Review of How Not to Die by Michael Greger and Gene Stone
The book is written in a breezy style and is filled with speculative, if intriguing health claims. The phrase “in a petri dish” appears 28 times. Nevertheless, the advice from this book is much more likely to help than to hurt. If there is any central message to this book, it is to eat your vegetables and that dietary interventions can be just as effective as drugs for a number of maladies. A typical sentence:
Even with no weight loss, subjects on the plant-based diet saw their insulin requirements cut by about 60 percent, meaning the amount of insulin these diabetics had to inject dropped by more than half. Furthermore, half of the diabetics were able to get off insulin altogether, despite no change in body weight—just by eating a healthier diet.
The book is not entirely pro-plant propaganda, though. In a rare sentence, “Kiwifruits flopped, though. In a study funded by a kiwifruit company, kiwi failed to offer any protection [against high blood pressure]”.
The book is clearly better written than the Harvard Medical School Guide to Healthy Eating, which I reviewed last month. While the former is composed largely of well-evidenced generalities, How Not to Die is filled with questionable specifics -for instance, “Having too much phosphorus in the blood may increase the risk of kidney failure, heart failure, heart attacks, and premature death.”, “Eating mushrooms and sipping at least half a tea bag’s worth of green tea each day was associated with nearly 90 percent lower breast cancer odds.”, “They found that people who drank two or more cups of coffee daily appeared to have about only half the suicide risk compared to non-coffee drinkers.”.
Perhaps one of the most important messages from this book is that one can’t live on a single substance alone. Different vegetables are likely to do different things- “Eating nicotine-rich vegetables, especially peppers, was associated with significantly lower risk of Parkinson’s disease. (This effect was found only in the nonsmokers, which makes sense because the flood of nicotine from cigarettes would likely overwhelm any dietary effect.)”, “Remember that natural antioxidants in food work synergistically; it’s the combination of many different compounds working together that tends to protect you, not high doses of single antioxidants found in supplements.”, “Different vegetables may target different cancers—sometimes even in the same organ. For example, cabbage, cauliflower, broccoli, and brussels sprouts are associated with lower risk of colon cancer in the middle and right side of your body, whereas risk of colon cancer farther down on the left side appears to be lowered more by carrots, pumpkins, and apples.”. And different foods (though the book mostly concentrates on animal foods) are likely to have different risks - “The number-one food source of arsenic was poultry among preschoolers and, for their parents, tuna. The top source for lead? Dairy. For mercury? Seafood.”.
The book is not as insistent on the high-quality nature of the “plant-based diet” as I would have liked, but the book makes it clear toward the end that low quality carbohydrates belong in the “red-light” category, which also includes vegetable oils - “I think of oil as the table sugar of the fat kingdom”.
Overall, this is a good book for anyone seeking to improve the quality of their diet, though its cited claims should by no means taken as Gospel, particularly on its crusading attitude against animal foods and its reliance on studies with surprising results.
As for the sequel to this book, “How Not to Diet”, which I ended up reading a quarter way through, it is simply too long for too little information for anyone to peruse, and largely comes out just confirming conventional wisdom and the occasional bit of basic mathematics (e.g., whole grains are a better source of fiber than vegetables, due to the latter’s much higher water content).