Title should include “in healthy lean individuals” which was the study title. Without that it sounds like the study contradicts a huge body of evidence which it doesn’t.
I remember a small experiment between two healthy identical twins who were both almost identically healthy. One went on a low carb diet and the other a low fat diet.
> They both lost some weight, although the brother who was on the low-carb diet ended up virtually pre-diabetic.
It's been known for decades (outside of the HN reality distortion field) that excess accumulation of intramyocellular lipids in skeletal muscle is the primary underlying mechanism driving Type 2 Diabetes, so that's pretty much the outcome you'd expect.
idk man, go look at the fasting glucose of anyone on keto and it's probably going to be below 90. Not sure where this claim is coming from. There's hundreds of thousands of people currently having success with low carb diets that can stick a CGM in their arm and show you this is just not true for them.
If I clock a bathtub with cement (insulin resistance) but I don't fill the tub with water (carbs) - then you won't get an overflowing bathtub (diabetes).
If I have an unclogged bathtub (normal metabolism) - I can fill the tub quickly with water (a carbed up meal) with water and then it drains out.
The problem is when you combine high fat with low fiber carbs (donuts, meat AND potatoes, cake, peanut butter) - you clog the tub and dump water into the tub.
Low carb diets are associated with higher all cause mortality - and are not sustainable for the planet.
> There's hundreds of thousands of people currently having success with low carb diets
There's hundreds of thousands of people currently having success with no-shellfish diets to manage their shellfish allergy; yet these people don't go around using words like "reversed" or "cured" in reference to their allergy, the way keto people do with insulin resistance. And most of those keto people having apparent success would fail an OGTT (a test that actually measures insulin sensitivity, unlike fasting BG/insulin or HbA1c) if they took one.
I didn't see any reference to the study, but from the first comment in that video it seems that the doctor said "his body would stop producing insulin" because his blood insulin levels were low? Doesn't sound right to me.
[1]"Prediabetes happens when your blood glucose levels are higher than normal, but not high enough to be diagnosed as diabetes. Prediabetes usually occurs in people who already have some insulin resistance."
So, it doesn't sound right that he would be pre-diabetic when his blood glucose levels would be low. Seems that doctor made the assumption that because his blood insulin was low, his body would just stop producing it at some point, and that's not how it works.
> the brother who was on the low-carb diet ended up virtually pre-diabetic
"Low-carb" dude removed all fruits and vegetables. He didn't do low-carb, he did no-carb - in his own words: "meat cheese eggs".
The whole clip just reeks of b.s. though, neither of these guys would be getting air time if the results weren't click-bait controversy fodder. The b.s. incentives are clear.
> Title should include “in healthy lean individuals” which was the study title
Weightloss improves various metabolic biomarkers, including markers of insulin sensitivity, and so the fact that people who lose weight following a particular intervention (low-carb or whatever else) see such improvements is unsurprising. That's why looking at subjects who are already lean is much more informative: it gives a better sense of the metabolic effects of the dietary intervention itself, not confounded by weightloss.
> Without that it sounds like the study contradicts a huge body of evidence which it doesn’t.
What huge body of evidence? All of the people drastically restricting their carbohydrate consumption so they can cheat on their fasting BG and HbA1C tests? Give those people an Oral Glucose Tolerance Test and measure their insulin response in real time, and the vast majority of them would fail, especially the ones on high (saturated) fat diets: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602127/
> Our finding of a strong relationship between VO2max and relatively unsaturated IMCL pools in controls and athletes points to a role of exercise in decreasing the amount of saturated fat within the IMCL store. The association of insulin resistance with the accumulation of saturated IMCLs, even within a healthy control population, could suggest an early involvement in its pathogenesis and provide a reason why combined exercise and diet are effective therapeutic options in the early stages of insulin resistance.
High-fat diets are atrocious for insulin sensitivity.
This is not pathological insulin resistance and is an expected adaptation. OGTT is useless for someone on a low carb diet. A normal person can go from failing to passing in ~72 hours by reintroducing higher levels of carbohydrates. Good luck reversing diabetes in 72 hours...
The "physiological insulin resistance" meme only started because so many people going on low-carb (and especially high-fat keto) diets saw worse fasting BG and A1C numbers, which flied directly in the face of the common-sense (but completely wrong) assumption that excess carbohydrate consumption is the primary cause of insulin resistance:
>Wait, I cut carbs out almost completely, why are my numbers getting worse?
Because you're eating more fat, and probably more saturated fat in particular, which means more intramyocellular lipids, and hence, you're becoming more insulin resistant. Cutting the carbohydrate consumption only masks the IR, at best. The simplest explanation is that "phsiological IR" is just plain-old insulin resistance: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602127/
Fasting BG, fasting insulin, and HbA1C only measure blood sugar control, which severe carbohydrate restriction can sometimes obtain, but without actually reversing the underlying pathology of IR. An OGTT, by contrast, measures your insulin response to a bolus of glucose in real time.
You're saying something that the low carb advocates already know.. but let's be clear it's not this underlying pathology that causes the damage.. it's the high blood sugar that causes the damage.. the high blood sugar is basically reversed by keto diets.. problem is that keto can put weight on you very easy because it's high fat and you can eat a lot of fat very quickly and get a lot of calories that way.. also keto is very hard to stay on for a long periods of time.. now lots of people will reply to me and say oh look at me my personal example look at my brother or whatever.... this is basically worthless data that you're giving me about your brother about you or whatever
> high fat and you can eat a lot of fat very quickly and get a lot of calories that way
Fat also has the lowest thermic effect, a paltry 2-3%. Besides having the most calories per gram (9 vs 4 for protein or carb), it provides by far the cheapest, easiest calories for your body to digest.
Well I am not too sure about that cheap easy calories as far as fat goes.. as far as the price yeah oils not too expensive but Meat is not cheap and meat is really the way you have to get most of the calories in fat... Easy to digest? Starchy carbs far and away the easiest
>provides by far the cheapest, easiest calories for your body to digest
I mean metabolically cheap and easy. Your body expends the least energy digesting fat (2-3%, or 2-3 calories worth of energy for every 100 fat calories you consume), and the most digesting protein (>20%). Add to that the fact that fat has more than twice the calories per gram that carbohydrate and protein do, and it's little wonder why so many people fail with keto.
This. From my experience doing Keto and based on what I’ve read, your body enters ketosis after blood glucose drops very low. When that happens, it switches to ketones for fuel. It doesn’t need glucose anymore (although glycogen plays a role).
The assumption here is that this is a temporary/reversible condition. At least it was in my case.
For the record, I did a low carb diet for 6 months. I was in ketosis for much of it, with temporary periods of break when it was unavoidable (during travel, lack of food options, social setting). I feel exogenous ketones helped me with the process of getting back in ketosis.
Sorry I’m not going to whip a metaanalysis together for you to refute your flippant HN comment. The evidence is out there, apparently you’re one of these people that turned your conclusions into a religion. That’s fine, please don’t waste other people’s time asking for evidence as if you’re willing to have a good faith discussion.
I've recently been trying to "eat better" in an effort to improve/maintain my overall health. I'm not overweight, just trying to be as healthy as I possibly can. Maybe prevent future disease if I can. I don't want to end up with diabetes. But it is surprisingly difficult to know what eating healthy actually looks like. One minute I'll be convinced that I should cut out carbs, then sooner or later something else comes along claiming that I should do the opposite.
The only thing that I feel comfortable doing with a surety is to cut out sugar as much as possible. Also eat a variety of fruits and vegetables.
Wondering if other feel that it's way too difficult and confusing to get serious about eating healthy.
It’s not you. The state of nutrition science is terrible. I think you’ve got it right: cut out sugar as much as possible. After that, I suspect exercise is much more important than any other diet intervention you could do.
Little story on this: I went low carb to have an easier time handling my diabetes. When the doctor found out, they sent me to a nutritionist. So the nutritionist would whip out the food pyramid and say: "you know this, right? We know that people who eat like that stay healthy in general. We don't know whether people who don't eat like that stay healthy." Then I got some specific advice for my diet. I still remember that intro as one of the best trust-building measures I've experienced with doctors.
One thing I learned the hard way in life is that unusual solutions can lead to unusual problems. Keto is very unusual and very recent, despite what people want to believe.
I am in the “ignore science and listen to your body” stage.
Eg, I tried vegan and was utterly miserable.
But I learned how to make delicious plant based dishes and as a result of my vegan period.
I actually eat much less meat/dairy and have higher plant intake now than before my vegan experiment.
Another is how much shit cardio gets from fitness experts.
The moment I stopped doing cardio and resistance only I gained weight, my face got a “haunted” look to it and I got depressed.
Added back my 40 minutes of cardio and I feel normal and healthy again. 30 min resistance followed by 40 minutes of cardio. 30 because thats the programme I follow.
I dont know why 40 min of cardio. Its just what seems optimal for me after a few years of trial and error.
I never eat breakfast. I eat more during the day if I am forced to eat breakfast.
I get heartburn if I dont have an evening snack.
Traditional (not “quick”) oatmeal is probably a safe bet, it contains carbs so you get some balance but due to its β-glucan is easy on your insulin levels.
Yeah, that's the only thing rock solid. That said, and contrary to popular opinion, the recommendations haven't changed too much.
There's been quite a bit of misinformation (eg. 90's food pyramid), but reputable professionals have been pretty close. I'm not sure on the history, but I think there we've semi-recently found that carbs can be less healthy than we initially thought, and the story with fat is pretty complicated (vs. all fat being bad).
I'll put this another way. If you had followed recommendations as far back as the 60's you should be perfectly fine. You would be reducing sugar, and eating lean meats, and plenty of fruits and vegetables. You might even be eating less refined carbs (although that could be a newer discovery).
People are simply off base to claim that we don't know what we're talking about and the recommendations change constantly. I'm sure you can find some shifts in recommendations, but you've always supposed to eat plants, and watch fats and sugar... I think even some of the ancients knew this.
This is so interesting to me. Totally anecdotal (and not totally related to the paper), but my father and my uncles on both sides all have the same story -- low carb works great -- ONCE. After a big weight loss in their early forties, every one of them are severely overweight in their late sixties and constantly struggle. I find myself beginning the same ride . . .
> The participants were then divided into three groups: the low carbohydrate intake group (LC) consisted of those who received less than 45% of their calories from carbohydrates, the recommended carbohydrate intake group (RC) received 45% to 65%, and the high carbohydrate intake group (HC) received more than 65%.
<45% threshold for a low carb diet classification seems off-putting as a research methodology here.
it's so fascinating when health/fitness discussions crop up on HN. absolutely not gatekeeping, but just observing that compared to the technical topics, there is sooo much more disagreement while at the same time, more conviction. Seems like people really believe they know what they are talking about, whereas when it comes to the technical discussions, the tone seems more curious/introspective vs. dogmatic.
I totally agree! I'm an MD with a BS in human nutrition and a deep personal interest in diet and fitness (which is what eventually prompted me to pursue medical school). One of my most common refrains is the paradox between the tremendous proportion of the human population that consumes food, the tremendous proportion for whom diet strongly impacts health, in contrast to the tragically small body of truly rigorous, adequately powered, properly controlled, sufficiently longitudinal, non-surrogate-outcome'd research on the topic.
It's also surprising how many on HN seem more willing to accept my half-baked self-taught opinions on tech topics than they are my opinions on health. ¯\_(ツ)_/¯
Isn't that just a manifestation of the old saying that "the more I learn, the more I realize how much I don't know"? On health/fitness forums, I'm sure the health/fitness discussions are more nuanced and the technical discussions are clownish.
Noticed the same the other day on an audit discussion. Got downvotes. Fine whatever. Thing is I’ve got about a decade experience in it…presumably a bit more than the average hn’er
Makes me wonder what I’m commenting on with strong opinions despite being less than well informed
I’ve spent a lot of time around smart and eccentric people and around various diet and exercise “communities” and one thing I’ve noticed is that smart and eccentric people are so much more likely to subscribe to faddish, heterodox diets and exercise routines.
Tech attracts a lot of smart, eccentric people with anti-authoritarian, anti-mainstream bents. Bizarre ideas strongly held about health and nutrition emerge naturally among this group.
Makes you wonder what else they’re not really experts about, but that can also be a feature. A guy doesn’t know you can’t just put a supercomputer touchscreen in everyone’s pocket but he also doesn’t know carrots don’t cure cancer.
I feel that apart from exercise, how much on uses their brain is bound to make a big difference given how much energy it can consume during tasks like playing chess or programming vs idle. Not sure to what extent this is taken into consideration in studies such as this. At least from personal experience carbs seem like the preferred fuel for the brain and its no wonder why its popular at long coding sessions and hackathons
Great. Now let’s have a pre-registered replication study.
Also, the article claims higher blood glucose in the LC group and I didn’t see that in my skim of the paper, nor what I was looking for, which is how the levels compare to healthy or optimal range.
I’m not a fanatic; I tried it and don’t like it, possibly for all the reasons mentioned here, but it has a very impartial feeling to it.
Is there a colloquial interpretation of 'low carb' == 'no carbs' going on here?
Because quite a lot of us are on low(er) carb diets forever, having reduced our intake of pasta and potato to a 'sometimes food' but boosted our fruit and veg overall because of 'eat lots of colours'
We still eat carb. we eat -> less <- carbs than we used to. Is this not low carb? A lot of the heat in this discussion appears to be from keto people, who are 'no carb' not 'low(er) carb'
It's not a temporary diet shift: in my case, its 5+ years of a significantly different diet model. I still eat toast, from time to time, and I still enjoy carbs from time to time but they no longer represent 40-50% of the lunch and dinner plate.
Carbs include sugars == coke and pepsi, if you cut down on fizzy drinks, are you now 'low carb' in this discussion?
Over 60s are advised to increase protein in the diet anyway.
>having reduced our intake of pasta and potato to a 'sometimes food' but boosted our fruit and veg overall because of 'eat lots of colours'
What do you think fruit and vegetables primarily are, if not carbohydrate? Pasta is actually lower in carbohydrate (as a total % of macronutrient composition) than many fruits. For example, apples, which have virtually no protein or fat, unlike pasta.
And let me guess, "pasta" for you meant lots of cheese, oil, and maybe even some butter? In other words, lots of fat.
It's true that fruit is heaps of carbs. But, in aggregate we probably eat less than we used to. and the veg component of carbs compared to potato is lower, if not zero. Spuds are 20%+ carbs by weight. green beans or fennel or cauli more like 7%. Carrot is 10%. Parsnip probably closer to a potato.
We upped the veg part of fruit and veg more than we upped the fruit part. Pulses too. Which of course are also carbohydrate rich, but with more protein.
Pasta indeed meant a lot of cheese and oil. It still does, but far less frequently. The mediterranean diet actually is ok with olive oil and cheese, oils ain't oils (the whole 'its just energy in: energy out thing is gross oversimplification. convert pasta or spuds to cold pasta and spuds, you get resistant starch, it becomes more beneficial for lower gut health)
Mainly now I just eat small portions of food my grandmother would complain didn't come with ration stamps or have enough salt in, but recognize, which is what Michael Pollan says counts: Hit your grandmother with it, and if she doesn't die and says its a carrot, its ok to eat.
> What do you think fruit and vegetables primarily are, if not carbohydrate?
I wouldn’t discount how much easier it is to eat heaps of grain based foods, even without sauce or extra seasoning. Last I checked, a cup of cooked rice has about the same amount of carbs at 3-4 cups of frozen blueberries. I can eat 3 cups of plain cooked white rice like it’s nothing, but 3 cups of blueberries takes some work — I know because, during some experimentation with my diet, that was my meal: 1.5 lb 95% lean ground beef, 3 cups blueberries, 3 cups broccoli.
Is it the low carbs though? I’ve notice I get inflammation flare ups on rapid weight loss. Even with generic cal restricted rather than low carb specifically
My father was a physician and one of his specialities was diet. Weight loss.
He told me just to eat well-rounded healthy meals, not to be a glutton, and walk for an hour a day.
There's too much splitting the hairs these days.
"Follow the crowd" people say: "I heard that hopping on one leg, eating a egg through the nose by sucking it in, and belching loudly in church is the best way to be healthy. This week. Next week it's going to be eating 45 tiny meals a day, somersault 5 times, click your heels three times and say "There's no place like Alpha Centauri.""
I'm glad you found something that worked for you, but while I had similar success with one-meal-a-day, I found that my hands/feet were always cold. It was hard to sleep, because if my hands or feet touched my body it would wake me up. Sex was also not great because nobody wants to touch a cold person.
I found that portion control, small meals throughout the day, is optimal in keeping my metabolism up and staying healthy.
Larger meals, carbs or not, cause large influxes in insulin eventually leading to insulin resistance, which I can feel because I'll be tired after eating a normal amount of carbs.
I don't think "Protein Poisoning" is of serious concern. The dietary guidelines people could find no suitable upper limit for protein. But I agree that it would be better to know more about these diets.
They also only followed metabolism for 7 days when it takes several weeks to adapt to low or high carb, so you kind of need to see what the markers look like at six weeks plus for this kind of study.
