Now we get to the third point in the list from the foreword to Wheat Belly. “3) Direct connections between wheat consumption and conditions such as diabetes, both type 1 and type 2, had been conclusively made … but virtually nobody had collected the data into one place nor dared question conventional advice that advocates essentially unconstrained consumption of the new modern strains of wheat.” There definitely are direct connections between wheat and both types of diabetes. But the sentence is misleading because it leads you to believe that wheat is implicated in the cause of diabetes type 1 and 2. Let’s see what the real connections show.
I’ll start with a brief rundown of diabetes. Type 1 diabetes is more common in younger, slender people and is associated with the immune system destroying the body’s ability to make insulin. Type 1 diabetes is known as insulin-dependent diabetes and without insulin, many of the people with type 1 diabetes will end up in a diabetic coma. It is not a curable condition at the moment, although it is possible that newer techniques may allow a cure in the future. Type 2 diabetes however is by far the most common, accounting for over 95% of all diabetes. These are typically heavier, older patients who become severely resistant to insulin (think King Henry VIII).
It’s important to point out that the book spends a great deal of time talking about celiac disease patients. To be sure, these patients have a serious illness, they should definitely avoid gluten and they have very disrupted immune systems. However the vast majority of people do not have celiac disease, just like the vast majority of people are not allergic to strawberries. The existence of people who are allergic to strawberries does not make strawberries dangerous to the general population, nor does the existence of people with celiac disease make wheat dangerous to the general population, but that is the trick the book is trying to pass off. It points out that children diagnosed with celiac disease have much higher rates of type 1 diabetes. This is a well-established fact. If a child is diagnosed with one, he has a greater likelihood of having both, but when we look at broad populations, we find very different cause and effect relationships.
Strictly limiting ourselves to type 1 diabetes in children, many studies have been done to determine what causes it. The most important thing to know is that there is a wide variation in global incidence. Countries with the most type 1 diabetes have over 300 times more cases than those with the fewest cases. In 2000, a study was published in the June issue of the American Journal of Clinical Nutrition by Dr. Sergio Muntoni at the Center for Metabolic Diseases and Atherosclerosis. His paper tried to determine which variables were most associated with developing type 1 diabetes. The paper concluded that of all foods, dairy products were the most associated with developing diabetes to a very high degree of significance, the other significant risk factor was meat consumption.
Whole grains were definitely protective against type 1 diabetes according to the study. A 2003 study published in the Annals of Nutrition and Metabolism by Dr. Inga Thorsdottir found that a diet high in saturated fat, meat and dairy products were all significant risks for developing type 1 diabetes. A review article on prevention of type 1 diabetes published by Dr. Wherret at Children’s Hospital in Toronto in 2009 states:
The specific environmental factors involved remain largely unproven, although both epidemiological and animal-model data suggest a potential role for dietary factors, and more specifically two, namely early exposure to cow’s milk and relatively low vitamin D concentrations, with much more data pointing to a role for cow’s milk proteins.
Wheat Belly recommends unlimited cheese consumption for anyone past weaning. Cheese is simply a block of fermented cow’s milk protein and fat. Now you can see that in large scale studies, rather than wheat, dairy is implicated in causing type 1 diabetes.
What do we see when it comes to type 2 diabetes? The book points to the high glycemic index of some wheat products and the obesity epidemic and tries to link those two in your mind without ever actually examining the large-scale studies that have looked at this exact question. Looking at large scale studies, the claim evaporates. The Health Professionals Follow-up Study was a trial where they looked at the diets of almost fifty thousand men over twelve years. Published in 2002, they found the men least likely to get type 2 diabetes were those eating the most whole grain! A Finnish study published in 2003 in the American Journal of Clinical Nutrition found that whole grains were very protective with those eating the most grain having the lowest rates of type 2 diabetes. The Nurses Health Studies I and II looked at over 160,000 women and followed them to see if they developed type 2 diabetes. They published a study in 2007 in PLoS Med that showed the women with the most whole grain consumption had the least diabetes, even when they adjusted for obesity.
In fact, the book doesn’t reference a single study that shows high whole grain consumption increases the rate of diabetes in a population of anyone other than celiac disease sufferers. The book doesn’t reference a single study that suggests wheat consumption causes type 2 diabetes. It does show that US wheat consumption went up a trivial amount between 1970 and 2008. But the book doesn’t mention that wheat consumption plummeted from 220 pounds per person per year in 1879 to 130 pounds per person per year in 1970. By reading this book, you would come away thinking that if Americans ate 220 pounds of wheat per year they would all be desperately sick from diabetes, yet in 1879, the incidence of diabetes of both types in the US was quite low. For instance, hospital records at a hospital in Boston showed only 0.004% of all patients admitted from 1824 to 1898 had diabetes, even though they were huge wheat-eaters.
All the references in the book to trials of diet changes for diabetes are short term studies of low carbohydrate diets on risk factors. They don’t limit the amount of gluten in the people of either wing of their trials. The longest follow up is a one-year study. Most last about six weeks. Again, when we look at the bigger picture, wheat clearly prevents both type one and type two diabetes. By showing only part of the information, the book tries to trick you into thinking that wheat is causing diabetes, when nothing could be further from the truth.
The next section will take up the claim that modern wheat is somehow more dangerous than the wheat of fifty years ago.