Book Review: How Not to Diet by Michael Greger, M.D.

How Not to Diet by Michael Greger

My rating: 5 of 5 stars

Last year the work of Dr. Michael Greger came to my attention as I was gradually moving toward a more plant-based diet and considering how I might solidify that commitment. Reading his first book "How Not to Die" (2015) proved to be a revelation. Supported by extensive research-based evidence, Greger walked the reader through 15 chapters covering the major chronic diseases and explaining the connection of each of these to diet. In chapter after chapter he reached the same conclusions: what he calls the Standard American Diet (SAD), heavy on animal products, sugar, fat, salt, and refined and processed production methods, contributed significantly to fostering these diseases in our bodies, while plant-based diets demonstrated effectiveness in preventing, mitigating, or even reversing them. The book concluded with several chapters detailing the benefits of what Greger called his "daily dozen," high-nutrient and beneficial foods, and he commended these to readers as the essential building blocks of any serious plan to move toward better health. I was convinced by the case Greger made and in January I moved decisively away from animal products and processed foods, shifting to a diet based on vegetables, fruit, and whole grains. The benefits were evident almost immediately. But there was more to learn.

In "How Not to Diet" (2019), Greger turns to one of the major consequences of the Standard American Diet, namely, its contribution to an explosion in obesity rates in the United States, most recently estimated at 41.9% of the population for the years 2017-2020. A major problem in its own right, obesity has been identified as a major risk factor in most of the serious chronic and deadly diseases that kill Americans at high rates. Not surprisingly, an entire weight-loss "industry" has accompanied this development, but how effective has it been? And are there better options?

Greger starts by taking us on a survey of the problem of obesity, clearly identifying the role that the oligopolistic food industry has played in promoting its profitable but extremely unhealthy products to Americans without regard for the health consequences. He then examines the various conventional approaches to weight loss, most of which have proven ineffective over the long term, including the more radical approaches like surgery. In the next section of the book, titled "Ingredients for the Ideal Weight-Loss Diet," Greger takes us through the key properties of foods that contribute to weight loss. These include such things as whether a given food is anti-inflammatory in nature, the extent of its fiber and water content, whether it contributes to a low or high glycemic load, the degree of its calorie density, how and why certain foods are experienced as satiating when we eat them, and other important factors. In the final and longest section of the book, titled "Weight-Loss Boosters," Greger provides an extensive evidence-based survey of techniques that have been demonstrated as effective in promoting weight loss over the long term. Here he covers everything from the role of exercise in weight loss (spoiler: it doesn't contribute much, but its other health benefits are highly significant so you should most definitely exercise as much as possible!) to topics I never previously encountered, such as adenosine monophosphate-activated protein kinase and how certain foods can activate this desirable enzyme. Not surprisingly, his findings support the conclusions reached in his previous book. A plant-based diet, supported by the application of some additional "tweaks" for those interested in weight loss, can lead to the permanent achievement of weight goals while also fostering good health.

While I would certainly recommend both of Greger's books, a reader who is more interested in effective weight loss strategies will be very well served by "How Not to Diet." At 570 pages, it's a long read, but it is well worth the time and effort for anyone who is serious about the issue.

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