Individuals have been consistently concerned about their overall health and risk factors for developing chronic illnesses and diseases over the years. There have been multiple diets discussed from daytime TV to medical journals alike. Does whole food, plant-based diets significantly reduce the risk of developing chronic illnesses and disease has become a significant part of our day to day conversations. Michael Greger takes on this question and looks at the standard American diet in relation to risk factors and developing chronic illness and diseases in his book How Not to Die. Specifically, the book looks at fifteen major illnesses and diseases which affect so many individuals. Greger uses scientific evidence to strengthen his opinions and thoughts on how to prevent, and in some cases, help to reverse these diseases.
Plant-based eating is the primary diet Greger focuses on throughout the book. Countless studies and articles are mentioned in the text of How Not to Die. These studies help make a strong case in supporting Michael Greger’s ideas. Comparing plant-based to diets containing more animal proteins, the plant-based diets have an overall better effect on reducing risk factors and developing chronic illness and diseases. People who have had a more plant-based, vegetarian diet and then started to eat meat at least once a week showed to have a 146 percent increase in heart disease, 152 percent increase for stroke, 166 percent increase for diabetes and 231 percent increase for weight gain. Not only is there a notable increase in overall risk factors for disease or developing these diseases, over the twelve-year transition from vegetarian to omnivore eating, a 3.6-year decrease in life expectancy was also seen. While the main discussion in Greger’s book is based on diet. Four other healthy lifestyle factors are mentioned to have a strong impact on prevention as well; non-smoking, healthy weight, physical activity, and overall eating healthier. Eating healthier is very broad and can be confusing and daunting for the average individual to understand.
How Not to Die is divided into two sections. The first few chapters discuss why to eat certain healthful foods and how those choices can reduce, prevent or reverse chronic illness and risk factors. Specifically looking at heart disease, lung disease, brain diseases, digestive cancers, infections, diabetes, high blood pressure, liver diseases, blood cancers, kidney disease, breast cancer, suicidal depression, prostate cancer, Parkinson’s disease, and iatrogenic causes. The second part of the book explains how to use what is learned in the first section in a more practical way and using Dr. Greger’s Daily Dozen: beans, berries, other fruits, cruciferous vegetables, greens, other vegetables, flaxseeds, nuts and seeds, herbs and spices, whole grains, beverages and exercise. Greger does not define a diet specifically like vegetarianism, veganism or any other ‘ism’ that should be followed. The pressure of defining a diet of what you cannot eat can cause individuals over think and stress about what they are eating. Instead, he recommends viewing the diet discussed as a whole food, plant-based nutrition, to put a more relaxed spin defining a diet. The main take away Greger wants readers to understand is a diet centered around unprocessed plant foods is the healthiest. Forty percent of annual deaths in America can be prevented by addressing diet and other lifestyle factors. The Book by Michael Greger, How Not to Die starts to investigate this statistic by looking at how a whole food, plant-based diet can significantly reduce the risk of developing chronic illness and disease and to reduce the annual deaths of Americans related to diet and lifestyle factors that could be prevented.
Understanding a healthy and balanced diet starts with understanding the effect of food in relation to risk factors and diseases. Association of protection between foods groups has been seen to show plant food are more protective than animal food in groups of individuals with diet-related chronic diseases. Plant food groups include fruit, vegetable, and grains. Diary/milk animal food group is found to be a neutral effect on risk factors while red meat and processed meats tend to increase risk the most. From this, a more healthful and balanced diet that would reduce the risk factors and chronic disease would be a vegetarian or plant-based diet. Examining various measures such as body mass index, total cholesterol, LDL – cholesterol, and glucose levels show a significant decrease in these numbers. As these biometric markers are being reduced, risk and the overall prevalence of chronic disease have seen to decrease as well. The lower intake of saturated fats and higher vegetable, fruit, whole grain, legumes, soy products, nuts, and seeds seem to be key factors in the reduction of chronic diseases risk factors and development. Decrease in inflammation in C reactive proteins and oxidative stress has been key in the reduction of chronic disease with those who follow a vegetarian diet. All these factors contribute to a vegetarian plant-based diet to have an overall lower mortality and giving more support to Greger’s conclusion of a plant-based diet being beneficial for reducing risks, development and even prevention of chronic diseases.
Diet and physical activity go together regarding prevention and risk factor reduction for chronic diseases. Greger stresses the importance of this correlation in his book. The World Health Organization (WHO) recommends a minimum total physical activity of 600 metabolic equivalent minutes (MET) per week for health benefits, about 150 minutes per week of brisk walking or 75 minutes of running. Relationships between physical activity and chronic disease are evident but there have been no studies to show the total amount required to lower the risk of these diseases, only estimates can be associated. The more physical activity the better for lowering the risk of chronic diseases, and should be well above the recommendation of 600 MET per week to see better results. By doing small breaks to walk, or stand instead of sitting are just some small ideas and steps that are recommended to help with achieving these active minutes. Over time, calories have increased while physical activity has decreased. Obesity rates have also increased, causing an increase in risk factors and chronic diseases. Around half of the adult population in America has at least one chronic condition and 12% has five or more. While there are other factors that play a part of increasing risk factors and chronic diseases, diet and physical activity are two that are critical.
How Not to Die has great knowledge, insight and studies, however, there are some limitations that need to be addressed. In some parts of the literature, Greger picks and chooses parts of literature that support his thoughts while not addressing parts that could be more inconclusive. This could lead to some misinterpretations and confusion among readers. Some of these studies that are used lack some issues that have not to be addressed as clearly as one may want. Some of the studies lacked validity in the subject selection that could be comparable, lack some controls, blinding, and some measurements were not as clear which results in some skewed outcomes. Not only is he picking some research very selectively to pre-frame for his insights, but he chooses some studies based off their overall strength to point out flaws and challenge research. From the surface, How Not to Die is a very solid diet book for the consumer to read. Readers should not just take all the information at face value, and do some research and form conclusions for themselves.
How Not to Die by Michael Greger uses scientific evidence to support claims and bring to light some interesting information for consumers to start to understand. While there were some limitations with some studies used throughout the book. Majority of the studies held more of validity with clear questions, focus, outcomes and procedure feasibility which made them reliable sources to be used in this publication. The main claim within the book is that a plant-based diet is the most healthful diet and will help to reduce any risk factors and chronic diseases for everyone. While there is much more to this topic, Greger makes some strong claims to support his views on a plant-based diet compared to omnivore style diet most individuals consume. Greger also touches on the topic of exercise and how both a healthful diet and exercise play a critical role in reduced risks and development of such diseases. Consumers should use the book as a tool to start to understand the effect of food on diets, and a guide for researching each topic in more detail.
