The day after Labor Day (six days from today) our new book comes out, and our publisher finally gave us permission to excerpt it.  I’m going to post the entire introduction so you’ll know why we came to write this particular book.

The story you will read will be true and the names won’t be changed to protect the ‘innocent.’  Until the events transpired that you will soon be reading about, I was not especially a proponent of fast weight loss.  I mean a low-carb diet will make people lose weight quickly, but that’s not what I’m talking about.  I’m talking about the people who used to come into my office saying, “I’ve got my high school reunion in a month.  How much weight can I lose by then?’  I always considered these as fairly ludicrous requests because the requesters clearly weren’t concerned about health issues, but simply about how they would look in the short run, without an eye to maintaining their lifestyle.

As a consequence of dealing with so many of these patients, I really developed an aversion to the notion of quick weight loss to meet some sort of deadline where appearance counted.  But, as with so many things in life, it’s easy to pontificate until you find yourself in the same position as the people to whom you’re pontificating.

Go ahead and read this excerpt so you can see what I’m talking about, and we’ll pick up this conversation after.  This excerpt is from the manuscript version and not from the actual book so there may be slight differences, if you’re comparing the two.  I used the manuscript version because I could paste it in – had I used the actual book version I would have had to type it in.

Bob Hope famously quipped that middle age is when your age starts to show around your middle, and the audience always obliged him with a hearty laugh.  But for millions of adults the sad irony of the middle-aged middle is anything but funny.  Except for a select few metabolically-gifted individuals, crossing the threshold into middle age heralds the beginning of a battle of the bulge that seemingly never ends.  Granted some reach that threshold sooner than others; some acquiesce to the larger belt and the broader silhouette with some degree of aplomb, while others rail against time and fate. They take up and discard first one diet and exercise program and then the next in a frustrating quest to recapture the slender waist they can still recall, but no longer see in the mirror.

We’ve spent the majority of our medical careers helping people of every description with just this battle, combating overweight and weight-related health issues.  Although some were in their teens and twenties and some were in their seventies and eighties, the vast bulk of the many thousands of patients we guided to better health and lower weights were in middle age.  What we learned from these many years in the diet trenches is that middle-aged weight is stubborn; it’s different to deal with; it doesn’t respond readily to modest dietary changes or the incremental increases in exercise usually recommended by the purveyors of received medical and nutritional wisdom.  The factors driving middle-aged weight gain—which really does go straight to the middle—are like a perfect storm, metabolically speaking.  A confluence of changes in hormones, stress, lack of sleep, alcohol intake, medications, fat and cholesterol phobias, and a mountain of other nutritional misinformation combines to create a mid-life tsunami that seems to swamp the metabolism and fill every nook and cranny of the middle of the body with fat.

For more than twenty years we have researched this area of science, refining the tools to deal with it effectively, writing about it, lecturing on it, so you’d think that our expertise would make protect us from the tsunami, if it came our way.  But it didn’t.  Like everyone else, when the middle-age wave hit, we found ourselves floundering in the tide, paddling as fast as we could, and still not making much headway.  At least not until we dug back into the medical bag of tricks we had used with success in our middle-aged patients and applied them to ourselves.  Here’s how it all began.

Mike’s Story

Our wake up call came the morning we walked onto the set to film the pilot for our TV cooking show. Years before, I had gained a tremendous amount of weight while pursuing my career as a busy, practicing physician, then lost it on a diet I cobbled together from information I got rereading my old medical school texts and delving into the medical literature.  My weight loss did not go unnoticed by my patients, and soon many were clamoring for me to put them on the same diet I had developed for myself.  I did so with great success.  In short order my practice changed.  My wife, Mary Dan, left her busy family practice and joined me in what became a huge bariatric (the treatment of obesity) practice.  We refined the original diet and wrote about our methods in Protein Power, a book that sold nearly 4 million copies.  During the never-ending promotion of the book, we met a producer who proposed that we star in a TV cooking show designed around the precepts of our diet and a cookbook we had written.   We said “Let’s do it.”  He put the deal together and set the shooting schedule for the pilot.

We walked onto the set in sunny Southern California one morning filled with both enthusiasm and apprehension.   As we wandered through the semi-organized chaos that is a film studio, stepping over giant cables, ducking under the scaffolding for the overhead cameras, and dodging production assistants darting here and there, we began to wonder what we had gotten ourselves into.  The whirlwind of activity and the 30 or so people on the set were intimidating to say the least.  We had done countless live and taped television and radio interviews in the previous years, but never a project in which we were the sole actors on the stage, the ones who had to carry the entire show on our own shoulders.  A young man recognized us and directed us to the Green Room, telling us the director would be in to talk with us shortly.

The director, a total stickler for every aspect of the production, didn’t mince words when he joined us in the Green Room.  “We’re going to have to do something,” he said, “you guys are too fat to be starring in this kind of a cooking show.”

We were stunned.  I was a much lesser version of my former fat self and thought of myself as pretty slender.  Mary Dan had gained a little weight in the ten years since the publication of Protein Power, but certainly wouldn’t have been considered fat by anyone’s estimation.  People we met at lectures, book signings, and other appearances uniformly commented on how thin and healthy we looked and always added that we were good advertisements for our diet.

“Yeah, well, it doesn’t work that way on TV,” said the producer.  “If you’re the stars of a show on healthy eating, you’ve got to be thin.  Granted, you look better than the average Joes and Janes out there, but they don’t have their own health show.  TV is a youth-driven medium.  You’ve got to look young to make it on TV and young means thin, especially around the middle.  It’s like the golfer, Lee Trevino, says, the young guys are the ‘flat bellies.’  You’ve got to have a flat belly if you want to make it in this biz.  The camera is going to put 10 pounds on you and you’ve both got bellies starting out.  Imagine 10 pounds added to that.”

Bellies…?

“When you do lectures you’re dressed up, right?  You wear suits, don’t you?”

We nodded.

“At book signings you sit behind a desk, shake a few hands and sign books.  It doesn’t work that way on TV.  You’re going to be moving around, bending over, putting stuff in the oven; you’re going to be seen from all angles.  If we try to hide the fact that you’ve got a little extra weight around the middle, which will be hard since the camera will magnify it, the viewers will know.  Putting you in baggy sweaters or loose clothing will just make them think you’re fat and trying to disguise it, and the show will lose all credibility.”

In a flash, Mary Dan and I had both gone from being confident in our own 50-plus-year-old bodies to being aware of the small paunches that had suddenly seemed to materialize out of nowhere.  What before had seemed nothing more than a little tightening of the waistband now suddenly assumed Falstaffian proportions.

“What can we do?” we asked. “If we try to hide it, they’ll think were fat; if we don’t, they’ll know for sure.  It’s a Catch-22.  We can’t win.”

Our director said, “I haven’t worked in this biz for over 40 years and not learned a trick or two.  Here’s how we’re going to make this work.  Since you, Mary Dan, are going to be the main cook, we’ll keep you standing behind the counter.  You’re short enough that with the height of the counter and a little work with wardrobe we can keep you covered without appearing to do so.  Mike, we’ll have you do all the moving and bending, so you’re going to have to take the bullet.”

“Take the bullet?  What do you mean?”

He reached into his large canvas bag and pulled out what appeared to be a giant piece of black foam rubber.  “Before you go to wardrobe, let me help you put this on under your t-shirt.”The giant piece of foam rubber turned out to be a device called an abdominal censure; in other words, a giant girdle.

“I can’t wear that…” I said.

“Hey, don’t think you’re the Lone Ranger,” he replied, “why do you think I have this?  I didn’t buy it just for you.  A surprising number of the people you see on TV daily are wearing one of these.  Lift up your shirt.”

“Who?” I asked.

“I’m not going to tell anyone about you and I’m not going to tell you about anyone else.  Lift your shirt.”

I lifted my t-shirt; he wrapped the thing around my abdomen and put his knee in the middle of my back to cinch me in.  Feeling a little like the male equivalent of Scarlett O’Hara in the corset scene, I dropped my t-shirt down and looked in the mirror.  I had to admit, I looked better.

I wore the girdle and Mary Dan stayed behind the counter for the two days it took to film the pilot.  (Now we shoot two shows per day, but then we were raw beginners.)  Our show got picked up by PBS and we scheduled to start shooting about three months later.  Fortunately, the pilot was only shown to others in the industry, and now the show with me squeezed into neoprene and Mary Dan cloistered behind the counter has been relegated to the never-to-be-shown file.  What we took away from that day was the certainty that something had to be done and quickly…but what?

Not long after returning home from this experience we attended a large charity event at which we were seated at a table with several middle-aged women.  One was significantly overweight, but the others would be considered within or close to their normal weight range.  The discussion turned to weight loss.  The constant thread through the conversation was how much easier it was to lose weight overall, compared to the difficulty of losing it in the waist.  All the women bemoaned their stubborn middles.

Meanwhile, still stinging from our recent brush with abdominal truth, we had begun looking at the mid-sections of non-obese middle aged men and it quickly became clear that they all had paunches of various sizes.  It appeared that there were no (or damned few) middle-aged flat bellies out there of either gender.  Young people who were a little overweight didn’t seem to have protuberant guts; they carried their excess weight all over.  But in middle age, it went straight to the middle.  Even young people with guts don’t look the same as middle-aged people with big bellies; there is a difference, easily recognized.  We realized that our director had been right; it’s not just normal body weight, but a flat belly that is the real sign of youth, so we set out to get one, too. .  Drawing on two decades of experience in clinical practice, helping thousands of patients of all ages, we dusted off and examined every weight loss trick in our armamentarium. We did the same thing we had done years before when we did our research for Protein Power, combing the worldwide medical literature for insight and scientific substance, but instead of concentrating on weight-loss in general, we focused our search on abdominal weight loss, more specifically abdominal fat loss.  We discovered that, although spot reducing is impossible, the diameter of the mid-section can be reduced quickly with the right nutritional tools.  Fortunately, many of those tools dovetailed perfectly with those we’d used successfully over the years with patients in our clinical practice.  After a couple of weeks of intense effort, we put together a flat-belly program for ourselves that combined a reworking of our old Thin So Fast and Protein Power diets that we had used in many thousands of patients, a number of nutritional supplements we had learned about from our wide-ranging medical research in the intervening years, and a unique, but simple, abdominal exercise plan, based on the laws of physics.

We had exactly 6 weeks before our next shoot, so we launched into the program with full vigor, with the goals of avoiding the dreaded cinch and the safety of the counter.  The regimen vastly exceeded our expectations.  The greatest changes occurred in the first two weeks with smaller, but still significant, changes taking place over the course of the next 4.  We appeared for the shoot with flat bellies, much to the delight of our director.  and were able to move from refrigerator to sink to counter, showing full physique and with nary a trace of neoprene.   We no longer had to suck it in every time we changed positions for fear that the camera might catch our mid-sections at an unfavorable angle. The regimen had been a slam dunk.

It’s been a little over two years (and 26 episodes of our show) since we developed and took The 6-Week Cure ourselves, but our success has inspired countless readers, viewers, relatives, patients, friends, and friends of friends to want to know exactly how we did it.  This book provides those answers.  In it, you will discover not only what happens in middle age that drives fat into your middle body, but more importantly, what you can do, physically and nutritionally, to harness the metabolic forces at work and turn the tide.  With a little hard work over a very short stretch, you, too, can regain a more youthful silhouette. When you do, we’re sure you’ll agree with what we discovered: there’s nothing that restores youth like curing your middle-aged middle.

MD and I have been on a low-carb diet (sometimes stringently; sometimes not so stringently) for about the last 25 years, so some may take this story to be a repudiation of such diets, but it isn’t.  Our diet wasn’t really at fault; it was the inexorable creep of time that caused the problem.

As we age, things change.  What worked 25 years ago, doesn’t work exactly as well now.  Especially when we get a little sloppy with it.  One of the problems with carb restriction is that people who do it for a while, get good at it.  They become experts at both abiding by the carb restriction yet consuming a lot of calories and tending to overlook small carb indiscretions—a small piece of bread at dinner, just a bite or two of dessert, an extra glass or two of wine or beer—that they would have scrupulously avoided during the first heady days of low-carbing.  We were certainly experts on low-carb diets and we fell into those traps.   And time marched on making us even more susceptible to little indiscretions and to carb creep.

Now, we never came close to Orson Welles or Mamma Cass proportions – in fact most people would have described us a slim – but we had picked up little middle-aged middles.  So we set out to lose them.  Fast.  To do so, we relied upon our 25 years in clinical practice, pulling out every tool we had learned to help solve stubborn cases of middle- aged overweight.

As we describe in the book, the kind of fat people pack on around their middles in middle age is different than fat packed on earlier in life, which is both good news and bad.  Middle-aged fat is, by and large, visceral fat, the kind that accumulates within the abdominal wall and around the organs.  The bad news is that it is a dangerous kind of fat – the good news is that it’s relatively easy to lose.  Especially if you do it the right way.  Which is why you can make enormous strides in only six weeks even if you have a lot to lose.

Although it does contain plenty of information you’re not likely to have read before, this book isn’t intended as a giant treatise on everything known about health and weight loss.  It’s, quite simply, a primer on how to get rid of middle-aged abdominal fat fast and safely.  We solved our own problem.  I hope those of you who grab a copy and give it a try achieve the success that we did.  And I hope you give us your feedback so that we can improve future editions.

I can probably muster up the gumption to do it annually, so here is the list of the bestselling books from 2008.  These are the books that readers of this blog purchased through Amazon by clicking on the links or book icons on my blog, MD’s blog and the home page of the website.  I’ve listed only books not written by MD and/or me.

The number one bestselling book was Mistakes Were Made, which is one of the better books that I’ve read in a long, long time.  It’s now out in paperback, so if you haven’t read it, get a copy.  It explains in an easy-to-read way how the confirmation bias works and why we all need to carefully examine why we believe what we believe.  And it shows the validity of Stuart Chase’s famous quote:

For those who believe, no proof is necessary. For those who don’t believe, no proof is possible.

I’ve read a slew of books on the confirmation bias and why we believe what we believe, but, in my opinion, Mistakes Were Made is by far and away the best of them all.

Here are all the books in descending order of sales:

#1. Mistakes Were Made by Carol Tavris and Elliot Aronson (my full review)

#2. Good Calories, Bad Calories by Gary Taubes (my review)

#3 Crucial Conversations by Kerry Patterson et al (my review)

#4 The Brain Trust Program by Larry McCleary, M.D. (my review)

#5 500 Low-Carb Recipes by Dana Carpender

#6 The Great Cholesterol Con by Malcolm Kendrick, M.D. (my review)

#7 200 Low-Carb Slow Cooker Recipes by Dana Carpender

#8 Dr. Bernstein’s Diabetes Solution by Richard Bernstein, M.D.

#9 How to Cook Everything by Mark Bittman (MD’s review)

#10 The Low-Carb Baking and Dessert Cookbook by Ursula Solom

As always, I appreciate all of you who have supported this site by purchasing your books, CDs, DVDs, clothing, electronics and all the other stuff you’ve purchased through the Amazon portal on this site.

For those of you who don’t realize how this all works, you can click on one of the above links or one of the book icons on the front page of this blog or the home page of the website and you will be taken to that particular book’s page on Amazon.com.  Once there, you can search for anything Amazon has available, and if your purchase it, I get a little kickback for providing the entry portal.  It is one of the few truly win-win deals out there.  You get your book (or whatever) at the regular (usually heavily discounted) Amazon price, and I get a little dinero to help pay the web guys who keep the site updated and running.  In looking over last year’s records, I was able to pay about two thirds of my tech bills with my Amazon kickback (I hate that word, but I can’t think of a better one), so thanks very much to all those who helped.

I’m constantly telling my own family members, most of whom order a lot of stuff from Amazon, to go to Amazon through the portal on this blog instead of just logging in on amazon.com and buying away.  But it often falls on deaf ears, so maybe I’ll have a little better luck with readers here.  I know it’s a little extra hassle to pull up this blog and click on one of the books to get to Amazon than it is to simply click on Amazon directly, but if you do take the extra couple of seconds, you’ll make an old man very happy.

In the fall of 1898 Sir William Crookes (right) gave his inaugural address as the incoming president of the British Academy of Sciences.   Unlike the typical such speech, this one was prophetic and alerted the British populace for the first time to a real and growing problem.  And the populace began to worry, because Sir William was the Al Gore of his day, alerting his country (and the world) to a looming danger.

Other than prophesying disaster, however, there were a few notable differences between Sir William and Al Gore.  First and foremost, Sir William was a true scientist, not a bloated former politician with no technical training.  He was the inventor of the predecessor of the tubes later used in televisions and radios and had discovered and added thallium to the periodic table.  The second major difference is that his worries were valid.  They weren’t concocted from a gibberish of people hoping to cash in on the public’s fears of an imaginary melting of the earth, but were born of a serious concern for the continued success of the human race.  Or at the very least, the continued success of the people of Great Britain.

Sir William Crookes was deeply (and rightfully) concerned that the world would soon run out of the ability to fertilize crops, and that, as a consequence, millions would die.  At that time Britain was importing guano (the droppings of sea birds) from islands off the coast of Peru and from the nitrate fields of Chile, but those sources were finite, and Sir William realized they would at some point run out.  (He predicted sometime in 1930 as doomsday.)

To those of us today who can go to our local hardware or garden store and grab all the fertilizer we can afford to pay for, this hand wringing seems a bit melodramatic, but at the time, it was of real concern to many scientists.  The world’s population was growing rapidly, and, like today, the vast majority of the world’s population depended upon grains – mainly wheat – for sustenance.  Most grains suck nitrogen from the soil to fuel their growth, and once that nitrogen is gone, it takes a long time to get back.  And until it does, most any crop grown in nitrogen-depleted soil fails to thrive, and yield per acre falls dramatically.

The fact that nitrogen is lacking in the soil seems strange since we all walk around breathing air that is about 80 percent nitrogen.  But the nitrogen in the air can’t get into the soil in a form plants can use unless it is ‘fixed.’  Which I guess isn’t so strange when you consider that we ourselves need nitrogen to grow and repair our tissues, but we can’t get it from the air we breathe either.  We have to get it from the protein in our diets.

Nitrogen-fixation process

Bacteria that live symbiotically with the roots of certain clovers and legumes (the so-called green manure) are able to fix nitrogen from the air and covert it to the form plants can use.  Over the years farmers had figured this out and planted clovers and legumes in fields for a year or two to replace the nitrogen and make the fields fit to grow cash crops.  Or they could use manure or compost – both traditional sources of nitrogen – to replace that needed for growth, but they needed a lot because these were not particularly rich in fixed nitrogen.  Consequently, crop rotation and spreading manure/compost wasn’t a particularly efficient way of keeping a profitable farming business growing.  A more rich and readily available source of nitrogen was needed.

When enormous deposits of guano -  about 10 stories high, extremely rich in nitrogen, and taking literally centuries to accumulate – were discovered off the coast of Peru, a bustling shipping business grew up hauling the stuff from there to Britain.  As those supplies started to dwindle, explorers found fields of nitrites in Chile that began to replace the guano.  But, as Sir William observed, those sources were finite as well, and would at some point be gone.  If nothing was done or no other sources discovered by time the Chilean fields ran out, then the world would be in real trouble.

Sir William pointed out that the populations of all the great wheat-eating peoples, the Brits, the United States and Europe mainly, would outstrip their grain of choice, resulting in the deaths of thousands and perhaps even millions.  He announced in the most racist of terms (common at the time) that if a solution of this problem weren’t discovered, and discovered fairly quickly, “the great Caucasian race will cease to be foremost in the world, and will be squeezed out of existence by races to which wheaten bread is not the staff of life.”

“It is through the laboratory,” he pontificated, “that starvation may ultimately be turned into plenty.”

I don’t know what the population at large thought about Crookes’ speech, but the scientific community took it seriously.  In Germany, a Jewish scientist named Fritz Haber, after years of work, developed a desktop working model of a machine that could convert the nitrogen from the air into ammonia, which is basically the form needed for both fertilizer and gun powder.  Other scientists thought Haber’s contraption was interesting but impractical in that the temperatures and pressures required couldn’t be produced with the technology available then in any kind of industrial-sized plant.  One non-naysayer was Carl Bosch, an engineer at BASF, the giant German chemical company.  Bosch thought he could make Haber’s machine work, and after intense effort he succeeded on a giant scale. Now Haber-Bosch machines use about one percent of the earth’s resources and provide the nitrogen that sustains around 40 percent of the earth’s population.  That’s the good news.  The bad news is that these machines allow us to live in a carb-dominant world, rich in wheat and corn. Had this technology never have been invented, who knows how the nutritional history of the world would have progressed.

The Alchemy of Air by Thomas Hager is the fascinating story of the development of the Haber-Bosch system as told through the lives of the main players.  The secrecy, the infighting, the suicides, the war-time intrigue – all provide high drama in this fascinating story.  What I found particularly interesting – not to mention germane for us today – was how Bosch, who could apparently do just about anything chemical engineering-wise, developed a method to make gasoline out of coal.  By the end of WWII, 35 percent of Germany’s gasoline and all of its gunpowder came from plants developed and built by Bosch.  Why aren’t we looking at this technology that’s already existent to help wean ourselves from foreign oil?

If a technical book is more your style, then grab a copy of Enriching the Earth by Vaclav Smil.  You will learn more about the science of ‘fixing’ nitrogen and less about the personal dramas of the main players on the stage.  I read both and found them complementary to one another.  If you read both, you will know just about everything there is to know about fertilizer and nitrogen. But if you just read one, make it The Alchemy of Air.

Below is a photograph of a Haber-Bosch plant operating in the United States today.

Fertilizer factory using the Haber-Bosch process

Let’s jump subjects and move into the world of fiction.  Mystery fiction, to be precise.  I’ve been doing a lot of traveling lately, and I catch up on my ever-growing stack of crime novels while on the airplane.  I enjoy all kinds of mystery fiction, but lately I’ve had a run of British police procedurals along with an Italian one and a few German ones thrown in the mix.

I just finished Peter Robinson’s All the Colors of Darkness, which I found so so.  I thought it a wee bit contrived, much more so than his previous books, which are good books to start with if you’re unfamiliar with the British police hierarchy.  The author was born and grew up in the UK, but has lived in Toronto for years. He writes with the knowledge that his readers won’t be up with all the British police jargon, so he goes easy on them.

Despite my ho hum feelings about this book, I did find a paragraph that caught my eye.  The paragraph describes a lazy, off-duty Saturday morning routine (which, after this setup, you know ain’t going to last long) followed by Detective Chief Inspector Alan Banks, the protagonist of the series:

Banks stopped at the newsagent’s and bought The Guardian, which he thought had the best Saturday review section, then headed to the Italian café for his espresso and a chocolate croissant.  Not the healthiest of breakfasts, perhaps, but delicious.  And it wasn’t as if he had a weight problem.  Cholesterol was another matter.  His doctor had already put him on a low dose of statin, and he had decided that that took care of the problem and allowed him to eat pretty much what he wanted.  After all, he only had to be careful what he ate if he wasn’t taking the pill, surely?

I suspect the author of this series takes a statin.  From his photos he doesn’t appear to be overweight.  I would be willing to bet that he, like his character, takes a low-dose statin (what with all the statinators around, who doesn’t these days?) and probably doesn’t watch what he eats because the statin makes him feel safe.  Bad mistake, probably, but one I’m sure more than a few who feel themselves invincible on statins make. (Who would’ve thought I could dredge an anti-statin blog out of a mystery novel?)

If you want to get started reading Peter Robinson, find a few of his earlier books.  Try Gallows View or Hanging Valley or Past Reason Hated.  Any of his books are a good introduction for the US reader into the intricacies of how the UK police works.

I read recently the second novel in Susan Hill’s mystery series, The Pure in Heart, which is a much different kind of book than the Peter Robinson books.  Susan Hill is a prolific writer of note who sticks mainly to contemporary fiction with the occasional ghost story thrown in.  The detective novel is a departure from her normal course of work, but she adds her own creative touch to the genre.  If you decide to read this book, read the one before it, The Various Haunts of Men, first or you will learn something in The Pure in Heart that will give away a big part of the plot in the previous book.  As I say, these aren’t your regular mysteries, but that’s what makes them nice.

If you want a mystery that’s a series you can get into and that is quick and fun to read, have a go at any of the novels by Andrea Camilleri about Sicilian police inspector Salvo Montalbano.  I’ve read most of these books and just finished the most recent one, August Heat.  With this series, you can start anywhere.  These novels will certainly show you the difference between the police systems in the UK and in Italy. I don’t know where I would rather be arrested, but I do know that I wouldn’t want to have been arrested in Germany in the 1930s.

If you really want to go back to pre and post WWII Germany, read the wonderful series of books by Philip Kerr about Berlin detective Bernie Gunther.  I am currently reading The Rise and Fall of the Third Reich (I always have a long, serious book going that I dip into read a little of daily. Right now I have two: The Rise and Fall and Dawin’s On the Origin of Species.), and Kerr’s novels describe pre WWII Germany to a tee.  If you want to see what life was like for Fritz Haber, Carl Bosch and others living in Germany as Hitler came to power, you’ll do no better than to read these novels.  The first three books in the series, referred to by aficionados as the Berlin Noir trilogy are March Violets, The Pale Criminal, and A German Requiem.  You can get all three now in one large paperback, but I would save it for last.  As far as I’m concerned, the best way to read these books is from last, to second to last, then the trilogy.  In other words, in opposite order in which they were written.  Start with the last book, A Quiet Flame, move on to the next-to-last one, The One From the Other, then finish with the trilogy.  You won’t be disappointed.

As I’m sure most of you know, I read a lot.  I’ll be happy to post from time to time about some of the books I enjoy if most everyone is game.  Let me know in the comments if you like these little book reviews.  And, please, feel free to recommend any of your own favorite books.

Thanks to ALLIED 2008 151 for the photo of the fertilizer plant

I usually try to put up a best seller list of all the books readers of this blog ordered through the Amazon links every quarter.  I just realized that I missed a quarter, so I’ll do the list for the last two quarters as one.  I love bestseller lists, so I assume everyone else does, too.  It’s nice to know what your fellow low-carb enthusiasts are reading.

These are books purchased through the Amazon links on this blog, MD’s blog, and the Protein Power website.  As always, the rules for selection are that no books authored  or co-authored by MD and/or me are included.  Only those written by others.

The number one book on the list was Crucial Conversations, a book I reviewed back in June.  This a tremendously good book that you should grab a copy of and read if you haven’t.  It’s one of those books that truly can change your life.

Here are the books in descending order of sales.

#1 Crucial Conversations by Kerry Patterson et al (Review)

#2 Mistakes Were Made by Carol Tavris and Elliot Aronson (Review)

#3 Good Calories, Bad Calories by Gary Taubes (Review)

#4 The Brain Trust Program by Larry McCleary, M.D. (Review)

#5 500 Low-Carb Recipes by Dana Carpender

#6 15-Minute Low-Carb Recipes by Dana Carpender

#7 200 Low-Carb Slow Cooker Recipes by Dana Carpender

#8 The Great Cholesterol Con by Malcolm Kendrick, M.D. (Review)

#9 Ending Aging by Aubrey de Grey, Ph.D. (Review)

#10 Dr. Bernstein’s Diabetes Solution by Richard Bernstein, M.D.

These are the books your fellow readers are reading.

I thank all of you who have purchased books, clothing, music, DVDs, household goods, sunglasses (several pairs), and even a wood chipping device through the Amazon portals on this site.  I really appreciate it.  The income from these Amazon purchases goes toward maintaining this site, which costs me about $800 per month.  The Amazon take covers about a fifth of that.

If you’ll indulge me a little, I’ll make on of those maddening pitches that fundraisers use on public TV and radio.  (MD and I actually did one of those phonathons once to raise money for Milwaukee PBS, which filmed our Low-Carb CookwoRx PBS series.  It was dreadful.  We had to be interviewed and beg for money on behalf of the station.  Not really my cup of tea.) But, here I am with hat in hand.  I don’t know if you know it or not, but if you go to Amazon through one of the links on this site (this blog, MD’s blog or the PP website) and shop for anything – not just the books linked on the blog, but anything – we get a tiny piece of the action just because you went there through our site.  It doesn’t cost you anything more, just the effort to go to this site and click one of the little book icons for our books to enter Amazon, and start shopping.  And, as I’ve said before, all I get is a list of stuff that was purchased and what my tiny cut of it is – I can’t tell who bought what.  So, if you’re contemplating a naughty book or video, don’t hesitate to purchase it through this site.  I’ll never know who you are, just what you bought. I can tell you, though, that readers of this blog are a clean minded lot.  I don’t think there has ever been an offcolor book or video purchased.  There it is.  My whinathon for help to keep this site paid for. Thanks for listening.

I’ve gone through and compiled a list of the most common questions and presented them to Gary.  Here are the questions followed by his responses.

The most commonly asked question was how do Asians and others living a seemingly high-carb existence manage to escape the consequences?

The Asian question first. I do address this in the book and I address it again in the afterward of the paperback. There are several variables we have to consider with any diet/health interaction. Not just the fat content and carb content, but the refinement of the carbs, the fructose content (in HFCS and sucrose primarily) and how long they’ve had to adapt to the refined carbs and sugars in the diet. In the case of Japan, for instance, the bulk of the population consumed brown rice rather than white until only recently, say the last 50 years. White rice is labor intensive and if you’re poor, you’re eating the unrefined rice, at least until machine refining became widely available. The more important issue, though, is the fructose. China, Japan, Korea, until very recently consumed exceedingly little sugar (sucrose). In the 1960s, when Keys was doing the Seven Countries Study and blaming the absence of heart disease in the Japanese on low-fat diets, their sugar consumption, on average, was around 40 pounds a year, or what the Americans and British were eating a century earlier. In the China Study, which is often evoked as refutation of the carb/insulin hypothesis, the Chinese ate virtually no sugar. In fact, sugar consumption wasn’t even measured in the study because it was so low. The full report of the study runs to 800 pages and there are only a couple of mentions of sugar. If I remember correctly (I don’t have my files with me at the moment) it was a few pounds per year. The point is that when researchers look at traditional populations eating their traditional diets — whether in rural China, Japan, the Kitava study in the South Pacific, Africa, etc — and find relatively low levels of heart disease, obesity and diabetes compared to urban/westernized societies, they’re inevitably looking at populations that eat relatively little or no refined carbs and sugar compared to populations that eat a lot. Some of these traditional populations ate high-fat diets (the Inuit, plains Indians, pastoralists like the Masai, the Tokelauans); some ate relatively low-fat diets (agriculturalists like the Hunza, the Japanese, etc.), but the common denominator was the relative absence of sugar and/or refined carbs. So the simplest possible hypothesis to explain the health of these populations is that they don’t eat these particularly poor quality carbohydrates, not that they did or did not eat high fat diets. Now the fact that some of these populations do have relatively high carb diets suggests that it’s the sugar that is the fundamental problem. Ultimately we can only guess at causes using this kind of observational evidence. To know anything with certainty we’d need the kind of randomized controlled trials I yearn for in the epilogue of GCBC.

What is your opinion on leptin in the grand scheme of obesity and fat storage?

I mostly ignore leptin in the book because I think leptin is primarily a signaling molecule and so a downstream effect. In other words, leptin is secreted from the fat cells; it doesn’t regulate directly the amount of fat that accumulates. Moreover, if the primary regulator of fat storage is insulin, which it is, and leptin is secreted in proportion to the amount of fat stored, which it is, then insulin has to regulate leptin.

Where leptin may play a primary role is in the liver. A few years ago Jeff Friedman of Rockefeller University published an article in Science showing that leptin down-regulates SCD-1 in the liver (the only place they looked), which worked in turn to increase oxidation of fatty acids. This makes sense homeostatically: if leptin is released in proportion to the fat accumulated then it is a signal of how much fat we have in reserve. So long as the mitochondria in our lean tissue and organs know that we have fat in reserve, they can continue to burn it without fear of systems failure should they run out of fuel completely. Leptin resistance would then work, like insulin resistance, to make us burn less fat and store more, while the rest of the body would have to rely on carbohydrates (blood sugar) for fuel.

In general, though, I’m interested in the cause of obesity and I don’t think discussing leptin adds much. Here’s what I say about this issue in afterward of the paperback edition of GCBC:

“Another variation on the can’t-possibly-be-so-simple argument that I have heard frequently since Good Calories, Bad Calories was published is the molecular biology theme. The last fifteen years, since the discovery of the hormone leptin in 1994, has seen obesity research become a sub-discipline of molecular biology. As a result, a search of the keyword “obesity” in the National Library of Medicine database will now identify over 100,000 relevant articles in the professional journals (nearly 20,000 review articles alone), a large proportion of which focus on the fruits of molecular biology research and the science of genomics.: It’s a burgeoning field with a cast of thousands, including the role of obesity-related gene variations known technically as polymorphisms, of signaling molecules with names like adiponectin, leptin and grhelin, of the receptors for those signaling molecules and the inhibitors for those molecules and inhibitors of the inhibitors, and so on. The obvious question is how can this research be so extraordinarily fruitful, and yet mostly irrelevant to the cause of obesity? It’s hard to imagine it’s not, and so, as I’ve frequently been told, any discussion of the cause of obesity that doesn’t discuss these molecules, receptors, inhibitors, etc. must be considered amateurish and woefully inadequate. The truth must be complicated.

“Again the counter-argument seems itself simple and straightforward: if you’re hit over the head with a hammer, it will cause both pain and inflammation. The mechanisms of pain and inflammation have also yielded up a wealth of knowledge to the tools efforts of the molecular biologists. These physiological phenomena are understood to be mediated via signaling pathways and molecules (in this case, prostaglandins, tumor-necrosis factors, etc.) that emerge in response to the damage done. The more researchers learn about these responses and the molecules involved, the more complex the pathway from hammer to pain and inflammation to healing will appear. But the relevant fact to all those immediately involved is that both the pain and ensuing inflammation were caused by the hammer and perhaps the person who swung it. Everything else is downstream and may be relevant only to the question of which drugs will best deal with the pain and perhaps accelerate the healing process. “

A number of questioners asked why you think it is more difficult to lose weight the second or third time around on a low-carb diet?  And why it seems more difficult to lose on low-carb with increasing age?

I’m curious whether this is in fact true. Another possibility is that it’s more difficult to lose weight on low-carb as we get older; that the carbs effectively do chronic damage to our tissue and so the longer we’ve been overweight or obese, the harder it is to lose weight. I can imagine a scenario in which the fat tissue becomes hypersensitive to the insulin we secrete, or the pancreas becomes hypersensitive to the carbs and secretes even more insulin, or the insulin resistance in the lean tissue becomes less tractable, and so the longer we remain fat, the more our fat tissue compensates when we restrict carbs. It’s also possible that repeated low carb dieting somehow exacerbates this process, but I’d want to see definitive studies (and on all this speculation) before I believed it.

Several people asked for a comment on any important studies that you may have left out of GCBC.

The issue isn’t leaving out studies so much as not wanting to get into the he-said, she-said game of quoting particular studies that support my preconceptions. In this business, you can always find studies that support a particular hypothesis, or at least seem to if you selectively interpret the data. So when I had to make a point about the efficacy of a particular treatment — exercise, for instance, or semi-starvation diets — used meta-analyses or Cochrane Collaboration systematic reviews, which are designed to minimize author bias, to make the general points. When I discussed the saturated fat/cholesterol/heart disease hypothesis in the first few chapters, I did indeed mention virtually every study and certainly every meaningful clinical trial, because I knew if I left anything out I would be accused of cherry picking the data (which, of course, I was anyway). I did omit much of the observational epidemiology on the nature of a healthy diet because I find it meaningless and impossible to interpret correctly, in part for the reasons I discussed above about the Asian diet issue.

When I cut the book down from the initial 400,000 word unfinished draft, a lot of what was removed were indeed the counter- and counter-counter arguments. For instance, obesity researchers will argue that obesity causes hyperinsulinemia, not the other way around. That way they can still say that obesity is caused by over-eating and once we get fat, that causes insulin resistance and jacks up insulin levels. I spent, literally, months writing a lengthy section explaining how this view came about and what the evidence actually did and did not demonstrate. Then when I realized the book had to shrink dramatically, and with the benefit of sage advice from my editor, I decided that it was unnecessary to explain why the mainstream researchers would disagree with my take and then spend yet more space explaining why they were wrong to disagree. One thing I did cut from the book that I regret was a section linking gout to fructose and uric acid, and discussing the history of gout and how it’s frequency in populations and socioeconomic groups paralleled the spread of sugar. Nobody had ever made that point before and I wanted to make it, considering that people have been speculating on what aspect of diet or lifestyle causes gout back to Hippocrates. Still, my friends rightly argued that when your book is a few hundred thousand words long, you can’t afford to keep a section about gout, even if a lot of people get gout these days and, of course, they’re more likely to get it if they’re overweight or obese. Along these lines Dan Harrington asked why his gout goes away on the Atkins diet and that’s my answer: no sugar, primarily, means no fructose and so no fructose-induced hyperuricemia. In other words, fructose raises uric acid levels and gout is caused by the elevated uric acid in the blood stream.

It is true that you can find studies in the literature that seem to contradict the hypotheses in GCBC but are not mentioned in the book, When Gina Kolata reviewed my book in the NY Times, she evoked a study by Jules Hirsch and Rudy Leibel, then both at Rockefeller, suggesting that nutrient composition of the diet has no effect on weight. As I explained in a letter to the Times, the study failed to refute the carbohydrate/insulin hypothesis of weight regulation for a variety of reasons — the subjects, for instance, could have gained as much as 15 pounds a year on one particular diet composition but not another, and the study would not have detected it. And the subjects, almost exclusively, were lean middle-aged individuals. What we’re interested in here, though, is why why people predisposed to obesity get fat, and that may not be something you can study in people who have remained lean into their 40s and 50s. Would Leibel and Hirsch have obtained a different result if they had used, say, obese subjects who had first been slimmed down by some kind of diet (Atkins or a starvation diet)? These types of subjects are considered pre-obese, since they’re so highly likely to go back to being obese. And if Leibel and Hirsch had used them, they might have found that they stay relatively lean on a low carb diet and put on weight easily on a high carb diet. Anyway, rather than get into this kind of too-and-fro in the book, I made the decision not to mention these types of ambiguous studies. I would like to think that had there been a single compelling study refuting the hypothesis — or better yet, two, since you’d like to see things replicated in science — I wouldn’t have written a different book.

What you think of a Slow Burn type of exercise and low-carb dieting?  Do you still stand by your notion that exercise doesn’t help people lose weight?

I haven’t looked into the science behind slow burn exercise (although I know Mike has) but I now do it regularly (with Fred Hahn in Manhattan at Mike’s recommendation) and it seems to be helping my lower back pain immensely. I can let you know next spring whether it helps my softball game, where my ability to hit with power has been deteriorating sadly with the advancing years. What fascinates me about it is the weird confluence of the desire for self-improvement with what seems to be deep-set sadomasochistic tendencies. It’s torture when you do it, and then you look forward to going back.

As for exercise, I do not believe that it causes long-term fat loss. I think it might be helpful in a weight loss program only because it gives you a kind of positive feedback that dieting per se does not. You can feel good after a work-out, while it’s hard to feel too good after a meal that didn’t include either the calories or the carbohydrates you preferred. On the other hand, since it does make you hungry — work up an appetite — I worry whether for some or even most people the psychological benefits could be counterbalanced by the drive to consume even more calories than you might have expended during the work-out.

Are you familiar with the work of Dr. Jan Kwasniewski, and, if so, what do you think of it?

I am not.

What kind of response have you gotten from the medical/scientific community about GCBC?

In general, I think it’s safe to say that I’ve been ignored. If obesity researchers have read the book, they haven’t bothered to tell me. When GCBC was published we sent out 150 copies to obesity researchers, authors of obesity task force reports, foundations that fund obesity research, everyone at NIH who funds obesity research, etc. etc. I heard back from 3 or 4 thanking me for sending them the book. Two followed up to tell me they had read it. Some later told me outright that they didn’t have the time to read a 500 page book, and particularly so when they already know what I think because of the 2002 NYT Magazine article and don’t particularly agree. That said, I may be making some progress in getting people to pay attention.

Whenever I do hear from someone who is sympathetic, I ask them to try to set up a lecture at their institution. Often I ask them to contact other researchers they might know and get me lecturers at those institutions. Through this kind of networking, I’ve been invited to lecture at some of the more influential obesity research centers and at least some of those people have taken my arguments seriously. A few months ago, I heard from some contacts at the NIH, that I might be invited down to lecture to the nutrition coordinating committee at NIH, which would be a big step forward, but the fact that I haven’t heard anything since then (August) makes me pessimistic.

When I do give these lectures a common response that I get from nutritionists and obesity researchers, and one that I find profoundly disturbing, is that they find what I say interesting but don’t see it as anything they should think about further. In other words, they have their schtick (as my wife, an almost-academic calls it); whatever research they get their funding to pursue, and even though in theory we’re all in this to cure and prevent obesity and chronic diseases, their schtick may have nothing to do with my schtick. If they’re studying, say, genetic strains of obese rats or questionnaires to improve the accuracy of diet assessment in epidemiologic studies, what does that have to do with my argument that obesity is caused by carbohydrates? So they listen politely, ask a few intelligent questions (in an ideal world) and then go back to their research, because that’s how they make a living. They don’t say to themselves, I’m going to read Taubes’s book and, if I find it compelling, switch my research over to studying the efficacy of carbohydrate restriction. And even if they did, they wouldn’t get funding to do so because they’d have no track record in that field.

So, bottom line, at the moment is that I know of a handful, maybe as many as a dozen researchers, who find the arguments in the book compelling and are doing what they can, in their limited spare time, to help get the message out and maybe get us to the place where the hypotheses are taken seriously and are rigorously tested. The rest either don’t care or don’t know GCBC even exists or just think what I say is wrong and so not worth further discussion, either because they read the book or some of it and think its crap or because they think its crap based solely on what they know about me or heard about the book and so don’t have to read it.

What’s next?  Another book?

What am I doing next? As suggested by many readers, I am going to write a short, easy-to-read version of the weight section of GCBC. It won’t be a diet book — no recipes — but it will be far more of a self-help book than GCBC. I might also do a weightier (no pun intended) serious investigation into the sugar and corn syrup industries; their history, political influence, lobbying, etc — that would be interwoven with a more intensive look at the potential health effects of sugar and HFCS and fructose particularly. The first book will definitely be done; the second depends on getting the funding to do so. I’d also like to get back to straight science writing for a while, since I do enjoy writing about good science, which is how I started my career, and it would be a pleasant change from the mainstream nutrition and health nonsense.

How about a blog?

As for a blog, I just haven’t got the time at the moment, although I always hope that that will change in the future.

Many wrote that GCBC had changed their lives.  Can you think of a book that has changed your life?

Did any books change my life? Yes, All the President’s Men, by Woodward and Bernstein. I read it in my last year of college or my first year of graduate school and it made me decide that I wanted to be an investigative reporter rather than go to business or law school, which was the direction I seemed to be headed.

What do you know about Dr. Simeon’s HCG protocol?

Mostly nothing.

What led you to the idea that saturated fat doesn’t cause heart disease?

It was a progression of steps. Back in the late 90s, I was reporting a story for Science on the salt-hypertension controversy and one of the worst scientists I ever interviewed (and having written a book about cold fusion, Bad Science, I had interviewed quite a few terrible scientists) took credit not just for getting Americans to eat less salt, but getting them to eat less eggs, meat and butter, too. I literally got off the phone with this guy and called my editor at Science and said, “when I’m done writing about salt, I’m going to do a story on dietary fat. I don’t know what the story is, but if this guy was involved in any substantive way, I know there’s a story to be done.” So that’s what I did. I finished the salt story and then spent a year working on the fat story, which was published in Science.

The story made the point that there was virtually no evidence that a low-fat diet prevented heart disease, but let open a window for saturated fat having some deleterious effect. Then a couple of years later, I was reporting the New York Times Magazine story that would become “What If It’s All A Big Fat Lie?”, when I heard about these five clinical trials comparing low-fat, calorie-restricted diets to Atkins diets. Since the Atkins diet is a high-fat, high saturated fat diet and it improved cholesterol profiles in all these trials, that pretty much clinched it. I’ve been arguing since that these diet trials have to be perceived as tests of the hypothesis that saturated fat is a “bad” fat, although the medical establishment still prefers to ignore that fact.

Is there anything new or updated in the paperback version of GCBC or is it the same as the hardback?

It’s the same as the hardback, but there is a 3000 word (or thereabouts) afterward that’s worth reading.

I tried to come up with a selection of questions that represented the majority of questions asked.  I know that some went unanswered, but when Gary agreed to do this I promised him that he wouldn’t have to answer an exhaustive list that would require days of time.  So, I’m sorry if any specific question went unanswered, and I hope you understand.  Thanks to everyone for the terrific response.

Several years ago I encountered one of the most gifted communicators I’ve ever been around. To watch this guy work was truly amazing. His ability to spread oil on roiling waters and bring people with violently disparate views together was almost magical. Now I’ve found a book that shows how he did it.

MD and I were involved with some other people in a business venture that had kind of blown up and was on the ropes. Interestingly, the business was not struggling – in fact, it was making money hand over fist. Which is strange because most blowups between partners come about when there is great financial strain in the business. In this case it was just the opposite.

We had all agreed on a CEO for the business, but at some point along the way, the other people involved had a falling out with this CEO and wanted to get rid of him. MD and I, on the other hand, really liked him, thought he was doing a good job, and wanted to keep him around. Every conference call and every face-to-face meeting became a sort of angst-ridden nightmare for all concerned. Even the CEO wanted out, but was afraid that his portion of the business would be at risk if simply walked away. He had a couple of people he knew could do the job, but he (and MD and I) figured the other partners would be suspicious of anyone this CEO recommended. We were all at a stalemate, with the distrust among us all growing by the moment.

As MD and I were championing our CEO our partners were, unbeknownst to us, looking for a replacement. They found someone they thought would be acceptable. They sent us this guy’s resume, which was impressive. He had been involved in both large corporate situations and in entrepreneurial ventures that had been monumentally successful. He had recently taken a company from start up to acquisition by a major corporate entity for a healthy sum. Our partners wanted us to talk to the guy on a conference call to see if we liked him. We grudgingly agreed. Grudgingly because we weren’t thrilled to be even giving the appearance of considering someone proposed by the opposition.

We got the guy on the phone and within about 20 minutes we were ready to hire him. We hooked him up with our CEO, who felt the same way. We met the guy and found him to be even more impressive in person. We all – MD and I, the CEO and the other partners – agreed to take him on after checking all his references, which were sterling. People couldn’t say enough good things about him.

He came aboard and, thanks to his communication skills, was able to dissolve a lot of the animosity and mistrust that had become a routine part of all company interactions. It was mesmerizing to watch a pro in action.

Unfortunately, the outcome didn’t have a happy ending. But it wasn’t entirely his fault. He was stuck in big company mode (even his startup was well capitalized) and couldn’t ever get his brain around our specific business model. He ended up pulling a lot of money out of the business for himself and his team (which is the one thing I feared from the get go), and when the funds ran low, he and his team moved on to greener pastures. Sadly, his big corporate outlook and strategies didn’t really work for our bootstrap business.

I did get to witness up close and personal (and at great expense) how a great communicator works, though.

Now I’ve discovered a book titled Crucial Conversations that teaches anyone to become a great communicator.

We all have conversations all the time about all kinds of things with family, friends and co-workers. But most of these conversations are the hum drum, everyday variety of communication that makes up most of our conversations. It’s the not hum drum, everyday conversations that we need to be able to deal with to be effective communicators, however; it is those conversations when the stakes are high and emotions are running strong that separates the real communicators from the rest of us. Those conversations that have large consequences that we constantly replay in our minds, telling ourselves over and over that if only we had said this or that things would have turned out differently. Crucial Conversations teaches us how to handle these conversations on the fly.

Sometimes we initiate these crucial conversations, other times we are sucked into them unawares. And when one is imminent, we have only three choices as to how to deal with them:

• We can avoid them, i.e., run away.
• We can face them and handle them poorly.
• We can face then and handle them well.

As the authors point out, these choices seem simple enough. We can avoid these conversations and suffer the consequences or handle them poorly and suffer the consequences. Or we can handle them well. Seems like an easy choice. Let’s handle them well. But it’s not that easy. Why? Because, typically, during these conversations we’re on our worst behavior. Why? Because of the same reason that makes us do so well on low-carb diets: our Paleolithic physiology. The authors explain:

When talking turns tough, do we pause, take a deep breath, announce to our innerselves, “Uh-oh, this discussion is crucial. I’d better pay close attention” and then trot out our best behavior? Or when we’re anticipating a potentially dangerous discussion, do we step up to it rather than scamper away? Sometimes. Sometimes we boldly step up to hot topics, monitor our behavior, and offer up our best work. We mind our Ps and Qs. Sometimes we’re just flat-out good.

And then we have the rest of our lives. These are the moments when, for whatever reason, we either anticipate a crucial conversation or are in the middle of one and we’re at our absolute worst – we yell: we withdraw; we say things we later regret. When conversations matter the most – that is, when conversations move from casual to crucial – we’re generally on our worst behavior.

Why is that?

We’re designed wrong. When conversations turn from routine to crucial we’re often in trouble. That’s because emotions don’t exactly prepare us to converse effectively. Countless generations of genetic shaping drive humans to handle crucial conversations with flying fists and fleet feet, not intelligent persuasion and gentle attentiveness.

For instance, consider a typical crucial conversation. Someone says something you disagree with about a topic that matters a great deal to you and the hairs on the back of your neck stand up. The hairs you can handle. Unfortunately, your body does more. Two tiny organs seated neatly atop your kidneys pump adrenaline into your bloodstream. You don’t choose to do this. Your adrenal glands do it, and then you have to live with it.

And that’s not all. Your brain then diverts blood from activities it deems nonessential to high-priority tasks such as hitting and running. Unfortunately, as the large muscles of the arms and legs get more blood, the higher-level reasoning sections of your brain get less. As a result, you end up facing challenging conversations with the same equipment available to a rhesus monkey.

We’re under pressure. Let’s add another factor. Crucial conversations are frequently spontaneous. More often than not, they come out of nowhere. And since you’re caught by surprise, you’re forced to conduct an extraordinarily complex human interaction in real time – no books, no coaches, and certainly no short breaks while a team of therapists runs to your aid and pumps you full of nifty ideas.

What do you have to work with. The issue at hand, the other person, and a brain that’s preparing to fight or take flight. It’s little wonder that we often say and do things that make perfect sense in the moment, but later on seem, well, stupid.

“What was I thinking?” you wonder.

The truth is, you were real-time multitasking with a brain that was working another job. You’re lucky you didn’t suffer a stroke.

This book is a well-written, no nonsense guide through the jungle of various crucial conversations we venture or even stumble into. Some of the examples of these kinds of conversations are listed by the authors below:

• Ending a relationship
• Talking to a coworker who behaves offensively or makes suggestive comments
• Asking a friend to repay a loan
• Giving the boss feedback about his/her behavior
• Approaching a boss who is breaking his/her own safety or quality policies
• Critiquing a colleague’s work
• Asking a roommate to move out
• Resolving custody or visitation issues with an ex-spouse
• Dealing with a rebellious teen
• Talking to a team member who isn’t keeping commitments
• Discussing problems of sexual intimacy
• Confronting a loved one about a substance abuse problem
• Talking to a colleague who is hoarding information or resources
• Giving an unfavorable performance review
• Asking in-laws to quit interfering
• Talking to a co-worker about a personal hygiene problem

I’m sure you can think of (and have actually been involved in) many more than this short list. One I can think of that is probably applicable to readers of this blog: Talking to a loved one who needs it about a low-carb diet.

Both MD and I found this book enjoyable and enlightening. It uses a minimum of management-type jargon and is totally devoid of psychobabble. As you read through it you will intuitively feel that the advice the authors give is on the money. Best of all, in my opinion, at least, is that the techniques described require some work and discipline to acquire and become proficient in. (I always mistrust any book that presents X number of easy steps to master some complex skill.) In order to become a virtuoso communicator requires practice in the techniques described. Since you can’t always predict when a crucial conversation will be on you and don’t always know beforehand what’s it’s even about, you’ve got to internalize the methods so that you can use them while on autopilot. Which takes some effort.

The first step in any crucial conversation is the easiest: determine what you want the outcome to be. Being able to skillfully execute the techniques described in this book will get you to that outcome with your emotions and your relationships intact. I can’t recommend Crucial Communications highly enough.

Q1 2008 #1 best seller

While working on the next post about low-carb and calories it dawned on me that I hadn’t posted the best seller list for the first quarter of 2008. I decided to take a break from the serious stuff for a bit, go through the Amazon.com records, and whip it out.

These are books purchased by readers of this blog (and MD’s blog and the Protein Power website) through the Amazon.com links. The rules of the list are that no books authored or co-authored by MD and/or me are included. Only those written by others.

The numero uno best seller was Mistakes Were Made (but not by me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts, a phenomenal book that I reviewed last March and that I heartily recommend if you haven’t read it. You’ll never look at decision making (yours or anyone else’s) the same again.

Here are the books in descending order of sales.

#1 Mistakes Were Made by Carol Tavris and Elliot Aronson (Review)

#2 The Brain Trust Program by Larry McCleary, M.D. (Review)

#3 Good Calories, Bad Calories by Gary Taubes (Review)

#4 The Great Cholesterol Con by Malcolm Kendrick, M.D. (Review)

#5 200 Low-Carb Slow Cooker Recipes by Dana Carpender

#6 15-minute Low-Carb Recipes by Dana Carpender

#7 500 Low-Carb Recipes by Dana Carpender

#8 The Omnivore’s Dilemma by Michael Pollan

#9 How’s Your Drink by Eric Felton

#10 Carb Wars: Sugar is the New Fat by Judy Barnes Baker

As you look over the list you’ll notice that I’ve made an addition: I’ve linked to the reviews I’ve written on any books on the list.

I give my thanks once again to those of you who have purchased books, household goods, tools, clothing, DVDs, CDs, and even groceries through the Amazon portals on this site. I really appreciate it. The income goes towards maintaining the site. I’ve ditched most of the Google ads and other ads that used to roam throughout this blog because I found them annoying and I suspect readers did too. As a consequence, the funds from Amazon purchases play a much larger role now than in the past in underwriting the site. Please keep purchasing.

For those of you in comment Limbo, I’m slowly working my way through. I’m trying to keep current on the comments on the most recent posts (and I’m falling behind a little there), and I’m knocking off a handful of the comments that stacked up while I was on the mad-dash-to-finish-the-book hiatus. Ultimately, I’ll get to them all. Thanks for your patience.

If you are anything like I am, you’ve probably found yourself wondering how on earth people can cling to the low-fat diet when all the data out there shows it is vastly inferior to the low-carb diet in virtually all parameters. If you’ve had great results yourself with a low-carb diet, you’ve also probably wondered why it is so hard to persuade others to try it. And you may have asked yourself – as I have asked myself – why every little study that comes out purporting to show that low-carb diets are somehow dangerous gets media coverage out the wazoo while studies showing the superiority of low-carb diets are ignored.

If you have pondered all this, have I got the book for you.

A few weeks ago I followed the recommendation of one of the readers of this blog and purchased the book Mistakes Were Made, (but not by me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts. This book gave me the answers to all the above questions. The good news is that now I know why people have the prejudices and biases they have. The bad news is that now I know how really difficult it is to change them. The sort of good news is that I can keep a watchful eye on my own tendency (which is inherent in everyone) not to slip into the same prejudiced, biased way of thinking myself.

Mistakes Were Made is one of the better books I’ve read in the last couple of years. It is well written, humorous in places, tragic in others where the devastating effects of pigheaded bias have lead to disaster, and informative all the way through. I can give it my highest rating as a must read book for all intelligent people.

The authors, Carol Tavris and Elliot Aronson, are both distinguished social scientists who have published widely and have been in clinical practice for years. Their writing is the model of clarity and devoid of the jargon for which most psychologists are infamous. It’s been a long time since I’ve pored through a book containing so much literally life-changing information that was such a pleasure to read.

Why do people make crazy decisions, then stick by them when all evidence should point them in the opposite direction? It all starts with an internal effort to resolve dissonance.

The book begins by giving the reader the real, psychological definition of cognitive dissonance, which the authors refer to as the engine of self destruction.

The engine that drives self-justification, the energy that produces the need to justify or actions and decisions – especially the wrong ones – is an unpleasant feeling…called “cognitive dissonance.” Cognitive dissonance is a state of tension that occurs whenever a person holds two cognitions (ideas, attitudes, beliefs, opinions) that are psychologically inconsistent, such as “Smoking is a dumb thing to do because it could kill me” and “I smoke two packs a day.” Dissonance produces mental discomfort, ranging from minor pangs to deep anguish; people don’t rest easy until they find a way to reduce it. In this example, the most direct way for a smoker to reduce dissonance is by quitting. But if she has tried to quit and failed, now she must reduce dissonance by convincing herself that smoking isn’t really so harmful, or that smoking is worth the risk because it helps her relax or prevents her from gaining weight (and, after all obesity is a health risk, too), and so on. Most smokers manage to reduce dissonance in many such ingenious, if self-deluding, ways.

Dissonance is disquieting because to hold two ideas that contradict each other is to flirt with absurdity and…we humans are creatures who spend our lives trying to convince ourselves that our existence is not absurd.

Once we find our selves in a position in which we are on the horns of a cognitively dissonant dilemma, we try to reduce our stress by making a decision that resolves the dissonance. Once we’ve made that decision another factor enters the picture. One we’re all familiar with: the confirmation bias.

Dissonance theory also exploded the self-flattering idea that we humans…process information logically. On the contrary: If the new information is consonant with our beliefs, we think it is well founded and useful: “Just what I always said!” But if the new information is dissonant, then we consider it biased or foolish: “What a dumb argument!” So powerful is the need for consonance that when people are forced to look at disconfirming evidence, they will find a way to criticize, distort, or dismiss it so that they can maintain or even strengthen their existing belief. This mental contortion is called the “confirmation bias.”

What this means is that Dean Ornish and others like him are not any stupider than the rest of us. Ornish believes (or so he says) in the sanctity of animal life and is a PETA supporter. This viewpoint would create great dissonance if he ate meat. But there is a ton of evidence that eating meat is a healthful thing to do and their is evidence that a vegetarian lifestyle is not so healthful. I am sure Ornish knows this, but to resolve his dissonance he has decided that the vegetarian diet is more healthful, and he chooses to consider only that evidence that confirms his bias. When scientific research produces irrefutable evidence that is counter to his bias, he distorts the meaning of the data to one more consonant with his bias. Look here to see what I mean.

What he should be doing is using the scientific method to try to shoot down his own theories.

The scientific method consists of the use of procedures designed to show not that our predictions and hypotheses are right, but that they might be wrong. Scientific reasoning is useful to anyone in any job because it makes us face the possibility, even the dire reality, that we were mistaken. It forces us to confront our self-justifications and put them on public display for others to puncture. At its core, therefore, science is a form of arrogance control.

Instead of trying to justify why his way of thinking is correct, Ornish should be trying to puncture holes in it. If he tries hard and can’t refute his own idea, then it probably has some merit. But he isn’t the only one guilty of that method of operation, we pretty much all do the same thing.

Consider this quote from Lenny Bruce after he watched the televised Kennedy-Nixon presidential debate in 1960.

I would be with a bunch of Kennedy fans watching the debate and their comment would be, “He’s really slaughtering Nixon.” Then we would all go to another apartment, and the Nixon fans would say, “How do you like the shellacking he gave Kennedy?” And then I realized that each group loved their candidate so that a guy would have to be this blatant – he would have to look into the camera and say: “I am a thief, a crook, do you hear me, I am the worst choice you could ever make for the Presidency!” And even then his following would say, “Now there’s an honest man for you. It takes a big guy to admit that. There’s the kind of guy we need for President.”

We’ve all seen this in action in politics. Have you ever pointed out the failings of a candidate to someone who is a fan of that candidate and had him/her say: “Oh, they all do that.” How many times have you said that about your own candidate? It’s called resolving dissonance because you can’t support a candidate who is a crook, cheater, embezzler, whatever, but if whatever your candidate is alleged to have done is simply something ‘they all do’ then you’re off the hook. No cognitive dissonance.

Mistakes Were Made describes how pharmaceutical execs read the data in a way that makes their drugs look like gifts from God. It ain’t greed. Most pharmaceutical execs are no different than you and I – they are nice, friendly, intelligent folks who love their families and wouldn’t consider doing anything harmful. So how then can they promote statins to everyone who breathes despite the evidence that statins don’t do any good for most people and are actually harmful to some? If they thought they were harming people they would be deep in the throes of cognitive dissonance, so they make the decision that they are really helping people, then use confirmation bias to convince themselves they really are helping people. And they ignore or blow off any data to the contrary as the ramblings of malcontent alternative healthcare types.

And it not just pigheadedness that keeps people thinking the wrong way once they’ve made a decision. Their brains actually change.

Neuroscientists have recently shown that these biases in thinking are built into the very way the brain processes information – all brains, regardless of their owners’ political affiliations. For example, in a study of people who were being monitored by magnetic resonance imaging (MRI) wile they were trying to process dissonant or consonant information about George Bush or John Kerry, [researchers] found that the reasoning areas of the brain virtually shut down when participants were confronted with dissonant information and the emotion circuits of the brain lit up happily when consonance was restored. These mechanisms provide a neurological basis for the observation that once our minds are made up, it is hard to change them.

This book describes how the combination of cognitive dissonance and the confirmation bias are involved in the medical profession, scientific research, business, law, police work, love and war. The chapter on recovered memory is alone worth the price of the book. And could be a surrogate chapter for the history of the low-fat diet: a ton of trouble due to doctrinaire adherence to a faulty hypothesis.

Many books such as this one are great at the start with all the early chapters filled with valuable info, but then the book runs out of steam. It becomes obvious that the author didn’t have enough material to stretch to a full-length book because the chapters near the end are filled with fluff. Not so with Mistakes Were Made. I gained some of my most valuable insights from the later chapters. In my opinion the book is a winner from beginning to end.

I’ll leave you with one last quote, this one from Albert Speer, the architect of Hitler’s war machine. Speer’s description must mirror the way academic physicians feel with their unshakable faith in the power of the low-fat diet and statin drugs to cure the world.

In normal circumstances, people who turn their backs on reality are soon set straight by the mockery and criticism of those around them, which makes them aware they have lost credibility. In the Third Reich there were no such correctives, especially for those who belonged to the upper stratum. On the contrary, every self-deception was multiplied as in a hall of distorting mirrors, becoming a repeatedly confirmed picture of a fantastical dream world which no longer bore any relationship to the grim outside world. In those mirrors I could see nothing but my own face reproduced many times over.

Buy the book and read it. You’ll be glad you did.

Hat tip to Sue for recommending the book to me.

Just to see what all the fuss was about I got a copy of the book and read a little here and a little there and found it to be in part a jihad against the Federal Trade Commission (FTC) and the Food and Drug Administration (FDA) and in part a collection of a host of “cures” for various disorders, most of which, in my opinion, are hogwash.

The parts about his dealings with the FTC and FDA I found interesting and true, at least according to people I know who do know how the system works. I’ll blog on Trudeau’s ongoing battles with these two government agencies sometime down the road and just stick now to my impression of the contents of his book from a health and scientific perspective.

In a book this large – over 500 pages – the law of averages militates that there are bound to be at least a few things that are correct, and indeed there are. Mr. Trudeau comes down hard on sugar and especially high-fructose corn syrup. He rails against processed white flour; he is down on trans fats; he encourages the consumption of fresh fruits and vegetables; he even recommends sunlight. In fact, the book is basically a book of lists of all the things Mr. Trudeau believes that you should or shouldn’t do or take or eat to achieve and maintain good health. Problem is most of the stuff he writes about is, in my humble opinion, absolute idiocy. But, of course, I’m a part of the unholy alliance between the government, drug companies, and doctors that is out to fleece you of your health and your cash, so I would take everything I have to say with a grain of salt.

Even when Mr. Trudeau gets something right, his rationale is totally wrong. For example, he advocates sunlight and sunbathing. So do I. It provides a number of benefits, not the least of which is the active form of vitamin D. Mr. Trudeau doesn’t believe that people should use sunscreen. Neither do I. But there the similarity in our views on the sunlight issue part company.

I don’t like sunscreens because the vast majority of them only block the UVB spectrum of sunlight, the spectrum that causes sunburning. Most people use sunscreens so that they can stay out in the sun longer than they should without burning. Problem is, most sunscreens don’t block the UVA spectrum of sunlight very well, and UVA is the spectrum that causes the development of melanoma, an extremely virulent skin cancer. So if you slather on the sunscreen and hit the beach on vacation for a week, you don’t get burned, but you get ungodly amounts of UVA. It is exactly these people who develop melanoma—people who normally work indoors then have massive amounts of sun exposure over the short term. People who work in the sun and have a tan have a much lower incidence of melanoma. A good tan, which you get from graduated exposure to the sun, blocks both UVB and UVA.

Mr. Trudeau has a little different take on the issue of sunlight, sunscreens, and skin cancer. He says, “Don’t use sun block.” Why not? I’ll let him tell it in his own words:

This is one of the greatest frauds in history. The sun does not cause cancer. Sun block has been shown to cause cancer. The ingredients in sun block are now strongly believed to be the number one cause of skin cancer. There is no skin cancer in Africa. People stay in the sun all day long with no sunscreen. It is not the pigment in the skin, as some suggest. People of African heritage living in America have the highest rate of skin cancer, and they stay in the sun the least.

And on and on. I read the medical literature all the time, and I’ve never seen a report on sun block causing skin cancer. Maybe somewhere lurking in some journal is a paper or two speculating a connection, but that is a long way from scientists believing that the ingredients in sun block are “the number one cause of skin cancer.” As to the people of African heritage having the highest rates of skin cancer, a quick trip to the statistics section of the American Cancer Society gives the lie to that.

Melanoma is primarily a disease of whites, and rates are more than 10 times higher in whites than in African Americans.

Mr. Trudeau’s book could have benefited greatly from the services of a fact checker. Had he hired one, however, the book wouldn’t have been nearly so long.

Let’s look at a couple of other small sections to get the true flavor of the book. Mr. Trudeau admonishes his readers to avoid pork.

Remember, you are what you eat. Pork is a highly toxic diseased animal. A pig eats anything in its path, including its own feces. Whatever it eats turns to meat on its bones in just a few hours. All pork products are laced with disease and viruses. It is toxic and unhealthy. The human body virtually goes into toxic shock by consuming pork. Massive amounts of energy go to the stomach and intestines to help breakdown and digest this toxic material. Pork is never fully digested in the human body; however, the human digestive system works nonstop in overdrive for up to eighteen hours attempting to neutralize and digest pork. If you didn’t eat pork for thirty days and then had some, there is an excellent chance you would be violently ill. Eliminating pork, or at least reducing it dramatically, can have a profound impact on your health an sense of well-being. Try and see.

No thanks. As I said before, in the words of Dave Barry, I AM NOT MAKING THIS UP. It’s right there on page 150-151. I don’t know that I’ve ever encountered a single paragraph anywhere containing as many incorrect statements. Except maybe this next one from page 183 under the heading: Most Fat People Have a Clogged and Sluggish Liver.

The liver is a detoxifying organ. When it’s clogged up, your metabolism slows down. What causes the clogging up of the liver? The number one reason your liver is clogged and not operating properly is the nonprescription over-the-counter drugs you have taken your entire life, and all the prescription drugs you have taken. Most notably, if you take any cholesterol reducing drugs, your liver is absolutely categorically clogged. Chlorine and fluoride in the water is another cause of a clogged liver. Food additives used in processed food and fast food dramatically clog the liver. Refined sugar and white flour clog the liver. Substances such as artificial sweeteners, monosodium glutamate, and preservatives all clog the liver. The bottom line is the pharmaceutical companies clog your liver and the publicly traded food industry clogs your liver!

You get the picture.

One of the statements that Mr. Trudeau makes on his infomercial is that there is a simple herbal cure for cancer that is being suppressed by the “cancer industry.” According to Mr. Trudeau, the multi billion dollar “cancer industry” is practically quaking in its boots in fear that this inexpensive, readily available substance will become known and destroy their empire. I searched for such a cure in the book so I could have it on hand just in case, but, alas, couldn’t find it.

If you’ve contemplated buying this book, I think you should save your money.