A Thumbs Down Book Review
Eat Up: Nutrition Advice and Food Ideas for People Living with HIV/AIDS
By Charlie Smigelski, PhD
Review by Stephen Byrnes, ND, RNCP
I pity the poor souls who will have to suffer through, with and because of this book. Smigelski, a Harvard-trained dietician who runs the HIV Nutrition Coalition with several other RDs in the Boston area, opens by saying that those who are HIV positive need to eat as many “healthy foods” as possible. But Smigelski’s idea of what makes up “healthy food” is standard dietician fare: the Food Pyramid with “tons” of grains and foods that are “lowfat, high fiber, whole wheat, dark green and low sugar.” This is his advice if one is asymptomatic.
However, if one has fought off a major infection, Smigelski recommends foods that are “buttery, sweet, rich, creamy, fatty, fried, syrupy, heavy” to put back lost weight and muscle mass. Further, if one is fighting a major infection, he recommends “candy, vitamins and supplement drinks” if one is feeling “very sick and uncomfortable.” He doesn’t say how eating candy will help a sick body fight off an illness.
Some of his food suggestions are: Wheaties, Cheerios, or Total for breakfast; Pretzels, potato chips, and soda with lunch; Milk or hot chocolate with Fig Newtons or other cookies for a snack; A slice of pie or cake, or three or four cookies with milk or juice as a late night snack; and “easy foods” like doughnuts, peanut butter with Marshmallow Fluff, a two-inch slice of angel food cake, and canned peaches.
Apparently, it’s OK to guzzle entire quarts of fruit juice and Gatorade during the day, but not OK to put some extra butter on your boiled parsnips and canned pears because it might be too high in fat!
Smigelski offers food tips for people with diarrhea. Recommended are white rice, Gatorade, Egg Beaters, tofu, gummy bears, Twizzlers licorice sticks and gum drops. Smigelski also recommends MCT Oil as a fat option during diarrhea, but fails to inform his readers that excessive MCT Oil causes diarrhea. Smigelski gives eight recipes for white rice for “when your intestines cannot handle milk, fats, and fiber.”
For supplements, Smigelski recommends low levels of synthetic vitamins which could not possibly supply an ailing body with any “nutritional insurance.” His advice on antioxidant supplementation (absolutely critical when dealing with AIDS) is pitiful and woefully inadequate.
Perhaps the most despicable thing about the book is the fatalism that is brimming under the surface of almost every page, the fatalism that the reader, no matter how many food tricks he may pull or how many cans of Ensure he drinks, will die of AIDS. “As you know,” says Smigelski, “HIV slowly destroys the immune system so that it cannot fight infections as well.” Later on he reminds the reader that, “You will most likely need special drinks . . . . A tube-feeding might be necessary.” One can only imagine the negative psychological impact of such horrific statements on an unsuspecting reader.
Instead of offering his readers choices for real nutrient-dense food and easy ways to prepare them, Smigelski stays mired in the muck of TV dinners, high-sugar sports drinks, sodas and packaged convenience foods that are devoid of any life-giving properties. Instead of reminding his readers that virtually all of their diarrhea and other side effects come from the toxic, carcinogenic drugs that they are terrified into taking, and that they’d be better off not taking them at all, Smigelski offers an endless array of white rice recipes to “cope.” Instead of offering his readers hope for the future and a sound supplement regime to stay on top of oxidative stress, Smigelski offers generic, synthetic vitamins and thoughts of death.
This book should have been titled: “How to Eat if You WANT to Die of AIDS.”
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Summer 2000.