Rating: WORTHY!
This is from an advance review copy for which I thank the publisher.
Erratum:
"...so information flow constantly back and forth between the gut and the brain....” should read "flows"?
Subtitled "How the Industrial Food System Is Changing Our Minds, Bodies, and Culture," this book is a tour-de-force of information on how our diet had changed over the last few generations to a point where it bears little relation to what our grandparents and great-grandparents ate. This may not seem like a problem: active change is pretty much the definition of life, when you think about it, but just like the ocean surface reveals very little about what’s going on underneath, so our dietary changes and the way food is grown, processed and packaged are having a significant, and in many cases dangerous, impact on our bodies and minds.
There's no table of contents in the front of this book. It's in the back! Whether there will be changed in the published print copy I can’t say. it was clickable back and forth - something which i see little value in. Imagine my amazement then to discover that the references - it was a very referenced effort - did not work at all!! So when it came to checking the copious references the author includes in her text, the lack of clickability (or tappability these days - if these were not words, they are now!) was a nuisance because it made it really hard to find the actual reference. In this book there are no footnotes and no chapter-end notes. There is a long set of references at the end of the book, but you can’t click to them or click back from them.
This isn't a problem with the writing quality or the book topic, but it bothers me how primitive this is in an era of common and very pervasive ebooks. These days it ought to be possible to reference something in your book and be able to tap that reference to have it pop up right there on the page without having to swipe to the back of the book to find it and hope you're looking at the right one! In a semi-scholarly work like this one, it ought to be possible to tap the reference and have it open your browser and go to the study or paper the book is referring to so you can see it right there and then. Evidently we're still a long way from that.
I know Amazon's crappy Kindle app is probably the worst in the business as compared with other formats such as PDF or the Nook, for example, for facilitating a good reader experience. Kindle is another way of saying 'mangle' in my experience, and we all know what 'kindling' is good for, but publishers are powerful entities. Some would argue they're too powerful, but that's not quite so true in this era of self-publishing as it used to be. That said, why are they not using that power to pressure the makers of reading apps to make books like this much more user-friendly? Pet peeve! Moving on!
I recommend this book because it carries an important message and not only that, it also marshals an impressive array of evidence. There are caveats to that though, which I shall delve into shortly, but that aside, this is, overall, a good effort. The author is not a scientist. She's a Certified Nutrition Educator, but she makes smart arguments and puts together a good basic case.
My problems with this book ran to referenced supportive material. References are often only tangentially supportive of the assertions made by the author, and they are not 'clickable' - once in a while there is one that is highlighted in blue and if you can tap it with your finger, will take you to a reference, but this applies only to rare end of chapter notes, not to book notes. It was often difficult to tap those references and get there, especially if it was at the top of a screen, because instead of going to the link, Kindle would drop down the little margin at the top of their screen which contains the time and settings icons! I actually tapped one link only by pure accident after I was ready to give up an trying to tap it! Annoying!
The lack of tappable links for the references though, made it a nightmare trying to verify the author's statements connected with the link because I had to jump to the back of the book and wade through the large number of references jammed together there, to try and find the one I needed. I think instead of starting numbering the references over for each chapter, they should have been continually numbered so a reader can be sure they have the correct one: was I in chapter two or chapter three? Which reference '1' out of several back there do I need to look at? I did not try to look at every reference, just a few. While noting that this was an advance review copy and therefore subject to change before publishing, what follows is what I found with regard to some of them.
At one point I read, "...the current generation of children is expected to have a shorter life span than their parents." yet when I followed the link and looked at the reference, the paper was by S. Jay Olshansky, et al, and the title was “A Potential Decline in Life Expectancy in the United States Note the word 'potential'! There is a big difference between an expectation of, and a potential for something happening! Things like this harm a book's message because they make the author look more sensationalist than sensational.
At another point I read "GMOs were not introduced to the American food supply until the 1990s, so we don’t know a lot about their long-term safety or healthfulness. Even organic corn is likely contaminated with GMOs." I have yet to see what the harm is in GMOs. My position is that some are probably a bad idea, others are fine. I, like the author evidently, do have reservations about the activities of a very powerful company like Monsanto, yet while keeping that caveat in mind, the fact is that nature mixes genes between plants all the time, and the human race goes on! I don't think the jury is in yet on the benefits or otherwise of GMO's in general, so I have to ask why the negative connotation added by the author and carried in that one word: contaminated? Like this is necessarily an evil thing? So again, the wording was overly dramatic.
After talking about how food monitoring agencies are funded by agribusiness, the author extolls a report by Monell Chemical Senses Center which is funded from a variety of sources including, according to Wikipedia, “unrestricted corporate sponsorships”! Pot meet kettle!
I read, “My grandmother...was always skeptical of the benefits of organic foods. She thought it a marketing ploy to get people to spend more money,” but in my understanding,there is no real regulation or inspection of organic foods, so I've never been a big fan. But let;s not get overly dramatic about them. I read, “The review stated that pesticide residues were found in only 7 percent of organics but 38 percent of conventional foods,” and while that's far from ideal, it's certainly not the massive contamination that's been suggested! Two third of non-oganic food is also fine! And some organic food is actually 'contaminated'!
The author mentions “Horizon Organic milk, with its bright red label and happy cow on the container, gives the impression of a bucolic standard” After buying a carton of Horizon milk that, when opened, smelled of fish one time, and complaining to Horizon only to be brushed off, I have never bought another thing with their name on it. I won't touch Horizon products, so I was onboard with the comments made about how big and blended they were! I am not a fan of mega-corporations.
The author says, “Some of that common sense wisdom that farmers speak of is being replicated in the lab with findings that the fruits and vegetables we eat today are far less nutrient dense than those our grandparents ate,” and she cites “a study” but gives no reference! This made me suspicious, as did a claim in an article that was quoted uncritically which said, “...the recipe for mother's milk is one that female bodies have been developing for 300 million years,” but the earliest known mammal is barely over 200 million years old! I'm not sure where the author of the article gets this ancient date from!
There's a section of this book which bemoans the increase of C-section births, antibiotics, and lack of breastfeeding, but https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350908/ published online in October 2014 makes no mention of the disappearance of Bifidobacterium longum subspecies infantis from our gut. In fact, I couldn't find anything online which did talk about the disappearance of this group of bacteria even as I found mention after mention of its benefits.
The paper referenced by me above says, "The colonization of the fetal gut begins in utero with swallowing of amniotic fluid" so it's not entirely dependent on vaginal delivery. I do agree though that antibiotics and C-Section pose threats of one sort or another, but the author fails to mention that while C-sections have risen alarmingly, so that they now comprise about a third of births in the western world, it's still only a third, and only in the last two to three decades. Allergies and other issues began rising long before that. It's the rather alarmist parts of this book which bothered me, even as I considered it a worthy read for the important information it does convey. A more measured tone would have been wiser.
Breastfeeding is also not a rarity. In Australia for example, almost all mothers start out breastfeeding. It's the lack of continuation of it that's a potential problem, because by the age of one year less than a third are still doing it. I guess they feel they need to wean children asap because breastfeeding is time-consuming and they're poorly educated with regard to the importance of continuing it. Prevalence of breastfeeding was the lowest in the United Kingdom, the United States, and France, but even in these countries, the prevalence was 70%, 69.5%, and 62.6% according to this study in 2012.
So it's misleading for this author to imply that Caesarian section has risen to such dramatic heights or that breastfeeding has plummeted so precipitously that it's affecting children's health and contributing massively to opportunistic disease, allergies, and conditions. I do allow that she has a point about antibiotics, but while we can suggest natural birth as much as possible, as an antidote to C-Sections, and a lengthy breastfeeding as an alternative to formula, what is the use of antibiotics going to be replaced with? Crossed fingers and a hope that infection doesn't set in?
We could ask that antibiotics only be used as needed and not routinely, but that's a medical decision and I think most doctors know this, but there's the ever-present danger, particularly in litigation-happy USA, of a lawsuit if something is omitted and there are consequences. What we can do is have children fed a dose of the good bacteria after they're born, and after any series of antibiotics has ended, in order to keep their gut in good shape, but the author never raised this option as far as I recall.
Instead, I read, “Because traveling down the birth canal is the critical means for acquiring your microbiota, those who miss out on this process face lifelong health consequences,“ yet the reference in this case was useless with regard to supporting the author's thesis and was really hard to get to to boot!
part of the problem with this book that I had was what was not covered. It seems to be largely US-based, like the USA is the only country int hew world worth considering. it;s nit. What I kept wondering, but was kept in the dark about, was how other countries fare. Yes, there was an occasional reference here and there that strayed outside the borders, but always it was back to the USASAP. I felt there was a lot that could have been learned by taking a more global view. For example, obesity is rare in Japan, so what is it they're doing that we're not? This book was silent on such things.
I read quite a bit about the Hadza bush people in Africa. The idea is that since they lead an existence far more akin to what all humans did before farming became prevalent in our culture, maybe we can learn things from them and their microbiota. A putative dissenting voice was addressed so: “The argument usually goes something like, 'Well, we live far longer than those populations so we must be doing something right'.” The response was along the lines of "But that argument falls flat with just a little bit of scrutiny. In hunter-gatherer societies most mortality occurs within the first five years of life because their sanitation isn’t on par with ours, thereby increasing the risk for infections. In addition, they don’t have access to antibiotics for true life-threatening infections, or access to vaccinations, so it is understandable that infant mortality rates are high.“
Isn't this a refutation of precisely the argument the author is making with regard to natural birth and eating whole, unadulterated food, which these people do exclusively? Never once did this author ask why infant mortality was so high. And yes, the Hadza do have a comparable life-span to the rest of us if they survive the first five years, after that, but this is one society. Why look only at one that supports your thesis and ignore others which do not - such as, for example, ancient Egyptians, who had a relatively stress-free life and very pure foods compared with ours, and yet who lived only into their thirties for the most part? It would have been nice to have seen the author play devil's advocate instead of harping only on her own theme.
The author references a 2016 paper regarding an experiment by Erica D. Sonnenburg et al with two sets of mice, each of which was artificially infested with the same specific set of gut microorganisms. One set of mice was fed a diet rich in fiber whereas the other was poor in fiber. The results over four generations showed that gut bacteria diversity was adversely impacted by the low fiber diet. I don't have a problem accepting this at all, but the author's report made no mention of the mice's health! Was thatadversely impacted or were both groups equally healthy? In which case, what did this study show that was relevant to her thesis?
I couldn't read the study itself, because it's hidden behind Nature journal's paywall. It may well be that health was impacted (or would be), but to present a study like this which does not directly support the author's thesis is confusing a best, and misleading in that it implies such a thing when it actually makes no such claim. Another example of this was when I read that “It’s important to remember that you first must have microbes that are capable of feeding on the short-chain fatty acids. The findings of German and his colleagues and the Sonnenburgs and their colleagues remind us that many strains of these beneficial bacteria have probably disappeared from the guts of those of us living in Western world.“ Probably? The reference for this was hard to find in the end notes, but seems to refer to insulin growth factor which isn't relevant here! i read a similar thing when I read, “The discovery that many of the chemicals we are consuming every day are EDCs, and are probably changing our bodies” Again, note key word 'probably'! That may well be true, but it’s not a strong argument!
Interestingly, while searching for the article to which the author referred, I came across one which explicitly says that "Human populations with a diet enriched in complex carbohydrates, such as the Hadza hunter gatherers from Tanzania, have increased diversity of the gut microbiota (Schnorr et al., 2014). In contrast, long-term intake of high-fat and high-sucrose diet can lead to the extinction of several taxa of the gut microbiota." This one would seem to fly in the face of earlier suggestions in this book that we should reduce carbohydrates and increase fats! It only goes to show that this is a very complex topic, and the welter of information flying around can be confusing to the lay person (which includes me!). The author sort of touches on this aspect of the problem without going into much of an exploration of it and how it can be counteracted. Even such a simple thing as defining terms can help.
I read of one man who had lived with the Hadza and followed their way of life for a while and he discovered: "The results showed clear differences between my starting sample and after three days of my forager diet. The good news was my gut microbial diversity increased a stunning 20%, including some totally novel African microbes, such as those of the phylum Synergistetes." note that this isn't a study and the plural of anecdote, as scientists ay, is not data But though it is just an anecdote of one man's experience, it does suggest, as a counter to some of the author's assertions, that all is not lost and a change in diet can increase diversity.
Note that this article: https://med.stanford.edu/news/all-news/2017/08/hunter-gatherers-seasonal-gut-microbe-diversity-loss.html
suggests that there are few Hadza and fewer still who pursue traditional lifestyle. Additionally, their diet is extremely restricted: "The Hadza number just over 1,000 people, fewer than 200 of whom adhere to the traditional hunter-gatherer lifestyle, which includes a diet composed mainly of five items: meat, berries, baobab (a fruit), tubers and honey." This isn't clear from what the author writes so again this book was misleading as to sample size, and dietary variation.
The article also says, "A 2016 study, published in Nature and led by Sonnenburg and senior research scientist Erica Sonnenburg, PhD, showed that while depriving mice of dietary fiber greatly reduced their gut-microbial species diversity, this diversity was restored when the dietary-fiber restriction was lifted. But if this fiber deprivation was maintained for four generations, microbial species that had initially bounced back robustly became permanently lost." This isn't exactly clear from the book, which talks only of diversity being lost over several generations, and doesn't emphasize that while we cannot replace what has truly been completely lost - not through ordinary means - we can repair what we have by a change in our diet.
It would have been nice in this book to have had less a tsunami of facts and references and more of a coherent story as to what the problem is, what the real connection is to diet and micro biota, and what we can do, realistically and practically to fix it. The author does get into that towards the end of the book and that made for impressive reading. It just takes a while to get there! I think that's one of the weaknesses of the book in that it makes for very dense reading and I cannot see this taking off popularly, which is really what a book like this needs to do, and if it doesn't, that will be a shame.
Another issue was the conflation of correlation with causation! I read, “As I mentioned, this also points to why colon and rectal cancers are now on the rise in people in their twenties and thirties in the Western world...” but just because two things happen at the same time doesn't mean they're connected. I encountered this error several times; perhaps the author has arguments and data to support such assertions, but these were either not made or not well made.
What really shone in this book for me was chapter nine where the author launches a polemic as breathtaking as it is depressing about the devaluation and even oppression of women over the last hundred years by confining them to the house and effectively enslaving them - because that's what unpaid labor is and that's what far too many women have been reduced to doing for far too many years as "housewives' stuck between the kitchen and a vacuum cleaner. This chapter is excellent, well-written, forceful, and really quite beautiful to read. It certainly won back a lot of my good grace (as well as "Goodness Gracious!") after some of the issues I'd had earlier.
So, overall, and with the caveat that this book takes some reading, I recommend it as a worthy read because it makes some really good arguments and is an important contribution to our understanding of an increasing lack of wellness in society and of possible counter-measures we - as individuals - can undertake - and the hell with government and agribusiness who, let's face it, aren't going to do a damned thing to help as long as they can keep on minting money on the backs of the sick people they;re promoting. And you can read that last clause however you like!
