Nutritional Medicine, 2nd edition, by Alan R. Gaby. Concord, NH: Fritz Perlberg Publishing; 2017. Hardcover, 1,453 pages. ISBN: 978-1-5323-2209-9. $195.00
In today’s age of electronic publishing, online and open-access journals, and almost instant access to the scientific literature, a reference book on any biomedical topic might seem quaint at best and instantly obsolete at worst. However, nothing could be further from the truth if context, perspective, and veracity are considered important.
These are critical characteristics of Nutritional Medicine, a “natural pharmacopoeia” first published in 2011 after a dedicated 30-year effort by the author, Alan Gaby, MD. The first edition contained 1,358 pages and 16,800 references. Six years later, this second edition contains 96 additional pages and more than 1,700 new references, with a special emphasis on recent clinical trials that help to either confirm or question results of previous research.
While clearly a reference volume, the book opens with an answer to the question “Why nutritional medicine?” and outlines its key components in a 52-page section on the fundamentals of the field. Gaby begins by describing the need to “clean up” the average diet by emphasizing the positive and minimizing the negative attributes of specific food constituents and overall dietary patterns. Aspects of clinical assessment also are touched on throughout the book. Thereafter, nutritional therapies, especially dietary supplements, are described to help individualize treatment, particularly through a clear understanding of their additive and synergistic effects.
Spanning more than 250 pages, 60 short chapters are dedicated to the basic “tools” of nutritional medicine, including individual vitamins, minerals, amino acids, and other therapeutic agents such as dietary bioactive components (e.g., carotenoids, flavonoids, probiotics, etc.). The author states that “this is not a book on herbal medicine,” and lamentably little attention is devoted to botanical medicine and its complementary role in the practice of nutritional medicine. Instead, readers are directed to the excellent but dated Herbal Medicine (Beaconsfield Publishers, 1988) by R.F. Weiss and The Complete German Commission E Monographs (Integrative Medicine Communications, 1998) edited by Blumenthal et al. In the one chapter on “Selected Herbal Treatments,” Gaby covers only three products — ginkgo (Ginkgo biloba, Ginkgoaceae), ginger (Zingiber officinale, Zingiberaceae), and licorice (Glycyrrhiza glabra, Fabaceae) root — with an emphasis on adverse effects and only brief comments on their clinical indications. Under selected chapters on specific conditions, reference is made to St. John’s wort (Hypericum perforatum, Hypericaceae) for depression; pygeum (Pygeum africanum syn. Prunus africana, Rosaceae), saw palmetto (Serenoa repens, Arecaceae), and stinging nettle (Urtica dioica, Urticaceae) for benign prostatic hyperplasia; lemon balm (Melissa officinalis, Lamiaceae) for herpes simplex; Phyllanthus amarus (Phyllanthaceae) for jaundice; and hawthorn (Crataegus laevigata syn. C. oxyacantha, Rosaceae) for congestive heart failure.
The largest section of the book comprises 264 chapters that discuss more than 400 health conditions, symptoms, and specific diseases, and the nutritional options for their treatment. The section covers a large swath of medical fields and includes entries on cardiology, dermatology, gastroenterology, hematology, hepatology, nephrology, neurology, ophthalmology, otolaryngology, psychiatry, pulmonology, rheumatology, and urology as well as specific topics in endocrine disorders, gynecology, infectious diseases, obstetrics, pediatrics, and oral diseases. Additional chapters address genetic disorders, drug-nutrient interactions, and some specific modalities like anesthesiology, detoxification, intravenous nutrient therapies, and radiation therapy.
While all the reference information provided is evidence-based, some chapters end with illuminating and intriguing summaries of the author’s personal clinical approach and recommendations regarding the condition. Gaby makes it clear that these comments are intended to give the reader an idea about his thinking processes and preferred order of treatment options. Thus, it is noteworthy that the preface contains a warning/disclaimer that the information provided in the book is for educational purposes only and about the possibility of errors, omissions, and misinterpretations despite the extensive efforts made to assure the accuracy of the contents.
Like the first edition, the second edition of Nutritional Medicine provides an evidence-based but clinically oriented guide for the prevention and treatment of an extensive array of physical and mental conditions. As most chapters range from one to four pages, the information provided in this volume is neither comprehensive nor extremely detailed. Each presentation is concise, clearly written, and touches on the essential knowledge most often needed by a practitioner such as clinical indications, dosage and preparation information, pharmacokinetics, and adverse effects including nutrient-drug interactions. This weighty tome should provide many practitioners with a quick but authoritative check on critical facts that can serve as a ready first step for a more thorough search of the literature.
—Jeffrey Blumberg, PhD, FASN, FACN, CNS-S
Friedman School of Nutrition Science and Policy