Gluten-free: Cultural or dietary choice?

The New Yorker in its next issue dives deep into the tasty dough of the gluten-free movement. It’s rightly skeptical (and that coming from someone who avoids wheat, and who knows when I do eat it that it is a luxury). A few highlights:

While there are no scientific data to demonstrate that millions of people have become allergic or intolerant to gluten (or to other wheat proteins), there is convincing and repeated evidence that dietary self-diagnoses are almost always wrong, particularly when the diagnosis extends to most of society. We still feel more comfortable relying on anecdotes and intuition than on statistics or data. Since the nineteen-sixties, for example, monosodium glutamate, or MSG, has been vilified. Even now, it is common to see Chinese restaurants advertise their food as “MSG-free.” The symptoms that MSG is purported to cause—headaches and palpitations are among the most frequently cited—were initially described as “Chinese-restaurant syndrome” in a letter published, in 1968, inThe New England Journal of Medicine. The Internet is filled with sites that name the “hidden” sources of MSG. Yet, after decades of study, there is no evidence that MSG causes those symptoms or any others. This should surprise no one, since there are no chemical differences between the naturally occurring glutamate ions in our bodies and those present in the MSG we eat. Nor is MSG simply an additive: there is MSG in tomatoes, Parmesan, potatoes, mushrooms, and many other foods.

[snip]

Peter H. R. Green, the director of the celiac-disease center at the Columbia University medical school and one of the nation’s most prominent celiac doctors, says that the opposition to gluten has followed a similar pattern, and that it is harming at least as many people as it is helping. “This is a largely self-diagnosed disease,’’ Green said, when I visited his office, at New York-Presbyterian Hospital. “In the absence of celiac disease, physicians don’t usually tell people they are sensitive to gluten. This is becoming one of the most difficult problems that I face in my daily practice.”

He went on, “I recently saw a retired executive of an international company. He got a life coach to help him, and one of the pieces of advice the coach gave him was to get on a gluten-free diet. A life coach is prescribing a gluten-free diet. So do podiatrists, chiropractors, even psychiatrists.’’ He stopped, stood up, shook his head as if he were about to say something he shouldn’t, then shrugged and sat down again. “A friend of mine told me his wife was seeing a psychiatrist for anxiety and depression. And one of the first things the psychiatrist did was to put her on a gluten-free diet. This is getting out of hand. We are seeing more and more cases of orthorexia nervosa”—people who progressively withdraw different foods in what they perceive as an attempt to improve their health. “First, they come off gluten. Then corn. Then soy. Then tomatoes. Then milk. After a while, they don’t have anything left to eat—and they proselytize about it. Worse is what parents are doing to their children. It’s cruel and unusual treatment to put a child on a gluten-free diet without its being indicated medically. Parental perception of a child’s feeling better on a gluten-free diet is even weaker than self-perception.”

As with all things, the key if one is going to make a change to one’s diet is to substitute in healthy things, not junk. I know plenty of vegetarians who aren’t healthy because what they eat — chips, Dorritos, cake and frozen vegetarian dishes — are crap. Same goes for replacing gluten. The New Yorker touches on that:

The diet can also be unhealthy. “Often, gluten-free versions of traditional wheat-based foods are actually junk food,’’ Green said. That becomes clear after a cursory glance at the labels of many gluten-free products. Ingredients like rice starch, cornstarch, tapioca starch, and potato starch are often used as replacements for white flour. But they are highly refined carbohydrates, and release at least as much sugar into the bloodstream as the foods that people have forsaken. “Our patients have jumped on this bandwagon and largely left the medical community wondering what the hell is going on,’’ Green said.

It’s a lengthy piece, but worth a read.

UPDATE:

Here’s Bobbie’s response to the article:

What frustrates me about articles like this is that they always lean in the direction of conventional wisdom (often in subtle and insulting ways) without spending any time actually deciphering if that wisdom is true. I mean, we used to hear from medical science that cigarettes were good for us. If you count native Americans, human beings also smoked for thousands of years. Did medical wisdom and historical use that make it true that cigarettes were good for us? The real problem is nobody really wants to admit it’s a problem, because to do so would lead to a major shift in human behavior. Americans seem predisposed to shifting behavior quickly if something new works. Which is why most of us don’t smoke, but most of the rest of the world still does.

It’s certainly true that mass wheat production saved human life. But that doesn’t make it healthy. And it’s also true that wheat is practical and portable food. But we have to process it to make that true, remove what’s good about it from it, and put it back later. I mean, hello, Michael Pollan, years ago, said that.

And there’s the complete dismissal of people like us. Half a dozen life-long health problems evaporated for me when I quit, and I lost weight. So I’m one of the “millions of people with vague gastric distress” who “found something to blame.” Fuck you, you smug ass hole. It wasn’t vague, and I didn’t find something to blame. I found a solution. Go eat your fucking bagel and stay out of my diet.

There.

Posted by Steve

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It ain’t the gluten that’ll get you, it’s the wheat

A couple of weeks back, we highlighted a recent study on gluten, which followed — and potentially debunked — the main one that found gluten sensitivity could be a widespread issue.

That study got a lot of coverage, because the initial research is pretty central to the boom in gluten-free products.

But, as we also noted, our aversion to wheat has nothing to do with gluten. We still find that the problems that Dr. William Davis found with wheat ring true to us — or maybe I should say, our gut reaction is still that there’s something amiss with today’s wheat.

Davis, the author of Wheat Belly, not surprisingly had a few things to say about this latest study. Here’s the crux of his response:

Likewise, wheat is far more than just the gluten protein. Among the most important of the tens of thousands of other components in wheat:

[snip]

In other words, wheat and related grains are still quite terrible for health, with or without gluten. Viewing wheat as nothing more than a vehicle for gluten is hazardous. Conducting a small study in which purified gluten is administered but elicits abdominal distress no different than whey or placebo possibly tells us that this group of 37 people do not have a specific intolerance to gluten–period. It does not exonerate wheat, any more than any apparent reduction in adverse health effects of smoking filtered, low-tar cigarettes exonerates smoking.

[snip]

Yes: Some people have problems with gluten. But EVERYBODY has problems with wheat. The healthcare system, nutritionists, dietitians, physicians, and the media need to get deglutenized: get rid of the notion that the only problem with modern wheat is gluten. It ain’t so.

Deglutenize yourself. Sing it to the tune of:

Posted by Steve

 

 

So, maybe the whole gluten thing is a bit overstated

In the interest of fairness and balance, we’ll pass on news that the scientist behind one of the main studies arguing for the existence of gluten intolerance now has done a follow-up study that calls into question his earlier findings.

Such follow-up studies are pretty standard, at least among serious-minded scientists. (It’s the rest of us who take one study and blow it out of proportion.)

There’s a good bit of coverage of this today. This Forbes piece seems a pretty solid one:

In 2011, Peter Gibson, a professor of gastroenterology at Monash University and director of the GI Unit at The Alfred Hospital in Melbourne, Australia, published a study that found gluten, a protein found in grains like wheat, rye, and barley, to cause gastrointestinal distress in patients without celiac disease, an autoimmune disorder unequivocally triggered by gluten. Double-blinded, randomized, and placebo-controlled, the experiment was one of the strongest pieces of evidence to date that non-celiac gluten sensitivity (NCGS), more commonly known as gluten intolerance, is a genuine condition.

[snip]

37 subjects took part, all with self-reported gluten sensitivity who were confirmed to not have celiac’s disease. They were first fed a diet low in FODMAPs for two weeks, then were given one of three diets for a week with either 16 grams per day of added gluten (high-gluten), 2 grams of gluten and 14 grams of whey protein isolate (low-gluten), or 16 grams of whey protein isolate (placebo). Each subject shuffled through every single diet so that they could serve as their own controls, and none ever knew what specific diet he or she was eating. After the main experiment, a second was conducted to ensure that the whey protein placebo was suitable. In this one, 22 of the original subjects shuffled through three different diets — 16 grams of added gluten, 16 grams of added whey protein isolate, or the baseline diet — for three days each.

Analyzing the data, Gibson found that each treatment diet, whether it included gluten or not, prompted subjects to report a worsening of gastrointestinal symptoms to similar degrees. Reported pain, bloating, nausea, and gas all increased over the baseline low-FODMAP diet. Even in the second experiment,when the placebo diet was identical to the baseline diet, subjects reported a worsening of symptoms!

[snip]

“In contrast to our first study… we could find absolutely no specific response to gluten.”

The Forbes piece notes, rightly, that gluten-free products have become a multi-billion dollar industry, and that the whole market seems to be driven more by consumers and smart marketers than any actual, you know, science.

We’d disagree with that, a bit. And we can only attest to what we’ve found by experimenting, if you will, on ourselves. Wheat products do seem to produce the symptoms that William Davis, the author of “Wheat Belly,” describes (and which we cover pretty extensively at the link to the right about the Yogi Diet.)

We feel better avoiding hybridized wheat, which is what you get in the U.S. And we feel a lot better passing on processed foods.

But results may vary, which I think is one conclusion we can draw from this study. So follow what works for you — not some silly fad.

Posted by Steve

Yogi diet: Should you be avoiding gluten, or are you being diet-washed?

We’ve talked enough about our avoidance of wheat — something different from a pure gluten-free diet. (Well, effectively the same, only the reason is different.)

This weekend, the New York Times delved into the big question: Should we be avoiding gluten? From one of the answers:

How was this gluten-free diet fad created? In the same way the low-carb fad was cooked up (celebrity endorsements, for one thing). Fads can run concurrently, but none of them seem to “have legs.” By their very nature they die. This fad too shall pass. Remember the Scarsdale and Atkins diets, or the vibrating belts? (Of course, if you have celiac disease, you should stick to a gluten-free diet.)

All we know is that staying mostly raw and staying away from wheat — Alas, poor bread, I knew him, Bobbie — works for us. But we’re fortunate to be able to think long and hard about our diet, to play around, to see what works.

Posted by Steve

Yogi diet: At last, we know what ‘gluten-free’ means

The title, before anyone writes anything, is a joke. Of course we know what “gluten-free” means. It’s just that the U.S. government didn’t, before now:

People with celiac disease can now have confidence in the meaning of a “gluten-free” label on foods.

The Food and Drug Administration (FDA) has issued a final rule that defines what characteristics a food has to have to bear a label that proclaims it “gluten- free.” The rule also holds foods labeled “without gluten,” “free of gluten,” and “no gluten” to the same standard.

This rule has been eagerly awaited by advocates for people with celiac disease, who face potentially life-threatening illnesses if they eat the gluten found in breads, cakes, cereals, pastas and many other foods.

As one of the criteria for using the claim “gluten-free,” FDA is setting a gluten limit of less than 20 ppm (parts per million) in foods that carry this label. This is the lowest level that can be consistently detected in foods using valid scientific analytical tools. Also, most people with celiac disease can tolerate foods with very small amounts of gluten. This level is consistent with those set by other countries and international bodies that set food safety standards.

The FDA released that last Friday. So now you know.

If you look over to the side of this blog, you’ll see our “Yogi diet” includes no wheat. It isn’t because either of us has celiac disease; it’s just that we’ve found we feel better, keep a more regulated weight (no wheat belly) and don’t get various sugar highs and lows when we aren’t eating wheat. All of that is caused by a change in modern wheat’s amino acids.

I haven’t seen anything that tried to link that change to the rise in celiac disease. In a lot of ways, the no-wheat thing when not attached to gluten-free is still sort of “out there.” (And it’s a bummer when you think about dosas or naan.) It’s our greatest nod to that vast changes that a yoga routine can cause (or the havoc it can wreck). But it is one we can’t but embrace.

And, to be clear: This FDA pronouncement doesn’t change things at all for us. We avoid gluten-free products like the plague because they are processed.

Posted by Steve

More on the problems with wheat

We haven’t talked much lately about the “yogi diet,” but I just saw a post at the appropriately named wheatbellyblog that breaks down the various problems with wheat.

The impetus? Apparently something written by Jillian Michaels. She is barely on my radar, so I can’t really say anything about her. Here’s the key thing, for me, from the wheatbellyblog post:

Wheat is the perfect obesogen, a food perfectly crafted to cause weight gain. That’s because wheat contains:

Gliadin–Upon digestion, gliadin is reduced to a collection of 5 polypeptides, each 4 or 5 amino acids long, that bind to the opiate receptors of the brain. Unlike opiates such as morphine and heroin, gliadin-derived polypeptides don’t provide pain relief nor euphoria, but only stimulate appetite. The power of the effect varies, but 400 more calories intake per day is common. In people susceptible to binge eating disorder or bulimia, the effect can be much greater, even dominating habit and mind, triggering intake of 1000 or more calories per day.

The appetite stimulation is, for me, the most apparent “side effect” of eating wheat. I know I started eating less when we cut out wheat. It’s the one that makes me think the others might not just be in my head.

And, since I know so many Ashtanga practitioners love talking about their bowels, I’ll point out that there is a discussion of “bowel flora” at the post, as well. So enjoy that!

Posted by Steve

Since we’re talking wheat again, here’s more on gluten-free pros and cons

After two nasty reminders that wheat just doesn’t seem to do a body good, I’m cutting it back out of the diet. And so this New York Times piece on the growing anti-gluten “fad” is timely.

You can count us among those, embarrassingly along with Miley Cyrus, who have found anecdotally that we feel better with wheat out of our diet. Here is a key part to the Times piece:

For celiac experts, the anti-gluten zeal is a dramatic turnaround; not many years ago, they were struggling to raise awareness among doctors that bread and pasta can make some people very sick. Now they are voicing caution, tamping down the wilder claims about gluten-free diets.

“It is not a healthier diet for those who don’t need it,” Dr. Guandalini said. These people “are following a fad, essentially.” He added, “And that’s my biased opinion.”

Nonetheless, Dr. Guandalini agrees that some people who do not have celiac receive a genuine health boost from a gluten-free diet. He just cannot say how many.

As with most nutrition controversies, most everyone agrees on the underlying facts. Wheat entered the human diet only about 10,000 years ago, with the advent of agriculture.

“For the previous 250,000 years, man had evolved without having this very strange protein in his gut,” Dr. Guandalini said. “And as a result, this is a really strange, different protein which the human intestine cannot fully digest. Many people did not adapt to these great environmental changes, so some adverse effects related to gluten ingestion developed around that time.”

Now, keep in mind that we aren’t saying here that we have celiac’s disease. We instead are part of what I guess, judging from this story, is a fringe group who believe there is solid evidence that we shouldn’t be looking 10,000 years back when we think about our wheat consumption. We should look back less than 100, when hybridization altered wheat’s amino acids.

And here’s where I think we veer away from the gluten-free fad. We aren’t replacing muffins with gluten-free ones. We aren’t eating that stuff at all. From the Times:

Anecdotally, people like Ms. Golden Testa say that gluten-free diets have improved their health. Some people with diseases like irritable bowel syndrome and arthritis also report alleviation of their symptoms, and others are grasping at gluten as a source of a host of other conditions, though there is no scientific evidence to back most of the claims. Experts have been skeptical. It does not make obvious sense, for example, that someone would lose weight on a gluten-free diet. In fact, the opposite often happens for celiac patients as their malfunctioning intestines recover.

They also worried that people could end up eating less healthfully. A gluten-free muffin generally contains less fiber than a wheat-based one and still offers the same nutritional dangers — fat and sugar. Gluten-free foods are also less likely to be fortified with vitamins.

Our replacement of all these goodies are, mostly, vegetables. And I think a key is that we’ve cut processed foods out, including processed sugar.

So we aren’t urging a gluten-free diet — the fad one. It sounds a lot like when everything went “fat free.” It was still a lot of processed, awful stuff — just without the fat. That’s not the solution.

The answer for us has been: tons of vegetables (I figure like 20 servings a day); a little fruit; nuts and other grains; maybe some raw milk cheese occasionally as a treat; once or twice a month, maybe, homemade bread from heritage grains that pre-date the hybridization. And then, every now and then, a fun meal — one that doesn’t include wheat.

Posted by Steve