by Paul Graham
The other part of my mind didn’t buy this for one second. It wanted the first part to just shut the hell up, stop intellectualizing, and find some food—and beer—that tasted like it was supposed to taste.
* * *
*1 There’s an exception, here, in more ways than one, with Omission Beer, about which I’ll say more later.
*2 In no other market have I found such a high density of punny product names. See also the Epic Glutenator Ale, Glutenberg, and New Grist. To this point, I’ve resisted calling in the artillery of beer-review websites, but in the case of Toleration I find it difficult to avoid doing so any longer: Toleration receives an average score of 64 out of 100 (“Poor”) on BeerAdvocate.com, and garnered comments such as “a body so light I’m surprised I finished it” and “absolutely horrible.” Toleration is, according to the brewery’s website, the only Paleo-friendly beer on the market. The archaeological evidence suggests, however, that cavemen were most likely getting their buzz by drinking early precursors to mead: honey that had fermented in the holes of fallen trees after it had been rained on.
*3 Here, and also in the case of the Mesopotamians, I am reminded of my maternal grandfather, who believed one of life’s grandest pleasures, in addition to fresh-squeezed orange juice, grilled onions and peppers, and German shepherds, was an evening spent on the porch sipping a can of Coors through a plastic flexible straw. My mother thought him ridiculous, but it appears that he was simply reclaiming a forgotten beer-drinking practice.
Eat enough fake bread, drink enough fake beer, and a person begins to ask, Why? I understood the genetic predisposition. I accepted the mystery over what causes a gene to flip to the “on” position. Lots of people have that question, from those who receive a cancer diagnosis to victims of Parkinson’s disease, and they had much more to worry about than I did. The fact remained, though, that I had not, thankfully, come down with cancer or Parkinson’s. I suffered from a sudden inexplicable intolerance to several grains. Why was this starting to happen to more and more people? And why now?
I’ll admit that I immediately suspected the grain. I wasn’t the only one. For the next two years, whenever I met someone with a gluten-related disorder—whether celiac disease, wheat allergy, or gluten sensitivity—I casually asked them where they put the blame, and often received the same answer: Something is in the wheat. It’s a sign of our times, revealing of our tense and troubled relationship with food producers. We immediately suspect corporate agribusiness when people start getting sick: glyphosate (the generic name for the weed killer Roundup), genetically modified organisms (GMOs), plant breeding, and the unsanitary conditions at feedlots and slaughterhouses. Big agriculture, whether the producer is harvesting chickens or watermelons, is far from a blameless industry, and investigations of contemporary foodways have taught eaters how and why to mistrust. The suspicions are valid. And yet the world we move through is far more complex than the dinner on our plates, and how that dinner got there.
Are gluten-related disorders caused by something in the wheat? Has wheat changed significantly from the plant it used to be? Sometimes I wondered what would happen if I flew to a dig site in the Nile Valley, located an ancient king’s tomb, and found viable seed in a ceramic vessel buried with him. I concocted a whole food/science fiction mash-up in which I stuffed the wheat grains into my pocket Indiana Jones–style and hastily departed, careful not to trip over the corner of the king’s sarcophagus and hoping he’d had his fill of the wheat already, or that he was so far into his trip to the other side that it was impossible for him to reach out and curse me.
I returned home. I ground the grain into flour with the Cuisinart. Using emmer or einkorn flour, I proceeded to make a loaf of bread according to the Artisan recipe. Or I could go old-school and mix up a paste with water and salt like they used to do in Anatolia, back in the day, and slap it on a preheated brick in the middle of the Weber.
When the bread was done, I timidly put a piece of this truly ancestral food in my mouth while it still steamed. I chewed, savoring the nuttiness. Then I took a deep breath and swallowed. What now? Would my stomach bloat in gaseous rage at my stupidity? Would I rush to the bathroom? Would the neurological storm of headaches, brain fog, and mood swings arrive?
Or would I smile a few hours later, realizing that I felt completely fine, and proceed to make a Dagwood-style seven-layer monstrosity that I nearly had to unhinge my jaw to eat? Maybe a portion of French toast so monstrous that not even IHOP, that purveyor of glycemic excess, would put it on their menu?
And then, thus fortified, inspired, and returned to my proper place at history’s table, I could begin the search for ancient barley with which to brew beer…
Besides the fact that such a plot is impossible to carry out, the problem—or one of them—is that the conversation about the causes of celiac disease (and other gluten-related illnesses) among doctors, researchers, and advocates is complicated. There are many studies and no shortage of opinions. One of the thornier issues is the multiple ways gluten and wheat can be reactive and harmful: there’s autoimmunity (celiac, for which a person needs the genes and the trigger), wheat allergy (non-autoimmune, with typical signs of allergic reaction, like histamines), and gluten sensitivity (no antibodies, histamines, or genetic markers present, but well-being improves demonstrably when the individual cuts out gluten). Taken together, the three disorders appear to present a variety of negative effects gluten can have on some people, but they all potentially have different routes to pathogenesis. At times it seems as if the only statement those involved in the research seem to agree on is “We don’t know for sure why this is happening.” This is not what a person wants to hear, given the limitations of the “cure” for the foreseeable future.
Broadly speaking, there are three camps in the causation debate: There are those who believe that raiding an ancient king’s tomb for wheat would result in my procuring safe grain, because something, though we don’t know exactly what or why, is indeed making modern wheat more reactive. On the other side are those who believe that stealing ancestral wheat from a dig site would only lead to my getting glutened in a more elaborate, expensive, and entertaining way. This camp is interested in environmental factors, from modern hygienic practices to the way we raise infants so as to either bolster or compromise their immune systems. And then there are those who say the cause of celiac disease and possibly other gluten-related disorders is a combination of all those factors, a synergy between plant changes, alterations to our environment, and our habits. It’s not hard to find this third position especially grim, because it suggests that the conditions of modern life have gotten so complex so quickly—our food, environment, and medical practices—that our bodies (especially our immune systems) cannot keep up with the pace of the changes. This complexity not only makes it challenging to identify a single cause of intolerance to gluten, but also suggests that gluten may turn out to be only one of many reactive foods.
Some basic immunology is required to understand the arguments about how and why modern wheat appears to be different from ancestral varieties, and thus harmful. Proteins like gluten contain components called peptides, or chains of amino acids. While some peptides are harmless, certain ones can, in people with the proper genetics (i.e., possessing the specific HLA markers for celiac), function as antigens—that is, they cue an immune response in the body. The surfaces of peptides have regions called epitopes, responsive areas that fit into the HLA proteins like a key into a keyhole, in order to bind with proteins on immune cells called T cells. T cells recognize gluten peptides, and with the appropriate additional trigger, they become activated as the main players in causing the damage in celiac disease. Usually this destruction gets visited on a foreign invader, not healthy tissue; autoimmunity is a case of misrecognition, when the immune system fails to recognize its constituent parts—like the walls of the small intestine—as belonging to itself. With celiac disease, a confluence of the correct genetic markers and other, poorly under
stood environmental triggers must occur before the immune system fires up. Stress, surgery, illness, pregnancy, or some other event could serve as a trigger to initiate the adverse reaction to gluten.
Most of the discussion about the differences between modern wheat and ancestral wheat (and barley, spelt, and rye) emphasizes a specific peptide present in modern gluten proteins called 33-mer gliadin. Since the early 2000s, this peptide has been identified in the celiac response to gluten, though research suggests there are likely other immunogenic compounds in gluten, as well. Numerous studies overlap in their assertions that ancestral wheat and barley, and even grains consumed by humans as late as the Middle Ages, contained less of this peptide, and so the wheat those people ate presented less of a challenge to their digestion and their immune systems. The 33-mer gliadin peptide might even have been absent from ancestral wheat strains entirely. Some researchers have also noted that even as celiac-causing peptides are expressed at higher levels in modern cereals, non-celiac-triggering epitopes—the safer peptides—seem to be expressed less.
Nobody knows for sure why this has happened. Possible factors include the industrialization of agriculture, the use of pesticides, and the hybridizing practices that produce new strains of wheat. New wheat hybrids have been presumed safe for human and animal consumption, and so they often come to market with virtually no testing. Furthermore, the time frame in which the changes from wheat breeding have occurred, relatively speaking, is short. While wheat has gone through thousands of hybridizations in ten thousand years—there are some 25,000 cultivars—the pace accelerated markedly between the 1940s and the late 1960s, during and after the Green Revolution, which revolutionized wheat hardiness and yields. Some views hold that the rapid alterations to a plant that provides up to 50 percent of the calories consumed in industrialized countries (and an average of 35 percent of caloric intake) have far outpaced the abilities of the human gut and immune system to keep up.
The handling of the wheat could also be a factor, and so industrialized bread-making has fallen under some suspicion (though it’s important to remember that modern eaters consume gluten in many more forms than bread). Fermentation times in modern factory bakeries are shorter than those used before the late nineteenth century, when bread-making became automated. Less fermentation time might prevent detrimental peptides from breaking down; in some studies, slow fermentation with lactobacilli seems to result in sourdough breads that those with less severe (i.e., less sensitive) gluten-related disorders, including celiac disease, can tolerate. Meanwhile, other industrial food-processing practices have further modified the proteins in cereals, and it’s been argued that the rising rates of celiac disease might be driven by the availability of large quantities of highly refined wheat with a high content of gluten, or reactive gluten fragments.
To add further complexity, it’s also possible that other parts of the wheat plant beyond the glutenin and gliadin proteins are immunogenic. In a recent study, pest-resistance molecules in wheat have been observed to cause an innate immune response in people who carry the HLA genetic markers. Did these molecules naturally evolve, or were they bred into the plant? At this point, thousands of times removed from the earliest wheat cultivars, we’re unlikely to find out.
Finally, the changes to wheat may be especially important since modern eaters consume high levels of gluten. At first such a claim appears to fly in the face of the historical data on bread consumption, which—the recent increased demand for artisanal bread and revival of small bakeries to the contrary—is at its lowest point in thousands of years (excluding times of famine, war, and natural disasters). But eaters who depend on processed and prepared foods because time, money, or both are short might in fact be consuming as much or even more gluten than a working-class eater in nineteenth-century England or France. It is a tough case to make numerically because the exact amounts are difficult to measure and are specific to each individual’s diet. It is possible to estimate, though. The average slice of whole-wheat bread contains about 4.8 grams of gluten. In addition to the obvious wheat flour, most commercially produced breads (and breading, bread crumbs, etc.) contain vital wheat gluten, a concentration of the protein that increases the elasticity of industrially made loaves and improves shelf life. Slice for slice, mass-produced bread might pack more gluten than the bread our ancestors ate. A typical serving of pasta contains 6.1 grams of gluten. And so it becomes easy to see how Europeans consume, on average, 10 to 20 grams of gluten per day, with some people ingesting as much as 50 grams if they’re following a Mediterranean or Middle Eastern diet (or drinking a lot of beer). Fifty grams might not sound like much, but that quantity would exceed my threshold for damage 2,500 times. According to the National Foundation for Celiac Awareness, 0.1 grams of gluten—the equivalent of 1/48th of a slice of bread—will do enough damage to a person with celiac disease to show up on a biopsy.
Vital wheat gluten, in particular, is an interesting consideration. It has contributed heavily to the increase in gluten consumption in the United States since the 1970s, which by some estimates has tripled. The increased usage of vital wheat gluten came when whole-wheat breads and other products began receiving praise for their positive health effects. Whole-grain breads presented a challenge for industrial-scale bakers, though: they stale and toughen up faster than breads made from highly refined flour. Vital wheat gluten was the solution. Even researchers who do not think wheat breeding itself has any causal role in celiac disease find the correlation between increased vital wheat gluten consumption and the rise in celiac disease interesting, and worth more exploration.
An eater can add up the gluten in his bread and pasta, but the rest he eats is likely to be hidden. Wheat goes into all kinds of premade sauces, from Asian condiments like ponzu and teriyaki to cheese sauces, salad dressings, and marinades. There is wheat and/or gluten in imitation crab, cream-based soups, sausages and hotdogs, and vegetarian “meat,” some of which is nothing more than a brick of gluten. Malt extract from barley is in Rice Krispies (and in other non-wheat-based cereals, cookies, and prepared desserts), and most other breakfast cereals—whether in flake, granule, dinosaur, or animal shapes—are made of wheat. Anything hit with brewer’s yeast or malt vinegar carries gluten. Licorice, Reese’s Peanut Butter Cups, most processed desserts and snacks, and hard candies can all contain gluten, as do some protein shakes, nutritional drinks, smoothies, vitamins, supplements, and medications. A trace amount turned out to be in the Augmentin I was once prescribed. In the midst of acute GI distress I called the manufacturer, who told me that the drug tested to be GF, but one of the inactive ingredients was derived from wheat.*1
Finally, there are sources of wheat and gluten that are not in food, but which a person still might ingest: cosmetics, shampoos, Play-Doh, the glue on the flaps of envelopes. The most extreme case of gluten poisoning from an unlikely source that I have ever heard of occurred in 2012, when forums on celiac-disease websites lit up over the story of a girl whose GI symptoms persisted despite a strict elimination diet. Careful investigation eventually revealed that the polymers in her orthodontic retainer were derived from wheat, leaching into her saliva, and causing a reaction.
—
There are some problems with the modern wheat hypothesis, though. Anyone who believes that the ancient physician Aretaeus accurately diagnosed celiac disease around 100 AD must also accept that the triggers for celiac disease existed in the wheat and barley. They might have been less concentrated, though. The HLA immune-response genes may not have been as prevalent in the population then, either, meaning that fewer people reacted to the harmful peptides.
One thing we can say for sure: while hybridization may play a role, genetically modified (GM) wheat is not the cause of gluten-related disorders. Hybridization occurs via the crossing of plants; genetic modification requires a laboratory to alter the genome of a plant so that it expresses traits that are not inherent to it. As of 2015, in the United States, Canada, and the European Union, there is no GM
wheat on the market. That doesn’t mean that bioengineering corporations haven’t tried to introduce GM wheat, because they have, and it doesn’t mean that they won’t try to introduce it again, because they will. By some forecasts, GM wheat could enter into the regulatory process within the next five years.
In fact, the resistance to the bioengineering firm Monsanto’s attempts to introduce GM wheat in Canada in the late 1990s and early 2000s highlights how wheat is still viewed as sacrosanct in contemporary culture. Monsanto’s GM wheat strain was modified to tolerate Roundup, also known by its generic name, glyphosate. “Roundup Ready” or “RR” crops tolerate doses of this pesticide (technically, it’s an antimicrobial) that are lethal to weeds, allowing for blanket treatments. It’s an efficient means to reduce competition for soil nutrients and sunlight, and glyphosate has been regarded as safe by the Environmental Protection Agency for years, although recent scholarship has suggested that it may not be as benign as initially believed. In 2014, the herbicide turned up as a possible cause not only of celiac disease itself, but also of gluten sensitivity. It is an effective desiccant used for “drying down” crops to speed them into processing. A review article hypothesized that malabsorption in carnivorous fish had been caused by glyphosate because its antimicrobial properties also targeted bacteria resident in the gut; the same might be happening in humans who come in contact with glyphosate. The problem with the review, as the study’s critics pointed out, was that the levels of glyphosate the fish were being dosed with were extremely high. Nonetheless, the World Health Organization’s research program recently declared the herbicide a probable carcinogen, independent of the celiac-causation studies.