Seth's Blog

• “ant tribes” near Beijing
• What exactly is umami?
• Is omega-3 an antidepressant?  “Initial analyses failed to clearly demonstrate the effectiveness of Omega-3 for all patients taking part in the study. Other analyses, however, revealed that Omega-3 improved depression symptoms in patients diagnosed with depression unaccompanied by an anxiety disorder.” Are they fooling themselves? Maybe not. My research suggests that morning faces can reduce only depression but also anxiety disorders. So if you have depression without an anxiety disorder it may indeed have a different cause.

Thanks to Anne Weiss.

If you know anything about heart disease epidemiology, you know that Japan has the lowest rate of heart disease in the world. The usual explanation is high fish consumption. But other countries, such as Norway, also eat a lot of fish but don’t have low heart disease rates.

My visits to Japan suggest to me that Japanese eat far more fermented foods than people in other countries, including Norwegians. If heart disease is due to infection, then it’s clear that the immune stimulation provided by fermented foods helps fight infection. My umami hypothesis — that we like umami, sour, and complex flavors to encourage bacteria consumption, which we need to be healthy — began with a trip to Japan in 2008, when I noticed, in a food court, many types of miso for sale. Back in Berkeley, I started making miso soup. I was stunned how well it worked. All you needed was miso. No other flavorings. It was so easy and good I ate it every day. It was my first bit of evidence that fermented foods are different and better than other foods.

Here are some fermented foods that are easy to get in Japan:

1. Miso soup. Most Japanese eat this daily. In a few countries, such as France, many people eat yogurt daily. Koreans eat kimchi daily. In most countries, as far as I know, it’s hard to find a fermented food (apart from cheese and alcoholic drinks) that’s eaten daily by most people. Miso is also used to flavor fish.

2. Japanese pickles. The best pickles in the world. Some are pickled as long as as two years, developing noticeable alcohol. Other countries have pickles, of course, but as far as I know the only pickle restaurants are in Japan. Moreover there are pickle shops in big Japanese cities. The only other pickle shops I’ve seen are in New York City.

3. Pickled apricots (umeboshi). At a food court you have a choice of acidity, anywhere from 5% (slightly sour) to 25% (extremely sour).

4. Vinegar drinks. Tokyo 7-Elevens sell a black vinegar drink. Vinegar and water. In food courts you can buy special vinegars for this purpose. I’ve never seen vinegar drinks for sale anywhere else.

5. Natto.

6. Yogurt. The Japanese yogurts I’ve tried were sweetened but weren’t as sweet as the yogurts sold in Beijing.

7. Yakult. The fermented milk drink. It’s sold in such small packages it’s pretty clear it must appeal to people who think it improves their health. It doesn’t boost energy, quench thirst, or taste especially good. The manufacturer says it is good for health and that one bottle per day is all you need.

8. Beer and wine.

Because soy sauce is used in small amounts, it doesn’t count. At a Tokyo restaurant I met a nurse who said she thought you should eat fermented foods every day to be healthy. She said perhaps a third of Japanese believe this.

I’ve never seen high Japanese consumption of fermented foods noticed by epidemiologists. Individual fermented foods (such as miso), yes; the whole category, no. You can see how hard it would be to combine across foods: how much miso equals how much Yakult? Yet I’m sure fermented food consumption is extremely healthy.

After I complained about lack of outrage in Daniel Carlat’s Unhinged, Bruce Charlton pointed me to this essay (registration required) by Simon Sobo, a psychiatrist. Sobo says something I may end up repeating every time the subject of antidepressants comes up:

Rat pups that are isolated from their mother and littermates produce ultrasonic sounds that are indicative of stress. SSRIs [the most popular type of antidepressants] reduce these sounds (Oliver, 1994). Is a chemical imbalance being corrected? I doubt it.

That’s a nice summing-up. Prozac (an SSRI) really does something, but the notion that it returns to normal something broken is absurd. Sobo also gives an example of how the anti-anxiety effect of such drugs works in practice:

Mrs. L. had originally required 40 mg of Paxil (paroxetine) per day to recover from a postpartum depression. After 12 months on the medication, an incident happened that disturbed her. During her lunchtime, she was visiting her 1-year-old son at his day care center when one of the workers began screaming at another infant instead of picking her up. The next day Mrs. L. went shopping during her lunch break. Later that week a co-worker became tearful during the course of a conversation with Mrs. L. regarding her own child’s day care center. Only then did Mrs. L. wonder about her decision to go shopping the day after she had witnessed the day care worker’s inappropriate reaction. She wondered if her Paxil had made her indifferent when ordinarily she would have reacted and worried about such a thing.

My research about mood suggests that depression is due to defective entrainment of a mood oscillator. It’s caused by something missing from the environment. “Chemical imbalance” has nothing to do with it.

I previously blogged (also here) about Carolyn Rodgers’s idea that prenatal ultrasound may cause autism. It turns out that she isn’t the only person with this idea; researchers at the University of Louisville recently published the same idea.

I learned about the Louisville study from Anne Weiss, who said the connection has been plausible for a long time.

Ultrasound was introduced into obstetrics in the 1970′s and was generally restricted to high-risk pregnancies.  By the 1980′s policy statements were issued by ACOG, the NIH and equivalent bodies in Europe and Canada stating that its use should remain limited to high-risk cases. Despite these recommendations, ultrasound technology became common in hospitals and doctors’ offices and routinely applied to low-risk populations. Within a short time the majority of pregnant woman were being exposed at prenatal visits, during multiple scans in hospitals, and during continuous monitoring during labour (which could mean 12 to 14 hours during childbirth alone). Skills and techniques used to monitor the fetus prior to the introduction of ultrasound (in utero and during the birth process) were slowly undermined by the technology and often underutilized.  Iatrogenic effects from false positive readings, – unnecessary C- sections, inductions, instrumental deliveries etc. caused harm to moms and babies, especially in the early 1980′s.

Three important names in the 1980s were (1) Robin Mole, who presented a paper “Possible Hazards of Imaging and Doppler Ultrasound in Obstetrics” to the Royal Society of Medicine Forum on Maternity and the Newborn:  Ultrasonagraphy in Obstetrics, April 1985. She was former director of the Medical Research Council Radiobiology Unit, England.  Also the work of (2) M.E. Stratmeyer – Research in ultrasound.  A public health view.  Birth and Family Journal 1980 and (3) Doreen Liebeskind – still at Albert Enstein and a prof of radiology- presented at a symposium at Columbia in 1983.   She was concerned that ultrasound may be producing subtle changes in the fetal brain perhaps affecting behavioral mechanisms, possible changes in reflexes, IQ, attention span or some of the more subtle psychological, psychiatric or neurological phenomena.  Referred to animal and lab studies that showed ultrasound may cause chromosomal damage, breakdown of DNA, etc.  There are others who sounded the warning that this was not a benign technology but these voices were crowded out for varied reasons like threats of litigation, loss of the traditions skills of birthing etc.

There were also Japanese studies that raised concerns about ultrasound. Weiss continued:

Unfortunately the use of ultrasound in obstetrics has not declined, despite safety concerns and the lack of research to rule out serious neurological effects.  It’s so entrenched in modern obstetrical practice.    Doctors use the machines to protect themselves from litigation – in the case of fetal abnormalities, undetected multiples, placenta previa, neurological or physical damage to the fetus during childbirth, stillbirth etc.  It has almost become a form of entertainment – you can get photos and videos of baby’s ultrasound.  It’s disturbing how benign it appears.

Within the context of the work I do, ultrasound is just one of many concerns I have with the over-management and medicalization of childbirth.  My clients come to me to find ways to subvert this within the hospital setting or to prepare for a home birth with a midwife.   I also get referrals from doctors whose patients are dealing with difficult issues while pregnant.

Bruce Charlton pointed me to this website full of information about how the University of Toronto rescinded a job offer to David Healy, a British psychiatrist, after he made negative comments about Prozac. Psychiatrists at the University of Toronto got a lot of money from Lilly, the maker of Prozac. Here’s something from a CBC documentary about it:

Although he refuses to interviewed, Dr. Nemeroff said through his lawyer that the [University of Toronto psychiatry] center asked for his opinion of Dr. Healy that day and he gave it. . . . Later that day he flew to New York where we do know he told a meeting of the American Foundation for Suicide Prevention exactly what he thought about Healy. One scientist who was there said Nemeroff’s attack was furious, angry, exercised, that the thrust was Healy was a nut.

If Charles Nemeroff calls you a nut . . .