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.
Customers were this awful long before the pandemic.
In May, I stood in the rear galley of an airplane and watched as a line formed to berate the flight attendant next to me. We were at a gate at LaGuardia, our flight half an hour delayed, and the air inside the cabin was acrid with the aromas of anxiety sweat and bags of fast food procured at the gate. Impatient passengers squeezed past others hoisting carry-ons into overhead bins to jockey for position in the complaining queue, lodging grievances largely about things over which a flight attendant would have obviously little control: the airline’s decision to sell middle seats, the disruptive wait, the insolent tone of a different flight attendant.
I was tucked inside one of the tiny spaces usually reserved for the flight crew, because I had arrived at my assigned seat to find a man who had no intention of getting up. He gave nothing in the way of an explanation; instead, he stared up at me blankly, as though he had never before encountered the concept of assigned seating. The flight attendant had noticed our stalemate and offered to roust the man from my seat, but the situation felt too combustible to me, and 25C like too stupid a hill on which to die. The attendant said he’d find me another if I’d just wait in the back.
The creative class was supposed to foster progressive values and economic growth. Instead we got resentment, alienation, and endless political dysfunction.
This article was published online on August 2, 2021.
The dispossessed set out early in the mornings. They were the outsiders, the scorned, the voiceless. But weekend after weekend—unbowed and undeterred—they rallied together. They didn’t have much going for them in their great battle against the privileged elite, but they did have one thing—their yachts.
During the summer and fall of 2020, a series of boat parades—Trumptillas—cruised American waters in support of Donald Trump. The participants gathered rowdily in great clusters. They festooned their boats with flags—American flags, but also message flags: Don’t Tread on Me, No More Bullshit, images of Trump as Rambo.
The women stood on the foredecks in their red, white, and blue bikinis, raising their Pabst Blue Ribbon tallboys to salute the patriots in nearby boats. The men stood on the control decks projecting the sort of manly toughness you associate with steelworkers, even though these men were more likely to be real-estate agents. They represent a new social phenomenon: the populist regatta. They are doing pretty well but see themselves as the common people, the regular Joes, the overlooked. They didn’t go to fancy colleges, and they detest the mainstream media. “It’s so encouraging to see so many people just coming together in a spontaneous parade of patriotism,” Bobi Kreumberg, who attended a Trumptilla in Palm Beach, Florida, told a reporter from WPTV.
Beyond limiting the coronavirus’s flow from hot spots to the rest of the country, allowing only vaccinated people on domestic flights will change minds, too.
When you go to the airport, you see two kinds of security rules. Some apply equally to everyone; no one can carry weapons through the TSA checkpoint. But other protocols divide passengers into categories according to how much of a threat the government thinks they pose. If you submit to heightened scrutiny in advance, TSA PreCheck lets you go through security without taking off your shoes; a no-fly list keeps certain people off the plane entirely. Not everyone poses an equal threat. Rifling through the bags of every business traveler and patting down every preschooler and octogenarian would waste the TSA’s time and needlessly burden many passengers.
The same principle applies to limiting the spread of the coronavirus. The number of COVID-19 cases keeps growing, even though remarkably safe, effective vaccines are widely available, at least to adults. Many public agencies are responding by reimposing masking rules on everyone. But at this stage of the pandemic, tougher universal restrictions are not the solution to continuing viral spread. While flying, vaccinated people should no longer carry the burden for unvaccinated people. The White House has rejected a nationwide vaccine mandate—a sweeping suggestion that the Biden administration could not easily enact if it wanted to—but a no-fly list for unvaccinated adults is an obvious step that the federal government should take. It will help limit the risk of transmission at destinations where unvaccinated people travel—and, by setting norms that restrict certain privileges to vaccinated people, will also help raise the stagnant vaccination rates that are keeping both the economy and society from fully recovering.
So many of us have been raised to see strangers as dangerous and scary. What would happen if we instead saw them as potential sources of comfort and belonging?
Nic spent most of her childhood avoiding people. She was raised by a volatile father and a mother who transferred much of the trauma she’d experienced onto her daughter. The combination left Nic fearful and isolated. “My primitive brain was programmed to be afraid of everybody, because everybody’s evil and they’re gonna hurt you,” she told me. (Nic asked to be referred to by only her first name to protect her privacy.)
Nic’s fear isn’t uncommon in a country where valid lessons about “stranger danger” can cast all people you don’t know as threats to be feared, but she recognized it was unhealthy, so she took steps to engage with the world. As she grew older, she began to travel to seek new people out. At 17, Nic visited Europe for 10 days with her high-school classmates and noticed that people began starting conversations with her. “If people in Europe randomly talked to me, then maybe I’m not so bad,” she figured. “Maybe I’m not gonna die if I randomly talk to them.” So she took more trips and connected with more people. She was anxious about these encounters, wired for fear and expecting the worst, but they always went well. She found that, contrary to what she’d been raised to believe, these strangers weren’t dangerous or scary. They were actually sources of comfort and belonging. They expanded her world.
Whether economic times are good or bad, the lament for the old days of factories and mills never changes.
“You’ll want to read this,” my wife said, handing me the Sunday Boston Globe. The cover story that week in late September 2020 was about a 62-year-old woman who had colon cancer that had metastasized. She died in a local hospital; her husband was also in poor health and could not take care of her at home. After she died, he moved into an area facility. Reading of someone so close to my own age succumbing to a highly preventable disease was a bit unsettling.
The dateline, however, was the reason my wife had given me the paper. The story was from my hometown in Massachusetts, and the facility where the husband now lived was down the street from my childhood home. When I was a boy, we joked, far too easily, about “putting” people there when they got old. In later years, the joking ended when my father had to stay there briefly as his health began to fail. My brother then passed through its doors on his way to the final stop in a VA hospital. The couple in the story had struggled for survival in the neighborhood where I grew up, and one of them, as the Globe put it, had experienced “the kind of death all too typical for people who work hard jobs for modest pay,” dying “too young … and too hard.”
The state GOP’s comeback runs through Latino communities.
At the end of the 2020 election, California’s Republicans had reason to feel hopeful. Although Joe Biden won the state by a landslide, Donald Trump won more votes (6 million) there than any other Republican candidate had ever. Increased Republican turnout led to victories in four competitive House races with large Latino populations. One of those districts even elected the state’s first Republican Latino congressman since 1873.
Hope hasn’t been California Republicans’ default emotion lately. Just three years ago, Democrats crushed the state GOP, cementing a supermajority in the legislature and winning four congressional seats in Orange County that had been in Republican hands for decades. But the 2020 results offered a taste of what a reinvigorated party could accomplish if it looked beyond its base and offered a palatable message to Latino voters. Trump won more votes from Latinos in California last year than he did in 2016, and he made similar gains around the country. With an effort to recall Democratic Governor Gavin Newsom now under way—the election is set for September 14—the party faces its first post-Trump test of whether it can be truly competitive in the state, and whether it’s willing to distance itself from a toxic legacy to make gains with California’s new, growing plurality.
Persistent hype around mRNA vaccine technology is now distracting us from other ways to end the pandemic.
At the end of January, reports that yet another COVID-19 vaccine had succeeded in its clinical trials—this one offering about 70 percent protection—were front-page news in the United States, and occasioned push alerts on millions of phones. But when the Maryland-based biotech firm Novavax announced its latest stunning trial results last week, and an efficacy rate of more than 90 percent even against coronavirus variants, the response from the same media outlets was muted in comparison. The difference, of course, was the timing: With three vaccines already authorized for emergency use by the U.S. Food and Drug Administration, the nation is “awash in other shots” already, as the The New York Times put it.
The country lifted all its COVID-19 restrictions just as Delta peaked. What happens next will tell us how well vaccines are working.
When the U.K. dropped all coronavirus restrictions on “Freedom Day,” July 19, critics called the move a “dangerous and unethical experiment.” Harsher critics called it “epidemiologically stupid.” At the time, cases in the country were still rising amid a Delta-fueled spike. Then, to nearly everyone’s surprise, COVID-19 cases started falling. This suggests that Delta hit a natural peak in the U.K. by mid-July—not because of Freedom Day, the effects of which are only just starting to show up in the data, but through some other mechanism.
Now, two weeks later, “the impact of Freedom Day is the big question,” says Paul Hunter, an epidemiologist at the University of East Anglia. “And I’m not at all sure which way it will go.” We will soon get the first glimmers of data that show how Delta behaves when all restrictions are lifted in a highly vaccinated country. This is uncharted territory. What happens in the U.K. can raise the rest of the world’s hopes—or dash them.
Why targets of deliberate deception often hesitate to admit they’ve been deceived
Something very strange has been happening in Missouri: A hospital in the state, Ozarks Healthcare, had to create a “private setting” for patients afraid of being seen getting vaccinated against COVID-19. In a video produced by the hospital, the physician Priscilla Frase says, “Several people come in to get vaccinated who have tried to sort of disguise their appearance and even went so far as to say, ‘Please, please, please don’t let anybody know that I got this vaccine.’” Although they want to protect themselves from the coronavirus and its variants, these patients are desperate to ensure that their vaccine-skeptical friends and family never find out what they have done.
Missouri is suffering one of the worst COVID-19 surges in the country. Some hospitals are rapidly running out of ICU beds. To Americans who rushed to get vaccinated at the earliest opportunity, some Missourians’ desire for secrecy is difficult to understand. It’s also difficult to square with the common narrative that vaccine refusal, at least in conservative areas of the country, is driven by a lack of respect or empathy from liberals along the coasts. “Proponents of the vaccine are unwilling or unable to understand the thinking of vaccine skeptics—or even admit that skeptics may be thinking at all,” lamented a recent article in the conservative National Review. Writers across the political spectrum have urged deference and sympathy toward holdouts’ concerns about vaccine side effects and the botched CDC messaging about masking and airborne transmission early in the pandemic. But these takes can’t explain why holdouts who receive respect, empathy, and information directly from reliable sources remain unmoved—or why some people are afraid to tell their loved ones about being vaccinated.
Like it or not, the way we work has already evolved.
In 2019, Steven Spielbergcalled for a ban on Oscar eligibility for streaming films, claiming that “movie theaters need to be around forever” and that audiences had to be given “the motion picture theatrical experience” for a movie to be a movie. Spielberg’s fury was about not only the threat that streaming posed to the in-person viewing experience but the ways in which the streaming giant Netflix reported theatrical grosses and budgets, despite these not being the ways in which one evaluates whether a movie is good or not. Netflix held firm, saying that it stood for “everyone, everywhere [enjoying] releases at the same time,” and for “giving filmmakers more ways to share art.” Ultimately, Spielberg balked, and last month his company even signed a deal with Netflix, likely because he now sees the writing on the wall: Modern audiences enjoy watching movies at home.