Transcend: Nine Steps to Living Well Forever Paperback – December 21, 2010

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.

Note: I read an advanced uncorrected proof. My copy was not entirely finished - it was missing a lot of diagrams, and had some notes from the authors to the publishers. However, the content (actual text) was entirely done. See below for the review.

*****

It's nice to see that while the authors of the book both have products and services that they sell in conjunction with the topics in the book, they barely mention those - there is no upselling like in a lot of other books. If you're worried about that, rest assured it is not an issue.

The first thing to note about this book is that in the first part, a lot of it is repetitive from "Fantastic Voyage". Where "Fantastic Voyage" was filled with technical detail and a thousands of scientific data points to back up the claims, this book does not have that level of thoroughness. However, in many instances that's no longer necessary; a lot of the data points from "Fantastic Voyage" have already been proven in the ensuing years - most of the information is available online from independent sources. There is enough new information to make it worth reading, but those who've read "Fantastic Voyage" will find that they recognise a fair amount of the material. Of course, if you haven't read "Fantastic Voyage", you will find it all new, and well worth the introduction to the science behind physiology, nutrition, and medicine.

The second part of the contains action steps that people can take to actually improve their lives. There are nine - the book's title, "Transcend", is a mnemonic for remembering the steps: Talk with your doctor, Relaxation, Assessment, Nutrition, Supplements, Caloric restriction, Exercise, New technologies, and Detoxification. With regards to each, there are practical steps that you can take (ideally in cooperation with your doctor). The items are useful - they discuss tests you can ask your doctor for (and how to interpret them); supplementation and how it improves well-being; healthy recipes that you can make with reasonable ingredients in your kitchen; and even exercises you can do using resistance bands in your living room.

It's the second part of the book that really separates this book from the last one. It was highly interesting to read the last one, and provided a lot of scientific information. This one provides that, as well as practical information, and can be used to put into place steps that you can use to extend your life significantly.