Category Close-Ups

Of Aging AND Ailments;
Boomers AND Bodyfat;
Calories AND Carbs
Edited by Daisy Maryles and Dick Donahue -- 11/27/00
Our panel of "medical mavens" checks out the condition
of this constantly evolving category

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PW :Who's buying diet/health books? What are the demographics of today's customers, and how do these differ from the demographics of 10-15 years ago?

Miller: Most health book buyers are baby boomers--there are about 77 million [boomers] in this country alone, and that's a huge number. Women buy most health books, especially diet books. But there are more and more men--and also younger people and seniors--buying health books as well. The changes from 10-15 years ago: the baby boomers are aging, and as they age, they think more about health. And men are increasingly willing to open up about health issues.

Wells: Anyone from 25 to 70 is buying these books. As baby boomers age, they are looking for books on how to maintain health and youthful looks, and that's a big segment of the market. And it's going to increase as the last wave of the boomers hit their 50s.

Dinas: The demographic as we see it are baby boomers and seniors, both of whom have particular agendas for health. The baby boomers have a longevity agenda and alternative culture agenda. The seniors have an agenda that has been disenfranchised by traditional medicine and they are more and more going after nontraditional approaches and supplementation. They are trying to help themselves with their chronic conditions and not have to rely on the medical establishment with HMOs and all, which are not giving them the service they need.

L wenthal: The demographic for readers of health and diet books is broader than ever. As health consciousness grows, the boomers age and obesity becomes more and more the norm. More men are turning to these titles in larger numbers as well, as it become societally more acceptable for them to be concerned about their health and the condition of their bodies.

Gold: In the diet/health market, "behavior" is slowly catching up with "awareness" and so I believe that a larger majority of consumers are looking for information to help them eat smarter and better rather than quick weight-loss schemes. Consumers are making the connection between mind and body, nutrition and lifestyle. Ten to 15 years ago, nutrition was an off-putting word, and chefs worth their salt (other than those who worked in hospitals or schools) knew nothing about it.

Model: In the past, say 15 years ago, people were looking for more diet books on eating habits, and now diet books are having to do more with lifestyle and exercise. That's the biggest trend we're seeing. Also, people are interested in supplements and vitamins.

Shepherd: I'm seeing a much more highly educated consumer. The individuals who attend the health trade shows where we exhibit are very knowledgeable. They ask very specific questions about the latest supplements and alternative treatments. With the amount of information available on the Web, consumers seem to know an awful lot. I don't feel I have to dumb books down these days, even when they are rather sophisticated and deal with scientific material.

PW: What are the current hot topics in these categories, and why are they hot?

Massey: Weight loss is a perennial. With the older age group hitting the arthritis years, arthritis is a very hot topic, as are allergies and asthma. Cholesterol is also a perennial. People are also interested in information about herbal interactions with the drugs they are already taking.

Gold: The hot topics today include the fields of alternative and herbal medicine, antioxidants, weight management (as opposed to weight loss), sustainable cuisine (including organic food, genetic engineering, "seasonal ingredients"), low-carbohydrate/high-protein diets, heart-healthy/low-fat menus and a handful of spas and top chefs who are marketing to a more health-
conscious--and probably more upscale--audience. With all the information available, people (well, some people) are finally beginning to make the connection between better nutrition and better health.
Baroni: Diet/weight loss is probably the most popular topic. People are continually searching for the quick-fix solutions to their weight issues. Since nearly half of all Americans are overweight and each year the number of overweight people increases, I don't see this topic going away anytime soon. Other issues we are currently having success with are menopause (and its related health issues), antiaging and cancer prevention--subjects important to the baby boomer generation.

Miller: A growing trend is mind/body/spirit self-improvement books--books that combine self-help, physical health and spiritual practice. Women's health books continue to sell well, as do motivational health/self-improvement books. And books that cover the general area of self-care are finding growing audiences.

Raymond: One of the hottest topics right now is antiaging. The quest now is how to build up your body to live longer. People are much less focused on just weight loss--the real trend is toward how we can adjust what and how we eat to live longer, stronger and healthier lives--and that involves building the immune system and the prevention of cancer, diabetes and heart disease.

Perez: Women's health always remains a hot topic; books on menopause and breast cancer are perennial sellers. We also see consistent sales on our yoga books.

Bollh fer: Yoga books have really taken off. That's a big growth category. We're selling yoga videos as well. There's a lot of interest in them because it's easier to learn from a video than having to look at an open book. There's been a glut of alternative healing books. Also, it's getting harder to separate alternative health from general health because of the blending of complementary treatments.

Jorgensen: Books on yoga, chronic pain. When [New York City mayor Rudy] Guiliani announced that he had prostate cancer, that raised the subject for books like The Prostate Cancer Protection Plan by Dr. Bob Arnot [Little, Brown]. Also books on osteoporosis, menopause, fibromyalgia. Five years ago you wouldn't have heard people on the street talking about fibromyalgia the way they do now.

PW: What new trends do you think might emerge in the near future in both diet and health titles?

Meredith: In health titles I think there will be a lot more concern about hormonal health. We have a book called The Thyroid Solution [by Ridha Arem, M.D.] that has been selling extremely well, and part of the reason is that once women hit 40 they are at risk of developing a thyroid condition.

Shepherd: I expect a huge backlash to the high-protein diet books that were/are so popular. Most nutritionists will tell you these diets do not work for the long haul and can be downright dangerous. They're impossible to sustain and can have serious impact on the kidneys and liver. Already the glycemic index books have become popular, and this is the beginning of the backlash, I think. If I had a nickel for every proposal I receive that's titled something like "The Commonsense Diet," I could retire early. I'm seeing a lot of interest in Ayurveda, yoga, Chinese medicine and body work.

Baroni: For the next 10 to 15 years, I think the trends will be linked to issues affecting the aging baby boomers. They are a book-buying demographic and are interested in exploring the health issues that affect them.

Massey: There are more and more studies being made on allergies, arthritis and back pain--studies that target certain diseases and problems hitting the baby boomers. We're doing a book next spring by Dr. James Rippe, The Joint Pain Prescription, which reports that taking a highly concentrated gelatin, along with a lifestyle program, can improve joint mobility.

Moran: We think the big issue next year will be body fat percentage. Most diet books now just address overall weight or body mass issues. Most nutritionists and trainers will tell you that you can still be your "ideal weight" but very unhealthy if you have a high percentage of body fat. As far as health titles are concerned, we think the so-called aging diseases--osteoporosis, etc.--will need to be addressed not just medically but from a lifestyle perspective.

To Their Health!
Many thanks to the helpful--and "healthful"--players who took part in this feature. In alphabetical order, they are:
Diana Baroni, senior editor, Warner Books
Kathy Bollh fer, diet/health book buyer, Denver's Tattered Cover, Cherry Creek location
Paul Dinas, editor-in-chief, Twin Streams (Kensington)
David G hring, publisher, Perseus Publishing
Rozanne Gold, author (Recipes 1-2-3; Entertaining 1-2-3; and, coming in February from STC, Healthy 1-2-3: The Ultimate Three-Ingredient Cookbook)
Rosemary Jones, owner, Healing Pages, formerly a walk-in store, now an online store only at www.healingpgs.com. Specializes in health and alternative medicine titles
Erica Jorgensen, health, mind & body editor, Amazon.com
Linda L wenthal, v-p and editorial director, Harmony Books and Three Rivers Press at the Crown Publishing Group
Susan Massey, publisher, Rodale Trade Books
Leslie Meredith, v-p and executive editor, Ballantine Books
Thomas Miller, executive editor, general interest books, Professional/Trade Division, John Wiley & Sons
Deborah Model, publishing manager, Trade Paperback Division, Simon & Schuster
Kevin J. Moran, publisher, Hatherleigh Press
Danielle Perez, senior editor, Bantam Dell
Rebecca Post, executive editor, Hazelden
Carl Raymond, marketing director, ReganBooks
Laura Shepherd, executive editor, Avery, a division of Penguin Putnam Inc.
Heather Jackson Silverman, senior editor, St. Martin's Press
Leslie Wells, executive editor, Hyperion
Thanks, too, to our interviewers: Michael Archer, Robert Dahlin, Lucinda Dyer, Heather Vogel Frederick, Suzanne Mantell and Shannon Maughan.

Gold: "Calories are the only thing that matter in weight management," says Dr. Marion Nestle, chair of New York University's Department of Nutrition and Food Studies, and so I believe that the emphasis will again be on calorie intake rather than rigorous fads that banish entire food groups. New science also suggests that all fat is not bad, and that it is saturated fat that needs to be monitored, not "good" or "healthy" fats like olive oil or the fats derived from fish and nuts. Since it is the mandate of most nutritionists to "eat all the colors," I believe that consumers will begin to eat a broader array of fruits and vegetables and take advantage of all the inherent "goodies" available in nature.

Perez: In the diet field, everyone has been concentrating on carbs and protein and fat lately. I think there may be a return to old fashioned calorie counting. We publish the Corinne T. Netzer Calorie Counter yearly, and it's always been a solid seller. We're also seeing men paying more attention to their own health, particularly prostate cancer and impotence.

L wenthal: The roles of genetic makeup and hormones in body weight and overall health is a major coming trend. Also, people are looking more and more to other cultures for answers to diet and health issues. One example on the Harmony list for February 2001 is Dr. Neal Barnard's Turn Off the Fat Genes!: The Revolutionary Guide to Taking Charge of the Genes that Control Your Weight, which helps you understand your genetic makeup according to what foods you like and dislike, and then offers a specific program for your type. Another example, on the Potter list, is The Okinawa Way by Dr. Bradley Willcox and Professor Craig Willcox (May 2001), based on a 25-year-study that tells how and why Okinawans' diet and lifestyle make them the healthiest and longest-lived population in the world, with a four-week plan for eating and living like they do.

Jorgensen: I think a new trend will be books on integrated medicine, books that combine Eastern and Western approaches in one title. Approaching health from a team prospective, coming at it from all angles, is certainly growing in popularity around Seattle. Also growing in interest are books with passwords or links directing to Web sites for updates. Diet books are getting more specific with all the research on metabolics. Publishers are sometimes too eager to put out a book on supplements, and then we find out later that this herb reacts with that one or that it shouldn't be taken by women.

Wells: In health, a big trend is the gender divide and how doctors treat women's health problems differently from men's. As it turns out, women can exhibit entirely different symptoms for the same health problem and a lot of times doctors miss the cues because they're looking for the symptoms that men would exhibit.
Silverman: Diet books
remain hot, but the
prescriptive advice
Silverman: It depends on the type of trend you're discussing. With regard to sales, I have seen a great increase in the sales of our books through nonbookstore channels over the last few years--drugstores, supermarket chains, etc. And I see that increasing as lives become busier and busier and customers want to do as much "one-stop" shopping as possible. They can get good books at great prices while doing their grocery shopping.

PW: Do you think there are any untapped markets in these categories?

Shepherd: There's always room for another new weight-loss book. I don't think we'll ever see them go away. It depends on the personality behind the book, the promise, the program and, of course, the title. I think we'll see more and more books that take a holistic approach to overall nutrition, not just weight loss. Consumers are beginning to understand that one size d s not fit all and they need to adopt an individual approach to their health and nutrition.

Jorgensen: There hasn't been a good book on AIDS for a while, one that mentions the latest treatments. And there's a need for AIDS information that's not just for men. Women have it, too. There hasn't been a good book on skin cancer lately, or uterine cancer. We could use books sensitively geared to older people, telling them how to maintain their independence. I'd love to see a book combining Eastern and Western wisdom on how to quit smoking. And I wonder why there is no book that can serve as a diet journal book. You're always told to write down everything you eat, when and where, how you feel, so a journal with an index in back giving calorie counts would be good. Publishers need to reconsider packaging. A book on macular degeneration should be in large print, so the poor person who has that can read it.

Post: Mental health issues continue to be a highly stigmatized topic, despite all the education that is now available. I'd like to see more publications that address mental health issues for children and young people, especially because of the interrelationship between mental health issues, drug experimentation and violence for young people.

Miller: Men, seniors, young people.

Model: I'm sure you've heard this from other people, but teens are the hot subject right now. I think that books that deal, at least in part, in teen eating will be something that is going to go forward.

L wenthal: I think food allergies are an untapped market. It has been estimated that 90 million people, or one-third of Americans, have some form of food allergy, leading to chronic fatigue, depression, digestive problems and more.
Massey: National media
is key in promoting
health titles.
Massey: There are lots of supermarkets opening that have everything in them, including natural food markets and their own supplements. To go along with these things, they're also selling books and magazines that tie in with the organic area. Health sections in bookstores are booming.
Wells: I think the raw food movement is going to keep gaining momentum and somebody will do a major health book on it.

PW: How do publishers refresh their backlist titles in these categories and keep them working?

Meredith: We see what has worked and try to see if it was just a figment of a past obsession, craze and fad or if it can be brushed up, updated and reissued to address current and continuing health needs. We will be revising significantly and reissuing a book on asthma that was the bible for asthma sufferers--the first book ever to provide self-help advice 12 years ago. And that problem has only been growing, plus there are a lot more discoveries in that field.

Post: We find that the authors of health-related books are more than happy to update their books. As the vernacular around American health issues changes, our authors are normally eager to expand on their original manuscripts, especially as consumers have begun to embrace practices that were once considered alternative, such as therapeutic massage and acupuncture.

G hring: One of the ways to maintain a strong backlist is to ensure that the books on the backlist remain thoroughly up-to-date. A health book that is five years old is unlikely to represent the most current thinking of the medical community. Perseus has just issued a new edition (the seventh) of Take Care of Yourself, one of the all-time bestselling self-care books, with over 14 million copies sold. It is in part the currency of that book that helps to keep it so successful in the market. Another example of the importance of revision to the long-term success of a book is Dr. Susan Love'sBreast Book, just released in a newly revised and updated edition. Publishing this new edition has given us the opportunity to include important new research.

Jones: Some publishers do it well, others don't. I'm really happy with the books from Keats Publishing. Since NTC bought it, they've gone through the backlist, revamped titles, brightened up the covers. If a book is dealing with a specific disease, people want to be assured that the book is up-to-date.

Perez: We repackage and update our backlist titles when needed. There's new research being done all the time in the health field, and we want our books to reflect new information and be as up-to-date as possible for our readers. For instance, we just published a completely revised and repackaged Infant Massage by Vimala McClure, which was first published 20 years ago. The book now includes the newest research as well as new, updated photos.
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PW: What areas (i.e., topics that are going out of fashion) are no longer garnering sales?
Moran: The next big
issue will be body-fat
Moran: In the diet area, we think the whole low-carb/high-carb thing will pass. In exercise, I wouldn't touch any sort of Tae-Bo type thing, or spinning.
Shepherd: I think the single-subject books on one particular herb or supplement are getting tougher. Low-fat cooking also feels tired now.

Silverman: It's harder to publish omnibus-type reference books in hardcover, as there's much competition on those shelves--and quite a lot of people are getting that type of information for free online.

Bollh fer: Some areas have hit their stride and are no longer growing. I don't sell as many chronic illness books. Books on grieving and body work seem to have hit their peak and are not growing as much. Books by Deepak Chopra are down.

L wenthal: There seems to be a plethora of books on trendy herbal remedies--from melatonin to natural antidepressants. Many of them just keep selling, and I do think people interested in a particular remedy tend to buy more than one title, but there are undoubtedly a few too many titles out there.

Jones: It's more the areas that are overpublished, like books on women's health. The amount of books is overwhelming. Menopause, for example. It's not a bad topic, but it's overpublished. I have noticed that there is no longer the huge craze for books on Saint John's Wort that there was a year or so ago. There hasn't been a big miracle herb that's surfaced this year.

Massey: Herbs have waned. People are still buying herbs, but they've had enough books about them--unless it's a book about something new. I do think that there may be a future for books on Chinese herbs for medicinal purposes. In three or four years, people may be a little more comfortable with them.

Miller: Traditional generic health topics without fresh hooks by authors without strong credentials.

Wells: I think many of the infomercial people have had their day as authors.
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