Somewhat resembles a gluten-free, dairy-free carob-chip cookie with no sweeteners. Looks appealing, potentially good for you, but by the end, potentially a little hard to swallow. I will say this for it: at the heart of the book is a truth we all need to hear: Our lifestyles are making us sick.
Divided into six somewhat disparate parts, book sections include: Understanding the Modern Plague, a section on the diabetics epidemic with a strong implication that most of us are pre-pre-diabetic; Seven Steps to Treating Diabesity, which includes a number of lifestyle surveys identifying one’s own insulin resistance; The Blood Sugar Solution: Preparation, or steps to implementing a healthier lifestyle; The Six-Week Action Plan, which includes a basic and ‘advanced’ diet plan for those who are more sugar-dependent; Take Back Our Health,how to including community support in your changes; The Meal Plan and Recipes; and of course, references.
For those sensitive to it, a note on formatting. Structure is very much of the “Dummies” school of writing, which includes (overuse) of bullet points, sections broken down into 2-page easily digestible segments, action steps, sidebars and (repetitive) life-style quizzes. This truly isn’t meant to be an educational tome so much as a motivational speech coupled with a plan for lifestyle change.
The first part inundates with statistics proving that the American diet is unhealthy, causing an epidemic of obesity. He attempts to link obesity to industry, government and pharmaceutical companies–certainly all implicated in problems with the modern food chain, as well as general individual confusion about nutrition. There’s vital substance here–much like the almonds in your chocolate bar–but it feels a little media-spun and breezy, and I would have preferred something more substantial. For instance, his assertion that “The food industry has decided to preempt any food-labeling regulations that would given consumers real, credible information” (p.47) is some what misleading. While I’d agree that industry isn’t/hasn’t been helpful, food labels now are more readable than ever before. It’s actually a voluntary front of package labeling that industry suggested that he has issue with. Certainly true, but spun in a way that diminishes consumer responsibility and government efforts to improve knowledge. Personally, I would have been interested to learn more factual information about the deliberate creation of (unhealthy) highly-processed food on the part of industry–after all, I’m a sucker for an big conspiracy, especially if I get to blame my weight on it. But for that, I plan on checking out the lauded Salt Sugar Fat: How the Food Giants Hooked Us.
Still, while every health care provider should already be aware of the current health crisis around poor diet and minimal exercise, some of this information might be new to the average American who may not have made the links between lifestyle and health (I don’t know how they wouldn’t have, but I’m trying to be generous here). Points he brings up include “low-fat” diets–there is now is strong evidence that defining healthy food strictly in terms of fat content is not enough. Likewise diet sodas–he cites a newer well-done study that links diabetes with higher diet soda consumption. I also like his assertion that too many medical practitioners–and their patients–accept the “pre-diabetic” label without actively fighting against further development of diabetes.
Other positives include linking inflammatory food choices with lifestyle stresses and inflammatory health conditions, although he often characterizes these as “toxins.” There’s a wide body of scientific research hoping to connect food, stress and inflammation, but as of right now, blanket statements are definitely out. Science is relatively certain inflammatory factors play a role in disease progression, specifically cardiovascular disease, breast cancer and autoimmune diseases (at least the ones that I know about off the top of my head). However, the link with inflammatory or “toxic” diets has been tenuous. A new European study on the Mediterranean diet was just released, and that seems to provide more conclusive proof. (However, contrary to Hymans’ recommendations, that diet does contain alcohol, so it is sure to gain wider support).
There is a lot of good information here, spun in a way the average consumer might appreciate. However, because so much is referencing his website, it somewhat limits the extent to which it is accessible to everyone. My dad, for instance, should read this book; however, as he is computer illiterate, the online questionaires and resources would be useless. This issue perhaps hints at one of the hidden plagues of the food revolution–it usually requires significant economic or time resources to change.
Recipes and meal plans seem healthy, and no doubt would be part of a great balanced diet. He includes smoothies, breakfasts, snacks and solid meals. I also appreciate his checklists of kitchen supplies and spices, undoubtedly helpful for the kitchen impaired. It truly is a step-by-step recipe for change for those who are interested.
There is also a lot of selective information. Hyman would prefer that you don’t drink alcohol at all. Not that I’m a fan, necessarily, but by not acknowledging the numerous studies that show a glass of red wine a day seems to be cardio-protective, he chips away at his own validity. And while I appreciate his emphasis on both ‘real’ food and food prepared by the consumer, I fail to understand how he doesn’t consider it hypocritical that he would also recommend supplements.
Although I certainly believe in increasing environmental and pharmaceutical toxins, I think there aren’t many studies that draw clear correlations with health, and those that do tend to center around asthma and cancer. Even then, connections are challenging to prove–if it was clearly provable, we’d have more success with EPA regulations. I feel his assertion of “increasing levels of toxins… are a significant cause of diabesity” (p.9) is seriously stretching the science. This truly is the section of the book that caused me the most skepticism. His self-analysis questions cover just about every symptom possible, so I think it would be hard to find someone that didn’t merit his detox diet with supplements.
As a side note, for people into testing, he recommends a battery of blood work that is unlikely to be supported by many doctors and many more insurance companies. A full thyroid panel and insulin testing are two of the more esoteric ones that most practitioners–and clinical guidelines–would only recommend a screening thyroid and fasting glucose. Again, this speaks to well-financed readers, and I feel it is somewhat irresponsible to suggest someone with limited financial resources spend $800 on lab testing (just guessing off the top of my head as I don’t have the book in hand–it’s actually more like a couple thousand if it was market cost) that would need to be repeated in order to assess “improvement.”
[ A side-side note. I recently saw a paper talking about the wide difference in gut enzymes between dogs and wolves, even though they are related species. Genes that sequence certain starch-digesting enzymes are to twelve times more common in dogs (Nature, Jan. 2013). It speculated that the gut evolution enabled dogs to take advantage of human’s more carb-heavy diets. Similarly, current human guts are built to digest carbs as well as proteins–a diet that immediately classifies all carbs as ‘toxic’ is problematic. His diet seems extreme and fails to acknowledge evolution with dietary change. Similarly, I remember a anthropological study that looked at how cereal grains enabled civilization to progress beyond the hunter-gatherer because it allowed for concentration of food and diminished fool-collection energy consumpton. So I’d be interested in knowing how Hyman connects his own dietary suggestions back to food industry. Where are all these lean meats coming from? Harvested nuts and beans? It’s ingenuous to suggest his diet is the answer to agribusiness’ “Frankenfoods” without recognizing it is a reciprocal relationship, and that demand for his type of foods will be no different.]
At the end of the day, I’m not sure to what extent cause matters. Humans are hard-wired to select sweets and fats, so whether its because of capitalism or choice, we’re gonna pick the unhealthy ones most of the time. I do buy into the ‘addictive’ component; again, whether it is from a dopamine cycle or habit is almost irrelevant. Almost, because knowing can help us with strategies. I do dispute Hyman’s tendency to equate heroin with sugar. A little extreme, maybe? But that’s where the addictive behavior figures in, and where behavior modification has to be an emphasized component of dietary and lifestyle change. I do like the way Hyman tries to connect that back to community, and how to enlist community support in ones’ change. I don’t know that the web community is the only option, but it is the one most strongly supported by this book.
I did chuckle at his Inflammation questionnaire: “At work, I am exposed to pesticides, toxic chemicals, loud noise, heavy metals, and/or toxic bosses and coworkers.” Tell me that isn’t funny stuff!
If only his prescription didn’t also include his own brand of products. There was one line I found quite ironically funny where he complains that the solution isn’t “diet and exercise” the way we’ve been hearing our doctors suggest for decades. Um, hypocritical much? Because that is, after all what he is recommending. Along with a healthy dose of his brand of supplements.
Summary: if it gets you to healthify your lifestyle–awesome. But don’t waste your money on lab tests and supplements.