3 ms·

I'm not convinced by some of the common beliefs about low-carb diets either. They seem to be good for weight loss[0] but bad for all-cause mortality[1]. If you'

by strken 4y ago

I'm not convinced by some of the common beliefs about low-carb diets either. They seem to be good for weight loss[0] but bad for all-cause mortality[1]. If you're making dietary recommendations, it's hard to justify choosing a diet that makes the people who eat it skinnier and less diabetic but also kills some of them. I'm also not convinced that "low-carb" in the literature means you can draw conclusions about ketogenic diets, especially ones that actually send you into ketosis. Some low-carb diets from that first meta-analysis had 35% carbs by energy! My impression of the available evidence is that if you want to lose weight, calorie restriction and high-satiety foods matter more than macros. [0] https://www.mdpi.com/2072-6643/12/12/3774/htm https://www.mdpi.com/2072-6643/12/12/3774/htm [1] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055030 https://journals.plos.org/plosone/article?id=10.1371/journal...

namdnay 4y ago
yeah, obviously nutrition is far from being the only factor for their longevity and health in old age, but if you take the japanese diet, rice is a pretty major component in their calorie input...
- phpisthebest 4y ago
  The Japanese diet contains small portions of rice, which may translate into a major component of total calories because it is calorie dense Like with most things food, portion control seems to be the biggest problem in the American Diet
sph 4y ago
"Our meta-analysis supported long-term harm and no cardiovascular protection with low-carbohydrate diets. However, the observational studies were limited and moderately heterogeneous. Our findings underscore the imminent need for large-scale trials on the complex interactions between low-carbohydrate diets and long-term outcomes." From your second link. Also not a surprise when many research about low carb diets is refined carbohydrates + unspecified oils. "Low carb" studies are as interesting as "high carb" studies. High carb is a Mediterranean diet or is the Twinkie diet, just like keto can be meat and vegs or low carb pizza and processed meat. Lumping everything under one very generic name is not very good science. The whole dietary world is made of bad science and repeated by bad journalists. The scientific jury is still out, as your very source stated, yet every HN thread the top voted comment is "low carb kills some people." Seriously? I am still waiting for someone to show me a long-term study based on low carb meat, nuts, fruit and vegetables, unrefined oils and fats diet. Even an observational one. Oh wait, there's none!
- strken 4y ago
  Not only my source, but me as well. I think it's plausible that e.g. keto (as in actually entering ketosis) could raise mortality but low carb diets could lower it, or that there's a confounding effect with dietary fibre, or that low carb diets usually involve increased processed meat intake, or [insert story here]. However, we're talking about general health advice. If you tell people to eat low carb diets, they eat less dietary fibre as a result, and some of them die, then your advice has killed them. Doesn't matter if there's some hypothetical better diet out there, until you've found it and proven it works.
  - Semaphor 4y ago
    > If you tell people to eat low carb diets, they eat less dietary fibre as a result That’s not a given, I’ve actually started getting more fiber on keto than before.
    - strken 4y ago
      That's not a given, it's the first two predicates of an illustrative example of how dietary advice is more complicated than "which diet is best?" If all three of those predicates hold true, then your advice has killed them, therefore all-cause mortality rate is important. It doesn't matter what the exact reason for higher all-cause mortality rates on low carb diets is unless you can give people advice on how to avoid them. What's important is the outcome of giving the advice, not a theoretical ivory-tower diet that most of the population won't or can't eat.
      - Semaphor 4y ago
        That’s like saying you should never give any advice unless you exhaustively list all possible ways for someone to fuck up the implementation. Telling someone the pharmacy is on the other side of the street will raise mortality unless you also tell them that they should check for cars before crossing. And not run into cars. Or walls close to the pharmacy.
Glench 4y ago
For another perspective on the parent comment: I've gotten some use out of Ayurvedic* diet and lifestyle tips (hailing from ancient India). Here's a balanced article on a ketogenic diet detailing some of the modern science as well as one practitioner's take from an Ayurvedic perspective: https://lifespa.com/diet-detox/diet/ketogenic-diet-ayurvedic-perspective/ https://lifespa.com/diet-detox/diet/ketogenic-diet-ayurvedic... *Ayurveda is cool — it's like a compendium of cause and effect relationships for foods and activities and their qualitative, subjective effects on the body and mind.

by strken 4y ago

namdnay 4y ago

yeah, obviously nutrition is far from being the only factor for their longevity and health in old age, but if you take the japanese diet, rice is a pretty major component in their calorie input...

phpisthebest 4y ago
The Japanese diet contains small portions of rice, which may translate into a major component of total calories because it is calorie dense Like with most things food, portion control seems to be the biggest problem in the American Diet

sph 4y ago

"Our meta-analysis supported long-term harm and no cardiovascular protection with low-carbohydrate diets. However, the observational studies were limited and moderately heterogeneous. Our findings underscore the imminent need for large-scale trials on the complex interactions between low-carbohydrate diets and long-term outcomes." From your second link. Also not a surprise when many research about low carb diets is refined carbohydrates + unspecified oils. "Low carb" studies are as interesting as "high carb" studies. High carb is a Mediterranean diet or is the Twinkie diet, just like keto can be meat and vegs or low carb pizza and processed meat. Lumping everything under one very generic name is not very good science. The whole dietary world is made of bad science and repeated by bad journalists. The scientific jury is still out, as your very source stated, yet every HN thread the top voted comment is "low carb kills some people." Seriously? I am still waiting for someone to show me a long-term study based on low carb meat, nuts, fruit and vegetables, unrefined oils and fats diet. Even an observational one. Oh wait, there's none!

strken 4y ago
Not only my source, but me as well. I think it's plausible that e.g. keto (as in actually entering ketosis) could raise mortality but low carb diets could lower it, or that there's a confounding effect with dietary fibre, or that low carb diets usually involve increased processed meat intake, or [insert story here]. However, we're talking about general health advice. If you tell people to eat low carb diets, they eat less dietary fibre as a result, and some of them die, then your advice has killed them. Doesn't matter if there's some hypothetical better diet out there, until you've found it and proven it works.
- Semaphor 4y ago
  > If you tell people to eat low carb diets, they eat less dietary fibre as a result That’s not a given, I’ve actually started getting more fiber on keto than before.
  - strken 4y ago
    That's not a given, it's the first two predicates of an illustrative example of how dietary advice is more complicated than "which diet is best?" If all three of those predicates hold true, then your advice has killed them, therefore all-cause mortality rate is important. It doesn't matter what the exact reason for higher all-cause mortality rates on low carb diets is unless you can give people advice on how to avoid them. What's important is the outcome of giving the advice, not a theoretical ivory-tower diet that most of the population won't or can't eat.
    - Semaphor 4y ago
      That’s like saying you should never give any advice unless you exhaustively list all possible ways for someone to fuck up the implementation. Telling someone the pharmacy is on the other side of the street will raise mortality unless you also tell them that they should check for cars before crossing. And not run into cars. Or walls close to the pharmacy.

Glench 4y ago

For another perspective on the parent comment: I've gotten some use out of Ayurvedic* diet and lifestyle tips (hailing from ancient India). Here's a balanced article on a ketogenic diet detailing some of the modern science as well as one practitioner's take from an Ayurvedic perspective: https://lifespa.com/diet-detox/diet/ketogenic-diet-ayurvedic-perspective/ https://lifespa.com/diet-detox/diet/ketogenic-diet-ayurvedic... *Ayurveda is cool — it's like a compendium of cause and effect relationships for foods and activities and their qualitative, subjective effects on the body and mind.