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This diet sounds miserable. You'd be hungry all the time. I would also much rather eat low-carb (and I do, I am a T2 diabetic that eats a ketogenic diet). Whic

This diet sounds miserable. You'd be hungry all the time. I would also much rather eat low-carb (and I do, I am a T2 diabetic that eats a ketogenic diet). Which sounds more sustainable? Drinking 800 calories of milk and juice every day, or eating real food like steak and broccoli, or chicken with brussel sprouts, or bacon and eggs? I am losing weight and reducing my A1c eating about 1300 calories of real food each day, and it doesn't leave me hungry at all. Keto is a very sustainable way of eating (in that you can keep doing it without misery). This "diet" looks like hell.

mattmanser 8y ago
A recent analysis posted here claimed that low carb, high animal protein/fat was the unhealthiest diet long term, resulting in a 4 year drop in life expectancy, compared to a 1 year drop with a high carb diet. Low carb looks to be dangerous for your body long term if you have too much meat. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2... According to a recent documentary I saw on the BBC about this very diet, the point of the 800 diet is to lose weight asap and then introduce food back in gradually over 3 weeks (I think it was restoring one meal time a week, dinner, lunch, breakfast), in a controlled manner to teach you better food habits. The documentary was focused on 4 normal people who had health problems due to weight, they all were trying this diet to see if it would help. One of them had just developed type 2. Wouldn't be surprised if that programme paved the way for this (it was on in June). https://www.bbc.co.uk/programmes/b0b53xqs https://www.bbc.co.uk/programmes/b0b53xqs
- cowpewter 8y ago
  I eat reasonable portions of meat, not excessively large ones. Most of your calories on a ketogenic diet come from fat, not protein, both dietary fat and fat your body burns off if you're also losing weight at the same time. I would also rather live 4 less years and be healthy til the end of my lifespan, than live 4 extra years post-foot-amputation and on dialysis because of complications from diabetes. My father was also a T2 diabetic, tried to follow the ADA recommended diet, but still wound up insulin-dependent and eventually on dialysis before his death. I do not plan to follow in his footsteps. I feel better on this way of eating than I have at any point in my life. My body has never metabolized carbs well. When I was younger, I was reactive-hypoglycemic, meaning that eating too many carbs would actually cause my body to over-respond with insulin, causing my blood sugar to plummet. I blacked out multiple times in high school from low blood sugar. Eating carbs (other than green veggies of course) is not for me.
- lhl 8y ago
  Obviously that publication didn't go over well with the keto crowd, and they found a lot to pick apart (See 1 and 2). The most relevant critiques: Methodology-wise, the prospective study seemed pretty poor * Those people filled out questionnaires on their eating patterns on two occasions, six years apart. Their health was followed up for 25 years, allowing for factors that might alter the results, such as smoking, income and diabetes. (the assumption presumably being that they ate the same for the rest of their lives? IMO this seems to make any results pretty much worthless) * low carb in this study is defined as "low carbohydrate consumption (<40%)" - typically LCHF is understood to be 50-100g, so typically 10-20%, and keto is even lower (5%) * The PURE study was cited as part of the meta-analysis but another analysis in the Lancet actually came to the findings that: "Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality." https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... * The "years in life expectancy" is very unusual - usually what's presented is relative risk or hazard ratio and absolute risk. This can be found in the data - from the ARIC study, the HR for high carb was 1.16 and for "low" carb was 1.37 - the annual death rate was 1.63%, so the absolute risk was a difference from 1.38% vs 1.88%. These calculations, and a full analysis of the article is available here: http://www.zoeharcombe.com/2018/08/low-carb-diets-could-shorten-life-really/ http://www.zoeharcombe.com/2018/08/low-carb-diets-could-shor... * I noticed that one of the authors listed is Willett, who invented the Mediterranean diet as we know it, and Sarah Seidelmann, the lead author is an outspoken vegan advocate, so it's worth keeping bias in mind when looking at the results. Sadly, the world of nutritional science (especially the epidemiological arm seems to really be as much about personalities as science (part of Ancel Keys' legacy, I suppose) Actually, since I'm a bit tired of listing out points here are a few other interesting rebuttals that are primarily interesting because they point to all the pitfalls of coming to conclusions from observational studies and meta-analyses (and why nutritional reporting is simply the worst): * https://cluelessdoctors.com/2018/08/17/when-bad-science-can-harm-you/ https://cluelessdoctors.com/2018/08/17/when-bad-science-can-... * https://www.linkedin.com/pulse/low-carbs-mortality-john-schoonbee https://www.linkedin.com/pulse/low-carbs-mortality-john-scho... * https://www.psychologytoday.com/us/blog/diagnosis-diet/201809/latest-low-carb-study-all-politics-no-science https://www.psychologytoday.com/us/blog/diagnosis-diet/20180... * https://anhinternational.org/2018/08/22/scientific-attack-on-low-carb-diets/ https://anhinternational.org/2018/08/22/scientific-attack-on... * https://asianwithoutrice.com/making-low-carb-a-murderer-part-2-of-2-broken-from-the-start/ https://asianwithoutrice.com/making-low-carb-a-murderer-part... 1: https://www.reddit.com/r/ketoscience/comments/98kx1w/all_nitpicks_criticism_refutations_and_discussion/ https://www.reddit.com/r/ketoscience/comments/98kx1w/all_nit... 2: https://www.reddit.com/r/ketoscience/comments/981ync/dietary_carbohydrate_intake_and_mortality_a/ https://www.reddit.com/r/ketoscience/comments/981ync/dietary...
- owlmirror 8y ago
  The study categorized everyone who ate below 40% of their calories into the low carb group. That's a lot of people who simply eat SAD. It would be much more interesting if they grouped the subjects into more categories. But I suspect the data for that simply isn't good enough.
wahern 8y ago
> This diet sounds miserable. You'd be hungry all the time. I would also much rather eat low-carb (and I do, I am a T2 diabetic that eats a ketogenic diet). Not eating anything, and only eating proteins and fats, are both difficult for me. And simply abstaining is actually easier. When I consume anything I begin craving not only carbs, but craving the stimulation of eating, period. I think its finally uncontroversial to say that not all calories are the same. But eating is more than just the metabolic process; like smoking it's about the physical habits and stimulation. In that way eating chips is not much different than eating pork rinds, and for some people that's what matters most. Remember the Master Cleanser and juice fast fads? People consuming nothing but raw sugar for days, weeks, and even months on-end derived similar benefits--weight loss, improved insulin sensitivity, etc. And for some people it was really easy because you could sip on your drink constantly throughout the day, which was in an important way the antithesis of abstinence. Not all calories are the same, but it's still the case that fewer calories are better. Just do whatever it takes to get you to fewer calories. I'm not trying to equivocate diets--vitamins, minerals, and fiber still matter. But, again, calorie count is ultimately the most important metric. How you manage it is largely a matter of your personal tastes and lifestyle. Few people can manage a perfect diet, but there's a least bad diet for everyone, and they're often wildly different. And that's basically what the expert stated in the article--the powdered diet isn't for everybody, but it was important to begin offering alternatives to the "balanced diet" recommendations.
- cowpewter 8y ago
  True, I don't disagree. Keto is just the easiest way I've found to eat at a caloric deficit without feeling deprived, hangry, or succumbing to cravings and eating half a cake in one sitting. Once you get past the first couple weeks, carb cravings fade, and it's not nearly as difficult. It's just far easier for me to say no entirely to carbs than for me to eat them in moderation, much like it's a bad idea for an alcoholic to try to have "just one" beer.

mattmanser 8y ago

A recent analysis posted here claimed that low carb, high animal protein/fat was the unhealthiest diet long term, resulting in a 4 year drop in life expectancy, compared to a 1 year drop with a high carb diet. Low carb looks to be dangerous for your body long term if you have too much meat. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2... According to a recent documentary I saw on the BBC about this very diet, the point of the 800 diet is to lose weight asap and then introduce food back in gradually over 3 weeks (I think it was restoring one meal time a week, dinner, lunch, breakfast), in a controlled manner to teach you better food habits. The documentary was focused on 4 normal people who had health problems due to weight, they all were trying this diet to see if it would help. One of them had just developed type 2. Wouldn't be surprised if that programme paved the way for this (it was on in June). https://www.bbc.co.uk/programmes/b0b53xqs https://www.bbc.co.uk/programmes/b0b53xqs

cowpewter 8y ago
I eat reasonable portions of meat, not excessively large ones. Most of your calories on a ketogenic diet come from fat, not protein, both dietary fat and fat your body burns off if you're also losing weight at the same time. I would also rather live 4 less years and be healthy til the end of my lifespan, than live 4 extra years post-foot-amputation and on dialysis because of complications from diabetes. My father was also a T2 diabetic, tried to follow the ADA recommended diet, but still wound up insulin-dependent and eventually on dialysis before his death. I do not plan to follow in his footsteps. I feel better on this way of eating than I have at any point in my life. My body has never metabolized carbs well. When I was younger, I was reactive-hypoglycemic, meaning that eating too many carbs would actually cause my body to over-respond with insulin, causing my blood sugar to plummet. I blacked out multiple times in high school from low blood sugar. Eating carbs (other than green veggies of course) is not for me.
lhl 8y ago
Obviously that publication didn't go over well with the keto crowd, and they found a lot to pick apart (See 1 and 2). The most relevant critiques: Methodology-wise, the prospective study seemed pretty poor * Those people filled out questionnaires on their eating patterns on two occasions, six years apart. Their health was followed up for 25 years, allowing for factors that might alter the results, such as smoking, income and diabetes. (the assumption presumably being that they ate the same for the rest of their lives? IMO this seems to make any results pretty much worthless) * low carb in this study is defined as "low carbohydrate consumption (<40%)" - typically LCHF is understood to be 50-100g, so typically 10-20%, and keto is even lower (5%) * The PURE study was cited as part of the meta-analysis but another analysis in the Lancet actually came to the findings that: "Higher saturated fat intake was associated with lower risk of stroke (quintile 5 vs quintile 1, HR 0·79 [95% CI 0·64–0·98], ptrend=0·0498). Total fat and saturated and unsaturated fats were not significantly associated with risk of myocardial infarction or cardiovascular disease mortality." https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32252-3/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... * The "years in life expectancy" is very unusual - usually what's presented is relative risk or hazard ratio and absolute risk. This can be found in the data - from the ARIC study, the HR for high carb was 1.16 and for "low" carb was 1.37 - the annual death rate was 1.63%, so the absolute risk was a difference from 1.38% vs 1.88%. These calculations, and a full analysis of the article is available here: http://www.zoeharcombe.com/2018/08/low-carb-diets-could-shorten-life-really/ http://www.zoeharcombe.com/2018/08/low-carb-diets-could-shor... * I noticed that one of the authors listed is Willett, who invented the Mediterranean diet as we know it, and Sarah Seidelmann, the lead author is an outspoken vegan advocate, so it's worth keeping bias in mind when looking at the results. Sadly, the world of nutritional science (especially the epidemiological arm seems to really be as much about personalities as science (part of Ancel Keys' legacy, I suppose) Actually, since I'm a bit tired of listing out points here are a few other interesting rebuttals that are primarily interesting because they point to all the pitfalls of coming to conclusions from observational studies and meta-analyses (and why nutritional reporting is simply the worst): * https://cluelessdoctors.com/2018/08/17/when-bad-science-can-harm-you/ https://cluelessdoctors.com/2018/08/17/when-bad-science-can-... * https://www.linkedin.com/pulse/low-carbs-mortality-john-schoonbee https://www.linkedin.com/pulse/low-carbs-mortality-john-scho... * https://www.psychologytoday.com/us/blog/diagnosis-diet/201809/latest-low-carb-study-all-politics-no-science https://www.psychologytoday.com/us/blog/diagnosis-diet/20180... * https://anhinternational.org/2018/08/22/scientific-attack-on-low-carb-diets/ https://anhinternational.org/2018/08/22/scientific-attack-on... * https://asianwithoutrice.com/making-low-carb-a-murderer-part-2-of-2-broken-from-the-start/ https://asianwithoutrice.com/making-low-carb-a-murderer-part... 1: https://www.reddit.com/r/ketoscience/comments/98kx1w/all_nitpicks_criticism_refutations_and_discussion/ https://www.reddit.com/r/ketoscience/comments/98kx1w/all_nit... 2: https://www.reddit.com/r/ketoscience/comments/981ync/dietary_carbohydrate_intake_and_mortality_a/ https://www.reddit.com/r/ketoscience/comments/981ync/dietary...
owlmirror 8y ago
The study categorized everyone who ate below 40% of their calories into the low carb group. That's a lot of people who simply eat SAD. It would be much more interesting if they grouped the subjects into more categories. But I suspect the data for that simply isn't good enough.

wahern 8y ago

> This diet sounds miserable. You'd be hungry all the time. I would also much rather eat low-carb (and I do, I am a T2 diabetic that eats a ketogenic diet). Not eating anything, and only eating proteins and fats, are both difficult for me. And simply abstaining is actually easier. When I consume anything I begin craving not only carbs, but craving the stimulation of eating, period. I think its finally uncontroversial to say that not all calories are the same. But eating is more than just the metabolic process; like smoking it's about the physical habits and stimulation. In that way eating chips is not much different than eating pork rinds, and for some people that's what matters most. Remember the Master Cleanser and juice fast fads? People consuming nothing but raw sugar for days, weeks, and even months on-end derived similar benefits--weight loss, improved insulin sensitivity, etc. And for some people it was really easy because you could sip on your drink constantly throughout the day, which was in an important way the antithesis of abstinence. Not all calories are the same, but it's still the case that fewer calories are better. Just do whatever it takes to get you to fewer calories. I'm not trying to equivocate diets--vitamins, minerals, and fiber still matter. But, again, calorie count is ultimately the most important metric. How you manage it is largely a matter of your personal tastes and lifestyle. Few people can manage a perfect diet, but there's a least bad diet for everyone, and they're often wildly different. And that's basically what the expert stated in the article--the powdered diet isn't for everybody, but it was important to begin offering alternatives to the "balanced diet" recommendations.

cowpewter 8y ago
True, I don't disagree. Keto is just the easiest way I've found to eat at a caloric deficit without feeling deprived, hangry, or succumbing to cravings and eating half a cake in one sitting. Once you get past the first couple weeks, carb cravings fade, and it's not nearly as difficult. It's just far easier for me to say no entirely to carbs than for me to eat them in moderation, much like it's a bad idea for an alcoholic to try to have "just one" beer.