Reading Time: 4 minutes
1. The Role of Medicine by Thomas KcKeown
McKeown's book had an extraordinary influence on the discussion of what we now call the "social determinants of health." The central argument of The Role of Medicine was that the vast majority of improvements in health through the 20th century have not been due to medicine--but due to social factors promoted by reformers, activists, and philanthropists. Although his hypothesis that nutrition undergirded much of the gains in 20th century health is now usually disregarded for one favoring cleaner water supply, McKeown's arguments are persuasive and they haven't been entirely set aside by many prominent social scientists. McKeown's enduring legacy is in having shown that the epidemics that had hitherto plagued civilization were not defeated by antibiotics or vaccination--but by improved environmental factors. (This does not mean that antibiotics or vaccination are not useful or have not helped--it just means that the majority of progress in the reduction of mortality was not made by use of them.)
Some recent counterarguments to McKeown claim that, in fact, statins, antihypertensives, and open heart surgery have made similar progress in recent years as McKeown's environmental revolutions made at the turn of the 20th century. Both views are likely right: historical developments in medicine are likely overblown, yet rapidly advancing medical technology is likely to make such feebleness a thing of the past. Yet still, for improving our countries' health environments, much work remains to be done.
2. Bad Science by Ben Goldacre
In this riveting book detailing quackery both within medicine and outside, Goldacre takes a scalpel to bad science and in doing so, lays open both the underbelly of the modern medical-industrial complex and suggests a better way. Goldacre while inclined almost to polemics at times provides a necessary corrective to Whiggish tendencies to falsely regard modern medicine or the quackery that stands against it as the solution to our health problems. Often, in terms of effective treatments, we are on our own. And that fear, not the effectiveness of quacks or of medicine, is probably why we run headlong into the open embrace of the reassurances of modern medicine or of the quacks who decry it. If we choose the more difficult path, it does not have to be this way. Most of us won't.
3. The Omnivore's Dilemma by Michael Pollan
The book that self-deluded quacks and shills alike can agree is, at the least, fairly well written, TOD is possibly one of the greatest books written about food in our generation. Covering different styles of eating, from the industrial to the agricultural to the hunter-gatherer, Pollan eviscerates the madness of the modern food system but tries to search for a middle-ground between the reckless ingenuity of man and the maddening and sometimes inhospitable vicissitudes of nature. Monsanto is, as always, singled out as a monster, spawning a cottage industry of green activists mistakenly obsessed with the toxic threat of pesticides to the purity of our food--and of a simpler way of life. Wendell Berry's quixotic and imaginary vision of a life of community based in agrarian values laid out in Culture and Agriculture features strongly. Pollan is a master storyteller but often places a folksy, modernity-anxious ideology ahead of science in his quest for coherent narrative. The Omnivore's Dilemma, more than any book, started my journey into the world of food. May people enjoy it and take it seriously, but not too.
4. In Defense of Food by Michael Pollan
Responsible for bringing the concept of nutritionism to modern consciousness (at least in book form), in this work Michael Pollan coined the now famous phrase, "Eat food, not too much, mostly plants." Food in this sense is meant in opposition to what Pollan calls "food-like substances," which are ingestible food-like items that are industrially produced but "would not be recognized by your grandmother" as food.
Like TOD, this text is shot through with modernity anxiety and a deep mistrust of established authority--an enduring theme in the genre, and of course, in American literature as a whole. But what will endure from this book is the idea that food when eaten is experienced--not studied. This concept would have a major influence in encouraging eating guidelines to abandon a focus on macronutrients, food groups, calories, etc., starting with Brazil and now Canada.
Whatever its flaws, this book can only be regarded as a masterpiece of the genre and a bedrock of progressive health culture.
5. Good Calories, Bad Calories by Gary Taubes
Largely responsible for putting hormones on the map in the popular discussion on nutrition, Taubes's impact has matched if not exceeded Pollan's, with Taubes's tendrils of impact spreading in popular culture as rapidly as Pollan's ideas are affecting government policy. Where Pollan may have impugned corporate America and the misplaced Mandarin musings of misguided researchers in a modest if sternly disapproving register, Taubes scribbled wild conspiracy-mongering screeds against the machinations of ambitious but illegitimate scientists who apparently tricked their colleagues into believing that blatantly cherrypicked research was not a grand farce. Except Taubes's claims in this respect were not true, as detailed in a recent white paper. These ideas continue to be perpetuated endlessly by conspiracy mongers and increasingly seedy participants (many of whom have extensive disciplinary records at the hands of health boards) in the keto community.
Ah, so something nice to say about GCBC. Well, it was right in saying that calories are not the end-all, be-all. Food quality is. However, Pollan said as much, so the real question is one about carbohydrate. Taubes was possibly partly right about carbohydrate but probably mostly not. The ketogenic diet may have important longevity and/or cancer treatment implications and may have caused the discovery of more than a few important metabolic regulatory steps.
I remain mostly convinced that Taubes was the master of not letting the facts get in the way of a good story. GCBC should be seen as a character study in how a brilliant mind can go wrong--akin to Newton's dabbling in alchemy or Einstein's obsessive rejection of the empirical implications of quantum mechanics--albeit at a likely lower register. As plant-based diets gain increasing popularity, Taubes's work will continue to provide the gunpowder to the counter-barrage, and mostly lacking justification. A few of its major contentions, that metabolic function can be undermined by certain kinds of foods, might be lasting in their implications, influence, and truth--in large part through the experimental verifications of David Ludwig, a Harvard professor and a Taubes spiritual (if not actual) low-carber-in-crime.
As a person, I cannot help but very much like Gary Taubes. As a science writer, I cannot help but write things that are not positive.