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Dr. R. Shatin of Melbourne, Australia, member of the Scientific Council of the International Society for Research into Nutrition and Civilization Disease, has, since 1963, been publishing reports on his treatment of cases of rheumatoid arthritis with a gluten-free, high protein diet, with supplements, introducing his concept that in these patients, as in celiacs, the primary lesion is to be found in the small intestine.

Shatin's concept rests on his view that "the domestication of cereals (wheat and later rye and oats) crucial to the development of civilization also confronted metabolism with a historical challenge." He points out that man changed from a food-gather to a food-producer, epochal changes in his ecology were paralleled by similar changes in his diet. This transition from animal flesh and milk with what nuts, berries, fruits and roots were still available from the times when he lived exclusively on these, to domesticated cereals obtained by culturing and farming the seeds of grasses, could have been too sudden for the digestive functions of a significant minority to have been able to adapt adequately to such drastic changes in dietetic habits. Dr. Shatin considers that celiac disease may have been very common in pre-history, but that since it would have been lethal before the age of reproduction was reached, a partially dominant trait could in this way have become rare (as it now is) and recessive.

He presents evidence that there is also small intestine malabsorption in RA and suggest the possibility that a susceptibility to this disease exists which can be activated by gluten and other factors into a primary lesion (injury). He claims that the apparent benefit from the use of a gluten-free-high-protein diet in a few cases of RA has given him some practical support for his theoretical considerations and points out that in its medical aspects, his hypothesis has the merit of being eminently capable of proof.

Taking up this challenge came a report from Yale that on testing six arthritis patients no abnormal mucosa had been detected; in 17 others there was no evidence of increased intestinal permeability, and in carefully controlled hospital trials on five patients a gluten-free diet had been of no value. However, these are small numbers and it would be of interest and, we hope of benefit, to see what happens in individuals who put Shatin's hypothesis to the test for themselves, especially if they give themselves the added advantage of cutting out refined carbohydrates as well as adding vegetable oils to ensure adequate unsaturated fats. They could have nothing to lose but there disability. Absolute assurance can be given that the gluten-free high-protein diet detailed in these pages, could in no way interfere with any medical treatment, or possibly do anyone going on it any harm. After all, apart from avoiding substances against which we have been medically warned, we all have the right to choose what we eat, for better or for worse. So why not plump for the better, and "give it a go," as Dr. Shatin, as a good Australian, might put it?

The above extracted from: Hills, Hilda Cherry, _Good Food, Gluten Free_, New Cannan: Keats Publishing, 1976.