Read Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health Online
Authors: William Davis
Wheat Belly: Lose the Wheat, Lose the Weight and Find Your Path Back to Health (16 page)
Ask any diabetic about the effects of this diet approach, and they will tell you that any of these foods increase blood sugar up to the 200 to 300 mg/dl range or higher. According to ADA advice, this is just fine … but be sure to track your blood sugars and speak to your doctor about adjustments in insulin or medication.
Does the ADA diet contribute to a diabetes cure? There’s the gratuitious marketing claim of “working toward the cure.” But
real
talk about a cure?
In their defense, I don’t believe that most of the people behind the ADA are evil; many, in fact, are devoted to helping fund the effort to discover the cure for childhood diabetes. But I believe they got sidetracked by the low-fat dietary blunder that set the entire United States off course.
To this day, the notion of treating diabetes by increasing consumption of the foods that caused the disease in the first place, then managing the blood sugar mess with medications, persists.
We have the advantage, of course, of 20/20 hindsight, able to view the effects of this enormous dietary faux pas, like a bad B-movie video on the VCR. Let’s rewind the entire grainy, shakily filmed show: Remove carbohydrates, especially those from “healthy whole grains,” and an entire constellation of modern conditions reverse themselves.
Fifth-century
B.C.
Indian physician Sushruta prescribed exercise for his obese patients with diabetes at a time when his colleagues looked to omens from nature or the position of the stars to diagnose the afflictions of their patients. Nineteenth-century French physician Apollinaire Bouchardat observed that sugar in the urine of his patients diminished during the four-month-long siege of Paris by the Prussian army in 1870 when food, especially bread, was in short supply; after the siege was over, he mimicked the effect by advising patients to reduce consumption of breads and other starches and to fast intermittently to treat diabetes, despite the practice of other physicians who advised
increased
consumption of starches.
Into the twentieth century, the authoritative
Principles and Practice of Medicine,
authored by Dr. William Osler, iconic medical educator and among the four founders of the Johns Hopkins Hospital, advised a diet for diabetics of 2 percent carbohydrate. In Dr. Frederick Banting’s original 1922 publication describing his initial experiences injecting pancreatic extract into diabetic children, he notes that the hospital diet used to help control urinary glucose was a strict limitation of carbohydrates to 10 grams per day.
18
It may be impossible to divine a cure based on primitive methods such as watching whether flies gather around urine, methods conducted without modern tools such as blood glucose testing and hemoglobin A1c. Had such testing methods been available, I believe that improved diabetic results would indeed have been in evidence. The modern cut-your-fat, eat-more-healthy-whole-grains era caused us to forget the lessons learned by astute observers such as Osler and Banting. Like many lessons, the notion of carbohydrate restriction to treat diabetes is a lesson that will need to be relearned.
I do see a glimmer of light at the end of the tunnel. The concept that diabetes should be regarded as a disease of
carbohydrate
intolerance
is beginning to gain ground in the medical community. Diabetes as a by-product of carbohydrate intolerance is actively being advocated by vocal physicians and researchers such as Dr. Eric Westman of Duke University; Dr. Mary Vernon, former medical director of the University of Kansas Weight Control Program and past president of the American Society of Bariatric Physicians; and prolific researcher Dr. Jeff Volek of the University of Connecticut. Drs. Westman and Vernon report, for instance, that they typically need to reduce the insulin dose by 50 percent the
first day
a patient engages in reducing carbohydrates to avoid excessively low blood sugars.
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Dr. Volek and his team have repeatedly demonstrated, in both humans and animals, that sharp reduction in carbohydrates reverses insulin resistance, postprandial distortions, and visceral fat.
20,
21
Several studies conducted over the past decade have demonstrated that reduction in carbohydrates leads to weight loss and improved blood sugars in people with diabetes.
22,
23,
24
In one of these studies, in which carbohydrates were reduced to 30 grams per day, 11.2 pounds of weight loss on average resulted and HbAlc (reflecting average blood glucose over the preceding 60 to 90 days) was reduced from 7.4 to 6.6 percent over a year.
25
A Temple University study of obese diabetics showed that reduction of carbohydrates to 21 grams per day led to an average of 3.6 pounds of weight loss over 2 weeks, along with reduction in HbA1c from 7.3 to 6.8 percent and 75 percent improvement in insulin responses.
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Dr. Westman has been successfully validating what many of us learn in clinical practice: Virtual
elimination
of carbohydrates, including the “dominant” carbohydrate of “healthy” diets, wheat, not only improves blood sugar control, but can
erase
the need for insulin and diabetes medications in adult (type 2) diabetics—otherwise known as a cure.
Prior to the discovery of insulin, childhood, or type 1, diabetes was fatal within a few months of onset. Dr. Frederick Banting’s discovery of insulin was truly a breakthrough of historic significance. But why do children develop diabetes in the first place?
Antibodies to insulin, beta cells, and other “self” proteins result in autoimmune destruction of the pancreas. Children with diabetes also develop antibodies to other organs of the body. One study revealed that 24 percent of children with diabetes had increased levels of “autoantibodies,” i.e., antibodies against “self” proteins, compared to 6 percent in children without diabetes.
27
The incidence of so-called adult (type 2) diabetes is increasing in children due to overweight, obesity, and inactivity, the very same reasons it is skyrocketing in adults. However, the incidence of type 1 diabetes is also increasing. The National Institutes of Health and the Centers for Disease Control and Prevention cosponsored the SEARCH for Diabetes in Youth study, which demonstrated that, from 1978 to 2004, the incidence of newly diagnosed type 1 diabetes increased by 2.7 percent per year. The fastest rate of increase is being seen in children under the age of four.
28
Disease registries from the interval between 1990 and 1999 in Europe, Asia, and South America show a similar increase.
29
Why would type 1 diabetes be on the increase? Our children are likely being exposed to something. Something sets off a broad abnormal immune response in these children. Some authorities have proposed that a viral infection ignites the process, while others have pointed their finger at factors that unmask expression of autoimmune responses in the genetically susceptible.
Could it be wheat?
The changes in the genetics of wheat since 1960, such as that of high-yielding dwarf strains, could conceivably account for the recent
increased incidence of type 1 diabetes. Its appearance coincides with the increase in celiac disease and other diseases.
One clear-cut connection stands out: Children with celiac disease are ten times more likely to develop type 1 diabetes; children with type 1 diabetes are ten to twenty times more likely to have antibodies to wheat and/or have celiac disease.
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The two conditions share fates with much higher likelihood than chance alone would explain.
The cozy relationship of type 1 diabetes and celiac disease also increases over time. While some diabetic children show evidence for celiac disease when diabetes is first diagnosed, more will show celiac signs over the ensuing years.
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A tantalizing question: Can avoidance of wheat starting at birth avert the development of type 1 diabetes? After all, studies in mice genetically susceptible to type 1 diabetes show that elimination of wheat gluten reduces the development of diabetes from 64 percent to 15 percent
33
and prevents intestinal damage characteristic of celiac disease.
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The same study has not been performed in human infants or children, so this crucial question therefore remains unanswered.
Though I disagree with many of the policies of the American Diabetes Association, on this point we agree: Children diagnosed with type 1 diabetes should be tested for celiac disease. I would add that they should be retested every few years to determine whether celiac disease develops later in childhood, even adulthood. Although no official agency advises it, I don’t believe it would be a stretch to suggest that parents of children with diabetes should strongly consider wheat gluten elimination, along with other gluten sources.
Should families with type 1 diabetes in one or more family members avoid wheat from the start of life to avoid triggering the autoimmune effect that leads to this lifetime disease called type 1 diabetes? Nobody knows, but it’s a question that truly needs answering. The increasing incidence of the condition is going to make the issue more urgent in the coming years.
In one of Dr. Westman’s recent studies, 84 obese diabetics followed a strict low-carbohydrate diet—no wheat, cornstarch, sugars, potatoes, rice, or fruit, reducing carbohydrate intake to 20 grams per day (similar to Drs. Osler and Banting’s early-twentieth-century practices). After six months, waistlines (representative of visceral fat) were reduced by over 5 inches, triglycerides dropped by 70 mg/dl, weight dropped 24.5 pounds, and HbAlc was reduced from 8.8 to 7.3 percent. And 95 percent of participants were able to reduce diabetes medications, while 25 percent were able to
eliminate
medications, including insulin, altogether.
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In other words, on Dr. Westman’s protocol using
nutrition
—not drugs—25 percent of participants were no longer diabetic, or at least had blood sugar control improved sufficiently to manage with
diet only. The remainder, while still diabetic, enjoyed better blood glucose control and reduced need for insulin and other medications.
The studies to date have achieved proof of concept: Reduction of carbohydrates improves blood sugar behavior, reducing the diabetic tendency. If taken to extremes, it is possible to
eliminate
diabetes medications in as little as six months. In some instances, I believe it is safe to call that a cure, provided excess carbohydrates don’t make their way back into the diet. Let me say that again: If sufficient pancreatic beta cells remain and have not yet been utterly decimated by long-standing glucotoxicity, lipotoxicity, and inflammation, it is entirely possible for some, if not most, prediabetics and diabetics to be cured of their condition, something that virtually never happens with conventional low-fat diets such as that advocated by the American Diabetes Association.
It also suggests that
prevention
of diabetes, rather than
reversal
of diabetes, can be achieved with less intensive dietary efforts. After all, some carbohydrate sources, such as blueberries, raspberries, peaches, and sweet potatoes, provide important nutrients and don’t increase blood glucose to the same extent that more “obnoxious” carbohydrates can. (You know who I’m talking about.)
So what if we follow a program not quite so strict as the Westman “cure diabetes” study, but just eliminated the most ubiquitous, diet-dominating, blood sugar-increasing food of all? In my experience, you will drop blood sugar and HbAlc, lose visceral fat (wheat belly), and free yourself from the risk of participating in this nationwide epidemic of obesity, prediabetes, and diabetes. It would scale back diabetes to pre-1985 levels, restore 1950s dress and pants sizes, even allow you to again sit comfortably on the airline flight next to other normal-weight people.
The wheat-as-guilty-culprit in causing obesity and diabetes reminds me of the O.J. Simpson murder trial: evidence found at
the scene of the crime, suspicious behavior by the accused, bloody glove linking murderer to victim, motive, opportunity … but absolved through clever legal sleight of hand.
Wheat looks every bit the guilty party in causing diabetes: It increases blood sugar more than nearly all other foods, providing ample opportunity for glucotoxicity, lipotoxicity, and inflammation; it promotes visceral fat accumulation; there is a fits-like-a-glove correlation with weight gain and obesity trends over the past thirty years—yet it has been absolved of all crimes by the “Dream Team” of the USDA, the American Diabetes Association, the American Dietetic Association, etc., all of whom agree that wheat should be consumed in generous quantities. I don’t believe that even Johnnie Cochran could have done any better.
Can you say “mistrial”?
In the court of human health, however, you have the opportunity to redress the wrongs by convicting the guilty party and banishing wheat from your life.
