One-Minute Book Reviews

December 29, 2007

If You’ve Made a New Year’s Resolution to Lose Weight, You May Want to Make Another Resolution to Read ‘Good Calories, Bad Calories’ Before You Start Your Diet

Good Calories, Bad CaloriesHave you made yet another New Year’s resolution to lose weight?  You may want to check out Gary Taubes’s Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease (Knopf,  601 pp., $29.95), which I wrote about in October  www.oneminutebookreviews.wordpress.com/2007/10/09/. This isn’t a diet book but one that investigates many of the claims that underlie other diet books.

Based on an exhaustive review of the scientific research, Taubes argues that obesity “experts” have demonized fat on the basis little or no evidence. Refined carbohydrates, he says, are a greater threat to health. And those fat-free brownies may hurt you more than foods that have more fat but fewer carbs. “Dietary fat, whether saturated or not,” he concludes, “is not a cause of obesity, heart disease, or any other chronic disease of civilization.”

(c) 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

October 9, 2007

Gary Taubes’s ‘Good Calories, Bad Calories’ (Books I Didn’t Finish)

 

The latest in a series of occasional posts on books I didn’t finish and why I didn’t finish themGood Calories, Bad Calories

Title: Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease. By Gary Taubes. Knopf, 601 pp., $29.95.

What it is: An investigative report on the diet advice fed to us by government and other nutrition authorities. A major theme is that obesity “experts” have demonized fat on the basis little or no scientific evidence. Refined carbohydrates, Taubes argues, pose a greater threat to health. And those fat-free brownies may hurt you more than foods that have more fat but fewer carbs. Taubes sums up his conclusions in a 10-point list on page 454. Point No. 1 is: “Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization.”

How much I read: The prologue and first chapter, the epilogue, and a couple of chapters in between, nearly 100 pages.

Why I stopped reading: I liked this book and, because of it, had a salad for dinner instead of the steamed pork dumplings from the Chinese place. But it develops ideas I’d read in other books and in an article Taubes wrote for The New York Times Magazine (“What If It’s All Been a Big Fat Lie?,” July 7, 2002). So its arguments, though strong, weren’t strikingly new to me. And Good Calories, Bad Calories is getting so much attention, it didn’t seem to need me as much as, say, books by obscure poets who live on canned ravioli because those ultra-refined carbs are all they can afford.

Best line in what I read: “Between 1987 and 1994, independent research groups from Harvard Medical School, the University of California, San Francisco, and McGill University in Montreal addressed the question of how much longer we might expect to live if no more than 30 per cent of our calories came from fat, and no more than 10 percent from saturated fat, as recommended by the various government agencies…

“The Harvard study, led by William Taylor, concluded that men with a high risk of heart disease, such as smokers with high blood pressure, might gain one extra year of life by shunning saturated fat. Healthy nonsmokers, however, might expect to gain only three days to three months …

“The UCSF study, led by Warren Browner, was initiated and funded by the Surgeon General’s Office. This study concluded that cutting fat consumption in America would delay 42,000 deaths each year, but the average life expectancy would increase by only three to four months. To be precise, a man who might otherwise die at 65 could expect to live an extra month if he avoided saturated fat for his entire adult life. If he lived to be 90, he could expect an extra four months. The McGill study, published in 1994, concluded that reducing saturated fat in the diet would result in an average life expectancy of four days to two months.”

Worst line in what I read: None by Taubes. So let’s go with a clinker written by the New York Times’s Jane Brody, who kept promoting high-fiber diets long after large-scale studies showed that they had few or no long-term benefits: “But dietary fiber … has myriads of benefits,” Brody wrote. Taubes quotes this line in a chapter on fiber that debunks much of the media hype about it.

Recommendation? This is not a diet book, but a book in the spirit of Eric Schlosser’s Fast Food Nation and Greg Critser’s Fat Land. Don’t miss Taubes’s brief and low-keyed – but nonetheless damning — analyses of Brody’s Personal Health column in the Times.

Published: September 2007 www.aaknopf.com

Furthermore: Taubes is a correspondent for Science magazine who, according to his dust jacket, is “the only print journalist who has won three Science in Society Journalism awards, given by the National Association of Science Writers.”

© 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

August 15, 2007

Self-Help Books by Quacks, Frauds and Incompetents: Why Don’t They Get the Kinds of Clinical Trials That Drugs Get? (Quote of the Day)

Filed under: Quotes of the Day — 1minutebookreviewswordpresscom @ 1:02 am
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How many times have you read or heard about a self-help book that struck you as pure quackery? Probably a lot. Some publishers make preposterous claims for how their books will improve your physical or mental health, or claims that the Food and Drug Administration would never allow other kinds of companies to make without proof that they were true. But publishers are rarely held accountable for false advertising.

Should some of this snake-oil-in-print be subjected to the kinds of clinical trials that drugs get? The Wall Street Journal ran a fascinating article recently suggesting that this is starting to happen. Here’s part of what it said about health-related how-to books:

” … this category is reminiscent of the market for elixirs, oils and pills before the advent of federal regulation. Despite the growth in research, fewer than 5% of the tens of thousands of self-help books on the market have been subjected to randomized clinical trials. And authors with no scientific credentials are just as likely to hit the jackpot as are renowned physicians. ‘When the book cover announces that it’s a bestseller, that means nothing,’ says John Norcross, a University of Scranton professor of psychology and researcher on the effectiveness of self-help books.

“Now, mental-health professionals in the U.K., the U.S. and elsewhere are determined to distinguish the most proven offerings. The aim is to recommend books that have been shown to be successful in published trials conducted by reputable, independent researchers.”

Kevin Helliker in “Bibliotherapy: Reading Your Way to Mental Health,” the Wall Street Journal, July 31, 2007, page D1. I couldn’t link to the article from this site but could find the story by cutting and pasting the following link into the address bar in my browser, so you might try that it if you want to know more: http://online.wsj.com/public/article/SB118583572352482728.html. You can also find this article easily by Googling “helliker + bibliotherapy.”

Comment by Janice Harayda:

I’m all for the kind of testing the Journal described. I’d also favor stricter regulation of advertising by book publishers, whether or not clinical trials were conducted. How about you?

(c) 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

July 18, 2007

Atul Gawande Tells What You Can REALLY Expect When You’re Expecting

A surgeon looks at the pros and cons of forceps, Cesarean sections, epidural anesthesia, fetal heart monitors and other fixtures of modern delivery rooms

Better: A Surgeon’s Notes on Performance. By Atul Gawande. Holt/Metropolitan, 273 pp., $24.95.

By Janice Harayda

Last year the New York Times published an article on a remarkable medical study that found that – contrary to a near-universal belief – pushing during labor helps neither the mother nor the baby. The study also found that women who were told to push may have more urinary problems after the delivery. One of the doctors who did the survey, published in the American Journal of Obstetrics and Gynecology, said that the research did not mean that women should never push. Instead, he said, they should do “what feels natural to do – and for some women that would be no pushing.”

I had two reactions to this news. First, if I were pregnant, I would ask my obstetrician if he or she planned to tell me to push and, if so, why, given there seems to be no benefit to doing this during every birth. Second, why didn’t we know this news sooner? Why have doctors for so long inflicted the needless agony of pushing on women? I had no idea what the answer to the second question might be until I came across a striking fact in the chapter on childbirth in Atul Gawande’s Better: Most doctors pay lip service to the idea that nothing should be used in medicine unless it has been properly tested and shown to be effective by a respected research center, preferably through a double-blind, randomized trial.

“But in a 1978 ranking of medical specialties according to their use of hard evidence from clinical trials, obstetrics came in last,” Gawande writes. “Obstetricians did few randomized trials, and when they did they largely ignored the results.”

That observation helps to explain why Gawande, a surgeon and writer for The New Yorker, may be our most important medical writer. Unlike many others working in the field, he doesn’t write mainly about the latest developments in medicine. He digs deeper, looking for the “why” behind the “what,” while taking on extraordinarily complex topics. But his writing is rarely harder to understand than in his lines about the 1978 survey of medical specialties. He seems to make a grail not just of accuracy but of clarity.

The chapter on childbirth in Better shows his work at its finest. It deals largely with why so many women have Cesarean deliveries, which account for about 30 percent of American births. Many people explain the statistic by saying that Cesareans are more convenient and lucrative for doctors than vaginal births. Gawande argues persuasively that there is a larger reason for the pattern. And part of it has to do with the virtual disappearance of forceps from delivery rooms.

In the 1960s fewer than 5 percent of deliveries were Cesareans and more than 40 percent involved forceps. And those numbers are related. Gawande makes a strong case that in the hands of experts, forceps are safe (according to some research, safer for mothers than Cesareans). But forceps are hard to learn to use properly – a process that can take two years. And if forceps are used by inexpert doctors, the results can be disastrous. Cesareans are easier to master. And this has led hospitals to phase out forceps and, in many cases, do C-sections instead. To discourage the inexpert from using forceps, Gawande says, “obstetrics had to discourage everyone from using them.” This change has come at a cost. Gawande notes that, as straightforward as Cesarean deliveries can be, they can go wrong. The baby can be lacerated. If the head doesn’t come free quickly, the child can asphyxiate. The mother also faces risks:

“As a surgeon, I have been called in to help repair bowel that was torn and wounds that split open. Bleeding can be severe. Wound infections are common. There are increased risks of blood clots and pneumonia. Even without any complication, the recovery is weeks longer and more painful than with vaginal delivery.”

With all of this, Gawande isn’t trying to frighten women away from having Cesareans or bring forceps back to every community hospital. He is instead trying to show the trade-offs that medicine involves. And this is only a small part of what he says in his chapter on childbirth, “The Score,” which also covers such delivery-room fixtures as fetal heart monitors, epidural anesthesia and the labor-inducing drug Pitocin. It is an even smaller part of what he has to say in the 11 chapters of Better that deal with subjects other than childbirth, including advances in military medicine and the need for doctors to wash their hands more often.

Women who are pregnant may reach for books like What to Expect When You’re Expecting and The Girlfriends’ Guide to Pregnancy. And patients who are facing surgery may turn to guides to their illnesses. But both groups could benefit from also reading this fine collection of essays. For some of them, Better may just be better.

Best line: Gawande writes about the Apgar score, which rates a newborn’s health: “In a sense, there is a tyranny to the score. While we rate the newborn child’s health, the mother’s pain and blood loss and length of recovery seem to count for little. We have no score for how the mother does, beyond asking whether she lived or not – no measure to prod us to improve results for her, too. Yet this imbalance, at least, can surely be righted. If the child’s well-being can be measured, why not the mother’s, too?”

Worst line: None.

Editor: Sara Bershtel

Published: April 2007

Furthermore: The New York Times article on pushing during labor, “Rethinking the Big Push During Contractions, appeared on Jan. 3, 2006, page F8. I can’t link directly to it, but here’s a link to a similar reprint in its sister publication, The International Herald Tribune. When you click on the following link, you will reach a page that says “Multiple Choices” and see another link that looks just like it (below the phrase “Available Documents”). You have to click on that one, too, to read the story (which appears below an article on “lazy eye”): www.iht.com/articles/2006/01/04/healthscience/snvital/php/php.

Links: Gawande has posted many of his articles on medicine at www.gawande.com.

© 2007 Janice Harayda. All rights reserved.

www.janiceharayda.com

May 15, 2007

Steven Johnson’s ‘The Ghost Map’: How Two Men Helped to End a Fearsome Epidemic

Filed under: History,Nonfiction — 1minutebookreviewswordpresscom @ 1:27 am
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The fascinating true story of a doctor and clergyman who defied the establishment view that cholera was an airborne – not waterborne — disease

The Ghost Map: The Story of London’s Most Terrifying Epidemic – and How It Changed Science, Cities, and the Modern World. By Steven Johnson. Riverhead, 299 pp., $26.95.

By Janice Harayda

Did you know that the doctor who gave chloroform to a grateful Queen Victoria during childbirth also helped to end a cholera epidemic? I didn’t. And details like this abound in Steven Johnson’s fascinating history of how two men took on the medical establishment after cholera erupted in London in 1854.

The Ghost Map reads at times like a cross between The Hot Zone with The Professor and the Madman, a medical horror story set in a gaslit city that bred disease and superstition. Johnson begins, unpromisingly, with a dozen pages on the difficulty of human waste disposal in a metropolis that had two million residents. But he quickly gets on top of his story of an epidemic that began when a mother tossed out a slop bucket in which she had soaked a sick baby’s diapers. From then on his book moves swiftly until he tries in the last chapter to extrapolate from cholera to modern threats such as suicide bombers and nuclear winter. This polemical leap is ultimately much less persuasive than what has come before it – a well-told tale of how a doctor and an Anglican curate changed the view of one of the world’s most feared diseases.

Best line: “At the height of a nineteenth-century cholera outbreak, a thousand Londoners would often die of the disease in a matter of weeks – out of a population that was a quarter of the size of modern New York. Imagine the terror and panic if a biological attack killed four thousand otherwise healthy New Yorkers over a twenty-day period. Living amid cholera in 1854 was like living in a world where tragedies on that scale happened week after week, year after year.”

Worst line: Any line that shows Johnson’s promiscuous use of the word “irony,” which he turns into a one-size-fits-all substitute for “sadly,” “oddly,” “coincidentally” or “paradoxically.” For example: “The sad irony of his argument for the waterborne theory of cholera is that he had all the primary medical explanations in place by the winter of 1848–1849, and yet they fell on deaf ears for almost a decade.” That is a sad fact, not a sad “irony.” Would you write, “The sad irony of Jan Harayda’s post on how Mitch Albom is writing at a third-grade level is that she did this on November 16, 2006, and yet it fell on deaf ears for almost five months and Albom continued to sell books at a frightening rate”?

Recommended if … you like popular history, especially books about the history of science or medicine, such as Dava Sobel’s Longitude.

Furthermore: Johnson also wrote Everything Bad Is Good for You.

Editor: Sean McDonald

Published: October 2006

Links: www.stevenberlinjohnson.com

© 2007 Janice Harayda. All rights reserved.

April 25, 2007

Erich Hoyt’s Modern Classic About Killer Whales

Filed under: Memoirs,Nonfiction — 1minutebookreviewswordpresscom @ 9:55 pm
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The true story of an acclaimed writer’s seven summers of living (and sometimes swimming) with orcas in the wild near Vancouver

By Janice Harayda

Many popular books about nature have a problem: They’re weak on science but strong on stories, or they’re strong on science but weak on stories. Erich Hoyt offers a rare blend of scientific authority and deep personal engagement in his modern classic Orca: The Whale Called Killer (Camden House, $12.95). First published 25 years ago by Dutton and still in print, this fascinating book tells the true story of the seven summers its author spent living (and sometimes swimming) with killer whales or orcas in the wild near Vancouver. And while I may be biased because Hoyt is a friend, the praise Orca has received from others is even more extravagant than mine. So instead of writing the usual review, I’d like to quote from some of that praise:

“I have never read a better book about whales …” The Philadelphia Inquirer

“Superb … One of the best nature books of the year.” Publishers Weekly

“One of those rare, genuine books about a wild animal.” Nikolaas “Niko” Tinbergen, co-winner of the 1973 Nobel Prize in Physiology or Medicine

“Erich Hoyt’s book is a splendid introduction to one of the most fascinating and charismatic animals in the world.” Sir Peter Scott, Founder, World Wildlife Fund

“Packed with action, [this] is the only [book] I have ever read that treats this glamorous sea predator in depth.” Roger Tory Peterson, naturalist and author of the Peterson Field Guides

A senior research fellow of the Whale and Dolphin Conservation Society, Hoyt has won many awards for his science writing. Those honors include the 2002 Outstanding Book of the Year Award from the American Society of Journalists and Authors for Creatures of the Deep: In Search of the Sea’s Monsters and the World They Live In (Firefly, $40). School Library Journal called Creatures of the Deep “a splendid overview” of undersea life for adults and high school students, adding: “The photographs, sidebars, and unique life-forms presented offer opportune ways of catching the attention of reluctant readers.” Orca is a similarly good choice for both adults and high school students who like science or real-life adventure stories.

Links: www.erichhoyt.com

© 2007 Janice Harayda. All rights reserved.

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