SEE FEB 2024 UPDATE AT THE END.

A month ago I was in my doctor’s office and there was a brief mention of a book a staff member had recently read titled “How Not to Diet“. I decided to read the book.

The basic thesis of the book is that (a) most nutrition books and fads are based on flimsy evidence, even cherry picking anecdotes and evidence,(b) people eat to much because of evil corporate food marketing, and (c) we should all eat a plant-based diet.

In about the first sentence of the book, the author says the diet promoted by Nathan Pritikin saved a family members life. Which thus started with an anecdote linked to some one (Pritikin) who committed suicide while suffering from leukemia.

The author says this single event changed his own life. As you know, “Is anecdotal evidence reliable? One man says yes” sums up this odd introduction, while the author then trashes the use of anecdotes and lack of evidence.  Very odd intro.

As I read the book, I saw inconsistencies and an agenda – and the methods of a propaganda used to have us adopt his agenda.

There is much good information inside the book, albeit, wrapped in politics, cherry picking and appeals to authority.

I decided to see what other reviewers had to say and found this critique in Healthline (the author is herself critical of many dietary approaches).

Cherry-Picked Evidence

Throughout How Not to Die, Greger distills a vast body of literature into a simple, black-and-white narrative — a feat only possible through cherry picking, one of the nutrition world’s most gainfully employed fallacies.

Cherry picking is the act of selectively choosing or suppressing evidence to fit a predefined framework. In Greger’s case, that means presenting research when it supports plant-based eating and ignoring it (or creatively spinning it) when it doesn’t.

In many cases, spotting Greger’s picked cherries is as simple as checking the book’s claims against their cited references. These foibles are small but frequent.

Source: How Not to Die by Dr. Michael Greger: A Critical Review

Consequently the book in some ways fall prey to other diet books he criticizes, albeit, this one with a massive number of references (over 5,000). Yet there is good information within the pages – best to read with an open mind – after getting past the first chapter.

The agenda is unloaded in the first chapter, blaming business, “Big Food”, “Big Pharma” (my words) for most of our problems. This comes across as a political rant and isn’t needed to make the important points – that is, evidence-based choices of how we eat.

He correctly notes how we often medicalize solutions – that is drugs or surgery are offered instead of meaningful lifestyle changes. There is much in the book that is reasonable – too bad about some of the odd and questionable sections.

For the record, I follow the modern DASH diet or the late Dr. Peter Gott’s incredibly simple idea: No flour, no sugar. (That does not mean avoidance of grains – but that by reducing ground flour-based products, and added sugar, about 4 out of 5 such eaters will lose weight gradually, over time.) By reducing refined flour and sugar, you naturally avoid many high calorie dense foods, eat more vegetables, whole grains and plant fiber. It’s also simple to follow – there are no complicated rules or food selection methods. Simply avoid foods with refined grain and added sugar. [Update – after reading the above book, I switched to almost exclusively plant-based – and became very ill – see update at the end of this post]

Either of these approaches encourages greater consumption of vegetables, whole grains, fruits and less or modest consumption of meat.

I expect to incorporate ideas from “How Not to Diet” into my own eating. [This turned out to be a disaster for my health]

I posted this here because the book illustrated – unintentionally – the use of cherry picking, appeals to authority and promoting someone’s agenda – within the pages of a dietary advice book.

UPDATE: FEB 2024

I drifted into vegetarian style eating – I did not view myself as vegetarian but was having meat as seldom as once per month, typically as a chicken stir fry, especially after reading the above book. I was what is called an “Accidental Vegetarian”. From summer 2021 onwards I saw a huge increase in visual auras (related to migraines) and migraine headaches. Since I had migraines, with aura, since I was a teen, I thought it odd that they had increased from about 1 to 4 per year to many per month. I didn’t see the correlation, unfortunately.

In July of 2022, the visual auras became more frequent – and instead of one, classic, flashing line migraine aura lasting 30 minutes, I would have 2 or 3 in the same day. In December of 2022, they began to occur every day, plus I began experiencing “scotomas”, which are a blind spot or area in your field of vision. This was new. By July 2023, I was experiencing multiple scotomas per day, and by the fall, had become 5 to 10 PER DAY. I also began to have episodes of dizziness and vertigo. During the year, I began shedding hair every time I combed my hair – my shoulders always had fallen loose hairs. I began to experience odd memory problems. And more.

I met with my doctor and many tests were run, going down the standard evidence-based guidelines for migraine headaches. This included EKG, stress tests of my heart, ultrasound exam of my carotid arteries, various blood tests. Before this whole thing concluded, I spent over $5000 out of pocket on tests – that found nothing. ($5000 because we have an ACA policy that costs $2,000 per month and has a $19,600 deductible in 2024, which is the nature of ObamaCare policies unfortunately).

Then, by accident in late December, 2023, I ate beef again for many days. We were prep’ing to defrost our freezer so were using up old foods. I notice my scotomas were just a couple per day, lasting a mere seconds instead of many minutes. That got me to reading – and discovering I had classic symptoms of vitamin B12 deficiency. We only get B12 from animal products. I began taking 1000 mcg of B12 and within 72 hours ALL OF MY HEALTH PROBLEMS WERE GONE. I notified my doctor, did more blood tests, and am now on 1000 mcg of B12 indefinitely. I am now also eating meat at least once each day. I was suffering from B12 deficiency – which is common among plant-based eaters who stick with this for a long time.

Now, let’s go back to the “How Not to Diet” book. Since I have it on Kindle, I could search for B12 – and the issue of B12 deficiency is mentioned in two sentences on page 276. In other words, hidden from view. Because Dr. Greger is a fanatic who did not wish to draw attention to the real problems of eating vegetarian. His was the only book I had read on the topic of vegetarian eating.

What I have learned since:

• Very few people eat vegetarian or vegan. Per a 2023 Gallop survey, 4% eat vegetarian, and 1% eat vegan, down from 6%/2% twenty years ago. Other surveys have similar results.
• Globally, 2-10% eat that way, depending on country.
• Those estimates may be biased high as a 2015 study found about half of survey respondents who said they were vegetarian actually ate meat/fish a few times per month. I would not have even said I was vegetarian but was apparently eating less meat than those people!
• India is the outlier – perhaps 20-40% are vegetarian.
• Between 65-84% of vegetarians eventually give up; almost 40% give up because of health problems.
• If you intend to eat vegetarian, this is not something that you do casually, despite the media propaganda and endless books selling you on doing this. You MUST let your doctor know, you MUST consult with an expert dietician, you MUST have blood tests done at least annually.
• For me, vegetarian eating was a very expensive disease, not a cure for anything.
• I know I did everything wrong (I’m not an expert and my exposure was from peers, bad journalism, and bad expert books). I had almost no vitamin B12 in my diet. I did not eat whole eggs, I had egg white cartons. I did not have much dairy. I also had hepatitis just before this began – I now know that hepatitis can greatly harm the B12 store in your liver. Most people have 2-6 years of B12 stored in their liver. Older people tend to have less.
• At the bottom line, I am critical of Greger for failing to put the B12 deficiency issue in chapter 1. There is a reason that product instruction guides have the warnings and risks up front! But he didn’t do that. Because of this serious defect in Greger’s book, I recommend against his book and his work. The risks of “plant-based eating” must be stated up front and not buried hundreds of pages into the text.

As of March 1, 2024, ALL of the VEGETERIAN INDUCED HEALTH PROBLEMS ARE GONE. I HAVE HAD NO MORE MIGRAINES, VISUAL AURAS, SCOTOMAS, DIZZINESS, VERTIGO, MEMORY PROBLEMS – AND THE HAIR LOSS HAS STOPPED. A long-time itchy skin problem also went away. While I eat foods without meat, I will never again participate in vegetarian eating due to what I experienced. B12 deficiency is very real and not pleasant to deal with.

Afterward

We live in a modern era where most of us are fortunate to be able to make choices in our food selections. Throughout history, having choices has been unusual – we ate what was available, when and where it was available. Food storage was mostly drying, and root cellars, until the 19th century when canning was invented. Frozen foods came about primarily as a result of WW II (to ship food to soldiers) and became popular in supermarkets after WW II. Meat, kept alive on the hoof, was one of the few items that could be obtained fresh, in the middle of winter.

Today, we get to choose fresh fruit and vegetables year round. Rather than a 4-6 month season in the late summer, we can now purchase most items year round thanks to a global food growing and distribution business. Is this environmentally friendly? Probably not. Yet those who advocate eating less meat or even eating only vegetarian, for eco-friendly reasons, generally ignore the environmental impact of making those choices. (Or similarly, I’ve dealt with people in mild climates and 10 month growing seasons who don’t understand that those of us in northerly latitudes have very short growing seasons!)

I’ve seen many here in the U.S. argue that we should not farm meat and should turn the land over to growing crops instead. This is naive. I live in the high desert environment of the western U.S. The land was created from massive volcanic lava flows long ago. The topsoil is nil. Water resources are low. This land grows grass and little else. Animals are an efficient way to convert grass, that people cannot consume, into calories that we can consume. If we did not grow animals on this land, then no food crops would be grown here. This land cannot be converted to growing wheat, corn or vegetables – not possible.