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A Pound of Prevention

Stacey Bell

Preventive Nutrition: The Comprehensive Guide for Health Professionals. Adrianne Bendich and Richard J. Deckelbaum, eds. 579 pp. Humana Press, 1997. $125.

Scientists and clinicians in the field of nutrition and related fields must own this book to have a truly complete library. Whether or not one is working directly in preventive nutrition, it provides a valuable resource to assess the latest thinking about a nutrient and health-risk reduction. As a clinical researcher, I also found it beneficial to have the opinions of different authors on how to evaluate the literature in this complex field. And, from a personal perspective, I have wondered about the effects of certain nutrients on disease—as have my friends and patients who often ask me about the merits of single nutrients or groups of nutrients, many of which are reviewed in this book.

The editors' objectives are to provide healthcare professionals with answers to their patients' queries on multivitamin supplementation (and exotic supplements such as dithiolthiones or isothiocyantes); to present studies that link nutrients to the major causes of mortality in the United States—cardiovascular disease and cancer—and to less common conditions—osteoporosis, macular degeneration, cataracts—also affected by nutrition; to prevent birth defects and promote optimum delivery; and to present benefits of preventive health around the world. The index is extensive, and there is a list of relevant, high-quality journals and books included at the end of the book.

Most chapter authors provide an overview of the field, review their publications, and draw conclusions and make recommendations based on the entire body of knowledge. I was particularly struck by the restraint exercised by most authors, who refrained from going overboard in recommending the nutrient that they study as a panacea in preventing major diseases. Most of these knowledgeable researchers have provided an unbiased review of the relevant literature.

As so many of these authors have done, he recommends maintaining an ideal body weight; eating more fruits and vegetables; avoiding refined grains, red meat, animal fat and trans fatty acids; taking enough calcium from dairy products; and using multivitamin supplements with possibly extra folic acid, vitamin E and iron (for women). The downside of this approach is the repetition that appears in the recommendations. True, eating fruits and vegetables, exercising regularly and avoiding excess weight appear to be beneficial in preventing all kinds of things; however, the readers of this book already know this. If only Americans followed what seems to be rather simple and straightforward advice, chronic diseases would surely be reduced. Unfortunately, all who work in this field know that these recommendations, no matter how convincing, are difficult for most to follow.—Stacey J. Bell, Surgery, Harvard Medical School

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