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The Diet That Might Cure Depression

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From March 2018, Olga Khazan writes in the Atlantic:

At the turn of the 20th century, prominent physicians who were trying to understand where mental illness comes from seized on a new theory: autointoxication. Intestinal microbes, these doctors suggested, are actually dangerous to their human hosts. They have a way of inducing “fatigue, melancholia, and the neuroses,” as a historical article in the journal Gut Pathogens recounts.

“The control of man’s diet is readily accomplished, but mastery over his intestinal bacterial flora is not,” wrote a doctor named Bond Stow in the Medical Record Journal of Medicine and Surgery in 1914. “The innumerable examples of autointoxication that one sees in his daily walks in life is proof thereof … malaise, total lack of ambition so that every effort in life is a burden, mental depression often bordering upon melancholia.”

Stow went on to say that “a battle royal must be fought” with these intestinal germs.

Another physician, Daniel R. Brower of Rush Medical College, suspected that the increasing rates of melancholia—depression—in Western society might be the result of changing dietary habits and the resulting toxins dwelling in the gut.

Of course, like most medical ideas at the time, this one was not quite right. (And the proposed cures—removing part of the colon or eating rotten meat—seem worse than the disease.) Your gut doesn’t contain “toxins” that are poisonous so much as it hosts a diverse colony of bacteria called the “microbiome.” But these doctors were right about one thing: What we eat does affect how we feel, and gut microbes likely play a role.

A poor diet is a leading risk factor for early death, responsible for one in five deaths globally. Depression, meanwhile, is the leading cause of disability worldwide. A relatively new line of research suggests the two might be related: An unhealthy diet might make us depressed, and depression, in turn, makes us feel even sicker.

In a recently released abstract, researchers studying 964 elderly participants over six and a half years found those who followed the dash diet, which emphasizes whole grains, fruits, and vegetables, had lower rates of depression, while those who ate a traditional Western diet were more prone to depression. The participants were asked how often they ate various foods, and they were screened for depression annually using a questionnaire.

“I think we need to view food as medicine,” Laurel J. Cherian, an assistant professor of vascular neurology at Rush University Medical Center in Chicago and the study’s lead author, told me. “Medications to treat depression are wonderful, but for many people, it’s going to be a combination of things.”

The research will be presented at the upcoming meeting of the American Academy of Neurology. The study has not been published yet in a peer-reviewed journal, but other researchers have found similar antidepression benefits from the dash diet, which was developed by the U.S. National Heart, Lung, and Blood Institute.

Past research has found that following the DASH diet was associated with reduced depression in adolescent girls and with less physician-diagnosed depression among thousands of Spaniards. The results in teens suggest that diet could be a way to stave off some mental disorders entirely, since half of all mental illnesses start in the teen years.

John Cryan, an expert in the gut-brain connection at University College Cork in Ireland, said he’s enthusiastic about this field, but there are a few cautionary notes about this study in particular. It’s an observational study, for example, and it studied a very old population. “Geriatric depression is a different beast,” he says.

Of course, rich people tend to be happier and can afford to eat better. Cherian’s study did not control for socioeconomic status. But overall, the evidence suggests diet improves depression symptoms even when controlling for factors like income or education, says Felice Jacka, a professor of nutritional psychiatry at Australia’s Deakin University.

Jacka found in 2010 that women who ate a diet high in produce, meat, fish, and whole grains had lower odds of major depression and anxiety than others. Since then, a meta-analysis of 21 studies found that “a dietary pattern characterized by high intakes of fruit, vegetables, whole grain, fish, olive oil, low-fat dairy and antioxidants and low intakes of animal foods was apparently associated with a decreased risk of depression.”

In fact, Jacka told me that at this point, the connection between diet and depression is so well-established that more studies like Cherian’s aren’t really necessary. “Given how many observational studies there are already published, the field does not really need more of these,” she said. “What it needs now are interventions that show that if you improve diet, you also improve depression.” Jacka found in a small study last year that depressed people were more likely to see improvements in their mood if they were given dietary advice over a three-month period, rather than just social support. She says such interventions are cost-effective, to boot. . .

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Written by LeisureGuy

12 November 2019 at 10:42 am

How the gut microbiome affects the brain and mind

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Written by LeisureGuy

10 November 2019 at 7:07 am

How to Increase Gut Bacterial Richness

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Dr. Michael Greger blogs:

We live in an “obesogenic environment,” with cheap junk food everywhere, thanks in part to subsidies going to the “‘food industrial complex,’ which manufactures obesogenic foods that foster addiction…The root causes…[may] make obesity difficult to escape,” but a lot of people do. If it were simply the external environment, why isn’t everyone obese?

“Some individuals seem to be more susceptible to the obesogenic environment…than others,” which suggests a genetic component, supported by studies of twins and adopted kids, but the genes that have been identified so far account for only 6 to 11 percent of the genetic variation in body mass index between individuals. Perhaps variation in our “other genome”—that is, all the different microbes that inhabit our body, known as the microbiome—may be playing a role. We have a hundred times more bacterial genes inside us than human genes.

As I discuss in my video Gut Microbiome: Strike It Rich with Whole Grains, a study found that people tend to fall into one of two groups: those who have lots of different types of bacteria in their gut (high “gut bacterial richness”) and those with relatively few types. Those with low bacterial richness had more overall body fat, insulin resistance, which is the cause of type 2 diabetes, high triglycerides, and higher levels of inflammatory markers, like C-reactive protein, compared to those with high bacterial richness. Not only did people with lower bacterial richness start out heavier, but the obese individuals with lower bacterial richness also gained more weight over time.

The question then becomes: Can a dietary intervention have any impact “A number of studies have associated increased microbial richness…with diets higher in fruits, vegetables, and fiber.”

Just giving fiber-type supplements doesn’t seem to boost richness, however, but the “compositional complexity” of a whole food, like whole grains, “could potentially support a wider scope of bacterial taxa,” types of bacteria, “thereby leading to an increase in diversity.” Human studies to investigate the effects of whole grains had been neglected, though…until now.

Subjects were given whole-grain barley, brown rice, or a mixture of both for a month, and all three caused an increase in bacterial community diversity. Therefore, it may take a broad range of substrates to increase bacterial diversity, and this can be achieved by eating whole plant foods.

Moreover, the alterations of gut bacteria in the study coincided with a drop in systemic inflammation in the body. We used to think that the way fiber in whole grains helped us was by gelling in our small intestine right off of our stomach, slowing the rate at which sugars were absorbed and blunting the spike in blood sugars one might get from refined carbs. We now know, however, that fiber is broken down in our colon by our friendly flora, which release all sorts of beneficial substances into our bloodstream that can have anti-inflammatory effects, as well. So, perhaps what’s happening in our large intestine helps explain the protective effects of whole grain foods against type 2 diabetes.

Interestingly, the combination of both barley and brown rice worked better than either grain alone, suggesting a synergistic effect. This may help explain “the discrepancy of the health effects of whole grains obtained in epidemiological [population-based] and interventional studies.”

Observational studies “strongly suggest” that those who consume three or more servings of whole grains a day tend to have a lower body mass index, less belly fat, and less tendency to gain weight, but recent clinical trials, where researchers randomized subjects to eat white bread rolls versus whole-wheat rolls, failed to provide evidence of a beneficial effect on body weight. Of course, whole grains are so superior nutritionally that they should continue to be encouraged. However, the “[i]nterventional trials might have failed to show [weight] benefits because they focused on a limited selection of whole grains, while in epidemiological trials [or the population studies], subjects are likely to consume a diverse set of whole grains which might have synergistic activities.”

Until recently, we knew very little about how powerfully our gut bacteria can affect our health. Catch up on the latest science with these related videos: . . .

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Written by LeisureGuy

10 November 2019 at 6:26 am

Scientist Who Discredited Meat Guidelines Didn’t Report Past Food Industry Ties

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Tara Parker-Pope and 

surprising new study challenged decades of nutrition advice and gave consumers the green light to eat more red and processed meat. But what the study didn’t say is that its lead author has past research ties to the meat and food industry.

The new report, published this week in the Annals of Internal Medicine, stunned scientists and public health officials because it contradicted longstanding nutrition guidelines about limiting consumption of red and processed meats. The analysis, led by Bradley C. Johnston, an epidemiologist at Dalhousie University in Canada, and more than a dozen researchers concluded that warnings linking meat consumption to heart disease and cancer are not backed by strong scientific evidence.

Several prominent nutrition scientists and health organizations criticized the study’s methods and findings. But Dr. Johnston and his colleagues defended the work, saying it relied on the highest standards of scientific evidence, and noted that the large team of investigators reported no conflicts of interest and conducted the review without outside funding.

Dr. Johnston also indicated on a disclosure form that he did not have any conflicts of interest to report during the past three years. But as recently as December 2016 he was the senior author on a similar study that tried to discredit international health guidelines advising people to eat less sugar. That study, which also appeared in the Annals of Internal Medicine, was paid for by the International Life Sciences Institute, or ILSI, an industry trade group largely supported by agribusiness, food and pharmaceutical companies and whose members have included McDonald’s, Coca-Cola, PepsiCo and Cargill, one of the largest beef processors in North America. The industry group, founded by a top Coca-Cola executive four decades ago, has long been accused by the World Health Organization and others of trying to undermine public health recommendations to advance the interests of its corporate members.

In an interview, Dr. Johnston said his past relationship with ILSI had no influence on the current research on meat recommendations. He said he did not report his past relationship with ILSI because the disclosure form asked only about potential conflicts within the past three years. Although the ILSI-funded study publication falls within the three-year window, he said the money from ILSI arrived in 2015, and he was not required to report it for the meat study disclosure.

“That money was from 2015 so it was outside of the three year period for disclosing competing interests,” said Dr. Johnston. “I have no relationship with them whatsoever.”

Critics of the meat study say that while Dr. Johnston may have technically complied with the letter of the disclosure rules, he did not comply with the spirit of financial disclosure.

“Journals require disclosure, and it is always better to disclose fully, if for no other reason than to stay out of trouble when the undisclosed conflicts are exposed,” said Marion Nestle, a professor of nutrition, food studies and public health at New York University who studies conflicts of interest in nutrition research. “Behind the scenes, ILSI works diligently on behalf of the food industry; it is a classic front group. Even if ILSI had nothing to do with the meat papers — and there is no evidence of which I am aware that it did — the previous paper suggests that Johnston is making a career of tearing down conventional nutrition wisdom.”

Notably, Dr. Johnston and colleagues thought it was important to fully disclose their personal eating habits. The meat paper includes an appendix titled “Summary of Panelists’ Potential Conflicts of Interest,” that discloses whether each author eats red or processed meat and how often. Johnston reported no financial conflicts of interest but disclosed that he eats one to two servings of red or processed meat per week.

“We think that’s a potential bias that is worth disclosing,” said Dr. Johnston about the researchers’ personal eating habits.

Dr. Johnston’s ties to the 2016 ILSI-funded sugar study show how ILSI has methodically cultivated allies in academia around the world, and how it recruits influential scientists to help shape global nutrition advice and counter what it perceives to be anti-food industry guidelines by health organizations.

When Dr. Johnston and his colleagues first published the sugar study, they said that ILSI had no direct role in conducting the research other than providing funding, but later amended their disclosure statement in the Annals after The Associated Press obtained emails showing that ILSI had “reviewed” and “approved” the study’s protocol.

Dr. Johnston said that when he published the sugar study in 2016, he put his connection with the food industry group “front and center.” He said in hindsight he was “naïve” when he agreed to work on the ILSI-funded study about sugar guidelines. It was during a conference call on the sugar study that he realized the extent that industry figures were involved with that organization. He declined to say who was on the conference call. . . .

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Written by LeisureGuy

9 November 2019 at 2:03 pm

What’s Your Gut Microbiome Enterotype?

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Yet another reason to favor a plant-based diet: it tilts your gut microbiome in your favor (and away from colon cancer).

Written by LeisureGuy

8 November 2019 at 5:57 pm

Trump’s ‘conscience rule’ for health providers blocked by federal judge

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Yasmeen Abutaleb reports in the Washington Post:

A federal judge on Wednesday voided the Trump administration’s “conscience rule” that would have allowed health-care providers to refuse to participate in abortions, sterilizations or other types of care they disagree with on religious or moral grounds.

U.S. District Judge Paul Engelmayer in Manhattan declared the rule unconstitutional in a 147-page decision that said it was “shot through with glaring legal defects.” The rule had been set to go into effect later this month.

The judge said the administration’s central justification of a “significant increase” in complaints related to conscience violations “is flatly untrue. This alone makes the agency’s decision to promulgate the sule arbitrary and capricious.”

The judge’s decision stemmed from a lawsuit brought this spring by New York and nearly two dozen mostly Democratic states, municipalities and health advocacy groups. They argued the rule illegally favored the personal views of health-care workers over the needs of patients, and threatened to hobble the ability of state-run health-care facilities to provide effective care.

“The refusal of care rule was an unlawful attempt to allow health care providers to openly discriminate and refuse to provide necessary health care to patients based on providers’ ‘religious beliefs or moral objections,’ ”New York Attorney General Letitia James, who led the groups, said in a statement Wednesday.

Many physician and health advocacy groups contended that the rule would have disproportionately harmed certain groups of patients, including LGBTQ patients. . .

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Later in the article:

It was part of the administration’s broader efforts to bolster the rights of religious health providers and restrict abortion access. The administration prevailed in earlier lawsuits against a rule that barred federal family planning grants from going to providers that perform abortions, most notably Planned Parenthood. It has also cut international aid to groups that provide or offer abortions. . .

Written by LeisureGuy

6 November 2019 at 3:55 pm

Change in mise en place

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As I note in the cooking section of this post, after bringing produce home from the supermarket, I like to prepare it for cooking — dice, chop, slice, mince, whatever — and put each veggie into a Glasslock storage container labeled with the veggie and date (using masking tape and an extra-fine Sharpie, “fine” being too coarse). Then when I want to cook something, I bring out the veggies I want to use and take out as much of each as I want, putting them all into a bowl. (I found that it’s better to have what I want to cook all in one bowl, ready to dump into the pan, so that when the pan’s hot, I can add a little olive oil and all the vegetables at once. If I wait until the pan’s hot and then take out some from each storage container, it takes too long to get them all into the skillet. FWIW, I like to use a cast-iron skillet, lately the Field Company No. 10.)

One change is that formerly I would go ahead and cook some of the vegetables that I was preparing: I would steam beets, roast carrots, roast winter squash (delicata, acorn, carnival). Now I find I prefer to dice them small and store them raw. They cook quickly enough, and they seem to keep better if raw. If they are not totally tender (still a little al dente), that’s fine.

Another, more recent change is that I mix veggies a bit. Examples: In the container labeled “Garlic,” I have minced garlic and minced ginger. (And the local garlic and ginger are really terrific.) The garlic-ginger mix is quite nice — I just scoop out as much as I need. “Tomatoes” contains both fresh cherry tomatoes — halved or quartered — and cut-up sun-dried tomatoes (dry pack, not oil pack — most easily cut using kitchen shears rather than a knife). “Jalapeños” contains a mix of jalapeños chopped small and ancho chiles cut into small pieces (again with shears).

I’ve stopped slicing mushrooms, and now I just chop them coarsely.

I use my Field Company No. 10 skillet — the workhorse size. Worth noting: the Duxor Cookware Glass Replacement Lid (11 Inches) fits the No. 10 perfectly — just an FYI. Heat the skillet on the burner (or in the oven), and when it is a good cooking temperature, add:

1.5 tablespoons extra-virgin olive oil

Then immediately add:

chopped scallions
minced garlic and ginger
small-diced beet
small-diced daikon radish
small-diced delicata squash
French green beans cut into 1″ lengths
jalapeños chopped small and cut-up ancho chile
celery chopped small
chopped tomatoes, mix of fresh and dried
about 1.5 Tbsp tomato paste (no salt added)
chopped domestic white mushrooms
chopped broccolini
chopped baby bok choy
diced tempeh (red kidney bean and kamut wheat)
about 1 Tbsp minced fresh turmeric
about 1 Tbsp dried marjoram
about 1 Tbsp dried mint
about 1.5 Tbsp freshly ground black pepper

If the amount is not shown, it means “some.” I just take out a small amount—generally around 1/4 cup, though at least 3/4 cup scallions. Use your own preferences to guide you. I use a smaller amount of minced garlic and jalapeños — around 2-3 Tbsp.

After sautéing that for a while, I added

about 1/2 cup low-sodium vegetable broth

When everything seemed cooked enough — vegetables don’t have to be cooked to complete doneness as does (say) pork — I put into a bowl:

about 1/3 cup cooked intact whole grain emmer wheat
1 Tbsp flax seed, ground
1 Tbsp nutritional yeast flakes
1 Tbsp hemp seed (without hulls: hemp hearts)
1/2 tsp ground tumeric

I topped that with about 3/4 cup of the cooked melange, stirred to mix, and had that with a glass of unsweetened almond milk. Nice warmth, very filling, good taste.

I think the next time I make this I’ll include a 10-ounce package of frozen chopped spinach as the leafy green.

This time, for lunch I’ll add a good handful of chopped bok choy (from a bag of bok choy I had already chopped) and cook that in the breakfast stew; and for dinner I’ll add a bag of shiritaki noodles (chopped) and heat it up again: cook once, get three meals.

Written by LeisureGuy

6 November 2019 at 11:11 am

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