This falls under the heading of probiotics more than herbalism.

The use of probiotics in children or adults can be helpful - or cause disease in persons with intestinal damage or immune compromise. With B. subtilis and other producs there are concerns about mislabeling and potential use of toxigenic bacteria ("food supplement" regulation being what it is, or isn't in this country).

Best to check with a physician for advice on reliable probiotic supplements and look for well-conducted research on any probiotic you're planning on using.

Here is a link that might be useful: more on probiotics

I have seen lacto-bacillus (acidopohilus, bifidus, l. casei, etc) probiotics do absolutely nothing & Natto give results in chronic cases.
Bacillus subtillis is a huge family & there are other varieties providing interesting research. The fact it is a bacterial form does not mean it acts the same as lacto-bacilli.
If you have a compromised immune system then caution about everything in the world is your way of life. I wish you the best & concur you should consult your doctor before using Natto.
When you know someone who is always splashing the back of the commode, wearing layers of protective undergarments, can't venture far from a bathroom, takes pro-biotics, seen licensed gastro-intestinal experts, been tested negative for organic pathology, eats sensible diet & is not content to suffer another year like that, please learn more about Natto.
It seems that Natto's ability to survive until reaching the large intestine (colon) is the difference over the lacto-bacillus, which fade in strength inside the course of the G-I tract.
Natto can maintain viability farther, unto the inner wall of the colon & this is where shows its activity. It has survivability to get between the colon's fecal stool content & colonize the colon wall mucosa.
A lot of loose stool is due to ionic driven osmosis, where by fluid from inside the body tissue (where high water potential) is diffused into the cavity of the colon. It may be that Natto nixes the high solutes (ie: low water potential state) carrying that ionic charge in the stool, by binding the solutes.
In fact huge intake of Natto can be constipating; although not of long duration & common sense cutting back on dose resolves that.
Here is how Natto came to be used for this purpose (there are other uses).
In feudal Japan an army was attacked while boiling soy beans for dinner, so they scooped up the beans in straw & wrapped it up, in order to eat later.
When they did finally dine on their soy beans they noticed that subsequently the troops' loose stool problem disappeared.
Armies world wide always suffered from serious gastro-intestinal problems & the natto variety of B. subtilis became Japans specialty. There have been other B.subtilis strains isolated in North Africa, by the Germans, which were used by the indigenous population to control diarrhea.
Modern strain purification of Natto allowed additional research, which is quite interesting. I buy Japanese Natto spore powder from GEM Cultures (now in Wash.).

Speaking of research, can you link to any that shows this particular bacterium (or certain strains of it) are effective and safe long-term against diarrhea of unknown origin when compared to other treatments (including other probiotics)?

Hi eric,
You seem better able than me to use the internet to search for things. I don't know how to translate Japanese scientific journals.
Should you ever find yourself in a situation similar to those people, that I've described & are getting no relief from your doctor's plans after a year, please remember my free suggestion.

There's a lot of information out there which doesn't require translating Japanese journals (the great majority of the literature on probiotics is available in English, which is the primary language of science). The Pub Med database has tons of articles that are easy to find, as summaries and also full-length online articles. Lots of good articles can be found through Google as well. Here's one review of probiotics in general that suggests that they have demonstrated effectiveness in viral and antibiotic-induced diarrhea as well as "pouchitis" (a post-surgical disorder), but less well-established roles in irritable bowel syndrome and other disorders.

"It is clear that although one probiotic agent may have a role for a specific condition, this does not mean that all probiotics are useful for that indication  there are clear agent-specific effects. Other factors, such as the quantity of organisms in the probiotic, are also important." Link.

So while the product you recommend may have some uses, it'd be important to learn those specific indications that are backed by good research. Maybe another probiotic would be better for a person with a given condition, or there's something else altogether that would work better.

Worldwide many lack medical options.
(B. subtilis is an effective colonizer & under sensible conditions precludes other contaminants. School biology experiment strains are not of the natto variety. Japan store brands of Natto are not sold in air tight containers.)
I do not label Natto as a pro-biotic, rather a traditional Japanese edible.
For clarity: "natto" is a type of B. subtilis & "Natto" is what Japanese call the actual soy bean food innoculated & cultured with "natto" spores .
Remember: Natto is not a pill that always works immediately & if ANY kind of blood thinners are being taken then do NOT take Natto ).
The enzyme "nattokinasse" has been isolated & marketed in Japan. Japanese research has attributed nattokinasse with good fibrinolytic (ie: dissolves arterial fibrin clots) activity. Whole Natto will have a nattokinasse content when eaten.
Another Japanesse sub-set of customers is women, because Natto has K2 that is a beneficial vitamin for bone calcium metabolism. Older women are using it to prevent the advance of osteo-porosis.
Some of my work with Natto has been in food industry & agricultural applications. If soy beans are cheap for you, then making Natto is too.
Add Natto to the secrets of Japanesse longevity, their annual consumption is a significant amount.
To surf for more information your key word is "natto".

So it helps you live longer too! This stuff gets better and better.

What with all these health claims, it'd be really nice if you could surf up some relevant publication, like a review article in a reliable medical journal with references.

Hi eric,
Look around the internet, or contact a Japan consulate for lists of scientific research bodies that meet your criteria.
I don't know if younger Japanese maintain the same dietary practices as their elders & if a potential drop in Natto consumption is a factor in the reported rise of coronary problems there.
Years ago much of Japanese longevity was hypothesized as diet related by people with an opinion. Soy beans got a lot of mention & data was interpreted several ways.
Westerners assume that either the soy bean itself is the thing that is, or is not healthy . This cultural focus is one reason why Natto scientific papers translated in English are scarce.
I have no financial stake in the USA Natto spore sales. Freeze dried cultures of specific B.subtilis varieties were free from the USDA's micro-biological strain bank in Michigan. Sorry, I don't know if they have the "natto" variety; or deal with private individuals since 9/11/2001.

>> So it helps you live longer too!

I wouldn't be at all surprised. I have seen epidemiological data showing that natto consumption reduces the risk of osteoporosis ... breaking a hip probably qualifies as a life-threatening mishap.

Also, consuming natto reduces platelet aggregation ('stickyness' of the blood), and may reduce calcification of arteries. Dietary studies have linked higher levels of vitamin K-2 with lower levels of heart disease, prostate cancer, and liver cancer. Not bad for a high protein food, if one can get over the taste and texture of it.

Any links to meaningful* human studies regarding this "wonder food" would be appreciated.

*For instance, an "epidemiological" study purportedly showing that eating natto lowers one's risk of osteoporosis would be meaningless if all the other potential factors affecting bone density in the study population weren't controlled for.

Hi eric,
See if these keep you interested - for a Japanese language Natto study needing translating we can ask someone.
I apologize to the authors whose names got botched by me.
* Journal of Bone Mineral Metabolism 2000
Tsukamoto, Ichise, Kakoda, Yamaguchi
* Journal of Nutrition 2006, May
Japanese Population Based Osteoporosis Study
* Acte Haematol 1990 vol. 84
Dpt. Physiology Miyazaki Medical College
Sumi, Hamada, Nikanishi, Hiratan
* Journal Nutrition 2003 Mar
Dpt. Pharmacology Hamamatou University School of Medicine
Suzuki, Kundo, Ichise, Tsukemoto, Urano, Umemu
* Journal of the Japanese Society of Hemorheology vol. 5
Hayashi, et. al
* Japan Review of Clinical Opthalmology 1994 Vol. 88
Nishimura, et. al
* Japanese Pharmacology & Theraputics 2006
can't read my writing who , et. al
* other treatise are linked on the internet, you can find more

A list of journal articles to look up in our copious spare time is nice, but since this is an Internet forum, what can you summarize from that list (using links, quotes etc.) that backs up the claims made for natto?

Hi Gringo,
I see your point. This would be hilarious if it weren't so sad.

Eric, I think the difference between the way you are using this forum and I am using this forum is you expect proof and I'm here for the conversation. If I want to, I will research what is brought to my attention to my own satisfaction. If it passes my requirements, I'll speak to my practitioners about it (Eastern or Western). The constant requirement to prove things to your satisfaction may work for you but isn't my cup of tea. I think others may feel the same way.

Hi eric,
I am not good with the computer & so hand copied those references, then typed them out for you. There are others & it was tedious to transcribe long titles, so I didn't. You can write 2 Japanese Medical Universities I made sure to name.
I read your posts & respect your intelligence, as well as everyone else contributing here. Since I could find those Natto references I know you could have done even better.
Summary :
Natto has G-I use, K2 role for calcium osteoporosis, fibrinolytic nattokasse enzyme, nutrition & is safe to use EXCEPT for those taking blood thinner medication/herbs & allergies to things like anchovy

Hi apollog,
I take no credit for Natto tasting as strong as Limberguer cheese.
For western taste acceptance here's some plans:
(A) liquid protein drink to blend up -
20 grams Natto + couple tbs. non-fat yogurt + banana
(B) solid intake -
salt cracker or rice cake + Natto on top
(C) fussy child -
sugar + Natto whipped together
O.K. & on the subject of taste, here is my method of getting fish oil taken :
blend cucumber & fish oil together for a palatable dose

OT, but when I was a child my DM would stir cod liver oil into my orange juice. She told me the fat globules were vitamins and I didn't find it bad at all. :-)

Thanks for the info about natto, gringojay. One can never know too much even if it is (hopefully) never necessary to put into practice.

Here's a link to one of the studies I have read. Yes, Eric, it is controlled for age, height, weight, smoking, exercise levels, and non-natto soy comsumption, among other possible confounding factors. But it probably won't meet your standards, as you demanded above that 'all potential factors' be controlled ... so all you have to do is find one potential factor not controlled for (like belief in astrology) and you can dismiss it as meaningless.

Conclusions of the study: The total hip Bone Mineral Density increased with increasing habitual natto intake in the postmenopausal women (P = 0.0034); Natto intake may help prevent postmenopausal bone loss through the effects of menaquinone 7 or bioavailable isoflavones, which are more abundant in natto than in other soybean products.

Here is a link that might be useful: Intake of Fermented Soybeans, Natto, Is Associated with Reduced Bone Loss in Postmenopausal Women

Hi apollog,
The Japanese Natto package is usually a plastic sleeve wrap bundling four individual 40 gram containers. This would conform with the osteoporosis study implication of good weekly consumption.
Natto beans amount needed for good nattokinase effect is hard to find mentioned, because the studies are done with just the enzyme itself.

First of all, it's not an idiosyncratic unreasonable "demand" of mine that potential factors influencing the outcome of a study (besides the drug/food being tested) be controlled for. As the study you link to shows, the authors attempted to control for a number of other factors that might have resulted in the observed changes in bone density. The authors themselves say their conclusions could be flawed by the possibility that the women eating natto could have had other dietary preferences that led to stronger bones (including higher protein and energy intake), and that the self-reporting nature of the questionnaires was a potential source of error.

They state that women who didn't eat natto lost an average of 1.5% of bone density in the hip over three years. Those who ate 1-4 packs a week lost 1.3% (probably not a statistical difference) and that those who ate the most natto lost 0.4%, which appears significant - except that there was no way of telling whether that difference translates into less hip fractures (they didn't measure for that outcome).
And to get the reportedly significant decrease in bone loss, the postmenopausal women had to eat a relative lot of fermented soybeans - a food that is described as less than appetizing.

They also note that one constituent of natto (vitamin K2), thought to possibly be an important factor in affecting bone density, is available at a much higher concentration in specific medication used in Japan as opposed to natto, which has a comparatively tiny amount. If this drug pans out as safe and effective against osteoporosis, it sounds like it would be far better accepted by women than scarfing down large amounts of a bacteria-impregnated non-tasty fermented soybean product.

So no, I don't "dismiss" the study (I'm glad that somebody finally posted a link to actual evidence), but note along with the authors that it represents preliminary findings regarding a substance that may help prevent undesirable effects of osteoporosis and become a more widely used treatment for this condition.

Taste of Natto, like ripe cheese, is cultural - in Japan that is not an issue. They sell Natto ice cream.
An isolate, or a pharmacy drug, is an excellent way to obtain the benefit of a compound by those who otherwise have no access to it.
A lot of Japanese women apparently have just been eating something right for them.
I think the ready made 4 pack of Natto was about US $1.50 , total for all week's 160 grams. If you make it at home you are using weekly maybe US $0.50+ of soy beans & energy. (Pardon my skipping over the US Dollar slide against the Yen.)
So annually the osteoporosis prevention cost is US$ 78 & that includes the protein snacks too; do it yourself annual cost is US $26+.
Anybody in the USA with cost data for purified menaquinone ?
Any women know the medical costs of osteoporosis treatment drugs?

I think you're assuming that natto is having a significant effect in Japan on protecting women from the effects of osteoporosis, when that is not known to be the case.

Look at the linked study - the authors themselves cite a variety of possible factors (including but not limited to overall diet and lifestyle) for why Japanese women have a lower incidence of hip fractures compared to women in Western nations. Are there genetic factors involved as well?

It's been noted by others previously in this forum that certain subsets of non-Western populations have less of a certain type of disease than Westerners, therefore it just has to be because they eat one particular food that we don't. Other differences in diet/calorie intake, lifestyle/physical activity and genetics are ignored or glossed over, because some want to believe in a wonder food that they can eat and gain benefits without making other necessary changes in their lives to achieve better health.

Some women in Japan keep on doing what they've always done.
Wimmins, can't live with 'em & can't out live 'em.
Anybody studied unique genetic characteristic of Japanese women?
I've eaten food from certain subsets of non-western populations for decades & it's done fine by me.

Japan Food Safety Committee (2005) recommends daily maximum intake of
70 - 75 mg total soy isoflavones (with only 30 mg isoflvones from natto &/or supplements).
Japan Ministry of Health & Welfare's 12 year study (20,000 people) asserts isoflavone molecular similarity to estrogen is relevant. Estrogen prevents liver cancer, but excess isoflavone can block estrogen. In women high isoflavone intake was a 3 fold epidemiological risk factor for liver cancer.
Because hepatitis B & C are greatest liver cancer risk factor women who are infected should decrease soy bean products consumed.
To calculate isoflavone content:
1 gram soy bean contains 1.4 mg isoflavone
1 gram natto contains 0.735 mg isoflavone
1 gram tofu contains 0.203 mg isoflavone

So people who ate the most natto in your linked study and saw the least reduction in their bone density (compared to non-natto eaters) are actually nearing the upper limit of safety for daily isoflavone consumption.

I guess there's no free lunch. :(

By the way, estrogen does not "prevent" liver cancer. Hepatocellular carcinoma is much more common in men than women, but some of that has to do with lifestyle-associated risks. The role of estrogen is still being studied.

Here is a link that might be useful: Risk factors for liver cancer

Hi eric,
The strogen role in liver cancer is from my Japanese translator - I won't nit pic his dictionary usage of "prevent". He did me a favor getting that data & pointing out a potential risk factor.
No free lunch is good axiom. What is good does not necessarily mean more is better.
I think the 12 year Japan study set good guidelines for the responsible consumption of Natto for it's female population.
I always wondered why most Natto units were 40 grams. Portion size seems a responsible result of the 2005 Japanese government to avoid super-sizing.

>> Look at the linked study - the authors themselves cite a variety of possible factors (including but not limited to overall diet and lifestyle) for why Japanese women have a lower incidence of hip fractures compared to women in Western nations.

There are other studies showing that within Japan, the incidence of hip fractures varies by prefecture, and that there is an association that suggests that (again) natto has a protective effect. There are also demonstrated biochemical mechanisms that have been described, particularly changes in the ability of bone protein to bind calcium.

The Japanese government has approved a health claim for natto after reviewing the evidence - I don't know how that compares to the US FDA process for a health claim. But the idea that a food can have health benefits is not outrageous - for instance, "regular consumption of whole oats or oat fiber can lower cholesterol, a risk factor for heart disease."

Epidemiological studies always need to consider genetics and other factors that can occur when using geography to identify patterns of disease. One can always critique epidemiological studies for not having considered, measured and analyzed every possible effect and interaction. That is just the nature of the beast. At the end of the day, we all need to decide to decide how strong the evidence is, and what the possible risks and benefits are from deciding to eat a particular food.

"There are other studies showing that within Japan, the incidence of hip fractures varies by prefecture, and that there is an association that suggests that (again) natto has a protective effect."

The previously linked paper notes that it has not been established that eating natto lowers the risk of hip fracture. Do you have studies to cite that make a definite claim in this regard?

"But the idea that a food can have health benefits is not outrageous"

Nor have I or anyone else here said so. It is always good to know if there is definitive evidence that 1) a food has such benefits, 2) it is palatable and cheaply and readily available, and 3) if there are alternative foods or supplements that supply the beneficial factor in a better or more palatable form.
For instance - apple cider vinegar is touted by its enthusiasts as being a nutrient-rich food. Nutritionists, however, report that ACV is actually quite low in nutrients compared to other foods.

"At the end of the day, we all need to decide to decide how strong the evidence is, and what the possible risks and benefits are from deciding to eat a particular food."

And we've had food for thought here, both in the evidence suggesting a possible but still unproven benefit for eating natto regarding osteoporosis, and the warning that eating too much soy isoflavone (found in natto and other soybean products) might lower an estrogen protective effect against liver cancer. I'm not on the "SOY BAD" bandwagon like some who've been quoted in this forum, but there could be an advantage to supplying a vitamin K2 supplement without the rest of soybeans' components.

Hi eric,
Yes, K2 supplementation (& other items) may be ideal.
The majority of people worldwide do not have access, or the financial means, to use western options.
Natto is cheap, simple & can be made in the developing world.
I read Japan has about 1,000 years eating the stuff.
So, that would mean their Natto learning curve began +/ year 1009 A.D.

>> I'm not on the "SOY BAD" bandwagon like some who've been quoted in this forum, but there could be an advantage to supplying a vitamin K2 supplement without the rest of soybeans' components.

I've been thinking the same thing (only different) for a while. We have people in our household that have immune issues with soy ... not something that makes soy generally bad, except for the minority.

So we make our own tempeh (beans fermented with Rhizopus) using non-soy beans. Not sure if the natto bacteria (B. subtilis) will readily grow on pintos or lentils or some other substrate. Based on the smell of some spoiled food I have encountered, I would say yes. I need to do a bit more research, and then may try it.

Hi apollog,
I think you are right, that natto spores would culture on a different bean. It seems lentil would be a far cry from soy in it's characteristics & a last resort.
In India the garbanzo was used to make an indigenous miso. It's hull is papery too, shape sort of round & may incubate similar to soy.
Garbanzo would be a good first try .

According to translation from the Japanese scientist who isolated nattokinase:
(it's content varies in Natto products) the equivalent biochemical activity of 1,600 IU of Urokinase is found in the nattokinase that is contained in +/- 1 (one) gram of Natto beans.
(Urokinase engenders a plasmin enzyme that breaks down fibrin; at weekly total dosage of 150,000 IU urokinase reduces angina by 24%, fibrinogen by 3% & red blood cell aggregate/viscosity by 6.4%; however, increasing that weekly total urokinase dose 10 fold for patients with end stage coronary artery disease reduces angina 70%, fibrinogen 33% & red blood aggregate/viscosity 19.9%.)
This is the math calculation:
+/- 93.75 grams weekly of Natto beans = 150,000 IU urokinase/week
+/- 134 grams daily of Natto beans = 1,500,000 IU urokinase/week
(Please remember: Natto is NOT to be taken unsupervised with blood thinner medications.)
Note: it is proposed by the text's author that the fibrinolytic activity of nattokinase is biologically more efficient than urokinase; and that 75 grams weekly of Natto bean is equivalent to a week's worth of 150,000 IU urokinase
(meaning 107 grams Natto beans daily would equate to 1,500,000 IU weekly urokinase).