A Paleo Primer on “Gluten-free” Beer

For many people, beer is the big stumbling block when considering the Paleo diet.

“Can I drink beer?”, with a look of alarm, is the first response one hears (usually from men) when explaining it.

So finding a beer alternative becomes a pretty high priority, for most folks who decide they want to adopt the diet.

I recently encountered a new species of the genus “gluten-free beer” and it was an interesting experiment for me.

My last regular beer…

First, a little background.  Before going Paleo three years ago somewhat against my will, I was a connoisseur of micro-brews and single-malt Scotch, both of which are brewed from barley (generally).  In hindsight the fact that I avoided beers brewed from wheat (weissbeer, in the trade) because they made me feel “not right”, and the fact that the hangovers I got from drinking scotch or beer were far, far worse than from any other alcohol should have clued me in that something was amiss, but I just assumed that it was “normal”.  And it was, for me, but it was not good.

The first sign that something had changed in my diet in a permanent fashion was when I gave my stock of beer and scotch to a friend.  (That friend is now also pursuing a wheat-free diet.)  That gift was prompted by my last attempt to enjoy a regular beer, back when I was gauging my tolerance to wheat.  I wound up waking up in the middle of the night in agony with intestinal cramps.  Not fun; I haven’t had a regular beer since.

Shortly thereafter I realized that I wasn’t a freak: I discovered that Anheuser-Busch, the brewers of Budweiser, had a gluten-free beer, “made without wheat or barley”.  Huzzah!  Redbridge is brewed from sorghum and was introduced by AB in 2006. They were way ahead of the curve…  The taste is a bit different, however.  Within the range of microbrewery beers, I think, but I’m not mad about it.  The Beer Advocate rates it as average, but the user ratings are “poor”.

There are some other sorghum-based beers around, some are better than others.  One of the better ones I’ve found recently (courtesy of my local liquor store) is New Grist, which is a light, summery beer.  The Beer Advocate crowd, with brutal honesty, also gives it a “poor”, and one rater says:

“So hard to rate these gluten free beers.. to be honest they are all bad, but if they were the only option I'm sure they would be fine. This one has a light taste to it that might be good for a summer beer.”

That’s a little harsh.  I’ve given friends these gluten-free beers, and no-one’s made an issue out of it, most people’s reaction is “it’s fine”.

If you happen to be in Vermont, a local brewery called the Alchemist produces a beer called Celia (get it?) which is pretty good, it rises to a stellar “average” with the BA crew.  If you’ve wondered what a brewmaster would make if his wife couldn’t drink beer, this is your answer (she is gluten intolerant).

Sorghum beers solve the problem of gluten by making beer from a grain that doesn’t contain gluten.  But, as you may have gathered, the taste is different.  So it was with great interest that I recently discovered a new variety of “gluten-free” beer, which are brewed from barley, but reduce the gluten content during the brewing process.

I was recently in Nashville, Tennessee attending an open-mic night at a local bar, and had just given the waitress my usual “I’m allergic to wheat” speech when she mentioned that they had a gluten-free beer that they’d just picked up.  Cool!  I ordered a bottle, took a sip, and… Head rush. 

(I’m not actually allergic to wheat, but that’s the easiest way to get them to take it as seriously as I do.)

The first symptom I get when I eat something that contains wheat or barley is a head rush.  It happens within seconds, and may be related to this phenomenon: “Beer's Taste Alone Gets People a Little High”; although that study blames it on alcohol, not beer.  I don’t get the effect with any other alcohol-containing beverage, and I do get it when I eat something non-alcoholic that does contain wheat, like soy sauce.

The mark of a gluten-free beer, in Europe

So I started looking all over the bottle for the “gluten-free” label.  There was none.  I went and spoke to the bartender and the manager, they assured me that the whole reason they’d picked up the brand was because it was gluten-free.  So I went back to my seat (the music hadn’t started yet) and got to work.

It turns out that they were right, and wrong, that this beer was gluten free. 

In Europe, a beer (or a food) can be labeled “gluten-free” if it contains less than 20 parts-per-million (ppm) of gluten.  This beer, Estrella Damm Daura, purports to contain only 6 ppm, and indeed, the beer’s web site states that it’s “A beer suitable for people with coeliac disease…” 

But the bottle in my hand didn’t have the gluten-free label on it.  Why not?

That’s a bit of a story.  It turns out that beer in the United States is regulated by the Department of the Treasury, the Alcohol and Tobacco Tax and Trade Bureau (TTB), not the Food and Drug Administration (FDA) as you would expect.  For further confusion, hard cider (more about which later) does carry a gluten-free label.

The difference is a key one, and (for once) a very logical decision made by the TTB (PDF). (Although why this would be covered under the “Homeland Security Act of 2002” is a mystery… Was Al-Qaeda attempting to poison us with mislabeled gluten-free beer?)

“Currently, there is no FDA regulation that defines the term “gluten-free.” In the preamble to a final rule on the declaration of ingredients on food packaging published in the Federal Register of January 6, 1993 (58 FR 2850 at 2864), FDA advised that the term “gluten-free” could be used in the labeling of foods, provided that when such claim is used, it is truthful and not misleading. Generally, and absent regulations to the contrary, FDA stated that it would regard a claim that a food is “free” of a substance as false or misleading if the food contains that substance.”

The TTB looks to the FDA for guidance on the meaning of the term gluten-free.  Since it’s not defined, they decided that beers like Daura could not use the term gluten-free, since they’re not.  They’re gluten-reduced.  Close, but no cigar.  When Daura was originally launched, it carried a label that said gluten-free, but not any more.  So is it, or is not “suitable for people with coeliac disease”?

Back to the FDA:

“In 2004, the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA), (Public Law 108-282, Title II) was signed into law. Section 206 of FALCPA required the Secretary of Health and Human Services to issue a rule to define and permit the term “gluten-free” on the labeling of foods. Accordingly, on January 23, 2007, the FDA published a notice of proposed rulemaking in the Federal Register (72 FR 2795) proposing to define the term “gluten-free” for voluntary use in the labeling of foods. Under the proposed FDA rule, a product may be labeled as gluten-free if it does not contain any of the following:

1. “An ingredient that is a prohibited grain (wheat, barley, rye, or crossbred hybrids of those grains);
2. “An ingredient that is derived from a prohibited grain and that has not been processed to remove gluten;
3. “An ingredient that is derived from a prohibited grain and that has been processed to remove gluten if use of that ingredient results in the presence of 20 ppm or more gluten in the food; or
4. “20 ppm or more gluten.”

That makes sense.  Now under that ruling, you’d think that Estrella would have gotten back the right to label Daura as gluten-free, right?  All they have to do is prove that their beer has less than 20ppm of gluten…

Well, that appears to be the sticking point.  The FDA hasn’t issued a final definition of “gluten-free” that would include foods made from wheat or barley but with the gluten removed, because:

“FDA recognizes that for some food matrices (e.g., fermented or hydrolyzed foods), there are no currently available validated methods that can be used to accurately determine if these foods contain < 20 ppm gluten. In such cases, FDA is considering whether to require manufacturers of such foods to have a scientifically valid method that will reliably and consistently detect gluten at 20 ppm or less before including a ‘gluten-free’ claim in the labeling of their foods….

“…In other words, a scientifically valid test is one that consistently and reliably does what it is intended to do.”

And we don’t have one.  So:

“Many alcohol beverage products subject to the FAA Act are produced without any ingredients that contain gluten. For example, a wine fermented from grapes, or a vodka distilled from potatoes, may be “gluten-free” if the producer used good manufacturing practices, took adequate precautions to prevent cross-contamination, and did not use additives, yeast, or storage materials that contained gluten. Under this interim policy, TTB will allow the use of a “gluten-free” claim in the labeling and advertising of such products. As always, it will be the responsibility of the importer or bottler of the product to ensure that the claim is truthful and accurate. TTB has further determined that it would be inherently misleading for products produced from grains containing gluten or their derivatives to make a “gluten-free” claim or a claim of specific gluten content levels absent a means to verify the accuracy of that statement through scientifically validated methods or other reliable means as might be revealed through FDA rulemaking.”

Regulatory bodies have many issues, but it’s tough to argue with the stance TTB is taking: prove it’s gluten-free, or don’t say it is.

Given all that, did I take a second sip of the bottle of Daura?

I did.  I finished the bottle  The things I do for science.

I felt like crap.  Got the droopy, tired feeling that I get after the head rush.  That lasted for an hour or so.  And it’s obvious enough that people ask me if I’m feeling OK.  Then I got some intestinal cramps, minor ones, but still…  I did not get diarrhea the next day, so that’s a plus.  Now mind you, this was the first barley-beer I’ve had in almost three years.

Then, a few days later, I got an asthma attack, when running a race.  I had more of an attack that afternoon, when mountain biking.  A couple of days later, I got a massive pimple on my nose.  I haven’t had an asthma attack in warm weather in years, so long I can’t remember when.  I haven’t gotten a zit in years, since before going paleo.  With my daughter, I can tell how much wheat she’s been eating by her skin and her allergies (which have continued to be minimal).  So both those effects are a red flag to me.

Now you might say that asthma’s to be expected, it’s spring time.  But I’ve not had a hint of allergies since then, even though it’s gotten warmer since, and everything is now blooming.  There are tons of anecdotal reports of exercise-induced asthma resolving on a gluten-free diet, and:

“The recent literature underlines the frequency of wheat allergy in exercise-induced anaphylaxis. The initial symptom reported by our patient was an allergic reaction related to exercise that progressed secondarily toward chronic urticaria without a direct relationship to exercise. Through the positivity of the oral challenge test and the effectiveness of the elimination diet for wheat flour, we documented the role that wheat allergy played in provoking his symptoms, both chronic urticaria and asthma. The elements that initially led us to the hypothesis of an allergy to wheat flour were based on the frequent implication of wheat flour in triggering exercise-induced anaphylaxis and on the analysis of the food survey, which revealed a large consumption of wheat flour.”

Urticaria is a skin condition.

There are, as it turns out, lots of other accounts of people having bad reactions to Daura.  But some folks report that they’re fine.  This is not surprising.  As Chris Kresser pointed out recently:

“Here’s the crucial thing to understand: Celiac disease is characterized by an immune response to a specific epitope of gliadin (alpha-gliadin) and a specific type of transglutaminase (tTG-2). But we now know that people can (and do) react to several other components of wheat and gluten — including other epitopes of gliadin (beta, gamma, omega), glutenin, WGA and deamidated gliadin – as well as other types of transglutaminase, including type 3 (primarily found in the skin) and type 6 (primarily found in the brain). (3, 4, 5, 6, 7, 8)

“This is a huge problem because conventional lab testing for CD and of gluten intolerance only screens for antibodies to alpha-gliadin and transglutaminase-2. If you’re reacting to any other fractions of the wheat protein (e.g., beta-gliadin, gamma-gliadin or omega-gliadin), or any other types of transglutaminase (e.g., type 3 or type 6), you’ll test negative for CD and gluten intolerance no matter how severely you’re reacting to wheat.”

Wheat-Germ Agglutinin (WGA) is toxic to 100% of people; and there’s Lord knows what else.

So it might be OK for celiac disease (although that remains to be seen) but it’s not OK for me.  I think that if you have any reaction to any wheat-related grain (wheat, barley, rye), you shouldn’t ever eat any of it.  But it’s a difficult thing to figure out what products made from wheat still contain a hazardous amount of wheat.

I just learned that my favorite vodka, Kettle One, is made from wheat.  It was, ironically, a martini made with Kettle One vodka that introduced me to the notion that the hangovers I got from beer or scotch were not from alcohol.  (Meaning I could drink enough alcohol to give me a hangover, but it wasn’t nearly so bad as the wheat poisoning I’d been suffering from.)  And I’ve continued to be able to drink Kettle One, and will continue to do so.  I have no adverse reaction to it whatsoever.  Vodka’s so purified that it’s pretty much just water and alcohol, but be mindful if you try it.

Mmm…

So I’ll pass on the Estrella Damm Daura, thanks.  And you know what?  It wasn’t all that great.  (Despite winning awards as “Best Gluten-Free Beer”, the critics at the Beer Advocate rate it a slightly higher “average” than the gluten-free beers discussed before.)  Drinking that beer made me realize that I much prefer the hard cider I generally consume as an alcoholic beverage.  I really don’t miss beer that much, after all.  I certainly don’t miss the side-effects.

(Estrella makes another beer, by the way, which is called Estrella Damm.  That beer is not claimed to be gluten-free, only the Estrella Damm Daura goes through whatever wizardry they’re using to attempt to remove the gluten.  So if you want to try your own experiment, make sure you get the right beer!  Hat-tip to GlutenFreeBeer.org for the info from the TTB.)

Wheat and Egypt

A while ago I posted "Wheat and Malnutrition" which contained this bit:

"We have recently completed a screening project on school children in Cairo City, Egypt. Blood samples were obtained from 1,500 children attending school in Cairo City between October 2001 and June 2004... The prevalence of [celiac disease] in this sample of Egyptian students was 53% (95% CI 0.17-0.89). This estimate may be low, as more CD cases could be diagnosed at the follow-up, e.g. in the group currently showing a positive tTG IgA and a negative EMA [partial CD symptoms]."

(This is in the Wall Street Journal, which is subscription-only.)

That's pretty incredible, as celiac is supposed to be a rare, genetically determined condition.  In my post "Wheat and Poison Ivy", I presented the notion that wheat is simply a toxic plant, like poison ivy.  Toxins are typically more toxic past a certain point, and toxicity increases with dose.  "The dose makes the poison", in other words.

Logically, therefore, those Egyptian kids should be eating a lot of wheat to induce that level of toxicity (a 53% rate of celiac disease, better understood as wheat poisoning).

Well, lo and behold:

"Wheat is the biggest dietary staple in much of the region, providing cheap nutrition in bread, pasta and couscous.

"Tunisians eat more wheat than anyone on the planet: 478 pounds per person a year, compared to 177 pounds in the U.S. Egyptians and Algerians also eat more than twice as much wheat as Americans, says the U.N. Food and Agriculture Organization."

(Also from the WSJ, titled "Mideast Staggered By Cost Of Wheat", May 19.)

Celiac is also common in Tunisia, although not at the level of that Egyptian school.  I'll note that that doesn't indicate a clear dose-response level.  One would expect some variation.

So what is also announced in the WSJ on the day that they published that article on wheat consumption in Egypt? A new aid plan for Egypt. Because they buy most of their wheat; from the United States, no doubt, since we're the largest exporter in the world.  They'll use the money to buy more wheat.

It beats starving, but not by much.  And, apparently, not for long.

Wheat and Poison Ivy

Teresa said:

"I believe you've put the cart before the horse: gluten does not cause celiac. It is a genetic disorder that can manifest in various ways. People with celiac react to gluten."

Yes, that's the conventional wisdom in the medical community. I happen to think it's wrong.

My wheat analogy is to poison ivy. Both contain chemicals that cause the body to initiate an auto-immune response, attacking its own tissues. In poison ivy, this is most commonly the skin, for wheat in celiac disease, it's the mucosal lining of the small intestine, although it can affect any tissue in the body. I can't imagine what effect eating poison ivy would have on the lining of the small intestine if you ate it, but it can't be good.

Neither wheat nor poison ivy affects 100% of the population.

"If ingested, poison ivy can produce severe gastrointestinal effects. Some individuals, however, can consume poison ivy without effect, apparently because of a lack of reactivity in the digestive mucosa."

One manifestation of celiac disease is a skin condition called dermatitis herpetiformis. This is commonly misdiagnosed as poison ivy.

Yet the medical community regards poison ivy as a toxic plant, best avoided. No one considers the reaction to poison ivy to be a human "genetic condition", although of course it is.  Dogs and cats aren't susceptible to poison ivy, for instance.  No one proposes that you ought to eat it.

So the difference between wheat and poison ivy is that wheat is a low-grade toxic plant that most people tolerate to some degree.  Poison ivy is a high-grade toxic plant that almost no-one tolerates.

Interestingly, both wheat and poison ivy produce what's known as "Type IV Hypersensitivity".  If you go look at the Wikipedia page on the topic, most of the causes of type IV hypersensitivity are either poison ivy or wheat-caused or -associated illnesses like celiac, Type 1 diabetes, and Hashimoto's thyroiditis.  I'll wager the list of poison-ivy-related illnesses would be longer if people were in the practice of eating it.

I read in one journal that celiac is the most common genetically-determined condition in the human species. But as I think I've demonstrated, poison ivy sensitivity is far more common.

The most commonly accepted estimate of celiac prevalance is 1 in 133 people. I've heard estimates of wheat sensitivity that go up to 99% of the population. It's clearly far higher than 1 in 133. My diverticulitis, for instance, is clearly caused by wheat. I can reproduce the symptoms at will be eating it. Diverticulitis affects 65% of the population by the time they're 80, and becomes common in populations after wheat is introduced.
Eating wheat is a mistake. You shouldn't eat toxic plants that humans are not adapted to eat.

Wheat Germ News

"Incorporation of N-acetylglucosamine-specific agglutinins from wheat germ (Triticum aestivum; WGA), thorn apple (Datura stramonium) or nettle (Urtica dioica) rhizomes in the diet at the level of 7 g/kg reduced the apparent digestibility and utilization of dietary proteins and the growth of rats, with WGA being the most damaging. As a result of their binding and endocytosis by the epithelial cells of the small intestine, all three lectins were growth factors for the gut and interfered with its metabolism and function to varying degrees. WGA was particularly effective; it induced extensive polyamine-dependent hyperplastic and hypertrophic growth of the small bowel by increasing its content of proteins, RNA and DNA. Furthermore, an appreciable portion of the endocytosed WGA was transported across the gut wall into the systemic circulation, where it was deposited in the walls of the blood and lymphatic vessels. WGA also induced the hypertrophic growth of the pancreas and caused thymus atrophy. Although the transfer of the gene of WGA into crop plants has been advocated to increase their insect resistance, as the presence of this lectin in the diet may harm higher animals at the concentrations required to be effective against most pests, its use in plants as natural insecticide is not without health risks for man."

So if WGA is spliced into other food sources, they can be toxic too.

"[Wheat germ agglutinin] is a toxic compound and an anti-nutritional factor, but recent works have shown that it may have potential as an anti-tumor drug and as a carrier for oral drugs.... Here we show that at nanomolar concentrations WGA is unexpectedly bioactive on immune cells.... These results shed new light onto the molecular mechanisms underlying the onset of gastrointestinal disorders observed in vivo upon dietary intake of wheat-based foods.

It messes up your gut, and you don't have to be celiac to enjoy the benefits.

 "Biologically intact wheat germ agglutinin was detected in ileostomy effluent and fecal collections from human subjects consuming a diet containing wheat germ. These studies demonstrate that wheat germ agglutinin can traverse the human small intestine intact. It is feasible that orally ingested wheat germ agglutinin and other plant lectins which interact with a wide variety of cell membranes may alter intestinal epithelial or bacterial cell function in the human bowel."

And it messes up your bowel, also.  This last one is from 1978, so I guess it's not "news"...

On the pro side of the equation we have this:

"The purpose of this study was to determine if WGA enters the circulation of healthy subjects following ingestion of wheat germ.... According to the protocol utilized, WGA was not detected in venous plasma samples from any of the subjects following consumption of 50 g of wheat germ. Further research will be required to determine if WGA enters the bloodstream and binds formed elements such as erythrocytes, platelets, and leukocytes in addition to other tissues and organs."

Wheat seems to do enough damage to enough people anyway...

Gary Taubes Interviewed By Jimmy Moore

Jimmy was kind enough to pass along a question to Mr. Taubes.  In the second part of the interview, my question starts at 35:02 and (interspersed with the next two related questions) finishes at 40:45.

"What do you think about alternative explanations for the metabolic syndrome [linoleic acid and wheat]?"

Taubes answers about the way I expected him to.  Thoughtfully, but wheat and linoleic acid have not been focuses of his research. 

He notes, correctly, that historically it's tough to separate wheat and sugar ingestion as the cause of metabolic syndrome when introduced to traditional societies, as they typically were introduced at the same time.  He mentions that he's curious to read Dr. Davis' new book, supposedly to be titled Wheat Belly, and to hear the case that he makes.  His answer concerning linoleic acid is a bit less satisfying, but, since it's not been his focus, it's not surprising, or disappointing.

Sugar, wheat, and industrial vegetable oils (linoleic acid) are the three problem foods that seem to be involved in metabolic syndrome.  Taubes has focused his work on sugar, and that's great.  I don't think that anything I've learned about the other two invalidates anything that he writes about, or contradicts it.

He notes that "Insulin resistance is a fundamental problem."  I agree with that, and think that sugar, wheat, and linoleic acid are all independently working on increasing insulin resistance.  In my humble opinion, I think that any one of them is bad, and all three together are really bad.

To note my own experience, I stopped eating sugar in my late teens, and have avoided it ever since.  I've been reading labels and skipping deserts for the most part for a long time, and I've not been a huge fruit eater.  So I think that I consume far less sugar and fructose than the average American.  But I was eating a lot of wheat and linoleic acid, and was well on my way to metabolic syndrome nevertheless, according to my doctor.  I didn't drop the "middle-age middle" until I stopped eating wheat and linoleic acid, in addition to the sugar, and this corrected my blood sugar readings.

So in a nutshell, I think Taubes' work is great so far as it goes, and it goes a mighty long way.  But I don't think his answer is complete.  Stephen Guyenet's work, along with other sources, makes it clear to me that carbohydrates in toto are not the problem.

As Taubes notes, it takes only a tiny imbalance to throw our metabolic processes out-of-whack, resulting in obesity.  Glucose, and starches containing glucose, have been part of our diet for a very long time.  Logically, therefore, it has to be one of the other three factors that has thrown us off: fructose, wheat, or linoleic acid.  The quantities in which we eat these three are very far out of line to what we ate historically.  Linoleic acid alone is probably not the primary cause, as it was introduced too late to account for all the changes we've seen.  My money's on wheat being the lever that moves a normal glucose metabolism, but I don't have any hard evidence.

In the meanwhile, I'm still plowing through Good Calories, Bad Calories, and if Mr. Taubes ever reads this blog, I want to thank him for all of his hard work.  It's really a wonderful public service that he did in writing that book.

Dr. Davis Versus The New York Times

"Can You Be Addicted To Foods?" the NYT asks.  They then present a bunch of near-useless pseudo-scientific blather from a psychiatrist.  Gary Taubes could have answered this question, but Dr. Davis does an even better job:

"So what do morphine-blocking drugs have to do with weight loss?

"An odd series of clinical studies conducted over the past 40 years has demonstrated that foods can have opiate-like properties. Opiate blockers, like naloxone, can thereby block appetite. One such study demonstrated 28% reduction in caloric intake after naloxone administration. But opiate blocking drugs don't block desire for all foods, just some.

"What food is known to be broken down into opiate-like polypeptides?

"Wheat. On digestion in the gastrointestinal tract, wheat gluten is broken down into a collection of polypeptides that are released into the bloodstream. These gluten-derived polypeptides are able to cross the blood-brain barrier and enter the brain. Their binding to brain cells can be blocked by naloxone or naltrexone administration. These polypeptides have been named exorphins, since they exert morphine-like activity on the brain. While you may not be 'high,' many people experience a subtle reward, a low-grade pleasure or euphoria.

"For the same reasons, 30% of people who stop consuming wheat experience withdrawal, i.e., sadness, mental fog, and fatigue...."

Dr. Davis has an older post on the topic as well.

And in poking around for this post I came across this:

"The effect of exogenous opioid peptides, gluten exorphins A5 and B5, which were isolated from the enzymatic digest of wheat gluten, on the postprandial insulin level were examined in rats. The oral administration of gluten exorphin A5 at a dose of 30 mg/kg w. potentiated the postprandial plasma insulin level and the effect was reversed by naloxone. The administration of gluten exorphin B5 showed a similar effect at a higher dose (300 mg/kg w). Furthermore, intravenous administration of gluten exorphin A5 at a dose of 30 mg/kg w. also stimulated the postprandial insulin release. The fact that orally and intravenously administered gluten exorphin A5 stimulates insulin release suggests that it modulates pancreatic endocrine function by the action after the absorption rather than within the the gastrointestinal tract."

So, in a nutshell, wheat gluten causes an insulin response, which naloxone blocks.  Gluten causing an insulin response, even if isolated from the carbohydrates in wheat, would certainly explain wheat's tendency to lead to obesity...  If insulin spikes, the body clears the blood of glucose, which leaves you with a state of low blood sugar, and that leaves you hungry for more carbs. 

Wonderful.

In my own experience wheat definitely acts on me like a drug, and a fast-acting one.  I can feel the rush from even inadvertent wheat ingestion in minutes, if not seconds.  If I have too much, I get light-headed and have to lie down for a while.

"Wheat" and Science

I most often get lunch from a Japanese market up the road from my office.  I started eating at this place shortly after going Paleo, after realizing that the office cafeteria was hopeless, and the local Whole Foods not much better.

The market offers an odd selection of foods, including a bunch of lunch-size offerings of cooked and raw fish and some meats.  (Lunch sized for me, anyway.  The Japanese ladies at the registers always ask me if I want two sets of chopsticks.)  The advantage, for me, is that they have simple foods that aren't prepared with a lot of ingredients.  This means that I can find food that is minimally prepared, and doesn't have any nasty surprises in it.

However, ingredient labelling is spotty at best, when present, and labels are often in Japanese.

My typical lunch is a piece of grilled salmon, maybe some tuna sashimi, a Japanese cucumber, a rice ball (wrapped in seaweed), and perhaps some salmon roe, if I'm in the mood.  This has been going on for about 18 months now.

So when they recently introduced pieces of roasted fatty pork I was quite excited.  I asked the manager if they prepared the pork with soy sauce (which, except for one variety known as tamari, contains wheat), and, when he answered in the negative, became a steady consumer.

And then one day, they added an ingredient label.  The listed ingredients contained soy sauce.  I skipped the pork that week.

And then today.  The pork reappeared, as did the soy sauce on the label.  Since the pork was one of my favorites, I decided to try an experiment (here's the Science part of the post).  I wondered if, maybe, the pork had included soy sauce all along, and maybe I'd just come to tolerate it.  I've had a couple of incidents recently when I suspected that I'd consumed wheat, but hadn't suffered the stomach and intestinal cramps that I've come to associate with it.

My gut certainly seems to have healed as I've avoided wheat and seed oils over the last 21 months.

So, inspired by Barefoot Angie Bee, I gave it a shot.  I bought two packages of the soy-sauce laden roasted fatty pork, a spicy tuna rice ball (wrapped in seaweed), a piece of grilled salmon, a Japanese cucumber, and an Asian pear.  My Japanese paleo lunch.

I got back to my office, ate the pear first, then the rice ball, and then the pork.  It went well.  I've had incidents where upon eating trace amounts of soy sauce I've had that spacey feeling that wheat gives me with in seconds, and cramps within minutes, invariably followed by the typical watery diahrrea of celiac the next morning.  No, I've not been diagnosed with celiac. 

I started eating the cucumber, and it hit.  The spaced-out, drugged feeling from wheat.  Not good.  Happily I didn't get any painful cramps, but within 45 minutes I was sitting on the toilet.  Next came some bizarre throbbing feelings in my head, and then a nice dull headache for the next few hours.  I once suffered from what I now suspect was a wheat-induced stroke, so the head issues are a major, major red flag.  (Nothing like a little brain damage to get your attention.)

Oddly, an old back injury in my upper back that hasn't bothered me for years sent me a sharp stabbing reminder that it was still capable of inflicting pain.  (I later read this post from Dr. Davis.)

So, the experiment was a success in that it indicated that the addition of soy sauce to the pork was recent, and it confirmed that my gut is in better shape than it was a year ago.  It also clearly indicated that wheat is a toxin, and I've got no business eating it.

The things we do for Science.  I'll have to speak to the management of the market and see if they can ditch the soy sauce.

I'll explain why I put "wheat" in quotes in the title of this post at another time.

Wheat And Dental Disease

Dr. Davis briefly surveys the history of wheat, and notes the following:

"Hunter gatherer humans who first began to incorporate wild einkorn into their diet experienced a downtown in health, including more dental caries, bone diseases, and probably atherosclerosis and cancer. Likewise, modern hunter gatherer cultures who do not consume wheat are spared these conditions."

(Einkorn is the orginal form of wheat, the least toxic variety.)

Oetzi the ice man (found frozen in a glacier), "had wheat and barley as major cereals in [his] intestines, together with some weed seeds..."

Therefore:

"'...Although the Iceman did not lose a single tooth until the his death at an age of about 40 years, he had an advanced abrasion of his teeth, profound carious lesions, and a moderate to severe periodontitis,' the researchers said."

The researchers conclude:

"'We already know that he was eating grains, such as einkorn or emmer. The contained carbohydrates clearly increased the risk of developing dental diseases,' Zink said."

This is mistaken.  There are plenty of high-carbohydrate diets that will leave you with perfect teeth. 
Dr. Weston Price visited Africa and surveyed the Kikuyu tribe:

"Their chief articles of diet are sweet potatoes, corn, beans, and some bananas, millet, and Kafir corn, a variety of Indian millet."

They have the typical malnutrition of a high-carbohydrate diet, "The Kikuyus are not as tall as the Masai and physically they are much less rugged." However, as Dr. Price observes:

Kikuyu teeth

"Note their fine teeth and dental arches."

Tooth decay seems to be a singular side-effect of eating wheat and related grains.  Dr. Mellanby discovered a tooth-decay reversing diet, which consisted of:

"...instead of cereals- for example, bread, oatmeal, rice, and tapioca- an increased allowance of potatoes and other vegetables, milk, fat, meat, and eggs was given. The total sugar, jam, and syrup intake was the same as before. Vitamin D was present in abundance in either cod-liver oil or irradiated ergosterol, and in egg yolk, butter, milk, etc. The diet of these children was thus rich in those factors, especially vitamin D and calcium, which experimental evidence has shown to assist calcification, and was devoid of those factors- namely, cereals- which interfere with the process."

Oetzi suggests that even a bit of wheat in the diet is going to be problematic.

A Gift

Seth and I corresponded via email occasionally. He was very generous with his time. I wanted to copy these two posts from his blog, as I don't know how long it will remain available.

Make Yourself Healthy: Diverticulitis


You have diverticulitis when “diverticula in your digestive tract become inflamed or infected. Diverticula are small, bulging pouches.” A man in his forties named Tuck had a serious case:

In my twenties I got really sick; lying in bed for 5 days, bleeding from the lower part of my digestive tract: not pretty. . . Delirious days later and ten pounds lighter and I was recovered, except for one problem: I had diarrhea for the subsequent 14 years. . . . Two years ago [2008] I passed out on the toilet on a ski weekend. The emergency room at Bennington Hospital [Vermont] told me it was a stomach flu.
Four weeks later I got cramps at work. I had to lie on the floor until it passed. Then I drove to my doctor’s office, and he told me that I had diverticulitis, and I had to go to the emergency room. I drove myself, and barely made it. I was in agony; I nearly passed out again while they were interviewing me to see if it was “serious”. . . . I had a perforated colon. . . . I spent the next four days in the pre-operative ward, so if it got worse they could cut me open immediately. I lost 10 pounds. Then I started bleeding, and I realized these were all the same symptoms that I had had 14 years before. My blood pressure got so low that the automated blood-pressure machine wouldn’t work . . .
I mentioned to all three of the doctors I saw that I had had constant diarrhea for the last 14 years, since the first attack, and they shrugged. They told me to eat more fiber, and whole wheat, even though that was what I had been eating for the last 20 years. So I avoided surgery, started eating salad with salad dressing (containing industrial seed oils) and lots of whole wheat. . . . But the more salad and whole wheat I ate, the worse it got. I couldn’t understand why. Finally had to have eight inches of my colon removed. The diarrhea continued, so obviously the cause remained.

Then something happened that, before blogging, wasn’t possible:

Someone sent me a post that Stephen Guyenet did about how dental problems were pretty much all due to diet, not genetics, as I’d been told. As someone who’d had a ton of cavities, and 8 teeth pulled, and was determined to spare his daughters the same fate, I found this of interest.
I started reading the blog. 6 months later, I decided to stop eating seed oils, which eliminated my carb cravings, hence no wheat. Two days later, [unexpectedly] my diarrhea stopped. A good bit of trial and error, some accidental, ensued. [I learned that both] wheat and seed oils cause distress, but different types. The two combined can cause me to pass out. If I eat wheat by accident, then eating saturated animal fats (like cream) causes things to settle down.

He found that “traditional” oils (palm, coconut, olive) are okay. Industrial oils (corn, canola, cottonseed) are not. Animal fats (butter, lard, beef tallow) are best.

After 16 years my symptoms are now completely under my control. . . . I read the ingredients on everything. I make a big mistake once every 6-9 months. [Other benefits:] I’m much more resistant to sunburn, for instance, and my vision improved a bit.

So his problems were due to (a) wheat and (b) too much omega-6. His doctors had no idea.
The Mayo Clinic recommends a “diverticulitis diet” that is clear liquids and low-fiber foods. According to the Mayo Clinic, “mild cases of diverticulitis can be treated with rest, changes in your diet and antibiotics. But serious cases of diverticulitis may require surgery.” The Mayo Clinic, it appears, has no idea what causes diverticulitis.
Tuck added:

It really pisses me off when people dismiss this, because it really makes a difference.  I had a colleague who was in the hospital for a colon resection for diverticulitis.  When he heard my story, he had the hospital put him on a gluten-free diet.  Four days later, instead of having surgery as scheduled, he checked out: cured.  He’s symptom-free on a gluten-free diet to this day.

I agree. As someone on the Shangri-La Diet forums put it, “you are handed a GIFT.” A story like this is a gift.


How Common Are Medical Errors? A Horror Story

In this post a contract artist who calls himself Wolverine gives a long list of life-threatening medical errors that happened to him. I hope that he will eventually add dates so that the rate of error becomes clearer [more: all the errors happened within a 14-month period] but even without them the stories suggest that life-threatening errors are common. (As does the effectiveness of surgical checklists.) Medicine is a job where if you make a mistake only the customer suffers not you. Surely this is why the error rate is so high. Wolverine was operated on by a surgeon who, because of a fatal error, had lost his license to practice in California. He changed states, was hired again, and made the same error on Wolverine.
I learned about this from Tucker Goodrich, who has been corresponding with the author and told me something remarkable:

He’s eating a paleo with raw milk diet.  The other transplant patients he knows are all eating the modern American diet and dying of infections; he’s been infection-free for two years.

Wheat and Malnutrition

Healthy whole wheat, on the left.

From all my reading Melissa is spot-on with this post.  The better the diagnosis of wheat-related diseases in a population, the higher the frequency with which they're found.

"Testing found that 5.6% of them have celiac. Unfortunately wheat flour is their staple food (I wonder what that started?). Before celiac was diagnosed, people thought their children were merely dying from a malnourishing diet or GI illness. Researchers are now finding celiac hotspots across the Middle East, India, and Africa.

"This is interesting because so much government food aid contains gluten. How many of the children you see on those "save the children" campaign ads are really suffering from celiac like this child?? How many such starving children will be given gluten-containing food aid and will die as a result?"

5.6% of a population is celiac?  And that's likely only the tip of the iceberg.

As I mentioned in a comment a while ago, wheat is a proven cause of heart disease, cancer, and even schizophrenia, in humans.  Would you eat any other food about which that could be said?

P.S. Added excerpt from Melissa's post.

P.P.S. Wow, Melissa buried the lede on this one.  I got around to following the link (To Frontiers in Celiac Disease by Alessio Fasano, et al) in her post above, and found this:

"We have recently completed a screening project on school children in Cairo City, Egypt.  Blood samples were obtained from 1,500 children attending school in Cairo City between October 2001 and June 2004...  The prevalence of [celiac disease] in this sample of Egyptian students was 53% (95% CI 0.17-0.89).  This estimate may be low, as more CD cases could be diagnosed at the follow-up, e.g. in the group currently showing a positive tTG IgA and a negative EMA [partial CD symptoms]."

53% of the kids!?  That's incredible.  This is from the region where wheat cultivation has gone on the longest, mind you.  (Alessio Fasano is the leading researcher on celiac disease.)

Wheat and Schizophrenia

In a comment to "Dr. Davis versus The New York Times" I quoted this study:

"A drastic reduction, if not full remission, of schizophrenic symptoms after initiation of gluten withdrawal has been noted in a variety of studies. However, this occurs only in a subset of schizophrenic patients."

I was hoping to expand this comment into a post at some point, but now I don't need to.  Today in Psychology Today, Emily Deans, a psychiatrist, writes about the topic: "Wheat and Schizophrenia".

Obviously you should read the whole thing, but just to give you a flavor:

"Anyway, there's a funny thing about schizophrenia, turns out that quite a few of the adult schizophrenics on an inpatient psychiatric unit in 1967 happened to have a major history of celiac disease (gluten/wheat intolerance) as children. As in 50-100 times the amount of celiac disease that one would expect by chance. Celiac doctors also noticed their patients were schizophrenic about 10X as often as the general population. That's a lot! In addition, epidemiological studies of Pacific Islanders and other populations showed a strong, dose-dependent relationship between grain intake and schizophrenia. The gluten-free populations had extremely rare occurrence of schizophrenia - just 2 in 65,000 versus about 1 in 100 as we have in the grain-eating West. When populations Westernized their diets (flour, sugar, and beer), schizophrenia became common. In some clinical trials, gluten made new-onset acutely ill schizophrenics much worse, but only occasional long-term patients responded to gluten restriction. The long-term sufferer has already had a lot of damage - if wheat somehow toxic to the brain, then it would be vital to stop the insult early on in the course of the disease to see improvement."

Want a bagel?

Via Jimmy Moore on Facebook.

P.S.  So I was driving home last night and listening to Robb Wolf's podcast, where he discussed Fasano's recent paper on wheat poisoning.  (Yes, I have no life.)  Robb said that a woman came up to him after one of his talks, and said she worked for some government health agency, and that her agency was of the opinion, although they could not yet prove it, that wheat is the cause of schizophrenia.  I doubt that's true, but there's clearly a pretty strong link.

Tom Naughton Reviews "Wheat Belly"

I'm ordering my copy now:

"...Perhaps overjoyed at the prospect of the feeding the world, the developers of modern wheat varieties weren’t interested in conducting tests to see if these genetically-modified strains were actually fit for human consumption. Dr. Davis believes they’re not. At the very least, we’re now consuming wheat that’s genetically different from what our ancestors consumed:

"Analyses of proteins expressed by a wheat hybrid compared to its two parent strains have demonstrated that while approximately 95 percent of the proteins expressed in the offspring are the same, five percent are unique, found in neither parent. Wheat gluten proteins, in particular, undergo considerable structural change with hybridization. In one hybridization experiment, fourteen new gluten proteins were identified in the offspring that were not present in either parent plant. Moreover, when compared to century-old stains of wheat, modern strains of Triticum aestivum express a higher quantity of genes for gluten proteins that are associated with celiac disease....

P.S. Dana Carpender also reviews it:

"...I had no idea that the list of health problems attributable to gluten was so long and so frightening. Among the health conditions Dr. Davis links to gluten are:...

...* Several forms of cancer, including bowel cancer.""

Lupine, A Novel Food That's Already Causing Problems

Mark G, a correspondent from Australia, drew my attention to this stuff:

Low-Carb Bread

Low carb, high protein bread! What could go wrong with that?

Well, if you zoom in on the ingredients, the first three are wheat protein, soy protein, and lupine protein.

Lupine protein? Lupine, the flower? Apparently:

"Lupine cultivation is at least 2,000 years old and most likely began in Egypt or in the general Mediterranean region. The lupine plant, like other grain legumes (beans, peas, lentils, etc.) fixes atmospheric nitrogen, and produces seed high in protein. There are over 300 species of the genus Lupinus (L.), but many have high levels of alkaloids (bitter tasting compounds) that make the seed unpalatable and sometimes toxic. Historically, lupine alkaloids have been removed from the seed by soaking. But plant breeders in the 1920's in Germany produced the first selections of alkaloid-free or "sweet" lupine, which can be directly consumed by humans or livestock. White lupine (L. albus L.), yellow lupine (L. luteus), and blue or narrow-leafed lupine (L. angustifolius) are cultivated as crops. Lupines are currently grown as a forage and grain legume in USSR, Poland, Germany, the Mediterranean, and as a cash crop in Australia, where it is exported to the European seed markets. Both winter-hardy and non-hardy types are available."

Uh-oh...

And since humans make such excellent guinea pigs for these sorts of things:

"The United States has a developing specialty human food market for lupine in the form of lupine flour, lupine pasta, and hulls for dietary fiber. Sweet lupines have been shown to increase the protein and fiber crops in conjunction with durum wheat in specialty pastures, and to be an excellent source of white-colored fiber, as an additive to breads and cereals."

("White-colored fiber" is most likely an euphemism for cellulose, the modern marketing name for sawdust. But that's a whole 'nother post.)

So what's wrong with using lupine protein in food? The most obvious problem is that many people with peanut allergies, one of the most common allergies, cross-react to lupine. Since lupine's novel, the regulators haven't caught up to this, and you could wind up with a nasty surprise:

"Lupine or lupin is a legume that may cause an allergic reaction in those with peanut allergy. Lupine is used in this country in many gluten-free and high-protein products. In many European countries, particularly Italy and France, lupine flour and/or peanut flour may be mixed with wheat flour in baked goods."

Also here:

"Amino acid sequence homology also suggests that these proteins could be responsible, at least in part, for some of the allergic cross-reactions between peanut and lupine reported in the literature."

And here:

"Lupine flour is allergenic and potentially cross-reactive with peanut allergen, thus posing some risk if used as a replacement for soy flour."

And of course:

"Conclusions:  A small but significant number of children with peanut allergy are allergic to lupin."

But you won't learn that from reading the allergen warnings, if you live in Europe:

"Tough new laws on food allergens that enter into force in Europe in November will require food manufacturers to list 12 potentially allergic ingredients, and their derivatives. Lupin flour is not included in the listing."

Of course that's after they allowed lupin flower to enter the food supply. But that's not all:

"Poisoning varies depending on lupine species and varieties, and it is difficult to pin point to specific plant or animal since different animals become susceptible in different ways under varying range conditions.

Species and taxonomic differentiations between species are insufficiently characterized. Different lupines produce varying syndromes in a a given species of livestock....

More than a dozen quinolizidine alkaloids, but some piperidine alkaloids and other types of alkaloids have also been isolated from species of Lupinus. These alkaloids are largely nicotinic in effect. The nitrogen oxides of some of these bases have also been detected in some lupines. The alkaloids are present in the foliage but the greatest concentration is in the seeds.

Lovely.

[P.S. I forgot to mention that this food has nearly the perfect profile for a novel, yet toxic, food to be introduced. It's enough to make you a Paleo paranoid. In it's new and improved form, it's not overtly toxic, but if it were to present symptoms of toxicity, they'd be diverse, and nearly impossible to tie back to the original source. Sort of like modern wheat. In the meanwhile the producers would be able to make a boatload of cash on it, until the truth finally starts to leak out.]

I'd guess that they're reduced the levels of alkaloids in the "sweet lupine" down to some tolerable level, and not completely eliminated them. So, like soy, wheat, or bok choy, if you start eating large amounts of lupin, you may find that you've exceeded the toxic amount.

Interestingly, I found that one of the major proponents (and producers) of lupine, George Weston Foods, applied to the US Food and Drug Administration for a "generally recognized as safe" designation for "sweet lupin" flour, fiber, and protein. They then withdrew the request:

"The subject of the notice is sweet lupin flour. The notice informs FDA of the view of George Weston Foods, Ltd. that sweet lupin flour is GRAS, through scientific procedures, for use as an ingredient in baked goods and baking mixes and grain products and pastas at a maximum level of 25 per cent.

"In a letter dated December 10, 2008, you withdrew your notice. Given your letter, we ceased to evaluate your GRAS notice, effective December 16, 2008, the date that we received your letter."

That's odd. I wonder what George Weston Foods knows about lupin that caused them to withdraw the request?

Nevertheless, if you're dying to give Lupin flour a try in the U.S., you can buy some here. What are the advantages they cite?

Type: Peanut Free, All Natural, Gluten Free, Kosher, Raw, Sugar Free, Vegan, Wheat Free, Dairy Free.

Technically, that's true, of course. But the only reason you'd be interested in the fact that a food was peanut-free is if you were allergic to peanuts...

Calling all attorneys.

Caveat emptor, as always. Look out for yourself, because you can't trust the food producers or the regulators to look out for you.

Gluten-free (Wheat-free) Foods...

Saltines.  Not wheat-free.

...Are becoming more and more popular. Our local pizza place now offers wheat-free pizzas, which is a great option for the girls. (It's nice to be able to order a pizza when we have kids over.)

A colleague of mine told me about some soups that were labeled wheat-free when he was ordering lunch yesterday, so I ordered one. It's pretty tasty, and hopefully I'll have no ill effects from it. I'm a little skeptical, as it arrived with two packs of Saltines on top.

At least they're trying. :)

(When I was a kid I would eat saltines by the sleeve, btw.)

P.S.  Well, the Saltines should have indicated that something was wrong.  As I was eating the soup (tomato, btw), I wondered what they used as a thickener to get the nice consistency.  Then I noticed I was getting a massive head rush, the first sign that I'm eating wheat.  Damn it.  Not much of a subsequent reaction, just mild cramping.

The downside of the growing popularity of gluten-free is the fact that restaurants, while trying to be helpful, don't really understand what it means.  But they're learning.

Wheat and The China Study

Miss Minger's latest is up. (This is part 1.)

Wow.  Read the whole thing, I can't even summarize it, it's too incredible.

Update: After some thinking, a summary is in order.  Wheat is implicated in causing heart disease.  If these correlations are indicitive of a causal relationship, wheat is worse for your heart than almost any other item you ingest, including cigarettes.

I'm in the middle of reading Western Diseases: Their Emergence and Prevention right now, which is a pretty dry read, unless faecal transit time is a hobby of yours (in which case, God help you :) ).

However, if you read between the lines, you'll see exactly what Stephan Guyenet has discussed: wheat seems to leave a trail of devastation where ever it goes.  Unfortunately in that book wheat and veggie oils are never really discussed as causes of disease.  But I'll do a review when I finish it.

Wall Street Journal Article on Wheat

"Giving Up Gluten to Lose Weight? Not So Fast. Diet Regimen Effective in Treating Celiac Disease, Wheat Allergies, But Not for Shedding Pounds

This is the evidence that the author provides that ditching wheat won't help you to lose weight:

"The notion that a gluten-free diet can help people lose weight or avoid carbohydrates is a myth. 'Many packaged gluten-free products are even higher in carbs, sugar, fat and calories than their regular counterparts, and they tend to be lower in fiber, vitamins and iron,' says Shelley Case, a registered dietician on the medical advisory board of the Celiac Disease Foundation. 'Gluten-free does not mean nutritious,' she notes."

That's it.

Now I agree that if you eat the gluten-free stuff you'll not lose weight.  What I've seen of it is mostly rice flour, which is not nutritious.

But what if you replace wheat with fruits and vegetables?  Unfortunately there's no discussion of this in the article at all.

The last sentence of the article is really the prize, however:

"Also, for dieters, going back to gluten after avoiding it can lead to stomach cramps, bloating, diarrhea and other symptoms, at least temporarily."

Why on earth would you eat anything that caused those symptoms?   If I gave you an egg that caused "stomach cramps, bloating, and diarrhea", the FDA would call it food poisoning and issue a recall.  But to Miss Beck, the WSJ Health columnist, they're perfectly acceptable side effects of eating wheat.

Now that's nuts.

First Primal Thanksgiving

Yesterday we had our first Primal Thanksgiving.  It went extremely well.

(I didn't offer the typical "Happy Thanksgiving" post because I was too busy living life.  So, a belated Happy Thanksgiving to you all.)

Celeriac Soup

For an opener, we had this Silky Celeriac Soup using a recipe from Mark Sisson.  Celeriac soup was a vegetable with which I was unfamiliar.  But I'd starred this recipe in Google Reader, and when I went to the farmer's market to pick up our turkey, I saw that it was available, and decided to wing it. (Pun intended.)

One of the attributes our Paleo ancestors would have had in spades was flexibility.  You eat what you find, not what you'd like.

After being appalled by the added mystery ingredients in the whole cream at Stop & Shop, I drove to Whole Wallet and bought some Sky-Top Farms pastured, unhomogenized (but pasteurized) cream, which featured prominently in this soup and in several other dishes.  (I doubled the portion of cream in the soup, replacing some of the optional water.)

I also made Nell Stephenson's brussell sprout recipe.  I hate brussel sprouts, but for some reason when I saw them at the farmer's market, I craved them.  I had also starred this recipe in Google Reader.  The sprouts turned out reasonably well, but I think they were a bit undercooked.  I would steam them for longer, or cut them in quarters, so they'd be a little less chewey.  As advertised, they were quite tasty.  I used dates but not pecans, as my older daughter has a nut allergy.  Bacon would also have been a good addition, and I think cooking them in lard or bacon grease would have been a good route to go.  Nell's recipe suggests using olive oil, but since we know that's not paleo, I felt free to replace it with another "not paleo", but more tasty and nutritious oil: pastured butter.  This is produced from May to September; I have a freezer-full of it for the winter months, since we use it liberally.  My occasionally-lactose-intolerant younger daughter does just fine on it, thank you very much.

I made mashed potatoes for the traditional aspect, with lots of raw milk, cream, and pastured butter included.  Note to self: do not use power tools when making mashed potatoes next year.  They rapidly became glue-like, and while the addition of dairy products rescued the taste, the texture was a bit lacking.

We had a salad, two different gluten-free stuffings, gluten-free corn muffins, and, of course, a pastured turkey, which was easily the tastiest bird I've eaten in my life.  Not to mention some cranberry sauce, and acorn squash.  And gravy, of course.  Skimming the turkey fat off the top of the gravy is key, by the way.  I omitted this step last year, and regretted it.  Turkey fat is high in linoleic acid, which is prime amoung the "bad fats", I've noticed that poultry fat with too much linoleic acid in it leaves me feeling out-of-sorts.

One of the stuffings' ingredients called for Campell's cream of celery soup, which is listed as "Heart Healthy" and approved by the American Heart Association.  Paranoid that I am, I read the ingredients anyway, and was horrified to note that this "cream" of cerery soup listed "vegetable oil" as the second ingredient, after celery.  "Truth in advertising" includes lies, apparently.  A high concentration of linoleic-acid-rich vegetable oils and it's metabolites are well-correlated with heart disease.  So I wound up making a quick cream of celery soup in the morning to be included in the stuffing, following an old recipe from Fannie Farmer.

For desert we had gluten-free brownies, ice cream, and, for our guests, a couple of pies with a wheat crust.

Strict observers of the Paleo or Primal diets will notice that we did not strictly follow either one.  A bit of grain (like corn) now and again isn't going to be harmful, IMHO.  Even my daughters appear to do fine with the occasional bit of wheat; my wife and I do not, however.  I think that regular, long-term consumption is what causes harm that the body cannot repair; as even celiacs who do not eat wheat for a period can tolerate it once in a while without symptoms.  This meal was more in line with Stephan Guyenet's research or Paul Jaminet's Perfect Health Diet, therefore.

This meal involved a fair amount of work and research, as you may gather.  But it was worth it.  Really the only fiasco was the potatoes.

What was fascinating to note was our guests' reactions.  They all loved it, and cleaned their plates.  But no-one went back for seconds, and one guest who had piled her plate particularly high was unable to get through it.  It was a very satiating meal, in other words, even with all the carbs.  Neither my wife or I had any of the bad effects that we've now come to associate with a meal including wheat or vegetable oils: we felt great after this meal.

This is in line with the theory that the harmful stuff in the Modern American Diet isn't the carbs, but wheat and vegetable oils.

I weighed myself after returning from my nine-mile Thanksgiving trail run prior to all the cooking and eating, and then again the following morning: zero weight gain, but I nevertheless skipped breakfast due to still feeling full.

I will note that if I was the only one planning this meal, it would have been more Primal, but marital concerns dictated some of the menu. ;)  I don't think that the meal would have been any less well-recieved if it had been more Primal.

Doctor Versus Doctor And Lame Journalists

A colleague sent me this article:

"Q. Other than celiac disease, is there any reason to avoid gluten in the diet?

"A. 'Though the hype continues on gluten-free diets being the panacea for all ills, science still lags behind in concrete evidence supporting this belief,' said Dr. Vandana Nehra, a gastroenterologist who specializes in celiac disease at the Mayo Clinic in Rochester, Minn.

Dr. Nehra said it was 'unclear if the benefit of a strict gluten-free diet in conditions other than celiac sprue may be related to the avoidance of carbohydrates and thus eventually to weight control' or was 'merely a placebo effect as individuals feel better eating a healthier diet.'

Gluten, a protein in cereal grains like wheat, barley and rye, has been blamed by some individuals for everything from indigestion to arthritis to depression. However, these people often do not have any allergic sensitivity to gluten, nor do they have celiac sprue, an autoimmune disease that damages the small intestine and interferes with food absorption. Gluten is known to aggravate intestinal irritation in the disease."

There are so many issues with just this part of the article it's tought to know where to start. First, the "if your symptoms don't match our diagnostic framework you must be crazy" approach to medicine drives me nuts. It's not scientific, for starters. Dismissing evidence contrary to your hypothesis is pretty much the definition of unscientific, in fact.  Second, I've never heard a single person claim that a gluten-free diet is "the panacea for all ills", so that's a straw-man argument.  Third, if it's 'unclear' to Dr. Nehra if it's only a placebo effect, she should consult with Dr. Fasano:

"'In your medical practice, how do you determine if a patient has non-celiac gluten sensitivity?'

“'Because gluten sensitivity is not a food allergy (like wheat allergy), or an autoimmune process secondary to exposure to gluten (like celiac disease), the diagnosis is based on exclusion criteria. In other words, people that experience symptoms that are suspected as being related to gluten exposure will be tested for wheat allergy and celiac disease. If they are negative for both, gluten sensitivity is considered. The diagnosis will be confirmed if symptoms resolve following the embracement of a gluten free diet.'"

Fasano is one of the leading researchers on celiac.

I don't mean to pit Drs. Nehra and Fasano against each other, however.  I'd wager that 90% of any difference in opinion between the two of them is the result of the journalist at the Times doing a bad job of asking questions of Dr. Nehra, and of conveying the answers, never mind trying to get more than one source.

Celiac and wheat sensitivity are difficult, complicated issues, and there's a lot more going on than what is conveyed in this New York Times article.

New Frontiers in Wheat Poisoning

Alesio Fasano, mentioned the other day in this post, has released the results of his newest study: Study Sheds Light On Gluten Sensitivity (WSJ, subscription required):

"For the first time, we have scientific evidence that indeed, gluten sensitivity not only exists, but is very different from celiac disease," says lead author Alessio Fasano, medical director of the University of Maryland's Center for Celiac Research.

"The news will be welcome to people who have suspected a broad range of ailments may be linked to their gluten intake, but have failed to find doctors who agree.

"'Patients have been told if it wasn't celiac disease, it wasn't anything. It was all in their heads,' says Cynthia Kupper, executive director of the nonprofit Gluten Intolerance Group of North America...."

"...Although much remains unknown, it is clear that gluten—a staple of human diets for 10,000 years—triggers an immune response like an enemy invader in some modern humans."

There we go. Eating wheat is functionally equivalent to eating poison ivy: wheat contains proteins that trigger autoimmune responses. One type of response causes celiac disease, the other causes gluten sensitivity.  I'd wager there are more to come:

"'Imagine gluten ingestion on a spectrum', says Dr. Fasano. 'At one end, you have people with celiac disease, who cannot tolerate one crumb of gluten in their diet. At the other end, you have the lucky people who can eat pizza, beer, pasta and cookies—and have no ill effects whatsoever. In the middle, there is this murky area of gluten reactions, including gluten sensitivity. This is where we are looking for answers about how to best diagnose and treat this recently identified group of gluten-sensitive individuals,' says Dr. Fasano."

Dr. Davis' hypothesis seems to be getting some currency:

"'People aren't born with this. Something triggers it and with this dramatic rise in all ages, it must be something pervasive in the environment,' says Joseph A. Murray, a gastroenterologist at the Mayo Clinic in Rochester, Minn. One possible culprit: agricultural changes to wheat that have boosted its protein [gluten] content."

(Emphasis mine. Murray is wrong about people not being born with it. Gastroenterologists are moving up there with podiatrists in my estimation of the medical profession.)

If you're interested in hearing more, there's an interview with Fasano here, and the study is here.

One real pet peeve of mine:

"'There's a lot more that needs to be done for people with gluten sensitivity,' she says. 'But at least we now recognize that it's real and that these people aren't crazy.'"

This is what the medical profession does when people present with symptoms they don't understand: they don't investigate, they tell the people they're crazy.  If your doctor tells you this, tell him to go to hell and find a doctor who takes you seriously.  Yes, I know there are people who are crazy, and sometimes the doctor is right, but there just aren't that many crazy people running around.  Gluten-free is turning into an industry while the medical profession has got its head in the sand.

P.S. A gluten-free diet is a pain in the butt.  No one would do it just because it's "a trend".  It's worth it, certainly in my case, but it's a pain in the butt. 

Einkorn Study

I've still not gotten around to testing the einkorn I bought: I received it, and it's very nicely wrapped, but there it sits.  I'm actually a bit nervous about trying it.

"This study does not support the hypothesis that wheat sensitive persons generally tolerate the ancient wheat einkorn better than modern wheat, but there seems to be a subgroup with better tolerance for einkorn than wheat."
 
Link to PDF.