Book Review: Better Than Before by Gretchen Rubin

Imagine you had a chance to watch segments of your life occur as though you were a spectating apparition. What would you notice?  What action would you witness your corporeal self committing that might make you cringe?   Would you be happy with what you hear your other-self say?  Do you feel judged or vindicated?  If this scenario makes you squirm even just a little bit, then Gretchen Rubin’s book Better Than Before is for you.

In this book, Rubin sets out to examine the multiple aspects of our personal habits.  She looks at four types of people who either look towards meeting obligations or reject them outright.  She then explores various aspects and tricks that allow us to follow through with habits we might want to incorporate into our own lives.

As someone who has spent their entire adult life in introspection and self-evaluation, I found this book enlightening in a few areas.  I really liked thinking through the four personality types in regards to obligations both internal and external and how a group of various personality types responds to the same set of obligations. This actually led to some great discussion with my wife and kids!  It help the four of us see the motivating forces behind the other’s actions and desires.

I don’t want to give too much away but I think this book is worthwhile reading.  I feel I’ll be able to apply some of the habit keeping techniques she describes to my personal pursuits for healthy eating and regular exercise.  She makes a solid point about understanding who you are and being that person.  Don’t try to develop habits to be a person that you aren’t.  The wisdom to understand who you are and how you change is powerful.

I would recommend you BORROW IT.

Book Review: “Good Calories, Bad Calories” by Gary Taubes


I hate to admit that I owned Good Calories, Bad Calories for several years before I made it through the first 100 pages.  Nutritional science history is not a favorite subject of mine and the first section is pretty dense with history.  However, now that I’ve read it, I’ve come to appreciate why the historical discussion is so important to a discussion of nutrition.  Much of what is taught today is the result of poor nutritional science that was championed by governmental agencies.  Once the government gets involved, it’s hard to get them un-involved.

I’ve been a student of low-carb science since medical school.  I started reading Protein Power Plan by the Eades on recommendation from a friend and upper classmate.  As I went through biochemistry learning the chemical processes of the human body, a carb conscious diet made more and more sense.  However, in my nutrition classes I was taught the prevailing theory of the day which remains still a low-fat, calorie conscious food pyramid/plan/plate.  Ironically, my biochemistry professor was also my nutrition professor and a diabetic.  I struggled to reconcile what we learned about the human body and what was taught about nutrition.  I remember thinking, ‘If I eat the way I’m taught in nutrition class, but my body works the way I’m taught in biochemistry, then the expected result would have to be diabetes and cholesterol disease.’  I didn’t fully understand yet the mechanisms of it all but I realized something wasn’t right here.

Fast forward eight to ten years to when I’m in private practice at Trinity.  Randy Pardue, MD, one of Trinity’s founder physicians, recommended to me that I read Taubes’ book.  Fully immersed in low-carb science, I take this book on a summer beach vacation with my family.  That week I read it twice.  I went back and underlined and took notes on everything.  It was a game changer for me.

Taubes, better than anyone else I’ve read so far, clearly outlines the reasons nutritional science holds to the philosophy they do and the science, in both anecdotal form and published research, behind the benefits of a carbohydrate restricted diet.  He outlines how insulin responds after a carb rich meal and what the myriad effects are.  In particular, I remember a light-bulb moment when he discusses the effect of insulin on an adipose or fat cell.  Insulin encourages the uptake of triglycerides for storage and slows the outflow of triglycerides for fuel in an adipose cell.  The result of faster inflow and slower outflow is a growth of the cell.  Fat cells get fuller from the effect of insulin.  Therefore, fat cells shrink when insulin is absent.  That is the primary principle for all weight loss.  Since then, I’ve verified it time and age in patients I treat.

He also begins to discuss what I’ve come to think of as the ‘Unifying Theory of Modern Disease’.  High carbohydrate nutrition and high insulin levels can be thought of as the single causative reason for many of modern man’s medical problems including diabetes, obesity, heart disease, hypertension, lipid disorders, gout, gall bladder disease, and PCOS just to name a few.  Like most medical problems, there are actually several things that have to go wrong in the body for these disorders to occur but hyperinsulinemia, high blood insulin levels, is the spark that sets it all in motion.

It’s like a forest fire.  Fires can’t spread far in a wet forest but they never even get started without the spark of a kid playing with matches.  A high insulin level is a match and a high carb diet is the naughty child.

I definitely recommend you read this book along with his follow up publications Why We Get Fat and The Case Against Sugar.  My recommendation for this book is to Study It.  You’ll want to reference it for sure as you study how to transition your lifestyle to a lower carbohydrate plan.  I have it in my lending library at the office so feel free to come by and borrow it when it is available.

If you’ve read this book please leave me a comment below.  I’d like to hear your thoughts.


Book Review: “Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health” by William Davis, MD

I listened to the audio version of Wheat Belly in 2011 during my daily commute and walks. I thought I would repost a review I did at that time here on our new website blog.

Dr. Davis lays out an argument against the use of wheat containing products in any of its various forms. He contends that wheat (especially the hybridized form developed for high yield in the 1960’s) is the single source of almost all of the current medical ills. He links wheat intake to the obvious and common problems of Celiac disease, diabetes mellitus, hypertension, elevated cholesterol levels, and metabolic syndrome. He extends the linkage to other disorders such as acne, allopecia areata, and mental disorders such as schizophrenia.

Dr. Davis describes his theory using a few very interesting studies on dietary intervention on biochemical markers such as serum glucose and cholesterol levels. He adds to this a substantial amount of anecdotes, both personal and professional, and never passes up an opportunity to turn a sarcastic phrase to describe the evils of wheat ingestion.

I think Dr. Davis provides some very intriguing ideas concerning the changes in wheat consumption in the modern American diet. His description of the genetic modification that occurred in the 1960’s is compelling as the single factor that changed to spark the growing incidence of Celiac disease and diabetes. He also provides one of the simplest explanations I’ve read about the connection between a high carbohydrate diet and the biochemical changes in the cholesterol metabolism pathway.

In the end though Dr. Davis is simply promoting his own hybridization of a low carbohydrate diet and a paleolithic diet. He advocates to avoid all wheat products given their reported disastrous effects on the human body but in practice he recommends a low carbohydrate diet of at most 100gm/day and for many he recommends 50gm/day as the maximum. He argues that the pancreas has been so abused over the years from a high wheat (read: carbohydrate) diet that it can no longer tolerate a higher carbohydrate diet. For all intents and purposes, a low carbohydrate diet reduces or eliminates the majority of wheat consumption anyway.  This has been something the physicians of Trinity have advocated as well and teach in our VitalSigns programs.

Overall I thought the book was only okay even though I agree with most of what he said. From a scientific stand point I wish there were more references to studies and actual evidence as wheat as the culprit. I think the evidence for his low carbohydrate intake is sound although he doesn’t necessarily prove that in his book. I wish too that he had toned down his use of anecdotes. One of my favorite medical cynics, Mark Crislip, MD is often heard saying “The plural of anecdote is anecdotes, not data.” Telling compelling stories about successes on a wheat free, low carb diet are good to hear and we want to rejoice with the individuals who now have better health but they don’t provide much to guide public health.

Lastly, I’ve taken some time and looked through his two websites and In several of his blogs he expounds on a style that is much more subtle in the book. He often describes the average working physician as someone rather uneducated about the higher matters of science. He comments frequently on how hard it is to find a physician who actually knows any of the ‘real’ medical facts. I think most of us who are actually seeing patients hurting and suffering from modern diseases are desperately trying therapies to help them. We want facts though, not stories. We want to be able to tell our patients more than the traveling snake doctor would tell his customers. “Come try this tonic! Why, a man down the road used it and it cured his ills!”

I’ve often said that the difference between alternative medicine and true medicine is the fact that alternative medicine by definition lacks evidence. Once an alternative therapy has been studied it moves out of the alternative medicine realm into the tool box of true medicine useful in treating patients.

My recommendation: Borrow It

Book Reviews Explained

As I read or listen to new books I will be leaving a short review here in our blog and recommend one of actions listed below for each book.

  • Skip It for those books you needn’t bother exploring. You only have so many books you’ll read in your lifetime and I don’t want you to waste it on one like this.
  • Skim It for those books that deserve some consideration. Maybe use a highlighted copy and read the yellow parts or even run by the bookstore and just browse the chapter headings. There are a few useful tidbits in these books but not many.
  • Borrow It is for books that you really ought to read fully. Once you’ve read them, send them packing so they don’t clutter up your life.  You may not need them again, ever.
  • Buy It are books you need to own. These books need a place on your shelves either in hardcopy or electronic format. They are books you’ll think about and lend out. Books you’ll look back on and be glad you own.
  • Study It are books that need a physical presence in your life and something close at hand. They are books you’ll review over and again. You’ll be reading your own highlighting and think “That’s a great point!” all over again.  Few books deserve this level of consideration and fewer still will hold this level of recommendation over the course of your lifetime.