One Pill Makes You Larger

By Scott Charles Anderson

Patient: “Are these time-release pills?”
Doctor: “Yes. They start to work as soon as your check clears.”

Jekyll and Hyde
Okay, so I have occasional mood swings…

As if we didn’t have enough crazy things to drive us around the bend, new research indicates that our happy pills are making us chubby. That’s right, the drugs that doctors give us to feel gladder are actually making us fatter. They’re converting our Oedipal issues into adipose tissues.

Antidepressants, antipsychotics and mood stabilizers (beware the mood that has fled the stable) are all implicated in this perverse reverse diet. In one study, ninety percent of the people who took Zyprexa, just to name one of the drugs, gained weight. A third of them managed to gain over twenty pounds, and half of that group topped up with an extra forty pounds. And that was just the first year. The long-term prospects are grim.

This particular drug is used to treat bipolar disease, which is a serious syndrome, but some of the other side effects include (this is straight from the manufacturer’s brochure): impaired judgment, discolored teeth and seizures. If you’re taking this drug, you should talk to your doctor about switching to Cheetos, which have similar contraindications, but may be better for your mood, if not your weight.

depression
Breaking out of depression without busting the scales

A large class of antidepressant drugs affect serotonin, a brain chemical that elevates your mood. They’re called selective serotonin reuptake inhibitors, or SSRIs, and they basically recycle serotonin to keep it in circulation, presumably ginning up your spirit. They are quite popular, and you might know them by their trade names: Prozac, Paxil, Zoloft, Celexa and many, many others.

Down the hatch

However, as important as serotonin is in the brain, it is even more important in your gut, where 90% of your body’s serotonin is located. I’ve been accused of thinking with my stomach and having gut feelings and it turns out, it’s all true. Your gut is a hotbed of neural activity and psychotropic drugs are everywhere. How cool is that? This is primo cocktail chatter, at least at a microbiology convention. It might even be a (dodgy) excuse for bad behavior: “My microbiome made me do it!”

When you pop an antidepressant, it splits it’s payload between your gut and your head, in that order. And the dose to your gut can be deadly to certain beneficial bacteria. In other words, some of these psychoactive drugs are also acting as antibiotics. That’s an underappreciated side-effect.

Psychiatrist and patientOn the other hand, SSRIs can encourage other bacteria that may help you pack on the pounds. In one study, a strong correlation was found between body mass index (BMI) and antidepressants. But the more intriguing finding was a connection to methane on the breath. Methane is a byproduct of certain kinds of bacteria associated with obesity and the tantalizing thought is that antidepressants may affect gut bacteria that can then alter your appetite and your ability to digest food.

We’ve actually known for a long time that the stomach affects the brain and vice-versa. In 1822, a fellow named Alexis St. Martin was shot in the stomach and was treated by Dr. William Beaumont, who didn’t expect his patient to live. Against the odds, St. Martin survived, but his body formed a fistula, or a hole, from his stomach to his side. It was gross and had to be bandaged up to keep stomach acids from squirting out, but Dr. Beaumont was delighted. It gave him an unprecedented window on digestion.

Seizing the opportunity, Dr. Beaumont took St. Martin on as a servant and semi-willing guinea pig. The doctor extracted  stomach juices through the fistula and had them analyzed. He also tied string around different foods, dipping them into poor St. Martin’s stomach and regularly retracting them to monitor the digestion process. St. Martin was not fond of these experiments, but it led to the discovery that heavy emotions can affect the amount and acidity of stomach juices. Dr. Beaumont realized that the brain could directly affect the chemistry of the stomach.

Evidence is accumulating that the reverse path, from the gut to the brain, is also viable. At least some of the intermediaries in this brain/gut axis seem to be bacteria. They are ambassadors mediating between the wishes of the host and the desires of the huge population of microbes in your gut. That two-way conversation can be sweet or horribly dramatic, running the gamut from bliss to high anxiety. The nasty end of that microbial scale may lead to illness, obesity and even death.

It’s easy to underestimate the extent of the brain/gut axis. Seemingly unrelated symptoms turn out to be strangely correlated. For instance, gut bacteria may play a role in Autism Spectrum Disorder (ASD). Granted, the best evidence comes from a mouse model of autism, but you can’t do these experiments on people yet. The ASD mouse, as well as having autistic-like behavior, also has a leaky gut, another hallmark of autism. When they dosed their ASD mice with some bacteria called B. fragilis, their entire gut ecology changed: they had a more natural mix of bacteria, with less Clostridia — and their leaky guts healed. At the same time, some (but not all) of their “autistic” behavior improved. Rebooting their bacteria seemed to lower their levels of anxiety and increased their desire to explore. The new gut bacteria changed the way their minds worked.

A pill for everyone

Two-thirds of autistic children are taking some kind of psychotropic medication, including antidepressants, but they aren’t the only ones. Antidepressants are prescribed for all kinds of mental issues, many of which are justifiable reactions to our modern, hectic world. These are people who are sad, anxious or just plain stressed out by life — some 50 million Americans. Talk about a depressing statistic! That’s one in six. Look around at five of your friends. If none of them is mentally distressed, then you’re it.

How is it that the richest country in the world has become so psychically impoverished? In the past, I might have had suspicions about a vast conspiracy between doctors and giant pharmaceutical companies to get us all on expensive medications. Fortunately, my doctor prescribed some very soothing pills that have completely purged me of such paranoid ramblings. I feel much better about it all now.

The best pill of all?

To add insult to injury, recent studies have shown that many of these wonder drugs are not much better than a placebo, which is a wonder drug of its own. Placebos are just cheap sugar pills, but that doesn’t mean they don’t work. Far from it. My Dad, who participated in more drug trials than was prudent, once told me he was addicted to placebos. He was joking (I think), but one study after another has shown that placebos really can reduce pain for people, and the more they cost, the greater the effect. In fact, red placebos work better than white placebos, probably because they seem more serious.

Doctors are now trying to get obesity classified as a mental illness. And when they do, of course, we’ll need some more drugs for that. Let’s hope they’re not too fattening.

Might we be heading down the wrong path? Instead of prescribing pills that screw up our digestion and make us fat (but not always jolly), maybe we should be getting happy by eating foods that encourage feel-good bacteria in the first place? Is there such a thing? Perhaps! New research is showing that certain kinds of gut-bacteria are associated with mood, and these fun bugs are termed psychobiotic.

That’s right, dear reader, this is a new paradigm (with a very catchy name) about the control that our bacterial overlords have over our own thoughts, so prepare for some overwrought comparisons to zombies and such. Nevertheless, evidence is piling up that there is a connection between our bacteria and our brain, and that we are swimming upstream with our current batch of psychrotrophic drugs. Instead of killing good bacteria with antidepressants, perhaps we should just be boosting our happy bacteria and skip the middleman.

Good mood food

Happy Paella
Can food make you happy? Is that really a question?

We still don’t know how to really change our gut ecology without major intervention, but there are certain “mood foods” that might help. Yogurt has been shown to make people happier, and it might work as well as a placebo or even an antidepressant.

Fiber feeds bacteria that produce butyrate, a short-chain fatty acid that helps to heal and maintain the integrity of your gut. It can even reduce the chances of getting colon cancer. Healing your gut and establishing a good ecology sends a message to your brain to be less anxious. So eat your beans and artichokes and lighten up a bit.

Bam!

A friend of mine, who has done much research on the subject, insists that the ginger they serve with sushi is better than most drugs, legal or not. I understand the feeling. Personally, I find it impossible to think bad thoughts when I’m eating spicy Jamaican food, even when they forget to add the ganja. And have you ever wondered how a miserably poor country like India manages to produce so many well-adjusted people, even when they’re employed in godforsaken call centers? Could it be the curry?

You might think this is a simplistic solution, and you would be correct. But what’s wrong with simple? Does it make better sense to take pills for depression that make us fat which then depresses us even more? Maybe simple isn’t so wacky after all; studies show that spices can be psychoactive, so why not kick things up a bit?

Okay, some of us have honestly nasty problems, and antidepressants help a lot of people get through some rough patches. And there are many researchers working on solving the weight-gain problem with some success. So listen to your doctor. But if I were borderline, I think I’d tell my doctor that I’m going to skip the pills and instead spice up my life with some good mood food.

Anxiety melts in spicy Tom Yum soup. Depression dissipates with yogurt. Sadness cannot thrive in the presence of coconut curry. Call me nuts, but I’m feeling better already.


RESOURCES

Basseri, Robert J., Benjamin Basseri, Mark Pimentel, Kelly Chong, Adrienne Youdim, Kimberly Low, Laura Hwang, Edy Soffer, Christopher Chang, and Ruchi Mathur. “Intestinal Methane Production in Obese Individuals Is Associated with a Higher Body Mass Index.” Gastroenterology & Hepatology 8, no. 1 (January 2012): 22–28.

Munoz-Bellido, J. L, S Munoz-Criado, and J. A Garcia-Rodriguez. “Antimicrobial Activity of Psychotropic Drugs: Selective Serotonin Reuptake Inhibitors.” International Journal of Antimicrobial Agents 14, no. 3 (April 2000): 177–180. doi:10.1016/S0924-8579(99)00154-5.

De Vadder, Filipe, Petia Kovatcheva-Datchary, Daisy Goncalves, Jennifer Vinera, Carine Zitoun, Adeline Duchampt, Fredrik Bäckhed, and Gilles Mithieux. “Microbiota-Generated Metabolites Promote Metabolic Benefits via Gut-Brain Neural Circuits.” Cell 156, no. 1–2 (January 16, 2014): 84–96. doi:10.1016/j.cell.2013.12.016.

Dinan, Timothy G, Catherine Stanton, and John F Cryan. “Psychobiotics: A Novel Class of Psychotropic.” Biological Psychiatry 74, no. 10 (November 15, 2013): 720–726. doi:10.1016/j.biopsych.2013.05.001.

Hsiao, Elaine Y., Sara W. McBride, Sophia Hsien, Gil Sharon, Embriette R. Hyde, Tyler McCue, Julian A. Codelli, et al. “Microbiota Modulate Behavioral and Physiological Abnormalities Associated with Neurodevelopmental Disorders.” Cell 155, no. 7 (December 19, 2013): 1451–1463. doi:10.1016/j.cell.2013.11.024.

Wattanathorn, Jintanaporn, Pennapa Chonpathompikunlert, Supaporn Muchimapura, Aroonsri Priprem, and Orathai Tankamnerdthai. “Piperine, the Potential Functional Food for Mood and Cognitive Disorders.” Food and Chemical Toxicology 46, no. 9 (September 2008): 3106–3110. doi:10.1016/j.fct.2008.06.014.

Gomez-Pinilla, Fernando, and Trang T J Nguyen. “Natural Mood Foods: The Actions of Polyphenols against Psychiatric and Cognitive Disorders.” Nutritional Neuroscience 15, no. 3 (May 2012): 127–133. doi:10.1179/1476830511Y.0000000035.

Scharlau, Daniel, Anke Borowicki, Nina Habermann, Thomas Hofmann, Stefanie Klenow, Claudia Miene, Umang Munjal, Katrin Stein, and Michael Glei. “Mechanisms of Primary Cancer Prevention by Butyrate and Other Products Formed during Gut Flora-Mediated Fermentation of Dietary Fibre.” Mutation Research/Reviews in Mutation Research 682, no. 1 (July 2009): 39–53. doi:10.1016/j.mrrev.2009.04.001.

Tillisch, Kirsten, Jennifer Labus, Lisa Kilpatrick, Zhiguo Jiang, Jean Stains, Bahar Ebrat, Denis Guyonnet, et al. “Consumption of Fermented Milk Product With Probiotic Modulates Brain Activity.” Gastroenterology 144, no. 7 (June 2013): 1394–1401.e4. doi:10.1053/j.gastro.2013.02.043.

Kirsch, Irving, Thomas J. Moore, Alan Scoboria, and Sarah S. Nicholls. “The Emperor’s New Drugs: An Analysis of Antidepressant Medication Data Submitted to the U.S. Food and Drug Administration.” Prevention & Treatment 5, no. 1 (2002). doi:10.1037/1522-3736.5.1.523a.

Jacobs, Keith W., and Frances M. Nordan. “CLASSIFICATION OF PLACEBO DRUGS: EFFECT OF COLOR.” Perceptual and Motor Skills 49, no. 2 (October 1979): 367–372. doi:10.2466/pms.1979.49.2.367.

Antibiotics are Killing Us!

By Scott Charles Anderson

You probably think of antibiotics as life-saving medicines that can cure everything; you name it. From fevers and flu to ear aches and colds, antibiotics are a god-send. Except, of course, that they are really not good for fevers, flu, ear aches or colds, which are largely caused by viruses, which we don’t really know how treat except to let them run their course.

That doesn’t mean that we don’t treat those things with antibiotics. We do. But antibiotics are only good at killing bacteria, not viruses. The reason to use something that is completely ineffective is partly because doctors are tired of arguing with patients (who are not interesting in letting something “run its course”), and they sometimes give in. As my doctor is always reminding me: patients are annoying and needy.

Bacteria and virus
Antibiotics only work on bacteria (the sausages), not viruses (the bug upper left).

So we over-treat with antibiotics – big deal, right? Well, except that it can lead to antibiotic resistance. This is when a bacteria comes up with a way to defeat the antibiotic using a sort of high-speed evolution. When you use antibiotics inappropriately, you inevitably kill bacteria that were just minding their own business. You also kill some of those that were doing you a big favor by keeping something worse at bay. Nastiest of all, you can create bacterial ghettos that have developed resistance – and might not be so benign.

When low doses of antibiotics are used for a long time, bacteria aren’t always killed outright and – because they multiply like mad – they have many chances to try to defeat the drug. Bacteria are very loose with genes, and they can actually steal resistance genes from other bacteria by simply eating them. These guys know how to evolve.

Resistance also arises when people feel better and then quit taking their antibiotic before all the germs are dead. Those that last the longest may have evolved some resistance. You feel great, but you may have created a rebel force in your own body that is just waiting for your immune system to get distracted and then wham! When you least need it, you get something like MRSA (Methicillin-Resistant Staphylococcus Aureus) or my personal favorite, flesh-eating bacteria.

But a little resistance never killed anyone, right? Well, except for at least 23,000 people that we know of each year, and probably closer to 100,000. According to the CDC, 2 million people a year get a nasty infection with one antibiotic resistant bug or another. Treating them is a major headache for hospitals. We are running out of antibiotics that can kill these super-germs.

But our own mindless self-infliction isn’t the only problem with antibiotics. The truth is much more irritating because we have no control over it: the biggest users of antibiotics – by far – are cows, pigs and chickens.

Are we getting resistant bugs from our meat? The studies aren’t conclusive, but they are strongly suggestive: in countries where they trace antibiotics in animal feed (unlike the US, where no tracking is required), the bacteria that are targeted in the animals also show up – in resistant form – in the guts of the consumers. When the antibiotics are pulled out of animal feed, the corresponding resistant bugs disappear in the population.

As compelling as these studies are, they are epidemiological – not the gold standard of a controlled study. Citing this lack of controlled studies, the meat industry claims that antibiotics are safe. And, assuming you cook everything properly, you should be killing all the resistant bacteria anyway. But the epidemiological studies are hard to ignore. Somehow, it seems, the resistant bacteria are sneaking off the farm.

A stronger connection can now be made between farm animals and their close human neighbors. From an ecological point of view, it’s a smart idea to use animal manure to fertilize crops, returning nutrients to the land. But when the animals are on continuous antibiotics, their manure contains antibiotics too, and then it may be a bad idea. The people who live near crops that are fertilized by pig manure suffer higher rates of infection by MRSA.

So that’s not good, but that may not be the worst of it. Have you ever wondered why they feed antibiotics to animals? Are they all sick? Well, when farmers stack up the animals in tight quarters, they do get sick. A lot. And good old fashioned veterinary care is part of the rationale for antibiotics. But the real reason that animals are continuously fed a low dose of antibiotics is a bit of an industry secret: it makes them grow faster.

Why? Although bacteria, once established in the gut, are useful to digestion and normal GI health, there are two ways that they can cause trouble. First, the gut needs to make sure that it is prepared with mucus and other defenses to keep new bacteria away from the cell lining, and that requires some energy. Second, the animal needs to routinely mount immune responses against the bad bacteria that breach that protection. The theory is that providing low doses of antibiotics ameliorates this situation, and with less gut trouble to attend to, the animal can grow faster.

Interestingly, the same trick works for humans, too. Think of it: although you kill bacteria when you cook food, do you destroy all the antibiotics as well? If not, then farmers aren’t just fattening their livestock, they are fattening you as well.

You might think that putting antibiotics in animal feed is new, but look at this quote from an article titled Public Health Significance of Feeding Low Levels of Antibiotics to Animals, written in 1973:

“The feeding of low levels of antibiotics to farm animals … was introduced experimentally in 1949 and commercially in 1950. Chlortetracycline, oxytetracycline, penicillin, and streptomycin were the first to be used, and other antibiotics, especially bacitracin and tylosin, soon came into use. The initial use of low-level antibiotic feeding was to promote growth of chickens, pigs, and calves.”

So, since 1950, we have all been on the second-hand end of a grand experiment to determine how fast and cheaply we could fatten up farm animals. Antibiotics work like a charm.

While the farm animals were plumping up, there was a corresponding increase in the average American waist line. Admittedly, we didn’t keep very good records on obesity until the 60s, but that was mostly because it wasn’t a big problem before then. Again, this is correlation, not causation, but it gives one cause to pause.

Today, 80% of all antibiotics sold in this country are used in farm animals. Where does all that go? It breaks down to 10% for treating sick animals and 90% for weight gain. That’s an alarming figure, because it doesn’t take a lot of antibiotics for weight gain: just a slow drip will make an animal grow bigger, faster. It implies that a staggering number of farm animals are receiving routine antibiotics. We don’t know exactly how many, however, because in the United States, antibiotic drugs are not tracked by any government agency.

Just a slow drip. When you add up all the meats we eat, it is not hard to imagine that we are getting a low maintenance dose of antibiotics as well. We may be having the same reaction: faster growth and weight gain. The fat of the land may be turning us into the land of the fat.

Selman Waksman
Selman Waksman, the scientist who discovered several antibiotics for farm animals.

This is a story that started with good intentions. Antibiotics have made the world a much safer place. Alexander Fleming discovered the first one, penicillin, in 1928. Selman Waksman discovered many other antibiotics in the early 1900s, including streptomycin, which was the first drug to cure tuberculosis. Routine use of antibiotics has cured dozens of diseases that plagued farm animals. Putting antibiotics into animal feed seemed like a great way to stop opportunistic infections, increase meat production and feed a hungry nation.

Eliminating so many communicable diseases allowed farmers to cram animals ever closer together. Because they are all being dosed, they can wallow in poop all day without coming down with something dreadful. And that helps to bring down the cost of meat, even as it raises the level of disgust about how we do it.

If you’re concerned about these problems, look for labels that say

  • No antibiotic use
  • no routine antibiotic use

The second label is to designate that on occasion, antibiotics are used to treat illness on these farms. Even so, the farmer using this label must provide a waiting period in order to flush out the antibiotics. That waiting period provides an interesting insight. It demonstrates that farmers are concerned that antibiotics remain in the flesh for some time, and they might make it into humans.

You’re going to have to pay to get rid of antibiotics. These animals can’t be as tightly packed and you will have to reimburse the farmers for that extra room. But it’s worth it if you want to opt out of the antibiotics being unwittingly prescribed for you by your farmer. We should declare this experiment successful: antibiotics can make all of us grow bigger faster. Now let’s stop it.

Earlier, I mentioned that we have no control over this, and it’s mostly true. You can talk to your congresspeople until you are blue in the face. People have been trying to ban routine antibiotic use for over forty years. The lawmakers have been briefed, so they know how dangerous the practice is. There has been progress in Europe. But American politicians need a lot of money to get elected, and the farm lobby is one of the biggest and richest in the world. Faced with such persuasive piles of money, very few politicians can find the courage to stand up to them. It’s a hard problem, but we shouldn’t give up.

We should, at a minimum, vote the bums out. But we should also show the animal industry that we are catching on to their tricks, and we should buy antibiotic-free foods whenever we can (that’s what your congresspeople are doing!). This money thing can work both ways. It may cost a bit more in the short run, but in the long term, the savings from being thinner and therefore less prone to heart disease and diabetes will more than compensate. Oh yeah, you’re also less likely to get a horrible disease caused by some rogue antibiotic-resistant bacteria.

The animal industry may not have a heart, but it has a very sensitive wallet. Once they realize their customers value healthy food over mere bulk, they will come around. It is time, dear reader, to take back our health!


Resources

Sieburth, John McN, Jose Gutierrez, James McGinnis, Joel R. Stern, and B. H. Schneider. “Effect of Antibiotics on Intestinal Microflora and on Growth of Turkeys and Pigs.” Experimental Biology and Medicine 76, no. 1 (January 1, 1951): 15–18. doi:10.3181/00379727-76-18375.

Jukes, Thomas H. “Public Health Significance of Feeding Low Levels of Antibiotics to Animals.” In Advances in Applied Microbiology, edited by D. Perlman, Volume 16:1–30. Academic Press, 1973. http://www.sciencedirect.com/science/article/pii/S0065216408700212.

Roura, E, J Homedes, and K C Klasing. “Prevention of Immunologic Stress Contributes to the Growth-permitting Ability of Dietary Antibiotics in Chicks.” The Journal of Nutrition 122, no. 12 (December 1992): 2383–2390.

Gaskins, H. R., C. T. Collier, and D. B. Anderson. “Antibiotics as Growth Promotants:mode of Action.” Animal Biotechnology 13, no. 1 (2002): 29–42. doi:10.1081/ABIO-120005768.

Phillips, Ian, Mark Casewell, Tony Cox, Brad De Groot, Christian Friis, Ron Jones, Charles Nightingale, Rodney Preston, and John Waddell. “Does the Use of Antibiotics in Food Animals Pose a Risk to Human Health? A Critical Review of Published Data.” Journal of Antimicrobial Chemotherapy 53, no. 1 (January 1, 2004): 28–52. doi:10.1093/jac/dkg483.

Dibner, J. J., and J. D. Richards. “Antibiotic Growth Promoters in Agriculture: History and Mode of Action.” Poultry Science 84, no. 4 (January 1, 2005): 634–643.

Casey JA, Curriero FC, Cosgrove SE, Nachman KE, and Schwartz BS. “HIgh-density Livestock Operations, Crop Field Application of Manure, and Risk of Community-associated Methicillin-resistant Staphylococcus Aureus Infection in Pennsylvania.” JAMA Internal Medicine (September 16, 2013): -. doi:10.1001/jamainternmed.2013.10408.

Feighner, S. D., and M. P. Dashkevicz. “Subtherapeutic Levels of Antibiotics in Poultry Feeds and Their Effects on Weight Gain, Feed Efficiency, and Bacterial Cholyltaurine Hydrolase Activity.” Applied and Environmental Microbiology 53, no. 2 (February 1, 1987): 331–336.


The Musical Fiber Diet

By Scott Charles Anderson

I tell you, we are here on Earth to fart around, and don’t let anybody tell you different.
— Kurt Vonnegut.

When I started to do research on fiber in diets, I quickly found that dietitians drone on and on about three sources of calories in your diet: carbs, protein and fat. Fiber is indigestible, so it is excluded. The resulting triumvirate of nutrients is all you need in order to define any particular diet. Or is it? The truth, as usual, is messier than that, but could be a life-saver. At the risk of making you think about pie, let’s start by looking at a typical American low-fat diet:

Low-fat American diet with no fiber

The amount of protein in your diet is the least flexible of the three food groups. Too little, and your blood vessels leak. You start to swell up like a water balloon. Unlike fats and carbs, a certain amount of protein is essential in your diet. We know those actual amounts thanks to chicken and pig studies. It turns out that it’s difficult to recruit humans – even college students – for starvation studies. That means much of what we know is extrapolated from farmers, who are always trying to minimize the amount of expensive protein they feed their animals. It’s far cheaper to fatten them up on carbs. That, um, applies to people, too.

It turns out that the minimum percentage of protein in the diet holds steady across most animals.  So, humbling as it may be, a pig’s lower limit is probably a good proxy for humans, at 15% of dietary calories.

Ammonia comes out where?

On the other hand, too much protein can put a strain on your kidneys and liver. The upper limit is harder to nail down, but when it exceeds the ability of your liver to process it and your kidneys to excrete it, your urine backs up into your blood, you become slightly green and you begin to pee ammonia. Sure, you might be able to wash windows with that, but it’s not good for you in the long run. You typically don’t reach that point until your protein intake exceeds around 35% of your calories. Depending on your overall calorie intake, that’s about 170 grams of protein, or 3 half-pound burgers a day. If you think about it, that’s just a snack for someone like Michael Phelps, which demonstrates that the amount of protein you can tolerate is also related to how crazy physical you are. Here are some sample diet plans, sorted by protein percentages, so you can see how wide the range is:

Diet Plan protein (%)
carbs (%)
fat (%)
American 15 65 20
Paleo 20 20 60
Moderate 25 50 25
Low-fat 25 60 15
Atkins 30 5 65
Zone 30 40 30
Low-carb 40 25 35
Ketogenic 45 10 45
P90X 50 30 20

The typical American diet has the least amount of protein, in favor of the highest carbs. Despite its macho meat-shredding image, America seems far happier with French fries and Twinkies. At the high end is P90X, a muscle-builder’s diet that calls for a heroic amount of protein. If you’re not pumping iron, this diet could turn you green.

The rest of us, according to more sober dietary recommendations, should constrain our protein to a fairly narrow range between 20% and 30%. For the sake of argument, let’s go with the average: 25%. But when we do, we run into several interesting problems.

Hope you like fat

The pie chart at the start of this article is for the low-fat diet that has successfully guided Americans to the greatest epidemic of obesity of all time. Switch to a low-carb diet with the same amount of protein, and you get this juicy fat pie:

low-carb diet

To lower carbs you have to increase fat, because we’re holding the protein at 25%. According to this analysis there are really only two parts of your diet that you have any control over, and lowering one will always raise the other. A low-fat diet implies a high-carb diet, which doesn’t sound nearly as healthy. Similarly, a low-carb diet is actually a high-fat diet, which sounds even less appealing. But the fact is, reducing one part of the triad inevitably raises another. So we’re doomed, right?

Well, of course we’re doomed. No one gets out of here alive. But in fact, this particular pie is only half-baked.

When do we get to the fiber?

One problem with this simple picture is that there are other sources of calories besides the big three. One that is dear to my heart is alcohol. My doctor says it is also good for my heart, although I had to go through a lot of doctors to find her. Alcohol is a source of calories, too. Unlike carbs and fats, though, alcohol is digested by the liver, which squeezes 7 calories out of each gram. So our pie really has four slices, not three. But before I cook up a new pie chart, we need to introduce another source of calories: fiber. Yes, fiber is considered to be indigestible, but that just means that your unaided gut can’t break it down. However, the bustling bacteria camping out in your bowels just love the stuff. Because you don’t digest it, the fiber makes it intact all the way to your colon, where your microbes eagerly feast on it. In doing so, they actually create fatty acids that – you guessed it – have calories after all. So fiber becomes the fifth slice of the pie. Here’s the pie chart for the final accounting, assuming a “moderate” diet:

nutrients by calorie

The fatty acids derived from fiber include something called butyric acid, which turns out to do marvelous things in your colon, such as thickening its lining, improving the mucus barrier and reducing inflammation. This is largely the work of bifidobacteria, which is a welcome bug to harbor in your gut, even if butyric acid stinks like rancid butter. People who eat fiber have far less GI inflammation, which means fewer episodes of irritable bowel syndrome and a lowered chance of getting colon cancer. As if that isn’t enough, it can lower your cholesterol and reduce your chances of getting type 2 diabetes, all as a consequence of bifidobacteria digesting “indigestible” fiber. In particular, bifido, as we call him around the house, likes inulin, a fiber found in veggies like Jerusalem artichokes, onions and chicory root.

This conversation goes south

Of course, there is the indelicate matter of gas that we must attend to. Those bacteria produce more than fatty acids, and that’s why adding fiber can be called a musical diet. You may not be surprised to learn that a primo source of fiber is beans. Most of the fiber you eat is either vegetable or fruitish in origin, because meat doesn’t have any fiber to speak of. For your amusement (or pun-ishment), I have assembled a short but perhaps memorable list of the vegetootles that may add some music to your day, including fartichokes, marshrooms, asparagas, bleets, patooto skins, bell poopers, and, of course, leeks. There are many more, but I couldn’t make funny words out of them. The Mayo clinic has a good list of them here:

http://www.mayoclinic.com/health/high-fiber-foods/NU00582

If you have to pick a gas to pass, choose hydrogen or carbon dioxide. They’ll have you tooting like a motorboat, which is fairly humorous, but not eye-watering. However, the bacteria that produce hydrogen sulfide can really clear the room. Although we know of no one who has actually been killed by hydrogen sulfide toots, we still refer to them as deadly. And don’t forget methane, which can turn your butt into a flamethrower if you light it. Many a frat house has been scorched this way. For some reason, probably related to decorum and civility, sorority houses are not similarly afflicted. Rest assured, women fart as much as men, but they may be more convincing when they blame the dog.

What’s wrong with these charts?

But wait! The chart above shows you the percentages of the five food groups by calorie. To make any sense of that, you need to know how that relates to real-world stuff like weight. How much does a calorie’s worth of food weigh? That depends on its energy density; for instance there are 9 calories per gram of fat, but only 2 calories per gram of fiber. When you take that into account, you have to slice the pie differently:

nutrients by weight

That big chunk of fat gets reduced to a modest slice, and the amount of fiber greatly expands. This is a better way to view the data; to truly visualize the balance of nutrients in your diet, you need to see actual quantities of food, not just abstract calories. When you look at the proportions based on the actual serving size, you realize that you probably aren’t eating enough fiber. Sadly, we may be drinking too much as well.

The moral of this story is that fiber is good for you and should be a bigger part of your diet. It is healthy for your colon and it provides bulk to stave off hunger pains. It lowers cholesterol and prevents type 2 diabetes. Taking fiber out of our diets with foods like white bread and refined sweets is a big contributor to the obesity plague. We need to figure out good ways of incorporating more fiber into each meal. A good start is to avoid processed food, which is like livestock feed: a modicum of protein and a bunch of cheap carbs. And add some veggies to your diet. I know, your mom told you that. The thing is, she was right.

So, even though it comes with a little musical accompaniment, that’s the way it goes. Fiber is neglected, but essential. You’ll just have to poot up with it.


Afterword

In my research for this article, I discovered that farting is one of the few biological functions that continue after death. You may be gone, but the microbes in your gut can party on for hours, dancing with tiny lampshades on their heads, long after the lights have been turned off. It gives the phrase “party-pooper” a whole new meaning. I know, it’s gross and irrelevant, and yet it seemed important to bring it up.


REFERENCES

Crampton, E. W. “Nutrient-to-Calorie Ratios in Applied Nutrition.” The Journal of Nutrition 82, no. 3 (March 1, 1964): 353–365.

Anderson, James W, Pat Baird, Richard H Davis Jr, Stefanie Ferreri, Mary Knudtson, Ashraf Koraym, Valerie Waters, and Christine L Williams. “Health Benefits of Dietary Fiber.” Nutrition Reviews 67, no. 4 (2009): 188–205. doi:10.1111/j.1753-4887.2009.00189.x.

Jh, Cummings, Bingham Sa, Heaton Kw, and Eastwood Ma. “Fecal Weight, Colon Cancer Risk, and Dietary Intake of Nonstarch Polysaccharides (dietary Fiber).” Gastroenterology 103, no. 6 (December 1992): 1783–1789.

Salmerón, Jorge, Alberto Ascherio, Eric B. Rimm, Graham A. Colditz, Donna Spiegelman, David J. Jenkins, Meir J. Stampfer, Alvin L. Wing, and Walter C. Willett. “Dietary Fiber, Glycemic Load, and Risk of NIDDM in Men.” Diabetes Care 20, no. 4 (April 1, 1997): 545–550. doi:10.2337/diacare.20.4.545.

Brown, Lisa, Bernard Rosner, Walter W. Willett, and Frank M. Sacks. “Cholesterol-lowering Effects of Dietary Fiber: a Meta-analysis.” The American Journal of Clinical Nutrition 69, no. 1 (January 1, 1999): 30–42.

Kumar, Chethan M, Kollegal S Rachappaji, Chilkunda D Nandini, Kari Sambaiah, and Paramahans V Salimath. “Modulatory Effect of Butyric Acid—a Product of Dietary Fiber Fermentation in Experimentally Induced Diabetic Rats.” The Journal of Nutritional Biochemistry 13, no. 9 (September 2002): 522–527. doi:10.1016/S0955-2863(02)00180-8.

Spiller, R. “Review Article: Probiotics and Prebiotics in Irritable Bowel Syndrome.” Alimentary Pharmacology & Therapeutics 28, no. 4 (August 15, 2008): 385–396. doi:10.1111/j.1365-2036.2008.03750.x.

Hague, A., A. M. Manning, K. A. Hanlon, D. Hart, C. Paraskeva, and L. I. Huschtscha. “Sodium Butyrate Induces Apoptosis in Human Colonic Tumour Cell Lines in a P53-independent Pathway: Implications for the Possible Role of Dietary Fibre in the Prevention of Large-bowel Cancer.” International Journal of Cancer 55, no. 3 (1993): 498–505. doi:10.1002/ijc.2910550329.

Osman, Nadia, Diya Adawi, Göran Molin, Siv Ahrne, Anna Berggren, and Bengt Jeppsson. “Bifidobacterium Infantis Strains with and Without a Combination of Oligofructose and Inulin (OFI) Attenuate Inflammation in DSS-induced Colitis in Rats.” BMC Gastroenterology 6, no. 1 (December 1, 2006): 1–10. doi:10.1186/1471-230X-6-31.

Brown, Lisa, Bernard Rosner, Walter W. Willett, and Frank M. Sacks. “Cholesterol-lowering Effects of Dietary Fiber: a Meta-analysis.” The American Journal of Clinical Nutrition 69, no. 1 (January 1, 1999): 30–42.


The Happy Diet!

By Scott Charles Anderson

Some cause happiness wherever they go; others whenever they go.
—Oscar Wilde.

The Scream
The Scream by Edvard Munch: in need of yogurt?

I’m grumpy, as usual, because daylight is so damned bright. Worse yet I’m at work, which really buzz-kills my day. If it weren’t for work, I could be doing something amazing and exciting, like watching Survivor reruns while crunching down Cheetos and chugging beer. Yeah, I know what you’re thinking: That’s what I want too! Yet, instead we plod off to work with a bunch of other depressed people whom we call our coworkers and stare at the poster of The Scream we have tacked to our cubicle wall.  Like millions of Americans, I’m depressed. And just a little anxious.

So when I came across some research that said eating certain foods could make you happier, I thought I would look into it. Okay, my wife insisted.

What I found was wild: Just when you think you might have a little free will after all, comes more proof that “you” are a vanishingly small satchel of hope that is being squashed flat under the boot of modern science.

In this particular study, scientists watched with hand-wringing glee as they fed mind-controlling bacteria to their hapless subjects. What insidious method did these Voodoo scientists use to inoculate these poor people? The bastards used yogurt!

That’s right, after eating yogurt for a month, the subjects were happier. Well, that’s just great. But how can you expect anyone to eat yogurt like that? I hate yogurt with all its smarmy, fruity unctuousness. The more I thought about it, the more I realized that this diet – at least for me – would be pretty humiliating. So I jumped on it.

Put Your Bacteria on the Happy Diet

The theory behind the Happy Diet is that bacteria can actually communicate with your brain through nerves, hormones and the lymphatic system. It’s called the gut-brain axis — an authoritative name for a dimly understood partnership. There is still a healthy debate about exactly how your gut talks to your brain and vice versa. Some of it, however, seems pretty settled: there is a second “brain” in your body, and it’s not Steve Martin.

The Man with Two Brains
Maybe The Man with Two Brains isn’t so weird after all.

It is called the enteric nervous system (ENS) and it’s big, covering your entire intestinal tract. From pie hole to poop chute, the ENS picks up information about what’s going on inside your gut and then sends signals to the muscles lining your GI tract. When something like food poisoning happens to you, it’s your ENS that gives the order to churn out massive quantities of fluid to flush everything out of your gut, from both ends, if necessary.

The ENS is wired to your brain via the vagus nerve, and this part seems pretty straightforward, at least as far as anything to do with neural circuits can be straightforward. In animal studies where nasty bacteria were used to induce anxiety, severing the vagus nerve stopped the anxious behavior. However, a complete understanding of the neural details remains elusive.

At least some of the basics can be roughly sketched out: a bacterially diverse gut is a healthy gut, and a healthy gut can make you happier. When you get some kind of microbe oligarchy where one bacterial family starts to dominate, you may be attacked from within: your gut barrier may be breached, your immune system then goes on alert and you become inflamed. That can spoil your day, even if you don’t recognize that the problem started in your gut. So maybe I’m not really grumpy. Maybe I just have cantankerous bacteria.

A Cast of Billions

There are four bacterial players that deserve top billing: lactobacillus, bifidobacteria, streptococcus and clostridia. You may recognize lactobacillus as the living part of yogurt. Bifidobacteria are also fond of yogurt and fiber. In this story, clostridia and streptococcus are the bad guys. When you feed the good guys with something like fiber or complex sugars like lactose (from milk), they multiply like crazy and push aside the nasty clostridia.  When you neglect the good guys, clostridia and other aggressive microbes take advantage of the chance to switch into Animal House mode.

We usually think of fiber as something like tree bark, and indeed tree bark is fibrous. But for all its tough-guy image, fiber simply consists of sugar molecules strung together in a chain that our humble human guts can’t process. Bacteria, which mammals welcomed into their wet spots some millions of years ago, just love fiber. They have no problem chowing down on these sugar chains, and when they do, they poop fatty acids – ambrosia for the cells lining your gut. This is a sterling example of symbiosis at its best; it signifies a long and fruitful partnership.

Dancing bacteria on the Happy Diet

But some of these bacteria are better for us than others, at least in the proper measure. The good guys feed you; the bad guys feed on you and may accidentally kill you. I say accidentally, because most of them really don’t want to kill you: they have a vested interest in getting you to feed them. When your gut feels good, that means your good bacteria are performing their most impressive job: protecting you from the bad bacteria. It’s a continuous battle, and these microscopic warriors are on the front lines.

Lactobacillus and bifidobacteria excrete a fatty acid compound called butyrate, which turns out to be a superfood for the cells that line your gut. In effect, these good bacteria feed and repair your gut, helping to address Crohns, IBS, ulcerative colitis and a host of other nasty problems all related to a leaky gut. And, it turns out, those maladies can also make you anxious and depressed. That might seem obvious, but the brain often receives some pretty hazy messages from the gut, like the feeling of butterflies or hot coals. Sometimes the feelings are so vague that it’s hard to know where they’re coming from at all. You simply feel anxious.

Messages of danger (or health) are transmitted in multiple ways. One is by way of the vagus nerve to your hypothalamus, a part of your brain that triggers hormones that can affect your appetite, mood and the movement of your gut. This is a fast communication link taking a fraction of a second, perfect for reacting quickly to poisons or bacterial toxins.

A slower, steadier communications channel uses cells of the immune system. For instance, leaky guts let bad bacteria through, which triggers an immune response. These inflammatory signals travel through your lymphatic system as well as your blood, affecting other parts of the brain/gut axis, again affecting your mood.

Long-term or short-term, the brain-gut axis contributes to our levels of anxiety and depression, and we ignore it at our peril.

So what to do?

The Happy Diet attempts to address this issue with “happy bacteria”. The first thing I had to do was ditch the fruity yogurt. Besides being unmanly (heaven knows I’m a lot of man), these yogurts have so much sugar they may have you bouncing off the walls and my walls just aren’t that sturdy. I found, instead, that thick Greek yogurt was basically the same as sour cream, and since manly men use sour cream on their manly baked potatoes, I felt safe. Plus, if god had meant us to eat fruits, they would grow on trees, not hide at the bottom of a yogurt cup.

So I started to eat Greek yogurt on everything. The idea here is to get the live bacteria, so you can’t actually cook with it. But you can add it on top of soups (yes!) or on top of other cooked veggies. Try it on scrambled eggs. Depending on your levels of gustatory fortitude, you could try it in your cereal, but I found that pretty disgusting, all the way to the bottom of the bowl.

And I found another source of lactobacillus that really blew up my skirt (my manly skirt): homemade fermented pickles! The making of pickles deserves an article on its own, because it is so surprising and so delicious. For instance, do you know the recipe for sauerkraut? It’s cabbage and salt. Yup! Slice some cabbage, salt it, and within minutes it starts to make its own juices. Lactobacillus is everywhere, and enough is on the cabbage to start a huge microbe party. Stick it in a room-temp crock pot, making sure it stays submerged under the juice (lactobacillus doesn’t like oxygen), and in a week you have the best kraut you’ve ever tasted. You can do the same with pretty much any veggie, turning a humble cauliflower, for instance, into a sublime snack.

These are not your ordinary pickles. Unlike vinegar pickles, which use acetic acid to do the job, these are primarily pickled by lactic acid. The taste is different, but awesome. If you take up pickling, I hope you remember where you heard about it, and send me some recipes. Sandor Katz is the czar of pickledom, and I simply can’t improve on his wonderful site Wild Fermentation. Check it out – it could change your life!

A few caveats are called for here. Getting bacteria past the acids of the stomach and the enzymes in the small intestines isn’t easy. And assuming some bacteria make it past that gauntlet, they still have to fight their way into a well-fortified colon. Not everyone gives that a winning chance. But including mess kits with this bacterial army, in the form of prebiotics like lactose, may help things along. Combining pre- and probiotics together is called synbiotics, and it is the basis of some new attempts to re-engineer your gut bacteria.

Keep in mind that your particular bacterial zoo gets well established early in your life and is difficult to dislodge. Although studies have shown that you can change the ratios of your gut bugs in less than 24 hours, the effect is transient. As soon as you start eating the same old food, your gut snaps back just as quickly. You may be able to make changes with a new diet, but once you start, you might have to keep it up forever.

A final caveat is that not all scientists agree that fiber is good for you. A group out of Stanford thinks that fiber can be bad for people, especially people with IBS. There is evidence on both sides, which makes this a scientific throw-down that should be fun to follow. Right now, I give the edge to fiber, which is natural and has been a key part of our diet for millennia, whereas the Stanford plan is a very restrictive elimination diet. Nevertheless, be aware that the final word has yet to be written on this topic.

The Happy Bottom Line

So did it make me happier? Well, that is pretty darn subjective. I made up my own checklist to track my changes. Overall, I came out somewhat happier at the end of the month. The day no longer seems so irritatingly bright. My coworkers seem less standoffish. But the best part is that my stomach seems more contented. Still, this is totally anecdotal, so don’t take my word for it. Try it yourself. And if you’re not a manly man, don’t fret: The original yogurt study was done with women, and the results were significant. There are tons of sources of fiber you can try, but just don’t go too sweet. In this story, the only good sugars are the ones that are chained up.

I can tell you one thing: unlike most of the humiliating diets I discuss at this site, which I can’t wait to terminate, I’ve now incorporated yogurt and fermented pickles into my life. And I don’t think I’ll ever go back.


RESOURCES

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Schulze, J, and H J Zunft. “[Lactose–a potential dietary fiber. The regulation of its microecologic effect in the intestinal tract. 3. Dietary fiber actions of lactose due to microbial activity].” Die Nahrung 35, no. 9 (1991): 903–20.

Tillisch, Kirsten, Jennifer Labus, Lisa Kilpatrick, Zhiguo Jiang, Jean Stains, Bahar Ebrat, Denis Guyonnet, et al. “Consumption of Fermented Milk Product With Probiotic Modulates Brain Activity.” Gastroenterology 144, no. 7 (June 2013): 1394–1401.e4. doi:10.1053/j.gastro.2013.02.043.

Foster, Jane A., and Karen-Anne McVey Neufeld. “Gut–brain Axis: How the Microbiome Influences Anxiety and Depression.” Trends in Neurosciences 36, no. 5 (May 2013): 305–12. doi:10.1016/j.tins.2013.01.005.

Gibson, Peter R, and Susan J Shepherd. “Evidence-Based Dietary Management of Functional Gastrointestinal Symptoms: The FODMAP Approach.” Journal of Gastroenterology and Hepatology 25, no. 2 (February 1, 2010): 252–58. doi:10.1111/j.1440-1746.2009.06149.x.