Book Review: The 4-Hour Chef

by | Nov 21, 2012

The 4-Hour Chef

In my humble opinion, there are few things on this earth that improve your life (not to mention your physique) more than learning to cook.

Like most urban kids in the late 20th century, I grew up thinking that “cooking” meant heating frozen lasagna or adding orange powder and butter to tubular noodles. Heating food is hardly the same as cooking, but even if you love Kraft’s neon version of Mac N’ Cheese, if this is where your culinary adventures end you’re selling yourself sadly short.

That said, by no stretch of the imagination do I consider myself a chef. The most common request I get from readers is for more recipes. But while I am touched by the overwhelming positive responses to my roasted cauliflower and delicata squash dishes (both ultra-simple kitchen homeruns), it has been difficult for me to provide more detailed cooking instructions on a regular basis.

The reason for this is that I almost never use recipes myself. I find them constraining, which means they generate a certain amount of stress for me—not dissimilar from the feelings I had running experiments in the lab (you can keep your frozen aliquots of DNAse, thanks). It’s slightly comforting knowing I could cook by the book if I had to. But the reality is I have more fun being creative with the ingredients I have at the moment, sort of winging it as I go.

The result of this method is that while I often eat delicious food, I rarely cook exactly the same thing twice, which does not make for reliable recipe development. If I do share a recipe here on the blog, it is usually because I’ve found a simple technique to make an ingredient taste lightyears better than it had ever turned out on accident with my random kitchen hacking methods. These are discoveries I think will change your life, and I am very confident you can reproduce.

Of course when I first started cooking I was not proficient enough to be so whimsical. It took years of kitchen experiments and more than a few screw-ups to get to a place where most of the things I cook at home are edible. This skill level (nothing particularly impressive, but head and shoulders above most open-heat-serve American dinners) is the minimum you should strive for if you’re serious about optimizing your healthstyle.

Enter: The 4-Hour Chef. Despite the cooking theme, this is not a cookbook. Think of it more as a cooking class, where each recipe is designed to teach a skill (e.g. braising, sautéing, knife skills, etc.) and every subsequent recipe builds upon those of the last. The idea is to teach the principles of cooking, so that after finishing the book you can tackle any recipe you come across and, more important, have the skills to improvise on your own.

If you’ve struggled with cooking in the past, this alone is enough of a reason to pick up the book. Not only will it ensure that you have the essentials under your belt, it’ll also give you a few crowd-pleasers to dazzle dates and parents alike. But the fun doesn’t stop there.

The 4-Hour Chef is divided into five main parts: Meta-Learning, The Domestic, The Wild, The Scientist, and The Professional. For those familiar with Tim Ferriss‘ previous work, these subdivisions make perfect sense. If not, here’s a quick rundown:

Tim* is a bit of a self-made savant, and has built his career on starting as a no-name, know-nothing then transforming himself into a world-class _(fill in the blank)    . The “blank” for Tim has included holding a world record in tango, being a champion Chinese kickboxer, #1 best-selling author, etc. The full list of Tim’s accomplishments is astounding. As such he’s developed a reputation for learning things incredibly quickly, unusually and effectively. In The 4-Hour Chef he unveils the secrets of this “meta-learning” using cooking (a skill he’d always struggled with) as an example.

At first glance I was most excited about the Meta-Learning, Domestic and Scientist sections (go figure), and I was not disappointed. In “Meta” he breaks down the basics of deconstructing problems (e.g. language learning, tango, swimming, tasting, launching companies, etc.) and solving them in the most effective way possible. (It also includes how to say “I must eat” in 9 different languages. Win.). Long-time Ferriss fans will love this section.

Despite having a decent idea of how to navigate a kitchen, I learned a lot from the “Dom” section as well, and found its instructions far more logical than most introduction cookbooks. He focuses on transferable skills, like learning to “eyeball” measurements (while clarifying when you need to be exact) and knowing when something is “done.” There are also dozens of little tips and tricks that’ll instantly skyrocket your kitchen confidence, which is half the battle of sticking with it. Though I didn’t cook my way through the lesson plan (I’ve only had the book for a few days), it seemed highly approachable and even a little fun. The first day you’ll learn to make osso “buko” without ever touching a knife.

The “Sci” section wasn’t at all what I expected (come to think of it, I have no idea what I expected—I just like science). It turned out to be a crash course in molecular gastronomy, which left me a bit crestfallen at first. While I love eating at fancy restaurants that serve elegant foams and spherical droplets of surprising flavors, I’ve never had any desire to recreate these things at home; some things are best left to the professionals. But the second I saw his “Crunchy Bloody Mary” recipe where chipotle infused vodka and bloody mary mix is transformed into a gel used to fill mini celery sticks, I had a change of heart. Reading the science behind all the culinary magic of restaurants like Alinea and El Bulli is fascinating, and I picked up a few parlor tricks to impress my friends. This section is a great way to feed your inner food geek.

I didn’t expect to be as impressed with the “Wild” section. Catching city pigeons in the park with my bare hands? Thanks, but no thanks. Yet sure enough, I was roped in after a few pages. The recent devastation of Hurricane Sandy really drove home the importance of this section. Though he dives deeper into shelter building and arrow carving than I probably need (Tim may beg to differ), this section is an excellent lesson on the value of life, the importance of life skills, and even a few things you’ll use on a more regular basis, like quartering a chicken. To my surprise, I found myself enthralled by the details of cooking a squirrel over a fire and removing pigeon (aka squab) breasts from a whole bird (feathers and all) with bare hands. Yum.

The “Pro” section was another surprise. As I’ve said, I’ve never aspired to cook like a pro at home. I just want simple, tasty food. And the quicker the better. But this section is essential for transferring the skills from the rest of the book into things you can use in the real world. It also covers some essential “classic” dishes, like roasted chicken, that weren’t covered in the “Dom” section. Most important, this section teaches you the basics of kitchen creativity, and how to branch out and improvise on your own using the techniques from the earlier sections.

The 4-Hour Chef is an incredibly ambitious book, but it is clear from the beginning that the goal is always to simplify and distill the essence of any task to its basic elements. It teaches the principles of cooking (and learning in general), not one-off recipes that you may or may not get around to making. I anticipate using it for years as a reference, whether it’s to find restaurant recommendations in NYC or as a reminder of the essential few ingredients that define a specific ethnic cuisine. I’ve flagged dozens of pages to revisit in the future.

On that note, I’d highly recommend getting the hardcover if you plan to buy it. I have both the print copy and the Kindle version, and while the latter will certainly suffice (and is much lighter, if that’s an issue for you) you really miss out on the beautiful design and experience of the printed book. That said, both the print ($21.00) and the Kindle versions ($4.99) are on sale right now, so you can get both for less than the price of one originally priced hard copy ($35).

Lastly, I also love that Tim revisits life philosophies in this book, which I loved in The 4-Hour Work Week, but missed in The 4-Hour Body. The 4-Hour Chef touches on several invaluable life lessons, including why it is important to not waste food (especially if it comes from an animal), and how cooking is a path that brings you closer to love and life. Feeding ourselves is one of our most basic human needs, and is at the root of our life, our culture and ultimately our happiness.

Bon appetit! 

*Full disclosure: As many of you know, Tim is a friend. He even included a jumbotron shot of me stuffing my face in the first few pages of the book. Hence my using his first name in this review and not his surname, which is more conventional in journalism. That said, he did not ask me to write this review, nor am I being compensated in any way for writing it (unless you count the $0.20 Amazon affiliate commission I’d get from reviewing any book in their inventory—blogging isn’t particularly profitable). The truth is I would have reviewed The 4-Hour Chef whether I knew Tim or not (I was a fan before we were friends, The 4-Hour Work Week changed my life), because I knew it had the potential to be particularly valuable to you (my readers). You may think you want more recipes, but what you really want is to feed yourself well in as many ways as possible. This book is the equivalent of teaching you to fish, rather than giving you fish. If you still have conflict of interest concerns, feel free to voice them in the comments. Just keep in mind that nothing trumps trust on the internet and I’ve spent years working to gain yours. As much as I like Tim, I’d be an idiot to jeopardize that.

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Book Review: Folks, This Ain’t Normal

by | Dec 19, 2011

Joel Salatin is one of the most interesting people I have ever met. Self-described as a “Christian-libertarian-environmentalist-capitalist-lunatic-farmer,” you’re probably more familiar with him as the “beyond organic” owner of Polyface Farm featured in Michael Pollan’s landmark book The Omnivore’s Dilemma and the documentary Food, Inc. (note: if you haven’t read/watched those do so immediately).

I sat down with Joel recently to talk about his latest book, Folks, This Ain’t Normal. On the outside, Joel does not appear abnormal in the least. He was well dressed, well spoken, extremely polite and fiercely intelligent—a gentleman in every way. But once you get him talking you quickly see that his ideas make him an anomaly in modern society, not because they are far-fetched, but because they come from so many different sides of the political and societal spectrums. People are rarely this thoughtful and well-rounded, and after finishing the book this is the point I keep coming back to.

You are almost certain to disagree with some of Joel’s ideas. Folks, This Ain’t Normal runs the gamut in controversial topics. He touches on politics, religion, the environment (including global warming), sustainable agriculture, big business, peak oil, taxes, protectionism, meat eating, government regulation, women’s role in farming (he told me to my face he’s “sexist”) and likely a few more subjects that will get your blood boiling. But this is not your usual liberal-conservative political banter.

Joel is a thinker, and just a few pages into the book it is clear that he has a more intimate understanding of these topics than most experts and advocates could even dream of. Folks, This Ain’t Normal is by far the best ecology lesson I’ve ever had, and I try to be a responsible person and keep up on sustainable food issues. While most people discuss this subject academically, Joel actually knows how an ecosystem works, because he works with one every day back at Polyface Farm. For example, despite the cries of some environmentalists to do away with cows and replace them with tofu (aka soy beans), Joel explains in detail why a tillage-based crop like soy depletes soil, while a grass-based system of herbivore feeding builds and protects soil, and is necessary for environmental sustainability.

Food politics is another topic where Joel’s position runs flatly against conventional wisdom. Most of us in the food movement agree that Monsanto is the devil, and Joel is no different. But while most foodists lean liberal and think more regulation is the answer, Joel explains why those very regulations are what protect the big companies and put small farms like his out of business (exactly what Monsanto wants). So contrary to what you might guess, his position on this topic is strictly laissez faire.

As mentioned above, there’s almost certainly something that Joel writes that will offend you. (Yes, he takes more than a few shots at urban farmers market goers with award winning poodles—Joel, in my defense I at least use my fancy kitchen and make my own sauerkraut). But I’ll argue that this is precisely why you should read the book. When crafted by a thoughtful, intelligent person, opposing viewpoints are among the most valuable thing in a thinking person’s arsenal. Even if he doesn’t convince you to change your opinion, at least it forces you to question your beliefs, think a little harder and refine your position. There are no worthwhile topics that don’t have valuable insights from both sides of the fence. Thinking is good for you, and it is something that is sadly laking in our current political environment.

In this spirit, the types of people who would certainly benefit from reading Folks, This Ain’t Normal include: vegetarians, carnivores, environmentalists, McDonald’s patrons, farmers market shoppers, Chipotle patrons, Tea Partiers, liberals, Christians, scientists, atheists, politicians, big farmers, small farmers, city folks, country folks, the 99% and the 1%. In short, everyone who eats.

What Joel wants us to understand is that it isn’t him who is historically abnormal. What’s not normal is having no idea where food and water come from, nor how to keep them healthy and safe. In other words, it is the rest of us who have lost the basic life skills necessary for survival. This, he argues, is what isn’t normal.

Grade: A

Note: The audio version of the book is particularly wonderful, since Joel reads it himself.

What’s your normal?


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Book Review: Wheat Belly

by | Dec 14, 2011

I had no idea what to expect from Wheat Belly, the new book by Dr. William Davis. Several of you had asked me about it so I picked it up, not knowing much about the author or its content.

Davis is apparently a medical doctor who treats patients for heart disease and other ailments using a wheat-free diet. Though this isn’t particularly revolutionary I was immediately intrigued by the first chapter of Wheat Belly, which gives a detailed explanation of how modern wheat is different both physically and genetically from the wheat “our grandparents grew up eating.”

How interesting!

He explains that selective breeding and genetic manipulation to increase wheat yield have dramatically changed the chromosome number of modern wheat compared to earlier versions grown before the 1950s. This, he claims, fundamentally changed the molecular properties of wheat and we are supposedly not yet adapted to the new product.

I haven’t gone through all the plant biology to determine if any of these claims hold water, but the premise is fascinating. If modern wheat were really a primary cause of the health issues plaguing Western society, not only would gluten be off the hook (once I started reading I thought this was going to be another gluten-free diet book), but all other grains would be back on the table, even older versions of wheat.

Had Wheat Belly gone on to further explore the differences between modern and traditional wheat and, most importantly, how they affect people differently, then this could have been a groundbreaking book. Unfortunately, that isn’t what this book is really about.

Davis doesn’t present a shred of evidence that modern wheat has a worse (or even different) impact on human health than pre-industrial wheat. The only anecdotal case he makes is that he personally found a farmer who grows traditional wheat, made a loaf of bread, ate it himself and seemed to be fine. This is not science.

Instead the rest of the book focuses on how his patients have benefited from removing wheat (presumably modern) from their diets, a premise that is much easier to swallow but brings us right back to Dr. Atkins. Wheat is the most abundant refined carbohydrate, and refined carbohydrates are almost certainly the biggest contributor to human health problems on the planet. Is it any wonder that eliminating the major one—not to mention the ingredient that is most often paired with sugar—would make people feel better?

When push comes to shove, the bulk of Davis’ argument is not about modern wheat at all, but about the Glycemic Index (GI) of foods (he’s sure to point out that the GI of wheat is even higher than sugar). His prescription is not just wheat elimination or even gluten elimination, but removal of all grains, sugars and starchy foods like potatoes and even beans.

Haven’t I heard this somewhere before?

To his credit, Davis promotes a relatively healthy diet. He discourages the use of gluten-free flour substitutes because for the most part they are just another form of unhealthy food. Though these ingredients can obviously play a role in the lives of people with serious gluten sensitivities, I agree that they do not qualify as health food just because they do not contain gluten. But extrapolating from processed carbohydrates to nutritious whole foods like beans and potatoes that most of us can eat without increasing risk of disease or obesity is less than helpful.

But all my criticisms aside, I think there are some valuable messages in Wheat Belly worth considering. Gluten (and maybe just modern wheat, who knows) is known to be one of the most inflammatory substances consumed by humans and many people would likely benefit from cutting it out. Davis recommends eliminating wheat for 4-8 weeks to see if there is an improvement in symptoms.

If you regularly struggle with any of the following issues, a temporary gluten-free experiment may be worth it for you:

  • fatigue
  • depression
  • arthritis
  • irritable bowel syndrome
  • autoimmune problems
  • attention deficit disorder
  • hair loss
  • bone loss
  • anemia

And there are probably many more. The nice thing is that while eliminating gluten for 4-8 weeks does take some effort, it is still a relatively simple, non-invasive way to troubleshoot health problems and potentially improve your life dramatically. If nothing improves, you can always go back to your bagels and Cheerios. It is important to keep in mind though, that many symptoms require an extended period without gluten before improvement is seen.

To summarize, I really wish Davis had done a better job of convincing me that it is modern wheat and not processed foods in general that is particularly problematic in the Western diet. From that perspective, this book is just another Atkins diet with a better title. That said, I do think Davis does a good job of illustrating how many ways patients could benefit from a temporary wheat elimination. The prescription is easy and harmless, and definitely worth trying if you have health problems you and your doctor can’t seem to solve.

Grade: B-

What did you think of Wheat Belly?

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Summer Tomato Holiday Wish List 2011

by | Dec 12, 2011

Photo by WTL photos

It’s time to start holiday shopping for all the wonderful healthy foodies in your life. My goal this year was to be extra creative and come up with an interesting and useful mix of items that I personally adore. I also tried to hit a range of price points.

Hopefully there’s some stuff in here you wouldn’t have thought of on your own. Happy shopping!

The 2011 Summer Tomato Holiday Wish List

1. Fitbit ($99)

Paying more attention to my daily activity has been the most positive behavioral change I’ve made this year. Since the Jawbone Up is no longer an option, my pedometer endorsement this holiday season goes to the awesome Fitbit pedometer.

Though the web interface and social features aren’t the greatest, there is a beautiful simplicity in the Fitbit’s ability to show you your daily steps at the push of a button. The latest version also shows you how many flights you’ve climbed, a nice feature for those of us who pride ourselves on taking the stairs whenever possible. I wear mine everywhere.

2. Harsch Gairtopf Fermenting Crock Pot – 5 Liter ($119.95)

What better way to get more probiotics into your diet than doing your own lactofermentation? We’ve been making our own sauerkraut, pickles and kimchi at home using this 5 liter fermenting crock pot. The biggest worry when doing this stuff on your own is contamination. This device is clever because you fill the seal with water, which allows gas to escape but doesn’t allow any air inside.

We’ve tried several methods of fermentation at home, and this is by far our favorite. It is way easier than it sounds, and the sauerkraut we’ve made is superior to anything we’ve ever found at the store or the farmers market. Bye bye stomach aches.

3. Wild Fermentation: The Flavor, Nutrition and Craft of Live-Culture Foods, by Sandor Ellix Katz ($14.48)

If you do decide to dabble in home fermentation (or are just curious and want to learn more before trying it out) you should also pick up this book. It was recommended to me personally by Michael Pollan, and is the definitive and most accessible book on the subject.

4. Modernist Cuisine: The Art and Science of Cooking, by Nathan Myhrvoid ($450.15)

Arguably the most amazing food book ever created, Modernist Cuisine combines breathtaking photography with cutting edge science and foolproof recipes. Created by the former CTO of Microsoft, this ostentatiously 1% item is the epitome of awesome for the special foodie in your life.

5. Bodum Bistro Automatic Gravity Activated Salt and Pepper Grinder ($39.74)

This is admittedly a little ridiculous, but the way it works is clever and I think it would make a great gift, particularly for guys getting into cooking (my boyfriend thinks it’s the coolest thing in our entire the kitchen). Basically it is both a salt and pepper grinder that creates perfectly calibrated seasoning by just tilting it over your food. It works really well and I’ve liked it way more than I expected.

6. Sleep Mate ($54.95)

Few things are as valuable as a good night’s sleep. If you’ve ever had trouble sleeping, particularly if you’re sensitive to background noise, the Sleep Mate really can help by creating soothing, ambient background noise. It’s like a blanket for your ears.

7. Withings WiFi Body Scale ($159)

When this scale first came out a couple years ago I thought it was a joke. Why would anyone want their scale to tweet out their weight to the world? But while the social feature got the most attention in the press, it is an optional feature (I opted out) and the scale is actually really cool.

The Withings scale talks wirelessly to your computer, creating simple to understand graphical displays of your weight and body fat over time. It can even tell the difference between different people in the house just by stepping on it. I was skeptical of the body fat readings, but I’ve found them to be very similar to measurements I’ve had from hydrostatic testing. And as long as you weigh yourself at the same time every day in the same outfit (aka first thing in the morning in your birthday suit) then the readings are consistent and can be a great way to track progress over time.

8. Bodum Pavina Double-Wall Thermo Tea/Coffee Cup (set of 2, $14)

Not only do these insulated cups look amazing, they keep your tea or coffee remarkably warm without heating the glass enough to burn your hands. We swear by them.

9. Sous Vide Supreme ($399)

By far one of the coolest cooking methods around, sous vide gives you the ultimate control when cooking meats and vegetables. It’s pricey (though it has dropped about $100 in the past year), but if you can afford it and are obsessed with food it is a fabulous addition to the kitchen.

Related: You may also want to pick up the vacuum sealer ($129.99) and some vacuum bags ($19.99) to get started.

10. Nesco 700 Watt Food Dehydrator ($59.49)

Baked kale chips are good, but dehydrated ones are even better and last longer. With a food dehydrator you can make your own dried fruit, vegetables and even beef jerky to your own preferences (cranberries without sugar!). Definitely go with this higher-powered device over the cheaper ones, you’ll get more consistent results in way less time.

Need more ideas? Check out last year’s list.

What do you want for Christmas?

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8 Inspiring Places To Find Recipe Ideas

by | Apr 27, 2011
Foodie Inspiration

Foodie Inspiration

Healthy eating and cooking for yourself go hand in hand. If you have the resources it is possible to eat healthy while dining out, but restaurants that don’t use processed foods can be difficult to find and tend to be pricey. They also limit you to a handful of different dishes that can become monotonous if you rely on them for most of your meals.

But keeping your healthstyle interesting can be a challenge even if you cook for yourself. Although shopping in season inevitably rotates you through new ingredients over the course of the year, we can still slip into the pattern of making the same dishes over and over again. And while repetition can be easy and comforting, it can also be problematic.

Monotony and boredom are your enemies if you are trying to make healthy eating a way of life; junk food will be extra tempting simply because it’s more interesting than the same boring meal you’ve had 10 times before.

To keep yourself from getting in a cooking rut you must actively seek inspiration for new dishes and flavor combinations. This is true for both kitchen newbies and seasoned chefs, and it gets easier with practice. The more you learn to outsource your creativity and experiment, the better you get at finding meal ideas in your daily life.

Inspiration can come from anywhere. These are some places I often find new ideas, but you are only limited by your imagination.

8 Places To Cook Up Recipe Inspiration

1. Farmers markets

My number one source of inspiration is always the beautiful produce and other goodies I find each week at the San Francisco Ferry Plaza Farmers Market. Not only do I often find interesting new ingredients to experiment with, I also find familiar foods that look so fresh and delicious I can’t help but buy them and turn them into something wonderful.

If you are thinking about buying something but do not know how to cook it, ask the vendor for ideas or common preparations. I recommend you get anything that looks new and interesting, since most vegetables are relatively cheap and Google puts a universe of recipes at your fingertips.

2. Restaurants

Most major cities (San Francisco especially) are home to amazingly talented and innovative chefs of all different styles and flavors. Steal their ideas! If you have a memorable meal while out on the town, take mental notes on the flavors and textures that capture its essence. You don’t have to be able to recreate it exactly at home, but you can definitely borrow the concept, simplify it and adapt it to your own skills and needs.

For example, I was recently struck by a dish at a spectacular restaurant that was composed of beets with dill–a flavor combination I had never tried. The dish was technically complicated and I wouldn’t bother attempting to make it the same way, but later that week I did roast some beets and change up my usual recipe to include dill instead of mint (sans chèvre). Turned out fantastic.

3. Food blogs

The number of outstanding food blogs today on the interwebs is staggering, and I love to skim through them looking for wonderful recipe ideas. I can’t even begin to list all my favorite sites here, but I try to highlight at least one mouthwatering recipe each week in For The Love of Food posts.

4. Travel

Nothing inspires enthusiasm for new flavors and recipes like traveling to a different locale. Eating traditional cuisines–the way they are supposed to be made–is one of the most intimate and meaningful ways to engage with a culture. Learn a few of the cuisine’s basic ingredients and cooking techniques and you can bring a tiny bit of your experience home with you. Think of this process as a procedural photograph you can use to remember your trip.

Again, you don’t have to recreate dishes exactly the same way in your own kitchen. Sometimes just a single special ingredient can evoke an entire cultural experience.

5. Friends

We all have that friend who is an amazing cook (love you guys!). Not only does this person sometimes hook you up with delicious treats, chances are your foodie friend also loves to talk about food and cooking. This is a goldmine for new ideas and sometimes even a little help and guidance. Maintain a healthy, food-centric relationship with this person and watch the inspiration roll in.

(Hint: If you don’t have a friend like this come hang out with me on Twitter @summertomato)

6. Books

Cookbooks are wonderful but, to be honest, I rarely use them. The reason is that I’m usually too busy to bother lugging the giant things off the shelf and thumbing through them for something specific. I usually either wing it in the kitchen or search online for what I need.

Literature, however, can be a huge inspiration for me to try out new things in the kitchen. It wasn’t until I read The Moor’s Last Sigh by Salman Rushdie that I really started exploring Indian cooking. The Last Chinese Chef helped me learn to appreciate the depth of Chinese cuisine. And I cannot eat enough Spanish tapas when I’m reading Hemingway.

7. Podcasts and radio

I love Mondays because all my favorite food podcasts are waiting on my iPhone for me to listen to on my commute. Both entertaining and educational, foodie podcasts never fail to inspire me to try new foods and cooking methods. They also make me a better cook by describing tips and techniques I am unfamiliar with.

8. TV

Although I do not watch TV regularly, there was a time when I would catch a periodic episode of Top Chef or other foodie show. What I enjoyed most about these programs was the times they would explain the decision making process that goes into creating a dish. But even if culinary improvisation isn’t in your cards, you can at least borrow their ideas (just like at a restaurant) and make similar meals for yourself at home. The recipes used are often posted online.

You can also get meal ideas from TV dramas and sitcoms. Remember Seinfeld’s Soup Nazi? That’s where I first learned about mulligatawny.

Recipe inspiration can come from anywhere, but if you aren’t looking for it a stroke of genius may pass you by.

Where do you get your inspiration in the kitchen?StumbleUpon.com

Originally published February 24, 2010.

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Book Review: Why We Get Fat, by Gary Taubes

by | Mar 2, 2011

I hadn’t planned on writing a formal review of Gary Taubes’ latest book, Why We Get Fat, because I already wrote an extensive review of his first book, Good Calories, Bad Calories, and the messages (and my criticisms) are basically the same. But after finishing the book I think Taubes is worth revisiting.

My biggest problem with Taubes’ first book is that it was very difficult to read, and that of course means most people won’t finish it. In Why We Get Fat Taubes repackages the data in a way that is much more logical and easy to digest. The book is substantially shorter, and is mostly free of the rants and tirades that peppered Good Calories, Bad Calories.

Instead, Why We Get Fat takes the reader through a clear and concise explanation of why all calories are not created equal, and that carbohydrates are the reason for the vast majority of the health and weight problems plaguing modern civilization. He also does a fantastic job demolishing the currently prevailing hypothesis that dietary fat and blood cholesterol are the causes of heart disease. They aren’t.

That so few people understand these points is why I recommend everyone read this book. It breaks my heart every time someone writes to me for nutrition advice and proudly points to their butter-less popcorn or baked chips as proof of their already “healthy” diet. Until it becomes common knowledge that fat is good for you and processed carbohydrates are the worst thing you can eat, I think this book is the best resource we have to explain it.

Still I do not agree 100% with Taubes’ conclusions. Though I do think the evidence is overwhelming that all calories are not created equal, I disagree that calories therefore do not matter and cannot be manipulated to help with weight loss. Taubes argues that how much we eat is dependent on our hormone levels (specifically insulin levels) that regulate energy balance, and that depending on this balance we naturally regulate our feeding and energy expenditure (exercise) so that we maintain our weight.

Taubes makes a compelling case that severe calorie restriction is counterproductive in weight management, and I agree. However there is some evidence that a small calorie deficit, on the order of 100-200 calories per day, is within the range of our natural homeostatic mechanisms and can be effective at controlling body weight.

In his book, Why We Eat More Than We Think (another must-read), Brian Wansink explores study after study where environmental cues are manipulated to get people to eat either significantly more, or significantly less than they believed. Importantly, the participants never reported any difference in satiation no matter how much they ate. Wansink argues that people can make small dietary changes resulting in a moderate 100-200 calorie per day deficit that does not affect hunger levels and can be used to effectively control weight.

Similarly, in The End of Overeating (here’s my review) Dr. David Kessler discusses how eating can become uncoupled from hunger when it is associated with external cues, making a strong case that some of us really do eat more than we need to. I think many of Kessler’s points about overeating are valid, particularly for emotional eaters. His argument is further strengthened by individual case studies of people who learn to eat less without experiencing sensations of starvation that are predicted by Taubes. One such example is Frank Bruni’s book Born Round (my review), in which he overcomes his weight struggles by moving to Italy and changing his relationship with food. Bruni is able to maintain his weight even after accepting the job of food critic at the New York Times.

These accounts conflict with Taubes’ argument that people overeat to satisfy a caloric deficit caused by a carbohydrate-induced faulty metabolism. Though there is good reason to believe Taubes’ metabolic hypothesis accounts for a large part of the health issues in today’s society, I think it is premature to conclude that this is the only force at work in why we get fat. Indeed, some research suggests learned feeding cues can directly impact insulin and metabolic pathways even in the absence of food. This data does not refute Taubes’ hypothesis, but rather makes it more complicated than he implies.

Even if we assume Taubes’ metabolic theory accounts for the majority of our health problems, insulin response (the ultimate cause of fat accumulation) should also be affected by eating rate and exercise, and vary among individuals. However Taubes handedly dismisses the possibility that any behavioral modification other than carbohydrate restriction can impact metabolic function because, he argues, we will modify our physical activity to adjust for any nutritional changes. His case is compelling, but not air tight, and my interpretation is that while carbohydrate consumption is clearly very important, there are likely other factors that may also be helpful in controlling metabolism and body weight.

In his book The 4-Hour Body (my review), Tim Ferriss describes how WordPress founder Matt Mullenweg lost 18 pounds by simply chewing each bite of food 20 times. Extra chewing or “masticating” was made popular as a weight loss technique in the late 1800s by Horace Fletcher and is explored in Gina Kolata’s book Rethinking Thin (not a particularly good read). Extended chewing and eating slowly are both effective at inducing weight loss, likely because they slow the glycemic response and almost always result in decreased meal size.

One of the most interesting points made in The 4-Hour Body was Ferriss’ personal glycemic response to a low-carbohydrate diet of just meat and vegetables. He claims that even with this meal he could easily spike his glucose to over 150 mg/dL (this is very high) by simply eating quickly, and that this effect could be controlled by slowing down and taking a full 30 minutes to finish a meal. Unfortunately I could not find a similar experiment in the scientific literature, but Ferriss’ observation suggests that behavioral modification can have a powerful impact on metabolic response independent of diet composition.

My final complaint about Why We Get Fat is that Taubes never considers that individual variation may preclude his theory from applying to everyone. He suggests that while some people are genetically blessed with a higher tolerance for carbohydrates, others will only thrive on an almost zero carbohydrate diet. Unfortunately this is the one part of the book he does not provide data to back up his assertions.

Though Taubes frequently argues the importance of paying attention to outliers, he never explores the possibility that some individuals may actually do better (rather than less bad) on a diet with slightly more carbohydrates. (Let’s assume for now that I mean slowly digesting, natural carbohydrates and not highly processed sugars and grains.) In a healthy person there is no reason to assume that such a diet would induce insulin resistance, and there may be some additional advantage outside of metabolic health for including such foods. I don’t think this is a possibility we should dismiss without solid evidence.

To summarize, Taubes does an excellent job describing the importance of carbohydrates in both weight management and health but oversimplifies the science, particularly neglecting the importance of behavioral factors on metabolism. However, the analysis presented in Why We Get Fat is still the most clear explanation of the relationship between metabolism and health that I’ve found and is an invaluable resource for the general public.

What did you think of Taubes’ latest book?

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Book Review: Born Round by Frank Bruni

by | Nov 1, 2010

Honestly, I didn’t expect much from Born Round, the latest manifesto in weight loss from the prominent New York Times food critic, Frank Bruni. Maybe it is because the last two health books I read from Times writers, Food Matters by Mark Bittman and Rethinking Thin by Gina Kolata, were both so vacuous and uninspiring. Or maybe it’s because it’s been years since I’ve been inspired by any diet book at all.

But whatever the reason for my skepticism, it was quickly put to rest with Bruni’s brutally honest tale of personal struggle and slow, determined road to health and self-confidence. Born Round is a far cry from the self-righteous, superficially researched works that normally come from dieters and journalists. His story is deeply personal and, though he goes into the scientific theories behind all the popular (and unpopular) diets he’s tried, he never pretends his experiences amount to anything more than his own reality.

It is this honesty that makes Bruni’s work great. It doesn’t take a clinical diagnosis to realize that Bruni struggled with an eating disorder from birth. He chronicles bouts of binging, extreme exercising, drug use, bulimia, excessive weight gain and occasional weight loss. His heart-felt narrative conveys the glaring truth of what it means to live in a perpetual loop of failure flecked with glimses of dietary “success,” and the subsequent torment and self-doubt that comes with each turn of the cycle.

Yet despite the extreme forms Bruni’s misadventures take, anyone who has experimented with diets or struggled with weight can relate to Born Round. We all have weakness, but few are as psychologically destructive as those surrounding physical appearance and body size. Intellectual or personality defects are relatively easy to hide or obscure, but extra body weight must be worn like a badge for all to see.

The insecurity bred by constant feelings of physical inadequacy can easily turn into obsessive thinking and occasionally to dangerous behavior. Born Round shows us how deep this lack of confidence can reach, even while Bruni himself achieves great success in other aspects of his life. Arguably the most glaring emotional paradox in Born Round is when Bruni describes the insecurity he feels over his physical appearance during his years as a championship swimmer in high school. But despite the irony, most ballerinas, gymnists and figure skaters probably understand what he was going through.

Ultimately, however, Bruni’s mind conquers both his emotions and his body. As with many chronic dieters, Bruni’s affliction was cured with a lesson in food culture he experienced after a move to Europe–Italy, to be specific. While living abroad Bruni learned to eat mindfully, value quality over quantity and develop a relationship with food that isn’t at odds with either his appetite or his appearance. In short, he found his healthstyle.

Even more remarkable is what happened next. Rather than shrinking from his former self, Bruni embraces it completely. Armed with his new skills and confidence, Bruni accepts a job as the New York Times restaurant critic, an occupation that sometimes demands 5-6 multicourse meals per day at some of the best restaurants in the world. Throughout this time, not only does Bruni avoid regaining any weight, he actually continues to lose a few pounds in the first months.

Bruni’s story is an inspiration and stands as a beacon of hope to anyone who battles with food and body weight. By training himself to develop new habits and thoughts about food and health, he was able to transform into a fit, healthy and confident man that trusts himself to eat in any situation.

What did you think of Born Round?

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Book Review: Good Calories, Bad Calories

by | Jan 6, 2010

good calories bad calories cover

Good nutrition advice is not easy to come by, but we have to start somewhere.

It is probably obvious to most of you that public education on diet and health is vastly inadequate. We learn virtually nothing in school, and what they do manage to pass on is less-than-useful or just simply wrong.

Advice changes from year to year, sometimes drastically.

Everyone claims to be a nutrition expert, but very few people are actually trained enough to understand the complex and sometimes contradictory findings made by scientists in the field.

But although there are few sources you can trust, some books do stand out as valuable for understanding the basics of health and nutrition. Good Calories, Bad Calories by Gary Taubes is by far the most thorough I’ve found, and is essential reading for anyone who has an honest desire or need to understand how diet impacts health.

Taubes makes a detailed and compelling case that refined carbohydrates are the primary cause of weight gain and “diseases of civilization” such as heart disease, hypertension and diabetes. In my view, any honest and opened-minded scientist would have to largely agree with him.

GradeAGood Calories, Bad Calories is 468 pages and contains over 100 additional pages of references, which is nothing short of astonishing. Taubes explores every aspect of the science behind weight control including the most puzzling and frequently ignored evidence, which he argues is the most important.

Scientists depend on statistics, but have a tendency to ignore outliers which can make data difficult to interpret. Taubes instead points to these anomalies as evidence of flawed or incomplete theories, and suggests that isolated populations (outliers) such as the Inuit and Maasai tribes actually help the most in explaining diet-related health patterns.

Taubes argues extensively (sometimes a bit heavy-handedly) against lazy scientific thinking that relies too heavily on conventional wisdom and the appeal of simple ideas. This point is a major theme of the book and is exemplified by chapter 2, “The Inadequacy of Lesser Evidence.” He goes to great lengths to explain how our tendency not to scrutinize established theories breeds scientific closed-mindedness and can perpetuate flawed ideas for decades.

Ultimately Taubes uses this argument to directly challenge one of the most prevailing health theories in Western civilization: the cholesterol–heart disease hypothesis.

Taubes provides hundreds of pages of data and analysis to make the point that total cholesterol is not a good predictor of heart disease or mortality. Specifically LDL cholesterol is only loosely associated with heart disease (at best) and HDL cholesterol (the higher the better) is a much better indication of vascular health. (Read more: How To Raise Your HDL Cholesterol)

Once this basic premise of health is thrown into question, Taubes carries you through the logic of why a high-fat diet cannot be responsible for heart disease (remember the Inuit) and instead presents why quickly digesting carbohydrates are the most likely culprit.

Fundamental to this argument is the tie between heart disease and type 2 diabetes (along with other “disease of civilization” or metabolic syndrome), which are both inextricably linked to carbohydrate consumption. The logical conclusion from his analysis is that all calories are not created equal, despite what we are told daily by the nutrition community and the media. Understanding the logic behind this argument can fundamentally change the way you approach food and is the best reason to read Good Calories, Bad Calories.

Despite this, Taubes’ book is rarely the first I recommend to people who come to me for nutrition advice. There are a few reasons for this, but the main one is that Good Calories, Bad Calories is not an easy read. I’m a scientist and nutrition data junkie, and this book still took me months to get through (I normally read 4-5 per month). For your average eater, a book like this can quickly become a burden and many people will give up before getting to the good part (about half way through it starts to pick up substantially).

In the first few chapters I was put off by the book’s almost defensive tone. A large part of the first section is dedicated to discrediting the character of a pioneering scientist and father of the dietary fat–heart disease hypothesis, Ancel Keyes. Presumably this depiction is intended as background so the reader understands why Keyes so aggressively disseminates a theory that isn’t fully proven. However, I found the extensive character attack unbecoming for a book espousing science and experimental data, and it seemed unnecessary.

Another reason I resist recommending this book as nutrition advice is that it doesn’t offer much in the way of actual advice. Taubes certainly provides compelling evidence that carbohydrates are best avoided and that dietary fat is safer than presumed, but how much of this knowledge can be translated directly to daily life isn’t clear. For practical advice, I prefer Michael Pollan’s In Defense of Food (based largely on the same data).

Scientifically I also have a few issues with Good Calories, Bad Calories. First, the vast majority of the experiments Taubes cites are early diet studies, many from the turn of the century. While these experiments are clearly important, most of them do not reflect long-term (more than 6 months), real life dietary habits. These studies were also almost entirely dependent upon self-reported dietary intake, which is known to be quite inaccurate.

Much of Taubes’ argument about calories is based on the premise that overweight people eat the same amount or less than lean people. This was once thought to be the case, but recently more thorough studies have shown that overweight and obese people do indeed eat more. The problem is that all people (both lean and obese) are poor judges of food intake, and this discrepancy is largest with the biggest meals consumed. This means people who eat the largest meals tend to underestimate their calories the most, and meal size is correlated with body weight.

This does not mean that I disagree entirely with Taubes’ theory on calories. I was more convinced by the rodent studies he presented where dietary intake was tightly controlled and measured. In some of these, obese animals did seem to eat the same or less than leaner animals (always be careful reading too much into rodent data). Interestingly, the difference in body weight was always accounted for by differences in physical activity, a point I find extremely fascinating.

Since mice obviously do not exercise for the purpose of fitting into skinny jeans, the activity differences observed between obese and lean mice is clearly a fundamental change in metabolism (balance of energy use and intake). If this is true and can be manipulated by diet composition rather than voluntary exercise (which causes overeating), as Taubes suggests, this has tremendous implications for treating obesity and disease through selective diets and metabolic manipulation. I think Taubes makes a strong case for this and it is a point that should be taken very seriously by the scientific community.

My final issue with the book is how the data was presented to seemingly support a diet of almost entirely meat and animal products. While Taubes does not come out directly and say “the healthiest diet is 100% meat,” people without a knack for thinking like a scientist can easily come away with this impression (I’ve seen it).

[note: My guess is this is why I get so many emails from people asking me to help them choose between this book and The China Study (click for review), which both come off as scientific but also as diametric opposites. Personally I do not see a huge conflict between the data presented in the two books, but see it as an issue of interpretation. On this point, my vote goes to Taubes for his superior logic and reasoning.]

My own interpretation of the data presented in this book, however, is not that all carbohydrates are the enemy, but rather that quickly digesting (processed) carbs are the real problem. Taubes never refutes this as far as I could tell, though he does glorify meat-based diets (again remember the Inuit) as the best for optimal nutrition, while belittling the case for a balanced diet. But there is an important difference between saying “meat is good” and “all plants are bad,” which he never directly asserts.

Yet many people still take from this book that a protein and fat-based diet is the healthiest option, which is a flawed interpretation. Vegan diets with no animal products whatsoever can be perfectly healthy, as can largely meat-based diets, and that both are perfectly legitimate is a point that is easily forgotten by the end of Good Calories, Bad Calories.

But while the value of eating plants is an important question for the practical implications of Taubes’ theory of calories, it is not fundamental it.

Summary

Taubes’ meticulous research and overly-thorough analysis represent both the strengths and weaknesses of this book. His case for the role of metabolism in health and obesity, and against the dogma that “a calorie is a calorie” is a tremendous contribution to the field of nutrition. However, this depth can make Good Calories, Bad Calories cumbersome and difficult to read.

Final Grade: A

What did you think of Good Calories, Bad Calories?


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Learning To Eat Less: How Understanding Your Brain Can Make You Healthier

by | Sep 16, 2009

the-end-of-overeatingIn a nation where obesity and health loom large in our public dialog, there is no escaping the simple fact that we eat too much.

On average Americans consume 500 more calories per day than we did in 1970 (more than we ever have), mostly in the form of refined and processed foods. This corresponds with a 25-30 pound increase in body weight and obesity rates near 30%.

Debates rage over the specifics of what is causing our weight and health problems, but it seems clear enough that the critical element is the amount of food we choose to put in our mouths.

But does everything we eat represent a true choice?

In his book The End of Overeating, former FDA commissioner Dr. David Kessler examines the role of the brain in eating behavior and the mechanisms involved in what he calls conditioned hypereating.

According to his findings specific combinations of sugar, fat and salt hijack the reward pathways of our brain and force us to behave more like food addicts than hungry organisms. This leads to a cycle of conditioned hypereating that makes the habit harder to break with each repeated episode.

But whether or not we are addicted to food is a point of debate. In my interview with Kessler, he made clear he does not use the word addiction for fear of oversimplifying conditioned hypereating. Our relationship with food is more complicated than it is with something like alcohol or tobacco because a human can live without cigarettes, but food is vital to survival.

When pressed to describe the neural differences between addiction and conditioned hypereating, however, Kessler conceded, “The fundamental circuits are the same.”

For this reason, treatment of conditioned hypereating can draw from the success of substance abuse treatments. These tactics involve cognitive and behavioral therapies we can use to train ourselves to override our instincts and adopt new behaviors in response to stimulus cues.

For conditioned and compulsive behavior, cognitive strategies are necessary because intuitive inclinations and “listening to your body” do more harm than good. If your body is telling you to have a cigarette, this does not mean it is in your best interest to do so.

At the FDA Kessler was instrumental in the fight to regulate tobacco, and now he believes some of the same lessons can be applied to the treatment of overeating.

“What took me a decade to understand is you need to change the valence of the stimulus.”

The positive emotional reaction associated with indulgent foods is at the center of our motivation to seek them out. Twenty years ago cigarettes had tremendous allure. But the FDA was successful at demonizing the tobacco industry, and the public no longer sees smoking as glamorous and attractive.

And smoking rates have plummeted.

Changing a conditioned behavior requires a fundamental shift in how we think about a stimulus. In conditioned hypereating the stimulus is food, which makes the task especially difficult, but not impossible.

To break the cycle of conditioned hypereating we must redirect our automatic response to the kinds of foods that cause us to overeat. Kessler calls these hyperpalatable foods, which are loaded with layers upon layers of sugar, fat and salt. The goal is to replace our automatic responses to these foods with different, equally enjoyable actions that are not detrimental to our health and do not reinforce compulsive behavior.

I asked Kessler what is the first step in controlling our eating habits and overcoming conditioned hypereating.

“I can tell you the last step. Change your relationship with food. If sugar, fat and salt are your friends, you will lose. You have to get to the point where that is not what you want.”

The End of Overeating outlines the four basic steps of habit reversal: awareness, competing actions, competing thoughts and support.

But Kessler believes the critical step is fundamentally changing the way we view what we eat, cooling down our emotional response to hyperpalatable foods. In essence, we must train ourselves to stop wanting what we believe we want.

According to the book, the first step in this transformation is becoming aware of the power food holds over us, which requires understanding how our brains work. We must recognize that when we are tempted to indulge, the urge is not generated internally but is a reaction to a cue that makes us respond automatically. You may think you are hungry, but really you are just reacting to an emotionally charged stimulus that tells you to eat.

Once you recognize a cue for what it is you have a brief moment to decide not to take the bait. To successfully divert yourself to another course of action you must have a plan ready in advance that allows you to do something completely different.

Considering alternative activities and the reasons you might prefer them can help you tremendously at this point of decision. Rather than focusing on the positive emotions you will experience by giving in to your desire for hyperpalatable foods, also remember the negative emotions that follow if you give in and the positive aspects of the alternative action.

For instance, it may help to remember that every time you get cued and give in, you are strengthening the neural circuitry that compels you to this behavior in the first place. If you even briefly entertain the possibility of indulging, you create a state of ambivalence that leads to torment, obsession and cravings. However, when you successfully divert your attention to another rewarding activity you have made a small step toward cooling down the positive valence of the food.

It is the state of mental torment and ambivalence that increases the positive emotional charge of a food, building and strengthening the neural reward circuitry that causes conditioned overeating. This may be one of the reasons dieting almost always results in long-term weight gain, since constant deprivation makes hyperpalatable foods more difficult to resist and creates severe anxiety.

Mentally, the best strategy to overcome conditioned hypereating is to develop new, positive associations with food that are independent of palatability–something you care more about than the fleeting reward of overeating. Kessler says this is a deeply personal process and must reflect an individual’s own set of values. For example, it helps some people to become vegetarian, while others value organics or local food. These decisions remove virtually all hyperpalatable food from the lives of people who choose these paths.

It also helps to develop aversions to hyperpalatable foods. Some may learn to demonize “Big Food,” while others turn away after educating themselves about health concerns. Developing a more sophisticated culinary palate can help make hyperpalatable foods less palatable. Kessler himself developed an aversion to over-sized portions, which he now sees as repulsive piles of sugar, fat and salt.

Developing positive associations with healthier foods while demonizing the hyperpalatable foods we have been conditioned to crave can fundamentally change your emotional response to stimulus cues. As you learn to recognize your brain’s response to cues, you can override conditioned behavior by consciously deciding to take alternative actions because you want to.

You will never win an internal battle with yourself. Instead use what you know about the brain’s reward system and give up trying to summon willpower to resolve the torment of conflicting desires. Reprogram your habits by closely examining your relationship with hyperpalatable food and begin making deliberate decisions that are consistent with your goals, breaking the cycle of conditioned overeating.

To read more about conditioned hypereating and habit reversal read The End of Overeating, by Dr. David Kessler.

Have you read The End of Overeating? Have you overcome conditioned hypereating?


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Summer Tomato Book Review: The China Study

by | May 6, 2009

the-china-studyIn the first official book review at Summer Tomato I examine Dr. Colin Campbell’s The China Study. Several readers have asked about this book since I wrote last week about who you can trust for diet advice, so I think it is a perfect subject for my first review.

The China Study was published in 2006 and branded itself as “The most comprehensive study of nutrition ever conducted.” It is written by Colin Campbell, PhD, a highly accomplished scientist that has worked for decades in the fields of nutrition and disease research. It was co-authored by his own son, Thomas Campbell.

Clearly both these men care deeply about health and nutrition and believe the information they provide can relieve a huge proportion of the world’s suffering. Their sincerity is apparent and, given the current dietary trends in Western culture, I am sure their recommendations would help the vast majority of people become healthier. Yet there are several logical flaws in The China Study that prevent me from giving it an A grade. Overall, however, The China Study offers a compelling view of nutrition and health from one of the leaders in the field and is worth reading.

gradebMy biggest disappointment with The China Study is how little of the book is devoted to the study itself–a large ecological-style research project, conducted by Dr. Campbell and his colleagues, examining the relationship between diet and health in rural China. As a scientist, I am a bit of a data junkie and always most impressed by strong statistics and rigorous logic.

UPDATE: [Denis Minger has taken it upon herself to re-analyzed the data from The China Study, and makes it pretty clear that Campbell vastly overstates his case. I agree with everything Denise writes, and every educated person who cares about these findings should read her analysis.]

Only a single chapter in the book is specifically dedicated to the work done in China (Chapter 4), and it conveys little new information. Most of Chapter 4 is spent reiterating the links between diet and chronic diseases such as cancer, heart disease and diabetes, discoveries that did not surprise me in the least. The two most important novel findings reported in the China study are discussed below.

The China Study is divided into four major sections. The first section describes Dr. Campbell’s original research and is the part I enjoyed most. It begins by discussing his work in the Philippines where he discovered a tight link between animal protein consumption and a specific kind of liver cancer induced by aflatoxin, a dangerous poison that is sometimes found in contaminated peanuts. He follows up this work with extensive studies in his U.S. laboratory elucidating the mechanisms of cancer promotion by the main protein found in cow’s milk, casein. Dr. Campbell makes a compelling case that this protein can influence cancer development in the presence of an extremely potent carcinogen, and his work should be taken very seriously in this regard. However,  he goes on to argue that this finding can be generalized to support the view that all animal proteins promote cancer and he recommends they be completely eliminated from your diet.

This was a logical leap I was not able to make after reading through his evidence. What about the benefits of fish for the heart and brain?

As mentioned above, the final chapter of the first section describes the China study. According to the book, the Chinese consume much less fat and protein than Americans, but more fiber and iron. Nothing too surprising there. It also reports that rural Chinese have substantially less heart disease, cancer and diabetes than Americans, but in more urban areas where diets follow more Western patterns the incidences of these diseases are higher. Again, not surprising.

Two pieces of information out of the China study did pique my interest. The first is that participants in the China study reportedly consume more, not fewer calories than Westerners. This was true even for Chinese office workers who consume 30% more calories but weigh 20% less than average Americans.

Part of this difference was accounted for by differences in physical activity (even office workers in China get more exercise than we do), but not all of it. Data in the China study suggests that Chinese have a more active metabolism and burn more calories than typical Americans. Dr. Campbell argues that this is because they eat less animal protein and fat, but the China study is observational (non-intervention) and cannot prove cause and effect.

Isn’t it possible that the Chinese metabolize their food differently because it is less processed than Western food (no matter the source)? From the literature I have read, this seems like a more plausible explanation. But regardless of the reason, the data from China suggests that all calories are not created equal in terms of both health and metabolism. This argues against the dogma offered by most nutrition experts that a calorie is a calorie.

The other surprising finding from the China study is the degree to which blood cholesterol levels predict heart disease. Although most Americans assume there is some connection between blood cholesterol and heart disease, there is still debate regarding how strong this connection is. Data from the China study suggests lower total cholesterol levels decrease risk of heart disease and death. Moreover, the data suggests that optimal cholesterol levels are far below what are recommended by Western medicine (150 mg/dL to 180 mg/dL). The healthiest Chinese had total cholesterol levels from 170 mg/dL to as low as 90 mg/dL. In the China study, lower cholesterol levels were also linked to decreased rates of several cancers. However, some scientists question the validity of this data.

The second section of the book is titled “Diseases of Affluence” and discusses the role of nutrition in the various chronic diseases that plague Western culture. In the third section Dr. Campbell offers his ideal (i.e. vegan) diet. If you are not familiar with the literature on diet and nutrition Dr. Campbell does a decent job going over it, particularly with respect to the role of dairy in prostate cancer, type 1 diabetes and multiple sclerosis. However, most of this information is available in other books that are easier to follow and less dogmatic about the need to eliminate all animal protein from the diet, which even Dr. Campbell admits “has not been absolutely proven” (p. 242).

In my opinion the most incongruous part of The China Study is the fourth section titled, “Why Haven’t You Heard This Before?” Here Dr. Campbell goes into great detail explaining the ties between food industries, drug companies, our government and, sadly, our education system from K1 through post graduate medical residency. While this section of The China Study is fascinating, it dilutes the primary nutrition message of the book with a disconcerting illustration of the roles money and politics play in our education system. But despite the jumbled message, the facts provided in this final section of The China Study are eye-opening and may be the best reason to read the book. It is shocking to learn how deeply opposed to and uneducated most of the medical community is about the life-saving benefits of dietary intervention for chronic diseases. Personally I would have liked this section to be an entirely separate book, as I would recommend it more often.

To summarize, The China Study provides an interesting but not entirely compelling argument for adopting a vegan diet. It also offers a hefty dose of skepticism about who you can trust for nutrition advice, particularly when it comes to the medical community. Overall I enjoyed reading the book and, despite my criticisms, agree with most of it. I have no doubt that for the vast majority of Americans Dr. Campbell’s advice and recommendations would be immensely beneficial.

Final Grade: B

Please add your thoughts on The China Study in the comments below.

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