Eat to Live. (Book Reviews).

Radd S, Setchell K, Hodder Headline, Sydney, 2002, 335 pages, $29.95, ISBN 0-7336-1459-0

Eat to live is designed to provide a 'phyto-protection plan for life'. It combines an informative evaluation of the current scientific evidence on possible health benefits of phytoestrogens (or 'plant protectants') with an excellent practical guide on how to incorporate phytoestrogens into your diet. The book is co-authored by two dynamic experts in the field: Sue Radd APD, an Australian nutrition consultant and communicator, well known for her long-standing interest phytoestrogens and enthusiasm for plant-based cuisines; and Dr Kenneth Setchell, one of the leading research scientists in this area whose pioneering work resulted in discovery of the first phytoestrogens in human urine, some 20 years ago.

The book is organised into three parts. Part 1 introduces the major theme that degenerative diseases in western countries are caused by a diet lacking in protective plant foods 'it is not so much what we eat but what we're not eating that's important to our health'. It explains what phytoestrogens are and how they work in the body.

Part 2 discusses the range of areas in which phytoestrogen-rich diets could be protective. Separate chapters are devoted to cancer, heart disease, osteoporosis and menopause, providing an overview of the scientific evidence and proposed mechanisms for protection. Each chapter concludes with a useful summary of key findings and the authors' own recommendations for consuming a phytoestrogen-rich diet in the context of other lifestyle choices to reduce risk of the disease. Possible effects on cognition are also discussed and the more tentative links with alcoholism, cystic fibrosis, endometriosis, inflammatory diseases and kidney disease. There is an interesting and challenging chapter on 24 frequently-asked questions, for example, will feeding soy to my daughter help reduce her risk of breast cancer when she is older?; are phytoestrogens safe during pregnancy? Although not all the questions have answers yet and perhaps not all readers will agree with the opinions offered, this section will encourage lively disc ussion on a range of controversial issues. The authors attempt to present both sides of the issues and cite supporting evidence. An overall conclusion is that phytoestrogen-rich foods such as soy, incorporated into a diet rich in a variety of plant foods, are unlikely to cause harm, although the authors do caution against use of large doses of supplements because they do not have the same long term history of safe use.

Part 3 focusses on the practical side of eating a phytoestrogen-rich diet with a seven-step daily food guide and over 75 pages of Eat to Live recipes. Designed and tested by the authors themselves, the recipes are divided into sections on breakfasts, soups, salads, light meals, main courses, desserts and drinks. Each recipe includes a guide to whether the meal provides a 'rich source', 'good source' or 'source' of phytoestrogens and for optimal phytoprotection, readers are encouraged to select a variety of different recipes and incorporate two 'rich sources' into their daily diet. Handy reference tables of the phytoestrogen content of foods, infant feeds and supplements are listed in Appendices. For readers who wish to delve further, there is an extensive list of references to support each chapter.

One of the strengths of the book is its broad scope, reflecting the combined wisdom and expertise of the two co-authors. Whereas some previous books have focussed on health benefits of individual phytoestrogen-rich foods such as soy, or of phytoestrogens in relation to a particular target group such as menopausal women, Eat to live discusses phytoestrogen as a feasible lifestyle choice for everyone--men, women, infants and adolescents, meat eaters and vegetarians. However one limitation is the underlying assumption that consuming more phytoestrogen-rich foods per se will reduce risk of chronic diseases. While there is good evidence in the scientific literature that traditional diets rich in plant foods are associated with reduced risk of many chronic diseases, it is not yet clear which constituents or associated lifestyle factors are responsible for this protection, and phytoestrogens are but one of many promising candidates.

Attractively presented, the book is written in a relaxed, persuasive writing style and authors have a gift for expressing scientific concepts clearly without foregoing the basic science. The book would appeal to interested lay readers who wish to take responsibility for their own health. It would also be of interest to dietitians and nutritionists who would like to update their scientific knowledge and at the same time, gain useful tips for incorporating phytoestrogens into their nutritional advice to clients.