How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease
Michael Greger with Gene Stone
This book is amazing, authoritative, life-changing, and overwhelming.
How Not To Die makes the case for diet as the biggest influence by far on health and longevity. Michael Greger is a medical doctor and expert in the field of nutrition, and is one of the founders of the American College of Lifestyle Medicine. The book is mostly his baby, with the help of Gene Stone, author of Forks over Knives.
Dr Gregor has a website, Nutritionfacts.org, and has followed up this bestselling book with two sequels- How Not to Diet, and the How Not to DieCookbook.
This book presents a compelling case that much of what our medical establishment is telling us about health is weighted way to far on medicines and treatment and not nearly enough on diet, exercise, and lifestyle. If doctors were really doing their jobs, they would work with us to prevent diseases before they happen through lifestyle interventions.
There's two problems with that. For one, doctors are barely trained in any type of nutrition science. Only one quarter of medical schools have any type of nutrition courses, and the profession in general avoids the topic because it's uncomfortable and complicated to talk about. The bigger problem is that there's no way the current system could exist if they did work upstream and stop most of the diseases. The system profits off of chronic diseases that require plenty of office visits, procedures, and medications. We become dependent on them. If we're eating healthier and don't need them, they lose money.
The book is divided into three parts- the top 15 causes of death, the Daily Dozen recommended foods, and a huge section of notes, references, and studies to back up all of his claims.
Let's start with the top 15 causes of death in the United States.
1- Coronary heart disease 375,000 deaths per year
2- Lung diseases (lung cancer, COPD and asthma) 296,000
3- Iatrogenic causes (hospital errors, medicine side-effects, hospital infections) 225,000
Dr Greger goes through each type of death and presents compelling evidence that proper diet can at least partially prevent all of them. The chapter on heart disease alone should be required reading for anybody with that diagnosis. Rather than relying on drugs like Lipitor, the book claims that a plant-based diet can heal much of the body and bloodstream.
For each cause of death there is an explanation of what happens to the body and how certain dietary ingredients like whole grains, flaxseeds, turmeric, or broccoli have been shown to heal patients after symptoms have shown up.
The chapter on hospital-related causes of death certainly was a shocker, and I know that most hospitals do their best. But when working with radiation, complex treatments, and medicine side-effects, it made sense that sometimes the cure is worse than the disease.
The claims in this section are bold, and my bullshit detector wants to believe that he's oversimplifying the impact of diet. But he does back it all up with scientific studies, and the evidence of a plant-based diet being better for you is pretty much shared by almost every science-based diet book out there.
The second section is devoted to exactly what you should eat and how often. Dr. Greger presents it as a guideline and avoids the strident tones of many diet books saying if you don't do it exactly my way you'll die. Everybody has to find what works for them. He provides the science and the guidelines and that's all I want from a book like this. There are green, yellow, and red light foods that you can probably guess based on their reputations. Obviously he recommends a plant-based diet, but not necessarily vegetarian or vegan.
Here is his list of recommended foods that we should strive to eat every day, a list he calls the Daily Dozen.
1- Beans (1/2 cup of beans, split peas, tofu or tempeh) 3 servings per day
2- Berries (1/2 cup fresh or frozen) 1 serving per day
3- Other fruits (1 medium fruit) 3 servings per day
6- Other vegetables (beets, carrots, mushrooms, onions, squash, tomatoes, sweet potatoes, asparagus- 1 cup) 2 servings per day
7- Flaxseeds (1 tablespoon per day)
8- Nuts and seeds (Almonds, pecans, pistachios, sunflower seeds, walnuts 1/4 cup) 1 serving per day
9- Herbs and spices (turmeric, parsley, pepper, cinnamon, dill, garlic, ginger, saffron) 1/4 teaspoon per day of turmeric
10- Whole grains (barley, brown rice, oats, popcorn, quinoa, whole-wheat pasta) 3 servings per day
11- Beverages (water, tea and coffee) 5 servings per day
12- Exercise (moderate intensity- 90 minutes or vigorous activity 40 minutes) once per day.
When I first read this section I found it overwhelming. I barely eat half of the items on the list, and he wants me to eat all 12 every day? It's a helpful list to refer to, if impossible to achieve for many, but it's all based on the science of what those ingredients can do for your health.
Flaxseeds are high on the list because of their help with high blood pressure, breast cancer, and prostate cancer. Turmeric plays a role in preventing lung disease, brain disease, and a variety of cancers as well as rheumatoid arthritis. Berries get special treatment because of their protection against cancer, boosts to the immune system, and protection of the brain and liver. Berries and other pigmented foods have antioxidants, so he recommends staying away from pale and white foods that are a staple of the American diet.
In each chapter he goes over some of the types of food and what their benefits are, as well as questions like how to tell if a whole grain bread is really good for you (make sure the fiber is at least 1/5 of the total carbs). There are helpful shopping tips and a minimal amount of recipe tips, and this section is packed with valuable information.
The third section is 133 densely packed pages of references and notes, and only the bravest nutrition nerds can look up the studies cited. Nutrition studies are notoriously conflicting, in part because many are sponsored by the food companies to make their products look good. I am trusting Dr. Gregor and his colleagues to use the most independent and scientific studies here.
In a way, we are all very lucky to have such a wealth of information from past behaviors to help us make choices for our future. Many people have devoted their lives to these studies that point the way to what works and what doesn't in the pursuit of health. Getting the information, understanding it, and putting it into practice in the midst of unimaginable temptations is another thing entirely.
I would recommend reading this book several times and not taking it in all at once. There's just too much content to digest, especially if your own diet, like mine, is closer to the standard meat and potatoes diet. Trying new, unfamiliar foods is hard, but this book made me want to at least give it a try. I've modified my diet some since reading this and continue to refer to the Daily Dozen from time to time for inspiration.
This is my favorite book so far on health and diet. It's not preachy, but it lays out the facts in a organized and overpowering way. I would recommend the audiobook, which is how I discovered How Not to Die. I learned so much I had to buy the physical book, something I rarely do these days because my bookshelves are full.
We all will die sometime. That's an unpleasant fact, and nothing in this book changes it. But we can have a longer and more enjoyable life if we can adjust our lifestyles to a healthier model. I love pizza and french fries as much as anybody else, and don't plan on giving them up entirely. But I have to think about what I eat, and look at the costs and benefits. (Which is something the food companies do not want us to do)
Life is too short to obsess about your food or your weight all the time. But we live in an age with poor diets and increasing obesity, and medical science (with a few exceptions) isn't doing a damned thing about it except charging us more for treatments. Reading books like this and taking charge of what goes into your body is one way to make your life healthier and longer.