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)

Cheers!