The lifetime risk of developing invasive cancer in the U.S. is four in ten: a little higher for men, a little lower for women. Those are scary odds. Cancer is second only to heart disease as a cause of death in Western societies. The Mediterranean diet has a well established track record of protecting against cancers of the prostate, colon/rectum, uterus, and breast. Preliminary data suggest protection against melanoma and stomach cancer, too. I'm not aware of any other way of eating that can make similar claims.
So it makes great sense to spread the word on how to eat Mediterranean-style, to lower your risk of developing cancer. Such is the goal of Zest For Life's author. The Mediterranean diet is mostly, although by no means excusively, plant-based. It encourages consumption of natural, minimally processed, locally grown foods. Generally, it's rich in vegetables, fruits, legumes, olive oil, whole grains, red wine, and nuts. It's low to moderate in meat, chicken, fish, eggs, and dairy products (mostly cheese and yogurt).
Note that one of the four longevity hot spots featured in Dan Buettner's The Blue Zones, Second Edition: 9 Lessons for Living Longer From the People Who've Lived the Longest was Mediterranean: Sardinia. All four Blue Zones were characterized by plant-based diets of minimally processed, locally grown foods. (I argue that Okinawa and the Nicoya Peninsula dwellers ate little meat simply due to economic factors.)
Proper diet won't prevent all cancer, but perhaps 10-20% of common cancer cases, such as prostate, breast, colorectal, and uterine cancer. A natural, nutrient-rich, mostly plant-based diet seems to bolster our defenses against cancer.
Ms. Middelmann-Whitney is no wacko claiming you can cure your cancer with the right diet modifications. She writes, "...I do not advocate food as a cancer treatment once the disease has declared itself...."
She never brings it up herself, but I detect a streak of paleo diet advocacy in her. Several of her references are from Loren Cordain, one of the gurus of the modern paleo diet movement.
She also mentions the ideas of Michael Pollan very favorably.
She's not as high on whole grains as most of the other current nutrition writers. She points out that, calorie for calorie, whole grains are not as nutrient-rich as vegetables and fruits. Speaking of which, she notes that veggies generally have more nutrients than fruits. Furthermore, she says, grain-based flours probably contribute to overweight and obesity. She suggests that many people eat too many grains and would benefit by substituting more nutrient-rich foods, such as vegetables and fruits.
Some interesting things I learned were 1) the 10 most dangerous foods to eat while driving, 2) the significance of organized religion in limiting meat consumption in some Mediterranean regions, 3) we probably eat too many omega-6 fatty acids, moving the omega-6/omega-3 ratio away from the ideal of 2:1 or 3:1 (another paleo diet principle), 4) one reason nitrites are added to processed meats is to create a pleasing red color (they impair bacterial growth, too), 5) fresh herbs are better added towards the end of cooking, whereas dried herbs can be added earlier, 6) 57% of calories in Western societies are largely "empty calories:" refined sugar, flour, and industrially processed vegetable oils, and 7) refined sugar consumption in the U.S. was 11 lb (5 kg) in the 1830s, rising to 155 lb (70 kg) by 2000.
Any problems with the book? The font size is a bit small for me; if that worries you, get the Kindle edition and choose your own size. She mentions that omega-6 and omega-3 fatty acids are "essential" fats. I bet she meant to say that, specifically, linolenic and linoleic fatty acids are essential (our bodies can't make them); linolenic happens to be an omega-3, linoleic is an omega-6. Reference #8 in chapter three is missing. She states that red and processed meats cause cancer (the studies are inconclusive). I'm not sure that cooking in or with polyunsaturated plant oils causes formation of free radicals that we need to worry about.
As would be expected, the author and I don't see eye to eye on everything. For example, she worries about bisphenol-A, pesticide residue, saturated fat, excessive red meat consumption, and strongly prefers pastured beef and free-range chickens and eggs. I don't worry much. She also subscribes to the "precautionary principle" (see Wikipedia).
The author shares over 150 recipes to get you started on your road to cancer prevention. I easily found 15 I want to try. She covers all the bases on shopping for food, cooking, outfitting a basic kitchen, dining out, shopping on a strict budget, etc. Highly practical for beginning cooks. Numerous scientific references are listed for you skeptics; I've reviewed many of them at my Advanced Mediterranean Life blog.
I recommend this book to all adults, particularly for those with a strong family history of cancer. But following the author's recommendations would do more than lower your risk of cancer. You'd likely have a longer lifespan, lose some excess fat weight, and lower your risk of type 2 diabetes, dementia, heart disease, stroke, and vision loss from macular degeneration. Particularly compared to the standard American diet. What are you waiting for? Let's get cookin'!
--Steve Parker, M.D.
Disclosure: The author arranged a free copy of the book for me, otherwise I recieved nothing of value for writing this review.