The gluten-free contagion

 

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Another good piece of journalism by Michael Specter writing for the New Yorker Magazine What’s So Bad About Gluten? Yes, that’s the same Michael Specter who wrote the excellent expose of Vandana Shiva [I’m a card-carrying anti-Shiva activist].

People seem to be afraid of an increasing range of things, and gluten anxiety has grown until it seems to be the hot new ingredient to avoid.

Why? We know that about 1% of the population has Celiac disease – which means truly dangerous gluten intolerance. There is some evidence that the incidence grew since the 1950’s to that 1% level. Since the chemistry of wheat is unchanged the implication is the cause is environmental. But the gluten panic isn’t about Celiac disease – it seems to be largely self-diagnosed quite possibly just a popular myth.

Here’s a couple of excerpts from Michael’s essay that will give you some hints:

Myhrvold wasn’t in town that day, but I caught up with him later. He is highly opinionated, and delights in controversy; saying the words “gluten-free” to him was like waving a red flag at a bull. “When I was a kid, I would watch National Geographic specials all the time,’’ he told me. “Often, they would travel to remote places and talk to shamans about evil spirits. It was an era of true condescension; the idea was that we know better and these poor people are noble, but they think that spirits are everywhere. That is exactly what this gluten-free thing is all about.” He stressed that he was not referring to people with celiac disease or questioning the possibility that some others might also have trouble eating gluten. “For most people, this is in no way different from saying, ‘Oh, my God, we are cursed.’ We have undergone what amounts to an attack of evil spirits: gluten will destroy your brain, it will give you cancer, it will kill you. We are the same people who talk to shamans.

(…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.”

(…snip…)

FODMAPs, an acronym for a series of words that few people will ever remember: fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Not all carbohydrates are considered FODMAPs, but many types of foods contain them, including foods that are high in fructose, like honey, apples, mangoes, and watermelon; dairy products, like milk and ice cream; and fructans, such as garlic and onions.

Most people have no trouble digesting FODMAPs, but these carbohydrates are osmotic, which means that they pull water into the intestinal tract. That can cause abdominal pain, bloating, and diarrhea. When the carbohydrates enter the small intestine undigested, they move on to the colon, where bacteria begin to break them down. That process causes fermentation, and one product of fermentation is gas. In Gibson’s new study, when the subjects were placed on a diet free of both gluten and FODMAPs, their gastrointestinal symptoms abated. After two weeks, all of the participants reported that they felt better. Some subjects were then secretly given food that contained gluten; the symptoms did not recur. The study provided evidence that the 2011 study was wrong—or, at least, incomplete. The cause of the symptoms seemed to be FODMAPs, not gluten; no biological markers were found in the blood, feces, or urine to suggest that gluten caused any unusual metabolic response.

In fact, FODMAPs seem more likely than gluten to cause widespread intestinal distress, since bacteria regularly ferment carbohydrates but ferment protein less frequently. Although a FODMAP-free diet is complicated, it permits people to eliminate individual foods temporarily and then reintroduce them systematically to determine which, if any, are responsible for their stomach problems. FODMAPs are not as trendy as gluten and not as easy to understand. But, biologically, their role makes more sense, Murray says.

Michael Specter happens to be a dedicated whole wheat baker. Based on what he learned researching this story, he says he has dumped his vital gluten additive in the trash. ” I have returned to baking whole-wheat bread the way it is supposed to be made: water, yeast, flour, and salt. I will try to live without the magic wand. But I am certainly not going to live without gluten. That just seems silly.”

One thought on “The gluten-free contagion

  1. Orthorexia nervosa – that’s really clever.I don’t know how it is where you have been spending your time, but here in the US every restaurant has numerous “gluten free” entres or those that can be modified to be “guten free.”  I have an article somewhere claiming that for every person who actually has celiac disease there are at least ten who have diagnosed themselves with it.

    Some wag has said that nutritionists have discovered gluten to be an essential nutrient: It is needed to prevent smugness and self satisfaction.

    I’ve come to love the tone in which people  (usually women) announce that they are “gluten free,” as if it is a religious or moral statement. Another case of “better than you”, rather than “better for you.”

    I recently sent Mary Jane a review of the execrable best seller “Wheat Belly.”

    I’ll find it and send it you you separately.

    Fred — Sent from Mailbox

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