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High Carb T2 Diabetes Trial Ends in Failure

Sid Bonkers said:
Yes he has but he has also repeatedly put that weight back on, if you read his blog you will know that he is a yo yo dieter, every year he takes another diet and looses weight then goes back to his usual eating habits and puts the weight back on.

As I said in another thread loosing weight is not that hard if you are competed and most diets will work in the short term, the trick though is to keep the weight off as that requires a lifestyle change not just a diet every year as yo yo dieting is known to be bad for your health.
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Let's stick with the facts:

From his own blog:
http://livinlavidalowcarb.com/blog/about-2
400lbs Jan 2004
220lbs Jan 2005 (180lbs loss)
305lbs Apr 2012 (85lbs gain)
255lbs Oct 2012 (50lbs loss)

So his net weight loss is 145 lbs on a low-carb diet. He lost 180lbs in his first 12 months, 85lbs of which he regained in the 7 year period between 2005 and 2012 (I don't think that kind of rebound is unreasonable from an almost 13 stone drop). He has subsequently relost 50lbs of that.

Unless he is lying (which I very much doubt), he's never been within 95lbs of his original weight, so whichever way you measure it he has had a sustained weight loss of almost 7 stone. Currently he is over 10 stone lower than his starting weight.

By any reasonable measure, this is sustained weight loss over a 8 year period. I think you need to look for n=someone_else.

Jca4.png


Of course this is academic. The real benefit of a low-carb diet (for diabetics) is glycemic control rather than weight loss. Most successful Low Carb dieters get their BG under control long before they lose any weight (although significant weight loss is usually a welcome side-effect).

The Look AHEAD study demonstrated that modest weight loss is not associated with any benefit in terms of cardiovascular mortality, and only very modest improvements in diabetic markers (of order -0.5% HbA1c).
 
xyzzy said:
The overwhelming vast majority of those posters over the years have reported that low carb works. They may have argued that this kind of low carb was better than that kind of low carb and even been at each others throats over which method is best. Some have said said lchf, some have said vlc, some have said lclf, some have argued for gi, some have argued for gl and others portion control with an effective carb control element.
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You show me yours and I'll show you mine.

Let's make a list of every T2 forum member that has successfully controlled their diabetes on a High Carb diet (NHS 50% by carb), with only metformin and/or diet.

I'll make a list of every T2 forum member (diet and/or met) that has controlled their diabetes on a Low Carb or GI/GL diet.

We'll agree to define HbA1c = 6% as "well controlled". Bet my list is longer than yours. Probably by an order of magnitude or more.
 
I guess we should also discard the 'anecdotal' evidence of writers like Jenny Ruhl and the conclusions she drew over many years on low carb/diabetic forums and also the 'anecdotal' evidence of Dr Bernstein's years of treating patients with low carb diets. Oh, and I forgot about Drs Westman, Vernon, Volek, Phinney, Eenfeldt, Dahlqvist, etc., etc... :crazy:
 
Indy51 said:
Dahlqvist
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God are you mad! Don't mention the Swedes. I did it once but I think I got away with it ...
 
Stephen , Jimmy's old blog has recently been disabled but in that were recorded his weight loss and his ups and downs. Your smooth graph is nowhere near reality.
How about the 2007 nadir or the ups and downs before (and after)
Losing 50lbs? He's done it many times. Here's one example still on the net because it's not his site.
http://forum.lowcarber.org/showthread.php?t=337684
He got down to 212lbs on this diet which he maintained was fine for him( ignore the diet plan and the subsequent very long thread, a whole other can of worms )
Not long after this period he was back up to 268 and employed a prominent low carb doc to help him lose the magic 50lbs again.
He may lose weight using a ketotic diet, but he regains quickly. He has so so far been unable to get to or maintain a normal weight using this method... and yes it's hard for him and everyone, there is no doubt about that.

This thread though has now gone from discussing the flaws in a study to something else entirely .
My own summary.
The study was flawed, too 'healthy' a population to show differences in CVD rates. It demonstrates the difficulties of implementing a programme that will help a large number of people over a long time to lose and maintain the weight loss. The lack of weight loss and better than expected outcomes in both groups made the hypothesis impossible to demonstrate. Quite honestly they should have shut it down after 2 years when they already realise that there were big flaws.

Paul_c said:
I'm convinced this forum has become infested with pharma industry shills determined for us all to end up progressing until we're all on insulin and completely dependant upon their products rather than successfully coping by means of the right diet and exercise to avoid progression...
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Would you like to name names or withdraw that insinuation ?
 
Paul_c said:
I'm convinced this forum has become infested with pharma industry shills determined for us all to end up progressing until we're all on insulin and completely dependant upon their products rather than successfully coping by means of the right diet and exercise to avoid progression...
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:clap:

I love a good conspiracy!

I have NO DOUBT that there are people here that are NOT contributing in the best interests of US diabetics.

And THAT is why you'll never see a karma/points/reputation system on this forum.
 
phoenix said:
Stephen , Jimmy's old blog has recently been disabled but in that were recorded his weight loss and his ups and downs. Your smooth graph is nowhere near reality.
How about the 2007 nadir or the ups and downs before (and after)
Losing 50lbs? He's done it many times. Here's one example still on the net because it's not his site.
http://forum.lowcarber.org/showthread.php?t=337684
He got down to 212lbs on this diet which he maintained was fine for him( ignore the diet plan and the subsequent very long thread, a whole other can of worms )
Not long after this period he was back up to 268 and employed a prominent low carb doc to help him lose the magic 50lbs again.
He may lose weight using a ketotic diet, but he regains quickly. He has so so far been unable to get to or maintain a normal weight using this method... and yes it's hard for him and everyone, there is no doubt about that.
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Everyone's weight goes up and down. Unless you can provide specific evidence otherwise, it looks to me like he has maintained a weight loss of 95lbs (from his starting weight of 410lbs). That is orders of magniture better than anyone achieved in the Look AHEAD trial.

It's pretty clear to me how disappointed that he was to have gone back over 300lbs in early 2012, I doubt that he got any closer to 400lbs at any time since 2004:
http://livinlavidalowcarb.com/blog/jimm ... 1-30/14409

To describe a 95lb weight loss sustained over 8 years as unsuccessful, is bizarre and disingenuous. Whether he is "near normal weight" (whatever that means) or not is irrelevant. His health outcomes at 300lbs are much better than at 400lbs. Nobody in the Look Ahead trial got anywhere near "normal weight" and they started from a much better place than Jimmy.
 
:lol:.....I can't say I'm bothered either way what this Jimmy guy says or does :lol:

Back to the discussion in hand me thinks!
 
phoenix said:
This thread though has now gone from discussing the flaws in a study to something else entirely .
My own summary.
The study was flawed, too 'healthy' a population to show differences in CVD rates. It demonstrates the difficulties of implementing a programme that will help a large number of people over a long time to lose and maintain the weight loss. The lack of weight loss and better than expected outcomes in both groups made the hypothesis impossible to demonstrate.

This thread though has now gone from discussing the flaws in a study to something else entirely .
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To be fair, this was my thread and it was never supposed to be about the flaws in the study.

I was rather hoping you were going to address my points about how you ever falsify a hypothesis, when everyone resorts to post-hoc-rationalisation about how the study was "underpowered", or how the subjects were "too healthy" or how "the control group did unusually well".

"The experiment must be wrong, because we always knew our hypothesis was correct in the first place." Can you not even accept the possibilty that studies such as this one fail, because the benefit that they are trying to measure is too small to be clinically significant?

Even if your objections are true, those arguments only relate to the CV mortality rate, they don't explain the modest improvements in diabetic markers. The fact that they only managed to reduce their HbA1c on average from 7.2% to 6.6% demonstrates to me that, even with intensive support, this NHS style intervention is pretty ineffective (HbA1c of 6.6% is roughly equivalent to an average BG of 7.9 mM).

Quite honestly they should have shut it down after 2 years when they already realised that there were big flaws.
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Or they should have shut it down when they realised that it wasn't going to validate their hypothesis. Clearly some of the people involved with the study weren't so dismissive of it's results (to their credit):

“We were hoping that a weight-loss program would help reduce cardiovascular disease, but now we have the answer that it doesn’t,” said Mary E. Evans, a physician at the National Institute of Health’s National Institute of Diabetes and Digestive and Kidney Diseases, which paid for the study.
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But the outcome is clear, said Dr. David Nathan, a principal investigator and director of the Diabetes Center at Massachusetts General Hospital. “We have to have an adult conversation about this,” he said. “This was a negative result.”
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“I was surprised,” said Rena Wing, the study’s chairwoman and a professor of psychiatry and human behavior at Brown University’s medical school.

Like many, she had assumed diet and exercise would help, in part because short-term studies had found that those strategies lowered blood sugar levels, blood pressure and cholesterol levels.

But, Dr. Wing added, “You do a study because you don’t know the answer.”
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noblehead said:
:lol:.....I can't say I'm bothered either way what this Jimmy guy says or does :lol:

Back to the discussion in hand me thinks!
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You might not be, but Sid has a rather blunt axe to grind.

And to be honest, the fact that he can maintain a 95lbs weight loss over 8 years is a great endorsement of low-carb dieting.
 
phoenix said:
Would you like to name names or withdraw that insinuation ?
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Who died and made you boss??? You don't get to bark orders at ANYBODY. :yawn:
 
Hi All...
Can we please keep on topic whilst debate/discussing things.
Anna.
 
borofergie said:
I was rather hoping you were going to address my points about how you ever falsify a hypothesis, when everyone resorts to post-hoc-rationalisation about how the study was "underpowered", or how the subjects were "too healthy" or how "the control group did unusually well".

"The experiment must be wrong, because we always knew our hypothesis was correct in the first place." Can you not even accept the possibilty that studies such as this one fail, because the benefit that they are trying to measure is too small to be clinically significant?
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I think you make a very valid point about scientists should accept the outcome of their experiments based on the accepted rules of the scientific method. These lot certainly seem to be ignoring standard practices. For anyone not clear on what the scientific method is just google it and then read up on people like Karl Popper etc.

Comapre the AHEAD Trial to say the LHC God Particle hunt at Cerne that physicists have just successfully completed this year. Both experiments were built to test theories that originate back in the 60's and 70's. Now think of all the brilliant technology that has come out of that Cerne stuff such as the World Wide Web, superconductors and just the actual intellectual achievements of extending our knowledge and understanding how the universe works. Real science that gave real benefits and produced real results that vindicated the work of nearly 100 years of physicists theories.

Whats the difference? Well to me it comes down to the quality of the original scientific theory the experiment was supposed to test. What I mean by that is physicists didn't just spend the billions of dollars it took to build the LHC equipment on a hunch. Right back in the 1970's their theories that they had built up carefully under peer review for that 100 years gave really good indications where to look for the God particle i.e if they had been able to build the LHC back in the 1970's they could have pretty much found it then. They couldn't because at that time the technology to do so hadn't been invented.

The problem is the AHEAD Trial seems to have used anything but an equivalent set of peer reviewed earlier studies. For example you can bet it uses things like Ansel Keys anti fat theories that were easily disproveable even before the trial began. Theories that were accepted at the time because it was politically expedient to do so. $200m dollars down the drain and what one benefit has this study actually achieved. The only benefit it can possibly achieve is for its negative finding to actually be accepted. If the people who have run the experiment do that then maybe just maybe they can redeem themselves as scientists.
 
Here is the study reference
Diabetes care. 2014 sep; 37(9): 2548-2556
I can’t post the link - this website won’t let me sadly!
 
Mr_Pot said:
You have posted on a 6 year old thread - I think this may be a record.
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I got caught! Just waded through the discussions (arguments) thinking I must have missed this news. Turns out I wasn't even diabetically born then.
Odd that the NHS seems to be persisting with Unhealthy Eating Carb Feast plate.
 
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