Saturday, May 28, 2016

Beware the Medical Beach Read - Slate

Out Tuesday, Gluten Exposed is a non-revolutionary, non-miracle-promising book of genuine science by Dr. Peter Green, director of Columbia University's Celiac Disease Center, and medical writer Rory Jones. It comes on the heels of such best-sellers as Wheat Belly and Grain Brain—and for people who have learned about gluten from these titles, it will be somewhat perplexing. Gluten Exposed contains no stories about astonishing autism reversals. No promises of Alzheimer's prevention. No weight-loss secrets the establishment doesn't want you to know. Dr. Oz has not endorsed it. There aren't even recipes in the back! (There is, however, an appendix that chronicles "diets throughout the ages" from 150,000 B.C. to the present.)

In other words: Green and Jones have refused to write a medical beach read. It's a courageous choice but one that will most likely limit sales. That's too bad, because the book is a model for how to communicate science to the public, an antidote to the breathless hype and simplistic headlines that too often dominate popular scientific discourse.

The medical beach read is a straightforward genre. Like its fictional counterpart, there are clear villains: grains, toxins, malevolent corporations, the mainstream medical establishment. There are heroes: good fats, natural foods, everyday people who refuse to be sheeple, maverick doctors who write books that go against the grain. The archetypal plot is uncomplicated: For too long we have neglected the dietary root cause of our suffering, and things have never been worse than they are today. Fortunately, there's always a happy ending, and it's usually as simple as eating (or not eating) certain foods.

Medical beach reads sell like crazy because they are easy, empowering page-turners. Each chapter promises secret scientific knowledge in terms that any person can understand. The knowledge is profound, conclusive, revolutionary, and extraordinary. There's invariably a map to the holy grail of effortless weight loss. And like advertisements, the books are written for you. ("If the thought of your brain suffering over a bowl of savory pasta or plate of sweet French toast seems far-fetched, brace yourself," warns Grain Brain.)

But science is not fiction, and medical beach reads are not harmless dramas. They encourage a view of scientific knowledge as propelled by sporadic revolutions rather than incremental advancement; great scientists as lone truthseekers rather than contributors to a communal endeavor. The drama is not a fantasy: It is real, it is religious, and readers are made to believe that they are confronting a clear choice between salvation and damnation.

Gluten Exposed avoids these pitfalls with the humility and honesty that ought to be standard in any discussion of contentious medical research. The book offers expert, up-to-date summaries of the scientific consensus (or lack thereof) on gluten, grains, the gut, the microbiome, and theories about how these come together in healthy and unhealthy people. What exactly is the truth about gluten? It turns out that with the exception of celiac sufferers, who can't ever eat it, we're just not sure—though it certainly isn't as bad as popular health gurus might have you believe. Every chapter emphasizes this complexity. The mechanism of irritable bowel syndrome is "poorly understood." There is "conflicting data" on the effects of a gluten-free diet. The relationship between autism and gluten-containing grains "must be studied further."

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