Yogurt Power

My interest in fermented food started in January, at the Fancy Food Show in San Francisco, where I had a theoretical idea: The pleasure we get from sour, umami, and complex flavors had the effect,  when it evolved, of increasing bacteria intake. This suggests we need to consume plenty of bacteria to be healthy. Three things happened at that convention that supported these ideas: (a) Someone trying to make a high-end non-alcoholic drink said he found it impossible to get enough complexity without fermentation. (b) I remembered that after a trip to Japan, I had started eating lots of miso soup. Miso (fermented soy beans) is an unusually effective flavoring agent. (c) A Stonyfield Farms employee told me that her health improved a lot when she started eating yogurt every day two years ago. (Stonyfield Farms makes yogurt.)

Recently I learned more about the health improvement. She started eating more yogurt about two years ago because she changed jobs — from an architecture firm in Boston to Stonyfield, in New Hampshire, where the employee kitchen has a refrigerator full of free yogurt. In Boston, she ate yogurt about once/week; at Stonyfield, she eats it once/day (for breakfast).

When she moved to New Hampshire, she also changed her diet in other ways. She now eats more foods that are “natural and organic” and less fast food. She doesn’t eat anything with aspartame any more; she also avoids caffeine. She eats more fruits and vegetables. Maybe the biggest change is that she eats three good meals every day instead of one meal on the run. Other changes in her life include less stress, a different atmosphere, and more exposure to nature.

In Boston, she had lots of colds and sinus infections, maybe 3-4/year. When she got sick it took a long time — 2 weeks — to get better. She also felt sick to her stomach a lot. In Boston she got mononucleosis; it took six months to completely recover. In New Hampshire, she’s had only 1 cold in the past year and it only lasted 3-4 days. No other illnesses. Another change she’s happy about is that she gained weight. In Boston she weighed about 90 pounds; now she weighs about 110. (She’s 5′ 4″ and 30 years old.)

She’s noticed that Stonyfield employees are healthier than other places she’s worked (as this study suggests). Fewer people are sick and when they’re sick they aren’t sick as long. Everyone eats the free yogurt, except the lactose-intolerant. Stonyfield yogurt contains less than half the lactose of milk; for some lactose-intolerant people that’s low enough, for others it isn’t low enough. (Stonyfield makes a soy yogurt without lactose.)

Microwaves and Microbes

Here is an interesting article about the danger of microwaved food:

Comparing the blood chemistry of people after eating food cooked in conventional and microwave ovens, a dismayed Hertel explained that “blood cholesterol levels are less influenced by cholesterol content of the food than by stress factors.” . . .

So was the blood chemistry of consumers. These abrupt measurable changes included a decrease in high-density lipoprotein (good cholesterol) and a sharp rise in low-density lipoprotein (bad cholesterol) levels following the consumption of microwaved food.

The two researchers also discovered marked declines in the number of red blood cells that carry oxygen to the tissues and collect carbon dioxide, as well as in white blood cells that fight infections.

The researchers say these bad effects happen because microwave heating makes cells “easy prey for viruses, fungi and other micro-organisms.” The author adds, “bad bugs are everywhere.”

Whereas I believe the opposite: The problem with microwaved food, when there is one, is that it is too sterile. The article later reports an experiment in which E. coli. grew much faster on microwaved milk than conventionally heated milk. I interpret that to mean the microwaved milk was more sterile: less competition for the E. coli.

Note I don’t mean to say don’t use your microwave. I use mine all the time to heat water and defrost stuff. It’s the experimental data and their interpretation that interested me

Can Probiotics Prevent Asthma?

From a UCSF press release:

In the first effort of its kind in the United States, researchers at the University of California, San Francisco have launched a study to determine whether giving active probiotic supplements to infants can delay or prevent asthma in children.

The intervention is a novel method for the primary prevention of asthma with enormous potential to have a public health impact, said Michael Cabana, MD, chief of the Department of General Pediatrics at UCSF Children’s Hospital and principal investigator for the study. There currently are no known ways to prevent asthma, he said.

“It would be a great thing to be able to prevent asthma,” Cabana said. “We believe that using probiotics is a safe and effective way to do that.”

The press release is from May 2006; the three-year study should be almost finished.

Thanks to Steve Hansen.

Worm Therapy

One reason I believe we are vastly bacteria-deprived (and thus greatly benefit from fermented foods) is the efficacy of hookworm therapy: Hookworm parasites can reduce autoimmune diseases. Hookworms, like fermented foods, stimulate the immune system in a chronic, harmless, low-level way. Here is a good introduction to the subject:

Musician Scott Richards and artist Debora Wade are two Bay Area patients on the hookworm treatment. Richards and Wade both suffer from an inflammatory bowel disease called Crohn’s. When faced with using a parasite as therapy, both patients felt they had nothing to lose. . . . Both Richards and Wade say they didn’t have to wait long to feel relief. Richards [described] waking up and the pain suddenly gone. For Wade, she needed to be reinfected, but today said she can eat foods that patients with Crohn’s could never eat: pizza & Thai food for example.

Related story.

What Causes Asthma? Not What the Tovars Think

From Joyce Cohen’s The Hunt column:

For reasons unknown, Florida didn’t agree with little Noah Tovar. Since his toddler years, Noah, now 7, had suffered terribly from asthma. His parents, Jari and Selene Tovar, moved their family several times, trying to escape the mold or pollen or whatever it was that caused his breathing problems. Nothing helped much.

Noah’s parents didn’t know, I can tell, about a 1992 study of childhood asthma and allergies in Germany. Maybe childhood asthma is caused by air pollution, the researchers thought. Let’s test that idea by comparing a clean West German city (Munich) with a dirty East German one (Leipzig). Here’s one of the results:

The lifetime prevalence of asthma diagnosed by a doctor was 7.3% (72) in Leipzig and 9.3% (435) in Munich.

Less asthma in the dirty city! It wasn’t a significant difference but similar differences, such as hay fever and rhinitis (runny nose), were in the same direction and significant. Hay fever was much rarer in Leipzig.

Noah’s asthma cleared up, to his parents’ surprise, on a trip to New York. So the family moved to New York.

Even though “everyone was under the impression that New York would cause him more distress, it was just the opposite,” Mrs. Tovar said. “Not one doctor nor myself can explain what it is.”

Mrs. Tovar’s doctors are badly out of date. The hygiene hypothesis has been around since the 1990s, supported by plenty of data that, like the German study, shows that childhood allergies are better in dirtier environments. Noah is better in New York because New York air is dirtier than Florida air — that’s the obvious explanation.

In The Probiotic Revolution (2007) by Gary Huffnagle with Sarah Wernick, which I’ve mentioned earlier, Dr. Huffnagle, a professor of immunology at the University of Michigan, describes a self-experiment he did:

Could probiotics relieve something as tenacious as my lifelong allergies and asthma? I decided to take a probiotic supplement and make a few simple changes to my diet to my diet, just to see what happened. Yogurt became my new breakfast and my new bedtime snack. I also upped my intake of fruits and vegetables. Whenever possible, I substituted whole grains for processed ones. And I tried to cut back on sugar. [Why he made the non-probiotic changes is not explained. In another part of the book he says he also increased his spice intake.] No big deal.

Because I doubted this little experiment would work, I didn’t mention it to anyone, not even my wife. And I didn’t bother to record my allergy symptoms. . . My “aha” moment came after about a month: I’d spent the evening writing a grant proposal, a box of tissues at my side. After all these years, I knew to be prepared for the inevitable sneezing and runny nose caused by my mold allergies, which kicked up at night. But when I finished working and cleared the table, I realized I hadn’t touched the tissues. And as I looked back on the previous month, I could see other changes. This wasn’t my first sneeze-free evening; I hadn’t needed my asthma inhaler for several months. To my astonishment, the experiment had been a great success.

This is a great and helpful story. Only after I read it did I realize I’d had a similar experience. I’ve never had serious allergies but I used to sneeze now and then in my apartment and my nose would run a lot; I went through more than one box of Kleenex in a month. Maybe 4 in one morning. In January, I made just one change: I started to eat lots more fermented foods (yogurt, kimchi, kefir, etc.). My sneezing and Kleenex use are now almost zero.

The Tovars can live wherever they want, I’m sure, if they feed their son plenty of fermented food.

Previous post about childhood allergies and fermented food.

More After the column appeared, someone wrote to the Tovars:

Funny, same thing happened to me.  I moved from England where I had chronic asthma, to New York City where I had none.  Stayed in NY for twenty years asthma free, then moved back to England with my wife for the last ten years and my asthma has returned all the time I’ve been back.

Probiotics and Resistance to Illness

A 2005 study compared workers who did and did not consume a daily straw of probiotic liquid. During the 3-month study, workers who got the probiotics were sick half as often as those who didn’t. Here are details:

262 employees at TetraPak in Sweden (day-workers and three-shift-workers) that were healthy at study start were randomised in a double-blind fashion to receive either a daily dose of 100,000,000 Colony Forming Units of L. reuteri or placebo for 80 days. The study products were administered with a drinking straw. 181 subjects complied with the study protocol, 94 were randomised to receive L. reuteri and 87 received placebo. In the placebo group 26.4% reported sick-leave for the defined causes during the study as compared with 10.6% in the L. reuteri group (p < 0.01). The frequency of sick-days was 0.9% in the placebo group and 0.4% in the L. reuteri group (p < 0.01). Among the 53 shift-workers, 33% in the placebo group reported sick during the study period as compared with none in the L. reuteri group(p < 0.005).

The paper gives no reason to think the probiotic dose was optimal. (How the dose was chosen isn’t explained.) A larger dose might have had a bigger effect.

When science writers tell about the “miracle” of antibiotics, they tell stories like this one, from The Probiotics Revolution (2007) by Gary Huffnagle with Sarah Wernick:

When my daughter was five, she pricked her left hand on a rosebud thorn in our garden. . . . The next day she ran a fever. . . . Doctors diagnosed an acute bacterial infection. Half a century ago, a child might have died from such an infection. But my daughter received antibiotics. After a day of intravenous treatment, she was better. . . . Antibiotics are true miracle drugs.

What goes unnoticed in these “miracle” accounts is the possibility that the person got so sick because their immune system wasn’t working well. (It wasn’t working well, I propose, because the infected person didn’t get enough bacteria in their food.) A child gets sick from an ordinary plant scratch? That child’s immune system has a lot of room for improvement. Huffnagle and Werrick say nothing about this.

Dr. Huffnagle is a professor of internal medicine, microbiology, and immunology at the University of Michigan. If the child of such a parent — well-off, well-educated, health-conscious, specializing in immunology — has a weak immune system, and the parent doesn’t realize this is possible, there is enormous room for improvement.

The Probiotics Revolution is 90% filler but the 10% substance makes it worth skimming.

The Dose-Response Revolution and Fermented Food

Edward Calabrese, a toxicology professor at the University of Massachusetts, has pointed to the existence of U-shaped dose-response functions in a great many cases. Chemicals harmful at high doses are helpful at low dose, a phenomenon called hormesis. He reviews the evidence here and here. I didn’t know that a low dose of dioxin reduces tumors. Nor did I know that a low dose of saccharine likewise reduces tumors.

The theory behind hormesis is that a damage-repair system is stimulated by the toxin. This isn’t far from my idea that the average American’s immune system is woefully understimulated, with many bad consequences (allergies, cancer, etc.), due to too-sterile food. If the rats or whatever used in the hormesis studies — probably fed sterile lab chow — were given immune system stimulation (e.g., from fermented food), the hormesis effect might disappear.

Thanks to JR Minkel.

Antibiotics Associated with Later Infection

A 2005 study by David Margolis, a dermatology professor at Penn, and others, found that acne patients given long-term antibiotic treatment, which often lasts more than 6 months, were more than twice as likely to have an upper respiratory tract infection during the year after treatment began than acne patients not given antibiotics.

Does this correlation reflect causality? Two additional analyses suggest it does:

1. Perhaps acne patients who get antibiotics are more likely to see a doctor than those who don’t. However, a study of patients diagnosed with high blood pressure, which also requires relatively frequent doctor visits, had the same risk of upper respiratory tract infections as acne patients not given antibiotics.

2. A later study found that the contacts of acne patients (such as their family) are more likely to have upper respiratory tract infections if the acne patient has such an infection — as you’d expect from contagion. But it makes no difference to these contacts if the acne patient was given antibiotics or not. This means that acne patients given antibiotics do not live in more infection-prone surroundings than acne patients not given antibiotics.

Bottom line: Support for the idea that the bacteria in our body help us stay healthy.

The Good Scots Diet

The Spring 2009 issue of Wise Traditions, a quarterly sent by the Weston A Price Foundation to its members, has an article by Katherine Czapp about traditional Scottish food. They too ate fermented food (pp. 56-7):

Farmers who grew their own oats but sent them to the local mill . . . received in return a bag of “sids” — the inner husks of the oats . . . From these sids, an ancient Celtic dish called “sowans” (or sowens) was made.

The sids were soaked in water for approximately one week (or even more) until they were well-soured.

Sowans takes more than week to make. Presumably the ancient Celts discovered this method of souring by accident and kept doing it because the result tasted good. It’s an example of how, in the right situation, what tastes good guides us to a good diet.

Mosquitoes Praise Fermented Food

A new study in PLoS Pathogen has found that mosquitoes benefit from bacteria-laden food. The bacteria stimulate their immune system and protect them against the malaria parasite. From the abstract:

Malaria-transmitting mosquitoes are continuously exposed to microbes . . . Global transcription profiling of septic and [microbe-free] aseptic mosquitoes [made aseptic with antibiotics] identified a significant subset of immune genes that were mostly up-regulated by the mosquito’s microbial flora . . . Microbe-free aseptic mosquitoes displayed an increased susceptibility to Plasmodium infection while co-feeding mosquitoes with bacteria and P. falciparum gametocytes resulted in lower than normal infection levels. Infection analyses suggest the bacteria-mediated anti-Plasmodium effect is mediated by the mosquitoes’ antimicrobial immune responses, plausibly through activation of basal immunity.

Another view of this study is that it is more evidence of the dangers of antibiotics: They weakened the immune system. As you may know, and as I was told recently by a pediatrician, doctors “hand out antibiotics like candy.”

Thanks to Janet Rosenbaum.

Less of a Foodie

Two weeks ago I was in New York City. I have been there many times. For the first time, I was unexcited by the prospect of eating in the city’s fascinating restaurants. I think it’s all the fermented food I eat (at least two servings per day). All of it has complex flavors; all the New York restaurant food I liked had complex flavors. I am no longer complex-flavor-deprived.

Parasites and Allergies

In 1973, a NIH parasitologist named Eric Ottesen discovered a high rate of worm infection on the tiny island of Mauke. He gave the islanders an anti-parasite drug. Nineteen years later, he did another survey of worm infection.

Compared with 19 years ago, Ottesen found, there was much less filarial infection on Mauke. Only 16 percent of the population harbored the microscopic worms, as opposed to 35 percent on his first visit. The reduction resulted primarily from treating the islanders with the antiparasite drug diethylcarbamazine, which Ottesen had initiated during his earlier visit. And what about allergies? There’s no question that there was a heck of a lot more allergy out there this time, says Ottesen. Nineteen years ago barely 3 percent of the people had allergies. This time it was at least 15 percent. The complaints ranged from eczema to hay fever and asthma to food allergies. What’s more, the dominant problem was one nobody had even heard of 19 years earlier: octopus allergy. It’s the number one offender, says Ottesen. People are breaking out in rashes, hives, swelling of the throat. Yet octopus is nothing new to them–they were eating it when we were there before.

Ottesen believes there is something specific to parasites that makes them protective.  I suspect this is another example of the protective effects of bacteria and bacteria-like chemicals, which I believe may come from both food and parasites. Another possibility is that the antiparasite drug killed bacteria. Nothing is said about obesity; I wonder how their diet changed over the 19 years. A switch from homemade (nonsterile) food to factory (sterile) food may be part of the problem.

Eczema, Nighttime Cough, Antibiotics, and Fermented Food

When Alex Comb’s son was an infant, he had pretty bad eczema. (Eczema is a reddish dry skin rash.) He also had a nighttime cough, a dry cough that started and stopped throughout the night. The cough lasted months. It turned out he was allergic to carragenen. The cough was mostly, but not entirely, eliminated by avoiding carragenen. Sometimes there were flareups.

When the son was 2 years old, he had a mild case of eczema. Doctors wanted to give him steroids. Alex started researching the causes of eczema and how to alleviate it. He came across research on the hygiene hypothesis. In a forum, he read that some people had tried probiotics for eczema with some success. Research on the subject had had mixed results but it seemed worth a try.

So Alex and his wife gave his son DanActive (a probiotic dairy drink) every day for over a year. After a week or so, he noticed improvement. The nighttime cough completely went away. The eczema went away 95%. This isn’t a use of DanActive I could find on their website.

When his son was 3 yrs old, Alex and his wife stopped the DanActive. They assumed his immune system was better. He had gotten tired of drinking it all the time. He drank it less. His diet got broader too; he started eating yogurt. He never really stopped drinking it, he just drank it less.

A few months ago, the son started a 10-day course of antibiotics for a nasal discharge. A few days later, the nighttime coughing mysteriously resumed. It lasted at least 5 nights, and ended around the same time the antibiotics did. It was an asthmatic cough rather than a respiratory infection cough. An asthmatic cough is much drier and shorter.

A few weeks ago, the son was put on antibiotics for an abscessed tooth. Two or three days after antibiotics started, the asthmatic cough started again. Was it the antibiotics? He had not been drinking the DanActive so Alex and his wife started giving it to him again. They gave him the antibiotics earlier in the day and the DanActive before he went to bed. The very first night they did this the cough went away. They kept doing that and the cough stayed away. He has had no cough since then.

What’s telling is the clarity of the correlations. They support the idea that we have a large need for bacteria-laden foods.

Live Food at Google? Nope

I ate lunch in the cafeteria of Google New York. Being monomanical, I was struck by the absence of fermented food. No kombucha, kefir, kimchi, pickles, wine, beer, natto, strong cheese, sauerkraut. Not even yogurt! (Of course there was vinegar at the salad bar and perhaps the meat was aged.) The absence was especially glaring given so much conventionally-healthy food: raw food, twenty kinds of vegetables, fruit, fish, diet sodas, gazpacho, sugar-free jello . . . I am sorry to predict those talented Googlers will be sicker than necessary.

Previous visit.

Would You Rather Have Lice or Eat Yogurt?

Research on mice shows that those carrying the most lice had calmer immune systems than uninfested rodents, and they [the researchers, not the mice!] said their finding may have implications for studying the causes of asthma and allergies in people.

From Reuters. The research paper. The data analysis is much better than usual. Among its strengths are: 1. Graphs of main points. 2. Transformation of variables. 3. Principal components analysis.

This study is more evidence that a high level of foreign substances in our body to which the immune system responds is beneficial. The researchers say nothing about fermented foods, which are an easy and easy-to-control way to ingest such substances. It’s hard to vary your dose of lice but easy to vary how much yogurt you eat.

Thanks to Oskar Pearson.

The Wisdom of the Five-Year-Old Picky Eater

Children are notoriously picky eaters. Could they be trying to tell us (adults) something? Such as how bad our diet is?

Alex Combs, a stay-at-home dad and equity trader who lives near Philadelphia, has a five-year-old son whom Alex describes as “a picky eater.”

His son will not eat rice, potatoes, and pasta. He will eat small amounts of meat.

Yet his son will eat pickles, balsamic vinegar, and old/stinky cheese (but not regular cheese).

This is a fair description of what I eat! No simple carbs, some meat, plenty of fermented foods. While lots of people advocate low-carb diets, only a few, including me, advocate large amounts of fermented food. His son’s counter-intuitive liking for such gourmet “adult” foods as pickles, balsamic vinegar, and old cheeses, all high in bacteria, puts the picky eating of children in a whole new light. They’re not picky — they’re smart.

The Hygiene Hypothesis (continued)

In this NY Times Op-Ed, Jessica Snyder, author of Good Germs, Bad Germs, agrees with my comments about the hygiene hypothesis:

In 1989, an epidemiologist in Britain, David Strachan, observed that babies born into households with lots of siblings were less likely than other babies to develop allergies and asthma. The same proved true of babies who spent significant time in day care. Dr. Strachan hypothesized that the protection came from experiencing an abundance of childhood illnesses.

Dr. Strachan’s original hygiene hypothesis got a lot of press. . . Less publicized was the decade-long string of follow-up studies that disproved a link between illnesses and protection from inflammatory disorders like allergies and asthma. If anything, studies showed, early illness made matters worse. . .
Still, Dr. Strachan’s original observation was confirmed — as a group, babies in large families and day care are less likely to develop allergies and asthma than are children born into smaller families and kept at home. The same protective effect can be seen in children born on farms and in areas without public sanitation.

But the link isn’t disease-causing germs. It’s early and ample exposure to harmless bacteria — especially the kinds encountered living close to the land and around livestock and other young children. In other words, dirt, dung and diapers. Just as disease-causing microbes clearly bring on inflammation, harmless microorganisms appear to exert a calming effect on the immune system.

No mention of fermented food.

Thanks to Michael Bowerman.

The Hygiene Hypothesis

Here is a nice review of the hygiene hypothesis, proposed in 1989 by David Strachan. The hygiene hypothesis is that the increases in childhood allergies and asthma in rich countries were due to decreases in “infection in early childhood, transmitted by contact with unhygenic older siblings or acquired prenatally.” It was inspired by the observation that allergies and asthma were less common in larger families.

In the original, it was infections that were the crucial thing you got from older siblings. This idea ran into trouble when actual measurements of number infections did not show the expected inverse correlation:

When a composite index of exposure was generated by combining histories of illness due to measles, mumps, rubella, varicella, and pertussis, the tendency was for a slightly higher risk of allergic disease in children with multiple infections.

Also bad for the infection idea is that vaccination for measles didn’t protect against hay fever or eczema.

It looks to my perhaps-biassed eyes that it is dirt (= harmless foreign proteins and bacteria) exposure that matters, not exposure to human infectious agents. Living on a farm helps. Plainly you get dirty living on a farm and exposed to animal viruses and bacteria — but that you get human infectious agents from pigs and cows is unlikely. (In technical terms, they aren’t vectors.) Older brothers are more protective than older sisters. Boys are dirtier than girls; it isn’t obvious they are more infectious. Dogs are more protective than cats. Again, dogs are obviously dirtier than cats but the notion that they are more infectious — few infectious agents cross the species barrier — is less obvious.

An emphasis on dirt rather than human-infectious agents is more compatible with my belief in the vast importance of ingesting bacteria-laden food.

Scary Effect of Food Irradiation

Continuing the theme that wiping out bacteria — as antibiotics do — might be a bad thing, here is a mysterious development:

The new study arose from a mysterious affliction of pregnant cats. A company testing the effects on growth and development in cats using diets that had been irradiated reported that some cats developed severe neurological dysfunction, including movement disorders, vision loss and paralysis. Taken off the diet, the cats recovered slowly, but eventually all lost functions were restored.

“After being on the diet for three to four months, the pregnant cats started to develop progressive neurological disease,” says Duncan, a professor of medical sciences at the UW-Madison School of Veterinary Medicine and an authority on demyelinating diseases. “Cats put back on a normal diet recovered. It’s a very puzzling demyelinating disease.”

Do Americans have bacteriophobia? I believe we need to eat plenty of bacteria-rich food for best health (the umami hypothesis). If so, then irradiating food is like taking all the vitamins out of it. Of course, food irradiation is big business. From a list of FAQs:

4. Does eating irradiated food present long-term health risks?

No. Federal government and other scientists reviewed several hundred studies on the effects of food irradiation before reaching conclusions about the general safety of the treatment. In order to make recommendations specifically about poultry irradiation, U.S. Food and Drug Administration scientists reviewed findings from additional relevant studies.

Independent scientific committees in Denmark, Sweden, United Kingdom and Canada also have reaffirmed the safety of food irradiation. In addition, food irradiation has received official international endorsement from the World Health Organizations and the International Atomic Energy Agency.

The International Atomic Energy Agency. It’s an interesting methodological question: Is Diet X (irradiated food) “safe” because it is no worse than Diet Y (ordinary food)? What if Diet Y isn’t safe?

Duncan, the researcher quoted above, said this:

“We think it is extremely unlikely that [irradiated food] could become a human health problem,” Duncan explains. “We think [what happened to the cats] is species specific.”

Hmm. If you don’t understand what causes the effect, how can you make strong claims about it? I think food with too-few bacteria is already a human health problem.

Thanks to Peter Spero.

What Did Eskimos Eat?

In the early 1900s, the anthropologist/explorer Vilhjalmur Stefansson, after living with Eskimos for a long time, returned to tell Americans what he had learned about nutrition. Eskimos ate meat almost exclusively, he said, which contradicted the usual emphasis, then as now, on diversity and fruits and vegetables. Yet Eskimos were healthy. Eskimo diet became even more fascinating when it was realized they had very low rates of heart disease — much lower than Danes, for example. In the 1970s, two Danish doctors, Bang and Dyerberg, found that Eskimos had large amounts of omega-3 fats in their blood, much more than Danes; that was the beginning of the current interest in omega-3 and the idea that fish and fish oil are “heart-healthy”.

As I pointed out earlier, discussions of the Eskimo diet have ignored the fermented food they ate. Here’s what Stefansson said in 1935:

I like fermented (therefore slightly acid) whale oil with my fish as well as ever I liked mixed vinegar and olive oil with a salad. . . .

There were several grades of decayed fish. The August catch had been protected by longs from animals but not from heat and was outright rotten. The September catch was mildly decayed. The October and later catches had been frozen immediately and were fresh. There was less of the August fish than of any other and, for that reason among the rest, it was a delicacy – eaten sometimes as a snack between meals, sometimes as a kind of dessert and always frozen, raw. . . .

[At first, Stefansson didn’t want to eat decayed fish.] While it is good form [in America] to eat decayed milk products and decayed game [well, well], it is very bad form to eat decayed fish. . . . If it is almost a mark of social distinction to be able to eat strong cheeses with a straight face and smelly birds with relish, why is it necessarily a low taste to be fond of decaying fish? On that basis of philosophy, though with several qualms, I tried the rotten fish one day, and if memory serves, liked it better than my first taste of Camembert. During the next weeks I became fond of rotten fish.

So Eskimos ate fermented whale oil and a lot of rotten fish. (“A lot” because if they didn’t eat a lot of it, Steffanson wouldn’t have felt pressure to eat it.) I had no idea that Americans used to eat decayed game.