By Izadora Lenna, JHBL Staff Member
Introduction
Fermentation has been used as a cooking technique through the ages. Although it is a technique which has been widely used, its benefits are continuing to grow. Fermented foods with lactobacillus are an innovative and unique approach to guard against depression and anxiety.[1] Anxiety and depression affects nearly 33% of people living in the United States.[2] Of those 33%, one in ten Americans are taking anti depression medication.[3] A prescription is required to obtain depression or anxiety medication. According to new research scientists have found that fermented foods, which are attainable for all, is an effective way to combat depression and anxiety.[4] The lack of regulation on fermented foods allows anyone who suffers from mental illness, or wants to prevent mental illness, an accessible starting ground.
The Food and Drug Administration (FDA) has imposed some regulations on fermented foods, though the regulations are minimal and do not concern the use of fermented foods as mental health aids, indicating that the FDA is not worried about the distribution of these foods. The FDA has very strict rules about prescription drugs that go on the market and requires drugs to go through clinical trials.[5] Some drugs undergo years of development before testing on humans even begins.[6] Increasing the public’s knowledge about the availability of fermented foods and their benefits regarding mental health could be a significant step towards more accessible health care.
Background
Research shows that there is a direct link between the gut and the brain.[7] Micro Bacteria living inside of the human gut have been found to influence cognitive performance because the gut and the brain are on the same axis and are connected through many nerve and circulation pathways.[8] The microbes inside of the gut can produce different substances that enter the bloodstream and circulate directly to the brain.[9] The probiotics and prebiotics in fermented foods enhance mental health through the pathways and gut-brain axis.[10]
A University of Virginia (“UVA”) study isolated lactobacilli and tracked how its presence influenced behavior.[11] The lack of lactobacilli was found to worsen depression and anxiety, while its presence maintained an immune mediator called interferon gamma, which regulates the body’s response to stress, anxiety and depression.[12] The research began with an attempt to manipulate the flora of gut bacteria; however, with over 39 million different gut bacteria present in the human body, the UVA scientists focused on the Altered Schaedler Flora, which is often overlooked.[13] This research is still in its infancy, but scientists are very excited about what these initial findings mean for the medical community.
Until recently, the only over-the-counter treatment for depression and anxiety was a surplus of daily vitamins. Scientists have researched different herbal supplements’ potential to treat depression and anxiety, but the results have been conflicting.[14] Herbal and over-the-counter medications can potentially help in very mild cases of depression, but very little research is available to back up this idea.[15] While over-the-counter medication is available at any pharmacy, some of these vitamins are quite costly. Fermented foods can be made at home or purchased at most grocery stores. Their accessibility and low cost make fermented foods a perfect alternative.
Analysis
The sale of fermented foods is regulated to protect the consumer from toxins and illness, those are the only regulation applied to fermented foods.[16] With additional studies demonstrating the benefits of fermented foods, as well as their open access to the public, there is no reason why the public should not invest in their own mental health and use a natural method alongside their own methods to treat/prevent anxiety and depression. Mental health treatment is evolving, and understanding how the brain is directly connected to the gut is a major advancement in treating anxiety and depression.
Despite the promising effects that fermented foods seem to have on the human body, the research is still in its infancy. The study of a single bacteria, Altered Schaedler Flora, does not capture the extent that fermented foods have on the gut to brain pathways.[17] The mental health benefits are also limited to the bacteria that can be found in the location where that particular fermented food was made. [18] Products that are fermented in different states or different countries may not have the same effect as those that are fermented locally. This research also falls under the assumption that someone starting to ingest fermented foods already has a healthy gut flora.
While fermented foods are unregulated and accessible to all, the question remains whether fermented foods require further regulation if they are being consumed solely for the benefit of improved mental health. There is a risk of a placebo effect where no real change is made in the brain gut axis, as well as bias in the scientific research.[19] There is no specific set standard for fermented products other than ensuring the products are not toxic.[20] Ongoing studies and clinical trials are continuing to test the gut-brain theories.
If research continues to demonstrate the positive benefits that fermented foods have on mental health, the Department of Health and Human Services should plan to endorse any further research that reinforces these initial findings. The more people that are aware of affordable and accessible mental health aids, the better anxiety and depression can be managed as a society. Anxiety and depression rates are on the rise, especially in young people.[21] Having a safe and easy solution for anxiety and depression is pivotal.
Fermented foods are not the cure-all for all mental health issues, but they are a potential start. With governmental reinforcement of the benefits that derive from consuming such foods, anxiety and depression may be reduced amongst the population. Mental health institutions should implement fermented foods into their nutrition plans, as well as anyone treating those with anxiety and depression. Additionally, regulation should not be applied negatively towards fermented foods and those who produce it, but rather positively to encourage the public’s consumption of them.
Disclaimer: The views expressed in this blog are the views of the author alone and do not represent the views of JHBL or Suffolk University Law School.
Izadora Lenna is a second-year law student at Suffolk Law School who graduated from William and Mary in 2022 with a degree in international relations. Izadora is interested in pursuing a career in international tax in the future.
[1] See Scientists Uncover How Fermented-Food Bacteria Can Guard Against Depression, Anxiety, UVAHealth (Nov. 28, 2023), https://newsroom.uvahealth.com/2023/11/28/scientists-uncover-how-fermented-food-bacteria-guard-against-depression-anxiety/#:~:text=University%20of%20Virginia%20School%20of,and%20other%20mental%2Dhealth%20conditions. [https://perma.cc/A9F9-WCG2]
[2]See Latest Federal Data Show that Young People are More Likely than Older Adults to be Experiencing Symptoms of Anxiety or Depression, KFF (Mar. 20, 2023), https://www.kff.org/mental-health/press-release/latest-federal-data-show-that-young-people-are-more-likely-than-older-adults-to-be-experiencing-symptoms-of-anxiety-or-depression/#:~:text=Nearly%204%20in%2010%20(39.3,to%2032.3%20percent%20in%202023 [https://perma.cc/L8AA-3QQT].
[3]See Antidepressant Use in Persons Aged 12 and Over: United States 2005-2008, CDC (Oct. 2011), https://www.cdc.gov/nchs/products/databriefs/db76.htm#:~:text=About%20one%20in%2010%20Americans,every%20level%20of%20depression%20severity. [https://perma.cc/FSS2-GR73].
[4]See UVAHealth supra note 1.
[5]See Conducting Clinical Trials, FDA.gov (June 30, 2020) (describing the procedure that prescription drugs go through during clinical trials).
[6]See generally id.
[7]See Kaitlin Vogel, Could Eating More Fermented Foods Help Improve Mental Health, MEDICAL NEWS TODAY (Feb. 2, 2024), https://www.medicalnewstoday.com/articles/eating-more-fermented-foods-help-improve-mental-health-gut-microbiome [https://perma.cc/UF3D-VSBU].
[8]See id. The brain to gut axis is the idea that the brain and the gut are connected in the body through nerve pathways and through the blood. Id.
[9]See id.
[10]See Sushama Chaphalkar, Fermented Foods Linked to Mental Health Benefits Through Gut-Brain Connection, NEWS MEDICAL LIFE SCI. (Jan. 29, 2024), https://www.news-medical.net/news/20240129/Fermented-foods-linked-to-mental-health-benefits-through-gut-brain-connection.aspx [https://perma.cc/KD8K-PDRH].
[11]See UVAHealth supra note 1.
[12]See id.
[13]See id.
[14]See Depression: Are There Non-Prescription Drug Options, Parkview Health (Oct. 1, 2018), https://www.parkview.com/blog/depression-are-there-non-prescription-drug-options [https://perma.cc/HNE7-TXWR].
[15]See id.
[16]See Federal and State Regulations on Selling Fermented Foods, IOWA STATE UNI. (2020), https://www.ncrfsma.org/files/page/files/ncr_fermented_foods.pdf [https://perma.cc/2XHV-WC8W].
[17]See Vogel, supra note 7.
[18]See id.
[19]See Elena Porras-Garcia et al., Potential Neuroprotective Effects of Fermented Foods and Beverages in Old Age: A Systematic Review, Frontiers (June 15, 2023), https://www.frontiersin.org/articles/10.3389/fnut.2023.1170841/full [https://perma.cc/CNF8-2ZP2].
[20]See Vogel, supra note 7.
[21]See KFF, supra note 2.