Eat Everything: How to Ditch Additives and Emulsifiers, Heal Your Body, and Reclaim the Joy of Food by Dawn Harris Sherling, is a thoughtful, explanatory book that is useful to almost anyone. The writer offers clear and valuable information about how she believes additives and emulsifiers in ultra-processed foods are causing illness, especially intestinal upset and disease. In addition, the author streamlines her advice to consumers by encouraging them to eat any whole food, closest to its original form, without worrying too much about variety. Though there is much debate about what kinds of fruits, vegetables, carbohydrates, or proteins are best, her salient message is similar to the opening epigraph—eat and enjoy real, nourishing foods and limit or avoid manufactured products whenever possible. People seeking dietary changes or better health are off to a great start if they simply implement this strategy.

Though this book is less memoir and more general nonfiction, the writer does share intimate glimpses of her personal struggles with irritable bowel syndrome (IBS) and her journey to wellness. Sherling vividly recounts how a family trip to Italy changed her perspective on what was causing her symptoms and also provides engaging scenes with patients as they explain their “gut-roiling” problems.

The author’s insight in Italy came after she threw her usual dietary caution to the wind by indulging in things like pizza, cheesy pasta, and gelato, and did not become ill. Back home in the US, such foods would frequently upset her gastrointestinal (GI) system and negatively impact her quality of life. Because of this excursion, the physician and sufferer began to rethink implicating what she thought were her usual intestinal upset suspects—gluten and dairy. (As the author notes, there are a small percentage of people who suffer from celiac disease and lactose intolerance and must avoid gluten and dairy to be well.) This suspicion led her into an expedition of reading academic medical journals, looking for answers and chronicling anecdotal evidence while treating patients. As a result, she argues in the book that much of what was making her (and her patients) sick involved food additives and emulsifiers. These are unfortunately found in a panoply of packaged products and include things such as gelling agents, modified starch, stabilizers, sweeteners, and thickeners. Some of these ingredients may appear on labels as soy lecithin, carrageenan, mono- and diglycerides, xanthan gum, guar gum, sucralose, maltodextrin, or Stevia, just to name a few.

Though not all Americans are suffering from IBS, other GI upset, or more serious inflammatory bowel disease (IBD) such as Crohn’s, many are dealing with disordered guts at a much higher rate than people in places like Italy or France. The author writes, “[a]ccording to some experts, 15 to 20 percent of Americans are thought to be suffering with IBS, one of the highest rates in the world.” This is due, in part, to ultra-processed foods entering the market in the mid-twentieth century. The Food and Drug Administration (FDA), too, has lax regulations for such additives and emulsifiers, with other countries setting higher standards.

Additionally, research and funding for studies on these has been limited. For example, Sherling cites one study that estimates only 21 percent of additives “have feeding studies necessary to estimate a safe level of exposure” for human consumption. In another, she quotes authors who say, “remarkably, there has been little study of the potential harmful effects of ingested detergents or emulsifiers in humans.” Many researchers like herself are working hard to change this trend.

Carlos Monteiro, a professor of nutrition and public health at the University of São Paulo in Brazil, is one of these. He not only coined the term “ultra-processed food” but also created the Nova classification system to help consumers identify and better understand food processing. Monteiro’s system ranks foods based on how much they have been altered with “category 1” being the least and “category 4” being the most. Some processing, like that to make flour or canned goods, is generally not problematic and historically helped humanity flourish. Category 4 foods, however, are of particular concern because they are new to human history and are chemical compounds, not actual foods. How they might impact our health is still under investigation. Many of these highly technological items are likely contributors not only to bowel disorders and gut microbiome imbalances, but also type 2 diabetes, obesity, nonalcoholic fatty liver disease, colon cancer, and other dietary illness.

As consumers, it behooves us to read labels and carefully consider what we ingest whenever possible. It is also beneficial to keep in mind something Sherling learned in her training as a physician—that you should generally be unaware of what your stomach and intestines are doing, much like the circulation of blood. An easy barometer to use when making selections is to ask the question Sherling poses to a patient named Martha. She asks “What is that?” when Martha arrives to her appointment carrying a “gloppy, semi-frozen, colorful concoction without much resemblance to coffee” and sets it down on the desk. If we do not know the answer, it is probably best to avoid or limit its consumption.

Yet, in consuming products such as this, Martha is not alone. It is estimated that 57 percent of the typical American diet is made up of ultra-processed foods. Many people seek these out because of harried schedules and convenience. Sherling recognizes the challenges so many of us face in obtaining and preparing quality meals, considering cost, availability, and time required. She is ever mindful of how we are often “overburdened, overworked, and overscheduled” and shares her knowledge with compassion and care.

Even though the book grapples with difficult health issues and their dietary causes, the author also gives readers hope with practical tools, like providing “Real-Food Recipes.” These range from the scrumptious sounding “Oven ‘Fried’ Chicken” to “Creamy Lemon-Pepper Dressing” to “Ridiculously Rich Chocolate Chunk Brownies.” Sherling encourages eating for health but also for pleasure and joy. We can all rejoice when she tells us, then, that Häagen- Dazs, a purveyor of one of our favorite food groups, has many delicious options that are emulsifier free. Perhaps we should all indulge in a scoop of their Cookies and Cream flavor while reading.

Buon appetito!