Will I become a world-class athlete—or will thinking so make it better?
The use of a gluten-free diet by famous people has enhanced its appeal. Publicized by Hollywood stars, it has also been endorsed by several high-profile athletes. The reasons behind this speak to our infatuations with celebrities and fad diets, and wanting to believe something enough to think it works—the placebo effect.fn1
An Australian study of nonceliac athletes, including eighteen world and/or Olympic medalists who followed a gluten-free diet 50 to 100 percent of the time, reported that self-diagnosed gluten sensitivity was the primary reason for adopting the diet. The leading sources of information on the gluten-free diet were online, a trainer/coach, and other athletes. Neither the diagnosis nor treatment was based on medical rationale, merely the perception that removing gluten provided “health benefits” and an “ergogenic edge.”
If you do not have chronic symptoms that require medical treatment, the gluten-free diet can be both placebo and minefield. We advise staying tuned to your local news for updates—the latest dietary trend may be announced on Entertainment Tonight.
If you are looking for more realistic scientific advice, the following chapters will explore what taking gluten and other foods out of your diet will really do to and for your body.
Picky Eaters—Orthorexia and the Hygiene Hypothesis
Water surges, only to overflow.
—CHINESE PROVERB
Things turn into their opposites when they reach their extremes. And “healthy” eating is moving in that direction.
There are good reasons that we have food on our minds. According to the U.S. Centers for Disease Control and Prevention (CDC), half of all Americans have a chronic disease or condition such as high blood pressure, heart disease, or type 2 diabetes and have been instructed to think about fat, sugar, and/or salt. More than 9 percent have diabetes and must monitor their sugar/glucose intake multiple times every day. At least 35 percent of Americans are obese and cycle through different diets, gaining and losing weight every year. About 1 percent has celiac disease and avoids gluten. Up to 15 million people in the U.S. have a food allergy, estimated to affect 1 in every 13 children under the age of 18. A study by the World Health Organization reported that noncommunicable diseases were responsible for 86 percent of all deaths and 77 percent of the disease burden in the European Region and noted that this primarily included conditions caused by high blood pressure and cardiovascular diseases. Three of the priority interventions recommended were dietary.
Unfortunately, the National Eating Disorders Association notes that 20 million women and 10 million men suffered from a clinically significant eating disorder at some point in their life, including anorexia nervosa, bulimia, binge eating, or an eating disorder not otherwise specified. In the UK, a National Health Service (NHS) study estimated that more than 725,000 people are affected by an eating disorder and that eating disorders can affect people of any age.
The current obsession with food is not surprising; mankind has been on some kind of restricted diet—by need or choice—since the beginning of time (see Appendix A), but for some it has taken a turn into the obsessively unhealthy.
Orthorexia Nervosa—Healthy Eating as a Disease
Food is an important part of a balanced diet.
—FRAN LEBOWITZ
I don’t like anything “lite”—that’s not my thing. I have one friend who goes to a chiropractor who tests you, and they take one thing after another out of your diet. He evaluates what you eat and decides what foods your body is not tolerating. She’s currently living on kale.
(ILYSSA, 39)
The focus of the press and social media on “healthy eating” as the source of, or cure for, disease has taken hold to the point of creating a new condition termed orthorexia nervosa. Individuals eliminate one healthy food after another (gluten, corn, soy, meat, dairy, all fats, carbohydrates, etc.) in the belief that these foods are “unhealthy”—until they are barely receiving adequate nourishment. It can reach the point of anemia, bone loss, vitamin depletion, and malnutrition.
The condition is not as yet recognized in the DSM-V (the Diagnostic and Statistical Manual of Mental Disorders, used professionally to diagnose psychiatric disorders) but is being seen by many doctors evaluating patients for symptoms related to nutritional deficiencies.
The term orthorexia was coined by Dr. Steven Bratman from the Greek ortho (correct or proper) and orexis (hunger or appetite). Unlike in anorexia, those with orthorexia focus on the quality rather than the quantity of food eaten. They start removing foods because they do not feel well, and when they do not feel better, they remove more and more until they are on an overly restricted and generally unhealthy diet.
Are You Orthorexic?
Have you eliminated entire food groups from your diet? (Gluten, dairy, corn, and soy are the usual suspects as well as red meat, carbohydrates, etc.)
Three or more food groups?
Do you constantly worry about which foods may be unhealthy?
Do you feel guilty when you eat food you consider unsafe?
Do you have problems finding healthy foods?
Do you have ritualized eating patterns?
Are you anxious when eating out or traveling?
Have you started avoiding lunches, dinner dates, and catered parties?
Do you lecture your friends and family about unhealthy eating?
Do you read medical journal articles about digestion, carbohydrates, protein, etc.?
Do you challenge others who disagree with your food choices?
Do you wish that you could just eat and not worry about the quality of foods?
Do you have symptoms that do not fit any medical diagnostic category for which you blame gluten, dairy, or a specific food?
Orthorexia affects a small percentage of individuals, but is yet another food-related disorder that has evolved from the increased focus on food as cause and/or cure for symptoms and disease.
The Hygiene Hypothesis—Are We Too Clean for Our Own Immunological Good?
My daughter-in-law sterilizes everything that goes into my grandson’s mouth. I raised four children on the 10-second rule—if it’s been on the floor for less than 10 seconds, pick it up and eat it—and not one had an allergy or food issue. Now we’re boiling the baby’s fork and spoon after it comes out of the dishwasher, and every other person’s child is allergic to peanuts or dairy or gluten. Something’s wacky here.
(GERI, 64)
The diagnosis of allergies and autoimmune diseases has risen dramatically in the last few decades. While there are many underlying and complex mechanisms at work, a great deal of scientific interest is being focused on the “hygiene hypothesis.” This states that childhood exposure to germs and certain infections helps the immune system develop normally, and that excessive cleanliness