Book comment: Neutral score (5 out of 10) for Chef MD’s Culinary Medicine

Dr. John La Puma’s book has many positive qualities: It gives sound basic advice, has interesting notes in the margins, questionnaires to engage the reader, information on specific foods, recipes with nutrient information, and an 8-week plan for those who need step-by-step guidance over time.  My minor issue with the book is that the recipes do not always provide a balance of nutrients and the book does not discuss how to modify or combine recipes to make balanced meals.  My major issue with the book is that the nutritional advice for specific medical conditions (chapter 7) is based on very brief reviews of the scientific literature (the quality of scientific conclusions are vague and only 2 selected research papers for each disease is referenced).  Dr. La Puma clearly read more papers than are referenced, and his being a medical doctor does give him credibility in his understanding of human health, but I teach a nutrition course in the medical schools at both UCSF and Stanford University and can tell you that the nutrition education in US medical schools, from both my and the National Institutes of Health’s perspectives, is drastically inadequate.  And even the best nutrition scientists in the world can give the wrong advice on nutrition when they have not reviewed all of the scientific literature on a specific topic (see my article on coconut).  If someone with a medical disease goes to this book looking for a saving cure, they will get sound general advice in Chapters 1-6, but will receive incomplete and even possibly wrong nutrition conclusions in Chapter 7.  Because a person with a disease is likely to become emotionally attached to advice that they believe they can trust, giving incomplete advice to those in medical need is, in my opinion, unethical.  Without Chapter 7, this book would score an 8 out of 10.  With a chapter added addressing how to balance meals using the recipes in the book (or, better yet, with comments on this underneath each recipe), it would score a 10 and I would recommend it to everyone I know.  But without these changes, I give it a 5, and would give it less if I thought people in earnest search of nutritional answers for specific diseases were the main audience.  I agree with both Dr. Walter Willet’s and Dr. Mehmet Oz’s endorsements on the back of Dr. La Puma’s book.  It has sound advice and the meals probably taste great.  But these endorsements don’t address the scientific incompleteness of the food “medicine” portion of the book.  While great for the general population, this book falls short of achieving the culinary medicine it strives for, which could give an unethical false hope to someone with a disease.