Alexa Fleckenstein M.D.

Gluten is a sticky protein in wheat, barley, rye, AND oats, naturally. But the gluten in oats is called avenin; the gluten in wheat, barley and rye is called gliadin. Shorthand, we use the broader term "gluten" in the place of the more specific term "gliadin". That's why we can call oats "gluten-free". And it is true that many people with a gliadin problem, are able to digest avenin. Some, however, are not. And no effort to label oats as "gluten-free" will make it so - it always will contain its specific gluten called avenin. For the people who think "gluten-free" is a health fad: It is not. Celiac disease is a severe autoimmune disease, with many consequences if neglected. Roughly 1 in 100 of people worldwide have gluten sensitivity. It's real (because it's in your genes), and it can't be wished away. [This article first appeared as a letter in the New York Times health blog 4/14/2018] Read More 

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