The Gravity of Weight

The daunting science of weight control.

When the "Proof of the Pudding" is Not in the Eating

Waterproof, weatherproof, bulletproof, shatterproof, and now "Disease Proof"

The proverbial saying, “The proof of the pudding is in the eating” dates back several centuries and has been attributed to Cervantes in his Don Quixote, though some believe it was a mistranslation of the original Spanish. “Proof” in this case means “test” and what it signifies is that we have to put something to a test or trial to know its value. You will find David L. Katz’s new book, Disease Proof, a worthy contender. 

David L. Katz, M.D., MPH is the founding director of Yale University’s Yale Griffin Prevention Research Center, editor-in-chief of the journal Childhood Obesity, and author or coauthor of over 100 professional papers and fifteen books. Incidentally, for those with a special interest in nutrition, there is no better or more comprehensive book than Dr. Katz’s Nutrition in Clinical Practice (2008).

This time, with his co-writer, Stacey Colino, Dr. Katz has written a very readable, psychologically-minded, practical approach to maintaining health in this age of epidemic obesity, type II diabetes, and heart disease. By the year 2050, for example, according to the Centers for Disease Control (CDC), says Dr. Katz, unless we reverse the current trends, one in three (or about 100 million people) will have diabetes in the U.S. alone. Katz is sensitive to the plight of those with serious weight issues: “The weight of shame, blame, and self-recrimination is far heavier than any number of pounds.”

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Reversing disease and maintaining health (not just losing weight), though, are no easy tasks in this age of overwhelmingly poor choices and enormous portions. Dr. Katz tells how his wife Catherine, who has her PhD in neuroscience from Princeton, could understandably not figure out which of four French breads--one with too much sodium, another multi-grain with the least amount of fiber, still another with partially hydrogenated (and potentially dangerous) fat, and the fourth with high fructose corn syrup--was the healthiest. Dr. Katz has devised a nutrition guidance program, called the Nu-Val system, (now used in thousands of markets) to help consumers choose among different options. He reminds us, “The longer the shelf life of the product, the shorter the shelf life of the person who consumes it regularly.” Reading labels can help us discern when a pasta sauce, for example, has more sugar than a chocolate sauce, says Dr. Katz.

Disease Proof focuses on the importance of sleep, exercise, and the people in one’s life, as well as proper diet. Katz even includes recipes and exercises, and discusses the questionable value of vitamin supplements that may contribute to "nutritional noise." The book takes a cognitive behavioral approach: Katz emphasizes the importance of and need for self-efficacy, i.e., the conviction that a person can succeed at a task. Katz suggests that dieters create a “social contract” with other people, i.e., make a public announcement of their intentions as a kind of way of being accountable. He also recommends what he calls “impediment profiling’”--assessing barriers that interfere with achieving goals, and he believes that when someone is not able to lose weight on a diet, it is not evidence of failure--rather, that person did not have the right skill set. He recommends constructing a "decision balance analysis” where people list advantages and disadvantages to changing behavior.

Botton Line: Disease Proof is a welcome addition to any library as it can give people some tools to help take control of their health.

Sylvia R. Karasu, M.D., is Clinical Professor of Psychiatry at Weill Cornell Medical College and senior author of The Gravity of Weight.

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