Alternative Medicine

In the 1970s, Dannon ran an ad that featured ancient yet appealing Russian villagers—robust men with full white beards, strong and sturdy women who had aged with grace and dignity. Their secret, of course, was eating lots of yogurt. (Here's a follow-up ad.) While I don’t think my daily yogurt will have me doing Russian dances on tables, a new study suggests that it may prevent the development of a real problem for many people—diarrhea caused by taking antibiotics.

In addition to killing bacteria that cause disease, antibiotics also kill bacteria in our intestines that help keep our guts healthy. These beneficial bacteria crowd out the less friendly strains that can cause problems like diarrhea. One of the worst of these is Clostridium difficile, a major scourge in hospitals, where it’s estimated that between 5 and 25 percent of people who receive antibiotics develop diarrhea. About 20 percent of those cases are caused by C. difficile, and the cost of treating one case of C. difficile diarrhea is estimated to be about $3,700.
Many dietitians—and, recently, some doctors—think that one way to fix this problem is by eating probiotics, or good bacteria, which helps to reset the natural balance in the intestines and thereby prevent a run on toilet paper. Yogurt contains active cultures that are thought to be probiotics, but we still have only a basic understanding of which bacteria actually are probiotics and exactly what they do.
In a recent study in the British Medical Journal, investigators divided up patients receiving antibiotics into two groups. One group received a commercially available probiotic yogurt drink called Actimel. The other group got a similar-tasting but sterile placebo. Only 12 percent of the patients who received Actimel developed diarrhea compared with 34 percent of the patients who got the placebo. None of the Actimel patients developed the more dangerous C. difficile diarrhea, compared with 17 percent of the placebo group. When you consider that the cost of treating a patient with Actimel was about $100, this seems like a pretty good deal.
As studies go, this one was well done. The investigators corrected for many factors that might have skewed their data, such as what antibiotics patients received, how long they took them, and what kind of infections they had. The researchers also did their statistical analysis using a rigorous standard called intention to treat, in which the results from all subjects involved in the study are counted, even if they fail to follow directions. The number of patients in the trial was relatively small (135), and we have no way of knowing which of the three bacteria in Actimel was responsible for the benefit, but these are small quibbles with a potentially important study.
Now, claims of the remarkable healing powers of dietary supplements generally among evidence-based, textbook-toting physicians who are all about the raise an eyebrow or twoscience of medicine. (I might even be labeled as one of those stodgy eyebrow raisers.) But when there is evidence to back up the claim, medicine does tend to embrace unusual treatments, and antibiotic-related diarrhea is a big problem just waiting for an effective remedy. There’s obviously still a lot we don’t know about probiotics, but this study provides us with the kind of credible information that could inspire doctors to prescribe little white tubs instead of little white pills.

So As Not To Stress

Nobody likes stress. Not only can it cause sleepless nights and irritable days, we all suspect, at some level, that it can’t be good for our health. Now we can add another reason to reduce the stress in our lives: It may impair our thinking when we’re older, adding tarnish to the luster of our golden years.
A recent study in the journal Neurology concludes that people who experience chronic psychological distress, such as anxiety or depression, are up to 40 percent more likely to develop mild cognitive impairment (MCI) than people not prone to distress. What is MCI? Well, it’s not dementia, but it does represent a measurable decline in thinking ability and may affect more than 15 percent of the older population. Now before you stress out about being stressed out, take a deep breath and keep reading.
In this study, more than 1,000 older people without any cognitive impairment were evaluated for their tendency to experience distress. This group was then assessed annually (for up to 12 years) for signs of MCI.

The study found that psychological distress did not appear to correlate with age, education, or gender. (It’s nice to know that stress is such an egalitarian problem.) But people with higher distress scores tended to have more depressive symptoms. And those participants with the highest distress score (in the top 10 percent) were 42 percent more likely to develop MCI than people with the lowest scores.
Is all this new? Well, not exactly. People who are prone to chronic distress have been shown to be more likely to develop Alzheimer’s disease. They also are more likely to have their thinking decline at a faster rate.
What this study doesn’t tell us is how chronic distress leads to the development of MCI. The authors of the study have some ideas: Perhaps being prone to chronic distress is one of the earliest signs of having MCI. I find this idea less than appealing, because it suggests that the horse is already out of the barn when it comes to chronic distress and the development of MCI. Fortunately, the authors believe there is a more likely explanation.
Their leading theory is that stress has adverse effects on the parts of our brains that help us form and keep memories. They point out that there is evidence that stress has been shown to reduce our ability to form memories, and that severe stress—like post-traumatic stress disorder—may cause changes in the memory-forming parts of the brain. I find this a far more appealing theory, as it’s based on studies of how our brains work and gives us a chance to "turn things around" by dealing with chronic distress in a positive way.
So for now, let’s focus on what we do know: that reducing the stress in our lives is good for lots of reasons. First off we’re happier, as are the people around us. It’s good for our complexions, probably good for our hearts, and maybe even good for our brains. Don’t sweat the small stuff and don’t let the small niggles become big problems. Whether you exercise, meditate, talk to a therapist, or just spend time on the beach, managing stress is a great investment in your short-term and long-term health.