A Comedy of Foxes

By Jacob Schor, ND, FABNO

Photo by Ciaran McGuiggan via Flickr, used under the Creative Commons License.

Every so often a fox pokes his head from a storm sewer opening just a few blocks west of our home on the corner of Dahlia and 22nd Street. I doubt he lives there but instead suspect he uses the city's storm drains as an underground passage way, a fox-style subway system. Early one morning last winter, a good hour before dawn, I saw him emerge and trot down the sidewalk south toward Montview Boulevard. Rather, I should say, we saw him emerge as, our dog Poppy has generally been with me for these various sightings. Suffice to say that our usually mellow dog is now obsessed with this storm drain opening, and has to sniff at it every time we pass by on our morning and evening walks on the off chance that the fox might be there.

I am contemplating my dog's habit of 'looking for the fox' as I think about my own habit of late: talking to my patients about Hirojme Kimata’s study published last June. Something about the implications of this paper keep drawing my mind back to it for another sniff whenever the opportunity presents itself.

This particular paper is one in a series of studies that Kimata has conducted and published over the last year on the effects of watching humorous movies on health, typically on allergic sensitivity. He has shown that viewing humorous movies has beneficial effects on a wide range of physiologic reactions, ranging from asthma and eczema to testosterone levels and erectile dysfunction. This June’s study is the most intriguing one to date.

This study looked at the effect of watching humorous movies on the polyamine levels found in stool samples of 24 patients with atopic dermatitis. Polyamines are fermentation products of particular bacteria that live in the human gut. In general these chemicals are considered undesirable, actually carcinogenic and potentially toxic. This past summer, French researchers reported that lowering polyamine levels in men with advanced prostate cancer significantly slowed disease progression.

It has always been considered difficult to change polyamine production in the gut. To do so requires changing the ambient bacterial flora living in the intestines, a process that involves eradicating unwanted bacteria and then encouraging desirable bacteria to colonize the area. This takes time to make happen, periods of time measured in weeks and months... or at least that is what we thought.

Kimata reported that having the patients in his experiment watch a humorous movie for an hour a day for a week was enough to make significant changes in the intestinal bacterial flora of his subjects and significantly lower polyamine levels in their stools.

There may be some of our readers who do not appreciate just how significant this is. Just by changing the moods of these people for a few minutes a day was enough to change a significant risk factor, polyamine production, for cancer development and progression.

Our patients put so much effort into eating healthy diets and taking the right supplements and exercising with the appropriate frequency and intensity... and in the end the greatest influence may simply be their moods. A little laughter may have greater impact on their health than what they eat or take.

It's this thought that I keep coming back to for another sniff. If this is true, why do we put so much emphasis on eating right or swallowing the right pills? Well, because these things help. But maybe they don’t help nearly as much as having a good laugh.

Over the years we've watched cancer support groups come in and out of vogue. In some studies, they seem to be useful in prolonging survival statistics. In other studies, no benefit is measured. Could the variance in benefit have little to do with deep emotional processing, but simply the character of the various groups? Groups that encouraged good humor and in which members wasted meeting time telling jokes might have been the ones whose members benefited the most. Those groups that spent their time in serious and weighty discussions, whose members were too serious to crack a joke, could those be the groups that did little to prolong the lives of their members?

Or circling back again for another sniff at this study, could those people who we typically diagnose with dysbiosis simply have an undeveloped sense of humor? That if they were to laugh more often and harder, might find their gastrointestinal flora rebalanced and then find themselves cured?

Once one starts wondering about things like this, it's hard to stop. How much of our lives are spent in serious endeavors versus comedic interludes? It's hard to let these questions drop and get this blog thing written. It's like my dog. Once she gets a sniff of that fox, even if it's only a distant memory from last winter, she can't let go of the idea. Nor can I let go of this newest Kimata study.

It may be that something as simple and natural as laughter may be key to improving the health of many of our patients.

Eur J Gastroenterol Hepatol. 2010 Jun;22(6):724-8.

Modulation of fecal polyamines by viewing humorous films in patients with atopic dermatitis.

Kimata H.

Department of Allergy, Moriguchi-Keijinkai Hospital, Osaka Prefecture, Japan. kimata-keijinkai@mkc.zaq.ne.jp

Abstract

BACKGROUND/OBJECTIVE: Alteration of intestinal flora was involved in the pathogenesis of atopic dermatitis. Patients with atopic dermatitis were less colonized with Lactobacilli or Bifidobacterium, whereas they were more colonized with Staphylococcus aureus or Enterobacteria. Consequently, fecal levels of bacterial metabolite (polyamines) were reduced. In contrast, stress also induced intestinal mucosal dysfunction against bacteria and impaired intestinal barrier function. We studied the effect of relaxation by viewing humorous films on fecal flora and fecal levels of polyamines.

METHODS: Twenty-four healthy individuals and 24 patients with atopic dermatitis either viewed seven control nonhumorous films or seven humorous films sequentially for 7 days. Before and after viewing, feces were obtained, and fecal flora and fecal levels of polyamines were assessed.

RESULTS: Neither viewing humorous films nor viewing control nonhumorous films had any effect on healthy individuals. In contrast, viewing humorous films (i) increased colonization with lactobacilli and bifidobacterium, (ii) decreased colonization with S. aureus and Enterobacteria, and (iii) increased fecal levels of polyamines; whereas viewing control nonhumorous films failed to do so in patients with atopic dermatitis.

CONCLUSION: Viewing humorous films may modulate fecal levels of polyamines by restoring intestinal flora in atopic dermatitis.

PMID: 19543102

Resilience

By Lise Alschuler, ND, FABNO
AANP Past-President (2008-2009)

Photo by OakleyOriginals via Flickr, used under the Creative Commons License.

I have a dear friend who is 71 years old and as spunky as they come. She is intensely inquisitive of everyone who has the good fortune of meeting her. With focused determination, in a matter of minutes, she can extract the most intimate details even from the most reticent person. At the same time, she has a constant twinkle in her eye and a belly laugh ready to erupt at any moment. She is entirely unreliable at making plans as something better is quite likely to come along and catch her attention.

Around a table filled with her friends, she loves to debate the deeper meaning of every movie that is showing within a 20 mile radius. At one of these dinner gatherings a few days ago, I asked her a question, “What do you most attribute your good health to?” Her response: “My good health is the most certainly the result of surviving all of my bad habits.” Perhaps she was referring to her daily evening bourbon cocktail. Perhaps she was referring to her disdain for structured exercise. She does have a few bad habits to be sure, but as the evening progressed, I wasn’t thinking of those.

I watched her listen to her friends with complete compassion, while gently and persistently pointing out the silver lining in every cloud that someone resolutely created and simply delighting in the joy of being with people she loves. I thought about her past, too, and the deep adversity and loss she has experienced. It dawned on me that the real secret to her health and vitality was resilience – her unceasing ability to rebound from all manner of disappointments and to emerge into a confident embrace of life within and around her.

Her resilience seeps into those around her as she constantly buoys them up, praises them, and revels in their unique brilliance. You just cannot help but to feel better about yourself when you are with her. She lives life with the expectation that we will swing at anything that life throws at us, that we will make contact with the ball, and that the point is to revel in wherever the ball flies. I smile as think of her now, likely snuggled into her bed, watching one of her favorite shows on TV, eager to fall asleep so that she can start her day tomorrow.

Charlie Chaplin, Mr. Bean, and Medicine

By Jacob Schor, ND, FABNO


Photo by Emmyboop via Flickr, under the Creative Commons License.

I've been reading up on what I call the Chaplin Studies over the last few weeks and they've given me a curious platform on which to observe both my daily life and that of my patients. By Chaplin Studies, I'm not referring to some academician by the name of Chaplin. Instead I'm thinking of the studies on laughter and humor's physiologic impact, most of which use a Charlie Chaplin movie, Modern Times, as their experimental control. In recent years though, Chaplin has been supplanted as a laugh inducer with videos of Mr. Bean in order to achieve similar effects. I suppose to be more accurate I should think of these studies as Chaplin, Bean, et al.

However we want to refer to them, there are an elegant group of research papers that was initially triggered initially by Norman Cousin's book on how he cured himself with laughter. Kimata's work an how laughter tempers allergic responses is probably the best known; laughter calms atopic dermatitis, asthma and related illnesses in adults and infants, even to the degree that having nursing mothers watch funny movies improves eczema and night time sleeping in their infants. Hayashi and his group of researchers have taken this a few steps further analyzing which genes are activated by laughter, analyzing thousands of genes before and after laughter provoking videos and no surprise the genes turned on mostly affect immune response, NK Killer Cell activation for the most part.

This isn't what I've been thinking about actually. I've been thinking about the controls they've used in these studies. For the most part in contrast to watching video of Chaplin, Bean et al. used to provoke laughter, the control groups in these studies usually got to watch the weather channel.

That the weather channel is a neutral control has triggered a chain of thought. There was a time that we watched television for entertainment, we would sit down to be amused, engaged but mostly entertained. Of course I may simply be thinking back to my childhood watching cartoons and the Three Stooges. Instead these days many people leave the television on to keep track of the weather, the news, or sports. As if I care what the weather is in Boston today? This does nothing good for us. What of the shows that fall on the opposite side of the spectrum from laughter, shows that my daughter groups under the category, 'Dead Body Shows?' If laughter improves or balances our immune function, what does the casual and constant viewing of shows that portray postmortem examinations? Is this good for us?

These ruminations have colored my observations during the day, as if I am turning a meter towards all experience. Does this make me laugh? Does this make me cry? Does this simply bore me to no end? These experiences are probably reflected in genetic expression and immune function.

Thank goodness for NetFlix and Mr. Chaplin and Mr. Bean I say. They have become my new after work antidote.