Sunday, May 20, 2012

Wheat a to-do about Gluten!

Believe me, I got lots more where that came from... and there is a pioneer bread pudding at the end of this, but let's go all Part Two and cerebral for a moment to look at a timeline of gluten as a medical issue in human history. 

Let me introduce this by recapping from my previous blog that wheat originally came from Asia. It went forth into China and Egypt etc etc. It landed in America by way of Chris Colombus (the explorer, not the film director) in the 15th century. So sensitivity to wheat has been around a long, long time, but most common among those of European ancestry, because for these peoples wheat was introduced into their diet, and not a natural part of it as in those civilisations who had eaten it for thousands and thousands of years - it's a theory, and it's a good one.  And all of us sensitive European types probably would have done a lot better with it but for those rolling flour mills and the hybridised strains I mentioned last time which killed it for us (that's my theory). Moving on...

You gotta love those ancient Greeks. In the 2nd century, Greek physician Aretaeus of Cappodocia first described the trouble some people had with gluten. His work was translated by Francis Adams in 1856, and in the chapter called "The Coeliac Diathesis" we find the crux of the matter. If you don't like medical details, turn away now... He describes fatty diarrhoea (I can't even begin to imagine the analysis that went into that), and weight loss and pallor, in people of all ages.

The word 'coeliac' is derived from the Greek word 'koiliakos' and it means 'suffering in the bowels'. Let me quote here from the work of Aretaeus as translated by Adams, the chapter on the Cure of Coeliacs: "If the stomach be irretentive of the food and it pass through undigested and crude, and nothing ascends into the body, we call such persons Coeliacs".

(You can come back now.)

You see, apart from the gluten making us sick, if food doesn't get absorbed, we don't thrive.

Let's see what happened next.

In 1888, Samuel Gee, a British paediatrician at St Bartholomew's Hospital wrote up the "affection" as "a kind of chronic indigestion", noting the "wasting, weakness and pallor of the patient". He recommended correcting the patient's diet was the way to cure the patient of this bowel complaint, which was then called non-tropical sprue, sprue being chronic nutrient malabsorption.

Between 1908 and 1924, paediatricians in Britain concentrated on this coeliac condition in children. So, over a period of months and years, they changed the diet of these patients and by introducing different kinds of foods in stages they determined that fats were better tolerated than carbs. Carbs, including bread and cereals, were the last to be introduced. Of course, here were the culprits. In 1924, the famous banana diet by Haas was recommended for people with gluten issues and it was used widely until the next stage in the unravelling came about in the Second World War.
Let's face it, bananas are just good for everything. When they don't know what to do with you, they stick you on bananas - I remember that from when I was a kid. If I woke up peckish in the middle of the night, my mother would feed me a banana. My sister had very bad asthma - they fed her bananas while they worked out what caused it.
Where were we... This, now, is so typical of how human beings find out about stuff (it's good, because it shows someone is paying attention). Due to the shortage of wheat in the Second World War in Holland, Dutch paediatrician (gosh, I'm tired of typing that word, it's so damn tricky) Willem Dicke, realised that children with gluten issues who had to eat other things instead of wheat were on the improve. When wheat was back on the menu after the war, these children went down hill again with symptoms of gluten intolerance.

In 1954, Dr John Paulley discovered the abnormal change in the lining of the small intestine for coeliacs; on a gluten-free diet, the lining returned to its normal state. This was very significant now, for doctors developed ways to stick tubes down patients and take biopsies of their sad and sorry insides. One such doctor was Dr Margot Shiner.

For next two decades nothing really helped advance the understanding of why gluten wrecks the lining of the small intestine. They threw some molecular biology at it, due to the advent of the study of DNA, so they were trying.

In 1990's there were lots of advancements and more understanding of the condition. A blood test was developed. In 1992 and 1993, optic fibres were invented to do the job of the tubes. Labelling laws helped people identify which foods contained gluten. An anti-endomysial antibody test came into use and a tissue transglutiminase antibody screening test.

It's all very interesting (snap out it - timeline's over)...

So why does gluten wreak havoc in  the small intestine? I'm going to quote direct from the source,, but just note this: gliadin is the culprit... read on:

"When gliadin in gluten becomes water soluble, it is free to bind to cells in your body. If you are sensitive, your body will make antibodies to gliadin and attack the cells gliadin has attached itself to, treating those cells as an infection. This immune response damages surrounding tissue and has the potential to set off, or exacerbate many other health problems throughout your body, which is why gluten can have such a devastating effect on your overall health, causing inflammation, diarrhoea, nausea and abdominal pain."

CONCLUSION (yes, there is one):

Back in 1883-85, in the time of The Liberty & Property Legends, and according to the timeline, Dr Jennifer Sullivan would have had a certain small amount of knowledge about non-tropical sprue; she would have been aware of the failing health of children and adults due to their diet and very likely advised her patients to correct it. She would have called them coeliacs. She would have known this from her own observations of their health, as well as the knowledge provided by Francis Adams' 1856 translation of the work of the ancient Greek physician, Aretaeus of Cappodocia.

The important work of Samuel Gee et al was still to come, but a good doctor always observes their patient and asks questions, and Dr Sullivan was a very good doctor, particularly with children, as we know.

Gluten intolerance was present in the population, but not to the extent that it is today because back then the population didn't consume over-refined, hybridised and/or genetically modified wheat. 

According to
"The hybridisation and genetic engineering of wheat has resulted in a staggering 500 fold increase in the gluten content of modern day wheats compared to the wheat our forefathers would have known."

One thing we clearly need to be aware of: stay as far away as possible from genetically modified wheat. Use organic flour and products wherever possible. And try to cut back on the amount of gluten in our diet.

We've gone from a few gluten-intolerant people in the population to an explosion of people affected! 

My GIO (gluten intolerant one) experienced mysterious symptoms of fatigue, stomach ache, bloating, pallor, headaches, lack of energy and feeling ill, before a gluten-intolerant friend suggested that she try 'going gluten-free'. It worked. Just as in times gone by, she eliminated those foods, felt better, ate them again, felt ill again... got better again! But the GIO is not a coeliac (as determined by a genetic test), meaning the consumption of some gluten may not cause symptoms. She has to be careful. She reserves the consumption of gluten for her very favourite wheat-based foods and then only a small amount. In our house we substitute all wheat-based foods for gluten-free versions, including pasta, pizza and baked goodies, although the GIO has her own gluten-free bread or bakes her own. More and more gluten-free goods are appearing on the supermarket shelves, which is good for our family and many others obviously, but what is it saying about the food the population as a whole is consuming in the 21st Century?

The millstones and the water-wheels and the poor old donkey clip-clopping in a circle may look quaint and olde-worlde to our eyes, but in actual fact they signify a time when that staple food of life - wheat - was better for us.


Ready for the pud?
Note: I used gluten-fierce bread. My GIO was not even given a sniff of this pudding because as yummy as it turned out to be, it wouldn't have been pretty if she'd eaten a bite of it!

Here we go...
bread, cubed - 2 cups
raisins - 1 cup
eggs, lightly beaten -2
butter - 3 tablespoons
vanilla - 1/2 teaspoon
sugar - 1/4 cup
milk, scalded - 2 cups
small pinch of salt

Place in buttered dish. Let's face it, bread pudding ain't rocket science, but four words!

Yes, that's all the instruction there is in this recipe, so I suggest you do similar to me and that was slice the bread, butter it and cube it and place in baking dish. Scald the milk and add slowly while lightly whisking the beaten eggs to make the custard mixture. Add the sugar, and the vanilla (which is extract in my pantry.) Now you have the custard mixture to pour over the buttered bread cubes in your baking dish.

I also squished the bread down in the custard mixture, so the bread took up the mixture. You can add the raisins - you know me and raisins, not really a fan, so in my dried-fruitless world I wouldn't add them, but I did follow the recipe and dutifully added a few... er, on top. (they're there for show, sorry raisin-lovers).

Place in a 350 F/ 180 C oven and bake for about an hour or until a skewer or knife comes out clean when inserted into the middle of the pudding.

As you know, my oven is on the fierce side so I lowered the temp to 325 F/160 C and reduced the cooking time - ended up being about 45 minutes. I could have lowered the temp further and cooked longer, which would have been better, but patience is not always a virtue with me when it comes to food. While it was cooking, I got a little peckish, and thought it was a shame to waste the crust from the end of the loaf. A scraping of left-over butter and a smearing of wonderful and nutritious manuka honey... now that's not bad, that is :).

It all turned out satisfactorily and smelling delicious. The pud was devoured to the tune of many compli-ments. The raisins were removed by you know who before eating. Make sure you put yours into the custard mixture, so they stay lush inside the pudding!

This recipe serves 4 - 6. 

As we have seen, there is now the option of using gluten-free varieties of bread to really bring some nutritional value and coeliac safety to this timeless dish. We know from the research that it would be better, perhaps even more authentic, to use bread of mixed grains. But it is a pudding afterall, almost a souffle really, and it should be light and delicate. It is our choice, and as I've discussed previously,  experimenting with food is half the fun... eating it being the other half of course! 

Next time, we leave the joys of gluten-fierce and gluten-free cooking behind and try something hearty and savoury... the venison stew perhaps. Sure sounds like a frontier cooking adventure to this city slicker living in a dominion of a one-time colonial power...

Sing a song of sixpence a pocketful of rye
Four and twenty blackbirds baked in a pie
When the pie was opened the birds began to sing
Now wasn't that a dainty dish to set before the king.

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