The American body is in trouble. Unprecedented numbers of us suffer from obesity, heart disease, diabetes, and other debilitating illnesses. The root cause is a once-revolutionary idea that seemed to offer so much promise, but instead has become the cause of a global health crisis: processed foods. Over the past seventy-five years, a number of factors aligned to create a reality in which processed carbohydrates became our main food source. In Fast Carbs, Slow Carbs, bestselling author and former FDA Commissioner David A. Kessler explains how the quest to feed a nation resulted in a population that is increasingly suffering from obesity and chronic disease and offers a solution for changing course.
For decades, no one questioned the effects of these processed carbohydrates. The focus was on fertile grassland, ideal for growing vast amounts of wheat and corn; an industrial infrastructure perfect for refining those grains into starch; a food production behemoth that turns refined grains into affordable, appealing, and ever-present food items, from pizza to burritos to bagels; and an efficient distribution network that ensures consumption by Americans nationwide.
But during those same decades, our bodies quietly contended with the metabolic chaos caused by consuming rapidly absorbable starch. Slowly but surely, these effects accumulated and became disastrous, leading to the public health crisis in which we find ourselves today.
In Fast Carbs, Slow Carbs, Kessler explains how eating refined grains such as wheat, corn, and rice leads to a cascade of hormonal and metabolic issues that make it very easy to gain weight and nearly impossible to lose it. Worse still is how excess weight creates a very real link to diabetes, heart disease, cognitive decline, and a host of cancers.
We can no longer afford to dismiss the consequences of eating food that is designed to be rapidly absorbed as sugar in our bodies. Informed by cutting-edge research as well as Dr. Kessler's own personal quest to manage his weight, Fast Carbs, Slow Carbs reveals in illuminating detail how we got to this critical turning point in our health as a nation--and outlines a plan for eliminating heart disease, allowing us to, finally, regain control of our health.
Supplemental enhancement PDF accompanies the audiobook.
(David Kessler is also the name of another author, a hospice expert who worked with Elisabeth Kübler-Ross, although David A. Kessler did co-author a book on elder care.)
David Aaron Kessler is an American pediatrician, lawyer, author, and administrator (both academic and governmental). He was the Commissioner of the Food and Drug Administration (FDA) from November 8, 1990 to February 28, 1997, and has subsequently held administrative and academic posts at Yale and the University of California at San Francisco.
I try to read a health and nutrition book each year to see what is changing in our attitudes, beliefs, and habits, as well as what changes, good or bad, are occurring in the food industry. I will say that each time I read such books, I find some information that directly contradicts what I've learned in another book. It's hard to keep it all straight and to know what to believe at any given time.
This easy-to-understand information is for the layperson interested in the ever-evolving American diet. The author explains that the food processing industry has changed the structure of many foods into highly palatable, ultra-processed carbohydrates that can be digested rapidly, i.e., fast carbs. We are consuming these fast carbs in greater quantities, and Dr. Kessler discusses the ways these fast carbs are damaging our bodies and his recommendations for lasting change in weight and health.
I see the logic and rationale behind his words and I took many notes to refer back to. He brings up many ideas and topics for further thought and exploration on the reader's part, if so desired. I see this information as one layer in the multi-layered obesity/weight control problem, but still a good start for a system and a lifestyle that needs a major overhaul.
*********************************************** Everything that follows are the things I learned, found interesting, and/or most want to remember. Most are direct statements from the text.
Part I: Food is the number one cause of obesity, heart disease, and diabetes in Americans. Fast carbs, which are highly processed, rapidly digestible carbs, hijack appetite, interfere with feelings of fullness, make it hard to control weight, and have a toxic effect on metabolic pathways which results in a cycle of insulin resistance, obesity, and chronic disease.
Ultra-processed foods are designed to be irresistible, and to prompt overconsumption. We absorb these fast carbs quickly and early in the digestive process.
What we eat matters almost as much as how much we eat.
The odds are stacked against us. Overeating is not caused by lack of willpower but by the reward system in our brains that is triggered by cues in the environment such as smells, sights, or location. Foods are engineered to make us overeat.
To achieve lasting change in weight and health: 1. Reduce fast carb consumption. 2. Reduce blood lipids. 3. Exercise daily.
Part II: We keep gaining weight as we get older; this shift lines up with the increase in consumption of processed carbohydrates, fats, and oils.
Six of the ten leading causes of death in the United States have been connected to diet.
Today's ultra-processed foods allow us to absorb more calories. We take in about 500 more calories each day than we did in 1970, mainly due to the fact that processed foods make up as much as 70% of the average American diet.
These processed foods are energy rich carbs that have been dramatically altered from their natural state. Their molecular structure has been destroyed, essentially making them streams of glucose.
While a food label reveals how many calories are in a serving size or packaged food, it does not reveal how many calories you will absorb. We absorb more calories from the processed grains in chips or puffed cereal than we do from the fiber in intact, whole grains. Processing makes more calories available to our bodies and that's what matters to weight gain.
The food industry claims there are no negative effects to processing; the difference between preparing and processing is just scale!
Ultra-processed products are made to be hyper-palatable and attractive with a long shelf life. Their formulation, presentation, and marketing often promote overconsumption.
The food industry understands and manipulates the public's skepticism and confusion about nutrition and confronts it by, in its own words, trying to reset and reframe the conversation. The marketing approach is one of balance, we should get all the nutrients we need from a variety of food groups. This argument would have merit if all calories were created equal.
The physical and chemical structure of a food determines how quickly it will be digested and absorbed by our bodies. Techniques for breaking down starch granules have a common result; they speed up digestion and absorption. The more processed the food, the faster it will be digested.
Food is often designed to achieve the optimal melt in your mouth, intense but fleeting. Starch is the canvas for sugar, salt, and fat.
Flavor, pleasure, and palatability are the messages the food industry is sending to our brains and fast carbs are the messenger they use.
Part III: Recommendation: Reduce or eliminate fast carbs for good to achieve and maintain a healthy weight.
Eating fast carbs at the beginning of a meal amplifies appetite and leads to weight gain.
Slow carbs do not include most products labeled whole wheat or whole grain. These terms are generally meaningless and are used for marketing purposes. Most of such products have undergone substantial processing that renders the grains anything but whole.
Fast carbs flood our system with spikes of glucose and insulin and because we are eating fast carbs all day long these spikes happen one after the other.
As much as 50% of the calories we eat may be consumed by the bacteria in our gut. Fast carbs never become food for these bacteria.
Highly processed food triggers speed eating.
Creating new habits can lessen the appeal of fast carbs. The less often you eat fast carbs, the less often you will crave them.
Part IV: Highly processed food is problematic not because of some weakness in ourselves but because of the design and nature of the food itself.
A vicious cycle connecting fast carbs, obesity, and diabetes traps many people who struggle with their weight.
When we halt glucose intake, even temporarily, our entire metabolic landscape shifts.
Improving metabolic health is important for preserving cognitive function, reducing the risk of certain cancers, and improving male libido.
Sick fat produces damaging inflammation.
Part V: Fast carbs pose as much of a threat to cardiac health as saturated fat.
Diet is the not the only source of LDL. Our bodies can produce their own lipids.
Eating less starch reduces salt intake and lowers blood pressure.
LDL is not only an internal toxin, it is a lifelong toxin. LDL accumulates in heart vessel walls over our entire lifetime. Reducing LDL over a lifetime is more important than short-term reductions. The benefits of reducing LDL are related to the magnitude and duration of that reduction.
Physical activity is important because it increases your energy expenditure and allows you to eat more. Without exercise, people who lose weight have to sustain the caloric restrictions that got them there despite a hormonal response that cries out for more food. Also, exercise helps to regulate metabolism.
Part VI: Most successful diets have one thing in common: limited fast carbs.
A diet emphasizing plants and slow carbs is optimal for your health.
Epilogue: Right now, it is more expensive to eat healthy unprocessed foods than processed starch heavy foods.
There were two chapters in this book that I found really interesting. One on “extrusion”, which is a commonly used method of food processing in which through enormous pressurization even whole grains are turned into essentially pre-digested fast carbs. The second was a chapter on the gut-brain connection which presented research findings indicating that a feeling of fullness does not only come from our stomachs but also from our lower intestines- a place that many fast carbs don’t reach. What I didn’t like is Kessler trying too hard to make everything fit into his ‘fast carbs are the root of all nutrition problems’ idea. Trying to simplify his message probably helps with book sales but it didn’t really make sense. For example his statement that “fast carbs are the delivery vehicle for fat, sugar and salt” is sort of true but it’s the combination of those four elements that is so unhealthy. Does he think we’ll stop eating fat, sugar and salt if fast carbs go away? Another issue I had was that the last couple of chapters went too much into the fad diet direction. The Meal Charts in the epilogue, especially the ‘low carbs’ versions seemed identical to the Atkins diet. But anyway, his central idea that ‘whole grain’ on a label does not mean that that food has whole grains in a beneficial and healthy form is very interesting and deserves to be highlighted. Trust the food industry to trick us into thinking they’re giving us what we’re asking for.
Author David Kessler has contributed a worthwhile addition to the growing collection of books highlighting the role of carbs in disease and weight gain. FAST CARBS, SLOW CARBS is well-organized and written in short chapters; easy to grasp and consider as readers reflect on the scientific and medical knowledge summarized within. Kessler really covered every aspect of the issue, from history to menus, everything is well-discussed without being redundant. I never felt I was receiving a lecture from a convert. Rather I was reading a comprehensive presentation from a knowledgeable source. I appreciated every bit of the book. There are references galore for readers who need them. This is an excellent book for all who seek control over their diets and health. I received my copy from the publisher through edelweiss.
I created an account on Goodreads several years ago and then never stopped to log a single book. We'll see if I feel motivated to document regularly, but today I read Fast Carbs, Slow Carbs (FCSC) by the former FDA commissioner, David Kessler.
FCSC is one of several books I've read in the past two months on nutrition and food. I recommend this book as an excellent overview of the current state of knowledge about how and what to eat to be healthy.
Kessler, like Pollan, recommends three basic principles to form a framework for a healthy life. First, stop eating high starch foods that are engineered to never allow for satiety; eat a plant-based diet as much as possible. Second, get your lipid panel under control, with diet or statin drugs or, like me, both. Finally, exercise regularly, with "regularly" defined as 30-60 minutes five times a week, with most of it aerobic. However, a couple times each week resistance training should done.
The most amazing factoid of the book? Highly engineered foods keep you eating (think of the Lays commercial about "no one can eat just one") because they are designed to be digested in the small intestine alone. The enzymes that create satiety, unfortunately for consumers of western diet products, are in the large intestine.
In short, you never know you're full and therefore continue eating and eating until the eventual disease process overtakes you in some form or other. Multinational food companies grow rich while populations sicken.
These "food products" are largely responsible for the epidemic of obesity, metabolic syndrome, heart disease, cancer , and other horrible health outcomes in the US. These companies profit while selling death much like the cigarette industry--they know exactly what they are doing. In the food industry, no one will ever make a fortune from selling broccoli, but gosh! There is a lot of money to be made in sugar and salt and fat.
I appreciate the non-judgmental approach taken by the author, who readily admits he struggles with overconsumption of fast carbs. This is an interesting book for anyone curious about the science of processed carbohydrates, even if you aren't looking to lose weight. I agree with the author's conclusion:
"Right now, it is more expensive to eat healthy unprocessed foods than processed starch-heavy foods. Those with discretionary income will be able to change their patterns more easily; those with limited means face an even greater challenge. What can government do to help all Americans? What industry regulations are needed to force this change? These are urgent questions that demand comprehensive answers and decisive action. The choices we need to make as individuals to achieve better health are clear, but the path to national health policies still needs to be mapped. Without doubt, to improve and save lives, we need to chart that path now."
Somehow this book at this point in my middle-age life finally made muddy health recommendations clear. Hearing the "why" behind how carbs. differ in how they affect satiety and overall health was impactful to my understanding and ability to create personal pivots in behavior and daily choices. It has the perfect balance of personal experiences, science, and research. I highly recommend it to anyone who is attempting to make changes in their health and dietary habits.
This is an excellent book! Kessler does a wonderful job presenting the clinical data that supports why we should not be eating ultra processed foods. The food industry wants to make money, they do not care about our health. All roads to health are based on consuming a predominantly plant-based diet.
My doctor put me on a low carb diet a few years ago to turn around pre-diabetes, so much of this was not new to me. However I was told that there are no "good" carbs, a carb is a carb is a carb. So the information about how the body breaks down carbs, and the difference between processed carbs and more natural carbs--bread vs peas, for example--was very helpful.
For me the pre-diabetes is gone, but I have struggled with keeping weight off. Understanding the difference between carbs, and what brings about hunger satisfaction was very helpful.
The part about how heavily processed foods are "too digestible" and that they put weight on you because our bodies are designed to PULL those carbs out of other foods is good. Basically--our bodies think it's bountiful harvest time and save the fat for those long winters...which now food wise never come. I'd have liked some ideas for smart carb swaps and food ideas but it's a good explanation of how these carbs work and why they're bad for us...and why I should probably cut down on eating crispies if I want to keep my weight off.
A couple of fun personal stories, some digestion science, and some dietary advice. Most of which I've heard before but was a nice refresher and perspective. Mostly down the bandwagon of high GL carbs - fast carbs - not great, low GL carbs - slow carbs - fine. Wasn't too worried about fruit so long as it was whole rather than drunk. More of an advocate for the Keto and Paleo diets that remove carbs. Talked about issues with losing weight and more importantly, the issue of trying to keep it off - main conclusion - eat less carbs.
Potentially life-changing new perspective of carbs and avoiding ultra-processed food but by the end I realized I was a little at a loss as to what I can eat that is actually readily available and at all appealing. (The menus at the end tried to address this but included smoked salmon which he had recommended eliminating all smoked meats a few chapters earlier.) Excellent way to start shifting thinking on what foods you eat though. He is definitely a credible expert.
I was looking for more information and examples. Maybe it's just the kindle version but I didn't learn anything new. There's 7 days of examples and that's really it and it's not really thorough. No concise list of fast and slow foods. Disappointed 😞
Meticulously researched and eye opening. This book is not only informative, it contains practical advice for making simple switches to improve the quality and nutrition of everyday meals.
Useful info, presented in an easy to read format with short chapters. Describes a lot of studies explaining how removing processed food from our diet results in reduction in LDL, blood pressure and other bio-markers. Touches on plant based diets but I wish they had gone into more detail on this.
The author does a tremendous job of explaining why processed foods are so damaging to health and why it’s difficult to distinguish the impact to say blood glucose from a nutrition label. A very valuable nutritional health read.
Very interesting. Book would be improved with a specific table listing fast and slow carbs. Right now, one must sort thru the final chapter with alternative menus.
Very informative. I appreciate that Dr. Kessler informs readers on how different foods affect your body as opposed to just telling you to eat a certain way!