As a co-founder of the Los Angeles Bread Bakers I go to a lot of public events where someone will walk up to me and announce that they are gluten intolerant. Their stories of getting off bread have the flavor of a religious conversion. My defensive reaction (I help run a bread club, after all) smacks of religious zealotry.
We know with a great deal of certainty that gluten intolerance in the form of celiac disease effects slightly less than one percent of the population. That actually makes it one of the most common
allergies disorders related to food. But a much larger percentage of people self-diagnose as gluten intolerant who do not have celiac disease. Peter Gibson, a professor of gastroenterology at Monash University and director of the GI Unit at The Alfred Hospital in Melbourne, kicked the gluten intolerance self-diagnosis trend into overdrive with a 2011 study that showed a large percentage of the population (those without celiac disease) as having a problem with gluten.
Gibson decided to take another look at gluten intolerance and construct a much more rigorous study in which all the meals were provided to the subjects and all urine and feces were analyzed. An article at Real Clear Science summarizes the results:
Analyzing the data, Gibson found that each treatment diet, whether it included gluten or not, prompted subjects to report a worsening of gastrointestinal symptoms to similar degrees. Reported pain, bloating, nausea, and gas all increased over the baseline low-FODMAP diet. Even in the second experiment, when the placebo diet was identical to the baseline diet, subjects reported a worsening of symptoms! The data clearly indicated that a nocebo effect, the same reaction that prompts some people to get sick from wind turbines and wireless internet, was at work here. Patients reported gastrointestinal distress without any apparent physical cause. Gluten wasn’t the culprit; the cause was likely psychological. Participants expected the diets to make them sick, and so they did. The finding led Gibson to the opposite conclusion of his 2011 research:
“In contrast to our first study… we could find absolutely no specific response to gluten.”
Nocebos, incidentally are placebos with a negative effect. If I tell you you are going to get sick there’s a good chance you will. All human beings are highly suggestible. How powerful are placebos/nocebos? A recent study showed that placebos/nocebos work even if you tell research subjects they are taking a placebo/nocebo.
What’s important to note about the nocebo effect is that it results in real physical ailments. Ioan P. Culianu, professor of divinity at the University of Chicago used to quip, when asked about the subject matter of his research (Renaissance magic and the occult), “It’s all in your head.” And then he would wink. His point? We don’t take seriously enough the life of the mind. We dismiss the placebo/nocebo effect as, “just being psychological.” And because it’s “psychological” it’s not “real.” We forget that what goes on in our heads has real world implications.
I think, many people are having a spiritual crisis as a reaction to their unhappiness and dissatisfaction with the modern world and the industrial food system. This system is making us sick both physically and spiritually. This crisis is manifesting as non-celiac gluten intolerance and other real health problems. The placebo/nocebo effect was known to the Renaissance magicians that Culianu studied, such as Giordano Bruno. It’s known to all shamans and spiritual healers. It should be taken seriously.
Manipulation of feelings and emotions in realm of our minds (done everyday through advertising, by the way) can be used for both good and bad. Bruno even wrote a treatise on the subject, De vinculis in genere (On bonding in general). But Bruno and other philosophers of his time took metaphysical matters seriously. In our modern world we value only the material, which is how our lack of awareness of the nocebo effect can get us into trouble. The only people truly aware of the power of the placebo/nocebo effect in Western culture are advertisers and they are largely black magicians. Advertisers harness the nocebo effect of our gluten fears, reinforce those feelings and then use them to sell us products we don’t need.
The nocebo effect raises some thorny questions. If I open a toxic waste dump that creates a psychological feeling of unease that in turn causes people to get sick am I a “psychological polluter?” Am I liable even if I don’t leak any toxic waste? Again, the illnesses are real and the people getting them aren’t crazy.
Back to gluten, there may still be a gastrointestinal problem with wheat, Gibson is careful to note. But he doesn’t think it’s gluten. Ever in defensive mode as a bread enthusiast, I have an unproven theory that the way we make bread may be contributing to the problem. Perhaps the pre-digestive power of sourdough cultures, ancient wheats and baking bread longer may have an effect on how our bodies process bread. But there’s no research yet to back up my idea.
As to the power of the mind, like sourdough it’s also about culture, but culture in the non-physical sense. On that note, we’ve got a lot of work to do. Thankfully we can harness the placebo effect to do a lot of good. That will have to be the subject of another post.