You asked, so here’s my gluten-free story (safe for Celiacs to read):
I’m not a Celiac, but I do have Crohn’s disease, an inflammatory autoimmune disorder which often causes similar symptoms in the digestive tract. When I was first diagnosed with Crohn’s, a course of steroids followed by immunosuppressive drugs was enough to keep me in relatively good health.
Slowly, though, my symptoms returned. After two years, I was again underweight and anemic (a six-foot-tall male in my twenties, I weighed about 130 pounds at my lightest), with chronic, debilitating stomach pains and other symptoms which made my life very hard.
Friends who hadn’t seen me in months asked about my health as soon as they laid eyes on me. On more than one occasion, I experienced stomach cramps so severe I vomited until there was nothing left but bile. Occasionally, upon standing up too quickly, my vision would fade and my head would spin until I fell to the ground or found something to hold onto. These weren’t the kind of symptoms that can be alleviated through the placebo effect.
People suggested going gluten-free, but I resisted it until I was desperate for many of the reasons laid out in James Hamblin’s piece (much of which I still agree with). But it worked. The pain receded. My digestion improved. I gained 30 pounds, leaving me thin, but not skeletally so.
I asked my gastroenterologist about this, and they suggested I pursue a low-FODMAP diet, which restricts foods like wheat which contain sugars that ferment during digestion. It kept the worst of the symptoms at bay and, along with my medicine, kept my inflammation at a low level. Eventually, even that low level of inflammation caused enough complications that I was put on more powerful medicine, but I've never again been as sick as I was.
In the end, it wasn’t the gluten that bothered me; it was the wheat itself. I found I could drink gluten-free beer, for example, but only the kind that was made from sorghum or other wheat substitutes. Wheat beer with the gluten removed still made me sick, and trace amounts of gluten never bothered me at all. But despite the fact that I wasn’t a Celiac, the availability of gluten-free products was a huge boon for me.
I appreciate what you, James, and TheAtlantic are trying to do by educating the public on these issues. There’s so much pseudoscience surrounding this topic that I’m sometimes embarrassed to admit that I prefer to avoid wheat. But to suggest, by omission or otherwise, that Celiacs are the only people who can benefit from the explosion of gluten-free products ignores the clinical and day-to-day experiences of a great number of people, and I think that’s worth mentioning.
This reader’s on the same page:
Credible sources place the percent of Americans with celiac as high as 1-in-35. But that understates the problem by ignoring people who are allergic to wheat but do not have celiac.
Since I was young my fingers swell (not subtly) when I eat wheat products, and it seems to be more likely to happen with products that are known to be high in gluten (like pizza). Yet I test negative for celiac.
Is the test imperfect? Am I allergic to wheat? I’ve no idea, but it is not a trivial matter. I’m afraid we are in another of those moments when experts think they know it all, while there is much more to be learned.
A reader in Bend, Oregon, is far from gluten-free but nevertheless provides some good, er, food for thought:
Some people have commented that the increased gluten sensitivity in recent decades is due to modern, hybrid wheat varieties, high processing, added gluten, and/or a move away from traditional bread dough fermentation. Michael Pollan’s view was summarized in The Huffington Post piece “Michael Pollan Wants You To Eat Gluten”:
Pollan goes on to say that some people would do well to experiment with fermentation. More specifically, he thinks fermented sourdough is a smart alternative for a healthy gut. Fermented foods in general have been found to be beneficial for gut health, but sourdough bread has a more specific benefit, according to Pollan.
“[The] tradition of fermenting flour with sourdough breaks down the peptides in gluten that give people trouble,” he said. “Anecdotally, I’ve heard from lots of people that when they eat properly fermented bread, they can tolerate it.”
There is some emerging research to support Pollan’s perspective: A 2008 study fed subjects with gluten intolerances either sourdough or regular bread. Similarly, a very small 2012 study fed sourdough to participants with celiac, finding few to no physical side effects.
There are essentially two ways to turn flour into bread. The first is the way it was done for most of human history: let the flour absorb as much water as possible and give it time to ferment, a process that allows yeast and bacteria to activate the dough. Kneading then binds the two proteins that come together to form gluten.
Most of the bread consumed in the United States is made the other way: in place of hydration, fermentation, and kneading, manufacturers save time by relying on artificial additives and huge industrial mixers to ram together the essential proteins that form gluten. . . . Most bakers, even those who would never go near an industrial mixing machine, include an additive called vital wheat gluten to strengthen the dough and to help the loaf rise.
I’m lucky; I can eat plenty of gluten and stay extremely healthy. I even eat seitan sometimes, which is pure wheat gluten. Yum.
[Avoiding gluten] has not been shown (in placebo-controlled studies) to benefit people who do not have the disease. Celiac disease is known to affect about one percent of people. Yet in a global survey of 30,000 people last year, fully 21 percent said that “gluten free” was a “very important” characteristic in their food choices. Among Millennials, the number is closer to one in three. The tendency to “avoid gluten” persists across socioeconomic strata, in households earning more than $75,000 just the same as those earning less than $30,000, and almost evenly among educational attainment. The most common justification for doing so: “no reason.”
He goes on to detail the downsides of gluten-free replica products. A reader responds with a solid bit of advice:
As someone who has had a lifelong gluten allergy (and gave it to two of my three kids), the increased “trendiness” is a mixed bag. Yes, it mean more choices, but it also means that people think my disease is just a trendy lifestyle choice and not a real thing. My general recommendation is not to use too many wheat substitutes. Instead of a gluten-free sandwich, have a salad or meat and veg. Instead of beer, have wine or hard liquor.
One of my part-time jobs right out of college, while interning and waiting tables, was doing research for a book that my roommate and his celiac-suffering business partner were putting together to help people travel and dine out gluten free. This was late 2004, and I had never heard of gluten, nor had any peers I talked to about the research gig. So over the past decade it’s been remarkable to see how rapidly and widespread “gluten free” has become. Now my best friend is GF, for dermatological reasons, as is my mother, who swears that her GF diet has snuffed out some mild health problems—and she’s been a nurse for 40 years, so she’s very science- and health-oriented. Here’s another gluten-free reader who works in the sciences:
I work in human research. Getting people to keep accurate records of what they eat, or to maintain a specific diet for a long enough time without keeping them in a lab environment 24/7 is incredibly difficult if not impossible. I am gluten-free due to promising science on Hashimoto’s thyroiditis (I am not celiac). If you have a problem linked to inflammation, it makes sense to see if going gluten-free can reduce that inflammation.
In the future, as more and more studies are done, they may find the culprit is other than gluten, or that gluten without other natural enzymes in food that’s more alive or containing more of the plants original components might be healthier.
As an N of 1, if I eat gluten now, I get depressed the next day. I don’t seem to have any other negative symptoms as others with celiac do. There is no other “cure” for Hashimotos, but I tend to have fewer symptoms of Hashimotos (lethargy, weight gain, skin issues) when I remain gluten free. I went off it for a while, started eating gluten again, and gained 20 lbs. But this might be also attributable to the fact that more foods were available (i.e. a whole pan of brownies).
I am realistic and yet still making the best choice for myself. I can understand if others are concerned it’s a harmful fad, but there also might actually be something to it, and so I don’t think it should be readily dismissed either.
Neither does this reader:
I recall Nobel prize winner Dr. Barry Marshall commenting that half of what is taught in academic gastroenterology is flat wrong. [CB note: I couldn’t quickly find that quote, but here’s a Kathryn Schulz interview with Marshall about how he was right about ulcers when everyone else was wrong.] So it was not surprising to find see solid research in the last few weeks showing that common reflux medications, proton pump inhibitors, pushed so hard by gastroenterologists, are strongly linked to dementia and cardiac dysfunction. [CB: Here’s a recent report along those lines.]
I have been gluten free for a dozen years. I am not celiac, don’t even have the DNA for it. Prior to going gluten free, which was against gastroenterologists advice, I suffered from chronic severe reflux and GI problems daily and was becoming overweight. Within months after going strictly gluten free, every trace of reflux and GI distress disappeared and over 12 years have never returned. Within six months of going gluten free, I lost the 35 excess pounds I was carrying and have stayed at my ideal weight ever since.
My toughest problem in going gluten free was weaning myself off the proton pump inhibitors that GI docs had pushed on me. What they failed to tell me is that if you start these meds and go off them, you get rebound hyper-acidity at double your pre-med levels, and that lasts a couple of months. Great for pharma marketers. I used an Internet protocol from Jacob Teitelbaum MD to wean myself off PPIs in a couple of months. Never a hint of reflux since, in a dozen years.
I wonder what is motivating the recent quasi-academic push back against gluten-free living? So many such as myself have found gluten-free living to resolve a host of problems even though not celiac. I wonder if the financial interests involved are pushing back. But then I recall Hanlon's razor: “Never attribute to malice that which is explained by incompetence.”
I know through experience that GF people love to talk about going gluten free, so if you’d like to sound off on the subject, drop us an email. Update from a reader with some quick advice:
To those out there (like myself) who are gluten free to decrease inflammation, I caution you about the risk of added sugar in products labeled as GF. What has helped me is to not eat processed GF foods as much as possible and focus on fruits, veggies, nuts, good fats and protein. It is not easy because I often feel deprived. Hence my new focus on detoxing myself off the sugar as much as I can without adding another feeling of deprivation. Sigh.
Starting the process will rein in a president who is undermining American ideals—and bring the debate about his fitness for office into Congress, where it belongs.
On January 20, 2017,Donald Trump stood on the steps of the Capitol, raised his right hand, and solemnly swore to faithfully execute the office of president of the United States and, to the best of his ability, to preserve, protect, and defend the Constitution of the United States. He has not kept that promise.
Instead, he has mounted a concerted challenge to the separation of powers, to the rule of law, and to the civil liberties enshrined in our founding documents. He has purposefully inflamed America’s divisions. He has set himself against the American idea, the principle that all of us—of every race, gender, and creed—are created equal.
This is not a partisan judgment. Many of the president’s fiercest critics have emerged from within his own party. Even officials and observers who support his policies are appalled by his pronouncements, and those who have the most firsthand experience of governance are also the most alarmed by how Trump is governing.
Insights into the little-studied realm of last words
Mort Felix liked to say that his name, when read as two Latin words, meant “happy death.” When he was sick with the flu, he used to jokingly remind his wife, Susan, that he wanted Beethoven’s “Ode to Joy” played at his deathbed. But when his life’s end arrived at the age of 77, he lay in his study in his Berkeley, California, home, his body besieged by cancer and his consciousness cradled in morphine, uninterested in music and refusing food as he dwindled away over three weeks in 2012. “Enough,” he told Susan. “Thank you, and I love you, and enough.” When she came downstairs the next morning, she found Felix dead.
During those three weeks, Felix had talked. He was a clinical psychologist who had also spent a lifetime writing poetry, and though his end-of-life speech often didn’t make sense, it seemed to draw from his attention to language. “There’s so much so in sorrow,” he said at one point. “Let me down from here,” he said at another. “I’ve lost my modality.” To the surprise of his family members, the lifelong atheist also began hallucinating angels and complaining about the crowded room—even though no one was there.
Dr. Sherman Hershfield woke up one morning and was surprised to find himself behind the wheel of his car. Somewhere between his Beverly Hills apartment and his practice in the San Fernando Valley, the silver-haired physician had blacked out. Somehow, he’d avoided a crash, but this wasn’t the first time. “I didn’t know what was going on,” he admitted.
Apart from his frequent blackouts, Hershfield was in fine health for a man in his 50s. He was tall and lean, ran six miles a day, and was a strict vegetarian. “I believe a physician should provide exemplary motivation to patients,” he once wrote. “I don’t smoke and have cut out all alcohol.” Hershfield specialized in physical medicine and rehabilitation, and for decades had helped patients with brain injuries learn to walk again and rebuild their lives. Even with his experience, Hershfield didn’t know what was wrong inside his own head.
She beat George W. Bush on Social Security privatization, and she’ll beat Trump on the wall.
Democrats sometimes portray themselves as high-minded and naive—unwilling to play as rough as the GOP. Speaker Nancy Pelosi is, once again, proving that self-image wrong. She’s not only refusing Donald Trump’s demand for a border wall. She’s trying to cripple his presidency. And she may well succeed.
Pelosi’s strategy resembles the one she employed to debilitate another Republican president: George W. Bush. Bush returned to Washington after his 2004 reelection victory determined to partially privatize Social Security. “I earned capital in the campaign, political capital,” he told the press, “and I intend to spend it.” Bush’s plan contained two main elements. The first was convincing the public that there was a crisis. Social Security, he declared in his 2005 State of the Union address, “is headed toward bankruptcy.” The second was persuading Democrats to offer their own proposals for changing it.
It’s not meant to be comforting, but somehow it is.
If you ever find yourself sinking into the plush blue couch of Dr. Jane Prelinger, you should know that she doesn’t want you to call her Dr. Prelinger. In her office, even when you’re on the couch and she’s facing you from her chair, looking at you through heavy eyeliner and the frame of her white-blond bangs, she insists: You’re just two humans. “It’s Faith and Jane,” she told me when I was in that position. “Here, it’s human to human.”
Jane is an existential therapist. She sees a lot of different clients with a lot of different problems, but she thinks all of those problems can be reduced to the same four essential issues: death, meaninglessness, isolation, and freedom.
Existential therapy isn’t new. Its roots go back to the existential philosophers of the 20th century, and specifically to Jean-Paul Sartre, who summed up his philosophy in 1943 when he wrote that humans are “condemned to be free.” Unlike other animals, humans are conscious and aware of their own mortality—but that means they have the possibility, and responsibility, of deciding in each moment what to do and how to be.
President Trump might be able to keep the government closed indefinitely. But the new Democratic speaker can deny him use of the country’s most effective pulpit to make his case to the public.
The latest casualty of the partial government shutdown might be President Donald Trump’s State of the Union address.
House Speaker Nancy Pelosi, in a letter to the president on Wednesday, suggested that the annual speech before Congress be postponed or scrapped altogether in light of the legislative impasse that has led to the ongoing shutdown, the longest in U.S. history.
“Sadly, given the security concerns and unless government re-opens this week,” the speaker wrote, “I suggest that we work together to determine another suitable date after government has re-opened for this address or for you to consider delivering your State of the Union address in writing to the Congress on January 29th.”
Pelosi’s missive was cloaked in the politesse of a formal communication from the leader of one branch of government to another. But it was nothing less than a threat to deploy Pelosi’s authority as speaker to deny Trump the use of perhaps the country’s most powerful pulpit in the middle of a partisan standoff.
Taxes collected from rich people help support a range of services, some of which make new business more likely.
When Alexandria Ocasio-Cortez suggested this month that the United States should tax income over $10 million by 70 percent, it galvanized something unusual: a broad and substantive national conversation about the design and purpose of federal tax policy.
From the cacophony of communist callouts, however, a subtler argument emerged. Entrepreneurs and center-right economists insisted that raising taxes dramatically on the rich would undo America’s ability to spark innovation and attract entrepreneurs who want to start companies and solve big problems.
In the abstract, their case is clear. “If income taxes are high enough, start-ups stop happening,” said Paul Graham, the founder of Y Combinator, the country’s preeminent start-up incubator.
Can marketers rebrand capitalism for young Americans?
On Monday, the men’s shaving brand Gillette released a new commercial and social-responsibility initiative, and the internet had some feedback. The ad, which shifts Gillette’s longtime tagline from “The Best a Man Can Get” to “The Best Men Can Be,” is intended to mark the brand’s 30th anniversary and reflect on the masculine ideals the razor purveyor has endorsed in the past and will demonstrate going forward. It also promises million-dollar donations to nonprofits with related goals over the next three years, starting with the Boys & Girls Club of America.
Reactions were very mixed and very loud, even though the ad itself is pretty moderate and diverse in its depictions of male behavior. It features fictionalized scenes and clips from the news or viral videos. Some of the men depicted bully or sexually harass others, while other men are active parents and healthy conflict-resolvers. The spot’s voice-over ends by reminding viewers that what they do is important, because it sets an example for the next generation.
On January 7, a group of 334 competitors began the 41st annual Dakar Rally: a punishing 10-day, 3,000-mile race across the Peruvian desert.
With a ceremonial start in Lima, Peru, on January 7, a group of 334 competitors started the 41st annual Dakar Rally: a 10-day, 3,000-mile (5,000 kilometer) off-roading adventure held exclusively in Peru this year. The vehicles—which include specialized cars, trucks, motorcycles, and quad bikes—are currently on stage 9 of 10 stages that travel south to Tacna, then back to Lima on January 17. Here is a look at Dakar 2019 in progress, as teams race to the finish line.
Shahira Knight is one of the most important policy staffers in the White House. The shutdown is proving to be her greatest challenge yet.
The ongoing government shutdown, the longest in U.S. history, has crystallized for many Americans that Washington skews more “day-care center” than “center of the free world.” And as Republicans and Democrats alike address the furlough with all the sophistication of a playground brawl—dropping f-bombs, throwing “temper tantrums,” and snubbing lunch invites—there is Shahira Knight, the adult encouraging everyone to play nice.
The press has appointed a handful of staffers as the “adults” in Donald Trump’s administration, a classification meant to distinguish the few officials who have government expertise from the many who don’t. But even some of those officials eventually surrender to the rhythms of this West Wing, especially as Trump chafes against their constraints and helps fuel rumors of their diminished standing. They call one another “morons.” They form interoffice coalitions. They become “senior administration officials” for the reporters they profess to hate.