Fats and Insulin Resistance

Sean_Raymond

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From my perspective this post is in a different tone to previous ones. To me it felt previously you denied our lived experience because there wasn’t a study that proved to you how we did it. Many have fought long and hard against many in the medical profession we have come across, rubbishing and denying what we sought to do and refused to accept what we have done. Many in the health, science or policy worlds have refused to do the studies to give the evidence to prove what we have achieved in order to get it widely accepted as a viable treatment protocol despite enormous anecdotal evidence and other studies done that don’t meet their standards but nonetheless do support us. This is why you sense hostility I believe.
I cannot say enough that I am not discarding anyone's personal experience, reasons or explanations - that is not how I am wish to come across at all. Clearly my view is that the insulin hypothesis doesn't stack up whilst many here do. That is my view and in a way I am here testing it with you all because I would not disregard all of your evidence, some of which conflicts with my opinion. I see the people here as experts and do not wish to appear to be lecturing people who obviously know best their experience with their condition and diet. I am not doubting what people have done or achieved.

I am aware of the limitations of my profession and that people here may have found some of my peers to be unhelpful (I have my own battle with Dr's/HCP's in my professional and personal life too). I am governed by a best practice policy and must use solid evidence and clinical guidelines which can straightjacket our approaches. Sadly the low carbohydrate approach still falls outside of what some would prescribe despite increasing evidence for them. This attitude is changing, I could better get away with guidance on a low carbohydrate diet than a few years ago (some departments/trusts less easily so) although I'd possibly lose my job if I trialled a keto diet for weight loss/blood glucose control. If I recommended a paleo diet I will have just committed career suicide. There can be a delicate balance between personal views, demand to adhere to professional clinical guidance and trying to be flexible and offer people safe alternative options whilst making sure I do not have my licence taken away! I am sorry if people in my profession haven't been helpful or disrespectful to what you have done.
 
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Sean_Raymond

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To me, the OP seems to be both knowledgeable, open-minded and polite. He's not denying people's personal experiences of low-carbing and is accepting of its use in the treatment of diabetes. He has made it clear from the outset that he is interested in increasing his understanding of what's going on at a physiological/biochemical level and has produced plenty of references to illustrate his current understanding. It's fine for people not to care why low-carbing works for them and not want to delve into it. However, it's also fine for those of us who want to increase our understanding of the underlying mechanisms to discuss them. Doing so is not an attack on any person and doesn't warrant hostility.
This is really nice to read! Sometimes it is hard to make words reflect the spirit in which you write something. But this is how I'd like to be coming across. I am open minded, I'm considering everything people are saying and and being given much food for thought. I would certainly adopt any relevant approach to reflect any change of opinion. Whilst I cannot see how Insulin is the reason a person gains/loses weight I would be willing to change my mind on that. I really am on the side of everyone here and I have tried to find a way I can reconcile the Insulin idea with peoples testimonies here.

I'll try and get around to writing in more detail why I feel the insulin hypothesis of obesity doesn't work for me so my thoughts can be examined by anyone interested. As a clinician, I have to understand the reasons of why something works or not for reasons explained. For a person getting results and not experiencing any deleterious effects it is understandable that how the reason may be less important.
 
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zand

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However the theory that it is because insulin has been reduced, in my opinion, doesn't explain it either based on everything I have looked at.
Maybe you haven't looked in the right places. Have you read the book that @bulkbiker recommended yet?

I have had my fasting insulin level measured and it was way above normal. Does that not point towards circulating insulin being a problem for me?
 
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Sean_Raymond

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Hi @Sean_Raymond - very curious and interesting that after reading about the low carb approach to type two diabetes, you take on the idea that it works so well because - it allows us to eat less. (That old tired - and wrong - idea about weight loss by simply eating less.)

As someone that practices basically every method out there to keep body-fat - particularly around my waist - to a healthier/protective state (apparently which is less than half one's height) (https://pubmed.ncbi.nlm.nih.gov/20819243/) the idea that I would spend the rest of my life being hungry all the time in order to do this is beyond comprehension. I am not alone - I am pretty sure that this is the reason that 'simply eating less' (ie calorie deficit) to be a healthy weight (ie have healthy fat cells) has not worked for soooo many.


Hunger is a normal physical response to not eating enough in order to get the nutrients and energy in order to keep you alive, let alone think clearly, and do things and lift things and move. Hunger is a good thing, not a bad thing and is natural and healthy. It is how we eat enough, after all.

Many with type two understand that their systems have been mucked up, and how their hunger and satiation hormones are not working well is part of the dysruption of the blood glucose regulation system. I agree with Gary Taubes, and Phinney and Volek (https://www.amazon.com/Art-Science-Low-Carbohydrate-Living/dp/0983490708), and et al ,that excessive carbohydrates, especially in the form of sugar, as yummy as they are, are the culprit for this, and that mammals like us have not evolved to eat carbs in the amounts that has become mandated from above and as normal, as we are seeing in our societies in the last 40 or so years. Also, the new fats that were introduced to our diets in order to lower the amount of saturated fats in our diets that became the dietary demon around the same time, uncoincidentally.

The amazingly complex diagrams about blood glucose regulation, called the Randle cycle, I have seen and refer to jokingly from time to time, absolutely involve dietary fat. But in those diagrams the raised glucose levels which bring about the raised insulin levels which tip the system way into chaos, seem obviously to be the point where chaos begins. (https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/randle-cycle)


This is not a personal individual dietary/regulatory phenomenon - this is us being an omniverous mammal. I don't think this is particularly controversial! The degree to which folks can take high carbs with high fat - and I would say - these new fats which we cannot digest properly or well - before their bodies break down is what is individual and different - not that it can break down big time. That is part of us being human and having human bodies which have evolved on certain dietary parameters. This is why type two diabetes is spiralling out of control into being a - dare I say it? - a global big health problem. (And especially in the wake of our big enemy - a very nasty virus - currently being a global health problem.)

Anyway - to go low carb, and when one has type two - to go as low sugar and carb as one can (and oh yes, that level can differ enormously between individuals, due, imho, to how sick your fat cells are) is not about not having enough nutrition and energy, ie to not have enough food and going hungry. It is about lowering the very foods (for me - anything with sugar added, and made from milk, and wheat, and I would add - with the new wheat strain,as with the new potatoes, maize and rice - https://croplife.org/news/the-evolutionary-story-of-four-vital-crops/ ) that have caused the hugely raised blood glucose levels which caused the insulin cascade and inflammed and sickened my ever expanding fat cells into the state they are in today. (https://www.frontiersin.org/articles/10.3389/fcvm.2020.00022/full).

As part of the low-fat eating folk since the late 1970s when it was governmentally mandated in the countries I have lived in, it was not the saturated fat and cholesterol-high food (eggs! for instance, and fatty cuts of meat) I unfortunately was not eating (I believed these governments - one of my greatest regrets), but the sugar and carb-heavy food I substituted, that got me here in this forum discussing this with you all today.
There can be limitations to the eating less approach and it hasn't been effective for many. I have worked with people that it has been very effective in also and used low Carb diets which were not tolerable. However I recognise a low carbohydrate diet is a great alternative option as many do find it just works better for them in achieving whatever particular goal they have. There are ways of manipulating a specifically calorie reduced diet to provide bulk, mitigate effects on satiety etc but it is a challenging area. Hunger is indeed a major barrier with the eat less/consume less calorie idea.

When we look at the diets of our ancestors, evidence typically favours diets that were higher in animal products than something like the 'eatwell' plate although tribes that come closest to hunter gatherers in the modern world do eat large amount sof plant foods (unprocessed).

Gary Taubes believes Insulin stimulates hunger driving over consumption of foods however the body of evidence indicates that insulin promotes satiety as a part of its role in energy homeostasis. Some may dismiss what research finds and prefer to be guided by their lived results, which I understand, but Gary is no different to me in offering a hypothesis and research to back it up. But I haven't seen research that definitively backs up the notion insulin makes you hungry (frank hypos which insulin has a role in can stimulate hunger).

The ease of access and availability to highly palatable high energy foods continues to increase and it makes sense that as a species which evolved seeking out high calorie foods to survive in an environment where food wasn't guaranteed we will be really attracted to them. Adding this to more sedentary behaviours is for me most likely the main factors driving the obesity epidemic rather than it being because of a particular macronutrient or hormone. We have not undergone a major genetic shift in just 50 years and I do not believe most people are inherently inflicted with greediness so maybe it is the unconscious aspects of the brain forged in a time of feast and famine that is what drives what are now unhealthy behaviours.

The topic of saturated fat as a cause of heart disease is a rabbit hole. I do not hold a firm opinion that it is as bad as some say or benign as others. Evidence exists linking it to heart disease and other evidence suggest there is not. People then argue over the strength of the studies on either side. My view is that whilst people do respond differently to fat, generally saturated fat does raise LDL cholesterol (if a person is losing weight on a high fat diet this potential rise may be offset by the cholesterol lowering effects of the weight loss). I've looked at many low CHO v High CHO studies and LDL does tend to go up more than down.

If we accept that saturated fat raises LDL cholesterol (as I do -many do not), it then follows that the next question should be, is this a risk for health? Again, we find studies that contradict each other over this. I cannot conclusively say either way. But even If we were to say it does a low CHO/high fat/sat fat diets also may cause an increase in HDL and decrease in TAG - so just because LDL went up have we increased our overall cardiovascular risk? Then we must consider that increasing LDL itself may not be as important as the number and size of LDL particles rather than the amount of cholesterol being carried. Large LDL particles may confer less atherogenic risk. When we look at MUFA/PUFA, in theory they do not raise LDL and so it is said that they are less likely to cause a furrying of the arteries. But, saturated fat in the arteries is unlikely to be oxidised because it is a saturated fat. This means the inflammation which sparks creation of plaque in arteries may not occur whilst MUFA/PUFA can be oxidised. So whilst unsaturated fats may be less likely to cause deposition of cholesterol in artery walls might be more readily oxidised if they do. Simply put - unsaturated fats may be more pro-inflammatory.

Again, this all needs to be considered in the context of energy balance, weight, other factors etc. So, I do not fear saturated fat however I am not sure MUFA/PUFA are the disaster some say. Saying that, I do try to avoid processed vegetable oils and get MUFA/PUFA from nuts, olive oil for example. So it may be not so much the type of fat per se but a shift towards consuming more unnatural oils in replace of natural SFA which may have had some unhealthy effects. So I can find some agreement with you on unsaturated fats but maybe not in quite the way. Sorry if I went on there.

The Randall cycle is interesting, it actually is closest to the topic I first raised about how dietary fat may exert an acute insulin resistant effect and consuming carbohydrate at the same time may mean the carbohydrate is less efficiently metabolised. This is in keeping with the Randall cycle principle but may not wholly be explained by it (this cycle looks at competition between fatty acids and glucose for fuel useage not acute insulin resistant effects of fat). If we look to our ancestors it is likely animal and plant foods were not generally consumed together (animal caught and eaten, berries forged and eaten). I think you do raise an interesting point here.

Unfortunately as we progress advice changes and advice once taught as healthy is shown not to be.
 
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Sean_Raymond

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Some people suggest that LCHF is more satiating than a low-fat diet so that people 'automatically' consume fewer calories without feeling hungry.
This very well may be true, good evidence shows unrestricted LCHF diets are as effective if not more so than calorie restricted diets for weight loss. The reasons maybe due to macronutrient ratios which lead to a spontaneous reduction in overall calorie intake. Protein is generally regarded as the most satiating macronutrient - whether a low Carb diet typically contains more protein is debatable and pretty individual. It is still not clear that fat is more satiating than carbohydrate, many hold the view carbs are.
 

bulkbiker

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@Sean_Raymond

"I am open minded, I'm considering everything people are saying and and being given much food for thought."

this unfortunately doesn't quite align with your earlier statement

"I personally wouldn’t buy anything by this Dr as I’ve seen enough interviews to know he is wrong."

The "Dr" in question being as associate professor who studies insulin mechanisms and has done for years.

https://lifesciences.byu.edu/https:.../2d5a532e40b88d5b820f1c8bf81b/bikmanvitae.pdf

I rarely make "appeals to authority" but on this occasion I'm pretty sure I know who I'd believe...
 
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Sean_Raymond

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Unless you are one of the researchers in question (which I can assure you you aren't) I fail to see how I have accused you of anything?
I pointed you at one of the newest and most up to date books on the subject in question yet you claim that is not producing evidence? If you can't be bothered to read it it's hardly my problem.
Within the context of our discussion I did take that to be aimed at me. I was obviously wrong on that. Regarding our discussion, I do find it unreasonable to suggest I go and spend money on a book in order to further it. It would be much easier to simply pick one of the studies out of the 30 pages of research so I can look at it. I am not saying you should go buy and read books I could recommend. Having seen interviews with Dr Bikman I am not inclined to spend money to access the research which has led to what I consider to be an incorrect theory. I know what he says. But I am talking to you not him - I think it makes sense that you just back up the claim. I won't be buying his book and it has nothing to do with not being bothered.
 

Sean_Raymond

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@Sean_Raymond

"I am open minded, I'm considering everything people are saying and and being given much food for thought."

this unfortunately doesn't quite align with your earlier statement

"I personally wouldn’t buy anything by this Dr as I’ve seen enough interviews to know he is wrong."

The "Dr" in question being as associate professor who studies insulin mechanisms and has done for years.

https://lifesciences.byu.edu/https:.../2d5a532e40b88d5b820f1c8bf81b/bikmanvitae.pdf

I rarely make "appeals to authority" but on this occasion I'm pretty sure I know who I'd believe...
That is a bit different to expecting someone to buy a book to investigate a claim YOU made to me. I know what the Dr says.
 

Sean_Raymond

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.


Hi @Sean_Raymond,

Just wondering, if insulin does not promote fat storage, why do T1s get puffy zones around their injection sites?
I'll need to find a reference for you, however not everyone gets fatty deposits at injection sites (I believe it is less than 30% in T1DM and under 10% in T2DM). Different type of insulin appear to be more or less likely to cause them. My view of this centres partially around the difference in administration of insulin subcutaneously verses peripheral release of insulin. Injecting insulin at the same site has been shown to cause an immunological inflammatory response leading to accumulation of inflammatory cells/scar tissue at these sites. They are not just composed of fat. In addition, as the site becomes inflamed/develops scar tissue absorption becomes less efficient and 'possibly' some of the insulin doesn't get fully administered into the blood. Also, the insulin is injected into subcutaneous fat from where it then enters the blood. Insulin does have anabolic fat building properties but this effect is under physiological regulation when released into the circulation however injected insulin into fat tissue which then may not be fully released into the blood means perhaps the method of administration causes some fat redistribution around the surrounding tissue. No more net fat is created but the anabolic effect of insulin in the subcutaneous area causes accumulation of fat into the fat cells around the site? This last part is entirely hypothetical and not proved as far as I am aware.
 
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zand

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Within the context of our discussion I did take that to be aimed at me. I was obviously wrong on that. Regarding our discussion, I do find it unreasonable to suggest I go and spend money on a book in order to further it. It would be much easier to simply pick one of the studies out of the 30 pages of research so I can look at it. I am not saying you should go buy and read books I could recommend. Having seen interviews with Dr Bikman I am not inclined to spend money to access the research which has led to what I consider to be an incorrect theory. I know what he says. But I am talking to you not him - I think it makes sense that you just back up the claim. I won't be buying his book and it has nothing to do with not being bothered.
Wow! Just wow! You won't buy a book that could help to you understand why you are wrong and that insulin really is the problem???!!! You are so sure that his theory is wrong that you won't spend a little cash to check? And all those pages of references that you supposedly want to see? You are a professional and you expect us who aren't professionals to waste time talking to you for free? And you won't buy a book? Gobsmacked by this.
 

Sean_Raymond

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I certainly find a lchf diet satiating, but I also think I consume a lot of calories. The difference is where they come from. Pre lchf I would need to eat every 3 or so hours, often pigging out in whole big bars of chocolate or whole packets of biscuits, not every day . Now I have none of those driven sugar cravings and I can say no to food quite often. But when I do eat it is filling, calorific food, cheese, cream and nuts in particular. On my old way of eating I would have small "healthy" low fat, low calories foods but would then be binging every few days. I think overall and over time I'm consuming similar amounts of calories but in bigger fewer meals and no binging or snacks.
This is one of the effects many people report which convinced me that some people will do better with a LCHF diet to avoid gaining weight and or lose weight. People are less hungry. Eating more regularly spaced out meals and less often will likely benefit your ability to clear fat and sugar from the blood. An issue with many current eating habits is that we are in the fed state for most of the day each and every day meaning our body is metabolising fat and sugar whilst adding more into the mix. Breaks from nutrition seem to confer positive metabolic benefits as seen in numerous timed restricting feeding and intermittent fasting protocols.
 

Sean_Raymond

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I agree in the most part, but the sticking point is that the OP insists that low carb works because we consume fewer calories. This is simply not true. I kept a good record of my calorie intake when I dieted using a low cal diet, before I discovered low carb and also during low carb,. Now the normal reply to this from HCPs is that people constantly forget to log everything they eat during a day. So presumably whilst calorie counting we forget things and when following LCHF we don't. Please HCPs listen to us. LCHF works when we consume more calories than before . It really does. When you can get your heads round that we might be getting somewhere. Now to me the most logical reason for this is that during low carb there is less circulating insulin and insulin is a fat promoting hormone, To some HCPs the most logical reason is that fat people are stupid and forgetful and can't count calories.
If the OP was really interested in learning about the subject he would buy and read the book that @bulkbiker mentioned. He would then have those 30 pages of references to hand and could take the matter up with all those learned people.
Being willing or unwilling to buy a book on the recommendation of someone on the internet cannot be fairly used as evidence to show I am or am not interested in learning. I think it is much better to support your case rather than tell someone to go away and spend time and money on a book. Especially when the authors view on this particular matter I am aware of and disagree with. The poster told me to read a book to confirm the posters view but I am in a discussion with the poster not the author. They can just post the evidence that has convinced them.

Regarding the insulin hypothesis of fatness, I do not find it is logical anymore and studies showing reduced insulin levels do not cause more fat loss supports this. I do not doubt that you logged your calorie intake meticulously and that HCP's, in response to a lack of their expected outcomes, said that you didn't log correctly etc. I'd find that infuriating too. And that you have found a diet that works for you to improve your health is amazing and these results to a diet that wasn't a part of my training and is still not generally recommended is part of why I am here. It is why I will use low carb diets and I can justify doing so. I am trying to work out the how and why more than to find out whether they work or not.
 

HSSS

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Out of interest when you consider your weight loss/insulin position are you taking the fact that you are discussing this with mostly t2 hyperinsulemic insulin resistant people whose metabolism doesn’t operate optimally or normally and this may be a difference that is often forgotten yet fundamentally changes our experience of weight loss v a metabolically healthy person with no carbohydrate “intolerance” as in the text books?
 

HSSS

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I'll try and get around to writing in more detail why I feel the insulin hypothesis of obesity doesn't work for me so my thoughts can be examined by anyone interested.
I’d actually be interested to read this. Please do post once you’ve had a chance
 
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lucylocket61

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Especially when the authors view on this particular matter I am aware of and disagree with. The poster
So having the links to studies won't help, will it. Your mind is already closed. I am reading so many posts about your opinion and beliefs, at the same time as you are saying you want our input. This is gaslighting - do you realize this?
 

Lamont D

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Out of interest when you consider your weight loss/insulin position are you taking the fact that you are discussing this with mostly t2 hyperinsulemic insulin resistant people whose metabolism doesn’t operate optimally or normally and this may be a difference that is often forgotten yet fundamentally changes our experience of weight loss v a metabolically healthy person with no carbohydrate “intolerance” as in the text books?

I asked a similar question, but he hasn't replied.
I do believe, that his belief, is based on research done on non diabetic patients were the imbalances in metabolic hormonal response to certain foods is normal..

That is why I asked him about the best dietary recommendations for someone like me.

Stay safe
 
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Sean_Raymond

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Wow! Just wow! You won't buy a book that could help to you understand why you are wrong and that insulin really is the problem???!!! You are so sure that his theory is wrong that you won't spend a little cash to check? And all those pages of references that you supposedly want to see? You are a professional and you expect us who aren't professionals to waste time talking to you for free? And you won't buy a book? Gobsmacked by this.
There really is nothing gobsmacking at all. It seems some want to take issue with everything I say.

I will repeat yet again that I am aware of what the author of the book says and I do not agree. There is nothing he will say in the book regarding his theory of insulin that will doesn’t say in the hour long interviews that I’ve seen. I know his views on insulin and I believe he is wrong. Just because a particular poster thinks the book is great does not oblige me to buy it.

I’m having a discussion with someone on here - they can cite any piece of evidence from book and I’ll respond to it in kind.

I do not expect you to talk to me at all- you do so at your own volition although you do not seem interested in constructive dialogue anyway.
 
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Lamont D

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Hi, again.

Just a query.
Have you looked at the insulin index, I know this was designed for non diabetic patients and for industry.

Why does certain meats get high insulin response numbers?
 

Goonergal

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All, the tone of a number of responses this evening is heading towards bickering rather than constructive discussion/debate.

There are some interesting points being raised here and it would be a shame for them to get lost in less helpful comments.

Please refrain from making judgemental remarks about the motivations of others. Disagreement is fine, but please keep it civil.

Any posts not meeting these criteria will be deleted.
 
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Sean_Raymond

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So having the links to studies won't help, will it. Your mind is already closed. I am reading so many posts about your opinion and beliefs, at the same time as you are saying you want our input. This is gaslighting - do you realize this?
Convincing evidence would be exactly that. My position on it isn’t fixed. I do not believe reducing insulin levels causes weight loss because the best studies I’ve seen show this whilst it also fits with the explanations for how various systems control energy expenditure. I would be happy to change my mind if the best evidence proved otherwise.

As I said. Some of the people here seem as if they want to argue. The post I am responding presumes things that are completely incorrect and not reflective of anything I’ve said but gets lots of likes and wins.

I’ll respond to genuine questions if I think it’ll be helpful but I’ll be avoiding posts like this.