Title: Gluten Freedom
Author: Alessio Fasano M.D., Susie Flaherty
Genre: Health and Diet
Publisher: Wiley / Turner
Dr Alessio Fasano is the Chief of Pediatric Gastroenterology at Massachusetts General Hospital for Children and Director of the Center for Celiac Research and Treatment. He is also professor of pediatrics at Harvard Medical School and professor of nutrition at Harvard T.H. Chan School of Public Health.
Dr. Fasano approaches Gluten Freedom from not only a place of great experience, but also from a place of great compassion. He tells the stories of many of his patients, both adults and children and how their struggles have fueled his search for treatments and a cure.
Having started his career in Naples, Italy in 1986 as a pediatric gastroenterologist, Dr. Fasano brings his perspective from Europe where celiac disease was well known, but still thought to be a childhood disorder that could be out grown. When he came to America, it was thought that celiac was very rare outside of Europe.
In Gluten Freedom, Dr. Fasano takes us through the evolution of celiac understanding and research to the present day where we know it to be a genetic disease that develops under specific conditions and has no cure.
Gluten Freedom is the first book I've read about Celiac disease that really gets into the mechanisms of how gluten affects people with and without celiac disease and especially, why we see symptoms outside of the gut. It's the first work I've read that delves into the role of the microbiome in the development and perhaps at some point, control of celiac disease.
Once we understand the importance of gut health and the role of the microbiome, we start to see the importance of a diet that is, not just gluten-free, but full of whole, real, fiber-rich, naturally gluten-free foods. Hence, the second half of the book is about practical advice for living with celiac disease, including meal suggestions and recipes that originate in Dr. Fasano's home country. Not surprisingly, he recommends the Mediterranean diet.
Since I first read Michael Pollan's Cooked, nearly 10 years ago, I've been fascinated by the new science of the microbiome. It turns out that nearly 90% of the DNA in our bodies is not human but belongs to the colonies of bacteria that live on and in our bodies. We still don't entirely understand exactly what all these little beasties do and how they do it, but we are coming to understand that keeping them healthy and "in balance" is supremely important to our own health.
What I love so much about Gluten Freedom is how Dr. Alessio Fasano has taken hold of the emerging science of the microbiome and worked to advance our human knowledge, specifically in the area of gut health and celiac disease. It's an unhealthy gut lining that becomes inflamed and "leaky" allowing undigested food proteins to escape and cause autoimmune reactions like celiac disease. These escaped proteins can also land in other areas of the body like the brain and the joints causing inflammation and symptoms in those other areas.
As a professor of nutrition, Dr. Fasano brings that expertise to bear as well. Hence he ties his knowledge of the gut and gut health to the food we eat and makes some very specific and practical diet recommendations.
I was captivated as he described the breathtaking scenery around his native region of Italy and then tied it back to the meals that his mother used to cook. All natural whole foods and many of them naturally gluten-free.
I was also intrigued by his discussion on refractory or non-responsive celiac disease. This is when celiac patients still have symptoms while on a gluten-free diet. This caught my attention because, like many others, I continue to have some digestive distress and like many others I've looked to other food intolerances as the possible cause.
In most cases, according to Dr. Fasano, symptoms continue because gluten is sneaking in there somehow. To investigate and treat this he developed the "Fasano Diet", also known as the "Gluten Contamination Elimination Diet". This is a diet of whole, naturally gluten-free foods without any processed gluten-free products. This just puts a song in my heart!
If you've been reading my other work, including my monthly newsletter, you know that I've been exploring the Mediterranean diet. This book has convinced me that this is the right direction for overall health, weight control and for my celiac disease.
Do I recommend this book? Yes! In Gluten Freedom Dr. Fasano make the science accessible to non-scientific readers and makes it interesting by weaving it into the story of how his own understanding and that of the medical community has evolved over the years. He adds to this the very human stories of his patients and practical lifestyle advice.