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The gluten thing


Fat Guy

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I haven't been paying much attention to all the gluten-free stuff that has been happening over the past few years. I really don't know much about the issue and the related conditions. I did just see, however, a forwarded Tasting Table email newsletter (you can read it online here) saying that none other than Thomas Keller is now selling gluten-free flour. That to me is a pretty serious trend marker.

So, can someone bring me up to speed? What's the deal with so many people being gluten-intolerant?

Steven A. Shaw aka "Fat Guy"
Co-founder, Society for Culinary Arts & Letters, sshaw@egstaff.org
Proud signatory to the eG Ethics code
Director, New Media Studies, International Culinary Center (take my food-blogging course)

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There are two diseases with genuine wheat gluten intolerance, celiac dz and dermatitis herpetiformis. If you don't have them gluten is harmless. There's a blood test that will diagnose the vast majority of susceptible people.

The rest of the claimed benefits of gluten avoidance are made without the benefit of study or rigorous thought. The net is full of spurious posts blaming gluten for all sorts of problems that have no evidence to back them up.

Its hard and expensive to be truly gluten free. The one benefit of the gluten avoidance craze is that its now much easier for people with real disease to avoid the stuff.

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To add to what gfweb said, unless I'm remembering something wrong, one of the reasons people go gluten-free is for managing autism; there's been a trend of parents of autistic children who swear by a gluten-free, dairy-free diet as a way of lessening the effects of the disorder.

"I know it's the bugs, that's what cheese is. Gone off milk with bugs and mould - that's why it tastes so good. Cows and bugs together have a good deal going down."

- Gareth Blackstock (Lenny Henry), Chef!

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In my opinion the number of people who claim to be gluten-intolerant is far in excess of the number of people who actually have celiac disease and other conditions that are truly affected by gluten.

I have known people that seem to be able to turn it off an on at will - when it is in their interest to be "GF" they avoid those foods but at other times they don't seem to care.

I too remember the "hypoglycemic" epidemic of the late '70s, early '80s.

It's not difficult to be tested for these conditions and one should be prior to going off the deep end, so to speak!

"There are, it has been said, two types of people in the world. There are those who say: this glass is half full. And then there are those who say: this glass is half empty. The world belongs, however, to those who can look at the glass and say: What's up with this glass? Excuse me? Excuse me? This is my glass? I don't think so. My glass was full! And it was a bigger glass!" Terry Pratchett

 

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1) Anyone know what Keller is milling for his GF flour?

2) GF seems to me to be the latest media-hyped fad. Not to minimize celiac disease, but there surely cannot be that many people suffering from the condition.

We've lived through "fat is evil," "nitrites are evil," "cholesterol is evil," "caffeine is evil," "proteins are evil," "alcohol is evil," "carbohydrates are evil," "MSG is evil," and so on, ad nauseum.

You know what I think is evil? Shrill media harpies, shrieking fear from the rooftops.

The tests are inexpensive. Easy enough to find out for sure. Nothing like hearing, "I'm a gluten-free pescatarian who doesn't really like the taste of fish," to really make me want to stay home that evening.

Who cares how time advances? I am drinking ale today. -- Edgar Allan Poe

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They addressed this issue during grand rounds at the University of Chicago Medical Center a couple of months ago. See point #2 on this fact sheet. "What is the difference between celiac disease, gluten intolerance, wheat allergy and gluten sensitivity?". Bottom line is they know that some people have problems with gluten that they neither understand nor have diagnostic tests for. It is an active area of research.

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I have taken master level classes in baking gluten free. People with celiac disease are in danger when exposed to the components of gluten (the two amino acids are sometimes found separate from each other in surprisingly non-grain related foods) in even microscopic amounts. When making foods for celiac sufferers it is vital to have an entirely separate environs to store the ingredients, prepare the foods, and wash the dishes. Most ordinary bakeries, for example cannot really prepare safe foods 'once in a while' or 'one day a week' because the air, air ducts, pans, ovens, sinks, commodity containers, etc. are all contaminated with gluten residue from other baking.

There are a lot of websites with incorrect statements posted in a factual tone. Like all medical information online, one needs to look critically at the source.

There are two reasons why it's 'big' right now. One is that it's a fad with all sorts of followers from movie stars to the pseudo-medical fringe healing crowd. It's the diet of the moment.

The other reason it's big is because it has been discovered to be more prevalent than previously known. 2002 Study HERE. It used to be thought that about 1 in about 6,000 people had the disease. Now, we know the number to be closer to 1 in 133 people. There are blood tests that accurately diagnose the condition, and the good news is that kids are being diagnosed earlier, so they stand a chance at a better life than people living in the past who endured the slow destruction of their intestines without treatment.

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If you don't have a (clinical) problem with Gluten, going 'gluten-free' puts you in the middle of the gullible crowd falling for the latest "I'm special" fad.

Is Keller's background in the medical science of nutrition? Or marketing food artistry? (Or another combination of those three words?)

Some people really do have problems with Gluten.

They seem to be a tiny minority of the gluten-free crowd.

Some minor digestive problems associated with "gluten" may actually be due to industrially manufactured (whipped) bread. Changing to traditionally fermentation-time-risen bread (extreme example: Sourdough) provides a "cure".

This is the hobby-horse ridden by Andrew Whitely in his book "Bread Matters" http://www.amazon.co.uk/Bread-Matters-Why-Make-Your/dp/0007298498/

The UK product "Doves Farm Gluten-Free Flour" (from potato, rice, tapioca, maize ...) is excellent for smooth sauce-making and stew-thickening, completely regardless of any nutritional claims!

"If you wish to make an apple pie from scratch ... you must first invent the universe." - Carl Sagan

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Some people who claim to be allergic to gluten are instead commercial yeast intolerant, and will tolerate sourdough bread.

Others its a case of eating too much or bad diet, or an unexpectedly rich retaurant meal and are looking for something to blame for their stomach pain...

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I don't know for sure, but just to repeat what our pediatrician has said regarding this issue, the definitive diagnostic test is not easy and not cheap.

My 18-mo-old granddaughter hasn't gained a single pound in four months, was already very small for her age, and has some pretty troubling digestive "issues" that I won't go into here. Suffice it to say that my daughter and her husband are justifiably worried as to what is going on, and are not gullible followers of the latest fad. They've been working with their pediatrician to try to come up with an answer to what is very clearly a problem (and would be so in anyone's book) and a treatment. The gluten thing is one of the big suspects, so my daughter, thinking like many of you, figured it would be just a simple, easy and cheap blood test to find out.

Not according to the pediatrician.

The pediatrician said that although they can do a blood test to find out whether or not it's a possibility, the test to make a definitive diagnosis is invasive and would have to be done under a general anesthetic. Anybody out there think that would be cheap or easy to do, especially on an 18-month-old baby? We don't. And neither does the pediatrician, who said that the first step is put the child on a gluten-free diet for a month and see if there's any improvement. We're doing that now. And I assure you that it's not been the sort of fun that one normally associates with fads. Especially since our too-small and not-thriving child is the middle child of three. It's a lot of extra work to always make something different for her, and to try to explain why she can't have the same things as her big sister or little brother.

So when you look at the stuff in the cart of the next folks behind you in line at the grocery store, and you see "gluten free," my request of you is that you don't judge so quickly. Or so harshly.

That might be us.

Edited by Jaymes (log)

I don't understand why rappers have to hunch over while they stomp around the stage hollering.  It hurts my back to watch them. On the other hand, I've been thinking that perhaps I should start a rap group here at the Old Folks' Home.  Most of us already walk like that.

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As the spouse of someone with celiac disease (and believe me, the hours spent in the bathroom after even a tiny exposure will quickly convince anyone that this is no joke), I am personally glad for the trendiness of GF right now, because it makes it much easier to obtain a variety of safe food products. That said, I do think it is extraordinarily silly to take on a GF diet when it isn't necessary. GF products are extremely expensive ($6+ for a bag of pretzels, anyone?), but much more caloric and with less nutritional value than their gluten-full equivalents. The only way someone could lose weight on a GF diet is if they stop eating foods with gluten and don't try to replace them with GF equivalents. That would basically mean a diet with fewer refined carbs, which is often a good prompt for weight loss.

Regardless of its silliness, I'm happy to take advantage of it for as long as the fad lasts.

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Lots of judgment on this thread. Not liking it.

There are two diseases with genuine wheat gluten intolerance, celiac dz and dermatitis herpetiformis. If you don't have them gluten is harmless. There's a blood test that will diagnose the vast majority of susceptible people.

In my opinion the number of people who claim to be gluten-intolerant is far in excess of the number of people who actually have celiac disease and other conditions that are truly affected by gluten.

I have known people that seem to be able to turn it off an on at will - when it is in their interest to be "GF" they avoid those foods but at other times they don't seem to care.

It's not difficult to be tested for these conditions and one should be prior to going off the deep end, so to speak!

This is not accurate. There have recently been several studies that show that gluten sensitivity does in fact exist, and 2 gastroenterologists have confirmed for me on a personal level that they have seen numerous patients with a gluten sensitivity but not celiac disease. There is no test for gluten sensitivity. So while you are entitled to your opinion, this isn't a matter of opinion. It's a matter of fact and science.

Anecdotally, I've had a host of gastro issues my entire life. I've never been allergic to anything and certainly never thought that food, which I love, would be making me sick. Last summer it had reached a point where it was no longer tolerable - the abdominal cramps alone were incapacitating. In desperation I went off gluten on an elimination diet and three days later my issues had resolved almost completely. No bloating, no cramping, no running to the bathroom. I do not claim to have a gluten allergy, but there is no doubt that I have a sensitivity. I seem to be able to tolerate small amounts of gluten in my diet, and it seems to have a cumulative effect. I do my best to avoid it, but do not avoid it 100% - which is extremely difficult to do - in an effort to stay sane and enjoy my life and food as much as possible. It seems to be working well for me.

I'm really taken aback by the amount of judgment I see here, and on other threads on the topic. There are thousands of people who anecdotally have had the same result i have by avoiding gluten - many people report decreased symptoms for migraines, joint pain, and a host of chronic gastro issues. Just because there isn't a test yet does not mean that gluten sensitivity does not exist. For me, this is not a fad diet whatsoever, it's a personal health decision. Why do you care if avoiding gluten makes me feel better?

ETA: here is a link to a recent WSJ article on the subject: WSJ Article

Edited by daisy17 (log)
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My apologies, Daisy (and Jaymes), if I came across as judgmental of people who would raise their hand to state that they have a gluten intolerance. I generally assume that--unless someone is trying to tell me that the way they eat is the "right" way--it isn't for me to judge the veracity of how certain foods effect them, or their reasons for avoiding certain foods. Even the gluten and casein-free diet, which I am critical of as similar to the anti-vaccine movement, doesn't make that big an impression on me, because a psychological benefit for the parents who feel it helps their child is still an improvement.

One of my college roommates had Celiac disease, as did her whole family, and I did some reading up on it a while back (where I too picked up the understanding that a simple blood test should be enough, though apparently not). I cooked with her sometimes and saw how it affected her diet. The gluten-free thing didn't pick up quite yet when we were in college, but Atkins was big, and she once proclaimed how happy she was about the diet because it made it easier for her to find or ask for gluten-free alternatives (she didn't seem to need or care about avoiding simple exposure back then, though I know she said her mother needed to).

Edit: The gluten and casein-free diet isn't, in my mind, actually worth of equal criticism as the anti-vaccine movement, just to be clear; the gluten and casein-free diet hasn't been researched thoroughly enough.

Edited by feedmec00kies (log)

"I know it's the bugs, that's what cheese is. Gone off milk with bugs and mould - that's why it tastes so good. Cows and bugs together have a good deal going down."

- Gareth Blackstock (Lenny Henry), Chef!

eG Ethics Signatory

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I think what's frustrating is that some of us try and be good children and eat everything to make our parents proud. It turns out it was hard at first and then we realized that being exposed to all kinds of good food is pretty cool and then you travel and it seems that all the super cool people keep an open mind and try and eat everything.

Then you meet a person with "special needs". This is not the same thing as someone with a nut allergy that closes their throat, or a celiac who will be up all night if exposed to gluten (or a young child not gaining any weight) or even someone who chooses not to eat meat. These people seem indulgent, strident and occasionally like a nut job. The way they go on is almost like they have an eating disorder. In fact, I suspect it might be. They probably are in the minority but they are so loud and they suck so much air out of the room that the poor people who are just trying to get by are shorted. Most of us try and be pleasant and eat everything and show our appreciation. Somewhere they got the message that being picky is the same thing as being discriminating. It isn't.

I mentioned this situation on another thread where I spend a lot of time with a gluten free person who was insisting we spend thousands to insure we had a gluten free warehouse. This might make sense until another gluten free person pointed out that beans need to be rinsed and any trace of gluten would go down the sink. Now when I meet these people I ask what they would do and I still meet people who wouldn't touch our beans and for this is the mark of "special needs" it's useless to deal rationally with someone like this. You can't win.

So i have sympathy all around. If people are coming off as cold, you have to consider what most of us have been exposed to.

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Some what off-topic:

It seems that cultures which have diverse eating habits have much less allergy issues.

I seem to have seen a report that even children with severe peanut allergies can be treated by exposing them to progressively increasing amounts of peanuts ( Warning: Don’t try this at home!!!! Disclaimer:I am not a doctor!!!!).

dcarch

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I have a MIL that has suffered with various symptoms over the years and has finally been diagnosed gluten intolerant. It has taken her years of a gluten free diet to finally get her health back...she does indulge in the odd bite of a dessert or yorkshire pudding over the holidays. She accepts it will make her feel bad for a few days afterward.

Her friend is in a nursing home and has a gluten allergy that seems to put her in the hospital frequently and is seriously affecting her life. The kitchen staff are aware of her allergy but continually contaminate her dinners with flour traces. I feel for her as it is just as serious for her as a nut allergy which the kitchen staff have to treat seriously but the wheat and gluten allergy is not taken nearly as seriously.

I have found that many of the items that have never had gluten in them (like spice blends) are now being labeled "Gluten Free" which does seem to me that they have jumped on the "marketing bandwagon" but my MIL has been pleasantly surprised with this development. Now she doesn't need to spend hours reading labels to buy things in the grocery store.

I find gluten free cooking a challenge, and I for one am happy to see more things on the market for it, I need all the "brownie points" with my MIL.

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To me it seems that the gluten free thing has been marketed as much as a weight control gimmick as anything else. However, there are definitely people who suffer when they eat wheat/gluten (some to a lesser and some to a greater degree) and it's a shame that they now find themselves associated with what to many people appears to be a dietary fad.

A good friend of mine in school was wheat intolerant in some way and her tummy basically swelled up like a balloon when she ate items like pasta or bread. It caused her horrible discomfort for hours afterwards but she really loved a lot of wheaty items so she often suffered for the taste! Also, being young and wanting to fit in probably meant that she would rather eat pizza out with friends and feel lousy afterwards than cause any kind of "fuss".

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It seems that cultures which have diverse eating habits have much less allergy issues.

Interesting thought... I wonder if there's evidence to support that. I feel like the US has pretty diverse eating habits. We're a wealthy nation with much available in our markets and representation in our country from other cultures all over the world.

Do other cultures have considerably fewer allergy issues? The first thought that came to my mind when I read that was that most of the Asians I know have lactose intolerance.

One of my college roommates had Celiac disease, as did her whole family, and I did some reading up on it a while back (where I too picked up the understanding that a simple blood test should be enough, though apparently not).

According to our pediatrician (and that WSJ article to which Daisy linked), you can do a blood test to determine susceptibility and likelihood, but a definitive diagnosis requires an intestinal biopsy. I'm not knowledgeable enough to know the procedure involved in performing an intestinal biopsy upon an intelligent and cooperative adult, but I do know that it requires general anesthetic with a child.

I don't understand why rappers have to hunch over while they stomp around the stage hollering.  It hurts my back to watch them. On the other hand, I've been thinking that perhaps I should start a rap group here at the Old Folks' Home.  Most of us already walk like that.

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It seems that cultures which have diverse eating habits have much less allergy issues.

Interesting thought... I wonder if there's evidence to support that. I feel like the US has pretty diverse eating habits. We're a wealthy nation with much available in our markets and representation in our country from other cultures all over the world.

Do other cultures have considerably fewer allergy issues? The first thought that came to my mind when I read that was that most of the Asians I know have lactose intolerance.

Many Asians are ideed lactose intolerant as well as alcohol intolerant.

I my spending time in the Far East, I had not come across allergy issue like here in the US. I have many Asian friends, none of them has allergies, except one is allergic to shellfish.

To me, the US has terrible eating habits when it comes to varieties. We are much better now. Meats, vegetibles, fish, fruits ----- there are so many things we don't have and don't eat.

dcarch

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It seems that cultures which have diverse eating habits have much less allergy issues.

Interesting thought... I wonder if there's evidence to support that. I feel like the US has pretty diverse eating habits. We're a wealthy nation with much available in our markets and representation in our country from other cultures all over the world.

To follow that up: When I was born some 70 years ago and then growing up, I do not recall any instances of children allergic to peanuts or much of anything else. And there was scarcely any asthma compared to our own children's generation...we had two asthmatic kids of three in a family which had never had any incidence of asthma ever...and then today's children who have many allergies and asthma and autism, etc. DH was a high school teacher who saw puffers galore in every class.

Not drawing any conclusions...can't..just wonderin about it all. In light of dcarch's question about diversity and Jaymes response...my generation, war babies, grew up on a much more limited diet than today's children. What does that signify? If any?

Darienne

 

learn, learn, learn...

 

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