5 ms·

...or you could not starve yourself on <900 calories a day and instead be a sane person and just eat low carb: https://link.springer.com/article/10.1007%2Fs1330

...or you could not starve yourself on <900 calories a day and instead be a sane person and just eat low carb: https://link.springer.com/article/10.1007%2Fs13300-018-0373-9 https://link.springer.com/article/10.1007%2Fs13300-018-0373-... "Insulin therapy was reduced or eliminated in 94% of users; sulfonylureas were entirely eliminated in the CCI. No adverse events were attributed to the CCI." Wow, that's pretty extraordinary, isn't it? Every single person in the non-control group eliminated the need for sulfonylureatic compounds and a massive 94% reduced their insulin level or completely got off insulin altogether. All with no adverse affects being recorded. You don't need to starve yourself or go on some ridiculous diet. You just need to eat low carb and eat clean (a.k.a. "real" food) and your body will begin to heal in nearly every case. I suspect the few test cases that didn't improve were so far gone they were too metabolically impaired to achieve any positive results. The damage was likely too extensive and age possibly played a factor. For everyone else, it appears they can get rid of diabetes...if they actually care enough to do so.

arkades 9y ago
Repeated studies have shown that weight loss plays a bigger role than carb restriction. The article you linked showed a 12% weight loss in the experimental group, which also had continued support by a health coach throughout its duration, which was the actual intervention. You make it sound like the intervention was carb elimination, rather than weight loss with a health coach. It was not.
- originalsimba 9y ago
  Repeated studies have shown that carb restriction leads to weight loss.
  - arkades 9y ago
    No, repeated studies have shown that -any diet- leads to weight loss. Drawing anyone’s attention to what they’re eating in a detail-oriented way helps lose weight. When someone says “carb restriction is the ticket,” they’re attributing the effectiveness -to the carb restriction-, explicitly, as having an effect on weight loss notably above and beyond that of calorie restriction. Pretty much no decently structured studies have supported that. A couple animal studies suggest shit like HFCS has a much more severe short term effect on insulin than other foods, but they’re small, animal based, and “don’t eat junk food” is world away from “carb restrict.”
    - trevyn 9y ago
      Carb restriction is a ticket because, if you can follow it, it almost magically stops craving and binging. If you have a perfectly healthy relationship with food without having to constantly fight cravings, awesome, and nobody who needs to lose weight is like you.
      - mykmallett 9y ago
        YMMV. I have used keto to much success in the past, however I've found it impossible to stick with on a long term basis, even after giving it 6 months and really trying to make it work. My cravings for carbs was unbearable and made me miserable. My body seems to reject it now, as every time I try it I have a ravenous hunger for pasta, breads, chocolate. So it's not really a panacea for limiting hunger. Fat is more satiating yes, but it's also pretty joyless after a short while. I find fasting to be more in tune with my life nowadays.
        tsmarsh 9y ago
        yeah. I was low carb for 18 months. I got down to 220 and felt really good except... I really wanted carbohydrates a lot. Even though I wasn't hungry. The first week or so was really hard. Close to no carbohydrates and all I could think about was sweet things. Even after I reintroduced healthier sweet foods like fruit, it just didn't hit the same spots as a good sandwich or a bowl of pasta. After I went back to regular food, I'd periodically do a month or so of paleo to try and the weight gain under control, but I got back up to 280. Currently I'm a couple of weeks into slimfast. I'm not hungry. I don't feel bad if grab a small piece of chocolate. Occasionally my evening meal is a small bowl of pasta, or a sandwich and I'm loosing a consistent amount of weight... for now.
        spion 9y ago
        Out of curiosity and if you recall, what were the approximate macros?
      - originalsimba 9y ago
        What you're talking about is addiction. It has nothing to do with food. People who tend towards addiction will be addicted to all kinds of things. Fighting addiction is very difficult, no doubt. If you recognize it as addiction instead of pretending that it's something else, that makes it easier.
  - omw192168 9y ago
    If you take the time to read the studies you would see the diet leads to weight loss, carbs are not specific.
- GreaterFool 9y ago
  I've been on keto (carb restriction) diet (lifestyle?). Just some thoughts learned from the experience: it is incredibly easy to lose weight on carb restriction since hunger goes away and relationship with food changes. I still like to eat but it's become more a number game. I eat once a day and structure my meal to hit my macros. Just figure out how many calories and protein / fat ratio and I can usually hit close to it with 1 meal and top up calories with butter coffee. Also, I can instantly do a 1-day fast. It doesn't bother me at all. Every few days I stretch my intermittent fast to proper "just coffee and water today" fast. It's very refreshing. Calorie restriction on carbohydrate heavy diet sounds like hell. Food cravings. Starvation. Fasting on the other hand is a different story. Zen.
  - wutbrodo 9y ago
    Yea, the shift in your eating habits is really kind of astounding. I'm not even that close to keto levels of carb intake[1], but I've been progressively minimizing any processed carbs since college (and I'm lucky enough to have been raised eating fairly healthy, so my baseline was decent). At this point, there are certain foods that all my friends feel are impossible not to crave and give into occasionally, that I simply just don't enjoy. One of the biggest examples is fat+grain in its various forms: pizza, grilled cheese, many pastas, funnel cakes, etc etc etc. Don't get me wrong: I'm not completely incapable of enjoying these categories of food. It just needs to actually be well-made and have some flavor: by contrast, most of the people I know enjoy the wireheading effect of this combo per se. To me, this seems like the difference between eating a nice dessert and eating a bowl of straight white sugar. This is something I think about a lot: there's so many unhealthy food items that I find pretty gross at this point that most of my well-educated, high-income social circles have resigned themselves to being a completely unavoidable flaw in the human brain[2]. It's kind of eerie to think about; My diet isn't even amazingly healthy, and I've already found myself brushing up against the "eccentric abstemiousness" that pg mentions in his essay on addiction. [1] every time I lift weights, I crave carbs too much to drop them entirely: most of my carbohydrates come from beans, pulses, and certain green veggies. [2] IMHO, this is the source of the popular-on-HN sentiment that each and every one of us are hopelessly devoid of agency when it comes to resisting the power of corporations to exploit the way our brains' taste centers work. The theory isn't implausible to me, but my experience indicates that you really don't need superhuman self-control to change your diet: it just takes time and patience.
- fmihaila 9y ago
  > You make it sound like the intervention was carb elimination, rather than weight loss with a health coach. It was not. And you make it sound like the intervention was weight loss with a coach, rather than carb restriction made possible by continuous care. The authors assert that carbohydrate restriction was the main cause of lowered blood glucose, weight, and medicine use (weight loss was not the cause of the improvements; rather, it was one effect among others). Continuous care was required for medicine management and in order to sustain the diet, as clearly stated in the summary (emphasis mine): > Blood sugar in patients with T2D can improve quickly when patients eat significantly fewer dietary carbohydrates. However, this demands careful medicine management by doctors, and patients need support and frequent contact with health providers to sustain this way of living. [...] After 1 year, patients in the CCI, on average, lowered HbA1c from 7.6 to 6.3%, lost 12% of their body weight, and reduced diabetes medicine use. [...] This suggests the novel care model studied here using dietary carbohydrate restriction and continuous remote care can safely support adults with T2D to lower HbA1c, weight, and medicine use.
  - arkades 9y ago
    They’re welcome to assert what they want, but that’s not the intervention they created.
  - YeGoblynQueenne 9y ago
    >> The authors assert that carbohydrate restriction was the main cause of lowered blood glucose, weight, and medicine use (weight loss was not the cause of the improvements; rather, it was one effect among others). Continuous care was required for medicine management and in order to sustain the diet, as clearly stated in the summary (emphasis mine): Well, to be fair, they didn't make any attempt to control for improvements due to weight loss alone. They compared their results with one "lifestyle change" study and one calorie restriction study (also with carbohydrate reduction, both of which references I didn't follow) and the difference in outcomes was not that groundbreaking, I'd say. But I'm not a doctor, or a biologist and I can't really say for sure. I'd welcome some input from a specialist on this.
stephenhess 9y ago
With you until that last part.. older populations that go through diabetes prevention / weight loss programs actually do better than younger folks. Also, "if they actually care enough to do so" is a tricky statement. Many folks that are overweight have tried losing weight numerous times only to gain it back and have leaned on confusing (and often incorrect) advice about diet, exercise and its relationship to weight loss (e.g. the food pyramid). They go through waves of motivation like anyone else. There's a good opportunity for the healthcare industry to engage with people at that level, in the way mental health professionals support people battling anxiety and depression. Would love to see more research targeted at that motivation point because I agree with you that the physiological mechanisms are pretty well understood at this point (at least in comparison).
omw192168 9y ago
lol make sure your "clean food" lacks gmos. You've obviously read too many fad articles. stick to science.
andscoop 9y ago
For some people "starving" themselves is easier. It requires less decision making and therefore less decision fatigue. Intermittent fasting is a perfect balance of physical discomfort and mental effort for me. I feel no physical discomfort when doing the standard 16/8 schedule these days and only feel slight discomfort on a 22/2 schedule. I'd much rather do this than have to meal plan and have anxiety over what restaurant my friends chose for the night. But I also understand that it's not for everyone and wouldn't push judgement on anyone who chooses some alternative method of controlling weight/insulin sensitivity
newnewpdro 9y ago
Calorie restricted diets confer other benefits like slowing the aging process. [1] Additionally, it's quite common for those embracing a keto/atkins diet to use it as a warrant to eat copious amounts of red meat or any meat at every meal. There's substantial evidence suggesting such a diet increases risks of a number of serious cancers. A friend of mine has been using the keto diet to try lose weight for a few years now. He burns through bulk cases of SlimJim beef sticks on a weekly basis. I am not looking forward to the future hospital visits. The last time I tried going on a hike with him he nearly collapsed on the first climb. I'm not trying to suggest keto diets are inherently bad for you, but it certainly seems more likely to be problematic than calorie restriction when viewed through the lens of how the average American is going to apply the keto concepts. [1] https://www.nih.gov/news-events/nih-research-matters/calorie-restriction-slows-age-related-epigenetic-changes https://www.nih.gov/news-events/nih-research-matters/calorie...
- sleavey 9y ago
  If your friend is just eating copious amounts of meat without any care for vitamin and mineral intake, then of course this leads to suboptimal nutrition. It's worth saying that recommended daily allowances are set for entire populations, and not individuals, and individuals' genes determine specific requirements. For example, people with the genetic mutation responsible for Morton's toe [1] typically absorb B6 with 65% efficiency compared to those who don't have this mutation [2]. Without adequate B6, zinc is also absorbed less. Another consequence of bad health on low-carb diets can come from high intake of linoleic acid (omega-6). This is found in "vegetable" oils such as canola, sunflower and nut (even though they are actually not vegetables) [3]. We're told to take this fatty acid for our health, but we only need trivial amounts when our diet is optimal, and too much can disrupt the way that cell mitochondria work. One fact I find absolutely amazing is that in cancer studies with rats, tumour formation is heavily influenced by levels of linoleic acid in their diet [4]. [1] https://en.wikipedia.org/wiki/Morton's_toe https://en.wikipedia.org/wiki/Morton's_toe [2] https://www.sciencedirect.com/science/article/pii/S0306987714003272 https://www.sciencedirect.com/science/article/pii/S030698771... [3] http://www.mdpi.com/2227-9032/5/2/25 http://www.mdpi.com/2227-9032/5/2/25 [4] https://www.ncbi.nlm.nih.gov/pubmed/3921234 https://www.ncbi.nlm.nih.gov/pubmed/3921234
- 9y ago
YeGoblynQueenne 9y ago
The study you quote was funded by Virta Health Corp. a health startup that advertises "The Virta treatment [that] reverses type 2 diabetes". They use this study as their main advertising item, quoting it extensively on their site, calling it "groundbreaking" etc etc. Besides the fishy smell emanating from this, and to address your comment directly, the quoted study compared the proposed treatment against "usual care", i.e. ordinary diabetes treatment. More specifically, the study did not directly compare the proposed treatment to other dietary or lifestyle interventions and particularly not to calorie restriction diets. It does, however, quote the results of such studies: The CCI [Continuous Care Intervention] reduced HbA1c by 14 mmol mol−1 (1.3%) at 1 year. HbA1c reductions up to 7 mmol mol−1 (0.6%) via intensive lifestyle intervention [25] and 11 mmol mol−1 (1.0%) via an energy-restricted low-carbohydrate diet with partial food provision delivered via an outpatient setting [26] were previously reported. So the difference between this and one selected calorie restriction diet (which was also a low-carbohydrate diet) was small (3%). These are just two studies, so it's hard to draw a conclusion. Anyway, I'm not a doctor or a biologist so I don't know just by looking at the studies to say what is significant and what isn't. For instance, sulfonylurea treatment was reduced in the "CCI" group, like you note, but that group already had ~24% lower use of sulfonylureas than the baseline to begin with. What does that mean? And what does it mean that people took less medicine at the end of a study? Did they absolutely need all the medicine they were taking at the start? Do you know how to answer those questions? Because I certainly don't. A single study, quoted by someone who isn't a doctor to people who also aren't doctors over the internet, doesn't really mean anything.

arkades 9y ago

Repeated studies have shown that weight loss plays a bigger role than carb restriction. The article you linked showed a 12% weight loss in the experimental group, which also had continued support by a health coach throughout its duration, which was the actual intervention. You make it sound like the intervention was carb elimination, rather than weight loss with a health coach. It was not.

originalsimba 9y ago
Repeated studies have shown that carb restriction leads to weight loss.
- arkades 9y ago
  No, repeated studies have shown that -any diet- leads to weight loss. Drawing anyone’s attention to what they’re eating in a detail-oriented way helps lose weight. When someone says “carb restriction is the ticket,” they’re attributing the effectiveness -to the carb restriction-, explicitly, as having an effect on weight loss notably above and beyond that of calorie restriction. Pretty much no decently structured studies have supported that. A couple animal studies suggest shit like HFCS has a much more severe short term effect on insulin than other foods, but they’re small, animal based, and “don’t eat junk food” is world away from “carb restrict.”
  - trevyn 9y ago
    Carb restriction is a ticket because, if you can follow it, it almost magically stops craving and binging. If you have a perfectly healthy relationship with food without having to constantly fight cravings, awesome, and nobody who needs to lose weight is like you.
    - mykmallett 9y ago
      YMMV. I have used keto to much success in the past, however I've found it impossible to stick with on a long term basis, even after giving it 6 months and really trying to make it work. My cravings for carbs was unbearable and made me miserable. My body seems to reject it now, as every time I try it I have a ravenous hunger for pasta, breads, chocolate. So it's not really a panacea for limiting hunger. Fat is more satiating yes, but it's also pretty joyless after a short while. I find fasting to be more in tune with my life nowadays.
      - tsmarsh 9y ago
        yeah. I was low carb for 18 months. I got down to 220 and felt really good except... I really wanted carbohydrates a lot. Even though I wasn't hungry. The first week or so was really hard. Close to no carbohydrates and all I could think about was sweet things. Even after I reintroduced healthier sweet foods like fruit, it just didn't hit the same spots as a good sandwich or a bowl of pasta. After I went back to regular food, I'd periodically do a month or so of paleo to try and the weight gain under control, but I got back up to 280. Currently I'm a couple of weeks into slimfast. I'm not hungry. I don't feel bad if grab a small piece of chocolate. Occasionally my evening meal is a small bowl of pasta, or a sandwich and I'm loosing a consistent amount of weight... for now.
      - spion 9y ago
        Out of curiosity and if you recall, what were the approximate macros?
    - originalsimba 9y ago
      What you're talking about is addiction. It has nothing to do with food. People who tend towards addiction will be addicted to all kinds of things. Fighting addiction is very difficult, no doubt. If you recognize it as addiction instead of pretending that it's something else, that makes it easier.
- omw192168 9y ago
  If you take the time to read the studies you would see the diet leads to weight loss, carbs are not specific.
GreaterFool 9y ago
I've been on keto (carb restriction) diet (lifestyle?). Just some thoughts learned from the experience: it is incredibly easy to lose weight on carb restriction since hunger goes away and relationship with food changes. I still like to eat but it's become more a number game. I eat once a day and structure my meal to hit my macros. Just figure out how many calories and protein / fat ratio and I can usually hit close to it with 1 meal and top up calories with butter coffee. Also, I can instantly do a 1-day fast. It doesn't bother me at all. Every few days I stretch my intermittent fast to proper "just coffee and water today" fast. It's very refreshing. Calorie restriction on carbohydrate heavy diet sounds like hell. Food cravings. Starvation. Fasting on the other hand is a different story. Zen.
- wutbrodo 9y ago
  Yea, the shift in your eating habits is really kind of astounding. I'm not even that close to keto levels of carb intake[1], but I've been progressively minimizing any processed carbs since college (and I'm lucky enough to have been raised eating fairly healthy, so my baseline was decent). At this point, there are certain foods that all my friends feel are impossible not to crave and give into occasionally, that I simply just don't enjoy. One of the biggest examples is fat+grain in its various forms: pizza, grilled cheese, many pastas, funnel cakes, etc etc etc. Don't get me wrong: I'm not completely incapable of enjoying these categories of food. It just needs to actually be well-made and have some flavor: by contrast, most of the people I know enjoy the wireheading effect of this combo per se. To me, this seems like the difference between eating a nice dessert and eating a bowl of straight white sugar. This is something I think about a lot: there's so many unhealthy food items that I find pretty gross at this point that most of my well-educated, high-income social circles have resigned themselves to being a completely unavoidable flaw in the human brain[2]. It's kind of eerie to think about; My diet isn't even amazingly healthy, and I've already found myself brushing up against the "eccentric abstemiousness" that pg mentions in his essay on addiction. [1] every time I lift weights, I crave carbs too much to drop them entirely: most of my carbohydrates come from beans, pulses, and certain green veggies. [2] IMHO, this is the source of the popular-on-HN sentiment that each and every one of us are hopelessly devoid of agency when it comes to resisting the power of corporations to exploit the way our brains' taste centers work. The theory isn't implausible to me, but my experience indicates that you really don't need superhuman self-control to change your diet: it just takes time and patience.
fmihaila 9y ago
> You make it sound like the intervention was carb elimination, rather than weight loss with a health coach. It was not. And you make it sound like the intervention was weight loss with a coach, rather than carb restriction made possible by continuous care. The authors assert that carbohydrate restriction was the main cause of lowered blood glucose, weight, and medicine use (weight loss was not the cause of the improvements; rather, it was one effect among others). Continuous care was required for medicine management and in order to sustain the diet, as clearly stated in the summary (emphasis mine): > Blood sugar in patients with T2D can improve quickly when patients eat significantly fewer dietary carbohydrates. However, this demands careful medicine management by doctors, and patients need support and frequent contact with health providers to sustain this way of living. [...] After 1 year, patients in the CCI, on average, lowered HbA1c from 7.6 to 6.3%, lost 12% of their body weight, and reduced diabetes medicine use. [...] This suggests the novel care model studied here using dietary carbohydrate restriction and continuous remote care can safely support adults with T2D to lower HbA1c, weight, and medicine use.
- arkades 9y ago
  They’re welcome to assert what they want, but that’s not the intervention they created.
- YeGoblynQueenne 9y ago
  >> The authors assert that carbohydrate restriction was the main cause of lowered blood glucose, weight, and medicine use (weight loss was not the cause of the improvements; rather, it was one effect among others). Continuous care was required for medicine management and in order to sustain the diet, as clearly stated in the summary (emphasis mine): Well, to be fair, they didn't make any attempt to control for improvements due to weight loss alone. They compared their results with one "lifestyle change" study and one calorie restriction study (also with carbohydrate reduction, both of which references I didn't follow) and the difference in outcomes was not that groundbreaking, I'd say. But I'm not a doctor, or a biologist and I can't really say for sure. I'd welcome some input from a specialist on this.

stephenhess 9y ago

With you until that last part.. older populations that go through diabetes prevention / weight loss programs actually do better than younger folks. Also, "if they actually care enough to do so" is a tricky statement. Many folks that are overweight have tried losing weight numerous times only to gain it back and have leaned on confusing (and often incorrect) advice about diet, exercise and its relationship to weight loss (e.g. the food pyramid). They go through waves of motivation like anyone else. There's a good opportunity for the healthcare industry to engage with people at that level, in the way mental health professionals support people battling anxiety and depression. Would love to see more research targeted at that motivation point because I agree with you that the physiological mechanisms are pretty well understood at this point (at least in comparison).

omw192168 9y ago

lol make sure your "clean food" lacks gmos. You've obviously read too many fad articles. stick to science.

andscoop 9y ago

For some people "starving" themselves is easier. It requires less decision making and therefore less decision fatigue. Intermittent fasting is a perfect balance of physical discomfort and mental effort for me. I feel no physical discomfort when doing the standard 16/8 schedule these days and only feel slight discomfort on a 22/2 schedule. I'd much rather do this than have to meal plan and have anxiety over what restaurant my friends chose for the night. But I also understand that it's not for everyone and wouldn't push judgement on anyone who chooses some alternative method of controlling weight/insulin sensitivity

newnewpdro 9y ago

Calorie restricted diets confer other benefits like slowing the aging process. [1] Additionally, it's quite common for those embracing a keto/atkins diet to use it as a warrant to eat copious amounts of red meat or any meat at every meal. There's substantial evidence suggesting such a diet increases risks of a number of serious cancers. A friend of mine has been using the keto diet to try lose weight for a few years now. He burns through bulk cases of SlimJim beef sticks on a weekly basis. I am not looking forward to the future hospital visits. The last time I tried going on a hike with him he nearly collapsed on the first climb. I'm not trying to suggest keto diets are inherently bad for you, but it certainly seems more likely to be problematic than calorie restriction when viewed through the lens of how the average American is going to apply the keto concepts. [1] https://www.nih.gov/news-events/nih-research-matters/calorie-restriction-slows-age-related-epigenetic-changes https://www.nih.gov/news-events/nih-research-matters/calorie...

sleavey 9y ago
If your friend is just eating copious amounts of meat without any care for vitamin and mineral intake, then of course this leads to suboptimal nutrition. It's worth saying that recommended daily allowances are set for entire populations, and not individuals, and individuals' genes determine specific requirements. For example, people with the genetic mutation responsible for Morton's toe [1] typically absorb B6 with 65% efficiency compared to those who don't have this mutation [2]. Without adequate B6, zinc is also absorbed less. Another consequence of bad health on low-carb diets can come from high intake of linoleic acid (omega-6). This is found in "vegetable" oils such as canola, sunflower and nut (even though they are actually not vegetables) [3]. We're told to take this fatty acid for our health, but we only need trivial amounts when our diet is optimal, and too much can disrupt the way that cell mitochondria work. One fact I find absolutely amazing is that in cancer studies with rats, tumour formation is heavily influenced by levels of linoleic acid in their diet [4]. [1] https://en.wikipedia.org/wiki/Morton's_toe https://en.wikipedia.org/wiki/Morton's_toe [2] https://www.sciencedirect.com/science/article/pii/S0306987714003272 https://www.sciencedirect.com/science/article/pii/S030698771... [3] http://www.mdpi.com/2227-9032/5/2/25 http://www.mdpi.com/2227-9032/5/2/25 [4] https://www.ncbi.nlm.nih.gov/pubmed/3921234 https://www.ncbi.nlm.nih.gov/pubmed/3921234
9y ago

YeGoblynQueenne 9y ago

The study you quote was funded by Virta Health Corp. a health startup that advertises "The Virta treatment [that] reverses type 2 diabetes". They use this study as their main advertising item, quoting it extensively on their site, calling it "groundbreaking" etc etc. Besides the fishy smell emanating from this, and to address your comment directly, the quoted study compared the proposed treatment against "usual care", i.e. ordinary diabetes treatment. More specifically, the study did not directly compare the proposed treatment to other dietary or lifestyle interventions and particularly not to calorie restriction diets. It does, however, quote the results of such studies: The CCI [Continuous Care Intervention] reduced HbA1c by 14 mmol mol−1 (1.3%) at 1 year. HbA1c reductions up to 7 mmol mol−1 (0.6%) via intensive lifestyle intervention [25] and 11 mmol mol−1 (1.0%) via an energy-restricted low-carbohydrate diet with partial food provision delivered via an outpatient setting [26] were previously reported. So the difference between this and one selected calorie restriction diet (which was also a low-carbohydrate diet) was small (3%). These are just two studies, so it's hard to draw a conclusion. Anyway, I'm not a doctor or a biologist so I don't know just by looking at the studies to say what is significant and what isn't. For instance, sulfonylurea treatment was reduced in the "CCI" group, like you note, but that group already had ~24% lower use of sulfonylureas than the baseline to begin with. What does that mean? And what does it mean that people took less medicine at the end of a study? Did they absolutely need all the medicine they were taking at the start? Do you know how to answer those questions? Because I certainly don't. A single study, quoted by someone who isn't a doctor to people who also aren't doctors over the internet, doesn't really mean anything.