Heparinm Warfarin

Sticky, Smelly Beans

It is well known that as a rule the Japanese are not an inclusive bunch. While Americans often take pride in their ethnic diversity, the Japanese self-identify as a homogeneous, island nation unique in language and culture. Current anthropological thinking puts the lie to this concept since it is believed that the modern day Japanese descended from a mixture of various races, including Micronesians, Southeast Asians, Koreans and Manchurian stock. Yet, the national psyche still clings to this idea with far ranging implications for the country. Foremost is that anyone coming to Japan for the briefest or the lengthiest stay is considered a ‘Gaijin’ - an ‘outside person’, and, as such, find it next to impossible to be integrated into the society. This includes anyone from the casual tourist to the the long term resident expatriate westerner to the ethnic Korean communities whose ancestors immigrated (or were brought as forced labor) centuries ago. Members of this latter group often do not even have Japanese citizenship - after 400 years.

This exclusiveness is not really racism (though there is plenty of that to go around) as much as ethnic consciousness. It isn’t necessarily that the Japanese feel superior (my experience was that the lighter your skin was the more inferior they felt, the darker it was the more superior - but that is another story), but that they feel distinct and that their island(s) were there to be inhabited by them.

One illustrative fact is that as of the 1980’s when I lived in Japan, only three westerners had ever been granted citizenship. Of the three, I know of two - the writer Lafcadio Hearn and the sumo wrestler Jessie Takamiyama. Both of them achieved this distinction not only because they were well known long term residents, but more importantly, because they exhibited an extreme cultural identification with their adopted homeland. In a word, they were more Japanese than the Japanese.

Along with the strong ethnic identification comes a social consciousness of cooperation to the extent of compliance. At the end of the 2nd World War, the government made it known that the road to prosperity would in large part depend on limiting population growth and they made abortion available on demand. Today, it is extremely rare to find a Japanese family with more than 2 children. Couple this low birth rate for the last half century to the fact that the Japanese have the highest average life expectancy in the world and you’ve got an aging population - and a big problem.

There just aren’t enough working age people around to drive the economy and create the wealth necessary to support the increasing numbers of retired and non-working elderly. In other nations with aging populations, the European countries come to mind, this dearth of workers is offset by the acceptance large numbers immigrants - which has not occurred without a tradeoff in terms of a host of accompanying social problems. But the fact that the Japanese are so intent on preserving the social fabric and homogeneity of their nation, that they are instinctively disinclined to absorb Gaijin into their society to resolve the problem also means that they are facing some dire consequences.

During my eight years in Japan, I didn’t quite aspire to become the fourth Gaijin to earn citizenship, but I did do my best to remove myself from the expatriate community of English speakers, to live amongst Japanese as a Japanese to whatever extent it was possible for me at the time. It was an unattainable goal because in the end, I spoke, looked, acted, thought - and most importantly, felt different than my neighbors. In America, you be that way and still be an American - a white American, a black American, an Armenian American, an Irish American, a Japanese American - but an American. In Japan, it was much more binary - a Japanese or a Gaijin.

It wasn’t that my efforts didn’t produce some small victories along the way. One such very minor one was that I developed a palate for some of the more subtle tastes that are distinctive to Japanese cuisine and which , as a rule, Gaijin find disagreeable.

I distinctively remember how my youthful pride was once bolstered when I ordered a dish of fermented soybeans. The chef raised his eyes off the chopping block and looked at me quizzically - I was sitting at the counter in a hole-in-the-wall sushi shop - and exclaimed, “Eh, you like that stuff? Gaijin don’t eat natto!” I would like to say that I answered him with a proud, “Well, this Gaijin does!” - but in all reality, I probably just shrugged embarrassingly.

Yet, it was true that natto had become very appealing to me, not unlike developing a taste for blue cheese. In fact, the pungent fermented taste and odor of the two are quite comparable. In addition to that, though, there is another potential barrier to becoming a natto enthusiast. Even if your tongue and nose learn to accommodate or even appreciate the taste of natto, there is a visual dimension to the process.

The fermentation process produces a sticky paste-like substance that adheres to the surface of the beans. Customarily, one eats them with rice, stirring them up with chopsticks to enhance the flavor, but which also increases the stickiness. So, scooping up a mouthful looks a bit like stuffing your mouth with a cobweb...

Two decades have passed since I’ve been in Japan and my natto eating days are mostly behind me - or so I thought until last year. For it was around one year ago that I started reading in the literature about the miraculous health properties of an enzyme that has been isolated form natto. Today, this enzyme, commonly known as “nattokinase” has become the hot new kid in the world of nutritional medicine.


In the old Chinese medical classics, it is mentioned that the highest form of medicine is food. Appropriate amounts of good quality food nurtures and balances the body, providing it with the strength to ward off illness and function optimally.

Even thousands of years ago, the authors of these texts considered the ingestion of medicines - and by that they meant herbal medicines - to be harsh and unnatural. They lamented the degenerative state of mankind which resulted in the need for people to ingest something that had no nutritional value per se, but was required for strictly the elimination of disease.

Well, we’ve come a long way since then - and maybe, in a sense, we are about to come around full circle. Certainly, as a society, we have a much higher awareness of the importance of nutrition - especially, of how poor nutrition effects our health - because the impact of our nutritional indulgences and negligence cannot be ignored.

Sometimes the line between food and medicine is not so clear. There are many foods that have medicinal effects, and there are substances we might consider medicines that are effective precisely because of their nutritional value. Garlic comes to mind as an example of the former; cod liver oil as an example of the latter.

The traditional Japanese food Natto is also one of those that cuts across both these categories. Like yogurt, sauerkraut, kvass and many other foods, natto is a fermented food with a long history. In this case, boiled soybeans are fermented with the bacteria Bacillus subtilisin.

The fermentation process creates a very pungent odor as well as sticky strands forming on the surface of the beans which look something like a cross between a spider’s web and super glue when eaten. Suffice it to say that it is cuisine for the aficionado who has developed an appreciation for its taste - not unlike a good smelly blue cheese. Most frequently it is eaten at breakfast with rice.

Although it is a rich source of protein, Vitamin B2 and Vitamin K2, the reason that natto has recently been the object of great attention in the nutritional circles is that it contains the enzyme ‘nattokinase’. In turn, the chief attribute of nattokinase that has made it one of the hot, new items in nutritional medicine its ability to dissolve blood clots, otherwise known as ‘fibrinolysis’.

Fibrin is a clot forming protein which serves to protect the body from excessive bleeding and ‘lysis’ means to break down. Thus, ‘fibrinolysis’ is a process that breaks down clots. The body produces an enzyme called ‘plasmin’ which has similar fibrinolytic properties, but for a variety of reasons its activity appears to diminish as we age. The effect of nattokinase not only is similar to plasmin, but research shows that it is four times more potent.

So, the question is: what is so important about fibrinolysis? While it is obvious that the capacity of the blood to form clots is extremely important, it appears that in many cases people have an overactive clotting mechanism. It is hypothesized that there are several possible causes of this dysfunction such as underlying nutritional deficiencies, physical tissue trauma, and acute or chronic infections.

Whatever the reason, this hyperactivity leads to a host of cardiovascular problems such as hardening of the arteries, heart attack, stroke, intermittent claudication (a common problem of pain that develops in the muscles of the legs when taking exercise due to peripheral vascular disease), varicose veins and high blood pressure. In addition, it is also thought to cause on be a contributory factor to many other conditions such as senility, infertility and impotence, hemorrhoids, eye conditions involving the retina and some types of chronic pain like fibromyalgia.

The enzymatic activity of Nattokinase is not only fibrinolytic, but also homeostatic. That is, not only does it break down existing clots, but it also works to prevent the formation of excessive amounts of fibrin and reestablish a healthy coagulation mechanisms of the body.

This regulatory action of Nattokinase means that, unlike the available pharmaceutical “clot busting” agents, it does not reduce the capacity of the body to form clots appropriately and quickly to stop bleeding.

There are other drawbacks to the anticoagulant drugs that are currently being used such as Heparin, Warfarin (better known as Coumadin), Streptokinase and t-PA (tissue plasminogen activator). In addition to increasing the risk of bleeding, Warfarin depletes the body of vitamin K - which has an important natural blood clotting action. Streptokinase has a very short lived action and over time becomes less effective. Heparin must be injected and its used can lead to allergic reaction, high potassium levels in the blood, osteoporosis, low blood platelets and even hair loss. t-PA is only administered as an IV, is effective for a relatively short period of time and generally is extremely expensive.

In contrast, nattokinase is easily taken as an oral supplement, has a longer lasting action, costs less and is without negative side effects. In fact, some of the noted possible positive ‘side-effects’ of nattokinase are increased energy, better circulation, better vision, less joint and muscle pain, and even has been used to manage migraine headaches.