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4.0 out of 5 stars TRANSCEND IS a good plan for living well..., May 25, 2009
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This review is from: Transcend: Nine Steps to Living Well Forever (Hardcover)
if not forever.

I stressed over what grade to give Transcend and ultimately gave it an Amazon **** grade (say, B+). Why that high? Why only that high?

First, I'm an MD, PhD with 30 years of clinical practice
and 10 years of medical research. (Google bobblum.com or just "Bob Blum")
Ray Kurzweil was a classmate of mine at MIT in the sixties.
I just met Terry at the Foresight Convergence Conference in 2008.

I had read Fantastic Voyage, their first joint effort, several times and always had a hard time deciding whether to recommend it to friends and colleagues. 80% of Fantastic Voyage was first rate information. 20% was highly controversial, fringe medicine (alkaline water and obscure supplements).

I complained to Ray in a letter expressing concern about his personal health - 250 pills a day is just too many, portending too many interactions - and also to Terry. My advice was to please label or rate the scientific evidence that forms a basis for each of their drug recommendations. Terry told me that their forthcoming book TRANSCEND would solve the problem. It DOES. Most of that controversial 20% has been surgically removed. Gone is much of the pseudoscience.

What's left follows closely (and expands) the world according to Drs. Dean Ornish, Andrew Weil, and many other admirable health writers.

The book summarizes the best of current medical advice on how to stay healthy. If you're not a health professional and have not read many books like this I would strongly recommend it. So, for most of you that's my advice... buy the book (and live by it).

Now, I'll be more specific.
TRANSCEND is a mnemonic for their health recommendations: Talk to your doctor, Relaxation, Assessment, Nutrition, Supplements, Calorie Reduction, Exercise, New Tech, Detoxification. That's a worthy list.

In re: Talk to your doctor and Assessments. Much of this is a list of tests to request, and as they rightly state, many of these tests will not be covered by insurance. This means you will have hundreds of dollars in unreimbursed expenses for tests of unproven efficacy.

During my meeting with Terry at Convergence he emphasized the importance of carotid ultrasound and coronary calcium scoring for men over 45 or women over 55. I totally concur. There is nothing like seeing the calcium plaque in your arteries to put the fear of the Lord into you.
However, for many of the other tests (neurotransmitter levels, mineral analysis, digestive function, eg) it is unclear how often, if ever, the tests should be done. With the country's economy in tatters and healthcare already climbing toward 20% of GDP some of these tests will always be for the well-to-do, worried well.

In re: Nutrition. I bristled when I saw that 66 pages were devoted to low fat recipes, since (IMHO) this is usually a worthless page-filler. However, I've changed my mind on this. In this era when so many foods that are readily available are condemned (most fats, much of animal protein, fast carbs) readers want to know "ok, so what DO I eat?"
I actually made their soy yogurt Waldorf Salad, the quinoa, and the zucchini and have lost 3 pounds from my usually cerebrotonic, ectomorphic frame. Basically, folks, this is where to get your vitamins and minerals. As Mark Bittman (NY Times Food Critic) says, "it's the carrot, not the beta carotene." I single out for especial praise their Transcend Food Pyramid - they nailed it - veggies and water are the base.

In re: Supplements. This is the arena in which Ray and Terry were particularly on thin ice in Fantasic Voyage. Ray's mammoth daily consumption of supplements to "reprogram his biochemistry" is notorious. I was delighted to see that their public recommendations for supplements have been greatly toned down. Whether this reflects a change in their own personal consumption is not stated. Since I'm a great fan of Ray's proselytizing on behalf of the Singularity, I hope it does. When I asked Aubrey (Engineered Negligible Senescence) de Grey (he of the Methusaleh beard) how many pills per day he takes (in contrast to Ray K's 250), he said "none. My wife is a good cook."

And now, here's the key problem - no discussion of methodology for arriving at medical truth. It's called evidence-based medicine -
Wiki it - and it needs to be a core piece of every book like this. Inquiring readers want to know, "should I take Resveratrol or alpha-lipoic-acid? How about CoQ10 or calorie restriction? Should I take vitamin E even though large clinical trials indicate that it might contribute to my death?

The hundreds of references that were in Fantastic Voyage were a good thing - they must be there. Furthermore, it needs to be absolutely clear that many of the supplements that are still on their recommended list have only weak, inconclusive, or contradictory evidence. That Ray and Terry (and Andrew Weil) sell supplements is an obvious conflict of interest. They owe it to their readers to present all the evidence not merely that which supports the consumption of particular supplements.

Again, I recommend this book, especially for the lay reader, since I endorse the TRANSCEND plan. My key reservation is that the presentation of evidence (con as well as pro) needs to be expanded and better referenced.

Addendum (February, 2012): My personal diet and nutrition recommendations have departed from
what Ray and Terry recommend. Please see my essay "Optimal Nutrition: Are Fats Killers or Saviors?"
on bobblum.com. That article includes scores of links to videos and pdfs on the web. Everything is free;
I sell nothing.

In another article on my website I also addressed the key issue of clinical evidence:
how do medical scientists/ statisticians determine "Does Drug X Really Work?"
Also see my short piece entitled "Transcend Drugs!" that shows exactly how the Natural Standard
(THE authority on supplements) rates the supplements that Ray and Terry recommend in Transcend.
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Tracked by 10 customers

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Showing 1-10 of 36 posts in this discussion
Initial post: Jun 9, 2009 6:14:27 AM PDT
Lynn says:
Thank you, Dr. Blum for taking the time and trouble to write this review. RG Texas

In reply to an earlier post on Jun 12, 2009 11:12:13 AM PDT
Last edited by the author on Jun 12, 2009 11:12:45 AM PDT
Bob Blum says:
Hi Roy, I appreciate your comment. While Ray and Terry are both (rightfully) zealous in pursuit of excellent health, they need to be far more skeptical when it comes to vitamins and supplements. The most impressive finding after years of clinical trials is that added supplements do NOT work. In contrast, Dean Ornish and others have repeatedly shown that a low calorie, low fat diet (which Ray and Terry also advocate) DOES work to slow atherosclerosis etc.
Best wishes, Bob Blum (MD, PhD)

In reply to an earlier post on Jun 17, 2009 8:46:59 AM PDT
A. Scrima says:
Thank you for this excellent review - I want to recommend this book to my book club but will preface it with your well reasoned reservations/cautions. I love Ray Kurzweil's earlier works but I haven't read his health related ventures. I completely concur that evidence based practice in all areas of science based application is the only valid approach and must be discussed and adhered to in any discussion of such a topic. I am a psychologist and advocate exactly the same advice to my students and whoever else will listen. Thank you for your extremely useful review.

In reply to an earlier post on Jun 17, 2009 10:50:09 AM PDT
Last edited by the author on Jul 5, 2009 9:12:05 PM PDT
Bob Blum says:
To A. Scrima: Thank you so much for your post. If you do discuss the book in your book club
(or in any case), I would also recommend taking a look at Ray and Terry's earlier work, Fantastic Voyage, because it is far more extensively referenced and is addressed at more of a Scientific American level
rather than a Time Magazine level. I particularly valued the chapters dealing with stress and type-A personality and the chapter on cardiovascular disease. I also liked the extensive personal health info on Ray and on Terry. (Terry is indestructible; Ray (and I) both have a family history of atherosclerosis and other problems, that Ray discloses.) I had hoped that Transcend would also be at the Scientific American level, but they evidently decided to go for a broader audience. Finally, evidence-based medicine needs to be a cornerstone of every book like this (and especially so with psychotropics and other interventions in your field).

Thanks again, Bob

PS: One huge service that Ray and Terry did was to summarize all their action items from Fantastic Voyage and post it free on the internet (Google "Fantastic Voyage short guide" to get that pdf)

In reply to an earlier post on Jul 2, 2009 6:23:36 AM PDT
NoOne says:
Thank you so much for your review Dr. Blum. I am a third year medical student and found this information very useful. Do you still recommend that I read Singularity or Fantastic Voyage since my medical knowledge is a little above the laymen?

In reply to an earlier post on Jul 2, 2009 10:36:13 AM PDT
Bob Blum says:
Vanitha: The Singularity is Near is by far Ray's best and most important work. You should definitely read it.
I do also recommend Fantastic Voyage, although you will quickly discover sections that are full of pseudoscience. However, the remainder of that book is better researched and presented at a higher level than the material in Transcend. Best of luck with your studies, Bob Blum.
PS: I think you'll also profit from the health essays at my website: www.bobblum.com as well as the material at Ray's websites (both are free and open).

Posted on Aug 21, 2009 1:59:18 PM PDT
Dr. Blum, I went to your website and found your essay pertaining to CAC CT, which I found personally pertinent, as well as medically interesting. Like you, I have a strong fam. hx of CAD but have been active and a runner/cyclist - but not the best of eating habits -all my life. Too, my cholesterol numbers are pretty similar to yours (although my post statin total is 185 but my HDL's are 60). While my MD would like to be more aggressive with my CHO, I'm more inclined to be conservative (I don't have full faith of the downward trending of acceptable cholesterol numbers; is this truly necessary or are the drug companies just stacking voices on academic position papers, which I understand there is some evidence). But most importantly, I want to know if my statin therapy is actually effective at the level of the vessel. This would greatly sway my mind either way.

(This is my interest in the book, Transcend, which you just reviewed)

Your article suggests ultrasound and CACCT. ARe there other diagnostic means available? What are the criteria for insurance payment. Any suggestions for direction?

Thanks,
Doug Winter,
Oregon

In reply to an earlier post on Aug 24, 2009 8:25:11 AM PDT
Bob Blum says:
Hi Doug,

The chapter on heart disease and atherosclerosis in Fantastic Voyage is far more detailed than the one in Transcend, and I would recommend it to you. You did not mention your LDL cholesterol,
which is pivotal if you have coronary risk factors. How low to get your LDLc depends on a number of factors that your physician should be familiar with. The medical literature supports a strong association between low LDLc and decreased rate of atherosclosis. (see, eg, LaRosa et al., New England Journal of Med., vol 352:1425 of April 7, 2005). A discussion of diagnostic tests for coronary disease is way beyond what I can accomplish here. I would start with info from www.nhlbi.nih.gov and the Mayo Clinic
and also the chapter in Fantastic Voyage.

Best of luck, Bob

In reply to an earlier post on Sep 2, 2009 6:36:21 AM PDT
Great. Thanks for your leads, Bob.
djw

Posted on Sep 16, 2009 6:55:56 PM PDT
Excellent review, much appreciated. I got a lot out of "Fantastic Voyage" and you've convinced me that "Transcend" is worth checking out as a next step.
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