Diets and diets

Daniel Engber has an interesting article up in Slate today about gluten-intolerance. Well, I wouldn’t call it a news article so much as a review-plus-editorial, really. But still, thoughtful and interesting.*

This article made me feel defensive. I don’t have Celiac Disease or a gluten-intolerance, but I do have an autoimmune digestive disease, and like many people with such illnesses, I have had to live with my share of food intolerances and a pretty sensitive gut. I started feeling the painful effects of lactose intolerance pretty young (and that was while continuing to eat a steady quantity of lactose-containing foods, not after increasing or decreasing my consumption). My intestine really just sucks at some things.

And there is some evidence that diets that restrict certain difficult-to-digest foods might alleviate symptoms (long-term, not just as a short-term effect like the one Engber describes) of these kinds of diseases. A popular diet to try for this “treatment” is the alleged research precursor to the gluten-free diet, now known as the Specific Carbohydrate Diet. The SCD is extreme and it is difficult to maintain; and because of the side effect of food restriction that Engber discusses in some detail in his article (that your body rapidly stops producing digestive enzymes you no longer need), it is actually dangerous to start and stop the SCD in fits and starts, if you have an immune disease that is triggered by the presence in your gut of substances you can’t properly digest. It’s practically a one-way ticket to a major flare-up. That said, unscientific as it may be, the patient testimony is impressive: done strictly**, the SCD may have success rates for maintenance of remission that are not unlike many of the medications prescribed for autoimmune digestive diseases (how much it can do in an active flare is less clear, I think). I don’t recommend the SCD or think doctors should prescribe it, because it is so difficult, but it probably does work.

I was a patient on the SCD for three years and saw a long-term lessening of symptoms and very long remissions of my disease. I have now reintroduced almost all of the restricted foods (hooray!) and am still in that remission, though sooner or later I will probably have another flare-up, and would have even if I had stuck with it (the diet is not a cure. There is no cure). Reintroducing foods after being on that kind of diet is tricky, no doubt about it, and I do believe that’s related to the issues Engber raises about how enzymes work in our digestive systems. But I don’t especially regret that.

The fact that “going G-free” means eating fewer cupcakes and less pasta suggests another source of relief. It is, after all, an elaborate diet—and so delivers all the psychological benefits of controlled eating and self-denial. “Once G-free, you are no longer simply robot-eating bag after bag of pretzels,” writes Hasselbeck, in a chapter of her book titled “G-Free and Slim as Can Be!” Gluten intolerance may be a medical condition, but according to Hasselbeck, it’s also an approach to eating—like South Beach or Skinny Bitch—that’s supposed to make you lose weight and feel good about your body.

Here he hits the nail on the head. Well, on the one hand, some people will use any new trend or idea to push weight loss, and for a profit. But that’s not what I mean. The mentality that comes along with being on a strict, restrictive eating regimen for disease management is essentially the same as the one that pops up with any weight loss dieting (including “lifestyle changes”), and they are both basically the same as the psychology of disordered eating. Honestly, it took a long while before the SCD was so second-nature that I stopped thinking about it. But I think that while “dieting for health” (ugh, I hate to call it that. I do not think healthy = thin; I’m really only talking about disease management) can absolutely lead a person into obsession and orthorexia, it is nonetheless different in some ways: If you are truly removing a few foods from your daily diet because they make you extremely ill, there’s no reason to reduce everything else. And it’s not about guilt or being a bad person if you mess up — it’s about not putting yourself in agony or even in danger. When it’s really, truly for your health, because you will hurt or be on an operating table or die otherwise***, 1) it is much more of a necessity, and 2) there’s no reason to stop enjoying the rest of your food, or to stop figuring out filling, satisfying substitutes for the things you can’t eat anymore. That’s why after a while I was able to stop thinking about it and to get back to a mentally healthier place. I wasn’t reducing quantity, I was still getting every necessary nutrient (the diet is decidedly not low-carb), and I was enjoying my food and eating until satiation every day. Intuitive eating is decidedly more difficult but is possible while on a gluten-free diet.

Frankly, overall I think I benefited from trying a poorly studied and controversial dietary treatment. Maybe that was dumb luck. But my gut had a chance to heal (a result that Engber acknowledges) and that did me worlds of good. I don’t know if I’d put myself through it again, but I am probably today at a lower maintenance medication dose than I would be otherwise. (If you don’t know how medicating works with autoimmune diseases: many of those illnesses become drug-dependent, so that over time you need stronger and stronger medication to treat flares and maintain remissions. Staying in remission on a low dose of one of the less-nasty treatments is a huge long-term benefit.)

I’m also a scientist. The graphs Engber includes in his article are compelling, though I wonder how big those spikes are when the y-axis isn’t normalized, or when you consider any of the hundred other factors that might have been occurring concurrently. Assuming causation there because the peaks line up (what is with the time lag in one plot, though, and not in the other?) is fun and exciting for my brain, but it isn’t the best science. I do like to do the best science!****

For what it’s worth, the additional expense of eating gluten-free (which I basically did for a long time, even after leaving the fanatical SCD) is minor. Rice pasta is pricey but rice itself is cheap, and in a pinch I could have been making a lot more straight-up rice and still been eating filling, tasty foods. And I wouldn’t take a dietmonger’s advice on how to eat G-free to lose weight as normal behavior among people who don’t eat gluten – a great many people are not embarrassed about our needs and would never throw a cookie on the floor because somehow that would be less rude than just politely saying “no thanks.” And only assholes are annoyed because their friends, family, or guests have allergies. Get better friends.

Ironically, the people who may benefit most from the current vogue are those who have been G-free all along. The proliferation of gluten-free products has made life for a full-blown celiac easier than it’s ever been, and a greater awareness of gluten-related disorders has more celiac patients getting diagnosed than ever before. (There are still thought to be millions of undiagnosed cases in the United States.) Let’s hope those gains aren’t erased when the conventional wisdom shifts again and we leave this diet craze behind us.

This is a major reason I’m writing this post. I suspect Engber has not personally been gluten-intolerant, or made meals regularly with someone who is. That proliferation of products means that if you truly cannot eat wheat, your life is now SO MUCH EASIER than it was 5 or 10 years ago. And going after gluten-free products as superfluous seems misdirected. People DO benefit immensely from the widespread and ready availability of those foods. Maybe only 1% of people, but that’s still a lot of people. I frankly do not care if those foods are so much more available now because there was a fad diet that made them popular.

The diet mentality goes much deeper than gluten-free, or lactose-intolerant, or whatever-the-hell is the latest not-well-tolerated food (that might or might not follow the latest diet craze that eliminated that same food). Dieting is socially pervasive, and predicated on this weird systemic belief that we are all incredibly unhealthy and that that makes us bad people. (Oh and unattractive, which makes us even worse people.) Self-denial is penance. If you try to point out that we are living longer, healthier lives than ever, they want to plug up their ears and yell LALALALA. Oh and Daniel Engber, I’m sure the continuation of these mindsets and promotion of fad diets has nothing whatsoever to do with anyone in your line of work. Just saying. (Though I don’t mean you. You’re pretty okay.)

* The title annoys me, though. No, we are not being “too tolerant of gluten-intolerance.” People deserve compassion and, yes, tolerance for their needs and choices. What are you going to do, shame someone for not eating gluten?

** The motto of people on the SCD is “fanatical adherence.” Not even joking.

*** No, “obesity” really doesn’t count, and if you don’t know why, go here or here, to start.

**** There is something to the gut flora argument, however. Even post-SCD but still gluten-free, my microbes were not happy campers. Well, some of them were. Just not the ones I wanted. Anecdatal support!

w00t

My fabulous friend, an other volcanista, has alerted me to this exciting news: Dr. Marcia McNutt has been nominated by President Obama as Director of the USGS!

The Department of Interior press release and her website both report many details about Dr. McNutt’s career, but I want to repeat some of them here. McNutt got her PhD in geophysics from Scripps, worked at the University of Minnesota and the USGS (on earthquake prediction), and then held a faculty appointment at MIT, where she was the Director of the MIT-WHOI Joint Program. She served as President of AGU (the ginormous geoscience society with its annual December Geoscientists-Take-Over-Frisco meeting) from 2000-2002. She did lots of other prestigious things along the way that you can go read about, and lately has been the president of the Monterey Bay Aquarium Research Institute.

McNutt is the first woman ever nominated to run the USGS. Finally. And she is also fucking awesome.

Paleoclimate students arrested

Kim at All of my Faults is passing on the news that U.S. and Brazilian students conducting paleoclimate research have been arrested in Brazil, presumably for not having all the correct paperwork, and could be held there for months to years pending trial. There is an open letter here, and you can email to co-sign the letter to Brazilian authorities. Please pass on the information.

ahhhhhh

*pop*

Today there was a big NPR headline smack in the middle of my Facebook home page. I usually ignore intrusions by companies into my Facebook page on principle, but in this case I smelled a blog post topic, so I clicked away. I have a good nose!

Now, studies that discover new things about what different cells do in our body are great, and interesting. I’m glad scientists are studying what brown fat cells do in adult bodies. I also know, as a scientist, that to some extent everyone pads their conclusions to be relevant to hot topics where possible (origin of life and paleoclimate have been hot ones in geoscience for a while), because it increases the chances of getting funding. Hot topics are usually where the money is. So I’m not entirely surprised that the scientists who discovered brown fat cells are related to metabolism included some conclusions about the implications for weight loss. There is money in that these days.

Weight loss sounding like the whole motivation for the study (and implied follow-ups) bothers me more. Weight loss as a goal is bad for people. And the results of this study are a little bit terrifying. Next up: The Biggest Loser: Antarctica! Where contestants have to work out with their insane trainer in the miserable cold to activate what little brown fat cell activity they have!* And if that doesn’t work, well, by getting so damn fat they must have lost those cells, so it’s their own fucking fault. And everyone is getting fatter, so that’s a problem. Don’t you dare lecture me on causation, either, that’s a perfectly logical argument! Don’t talk to me about how fatness is inherited so there’s no blame to place, either. LALALALALA.

(Injecting people with fat cells sounds pretty risky to me. The article doesn’t talk about any of the potential risks. As a non-biologist and non-doctor, I’d like that information. That’s the kind of thing these articles always lack – you know, Science and stuff. But that would be boring. We have to tell people about weight loss!! Weight loss sells!)

Anyway, I’m being silly. After all, if people sit in cold rooms, they’re just going to eat more, and we all know that fat people just eat more and worse, and that’s why they got fat. Consumption totally correlates with body size. And cold. Everyone eats more when they’re cold. THAT’s at least true.

GAH. The stupid, it burns.

* I say that as a JOKE, but let’s just watch and see what comes out next season.

Awesome

Photograph of lightning from Redoubts 1:20 am, March 28 eruption, courtesy of Bretwood Higman.

Photograph of lightning from Redoubt, 3/28/09, courtesy of Bretwood Higman.

The Volcanism Blog has put up a heads-up about some spectacular Redoubt plume lightning pictures that have gone up at the AVO. I LOVE plume lightning pictures!

Redoubt update

Webcam image from March 23, 2009 19:55:58, Alaska Volcano Observatory

Webcam image from March 23, 2009 19:55:58, Alaska Volcano Observatory

My laptop is being repaired, so I’m internet-less at home right now and a bit behind on the reporting. Eruptions and the Volcanism Blog are on top of this, though, so I suggest you read their excellent posts since yesterday afternoon. I’ll offer a brief summary, based on the information available from the AVO so far: The Hut webcam came back online yesterday afternoon and has provided some good pictures of a sixth explosive blast from Redoubt’s summit. A video recap is available here. There continued to be small eruptive blasts after the first five major ones, and an overflight was conducted yesterday afternoon. There are AVO photos here, some of which show that the increased meltwater caused flooding at the margins of the Drift glacier and mudflows on the upper Drift River. Following the sixth explosive eruption there were more mudflows and also pyroclastic flows on the north flank of the volcano.

Photos of the flooding in Drift Valley and tephra deposits from the eruption of Redoubt Volcano, March 23, 2009 (McGimsey, Game, AVO/USGS)

Photos of the flooding in Drift Valley and tephra deposits from the eruption of Redoubt Volcano, March 23, 2009 (McGimsey, Game, AVO/USGS)

Massive flooding in Drift Valley from the eruption of Redoubt Volcano, March 23, 2009 (McGimsey, Game, AVO/USGS)

Massive flooding in Drift Valley from the eruption of Redoubt Volcano, March 23, 2009 (McGimsey, Game, AVO/USGS)

Eruption at Redoubt

NCT EHZ AV

NCT EHZ AV Seismic Station, Mt. Redoubt, March 23, 2009 04:24:35 (AKDT)

After months of elevated activity and waiting for a likely eruption, Redoubt has gone to Color Code RED and had four explosions recorded since last night. The Volcanism Blog has reported quite a few of the details during the night. Ashfall from the 50,000 foot plume should start this morning in affected towns (not expected to include Anchorage). The AVO doesn’t have photos of the eruption up yet, I assume because it’s dark, but there are some great seismics, and there is a good map of the plume on Weather Underground. Ash advisories for locals can be found at NOAA. The eruption appears to be ongoing with continuing strong tremors.

ETA: RSO, the closest seismometer to the summit, stopped transmitting at 4:15am local time. Exciting!

Hunga Tonga-Hunga Ha’apai

Hunga Tonga-Hunga Ha'apai, March 18, 2009

The Volcanism Blog is reporting on the eruption occurring at Hunga Tonga-Hunga Ha’apai, complete with pictures and a link to a great BBC video. As described in the first link, this is pyroclastic activity interacting with seawater. It is spectacular!!

Back to Redoubt

Well, after all that, apparently Redoubt is not quite done.

Summary: Mt. Redoubt showed an increase in activity (new fumarolic and generally increased gas emissions, elevated seismicity) a few months ago, and kept it up for a while with no actual eruption. The activity suggested magma was on the move, so it was monitored closely. The media got very excited. The volcano stayed in something of a “holding pattern” for a few more weeks, and then last week it calmed back down – although the new degassing continued, the seismicity decreased.

But it was just tricking us, or maybe it liked the attention. Yesterday it had new tremors:

Volcanic tremors at Redoubt

Volcanic tremors at Redoubt; image from the Volcanism Blog!

…and put out a 15,000′ steam plume:

Redoubt plume - March 15, 2009

Redoubt plume - March 15, 2009

…with no ash ash that may be old, so technically not necessarily an eruption. The internet is suggesting a phreatic blast, which would make sense. But eruption or not, it’s a large burst in activity nonetheless, bumping it back up to aviation code Orange and alert level Watch. More details at Eruptions and the Volcanism Blog.

YES

Why doctors hate science!!

I have been fed up with the medical establishment for what feels like a decade over this issue now. It needs lots more attention, but I’m really glad that SOMETHING is happening, even if it’s just a small step in the right direction. (What I want to see next: maybe some on-the-job training of practicing doctors that is NOT provided entirely by big pharma. I know, I can dream.)

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