Not that I should luxuriate in writing blogs while I am finishing my diabetes book, but to call attention to the problems with wheat – on this occasion I just have to do it.
Since this is my big theme presently, let me roll up the whole gluten conundrum from the diabetic side: Ninety percent of people with diabetes type II are overweight; ten percent are not. Now – what gives the ten percent their diabetes?
Genes, of course. But genes account only for part of the puzzle. Most slim diabetics have either type I diabetes (which I will not discuss here), or they have gluten intolerance. Disclosure: I am one of those ten percent, and while I don’t yet have full-blown diabetes with all the dismal consequences down the road like blindness, kidney failure, amputations, neurological damage, my number always hover at the upper border of normal or the low border of diabetes. For somebody who has brittle diabetes and ends in the hospital frequently, this seems a good place to be, and sure it is. BUT: By the time people are diagnosed with diabetes, a good third already shows sign of end-organ failure. Which means: They really already have advanced disease. I don’t want to wait doing nothing and closing my eyes.
So, what do I do? I move, for starters. I don’t go to the gym, but I work in the garden, play my cello, go for a walk after dinner with my husband, and do tiny exercises every time I get up from my chair during my long writing sessions (aaah – writing a book about health is not such a healthy thing, after all).
And I eat healthily. Fresh vegetables, fresh herbs, some fish, much less meat (but meat I do eat – and recommend), no dairy, no sugar, no sweeteners either, no trans-fats, and basically, nothing processed.
But back to gluten. We pray for our daily bread – and are not aware how recent the “daily bread” was invented – not longer than five to ten thousand years. Which is nothing in terms of evolution and our genes. Actually, our “daily bread” is around not much longer than monotheism – the belief in a single, singular god. I find that interesting: When we were hunter and gatherers, eating and nibbling and plucking from Nature wherever we went, we had multiple gods – the ones that were hidden in the groves, in the deep lakes, in the skies – and everything was whispering to us: Holy, holy, holy.
Then agriculture was invented with cattle and sheep husbandry, and we learned to sow and to reap, and suddenly there was that one stern god over us, telling to adhere to his rules – one obviously needs rules and timetables and schedules and order to be a farmer.
Forward a few thousand years to Mr. Kellogg, who gave us our breakfast cornflakes, and modern scientists who gave as bigger kernels of wheat, and then all the abundance that came with industrialization and prosperity – and here comes the modern American wave of obesity and diabetes. Where for millions of years always was scarcity – and that is what our bodies were adapted to for millions of years – now we can get the whopping calories of a burger for one dollar. Without to move out into the woods and hunt and gather.
If gluten is at the root of those ten percent of slim diabetics – so what! you exclaim, because you are fighting the pounds for most of your life. Gluten makes a few of us very sick – with celiac disease. Gluten makes a lot of us fat, with sickness down the road from the excess pounds.
Celiacs have no immune tolerance for gluten; they might get diarrhea, skin rashes, bloating, and all kinds of weird symptoms – including neurologic and psychiatric. Half of the symptoms are not showing in the belly, which is one reason gluten intolerance is still one of the widely under-diagnosed disease – even that the last ten years has turned the tide a bit.
The funny thing is: Wheat does not want to be eaten. Like basically all nuts and seeds, the wheat grain contains a family of compounds called lectins that are there to protect the grain from being eaten. The wheat plant has no interest, so to speak, to be gobbled up and extinguished. On the other hand, from the wheat’s point of view, of course, it is extremely advantageous that farmers everywhere now growing this seed that originally had a very narrow distribution, namely the Fertile Crescent of Mesopotamia. Somehow we managed to spread it more or less worldwide – or did the plant entice us to do its business?
Not sure. But nuts and seeds contain lectins that hinder digestion and make people sick with arthritis, depression, heart disease, cancer, diabetes, and so on – the celiac who runs to the bathroom ten times a day is only the tip of the iceberg. And it shows the wisdom of our bodies: To get rid as fast as possible of a toxic substance.
Wheat is addictive – it contains morphine-like substances that play with your brain and your longings just as cocaine and heroin do. I always picture how the first farmers, sitting placidly and satisfied in their hovels, invited the last hunters who came in from another fruitless hunt for something to eat (the rise of agriculture happened parallel to the extinction from overhunting the very large ice-age mammals – they had bison the size of elephants, and deer like cows at that time. The rise of monotheism happened at the same time … did we feel guilty for the overhunting??). The hunters got their bowl of gruels or their flat breads; it must have seemed heaven to them. As they never got enough of it, they came back for more and more, until they one day decided to plough a piece of land, and settle down as farmers themselves.
So, if you want to get healthy and/or slim, you first have to break the wheat (and corn! And sugar! But those are other topics …) addiction. You don’t die of starvation, if you leave out bread and pizza and cakes and cookies and muffins. You just get healthier. The food to eat: Vegetables, vegetables, vegetables. And some brown rice, as rice does not seem so addictive as wheat. It just doesn’t taste so yummy, yummy that you want more and more of it.
In all of this, I haven’t even talked about what they do nowadays once the too-big, overinflated-by-starch wheat kernel is harvested: They mill it and grind it and take the good stuff out, namely the coarse outer layers that contains vitamins and ls . The make white flour from naturally brown flour, and because it is known that white flour contains nothing healthy and leads to deficiency diseases down the road, the “fortify” the flour with vitamins and iron.
Believe me, nothing is as well “fortified” as the original grain. I mean the really “original” grain which we cannot retrieve anymore because the first grains were so puny – not much more then a few hard nibs in your mouth while you were searching for the really belly-filling rabbit or root. If you want to do wheat at all (and if you are a celiac, you can’t have it ever again! Also not rye and barley; perhaps not even oats), at least stick to dinkel and kamut, some of the older grains. Not as old to go back to the dawn of times, but going back a few thousand years, to the first cultured strains. They contain more hulls and “waste”, less gluten and starch. You also can try sprouted breads where most of the gluten has been used up in the process of sprouting.
Our modern degenerative diseases have to do with mostly four culprits: Wheat, dairy, sugar, trans-fats. Our redemption lies in the plant world: vegetables, herbs, fruit. A few beans, a few nuts. Some fish. And occasionally … a rabbit. Read More
Blog: On Health. On Writing. On Life. On Everything.
My Hospital Manifesto
October 30, 2011
If I would decide how hospitals are governed (and I don’t), these would be important points for me:
1. Food: Thy food be thy medicine – and vice versa – Hippocrates said. What is served as “food” in hospitals these times, is mostly abysmal and just goes to show that conventional medicine is not interested in really finding out the root cause of disease. In many cases, it is nutrition, stupid!
2. Cafeteria: Same for the place where all the visitors come and eat. It could be an educational experience, instead just another gorging with inferior foodstuff, filled with chemicals, trans-fats, sugars and dairy.
3. Quiet: When I was a child in Germany, and my father was a doctor, he used to take me on his rounds. Hospitals then were very quiet places. The nurses (often nuns) would walk on their rubber soles like on cushions, and they spoke with low voices. The doors to patient rooms were double doors – the patient had privacy and quiet.
4. What hasn’t changed much: That the hospital routine is not geared toward patient recovery but to a ward schedule convenient for doctors and nurses: Then as now patients are pulled out of sleep to measure their temperature or draw blood tests at four am. I would like to see more concern for the patient’s wellbeing than for the organization’s.
5. No TV in patient rooms: My guess is that at least seventy percent of all illness is self-inflicted. It used to be that being in the hospital was a time for contemplation about what brought one there. Not any longer – as TV is squeaking and squealing day and night.
6. Conventional and complementary medicines are BOTH used. There should be no bias toward the one or the other – what has been proven to work should be applied: Hydrotherapy, movement therapy, food, herbal medicine and art, music, journaling, acupuncture, massage, and so on – they all should be used to make patients better. As they are in most European hospital. And paid for by national health insurance. And, no, they are NOT going to be broke …
7. More cleanliness in the facilities. More cleanliness of the patients. Used to be that hospital were spic-and-span places where you could eat from the floor; not any longer. Instead of on cleanliness we trust in antibiotics – to our detriment. Same with patients’ cleanliness: Used to be that nurses washed the patients daily; not any longer. Nurses have gone scientific (necessarily so – but who is now responsible for caring?); the paperwork has become overwhelming. Housekeeping has been out-sourced. And simple ideas like a washing and cleaning have become obsolete. But hospital infections are skyrocketing.
8. More friendliness and caring toward the patient. The patient has become a moneymaking device.
9. Less care and resources to be spent on very old, very sick people in their last days of life – more on pediatric and under-served populations. DNR (Do Not Resuscitate orders discussed with every patient and/or every family). It will lead to savings of money and will allow people to die with dignity.
10. In medical schools, only half of the students should be A+ nerds; the other half should be people who really want to become doctors and patient advocates from all walks of life. We need very brilliant students because they push medicine’s frontiers ahead. But we also need caring primary care physicians. And putting them together in medical school will hopefully lead to a dialogue between them.
As I am thinking more about this, I might come up with more ideas. What would you wish to implement in the hospitals of the future? Read More
Varicose Veins - Phlebitis - Thrombosis
July 29, 2011
Varicose veins are thought to be ugly, and in a way, they are. But as a doctor, I am less concerned with beauty, more with health problems – and varicose veins are not always as harmless as they seem.
Thrombosis is a clot that blocks a vein, usually in one leg. Thrombosis may lead to pulmonary embolus and, in rare cases, to a stroke; both can be fatal. The symptoms are swelling and pain and warmth of the affected limb. Physicians order a Doppler scan, to make sure the patient does not have the feared clotting situation. If it is a clot, the patient will be admitted to a hospital and a severe thinning of the blood will be administered with heparin, Coumadin and other anti-coagulants, until the clot is gone or at least stabilized.
Often the Doppler test comes back negative – no clot, good news! The patient has “only” phlebitis, an inflammation of the wall of a vein. The symptoms are exactly the same: pain, swelling, warmth. In German phlebitis is generally called “cramping veins” because cramps are also a feature of phlebitis/thrombosis. What can you do against inflamed veins?
Phlebitis and thrombosis can have several causes, sometimes combined: A genetic disposition plays a role. Longtime immobility - like sitting on a long trans-Atlantic flight without getting up, or being bed-ridden, especially after surgery – is known to cause clots. Hormone therapy can lead to clotting. Less well known reasons are cancer and food sensitivities, or even just plain food that is not healthy.
Nutrition that is less than optimal is known to promote inflammation. That inflammation can show up as different diseases in the body; one is phlebitis/thrombosis. Junk foods with high sugar content, white starches, trans-fats and particularly dairy are highly inflammatory for everybody. Food sensitivities, on the other hand, specific for individuals, can also inflame, but the causative foods are sometimes hard to pinpoint. I have seen reactions to banana, avocado, nuts, beef (it might be more what the cattle ate than the cows themselves) and cherries – but there are endless possibilities; a food diary might help in recurrent cases.
Varicose veins frequently occur in people with unrecognized gluten intolerance. Slowly, over the years, the varicosities grow, which is often thought as being just another sign of aging. However, varicosities can be viewed as a sign of chronic inflammation of the body. Pregnancies and much standing can aggravate the condition.
What to do in phlebitis:
1. Eliminate all offending foods.
2. Move moderately every day. Don’t sit for prolonged times. Go for a walk every day.
3. Don’t sit with legs crossed – that clamps down of the veinous blood flow.
4. Elevate legs as often as possible.
5. High-dosed fish oil, three capsules three times a day. Fish oil is a mild blood thinner (and could be contra-advised in some conditions) and a strong anti-inflammatory agent.
6. Cold washings and gushes of the legs, cold sitzbaths and barefoot walking in the ocean all are beneficial.
7. In the acute situation, an icepack (not longer than 16 minutes at a time) might bring relief.
8. Wear support panty hose. It prevents the veins to bulge out bigger and bigger. On very hot days cut out the crotch of the panty hose. Wear the support hose also after you are better.
9. Don’t rush into surgery. Phlebitis is often not just a mechanical problem – think about the food connection first.
10. If symptoms get worse with fish oil therapy, you better return to your physician – soon! Read More