannon of cholesterol research like few other authors we have ever read.  And during these infrequent moments in the text, you can see what this book could really be – a true guide to the future of heart disease research  – but ultimately that is not this text.

    At its best, Cholesterol Myths is a scathing review of literature instead of a gateway to where this literature should guide the national discussion.  Instead of using his knowledge to lead us into a more beneficial discussion on heart disease, Ravnskov exhausts his mental energy on tearing down cholesterol.  At times, I found myself hoping he would direct that massive brain of his towards constructing a new paradigm in which we could view heart disease.  Don’t hold your breath for that one.

    Instead, Ravnskov frequently leaves the reader to infer ulterior motives about each study he rips into, all without ever saying it explicitly, a sort of intellectual dishonesty that I did not appreciate as a reader.    Additionally, the book’s nine myth sections overlap and repeat each other often.  Invariably, he finds problems with about every major study that shows a relationship between cholesterol and heart disease.

    From the beginnings of Myth 6, you can see a familiar line of reasoning repeated throughout the book:

    “It is extremely difficult to design even the initial steps of a scientifically acceptable trial.  The standards of science are high, however.  In fact, they are so high that, even if we manage to select a test group and a control group with almost identical risk factors for heart disease, we must remember that almost identical and absolutely identical are not the same thing, and that we will never know all the factors that may, or may not, contribute to the development of the disease in these people.”

    While he is technically correct, studies that contain a control group mitigate these confounding factors.  No study will ever be perfect but we can’t use that as an excuse to dismiss significant research findings completely.  Ravnskov is wise to highlight study oversights but that does little to forward the heart disease dialogue.  Arguments like the above really dog this book in our opinion – and they appear far too often.

    Where we go from here

    Simply addressing heart disease as a cholesterol problem has not brought the world any closer to eradicating it.  Ravnskov’s arguments about the sometimes flimsy science surrounding cholesterol theory are an extremely valuable addition to this discussion.  His commendable goal of educating the public on the many problems with the singular cholesterol argument was accomplished ten times over in this volume.  Even a casual reader of this work comes away from it with a better understanding of the scientific method and heart disease in general – and that is a welcome development.

    Still, Cholesterol Myths misses the larger target in our opinion.  After destroying cholesterol in his book, Ravnskov does not forward any additional theories on the causes of heart disease.  This may not seem like much of a problem but it is in the scientific world.  The best theory ‘wins’ out in science because it can explain the most behavior present in a given situation; it need not explain all of the behavior.

    With a chronic disease like heart disease, it has already been well established in scientific literature that many factors, like stress and inactivity, contribute.  Only one of these factors, cholesterol, is ever considered in this text – and in that way this book is attempting to topple a myth that simply does not exist anymore.  Even, more, Ravnskov may thoroughly debunk cholesterol as a singular cause of heart disease but he freely admits there is a correlation between the two.

    From Myth 2 in his work:

    “Table 2B shows, in accordance with many other studies, that more heart attacks occurred among those with the highest cholesterol levels.  The differences were not impressive, however, considering that the figures were not adjusted for anything but age….”

    Major studies controlling for various factors show somewhere between 10-33% of the total heart disease death rate decline can be attributed to cholesterol reduction, depending on the country in question.  While this doesn’t prove cholesterol singularly causes heart disease, it definitely shows cholesterol is somehow involved.

     

    Heart Disease Decline Factors, Credit: NEJM

    And thats just the problem for us.  These conflicting facts often leave us in the lurch during Ravnskov’s elaborate presentations, knowing cholesterol plays some role with heart disease but not truly being the cause.  Admittedly, uncovering the cause of heart disease may be beyond the scope of his book but Ravnskov’s omission of a more comprehensive theory looms largely over this book.

    Overall, this book is a necessary addition in the discussion about heart disease.  Ravnskov’s book should be read by anyone with a critical eye and a curiosity about the origins of heart disease.  But it could have been so much more.