While reading “In Search of the Optimal Brain Diet,” by Bret Stetka, I wondered if the studies cited considered vegetarian and vegan diets. As a vegetarian myself, I believe that I have become healthier by eliminating meat from my diet, but after reading this article, one might deduce that individuals who do not consume fish are more likely to experience mental illness at some point in life. If the optimal brain diet includes seafood, should vegetarians be concerned?

Mare Andon
via e-mail

STETKA REPLIES: Based on the research, a vegetarian diet is certainly one of the healthiest options for the body. It just might not be the healthiest for the brain, at least for some people. Vegetarianism has been associated with conditions such as depression, anxiety and vitamin B12 deficiency, itself associated with developmental delay and a range of neurological problems. Furthermore, the Mediterranean diet, which includes plenty of fish, has been linked with a lower risk of depression and dementia.

One way to counter the possible brain health shortcomings of a vegetarian diet is supplementation. Some psychiatrists recommend that vegetarians supplement with B12 and with omega-3 fatty acids derived from plants, but at least one study found that omega-3 fatty acids from seafood are incorporated into the brain far more efficiently than those from plant sources.

For herbivores who avoid meat for ethical reasons but who could be at risk for mental illness—or for those who just don't want to take any chances—shellfish could be an option. Given that bivalves such as mussels and oysters do not have a central nervous system, many experts believe they do not feel pain.


I am extremely grateful for “The Carriers,” by Anne Skomorowsky—an excellent and informative article on the fragile X premutation.

For those of us who are afflicted with fragile X–associated tremor/ataxia syndrome (FXTAS) and fragile X–associated primary ovarian insufficiency (FXPOI), Skomorowsky's article provides some relief because now we know that this syndrome is getting attention in the scientific world. Perhaps as a result, there will be a treatment someday.


Two Web sites have been launched for sufferers of FXTAS and primary ovarian failure (which can affect women with FXPOI) in the hopes of creating a sense of community for those who are afflicted with these conditions and for their families: www.fxtassupportgroup.org and www.pofus.org.

Please continue your superb coverage of fragile X.

J. W. Yanowitz

I write to you as the executive officer of the Fragile X Association of Australia, a small, member-based nonprofit charity that provides support to individuals and families affected by fragile X–associated disorders in Australia.

We found “The Carriers” to be extremely well written and informative, and we would like to commend you for carrying an article on a topic that is critical to so many people and families around the world.

Our organization would also like to extend our congratulations to Anne Skomorowsky for making quite complex information about the fragile X premutation understandable and accessible in her article.

Wendy Bruce
Manly, New South Wales, Australia


I'm curious about some other variables that might affect the health data gleaned from Google, Facebook and Twitter, as discussed in “Status Update: Stressed, Angry, at Risk?” by Johannes C. Eichstaedt.

The article states that certain negative words used online by people engaged in social media are representative of various health risks such as heart disease. I wonder if there have been any studies of how often these people engage in social media. Perhaps the “positive” people are online less than the “negative” ones, giving the former a better outlook on life and better overall health.

Laura Irwin
Vancouver, Wash.


What I'm most struck by after reading “The Invisible Girls,” Maia Szalavitz's article on autism diagnoses in females, is how laughably we are stumbling through this whole terrain. Words matter. With some borderline cases, the stigma of a diagnosis may be worse than any benefit from classification.

“Autism spectrum disorder” has a negative connotation because “autism,” at its most extreme, is a disadvantageous condition that handicaps one in society. Thus, to say one is on its spectrum is to say one is on a spectrum of disadvantage. And because, this article implies, autism's underlying qualities apparently manifest within all humans—and these manifestations come with such delicate shadings as to be easily muddled among all the other delicate shadings of the human condition—everyone can be put on this spectrum of disadvantage.

Take the example of psychopaths, as we commonly call individuals with an extreme lack of empathy. We all have varying degrees of empathy. Would you say that we all lie on a psychopathic spectrum? Would you say that Mother Teresa did? Perhaps you argue, “Well, she was closer to an extreme degree of empathy. Let's reverse the spectrum nomenclature for her. Instead of low on the psychopathic spectrum, we'll say she was high on the empathy spectrum.” But if so, then where does your exceptionally successful businessperson, the CEO who must lay off 10,000 people in the morning and still sleep at night, lie? Compared with the average individual, would you say that person is “high on the psychopathic spectrum?”

Rather than putting people on this psychopathic spectrum, let's just say we know what a psychopath is: someone with so little empathy it is truly extremely disadvantageous. If a spectrum must be used, let's say that the CEOs have less empathy than the norm or maybe that they are lower on an emotional sensitivity scale. People can be low on that scale and still be good people. They can compensate by using cognitive abilities. Perhaps they can even do more good than someone with slightly greater empathy but much less cognitive skill. It would obviously be a disservice to label these people as being on the psychopathic spectrum.

Back to autism. Rather than putting everyone on a spectrum of disadvantage, let's invent a word for it without that connotation. Say, “focusivity”—a proclivity for a singular focus. Because not only are we doing a pretty poor job of diagnosing it, we are doing an even worse job of knowing whether or when being on the autism (or focusivity) spectrum is bad or good.

Alfred Winsor Brown V
Huntington Beach, Calif.


“The Fantasy Advantage,” by Deena Weisberg, was brilliant in talking about how fantasy-themed stories could produce better vocabulary and learning outcomes in children. Beyond children, it occurs to me there are increasing numbers of adults who regularly immerse themselves in the world of role-playing, simulation games, Japanese anime, and hybrids of live-action and computer-animated movies. I wonder if researchers could learn more about why fantasy is so beneficial to children by studying the common factors between fantasy-loving adults and kids. Why are certain individuals more inclined toward the imaginary?

Rowena Kong
via e-mail