This book has me torn. It contains so much good… and yet, it has so many problems. It’s an important read for everyone… but also misleading. Overall, I learned a lot from it… but also ended up more confused than ever.
Let me break it down.
Good insights
Let’s start with the key insights:
Eat more veggies, fruits, nuts, seeds, and whole grains and less processed foods and animal products
- This is one of the central recommendations in the book, and it seems spot on.
- For the most part, this book does a good job of covering the vast amount of research backing the health benefits of fruits & veggies (though see below for some of the issues with the research).
Many of the leading causes of death in the US are a choice
- Most heart disease, lung disease, liver disease, kidney disease, cancers, and so on are due to lifestyle choices.
- You can dramatically reduce your chance of death from these diseases by choosing a different diet and lifestyle.
I don’t mind dying. But I don’t want it to be my fault.
Distressing health facts
- Hospital care is one of the leading causes of death in the US (roughly ~3rd). A huge number of people die every year from prescription side effects, infections, medical errors, and so on.
- It is legal (in the US) to inject chickens with additives. These additives increase the chicken’s weight. Some of them (e.g., phosphates) can have serious negative health consequences.
- 3rd hand smoke. The smoke that stays in the walls, carpets, etc. can have negative health consequences. Smoking in any indoor area is not safe.
- Oxidation causes aging. One theory of aging is that oxidation is damaging our DNA. We are literally rusting!
Conflicts of interest
- Doctors only make money from procedures and medications. They do not make money from prescribing diet and exercise. Moreover, most doctors have only minimal training in diet and exercise. All of this creates a horrible conflict of interest.
- Many US government agencies take money from corporations. Many of the government agencies in the US that make recommendations around food and health (e.g., the FDA) take in huge amounts of money from corporations (e.g., from Coke and Pepsi) and ignore scientific findings when making recommendations. Greger’s argument is that we should show people the science and let them decide, rather than making (biased) recommendations.
- The author, Michael Greger, is trying to avoid conflicts of interest. He says all the proceeds from this book will go to charity, his nutritionfacts.org website is a donation-driven nonprofit, and he doesn’t offer any products (in fact, his main recommendation is to avoid any products and just eat whole, natural food!). Unlike many other authors of diet books, it doesn’t seem like Greger is trying to sell anything here, and I commend him for that.
Food matters more than medicine
- Greger makes a strong case in the book that the contents of your fridge are far more important to your health than the contents of your medicine cabinet.
- Most supplements and magic pills don’t work, are expensive, and have nasty side effects.
- Whole, natural foods have powerful beneficial effects, don’t cost much, and have only positive side effects.
- If drug companies could create a pill that reduces your risk of death by 10% and only had positive side effects, they’d make billions; the good news is that fruits and veggies are just such a pill!
Weaknesses of the book
Now let’s turn to the drawbacks:
It’s basically veganism
Although Greger tries to dance around it, his ultimate recommendation is that everyone should become a vegan.
- He says he doesn’t subscribe to any diet “ism,” and instead is merely recommending a “plant based diet.”
- However, he categorizes ALL animal products as “red light” foods which should be completely avoided.
- And what do we typically call a diet that avoids all animal products?
Why is he avoiding the term veganism? Perhaps it’s because veganism has been studied quite a bit. Some of the findings are good, but there are also downsides:
- Almost all vegans must take B12 supplements.
- Many vegans need vitamin D supplements.
- Many vegans need iodine supplements.
This is a critical point, as it shows a purely plant based diet is:
- Lacking critical nutrients.
- Not “natural,” as it would not have been possible in the wild until supplements were invented in the 20th century.
Moreover, Greger spends much of the book talking about how supplements don’t work, but the very diet he recommends doesn’t work without supplements!
It’s not a traditional diet
Greger often praises “traditional diets” of Japan, India, China, etc. and argues that those diets are responsible for the lower incidences of many diseases in those countries, and therefore, have influenced the diet he recommends. However, most of the people in these countries do NOT eat the diet recommended in this book.
- Some eat meat
- Some eat fish
- Some eat animal products such as milk, yogurt, and cheese
Those cultures may eat more plant-based foods too, but their diets are still very different from what Greger recommends.
Cherry-picked data
Greger mentions frequently how the US government should just “show us the science and let us decide.” And yet, Greger himself doesn’t do that. He shows us some of the science, but it turns out his data is heavily cherry-picked:
- Greger comes down very hard on dietary fat and cholesterol, but many recent studies have shown compelling evidence that these are not as bad for you as we used to think.
- Greger’s recommendations around Omega-3 fatty acids, fish, fat, impact of vegetarianism/veganism on health, soy, and many other topics are questionable, at best.
- There’s a great overview of some of the cherry-picking here.
In other words, it’s not that Greger is lying (though the interpretation of some of the studies is definitely questionable), but omitting critical facts.
This is what frustrates me the most about this book.
- Surely Greger and his team know of the MANY studies that contradict his claims.
- Why not show us this science and let us decide, as he advocates in the book?
- And if these contradictory studies are in some way invalid, why not say so?
- The book would’ve been so much stronger if he had taken on these counterpoints head on.
- Instead, they are completely missing, and I’m now left to try to figure out who to believe.
I’m not a nutrition expert, so how should I know if Michael Greger (go vegan!), Gary Taubes (avoid carbs!), or Michael Pollan (eat traditional diets!) is right?
Too eager to try unproven things
Greger seems a little too eager to recommend things, even those with relatively little research about them, saying “why not try it?” Why not? Because:
- It could have unintended side effects (e.g., Americans who started eating less fat ended up eating more refined carbs, which may be worse).
- Making lifestyle changes is hard, and we shouldn’t waste our time and energy on things that might not work.
Overall
Overall, this book is worth reading. There’s no doubt it’ll make you reconsider some of your dietary habits. I’m already trying to get more veggies, berries, and beans into my diet. But if you take the time to research things yourself, you find that the story is not nearly as simple as Dr. Greger makes it out to be. In part, this is because the food industry intentionally funds bogus studies that confuse the issue. But in part, it’s because the human body is complicated, and the state of food science and research today is still quite primitive.
At the end of the day, the most reasonable advice to me seems to be that of Michael Pollan:
Eat food. Not too much. Mostly plants.
