Physician Phollies ~ II: Dr. William "Wheat Belly" Davis

Next up in our "how can he/she even say that?" series of blatantly erroneous things said by practicing physicians in furtherance of the carbophobic agenda ...

I bring you, an Asylum favorite, Dr. William "Wheat Belly" Davis.  In the most recent post on his WB blog, Wheat Belly trips over himself trying to implicate wheat, specifically, in the diabetes epidemic.  
But can we blame diabetes on wheat?
Yes, absolutely, as much as you can blame poor oral hygience for toothlessness in West Virginia.
Wow!  Gratuitous slam on WVa's aside, Dr. Wee Bee goes on  to list all the ways wheat causes diabetes:
–Any food that increases blood sugar to high levels (i.e., high glycemic index) also increases insulin to high levels. Repetitive high insulin leads to insulin resistance, which leads to visceral fat deposition, more insulin resistance, inflammation, etc., eventuating in diabetes.
–High blood sugar, such as that resulting from eating two slices of whole wheat bread, is toxic to pancreatic beta cells, the cells that produce insulin: glucotoxicity.
–Triglyceride-containing lipoproteins, such as chylomicrons and its remnants, are toxic to pancreatic beta cells: lipotoxicity.

–The gliadin protein of wheat stimulates appetite, causing the unwitting wheat consumer to eat, on average, 400 more calories per day, mostly from carbohydrates. 400 calories per day, 365 days per year . . . that’s a lot of extra calories, a lot of potential weight gain.
–The lectins of wheat (wheat germ agglutinin) are inflammatory, generating inflammation in multiple sites, such as joints, intestinal tract, and endocrine glands. Higher levels of inflammation and its various mediators (tumor necrosis factor, the interleukins, etc.) worsen insulin resistance, worsening the vicious cycle.
I've addressed most of the other stuff in small print, and won't rehash that here, but I had to address that bolded/emphasized bullet point.  Sigh.  How can a cardiologist who should be intimately familiar with blood lipids/lipoproteins make such a critical error here?   Oh, CarbSane you're just being mean.  Davis is trying to help people!  He has cured his diabetes, surely this was just a typo.  Feh.

Chylomicrons, folks, as any idiot introductory soft-science nutrition student will learn, are the lipoprotein particles that carry dietary fat in the bloodstream.  Their triglyceride load is delivered to peripheral tissues for energy and the adipose tissue (the proportion of which is determined by nutrient state and size of fat load with more going to periphery in fasted state, and more going to adipose tissue in recently fed state and/or large fat load).  When these chylomicrons are depleted of triglycerides, they become .... chylomicron remnants (nothing fancy about that name!).  Bottom line, chylomicrons themselves have nothing to do with carbohydrates in general, or any carbohydrate or protein component of wheat in particular.  Zilch, nada, etc.  It is true that carbs can reduce clearance of chylo remnants, but (a) there wouldn't be as many remnants if there were fewer chylo to begin with, and (b) excess circulating lipids of this nature are more a function of caloric excess.

Anyone of Davis' supposedly vast knowledge of diabetes, and anyone who's read any of the various and several peer review articles on lipotoxicity, should know that it is the free fatty acids (NEFA or FFA) that are potentially toxic, and that the triglycerides implicated are the excessive ectopic (non-adipose tissue) deposits within the cells like pancreatic beta cells.   Circulating triglycerides are not directly implicated in beta cell lipotoxicity.  Perhaps he should read here at the Asylum where he'll learn all about free fatty acids ;-)

In any case, we have a Double Whammy Physician Phollie here:
  1. Suggesting wheat has anything to do with chylomicrons and formation of their remnant particles 
  2. Blaming dietary fat, the source of chylo/remnants for killing beta cells
I'd say #2 is a huge oops for someone trying to sell books help people prevent diabetes out of the kindness of his heart by implicating a singular food -- evil wheat!  If it's chylo that kills, wheat is not the devil!  That's for the mainstream to get wrong, right?

Perhaps I'm being too hard on Wheat Belly.  I don't think so, because this is not the first time Davis has done this.  Flashback:  What to think when "experts" get it wrong ... repeatedly??.  Among other phollies by Davis, that post highlighted this from his blog, saying virtually the same thing:
Because carbohydrates, such as products made from wheat, increase triglycerides and triglyceride-containing lipoproteins (chylomicrons, chylomicron remnants, ...

Given that a, then ardent low carber, Hans Keer corrected him and Davis couldn't be bothered to respond,  no further pass on this can be given. 

The F'en Wheat Belly Button
It's only Thursday morning, but it's after noon somewhere, so perhaps some of you want to get a jump on the weekend!  As such, I've decided to introduce a cocktail in honor of Dr. William "Wheat Belly" Davis.  Let's do our own take on the fuzzy navel, traditionally made with peach schnapps and orange juice.  We wouldn't want to carb it up too much so we'll use a splash of a light orange drink, sugar free peach syrup and vodka.  Oh, but let's poke a just a wee bit and use Effen (wheat) vodka! 

Enjoy an F'en Wheat Belly Button on the house!

(Be sure to use the coupon code CRUISEGATE2012)



bentleyj74 said…'s safe to say he's not concerned about book sales in WV? What with all the poor oral hygeine [and speed].
bentleyj74 said…
I drove through WV rather than fly over it for the first time when we moved to DC. I was suprised more people didn't go there. The landscape was so beautiful!

Then we stopped for gas at an out of the way place that had some sort of retro gas pump I couldn't figure out how to run and had to step past some very obese "jean overalls with no shirt" wearing individuals hanging out by the picked fetal pig in a big glass container on the counter to ask for help.

Yeah, we didn't linger.
Lerner said…
For curiosity's sake: here's am interesting photo of chylo-clouded dog serum:

(it's at the bottom of the page)

Also for curiosity: there is a spanking new wikipedia article on lipotoxicity:

(started October 2011)
Diana said…
"Yes, absolutely, as much as you can blame poor oral hygience for toothlessness in West Virginia."

Hm. Is toothlessness in NYC due to good oral hygiene?

@bentley, "he landscape was so beautiful!" I spent summer of 1988 in DC (summer in DC is not recommended) and heard that WVA was a favorite 2nd home place for rich DCers. Don't know if that's still the case. It is spectacularly beautiful.
bentleyj74 said…
" I spent summer of 1988 in DC (summer in DC is not recommended)"

I know right! I arrived in Feb and it was Tolkienesque. Dreamy, fog laden, and chill. May rolled around with an immediate and unapologetic sucker punch. Our first year there was a cicada year as well which [if you've never experienced] is surreal. Half expected tripods to erupt from the streets. Rain of toads at least.

PS, I suspect it's the housing prices in DC that drive markets in WV :)
Tonus said…
"Hm. Is toothlessness in NYC due to good oral hygiene?"

Toothlessness is NYC is usually due to giving the wrong reply to "what the %$@$ you lookin' at?"
Diana said…
@Tonus: LOL!

Re: Wheat...and its toxicity and allegedly magically fattening effects. I got interested (again) in baking since the holidays and I read up about wheat, different kinds, etc.

Wikipedia: "Wheat was a key factor enabling the emergence of city-based societies at the start of civilization ..."

I realize I'm not telling folks here (a smart lot) anything they don't already know. Just sayin'. (actually, quoting).

So, Dr. Wheat Belly wants us to believe that suddenly, in the last 30 years, wheat developed unique properties to destroy the human metabolism, and selectively, in certain countries?
Lerner said…
What confirmation of rebuttal is there on the study I'd heard of in Paleoland that everybody has their microvilli damaged/eroded by inflammation due to gluten (just that most cases are subclinical)?
Anonymous said…
"Yes, absolutely, as much as you can blame poor oral hygience for toothlessness in West Virginia."

This is inadvertently true and goes against Davis' point if you think about it.

Meaning, you cannot blame the wheat or the "poor oral hygiene" in either case...

You can't really blame toothlessness on poor oral hygiene. Tooth brushing and flossing are merely palliative inventions that become necessary mostly in the context of sugar and grain-containing diets.

Ask any dentist to tell you what a "Dew-head" is. These are folks (both children and adults) who drink mountain dew continuously for the high caffeine and sugar content. Many of them actually do brush their teeth daily and some even floss, yet this is to no avail when one is bathing the oral cavity in such a cariogenic medium. Add in the lack of vitamin K2 and other micronutrients that fight plaque and repair incipient caries, and even owning a toothbrush is just pissing in the wind.

The contrapositive example is all the pre-contact tribes that ate nonindustrial diets of whole foods without any added sugar or other processed food and suffered little caries without any kind of modern "oral hygiene" other than eating meat which is relatively non-cariogenic and fibrous fruits and veggies that mechanically clean the teeth naturally.

PS I am not of course claiming efforts to clean the teeth were not made - even animals do that....
Tori Spinoso said…
Diana, Yes, that is what Dr. D is saying. It has been hybridized and the proteins have changed from the wheat of 50 years ago. You might want to read the book before commenting! I am not so sure that the WV comment is the most important part of Dr. D's post.
bentleyj74 said…
" I am not so sure that the WV comment is the most important part of Dr. D's post."

Oh I don't know, it isn't any worse than several of his other points. I might run with it if I were him.
Sanjeev said…
I guess I'm not familiar enough with hybridization - how can you get brand new proteins (plural) that function properly within an organism in one step - it took Lenski a long, long time to get citrate eating e. Coli.

Sounds impossible to me - the equivalent of (hundreds of?) millions of years of evolution in one swell foop (swell for the breeders).

Maybe the claim is the MIX of proteins has changed, not that the PROTEINS have changed?
Nigel Kinbrum said…
I thought that all proteins are broken down into amino acids & very short peptide chains by peptidase enzymes before absorption (except in people with "leaky" guts).

Is Dr D suggesting that these new wheat proteins are somehow getting into the blood?
Sanjeev said…
It's standard to find wheat protein (full, intact proteins, not radio-tagged aminos) in the blood of celiac sufferers.

Also antibodies to some wheat proteins are found in many more people than have full celiac (or coeliac) or leaky guts suggesting intact wheat proteins are getting into blood/lymph somewhere somehow.

I don't recall reading about full wheat proteins being confirmed in non-celiacs, just the antibodies.

that was peer a peer reviewed paper, unfortunately I didn't keep a reference handy.

I haven't seen it confirmed though so I'm still skeptical
Sanjeev said…
from memory they reported the antibodies in not more than 10% of the subjects they had looked at so far.
Nigel Kinbrum said…
"It's standard to find wheat protein (full, intact proteins, not radio-tagged aminos) in the blood of celiac sufferers."
Coeliacs' guts must leak like a sieve!

RE AGAs:- Are you thinking of Ataxia, peripheral neuropathy, and anti-gliadin antibody. Guilt by association?

As leaky guts let through other hard-to-digest proteins e.g. casein (associated with T1DM in children), I would have thought that it's far better to stop guts from leaking than worry about what proteins we're eating.
Dawn said…
Dr. D's hysteria regarding hybridized wheat (which he vilifies as "dwarf wheat" generally) is what turned me off his blog for good. I don't have much patience for the anti-GMO people, either. I haven't seen any persuasive evidence that any hybridized or genetically modified foods are bad for people. (Now there are certainly some valid cultural and economic reasons to oppose some of these creations, but that's a whole different story.)
Sanjeev said…
I've never gotten a response from the "changed proteins" crowd - what's NEW? Maybe someone replied after I stopped checking for answers?

all the proteins that are in wheat now existed in the diet before, in one strain / cultivar or other. Hybridization creates no new functioning proteins, except in the simplest organisms (flu virus[0] for example - and what happens with very DNA commingling and exchange between very simple viruses and simple bacteria is nothing like plant breeding)

The whole argument is just so fishy to me. I'm not a hybridization expert though. Apparently, from the times I've asked and not received information (as opposed to plain, unsupported assertion), this argument's proponents aren't either.

[0] and even here, billions of trials happen that produce non-functional new proteins
Sanjeev said…
> nothing like plant breeding

In the sense that there's human selection (meaning a very "narrow bandwidth"), and it's selecting between existing traits ... @ the risk of becoming repetitive, no new protein.
Sanjeev said…
the reports I recall [0] were about the finding specific antibodies in asymptomatic (definitely non-celiac) people.

This was one form of research a few people I read were relying on to make the "no wheat for anyone" case, to wit: there's much more disease than people know about - just look at the huge numbers with these antibodies, and until we know what these antibodies are doing no one should eat wheat.

[0] of course I can't find it now that I need to reference it. If I remember my search terms I'll follow up
Sanjeev said…
There was also specific exclusion of leaky gut.

It's been a while since I looked at this but the "gluten sensitivity" world seems to have gotten a lot bigger; this is just one site

Gluten causing or playing a role in migraine, ADHD, autism, chronic fatigue, various cancers ...

it "fits a certain profile"; an agent that can be blamed for the symptoms of life. Next up: gluten sensitivity causes fibromyalgia, AIDS, obesity.

Sigh ... more fodder for my inner hypochondriac.
Sanjeev said…
> an agent that can be blamed for the symptoms of life

didn't mean to include serious actual diseases in that ... just noting that when an agent is proposed for such a wide spectrum it draws attention from all corners.

Well, we can look at the bright side ... if the anti-wheat campaign draws the autism lobby away from the anti-vaccination campaigns ... less wheat is a small price to pay.
CarbSane said…
Welcome to the Asylum Tori! Interestingly we're seeing signs of the obesity epidemic leveling off and/or receding a bit. How would genetic changes in one food really explain all that?

@Nige: I've seen studies where antibodies have been seen in humans to (obviously nonhuman) meat proteins too. It's funny many, like myself, do not tolerate MCT's too well. CO has a lot less than the purified MCT oil but one can overdo on the stuff (especially with the coconut milk) and it will "send you". Folks don't see this as an intolerance though for some reason. Meanwhile, eat a few beans and your gut flora get a bigger lunch than usual, well, THAT'S an intolerance.

@Sanjeev: There's always someone for whom eliminating one thing cured all their ills. I am happy for such people. Problem is if it were really the root cause for all, why doesn't everyone try it at least once? There's lots of stuff about gluten and infertility, so I know someone who went gluten free to try to conceive. Well, it didn't work.

Re: Autism, I've got a more general post coming up addressing a slightly off-topic topic -- overdiagnosis.
Woodey said…
@Dawn "I don't have much patience for the anti-GMO people, either"

Me neither!!! Typical human response to something we don't understand is apprehension and fear. A lot of whack-jobs out there that would love to keep us in the Stone Age. The internet doesn't help since any mental midget can create a site and post whatever comes to mind, then people cherry pick and read anything that feeds their bias.

I posted a link on another thread to Penn & Teller's bullshit episode "Eat This!" which discusses GMO's and how ignorant fearful people try to keep starving nations from getting GMO foods to feed their people. Like Penn said, "Unless you and yours are starving, you need to shut the f**k up!"
Dale said…
I absolutely agree, none of Monsanto's own internal studies (for that's all the FDA requires) showed that any of their GMO's are bad for people. However, given that they were only for 90 days and limited in scope they also didn't show a) That the GMO equivalent was any better than the original non-GMO crop or b) That there are no long-term side effects. When companies like Monsanto are allowed to genetically manipulate our food sources (and they don't even have to label it such) you will eventually end up with something akin to the Thalidomide scandal (this is an analogy, not a literal comparison for any nit-pickers). These foods need stricter - long term trials. I've heard the anti-starvation rhetoric before. The truth however is that no one need starve with standard crops today when the correct techniques and farming technologies are employed - tried and tested technologies rather than experimental ones that alter (possibly irreversibly due to seed cross over etc) the very genetic makeup of our food sources.
Kevin Klatt said…
The fact that caries are a modern creation is not exactly true :