A Book Full of Myths

I wasn't impressed with this one. I appreciate the goal, and I like how Dr. Shapiro is rational and evidence-based, but I don't think she does a good job of explaining the information or reaching the correct conclusions.

For instance, near the beginning of the book, she lists how we're most likely to die in each decade of our lives. In the first few decades, the leading cause of death is accidents. Her conclusion, then, is to worry most about avoiding accidents, less about other aspects of our health. But most people don't die young, and if we aren't managing other aspects of our health, we risk running into more problems in our later decades. It's almost like saying, "You don't need savings when you're working. You only need them when you retire. So worry about your savings when you're seventy!"

Some of this book seems incorrect, too. At one point, the author claims that people with a genetic predisposition for heart disease can be just as healthy as everyone else if they live a healthy lifestyle. That's a nice message to hear. I wish it were true. I have a genetic predisposition for heart disease—familial hypercholesterolemia. I meet all the requirements for exercise (strength training + cardio), I maintain a healthy body-fat percentage (11%), a healthy amount of muscle mass, and I eat a healthy diet. In fact, my heart specialist told me that I've done the best job of managing the condition that he's ever seen. But no matter what I do, I still lack the gene required to regulate and remove cholesterol from my blood. I still have double the risk of suffering from a heart attack.

Dr. Shapiro also says that obesity isn't unhealthy, then goes on to talk about how visceral fat is unhealthy. That doesn't make any sense. Obese people have more visceral fat. If visceral fat is unhealthy, you'd think that obesity would worsen health. Plus, in another chapter, she explains how being overweight can cause a variety of cancers. What's going on here?

In another section, she says there's no such thing as "muscle food." Her reasoning is that our bodies don't magically add the amino acids we eat to our muscle tissue. But, uh, yeah, our bodies can indeed use the amino acids we eat to build muscle. In fact, eating a meal that's rich in protein will cause a few hours of increased muscle-protein synthesis. And diets rich in protein (which break down into amino acids) really do help people build more muscle. This is true with or without exercise, though obviously exercise helps, and resistance training (such as lifting weights) helps most of all.

Finally, she argues that sugar is the cause of obesity, not fat. This argument is flawed because it assumes that obesity is caused by a single macronutrient. In reality, if people eat more calories than they burn, they'll gain weight. Both sugar and fat contain calories. So does protein. So does alcohol. You can gain weight by eating too much of any of those sources of energy. Most people don't gain weight by eating macronutrients in isolation, though. Think of foods like chocolate, cake, chips, and donuts—foods that contain a mix of both fat and sugar. Those are the foods that tend to be the easiest to overeat.

Plus, seafood contains fat. Fruits contain sugar. Most people don't get fat by eating seafood and fruits. So it's not the macronutrients that are the problem. It's the fact that people burn fewer calories in their sedentary lifestyles, eat processed foods that taste great and aren't very filling, have an abundance of food readily available to them, enjoy snacking while watching TV, and so on. The reason people eat too much isn't so simple. The problem isn't just "sugar."

Maybe the medical information in this book is great. I have no idea. That's not my area of expertise. But when it comes to diet and exercise, this is the sort of information that confuses people, making it harder for them to get and stay healthy.

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