4 ms·

Also worth noting that ketogenic diets seem to increase all-cause mortality significantly. https://pubmed.ncbi.nlm.nih.gov/23372809/ https://pubmed.ncbi.nlm.ni

Also worth noting that ketogenic diets seem to increase all-cause mortality significantly. https://pubmed.ncbi.nlm.nih.gov/23372809/ https://pubmed.ncbi.nlm.nih.gov/23372809/

funnymania 6y ago
This doesn't say much about ketogenic diets. Were these diets even high fat?
- deeviant 6y ago
  The literal name of the study is "Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies". It specifically found " Low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality and they were not significantly associated with a risk of CVD mortality and incidence." Perhaps you are on the "oh but the study does specifically say, "low carb, high fat" diet, so it obviously only looked at people eating low carb, low fat diets!" train? There seems to be some fantasy with the Keto crowd that these studies somehow only look at some mysterious section of the population in which eats a very low carb diet but also low fat? People don't eat a low carb diet by accident, when they do they often follow the horrible advice given by the many misguided keto diet proponents: eat low carb, high fat, medium protein. You can find a near endless amount of longitudinal meta analysis and more focused studies that nearly universally find diets that are lowest in carbs (regardless of protein/fat ratio) produce the highest all-cause mortality. https://www.acc.org/latest-in-cardiology/journal-scans/2019/09/16/15/00/lower-carbohydrate-diets-and-all-cause https://www.acc.org/latest-in-cardiology/journal-scans/2019/... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/ https://academic.oup.com/eurheartj/article/40/34/2870/5475490 https://academic.oup.com/eurheartj/article/40/34/2870/547549... https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2... And so on...
  - astrostl 6y ago
    > People don't eat a low carb diet by accident, when they do they often follow the horrible advice given by the many misguided keto diet proponents: eat low carb, high fat, medium protein. This is not remotely my anecdotal experience. The overwhelming majority of those I know that I have dabbled with low carb ran the bunless burger, chicken wings, bacon, and steak game and I would guess that their macro intake was high protein, medium fat (if that), low carb. The textbook versions are high fat, medium protein, low carb. And seemingly pretty hard to pull off without eating a lot of stuff like salads with a cup of olive oil.
    - deeviant 6y ago
      burger, bacon, steak? This is your "medium" fat diet? Ok. Regardless the studies are quite clear. It doesn't matter the fat/protein ratio, the diets with the lowest carbs produce the highest amount of death.
      - astrostl 6y ago
        This is not my diet, it is the diet I commonly observe from those going simply lo-carb or attempting "keto": hi-protein, rather than hi-fat. This directly questions the unvalidated assertion that, "People don't eat a low carb diet by accident, when they do they often follow the horrible advice given by the many misguided keto diet proponents: eat low carb, high fat, medium protein." Hi-protein is glucogenic and thus not ketogenic, so the ratio would seem to matter. So would the resolution between an avocado and a fistful of bacon, given the safe assumption that the materials and cooking of them rate to have different impacts on human health. This is backed by other meta-analyses such as https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2... : > Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality. Stressing that both hi carb (contra your claim) and lo carb when specifically overindexed on animal protein had higher mortality, not just lo carb.
astrostl 6y ago
I would expect all explicit diets to feature higher mortality, as the correlation with having some sort of health concern (obesity, chronic condition, etc.) is going to be extreme. Skimming the whole study at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/ the "compared to what?" question does not appear to be asked or answered. Is it?
- deeviant 6y ago
  They analyzed multiple studies that included 272,216 people, they scored the subjects for LCD (higher score, less carbs). Statistically, the study found an overwhelming (my adjective) correlation that the higher a population scores on the LCD scale, the higher their mortality, showing an average of ~30% higher mortality for those eat a low carb diet. Pretty much every major study that has done this has found similar results. I linked 4 more large studies below.
  - astrostl 6y ago
    Nod to that. Where I'm going is the possibility of comparing people with "normal" diets and low-carb diets, and thus running the risk of comparing people who do not feel compelled to lose weight for health reasons and those who do. Same story as the various vitamin supplementation paradoxes, which can also be influenced by the fact that people supplementing are more likely to have some pre-existing cause to worry about their health.
    - deeviant 6y ago
      The studies control for weight and many other health factors. Controlling for weight basically counters your suggestion outright. There are also many diets that aren't keto so the population of people who felt compelled to lose weight but chose not to do a keto diet, but perhaps a low fat diet (which tends to be high carb) are well represented in the study, once again rebuffing your hypothesis. In terms of your vitamins supplementation paradoxes, which is a separate point. I also disagree with with you there (these supplement studies also control for various health factors as well), and feel it's much more the problem of absolutely no regulation and there really is nobody making sure the supplement contains the thing it says it is in the quantities it says it does, with nothing else. Also people tend to over do things, and over supplement with the "if some is good more is better". Taking to much vitamin C for instance, spikes your iron absorption, and iron is the most powerful oxidant in your body, or just taking too much iron outright. I could go on and on about supplements, but I'll spare you.

Also worth noting that ketogenic diets seem to increase all-cause mortality significantly. https://pubmed.ncbi.nlm.nih.gov/23372809/ https://pubmed.ncbi.nlm.nih.gov/23372809/

funnymania 6y ago

This doesn't say much about ketogenic diets. Were these diets even high fat?

deeviant 6y ago
The literal name of the study is "Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies". It specifically found " Low-carbohydrate diets were associated with a significantly higher risk of all-cause mortality and they were not significantly associated with a risk of CVD mortality and incidence." Perhaps you are on the "oh but the study does specifically say, "low carb, high fat" diet, so it obviously only looked at people eating low carb, low fat diets!" train? There seems to be some fantasy with the Keto crowd that these studies somehow only look at some mysterious section of the population in which eats a very low carb diet but also low fat? People don't eat a low carb diet by accident, when they do they often follow the horrible advice given by the many misguided keto diet proponents: eat low carb, high fat, medium protein. You can find a near endless amount of longitudinal meta analysis and more focused studies that nearly universally find diets that are lowest in carbs (regardless of protein/fat ratio) produce the highest all-cause mortality. https://www.acc.org/latest-in-cardiology/journal-scans/2019/09/16/15/00/lower-carbohydrate-diets-and-all-cause https://www.acc.org/latest-in-cardiology/journal-scans/2019/... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/ https://academic.oup.com/eurheartj/article/40/34/2870/5475490 https://academic.oup.com/eurheartj/article/40/34/2870/547549... https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2... And so on...
- astrostl 6y ago
  > People don't eat a low carb diet by accident, when they do they often follow the horrible advice given by the many misguided keto diet proponents: eat low carb, high fat, medium protein. This is not remotely my anecdotal experience. The overwhelming majority of those I know that I have dabbled with low carb ran the bunless burger, chicken wings, bacon, and steak game and I would guess that their macro intake was high protein, medium fat (if that), low carb. The textbook versions are high fat, medium protein, low carb. And seemingly pretty hard to pull off without eating a lot of stuff like salads with a cup of olive oil.
  - deeviant 6y ago
    burger, bacon, steak? This is your "medium" fat diet? Ok. Regardless the studies are quite clear. It doesn't matter the fat/protein ratio, the diets with the lowest carbs produce the highest amount of death.
    - astrostl 6y ago
      This is not my diet, it is the diet I commonly observe from those going simply lo-carb or attempting "keto": hi-protein, rather than hi-fat. This directly questions the unvalidated assertion that, "People don't eat a low carb diet by accident, when they do they often follow the horrible advice given by the many misguided keto diet proponents: eat low carb, high fat, medium protein." Hi-protein is glucogenic and thus not ketogenic, so the ratio would seem to matter. So would the resolution between an avocado and a fistful of bacon, given the safe assumption that the materials and cooking of them rate to have different impacts on human health. This is backed by other meta-analyses such as https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30135-X/fulltext https://www.thelancet.com/journals/lanpub/article/PIIS2468-2... : > Both high and low percentages of carbohydrate diets were associated with increased mortality, with minimal risk observed at 50–55% carbohydrate intake. Low carbohydrate dietary patterns favouring animal-derived protein and fat sources, from sources such as lamb, beef, pork, and chicken, were associated with higher mortality, whereas those that favoured plant-derived protein and fat intake, from sources such as vegetables, nuts, peanut butter, and whole-grain breads, were associated with lower mortality, suggesting that the source of food notably modifies the association between carbohydrate intake and mortality. Stressing that both hi carb (contra your claim) and lo carb when specifically overindexed on animal protein had higher mortality, not just lo carb.

astrostl 6y ago

I would expect all explicit diets to feature higher mortality, as the correlation with having some sort of health concern (obesity, chronic condition, etc.) is going to be extreme. Skimming the whole study at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3555979/ the "compared to what?" question does not appear to be asked or answered. Is it?

deeviant 6y ago
They analyzed multiple studies that included 272,216 people, they scored the subjects for LCD (higher score, less carbs). Statistically, the study found an overwhelming (my adjective) correlation that the higher a population scores on the LCD scale, the higher their mortality, showing an average of ~30% higher mortality for those eat a low carb diet. Pretty much every major study that has done this has found similar results. I linked 4 more large studies below.
- astrostl 6y ago
  Nod to that. Where I'm going is the possibility of comparing people with "normal" diets and low-carb diets, and thus running the risk of comparing people who do not feel compelled to lose weight for health reasons and those who do. Same story as the various vitamin supplementation paradoxes, which can also be influenced by the fact that people supplementing are more likely to have some pre-existing cause to worry about their health.
  - deeviant 6y ago
    The studies control for weight and many other health factors. Controlling for weight basically counters your suggestion outright. There are also many diets that aren't keto so the population of people who felt compelled to lose weight but chose not to do a keto diet, but perhaps a low fat diet (which tends to be high carb) are well represented in the study, once again rebuffing your hypothesis. In terms of your vitamins supplementation paradoxes, which is a separate point. I also disagree with with you there (these supplement studies also control for various health factors as well), and feel it's much more the problem of absolutely no regulation and there really is nobody making sure the supplement contains the thing it says it is in the quantities it says it does, with nothing else. Also people tend to over do things, and over supplement with the "if some is good more is better". Taking to much vitamin C for instance, spikes your iron absorption, and iron is the most powerful oxidant in your body, or just taking too much iron outright. I could go on and on about supplements, but I'll spare you.