الضجيج: دليلك الطبيّ حول الخرافات والادعاءات المبالغ فيها والنصائح السيئة

by Nina Shapiro, Kristin Loberg (contributor), Aicha Yakan عائشة يكن (translator)

A straightforward appraisal of why health myths exist, dispelling many of them, and teaching readers how to navigate the labyrinth of health advice and the science and misinformation behind it.

Hype is Dr. Nina Shapiro’s engaging and informative look at the real science behind our most common beliefs and assumptions in the health sphere.

There is a lot of misinformation thrown around these days, especially online. Headlines tell us to do this, not that—all in the name of living longer, better, thinner, younger. Dr. Shapiro wants to distinguish between the falsehoods and the evidence-backed truth. In her work at Harvard and UCLA, with more than twenty years of experience in both clinical and academic medicine, she helps patients make important health decisions every day. She’s bringing those lessons to life here with a blend of personal storytelling and science to discuss her dramatic new definition of “a healthy life.”

Hype covers everything from exercise to supplements, alternative medicine to vaccines, and medical testing to media coverage. Shapiro tackles popular misconceptions such as toxic sugar and the importance of drinking eight glasses of water a day. She provides simple solutions anyone can implement, such as drinking 2% milk instead of fat free and using SPF 30 sunscreen instead of SPF 100. This book is as much for single individuals in the prime of their lives as it is for parents with young children and the elderly.

Never has there been a greater need for this reassuring, and scientifically backed reality check.

Genres: Nonfiction, Health, Science, Medical, Medicine, Audiobook, Nutrition

408 pages, Paperback

First published May 1, 2018

About the author

Dr. Nina Shapiro, a graduate of Harvard Medical School, is the Director of Pediatric Ear, Nose, and Throat at the Mattel Children's Hospital UCLA, and Professor of Head and Neck Surgery at the David Geffen School of Medicine at UCLA. With more than two decades of experience in clinical and academic medicine, she's a trusted expert whom her patients and the media rely on to set the record straight about the latest health fads and misconceptions. Her trademark wisdom and no-nonsense attitude will be accessible to readers everywhere in her new book "Hype" to be published by St. Martin's Press on May 1, 2018.

She has appeared on NPR, CNN, CBS's "The Early Show," and is a regular guest on the Emmy-Award winning television show "The Doctors." Her work has been featured and published in the Wall Street Journal, Los Angeles Times, Hollywood Reporter, Redbook, First for Women, Real Simple, and many other print and online publications.

She lives in Los Angeles with her husband and two children.

http://www.drninashapiro.com

@drninashapiro

Reviews

[أحمد عبد الرحمن · Rating 4 out of 5]

كتاب رائع، مفيد للغاية.. كأنه كاتم لأصوات الضجيج الهادرة في كل وسائل الإعلام، بمعلومات صحية مغلوطة وترويج لعلاجات زائفة وأفكار طبية خاطئة، لأغراض تجارية أو دعائية أو بناء على أبحاث غير مكتملة

في شتى مجالات الرعاية الطبية والوقاية من الأمراض والحمية الغذائية والتمارين الرياضية والأطعمة والمشروبات الصحية المزعومة.. إلى غير ذلك من شائعات عن أشياء مفيدة أنها ليست كذلك، وعن أشياء ضارة بأنها مفيدة.. فضلاً عن اتخاذ الانترنت وسيلة لاستقاء المعلومات الطبية أو حتى تشخيص الأمراض

حقيقةً استفدت جداً من الكتاب
وأدعو لقراءته والاستفادة منه

[David Wineberg · Rating 5 out of 5]

The state of medicine is at best uncertain. We are warned that red wine contains sulfites (on every label), but two ounces of dried apricots contain six times as much. Coconut oil used to be heart-healthy, but no more. Doctors used to recommend no nuts until the age of two. Now they say the earlier the better. Except that they choke infants. Foods become superfoods – for a while. Fatty bran muffins used to be superfoods, for example. Doctors used to recommend smoking, and even appeared in ads. All kinds of useless products claim to be clinically tested and proven. UCLA surgeon and professor Dr. Nina Shapiro is here to straighten it out for you in an encyclopedic tour of her world that she calls Hype.

The book divides easily into lifestyle segments, from foods to fads to surgery to exercise. The chapters list their main points up front, and their takeaways at the end. Very user-friendly.

Medicine is still very much in flux, but Shapiro can say with certainty what we should look out for, avoid, or do moderately. It’s one of those books where it’s pointless to use a highlighter, because the whole thing would be stained yellow and you’d never find anything.

Here are some of the things I want to remember:
-One in 1477 women’s lives is saved by mammograms. False positives put more through expensive and pointless torture.
-A baby aspirin a day for a minimum of five years may save one life in 2000. But can cause excessive bleeding in many others.
-.0000004% of vaccinations result in claims against the vaccination compensation fund.
-Vaccinations only work if the “herd” is protected. Depending on the disease, 80-90% need vaccinations or the disease will spread. Those who opt out put the whole community at risk – for nothing.
-Vitamins are a racket. We get more vitamins daily from our food than we require. Additional supplements do nothing, but possible harm. On the other hand, Shapiro says, the placebo effect is extremely powerful, even on her. So if you think taking vitamins helps, then they do. So keep taking them.
-Vitamin E doesn’t so much prevent cancer as cause it.
-Drinking eight glasses of water day on top of all the water you get from food can kill you.
-Homeopathy is ”an elaborate placebo system”. It has no way to cure anything – unless you believe and expect.
-Homeopathy for cancer is basically suicide. You want real surgery and heavy-duty meds to fight cancer.
-Sitting is the new smoking. It reduces calorie burn, increases bad cholesterol …. And standing all day is no better, just different. We need to move.
-Sugar is the new fat. We need fats. Sugar is killer.
-“Sweat does not contain BPA, pesticides, asbestos, pollutants or other ills we wish to flush out of our system.” Or burn calories.
-Don’t worry so much about toxic chemicals in everything. They are everywhere and not in sufficient quantity to cause damage. Until proven otherwise. (Which is the whole problem.)
-Be wary of bragging: Farm Fresh! No added sugar! Organic! Gluten-free! All Natural! What these actually mean is little or nothing. Fruit juice is just sugar water. With all the valuable fiber removed.
-Published studies are not to be believed. Headlines taken from them are often totally wrong when not just misleading. Every study has its weaknesses. There is no certainty.
-In western consumer societies, buying food is astonishingly complicated. Fraud permeates everything. Fake food abounds. Tune out the marketing and buy basics: raw, fresh and unprocessed. Then make it into whatever you want. (Shapiro however, still hits the vending machines.)
-Western doctors no longer look at patients. They are too busy keying in notes. Nor do they listen any more. They simply order tests. One of Shapiro’s mentors (wisely) says: if you would just listen to the patient, they will eventually tell you exactly what the issue is. (And you don’t have to go to the lab and wait a week.)

There is a lot of common sense and humanity in Hype. Shapiro has a swift and easy style, and likes to sneak the odd sarcastic comment in there too. She gives lots of examples from her own family and friends, as well as memorable cases. Unlike so many in the God business, she is accessible, clearheaded, and forthcoming. She doesn’t always follow her own advice, and owns up to it. If there is an overarching takeaway, it is moderation, as in: processed foods are no good for you, but they won’t kill you.

And eat more fish.

David Wineberg

[Julie · Rating 4 out of 5]

With daily doses of email, television, radio and the internet, we are all bombarded with information about medical studies, new medicines and supplements, herbal remedies, almost magical instant cures for everything from foot fungus to obesity, superfoods and dangerous carcinogens. How much of what pops up in our email inboxes, on television commercials and on websites is actually true? And how much is exaggerated, based on skewed data, and outright trickery? This morning alone I woke up to 10 emails about medical and health related subjects ranging from herbal supplements and weight loss to cancer prevention and hair loss. Most were trying to sell me something and others provided links to various websites. It's really hard to rake through all the muck and pick out the factual information, if any. And I get really concerned when I see television ads for new "breakthrough" medications that require almost a minute of disclaimers at the end about it may cause suicidal thoughts, seizures, cancer and a host of other horrible side effects. What is true....and what's BS or media hype?

Nina Shapiro is a surgeon. After working in the medical field for decades, Shapiro has concerns about medical misinformation that most people come across on a daily basis and the potentially dangerous consequences of self-diagnosing illnesses based on misleading, incomplete or exaggerated information. This book seeks to provide a common sense approach for the average person to learn to separate fact from fiction. Shapiro discusses what certain terms like clinical study and scientific study mean, how companies get survey information so they can say their products are "doctor recommended,'' the exaggerated benefits of supplements, how to tell bogus study data from scientific data, the dangers of self diagnosis using unreliable information, benefits and concerns about alternative medicine, and the origins of several myths largely touted as true (like vaccinations supposedly causing autism).

I enjoyed reading this book. Shapiro introduces herself and gives credibility to her opinions by talking about her experiences as a surgeon and her career. Then she gives common sense approaches to wading through all the information readily at our fingertips in today's modern, internet-centric society. She doesn't just point out fallacies believed by ordinary people, but also talks about myths and other beliefs that doctors held as true that had to be disproved by scientific evidence (like red haired people have more problems during and after surgery). We all have been duped by product advertisements, false or misleading information backed by skewed studies and read articles printed by bogus medical journals. I enjoyed reading a book that points out common sense ways to tell truth from fiction, and firm facts from weak correlations. The book is written in easy to understand language with a conversational tone. I found the information interesting and very informative.

**I voluntarily read an advance readers copy of this book from St Martin's Press via NetGalley. All opinions expressed are entirely my own.**

[Holly · Rating 2 out of 5]

While I agreed with and basically appreciated many of the author's observations, I think some of her views (e.g., on dairy consumption) are based on her personal opinions and not on the evidence-based medicine she claims to represent. Nor did I learn anything I didn't already know. Perhaps the biggest problem for me was Shapiro's snide and patronizing tone, revealed in comments where she - a surgeon - talks down to her readers (e.g., ~of course you (reader), won't know what DNA, or an MRI, or a nutritional supplement is, because you're a lazy, science-ignorant American . . . ). I'm surprised her editor didn't work to eliminate that elitist tone, because who is the book's audience if not the people already interested in learning about science, health, and how to spot bullshit when they see it? I'd recommend Dr. Paul A. Offit's books before this one.

[Ell · Rating 5 out of 5]

This book is well-researched, well documented and well written. Of course not everyone will agree with everything in the book, which is often the case with books these types of books, but this book is truly informative and worth the read. In many ways this book is empowering, assisting the Average Joe in distinguishing between evidence-base claims and fallacy. I particularly like the fact that this book is useful to everybody, from day-to-day decisions to larger, more meaningful health decisions. Author Dr. Nina Shapiro has compiled a worthy reference that should be on everyone’s shelf.

[Philip · Rating 2 out of 5]

Nina Shapiro wants you to listen to the experts of the field - at least when the expert is her.
In pretty much every other field, she wants you to listen to her.

Any book that tells you that experts and professionals in the field are the ones you lean on, and then promptly tromps around telling you what is right and wrong in a whole plethora of fields that aren't her own... Ms. Shapiro, I'm pretty sure that's a textbook definition of shitting where you eat.

Now, I'm not sure if Shapiro realizes this, or if she does but simply think the reader is too dumb to realize it - certainly the tone throughout the book indicates that she doesn't think particularly highly of her readers' intellects. She does, however, think she herself is brilliant - no ifs, buts, or "hype alerts" about that.

Yeah. No, I did not like this book. On a general level, the central message of not believing everything you read or see is a good one. There's definitely a lot of "Hype" out there. However, I find it flat-out mind-boggling that a book with the purported purpose to not base decisions or ideas on other people's hyped claims and make-belief, includes so much of the author's own hype and make-belief.

The extra star for the general message aside, I do not recommend this to anyone.

[Patrícia⁷ · Rating 2 out of 5]

RATING: 2.5 stars

Confusing and repetitive. The only thing I got from this was that you should do everything in moderation and not search for your symptoms on Google. Thanks, Ms Obvious.

Oh... and vaccines are good, bottled water is bad because plastic and homeopathic remedies are probably scams. Color me surprised.

I get where she's coming from. There are a lot of myths still spreading around and ready access to biased information is many times a bad thing. We're all obsessed with being healthy when "healthy food" is not that much healthier than "normal" food. But she took too long saying all this and I guess her need to explain everything as if people are dumb got on my nerves a bit.

[Ron Bahar · Rating 5 out of 5]

With Hype, Nina Shapiro has become my hero; she has beautifully and successfully written the kind of book that has desperately needed to be available to both lay readers and physicians like me for a very long time in our brave new digital world of accelerated medical misinformation. Dr. Shapiro emphasizes the importance of an evidence-based approach to everyday problems in a sometimes humorous, sometimes serious, but always a relatable and disarming fashion that will guide any rational reader toward a sensible approach to health. Bravo. A must read.

[Megan · Rating 1 out of 5]

A trash panda would devour this!!
Almost gave it two stars due to the fact that I couldn’t stop listening to her nonsense. A real page turner and an eye roller.

[J · Rating 5 out of 5]

I received this book from a Goodreads giveaway. Presently, it is easy for individuals to believe what they hear from others. However, it is important to have some form of personal, educated judgement when deciding what is right and what is wrong in regards to medical advice. Hence, this book is a great read as it comes an actual doctor.

[Shane Duquette · Rating 1 out of 5]

I wasn't impressed with this one. I appreciate the goal, and I like how Dr. Shapiro is rational and evidence-based, but I don't think she does a good job of explaining the information or reaching the correct conclusions.

For instance, near the beginning of the book, she lists how we're most likely to die in each decade of our lives. In the first few decades, the leading cause of death is accidents. Her conclusion, then, is to worry most about avoiding accidents, less about other aspects of our health. But most people don't die young, and if we aren't managing other aspects of our health, we risk running into more problems in our later decades. It's almost like saying, "You don't need savings when you're working. You only need them when you retire. So worry about your savings when you're seventy!"

Some of this book seems incorrect, too. At one point, the author claims that people with a genetic predisposition for heart disease can be just as healthy as everyone else if they live a healthy lifestyle. That's a nice message to hear. I wish it were true. I have a genetic predisposition for heart disease—familial hypercholesterolemia. I meet all the requirements for exercise (strength training + cardio), I maintain a healthy body-fat percentage (11%), a healthy amount of muscle mass, and I eat a healthy diet. In fact, my heart specialist told me that I've done the best job of managing the condition that he's ever seen. But no matter what I do, I still lack the gene required to regulate and remove cholesterol from my blood. I still have double the risk of suffering from a heart attack.

A bit later, Dr. Shapiro states that maintaining a healthy body-fat percentage isn't as important for our health as being physically active. Here's a quote:

In finding healthy foods in the hopes of being healthy, fitness trumps fatness. In other words, the obsession in our culture to be thin can be deadly. So many well-meaning dieters have missed the boat on this. Healthy fats are part of a healthy diet. Some low-fat or no-fat products lose so much on the nutrition side—substituting sugar for fat or fake fat or fake sugar—that the calories saved are hardly worth it.

Dr. Carl Lavie, author of the Obesity Paradox, demonstrated that fat-free people are not necessarily healthier in the short or long run. And you can look thin but still have too much visceral fat—unhealthy fat deep in your midsection, around your healthy organs, increasing your risk for metabolic disorders or overall mortality.

So many things are being conflated here. Dietary fat isn't the same as body fat. Eating less fat isn't the same as being less fat.

There's a strawman argument here, too. Being "thin" isn't ideal for general health. Every major health organization recommends being lean enough, strong enough, and having a healthy BMI—a BMI that's neither underweight nor overweight. The goal isn't to be thin, the goal is to have an athletic body composition. To do that, the recommendation is to do both resistance training, cardio, and eat a good diet. Part of eating a good diet is eating an amount of food that helps you maintain a healthy body weight. This advice isn't controversial or complicated. It's difficult advice to follow, yes, but it's relatively easy to explain. She doesn't explain it.

Dr. Shapiro also says that obesity isn't unhealthy, then goes on to talk about how visceral fat is unhealthy. That doesn't make any sense. Obese people have more visceral fat. If visceral fat is unhealthy, you'd think that obesity would worsen health. Plus, in another chapter, she explains how being overweight can cause a variety of cancers. What's going on here?

I don't think her reference to the Obesity Paradox was very well done, either. It's a contentious idea. When talking about an idea that goes against the expert consensus (or when no consensus has been reached), I think it's important to present both sides of the argument. If you're interested, here's an article in Nature going over some of the potential flaws in the Obesity Paradox: https://www.nature.com/articles/ijo20...

A few examples of the flaws:
-Some diseases cause people to lose weight. Being thin isn't causing the diseases, the diseases are causing the thinness.
-Being thin isn't the same as having a healthy body composition. I say this as someone who was underweight for many years. When I gained weight, all of my health markers improved. But I didn't gain fat and become obese, I gained muscle and became stronger. I did this by following conventional exercise recommendations.
-Obesity does indeed seem to reduce lifespan and healthspan. Of note, the more obese someone is, the more likely they are to suffer from heart disease. So it's debatable whether there's even a paradox to begin with.

With all of that said, there's such a thing as being too lean, too. The goal isn't to have zero body fat. Rather, the goal is to have a body-fat percentage that's somewhere within the healthy range. It's a fairly wide range.

There may indeed be something to the idea that having some extra body fat can help people survive illnesses that make it hard to eat enough. They have reserves of energy. It seems that's one of the reasons why being muscular is healthy, too. The body can break down the muscle in an emergency, using it for energy.

I just don't like how she's tossing out this controversial hypothesis and only presenting one side of the argument. I think it will confuse and mislead people. It's already hard enough. why make it harder through obfuscation?

Anyway, Dr. Shapiro's point in this section is that we should focus more on exercise than diet. I think that's wrong, too. Out-exercising a bad diet is damn near impossible. That doesn't mean exercise isn't important, just that the two go hand in hand, especially if the goal is to reduce visceral body fat. The best way to reduce visceral body fat is to exercise (causing proportionally more visceral fat to be lost) and lose weight (causing more overall fat to be lost). Pitting exercise against diet is the wrong way to think about it. They make better allies than enemies.

In another section, she says there's no such thing as "muscle food." Her reasoning is that our bodies don't magically add the amino acids we eat to our muscle tissue. But, uh, yeah, our bodies can indeed use the amino acids we eat to build muscle. In fact, eating a meal that's rich in protein will cause a few hours of increased muscle-protein synthesis. And diets rich in protein (which break down into amino acids) really do help people build more muscle. This is true with or without exercise, though obviously exercise helps, and resistance training (such as lifting weights) helps most of all.

Finally, she argues that sugar is the cause of obesity, not fat. This argument is flawed because it assumes that obesity is caused by a single macronutrient. In reality, if people eat more calories than they burn, they'll gain weight. Both sugar and fat contain calories. So does protein. So does alcohol. You can gain weight by eating too much of any of those sources of energy. Most people don't gain weight by eating macronutrients in isolation, though. Think of foods like chocolate, cake, chips, and donuts—foods that contain a mix of both fat and sugar. Those are the foods that tend to be the easiest to overeat.

Plus, seafood contains fat. Fruits contain sugar. Most people don't get fat by eating seafood and fruits. So it's not the macronutrients that are the problem. It's the fact that people burn fewer calories in their sedentary lifestyles, eat processed foods that taste great and aren't very filling, have an abundance of food readily available to them, enjoy snacking while watching TV, and so on. The reason people eat too much isn't so simple. The problem isn't just "sugar."

Maybe the medical information in this book is great. I have no idea. That's not my area of expertise. But when it comes to diet and exercise, this is the sort of information that confuses people, making it harder for them to get and stay healthy.

[Youghourta · Rating 3 out of 5]

القهوة مفيدة للصّحّة أم أن القهوة من الأمور التي يجب أن تتجنّبها. هل يجب عليك أن تكثر من أكل الشوكولاطة. أم أنه لا فائدة منها إطلاقًا. ما كمّية الماء التي يجب أن تشربها يوميا؟ وهل هناك أضرار من الإكثار من الماء؟ هل فعلا هذا الطعام أو ذاك مُسبب للسرطان؟ أو ربما إنه يقي منه؟ إن كنت تحس بالصداع من كثرة هذه التناقضات وبسبب كثرة الأخبار والنصائح المتضاربة، فإن الكاتبة تُحاول أن تجيب على هذه الأسئلة وأكثر من خلال هذا الكتاب، وتحاول مُساعدتك في معرفة الصحيح من المكذوب مما هو مجرد حملات تسويقية. أو ربما يجب عليك تناول بعض الإسبيرين لتخفيف ذلك الصداع، فحسب بعض الدراسات هي مفيدة لك، في حين تشير دراسات أخرى إلى أنه قد يسبب لك نزيفا داخليًا. الأمر سهل كما ترى :)

قبل أن أدلي بدولي وأعطيك رأيي حول الكتاب، إليك أهم ما ورد فيه:

- أغلب المكمّلات الغذائية لا فائدة منها. إن كنت تحصل على تغذية متوازنة فإنك ستحصل على ما ستحتاجه من فيتامينات من خلال أكلك. أغلب المكملات الغذائية لا تخضع للفحص والتمحيص الذي تمر به الأدوية، يعني قد لا يكون المكمل الغذائي التي تتناوله مضرًا لك (يتم التحقق من سلامته) لكنه ربما لن يفيدك، واحتمال أنه يحتوي كمية الفيتامين أو المعادن المذكورة على العلبة بشكل كامل غير مُحتملة. مع ذلك تشير الكاتبة إلى أنها هي نفسها تستهلك تلك المكملات الغذائية، وترجع سبب ذلك إلى تأثير البلاسيبو. بعبارة أخرى إن كنت تعتقد بأن تناول هذا المُكمّل أو ذلك سيفيدك، فمن الوارد جدًا أنك ستلحظ تلك النتيجة.
- كثرة التحاليل والاختبارات الطبّيّة قد يساهم في اكتشاف أمراض كثيرة قبل فوات الأوان أو حتى قبل أن تظهر أعراضها بشكل واضح. لكن الكثير من هذه الاختبارات لديها أضرار أكثر من الفوائد. فعلى سبيل المثال من يموت "مع" سرطان البروستات (يعني يموت إما لمرض آخر أو يموت موتا طبيعيا لكنه يكون مصابًا بهذا السرطان) أكبر بكثير ممن يموت بسببه، لكن لو اكتشف السرطان في الكثير من الحالات فإن إجراء خزعة* والمخاطر والتعقيدات التي تصحب ذلك قد تكون أضر من عدم اكتشاف السرطان من أساسه. نفس الأمر يحدث مع عمليات التصوير الشعاعي للثدي** والذي يعرف معدلات إيجابية كاذبة*** مُعتبرة (يُعتقد بأن هناك ورما سرطانيا في حين أنه لا وجود ذلك) وقد يكون التعرض المُتكرر للأشعة أكثر ضررا من عدم إجراء التصوير الشعاعي وعدم اكتشاف تلك الأورام.
- علاج السرطانات بالمواد الطبيعية فقط**** قد يكون نوعًا من الانتحار. تفيد هذه العلاجات إلى جانب العلاجات الطبّيّة "الكلاسيكية" ولوحظت نتائج أفضل لدى من يستخدم العلاج الطبيعي إلى جانب العلاج "الطبي" لكن لا يجب الاعتماد عليه لوحده.
- الكثير مما تقرأه على مغلّفات المنتجات مثل "خالٍ من السكر" أو "بدون سكر مضاف" أو "خال من الدهون" أو حتى "طبيعي" أو "بدون مواد حافظة" أو غيرها قد لا تعني بالضرورة ما تفهمه منه. استخدام هذه الأوصاف غير مُقنّن وقد يستعمله مُنتج ما ليعني شيئا ما في حين أن الحقيقة أمر آخر كلّيّة. الأدهى والأمر هو استخدام تلك الأوصاف بشكل يهزأ بذكاء المُستهلك. فمثلا قد تجد وصف "خال من الدهون" على علبة قهوة أو من "من دون جلوتين" على حبة حلوى.
- لا تحمي جميع مضادات الأكسدة من الشوارد/السرطانات بل هناك من يسببها. نفس الأمر مع بعض الفيتامينات.
- المشي قد يكون أفيد لك من ممارسة الرياضة، لا تمارس الرياضة بشكل كثيف فقد يعود ذلك بالضّرر عليك.

نأتي الآن لرأيي في الكتاب. الكتاب في رأيي يعبر بشكل واضح عن غرور وعجرفة ما يُسمى بالعلم الحديث بشكل عام وبالطب الحديث بشكل خاص. الكاتبة طبيبة، لكنها طبيبة أطفال، يعني تكتب في مجال ربما يكون قريبًا من مجالها (طب الأطفال) لكن تجاوزت ذلك إلى مجالات أخرى كالتغذية والرياضة.

لكن ما أثار حفيظتي كثيرًا هو أن ما يُمكن استخلاصه من الكتاب أن الطب الحديث لا يزال قاصرًا ولا تزال أسئلة كثيرة من دون إجابات، بل وهناك من الأمور ما كان منصوحًا به منذ سنوات والآن يحذر الطب الحديث منه. مع ذلك تم الإنقاص من قدر الطب البديل بشكل كبير، وتُرجع الكاتبة أية نتيجة إيجابية حصلت من الطب البديل مثلًا إلى تأثير البلاسيبو والذي يبدو بأنه "تهمة" تلصقها بكل ما لم تجد له تفسيرًا علميًا، كما أنها تصف تلك الحالات بالشاذة (يعني مجرد قصص لا يُمكن أن نبني عليها) لكن مع ذلك لا تتحرّج من ضرب أمثلة (يعني تقصّ قصصا هي أيضًا) لتعزز آراءها لما لا يكون لديها من البيانات والأدلة العلمية ما تدعم بها رأيها. بعبارة أخرى وكأن الطب الحديث على لسان الكاتبة يقول "أنا لا أدري ما الذي أتحدث عنه ولا أفهم المجال الذي نتناقش فيه بشكل جيد لكنني متيقّن بأن ما تقوله خا��ئ لأنه لا يتوافق مع منهجي".

ما عزّز رأيي هذا هو ما ورد في آخر الكتاب حول زيت جوز الهند، حيث أن جمعية القلب الأمريكية كانت تنصح به منذ سنوات على أنه بديل صحّي ومفيد للصّحّة مُقارنة بباقي الزيوت النباتية، لكن مؤخّرًا غيّرت رأيها 180 درجة وأصبحت لا تنصح به إطلاقًا. يعني كقارئ يهتم لأمر صحّته ويرغب في معرفة الصحيح من الصواب، هل يجب أن أصدّق مثل هذه المؤسسات المرموقة؟ أم يجب أن أنتظر سنوات علّها تغيّر رأيها؟

ربما تكون الخلاصة الوحيدة المفيدة والعملية التي خرجت بها من الكتاب هو أنه يجب الاعتدال والوسطية في كل شيء، لا إفراط ولا تفريط، لا تفرط في أكل هذا الغذاء أو ذلك لا وتُفرّط في ممارسة الرياضة أو شرب الماء (وكلوا واشربوا ولا تسرفوا). كما أن الكثير من الدراسات العلمية هدفها تجاري بحت والعديد مما ينشر على أنه أبحاث علمية ليست كذلك ولا تملك كامل مقومات الدراسة العلمية الصحيحة (خاصة حجم الدراسة وعدد المشاركين فيها).

هل أنصح بقراءة الكتاب؟ صراحة لا أدري، قد تستفيد من بعض المعلومات الواردة فيه لكن قد يزيد من مقدار التشتت الذي لديك والحيرة مع كامل المعلومات المتضاربة التي تقرأها بشكل دوري.

-----
* خزعة: biopsy
** التصوير الشعاعي للثدي mamography
*** إيجابية كاذبة false positive
**** العلاج بالمواد الطبيعية Homeopathy

[Kristy · Rating 3 out of 5]

Parts of this were interesting, parts were rambling. Some of the "hype" she mentions has been debunked in the time since this book was published...ah, science.
.
Overall this book wasn't bad, but I don't know that it was worth my time in the end.

[Charles Selden · Rating 5 out of 5]

HYPE Will Upset Pharma

The pharmaceutical industry is not going to like HYPE, the recently published book whose subtitle promises to inform readers about medical myths, exaggerated claims, and bad advice—and how to tell what is real and what is not.

This book delivers what the author promises. Her writing challenge was how to explain to ordinary readers the complicated and complex realities of what is known, not known—and unexpectedly can change—about how drugs work and interact in our bodies. The author, Dr. Nina Shapiro, is the Director of Pediatric Otolarynology and a Professor of Head and Neck Surgery at UCLA.

Dr.Shapiro pulls it off with drug explanations in plain English backed with informative anecdotes from over 30 years of medical training and practice. Of special interest to my fellow consumerists are her comments on free-range foods and fish, over-the-counter medicines, vitamins and incidentalomas, which are tumors accidentally found when looking for something else: “Sometimes finding them can save your life, but sometimes finding them can end it.”

Her chapter on Complementary Alternative Medicine is particularly incisive.
An excerpt:

Perhaps since time immemorial we as humans have been vulnerable prey for alternative treatments and approaches that buck tradition. We want to be the anomaly—the outsider—the one who beats the odds and statistics, especially when it comes to an illness as scary and grave as cancer.

Dr. Shapiro has seen the results—and imminent dangers—of hyping drugs. The pharmaceutical industry fully understands the power of using the tools of propaganda to convince consumers to buy drugs. They spend millions on their promotions—all worked into the selling prices of drugs—and lobbyists to protect their interests.

Sophisticated marketers hype drugs with highly effective disinformation techniques that help sell prescription and non-prescription drugs. Their promotions are first tested on focus groups and only then expertly targeted to overcome consumer resistance to advertising. The success of these campaigns is evidenced by their continual use. And make no mistake, ad marketing is costly. Obviously if the pharma industry did not see evidence of success in sales connected to the power of hype, ad orchestration would have changed long ago.

More exposure for consumers about harmful drug promotion is needed, especially in the current political environment because consumer protection is not high on the agendas of both political parties this election year. Dr. Shapiro’s book will increase consumer awareness of pharmaceutical industry connivance with drug information. (Perhaps copies should be sent to all the candidates for Congress this November.)

To “protect” their promotional practices, the pharmaceutical industry opposes regulations that might pull back the curtains around the marketing costs of drugs, which at times can be greater than the development costs of drugs. Pharmaceutical folks will not like this book because it could arouse consumer curiosity about marketing hype, which is exactly why consumers and their doctors should read it.

[BOOKLOVER EB · Rating 5 out of 5]

Dr. Nina Shapiro's "Hype," written with Kristin Loberg, deals, in part, with the marketing strategies that companies use to sell products. Buzzwords such as "all natural," "farm fresh," and "organic" attract consumers, but what do these words really mean? In addition, Dr. Shapiro offers her opinions on the health information we obtain from the Internet. She addresses the following questions: Which medical tests are unnecessary? What are the benefits and risks of alternative medicine? What constitutes a nutritious diet? What are the best forms of exercise? Can we reverse the physical effects of aging? Although there are no absolute answers that everyone agrees on, Shapiro encourages us to be savvy, inquisitive, and skeptical of claims that seem too good to be true.

A graduate of Harvard Medical School, Dr. Shaprio is a pediatric otolaryngologist, surgeon, and professor at UCLA, who worries that "many individuals don't know where to turn for unbiased, trustworthy advice." The author dispels commonly believed myths and tackles controversial issues. She takes on those who fail to have their children vaccinated; challenges the contention that gluten-free is good for everyone; advises us to avoid taking large doses of vitamin pills and unregulated supplements; and cautions people who suffer from life-threatening illnesses to beware of charlatans.

"Hype" is entertaining, occasionally humorous, and comprehensible to the average reader. Shapiro offers pertinent anecdotes from her career as a physician and backs up her assertions with scientific data (there are copious endnotes in the back). "Hype" is not a how-to manual that provides a clear-cut blueprint on how to live well. Rather, Dr. Shapiro encourages us to think before we make purchases in the supermarket, speak intelligently with our doctors about the pros and cons of treatment options, and become as knowledgeable as possible about our bodies. Above all, we should not believe everything we see, read, and hear, since so many advertisements, labels, and statements in the media turn out to be false, misleading, or exaggerated.

[Marsha · Rating 5 out of 5]

We are constantly being bombarded with information about our health. What's good for us in one study causes cancer in the next. What's the truth about gluten, vaccines, anti-aging products, sugar and fat? How many medical tests are too much or not enough? Should you have the same kind and duration of exercise in your twenties as you do in your forties? Not only does Dr. Shapriro peel off the layers and give us context for each issue, she gives us the tools to find out things for ourselves. I particularly appreciated her chapter on how to judge the value of a study/clinical trial/scientific abstract and how to do unbiased consumer research yourself.
If you're going to buy one health guide, make it this one.
Thank you Netgalley for the e-review edition of this book.

[Ahmed · Rating 1 out of 5]

It might be my background knowledge being an insider of the medical field. Still I wouldn't recommend this book for you at all.

[أبو فاطمة 14 · Rating 2 out of 5]

الكتاب ليس دليلاً بالمعنى الحرفي
لأن الدكتورة تتناول الموضوعات بطريقة اشبه (بالسوالف)، كأنك قاعد معها في الكوفي شوب وقاعدة تشرح لك وتعطي ارائها حول المواضيع المطروحة في هذا الكتاب.

[Renee · Rating 5 out of 5]

I thought this book was a well-balanced look at today's confusing health data. I really appreciated her perspectives as a long-time surgeon and how she can pull out what is important and what is hype.

Notes:
-"In academic circles, the number of times a given article is cited in other academic articles is one metric to measure its quality, validity, reproducibility, and even popularity"
-scholar.google.com
-"The knowledge of a risk does not make that risk bigger."
-"In-home genetic testing is not what it's cracked up to be (yet). Proceed with caution."
-"We can't say that aluminum-based deodorants cause breast cancer (at least not yet)."
-"Products labeled unscented may -- get this -- actually add fragrance to block out the scent. And fragrance-free may simply mean that no added fragrances were included to block out the already-present fragrance in a given product. Neither term is backed by a legal document or FDA regulation, so their meanings are up for grabs, depending on the manufacturer's angle."
-"How many subjects were there, over how much time, and when looking at cure, for how long did subjects remain cured?"
-PubMed.gov
-"If none of this is provided in an abstract, or an abstract is nowhere to be found online, question your source."
-"...doctors recommend, clinically proven, and studies show can mean something substantive or absolutely nothing. In general, real studies don't apply these claims to results.."
-"Kale can cause hypothyrodism if eaten in excess. Kale, as well as other cruciferous vegetables such as broccoli and cauliflower, are whats know as goitrogenic. A goiter is an abnormally enlarged thyroid gland, and those with known thyroid disorders are at risk of developing more thyroid problems when such vegetables are eaten to excess. How much is too much? ...consumption needs to be inordinately large to cause a problem. But the juicing craze has led to just that -- inordinate amounts...And when it's blended into a gnarly green smoothie, one of kale's prime benefits -- fiber-- is lost."
-"Blueberries do contain the antioxidant anthocyanin; however the antioxidant properties are only active in a petri dish, not when consumed. And...when whole fruits are pulverized in a blender as part of a juice, or juice cleanse, you lose that all-importatnt fiber that helps control blood sugar."
-"What aides in satiety and digestion with these superfoods is that they are eaten and digested slowly. ... The vitamins are a small added bonus. Squeezing supposed superfoods into bottles and jars takes the super quality away."
-"Gluten is not a carb...it's actually a group of proteins."
-"...the rise in gluten-free diets has led to an uptick in type 2 diabetes."
-"MSG is also found naturally in many other foods such as tomatoes, peas, Parmesan,...potatoes, grapes, and mushrooms."
-"These giants of the sea...bioaccumulate the toxins from all the fish below them in the chain. ... The fish least likely to be as contaminated are the smaller, shorter-lived ones: salmon, pollack, anchovies, sardines, herring, sablefish/black cod, and sole."
-"The big bad one is raw milk, meaning unpasteurized."
-"Early life-forms, several billion years ago, were able to make their own vitamins, but most species, ours included, evolved ad lost that ability."
-"Pineapples, oranges, and raspberries...are 87% water."
-www.thennt.com
-"The combination of not drinking for long periods, standing for long periods, working under hot lights, and eating salty snacks in between surgeries leads to literal sludge in the kidneys." (on surgeons getting kidney stones)
-"He defines alternative medicine as a 'set of practices which cannot be tested, refused to be tested, or consistently fail tests. If a healing technique is demonstrated to have curative properties in properly controlled double-blind trials, it ceases to be alternative. It simply...becomes medicine.'"

[BethK · Rating 4 out of 5]

Quite a good book, with generally good advise. It adds a layer to realism to our expectations from medical care overall. It's invaluable for a consumer to read, to help him or her what medical products and services are good, bad, unproven, or proven not to work, all without being overly technical. Moreover, in the very first chapter, she gives a short but pretty-effective description of how to evaluate the quality of information found on a web page - or even a magazine or book. It talks about evaluating the risks and benefits of any proposed test or treatment, and why it might be better not to know every abnormality you may have - and pointed out that all of us have them.

Indeed, extraordinary healthcare claims come out nearly every day. Very few of them are true. Some of them turn into health fads, and those often show themselves to have bad results - seen over the long term.

The book talks about some things which are fairly technical in language understood by most people - including how to look at such things as Number Needed to Treat (NNT), Number Needed to Harm (NNH), genes - their functions and how they pass traits, and how to look at risks and benefits.

She personalizes it! Raw data can be intimidating, but brings it back to the personal level - what level of risk are you willing to take? Are risks of some outcomes better or worse (in your mind) than the risk of other outcome? That's a question that no one else can answer for you in a specific situation.

Then, there's HYPE! involve in many things - including our quest to live forever, be forever young, and that things which are touted and seem to be too good to be true almost certainly are.

I only give it 4 stars because in several places she makes specific claims that seem to recommend a few things which seem to come out with a significant risk and little benefit.

[Ann T · Rating 4 out of 5]

Thank you St Martins Press and Netgalley for an ARC of this book in return for my honest review.

I have been reading this book slowly over a number of weeks, Simply because it is full of medical myths that make the reader sit up and take note of medical “hype”. Some of the hype we have all heard before but there are also many new sources that have woken me up amd made me question what is true.

The author is a surgeon and she opens the book encouraging the reader to become more questioning of the information they read and the sources it comes from. I had thought I was quite good at both of these aspects but my eyes were opened on a number of occasions.

One of my favourite quotes in th book was “there is no such thing as alternative medicine, it is either medicine or it is not”. I have always sat on the fence with alternative medicine, not having a particularly strong view either way. This quote has really had me thinking, particularly coupled with the newly emerging evidence (for me) that vitamins are not the great thing I had been lead to believe for many years. If anything I have saved lots of money on unnecceary products for our family in the quest of doing the right thing.

I highly recommend this book.

[Vlad Ardelean · Rating 4 out of 5]

Very nice book. Good to have a comprehensive introduction to the world of health, from a professional doctor.

My review contains spoilers:
The humam body is very complex, and you'll be surprised what harms you. Apparentlyn you shouldn't worry too much about chemicals. They are not as bad. Apples contain cyanide, and pears formaldehyde.

Still:
Don't give whole nuts to children under 5.
Do let new-borns get a vitamin k shot.
If you're a pregnant woman, do take folic acid supplement, unless you have some mutation which makes to harder to use the nutriens, but then do eat lots of greens.

Exercising just half an hour every day at a not too intense pase if good, but sitting is really bad.

Hydration: you don't need to drink 2 liters of water a day. Most water intake comes from the food you eat. As long as your pee looks yellow, you're fine :p

The author seems to have put some effort into looking at both the up and down sides of the things she talks about, so this seems a balanced book.

[Heidi]

First off, I loved the writing style. Pithy, pointed, humorous, humble. I came away with the over-arching lesson being this: medicine is always evolving based on new scientific discoveries and study results, so don’t pick a hill to die on (or live forever on) because tomorrow it might be the wrong hill. Live in moderation, and that includes your consumption of vitamins and antioxidants as well as your level of exercise.

Lastly, I came away with points to ponder in areas where I’ve seen differently than Shapiro does, and not always with good reasons. Excellent read.

[Sara · Rating 4 out of 5]

I found this an interesting book from a surgeon's POV. It lost a little credibility when she said all the stuff about vitamins, but admitted she still takes one anyway. I think we want our doctors/surgeons to know what's best for us so hearing that they don't always...
Good info on how to tell apart good medical websites from bad ones.
An interesting read.

[Phantom_fox · Rating 4 out of 5]

Not much I wasn't aware of here, but I appreciate this literature existing. I think it has a lot of great info for people that struggle with these topics. I'd like to know how it is received by those who believe the hype. Did this book convince you otherwise or is it just for confirmation bias for me? Would people that believe it ever read something like this?

[Linden · Rating 3 out of 5]

The author, a pediatric ENT surgeon, addresses some of the controversial issues in contemporary health and medicine: exercise, weight, longevity, and aging. My favorite parts of the book were her caveats on medical studies and the proliferation of journals which require an article author to pay for publication.

[Carissa Woolf · Rating 4 out of 5]

Really informative!

[Steve · Rating 4 out of 5]

Interesting take on health hype

I found the book interesting and at times hard to put down. I enjoyed Dr. Nina Shapiro`s writing style which I found conversational and friendly. There is a broad theme for each chapter (e.g., putting risk into perspective and cause vs association) which made for interesting reading, but she gives so many examples that it is easy to lose the thread of any given chapter. The biographical parts of the book were not that interesting and there was too much on why a surgeon is appropriate to write a book like this. And like Nicola Temple in “Best before”, Dr. Shapiro will make a statement like there is no evidence that organic foods are better but then proceed to say that she selects organic food. She will also question the safety of GMO foods but not the safety of foods produced by mutagenesis. Overall, I enjoyed reading the book but enjoyed Mark Crislip’s “Flies in the ointment” and Paul Offit’s “Do you believe in magic” more.
Disclosure: I received a complimentary copy of this book via Netgalley for review purposes.

[Ashley · Rating 5 out of 5]

When you agree with what a doctor/expert has to say of course you think they're brilliant. The ideals she expresses more or less align with mine. In the forward Dr. Shapiro sounded arrogant and annoyed...but also competent. I like she says that medicine should not be about beliefs, but about facts. Far too often I think people make serious health decisions based on emotion. She even says people trust those with a lot of likes and followers, tug at heart strings, and are high profile rather than dry science. And; 'The unconscious bias related to what you think should be good more often than not overtakes your ability to asses a situation from scratch.'

Points she makes I loved:
-Dr. Shapiro points out terms like 'all natural' are not FDA regulated terms. OMG do you know how many times I've said that same thing?? If she would have thrown in 'vegan' or 'gluten free' I would have died. I get so frustrated when people choose their foods based on those handy little labels. They mean nothing, have no regulation, and are enormously misleading. Especially the fragrance free bit- they often have chemicals added to mask smell. We have to realize too, some chemicals while not natural, are not bad. Some were specifically developed to replace the more harmful, but organic, ones.
-I love that she talks extensively about the difference between causation, connection, and linked. We should NOT be making medical, health, and dietary decisions based on things that are 'linked'. Linked only means there may be a connection but that there's no telling what that connection is or if it is in fact even real. It's the quickest way to get a fad to start. She says "x can cause y in a laboratory setting, but have no significant health impact on humans". An example of this was certain antioxidants. In petri dishes they destroy cancer, in the human body they do nothing. Other antioxidants (such as beta carotene) suddenly can be cancer causers. And yet, food containing them can still be marketed as having cancer fighting antioxidants.
-94% of published studies are garbage. Even if you've read the blogs, and all the fun little info graphs on Pinterest, you still are not an authority. TALK TO YOUR DOCTOR. If you can't trust your doctor...get a new doctor. You like following someone because you like their recipes? Cool. But unless their name if followed by MD they don't have any medical advise to offer. And just because something was reported, doesn't mean it's true. And if it is true- it doesn't mean it's been peer reviewed, undergone human trials, or enough information with which to influence human behavior.
-This is not a diet book, but as she does touch on diet and nutrition. She doesn't push any diet, or even recommend any. As I've said so many times-every person is different, and any diet that says it works for everyone is garbage. Also any diet that says anything beyond-everything in moderation- is garbage. Since she totally agrees, I'm good haha. She says: "there is no best diet, there is no best exercise." Amen. I also love that she says any diet that has the selling point of 'you can eat all you want of a certain food all day' is wrong and unhealthy. Even if that certain food is normally healthy. Why do we need to eat so much? She also cautions about juicing. Before you never had to really worry about eating too much of certain foods like kale. There was no way to, but now you can eat weeks worth in one brightly colored, Instagram worthy beverage (I do like the occasional smoothie/juice to be honest). Same for detox diets. No studies have shown any benefit, yet detox juices, cleanses, diets, and pills are everywhere. Now, I do think at times you can boost the foods that support your body's natural detox organs, but as I've done no studies I'm not going to recommend that haha.
-DAIRY-"While many are lactose intolerant, few are truly allergic to dairy." If you have too much you may get an upset stomach, but you aren't allergic. And there's no connection to colds and/or ear infections. This made me laugh. I was always told as a kid that dairy led to colds. So if I had a sniffle and really didn't want to go to school I'd drink SO MUCH milk. Of course I'd wake up the next day totally fine.I know, such a rebel. My sister and I used to get itchy noses when we'd have too much milk when I was a kid. So until I was a teenager we everything from Jersey, to goat, to soy to almond milk. We grew out of it. Or maybe our bodies just surrendered. Side note- I think with dairy there is a danger of making broad statements. If studies are done on a population that is famously more sensitive, will the findings hold true for those who aren't of that ethnicity?
-She also discusses vitamins. Full disclosure, I do take vitamins and supplements. HOWEVER. I only take specific ones I've discussed with my doctor to treat a specific medical condition. I very firmly believe if your diet isn't fulfilling your nutritional needs and you need to rely on vitamins IT IS NOT A HEALTHY LIFESTYLE. It was interesting to me that she discussed Linus Pauling, Nobel Prize winner and doctor, and how he was so wrong about vitamins. This because a few times lately I've seen little health infographics or headlines that claim the support of certain Nobel prize nominees, as if that means everything they say and do is correct. Did they win/get nominated for the recommendation they are giving? No? Then it's irrelevant.
-Dr. Shapiro talks about how cancer is sneaky, you don't die overnight. So, in one case, you can completely change your diet and lifestyle and look like you've beat cancer with the change, but if you didn't treat it medically it doesn't mean the cancer is gone. A lot of lifestyle changes work well as complements to cancer treatment, not instead of.
-Vaccines. This subject is complicated for me. My family has, over several generations, had very bad reactions to certain vaccines. In fact a few of those reactions are mentioned in this book- asthma, allergies, brain swelling, seizures. In fact, in even very common vaccines we manage to get all the side effects (I had my flu shot this past week and my body is still aching). However, that is my family. Not yours. What I may decide for my family, is not what would work for yours. We are of such a minority as to be negligible. And as an adult, I suck it up. I am around the very old and the very young all the time. I am not about to see someone I love sick because I couldn't handle the pain. We know which shots series causes most of the issues in my family now anyway so we know to be extra careful.
-Love the discussion about whether or not to get tested for certain things. I didn't really learn anything new, but it's nice to read the science to reinforce my beliefs. I had researched a lot of the same stuff last year. I have a tumor that up until a few years ago would have been considered cancerous and major surgery performed. But tests get better all the time and now we know unless the tumor grows too large, surgery isn't necessary.
-I didn't have many thoughts on the hormones/anti aging chapter. We're all aging. Deal with it. I do think more people need to hear that there is no way to stop or slow down the aging process. Live as healthfully as you can, there's not much more to be done.

Random thoughts and facts I want to remember:
-It's recommended Children under five don't eat nuts-I wonder if this was misunderstood in years past as an allergy, but really it's because they're a choking hazard?
-Hearing loss is the most common congenital anomaly (1 in 300 babies).
-11 times as much money is spent trying to lose weight than on cancer research. Really people? We care that much? Shame on you.
-Celiac's disease is tied to type 1 diabetes, but the unnecessary gluten free diet is tied to type 2 diabetes because of the rise in simple carbs and sugars, unless the dieter goes low/no carb.
-Studies have shown "higher maternal intake of peanuts, milk, and what products during pregnancy has been associated with a lower incidence of nut allergies, asthma, and allergy related skin conditions respectively." She also talks about how some ill effects of our diets may never be experience by us, but by our child when they reach adulthood. So it makes me wonder- how much of the severe allergy problems we see in the very young are because their mother went on a diet. In my own family-my grandmother doesn't like milk and my mother has severe asthma. Hmmm.
-Adults make about 35,000 remotely conscious decisions a day. Young children make about 3,000.
-Amish experience less cancer. They eat predominantly meat, potatoes, butter, bread, eggs, and milk.
-The point that it doesn't matter if chickens were given hormones (they're not) because the hormones wouldn't survive digestion. I do like that she says it's not great to eat eggs from vegetarian chickens since they're natural omnivores. I do think none of this really applies to me as my egg source it different. So pretty much all the 'dangers' from eggs are moot. For me.



Basically, this whole book summed up: Sometimes bad things happen. Sometimes we get sick, and we're all dying. We can't get so desperate to protect ourselves that we harm ourselves. Take preventative measures, eat what you want in moderation, exercise in moderation. Pay attention to medical research, but unless it's been proven conclusively (by scientific peer review, not testimonials) don't stress too much about it. And absolutely....TALK TO YOUR DOCTOR. And live your life.

[Denise · Rating 3 out of 5]

Shapiro explains (much like librarians do!) that not everything you hear or read is true. She explains how to evaluate conflicting claims, how to weigh the choices we each have everyday regarding our health. Excellent chapter on immunizations. (Do it!!!!)