9 ms·

> So easy to resolve using fasting, intermittent fasting, keto, carnivore etc diets. Or, you know, you could resolve it by eating a balanced diet too.

arcticbull 6y ago
There's a solid argument to be made that when you eat, and how often you eat, is more important than what you eat. Specifically, the thesis is that if you eat constantly, you constantly have a high level of insulin, which your body becomes used to, and then has to produce more to actively control your blood sugar. Insulin resistance is a runaway positive feedback process. Insulin is particularly challenging because it actively causes sugar from your blood to be converted to fats and stored in your adipose tissue -- and blocks the release of fats from your adipose tissue. Eating frequently actively inhibits your ability to lose weight. By creating long gaps between meals, your body re-establishes what baseline level of insulin should be. Studies are starting to bear this out, more are needed. I can dig up some more papers if you like, but this is a good place to start [1]. [1] https://www.sciencedirect.com/science/article/pii/S1550413118302535 https://www.sciencedirect.com/science/article/pii/S155041311...
- conistonwater 6y ago
  I got into it when I read https://www.nature.com/articles/nrn.2017.156 https://www.nature.com/articles/nrn.2017.156. The thing is that a lot of nutrition research is rather low-quality compared to the rest of science (low n in studies, small effect sizes, low study power, high chance of finding false positives, etc.), and it gets even worse once you start reading sports science papers especially nutrition for sports performance. The best conclusion I found was that a lot of these things like intermittent fasting have small but noticeable effects, meaning that if you can follow IF easily then you may as well do it (like Pascal's wager!), but there is no solid evidence that you actually should do it because the effects are uncertain and small. One pitfall of a lot of these discussions is that people point to papers that show "an effect exists", but forget to ask "how big is the effect?". I was okay with IF for uncertain small positive brain effects, because my brain is important to me, and it's kind of free, so IF will do. But I think people overstate the effects a bit compared with what's actually known by science. Take the study you linked to, for instance. I can quite believe that IF would increase insulin resistance based on what I've read, and it's cool that they found lower blood pressure and higher insulin resistance in pre-diabetic men. But the study has 12 people (mid-50's pre-diabetic overweight men) in it, and I don't really know what to make of that? Is this type of study particularly expensive to conduct? Should I find it convincing because I already agree with the result? My gut reaction to the study is even simpler (not scientific, just personal): Why on Earth would anybody eat dessert for breakfast (Honey Nut Cheerios, waffles with maple syrup, etc, in Figure 1)? If you're already overweight and pre-diabetic, why is the control diet making you eat that? But they get a boiled egg, I'm guessing one?, to, you know, control cholesterol levels or something, two eggs would be crazy. They were probably trying to separate the effect of IF from the effect of eating a normal diet, as compared to the standard American diet, so didn't include a normal diet at all.
- wtetzner 6y ago
  > There's a solid argument to be made that when you eat, and how often you eat, is more important than what you eat. Yes, there is good research suggesting that fasting can offset many (most?) of the ill effects of eating poorly. > By creating long gaps between meals, your body re-establishes what baseline level of insulin should be. One of the nice things about Keto is that you can get many (if not most) of the benefits of fasting without needing to fast. Some research suggests that some of the benefits of fasting likely come from being in ketosis during the fast. It's starting to look like ketones do more than deliver fat to your cells. They are also treated sort of like a hormone, which has other beneficial effects on your health.
ashtonkem 6y ago
"Just eat a balanced diet" has been the advice given to Americans for my entire lifetime. A casual perusal of the statistics implies that this is not working.
- conistonwater 6y ago
  Note that it is giving the advice itself that is not working, a casual perusal of statistics would show few people are actually doing it. The actual advice, if actually followed, is pretty sound though.
  - 49para 6y ago
    Balanced with seed oils and grains ? Probably the worst advice ever.
  - ashtonkem 6y ago
    Are they not listening? I remember the fairly extreme measures we took to eliminate saturated fat and cholesterol from the public diet, including using margarine and eliminating egg yolks. Remember “I can’t believe it’s not butter”? That didn’t sell that well because Americans ignored the official advice.
    - cyphar 6y ago
      The anti-fat push in the last few decades was the result of the sugar lobby actively pushing pseudoscience to argue that fats were responsible for the rising rates of heart disease rather than sugar[1]. This is somewhat reminiscent of the "science" funded by the tobacco lobby. Ironically, margarine was arguably worse for your health than butter because it contained transfats (a side effect of the hydrogenation process on oil) which are now known to definitely cause heart disease[2]. In fact the link is so clear that a 2006 review flatly stated that "on a per-calorie basis, trans fats appear to increase the risk of [coronary heart disease] more than any other micronutrient"[3]. [1]: https://www.npr.org/sections/thetwo-way/2016/09/13/493739074/50-years-ago-sugar-industry-quietly-paid-scientists-to-point-blame-at-fat https://www.npr.org/sections/thetwo-way/2016/09/13/493739074... [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955571/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955571/ [3]: https://www.nejm.org/doi/full/10.1056/NEJMra054035 https://www.nejm.org/doi/full/10.1056/NEJMra054035
bityard 6y ago
Keto (and to a degree, paleo) is a balanced diet. These diets, or something very much like them, were what humans were eating when we evolved into our present state. The Western diet is highly unbalanced in favor of carbohydrates and sugar because these are easy to farm, store, transport, and sell. The food pyramid we all know and love is a product of over two centuries of industrial agriculture.
- cyphar 6y ago
  Keto is not a balanced diet -- by definition the goal is to place your body into ketosis (by removing carbohydrates from your diet). I'm not sure what definition of "balanced" you're using, but I wouldn't call removing an entire class of macronutrients "balanced". Note that hunter-gatherer human societies didn't just eat meat, they almost certainly ate berries and fruits (both of which contain sugars and are thus excluded from Keto diets -- though to be fair, modern fruits are quite different to their ancient counterparts). And early human societies definitely consumed grains. Don't get me wrong, feel free to have whatever diet you prefer. But Keto is by design not an example of a balanced diet, nor is it accurate to make an appeal to nature when discussing it. > The Western diet is highly unbalanced in favor of carbohydrates and sugar I don't disagree with the sentiment that modern western diets are on the whole incredibly unhealthy (though large quantities of unhealthy fats are hardly blameless). But carbohydrate consumption is not limited to the Western world, nor is it a new phenomenon. Rice has been a food staple in Asia for an incredibly long time (having been domesticated in the Neolithic Period). And bread has existed in the Middle East and Europe for even longer.
  - wtetzner 6y ago
    > Note that hunter-gathers didn't just eat meat, they almost certainly ate berries and fruits (both of which contain sugars and are thus excluded from Keto diets). One can safely eat berries and fruits on Keto, just not too much of them. It's entirely possible that those hunter-gatherers were in ketosis even if they sometimes at berries and possibly other fruit. Not to mention fruit wouldn't have been available all year, which means they were likely in ketosis for most of the year. > by definition the goal is to place your body into ketosis You say that like ketosis is somehow a strange state for your body to be in. But given that fat is a more efficient fuel source for your cells, it seems that ketosis might be the normal state for your body to be in, and running on carbs the uncommon state. > but I wouldn't call removing an entire class of macronutrients "balanced". You're not necessarily removing it, you're reducing it so that it's no longer your primary fuel source. It's also the only macronutrient humans can survive without consuming. Gluconeogenesis provides enough glucose for the parts of your body that require it, and everything else runs on fat, which is more efficient than using sugar. > Rice has been a food staple in Asia for the vast majority of human history (having been domesticated in at least the Neolithic Period). And bread has existed in the Middle East and Europe for even longer. Human evolution is much much longer than human history, which is just a blip in comparison.
dghughes 6y ago
On my mother's side of the family they were practically vegetarian or normal as it was called back then. Vegetables all week and maybe on Sunday a roast probably fowl of some sort. This was during the 1940s. There were nine children and the parents on a farm in a small rural area. So no extravagant purchases no pop, candy, etc. My mom told me one Christmas her present was an apple and she was excited! The apple came from the tree out back. Sounds good? But all the women (grandmother and aunts) in the family developed diabetes, one male (uncle) too. Type 2 diabetes isn't always due to a poor diet.
- 49para 6y ago
  All carbohydrates become sugar, sugar elevates insulin, constantly elevated insulin leads to diabetes. I'm not sure all the causes of Type 2 diabetes but I would wager that the current epidemic of Type 2 Diabetes is caused by too much sugar.
  - papeda 6y ago
    > All carbohydrates become sugar, sugar elevates insulin, constantly elevated insulin leads to diabetes. But my understanding is that some carbohydrates get turned into sugar more slowly, and this "flattens the curve" of blood sugar relative to consuming sugar.
  - conistonwater 6y ago
    It is not currently established what the exact relationship is between sugar in your diet, obesity, diabetes. They are all basically risk factors for the next one, but they definitely don't cause (in the strict scientific meaning of the term) one another---there is nowhere near enough scientific evidence that would support that. There's enough uncertainty about the whole process that saying "avoid known risk factors" is about the best advice you can get.
- deathgrips 6y ago
  >Vegetables all week and maybe on Sunday a roast probably fowl of some sort. That's not a balanced diet.
- 6y ago
wtetzner 6y ago
> Or, you know, you could resolve it by eating a balanced diet too. This comment contains no actionable information. What is a balanced diet? Follow the food pyramid? That clearly isn't working. Keto appears to be a balanced diet, i.e. it has the right balance of macronutrients for the human body to run well. Likely it's not the whole story, since there's still a lot we don't understand, but it certainly seems to be on the right path when compared to a standard western diet.
CIPHERSTONE 6y ago
It's easy to eat a balanced diet that without starches. A steak with a double portion of vegetables and a side salad will still get you some carbs and sugars naturally. Keto/Paleo etc. all include veggies. its really not just meat.

arcticbull 6y ago

There's a solid argument to be made that when you eat, and how often you eat, is more important than what you eat. Specifically, the thesis is that if you eat constantly, you constantly have a high level of insulin, which your body becomes used to, and then has to produce more to actively control your blood sugar. Insulin resistance is a runaway positive feedback process. Insulin is particularly challenging because it actively causes sugar from your blood to be converted to fats and stored in your adipose tissue -- and blocks the release of fats from your adipose tissue. Eating frequently actively inhibits your ability to lose weight. By creating long gaps between meals, your body re-establishes what baseline level of insulin should be. Studies are starting to bear this out, more are needed. I can dig up some more papers if you like, but this is a good place to start [1]. [1] https://www.sciencedirect.com/science/article/pii/S1550413118302535 https://www.sciencedirect.com/science/article/pii/S155041311...

conistonwater 6y ago
I got into it when I read https://www.nature.com/articles/nrn.2017.156 https://www.nature.com/articles/nrn.2017.156. The thing is that a lot of nutrition research is rather low-quality compared to the rest of science (low n in studies, small effect sizes, low study power, high chance of finding false positives, etc.), and it gets even worse once you start reading sports science papers especially nutrition for sports performance. The best conclusion I found was that a lot of these things like intermittent fasting have small but noticeable effects, meaning that if you can follow IF easily then you may as well do it (like Pascal's wager!), but there is no solid evidence that you actually should do it because the effects are uncertain and small. One pitfall of a lot of these discussions is that people point to papers that show "an effect exists", but forget to ask "how big is the effect?". I was okay with IF for uncertain small positive brain effects, because my brain is important to me, and it's kind of free, so IF will do. But I think people overstate the effects a bit compared with what's actually known by science. Take the study you linked to, for instance. I can quite believe that IF would increase insulin resistance based on what I've read, and it's cool that they found lower blood pressure and higher insulin resistance in pre-diabetic men. But the study has 12 people (mid-50's pre-diabetic overweight men) in it, and I don't really know what to make of that? Is this type of study particularly expensive to conduct? Should I find it convincing because I already agree with the result? My gut reaction to the study is even simpler (not scientific, just personal): Why on Earth would anybody eat dessert for breakfast (Honey Nut Cheerios, waffles with maple syrup, etc, in Figure 1)? If you're already overweight and pre-diabetic, why is the control diet making you eat that? But they get a boiled egg, I'm guessing one?, to, you know, control cholesterol levels or something, two eggs would be crazy. They were probably trying to separate the effect of IF from the effect of eating a normal diet, as compared to the standard American diet, so didn't include a normal diet at all.
wtetzner 6y ago
> There's a solid argument to be made that when you eat, and how often you eat, is more important than what you eat. Yes, there is good research suggesting that fasting can offset many (most?) of the ill effects of eating poorly. > By creating long gaps between meals, your body re-establishes what baseline level of insulin should be. One of the nice things about Keto is that you can get many (if not most) of the benefits of fasting without needing to fast. Some research suggests that some of the benefits of fasting likely come from being in ketosis during the fast. It's starting to look like ketones do more than deliver fat to your cells. They are also treated sort of like a hormone, which has other beneficial effects on your health.

ashtonkem 6y ago

"Just eat a balanced diet" has been the advice given to Americans for my entire lifetime. A casual perusal of the statistics implies that this is not working.

conistonwater 6y ago
Note that it is giving the advice itself that is not working, a casual perusal of statistics would show few people are actually doing it. The actual advice, if actually followed, is pretty sound though.
- 49para 6y ago
  Balanced with seed oils and grains ? Probably the worst advice ever.
- ashtonkem 6y ago
  Are they not listening? I remember the fairly extreme measures we took to eliminate saturated fat and cholesterol from the public diet, including using margarine and eliminating egg yolks. Remember “I can’t believe it’s not butter”? That didn’t sell that well because Americans ignored the official advice.
  - cyphar 6y ago
    The anti-fat push in the last few decades was the result of the sugar lobby actively pushing pseudoscience to argue that fats were responsible for the rising rates of heart disease rather than sugar[1]. This is somewhat reminiscent of the "science" funded by the tobacco lobby. Ironically, margarine was arguably worse for your health than butter because it contained transfats (a side effect of the hydrogenation process on oil) which are now known to definitely cause heart disease[2]. In fact the link is so clear that a 2006 review flatly stated that "on a per-calorie basis, trans fats appear to increase the risk of [coronary heart disease] more than any other micronutrient"[3]. [1]: https://www.npr.org/sections/thetwo-way/2016/09/13/493739074/50-years-ago-sugar-industry-quietly-paid-scientists-to-point-blame-at-fat https://www.npr.org/sections/thetwo-way/2016/09/13/493739074... [2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955571/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955571/ [3]: https://www.nejm.org/doi/full/10.1056/NEJMra054035 https://www.nejm.org/doi/full/10.1056/NEJMra054035

bityard 6y ago

Keto (and to a degree, paleo) is a balanced diet. These diets, or something very much like them, were what humans were eating when we evolved into our present state. The Western diet is highly unbalanced in favor of carbohydrates and sugar because these are easy to farm, store, transport, and sell. The food pyramid we all know and love is a product of over two centuries of industrial agriculture.

cyphar 6y ago
Keto is not a balanced diet -- by definition the goal is to place your body into ketosis (by removing carbohydrates from your diet). I'm not sure what definition of "balanced" you're using, but I wouldn't call removing an entire class of macronutrients "balanced". Note that hunter-gatherer human societies didn't just eat meat, they almost certainly ate berries and fruits (both of which contain sugars and are thus excluded from Keto diets -- though to be fair, modern fruits are quite different to their ancient counterparts). And early human societies definitely consumed grains. Don't get me wrong, feel free to have whatever diet you prefer. But Keto is by design not an example of a balanced diet, nor is it accurate to make an appeal to nature when discussing it. > The Western diet is highly unbalanced in favor of carbohydrates and sugar I don't disagree with the sentiment that modern western diets are on the whole incredibly unhealthy (though large quantities of unhealthy fats are hardly blameless). But carbohydrate consumption is not limited to the Western world, nor is it a new phenomenon. Rice has been a food staple in Asia for an incredibly long time (having been domesticated in the Neolithic Period). And bread has existed in the Middle East and Europe for even longer.
- wtetzner 6y ago
  > Note that hunter-gathers didn't just eat meat, they almost certainly ate berries and fruits (both of which contain sugars and are thus excluded from Keto diets). One can safely eat berries and fruits on Keto, just not too much of them. It's entirely possible that those hunter-gatherers were in ketosis even if they sometimes at berries and possibly other fruit. Not to mention fruit wouldn't have been available all year, which means they were likely in ketosis for most of the year. > by definition the goal is to place your body into ketosis You say that like ketosis is somehow a strange state for your body to be in. But given that fat is a more efficient fuel source for your cells, it seems that ketosis might be the normal state for your body to be in, and running on carbs the uncommon state. > but I wouldn't call removing an entire class of macronutrients "balanced". You're not necessarily removing it, you're reducing it so that it's no longer your primary fuel source. It's also the only macronutrient humans can survive without consuming. Gluconeogenesis provides enough glucose for the parts of your body that require it, and everything else runs on fat, which is more efficient than using sugar. > Rice has been a food staple in Asia for the vast majority of human history (having been domesticated in at least the Neolithic Period). And bread has existed in the Middle East and Europe for even longer. Human evolution is much much longer than human history, which is just a blip in comparison.

dghughes 6y ago

On my mother's side of the family they were practically vegetarian or normal as it was called back then. Vegetables all week and maybe on Sunday a roast probably fowl of some sort. This was during the 1940s. There were nine children and the parents on a farm in a small rural area. So no extravagant purchases no pop, candy, etc. My mom told me one Christmas her present was an apple and she was excited! The apple came from the tree out back. Sounds good? But all the women (grandmother and aunts) in the family developed diabetes, one male (uncle) too. Type 2 diabetes isn't always due to a poor diet.

49para 6y ago
All carbohydrates become sugar, sugar elevates insulin, constantly elevated insulin leads to diabetes. I'm not sure all the causes of Type 2 diabetes but I would wager that the current epidemic of Type 2 Diabetes is caused by too much sugar.
- papeda 6y ago
  > All carbohydrates become sugar, sugar elevates insulin, constantly elevated insulin leads to diabetes. But my understanding is that some carbohydrates get turned into sugar more slowly, and this "flattens the curve" of blood sugar relative to consuming sugar.
- conistonwater 6y ago
  It is not currently established what the exact relationship is between sugar in your diet, obesity, diabetes. They are all basically risk factors for the next one, but they definitely don't cause (in the strict scientific meaning of the term) one another---there is nowhere near enough scientific evidence that would support that. There's enough uncertainty about the whole process that saying "avoid known risk factors" is about the best advice you can get.
deathgrips 6y ago
>Vegetables all week and maybe on Sunday a roast probably fowl of some sort. That's not a balanced diet.
6y ago

wtetzner 6y ago

> Or, you know, you could resolve it by eating a balanced diet too. This comment contains no actionable information. What is a balanced diet? Follow the food pyramid? That clearly isn't working. Keto appears to be a balanced diet, i.e. it has the right balance of macronutrients for the human body to run well. Likely it's not the whole story, since there's still a lot we don't understand, but it certainly seems to be on the right path when compared to a standard western diet.

CIPHERSTONE 6y ago

It's easy to eat a balanced diet that without starches. A steak with a double portion of vegetables and a side salad will still get you some carbs and sugars naturally. Keto/Paleo etc. all include veggies. its really not just meat.