Summary of Too Much of a Good Thing

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  • Scientific
  • Eye Opening
  • Concrete Examples


People endured for millennia due to four survival traits: “hunger, thirst, fear” and the “blood’s ability to clot.” Now, instead of keeping people alive, these traits account for more than 40% of US deaths. Cardiologist Lee Goldman, dean of health sciences and medicine at Columbia University, provides a fascinating overview of natural selection and genetics. He explains how these traits now work against people’s well-being and why willpower can’t save you, but diet and exercise will help. His insights will inspire health professionals and those who’d like to know why people crave fatal comforts.

About the Author

Lee Goldman, MD, is a cardiologist, dean of health sciences and medicine at Columbia University, and chief executive of Columbia University Medical Center. He has been lead editor of the last six editions of the Goldman-Cecil Medicine textbook, the longest continuously published text in the United States, and has published more than 450 research articles.



Four traits that kept ancient humans alive now threaten your health and survival: “hunger, thirst, fear” and the “blood’s ability to clot.”

Those very traits which sustained human life over the course of 200,000 years are impediments to health today. People have changed the environment faster than the human body can adapt. Will human beings survive the environment they created? Scientists recognize three possibilities:

  1. People will continue to develop diabetes, heart disease, obesity, stroke, depression, and other diseases at earlier ages and not live long enough to reproduce. The human species will die off. This is highly unlikely. 
  2. People will embrace diet, exercise and other healthy habits, allowing them to maintain their health despite the modern environment. Some motivated individuals manage this due to brute determination, but most self-help efforts are not effective.
  3. People will harness science – medication, surgery and, perhaps someday, targeted genetic modifications – to limit the influence of hunger, thirst, fear and blood clotting.

The survival rate of all the species that once lived on Earth is a mere...

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