The World Health Organization changed impaired fasting glucose levels from 6.9 to 6.1 in 1999.  The curve used to illustrate the incidence of diagnosed type 2 diabetes indicates a steepening at this time.  If data would have been collected for all patients prior to 1999 and utilized as a retrospective for type 2 diabetes in the population, the incidence rate prior to 1999 would likely have been significantly higher.

Very true, Dr. Davis.  Wheat consumption is up since 1970.  The strange thing is, it was much higher in the 19th century...something like 225 pounds per capita.

historical wheat consumption

Maybe we were eating fewer total carbs then, or expending more energy, if in fact the recent increase in diabetes is wheat-related.

I think since so much wheat is eaten in products that are mixtures of wheat, sugar, and vegetable oil, there's no way to know what the culprit is.

Well the reason is that wheat is the most important factor for our lives.

Hi, Anon--

Yes, indeed. Human life was different for at least rural people.

Also, wheat has changed. This is a crucial, crucial point that explains much of this phenomenon, I believe.

It would be interesting to plot diabetes rates against various possible culprits (pointing out on the graph when diagnostic cutoff changed): wheat, all carbohydrates, size of sodas, computer ownership, average size of restaurant meals, bicycle ownership, hours spent commuting, population older than 65, exposure to Agent Orange, service in Gulf War, and some really silly things like hair length and popular nailpolish colors.

If only wheat consumption seemed correlated, this would be suggestive.

Wre there ads for All Bran bars and wheat links on this site?

Wheat is ingrained in us, beginning with bread as the "staff of life."

correlation does not equal causation.

I don't eat wheat, I suffer from all of the problems you describe and it's also related to my psoriasis.  Good hypothesis with all your measurements of post consumption measurement of blood sugars, but someone needs to do a mass study.

The graph on this post is also very educational:
http://www.gnolls.org/1086/the-lipid-hypothesis-has-officially-failed-part-1-of-many/

The concentrations of zinc, iron, copper and magnesium remained stable between 1845 and the mid 1960s, but since then have decreased significantly, which coincided with the introduction of semi-dwarf, high-yielding cultivars.
at the same time
wheat breeding may have contributed to increased prevalence of celiac disease. and other conditions.
Perhaps other readers are not aware that MAGNESIUM deficiency increases iron absorption so there is increasing danger of Iron Behaving Badly and resulting damage to mitochondrial function.

Hi, Ted--

Great find!

I wasn't aware of these data. Yet another way that increased yield comes at a price.

Dramatic changes in the slope of a curve are easy to see if you're looking for them, but you've displayed an arithmetic, not a logarmitic axis.  Your point would be better made if you could switch the axis and if we still see the association between the variables.

Gretchen - Well said.

I think many things in our modern environment play a role in tipping the scales toward diabetes - including disrupted circadian cycles and environmental toxins, such as fire retardants, plasticizers, and pesticides.  (I don't have time right now to find links from stuff I've read on this - but try Googling these things - the research is there.)  

Jenny Ruhl claimed a short time ago that while prediabetes has risen, actual diabetes has not.  She is a good resource and I would take her arguments on most things diabetes pretty seriously.  Check her blog if interested:  Diabetes Update.  

As a mother of a kid with celiac disease, and for other reasons, I am hardly pro-wheat or pro-gluten, but I'm not convinced grains have caused a rise in diabetes.  My daughter's gastroenterologist, however, has Type I diabetes and says that eliminating gluten has greatly improved her glucose control.

When I eyeball this figure, it looks like the change occurs around 1993-1996.

Helen has a point that under counting of who is "pre-diabetic" is quite possible skewing the data. The CDC changed it's diabetes diagnosis criteria; 1985 wasn't when they did that however.

CDC took their raw 1995 - 1997 data and in 1998 decided to only use fasting glucose, and not the old standard oral glucose tolerance test, as the CDC diabetes template. For all individuals  whose data was showing greater than ( or equal to) 126 mg/dl fasting glucose they were then counted as diabetic by the CDC.

This methodology caused CDC to say U.S.A. diabetics went from 8 million in 1995 to 10.3 million diabetics in 1997; a statistically massive 2 year jump of diabetics. And furthermore, the number of un-diagnosed diabetics was claimed to have gone down (in same period of time); they cut out a whole slew of "pre-diabetics", so to speak.

The other criteria CDC website shows from 1998 is, that when non-fasting glucose hits 200  mg/dl (or more) they are considered diabetic. The reproduced graph Doc posted shows an exponential climb upward right at the time CDC  began using it's altered criteria.

"Note that, from 1958 until 1985, the curve was climbing slowly. After 1985, the curve shifted sharply upward."

As I look at the presented graph, from 1986 to about 1991 the trend decelerated slightly, then resumed its prior long-term value, then accelerated in about 1997

However, I must admit that 1997 is "after 1985."

Other suspects that became prevalent in the food stream in the 1980s were high-fructose corn syrup and artificial trans-fatty acids, both of which are linked to hepatic insulin resistance and metabolic syndrome.

I think of all the intelligent, scientifically-reasoned arguments all lead back to the commonsensical notion "Don't eat junk." To start, anything with enriched (aka processed) flour, partially hydrogenated oils, or high fructose corn syrup qualifies as junk. Which isn't to say all disease eminates from just those three ingredients, but I believe completely eliminating those three ingredients would yield a large health benefit to most Americans.

It takes years for type 2 diabetes to develop. A shift in the rate at which people are diagnosed with it would be caused by something that happened some time before the shift.

1960 to 1970 is also the time frame that chemical fertilizer came into the mainstream. On the farm I was raised on, along with chemical fertilizers came mineral supplements for the hogs that were living on the fertilized barley. They "failed to prosper" on fertilized barley, where they did just fine on unfertilized barley. By the why, fertilized barley produced over twice the volume of grain, and I assume the same mineral absorption. You can blame the grain, but I believe it could be the fertilizer.

@  justdoinglife
You can blame the grain, but I believe it could be the fertilizer.
Does early-life exposure to organophosphate insecticides lead to prediabetes and obesity?
Slotkin TA.

The chart for the growth of the national debt looks the exact same. I wonder if there is a correlation between the advance of socialism and the cultural ascendancy of the Lipid hypothesis? I'd bet the ranch that the destruction of American health and the destruction of the American economy is not a coincidence.

Duke university 2008 study fed new born rats 0.1 mg/kg body weight of the organophosphate pesticide parathion, for 4 days. When the rats were adults and fed a high fat diet they noticed a different response among the sexes.

In the adult females the high fat diet resulted in a 30% higher weight gain ( vs. high fat fed males' 10% weight gain) over controls (according to respective sex) on the same diet. This type of pesticide exposure to young children may be part of how obesity is rising; the standard western fare is high in generic fat content.

For the parathion early exposed adult male rats fed on a normal diet (ie: not high fat) the results also seem troubling. They gained weight, glucose levels rose, fat break down was inhibited and they were pre-diabetic; as compared to male controls.

Counter-intuitively, another group of male new born rats fed parathion at 0.2 mg/kg body weight (4 days) when fed a normal diet as male adults actually weighed less than their male controls. Whereas, the female rats (fed normal diet in this case) who got both 0.1 & 0.2 mg/kg parathion (4 days) all weighed less than their female controls. Mothers, don't try this at home.

Another culprit:

SSRIs.  Prozac was first marketed in 1988.  (It was not the first, however - some came on the market slightly earlier that decade.)  SSRIs impair glucose tolerance and are associated with an increased risk of diabetes.  

I think there are some modern-day smoking guns more convincing that increased grain consumption for increased obesity, insulin resistance, and risk of diabetes.  Although they are a neolithic food some of us may not be exquisitely adapted for, they have been around for 5,000 years, while the obesity epidemic is quite recent.

Hi Helen,
In 1938 there was a U.S.A. National Conference of Governmental Industrial Hygienists ; since 1941 the word national was replaced by "American" (ie: now is the ACGIH). 1946 the ACGIH set maximum limits on 148 compounds; which in 1956 became their "Threshold Limit Value", (TLV).

TLV is not saying "x" level is always safe; just what is supposedly tolerable exposure for most "healthy" adults. ACGIH lays their TLV data out for industrial hygenists to use in their field, not for laymen's general use.

2-butoxy-ethanol TLV (as a gas or evaporating vapor) is set at 20 ppm. This chemical is the favorite solvent in household spray and wipe cleaning products.

It makes me wonder if the U.S.A. adult female house cleaner suffers metabolic syndrome at a higher rate than other individuals. If so then might not close decades of breathing 2-butoxyethanol droplets have had/has epigenetic synergy?

1971 O.S.H.A. took 470 TLVs from ACGIH data and now calls those TLV by the phrase "Permissible Exposure Limit" (PEL). Meanwhile, as of 2010 there are 642 TLVs set out by ACGIH.

The European Union has a registry of 143,000 chemicals in use (or used); and there are +/- 50,000,000 chemicals known to exist (as per Chemical Abstract Service Registry). The EPA has more details; for searching if you're curios: www.epa.gov/grtlakes/toxteam.
pbtrept/pbtreport.htm

2012 the European Union is set to report on chemical testing of all chemicals manufactured in excess of 1,000 tons annually. You'll see that as data reported from "REACH" (Registration, Evaluation, Authorization and Restriction of Chemical Substances).

If you want to track down what chemical is in a product then search out the manufacturers "MSDS" (material safety data sheet). Some claim "trade secret" ingredients and then you can only guess on what is involved.

I love the triglyceride posts as I have been working on mine for a number of months.  Was well over 1000.  On low carb, virtually no grains, tricor (200mg), and a healthy dose of fish oil I was still at 233.  I am wondering if it will take my body/metabolism some time to heal before I can get lower.  As you might imagine I am sporting an HDL below 25.  I am working it diligently, have lost a ton of weight and get healthier by the day.  I should be sending Dr Davis a stipend for my improvement!

Dr. Davis,
please kick out of your spam filter the post I just sent on the 12th saying "Hi Helen,". It had resources for her interest in modern chemicals.

To Helen,
If my 12th post doesn't show up soon (2 days?) and you request it on this thread I will try to recreate it here. Maybe you've moved on to newer threads; I don't usually monitor old threads, but I will this for a few days.

Unfortunately, it doesn't seem like this ascent is going to slow down anytime soon.  Even if people in recent years seem to be taking a more health-savvy approach to their eating habits, it wouldn't be surprisingly to see this trend continue regardless.

Western countries have also seen a rise in sugar consumption along with wheat consumption over the same time period.

Taubes has just published a piece
"Is Sugar Toxic" and winds his way through diseases of Western cultures from sugar causing metabolic syndrome to sugar be implicated in cancer formation.
http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html?pagewanted=1&_r=2&ref=magazine

No where was there any mention of wheat..I don't think we can isolate wheat as the primary culprit in Diseases of Civilization.  Wheat Plus Sugar, the double whammy.

I'm probably way off here, but vitamin D derivatives are mainstays of topical therapy for chronic plaque psoriasis; I have to wonder if coronary plaque can form if vitamin D is deficient since vitamin D is involved with insulin regulation and insulin and hyperglycemia is also implicated in heart disease; often those with diabetes are found deficient in vitamin D, and they're a population most at risk for heart disease?  Makes you wonder, doesn't it?

You're absolutely right. There is solid evidence that vitamin D deficiency increases diabetic patterns, including higher blood sugar and insulin levels. Whether this is part of the reason why vitamin D might exert benefits on coronary plaque remains uncertain. I suspect that there are many reasons, this being a major one.

You may be interested in the following papers.
The case against ergocalciferol (vitamin D2) as a vitamin supplement.
http://www.ajcn.org/cgi/content/abstract/84/4/694
Risk assessment for vitamin D
http://www.ajcn.org/cgi/content/abstract/85/1/6
http://www.ajcn.org/cgi/content/full/77/1/204
Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol

Dr. Prendergast has posted today an astonishing story of benefit from D3. The patient was switched to D2 in an effort to move to generic alternatives and he went rapidly downhill toward death. The mistake was discovered, the patient was switched back to D3 and he immediately recovered.
Here's the link to the short video:
http://enews.endocrinemetabolic.com/2007/11/generic-wars.html

Thanks for the heads-up, Rich. It is truly an astonishing story.

Dr Davis!
   Sometime back I had posted a comment on your entry about wheat. And you had suggested that my Vitamin D3 levels might be low. Your diagnosis from 3000 miles away proved right! I had a 25-OH-D3 test and the value was less than 4ng/ml. I consulted my cardiologist and he brushed away the fact and asked me to drink more milk! I'm planning to switch doctors now.
   My copy of TYP reached me and I'm through cover to cover. The level of  details in the book is amazing and I've started correcting my lifestyle, food habits and medicines(of course, after discussing with the doctor).
   Many doctors here prefer a CT angiogram to a heart scan. My doctor was unable to give a good reason for why I should not have a heart scan but a CT angiogram. ("You are too young to have a heart scan"). So the situation here in India is no better.
  Many thanks!
-Neelesh