Wednesday, February 19, 2014

The Brain Diet?

Immediately after I typed the title for this blog I realized that those who know me, and my twisted sense of humor, would assume that I was making a zombie joke.  While I do entertain a fondness for The Walking Dead (both the graphic novels and the TV show) I actually happen to be referring to an article that was linked from a blog post giving otherwise good advice on helping your loved ones who have depression; the related tip involved making healthy food for people whose desire to get out of bed, let alone go to a grocery store and cook, is little to none.  While the tips were actually very good (speaking from my experience), this article linked to this post which had me asking why I click on links in the first place.  Is there any evidence to any of advice she is giving?

This article does not start off well, as she starts off talking about our depression caused by "toxins."  As I have said before, "Toxin" is usually just a modern day word for "miasma," "imbalanced humors," or even "evil spirits."  So it is a) unlikely that you can be cleansed from something that doesn't exist, and b) if you really were poisoned, it is highly unlikely that eating cilantro, eating certain herbs, eating diatomaceous earth, or juicing your vegetables will remove the poison (or clear up your depression for that matter).  Remember to, there really isn't any good evidence that organic food is always safer or healthier for you.  Now to qualify that last statement, I'm not talking about taste, environmental issues, or supporting your local farmers, or saving money by growing your own food here--that's another blog post.  the point is that this paragraph on toxins is about fear and selling a book on a pointless "cleansing" procedure.

The section foods to include for a healthy brain is another interesting mixture or information that might have some truth to it mixed in with unfounded assertions.  The assertions about obtaining adequate protein, adequate fat, adequate B vitamins, and antioxidants is good information for anybody, and basically part of a general healthy diet for anyone.  And as I've said before, this really is an "anti-depression" diet, it's a "be healthy so you don't aggravate or develop underlying health conditions that might contribute to depression" diet.  Now, the point about getting adequate fat is intriguing to me, as there have been some studies (1, 2) that indicate that a very low fat diet can also increase a risk for depression, but, as the Psychology Today article pointed out, finding the causes is complicated.  It is possible that those who ate too low in fat didn't get enough essential fats (like the omega-3s), or that they weren't getting enough fat to keep them satiated at meals and the subsequent hunger influenced depression, or that they replaced the fat with refined carbohydrates which led to blood glucose regulation issues which influenced depression, or maybe some combination thereof.  I also find the link between gut bacteria and depression to be intriguing, but there isn't really a clear link there either (Link).

When it comes to testing urine for neurotransmitters, I recommend reading this excellent post from Bogus Diagnostic Tests.  Neurotransmitters are found in other tissues in the body (peripheral), and so any neurotransmitters that appear in the urine do not reflect the levels in the brain.   As far as the supplements are concerned, remember that you don't need to supplement unless you are deficient, and that "natural" does not mean better or free of side effects.  Notice that one of the supplements recommended, 5-HTP, has been associated with dizziness, nausea, and diarrhea (Link).

Several of the lifestyle changes like getting adequate sleep, meditation, limiting alcohol, and exercise have evidence to back them up, the others, not so much.  Also remember too that when I talk about eating in such a way as to not aggravate other health conditions, I am not talking about dubious diagnoses like "Dubious Yeast Allergies."

Take home message--Eating a healthy diet, particularly with the help of loved ones when you don't feel like cooking, can help alleviate symptoms of depression.  Unfortunately there are no certain "magic" foods or supplements that will relieve it.

Tuesday, February 11, 2014

Rehydration Solutions?

The norovirus has been in the news lately thanks to outbreaks at local schools and on a few cruise ships. As people recover from this illness the focus is often on rehdyration (replacing fluid loss from diarrhea and/or vomiting) as well as electrolyte replacement (replacing sodium and potassium lost from diarrhea and/or vomiting). You also want to make sure that the beverages that you use don't aggravate any nausea or diarrhea that you might currently have and make sure that the solution can be absorbed by the digestive system efficiently. Of course many people who are feeling terrible (or feeling stressed from caring for an ill person) will reach for what is readily available, which is often a sports drink such as Gatorade or Powerade or even just a regular sugary drink like a soft drink or kool-aid. But are these really the best things to offer for oral rehydration therapy after severe illness?
The evidence points to the answer being no for a variety of different reasons. First of all, the sports drinks like Gatorade may have enough sodium/potassium to replace sweat losses but not to replace losses from protracted/frequent vomiting and diarrhea. Second of all, the amount of sugar in sports drinks, and some sodas/sugar beverages, causes them to have a 
high-osmolarity and can actually cause diarrhea and therefore more fluid/electrolyte losses. Third, sugary drinks like sodas also don't have the sodium and potassium needed to replace electrolyte losses. Fourth, some of the carbonated beverages might cause more stomach distension and promote that nauseated feeling.
A better option would be to choose a solution formulated to have the right amount of sodium, potassium and glucose (sugar) such as Pedialyte. For those of you who want to have additional control over the taste and flavoring of the solution, you can also make your own oral rehydration solution using this recipe used by the World Health Organization:
  • 2 level Tablespoons (TBSP) of sugar
  • ½ level teaspoon (tsp) of table salt (sodium chloride)
  • ½ level teaspoon (tsp) of salt substitute such as No Salt (potassium chloride)
  • ½ level teaspoon (tsp) of baking soda, dissolved into
  • 4¼ cups (1 liter) of clean water
  • Add your favorite sugar free beverage mix to improve the taste.

  • All that said, an oral rehydration solution is only useful if to the sick person if he/she is willing to drink it.  (One of my co-workers told me a story about how his cranky toddler threw a Pedialyte popsicle at him after tasting it).  So you might be better off mixing your own where you can control the taste.
    • You might be able to to get away with using Gatorade, etc if your diarrhea/vomiting was very mild.
    • Infants, frail elderly, and those who are immunocompromised are at a higher risk for dehydration and may need medical care.
    • If you show signs of severe dehydration you need to seek medical care.
    Take home message--A commercial rehydration solution such as Pedialyte or a homemade solution is more appropriate for rehydration after suffering losses from severe diarrhea and/or vomiting.

    Thursday, February 6, 2014

    Coconut oil for Everything?

    Those familiar with this blog will be familiar with my love of infographics, where I get to dissect them, that is.  So I was happy to see this appear in my feed to provide some blog fodder:

    Coconut oil is a boon for those of us who don't eat dairy (for allergy or avoidance of animal products)but still need a cooking fat that will take high heat (think roasting vegetables), give a good mouth feel comparable to butter (think pie crust), can provide a creamy texture to soups (like a butternut squash bisque) and curries.  But does it actually provide the above benefits?

    1) Thyroid stimulating.  There are no reliable sources or studies that indicate that coconut oil can help get people off their thyroid medication, not to mention that this particular paragraph says anything about the thyroid at all.  As far as increasing your metabolism, the consistent use of coconut might help you burn a whopping 25-50 more calories a day.  Every little bit helps, but keep in mind that 1/4 to 1/2 a slice of bread will give you 25-50 calories.  So you still don't have much wiggle room there (Link)

    2) Lowers cholesterol.  The lauric acid can raise both HDL and LDL, which might improve the overall lipid profile, particularly if you are a lab rat.  The human data is a little more sketchy. (Link). 

    3) Helps keep diabetes in check.  There isn't any evidence that coconut oil stimulates the pancreas to produce more insulin, nor would this necessarily be beneficial if it did (because in the early stages of Type 2 diabetes the individual may be over producing insulin but the body can't use it efficiently).    There is a possibility that coconut oil might improve one's sensitivity to insulin, which could ultimately help an individual have better blood glucose control or prevent the progression from pre-diabetes to diabetes, but we don't have enough good human studies to recommend it as a treatment.

    4) Gastrointestinal malabsorption. Once again, there is no evidence that coconut oil applied to the skin can help people with fat absorption issues prevent fatty acid deficiency.  The only human studies I could find used sunflower oil, and even those were small and requiring more research.  Since coconut oil contains medium chain triglycerides, they do not require bile salts for digestion and passively absorb through the GI tract into the liver.  This is a boon for those with fat malabsorption problems, but you still have to take it orally.

    5)  Helps with weight loss. The ways this is worded it makes it sound like any other fat would go immediately to the fat stores in your body, which sounds an awful lot like that tired old Weight Watchers' saying "A moment on the lips, a lifetime on the hips!"   Of course, the body's ways of digesting, metabolizing, and storing is more complicated than that.  I think what they might be getting at here is the problem/question that many people trying lose weight have to face, "How do I cut back on "x" without facing hunger that so intense that I can't think straight?"  (There are many variations on that same question).  Fat is satiating so those who try to cut out ALL fat will probably wind up with excessive hunger and have trouble keeping with their plan (or having a good quality of life).  People who consume fat with abandon (and don't cut out the extra calories somewhere else) will have trouble losing weight as well.  So an easily absorbed satiating fat, taken in the context of you cutting out calories somewhere else could be a useful tool in your weight loss regimen.

    6) Kills Candida.  I think in this case they are actually referring to a condition that Quackwatch calls the "Dubious Yeast Allergy" category, you can read Dr. Stephen Barrett's article about this here.  You can't actually kill off a disorder that doesn't exist.

    7) Supports the Immune System. The lauric acid has actually been studied as an anti-microbial agent in the treatment of acne, but no good studies exist as far as eating coconut oil to stave off the flu, etc.  And remember, you may not want to "boost your immunity."

    8) Reduces Heart Disease.  There is a correlative link, but not a causative one in this case.  Although it does cast doubt on the theory that all saturated fats raise your risk for heart disease.

    9) Nourishing for the Brain.  There was one doctor who performed one case study that said her husband's symptoms of Alzheimer's Disease improved through the use of coconut oil, but there have been no peer reviewed studies to support this. (Link)

    10) Good for the Skin.  This one actually shows some promise, at least in animal studies. (Link).  Applying non-medical grade oil to any open wound would not be recommended, however.

    Take home message--Including coconut oil as part of a portion controlled plan for weight loss and a carbohydrate controlled plan for diabetes can be useful, but don't expect a magical drop in weight.