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Department of Nutrition and Food Studies New York University 35 West 4th Street, 10th Floor New York, NY 10012-1172 E-mail: marion.nestle{at}nyu.edu
This book is the latest volume in a series edited by Adrianne Bendich and Richard Deckelbaum. Their first book, Preventive Nutrition: The Comprehensive Guide for Health Professionals, appeared in 1997; a second edition followed in 2001. This book extends the content of those volumes to cover secondary as well as primary prevention of diet-related conditions such as cancer, cardiovascular disease, and osteoporosis. Overall, the multiauthored chapters, although focused exclusively on prevention, are similar in style and content to those in the Annual Review of Nutrition.
The present volume is organized into 24 chapters written by one or more authors and grouped into sections on various disease conditions and critical issues such as ethnicity, micronutrient deficiencies, nutrition in medical education, and the economic benefits of prevention. The book also lists recent books and websites related to its themes.
Books of this type are only as good as their authors, and in this case the standard is high. The research reviews are rigorous, balanced, and critical. I especially liked Vermunt and Mensink's chapter on trans fatty acids ("The underlying mechanisms for these effects are not exactly known"), the review by Allison et al on genetic compared with environmental causes of obesity ("if we are to be responsive to the obesity problem . . . the environment must be changed to become less obesegenic and more promoting of healthy diets and activity patterns"), and Underwood's compelling case for "contextually appropriate and affordable" vitamin A interventions that involve the poor and women as partners in every aspect of planning and implementation. Kumanyika and Krebs-Smith provide a thoughtful analysis of the limitations—and political sensitivity—of dietary intake data parsed by ethnicity and socioeconomic status. Lands's chapter on the "balancing act" of alcohol recommendations explains why it is so difficult to determine the risks and benefits of moderate drinking when much of the evidence "is indirect and imprecise at this time." In short, many of the chapters in this book are well worth reading.
With that said, many of the chapters are also highly technical, densely written, and likely to be accessible only to specialists and graduate students. The most annoying feature of these chapters is the frequent use of abbreviations; these are defined at their first mention but tax memory when a single paragraph may contain a dozen. Dickenson blessedly includes a glossary of the 24 (!) abbreviations she uses to explain how health claims are regulated; the entire book needs such a glossary.
Reading the chapters as a whole is an interesting experience; taken together, they make a strong case for the importance of plant-based diets to health. Although many chapters review the effects of single nutrients on disease risk, they typically conclude that individual dietary components or supplements cannot replace the benefits of fruit and vegetables. Overall, the book is a useful reference. Whether it is worth its exorbitant price is another matter, especially in comparison with the much lower cost of the Annual Reviews.