Garlic: the hope and the current studies

Garlic is known to have been used for 7,000 years in cooking and as a medicine.  It is one of the first plants cultivated by humans.  Garlic has a long history of medicinal uses – including its use by grave diggers during the terrible episodes of bubonic plague in the 14^th and 15^th centuries that killed half of human populations in areas where it struck.   Grave diggers drank wine with crushed garlic to prevent catching the plague – perhaps their skin odor repelled the fleas that transmitted plague from infected rats.  Perhaps this was hype, and hope.  However, there are numerous current studies on the medicinal properties of garlic that are promising,

Garlic as an antioxidant: Studies from the National Research Council of Canada have shown that allicin, which gives garlic its aroma and flavor, acts as an extremely powerful antioxidant.   Garlic does not have a substantial amount of the compounds responsible for antioxidant activity in green tea or grapes.  The researchers found that a decomposition product of allicin, called sulfenic acid, acts rapidly when in contact with free radicals.  The author wrote ‘The reaction between the sulfenic acid and radicals is as fast as it can get, limited only by the time it takes for the two molecules to come in contact.  No one has ever seen compounds, natural or synthetic, react this quickly as antioxidants.’  While onions, leeks and shallots have a compound similar to allicin, they do not have the same medicinal properties, due to a slower rate of decomposition of allicin.

Cystic Fibrosis: this is an inherited lung disease that causes lung infections and limits the ability to breath. It is usually diagnosed in childhood and may be fatal. A group of infectious bacteria in cystic fibrosis are resistant to most antibiotics.  The chemical known as allicin produced by garlic bulbs may be helpful in the future to kill resistant bacteria.  Research is being done at the University of Edinburgh’s School of Chemistry.  Research on garlic’s antibiotic actions is also going on at the University of Copenhagen and many other centers. More effective antibiotics are desperately needed.

Brain protection:  Researchers at the University of Missouri have found a nutrient in garlic that protects brain cells against the kind of cell damage that promotes  cognitive problems, Parkinson’s disease and stroke.  This garlic nutrient, which they call FruArg,,  promotes the production of antioxidants which offer protective and healing benefits to brain cells,  Research is ongoing.

Reduction of “soft plaque” in arteries: Research at UCLA Medical Center has shown that patients at risk of heart attack benefited from using aged garlic extract.  ‘Soft plaque’ in the linings of arteries is composed mainly of white blood cells, which when released promote blood clotting.  Researchers studied 55 patients who had been diagnosed with ‘metabolic syndrome’ (obesity, high blood pressure, and other cardiac risk factors). After a workup that measured the plaque in their coronary arteries, they were given either a placebo or a dose of 2,400 mg of Aged Garlic Extract daily.  A year later those who had taken the garlic extract showed slowed total plaque accumulation by 80%. 

Cancer protection: Several population studies show an association between increased intake of garlic and reduced risk of certain cancers, including cancers of the stomach, colon, esophagus, pancreas, and breast. An analysis of data from seven population studies showed that the higher the amount of raw and cooked garlic consumed, the lower the risk of stomach and colorectal cancer.  These studies are from Europe, the U.S. and China.  Chinese studies also show a decreased risk of prostate cancer with greater intake of garlic and scallions.

Garlic as a ‘blood thinner’:  Garlic has an anticoagulant effect.  Many doctors advise stopping high doses of garlic 10 days before surgery.  If you are on an anticoagulant medicine, discuss this with your doctor.   Usual doses of garlic in cooking should not be a problem.

There is a restaurant in San Francisco called The Stinking Rose, which features garlic in every course.  If any reader wants to organize a trip there, count me in!

Sadja Greenwood MD, MPH  past issues on this blog

Caution – Nexium, Prilosec and Similar Meds Are Associated with Dementia, and Other Problems

A recent study of drugs to reduce stomach acidity is causing doctors and patients to reevaluate their use.  These drugs are known as proton pump inhibitors (PPIs); they are commonly used to reduce the discomfort of ‘heartburn’, a form of indigestion felt as a burning sensation in the chest, caused by acid regurgitation into the esophagus.  PPIs can be very important in cases of stomach ulcers or precancerous changes in the esophagus.  However, heartburn can be treated in other ways, as explained below.

Increased risk of Dementia: Here is a summary of the recent study that has raised awareness about the dangerous side effects of PPI drugs.  Older adults who use PPIs may be at increased risk for developing dementia, according to an observational study in JAMA Neurology.

Using claims from a large German health insurer, researchers studied nearly 74,000 adults aged 75 and older without dementia in 2004. By 2011, roughly 40% were diagnosed with dementia. Overall, 4% of participants used PPIs regularly during at least one 12-to-18-month interval during the study period.

After adjustment for confounders, including age, other drugs used, stroke, and depression, PPI use was associated with a 44% increased risk for incident dementia.

As potential mechanisms of action, the authors cite evidence suggesting that some PPIs can cross the blood-brain barrier and affect brain enzyme levels. They call for randomized trials to confirm their observational findings.

Other risks : Prolonged use of PPIs has been associated with iron and vitamin B12 deficiencies, low blood magnesium, osteoporosis-related fractures, small intestinal bacterial overgrowth, and community-acquired pneumonia.  These effects are believed to be related to changes in the intestinal bacteria (the microbiome) due to acid suppression. In the case of pneumonia, it may be due to growth of bacteria in the stomach and lungs because of insufficient stomach acidity. Whether less potent acid inhibitors like histamine H2 antagonists, cause similar changes to the microbiome is unknown. These drugs, such as Tagamet, Pepsid, or Xantac, act within an hour or less to decrease stomach acidity, and wear off within 12 hours.  They can be used intermittently, as needed, whereas PPIs are commonly used long term.

Home Remedies for heartburn

• Eat smaller portions at meals • Consume less fat • Avoid lying down for at least 2 hours after eating (avoid late-night snacks) • Wear loose fitting clothing • Elevate the head of the bed about 6 inches (this is best done by placing a block under the headboard, rather than stacking pillows) • Use a ‘bedlounger pillow’ or sleep in a reclining chair. Lose weight if needed (as little as 5 to 10 pounds may help) • Avoid alcohol, tobacco and foods that trigger symptoms, Chew gum (xylitol gum – available at the People’s store or online as Spry) is helpful when heartburn strikes.  Sip an ounce or two of water with added baking soda.

Because PPIs are among the most widely sold drugs in the world, the news about increased dementia risk and other complications is very important.  Be sure to talk to your doctor, nurse practitioner or physician’s assistant about your questions.  Here’s to a healthier you!

Sadja Greenwood, MD, MPH

Ginger – Medicinal Uses for its Peppery Zing

Ginger has long been known to help with nausea, from motion sickness to pregnancy.  A recent study from the University of Rochester showed that ginger capsules significantly reduced nausea severity due to chemotherapy, and that anticipatory nausea was a key factor in the severity of the problem for patients. 

Working with mice, researchers in Taiwan found that an extract of ginger blocked the toxin responsible for diarrhea caused by toxic strains of E. coli, which causes millions of cases of diarrhea worldwide each year, and many infant deaths in poor countries.

If confirmed by further studies, the findings could lead to an inexpensive, easy-to-obtain alternative to drug therapy for the condition, the researchers say. Additional studies are needed to determine the effective doses of ginger needed and whether it is safe for infants, who may experience unexpected side effects from large doses.

 Researchers at Columbia University shows purified components of ginger may have properties that help asthma patients breathe more easily. Asthma is characterized by bronchoconstriction, a tightening of the bronchial tubes that carry air into and out of the lungs. Bronchodilating medications (beta-agonists) work by relaxing the airway’s smooth muscle tissues. This study looked at whether specific components of ginger could help enhance the relaxing effects of bronchodilators. They found that ginger constituents 6-gingerol, 8-gingerol and 6-shogaol act synergistically with the β-agonist in relaxing the airway’s smooth muscles. The researchers at Columbia plan future studies to get a better understanding of the cellular mechanisms involved and to determine whether aerosol delivery of purified constituents of ginger may have therapeutic benefit in asthma and other bronchoconstrictive diseases.

For centuries, ginger root has been used as a folk remedy for a variety of ailments such as colds and upset stomachs. But now, researchers at the University of Georgia have found that daily ginger consumption also reduces muscle pain caused by exercise. Researchers directed two studies examining the effects of 11 days of raw and heat-treated ginger supplementation on muscle pain. Participants in the studies, 34 and 40 volunteers, respectively, consumed capsules containing two grams of either raw or heat-treated ginger or a placebo for 11 consecutive days. On the eighth day they performed 18 extensions of the elbow flexors with a heavy weight to induce moderate muscle injury to the arm. Arm function, inflammation, pain and a biochemical involved in pain were assessed prior to and for three days after exercise. The studies showed that daily ginger use reduced the exercise-induced pain by 25 percent, and this effect was not enhanced by heat-treating the ginger.

News from Women on Web

Since abortion is totally illegal in Poland, Women on Web people in Germany are sending medical abortion pills across the border by drone.  Apparently the senders and receivers are in visual contact.  In Brazil, and other Latin American countries where abortion is illegal and/or inaccessible, Women on Web is making medical abortion pills available – by mail – at greatly reduced rates or free if necessary.  Many pregnant women are terrified by the problem of microcephaly due to the zika virus.  Medical abortions must be done in the first 9 weeks.  You can support the work of Women on Web or Women on Waves if you are so inclined.  They give accurate information and have saved many women from dangerous, do-it-yourself abortion attempts.

Sadja Greenwood, MD, MPH

Cinnamon - Some Unexpected Findings

Cinnamon has been used since remote antiquity as a spice, a food preservative and a medicine. The kind we usually buy is Cassia Cinnamon - the bark of a tree grown mainly in China and Indonesia.  Cinnamon from Sri Lanka – so called Ceylon Cinnamon, is more expensive; it is prized for its flavor and its low content of a substance called coumarin.  Coumarin is a fragrant chemical compound found in many plants.  In high doses it may be toxic to the liver, and may have anticoagulant properties.  Cassia cinnamon has more coumarin, while Ceylon cinnamon has very little.  This is not a problem for most people, using cinnamon as a flavoring in the kitchen.  People with liver disease or on anticogulants should not use large amounts of Cassia cinnamon as a medicine.

Colorectal Cancer – in mice:  Adding cinnamaldehyde, the compound that gives cinnamon its distinctive flavor and smell, to the diet of mice, scientists at the University of Arizona found that mice were protected against colorectal cancer. In response to cinnamaldehyde, the animals' cells acquired the ability to protect themselves against exposure to a carcinogen through detoxification and repair.  The study appeared in Cancer Prevention Research in 2015.

The next step in the research is to test whether cinnamon, as opposed to cinnamaldehyde, prevents cancer using this same cancer model. Human studies have not been reported

Polycystic Ovary Syndrome: Women with this problem have enlarged ovaries with multiple cysts, infrequent menstrual periods, excess hair growth and sometimes obesity.  Previous research has shown that the use of cinnamon can reduce insulin resistance in women with PCOS.  Researchers from Columbia University enrolled 45 women with PCOS into a 6 month trial; those who received cinnamon had more regular menstrual cycles than women who were given placebo. The cinnamon group had 3.82 menstrual cycles during the 6 month trial, while women in the control group only had 2.2 cycles. Two of the women in the treatment group reported spontaneous pregnancies during the trial. "Though small, this rather elegant study shows that cinnamon may be an effective and inexpensive treatment for PCOS patients," said Steven T. Nakajima, MD, President of the Society for Reproductive Endocrinology and Infertility.  He is currently at Stanford.

Parkinson’s Disease – Study in mice: Scientist at Rush University Medical Center used cinnamon to treat the brain changes in mice with Parkinson’s disease (Journal of Neuroimmune Pharmacology, 2014). The study, supported by grants from National Institutes of Health, found that after oral feeding, ground Ceylon cinnamon was metabolized into sodium benzoate, which entered the brain, stopped the loss of important neurons, normalized neurotransmitter levels, and improved motor functions in mice with PD.  The researchers hope to translate their findings into human studies.

Cinnamon in type 2 Diabetes: Cinnamon has been said to lower blood sugar levels, but studies showing this effect have been small, with conflicting results.  Researchers at the College of Pharmacy, Western University of Health Sciences, looked at all published studies in a systematic review of cinnamon’s effect on blood sugar and lipid levels.  They found that the consumption of cinnamon in various trials resulted in a statistically significant decrease in levels of fasting plasma glucose, total cholesterol, LDL-C, and triglyceride levels, and an increase in HDL-C levels; however, no significant effect on hemoglobin A1c was found. They concluded that the variability found in these studies may limit the ability to apply these results to patient care, because the preferred dose and duration of therapy are unclear.

Writing this column made me want to investigate the properties of Ceylon cinnamon.  It is available for about $15 on the internet – for ½ pound, which should last a long time.  You can find 2 ounces for less than $5.  Whichever kind you use, think of the long past history of this spice –Egyptians used it for enbalming in 2000 BCE; Nero burned it on the pyre of his second wife to atone for his role in her death; Arab traders brought it to Europe, Portuguese and Dutch traders fought over Ceylon. 

Sadja Greenwood MD, MPH - back issues on this blog

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Update on the Benefits of Coffee, Fiber and Oregano

In a study from the Harvard School of Public Health, people who regularly drank moderate amounts of coffee daily --less than 5 cups per day -- experienced a lower risk of deaths from cardiovascular disease, neurological diseases, Type 2 diabetes and suicide.  The benefit held true for caffeinated and decaffeinated coffee, suggesting it's not just the caffeine providing health perks but possibly the naturally occurring chemical compounds in the coffee beans. The findings are based on data from three large ongoing studies: 74,890 women in the Nurses' Health Study; 93,054 women in the Nurses' Health Study 2; and 40,557 men in the Health Professionals Follow-up Study.  The study’ first author, Dr. Ming Ding, wrote that bioactive compounds in coffee reduce insulin resistance and systematic inflammation. In general, people who frequently drank coffee were more likely to smoke and drink alcohol. To separate the effects of coffee from smoking, researchers repeated their analysis among never-smokers, and found that the protective benefits of coffee on deaths became even more evident.  The researchers warned that some people should be cautious about their caffeine intake, such as children and pregnant women

Women who eat more high-fiber foods during adolescence and young adulthood--especially lots of fruits and vegetables--may have significantly lower breast cancer risk than those who eat less dietary fiber when young, according to a new large-scale study led by Maryam Farvid at Harvard School of Public Health. Among all the women, there was a strong inverse association between fiber intake and breast cancer incidence. For each additional 10 grams of fiber intake daily--for example, about one apple and two slices of whole wheat bread, or about half a cup each of cooked kidney beans and cooked cauliflower or squash--during early adulthood, breast cancer risk dropped by 13%. The greatest apparent benefit came from fruit and vegetable fiber. The authors speculated that eating more fiber-rich foods may lessen breast cancer risk partly by helping to reduce high estrogen levels in the blood, which are strongly linked with breast cancer development.

Fiber intake is also associated with longevity – studies show a reduced risk of cardiovascular, respiratory and infectious diseases.  Fiber intake also lessens the risk of type 2 diabetes and obesity; intestinal bacteria (the microbiome again!) ferment dietary fiber and reduce the amount of glucose absorbed into the blood.

Oregano: Dr. Supriya Bavadekar, at Long Island University, is currently testing carvacrol, a constituent of oregano, on prostate cancer cells. The results of her study demonstrate that the compound induces apoptosis (cancer cell death) in these cells. Dr. Bavadekar and her group are presently trying to determine the signaling pathways that the compound employs to bring about cancer cell suicide. "We know that oregano possesses anti-bacterial as well as anti-inflammatory properties, but its effects on cancer cells really elevate the spice to the level of a super-spice like turmeric," said Dr. Bavadekar. "Some researchers have previously shown that eating pizza may cut down cancer risk. This effect has been mostly attributed to lycopene, a substance found in tomato sauce, but we now feel that even the oregano seasoning may play a role," stated Dr. Bavadekar. More work is needed on this promising finding.   Recent studies also indicate that oregano may inhibit liver cancer, breast cancer and foodborne bacteria.   

 Many herbs have an anti-inflammatory effect that make them helpful against a variety of health problems.  Tune in next week for an update on turmeric, cinnamon, ginger and coriander. 

Sadja Greenwood, MD, MPH back issues on this blog

New Year's Resolution #3 - Find an Enjoyable Way to Move Your Body

Here are some suggestions from the experts:

*If you haven’t been exercising, check in with the clinic to make sure your plan is safe and right for you.

*While 30 minutes a day is widely recommended for dedicated exercise, this can be broken into shorter times. In a study conducted at the University of Virginia, exercise physiologist Glenn Gaesser, PhD, asked men and women to complete 15 10-minute exercise routines a week. After just 21 days, the volunteers' aerobic fitness was equal to that of people 10 to 15 years younger. Their strength, muscular endurance, and flexibility were equal to those of people up to 20 years their junior. "It would be useful for people to get out of the all-or-nothing mind-set that unless they exercise for 30 minutes, they're wasting their time," says Gaesser.

*From a wise website called Zen Habits: when you make an exercise plan:

*write it down, and post it up.  

*Set an easy goal – like 5 minutes of exercise a day.  

*You can build a habit, and gradually increase it.  

*Be specific about what you are going to do, and when.  

*Have a trigger – such as breakfast – always exercise after breakfast – or any other daily event.

*Know exactly what your goal is – walk around one block, do 5 pushups from the sink, dance for 10 minutes to your favorite music.  *Stick to your goal for a month, before changing it.  

*Log your daily habit right after you do it.  

*Report it to others in your friendship group or family, by phone, email or just plain talk. Arrange in advance that this person will expect a daily report from you.  Reward yourself for your progress with something you love, like a great movie, or a dinner with friends (make it healthy!).

*Here are some ways to exercise that work for me:  I ride my stationary bike while I watch television or a movie.  I’m slow, but I can bike 6-8 miles without noticing it, and I feel great afterwards.  I keep 4 pound weights by my bedside, and do arm exercises while listening to music.  I dance to the California Cajun Orchestra – an easy Cajun line dance step I’m happy to teach anyone who give me a call (868-0493).  I walk the shaded streets of Bolinas to clear my mind. 

Sadja Greenwood: MD, MPH

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Easy New Year's Resolutions - Know Your Vitamin D Level

According to the Harvard School of Public Health – ‘If you live north of the line connecting San Francisco to Philadelphia and Athens to Beijing, odds are that you don’t get enough vitamin D. African-Americans and others with dark skin, as well as older individuals, tend to have much lower levels of vitamin D, as do people who are overweight or obese. Being “D-ficient” may increase the risk of a host of chronic diseases, such as osteoporosis, heart disease, some cancers, and multiple sclerosis, as well as infectious diseases, such as tuberculosis and even the seasonal flu.   Several studies link low vitamin D levels with an increased risk of fractures in older adults, and they suggest that vitamin D supplementation may prevent such fractures—as long as it is taken in a high enough dose. A summary of the evidence comes from a combined analysis of 12 fracture prevention trials that included more than 40,000 elderly people, most of them women. Researchers found that high intakes of vitamin D supplements—of about 800 IU per day—reduced hip and non-spine fractures by 20 percent, while lower intakes (400 IU or less) failed to offer any fracture prevention benefit.

Vitamin D may also help increase muscle strength, which in turn helps to prevent falls, a common problem that leads to substantial disability and death in older people.  Once again, vitamin D dose matters: A combined analysis of multiple studies found that taking 700 to 1,000 IU of vitamin D per day lowered the risk of falls by 19 percent, but taking 200 to 600 IU per day did not offer any such protection.

The heart is basically a large muscle, and like skeletal muscle, it has receptors for vitamin D. So perhaps it’s no surprise that studies are finding vitamin D deficiency may be linked to heart disease. The Health Professional Follow-Up Study checked the vitamin D blood levels in nearly 50,000 men who were healthy, and then followed them for 10 years. They found that men who were deficient in vitamin D were twice as likely to have a heart attack as men who had adequate levels of vitamin D. Other studies have found that low vitamin D levels were associated with higher risk of heart failure, sudden cardiac death, stroke, overall cardiovascular disease, and cardiovascular death. How exactly might vitamin D help prevent heart disease? There’s evidence that vitamin D plays a role in controlling blood pressure and preventing artery damage, and this may explain these findings.

Dozens of studies suggest an association between low vitamin D levels and increased risks of colon and other cancers. The evidence is strongest for colorectal cancer, with most (but not all) observational studies finding that the lower the vitamin D levels, the higher the risk of this disease. Vitamin D levels may also predict cancer survival, but evidence for this is still limited.  Yet finding such associations does not necessarily mean that taking vitamin D supplements will lower cancer risk.

 Multiple sclerosis (MS) rates are much higher far north (or far south) of the equator than in sunnier climes, and researchers suspect that chronic vitamin D deficiencies may be one reason why. One prospective study to look at this question found that among white men and women, those with the highest vitamin D blood levels had a 62 percent lower risk of developing MS than those with the lowest vitamin D levels.  The study didn’t find this effect among black men and women, most likely because there were fewer black study participants and most of them had low vitamin D levels, making it harder to find any link between vitamin D and MS if one exists.

The flu virus wreaks the most havoc in the winter, abating in the summer months. This seasonality led a British doctor to hypothesize that a sunlight-related “seasonal stimulus” triggered influenza outbreaks. More than 20 years after this initial hypothesis, several scientists published a paper suggesting that vitamin D may be the seasonal stimulus. Among the evidence they cite: Vitamin D levels are lowest in the winter months. The active form of vitamin D tempers the inflammatory response of some white blood cells, while it also boosts immune cell’s production of microbe fighting proteins. Children who have vitamin D-deficiency rickets are more likely to get respiratory infections, while children exposed to sunlight seem to have fewer respiratory infections. Adults who have low vitamin D levels are more likely to report having had a recent cough, cold, or upper respiratory tract infection.

For most people, the best way to get enough vitamin D is taking a supplement, but the level in most multivitamins (400 IU) is too low. Encouragingly, some manufacturers have begun adding 800 or 1,000 IU of vitamin D to their standard multivitamin preparations. If the multivitamin you take does not have 1,000 IU of vitamin D, you may want to consider adding a separate vitamin D supplement, especially if you don’t spend much time in the sun.’

 It is important to know your blood level of vitamin D – most researchers agree it should be 30 ng/ml or above. Talk to your healthcare provider. Knowing your level will enable you to take the correct dose of vitamin D.

Daily Probiotic – In my last column I wrote about the benefits of probiotic supplements.  It is posted on this blog.  Here are two supplements that are easy to obtain and are of high quality; each pill contains 5 billion or more of the most helpful bacteria for your gut: Jarro-Dophilus and Floragen3.  Keep your probiotic refrigerated – not frozen – and take one daily with water on an empty stomach first thing in the morning.  It is helpful to use a probiotic daily, rather than intermittently if you have a digestive upset or need an antibiotic.  Foods containing helpful probiotics include plain yogurt, kefir, and many fermented foods.

Sadja Greenwood, MD. MPH  stay tuned for another easy resolution.

Easy New Year's Resolutions - Take a Daily Probiotic

Here is my advice on feeling better in 2016, by making some easy changes.  This week it is: take a probiotic daily.  Next week – know your Vitamin D level. After that – keep moving!

*From Harvard : Since the mid-1990s, clinical studies suggest that probiotic therapy can help treat several gastrointestinal ills, delay the development of allergies in children, and treat and prevent vaginal and urinary infections in women. 

*From the University of Maryland: Now, researchers at the University of Maryland School of Medicine (UM SOM) have come up with an explanation. It appears that LGG (Lactobacillus rhamnosus GG) LGG may act as a facilitator, modifying the activity of other gut bacteria. This is the first time this mechanism has been described; the discovery could eventually help scientists create more effective strategies to foster a healthy gut. Claire M. Fraser, PhD, professor of medicine at the UM SOM, as well as director of the Institute for Genome Sciences, studied the effect of LGG on a group of elderly subjects “This species of bacteria has a reputation for being really useful to humans,” says Prof. Fraser. “So we wanted to better understand how it might work in the human intestine.”  She and her collaborator, Dr. Patricia Hibberd at Massachusetts General Hospital, tested 12 subjects, who ingested LGG twice a day for 28 days. She analyzed gut bacteria before and after this regimen, and found that ingesting LGG led to increases in several genes that foster several species of gut bacteria, including Bacteroides, Eubacterium, Faecalibacterium, Bifidobacterium and Streptococcus. These microbes have been shown to have a range of benefits in humans, including the promotion of a healthy immune system. “This is a new idea, that some probiotics may work by affecting the overall ecosystem of the gut,” said Prof. Fraser. “Previously we tended to think that LGG and other probiotics worked directly on the host. I think this finding has many exciting implications.” For one, Fraser says, it lends support to the idea that we need to look at the microbes in the gut as an interconnected ecosystem rather than a series of solitary bacteria. Modifying the behavior of microbes already in the gut may be just as important as adding any single species to this population.

*From the Leiden Institute of Brain and Cognition at Leiden University in the Netherlands A new study suggests that probiotics may actually aid in improving mood. They might be a good way to fight anxiety or depression, or simply make you feel better after a bad day.

The researchers examined 40 healthy young adults who had no mood disorders. Half of them consumed a powdered probiotic supplement every night for four weeks. The probiotic supplement was called Ecologic Barrier, and contains eight types of bacteria, such as Bifidobacterium, Lactobacillus, and Lactococcus (these three types of bacteria that have been shown in the past to mitigate anxiety and depression). The other half of the participants took a placebo, although they thought they were taking probiotics.

The people who took probiotic supplements began to see improvements in their moods; they reported less reactivity to sad moods than those who took placebos. They had fewer depressive thoughts following bouts of sadness.“Even if preliminary, these results provide the first evidence that the intake of probiotics may help reduce negative thoughts associated with sad mood,” said Lorenza S. Colzato, an author of the study. “As such, our findings shed an interesting new light on the potential of probiotics to serve as adjuvant or preventive therapy for depression.” One recent study examined this link and found that people who took probiotics experienced lower levels of anxiety and depression, and had lower levels of cortisol — the stress hormone — in their saliva when they woke up in the morning..

Sadja Greenwood, MD, MPH

Gun Control in California - What You Can Do

The U.S. has more than 30,000 gun deaths per year.  Mass shootings, including 4 deaths, occur at least weekly in this country.  Countries with stricter gun control laws, such as the U.K., Japan, Canada and Australia, have come close to ending gun violence, with strict rules on the possession of guns.

Lt. Gov. Gavin Newsom, a Democrat, has proposed a ballot initiative that can set the gold standard for meaningful reforms in Cailfornia, creating a model that could be applied in other states. It's called the Safety for All Act; it would require on-the-spot background checks when buying ammunition, ban the possession, not just the sale, of large-capacity magazines with 10 rounds or more, and require police reports when guns are lost or stolen. This measure would make California the first in the nation to implement point-of-sale background checks for ammunition purchases, giving them the same level of scrutiny as gun purchases.

 The recent deadly shooting in San Bernardino happened in a state with some of the nation's toughest gun laws: California already bars assault weapons, blocks the sale of large-capacity magazines and requires universal background checks for all gun purchases. Authorities say they believe suspected gunman Farook and wife Malik had legally obtained two handguns and that two rifles were also legally purchased in California. Federal officials say the attackers had large-capacity magazines that violate California law in their SUV.  Since the attack, the state's strict laws and the apparent legal purchase of the weapons have set off a debate over the effectiveness of gun measures and whether getting tougher would help prevent more violence.

"Strong gun laws do prevent gun deaths. Not every law can prevent every gun death," said Allison Anderman, a staff attorney with the Law Center to Prevent Gun Violence in San Francisco. "They work most of the time."

The gun-control advocacy group rates California's gun laws No. 1 in the nation; the state ranks 42nd in its rate of gun deaths. Louisiana's gun laws were ranked 50th and it is No. 2 in deaths, according to the group's 2014 rankings. 

Gun laws vary dramatically state-to-state, even city-to-city. The patchwork of regulations means it's often easy for determined gunmen to acquire weapons by skirting laws in their home state, they say. Untraceable weapons can be built from scratch using parts bought online.

As a result, gun control advocates in the days since the shooting have called for more stringent laws in California and nationwide.

You can support Gavin Newsom’s ballot initiative by making a contribution to the Courage Campaign, at couragecampaign.org.  Sign the ballot initiative, which will require 366,000 certified signatures, when you see it outside your market or post office next year 

Sadja Greenwood MD, MPH

Genetically Modified Salmon approved by the FDA

The U.S. Food and Drug Administration has approved a genetically engineered salmon as fit for consumption.  It will be the first genetically altered animal to reach American tables. (Plans for genetically modified pigs are being pursued in the U.S. and Korea.)  The salmon, produced by AquaBountyTechnologies, are genetically engineered with DNA that causes them to grow to market size much faster than other salmon.  They will be raised in contained, inland facilities in Panama, from eggs produced in Canada.  The company says that the fish will be all-female and reproductively sterile. Once harvested, they will be imported for sale in this country.  It is not clear when they will show up on store shelves. 

Consumer and environmental groups have strongly opposed the approval of these salmon, arguing that its safety is not certain and that wild salmon populations could be affected if the GE fish were to escape into rivers and oceans.  Being larger, they could eat more food and thus out-compete natural salmon. 

The FDA does not require, and has refused to consider, labels for genetically engineered foods, so the GE salmon will not be labeled as such.  A decision to label the new fish will be voluntary and up to the companies selling the fish. So far, Costco, Safeway, Kroger, Target, Whole Foods, Trader Joe’s and Aldi say they have no plans to sell the GE salmon.  Walmart has not said what they will decide on this matter.  Because the Aqua-Advantage salmon will be raised in Panama, it will have to carry the country of origin label required by the US Department of Agriculture.    Their rules also require imported fish to be labeled ‘farm-raised’ or ‘wild-caught’.  If shoppers see ‘’Product of Panama’ and ‘farm-raised’ on a package of salmon, it will probably be GE.  Restaurants and cafeterias must make such information available, but are not required to do so.

The Center for Food Safety, a consumer advocacy group, plans to sue the FDA in an attempt to block the sale of the fish, or to require labeling.  Food and Water Watch is also planning a lawsuit. 

On January 19^th, 2016, the California Sate Assembly will vote on legislation to require that all GE fish sold in California be labeled as ‘genetically engineered’.  The Consumer Right to Know Act was introduced by into the California Assembly by Jared  Huffman, who is now on our congressman. 

There are arguments on both sides for genetic engineering of food, based on the need for more calories and protein in a world of growing human numbers.   However, the ways that GE corn and soy have been used is open to criticism.  Weeds have become resistant to the herbicides Roundup (glyphosate) and 24-D, so that larger amounts are needed.  Toxicity to beneficial soil bacteria, the Monarch butterfly and many other animals is a result.  Much of the GE soy we produce is used for animal feed, and GE corn is also made into ethanol for our cars.

The need for labeling as these questions are further analyzed is clear to me.   Please pay attention to the January vote on GE salmon in our California assembly.  You can call our Assemblyman Marc Levine at 415 479 4920 and register your opinion on labeling of this new product.

Sadja Greenwood MD, MPH   past issues on this column.