The vast majority of people who avoid gluten don’t have celiac disease or even a gluten sensitivity, but as reader Rachel can attest, there’s a big upside to the proliferation of all the GF products and menus fueled by the fad (even as Hamblin noted the downsides):
I found out 10 years ago this month that I had Celiac. I was having horrible stomach pain, reflux, ulcers, etc, and at 19 I had zero quality of life. My biopsy came back positive for Celiac but my blood-work was negative, so my doctors weren’t sure at the time how to diagnose me.
Going gluten-free 10 years ago was one of the most overwhelming and terrifying things I had ever experienced. My doctor flat told me I could continue to eat gluten but I would most likely develop colon cancer by the time I was 40.
I was living in Nashville, where everything was fried, I had no family around me, and nothing was labeled on food items. I remember crying in the grocery store because I had no idea what to buy. I thought, “Am I ever going to be able to eat a sandwich again??” I ate corn tortillas, hummus, eggs, and cheese for an entire month until I found some resources on Celiac.
As there has been a lot more awareness of Celiac over the years and even a cool factor to being gluten free, I have found it much easier to live this way without getting sick. I have traveled around the world and all over the U.S. and it’s been almost a non-issue with many places. I’m grateful for the awareness.
(Also, as a helpful hint, if I get gluten in my meal, I’ve found that sipping Apple Cider Vinegar in water helps alleviate the symptoms. I’m note a doctor, but it helps tremendously.)
On the flip side, I tend to get many disparaging looks when I ask for a gluten free menu, if something has gluten in it, or when I tell people I’m not able to eat it. In fact, I'm more likely to not tell someone and either go hungry or try to figure out an alternative option because of the negative responses.
I know that Celiac is genetic, and though I don’t have children right now, I worry about if they will inherit the gene and whether or not I should start them on a gluten-free diet as babies. I guess I’ll just have to take it one day at a time, but all I know is that I’ll still be gluten free even when it’s not a cool thing to do.
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.
The president is failing, and Americans are paying for his failures.
“I don’t take responsibility at all,” said President Donald Trump in the Rose Garden on March 13. Those words will probably end up as the epitaph of his presidency, the single sentence that sums it all up.
Trump now fancies himself a “wartime president.” How is his war going? By the end of March, the coronavirus had killed more Americans than the 9/11 attacks. By the first weekend in April, the virus had killed more Americans than any single battle of the Civil War. By Easter, it may have killed more Americans than the Korean War. On the present trajectory, it will kill, by late April, more Americans than Vietnam. Having earlier promised that casualties could be held near zero, Trump now claims he will have done a “very good job” if the toll is held below 200,000 dead.
The U.S. may end up with the worst COVID-19 outbreak in the industrialized world. This is how it’s going to play out.
Three months ago, no one knew that SARS-CoV-2 existed. Now the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. Like World War II or the 9/11 attacks, this pandemic has already imprinted itself upon the nation’s psyche.
A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. In October, the Johns Hopkins Center for Health Security war-gamed what might happen if a new coronavirus swept the globe. And then one did. Hypotheticals became reality. “What if?” became “Now what?”
Netflix’s Tiger King is the apotheosis of extreme storytelling: The more unfathomable and ethically dubious, the better.
This article contains spoilers through all seven episodes of Tiger King.
At this particular moment, the most-watched show in America is a seven-part documentary series about a gay, polygamous zoo owner in Oklahoma who breeds tigers, commissions and stars in his own country-music videos, presides over what he describes as “my little cult” of drifters and much younger men, and ran for governor of Oklahoma in 2018 on a libertarian platform. He’s also currently serving a 22-year prison sentence for, among other charges, trying to arrange the assassination of his nemesis, an animal-sanctuary owner in Florida. And his business allies include another big-cat breeder, a yoga-loving guru in Myrtle Beach who runs what appears to be a tiger-themed sex sect.
Contact tracing is working in South Korea and Singapore. But it raises privacy issues.
It’s a cool fall evening in September 2020. With a bottle of wine in hand, you slide into the front seat of your car to drive to a dinner party with close friends. It’s been eight months since you’ve seen most of them, at least outside of a computer screen.
As you’re pulling out of the neighborhood, you feel your phone buzz. It’s an alert from the new agency overseeing the coronavirus outbreak. On the lock screen, you can read the words “BE ADVISED.” Your heart sinks as you unlock the phone to read the rest of the message:
We have determined that in the past few days, you may have interacted with somebody who has recently tested positive for COVID-19. There is no need to panic. But for the sake of your family, friends, and neighbors, we are relying on your support. As soon as you can, please …
Defenders of the president seem to have settled on the excuse that the White House botched its pandemic preparations because it was too distracted by the drama on Capitol Hill.
“The White House was focused on addressing the threat to its survival,” argued the columnist Henry Olsen in The Washington Post, “not on preparing for a threat from China that might not even materialize.”
Senator Tom Cotton has also adopted the theory, telling Politico, “It’s unfortunate that during the early days of a global pandemic, the Senate was paralyzed by a partisan impeachment trial.”
Senate Majority Leader Mitch McConnell has been pushing this theory too, telling the conservative radio host Hugh Hewitt that the Senate impeachment trial “diverted the attention of the government” from the virus, “because everything every day was all about impeachment.”
The coronavirus pandemic and a chapter of history that should have expired long ago
In a large windowlessroom in the bowels of the CIA, there is a sign that reads Every day is September 12th. When I first saw those words, during a tour of the agency’s operations, I felt conflicted. As a New Yorker who witnessed the 9/11 attacks, I once felt that way myself, but by the time I saw the sign, during the second term of the Obama administration, it seemed to ignore all the things that our country had gotten wrong because of that mindset. Now, as COVID-19 has transformed the way that Americans live, and threatens to claim exponentially more lives than any terrorist has, it is time to finally end the chapter of our history that began on September 11, 2001.
I say that as someone whose life was shaped by 9/11. I was a 24-year-old graduate student working on a city-council campaign when I watched the second plane curve into the World Trade Center and then saw the first tower collapse. Everything that I’d done in my life up to that point suddenly seemed trivial. I walked several miles to my apartment, as my fellow New Yorkers came out into the streets to be near one another (as we can’t be today). In the days that followed, my Queens neighborhood was the setting for a number of funerals for firemen. I will never forget the image of one devastated widow sitting in a lawn chair in her front yard, receiving condolences from a line of the toughest—but most broken—men I had ever seen.
Widespread social-distancing measures have produced some jarring effects across land, air, and sea.
From inside her living room in London, Paula Koelemeijer can feel the world around her growing quieter.
Koelemeijer, a seismologist, has a miniature seismometer sitting on a concrete slab at the base of her first-floor fireplace. The apparatus, though smaller than a box of tissues, can sense all kinds of movement, from the rattle of trains on the tracks near Koelemeijer’s home to the waves of earthquakes rolling in from afar. Since the United Kingdom announced stricter social-distancing rules last month, telling residents not to leave their home except for essential reasons, the seismometer has registered a sharp decrease in the vibrations produced by human activity.
With fewer trains, buses, and people pounding the pavement, the usual hum of public life has vanished, and so has its dependable rhythms: Before the spread of COVID-19 shut down the city, Koelemeijer could plot the seismometer’s data and see the train schedule reflected in the spikes, down to the minute. Now, with fewer trains running, the spikes seem to come at random.
Critics are letting their disdain for the president blind them to geopolitical realities.
When a new coronavirus emerged in China and began spreading around the world, including in the United States, President Donald Trump’s many critics in the American foreign-policy establishment were quick to identify him as part of the problem. Trump had campaigned on an “America first” foreign policy, which after his victory was enshrined in the official National Security Strategy that his administration published in 2017. At the time, I served in the administration and orchestrated the writing of that document. In the years since, Trump has been criticized for supposedly overturning the post–World War II order and rejecting the role the United States has long played in the world. Amid a global pandemic, he’s being accused—on this site and elsewhere—of alienating allies, undercutting multinational cooperation, and causing America to fight the coronavirus alone.
What is actually known about hydroxychloroquine, the medication that Trump is fixated on recommending for COVID-19
Two weeks ago, French doctors published a provocative observation in a microbiology journal. In the absence of a known treatment for COVID-19, the doctors had taken to experimentation with a potent drug known as hydroxychloroquine. For decades, the drug has been used to treat malaria—which is caused by a parasite, not a virus. In six patients with COVID-19, the doctors combined hydroxychloroquine with azithromycin (known to many as “Z-Pak,” an antibiotic that kills bacteria, not viruses) and reported that after six days of this regimen, all six people tested negative for the virus.
The report caught the eye of the celebrity doctor Mehmet Oz, who has since appeared on Fox News to talk about hydroxychloroquine 21 times. As Oz put it to Sean Hannity, “This French doctor, [Didier] Raoult, a very famous infectious-disease specialist, had done some interesting work at a pilot study showing that he could get rid of the virus in six days in 100 percent of the patients he treated.” Raoult has made news in recent years as a pan-disciplinary provocateur; he has questioned climate change and Darwinian evolution. On January 21, at the height of the coronavirus outbreak in China, Raoult said in a YouTube video, “The fact that people have died of coronavirus in China, you know, I don’t feel very concerned.” Last week, Oz, who has been advising the president on the coronavirus, described Raoult to Hannity as “very impressive.” Oz told Hannity that he had informed the White House as much.
The pandemic seems to be hitting people of color the hardest.
I dread every time my partner leaves our home. I dread every time Sadiqa marches to the front lines of the war against COVID-19—the emergency department. I dread every time she comes home and removes her personal protective equipment.
Sadiqa is worried like a soldier in a total war, seeing so many medical providers going down, seeing so many patients going down. I am worried about her health—and my own, as someone surviving metastatic cancer. I am worried about all medical providers, all Americans who have compromised immune systems, all Americans who are infected, all Americans who are healthy and want to remain that way.
As a student of health disparities, I am especially worried about the well-being of people of color. And people of color appear to be especially worried about their own well-being. Black people, at 46 percent, and Latinos, at 39 percent, are about twice as likely as white people, at 21 percent, to view the coronavirus as a major threat to their health.