8 ms·

Dietary Carbohydrates Impair Healthspan and Promote Mortality

• whalesalad 9y ago
  I’ve been living a ketogenic lifestyle for a few years now. I go in and out once and a while but seeing the “fat is bad” theory thrown out the window with research like this makes it easier to remain committed. The trouble comes with the way society has been conditioned to have carbs with every meal. Like 90% of the food my peer group eats are surrounded in carbs. Even for a company-wide lunch in the office: the go-to is usually a couple dozen pizzas. Once you’ve lived low carb for a long time you look at people in line at a coffee house grabbing a bagel and a milkshake and just feel bad for the crash they will have later. I’m happy to see Keto becoming more and more socially known. Accessiblity around low carb options is getting better and better. My favorite will always be a protein style burger from In-N-Out though.
  • wasted_intel 9y ago
    Yep, it's surprising how hard it is to avoid. Compound that with sugar being in almost everything and it ends up being remarkably hard to find options that won't cause your blood sugar level to spike.
  • hduwvzvshsuz 9y ago
    You hit the nail on the head for exactly why I couldn't stick with a ketogenic diet. It became too much of a burden on the people I was with to feed just me because everything they wanted was stuff like tacos, pizza, rice dishes, fried dishes, etc. I have an unresearched (by me) theory that the reason we have so many carb heavy diets is due to the fact that carbs are such cheap calories. They were good for surviving when we were poor but now we should move past them
    • whalesalad 9y ago
      Yep. It’s all thanks to the agricultural boom. Grain is everywhere and it is CHEAP.
      • jamesdftx 9y ago
        And subsidized!
    • jlebrech 9y ago
      rice and tortillas are carbs.
    • smn1234 9y ago
      agreed. I wish ketogenic meal kits and keto-friendly restaurant ratings / reviews / guides / accreditation were more prominent.
      • toomuchtodo 9y ago
        Check out the /r/keto sidebar on Reddit. I keep various PDFs in Dropbox of keto options at various fast food establishments. You can always get taco bowls with no tortillas, McDonald's without the buns, a burger without the buns at a burger joint, etc. For emergencies, I keep a few shaker bottles in my car with protein power already added. I just add water if we go somewhere with no keto options.
    • tzs 9y ago
      Americans have a tendency to go to extremes. The normal American diet is way too high in carbs, and so when we try to do something about that we go way farther in the other direction than we have to. We aim for very low carbs, and that ends up being a pain, and we revert back to our default ridiculously high carb diet. It doesn't have to be so binary. Try aiming for a modest level of carbs. I aimed for 40% of calories from carbs, and ended up around 30-35%. That was a significant reduction, but nowhere near what most would consider low carb. At that level of carbs you can have tacos, and pizza, and those other things. You might have to tweak some of them (add more meat to your pizza, for example) or pair them with other dishes to balance them out, but tweaking is a lot easier than foregoing them. Are the very low carb diets better? It's unclear but even if they are, a merely OK diet that you can stick to long term is better than a great diet that you cannot stick to. Will this work for you? Maybe not--one of the most important things researchers are learning is that there is no one size fits all in diet. It worked well for me [1], and it is pretty easy to try, so why not give it a shot? I picked 40% as a first goal because it is easy to compute from the nutrition label. Take calories, divide by 10, and change the unit from "calories" to "grams", and that is how many grams of carbs that food can have and still meet the 40% goal. To see if the whole meal meets the goal, just do the check for each item, and keep track of the total of the differences between cal/10 and g carbs for each item. For example, suppose you are considered a Wendy's double with cheese, and large fries. The burger is 810 calories, 36g of carbs. 81 > 36, so it easily meets the 40% goal. The fries are 530 calories, 64g of carbs. 53 < 64, so they are over the goal. But how about the meal as a whole? You could add the calories, and add the carbs, and compare, but better is to look at how many carbs you would need to add or remove to each item without changing the calories to make it 40%. For the burger, you could add 45g of carbs and meet the goal. For the fries, you would have to remove 11g of carbs, or add -11g carbs. 45g + -11g = 34g of carbs. Your proposed meal is OK. Now suppose that afternoon you have the chance to have a chocolate chip cookie. 200 calories, 30g carbs. It's over 40% (20 < 30) by 10g. But you were ahead 34g after your earlier meal, so you can have the cookie and still be OK for that day. Having the cookie brings you to 24g ahead for the day. What I did was try to make sure that the first meal of the day had lots of protein and fat, so that I would be ahead by quite a bit. I'd then keep track mentally of how far ahead I was during the day, and would try to avoid letting myself get behind. In theory there is nothing wrong with letting yourself get behind at breakfast or lunch, and making it up at dinner. In practice, though, that means that if anything happens that disrupts your dinner plans you could end up behind for the day. If you start ahead disruptions are less likely to blow the whole day. [1] Result: 140 pounds lost over 18 months, and stable weight since then (six months). (Also a drop in blood sugar, from an A1C of 8.1 on multiple diabetes meds to 4.8 on no meds. I've been under 5 for the last six months, and my doctor removed the diagnoses of diabetes from my chart).
  • 189243234 9y ago
    >The trouble comes with the way society has been conditioned to have carbs with every meal. I am pretty sure that isn't conditioning. Eating a burger with no chips is just plain wrong, and the same the other way around as well. When I am eating rice and meat together, if I eat just meat, it doesn't taste good. It is so specific, that there is a specific amount of rice that has to go with the meat. Everyone knows this. That can't possibly be conditioning. People complain of "too little rice", "too much meat" etc. No one could have been conditioned so specifically.
    • deleted 9y ago
      [deleted]
  • keymone 9y ago
    totally agree. when there are no carbs around me - i have zero problems sticking to keto. whenever there's a party and some snacks - i'm in a danger zone unless i brought my own snacks in which case i'm a weirdo.
    • neves 9y ago
      Don't bother about it. In the eyes of the others, everybody who is in a keto diet is already a weirdo :-)
  • miguelrochefort 9y ago
    I've been on keto (on and off) about 50% of the time in the past 3 years. The worst part is not being able to eat/drink at social events, and dehydration. The best part is never feeling hungry, stable energy levels throughout the day, and not needing to sleep as much. I also tend to binge a lot when off keto...
    • 189243234 9y ago
      >I also tend to binge a lot when off keto... Probably on carbohydrates because that is why everyone here is "on and off".
    • hueving 9y ago
      You can drink at events. Stick to soda water and vodka or diet coke and vodka, etc.
    • mkrecny 9y ago
      Not needing to sleep as much?
      • miguelrochefort 9y ago
        I tend to wake up earlier when on keto (~1 hour).
    • gebeeson 9y ago
      Oddly enough, every time I practice Keto, I am almost the exact opposite; always hungry, cruddy energy but I sleep like a rock. On low(ish) fat and high carb; easily satiated, decent energy, sleep like a baby (awake a lot but no screaming or poop). With the above explained, I have not tried A Balanced Diet - perhaps to get the positives of both modes and mitigate or lessen the negatives. Honestly this is the first time, while I am typing this, that I've come up with that angle for myself.
  • jrs95 9y ago
    Fat is bad for some people, though. How satiated someone is by carbs or protein tends to be pretty consistent, but fat is more variable between individuals. Some people are just predisposed to overeating fats.
  • cup-of-tea 9y ago
    But this research says nothing about such a strict and artificial diet over a long period of time. I wonder, do you know of any people who have eaten keto all their life and lived to an old age?
  • huehehue 9y ago
    Do you have any recommended reading on your diet, and the potential problems of a modern milkshake-abundant one? I could just Google it but it's hard to cut through the noise/misinformation when researching diet stuff for the first time. Mainly asking because my diet yesterday was a six pack of Kirin Ichiban beer, a double cheeseburger, and a large P. Terry's chocolate shake, and I felt fine and still had a very productive day. I want to know why I'm able to tolerate stuff like that, and how/if that armor might start falling off as I get older.
    • eisrep 9y ago
      Not GP, but I've also followed a ketogenic diet for a couple of years now. When I first started I learned a lot from Dr. Peter Attia and the videos he has on YouTube. One example[1] goes through him talking about the self-experimentation he's done with the diet and the variations of it. From memory, it was pretty informative (albeit general) on the chemistry/biology surrounding it. [1] https://www.youtube.com/watch?v=NqwvcrA7oe8 https://www.youtube.com/watch?v=NqwvcrA7oe8
  • mentallimits 9y ago
    what crash? are all these people you see in the coffee shop diabetic?
  • gebeeson 9y ago
    Reading through all the comments and this one stood out. I am currently a 'reluctant vegetarian' for health reasons of course (bad choices were made during my younger years and now I am so paying for it). However. In-N-Out would be allowed were I near one. I like to eat grass (grass like veggies). Cows eat grass. I will eat the cow that ate the grass at In-N-Out burger. /shrug. Sounds legit to me. - I'd also have a 'healthy shake' there as well. I remember their adverts that mimic'd/mocked the shake diets and it still makes me chuckle.
  • coldcode 9y ago
    A few years does not prove a lifetime. If a million people ate your diet and lived X% longer than a similar set of people who didn't it might prove a useful stat. You might wind up dying of something not obvious today at 70 due to your diet, or not. No easy way to know. That's the problem of dietary knowledge.
• kbougy 9y ago
  Does it bother anyone that this study is intentionally misleading by masking the fact that the carbohydrates tested were refined sugars?
  • shlant 9y ago
    as I mentioned in my comment, any study that lumps together all of one macronutrient into one group and then attempts to reach conclusions based on that grouping has very little understanding of nutrition.
• trevyn 9y ago
  I’ve found eating out socially on keto a big challenge (carbs still look delicious) until I found a hack: unreasonably large portions of salad, covered in salt. Salt is fucking delicious. Add olive oil too if you feel like it.
  • smn1234 9y ago
    I drown everything in olive oil. Good, European protected designation of origin (PDO), protected geographical indication (PGI), and traditional specialities guaranteed (TSG) type olive oils. They're delicious. And you get full rather quickly. That feeling lasts. And I'm fairly certain the plant fat is not what's making us jiggly
    • cup-of-tea 9y ago
      Oil is an extremely concentrated form of energy and your body will most certainly store it as fat if you eat too much of it.
      • nf05papsjfVbc 9y ago
        "Too much" is by definition more than what you ought to consume. On a keto diet, olive oil is an excellent source of fat. Used as salad dressing, it's highly unlikely to cross the "too much" threshold.
    • neves 9y ago
      Why so many labels in your oil? Isn't extra virgin sufficient?
      • allwein 9y ago
        Actually, no. A large majority of "olive oil" sold is either fake or adulterated. Those extra labels he mentions are to identify genuine and clean olive oil.
        • splintercell 9y ago
• sjroot 9y ago
  Can anyone provide a TLDR on what exactly the conclusion of this article is? My experience with a low-carb diet is quite similar to that of @whalesalad, and it remains much more effective than any other diet or a strict exercise regimen.
  • kaolti 9y ago
    Dehghan et al. (2017)) found that carbohydrate intake was associated with increased total mortality. By contrast, any (saturated/monounsaturated/polyunsaturated) type of dietary fat reduced the likelihood of dying.
  • shlant 9y ago
    the TLDR is that this study tells us nothing about what diet is good for longevity. See my comment: https://news.ycombinator.com/item?id=15465516 https://news.ycombinator.com/item?id=15465516
• fasteo 9y ago
  Note that this is probably not what you are thinking (low-carb, very-low carb or even keto diets are good for your healthspan). The lowest quintile in this study were consuming 46,4% of kcal from carbs (that's about 230 gram of carbs for a 2000 kcal total intake). Not even close to low carb by today's standard in the health blogosphere. The authors make this explicit in the discussion section: >>> However, the absence of association between low carbohydrate intake (eg, <50% of energy) and health outcomes does not provide support for very low carbohydrate diets. Importantly, a certain amount of carbohydrate is necessary to meet short-term energy demands during physical activity and so moderate intakes (eg, 50–55% of energy) are likely to be more appropriate than either very high or very low carbohydrate intakes.
  • internetman55 9y ago
    That is about what I have been eating naturally (~150-250g carbs daily, pretty much from oats, potatoes, sweet potatoes, dairy, and 1-2 servings of fruit per day).
  • smn1234 9y ago
    I think the assumption there is very-low carb (as a macro-nutrient, not "healthy" v "unhealthy") can be better if _lower_ carb demonstrates improved outcomes... ?
  • randallsquared 9y ago
    > Importantly, a certain amount of carbohydrate is necessary to meet short-term energy demands during physical activity [...] Why would they make such a claim? Anyone who has done keto and worked out has probably had the experience of doing quite a lot of physical activity while having had no carbohydrate intake at all for half a day before, or more.
    • mkrecny 9y ago
      Half a day of carb restriction wouldn't meaningfully deplete glycogen stores.
      • 9y ago
• cko 9y ago
  > Next, a number of studies have evaluated the effects of specific macronutrients on lifespan, initially in S. cerevisiae (Lin et al., 2002), subsequently in C. elegans (Schulz et al., 2007 and follow-ups), and mice. Out of the latter, two studies in the previous issue of Cell Metabolism have studied this in mice starting at 12 months of age. In regards to the PURE study, most notably, the almost complete removal of carbohydrates (<1%) from the diet to generate a ketogenic diet extended lifespan compared to a high-carb diet. However, reconstituting only 10% of energy of the ketogenic diet by sugar abolished this effect (Roberts et al., 2017), suggesting that specifically sugar (rather than carbohydrates in general) has the most relevant effect on lifespan. Along this line, it is also interesting to note that when nutritive sugar content is kept constant, a different (and less extreme) high-carb diet exerts the best effects on murine lifespan. By contrast, a high-fat diet still containing the same amount of sugar, but no other carbs reduced lifespan slightly. Lastly, when combining high-fat and high-carb components from the two previous diets, the worst effect on lifespan was observed (Keipert et al., 2011). Moreover, lifespan extension in mice was also obtained when dietary protein was replaced by carbs, possibly independent of the total uptake in calories (Solon-Biet et al., 2014). Taken together, these studies suggest that dietary sugar may be one important, but not the only, nutritional factor in limiting healthspan in rodents, hence additional studies are definitely required to establish firm evidence in model organisms. This section of the article does not correspond to the title. In fact it seemed all over the place, then goes on to conclude ‘maybe it’s refined sugars.’
• bigtunacan 9y ago
  Related; I saw on Hacker News awhile back a really great website that aggregates a lot of this health research and then gives summaries of, "What's the current known truth" based on all of the varying research. They then re-market that data as a service somehow. Anyone on here recall this by chance as I'm no longer able to locate it?
  • blakesterz 9y ago
    This one maybe? https://www.hsph.harvard.edu/nutritionsource/ https://www.hsph.harvard.edu/nutritionsource/
  • lurcio 9y ago
    Perhaps examine.com https://news.ycombinator.com/item?id=8138784 https://news.ycombinator.com/item?id=8138784 https://news.ycombinator.com/item?id=9956839 https://news.ycombinator.com/item?id=9956839
    • bigtunacan 9y ago
      Yes, thank you! I've favorited it so I won't lose it again.
• heliodor 9y ago
  As usual, correlation is incorrectly assumed to mean causality. The summary text says there's causality. A few paragraphs into the study, the text interchangeably uses causality and correlation: >> found that carbohydrate intake was associated with increased total mortality. >> By contrast, any type of dietary fat reduced the likelihood of dying.
• cageface 9y ago
  This study is highly flawed: https://www.hsph.harvard.edu/nutritionsource/2017/09/08/pure-study-makes-headlines-but-the-conclusions-are-misleading/ https://www.hsph.harvard.edu/nutritionsource/2017/09/08/pure... Be careful making any changes to your diet based on these "findings". The healthiest populations on the planet eat plenty of carbs, but not refined sugars.
  • CuriouslyC 9y ago
    I always wonder, when nutrition studies are usually so poorly designed and controlled, why people don't just look at the blue zone diets for nutrition guidance.
    • shlant 9y ago
      Yep. We have multiple examples of multigenerational communities that regularly live to 100+. Poorly done studies like this one only serve to obscure the truth about what we should be eating for longevity.
    • cloverich 9y ago
      Had not heard of "Blue zone"s before [1]. (EDIT: Added [2]) [1]: http://www.npr.org/sections/thesalt/2015/04/11/398325030/eating-to-break-100-longevity-diet-tips-from-the-blue-zones http://www.npr.org/sections/thesalt/2015/04/11/398325030/eat... [2]: http://bluezones.com/recipes/ http://bluezones.com/recipes/
  • oaijdsfoaijsf 9y ago
    Even without the data quality issues, there are obvious uncontrolled confounding factors. I don't understand how a real scientist can title this study "Dietary Carbohydrates Impair . . ." when the finding is actually "Dietary Carbohydrates Are Associated With Impaired . . ." Clear evidence that statistical training (or perhaps just incentives) for scientists remains insufficient. What's really surprising is how many people on here are like, "of course, ketogenic diets!" Where is all the skepticism that is so vividly on display when discussing the latest Google or Facebook product announcement?
• metalliqaz 9y ago
  Man I'm screwed. Don't drink, don't smoke, but totally addicted to carbs. Granola bars...mmmmmm
  • digitalsushi 9y ago
    are you addicted to carbs, or are the critters living in your gut that get hangry when you starve them? more of a talking point because i dont have my head around it. my wife had me do a "die off" diet for several weeks of doing keto; i got super bloated, got a rash everywhere, and then all of a sudden felt skinny and good. ...then i binged and it was all normal again
    • metalliqaz 9y ago
      I am my critters and my critters are me.
• cup-of-tea 9y ago
  I've read a lot of, often conflicting, dietry guidance. I have realised one very important thing: humans will very easily accept that something they enjoy is bad for them (see fat, sex etc.) So listening to what people say is bad for them is stupid. Instead I have taken a simpler approach: I observe the lifestyles of people who are healthy and live a long time. I have observed that eating simply "good, old-fashioned" home cooked food is important. My grandmother lived into her 90s. Ate fat and carbs. Julia Child lived into her 90s. Ate fat and carbs. Edna Lewis lived into her 90s. Ate fat and carbs. I could go on. Just do what they did and you'll have as good a chance as any.
  • maxxxxx 9y ago
    The problem is that simple home cooked food can't be commercialized. So all advice that gets published will be for something where you can buy a product. Same for exercise. We already know how to exercise but there are always people who want to make money by repackaging it.
    • cup-of-tea 9y ago
      I fear you may be correct.
    • ianai 9y ago
      I think those things can be commercialized but they have not been to the extent that Keto diets have.
    • moretai 9y ago
      I don't know why, but I always felt that there was a market for a no-bullshit movement, but I fear that the appeal of more money perverts the movement, and then it just becomes like every other commodity. I think most things probably start as well-intentioned, and whether it's money or power, something happens along the way and subverts the whole thing.
  • iridium 9y ago
    Selection bias is something worth avoiding in understanding health studies. It’s quite likely that you know about these folks because they had the right genetics to be healthy outliers, and by extension, famous. It’s no different than saying I know x people who didn’t die of lung cancer due to smoking, which doesn’t change the implication that y% of smokers will always get lung cancer, we just haven’t figured out what fully constitutes your risk ( genetics etc)
• drpgq 9y ago
  "Moreover, there was no link to cardiovascular events or related mortality, except for saturated fats, which were unexpectedly associated with a lower risk of stroke." That's interesting.
• H1Supreme 9y ago
  tl;dr Refined sugar contributes to getting fat, and an early grave. No shit, Sherlock. They conveniently left out any reference to fiber, or the exact sources of said carbohydrates. Sources matter tremendously due to fiber content and levels of refinement. Stick to fibrous veggies, beans, nuts, some fruit (berries are best), and you'll be just fine eating carbs. I'm not contesting the fact that ketogenic diets work for people. But this study is kinda bullshit since it's basically alluding to the worst kind of high GI refined carbs
• shlant 9y ago
  I'm not surprised to see this at the top of HN considering how many people seem to be fans of the Keto Diet. I am very excited for people who find something that works for them, but I would be very wary of a study like this if you are looking for confirmation for multiple reasons: 1. The study "did not analyze which specific source of carbohydrates (e.g., sugar/refined carbs versus whole-grain products) may contribute to the detrimental effects of carbs observed, especially since income and wealth do impact the quality of dietary choices significantly." This is HUGE. Any study or person that attempts to label an entire macronutrient as "bad" or "evil" is not helping anyone understand the whole picture. The most nutritious foods in the world are carbs. Many of the least nutritious foods are also carbs. Not distinguishing the two gets us nowhere. 2. With this study and most high fat/keto diet studies as well, the timeline is not long enough to tell us about true "lifespan" impact. This one is over 7.4 years. I know it's more difficult to do 10, 20, 30 year studies, but until something can be correlated over those timespans, I would not bet everything on that diet for longevity. There are a handful of generational studies, and almost all have shown that "high carb" or more specifically "plant based" ARE good for longevity. Not saying high fat aren't good for longevity as well, but we have yet to really see examples yet. 3. As many who have tried Keto specifically will tell you (as some have mentioned in the comments), it is very difficult to maintain a ketogenic state. You have to be very disciplined, and this is made harder when you are a social person. This is a big problem when talking about diet and longevity. If it's not fairly easy to maintain, then it's not a feasible diet for longevity where the average person is concerned. 4. As someone else mentioned, the percentage of carbs that the studies participants were eating were not even close to the level required for a Keto Diet
• bmcusick 9y ago
  And yet many of the longest-lived populations on earth have diets rich in carbohydrates, like the Okinawans. I hate associational studies like this which don't distinguish between types of carbohydrates (sugar vs starch) or other factors, like whether they were eating whole meals of natural foods or snacking on potato chips 24/7. But at least they've finally noticed they were completely wrong about saturated fat for 80 years.
• marze 9y ago
  Take home message? Eliminate sugar, increase saturated fat. This study provides little guidance on question “is total keto good or not”.
• shepardrtc 9y ago
  >>> (1)The conversion of D-glucose into metabolic intermediates, namely glycolysis, can be inhibited by compounds like (the highly efficient but rather toxic) 2-deoxy-D-glucose or (the less efficient but completely harmless) D-glucosamine (GlcN). The latter is widely used to treat arthrosis with the questionable claim of inducing cartilage regeneration. Both compounds have been shown to extend C. elegans lifespan (Schulz et al., 2007, Weimer et al., 2014), while only GlcN extends lifespan in rodents (Weimer et al., 2014). Notably, GlcN uptake has been also associated with reduced mortality in a large human cohort (Bell et al., 2012). So does this mean the glucosamine chondroitin pills I take for my joints will help reduce glucose conversion and extend my lifespan?