The FIRST Program: Fighting Insulin Resistance with Strength Training: Your Optimal Exercise Guide to Diabetes Prediabetes Metabolic Syndrome Cholesterol, a Science Based Approach

I have battled belly fat the visceral kind that is so damaging to health and impossible to kill for as long as I can remember, male 70 years old. I have a large bookcase full of health "help" books on this subject and useless. I exercise religiously without meaningful weight loss that soon returns. No matter what I did or eat my pre-diabetes lab numbers as well as waistline kept inching up. I have not had Dr Shangs' book long and will be finishing in the next few days. I slowly started weight resistance exercising following his methodology and to my surprise not only do I feel better, old tingling nerve issues in one arm I put up with for many years seem to be gone. Same for knee osteoarthritis pain I've had for at least six years not bothering me and without cortisone injections. What Dr Shang has done is SHINE A LIGHT on the importance of dutifully exercising our Type 2 skeletal muscle fibers. He gives awesome detailed explanation on how that phenomenon works. He covers so many important topics related to good health and particularly pre and type 2 diabetes that it's mind blowing. I have never seen so much detailed information explained in such a clear and easy to understand fashion before. His analogies, charts and graphs are very helpful. His advice is refreshing. My understanding of what is going on inside me has increased tenfold. This is what reading this book has accomplished. Other book reviewers have pointed out that the book needs better editing, I agree but only in the very beginning. After the first chapter or so it reads just fine. Not sure why that is but to me the value of his advice and recommendations is higher than I have seen in other books that just briefly mention what is common knowledge ( fluff ). This book is the opposite, loaded with information, data and advice I have not run across to date. Dr Shang by training knows what is going on inside us. His years as a pathologist and autopsy examiner has given him the opportunity to see what many of us look like inside with the passing of time. He is a director of laboratory at Cornell University, previously US Air Force flight surgeon and certified by the American College of Sports Medicine and American Board of Pathology. All told I am impressed with this guy and trust his no nonsense medical judgement. I will happily return to this book review and report on my progress using Dr Shangs' medical prescription that according to him simple states : "Do resistance strength training". I have tried just about everything else with no loss of waist size, body weight and rising A1C numbers. What do I have to lose? .... $12 ! Being physically strong in good heath as I age is priceless. Aside from sales of this book going to Dr Shang and publishers, only people making real money due to Dr Shang are the dumbbell, inflatable fitness ball and workout bench manufacturers. The sample exercises are guidelines recommended by fitness trainer people. There is no shortage of internet and books with details on weight training. To use this as reason to drop rating is unfair as the information is out there. You do not buy this book to get exercise details ! The real value of this book is Dr Shangs' experience, medical training and willingness to make the reader aware of the fact that when it comes to good general health, pre-diabetes prevention/rolling back existing, we have an organ (skeletal muscle) that to use his term, is "malleable". This means we have the power to be healthy if we choose to act. I highly recommend this book. Will post again with progress reports.

Dr Shang has written a masterpiece which assembles the clinical research about increased insulin resistance resulting from loss of skeletal muscle. And highlights the critical importance of increasing muscle mass through weight training as we age. Bottom line - if you don't weight train as you get older (I'm 62), your risk of chronic illnesses (hyperlipidemia, hypertension, fatty liver etc) dramatically increases (already happening to me :-( as my bloodwork looks increasingly bad, hence this book is so important personally). The genius of Dr Shang is in explaining the science behind it, and in marshalling the scientific evidence so thoroughly and compellingly. The reference citations he gives at the end of the book are particularly invaluable to me, as I can read the papers for myself, and find the latest research through the "cite" function in Google Scholar in future years. Besides the scientific explanations, Dr Shang covers the whole area of exercise motivation, of how to start and maintain a weight training program long term. He offers important guidelines as to safety and how to conduct the exercises with regard to choice of weight size, sets and repititions. He offers sound medical advice in all these aspects. The book is not perfect. Dr Shang advises because of increasing anabolic resistance as we age, our protein requirements are higher (1.4g/Kg BW/day) but he does not fully tell us how to get that amount (whey protein is mentioned, but too much is toxic.) Without sufficient protein, weight training may not increase muscle mass. So that's a weak point in the book. Dr Shang doesn't give illustrations to the weight training exercises he mentions. I would have like to see simple illustrations of how the exercises are performed (perhaps his gifted daughter can help?) He does advise, however, that the exercises are standardized and can be found on YouTube. In any event, my exercise physiotherapist will be able to immediately recognize the exercises and guide me how to correctly perform them. And, lastly, some of the columns on the last page of his printed book have collapsed, and the words have disappeared. So the formatting of the book needs looking at. 11 Aug 2017 Update - the pages aforementioned are downloadable at the link Dr Shang gives in his book, so readers won't be missing anything here. If you are at all interested in doing something to improve your health as you age, this book is critical reading. Thank you, Dr Shang, if you read this review. You have helped change my life, Sir.

I don't like spend more time reviewing the book than author spent when writing it. Important info very poorly written. Total lack of references to literature. Some statements are questionable. However,it is difficult to discuss them because of the lack of sources. A few examples of well-written books with similar themes: Maimonides & Metabolism: Unique Scientific Breakthroughs in Weight Loss The Great Cholesterol Con The Obesity Code: Unlocking the Secrets of Weight Loss Edit: November 2017 I returned first edition, however after reading Mr. Shang comment I felt compelled to purchase new book. It is much better, so rating change from two into four stars. My only objection is exercise program - is so complex that one should work in the gym with trainer. For some people it is the best solution. I prefer simple programs done at home or at work. Good example is One Minute Workout by Raymond Wu, M.D.

UPDATE. New glucose test show normal A1C1 of 5.4 and fasting blood glucose of 89. Am out of the pre-diabetes range. I also ditch all high fructose corn syrup and limited my carbs but my numbers are where I want them and I think the principles in this book are spot on. I thank the author. No way am going down the diabetes road if avoidable!! Previous: I got this book as I was at the very start of pre-diabetes A1c1 of 5.7 two years in a row. Aw hell no was I ignoring this any longer. I have known too many diabetics. I tackled my cholesterol through diet and exercise in 2018, but this glucose problem did not budge when tested at the end of 2018. Now my previous exercise program WAS only aerobic, no resistance. BUT I expected a drop in blood glucose, I was putting in 7 hours a week. Nope. Great cholesterol numbers no movement on glucose. So I was fascinated with this book and bought it and have begun resistance training. He explains in great detail the science behind going from metabolic resistance to diabetes. He explains why resistance is better than aerobics for improved insulin function. Am lucky am at the point of reversing the progression. I will update my review after at least 3 months of resistance training after a new A1c1. I also recently went to a dietician at a diabetes center to tweak my diet, which served me well to lower blood lipids, but also did nothing on glucose. I feel very confident after reading this book (it is a lot to digest for a non scientific type) that resistance training will help keep normal cholesterol and finally lower A1C1 into normal zone again. I also purchased the New Me dumbbell exercise cards here on Amazon, which not only show you how to perform an exercise but the muscles used. That is helping me choose exercises which use the largest muscles (chest, back, abs, glutes, quads and hamstrings) as recommended by Dr. Shang.

The concepts presented are good, and I like the suggested workout schedule. There are no cited references, which I didn’t like, but there are 18 pages of “Additional Resources” which could be the author’s reference materials. One huge negative, which nearly brought my rating down to 2 stars, is the editing, actually the lack of editing. There are a multitude of spelling, grammar, and punctuation errors that make for very difficult, and in some cases incomprehensible, reading. I probably wouldn’t recommend this book to friends.

This is not a flashy book, and there are some typos. It’s low budget; it’s also inexpensive. However, the main idea that active type 2 muscles facilitate healthy glucose uptake and prevent insulin resistance IS special and flashy, and even reassuring. Because I, for one, do not do well on a keto diet BUT I am willing to put in the effort and small amount of time needed (45min per day, for me) to progressively challenge my muscles enough so that I can live a healthier, longer, and more satisfying life (with bread). Further, the emphasis on exercise rather than weight or body fat, per se, and the clear explanation of how potentially meaningless proxy measures are used in medicine, are both appreciated. I’m surprised these ideas- and the research- aren’t more widely understood and promoted. As far as the prescribed exercises, they’re all very good; but the author also seems to suggest that as long as you are exercising your largest muscles to failure- and doing so correctly, incrementally, and using adequate recovery- you can probably come up with your own similar routine (which is what I have done).

I have lean PCOS and have been powerlifting/bodybuilding for years. I really appreciated learning about the science of how resistance training impacts glucose metabolism. This book further convinces me that weightlifting is a necessity for proper health, despite living in a society that tells women to be small and dainty (read: unhealthy). Thank you so much, Dr. Shang, for putting this book together. I am so thankful to have come across it.

Truly recommend this book for those of us that have trouble losing weight. The first half of the book is packed with information that is backed by reliable sources. If you choose to purchase this book, get the Kindle version and read via web as the graphs and photos are in color. I did take off a star because it started to get repetitive towards the end. Overall, I don't regret picking up this book and can't wait to apply the information to my journey.