Healthy, Wealthy & Wiser 101 is written by fellow afibber, Joe Osga. Joe was diagnosed with atrial fibrillation in April 2001. Over the next three years he spent an average of 240 hours/month in afib sometimes with a heart rate over 200 bpm and other very uncomfortable symptoms. As most of us have done he tried changes in diet, lifestyle and medications as well as massage therapy, chiropractic treatments, meditation, yoga and deep breathing - all to no avail. At this point Joe decided to apply the same principles he had used in establishing a successful business to vanquish his afib. He and his wife, an integral partner in "the project", sat down and discussed what had to happen for Joe to get better.

On January 21, 2004 Joe had a break-through. He was watching the "Dr. Phil Show" and was hit by the realization that perhaps the most important thing for him was to learn to let go of the past with the help of Dr. Phil's mental imagery techniques. In less than two months he experienced a 96% drop in his afib burden, going from an average of 240 hrs/month to only 8 hours/month. A subsequent pulmonary vein ablation reduced his time in afib to less than one hour per month. Joe writes eloquently about each of the components of his program; the importance of your personal environment including your home environment and the environment of your mind, your lifestyle and your spirit and body.

Joe's journey in dealing with his afib is a fascinating, inspirational read and not only that. The principles developed in Healthy, Wealthy & Wiser 101 can be used to deal with any illness or other personal challenge.

In the past few years several books have been published that present a contrarian’s view attacking the conventional wisdom regarding fat, cholesterol and cardiovascular disease. Now a new book by Gary Taubes has just been published. The author’s name should already be familiar to readers of this newsletter because his articles in the New York Times Magazine have been repeatedly quoted in connection with high vs. low fat diets and the issue of cholesterol and heart disease. He is a highly regarded medical journalist and the only print journalist to have won three Science in Society Journalism awards. In Taubes’ latest effort we have a comprehensive treatment of the title subject which includes fascinating early history and a very detailed discussion of the scientific research and clinical and epidemiologic evidence associated with the establishment views of diet, heart disease and diabetes as they have evolved over the last 50 years, views that in some cases have generated dogma now cast in stone, enshrined in medical textbooks and public health policies, and indelibly etched in the minds of both the general public and a substantial fraction of nutritionists and the medical profession. This book critically reviews alternate hypotheses which are contrary to this conventional wisdom and explores in great detail the research that forms their foundations and the culture that is responsible for these hypotheses being ignored and ridiculed. The title of the book is misleading—it is not a diet book in the usual sense, but if one accepts the author’s arguments, it could profoundly alter the way the reader looks at the connection between diet and health.

This book represents, according to the author, five years of research which included a comprehensive examination of the published literature and a careful look at the older literature that is so casually dismissed today. Included are interviews with some of the principal players including those now retired, and an examination of the impact, as reflected by the media coverage and official guidelines that periodically appear, on public behaviour, beliefs and public health positions. The author is neither an academic nor an employee of an industry with a vested interest in the status quo, but rather a keen and experienced observer of science and pseudoscience in action, and he brings to this project a fresh viewpoint presumably uncontaminated by the profound influence of dogma and the conventional wisdom, forces that, as this book clearly demonstrates, play a dominant role in undermining science’s supposed goal, search for truth. The thrust of the book is best described by quoting his conclusions which most readers will recognize as contradicting the conventional wisdom now firmly enshrined as a set of sacred truths which will probably endure over the professional careers of their influential contemporary proponents. In addition this conventional wisdom will probably continue to influence public health pronouncements and the areas and focus of intense and well supported research. These are consequences which individuals in the developed world may someday come to profoundly regret. Here are his conclusions, which also provide a general outline of the book and its topics.

1. Dietary fat, whether saturated or unsaturated, is not a cause of obesity, heart disease, or any other chronic disease of civilization.
2. The problem is carbohydrates in the diet, their effect on insulin secretion, and thus the hormonal regulation of homeostasis, i.e. the entire harmonic ensemble of the workings of the human body. The more easily digestible and refined the carbohydrates, the greater the adverse effect on our weight, well-being and health.
3. Sugars, and specifically sucrose and high-fructose corn syrup, are particularly harmful, probably because the combination of fructose and glucose simultaneously elevates insulin levels while overloading the liver with carbohydrates.
4. By virtue of their direct impact on insulin and blood sugar, refined carbohydrates, starches and sugars are the dietary cause of coronary heart disease and diabetes. Also, they are the most likely dietary causes of cancer, Alzheimer’s disease and other chronic diseases.
5. Obesity is a disorder of excess fat accumulation, not of overeating and or due to a sedentary behaviour.
6. Consuming excess calories does not in general cause humans to become fatter. Expending more energy than we consume does not necessarily lead to long-term loss of weight but it leads to hunger.
7. A disequilibrium in hormonal regulation of adipose tissue and fat metabolism results in fattening and obesity.
8. The primary mediator of fat storage is insulin. When insulin levels are high, either chronically or after eating, we accumulate fat in the fat tissue. When insulin levels fall, there is a release of fat from fat tissue for use as fuel.
9. Carbohydrates make us fat and ultimately cause obesity by stimulating insulin secretion.
10. Carbohydrates also increase hunger and decrease the amount of energy we expend in metabolism and physical activity by driving fat accumulation.

Thus Taubes makes a case for what might be called The Carbohydrate Hypothesis of Chronic Diseases, and this book concentrates on the potential impact of this hypothesis on heart disease, vascular disease and diabetes.

In spite of the very high order of scholarship and meticulous research reflected in this work, it is probably not a book that mainstream medicine will welcome, nor is it one that they will recommend to patients, medical students, graduate students, etc. After all, aside from an attack on the conventional wisdom, the message that comes through loud and clear is that we now have a milieu associated with medical and nutritional research where the standards of evidence are considerably more lax than in the hard sciences such as physics, chemistry, molecular biology, etc. and that this has had a strong impact on the time honoured processes associated with getting at the truth concerning questions of great importance.

A lot of what Taubes describes might be called “Official Science,” a term used by Christopher Essex and Ross McKitrick in a book on climate change (Taken by Storm, Key Porter Books, 2007, Toronto). Official Science is the end result of the evolution of a hypothesis or mere model to an accepted truth and then to a dogma without any justification for this elevation. The status as Official Science makes it almost impossible to challenge the dogma, publish a contrarian view or results, or even obtain funds to study the matter, and anyone even questioning the dogma runs the risk of becoming a professional outcast. Hypotheses should survive by withstanding attempts at falsification. This is the way science is supposed to work. But this process has been cleverly undermined by using the media, individuals with vested interests and appeals to so-called authority in order to keep alive questionable hypotheses, prevent studies that might invalidate them and allow citation bias, even in refereed journals, to conceal inconvenient truths. Taubes presents case after case to illustrate this deplorable state of affairs in what most people look up to as the sacred and highly esteemed establishment that creates so-called evidence based medicine. Thus this book is in fact an expose of what has fundamentally gone amiss today with science as it is used and manipulated in the fields of health and nutrition.

This book may erode or even destroy the reader’s confidence or belief that medical and nutritional research, as it has been conducted for the past 50 years in fields such as diet, diabetes and heart disease, is capable of providing guidance that is based on sound principles of scientific research and an unemotional, unbiased and open-minded search for the truth. But Taubes’ carefully researched and documented history of the conflict between dogma and authentic science should prove to be of value for anyone trying to sort out the steady stream of conflicting views that have emanated from the recognized experts and their critics, gain a perspective regarding the role of various high profile organizations attempting to influence public health issues and rethink long held beliefs, recognizing that they may only be either hypotheses or in fact merely the result of junk science.

Reviewed by William R. Ware PhD

ORDER Good Calories, Bad Calories NOW

The Unbroken Field is Michael Greenwood's third book in his fascinating series on the use of acupuncture and bodywork in effectively dealing with pain and chronic illness. In his first book Paradox and Healing (co-authored with Dr. Peter Nunn) Michael explores the use of acupuncture and guided hyperventilation in releasing pent-up emotions often underlying chronic pain. This theme is further explored in Braving the Void in which Michael describes numerous cases of patients who were guided to markedly reduce or eliminate their chronic pain by exploring and releasing their underlying emotional and physical blockages.

In his new book The Unbroken Field Michael goes one step further in its exploration of the ancient wisdom of Traditional Chinese Medicine as a guide in optimizing the acupuncture treatment which forms the basis for the successful pain relief work carried out at the Victoria Pain Clinic where he serves as medical director. The chapters on dynamic meditation and dynamic interactive acu-bodywork are particularly fascinating and well worth further exploration.

Michael's books are "must reads" for anyone interested in exploring and effectively using the body/mind connection as a means of dealing with chronic pain and illness.

The Inflammation Cure
by William J. Meggs, M.D., Ph.D. with Carol Svec. Contemporary Books, New York, 2003
ISBN 0-07-141320-0 (hard cover edition)

Stop Inflammation Now!
by Richard M. Fleming, M.D. with Tom Monte. G.P. Putman’s and Sons, New York, 2004
ISBN 0-399-15111-7 (hard cover edition)

There is currently considerable interest in the subject of inflammation both among medical researchers and clinicians and as well, the general public. The February 23, 2004 issue of Time magazine featured “Inflammation, The Secret Killer” as the cover story, and recent issues of several health oriented magazines have had inflammation as the feature topic. While inflammation is an essential and integral part of the normal immune reaction and the response to injury, chronic inflammation may be asymptomatic and present serious health risks which can be much more dangerous and extensive than one might expect. Chronic inflammation, which is involved in diseases such as rheumatoid arthritis, inflammatory bowel syndrome and Crohn’s disease, is now implicated in diseases where the connection is far less obvious, such as atherosclerosis, cancer, and Alzheimer’s disease. Thus from the layman’s point of view, the obvious questions are:

• Do I have or am I at risk of having chronic inflammation?
• What are the causes?
• What can I do about it?

These are questions that might reasonably be put to one’s physician, but the complexity of the subject does not lend itself to the fifteen minute office visit setting, and some, perhaps even many individuals are interested in acquiring a fairly detailed knowledge of what is now considered a serious health issue.

The three books address the above questions, although the approach, depth of treatment, and emphasis differ considerably. The principal authors of two of the books are MDs. Jack Challem is a leading health and medical writer and coauthor of the popular and widely-read book Syndrome X.

Challem’s book introduces the reader to what he calls the Inflammation Syndrome, which he describes as the cumulative effect of low-grade inflammation that grows into chronic, debilitating disease. He discusses six general categories of inflammatory triggers: (1) age-related wear and tear; (2) physical injuries; (3) infections; (4) environmental stresses including tobacco smoke, air pollution etc.; (5) allergies and food sensitivities; and (6) dietary imbalances and deficiencies. He carefully distinguishes between the triggers of inflammation and what causes the normal response to go out of control. There is a very strong emphasis on the dietary aspects of inflammation and his “anti-inflammation” approach is primarily through diet modification involving both the elimination of foods that trigger inflammation and adding and emphasizing foods he considers beneficial in this context. Challem also provides a simple questionnaire that readers can use to evaluate their level of inflammation.

Part II of the book outlines fifteen steps to fight the Inflammatory Syndrome, and both diet plans and recipes are presented. While anti-inflammatory drugs are discussed, Challem’s attitude is somewhere between negative and highly cautious. Part III is titled “The Anti-inflammatory Supplement Plan” and includes a detailed discussion of omega-3 fatty acids, vitamin E, glucosamine, the B vitamins, etc. Finally, in Part IV there is an informative discussion of about twenty diseases and specific conditions that have a connection with chronic inflammation. This final section should leave little doubt in the reader’s mind as to the importance of avoiding or dealing with chronic inflammation.

In The Inflammation Cure, Meggs and Svec, after a brief introduction to the nature of the inflammatory process, provide a lengthy and informative discussion of the connections, both proven and suspected, between inflammation and heart disease, stroke, diabetes, cancer, fatigue, obesity, depression, autoimmune diseases, allergies, asthma, arthritis and Alzheimer’s disease. They then deal with the question “what does one do” by offering a game plan involving dietary and lifestyle solutions, as well as suggestions regarding the modification of triggers at home and in the workplace. Considerable emphasis is placed on so-called mind-body solutions which reflect the connection between psychological stress and inflammation. The book also contains a quiz readers can take to estimate their level of susceptibility to inflammation-related disorders by measuring exposure to the most common sources and causes of inflammation. There is also a short discussion of laboratory inflammation tests, supplements and anti-inflammatory drugs. One of the merits of this book is the comprehensive approach to the problem of dealing with chronic inflammation and its risks.

Stop Inflammation Now! This book is sub-titled “A step-by-Step Plan to Prevent, Treat, and Reverse Inflammation—the Leading Cause of Heart Disease and Related Conditions.” The principal author, Richard Fleming, is a nuclear cardiologist. The main emphasis of this book is on heart disease, and the depth of the discussion of this topic is one of the book’s strengths. But aside from the title, it would seem appropriate to classify it as a diet book rather than a book on inflammation. It promotes a two-step, very low-fat (15% of energy intake in the phase 2 diet) and low-protein diet plan coupled with exercise. Inflammation is discussed here and there in the book, but the level of treatment of the subject is minimal compared to the books by Challem and by Meggs and Svec. It in fact differs from these two books in many respects. For example, Fleming considers fish to be an inflammatory food (page 20), and fish is a very minor part of his Phase II diet (page 163), whereas fish is a significant part of the anti-inflammatory diet plans of both Challem and Meggs. Fleming is also against fish oil supplements. But while Meggs recommends eating fish three to five times a week and imitating the Mediterranean diet by the liberal use of olive oil, he is close to Fleming in suggesting very little meat, poultry, cheese, butter, milk, and other animal products. Challem deals with the meat issue by recommending meat from free-range or grass fed animals and eggs from free-range chickens or eggs enriched with omega-3 fatty acids. Challem is also enthusiastic about olive oil and eating lots of fish.

In the opinion of this reviewer, Fleming’s book should be viewed in the context of the high-carb vs. low-carb controversy and the debate as to the connection between fat and heart disease. The book, by and large, promotes one view favored by the very low-fat school. The philosophy is similar to that of Dean Ornish before he started recommending fish oil and fish in his diet (see www.Ornish.com). Also, there are some, perhaps many, who would find the Phase II diet consisting of 17 servings of fruits and vegetables per day to be a bit difficult to manage. At issue is the balance of macronutrients and the emphasis on very low fat consumption that puts him at odds with other interpretations of the modern nutritional literature. This is a highly complex and controversial subject. Fleming’s book should be read along with such books as Walter Willett’s Eat, Drink and be Healthy, the Harvard Medical School Guide to Healthy Eating, Arthur Agatston’s The South Beach Diet (Agatston is also a cardiologist) and Stephen Sinatra’s Heart Sense for Women (Sinatra is also a cardiologist) to obtain a balanced picture (see also the IHN research reports “The Diet Zoo” and “Dietary Fat and Coronary Heart Disease: Is There a Connection?”).

Readers desiring a broad background on the subject of inflammation should be well served by either The Inflammation Syndrome or The Inflammation Cure or better, by both.

Reviewed by William R. Ware

The front cover of the paperback edition expands on the title as follows: “How one simple nutrient can prevent, treat and reverse high blood pressure, heart disease, diabetes, and other chronic conditions.” A bold claim indeed! Dr. Seelig has been studying the role of magnesium in health and disease for over 35 years. She is chair of the Magnesium Advisory Board which oversees the New York Weill Cornell Medical Center’s Magnesium Information Center. Dr. Rosanoff has been involved in the study of magnesium nutrition for the past 17 years. The authors’ thesis is as follows; (a) Magnesium deficiency is widespread and aggravated in part by its removal from many foods during processing. (b) Magnesium is involved in innumerable human biochemical processes and is directly involved in the action of more than 350 enzymes and indirectly implicated in many more. (c) Magnesium deficiency is involved in many disease states, including heart disease, hypertension, Syndrome X and diabetes. (d) Deficiency is easily corrected with rather low levels of supplementation (up to 700 mg/d) or attention to diet or both. Supplements are inexpensive, safe for almost everyone, and normally very well tolerated.

The following list of chapters provides a good indication of the scope of this book and the relevance of magnesium to health and disease:

• Magnesium: the mineral that combats heart disease and keeps blood vessels healthy.
• Metabolic Syndrome X, diabetes and magnesium.
• High blood pressure, salt and magnesium.
• Obesity, physical activity and magnesium.
• Fat, cholesterol and magnesium.
• Magnesium, stress and the Type A personality.
• Magnesium and genetics; family history and sex differences.
• Magnesium and other heart disease risk factors.
• Are we really low in magnesium?
• Do you need more magnesium?
• Making sure you have enough magnesium.
• Magnesium, the silent guardian of our hearts and arteries.

In the chapter “Making Sure You Have Enough Magnesium,” guidance is provided on maximizing magnesium from food and water, and on selecting supplements. Guidance is also given on the appropriate ratio of magnesium to calcium intake. Many readers will find the discussion of magnesium and hypertension of particular interest, and as well, the chapter titled “Fat, Cholesterol and Magnesium” contains a modern discussion of this subject which is currently very relevant. Included is a section on the HMG-CoA reductase inhibitory action of magnesium which includes a discussion of the similarities and differences in its action compared to the statin class of drugs which inhibits the same enzyme.

Ten appendices include a magnesium questionnaire which is provided for self-assessment of status, tables of common foods classified by magnesium content and a list of common medications that influence magnesium status. The book also contains some interesting case histories describing the almost magical effects of correcting a magnesium deficiency.

This appears to be an authoritative treatment of a very important subject, both for the layman and the health-care professional. It is up-to-date and comprehensive. The authors make a strong case that magnesium is clearly an important and often overlooked factor in some of the most serious and prevalent disorders that are encountered in the practice of medicine, in fact, frequently on a daily basis. It is probably true that not nearly enough attention is given to this essential mineral nor is there sufficient awareness of the potential role magnesium plays in a number of disease states or the need in some cases for aggressive supplementation. This book should provide a wake-up call.

Published in 2003, The Magnesium Factor includes very recent research and an extensive set of references. Unfortunately, while the references are listed by chapter, they are not cited in the text.

Reviewed by William R. Ware

Bypassing Bypass Surgery
Elmer M. Cranton, M.D.
Hampton Roads Publishing Company, Charlottesville, VA., 2001

Chelation therapy has been practiced for over 40 years and today there are chelation clinics worldwide as well as physicians treating patients on an individual basis. Aside from its FDA approved use for lead poisoning, which was the first medical application, mainstream medicine is almost universally opposed to chelation therapy, holding there is no evidence that meets their scientific and evidence-based standards for pronouncing treatments effective. The mechanism of alleged action is viewed as unknown, and the treatment is considered a waste of money and even dangerous. The majority of physicians routinely and strongly discourage their patients from initiating chelation for the treatment of stable angina, carotid artery occlusion, untreatable restenosis (recurrence of blockage) after coronary bypass surgery, impaired peripheral circulation, or for the prevention of amputation due to diabetes related severe peripheral vascular problems with lower extremity gangrene, to mention only some of the conditions for which chelation is supported by more than thirty years of anecdotal evidence and a number of clinical studies. In spite of the strong opposition from mainstream medicine, there have recently been roughly as many individuals who have undergone chelation therapy as have received coronary bypass surgery. According to chelation experts, the therapy has a forty-year record of safety. In Ontario, physicians are permitted to use chelation therapy without harassment or disciplinary action from the College of Physicians and Surgeons thanks to a private member's bill passed in the provincial legislature several years ago.

The therapy involves intravenous (IV) infusion of a common metal binding chemical, ethylene diamine tetracetic acid (EDTA), generally combined with a magnesium salt and a variety of other compounds to create an IV fluid that is well tolerated. It appears important that each treatment be done over a period of about three hours to infuse 3 grams of disodium EDTA. As many as 30-50 treatments are frequently required, although many individuals report symptom reduction after 5 to 10 treatments. EDTA is not metabolized, but binds a large number of metals and rapidly eliminates them in the urine.

An oversimplified description of what is thought to be the mechanism of action is related to this metal (ion) removal and the attendant decrease in the oxidative load, which results in the healing, over a long term, of oxidative damage, especially to the circulation system, and allows a redistribution of metals in the body and in enzymes that is closer to normal. The notion that the therapeutic action of EDTA is mainly due to calcium binding and elimination is no longer believed by most researches in this field and was never believed by the critics of the therapy.

Dr. Cranton's textbook is actually a collection of articles, each with references, by medical scientists and physicians associated over the years with chelation therapy. It has sections on the scientific rationale of the therapy, twenty chapters on clinical trials, and sections on safety, the modern protocol for administration, and laboratory methods associated with EDTA plasma level measurements, monitoring of renal function, and data on urinary toxic and trace element excretion. This second edition has been updated to include some recent studies and additional anecdotal evidence, and includes the present-day protocol that has become standard for the IV administration of EDTA. While this book is perhaps mostly of interest to physicians practicing or contemplating practicing chelation therapy, some of the chapters should be of great interest to the layman since countless successful case studies are presented. Individuals with coronary heart disease, failed bypass surgery, cardiovascular or peripheral circulation problems, end-stage occlusive peripheral arterial disease with gangrene (the diabetic's nightmare since amputation is generally the only solution offered by mainstream medicine) etc., will find patients described with symptoms and problems to which they can relate.

Bypassing Bypass Surgery is written by the editor of the book discussed above and is intended for the layman, although it should also provide a useful introduction to physicians interested in the subject. The title is misleading, since this is in fact a comprehensive book on chelation. The sub-title reads "Chelation Therapy, a Non-Surgical Treatment for Reversing Arteriosclerosis, Improving Blocked Circulation, and Slowing the Aging Process." Elmer Cranton is a graduate of Harvard Medical School. For a time he served as chief-of-staff of a U.S. Public Health Service Hospital. He has authored many books and scientific articles in the field of medicine and is certified as a fellow and diplomat of the American Board of Family Practice. At present, he oversees the operation of two clinics. The book begins with five endorsement letters regarding chelation therapy from cardiac surgeons and medical school professors which provide evidence that not all of mainstream medicine is against chelation. In the seventeen chapters that follow, virtually all aspects of chelation therapy are explored, including the early history, modern views as to the mechanism of action, a discussion of the clinical research, a comprehensive risk vs. reward analysis of bypass surgery and angioplasty (Chapter 16), a discussion of other conditions than heart disease where chelation is indicated, and a disturbing history of the politics of chelation. While no informed person would have grounds for suggesting that bypass surgery or angioplasty is unnecessary in some clinical situations, there are many instances where the evidence described by Dr. Cranton would suggest that there are sound reasons for considering chelation as either an alternative or as a therapy to try initially in the hope that surgery or angioplasty could be avoided.

For diabetic patients facing the amputation of toes or a foot because of gangrene, serious attention should be given to the anecdotal evidence quoted in this book as well as in the Textbook on EDTA Chelation Therapy (Chapter 11, "Effect of EDTA Chelation Therapy: Treatment of Peripheral Arterial Occlusion, an Alternative to Amputation"), since the reported success for complete reversal of this peripheral circulation problem and the concomitant saving of a foot (and ultimately probably a leg) seems compelling. When a person starts chelation in a wheelchair after being told that immediate amputation is a necessary and in fact lifesaving operation, and a few months after chelation therapy can walk normally, play golf, and has pink rather than blue feet with no evidence of seriously impaired peripheral circulation, one can only wonder what more evidence mainstream medicine wants, given that these patients were pronounced hopeless and offered life-altering amputation as the only solution. By now, practically every chelation clinic in the world can probably provide a number of case histories of this particular application. Only the most ardent believer in the power of the placebo would dismiss these anecdotal results for end- stage occlusive peripheral arterial disease as unrelated to EDTA chelation, and demand double blind, randomized placebo controlled studies. In addition, placebo effects do not generally result in permanent alleviation of symptoms, nor are they consistent with the common observation that the benefits of chelation often fully appear only several months after the end of treatments. It can be argued that such studies would be highly unethical, given the nature and weight of the anecdotal evidence. It is also doubtful if many individuals would be interested in a study where they were hooked up to an IV for 3 hours per treatment for perhaps 60 treatments over 20-60 weeks without knowing if they were getting EDTA or just a drip containing everything but EDTA. If they were in a room with patients nearing the completion of their course of treatments and experiencing great improvement, it would be even more difficult to maintain the condition of a blind or double blind study, since everyone would probably soon want or even demand the EDTA treatment.

In view of the opposition from mainstream medicine, clearly the reader must make up his or her own mind as to the merits of chelation. Reading one or both of these books should help. Two quotations presented at the beginning of Bypassing Bypass Surgery seem appropriate to end this review (page x-xi, paperback edition):

"….I now achieve more lasting results with less risk, enhancing the benefits of surgery, and often avoiding surgery, by providing chelation therapy for my patients." Peter J. van der Schaar, M.D., Ph.D. Cardiac Surgeon and Director, International Biomedical Center, The Netherlands.

"….Bypassing Bypass is a book that will help patients to take responsibility for their own health, and it must be considered required reading for every serious student of preventive medicine, physician and patient alike." H. Richard Casdorph, M.D., Ph.D. Assistant Professor of Clinical Medicine, University of California, Irvine.

Reviewed by William R. Ware, Ph.D.

Loren Cordain is a professor in the Health and Exercise Science Department of Colorado State University, is a respected expert on the early human diet, and has published significant original research in this area.

The thesis of "The Paleo Diet" is that we have essentially the genetic make-up and metabolism of our Stone Age ancestors, and that the human genome has changed less than 0.02% in the last 40,000 years. The Stone Age or Paleolithic era actually covers the period from the first appearance of stone tools, about two million years ago, up to the end of the last Ice Age about 15,000 years ago. Homo sapiens are thought to have arrived on the scene in Africa about 100,000 years ago in the so-called Upper Paleolithic period. It is now reasonably well established that when Homo sapiens migrated out of Africa to Europe, Asia, and beyond, replacing earlier Homo species, they were still hunter-gatherer tribes, a situation that prevailed for thirty to forty thousand years prior to the advent of raising, grinding and storing grains and raising animals for food (see for example "The Seven Daughters of Eve", by Bryan Skyes, W. W. Norton, 2001, for a fascinating and up-to-date discussion by an Oxford genetics professor of the use of female mitochondrial DNA in this context). Basic to Cordain's argument is the belief that the rate of mutation would not have allowed humans to adapt to the profound changes brought about in diet that came with the advent of agriculture and animal husbandry, which occurred about 10,000 years ago. Thus it is argued that modern man should still eat a diet based on the balance of nutrients in the diet of our Stone Age ancestors, i.e. based on our genetic blueprint, a diet which for example included nuts, seeds, roots, leaves, fruit, honey (rarely!), lean meat and fish. Thus the Paleo philosophy requires avoiding many of the diet changes that started about 10,000 years ago. Further rapid and profound changes have occurred in the last century with the development of the modern food and drink industry.

Cordain develops this thesis early in the book and then moves rapidly to apply its basic principles. In Part One he develops arguments for the proper balance of fat, protein and carbohydrate, and the types of each that are consistent with the Paleo Diet. The ground rules are simple: eat only lean meats, fish and other seafood, fruits and non starchy vegetables, and avoid cereals, legumes, dairy products and processed foods. Finally he discusses how, in his opinion, our modern diet went wrong and how his approach corrects the problem. He also discusses the optimum balance of omega-3 vs. omega-6 essential fatty acids.

Part Two, titled "Losing Weight and Preventing and Healing Disease," includes a discussion of Syndrome X (also called the "Metabolic Syndrome") which he calls "The Civilization Disease" and attributes the syndrome, as have a growing number of nutritional scientists, to our modern Western diet with its emphasis on refined grains and sugars, which results in problems with glucose and insulin control, obesity, diabetes, heart disease etc. At the end of Part Two the author elaborates at some length on the proposed connection between the modern Western diet and a variety of diseases and health problems. An example is the relationship between celiac disease and cereal grains. Another is lactose intolerance. The remainder of the book provides detailed information on applying the principles of the Paleo Diet with a discussion of what to eat and what to avoid, meal plans, recipes, and the general principles of "Living the Paleo Diet."

This book is an important addition to the modern diet literature, and its theme is related to the debate regarding high vs. low carbohydrate diets, although the author's criticism of low-carb "fad diets" seems at variance with recent research results as well as most modern versions of this type of diet. Some readers may consider his restrictions too severe, and may find some of his beliefs debatable (e.g. "saturated fats are mostly bad"), but the general principles seem definitely worthy of serious consideration. "The Paleo Diet" is highly recommended reading for anyone trying to adjust their diet to optimize health.

Reviewed by William R. Ware, Ph.D.

New books on diet and health appear monthly on bookstore shelves. The discriminating reader will have long since discovered that many, ranging from the bizarre to the mundane, are not worth a second look. Walter Willett's new book Eat, Drink and Be Healthy is different, and in fact has little in common with the majority of books that aim to provide guidance on what to eat and drink. We now live in a world where "evidence based medicine" has become the norm, at least among many physicians and medical scientists, and this book may well have the soundest and most extensive foundation in nutritional science of any diet book recently published.

Walter Willett is chairman of the Department of Nutrition at the Harvard School of Public Health and a professor of medicine at Harvard Medical School. He is one of the principal architects of three major and highly significant investigations, the Nurses' Health Study, the Physicians' Health Study, and the Health Professionals Follow-Up Study. These epidemiologic studies are the basis of much modern thinking on health and nutrition. Willett is one of the world's leading nutritional epidemiologists and author of a definitive textbook on nutritional epidemiology. This new book, written for the lay public, offers his views on diet and health based on a careful and thoughtful analysis of the underlying science. One-third of the book is devoted to recipes, which serve as illustrations of the principles set forth.

Central to the book's basic philosophy is a new food pyramid, Willett's so-called "Healthy Eating Pyramid," which is radically different than the pyramid promoted for decades by the U.S. Department of Agriculture—the so-called USDA Food Guide Pyramid, which Willett describes as follows: "At best, the USDA Pyramid offers wishy-washy, scientifically unfounded advice on an absolutely vital topic, what to eat. At worst, the misinformation contributes to overweight, poor health, and unnecessary early deaths. In either case it stands as a missed opportunity to improve the health of millions of people." This represents a strong condemnation of what has been for decades the basis of nutritional advice, and sets the tone of the book. Willett's pyramid is based on seven fundamental principles: (a) exercise and watch your weight; (b) eat fewer bad fats and more good fats; (c) eat fewer refined-grain carbohydrates and more whole-grain carbohydrates; (d) choose healthier sources of proteins; (e) eat plenty of vegetables and fruits but hold the potatoes; (f) use alcohol in moderation; and (g) take a multivitamin for insurance. Chapters 3-11 address the scientific basis of this advice and provide valuable details, while gently introducing the reader to the mysteries of randomized trials, cohort studies, case-control studies and what has been learned from metabolic studies. Chapter 4, titled "Surprising News About Fat" provides the basis for the growing consensus that very low-fat diets are not necessarily healthy and instead one must be selective about their fat intake to make sure that healthy fats are plentiful. In fact, each chapter (except perhaps the recipes) is likely to provide "surprising news" for many.

Readers will find the chapter on vitamins and minerals of particular interest. The author discusses the role of selected micronutrients in health and disease, discusses relevant studies, and provides useful information on food sources. He concludes that many diets are probably deficient in vitamins E, D, B6, B12, and folic acid, and, while encouraging the reader to derive their micronutrients from food, nevertheless recommends a daily multivitamin or vitamin-mineral containing the recommended daily allowance (RDA), advice that one does not often hear from mainstream medicine. Some readers, while agreeing with the author's position that this insurance is desirable, will in fact want more insurance than is provided by the RDA.

Willett's stated goal is to "…offer straightforward, no-nonsense advice on nutrition based on the best information available," and anyone reading this book will probably agree that he has achieved this objective. Anyone interested in diet, health and longevity should definitely read this book.

Reviewed by William R. Ware, PhD

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