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Celiac is the only autoimmune disease for which we know the trigger that turns the immune system against the body. The culprit? Gluten. (Photo: Pixabay)
Our latest Freakonomics Radio episode is called “The Demonization of Gluten.” (You can subscribe to the podcast at Apple Podcasts or elsewhere, get the RSS feed, or listen via the media player above.)
Celiac disease is thought to affect roughly one percent of the population. The good news: it can be treated by quitting gluten. The bad news: many celiac patients haven’t been diagnosed. The weird news: millions of people without celiac disease have quit gluten – which may be a big mistake.
Below is a transcript of the episode, modified for your reading pleasure. For more information on the people and ideas in the episode, see the links at the bottom of this post.
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In the 1930s, a Dutch pediatrician named Willem Dicke began to study a mysterious, often-fatal disease that was afflicting his patients. Children were losing weight and becoming malnourished despite consuming plenty of calories. The symptoms were intense and widespread.
Alessio FASANO: The damage is the intestine. This is a systemic disease that does not spare any tissue organ in your body.
That’s Alessio Fasano.
FASANO: I’m professor of pediatrics at Massachusetts General Hospital for Children.
Willem Dicke suspected the illness was somehow related to the children’s diet. But it wasn’t until years later that he found the proof he was looking for. It came in the form of a grotesque natural experiment produced by the Second World War. In 1940, Germany had invaded and occupied the Netherlands. In 1944, Dutch railway workers held a strike in support of the Allies. This prompted the Nazis to cut off food shipments to Dutch civilians.
Alan LEVINOVITZ: This was called the Hunger Winter.
That’s Alan Levinovitz, a religion scholar at James Madison University.
LEVINOVITZ: It was horrific. Children everywhere were starving.
Some people resorted to eating grass or tulip bulbs; thousands died of starvation. But Willem Dicke noticed something strange. His pediatric patients who’d been sick before the war …
LEVINOVITZ: … were actually improving. Then in 1945, the Hunger Winter ended. Bread was dropped over Holland and everyone’s lives improved — except for those of the children , who immediately relapsed into the condition that they had been suffering before.
FASANO: And this pediatrician, Dr. Dicke, would reason what we did not have during the war, now, is coming back. That can be the culprit. He made the hypothesis where grains are the culprit.
That’s right, grains. Which the kids hadn’t been eating during the Hunger Winter — but now, after bread came back, they were. So Dicke ran a little experiment.
FASANO: He took six of these kids, put them on a gluten-free diet, showing that the symptoms were completely gone, put them back on a regular diet, showing that the symptoms came back. That was the cornerstone, and still is of our understanding of how you trigger celiac disease.
And that is how our modern understanding of celiac disease came to be. Even today, it’s still somewhat mysterious. But one thing that isn’t mysterious at all is the trigger:
FASANO: And it’s gluten.
Today on Freakonomics Radio, we’ll look at the recent spike in celiac disease, and why, historically, it’s been underdiagnosed:
FASANO: The symptoms unfortunately are not straightforward like many autoimmune diseases.
We’ll look at the intersection between health trend and media sensation:
LEVINOVITZ: Jenny McCarthy was hugely influential.
We look at the economic implications of the gluten-free movement — both micro …
Kadee RUSS: I probably spend upwards of $1,200 a month on groceries.
And macro …
Jennifer BOND: The northern plains of the U.S. have seen declining plantings of wheat.
“Gluten, Gluten Everywhere.” Right after this:
- * *
Alessio Fasano is one of the world’s leading authorities on celiac disease and gluten.
FASANO: I can’t make that statement myself.
But we can. And he is. By the time Fasano started his medical studies, in the 1980s, celiac disease was understood much better than in Willem Dicke’s era. So let’s start with what we know. First of all, the name, celiac. It’s from the Greek, meaning “a sickness of the belly.” And how is the disease defined?
FASANO: This is truly an autoimmune disease. It’s like having diabetes, multiple sclerosis, or rheumatoid arthritis.
So celiac is an autoimmune disease — with, as Fasano puts it, a recipe containing at least two ingredients.
FASANO: 1) A genetic predisposition — many genes needs to come together to make you at-risk. 2) An environmental trigger that is mismanaged by your immune system.
And what sometimes happens when the environmental trigger meets the genetic predisposition …
FASANO: The immune system starts to attack its own body rather than get rid of the enemy.
An immune system attacking its own tissues — that’s the definition of an autoimmune disease. But there’s one major way in which celiac is unlike other autoimmune diseases like rheumatoid arthritis or diabetes or multiple sclerosis. Celiac is unique among autoimmune diseases …
FASANO: … because the culprit, the enemy, that turn the immune system to attack your own body, is known. And it’s gluten.
This known enemy, gluten, is a protein that’s found in rye, barley, and, most prominently, in wheat. Gluten is what gives structure to foods like bread, pasta, and cake. So gluten is the trigger for celiac disease; and the treatment then is what?
FASANO: The treatment is the elimination of gluten from the diet.
Stephen J. DUBNER: How quickly and how completely does that treatment address the issue?
FASANO: Some people will have resolution of the symptoms rather quickly. Others will take much longer. [In] the vast majority, it will be a complete resolution.
DUBNER: How does it feel to know that you’re responsible for people crossing those beloved food items off their lists forever?
FASANO: Being Italian, I feel awful. It is definitely a tremendous change in lifestyle. No question about that. We face this all the time. A newly diagnosed celiac will go through a serious change and feel [things] from denial to be[ing] upset — to frustrated, to depressed — because one of the most natural [things] to humankind, eating, will become a very challenging mental exercise rather than a very spontaneous activity.
Fasano got his medical training in Italy.
FASANO: There was a university in Naples where celiac disease was a big deal.
Indeed, the University of Naples had a celiac research center; Italian schoolchildren were enrolled in large-scale screening programs. Epidemiological studies showed that roughly 1 in 300 Italians had celiac disease. That’s pretty common! And because it was fairly common, Fasano wasn’t that interested in studying it further.
FASANO: One of the reason why I decide to move to the United States was because I was sick and tired [of] talk[ing] about celiac disease and work on it.
In 1988, he arrived at the University of Maryland. In the U.S., celiac disease was thought to be much rarer than in Europe: 1 in 10,000 people versus 1 in 300.
FASANO: Days passed by, weeks passed by, months passed by, and I didn’t see a single case of celiac disease. I went from the twenty cases a day that I [was] forced to see in Italy, to zero.
Fasano’s plan to get away from celiac disease had worked. But he began to wonder why there was such a huge difference.
FASANO: I was wondering, “If the genetic background is the same in Europe, and we eat the same gluten-containing grains that they consume in Europe, why is celiac disease so frequent there and does not exist here?” I reasoned, “Either the disease does not exist in United States, so it will be a very interesting proposition to understand why.” And the alternative was that it was overlooked and so was underestimated.
In other words: was celiac disease really so rare in the U.S. or were American doctors just missing it? Fasano decided to find out. He headed over to his local Red Cross to get some blood samples …
FASANO: … I was shocked to know that I had to pay for it. They asked me for $6 apiece. I said, “You must be out of your mind. I would never pay [that] amount of money.” We engage in this back-and-forth negotiation that is actually the heart and soul of the Neapolitan attitude. You never pay whatever they ask for.
Eventually they settled on $3 apiece. Fasano bought 2,000 samples and began testing them. If someone who has celiac disease eats gluten, their body produces abnormally high rates of certain kinds of antibodies. Gluten has been recognized as an intruder and their body is trying to fight it off — but instead the antibodies end up attacking healthy cells. This activity can be detected in a blood test. So, when Fasano screened the Red Cross blood samples, what did he find?
FASANO: The prevalence was one in 250.
A prevalence of 1 in 250! The previous estimate in the U.S. remember, was 1 in 10,000. This new finding would make celiac disease 40 times more common in the U.S than previously thought. Under the old estimate, only 27,000 Americans likely had celiac disease; the new estimate suggested it was more like a million.
FASANO: That gave us the impetus to move to this large epidemiologic study on the national scale, in which we recruited more than 40,000 people.
This new, national study, published in 2003, yielded an even higher estimate. It found that 1 of every 133 Americans had celiac disease. This was pretty much in line with the most recent European numbers. So America wasn’t so different from Italy after all! According to Fasano’s research, more than 2 million Americans had celiac disease. How was it possible that a disease so well-identified in some places had been practically invisible in the U.S.?
FASANO: The symptoms of celiac disease unfortunately are not straightforward like many autoimmune diseases. Intuitively, the vast majority of the symptoms are gastrointestinal: chronic diarrhea, weight loss, failure to thrive.
The knock-on effects are various, and serious.
FASANO: You can have anemia because you can’t absorb iron and with that, chronic fatigue. You can have joint pain, a skin rash. You can change your behavior because inflammation spills into the brain. You can have infertility.
Over the last couple decades, the diagnosis and treatment of celiac disease in the U.S. have greatly accelerated. That’s good news, especially since an effective treatment — the gluten-free diet — is well known. But rather than waiting to be diagnosed, and then going on a gluten-free diet, wouldn’t it be better if we could prevent celiac disease in the first place? If we could understand where it exists, and why, and exactly how it’s triggered?
Benjamin LEBWOHL: If you ask someone, “What causes celiac disease?” the pat answer is, “Gluten causes celiac disease.” But I don’t think that’s a fair response. That’s like saying that peanuts are the cause of peanut allergy. Right?
That’s Benjamin Lebwohl. He, like Fasano, is a gastroenterologist.
LEBWOHL: I’m the director of clinical research at the Celiac Disease Center at Columbia University.
Lebwohl and other researchers have looked all over the world for clues that could explain why celiac disease is triggered in one person and not another.
LEBWOHL: It used to be thought that people who were susceptible to celiac disease were Irish or Northern European and perhaps, more broadly, Caucasians. But celiac disease is present in Asia. It’s actually quite prevalent in northern India. In virtually every country in the world, celiac disease has been identified.
Okay — but: are people who eat a lot more gluten more likely to get celiac disease?
LEBWOHL: We know that there is this necessary genetic makeup. We also know that there are regions in the world where the genetic makeup isn’t so different but the environment is quite different and there’s a lot more celiac disease in one spot than another. For example, in India we know that the necessary gene is similarly present in the north and the south of the country. But there’s a lot more celiac disease in the north than the south and it’s not just a matter of increased detection.
The going explanation — and I think this is a plausible explanation — is that there is a lot more gluten consumption in the north. Whereas in the south it’s a much more rice-based cuisine. Now, that has not been conclusively proven but it’s awfully compelling when you have a population with a similar genetic makeup but very different gluten levels in their diet and suddenly you’re seeing these widely disparate rates of celiac disease.
FASANO: The highest frequency, believe it or not, is the Berber nomadic population in North Africa — six percent. This is a very ancient population that was displaced from their normal position because of the civil war in Northern Africa.That led to very high mortality because of malnutrition, famine, no food available. Unicef and the W.H.O. stepped in and they have to decide what to send there to save these people. The question was, “What we can send the desert that is not perishable, that can be used for many purposes?”
The answer was wheat. The population there for 4,000 years — whose diet was based mainly on camel milk, camel meat, fruits and vegetables — for the first time in their history, were introduced to gluten.
DUBNER: Was it the sudden influx of that diet that triggered it or was it a case of selection among the population just the way that natural selection works over time? Was it related to that?
FASANO: The latter. That’s the reason why probably this really reflects the natural history of celiac disease. There were people there were much more susceptible. Remember, once upon a time there was high mortality of celiac disease. The most violent reaction to gluten destroy[ed] the vast majority of the intestine, making intestine not capable to absorb or digest food stuff are the ones that didn’t make it.
So it’s likely that celiac disease used to be much, much more prominent among earlier generations, and that natural selection has worked its magic. But since it’s still relatively prominent, researchers are trying to learn everything they can about how it strikes — often by studying populations where it strikes the hardest. Benjamin Lebwohl again:
LEBWOHL: Not everyone knows about the great celiac disease epidemic in Sweden from the mid-1980s to the mid-1990s. But there was one. This was an epidemic that primarily affected the youngest children, so infants and children under two years of age. It typically caused what we call the classical form of celiac disease: babies with diarrhea, failing to grow, etc. Then in the mid-90s, just as rapid as the rise was a rapid fall. The working hypothesis was that it had to do with how those infants were being fed.
Rates of breastfeeding were not very high and in general were not overlapping with the first introduction of gluten into the diet. Moreover, infant formula had very high quantities of gluten, which is very different from today. When more overlap with breastfeeding was encouraged and when gluten was minimized from the infant formula, that coincided with the end of the epidemic. But that’s correlation, and we have been hesitant to say that’s causation.
There’s another clue from a study in Finland and Russia.
LEBWOHL: There was a study that compared rates of celiac disease in two regions very close to each other geographically but very different socioeconomically. These two regions were in Finland and right across the border with Russia in a region called the Russian Karelia. The genetic makeup of those two populations was similar. They both had rates of the celiac disease genes that were comparable. But when screened, celiac disease was present in about one in 100 in Finland and about one in 500 in the Russian Karelia, right across the border.
The researchers suspected that income had something to do with it. One theory: lower-income people had more exposure to certain bacteria that somehow protect them from celiac disease. For instance, the bacteria H. Pylori, known to cause ulcers, seems to cut the risk of celiac disease in half.
LEBWOHL: We found that, actually, there’s more celiac disease in people who live in ZIP codes of a higher income than those who live in ZIP codes of a lower income. The effect is not large, it’s not very strong, but it’s there and appears to be independent of other factors we controlled for. There’s something about either growing up wealthy or being in a wealthy environment and subsequently losing the ability to tolerate gluten.
Okay, so: people are still getting sick from celiac disease, they’re still dying from it, and the epidemiology isn’t locked down. So, given that the disease’s trigger is known, how much sense would it make, as a preventive measure, for everyone to go gluten-free?
LEBWOHL: Adopting a strategy of going gluten-free can really backfire.
- * *
DUBNER: Can we hear the story of your being diagnosed with celiac disease?
Emma MORGENSTERN: It was about eight years ago in 2009 and I started having heartburn for about six weeks.
Emma Morgenstern is a producer on our show. And she’s the reason we’re doing this episode about celiac disease.
MORGENSTERN: I didn’t really get a full diagnosis until I went to see a G.I. specialist. Then he did an endoscopy — where they stick a camera down your throat and take a biopsy of your small intestine — and he did confirm with that endoscopy that I had celiac disease.
DUBNER: How hard was it for you to go gluten free?
MORGENSTERN: Ugh. [Laughs.] It was just awful. I came to terms with it fairly quickly because I had to. But you start having to think so much about what you’re eating and it’s just it’s a lot of work to be gluten-free.
DUBNER: I know that you recently came back from your honeymoon in the south of France. Congratulations. Mazal tov.
MORGENSTERN: Thank you.
DUBNER: I know you had a great time. But I would imagine that that is a relatively challenging and tempting place to not be eating gluten, yes?
MORGENSTERN: Oh, you mean with the croissants and the baguettes and the pain au chocolat?
DUBNER: I wasn’t going to name them by name. I didn’t want to torture you.
MORGENSTERN: Yeah, that was a bummer.
As much of a bummer as celiac disease has been for Morgenstern, it’s been helpful for us to have a producer on this episode who actually has the disease. Because she knows a lot about it and has been thinking about it for years. But, alas, Emma Morgenstern is a radio producer with celiac disease; for our show, it sure would be nice to speak to an economist with celiac.
DUBNER: Hey, it’s Stephen Dubner. Is that Katheryn Russ?
RUSS: Hi, Stephen. Yes. You can call me Kadee.
Kadee Russ teaches economics at the University of California, Davis.
RUSS: I specialize in international trade and finance.
Russ had overcome a lot to get to where she is today.
RUSS: I’ve had stomachaches and stomach problems since I was very small. I had a pre-term birth due to HELLP, which is another autoimmune disease. I had vitamin D deficiency for years. Anemia for years. These persistent headaches for years.
After all of those medical problems, Russ was diagnosed with celiac disease in 2011.
RUSS: You read in the news that everyone thinks they have celiac disease or are gluten sensitive. I was really afraid to say anything to the doctor until I thought I had some evidence of it. I went gluten-free for about four months first, maybe closer to six. Just to be sure. Then she told me that I had to eat gluten for six weeks before I could be tested.
DUBNER: Were you willing to do that?
RUSS: Yeah. I wasn’t sure at first whether or not it was necessary to be tested. It makes a night and day difference.
RUSS: First, the way that you’re treated in the medical community. They take the gluten issue very seriously. If you’re admitted to the hospital or something, people need to be watching out for any gluten exposure for you. Second, it’s hereditary. If you test positive for celiac disease, then everyone in your immediate family at least needs to be tested. Celiac disease, if left untreated, shortens your life. It’s very important that people know. Then, also, how seriously you as a person take it.
If you know that you have an autoimmune disease, then you’re much more likely to take it seriously than if you think, “I get a stomachache or something after I eat something, so I only take a bite every once in awhile.” Whoa! No. Celiac disease is a totally different world than that.
The landmark 2003 study, you’ll recall, put the incidence of celiac disease in the U.S. at 1 out of every 133 people. But then there are people who say they have a gluten “sensitivity,” or perhaps an “intolerance” …
LEBWOHL: … having symptoms that might resemble celiac disease — that are not celiac disease but you still get better on a gluten-free diet. The term for that is non-celiac gluten sensitivity or non-celiac wheat sensitivity.
That, again, is Benjamin Lebwohl. A diagnosis of non-celiac gluten sensitivity, he says, is trickier to pin down because there’s no test for it. We asked Lebwohl, therefore, if non-celiac gluten sensitivity is a real thing.
LEBWOHL: It’s really counterproductive to question whether non-celiac gluten sensitivity is real. Clearly, the symptoms are real. The suffering is real. I don’t have to tell you how many patients I’ve seen. I promise they’re real. What we don’t know is what exactly is driving their symptoms. What’s the biological basis? Many of them are coming to celiac-disease specialists because they really don’t have elsewhere to go in the area of so-called conventional medicine because there isn’t a well-defined pathway for these patients.
We need to better understand them, listen to them, try to understand what’s driving your symptoms. I’ve certainly seen patients where it really appears to be gluten that’s driving symptoms, even though we can’t for the life of us find a marker in the blood or the intestine. We need to study these patients. We need to take care of them. I certainly wouldn’t doubt that it’s real, though. We just need better science.
There are also plenty of people who go gluten-free apparently because they’ve heard that going gluten-free is a good idea. Here’s a Jimmy Kimmel segment from a few years ago.
Jimmy KIMMEL on Jimmy Kimmel Live: Now some people can’t eat gluten for medical reasons, which that I get. It annoys me, but I get it. But a lot of people here don’t eat gluten because like, someone in their yoga class told them not to. I started to wonder, how many of these people even know what gluten is. So we decided to find out.
Interviewer on Jimmy Kimmel Live: Do you maintain a gluten-free diet?
Interviewee on Jimmy Kimmel Live: I do indeed.
Interviewer on Jimmy Kimmel Live: What is gluten?
Interviewee on Jimmy Kimmel Live: For me, how it affects my body …
Interviewer on Jimmy Kimmel Live: But what is gluten?
Interviewee on Jimmy Kimmel Live: This is pretty sad because I don’t know.
LEBWOHL: There are people who go on a gluten-free diet under the assumption, and this is largely a mistaken assumption, that it will promote weight loss. There are probably people who are buying gluten-free food and avoiding gluten simply because of a vague notion that it’s healthier, even though that might not be the case. Among people who are on a strictly gluten-free diet, the great majority do not have celiac disease. The best data we have to date gives an estimate of about 1.5 percent of people in this country being strictly gluten-free even though they don’t have celiac disease.
Recent studies suggest that as many as 30 percent of Americans are trying to reduce their gluten consumption or avoid it altogether.
FASANO: We went from the complete obsolete, not known, field of what celiac disease is and what gluten really can do to your body to the opposite extreme.
Alessio Fasano again.
FASANO: We did such a good job that now, the awareness of gluten and gluten-free lifestyle becomes one of the most popular if not the most popular diet ever embraced the United States. And this creates a tremendous amount of confusion.
Part of that confusion is that “gluten-free” doesn’t really mean “healthy.”
LEBWOHL: Adopting a strategy of going gluten-free can really backfire. First of all, because gluten is everywhere it’s so difficult to avoid. It can make eating out, grocery shopping, socializing or dating really fraught. There are also potential health concerns with going gluten-free. Gluten-free substitute foods often have more calories than a gluten-containing item. They often have higher fat content. A gluten-free diet is often a diet low in whole grains, low in fiber. We actually compared people who ate high-gluten diets to those who ate the lowest-gluten diets.
We found, actually, that overall, when looking at the outcome of rates of heart attack, for example, there was no significant difference with regard to heart attack risk according to how much gluten you eat in your diet. But if you then take into account whole grains, those who ate more gluten in their diet, due to having a higher whole grain content in their diet, actually had a lower heart attack risk. In other words, a gluten-free or low-gluten diet, if deficient in whole grains, could actually increase the heart attack risk.
FASANO: Let me clarify something. Not only gluten is not a villain, but without gluten you and I, we still jump from one tree and another. We [would] not have build the Coliseum or the Eiffel Tower because before the agriculture and, therefore, predictability — humankind spend 90, 95 percent of activity for food procurement and 5 percent for reproduction. No time to unleash ingenuity or doing anything about it.
Without agriculture — therefore, without gluten — we would definitely be at the same level of any other species and probably would not be the dominant species. I would personally never, ever recommend a gluten-free diet to somebody that does not have the medical necessity. Myself, I eat gluten. I do this with moderation as we should do for anything.
LEBWOHL: A gluten-free diet is also potentially more expensive, particularly if looking at gluten-free substitutes.
RUSS: Oh yes. It’s much more expensive.
The economist Kadee Russ again.
RUSS: I’m afraid to tell you how much I spend on groceries a month. I spend a lot of money.
DUBNER: I’d like to know.
RUSS: I probably spend upwards of $1,200 a month on groceries. There are three of us in the household. It’s very expensive. You can do just gluten-free and that would probably be a bit cheaper. I’m one of those people that does the gluten-free and tries to go organic, pastured, grass-fed, etc.
DUBNER: Tell me what you can about how much more expensive gluten-free foods are.
RUSS: The few studies that I’ve seen have put gluten-free foods at somewhere between two and four times the price of —
DUBNER: Holy cow.
RUSS: — non-gluten-free equivalents. One of the more widely cited studies says 242 percent higher.
DUBNER: Wow. Fortunately, you’re an economist. You can answer this question from a price-theory standpoint: how much of that has to do with supply and how much to do with demand?
RUSS: I did some sleuthing to try to look into that question. I looked at brownie mix and if we look at a standard national brand, it may cost 12 cents per ounce. Now the lowest cost gluten-free alternative that I could find was 16 cents per ounce.
DUBNER: Not bad.
RUSS: Yeah. About a third more. But I don’t know if it was a loss leader or not. The next lowest I found was about 23 cents per ounce. That was also on sale.
DUBNER: Now getting into the two times range.
RUSS: Exactly. If we take the lowest cost one and then separate out the others, at 30 cents per ounce or more into a premium category, then among those premium categories we see markups of between three and 40 percent.
So if the gluten-free diet is less nutritious and more expensive — why would someone who doesn’t have celiac disease, or gluten sensitivity, want to go gluten-free?
LEVINOVITZ: Gluten-free came on the heels of the low-carb craze. In the aftermath of Atkins, the idea that carbohydrates are bad for you is still very prevalent. For a population that has been told time and time again that what is making their waistlines expand is carbohydrates, it makes complete sense to think that there’s a hidden villain in these high-carbohydrate foods: gluten. That’s the real culprit.
That’s Alan Levinovitz.
LEVINOVITZ: I’m an assistant professor of religious studies at James Madison University.
He’s also the author of a book called The Gluten Lie: And Other Myths About What You Eat.
You may be wondering why a religion professor has written a book about diet.
LEVINOVITZ: If people reflect on it, they’ll find that diet is actually at the heart of whatever knowledge they have of religion. One of the first things people think of when they think of Judaism is keeping kosher. There are certain foods that are prohibited by God and certain foods that you’re allowed to eat.
But Levinovitz doesn’t study Judaism, either.
LEVINOVITZ: I specialize in classical Chinese thought as well as the intersection of religion, science, and medicine.
And what he realized …
LEVINOVITZ: I realized that there were some really interesting parallels between Taoist monks’ prohibitions on the five grains — the so-called wugu — and modern avoidance of grains. The promises that these monks made were promises of miracles. They said you could fly if you didn’t eat the grains. You could teleport. You could avoid disease, live forever, clear up your skin. I started to think to myself, “What if what seem like scientific prohibitions on foods today actually have more in common with these religious prohibitions than most people think?”
Instead of Taoist monks, now we have celebrities.
LEVINOVITZ: Jenny McCarthy was hugely influential when she told everyone that she had put her autistic 3-year-old on a gluten-free, casein-free diet. Once you had celebrities coming out against eating gluten-containing foods, you immediately got unscrupulous physicians jumping on the bandwagon.
Jumping on the bandwagon and pointing at gluten as the cause of any variety of ailments.
LEVINOVITZ: They would say things like, “If you go gluten-free, it will cure your arthritis.” “If you go gluten-free, it will help you lose weight instantaneously.”
It hardly seems to matter that many such claims are light on facts. Food companies, sensing a spike in demand, have been only too happy to supply the supply. You’ll see “gluten-free” tags all over the grocery store these days, as if it’s a symbol of excellence and purity; the same goes for a lot of restaurants. And you can see this shift reflected on a macro scale.
BOND: My position allows me to really dig deep into what’s going on in domestic markets for all classes of wheat, as well as crops that are called pulses like dried peas, lentils, chickpeas, which are real popular right now, and dry beans.
That’s Jennifer Bond. She’s an economist with the U.S.D.A.’s Economic Research Service. She points out that when it comes to the consumption of certain foods, it’s a lot easier to establish correlation than causality. Furthermore, wheat consumption has had plenty of historical ebbs and flows.
BOND: In the 1800s, Americans were eating 225 pounds of flour per person. A hundred years later, that dropped by almost 100 pounds per person. Then it rose again slightly as incomes increased and we had access to more diverse food. Then in the ’70s, there was actually a trend towards increased consumption of wheat again, in part driven by the desire to consume less animal protein. For about three decades, we saw increasing per-capita consumption until the recent high point in the 2000s.
Then Atkins hit and put some downward pressure on per-capita consumption for the next seven years. Per-capita consumption began to rebound a little bit, until, perhaps, the emergence of the gluten-free trend — which we are seeing a correlation between per-capita consumption of wheat flour and increasing sales of gluten-free products.
Okay, so wheat demand has been all over the place. What’s the current trend on the supply side?
BOND: On one hand, we have record-low plantings of wheat and on the other hand, pulse-crops plantings reached a new record high this last year. Again, it’s hard to say specifically that consumer tastes and preference trends are driving the expanded availability of pulse crops. But what the data is showing us is that there has been some pretty steady growth in chickpea and lentil per-capita availability in particular. Pulse crops tend to be grown in the same area as wheat is grown too.
The northern plains of the U.S. have seen expanded production of chickpeas, dried peas, lentils, and declining plantings of wheat.
So for people with celiac disease, or otherwise concerned about gluten, this would seem to be a big win. Gluten-free products are becoming more easily available, and awareness is growing. And on the medical front: it no longer takes a large-scale famine, like the one in Holland during World War II, to identify celiac patients. These developments are exactly what doctors like Alessio Fasano and Benjamin Lebwohl have been working towards. Right? Well …
LEBWOHL: Despite all of our interest in celiac disease and efforts to raise awareness….
LEBWOHL: … it looks like the majority of patients with celiac disease are still going undiagnosed, and therefore eating gluten possibly to long-term medical harm. Despite that we have all these other people who don’t have celiac disease and have adopted the gluten-free diet. It could very well be that our efforts for outreach and awareness of celiac disease have been basically met on the wrong audience or a different audience.
Our efforts to say “celiac disease can affect all races and ethnicities, young and old, the many faces of celiac disease” has not fallen on deaf ears, but fallen on other ears, a different set of ears. Those with celiac disease by and large haven’t gotten the message.
I went back to Emma Morgenstern, our producer who has celiac disease, to ask about Lebwohl’s concern with all the undiagnosed cases still out there.
MORGENSTERN: We should be concerned about it. Celiac can be really harmful to people who don’t know they have it.
DUBNER: I guess one prescription would be for much more widespread screening. But as we’ve seen with a lot of maladies, an increase in screening can also turn up a lot of false positives, which can lead to its own set of problems. How much of a concern is that in the case of celiac disease?
MORGENSTERN: I definitely think that’s a concern. I have recently found myself in the position of maybe having been overdiagnosed.
DUBNER: [Laughs] For celiac disease?
MORGENSTERN: Yeah. [Laughs]
DUBNER: Tell me more.
MORGENSTERN: With doing research for this episode I was reading about the recommendations for celiac patients and follow-up, and I realized that I hadn’t actually done any follow-up for almost eight years since I was diagnosed. I decided that I would go to see a celiac specialist.
DUBNER: How did that work? He or she looked at your file or ordered up new tests and data? What happened?
MORGENSTERN: I had brought my medical records, including the records from my original diagnosis. I gave that to her. She started flipping through it. Then, she looked up at me and said, “You know what? I would not have diagnosed you with celiac disease based on these results.”
DUBNER: Oh my goodness.
MORGENSTERN: I was just totally shocked to hear her say that and didn’t quite understand how it was possible that she and my original doctor could come to different conclusions.
DUBNER: I have to say that I feel like the story that we’ve been telling in this episode and the image that we’ve been drawing is that it’s a thing that you have or don’t have. But is there that much gradation in the “yes” or “no,” whether you have it or not. Or were you in, maybe, some kind of pre-celiac condition that your original doctor was concerned would tip into full celiac?
MORGENSTERN: That is exactly my understanding of it. When they do the biopsy with the endoscopy, they categorize the damage to your intestine on this thing called the Marsh scale. So they categorize the symptoms as Marsh 1, 2, or 3. Marsh 3 is the most severe damage. Marsh 1 is the least severe. I had Marsh 1 symptoms when I was diagnosed, which I didn’t even really think about. I didn’t assimilate that information when I was diagnosed.
According to my new doctor, that Marsh 1 symptom level is not enough for her to put somebody on a gluten-free diet. She doesn’t think the original diagnosis was wrong exactly, but she would call it aggressive.
DUBNER: I assume the way to test whether you truly don’t have celiac disease is to ingest a lot of gluten. Question number one: does that mean that you have been commanded to go eat a whole bunch of bagels and pizza for a while? Number two: if so, don’t you feel like the world’s biggest sucker for not eating them for eight years?
MORGENSTERN: It’s how you look at it. I have been commanded to eat gluten for six to seven weeks and then have an endoscopy.
DUBNER: What was the first piece of food you ate with gluten and what did it taste like?
MORGENSTERN: I had pizza and it was not that amazing but then I had croissants and those are amazing. That is just something you cannot replicate gluten-free.
DUBNER: Are you having any adverse effects?
MORGENSTERN: I feel pretty much fine. I’m a little bit worried to say that or superstitious about saying that, but so far I haven’t had any problems.
DUBNER: Do you think there’s still a good chance that you actually do have celiac disease?
MORGENSTERN: Yeah. I’ve been trying to manage my expectations about not having it because it’s very possible that I’m going to go have the endoscopy and they’ll say, “You need to stay gluten-free forever.” I will be OK with that. As far as being a sucker… I do feel a little …
DUBNER: I don’t mean to call you a sucker, Emma, because I’m so fond of you. Let me rephrase it: have you thought about a lawsuit perhaps?
MORGENSTERN: It’s crossed my mind. When I told my sister about this whole situation, she said to me, “You should sue that doctor for a million croissants.”
- * *
Coming up next time on Freakonomics Radio — we check in on a wildly ambitious project we first told you about several months ago. It set out to solve a problem …
Katy MILKMAN from a previous Freakonomics Radio episode: A problem that, if we fixed it, could truly solve every social problem we could think of.
The project is called Behavior Change for Good. It’ll involve millions of real-world research subjects, a long list of corporate partners, and one of the most impressive collections of academic researchers we’ve ever seen.
Angela DUCKWORTH: We think because this is like the Hall of Justice, with all the superpowers in one place, that we might have a shot at doing something that hasn’t been done before.
These academic superheroes spent a couple days together drawing up their plans for world behavioral domination — and we were there. We’ll share with you the bold ideas:
David LAIBSON: We’re spending hundreds of billions of dollars in colleges and we’re not getting much value for our money.
The candid pushback:
Lyle UNGAR: I disagree actually.
And the risks of such a high-stakes enterprise.
Danny KAHNEMAN: If they fail, that’s going to be quite costly for a long time.
That’s next time, on Freakonomics Radio.
Freakonomics Radio is produced by WNYC Studios and Dubner Productions. This episode was produced by Emma Morgenstern. Our staff also includes Alison Hockenberry, Merritt Jacob, Greg Rosalsky, Stephanie Tam, Eliza Lambert, Harry Huggins and Brian Gutierrez; the music you hear throughout the episode was composed by Luis Guerra. You can subscribe to Freakonomics Radio on Apple Podcasts, Stitcher, or wherever you get your podcasts. You can also find us on Twitter, Facebook, or via email at firstname.lastname@example.org.
Here’s where you can learn more about the people and ideas in this episode:
Jennifer Bond, agricultural economist with the United States Department of Agriculture.
Alessio Fasano, professor of pediatrics at Massachusetts General Hospital for Children.
Benjamin Lebwohl, director of clinical research at the Celiac Disease Center at Columbia University.
Alan Levinovitz, professor of religion at James Madison University.
Kadee Russ, professor of economics at the University of California, Davis.
30% of U.S. Adults Trying to Cut Down on Gluten, claims NPD Group, Elaine Watson (March, 2013).
“Gluten-free and Regular Foods: a Cost Comparison,” Laci Stevens and Mohsin Rashid (2008).
Gluten Freedom: The Nation’s Leading Expert Offers the Essential Guide to a Healthy, Gluten-Free Lifestyle by Alessio Fasano, Rich Gannon, and Susie Flaherty (Wiley, 2014).
“Pioneer in the Gluten Free Diet: Willem-Karel Dicke 1905-1962, over 50 years of gluten free diet,” by Gerard van Berge Henegouwen and Chris Mulder (November, 1993).
The Gluten Lie: And Other Myths About What You Eat by Alan Levinovitz (Regan Arts, 2015).
“Prevalence of Celiac Disease in At-Risk and Not-At-Risk Groups in the United States: A Large Multicenter Study” by Alessio Fasano, MD; Irene Berti, MD; Tania Gerarduzzi, MD; et al (February, 2003).
“Lower Economic Status and Inferior Hygienic Environment may Protect Against Celiac Disease” by Anita Kondrashova, Kirsi Mustalahti, Katri Kaukinen, Hanna Viskari, Vera Volodicheva, Anna‐Maija Haapala, Jorma Ilonen, Mikael Knip, Markku Mäki, Heikki Hyöty & the EPIVIR Study Group (July, 2009).
“Long Term Gluten Consumption in Adults Without Celiac Disease and Risk of Coronary Heart Disease: Prospective Cohort Study” by Benjamin Lebwohl, Yin Cao, Geng Zong, Frank B Hu, Peter H R Green, Alfred I Neugut, Eric B Rimm, Laura Sampson, Lauren W Dougherty, Edward Giovannucci, Walter C Willett, Qi Sun, Andrew T Chan (May, 2017).
Celiac Disease Center at Columbia University.
Center for Celiac Research and Treatment at Massachusetts General Hospital.
Celiac Disease Foundation
“Pedestrian Question — What is Gluten?” Jimmy Kimmel Live (May 6, 2014).
TranscriptAmen! If you have your Bibles, go ahead and grab those. Colossians, chapter 3, is where we’re going to be again. If you were here last weekend, we started what was going to be three weeks in Colossians 3, verses 1 through 17. Really what we’ve been talking about is really how God takes us, transforms us, smoothes off kind of our sharp, jagged, broken edges and transforms our heart over an extended period of time.
We used last week this imagery or this illustration of sea glass, which is pieces of broken pottery, glasses, wine bottles, or whatever, and it spends 30 to 40 years in the ocean immersed in saltwater. Via calm seas, rough seas, and currents in the ocean, it is smoothed out, smoothed over. Its surface is transformed. Then it becomes something that’s kind of valuable, where people gather it. They make jewelry out of it, and it becomes this really beautiful thing.
I said it’s just a beautiful illustration of what God has done for us. He grabs us when we’re broken, fractured, and jagged, and he begins over a long period of time to transform us, shape us, and turn us into something beautiful. We looked last week at the first four verses, but we started in verse 17 because we said verse 17 was really the summarization of all 17 verses. Why don’t we look at that quickly together, and then we’ll dive into the text for today?
In Colossians 3:17, we get a sense of God’s vision for our lives. Here’s what it is: “And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him.” You see two things God is actively up to in our lives. Here’s the first one: God is after our greater integration as human beings…word and deed, head and heart. He is shrinking the gap of hypocrisy over time.
What was interesting to note last week is actually kind of astonishing. When I asked the question, “How many of you sense a gap between word and deed, head and heart?” the only people who didn’t raise their hands were liars. It was amazing! We all feel this. We get a sense that there’s a gap. We can call that gap hypocrisy, but God’s vision for our lives is for that to be ever shrinking until there’s integration of head and heart, word and deed.
That’s not all God is up to. We see also in this text that on top of integration, on top of head and heart, word and deed, he also is transforming us to be a people marked by gratitude and gladness. There is not a greater apologetic for the Christian faith in 2017 than lives marked with gratitude and gladness. We live in a day and age that’s pessimistic. It is hyper-aware of what it does not have. It is ready to be offended by anything.
What happens when the people of God just shine brightly by not being perturbed but just being grateful for what we’ve been given, for what God has entrusted to us, for his kindness to us in Jesus, I’m telling you, that will shine brightly in the cynicism of our day. We said this is what God is up to. He is after our integration. This is his vision for our lives: integration, gratitude, and gladness.
Then we looked at kind of how that path starts, how that process starts. It starts with this mindset, a mind that’s set on the things that are above, not on the earth that’s below. We have our mind set on Jesus. We went really kind of radical. We said as Christians, we’re like all in on Jesus. We’ve pushed all our chips in. We don’t have another bet. We’re not hedging. Jesus is our guy, so much so that whatever you want to talk about, we’re going to need to talk about Jesus.
You want to talk about marriage? We’re going to need to talk about Jesus. You want to talk about children? We need to talk about Jesus. Do you want to talk about work? We need to talk with you about Jesus. Do you want to talk vacation? Jesus. Right! You name it, I need to talk about Jesus so we can understand one another. We are all in on Jesus Christ. “Christ-ins.” I know that doesn’t make sense, but it makes the point. Then in one of my favorite passages, one of my favorite ideas in those first four verses was found in verse 3, where it says, “…your life is hidden with Christ in God.”
It’s this idea that our lives, all our failures, all our shortcomings, everything about us, is actually hidden in Christ in God, which creates a kind of freedom that empowers and enables us to live the Christian life in greater power, in greater freedom, and in greater joy the longer we follow after him. We are hidden in Christ and Christ in God. Therefore, since that’s true (since your life is hidden with Christ in God), here’s what the next part of this process of sanctification, of being made more like Jesus, looks like.
Colossians 3, starting in verse 5: “Put to death therefore what is earthly in you…” Then he lists them. “…sexual immorality, impurity, passion, evil desire, and covetousness, which is idolatry. On account of these the wrath of God is coming.
In these you too once walked, when you were living in them. But now you must put them all away: anger, wrath, malice, slander, and obscene talk from your mouth. Do not lie to one another, seeing that you have put off the old self with its practices and have put on the new self, which is being renewed in knowledge after the image of its creator.”
That’s all next week’s stuff. Verse 11: “Here there is not Greek and Jew, circumcised and uncircumcised, barbarian, Scythian, slave, free; but Christ is all, and in all.” Now if you have a background in church or you have a cursory understanding of religion, nothing I just read is somewhat shocking or surprising to you. I don’t think anyone in here was like, “Wait a second! We shouldn’t be a part of sexual immorality? Why has no one told me this?”
We have an understanding of what’s going on here. Something I want to draw your attention to is the seriousness of what’s going on in this text. The Bible just said, “You should put to death, you should murder, you should kill, you should act violently toward…” and then this list of behaviors. John Owen said, “Be killing sin, or it will be killing you.”
He is pushing this point. When it comes to sexual immorality, when it comes to sex outside the bounds God has given us, you should be serious about putting that to death. Do not play with that thing. Do not try to train that thing. That thing is not a friend. It is not a pet. It will devour and destroy you. Something is trying to kill you, and you shouldn’t play around with that.
He doesn’t just mention sexual immorality here. He mentions impurity, and impurity is any moral corruption. If you are morally corrupt… So you’re shady at work. You’re underhanded in a relationship. That’s moral corruption. He moves on from there and talks about passion. Now don’t go all Nike commercial on me, all right?
He is not saying you can’t be passionate about things. He is saying you shouldn’t be led by your stomach. Are you tracking with me on that? You just give yourself over to various passions. Then when he talks about evil desires in this text, he is talking about impulses or compulsions that are out of step with God’s good plan for our lives. Everyone in this room, regardless of how long you’ve been around church, will have these impulses, these compulsions, to give ourselves over to things that are out of God’s good design for our lives.
Then he moves on, and he talks about covetousness. Here’s why coveting is such a big deal. I think coveting is one of those things that we’re like, “Oh, I mean, in the list of sins, surely, man, that’s like junior varsity, B-team, third string tight end in a system that doesn’t use a tight end.” But coveting is an accusation against God.
When you covet, you make the accusation against God that he is not good, that he has not done what’s best for you, that he is cruel, that he withholds from you what is good for your flourishing. You make an accusation against God that is a lie and smears his character. Coveting is a very serious sin. In fact, this is the one he calls idolatry.
You make yourself your own God when you covet, because you say, “You don’t know what you’re doing. You don’t know what’s best. I know what’s best, and I deserve this. I should have this, and I need these things. You have not given them to me.” That’s coveting.
What he says here if you stop and think is you have this permission toward violence. He is saying, “Put these things to death. Drag these out back, and put a bullet in their brain. Then empty the clip, and if you have any more rounds, you need to reload that thing. If you’re out of rounds, then you grab a shovel, and you just pound it until you don’t even know what it is anymore. Then you bury it, and then you burn the shovel you did all of that with with the weapon. Then you vacuum that up, and then you destroy the vacuum.”
You don’t play with this stuff. Now he is not talking about harming yourself or physically punishing yourself. He is saying where you catch whiff of these, this is your flesh and your Enemy trying to kill you. You shouldn’t play around with that. You shouldn’t pretend this is no big deal. You should not be like those fools who take baby lions and try to train them as pets.
Don’t be that person. You end up on a show called When Animals Attack! It’s just like, “Oh, he is so…! Let me stick my head in his mouth.” Right? Yeah. Then you or your children die, and you’re like, “It’s crazy! He was so cute! I raised him since he was a kitten!” He is an apex predator. He kills stuff. That’s all apex predators do. They eat things. Nothing eats them. They eat everything else.
This is what’s happening in this text. Don’t play with this. That’s what the apostle Paul is saying here. “Hey, you mess around with this, someone is going to die.” I’m just saying very few of us take this approach to sin. When we have impulses and compulsions and they’re toward sexual immorality or they’re toward moral corruption, very few of us have the thought, “Something is trying to kill me here!”
We don’t go, “Hey, I need some help! Someone is trying to kill me!” No, we’re like, “Yeah, I’m good, man. Hey, sit. Sit! Here. Here’s a treat. You just do what I tell you to do. I’m in control. I’ve trained you. I’ve got this.” You are not Cesar Millan. “You will not psssssssst. Sin!” It will devour you. This is what the text is saying. Don’t mess around with this stuff. Put it to death.
Then the next part. I love this. I think we don’t think well about this because of a lot of propaganda, but he says that because of these things (sexual immorality), because of impurity, because of passion, because of evil desires and covetousness, the wrath of God is coming. I think one of the biggest, silliest lies our generations represented in this room are just lapping up as though it is true with no thought and no reason is, “God is a God of love. Therefore, he could never be angry with anyone. If God is a God of love, there is no room for him to have any wrath.”
Yet common sense would tell you the greater the love, the greater capability of wrath. I’ll say this. If you came over to my house and you took my rake… It’s not a nice rake. It’s like $5. You took my rake, and you broke my rake. You ran over it with your car. I mean, I’m going to think you’re a psychopath, but I’m just going to go get another rake. But try that with one of my children. Try that with my wife. I’m a pretty stable brother, but I know I have some capabilities.
The greater the love, the greater the wrath. It is a silly god of your imagination when you think God could never be wrathful toward what destroys the crown jewel of his creation, namely humankind. What does sexual immorality do? What is this kind of compulsive, impulsive thing? What does moral corruption do? It sows discord, destruction, and devastation to things God cherishes and loves, so he is rightly wrathful about the disintegration of something he loves so deeply, namely you and me.
Then the next part of this text is this really beautiful encouragement to Christians. “Hey, hey! That’s not you anymore. You used to do this thing, and now since you have a new relationship with Christ and you have a new relationship because of Christ with sin, your relationship with sin has changed. Therefore, put it away.
This is the ”hide the body“ part. We have the ”put it to death,“ and now we have the ”hide the body.“ Put them all away. This next list shows you kind of the devolution of relationships. The first list ends with covetousness. ”You have what I think I deserve. I’m not getting what I deserve.“
By the way, just for free. It’s not in the notes. If you ever have the thought about God, ”I am not getting what I deserve,“ you are correct, but you’re probably just correct differently than you think you are. You are not getting what you deserve, and that should make you worship your faces off.
He gets into now we’re coveting. We’re looking at, ”I don’t have that. I deserve that.“ Then watch the progression. ”…put them all away: anger, wrath, malice, slander, and obscene talk… Do not lie to one another…“ Now what you just saw there is the disintegration of relationships and the kind of relationships that form us and sustain us. When I covet, that creates anger in my heart. Like I’m angry that you have something I don’t have or that I have not experienced what you have been able to experience.
That anger leads to wrath. Wrath is not explosion. It is steadily building opposition against. Here’s how you’ve experienced this. You have coveted. You have begun to be angry. Then you begin to steadily build opposition against. Have you ever been in an argument or a disagreement with someone, and then over the next couple of days, you begin to remember, ”Man, I wish I would have said… I tell you what, if I could go back in time, I’d tell her, ’Who are you looking at?’“
You start to replay things in your head, and it starts to build. You have anger leading to wrath leading to malice. Now in your wrath that’s steadily building opposition rooted in anger, stemming from that list above now we’re to malice. We want to harm them. We’re not psychopaths, so we’re not going to roll up on them and punch them in the face or something like that. No, no, no. We’re far too civilized for that.
We’ll slander them instead. We’ll slander. We’ll make up stories. We will point out their weaknesses. We will take any credit they receive from others. ”Hey, that guy is great.“ ”I mean, yeah. He is great for a guy who has gone through three divorces.“ You know? It’s that kind of stuff where we just want to discredit and slander. Then slander leads to obscene talk.
Now because we’re Westerners, when we hear ”obscene talk,“ we think of cuss words. All right? That’s not what ”obscene talk“ is in this text. This is cursing, not language but cursing someone. Like placing a curse on them. Don’t think witchcraft. Just think, you can hurt people with your words. You can recover from a good punch to the jaw. There are some things that can be said to you that will haunt you for the rest of your life.
When he talks ”obscene talk“ here, he is saying basically you curse someone with your words. Then that leads to lying, because when you get confronted about all this stuff, ”No, that’s not what happened. What had happened was…“ You begin to lie to get out from under the weight of your conviction.
Then he moves on from there to say then put off. What you’re supposed to put off in particular is the old self with its practices. Once again, he is reworking our relationship structure. Since you have been raised with Christ, since your life is hidden with Christ in God, you used to do these things, but now you’ve been made new. So take off those old practices.
The New Testament loves the imagery of clothing and armor and taking it off and putting it on and those kind of things. Maybe to make this more visceral, when I was in college, my potluck roommate and I would play basketball late in the evenings because that’s what you do in college, right? You’ll sleep when you get out of college (at least that’s what you think). We would go start playing basketball at 8:30 or 9:00 at night and then just play until sometimes midnight, sometimes north of midnight. Then we’d come back to our dorm.
Man, I don’t know your college experience. I lived in the dorm, and we didn’t have showers in our dorm. We did, but they were down the hall. I think these are illegal now, but it wasn’t even like you had your own stall. It was like a ”See you at the pole“ shower where there are like five of you around it, nobody making eye contact.
We would get back from playing basketball and just be drenched in sweat. I would run, and I would rinse off. By the time I got back to my room, my roommate would just be in bed all sweaty and nasty. That dude didn’t shower before he got in bed. The dude just got in bed. I mean, dirty stank, wet tee shirt on the floor. It actually prepared me for parenting. He is family now. This is awful.
In the middle of this, this is kind of the visceral picture Paul is painting. ”Why are you wearing those grotesque clothes? Why are you?“ The imagery here would be if my college roommate woke up the next morning, got that wet tee shirt, put it back on, and headed to class, which he may or may not have done. That kind of, ”Oh, that is disgusting!“
This is what Paul is trying to create in the minds of his hearers. ”Stop wearing that. That’s not who you are anymore. You’re wearing the wrong uniform. Take off those practices.“ Now my guess is if you have a church background, none of this is new. Again, like I said, nobody in here (I don’t think) is going, ”Wait a minute! Are you saying sexual immorality is wrong? Why has no one ever told me that at church?“
No, no. We know these things. What I want to talk about is why it’s so difficult for us to actually practice them. I haven’t said anything here that most of us aren’t aware of. I think the real question is why are we so inconsistent in their application, and why do we seem to lack the power to surrender to this in such a way that we live lives that line up with God’s good grace for us?
Well, I think the whole key to this text (both this aspect of it, which is putting to death, putting off, putting away) and next week (which is put on and be informed by and be shaped by) all hinge around a singular idea. The more we can grasp that concept, the more victory we walk in. The more we can’t grasp it in our guts (not in our minds), the more we’re hamstrung by holiness being an ever-increasing part of our lives.
With that said, let me give you the concept. The concept that’s woven throughout these 17 verses is the concept of identity (who we are at the core of our essence). You see this starting in verse 1. ”If then you have been raised with Christ…“ Notice the text does not say, ”If you believe Christ was raised…“ No, no, no. It puts you with Christ. ”If you have been raised with him…“ Then in verse 4, ”When Christ who is your life…“ It’s not, ”Christ, who you worship on the weekends.“ No. ”When Christ who is your life…“
Then you see it most fully in verse 11. Here. Here, in Christ. Life is hidden with Christ in God. ”Here there is not Greek and Jew, circumcised and uncircumcised, barbarian, Scythian, slave, free; but Christ is all, and in all.“ What the apostle Paul does here so effectively is he is saying, ”Whatever your go-to, ’Here is my identity,“ is now obsolete in Christ.” You might have secondary identity markers, but your primary identity marker is you are in Christ in God. You have been raised with Christ.
He is saying, “Oh, you want to go ethnically? Well, there’s no longer Jew or Gentile. Oh, you want to go by education? There is no longer barbarian or Scythian. You want to go by social status? Well, there is no longer slave nor free.” Your identity is not made up where you decide it’s made up. It’s given to you. I think this is the concept we must grasp in its fullness. It won’t be easy for us to do because we’re living in a day where what I’m talking about right here is almost villainy.
I’ve been reading a book over the last couple of weeks by Tim Keller. It’s called Making Sense of God. If you don’t know who Tim Keller is, he is an academic, pastor, theologian. Just think Yoda. He would be an example. If you’re thinking about pastors… Google asked Tim Keller to come teach their employees. You know, I got to do a youth camp a couple of weeks ago. Google is like, “Hey, could you come help our employees think well about what it means to be human?”
I’m reading his book Making Sense of God. He has a chapter on identity, and in that chapter… I just can’t encourage you enough to grab that book. Read it slowly, but he is brilliant. Making Sense of God. On his chapter in identity, here is what he says. He says there are two ways to think about identity. There is achieved identity (an identity I achieve for myself), and there is a received identity (or an identity someone from outside of me gives me).
He says the way to best understand this is maybe to compare and contrast it. But before that, let me just define it. Let me define identity. Here is how Keller defines identity. He says identity is your self-understanding (who you really think you are most fundamentally) and whether you feel good about that or not. That’s your identity, who you are most fundamentally. At the core of who you are, who are you?
I think the best way to understand achieved identity (this is Keller) is to contrast it with some history. In non-Western traditional cultures, in ancient cultures, the question, “Who are you?” is answered this way. You’re a father. You’re a mother. You’re a son. You’re a daughter. You are a husband or a wife first. Who you are in the group and who you are in the family is who you are. If you fulfill that role, then you should feel good about yourself.
Then the culture bestows honor on you. You are an honorable person. You should feel very good about yourself. You should have high self-esteem because you’re a good son. You’re a good father. You’re a good husband because you’ve fulfilled your role in the community. Identity is found through self-sacrifice.
Now starting post-World War II (that’s the first hint of it we’ve had in human history), culture has shifted and said, “No longer will you find your identity in community via self-sacrifice. You will find your identity via self-assertion.” You will not find it outside of you. In fact, that is no longer the heroic narrative of our culture. It was a hundred years ago, but the last 75, the heroic narrative of our culture is you find yourself inside of yourself.
You don’t go out of you; you go inside of you. You base it on your feelings, your deepest dreams, and your desires. If anybody else tries to stop you from achieving your greatest desires, then they are to be rejected as villains, tyrants, and oppressors. You go find yourself. This is the air we’re breathing.
Some of you are like, “Ah, I think you might be overstating.” Well, I’m glad. I want to just quote some more modern-day “theologians” who I think are quite well-known. The first is a Norwegian woman. She is the queen of Arendelle. Here is what she would have to say about the subject:
Let it go! Let it go!
Turn away, and slam the door.
I don’t care what they’re going to say.
Let the storm rage on.
The cold never bothered me anyway.
It’s funny how some distance
Makes everything seem small,
And the fears that once controlled me
Can’t get to me at all.
It’s time to see what I can do
To test the limits and break through
No right, no wrong, no rules for me.
Now I’m not baggin’ on Frozen. I’ve seen the movie 100,000 times. I have three kids. What I quoted is going to haunt me all day long. I’ll just be driving this afternoon. “Let it go! Let it go!” I’m not baggin’ on this, but this is the air we’re breathing.
“Nobody gets to define me but me. I get to define me! There’s no right. There’s no wrong. There are no rules. There’s an inward journey of me finding the true self. Then I have to live out that true self. If there’s any opposition, then they’re tyrants and oppressors. I have to find the real me. My only hope at ever being happy is to find the true me.”
Maybe you’re like, “Well, those Norwegians are liberals.” Okay, so I have another one for you. This is from Mother Superior. Here’s what she would say:
Climb every mountain
Ford every stream
Follow every rainbow
Till you find your dream.
All right. Now let’s just stop for a second. That sounds exhausting!
Climb every mountain
Ford every stream
Follow every rainbow
Till you find your dream.
What happens when you climb that first mountain and you realize, “The dream ain’t up here” and you’re 30? Well, now you have to climb down the mountain and start fording streams. Then, man, you still haven’t found your dream, so now you’re chasing rainbows. This is exhausting and silly, but this is the air you’re breathing. Even walking the hall earlier, I was looking at the thousand backpacks you came up with. On multiple backpacks out in our foyer, there are these kind of sentiments: “Make your own magic. Be true to you.”
What does that even mean? Keller says there are four reasons in particular that this idea of finding your identity from the inside is toxic and destructive. Now before we dive into it, I’m not saying the old way was better. I don’t believe in glory days. I think there’s one coming. I don’t think there’s one behind us. If you’re the son of a blacksmith in the fifth century and you want to get into the arts, you’re just kind of out of luck. You know?
“Dad, I want to sing.”
“Okay, well, you’re going to sing while you beat this metal into the shape it’s supposed to be in.”
“Well, I just feel like I want to act.”
“Okay, act up this ax for me really quickly.”
If you were like, “I hate you, Dad” and you were to storm off to the next village, they would be like, “Oh, now who are you? We haven’t seen you around our village.”
“Well, I’m Ebenezer, the blacksmith’s son from two towns over.”
“Well, we have a blacksmith. Why are you here?”
“Well, because I want to act.”
“Well, you’re an outsider. We have our actors. You need to go back to your daddy.”
I’m not trying to paint a picture of yesteryear like it was glorious. In fact, there was plenty of tyranny, plenty of oppression. But Keller is going to give four reasons why this idea of finding your identity inside, achieving your identity, is toxic. Here is what they are. The first is he says…
It’s incoherent. It’s unclear. Here’s what he said. At the deepest part of who you are, there are conflicting loves. You will have multiple dreams and not be able to achieve all of them. It’s incoherent. It’s not clear. You won’t know. Think of how unstable this leaves our souls. If you’re like, “Oh, I have to find my meaning, my core, my essence inside of me…” We’re digging around in those feelings, and we’re like, “Oh, I need this, but gosh! This! I love both these things, but I can’t do both. Which one?” It’s incoherent.
It’s unstable. Here’s how I would paint Keller’s point of unstable. When I turned 23, I could look back and see 13-year-old Matt was an idiot. I was 23, and I was like, “Good God! I can’t believe I am still alive!” But at 23, I thought I was wise beyond my years. I thought I had some life experience. I thought I had a lot to offer the world. At 33, I couldn’t believe 23-year-old Matt was allowed to do anything, much less have a driver’s license.
Then at 43 (where I am now), I look back at 33-year-old Matt and go, “Oh the mercy of God is unreal! They gave that kid a mic. Why would they have given him a mic?” Straight up. I’m 43. I feel like I’m seasoned. I feel like I have better nuance than I ever have. I think I have a good head on my shoulders. I think I understand well. My marriage is flourishing. My kids are doing well. I’ve learned some things I’ve needed to learn (a lot of times the hard way at your expense). That’s why I’m going to give you my sixties, Lord willing, because you have had my twenties and thirties.
Now here’s what I’m fully convinced of. At 53, I’m going to think where I am right now was silly, uninformed, and harmful. Which one of those do I trust? My guess is when I’m 63, I’ll have some issues with 53-year-old Matt and 73, 63-year-old Matt and 83, 73-year-old Matt. Right? At what point do I trust these feelings that are so fickle and change so quickly to self-identify with? He is saying not only is it incoherent (not clear), but it’s also unstable.
It’s an illusion. Here’s what he says. Here’s his illustration about finding your identity inside of yourself is an illusion. He argues that every culture always never talks about culture itself but lays a grid over the entirety of that culture that informs what they find when they look inside themselves. He says when you go inside, you’re going to find out who you are. You’re going to look at your dreams and your feelings. You’re going to self-identify with those things. You’re going to say, “Here’s who I am, world.” When you do that, it feels pure, but it’s not. It’s an illusion.
Here was his illustration. He said imagine in the fifth century an Anglo-Saxon warrior. If you don’t know history, the Anglo-Saxons were a brutal, violent group who really established the English Empire in the fifth century. Imagine we have an Anglo-Saxon warrior, and he has two competing impulses in his heart. The first is an impulse toward violence. Upon any threat to the empire, any threat against the rule and reign of the Anglo-Saxons is to be met with force, violence, and death swiftly. He has that impulse.
He also has the impulse of same-sex attraction. In the fifth century, it’s a no-brainer. “I will embrace violence and anger, and I will reject same-sex attraction.” Now fast-forward to 2017. A young man or a young woman finds two impulses inside of themselves: the impulse toward anger (the impulse of violence) and the impulse of same-sex attraction. What does our cultural grid say? “No, no. You can’t be angry. You need to go to counseling and anger management for that. Apparently, you were born gay. That’s your identity. You should define yourself that way.”
This is an illusion. It’s culturally informed, and we don’t know it’s happening. It feels pure to us. We get down in to our heart. We’re like, “I feel this. I sense this. This is who I am.” It’s an illusion. It’s been culturally informed. The last thing is he says finding your identity inside of yourself (trying to achieve your identity) is not just incoherent, unstable, and an illusion.
It’s crushing and excluding. Here’s what he means by crushing and excluding. When no God, no Bible, no parents, no community get to help form and shape our identity, all the weight of that lands on us. When the weight of self-identification lands on us, we will, by nature, take good things and make them ultimate things. Let me give you some of those examples that I think most of us experience.
For example, love relationships. If I need my wife to justify me, if I need my wife to help me make sense of who I am, if I need my wife to (Jerry Maguire) “complete me,” then I am jamming up our relationship day one. I am asking her to be for me what she cannot be. “I need you to justify me. I need you to give me meaning. I need you to help me understand that I matter.” That is a crushing weight placed on my wife’s shoulders. She is unable to do those things.
Take this the way I’m saying it. She is too unstable. She is not firm enough to do that for me. She has not been designed to do that for me. She can’t be that. So what I’ll do is I’ll smother her in an attempt… “I need you to be… I need you to be… I need you to be…” She would be like, “Oh gosh!” My wife is independent, so she isn’t having that. What am I going to do? She is going to run off, and I’m going to chase her. “I need you to validate me! Oh! I need you to validate.” Then the marriage disintegrates.
Another way this happens all the time is through children. I mean, you live vicariously through your children, where their victories are your victories. You put a pressure on them to perform. You put a pressure on them to mirror back to you your value and worth in a way that does not enable them to see and form their own identity because you need them to help you form yours.
Man, I’m not saying parenting isn’t complex. It’s hopelessly complex. A few weeks ago, I had a meeting with one guy. He was like, “My dad never came to any of my games. He just wasn’t interested in me at all. He didn’t know how to relate to me. Literally, he never came to one game. I played sports through college, and I don’t think he ever saw me play.” We worked through that, prayed, saw forgiveness, and all that.
Then later in the week, I had a guy who was going, “My dad was at everything. He was at every practice. He was at every game. I just felt this pressure. He never really put any pressure on me. He was just always there, and because he was always there, I was like, ’Oh gosh! I’d better be good at this to be loved by him.’”
I’m a dad of a son. I’m like, “Gosh! Do I go to games? Do I not go to games? Do I just go to half his games? I don’t want to jack up my kid. How do I do this?” All right? “Maybe I’ll go to every other game and look disinterested on two of them and really interested in one.” Right? I mean, this is complex stuff!
I think the best we can be is just to be emotionally available. I think that’s the best we have (to be emotionally available), and that requires us to have an emotional IQ, but that’s a different sermon for a different day. When you expect your kid to hold the mirror for you so you can get your identity from them, this is making them ultimate in a way that’s crushing to them and never going to help you.
If you ever saw the movie Chariots of Fire or read the book (the book is better than the movie, per usual), you get the story of Eric Liddell. Eric Liddell was a strong believer in Christ. In fact, after the Olympics, he actually went to China and served as a missionary in China until he died. The gold medal race was on the Sabbath, and he refused to run on the Sabbath.
If you can imagine, there’s this immense amount of pressure on Eric. I mean, for your country, for your family, your legacy. He is like, “No, no, no. I belong to the King. I will not violate the Sabbath.” He has these great lines. He has this great line where he feels the pleasure of God when he runs. I love that sentence, but my experience is the exact opposite. I just feel the wrath of God when I run. I feel the brokenness of a sinful world when I run. Eric is like, “When I run, I feel the pleasure of God.”
All the focus is on Eric, but it’s actually the other runner, Harold Abrahams, who gives us some insight into making good things ultimate. He is frothing at the mouth. He is ready to go. He is kind of glad Eric is not running. He likes his chances now. He is asked about the race, and here’s what he said: “[I have] 10 lonely seconds to justify my whole existence.”
See what happens? His achieved identity is…what? “I’m an Olympic sprinter.” Now think about this. His whole life he has been running and training. Everybody is going, “You’re fast. You’re amazing. You’re the fastest guy I know.” Then he shows up on the Olympics. He is still one of the fastest. Eric is a little bit faster, but he is still fast. Who knows what’s going to happen? “I am an Olympic sprinter. I am a runner. It is who I am. It is my core essence. It’s what defines me. Who I most fundamentally am is a sprinter.”
If he loses this race, he is dead. He has no idea who he is anymore. Now the reason this is not just crushing but also excluding is if my identity is that I am a salesman, then you cannot outsell me. If you outsell me, that knocks my identity. That sends me into a tailspin where I don’t know who I am anymore. I can’t celebrate you. I have to honestly try to destroy you.
I would do that in really subtle, underhanded ways. I would (back to the list) need to slander you a little bit. I would need to curse you a little bit. I would need to maybe lie about you a little bit. If my identity was in the house I’m in or the car I drive or the money I make, what you will find… I see this. People don’t so much want to be rich as much as they want to be richer than the other people they know. I’m telling you!
What people want is to be richer than the people around them, prettier than the people around them, have nicer things than the people around them, have more… Now what is this? This is all identity stuff. This is all jostled hearts. So what does this have to do with putting to death, putting away, putting off? Well, as Christians, we don’t believe you achieve your identity but rather you receive it. You receive the identity from the creator God of the universe.
Where you and I have longed all of our lives to be delighted in, to be rejoiced in, to have a safe place, to be affirmed, and to have a solid foundation on which we can operate and feel free to fail and still be loved and to stumble and be exactly who we are, which is messy, complex, silly, serious, and all the complexities of the human soul find their rest in a received identity that is bestowed upon them by the creator God of the universe.
This starts to solve some things. You need someone, I need someone, from outside of me to bless me. It does not work for me to bless myself. Do you remember the old Saturday Night Live sketch where the guy looked in the mirror and was like…? He just started to give himself a pep talk. “By golly, people like you. You’re a good person.”
You are where you are, so you can try to pep talk yourself all you want, but you know what’s going on. You know where you doubt. You know where you screw up. You know where you’re morally corrupt. You know where you’re given to impulses and compulsions that are out of step with God. You know this about you. So you can give yourself that pep talk, but there you are lying to yourself aware that you’re lying to yourself, which then does what? Makes you angry. Which leads to what? Coveting, malice, and wrath. We’re back in this cycle we’re supposed to be out of as Christians.
The Bible says we are esteemed by God. We are adored by him. If you’re like, “Well, I’ve never read those verses,” I’m glad you asked. Romans 8 says we have been adopted as sons and daughters. Zephaniah 3 says God sings over us and rejoices in us. Stop for a second. Do you believe the creator God of the universe sees you today hidden in Christ in God, sings over you, and rejoices in you? I’m telling you, most people can’t get that. They might go, “Oh, I’ve seen that verse,” but like get it.
In the book of Psalms on repeat, you’re delighted in, you’re delighted in, you’re delighted in. In Ephesians 2, you’re holy and blameless in his sight. In Colossians 1, you are spotless. He never lets us down. He does not fatigue of our failures. We are his sons. We are his daughters. He delights in us. He rejoices in us. He sings over us. This is an identity that is secure and unshakable.
So watch. If I were to be fired from The Village… I am a pastor and a preacher. If the elders had a meeting with me after service and were like, “Hey, man, I can’t believe you dogged out Frozen like that. We’re going to have to ask you to leave” and I were to leave, now I wouldn’t have that title, but who I am would not have changed, because what I am is an adopted son of the King of Glory who, by the grace of God, gets to preach and pastor.
If (God forbid) something were to happen to my bride and best friend, I would be crushed, but I would be a son of the Most High God, adored, esteemed, loved. Who I am would not fundamentally change. Now I’m going to need a lot of help. I’m going to need a lot of support. I’m going to need some time off, but I’m his.
If there was no money in my account or a lot of money in my account… Now this frees me up to love you, support you, and cheer you on. This gives crystal-clear clarity to what my life is about. This forms an identity in me that you cannot take from me. You can’t do anything to take that from me! You can send me a scathing email about what an utter failure I am, and I’ll just be able to go, “Gosh! I’m far worse than that! Is that all you saw? Are you serious? That’s it? You should probably pay better attention!”
I don’t need to pretend I’m more than I am. I don’t have to carry that weight. I do a few things really, really well, and then I really stink at a lot of other things, which, if you pay attention to our staff, you’ll kind of understand how we’re put together. There’s a freedom to be found in our identity being in Christ. How does that equate to putting things to death? Well, as a child of the King, I have access and benefits as a child of the King that I’m going to choose easily over what the world offers up to me.
You want to offer sexual immorality to me? You want to offer swipe-left hookup when what I have is the mingling of souls with my best friend, the coming together of mind, heart, body, and soul in a depth of intimacy? Look. I don’t care what kind of freaky hook-up sex you’re talking about; that wins.
You want to tempt me with being enslaved and burned up by anger when I can be free of that and trust God to be God and trust that people are as broken as I am and I should extend grace to them as God has so consistently extended grace to me? On and on we go. It’s in understanding who we are that putting things to death, putting them away, and putting them off is possible. But when you don’t get this and you don’t quite have your identity…
I think this is a huge deal in evangelicalism right now. We’re so influenced by this view of identity that we constantly kind of step away from who God says we are to try to make our own name, our own self, our own view. It’s near impossible to not at times give into this. The cultural pull is so hard. It’s so powerful, and yet it must be rejected. It must be rejected!
I so want you to get this. Like not go, “I get it.” I don’t want to give you talking points for a shallow coffee later this week. I don’t want to give you kind of new phrases to in Home Group go, “I really love that.” I don’t want that. I want you to get this. I want you to be transformed by it. In fact, at this point, my sermon is done. I’m just like, “Come on!” But that’s not how this works. That’s not how any of this works. Let’s pray.
Father, I thank you for these men and women. I thank you for your Word. I thank you that you are working in us, moving in us, shaping us. Help us believe what you say about us is true. Thank you that we are hidden in Christ in you. Thank you that you see us as holy, spotless, and blameless in your sight. Help us then with that understanding get violent over sins that are trying to destroy, hooks that are trying to be set deep.
Let us be serious about our adversary and your power to destroy him. Let us walk in the power of being the princes and princesses of glory. Let us sit at your table and feast on what you have provided us. Why would we choose the rags of rebellion when the cloaks of righteousness await us? Help us. It’s for your beautiful name I pray, amen.
Matt Chambers is a farmer from Iowa that talks about an accident that changed his family for ever. It’s an heartbreaking story, but you wont believe what happens at the 40 minute mark. Please follow our advertisers on Twitter @BASFAgProducts @HalesBells82
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