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A medical review of the documentary The Magic Pill

The Magic Pill

The Magic Pill is a 2017 Australian documentary by celebrity chef Pete Evans, a man also known for his campaigns against fluoridation and sunscreen and his support of anti-vaccinationists. The result is an entertaining yet flawed documentary promoting a ketogenic diet (low carb/high fat) with the healthy twist of also recommending the avoidance of processed foods.

“What we have been taught about nutrition is dangerously wrong.” – Pete Evans

Some of it certainly has been wrong, but a more accurate statement would be: “What we have been taught about nutrition is confusingly contradictory.” Unfortunately, this documentary only adds to the confusion.

Despite its many flaws, I enjoyed this documentary. In this post, I will discuss what worked, what was problematic, and what the known health effects of ketogenic diets are.

What worked?

The documentary tells a story, and I connected with the people who agreed to a 10-week keto diet program, especially the New Jersey family with their autistic daughter. One can’t help but root for this likable and medically troubled family. The scene where the nutritionists ransack their kitchen by removing processed foods is a vivid commentary on the Western diet. Take a look at your own pantry or just go to the supermarket and you’ll see, the majority of food is processed (in bright, wordy packaging). I also liked how the documentary focused on health rather than weight.

What was problematic?

Because the keto diet is opposed to all carbs, they advise avoidance of whole grains (recommended by practically all other diets), lumping these in with unhealthy carbs. The case they make against wheat is particularly feeble. While every analysis of human history points to the cultivation of wheat 10,000 years ago as the basis of modern civilization, this documentary actually laments the change in diet away from high meat and fat. Yet, they seem to understand that the reliance on processed food, which has led to an epidemic of obesity and chronic disease, has taken place in the last century, ignoring the 9,900+ years in between.

Eventually, they declare the keto diet is the “magic pill” (in case you had any doubt) and they suggest that medications (the things proven to be effective by rigorous studies, unlike the keto diet) should be discarded. I’m all for improving your diet to reduce disease and reliance on medication, but a documentary demonizing proven prescription medication promotes a potentially dangerous attitude. The Australian Medical Association called for the documentary to be removed from Netflix.

That’s a bit extreme, but so is calling the treatment type 2 diabetes mellitus with insulin “criminally insane.” Most type 2 diabetics don’t require insulin, but if the diabetic control is poor enough, then refusing to prescribe insulin is criminally negligent. Will improving your diet help you get off insulin? Maybe, I’ve seen this in my own practice, but many will still need insulin at a reduced dose while others will need insulin because they cannot take oral medications due to other health problems like kidney and liver disease. The lack of nuance in this documentary limits its argument.

My biggest criticism of the documentary is that they followed the subjects for only 10 weeks, and during this time they provided a level of support most people could only dream about. I have no doubt the benefits the subjects experienced were real, but what happens to that family when they go out to eat or if they take their children to birthday parties? Maintaining a strict diet long-term while the rest of the world is engaged in a gluttonous orgy of processed food requires a level of willpower most adults can’t muster and are especially challenging for children.

Ultimately, the faults of this documentary are the same as those for fad diets in general. Most work in the short term but are not sustainable in the long term because the severe restrictions lead to cheating and binging. They are often promoted or endorsed by celebrities with an interest in self-promotion and profit. And they are described with exaggerated claims with no discussion of any downsides. I found that last point particularly frustrating. Every documentary is bolstered by at least discussing the difficulties of whatever they are promoting. All negative issues in this documentary were ignored.

What are the known effects of a ketogenic diet?

Doctors do recommend a ketogenic diet for drug-resistant epilepsy, especially in children. There is no conclusive data for other disorders but it may be beneficial in certain neurologic problems like Alzheimer’s, Parkinson’s, multiple sclerosis, and autism. Ketogenic diets do result in short-term weight loss but are no more effective than other fad diets in the long term. And ketogenic diets do show short-term improvement in glycemic control for diabetics, as expected with any low sugar diet.

There are also known problems. Symptoms include fatigue, nausea, vomiting, constipation, bad breath, and sleep problems. It can worsen the kidney function for those people who have chronic kidney disease. And as with any fad diet, it is difficult to sustain and may result in “yo-yo dieting” with rapid weight fluctuations that are associated with increased mortality.

 

Conclusion

The Magic Pill accurately demonstrates the real difficulties of individuals and families suffering from chronic medical problems and how a change in diet can have meaningful benefits. Their biased approach and neglect of any downside severely limit their argument in what was otherwise an enjoyable documentary. If you are already interested in trying a keto diet, this documentary provides a framework you might find beneficial. Personally, I found it more misleading than convincing.

If you are looking to improve your health with a low carb diet by reducing sugar, I recommend checking out Sugar Coated. If you want to learn about a balanced (not ketogenic) healthy diet that cuts out processed foods, I recommend checking out In Defense of Food. If you are interested in a healthy diet that cuts out animal meat and fat, I recommend checking out What the Health. What the Health and The Magic Pill are very similar in terms of cherry picking data to fit their predetermined narratives and come to opposite conclusions. Yes, confusingly contradictory. It’s almost as if there isn’t one “correct” diet for every individual…

Most relatable moment: When young Abigail is abruptly taken off her regular diet of chicken nuggets, apple juice, and Doritos, she has a histrionic meltdown. I think every parent has experienced something like this at one time or another. I found it encouraging that after 2 weeks of what must have been absolute torture for the entire family (a convenient jump cut spared us the details), Abigail did eat the healthy foods she had previously refused, resulting in a marked improvement in her behavior and health.

Most egregious cheat: The documentary opens with a written CYA (cover your ass) noting how other factors like exercise and lifestyle choices also affect health, how the stories told are anecdotal and not necessarily typical, and how you should consult your doctor before starting any new diet. All very true and easy to disregard since they fail to mention any of this at any time during the documentary. This cheat may absolve them legally but, morally speaking, that was super lame.

Dumbest non-ironic moment: When they took the original unsubstantiated food pyramid based entirely on wishful thinking and flipped it over to create a new unsubstantiated food pyramid based entirely on wishful thinking. Stop. Just, stop.

The Magic Pill is available for streaming on Netflix.

 

About the Author

David Z Hirsch is the pen name of the author of the award-winning novel Didn’t Get Frazzled, a medical comedy-drama described by BlueInk Review as “the best fictional portrayal of med school since ER” (starred review). He also published (under his actual name) the award-winning novel Jake, Lucid Dreamer hailed as “a fantastical tale with a powerful message” by SPR.

Also, check out his YouTube channel featuring educational videos on common medical conditions.

He is a practicing internal medicine physician in Maryland.

 

Check out my other reviews:

A medical review of the documentary In Defense of Food

A medical review of the documentary What the Heath

A medical review of the documentary Forks Over Knives

A medical review of the documentary Super Size Me

A medical review of the documentary Sugar Coated

A medical review of the documentary Fed Up

A medical review of the documentary Feel Rich

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A medical review of the documentary In Defense of Food

In Defense of Food

Compared to other health documentaries, In Defense of Food makes a more modest yet still compelling argument for healthy eating that serves to transform the viewer’s perspective of food. This documentary was made in 2015 by PBS and journalist Michael Pollan based on his book of the same name, a follow up to The Omnivore’s Dilemma.

Pollan summarizes his advice in 7 words: Eat food. Not too much. Mostly plants. “Eat food” turns out to be more complicated than it seems. Most of the “food” eaten in the Western Diet is processed food, junk that Pollan deems unworthy of the moniker “food” and calls “edible food-like substances” instead.

Actual food would be recognized by your great-grandmother and can rot. Processed food is easy to spot because it is “loud” due TV ads and screaming health claims like REDUCED FAT or LESS SODIUM.

Pollan argues that quieter food is healthier and sums this up in his usual creative way: “If it came from a plant, eat it. If it was made in a plant, don’t.” This is one of his many Food Rules, a list of pithy recommendations that he reveals throughout the documentary.

The narrative moves at a rapid clip, sliding from topic to topic, occasionally diving in political waters like when he advocates for a beverage tax as a means to reduce sugar intake. He also addresses psychological issues that lead to overeating and offers simple suggestions like using smaller plates, eating slower, and serving vegetables first.

As in most health documentaries, he recommends a predominantly plant-based diet but doesn’t suggest that you stop eating meat entirely but rather consider meat a “flavoring or special occasion food.”

The most inventive concept is his discussion of Nutritionism, which Pollan defines as nutrition complicated into an ideology. He explains that so-called food experts redefine food as a collection of nutrients and have historically made faulty assumptions that contradict previously held ideas. The consequences of this over complication of nutrition is contradicting health claims that have led to a decline in health, the opposite of what it was meant to do.

This may be his most controversial contention since he leaps to the opposite extreme by suggesting that nutrients are unimportant. Still, he makes a relevant point in calling out the preoccupations of nutrients over actual food endemic to the many ineffective fad diets (Atkins, South Beach, Ornish, Pritikin, etc.) Nutrients are important, they just shouldn’t be a substitute for eating real food.

In his most effective segment, Pollan exposes how processing food takes out naturally occurring nutrients and vitamins. Food companies have reacted to pseudo-scientific Nutritionism by using marketing strategies that tweak nutrients. They enrich processed food with vitamins or artificially adjust nutrient content (hence the REDUCED FAT or LESS SODIUM above) to make unhealthy processed foods sound healthy.

This convoluted reasoning is why many people believe that sugary drinks like Gatorade or VitaminWater are actually good for you. The government, in turn, has subsidized processed food ingredients like high fructose corn syrup and hydrolyzed soy protein to create an inexpensive “calorie conveyor belt” that fuels the obesity epidemic.

Practically every health documentary has identified the same problem, but Pollen makes an interesting and quite sensible case as to how we got here. In my experience, many people think they are eating healthy foods when they are not and become frustrated when they continue to gain weight or find their blood sugar and cholesterol have worsened despite their efforts.

I do what I can during a 15-minute office visit to challenge a lifetime of misinformation that has led to poor food choices, but this nearly 2-hour documentary does a more exhaustive job. I highly recommend it. No insurance or co-pay required.

Conclusion

Pollen’s thesis is that we have been devaluing actual food with disastrous results for our health and our happiness. His food rules offer reasonable suggestions for how to shift into a healthier diet. For individuals with obesity-related disease who are not ready to commit to a strict vegetarian or vegan diet, this documentary offers a moderate course towards healthier eating.

Biggest criticism: Pollen never bothers to match any of the health claims in this documentary with an actual source. I suspect the book version does cite sources, but the documentary just expects you to take his word for everything he says. That doesn’t work for me, even when I agree with him.

Best Quote: “We’re eating fat on fat on fat on sugar on fat, sugar, and salt.” – former FDA Commissioner Dr. David Kessler describing Buffalo wings.

The full quote is worth reading: “Take Buffalo wings. What are they? You start off with the fatty part of the chicken, usually fried in the manufacturing plant first. That pushes a lot of fat into that chicken wing. Fried usually again in the restaurant – that pushes more fat into that wing. Then red sauce, what is it? Sugar and salt. Then white creamy sauce on the side. That’s sugar and salt. What are we eating? We’re eating fat on fat on fat on sugar on fat, sugar, and salt.”

Eew. I can feel my arteries clogging just thinking about it.

In Defense of Food is available for streaming on Netflix and on the PBS website.

 

About the author

David Z Hirsch is the pen name of the author of the award-winning novel Didn’t Get Frazzled, a medical comedy-drama described by BlueInk Review as “the best fictional portrayal of med school since ER” (starred review). He also published (under his actual name) the award-winning novel Jake, Lucid Dreamer hailed as “a fantastical tale with a powerful message” by SPR.

Also, check out his YouTube channel featuring educational videos on common medical conditions.

He is a practicing internal medicine physician in Maryland.

 

Check out my other reviews:

A medical review of the documentary What the Heath

A medical review of the documentary Forks Over Knives

A medical review of the documentary Super Size Me

A medical review of the documentary Sugar Coated

A medical review of the documentary Fed Up

A medical review of the documentary Feel Rich

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A medical review of the documentary Feel Rich

Feel Rich

This 2017 documentary applies hip hop’s influence as a force for social change to the field of health. Troubled by the many hip hop stars who died young due to obesity-related problems, the documentarians look to reverse the rising incidence of children being diagnosed with adult diseases like diabetes, hypertension, and stroke due to poor eating and living habits. This is a nationwide problem but is especially prevalent in the African-American and Latino populations.

They identify a profound shift in diet as a consequence of the Great Migration of the early 20th Century when many black families turned their backs on farming for more urban jobs and changed their diet from plant-based foods to fast foods and fried foods. In the hip hop community, success has been linked to eating. The goal of the documentary is to flip the script and link success to health instead.

More than just the title of the documentary, Feel Rich is a health and wellness brand for the multicultural, urban community founded by Shawn Ullman and Quincy D. Jones, III (son of Quincy Jones, Jr, the famous producer, musician, and activist). At times, this documentary comes off as a 70 minute advertisement for the brand, but considering the product is improved health in a community that desperately needs it, I had no problem shrugging off the brazen corporate synergy.

While many health documentaries focus almost exclusively on food, this documentary takes a more holistic approach. They promote a commitment to lifestyle change including avoiding drugs and smoking, eating right, daily exercise, and meditation. I found that last part particularly significant. Severe obesity and mental health have a chicken-and-egg relationship – it’s not always clear which comes first – but emotional distress and obesity are invariably intertwined. Focusing solely on diet and ignoring anxiety and depression only addresses part of the problem.

Understanding this, the documentarians spend a fair chunk of the documentary discussing meditation. They argue that a 10-year-old growing up in a distressed urban neighborhood is dealing with the same level of post-traumatic stress as a man or woman coming back from combat in Iraq or Afghanistan. Not graduating high school results in a high risk of joining the prison population. Poverty will make you angry, but meditation can settle you emotionally. They show a large group of (remarkably well-behaved) children meditating together in a school gymnasium and link this to improved behavior and learning.

Near the end, they discuss comfort food, accurately identifying it as seeking unhealthy food for comfort. They recommend finding comfort in people, community, and activities instead. They also point out a mental bias many people have against vegetarian and vegan eating and anticipate that as more people eat better it will inspire others.

As hip hop artist Common explains, you can’t enjoy your money if you don’t have your health. “Healthy living is a way of showing love to myself.” If health is the new wealth, anyone can feel rich.

Conclusion

Feel Rich advances the revolutionary shift in hip-hop to promote healthier lifestyles with a holistic approach to eating better, exercising more, and meditation. This documentary focuses on urban minorities, but the advice and concepts are relevant for everyone.

Most inspiring moment: the interview with Taja Sevelle, founder of Urban Farming who helps to establish gardens on unused land as both a solution to urban food deserts and a way to uplift communities. “This is powerful and you control your destiny.”

Most egregious moment: Using the funeral of Heavy D, a hip hop star with heart disease who died at age 44, as an opportunity to film interviews with celebrities.

Feel Rich is available for streaming on Netflix.

 

About the Author

David Z Hirsch is the author of the medical novel Didn’t Get Frazzled, described as “unflaggingly funny” by Kirkus Reviews and “the best fictional portrayal of med school since ER” by BlueInk Review (starred review).

He also has a YouTube channel featuring educational videos on common medical conditions.

He is a practicing physician in Maryland and writes under a pen name.

 

Also check out my other reviews:

A medical review of the documentary What the Heath

A medical review of the documentary Forks Over Knives

A medical review of the documentary Super Size Me

A medical review of the documentary Sugar Coated

A medical review of the documentary Fed Up

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A medical review of the documentary Fed Up

Fed Up

Narrated by Katie Couric, Fed Up (2014) is light on medical details but presents a compelling political case for the causes and history of the obesity epidemic. They argue that the concept of “eat less and exercise more” as a means to lose weight started in 1953, creating a billion-dollar fitness industry and handing the food industry a convenient excuse to blame obesity on a lack of exercise rather than unhealthy foods. The 1977 McGovern Report attempted to counter this, predicting that obesity would become the #1 cause of malnutrition due to foods high in saturated fat, cholesterol, and sugar. This could have been a turning point, but the egg, sugar, dairy, and beef associations united to fight it. The results, of course, have been catastrophic.

For example, what we now call type 2 diabetes mellitus (T2DM) used to be called adult-onset diabetes mellitus. Why the name change? In 1980 the number of T2DM cases in adolescents was 0. In 2010 the number of cases ballooned to 57,638. Thanks to the obesity epidemic, T2DM is no longer “adult-onset.”

Further fueling childhood obesity are the toys, cartoons, and TV ads targeting children with fast foods, soft drinks, and processed foods. The documentary compares these to cigarette ads, which fueled increases in smoking rates. But when cigarette ads were removed from TV and print, the result was a striking drop in smoking rates. “Yet we let fast food, processed foods, and soft drink companies do the same thing as the tobacco industry did 30 years ago.”

Tasked with creating dietary guidelines is the USDA, the department initially formed to promote the agriculture business. This has created an obvious conflict of interest. For example, the USDA recommends limits on sugar intake yet has provided over $8 billion in subsidies for corn-based sweeteners since 1995. In fact, on the Nutrition Facts listed on every product, the amount of sugar is listed in grams but does not have a percentage daily value. Why the heck not? Because if we knew, we would be appalled (or maybe we’d cry – there are many reasonable reactions). For adults, the daily goal is no more than 24g. One fruited yogurt cup has 24g. A 12-ounce can of soda has 39g. Just one. Eating a diet involving processed foods, one simply cannot avoid overeating sugar.

There are numerous other examples discussed, each one more depressing than the last. Fast food restaurants operate in many schools. The government helps schools get around their own health regulations meant to protect children by allowing pizza and French fries to count as “vegetables.” This documentary makes a good case that we have ceded the battle for our health to corporate shareholders and their political shills.

The documentarians also spend a fair amount of time talking about Michelle Obama and her Let’s Move initiative. They argue that her initial focus was on eating healthy, but the food industry responded by offering to “help” her by making processed foods “better” and supporting her initiative financially. Accepting their “help” was a savvy political move but a Faustian bargain. Already under fire by critics accusing her of “forcing children to eat their vegetables,” Michelle Obama shifted the focus of her program to promoting exercise, a politically safe topic that circles back to the same misdirection of 1953.

The documentary concludes with actionable suggestions, 3 good and rather one silly:

Warning labels on soft drinks (like we have on cigarettes)
Fast food chains banned from public schools (seriously, how is this even a thing?)
Nutrition labels add a percent daily value to sugar (transparency may well shock people into making healthy choices – no wonder the food industry fights this)
Every time a celebrity sold a soft drink, they also had to pitch a vegetable (yes, this is the silly suggestion, but the images they produce are the only humor in this whole gloomy documentary)

You can go to the Fed Up website to take their Fed Up Challenge and go sugar free for 10 days. If you’re interested in whether you can pull this off and wonder how much better you’ll feel, give it a shot.

 

Conclusion

While light on medical details, Fed Up makes a compelling political case for how we got to this point and at least a few suggestions about how we can get out of it. Personally, I think waiting for our government to solve this is politically doubtful. Change will come one consumer at a time. Educate yourself and adjust how you eat. Even small modifications like cutting out sodas and fruit drinks and eating more real (not processed) foods can make a significant improvement in your health and weight.

Most sigh-inducing moment: When the beleaguered mother of a morbidly obese child says, “He likes Hot Pockets so I make sure he eats the Lean Hot Pockets instead of the regular ones” as though this will make the slightest difference. Here are the Nutrition Facts comparing Turkey, Ham & Cheese and “lean” Turkey, Ham & low-fat Cheese: calories 300/280, fat 13g/7g, Sodium 740mg/690mg, Sugar 8g/11g, Carbs 37g/43g. Basically, the lean version replaces fat with sugar and drops the calorie count by 20. Both versions are junk food.

Most dispiriting moment: The discussion of how health insurance companies buy stock in fast food companies to “cover their bets.” In financial parlance that is called hedging, in human parlance that is called abandoning hope.

Fed Up is available for streaming on Netflix.

 

About the Author

David Z Hirsch is the author of the medical novel Didn’t Get Frazzled, described as “unflaggingly funny” by Kirkus Reviews and “the best fictional portrayal of med school since ER” by BlueInk Review (starred review).

He also has a YouTube channel featuring educational videos on common medical conditions.

He is a practicing physician in Maryland and writes under a pen name.

 

Also check out my other reviews:

A medical review of the documentary What the Heath

A medical review of the documentary Forks Over Knives

A medical review of the documentary Super Size Me

A medical review of the documentary Sugar Coated

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A medical review of the documentary Sugar Coated

Sugar Coated

This 2015 Canadian documentary examines sugar’s role in the obesity epidemic, addressing the health and political issues. The documentary is uneven and less entertaining than others I’ve seen, but they do make a few good points worth discussing. When the body is overloaded with sugar, the liver will convert the excess sugar into fat. The World Health Organization defines a moderate level of sugar as 6-12 teaspoons per day. The average North American diet is 19.5 teaspoons per day and for teenagers, 30-41 teaspoons per day. This excess of sugar fuels the obesity epidemic and increases the risk of fatty liver, diabetes mellitus, and heart disease. Which begs the question, how can someone possibly eat that much sugar every day? The answer, of course, is processed food.

Processed foods obfuscate the level of sugar by using 56 different names for what is essentially the same compound. This includes chemical terms like fructose, sucrose, dextrose, and glucose along with common terms like corn syrup, maple syrup, agave, sorbitol, and fruit juice. Foods advertised as “no sugar added” are often very high in sugar. Low-fat processed foods are promoted as a healthy alternative but when the fat is removed, the taste is removed, so companies add vast quantities of sugar, often making them less healthy than the original fattier version.

Much of the documentary focuses of the politics of the sugar industry. Denver dentist Cristin Kearns discovered 1500 pages of internal sugar-industry documents at the offices of the Great Western Sugar Company after it went out of business. The documents show a concerted effort to counter all scientific evidence with ambiguity, much like the tobacco industry’s efforts to confuse the link of smoking to health problems. I found this depressing but not particularly surprising. The sugar industry declined to participate in the documentary (also not particularly surprising) but they did issue a “reply” to the documentary in PDF form. Their main points were as follows:

“Obesity is a multi-factorial issue.” That is true and one of the problems with limiting a health documentary to just one issue. Still, sugar is certainly one factor in the obesity epidemic.
“All calories are the same and excess calories is what leads to obesity.” That is probably not true even though it sounds reasonable. Calories are a measure of the energy content in food. Obesity is related to how the body metabolizes food.
“Increased diabetes rates are from population growth and aging.” It’s like they think we don’t understand how math works. Yes, population growth and aging will lead to more cases but the percentage of diabetes is significantly higher since the Western diet has incorporated processed foods.
“Sugar can be enjoyed in moderation.” This is true, obviously, but the statement is more pernicious than it looks because is part of the sugar industry’s effort to push the blame on consumers. Processed food is packed with so much sugar that most people have little conception of just how much sugar they are actually taking in. (If you want to know, get the free app. Better yet, cut out as much processed food as you can and save yourself the trouble.)

Conclusion

An uneven but still interesting documentary, at its best when showing how the sugar industry uses money and influence to sow confusion in research and policy to the detriment of public health. Sugar’s role in helping processed foods become a stable of the Western diet is clear, exactly how great of a role it plays in the obesity epidemic is not.

Most groan-inspiring moments: every time a talking head said “sugar is toxic.” Look, you can compare the tactics of the sugar industry to the tobacco industry, but sugar is not tobacco. Tobacco is toxic. Sugar is not toxic unless eaten in excess. Exaggeration does not help your case.

Most disturbing moment: an animated depiction of force feeding ducks to make foie gras (French for “fat liver”), then comparing this with an animated depiction our children doing much the same thing to their own livers by ingesting massive amounts of sugar. If you look at childhood obesity rates, it is difficult to argue that we are not all complicit.

Sugar Coated is available for streaming on Netflix.

 

About the Author

David Z Hirsch is the author of the medical novel Didn’t Get Frazzled, described as “unflaggingly funny” by Kirkus Reviews and “the best fictional portrayal of med school since ER” by BlueInk Review (starred review).

He also has a YouTube channel featuring educational videos on common medical conditions.

He is a practicing physician in Maryland and writes under a pen name.

 

Also check out my other reviews:

A medical review of the documentary What the Heath

A medical review of the documentary Forks Over Knives

A medical review of the documentary Super Size Me

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A medical review of the documentary Super Size Me

Super Size Me

One of the first and most popular food documentaries is the 2004 film Super Size Me by Morgan Spurlock. He has a sequel (of sorts) coming out, so I thought this would be a good time to revisit the original. The documentary holds up very well save one glaring exception – see “most cringe-worthy moment” at the bottom.

Inspired by a lawsuit against McDonald’s filed by lawyers representing two morbidly obese children, Morgan resolves to eat McDonald’s every day or every meal for 30 days. Yes, that is insane, but it also provides the tension that drives the story.

While a food documentary at heart, Super Size Me spends a fair amount of time addressing the health issues. Morgan enlists a cardiologist, a gastroenterologist, and an internist among others to monitor him for the month. Amazingly, none of doctors realize just how devastating this will be for his body. They predict an elevation of triglycerides (fatty cholesterol) and mild weight gain. Instead Morgan experiences high blood pressure and high cholesterol (with elevated stroke and heart attack risk), abnormal liver enzymes (caused by fatty liver and worrisome for liver failure), significant weight gain, and high uric acid levels (with risk for gout and kidney stones) along with symptoms of nausea, fatigue, sexual dysfunction, and depression. His physicians and his then vegan girlfriend (current ex-wife) beg Morgan to stop the experiment. He doesn’t because, well, he’s making a documentary.

Morgan also makes a good political case throughout the film, showing how McDonald’s attracts children into the cycle of unhealthy eating with the use of cartoons, Happy Meals and toys, playgrounds, birthday parties, and $1.4 billion worth of advertising in 2001 alone. He also shows how the original largest sizes of French fries and soft drinks are now the “small” or “kids” size, psychologically encouraging unhealthy portions of obscene girth.

Medically speaking, this is a case study, not a controlled trial. Since the film’s release, others have claimed to maintain or even lose weight on a fast food diet. This is both plausible and beside the point. Weight is just one of many markers of health. And fast food is just one of many causes of obesity.

Conclusion

Morgan’s attempt to get someone from McDonald’s corporate for an interview fails, but they got his message just the same. Six weeks after the documentary aired, McDonald’s discontinued the Super Size option. Later they put out a line of salads. In true McDonald’s form, many of the salads are higher in calories and sugar than the burgers. Recently I heard that McDonald’s is testing a vegan burger. No, just … please no. That’s like coming out with kosher bacon. No self-respecting vegan puts anything with a McDonald’s wrapper into her mouth.

This documentary is still entertaining and, sadly, still relevant well over a decade later.

Best moment: Morgan vomiting out of his car window after wolfing down a McDonald’s meal. That’s how I feel when I watch anyone eat McDonald’s food (and I have the same reaction when I smell the food).

Most cringe-worthy moment: Jared Fogle, formally of Subway commercials, saying “my big vice was food” (we all know his other one). Under his photo at the end is “continues to inspire millions.” Yeah, no, not so much anymore.

Super Size Me 2: Holy Chicken! premiered at the Toronto International Film Festival and distribution rights were purchased by YouTube Red. The second installment brings the chicken industry and Chick-fil-A into the spotlight. One of the reviews I calls it “less funny and more horrifying” than the original. I look forward to being horrified.

Check out the Super Size Me app, which gives you the access to full nutrition facts for all major chain restaurants in the US and Canada. Super Size Me is available for streaming on Netflix.

 

About the Author

David Z Hirsch is the author of the medical novel Didn’t Get Frazzled, described as “unflaggingly funny” by Kirkus Reviews and “the best fictional portrayal of med school since ER” by BlueInk Review (starred review).

He also has a YouTube channel featuring educational videos on common medical conditions.

He is a practicing physician in Maryland and writes under a pen name.

 

Also check out my other reviews:

A medical review of the documentary What the Heath

A medical review of the documentary Forks Over Knives

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A medical review of the documentary Forks Over Knives

Forks Over Knives

This documentary from 2011 remains one of the most interesting heath documentaries I’ve seen. The focus is on two doctors, T. Colin Campbell, PhD and Caldwell Esselstyn, MD, who separately and then in combination have come to the conclusion that a whole foods plant-based diet is the best way to treat medical problems.

Via interviews, archival footage, and graphics we learn about the doctor’s experiences, research, and conclusions over the ensuing decades. While light on data from rigorous clinical trials, this documentary shows plenty of observational evidence that the Western diet is a major factor in the obesity epidemic and its corresponding explosion in diabetes, heart disease, and cancer rates.

Most remarkable are the many examples (in people or rats, depending on the study) of how increasing animal protein in the diet worsens disease but changing to a plant-based diet reverses disease in the same individuals. Focusing on cancer is the China study by Dr. Campbell (and Chen Junshi among others), which showed drastic variations of cancer rates and types in different areas of China, which the researchers correlated to dietary intake of meat.

While this documentary makes a compelling case for a plant-based diet, it falls short of making the case for cutting out meat and dairy entirely. I’m not the only one who thinks so. The American Institute for Cancer Research (AICR) has read the China Study and has seen Forks Over Knives. Nevertheless, they recommend a plant-based diet that can include fish, poultry, limited amounts of red meat and moderate amounts of dairy. They explain why here.

There is nothing wrong (or unhealthy) about following a strict vegan diet if desired, but overselling the data to support a diet that is untenable for most Americans is just setting us up for failure. Don’t panic after watching this documentary. Instead, get inspired to improve your health with realistic goals. The AICR recommends “at every meal, fill at least 2/3 of your plate with plant foods and 1/3 or less with animal foods.” This is excellent and practical advice.

The documentary ends (almost as a footnote) by discussing the politics of the USDA in their food recommendations over the last several decades, and the environmental effects of food choices with regard to energy consumption and the rain forest.

Conclusion

This is an engaging documentary that forces you to question the very act of what you eat and how it affects your health. The 3-D graphics showing endothelial damage from the Western diet and reversal of the disease from switching to a whole foods plant-based diet are impressive and can easily inspire you to dump half the stuff in your freezer. If I could prescribe this documentary I would. It would certainly be cheaper (and more effective) than Lipitor.

On the Forks Over Knives website, they have many vegan recipes. Forks Over Knives is available for streaming on Netflix.

Note: a whole foods plant-based diet focuses on fruits, vegetables, tubers, whole grains, and legumes; and it excludes or minimizes meat (including chicken and fish), dairy products, and eggs, as well as highly refined foods like bleached flour, refined sugar, and oil.

 

About the Author

David Z Hirsch is the author of the medical novel Didn’t Get Frazzled, described as “unflaggingly funny” by Kirkus Reviews and “the best fictional portrayal of med school since ER” by BlueInk Review (starred review).

He also has a YouTube channel featuring educational videos on common medical conditions.

He is a practicing physician in Maryland and writes under a pen name.

 

Also check out my other reviews:

A medical review of the documentary What the Heath

A medical review of the documentary What the Heath

The idea to write a series of blog posts reviewing health documentaries came to me in the form of a young man with morbid obesity who presented to my office for a new patient evaluation.

Early into the visit, we discussed the many health risks related to his weight and how diet is a huge factor. While this topic is often greeted with platitudes followed by requests for diet pills, this new patient impressed me with his understanding of the subject and genuine interest to drastically alter his diet to reduce his risk for heart disease, stroke, and cancer. Most people aren’t this motivated until they suffer a major medical event, if then. How had he gotten here so quickly? Before I had the chance to ask him, he answered me with his own question: “Have you ever seen the documentary What the Health?”

Documentaries as a motivational force to improve health hadn’t really occurred to me until that moment, but in retrospect I should have known. Exhibit A … me. I have personally adjusted my own diet over the last few years, cutting out soda, reducing animal fat, and increasing fruit and vegetable intake. I’d like to say this is a healthy by-product of a career reading medical journals, but I have always found documentaries to be considerably more compelling. Clearly I am not alone.

What the Heath

Despite its title, this documentary focus on the political at least as much as the health issues. We follow Kip Andersen as he discusses government and other public health organizations, their ties to the meat, poultry, dairy, fast food, and pharmaceutical industries, and how money influences their recommendations, creating egregious conflicts of interest. Mostly, the documentary is depressing. I don’t know if there is anyone in the world who finds the collusion between government and big business surprising, but Kip makes a good case for it here.

On his website, he lists all the “facts” discussed in his documentary and it is, in a word, overwhelming. Click the link to see for yourself.

The rest of the time, he promotes a vegan diet. While he relates convincing evidence to cut or at least reduce animal fat and follow a more plant-based diet, he is prone to exaggerations that undercut his argument. Equating eggs and processed meat to smoking cigarettes and breathing asbestos only undercuts his credibility. He is correct in pointing out how excess fat in the diet will worsen diabetes, but inexplicably argues that sugar and carbohydrates are not a problem in diabetes at all.

He tends to focus on the studies that support a vegan diet and ignore all other conflicting data. This is a shame because he does an excellent job presenting the health and environmental problems with eating meat, poultry, fish, and dairy. Even watching this with a jaundiced eye, I found the overall documentary to be a gripping argument against eating processed meat (which include hot dogs, sausages, canned meat, and most deli meat) and for reducing animal fat in favor of plant-based options.

Conclusion

This documentary has interesting graphics and is often entertaining when it doesn’t get bogged down with exaggerations and cherry-picked data. I think it is worth watching for more of a political than a heath perspective. The highlight is Kip’s interview with Dr. Robert Ratner, the (now former) chief medical officer of the American Diabetes Association, whose squirming in the face of fairly benign questions about diet recommendations for diabetes creates cringe-worthy drama. What the Health is available for streaming on Netflix.

 

About the Author

David Z Hirsch is the author of the medical novel Didn’t Get Frazzled described as “unflaggingly funny” by Kirkus Reviews and “the best fictional portrayal of med school since ER” by BlueInk Review (starred review).

He also has a YouTube channel featuring educational videos on common medical conditions.

He is a practicing physician in Maryland and writes under a pen name.

 

Loser! Scenes from the Trump Inauguration

Once the inauguration ceremony ended, I moved away from the speaker and sat on the ledge across from the barricades to eat my lunch. The area soon filled with protestors, and I stood on the ledge with them to secure my place to watch the parade.

I would stand there for the next 3 hours:

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Photo: Protestors awaiting the Inauguration Parade down Pennsylvania Avenue

During that time, Trump supporters trickled by. Those who had made it to the National Mall entered the stands set up on the south side of Pennsylvania Avenue, but those who had never made it past the barricades walked on the north side where they had no choice but to mingle with the rest of us.

As sociology experiments go, I could not have set this up better myself. Here are my findings. The interactions fell into 3 categories:

Reasonably pleasant

While most Trump supporters walked past us like they had wondered into the lion’s den, uncertain the bars on the cages were secured tightly enough, a few actually stopped to enjoy the signs. I saw several requests for photos, and the protestors always complied with good cheer. The man holding the (somewhat doctored) photo of a shirtless Putin and Trump snuggled together on horseback was particularly popular.

This is the sort of thing that gives one hope for the fate of humanity. That is, of course, only if you ignore the other two categories.

Combative but not horrible

A Trump supporter came up to a group of protestors to express his views on the Affordable Care Act (the ACA, soon-to-be-formerly known as Obamacare). Eventually, one of the protestors stepped off the ledge and these two debated the issue for a solid half hour. See if you can guess which man supported which side. You might be surprised.

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Photo: Two men debate the ACA at the Trump Inauguration

Okay, I’m kidding. You won’t be surprised. The large gentleman on the left, the one with morbid obesity putting him at high risk for diabetes, hypertension, hyperlipidemia, stroke, heart attack, sleep apnea, and multiple cancers, argued against universal health care. The young, fit guy on the right argued for it.

Watching this debate was like reading the comments section after any political article on the internet: mind-numbingly pointless. I will give these two some credit. Unlike most comments sections, their discussion avoided yelling or personal insults. Like most comments sections, their discussion changed nobody’s position in the slightest and didn’t end until long after it should have.

Combative and absolutely horrible

I only saw two examples that fit this category. Considering I stood there for three hours, I suppose this really isn’t that bad. Right? I suppose it helps to have low expectations.

First, a group of 3 young, white, male Trump supporters who looked like they had stumbled out of a bar (this was at approximately two in the afternoon) passed us bearing angry scowls. One guy held up his fingers in an L shape and shook it at us. I’m pretty sure you’re supposed to put the L on your forehead if you want to sign “Loser” but given his coordination difficulties, I may be expecting too much.

We all ignored them.

A short while later a group of 4 young, white, male Trump supporters stormed past with looks of absolute horror and disgust. Here’s a smattering of the offending signs they had passed:

Their agitation reached a fever pitch by the time they came to the part of the ledge where I stood. One loudly declared to the others, “All the anti-Americans.”

I think this is the most important fallacy of the day and certainly one worth discussing. It’s facile but common to declare anyone with opposing views as not truly American. During the George W. Bush presidency, Fox News accused anyone who opposed to the Iraq War as working against America. During the Barack Obama presidency, the left often dismissed the Tea Party as racist crazies and, therefore, not relevant to America.

Sadly, that was equally untrue. No one knew at the time where a movement sporting agitated older white folks with a disturbingly poor grasp of reality holding racist anti-Obama signs would end up. But now we do. They would elect President Donald J. Trump.

Okay, that just depressed me. Here’s my antidote: a man holding a papier-mâché Donald Trump devil.

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Photo: A man holding a papier-mâché Donald Trump devil

And a woman with one of the more hopeful signs of the afternoon.

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Photo: A woman holds a sign showing a Trump fish about to be eaten by patriotic minnows –“Organize!”

Is it wrong that I think that Trump fish is adorable? Don’t tell Melania. Kind of makes you want to buy a tank and feed that thing truth pellets, right? If only.

At around 3:30, the first marching band reached us, and I realized there was no way I was going to see the actual parade thanks to the abundance of protest signs. I gave up my spot and mingled with the crowd.

Sometime later, the speakers announced the arrival of our new president.

I saw footage the next day that showed President Trump walking in the parade past supporters and half-empty stands. This must have been early in the parade route. By the time he made it to the National Archives Building, just under a mile from the Capitol, he was safely ensconced in his limo, racing past the angry crowd of shouting protestors like he was being smuggled out of East Germany.

Boos alternated with cheers. And I mean that literally – this was a gospel call and response: “Boo!” “Yay!” “Boo!” “Yay!” We were calling out to each other as much as to the blur of limos. There were so many opportunities for violence among passionate individuals, but none occurred. We coexisted. I take solace in that.

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Photo: The crowd is animated just moments before the president’s limo would speed by. The largest sign reads “We Deserve Better”

By executive order, President Trump would proclaim January 20, 2017 as A Day of Patriotic Devotion. I’m not comfortable with the word Devotion – that makes Donald Trump sound a bit too much like Kim Jong-un for my tastes – but the rest of it is true. I saw patriots on both sides of Pennsylvania Avenue. Cheering or booing, we made our opinions known, and this is crucial to any functioning democracy.

It’s easy and understandable for the majority of the country (and, let’s face it, the majority of the world) to despair, but it’s better and more useful for us to rise up instead and make our voices heard.

Resist!

I’ll let the former president and current icon of hope have the last word. Thanks for reading this, everybody!

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Photo: Sign shows a picture of President Barack Obama with his quote “The best way to not feel hopeless is to get up and do something.”

 

 

I hope you’ve enjoyed my 6-part series on Scenes from the Trump Inauguration: Sad! Weak! Pathetic! Clown! Terrible! Loser! How remarkable that our president’s childish Twitter insults so perfectly define him…

Please share these posts with anyone and everyone you’d like.

Want to read from the beginning? Go to Sad! Scenes from the Trump Inauguration

About me: I am a Maryland-based physician that writes under the pen name David Z Hirsch. Check out my YouTube channel for videos on common medical conditions

and my best-selling novel, Didn’t Get Frazzled, a provocative story about life and love in medical school.

Terrible! Scenes from the Trump Inauguration

The 2017 inauguration ceremony is brought to you by … the middle finger.

Unable to compete with thundering voices over the mammoth speakers that relayed the oaths of office, the protestors resorted to symbolic contempt. Signs sagged but fists rose up, many accented by a flipped bird.

“Vice President Michael Richard Pence!”

Obscene hand gestures abounded.

“President Donald John Trump!”

Middle fingers waved, they waggled, they thrusted with rage. I thought back to a sign I had seen only moments earlier:

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Photo: Sign reads “The Racist Bigot is Not My President”

I have bad news, my friend. He is now.

Throughout President Trump’s inaugural address, digitus impudicus raged. But more interesting and considerably wittier were the signs:

“Welcome to Post-Truth America”          We would learn just within the first few days of President Trump’s term just how true that was.

  “Alt-Right? More like Alt-Reich”          Because who doesn’t love a Nazi pun?

  “Illegitimate Unfit Mentally Ill”          What it lacks in subtlety it makes up in brevity.

“I Want a Dyke 4 Prez”          Sure, and I want world peace and a billion dollars. I think we are both destined for disappointment.

“I want to live in an America where human rights are realized”          See disappointment above.

“No White Supremacy in the White House”          A reasonable request. But we knew this was coming back in November.

Speaking of Steve Bannon, how exactly is an avowed neo-Nazi white supremacist occupying the same political space as Trump’s very conservative yet still very Jewish son-in-law? I’m sure there exists a physics term to explain this. Someone please reanimate Albert Einstein’s brain and let me know what you find out.

Presidents usually take the opportunity to talk up America in their inaugural address but not Donald J. Trump. He spoke of “this American carnage” and how we had “fallen into disrepair and decay” while “the wealth, strength, and confidence of our country has dissipated over the horizon.” Seriously? I don’t know about the wealth, but the strength and confidence surrounded me:

“Build a wall around Trump and I’ll pay for it”          Me too, me too!

“We Shall Overcomb”          Bit of a cheap shot, but I’ll bet MLK Jr. would have laughed.

“Leak the Piss Tape”          Toilet humor and a pun? Bonus points!

“Putin is grabbing the US by the President”          Seriously, anyone who thinks liberals are humorless really should have spent the day hanging out with me.

And now for my favorite TRUMP acrostic of the day:

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Photo: sign reads “Tax-evading Racist Unfit Misogynist Plutocrat”

The ceremony would feature six religious leaders, more than any other inauguration in history. Compensating much, Mr. President? Seriously, if you wanted someone to read you that Good Book everyone keeps talking about, you could have done this on your own time.

My wife, who refused to come with me and no doubt thinks I’ve lost my marbles for wanting to come to the inauguration in the first place, saw the weather report and joked that it would rain because God was crying. So when Reverend Franklin Graham proclaimed that the rain was a sign that God had bestowed his blessing, we had ourselves a good ol’ theological conundrum.

While I believe in God, I’ve always considered God as the positive force in life expressed as love and the astounding beauty of nature. The more familiar concept of God as a Big White Guy sitting on a cloud picking football games based on which side prays more has always struck me as patently ridiculous. The concept of God choosing weather patterns to express an ambiguous opinion falls squarely into this category. But if the good Reverend wants us to be ridiculous, then let’s go ahead and be ridiculous. Had God cried or had He bestowed His blessing?

Let’s look at the facts. We had a light drizzle that began the moment Donald Trump opened his mouth and dissipated only moments later. That was way too brief for a cry (especially of this magnitude) and if this was a blessing, it was a paltry one. No, I think if we’re going to personify God, then there can only be one explanation for His behavior:

God spit on Donald Trump.

There you have it. Theological conundrum resolved. You’re welcome.

The ceremony ended with the singing of the national anthem. I admit to being concerned how my friends with the flippy middle fingers would react, but with one glaring exception, everyone displayed appropriate decorum.

Two men held signs against fascism with one hand and fingers raised in a peace sign with the other. About twenty of the protestors chose to kneel, some with raised fists but all with reverent silence. The rest of us stood, stony but dignified. No one offered any of the boos or catcalls that had punctuated Donald Trump’s speech.

So what was the glaring exception? The press.

Yes, I know. The last thing I want to do is pile on, especially now when we need a free and fair press more than ever. In fact, the very next day President Trump with his typical bombastic hyperbole called the press “among the most dishonest human beings on Earth” (while speaking to the CIA of all people).

But I call it as I see it, and what I saw was the press dashing around sticking cameras in people’s faces during the national anthem while I, for one, silently contemplated the fate of our nation.

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Photo: Lady Liberty hides her face. Below are the picture reads “What has our country become?”

 

Next post: Loser! Scenes from the Trump Inauguration

Previous post: Clown! Scenes from the Trump Inauguration

Want to read from the beginning? Go to Sad! Scenes from the Trump Inauguration

About me: I am a Maryland-based physician that writes under the pen name David Z Hirsch. Check out my YouTube channel for videos on common medical conditions

and my best-selling novel, Didn’t Get Frazzled, a provocative story about life and love in medical school.