Too Much of a Good Thing: How Four Key Survival Traits Are Now Killing Us

by Lee Goldman

Overview

The dean of Columbia University's medical school explains why our bodies are out of sync with today's environment and how we can correct this to save our health.

Over the past 200 years, human life-expectancy has approximately doubled. Yet we face soaring worldwide rates of obesity, diabetes, high blood pressure, mental illness, heart disease, and stroke. In his fascinating new book, Dr. Lee Goldman presents a radical explanation: The key protective traits that once ensured our species' survival are now the leading global causes of illness and death.

Our capacity to store food, for example, lures us into overeating, and a clotting system designed to protect us from bleeding to death now directly contributes to heart attacks and strokes. A deeply compelling narrative that puts a new spin on evolutionary biology, Too Much of a Good Thing also provides a roadmap for getting back in sync with the modern world.

Product Details

ISBN-13:	9780316236812
Publisher:	Little, Brown and Company
Publication date:	12/08/2015
Pages:	352
Product dimensions:	6.10(w) x 9.40(h) x 1.40(d)

About the Author

Dr. Lee Goldman is dean of the medical school at Columbia University. An internationally renowned cardiologist, he developed the Goldman Criteria (a set of guidelines for healthcare professionals to determine which patients with chest pain require hospital admission) and the Goldman Index (which predicts which patients will have heart problems after surgery). He's the author of more than 480 medical articles and also the lead editor of Goldman-Cecil Medicine, the oldest continuously published medical textbook in the U.S.

Table of Contents

Introduction 3

Part I The Pros and Cons of Four Key Human Survival Traits

1 How Our Bodies Became What They Are 11

2 Hunger, Food, and the Modern Epidemics of Obesity and Diabetes 39

3 Water, Salt, and the Modern Epidemic of High Blood Pressure 88

4 Danger, Memory, Fear, and the Modern Epidemics of Anxiety and Depression 120

5 Bleeding, Clotting, and the Modern Epidemics of Heart Disease and Stroke 157

Part II Protecting Our Bodies in the Modern World

6 Can Our Genes Evolve Fast Enough to Solve Our Problems? 193

7 Changing Our Behavior 218

8 Changing Our Biology 248

Acknowledgments 283

Notes 285

Bibliography 327

Index 331

Editorial Reviews

Dr. Goldman takes the long, long view in Too Much of a Good Thing, arguing that many common modern ills result from the surpassingly excellent genes that allowed our species to endure over the millenniums. Only very recently did these survivor genes turn on us, creating the collection of overweight, hypertensive, jumpy and miserable individuals we are today. Some of his argument will probably be familiar, at least when it comes to the question of why we have all become so fat. Less has been written about other areas of human physiology where our genetic programming seems to butt up against the circumstances of modern life. Dr. Goldman integrates it all into a complex narrative—a little tough sledding at points, but still thought-provoking.

The New York Times - Abigail Zuger M.D.

"In this highly original and profound book, Lee Goldman describes how the same physical traits that evolved to ensure our survival are now working against us. For anyone interested in their own and their family's well-being, Too Much of a Good Thing is a must read!"—Eric Kandel, Winner of the 2000 Nobel Prize in Physiology or Medicine, University Professor, Department of Neuroscience, Columbia University, author of The Age of Insight and In Search of Memory

"A fascinating look at the health problems that plague us, illuminating why they happen and what to do about them."
—Jerome Groopman, M.D., Pamela Hartzband, M.D., Harvard Medical School, Authors of Your Medical Mind: How to Decide What is Right For You

"This book, written from a deeply expert yet broad medical viewpoint, sets current medical challenges into their larger contexts of our human history and biological pre-history, to provide a crisply related and refreshingly clear-eyed perspective on much that ails us these days. And throughout the book, I also enjoyed the fascinating snippets on topics ranging from platelets to percentages of paleolithic food components to polyandry to presidential obesity."
—Elizabeth Blackburn, Winner of the 2009 Nobel Prize in Physiology or Medicine

"Lee Goldman is a pioneer in medicine in the best sense of the word: his 'Goldman Criteria' and 'Goldman Index' are in the vernacular of daily practice. As an educator and writer, he has influenced many: as just one example his visionary ideas created the first hospitalist movement in America. In this provocative and elegant book, Goldman examines the very survival traits that have brought our species this far. It could be that these traits are now killing us-the arguments, insights and solutions offered here are profound. It is a book that I think only someone with the stature and perspective of Lee Goldman could write. It's an important book for our times."
—Abraham Verghese, author of Cutting for Stone


"An interesting explanation for our current medical woes....Goldman presents a convincing case for the power of our genetics and explains why conquering these inclinations is so difficult."—Candace Smith, Booklist


"Goldman goes beyond diet issues to talk about survival mechanisms that worked well for thousands of generations but have now turned against human health."—Nancy Szokan, Washington Post

From the Publisher

02/01/2016
Obesity, high blood pressure, depression, and heart disease are leading causes of death in the United States today. The statistics are startling—more than one-third of Americans are obese and an additional one-third are overweight; approximately 30 percent of adults have high blood pressure; one in ten have depression; and more than 600,000 die every year from heart disease. Here Goldman (MD, Columbia Univ. Medical Ctr.) argues that each of these diseases has its roots in the basic needs of our prehistoric ancestors to eat, remain hydrated, evade danger, and stanch bleeding. These predecessors developed behaviors—calorie loading, salt cravings, anxiety, and rapid clotting—that helped them survive. Now, these behaviors result in serious health problems. Goldman writes persuasively about each of these traits, tying present problems to past instincts and weaving biological explanations with historical research. He expresses skepticism that humans can overcome these problems through behavior modification or natural genetic selection, but he is optimistic about future medical treatments, including surgery, medications, and gene therapy. VERDICT Recommended for a general audience, including readers of popular health literature such as Michael Pollan's The Omnivore's Dilemma.—Talea Anderson, College Place, WA

Library Journal

2015-09-08
A renowned cardiologist explores the paradox that traits essential to human survival in prehistoric times are today the cause of countless human deaths. Goldman (Dean, Health Sciences and Medicine/Columbia Univ. Medical School), the lead editor of Goldman-Cecil Medicine, "the oldest continuously published medical textbook" in the country, cites these traits as the ability to form blood clots to prevent bleeding to death, the ability (or tendency) to gorge when food was available to prevent starvation when it was not, the craving for salt and water to prevent fatal dehydration, and the hypervigilance needed to avoid a violent death. The author points out that the world that demanded these protective attributes has changed dramatically in recent centuries, and our genetic makeup cannot change rapidly enough to get our genes into synch with our environment. He expands on this theme in Part I with historical data, statistics, medical insights, and anecdotes about individuals as disparate as Franklin Roosevelt, Gen. George Custer, and Ötzi, the mummified Ice Age man. This highly readable section is packed with information about depression, obesity, and heart disease and strokes. Part II, however, turns from this expansive and detailed view of the problems to Goldman's own views of the solutions. He considers two options for coping: harnessing willpower to change our behaviors and our lifestyles, an approach he views with considerable skepticism; or using brain power to change our biology, which means using modern science and medicine to help our bodies adapt to the modern environment. From his perspective, the precision approach of personalized medicine offers great hope, and he sees a future in which medications and procedures compensate for the failure of our genes to adapt rapidly or even alter the ways in which our genes work. Part I gets kudos for being informative and accessible, but the presumptions of Part II make for a controversial conclusion.

Kirkus Reviews

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