Sunday, July 24, 2011

Maybe it's Not All in Your Head

Para nuts, fresh from the rain forest, at the outdoor market
 in Belem, Brazil
Everyone knows that food can cause all sorts of physical effects on our bodies. Sugary desserts can cause cavities, sodas can leach calcium out of our bones, and too many carbs can make us soft and push us toward diabetes. None of that is disputed.

What is disputed, and is a topic of ongoing research, is the effect certain foods have on our mental health. There is a growing body of evidence showing that for certain individuals, some foods can cause mental fogginess, depression, anxiety, and can aggravate more severe mental issues, such as schizophrenia. The flip side to that cause and effect is that removing the offending foods may allow individuals to alleviate their symptoms and eliminate or reduce certain medications - a very promising concept.

Before I go on, a quick fact: did you know that about 10% of all adults in the United States (and about 2% of all children - yikes) have prescriptions for anti-depressants? And that number doubled between 1995 and 2005 (coinciding with the advent of direct-to-consumer advertising, by the way). So there are a lot of people out there being medicated for depression.

Let me state up front that I believe some individuals do have brain chemistries that can benefit from anti-depressants. And for those individuals, medications can be lifesaving. However, I am suspicious that 1 in 10 adults in the United States need an anti-depressant. Therefore, I do wonder if there are commonalities in our environments, like, say, an intolerance to wheat or dairy products, or an inability to process ever-increasing amounts of sugar, that affect the brains in individuals with susceptibilities to those products.

There is a lot of interest in the food/brain connection.

Recently, Alice Bradley, the talented writer of the blog Finslippy, wrote about her new diet that eliminated wheat, dairy, sugar, and grains, and focused on fruits, vegetables, and protein. After only a few weeks, she was able to wean herself off of Remeron, Klonopin, and sleep meds, retaining only her prescription for Prozac. If you Google "wheat and depression," you get 11,900,000 hits. Google sugar and depression and you get a whopping 30,600,000 hits. Part of the interest in sugar can be traced to Gary Taubes' fascinating New York Times article on the perils of sugar.

However, once you delve into the research behind the claims, you are quickly confronted with a wide divide between medical professionals who believe food intolerances can cause all sort of mental problems and those who pooh-pooh the entire concept, chalking up any gains made in mental health from altering one's diet to the placebo effect. It's confusing.

A lot of the confusion comes from the research not catching up to the anecdotal evidence. Mental health is difficult to quantify because symptoms are, for the most part, self-reported. Depression and anxiety can vary from person to person and treatment success often boils down to, "I feel fine." But the fact that the placebo effect exists tells us that there are still many mysteries in medicine that cannot be fully explained by science.

Despite the problems with quantifying mental health, there has been compelling information published on how the gut is like a "second brain," with its own nervous system operating independently of the brain. A new field, neurogastroenterology, has been proposed to better understand how the gut mediates the immune response, and there are even murmurings of psychiatry expanding to include treatment of this second brain in addition to the one the field currently focuses on. (Side note: sounds a bit like holistic medicine, no?).

Further, research on the different antibodies, IgE (immediate ones associated with hives and anaphylactic shock) versus IgG (delayed ones associated with food intolerances, a concept that current medical practice does not fully embrace), is plodding along. Fascinating stuff from an academic perspective. But frustrating when you are interested in the practical application of the information. Thus far, no one has scientifically mapped out why foods being digested in the gut can have effects on the brain. So a lot of medical professionals are skeptical of any food/brain effect link.

But I don't think you need clear-cut answers in order to move ahead with managing your health. If you are being treated for anxiety or depression you might want to talk to your doctor about trying an elimination diet to determine if some of the common allergens, such as wheat, dairy, or soy, could be underlying or contributing to your condition.  Here is information on elimination diets, and a good nutritionist can guide you through the challenges of what may at first seem to be a daunting task.

I look forward to the emerging research that will map out how our second brain interacts with our "first" brain. Until then, I think there is enough information to encourage us all to look closely at the link between our diets and our mental health.


Thursday, July 21, 2011

The Green, Green Grass of Home Part II

Just a few weeks ago, I wrote about lawn chemicals and their effects on children's health. Today I learned that that EPA's science advisors will be delivering the results of a two-year study on atrazine, one of the most common weed killers used in the United States. You can weigh in on this issue over at Takepart, the advocacy arm of Food, Inc. Lots of good links on that page, too.


Sunday, July 10, 2011

This is So Bad

Trust for America's Health and the Robert Wood Johnson Foundation have released their annual obesity statistics, and they're not pretty. See that map above? See how it's mostly red? That means over 25% of the adults living in those states in 2010 were not just overweight, but obese. Kids don't far much better. Click here for the children's obesity map, as well as interactive maps for both populations, and the full report (fittingly titled "F as in Fat: How Obesity Threatens America's Future").

What's even more shocking to me than the high percentages of obesity is how quickly the rates are rising. Eight states have obesity rates that are over 30%. Just four years ago, only one state was above 30%.

The report outlines troubling racial and economic disparities - more African Americans and Latinos were obese compared to whites, and more people making less than $15,000 per year were obese compared to those making more than $50,000 per year.

I'm not sure we can legislate ourselves out of this mess. A junk food tax might help pay for the end result of all the medical care that obesity-related conditions require and might dissuade some from purchasing sodas. Better labeling might enable consumers to see how much sugar is in certain foods by grouping all the sources of sugar together, for example. And subsidizing fruits and vegetables might help bring the costs of those important foods down. But the answer still comes down to education and choice. Unfortunately, changing behaviors is one of the most difficult public health challenges to take on, especially after those behaviors have become the norm. For example, if everyone you know snacks on sodas and chips, it is normal. You are odd if you choose fruit or yogurt. If you are surrounded by overweight people, that becomes the new normal for your community, which means it is accepted and even supported in the options available. Slim people may have trouble finding clothes that fit and healthy foods may be even scarcer as merchants cater to the tastes of their clientele. Those barriers are difficult to overcome.

Do you think changing the food labels like the Center for Science in the Public Interest suggests below will help? (Here is the report from which this image was taken.)

Michelle Obama is trying to bring attention to this issue, and kudos to her for using her platform as First Lady for this issue. States are trying to address the problem through school lunch nutrition guidelines and other legislation. But the problem just keeps getting worse. Any ideas?

Update: If you can't view the graphic for the food label, following the link to the report. The graphic is on page 10.

Wednesday, July 6, 2011

The Green, Green Grass of Home

My neighborhood is very diverse when it comes to yards.

Directly across the street from me lives the former president of my state's organic farmers society. Because his front yard gets a lot of sun, he has transformed it into a yard/garden, with tomatoes, peppers, squash, eggplants, sunflowers and more. He has planted fig trees, locust trees, and blueberry bushes. When I walk my dog past his yard in the mornings, my movements flush out indigo buntings, yellow finches, and cardinals. There are good caterpillars that turn into blue butterflies, and bad caterpillars that eat the tomatoes. There are bees to pollinate the plants, and rabbits that sneak in to nibble the greens. It is a lively place if you look closely.

At the other end of the yard spectrum are the perfectly green, perfectly clipped lawns.  The chemical trucks show up a couple times each month to visit these lawns. The drivers spray the lawns and then stick little warning signs in them noting that children and pets should stay off of them for at least 24 hours. Even though it is dangerous to walk barefoot on them, these lawns look inviting, like outdoor carpets. When I walk my dog past those lawns, I don't startle many birds.

Other lawns are somewhere in the middle. They do not receive regular pesticide applications, but the owners use chemicals periodically to treat acute problems, like fungus, or use fertilizers to boost the blooms of ornamentals.

But by far  the outdoor carpet yards outnumber the others by a significant amount in this neighborhood. 

That's unfortunate for a number of reasons. Our neighborhood is beautifully hilly. When it rains, the runoff from all of our yards drains into storm sewers and creeks. Many of those chemicals that children and pets are warned against walking on eventually end up in the water supply, where they have to be (one hopes) removed. But before they are, those chemicals affect the wildlife that live in or drink from the creeks. When we first moved to this neighborhood years ago, we would see crayfish and minnows in the creeks near our house. I can't remember the last time I have seen any forms of life in them. I try my best not to let my dog drink out of them.

But the problems with the chemicals are not just in our water supply. We can breathe them in when they are sprayed, track them into our homes, and get them on our hands when we pick up baseballs that have been hit into the next yard. Our pets pick them up on their feet, and then they lick them off (did you know up to 50% of dogs develop cancer in their lifetimes? While not all canine cancers can be attributable to lawn chemicals, some probably are. Here is a veterinarian-written article on the risk of various chemicals to our canine friends.) I've come to view these yards as dangerous to my family's health as second hand smoke.

More and more research is showing that those green carpet lawns are wildly dangerous to the environment and to humans - especially children. ADHD, autism, and cancers are just a few of the terrible endpoints that have been linked to lawn chemicals, with headaches, rashes, and asthma, and many other health problems occurring frequently enough to serve as warning signs that something serious is amiss. Recent news noting that environmental factors play a role as large, if not larger, than genetics in autism should have everyone scrambling to remove as many impurities as possible from their personal environments until more is known about this issue.

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Object name is apa0098-0664-f1.jpg Object name is apa0098-0664-f1.jpg
The United States birth defect rate by month of LMP
versus atrazine concentration.
Source: Winchester, et al.
Acta Paediatr. 2009 April; 98(4): 664–669.
There is so much research on this topic! The graph to the right was published in a 2009 study. Even a grade school kid can see that the months that the concentrations of the weed killer atrazine were highest in surface water is associated with birth defects in kids conceived during those months (LMP stands for last menstrual period and is a marker for conception).

This chart is for atrazine only, which, coincidentally, is banned in many European countries and parts of Canada (the US periodically considers banning it, but never does). Chalk up another instance where our European friends have made it a priority to protect the health of their citizens. In the United States, the northeastern states, such as New Hampshire and Connecticut are leading the way in restricting the use of lawn chemicals. For example, in 2005, Connecticut banned lawn pesticides around daycare centers and schools out of recognition that children should not be playing on them. I think that's a great start.

Choosing to go pesticide free does not mean you are signing up for a patchy eyesore of a lawn. There is a lot of knowledge to tap into, and a lot of tips and techniques to create a green lawn that is indistinguishable from one that uses pesticides.  Here's a nice article from Organic Gardening that offers tips on a healthy lawn. Beyond Pesticides supplies information on lawn care, fact sheets, and "Tools for Change" to work with your neighborhood and policy makers to tighten up control measures for unnecessary pesticide application.  Even the Environmental Protection Agency encourages integrated pest management for lawn care, which includes the use of some chemicals for problems, but stresses the use of beneficial insects to counter harmful ones.

What does my lawn look like? Well, it's a mix of sod and other green things, like clover (obviously we're in need of nitrogen). It was originally all sod, but an unfortunate sewer line incident caused part of the sod to be replaced, and the replacement ground cover didn't completely take. This green mix is quite pretty when it's mowed to a uniform height. (We're not fooling ourselves when we think it's pretty - the EPA notes that the average consumer thinks lawns consisting of up to 15% weeds look fine.) We use dirt from our compost bin to fill the beds where our herbs and flowers live. If you dig into those beds, you'll find lots of worms. I'm thinking about getting one of these signs. After all, the birds in my yard need a place to rest, don't you think?