Category: probiotics

Assorted Links

Seth Roberts2 Comments
  • Probiotics reduce frequency of colds, Cochrane review finds
  • A dentist says prophylactic removal of wisdom teeth is a bad idea. “Ten million third molars (wisdom teeth) are extracted from approximately 5 million people in the United States each year at an annual cost of over $3 billion. . . . More than 11000 people suffer permanent paresthesia—numbness of the lip, tongue, and cheek—as a consequence of nerve injury during the surgery. At least two thirds of these extractions, associated costs, and injuries are unnecessary, constituting a silent epidemic of iatrogenic injury.”
  • Duke University trustees defend endowment secrecy in funny ways. “David Rubenstein ’70, the Trustee chair, [says] Duke can keep a student’s grades secret — available only to a few administrators — and the principle is the same with Duke’s money.”
  • Self-assembling robots

Thanks to Allan Jackson and Bob Levinson.

Assorted Links

Seth Roberts10 Comments

Thanks to Nicole Larkin and Tim Beneke.

Hospitals and Their Employees: Stuck in the 1800s

Seth Roberts3 Comments

An article in the New York Times describes how difficult it has been for hospital administrators to get their employees to wash their hands. Hospital-acquired infections are an enormous problem and cause many deaths, yet “studies [in the last 10 years] have shown that without encouragement, hospital workers wash their hands as little as 30 percent of the time that they interact with patients.” Hospitals are now — just now — trying all sorts of things to increase the hand-washing rate. The germ theory of disease dates from the 1800s. Ignasz Semmelweis did his pioneering work, showing that hand-washing dramatically reduced death rate (from 18% to 2%), in 1847.

So hospitals are only now (in the last few years) grasping the implications of facts and a well-established theory from the 1800s. What goes unsaid in the usual discussion of how awful this is — how dare doctors refuse to wash their hands!, a sentiment with which I agree — is how backward both sides of the discussion are. A discussion in which many lives are at stake.

The Times article now has 209 comments, many by doctors and nurses. The doctors, of course, went to medical school and passed a rigorous test about medicine (“board-certified”). Yet they don’t know basic things about infection. (One doctor, in the comments, calls hand-washing “ this current fad“.) They appear to have no idea that it is possible to improve the body’s ability to resist infection. I read all the comments. Not one mentioned two easy cheap low-tech ways to reduce hospital infections:

1. Allow patients to sleep well. The body fights off infection during sleep, but hospitals are notoriously bad places to sleep. Patients are woken up by nurses, for example. You might think that everyone knows sleep helps fight infection . . . but apparently not hospital administrators nor the doctors and nurses who commented on the Times article. It was in the interest of these doctors and nurses to suggest alternative solutions because they dislike washing their hands.

2. Feed patients fermented foods (or probiotics). Fermented foods help you fight off infections. I believe this is because the bacteria on fermented food are perfectly safe yet successfully compete with dangerous bacteria. In any case, plenty of studies show that probiotics and fermented foods reduce hospital infections. In one study, “use of probiotics reduced the new cases of C. difficile-associated diarrhea by two thirds (66 per cent), with no serious adverse events attributable to probiotics.” Maybe this just-published article (Probiotics: a new frontier for infection control”) will bring a few people who work in hospitals into the 21st century.

That hospital administrators and their doctors and nurses — and, in this discussion, their critics — are stuck in the 1800s is clear enough. What is slightly less clear is that our understanding is better now than it was in the 1800s and some of the new knowledge is useful.

Thanks to Bryan Castañeda.

The Yakult Women of Seoul

Seth Roberts6 Comments

Their name in Korean means Yakult women: street peddlers who sell several probiotic drinks, including Yakult. I encountered them in a Seoul suburb (Bundang) on the way to the subway. During one 15-minute walk, I saw three of them. Other street peddlers in Bundang were often men (selling cookware or socks, for example) but the probiotic sellers were always women. I haven’t seen street peddlers selling probiotic drinks anywhere else. In Japan, Yakult and other probiotic drinks are sold door-to-door but apparently not on the street.

I asked a Korean friend how she (and Koreans in general) got the idea that probiotic drinks are good for health (which I am sure is true). She said she knew it before she went to school and believed she picked it up from TV ads. Apparently these ads are more successful in Korea than elsewhere. General Foods recently paid $9 million to settle a legal case based on Yoplait Yo-Plus ads in America that made similar claims. The lawyers who sued General Foods claimed that healthy people don’t benefit from Yoplait Yo-Plus.

I can think of several reasons that Yakult women exist in Korea but (apparently) nowhere else. Maybe the fact that Koreans eat a lot of kimchi makes them more likely to believe that a probiotic is healthy. Maybe Koreans care more about health than other people. Maybe Koreans are unusually sophisticated about health. Bundang’s density (it is full of tall apartment buildings) is surely one reason, because Yakult women weren’t the only street peddlers. American suburbs, where I almost never see street peddlers, are much less dense. Another certain reason is that Bundang is a wealthy suburb. A third certain reason is that Yakult and similar drinks help you digest lactose. Lactose intolerance is much more common in Asia than elsewhere.

It would be interesting to compare the rate of digestive problems in South Korea versus other countries, especially the United States. I think they are likely to be much less common in South Korea.

Is Crohn’s Disease Really “Incurable”?

Seth Roberts8 Comments

I recently came across two different people who, diagnosed with Crohn’s disease, repeated the standard line that it “has no known cure”. Really? Never? The people who said this were just repeating what they had been told. Unlike twenty or thirty years ago, however, it is easy to do one’s own research. The people who said this gave no indication they had done any research. Because Crohn’s is so unpleasant, their passivity was curious.

I knew that calling Crohn’s disease “incurable” was an overstatement because I had written about Reid Kimball, who had found a way to eliminate via diet essentially all the symptoms. For practical purposes, he was cured. (Reid objects to the word “cure”.) I knew he was hardly the only one. But what if I started from ignorance? How hard would it be to challenge the conventional “incurable” line?

Not hard at all. I googled “Crohn’s success” (without quotation marks in the search query). The top search result (titled “Crohn’s Disease: Success with Diet and Probiotics”) included this:

I learned of a pediatric gastroenterologist, Dr. J. Rainer Poley, who had conducted extensive studies on the effect of certain sugars and starches on people with intestinal diseases. My husband and I decided to take our daughter to see this doctor for another opinion. When we asked him if there was any other treatment she could try besides medications, he explained that at a recent medical conference in Europe, he had learned of success medical doctors were having with probiotics. He instructed our daughter to eat plain yogurt every day and to take a specific probiotic capsule called Culturelle® containing Lactobacillus GG [Gorbach and Goldin] twice daily. Based on Dr. Poley’s research, he wanted her to limit the consumption of concentrated sugars (specifically table sugar, technically known as sucrose). The intent of the sucrose-restricted diet was to starve the harmful bacteria by taking away their major food source. The yogurt and Lactobacillus GG would help replenish the “good” bacteria. Since it has been well documented that an overgrowth of bacteria is prevalently seen in people with Crohn’s disease, this treatment sounded like a plausible solution.

Our daughter, feeling drained from the effects of Crohn’s disease, felt motivated to try the doctor’s recommendations. . . . After about two weeks, she began to feel better in general. At the follow-up doctor’s appointment three months later, she had gained six pounds and her lab work was ALL NORMAL! . . . She continues to remain well [over 7 years later] with normal lab work and without clinical symptoms.

I asked Ms. Kalichman how others had fared with this treatment. She replied:

Periodically, I hear from others who have tried the treatment that my daughter does, and it seems that many have been helped a lot. Unfortunately they don’t always continue to keep in touch, so I don’t have any idea how many are totally well. Our daughter continues to be well as she has been for almost 9 years now…no meds and no clinical symptoms.

That took about 5 minutes, including emailing Kalichman. She referred me to a video about it.

The Power of Blog (Fermented Foods Division)

Seth Roberts3 Comments

A few weeks ago I posted a short note about Yakult, a probiotic dairy drink popular in Asia. Yesterday, I came across someone who had read that note. He wrote about it in a post categorized as Learning Koanic Soul.

To test whether I did indeed now possess Melonhead powers, I attempted to manifest the thing I wanted most, and had been striving to attain the longest: a cure for the adverse side effects of the Accutane I’d taken 8 years ago.

Here’s a brief list of the side effects I suffered:

  • chronic diarrhea
  • chronic fatigue
  • inability to eat almost every food, including pills
  • insomnia
  • additional symptoms, increasing exponentially when I eat forbidden foods or miss sleep

Over the last 8 years I’d painstakingly developed a coping regimen that worked in theory, as long as I did it perfectly. But it was so strict that holding down a job or traveling were almost impractical. And any error meant days if not weeks of down time. I rarely achieved better than than 50% functionality. And my diet was so limited that I ate only one meal continuously – lean steamed meat with rice, scallops and shrimp.

All attempts at a cure had failed, and not only failed, but proven that I couldn’t even digest the pills that might make me better. Instead, the difficulty of digesting the pills induced a failure cascade, a reinforcing feedback loop of insomnia, stress, fatigue and diarrhea. After years of fighting this illness, I had learned a great deal but was running out of things to try.

So, for my first manifestation attempt, I decided to demand an INSTANT cure.

Not a regimen for coping with symptoms… Actual, immediate, damage reversal. . . .The experiment began as I wrapped up a Skype conversation with a Melonhead. He’d just finished describing his “powers” to me. I got the idea for the experiment, and told him what I’d try to manifest. Immediately I experienced a boost in energy – I’d been feeling sick. I was shocked – it appeared to be already working.

I finished talking to the Melonhead, and flicked open my RSS reader while deciding what to do next. Up popped an article by Seth Roberts mentioning the GI healing properties of Yakult, a fermented yoghurt drink common in Asia. Accompanied with link to scientific paper and news report.

This startled me, because I’d been planning to try fermenting my own yoghurt next, although I had low expectations for success. I was planning on getting a yoghurt making machine, yada yada. I began reading with interest. Could this be the sign I’d requested?

As I finished reading, my girlfriend arrived home. I told her I wanted to buy some of this “Yakult” stuff tomorrow, figuring the grocery stores were closed tonight. She replied that she had some in the refrigerator.

This got my attention. I’d requested an instant cure… and the cure, if it was one, had been sitting IN MY REFRIGERATOR before I requested it.

The main problem was the massive sugar content of Yakult. I knew that I had sugar malabsorption issues – I can’t eat fruit. There was an excellent chance that if I tried the Yakult, I would become sick for at least 3 days, and endure excruciating pain. For the record, torture by several consecutive days of gut cramps is one of the few things I am afraid of, being a subset of torture in general. Nevertheless, I elected to drink two (disgustingly sweet) Yakult bottles that night.

Over the next couple of days I continued to ramp up my Yakult dosage. My body rebelled some at the radical change, but it also showed signs of improvement. The expected disaster failed to materialize.

Day two was the worst. I felt as if I might be becoming genuinely sick. Given the amount I’d drunk, this meant a solid three days of agony were kicking off. That night I endured some physical pain, but I was also strangely energized, so that I had the mental reserves to face it out. Normally the illness saps all capacity for resistance.

That night I received a “message” (or had a thought, whichever you prefer) that “it would take three days.” Sure enough, on day 3 I knew was better, significantly so, instead of worse. There could be no further doubt that it was working. For me, something had finally changed.

Note that I would expect a full gut healing to take place over 3-6 months. It’s not simply a matter of fixing diet or finding the right pill, but 1. rebuilding bacterial colonies and 2. regrowing and healing intestinal lining damaged or eaten away by inflammation and acidity. While these results are not instant, they are screamingly fast in GI terms.

Impressed by this initial success, over the next few days I began to let manifestation guide my behavior intuitively, rather than using logic to determine my actions. An image of a key supplement appeared in my head – I went and bought it at the precise store I remembered seeing it. When I arrived I discovered it was on sale: 2 for 1.

At the grocery store, I simply wandered, letting manifestation dictate my purchases. I grew disgusted with the excessive sweetness of Yakult: lo and behold, I found a bulk yoghurt with a lower sugar content. I tested a few key supplements I had lying around, and found I could now digest pills. So I started taking everything I’d stored up but been unable to use. This resulted in a major improvement. At the same time, I gradually began eating a more diverse collection of foods, letting intuition guide me. No disaster ensued.

Once it was clear that I was cured, I wanted to know my new limits. And I didn’t intend to wait 6 months to find out. Among other things, I’ve tested a half block of cheese (lactose and fat intolerance), modest amounts of fruit (fructose and insoluble fiber intolerance), and the finisher, a greasy-spoon restaurant meal.

None of these could induce a return of the diarrhea that has plagued me for the last 8 years. However, the first and third did make me tired and give me gas for a couple of days. So I’m not invincible. The former was probably a matter of trying too much fat too soon (I have liver damage impairing fat digestion), and the latter was simply unfit for human consumption.

All this took about two weeks to transpire, from June 15 to June 28 [2012], and brings us to the present. I am eating a varied and delicious diet, and enjoying good energy and good health. My 8 year torment is at an end.

Conclusion: His girlfriend is Asian, he isn’t. More seriously, it really does show the power of fermented foods, in this case Yakult and yogurt.

Double Interview on the Benefits of Probiotics

Seth Roberts2 Comments

This curious 2006 article has an interview with one researcher in one column and an interview with another researcher in another column. Their results differed.

Pro probiotic. “Children with [infectious acute diarrhea] who took Lactobacillus [various strains and species, in nutritional supplement form, not in yogurt form] had a shorter duration of diarrhea (on average 0.7 days shorter) than those who took placebo. Also, they had fewer episodes of diarrhea, i.e. fewer stools, on the second day of treatment than those in the placebo group. Interestingly, the children who took higher doses of Lactobacillus had shorter duration of diarrhea, and it seems that a daily dose of at least 10 billion viable bacteria is necessary to have a beneficial effect.”

Anti probiotic. “I published a big study looking at Lactobacillus GG in kids with Crohn’s disease who were already doing fairly well on medication. We put them on the probiotic or a placebo for two years. We followed them for two years and looked for whether the probiotic group had a lower rate of relapse and whether there were any differences between the two groups. We didn’t find any differences.”

Assorted Links

Seth Roberts7 Comments
  • New study shows that a Yakult probiotic drink helps people with lactose intolerance and the benefits persist 3 months after one month of drinking it. Yakult is common in Chinese and Japanese supermarkets but rare in American ones. Until I read this article, I didn’t realize that people drink it because of lactose intolerance, which is much more common in Asia than America. Via Cooling Inflammation.
  • news from the Human Microbiome Project. “To the scientists’ surprise, they also found genetic signatures of disease-causing bacteria lurking in everyone’s microbiome. But instead of making people ill, or even infectious, these disease-causing microbes simply live peacefully among their neighbors.” You may recall that a Nobel Prize was given for the discovery that ulcers are caused by a certain species of bacteria. However, almost everyone with the “disease-causing” bacteria does not get ulcers. Apparently the “surprise[d]” scientists studying the human microbiome did not know that. If it were better known that you don’t need to kill bacteria to make them harmless, antibiotic usage would be less attractive.
  • Air pollution epidemiologist fired from UCLA after his research contradicts claims about the danger of air pollution.
  • How to conduct a personal experiment: biphasic sleeping

Thanks to Melissa McEwen, Peter Spero, Tim Beneke, Dave Lull and Bryan Castañeda.

Assorted Links

Seth Roberts3 Comments
  • Probiotics reduce/prevent diarrhea caused by antibiotics. News article. The abstract says “The pooled evidence suggests that probiotics are associated with a reduction in AAD [antibiotic associated diarrhea].” It should say that the evidence suggests — very strongly, in fact — that probiotics cause a reduction in AAD (because there is no plausible alternative explanation of the association). This mistake is so elementary it is like saying 2 + 2 = 3. And JAMA is one of the world’s most prestigious medical journals.
  • Living without money. The author was much healthier than when he lived with money. Among the many possible explanations is that dumpster food, old enough to allow microbes to grow on it, is healthier than fresher and therefore more sterile food.
  • Not just farms. Children who grow up on farms have fewer allergies and less asthma than children who grow up in cities — important support for a modified version of the hygiene hypothesis (and my umami hypothesis). This study finds that living near other sorts of biodiversity provides similar benefits.

Thanks to Brody, Jazi Zilber and Mark Griffith.

Fermented Foods Improve Irritable Bowel Syndrome

Seth Roberts5 Comments

It’s hard to get scurvy. If you eat anything resembling an ordinary diet you won’t get it. The existence of scurvy, produced by extreme conditions, led to the discovery of Vitamin C. From the case of scurvy and Vitamin C we learned — well, most people learned — that some diseases are clues to what we need to eat to be healthy.

There is no lab test for irritable bowel syndrome (IBS). It is diagnosed if you have “abdominal pain or discomfort in association with frequent diarrhea or constipation,” says Wikipedia, and a dozen other things (colon cancer, lactose intolerance, celiac disease and so on) can be ruled out. It is common. In the United States, one study found that 14% of those surveyed had it. Surveys in other countries produce even higher values — the United States is not a hotspot. “It is one of the most common diseases diagnosed by doctors,” says an NIH webpage.

What is it telling us? According to the NIH webpage, “medications are an important part of relieving symptoms.” Those medications include anti-depressants. If you treat the problem with drugs, you completely ignore the possibility that a digestive problem is due to eating the wrong food. You might think that would be obvious — but no. Of course, people with IBS are less interested in taking medicine so they often believe they are “intolerant” to various foods. But they have a hard time figuring out what those foods are, and their problems persist. The Wikipedia section about causes is a monument either to the ignorance of medical school professors or Wikipedia contributors:

The cause of IBS is unknown, but several hypotheses have been proposed. The risk of developing IBS increases sixfold after acute gastrointestinal infection. Post-infection, further risk factors are young age, prolonged fever, anxiety, and depression.Publications suggesting the role of brain-gut “axis” appeared in the 1990s, such as the study “Brain-gut response to stress and cholinergic stimulation in IBS” published in the Journal of Clinical Gastroenterology in 1993. A 1997 study published in Gut magazine suggested that IBS was associated with a “derailing of the brain-gut axis.” Psychological factors may be important in the etiology of IBS.

That’s all. Nothing about eating the wrong food. And people wonder what to do about the cost of health care! My suggestion: get rid of everyone (especially medical school professors) too blind or biased to consider that a digestive problem may caused by the wrong food.

Fortunately not everyone is rushing to treat IBS sufferers with drugs. In an obscure journal called Molecular Medical Reports, an open-access article recently appeared about diet and IBS (“Diet and effects of diet management on quality of life and symptoms in patients with irritable bowel syndrome”). The authors are from Norway, which makes the sanity more understandable. The article looks at the effect of dietary advice on IBS symptoms. It compares three groups of patients (IBS patients given dietary advice, IBS patients not given dietary advice, and people without IBS). Patients with IBS eat quite differently than everyone else (for example, they eat less dairy, thinking they might be lactose intolerant), but they are still bad off.

The main point of the article is that the dietary advice was helpful. IBS patients given the advice two years before the study were better off than IBS patients not given the advice, although even those given the advice were considerably worse than normal. Looking at the difference between the diets of the two IBS groups, the better-off group ate a lot more probiotic dairy:

The guided IBS patients reported a consumption of sour milk products containing probiotics almost twice as often as the unguided IBS patients and one and a half times that of the controls. The products used were supplemented with Lactobacillus rhamnosus GG, Lactobacillus acidophilus La-5 and Bifidobacterium Bb-12. Patients with IBS were found to have fewer Lactobacillus spp. and Bifdobacterium spp. in their intestinal flora than healthy individuals (44). These bacteria have been shown to bind to epithelial cells and inhibit pathogen binding, and to enhance barrier function (46). Furthermore, these bacteria do not produce gas on fermenting carbohydrates, an effect which would be amplified as they also inhibit Clostridia spp. (46). A number of studies have shown an improvement in flatulence and abdominal distension with a reduction in the composite IBS symptom score, following probiotic intake (45,46) [emphasis added]

It is highly unlikely that we need to eat sour milk products containing probiotics to be healthy — such products are new in evolutionary history. But it is entirely possible that we need to eat plenty of microbe-laden (e.g., fermented) food to be healthy, as I have said countless times on this blog. The big improvement in IBS symptoms produced by probiotics supports my belief that we need to eat plenty of fermented foods to be healthy. (The Wikipedia entry about IBS mentions probiotics and yogurt, but not fermented foods.) Maybe IBS, like scurvy, is a clue to something really important.

Thanks to Melissa McEwen.