I don’t have a copy of wheat belly, but I will comment on a few excerpts I found on the internet. Just to be clear, I am not against the idea of wheat-/carb-free diets. I just don’t think that is the important concept in insulin resistance/obesity in populations.
[quote]
The early phase of growing visceral fat and diabetes is accompanied by a 50 percent increase in pancreatic beta cells responsible for producing insulin, a physiologic adaptation to meet the enormous demands of a body that is resistant to insulin. But beta cell adaptation has limits.
High blood sugars, such as those occurring after a nice cranberry muffin provoke the phenomenon of â??glucotoxicity,â?? actual damage to pancreatic insulinâ??producing beta cells that results from high blood sugars.9
The higher the blood sugar, the more damage to beta cells. The effect is progressive and starts at a glucose level of 100 mg/dL, a value many doctors call normal. After two slices of whole wheat bread with low-fat turkey breast, a typical blood glucose would be 140 to 180 mg/dL in a nondiabetic adult, more than sufficient to do away with a few precious beta cellsâ??which are never replaced.[/quote]
First of all, glucotoxicity is an accepted mechanism of beta cell dysfunction and loss. However, the doctor states that a turkey sandwich will raise blood sugar levels high enough to destroy a few beta cells. This is completely false. Glucotoxicity is a chronic condition; a transient increase in blood glucose is not sufficient to destroy these cells. Furthermore, the doctor implies that raising blood glucose above 100 mg/dL would lead to irreplaceable loss of beta cells. A number like that could not definitively be defined. If the doctor has a scientific reason to speculate such a thing, it would be based in poor reasoning.
[quote]
Your poor, vulnerable pancreatic beta cells are also damaged by the process of lipotoxicity, loss of beta cells due to increased triglycerides and fatty acids, such as those developing from repeated carbohydrate ingestion. Recall that a diet weighted toward carbohydrates results in increased VLDL particles and triglycerides that persist in both the after-meal and between-meal periods, conditions that further exacerbate lipotoxic attrition of pancreatic beta cells.[/quote]
The post-prandial hyperlipidemia that the doctor talks about is a consequence of insulin resistance and diabetes, something which is not necessarily attributed to wheat consumption. Furthermore, a high fat diet would lead to the above much faster than excess carbohydrates. The take home message is that anything in excess (pathological amounts) can directly result in a particular dysfunction, which also impacts other systems. carbohydrates → glucotoxicity → dyslipidemia. fats → lipotoxicity → high blood glucose.
[quote]
Pancreatic injury is further worsened by inflammatory phenomena, such as oxidative injury, leptin, various interleukins, and tumor necrosis factor, all resulting from the visceral fat hotbed of inflammation, all characteristic of prediabetic and diabetic states.10
Over time and repeated sucker punches from glucotoxicity, lipotoxicity, and inflammatory destruction, beta cells wither and die, gradually reducing the number of beta cells to less than 50 percent of the normal starting number.11 Thatâ??s when diabetes is irreversibly established.[/quote]
I don’t think anybody would disagree with the above.
[quote]
I think wheat is the worst of the worst carbohydrates, not only because of the blood-sugar effect but also because it increases consumption. You take the wheat away from the average person’s diet, and there’s a natural reduction in appetite to the tune of 400 calories a day. That would happen if the only thing I asked you to do is to eliminate wheat.[/quote]
Maybe. I haven’t read any studies on appetite regulation and wheat. Anybody that has can comment on this.
[quote]
There’s a very close connection - that’s how I stumbled onto this. The most flagrant cause for heart disease that’s rarely talked about is small LDL particles. I’ve watched small LDL particles explode over the last 15 years. It has become not just common but the dominant pattern we see now in virtually everybody. I’ll see maybe a handful of people a year who don’t have it, and they’re all young, slender, pre-menopausal females who are marathon runners. Everybody else has at least moderate-to-severe degrees of LDL.
There are only two ways to get small particles, the flagrant kind that causes heart disease. One is genetically determined; the other is carbohydrate. I used a very simple line of reasoning. The foods that trigger the LDL pattern the worst, once removed, give you the most extravagant benefits. If wheat raises blood sugar and triggers small LDL particles higher than almost all other kinds of foods, let’s see what happens when I took the wheat out of the diet of those with small LDL and high blood sugars. [/quote]
Small LDL is ONE theory about heart disease. There are many others that stand out as well. Secondly, there are numerous ways that small LDL particles can be generated, not just two. On a side note, it is not the size of the particle that makes these particles pathogenic, as is commonly stated. It has been known for more than 10 years that large particles can easily transverse the endothelium. It is a misconception that only small particles make it through.
[quote]
Patients would come back with much lower fasting blood sugars and weight loss, but I’d also hear stories about how their asthma improved. Leg swelling decreased; mood and depression improved. Other forms of arthritis and inflammatory diseases improved. Crohn’s Disease improved. Acid reflux went away. At first, I thought: “This has to be a coincidence. Why would this have anything to do with eliminating wheat from your diet?”[/quote]
Is this really so surprising. People lost weight, became more insulin sensitive and improved in a number of areas of health.
but there are numerous studies showing that physical activity w/o dietary intervention fail at weight loss.