5 ms·

Article is paywalled, but anecdotally, last year I inched past that magic A1C reading where the doctor tells you you are Type 2 Diabetic. I switched to a low-ca

by spilk 10y ago

Article is paywalled, but anecdotally, last year I inched past that magic A1C reading where the doctor tells you you are Type 2 Diabetic. I switched to a low-carb/high-fat diet ( https://reddit.com/r/keto https://reddit.com/r/keto ) and fairly rapidly lost 30 pounds while eating things like avocados, eggs, cheese, butter, coconut oil and bacon. Several months of this diet and my A1C has dipped back to almost-normal, not even "pre-diabetic" levels. For me at least, carbs are definitely a killer.

josu 10y ago
Click on "web" and then click on the link to avoid the paywall. 143 points by prostoalex 12 hours ago | flag | hide | past | _web_ | 128 comments | favorite | save to pocket
calvano915 10y ago
While keto seems promising in the short term, there isn't much data to validate whether it would be best for "most people". There is a definite concern long term with organ failure associated with ketoacidosis.
- Sklavenmoral 10y ago
  Ketoacidosis and ketosis are two different things.
  - calvano915 10y ago
    Ketoacidosis is a definite concern with ketosis. Perhaps "common effect" was a bit overstated :/
    - deegles 10y ago
      It's only common for diabetics or people with impaired kidneys. It's perfectly safe otherwise. Ten minutes of research would show that.
    - maneesh 10y ago
      yea that's just not true.
- greensoap 10y ago
  I don't think you are right. The long term impact of ketogenic diets have been study, especially in kids that have been on them for 10+ years to control seizures. (https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=ketosis%20seizure%20children%20long%20term%20impact https://www.google.com/webhp?sourceid=chrome-instant&ion=1&e...)
  - calvano915 10y ago
    "Most people" don't have issues with seizures. The children studied were receiving medical nutrition therapy from experts, thus having several blood markers checked constantly and having precise diets formulated and adjusted to their individual and changing needs. Ketoacidosis may be a low likelihood, but there is definite concern. The article linked also mentions "However, side effects, such as slowed growth, kidney stones, and fractures, should be monitored closely." If we just start telling everyone to go keto, there is a high probability for harm (both known and unknown) in some percentage of the population.
- overgard 10y ago
  Whereas, the "standard" USDA diet has created an obesity epidemic. That is also a definite concern. I would take the diet with insufficient evidence over the diet that has years of evidence in provably not working.
  - JamesBarney 10y ago
    There are plenty of healthy diets recommended by leading nutritionists and doctors that aren't the food pyramid. And bringing this up as a straw-man doesn't seem to further the discussion. There are lots of very healthy diets with much more long term data behind them like the Mediterranean diet.
    - overgard 10y ago
      The food pyramid is literally taught to every child in the united states, and, uh, we're kind of a fat nation. I think it's totally fair to call it out, it's not a straw-man, the government is literally forcing bad advice on people that's making them fat.
      - calvano915 10y ago
        The food pyramid has been out of date since 2011
        overgard 10y ago
        The people that followed its advice are still around, and you'll have to forgive me if I'm not going to trust newer USDA guidelines after what a spectacular (and politically motivated) fuck up that was.
      - hash-set 10y ago
        We're a fat nation because people eat at restaurants too much where the portions are too large. Also, they have no self control.
  - PepeGomez 10y ago
leshow 10y ago
almost eliminating one of three macro nutrients probably led you to consume far fewer calories. the reduction is calories is what causes weight loss, this is not a magic effect of consuming less sugar. your body will not lose weight without a reduction in caloric intake, that you successfully lost weight is proof that your new diet was a caloric deficit. i'm glad you had such success, i just wanted to point out to other readers that there's nothing magic about low carb diets.
- bostonpete 10y ago
  There's a little magic -- by keeping your body in a state of ketosis, you end up with a lot less in the way of blood sugar fluctuations that can lead to cravings.
- spilk 10y ago
  Calorie cutting is definitely part of it, but it is not the whole picture. I've done calorie-restrictive diets that were more carb-based (low-fat) in the past and saw very minor weight loss in comparison. I think this works differently in overall healthy people versus someone like me who is predisposed/skewed towards type 2 diabetes - where the insulin response is all screwed up.
- overgard 10y ago
  Calorie cutting is generally useless. Here's a link explaining: http://www.drfranklipman.com/q-dr-jason-fung-book-obesity-code/ http://www.drfranklipman.com/q-dr-jason-fung-book-obesity-co... I'd read the whole thing, but the first couple paragraphs set the scene: Obesity is often considered a problem of excessive calories. This caloric obsession has been indoctrinated into all of us since we were children. Too many calories in, too few calories out, or some combination is what we believe leads to weight gain and obesity. If it were indeed true that excess calories leads to weight gain, then the solution is simple: Reduce calories eaten. This has formed the standard dietary advice of the last 50 years. And it has failed spectacularly. Obesity rates have skyrocketed upward despite continual exhortations to cut calories. So, the proof is in the pudding. This advice does not work. The other major strategy has been to increase exercise. Total calorie expenditure is not simply exercise, but includes basal metabolism. However, basal metabolism is not under conscious control, so it is assumed to be stable. In fact, the basal metabolic rate may increase or decrease up to 40% depending upon many factors, but one major one is caloric intake. But here once again, this advice has failed us. Exercise comprises a very small proportion of our daily calorie expenditure. Let us assume basal metabolism of 2,000 calories per day. Walking for 45 minutes might burn 100–150 calories. If you’ve ever watched the calorie counter on your treadmill, you’ve probably already noticed how few calories are actually burned. This means that 95% of caloric expenditure is not related to exercise.
PepeGomez 10y ago
You are basically guarranteeed to get a false negative A1C on keto.
- spilk 10y ago
  Do you have some sort of reference for this? I'd like to learn some more about the impact of ketogenic diets on A1c.
overgard 10y ago
It sounds like you're already doing the right thing (congrats!), but if you're interested in the subject "The Obesity Code" by Jason Fung is an incredibly good book. It delves into why/how of type 2 diabetes and how it can be cured/managed.

by spilk 10y ago

josu 10y ago

calvano915 10y ago

While keto seems promising in the short term, there isn't much data to validate whether it would be best for "most people". There is a definite concern long term with organ failure associated with ketoacidosis.

Sklavenmoral 10y ago
Ketoacidosis and ketosis are two different things.
- calvano915 10y ago
  Ketoacidosis is a definite concern with ketosis. Perhaps "common effect" was a bit overstated :/
  - deegles 10y ago
    It's only common for diabetics or people with impaired kidneys. It's perfectly safe otherwise. Ten minutes of research would show that.
  - maneesh 10y ago
    yea that's just not true.
greensoap 10y ago
I don't think you are right. The long term impact of ketogenic diets have been study, especially in kids that have been on them for 10+ years to control seizures. (https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=ketosis%20seizure%20children%20long%20term%20impact https://www.google.com/webhp?sourceid=chrome-instant&ion=1&e...)
- calvano915 10y ago
  "Most people" don't have issues with seizures. The children studied were receiving medical nutrition therapy from experts, thus having several blood markers checked constantly and having precise diets formulated and adjusted to their individual and changing needs. Ketoacidosis may be a low likelihood, but there is definite concern. The article linked also mentions "However, side effects, such as slowed growth, kidney stones, and fractures, should be monitored closely." If we just start telling everyone to go keto, there is a high probability for harm (both known and unknown) in some percentage of the population.
overgard 10y ago
Whereas, the "standard" USDA diet has created an obesity epidemic. That is also a definite concern. I would take the diet with insufficient evidence over the diet that has years of evidence in provably not working.
- JamesBarney 10y ago
  There are plenty of healthy diets recommended by leading nutritionists and doctors that aren't the food pyramid. And bringing this up as a straw-man doesn't seem to further the discussion. There are lots of very healthy diets with much more long term data behind them like the Mediterranean diet.
  - overgard 10y ago
    The food pyramid is literally taught to every child in the united states, and, uh, we're kind of a fat nation. I think it's totally fair to call it out, it's not a straw-man, the government is literally forcing bad advice on people that's making them fat.
    - calvano915 10y ago
      The food pyramid has been out of date since 2011
      - overgard 10y ago
        The people that followed its advice are still around, and you'll have to forgive me if I'm not going to trust newer USDA guidelines after what a spectacular (and politically motivated) fuck up that was.
    - hash-set 10y ago
      We're a fat nation because people eat at restaurants too much where the portions are too large. Also, they have no self control.
- PepeGomez 10y ago

leshow 10y ago

almost eliminating one of three macro nutrients probably led you to consume far fewer calories. the reduction is calories is what causes weight loss, this is not a magic effect of consuming less sugar. your body will not lose weight without a reduction in caloric intake, that you successfully lost weight is proof that your new diet was a caloric deficit. i'm glad you had such success, i just wanted to point out to other readers that there's nothing magic about low carb diets.

bostonpete 10y ago
There's a little magic -- by keeping your body in a state of ketosis, you end up with a lot less in the way of blood sugar fluctuations that can lead to cravings.
spilk 10y ago
Calorie cutting is definitely part of it, but it is not the whole picture. I've done calorie-restrictive diets that were more carb-based (low-fat) in the past and saw very minor weight loss in comparison. I think this works differently in overall healthy people versus someone like me who is predisposed/skewed towards type 2 diabetes - where the insulin response is all screwed up.
overgard 10y ago
Calorie cutting is generally useless. Here's a link explaining: http://www.drfranklipman.com/q-dr-jason-fung-book-obesity-code/ http://www.drfranklipman.com/q-dr-jason-fung-book-obesity-co... I'd read the whole thing, but the first couple paragraphs set the scene: Obesity is often considered a problem of excessive calories. This caloric obsession has been indoctrinated into all of us since we were children. Too many calories in, too few calories out, or some combination is what we believe leads to weight gain and obesity. If it were indeed true that excess calories leads to weight gain, then the solution is simple: Reduce calories eaten. This has formed the standard dietary advice of the last 50 years. And it has failed spectacularly. Obesity rates have skyrocketed upward despite continual exhortations to cut calories. So, the proof is in the pudding. This advice does not work. The other major strategy has been to increase exercise. Total calorie expenditure is not simply exercise, but includes basal metabolism. However, basal metabolism is not under conscious control, so it is assumed to be stable. In fact, the basal metabolic rate may increase or decrease up to 40% depending upon many factors, but one major one is caloric intake. But here once again, this advice has failed us. Exercise comprises a very small proportion of our daily calorie expenditure. Let us assume basal metabolism of 2,000 calories per day. Walking for 45 minutes might burn 100–150 calories. If you’ve ever watched the calorie counter on your treadmill, you’ve probably already noticed how few calories are actually burned. This means that 95% of caloric expenditure is not related to exercise.

PepeGomez 10y ago

You are basically guarranteeed to get a false negative A1C on keto.

spilk 10y ago
Do you have some sort of reference for this? I'd like to learn some more about the impact of ketogenic diets on A1c.

overgard 10y ago

It sounds like you're already doing the right thing (congrats!), but if you're interested in the subject "The Obesity Code" by Jason Fung is an incredibly good book. It delves into why/how of type 2 diabetes and how it can be cured/managed.