A superfood to 'keep death away'

Japan's most polarising superfood?

The Japanese have long hailed natto as a superfood – but its ammonia-like smell and mucus-like consistency make the fermented soybean dish a turnoff for many.

BBC Future

• By Erika Hobart

28 July 2020

Every day without fail, my 65-year-old mother prepares a dish that many people would say looks, smells and tastes revolting.

Nattō is very stinky. You definitely notice the smell.

Nattō is a traditional Japanese food made from fermented soybeans. It has an ammonia-like smell and mucus-like consistency that makes it polarising, even among people who grow up with it. A 2017 survey by Nifty, a Japanese internet service provider, found that only about 62% of Japanese people actually enjoy nattō. It also revealed that 13% actively dislike the taste. Regardless, many eat it anyway because of the health benefits.

Nattō is a fermented soy-based food that’s often served with spring onion and raw egg (Credit: Hungryworks/Getty Images)

“Nattō is very stinky. You definitely notice the smell,” said Yuki Gomi, a Japanese chef who runs the cooking school Yuki’s Kitchen in London. “But I always have it in my fridge.” She says it’s a staple in her home, the same way that cheese and yoghurt is readily available in many Western households.

The Japanese have long hailed nattō as a superfood and believe that consumption is linked to improved blood flow and reduced risk of stroke – factors that are particularly appealing in a country that is home to one of the world’s oldest populations. My mother often boasts that nattō keeps her blood “sara sara” (silky). Japanese news site SoraNews24 has gone as far as to declare that "a pack of natto a day keeps the death away”. Hitoshi Shirakawa, professor of nutrition and food science at Tohoku University's Graduate School of Agricultural Science in Sendai, muses this is “probably true”.

He cites a long-term study published in the British Medical Journal earlier this year: researchers at the National Cancer Center in Tokyo found that men and women who ate fermented soy-based foods like nattō on a daily basis reduced their risk of dying from a stroke or heart attack by 10%. 

Japan is one of the world’s most elderly societies, with senior citizens accounting for more than 28% of the nation’s population (Credit: bee32/Getty Images)

“Fermented soybean foods are less likely to lose [nutritional] components during processing, which is considered to be one of the reasons for the clear association between nattō consumption and [a reduced] risk of cardiovascular diseases,” Shirakawa said. Those nutritional components include plenty of protein, iron and dietary fibre, which have positive effects on blood pressure and weight.

Nattō might even help people feel and look younger. One serving (roughly 40-50g) has the same levels of vitamin K as the daily requirement set by the Japanese government and may help prevent osteoporosis. Nattō is also packed with vitamin B6 and vitamin E, which Shirakawa says boosts cell turnover and slows skin aging.

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But fermented soybeans were an integral part of the Japanese diet long before its nutritional benefits were understood. Dr Samuel Yamashita, professor of Japanese history at Pomona College in Claremont, California, says the food was first introduced to Japan from China during the Nara period (710-784AD).

“The historical record in Japan suggests that although nattō was introduced in the 700s, it became popular among both aristocrats and warriors in the Kamakura period (1192-1333) and became important, together with tofu, in the Buddhist-inspired vegetarian cuisine that emerged in the succeeding Muromachi period (1338-1573),” he said.

A set of nattō typically contains three small polystyrene foam containers, each with a single serve of the fermented soybeans (Credit: Yankane/Getty Images)

Yamashita says nattō evolved into a staple in the Japanese diet by the Edo period (1603-1867), when it appeared in cookbooks and started being prepared in the home. Soybeans were soaked in water, boiled or steamed, then blended with the bacterium Bacillus subtilis. They were then wrapped in straw and left to ferment for about a day, depending on the season and temperature.

When you add nattō to your recipes, it manages to add both rich and mellow notes to the food

Today nattō involves far less preparation and is available in convenience stores and supermarkets throughout Japan. A set of nattō, typically containing three small polystyrene foam containers, costs about 100 to 300 yen (£0.75 to £2.25). Each container has a single serving of nattō and tiny packets of tare (a soy sauce blend) and karashi (hot mustard).

To prepare nattō, you simply stir the three items and then pour the sticky concoction over a bowl of steamed white rice. Other ingredients commonly used to spruce up the dish are chopped negi (spring onions) and raw egg. When you lift your chopsticks to eat the end result, each bite is trailed by sticky strings.

Nattō is commonly available in convenience stores and supermarkets throughout Japan (Credit: Recep-bg/Getty Images)

In Japan, it’s most common to eat nattō for breakfast. My mother isn’t particularly fond of the taste, but consumes a bowl each morning, solely for its nutritional benefits. Akemi Fukuta, a jewellery salesperson in Tokyo’s Ginza district, says she eats it several times a week because she finds it both healthy and delicious. Gomi likes to make nattō for her four-year-old daughter’s dinner and says it’s a godsend for busy mothers.

Some people, like Mayuko Suzuki, have an entirely different level of appreciation for the simple dish. She eats nattō two to three times a day and has made a career out of being a “nattō influencer”. Known on YouTube and Instagram as Nattō Musume (Nattō Girl), Suzuki promotes restaurants serving unusual nattō-inspired dishes and shares her own recipes containing the slimy soybeans. She regularly shares photos of dubious combinations like nattō pasta, nattō pizza and even nattō gelato.

“I like the unique taste that the fermentation brings,” she explained. “When you add nattō to your recipes, it manages to add both rich and mellow notes to the food.”

Nattō’s sticky, slimy texture is a natural result of the fermentation process (Credit: Kuppa_rock/Getty Images)

Given her enthusiasm, it’s no surprise that Suzuki has made three visits to Sendai-ya, an all-you-can-eat nattō restaurant in Tokyo. For about 900 yen (£6.75), customers can devour several variations on the dish, including edamame nattō, goma (sesame) nattō and wakame (seaweed) nattō. The business also sells an unlikely dessert: nattō doughnuts.

Sendai-ya president Itō Hidefumi is the third generation of his family to take over the business, which was established in the Yamanashi prefecture in 1961. He says Sendai-ya expanded to Japan’s capital as a response to customer demand. There are also several vending machines containing Sendai-ya’s nattō products in the city.

"It’s very rewarding to take over a family business that provides people with such a healthy product,” he said.

Despite its reputation as a superfood, however, nattō has failed to gain popularity outside of Japan. It has, however, attracted enough attention to end up in the Disgusting Food Museum in Malmö, Sweden.

Variations on the dish include natto sushi and even natto doughnuts (Credit: Ma-no/Getty Images)

“The two things that most people find problematic with nattō are the sliminess and the smell,” said museum director Andreas Ahrens. “It does contain bacteria that’s also found in dirt, so it has that earthy kind of smell to it.”

What we find disgusting and delicious is very cultural

The Disgusting Food Museum features nattō alongside dishes like cuy (roasted guinea pigs from Peru) and casu marzu (maggot-infested cheese from Sardinia). The exhibit also includes American snacks like Pop-Tarts and Twinkies.

“What we find disgusting and delicious is very cultural,” Ahrens said. “It all depends on what we grew up with and what we are conditioned to like. Something like nattō is a very good example of that.”

Gomi understands that sentiment all too well. She remembers being hesitant to include a recipe for nattō maki (sushi rolls) in her 2013 book Sushi at Home: The Beginner’s Guide to Perfect, Simple Sushi. “I was scared that people wouldn’t like such stinky stuff. I was almost embarrassed,” she admitted.

Traditionally, the steamed soybeans were wrapped in rice straw to initiate the fermentation process (Credit: KPS/Getty Images)

But Gomi says that she’s since seen an uptick in students who come to her cooking classes and want to know more about nattō.

“More people are traveling to Japan and staying in ryokan (traditional Japanese inns) that serve nattō for breakfast,” she said. “They come back and tell me they had some strange, sticky stuff… some of them hate it. I don’t blame them. But some of them say they quite like it and want to know where they can buy it.”

Gomi says it makes her hopeful that her non-Japanese peers will come to appreciate nattō as much as she does.

“I'd love to see it more widely available in places like a farmer's market,” she said. “There is certainly a trend towards fermented food [and drink], such as kimchi, kefir and kombucha. It feels like nattō’s time is just around the corner.”

BBC Travel’s Well World is a global take on wellness that explores different ways that cultures the world over strive for a healthy lifestyle.

http://www.bbc.com/travel/story/20200727-japans-most-polarising-superfood

The woman who urinates ALCOHOL: 61-year-old denied accusations she was an alcoholic

The woman who urinates ALCOHOL: 61-year-old denied accusations she was an alcoholic until doctors found her bizarre condition

• Unidentified woman, from Pittsburgh, put on a waiting list for a liver transplant  
• Had suffered cirrhosis and urine tests repeatedly came back positive for alcohol
• Specialists eventually able to diagnose her with bladder fermentation syndrome
• The 61-year-old is the first person in the world to have the bizarre condition 

By CONNOR BOYD HEALTH REPORTER FOR MAILONLINE

PUBLISHED: 22:00 GMT, 24 February 2020 | UPDATED: 07:52 GMT, 25 February 2020

+2

A woman who started urinating alcohol due to a never-before-seen condition was accused of being an alcoholic by baffled doctors (file)

A woman who started urinating alcohol due to a never-before-seen condition was accused of being an alcoholic by baffled doctors.

The unidentified 61-year-old was put on a waiting list for a liver transplant after suffering cirrhosis, a condition synonymous with alcohol abuse.

Two teams of doctors believed she was hiding an addiction when urine tests for the drug were repeatedly positive.

But she was eventually diagnosed with bladder fermentation syndrome after seeing  specialists at the University of Pittsburgh Medical Center. 

They initially thought she was a secret alcoholic but changed their mind after blood tests for metabolites of ethanol were negative. 

Further examinations found high levels of Candida glabrata, yeast naturally produced by the body, were accumulating in her bladder when she ingested sugar. 

The yeast is similar to Saccharomyces cerevisiae, a fungus known as brewer's yeast because it's used by beer-makers to convert carbohydrates in grains into alcohol. 

Tests showed this conversion process was taking place inside the patient's bladder.

WHAT IS AUTO-BREWERY SYNDROME? 

Auto-brewery syndrome (ABS) causes sufferers to feel intoxicated and unable to perform simple tasks.

It usually occurs due to yeast accumulating in the intestines after the sufferer ingests sugar. 

But for the most recent patient, yeast had accumulated in her bladder. 

The syndrome occurs when a sufferers' yeast in their intestines grow out of control. 

ABS may also be caused by abnormal enzymes in the liver. 

Anyone of any age can suffer. 

ABS is so rare its prevalence is unknown. 

There is no cure. 

Avoiding sugar and carbohydrates may help to control symptoms, as well as frequently monitoring a sufferer's blood alcohol content.

Source: Gundry MD 

This was taxing on her liver which was forced to try and eliminate it from her body every time she ate certain foods.

To get rid of the yeast infection, she was prescribed oral antifungals.

The case report was revealed by medics from the University of Pittsburgh's Presbyterian Hospital in Pennsylvania.

They said it showed 'how easy it is to overlook signals that the syndrome may be present' in some liver transplant patients.

The medics have called for doctors to be aware of the condition so patients are not wrongly labelled alcoholics.

Writing in the journal Annals of Internal Medicine, the medics said: 'Acquiring all of the data necessary to evaluate a transplant candidate is complicated because of the high stakes, time constraints, and workload of the persons acquiring the data. 

'Proper processing of data is even more difficult— it is all too easy to order alcohol monitoring tests inconsistently, overlook discrepancies in the results, and allow bias to enter and persist in the decision-making process.

'Standardized guidelines for abstinence monitoring laboratory interpretation are needed.'

While the woman is the first to have bladder fermentation syndrome, a handful of people around the world have a similar condition known as auto-brewery syndrome, which occurs in the gut.

Last October,it was reported a man had been charged by police for drink driving due to the extremely rare condition.

The unidentified 46-year-old was pulled over in 2014 and a breathalyser showed he was five times over the drink-drive limit. 

He maintained he hadn't consumed anything alcoholic, but neither the police nor his family believed him.

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A 46-year-old man in the US is one of only five people in the world to have been diagnosed with auto-brewery syndrome (file)

The man was eventually diagnosed with auto-brewery syndrome (ABS) in 2017. He was found to have high levels of a fungus called Saccharomyces cerevisiae in his faeces. 

Every time he consumed carbohydrate-packed foods his blood alcohol level shot up, sometimes to as high as 400 milligrams per 100 millilitres – 11 times the drink-drive limit.

It is thought that the condition was triggered by a course of antibiotics that he was prescribed in 2011 for a thumb injury.

He told medics he had experienced mental fogginess, dizziness and memory loss since the injury.

The symptoms, which were repeatedly misdiagnosed as depression, forced him to give up his job. 

Dr Fahad Malik, a gastroenterologist at Richmond University who treated the man, believes the drugs disrupted the patient's balance of gut microbes.

This, he said, most likely caused the rapid growth of the fungus S. cerevisiae, which is normally present in low levels in the gut.

https://www.dailymail.co.uk/health/article-8037745/The-woman-urinates-ALCOHOL-61-year-old-denied-accusations-alcoholic.html


ALSO:

Doctors rejected a woman for a liver transplant because of drinking. Then they learned her bladder was brewing alcohol.

Woman urinates alcohol without drinking due to yeast in her bladder

A woman who urinates alcohol without having consumed any is the first person to be diagnosed with “urinary auto-brewery syndrome”. The condition is caused by yeast in the bladder, which ferments the sugar in urine to produce alcohol.

HEALTH 24 February 2020

By Jessica Hamzelou

A similar process to the one breweries use to make alcohol can happen inside our bodies

urbancow/Getty

The 61-year-old, who has requested anonymity, has diabetes and liver cirrhosis, and was recommended a liver transplant. But repeated tests found alcohol in her urine.

Even though the woman denied drinking any alcohol, she was taken off the waiting list for a donor organ, and was instead referred for treatment for alcohol abuse, says Kenichi Tamama at the University of Pittsburgh Medical Center Presbyterian Hospital in Pennsylvania, where the woman later moved.

Doctors there again found alcohol in her urine, but further tests revealed that there was no alcohol in her blood. Stumped, the doctors asked Tamama, a pathologist at the hospital, to investigate. As Tamama conducted some basic tests, he found that the woman’s urine contained yeast.

Bladder brewery

“That’s not unusual,” he says. But because the woman’s poorly controlled diabetes meant that she had a lot of sugar in her urine, Tamama wondered if the yeast might be fermenting this sugar to produce alcohol.

To find out, he separated portions of urine that contained lots of yeast and portions with barely any yeast in them. He also added a compound that blocks fermentation to some of the batches, before leaving them all in the lab overnight.

“Even before the incubation, we noticed the alcohol smell of the specimen,” says Tamama. “The next day, the smell had intensified.”

Read more: Man’s body brews its own beer after yeast take over his gut microbiome

In the urine with high amounts of yeast, the alcohol level had increased from 40 to 800 milligrams per decilitre. Considering that the test used by the hospital detects alcohol at concentrations of 20 mg/dL, that is an extreme amount, says Tamama.

Samples of urine with very little yeast, or the added compound that stops fermentation, didn’t show the same hike in alcohol content.

“The doctors were surprised and shocked,” he says. But the woman herself is relieved, he says. “Initially, clinicians thought the patient was not honest about disclosing her alcohol usage,” he says. “This alcohol thing has been haunting her.”

This case is different to other reports of “auto-brewery syndrome”, in which yeast in the gut appears to produce alcohol that is absorbed into the bloodstream. Individuals with this syndrome have high levels of alcohol in their blood, and they can experience debilitating mental fogginess along with other symptoms.

Not so rare?

Tamama and his colleagues call the woman’s condition “urinary auto-brewery syndrome”. Because the alcohol isn’t in her blood, she doesn’t feel its effects. An attempt to treat her condition with an antifungal drug failed to work, but that might not matter so much because it isn’t affecting her health, says Tamama.

“It is fascinating that it can happen in the bladder as well,” says Fahad Malik at the University of Alabama at Birmingham. After he published a report on the condition, he received between 40 and 50 emails per day from people who thought they might also have it.

“Initially I thought it was a very rare condition,” says Malik. “But the more I reach out to people, the more I realise that a lot of people probably have it and are not diagnosed.”

Journal reference: Annals of Internal Medicine, DOI: 10.7326/L19-0797

Read more: https://www.newscientist.com/article/2235081-woman-urinates-alcohol-without-drinking-due-to-yeast-in-her-bladder/#ixzz6GBcGmRTv

Is this why the Japanese live longer?

Middle-aged adults who regularly eat miso paste added to sushi and soups are 10% less likely to die young, study finds

Vanessa Chalmers

4 hrs ago 30 Jan 2020

Middle-aged adults who regularly eat miso paste added to sushi and soup may add years to life, according to Japanese researchers.

Almost 100,000 people in Japan were quizzed about their diet and then tracked for 15 years. 

Those who ate trendy fermented soy products - such as miso and natto - were 10 per cent less likely to die an early death.  

The researchers say this is likely to be because these products are high in beneficial compounds which help keep cholesterol stable, for example.  

Soy products in general, such as vegan favourite tofu, did not have an effect on mortality. 

Miso, which means 'fermented beans', is a paste added to sushi, soups and salad dressings. Natto is a dish consisting of fermented soybeans which are sticky and stringy.

Recently, soy has been increasing in popularity particularly among vegetarians in Western societies who are searching for protein sources. 

© Getty Miso paste.But Asian populations have typically eaten soy since ancient times. 

People in Japan - who typically live up to 84 years in comparison to the UK's 81 years - often begin their day with a hot bowl of miso soup to kick start their digestion.

The team led by National Cancer Centre, Japan investigated links between several types of soy products and death from any cause and from cancer, cardiovascular disease, respiratory disease, and injury. 

Data on 42,750 men and 50,165 women aged 45-74 years was collected from a study based in 11 of Japan's public health centre areas.

What else do the Japanese eat to boost life expectancy?

It’s widely known that the Japanese live long and healthy lives and experts believe it's down to their immaculate diet.

1. Fish 

© Getty Fish.

Fish are a great source of omega-3 fatty acids, responsible for maintaining a healthy heart. But not only do they keep the blood flowing, but they also benefit the brain, eyes and reduce inflammation. Fish are rich in selenium, which is vital for our antioxidant defences and immune system, and B vitamins that help to keep our brain chemistry in balance.

2. Seaweed

© Getty Seaweed.

Seaweed is rich in minerals, including iodine, zinc, magnesium, calcium, potassium and dozens of other trace minerals we need for our immune system, antioxidant defences and heart health.

3. Matcha tea

© Getty Matcha tea.

Matcha is a traditional powdered green tea made from the fresh leaf tips of the tea plant. Green tea – matcha in particular – is high in a specific type of flavanols called catechins. These substances are thought to boost our body’s antioxidant defences. 

 4. Pickled vegetables

© Getty Pickled vegetables.

Traditionally fermented pickled vegetables are a great source of natural probiotics. They can favour digestive health, help to digest and absorb the nutrients in the food we eat, which then benefits all areas of our health.

Participants filled in detailed questionnaires about their dietary habits, lifestyle, and health status, according to the findings published their findings in the British Medical Journal today.

Deaths were identified from residential registries and death certificates over a follow-up period of nearly 15 years.

The researchers found that a higher intake of fermented soy was linked to a significantly lower risk of all cause mortality at 10 per cent.

Total soy intake, including products like tofu, soy milk, okara, did not affect mortality.

5. Natto

© Getty Natto.

People who ate natto also had a lower risk of death from cardiovascular diseases, such as heart disease, than those who did not eat natto.

Natto is a traditional Japanese food made by fermenting soybeans with a fungus called bacillus subtilis natto.

No links were found between soy intake and cancer-related deaths.  

Results persisted even after further adjusting for the intake of vegetables, which was higher among those consuming larger portions of natto.

The authors point out that fermented soy products are richer in fibre, potassium and bioactive components such as isoflavone than their non-fermented counterparts.

Soy fibre has been shown to reduce cholesterol and keep weight stable, while isoflavone compounds may reduce blood pressure. 

However further research could investigate the exact mechanisms on the body.

In a linked editorial, experts said evidence such as this is increasingly suggesting that fermented soy products have health benefits. 

© Getty Natto snack.Kayo Kurotani and Hidemi Takimoto, of National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, wrote: 'Increasing evidence has suggested that fermented soy products are associated with health benefits. 

'Whether people eat those products depends on their food culture, but some countries already include soy and fermented soy products in their dietary guidelines.'

This is an observational study, so can't establish cause, and the researchers cannot rule out the possibility that some of the observed risk may be due to other unmeasured factors

For example, miso soup contained a high amount of salt in 1995 and 1998, when the surveys were conducted, before salt reduction measures came into place.

It could be that fermented miso is protecting those in the study from the health risks of salt.

https://www.msn.com/en-my/health/nutrition/is-this-why-the-japanese-live-longer-middle-aged-adults-who-regularly-eat-miso-paste-added-to-sushi-and-soups-are-10percent-less-likely-to-die-young-study-finds/ar-BBZsVRI?ocid=ientp