Low-Carbohydrate Diets and All-Cause Mortality:

[Sid Bonkers]

Well I found the research rather interesting and like the study suggested I would like to see more research done which is exactly what I said in my original post, although some perhaps chose not to read that.

Its a shame that research that could have far reaching effects for many of us here cant be posted and talked about without it descending into a gangfight. If you blindly believe in something then why read a forum in the first place, your not going to learn anything new are you?

 

[hanadr]

I suggested this research to a DUK scientist at a conference a couple of years ago and she thought they wouldn't be able to get funding, since no-one would make any money from it.
Hana

 

[Superchip]

Point well made hanadr !

Where there is profit there are downright lies..

Where there is no profit there is truth..

Who listens ?

Who cares ?

 

[AMBrennan]

All cause mortality is a catch all, it doesn't tell us that anyone on a low-carb diet has perished from a cause directly related to the diet. It just tells us that people have died and some of them happened to have claimed to be on a low carb diet. No doubt a majority of those people who died also claim to be christian, does that mean religion kills?

All-cause deaths not causally related to diet are included in both the low-carb and high-carb group, and assuming that diet is not causally related to deaths in ferry accidents then including these deaths in both groups will not change the result (x+c>y+c => x>y)

I'd anything, I'd conjecture that low-carb is correlated with attitude to authority (following official NHS advice vs more fringe ideas) than health consciousness, so I don't think that sports accidents are a good explanation for the excess deaths.

If it turned out that Christians had a significantly higher death rate I'd suggest that sick people might be more inclined to try religion. If it turned out that Christians had a significantly higher death rate from ferry accidents I'd be baffled (maybe pilgrimages might cause them to travel more?).

 

[Yorksman]

I suggested this research to a DUK scientist at a conference a couple of years ago and she thought they wouldn't be able to get funding, since no-one would make any money from it.

There are lots of research projects but competition for funding is intense. Academic institutions are often measured these days on the amount they publish and they attract more funding because of the reputation. Those that fall behind tend to be bitter because they find it hard to get a foot on the funding ladder.

PubMed are a leading online publisher of biomedical peer science. They published a relevant paper in March 2013:
Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. (Ajala et al 2013)

http://www.ncbi.nlm.nih.gov/pubmed/23364002

 

[jddukes]

Well I found the research rather interesting and like the study suggested I would like to see more research done which is exactly what I said in my original post, although some perhaps chose not to read that.

Its a shame that research that could have far reaching effects for many of us here cant be posted and talked about without it descending into a gangfight. If you blindly believe in something then why read a forum in the first place, your not going to learn anything new are you?

Hi Sid,

I don't think that it has completely decended into "gang fights" ! I would like to think most of us can have a good, reasoned and rational discussion about the merits and pitfalls of any research article posted on here. I certainly would not say things like this cannot be posted here - the problem is we all have our own experiences which causes us bias and leads us to discuss such a topic very emotively at times.

Your arguments though (blindly believing in anything / wanting to actually learn) must also be applied to the reasoned approach that science demands. And that reasoned approach does not stop at the level of a published article. A good scientist learns early on that you must very carefully read anything published, including context, methodology and findings and see if they stand the test of appropriateness to how you are interpreting them.

This is posted on a forum where many people do low carb diets - therefore if the title is true in the most broad sense that it suggests, it is our duty to analyse the content in a rigorous manner to determine the impact to us as diabetics. That was the reasoning behing my post, and I am sure many others. Just because something is published does not make it true or a good study. I'm sure in many ways this is a very good study and it is interesting - however we are viewing it in the context of diabetes and therefore to analyse it's appropriateness to this is paramount. Many people have raised issues with the study design, inclusion/exclusion criteria and key definitions (eg. what is low carb). This is a completely valid approach and is not "accepting anything blindly." I would say just to take any published research at face value is in fact, accepting something blindly. When our own rates of mortality for those who do adopt a low-carb lifestyle is in question, it is all the more serious of matters.

So I would encourage you or anyone to continue posting studies but we have to all remember that every study should be carefully analysed and just because something is published with a suggestive blanket title does not make it true. I firmly believe having looked at this paper that it is not appropriate for a diabetic who adopts a ketogenic diet to ever be inclined to think that they have a greater risk of mortality over a high carb diet, based on this study. This study does not show that (and is not even addressing diabetics).

Regards,
J

 

[jddukes]

I suggested this research to a DUK scientist at a conference a couple of years ago and she thought they wouldn't be able to get funding, since no-one would make any money from it.

There are lots of research projects but competition for funding is intense. Academic institutions are often measured these days on the amount they publish and they attract more funding because of the reputation. Those that fall behind tend to be bitter because they find it hard to get a foot on the funding ladder.

PubMed are a leading online publisher of biomedical peer science. They published a relevant paper in March 2013:
Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. (Ajala et al 2013)

http://www.ncbi.nlm.nih.gov/pubmed/23364002

This is very true (the bit in bold) - and a reason why I left academia. The success rates for grant applications used to bearound 25-30% and if you were a good young investigator you had a good chance of start-up grants. In recent years, this has fallen to 5-6% which means many are struggling for funding. The days are gone when you could study something just because it was novel, and interesting science. I saw my own supervisors with years of experience - and other professors around me get grant after grant after grant rejected, all good science. I had a good publication record with numerous first author papers in my first post-doc but did not want to spend my life chasing after grants, no job security, constantly having to move around the country/world just to hopefully one day get a secure position (but still struggle to maintain lab funding). That is one of many reasons I decided to go into industry, where the research then is drug-focused, i.e. a product to treat and cure disease (or in my case cancer).

The point - science is not funded for the minority well, the funding is low as governments and funding bodies have less and are cutting back. Therefore only the trendy and "cool" science and things that are really relevant and hot topics are going to get funding. If something is seen as not being important enough, then it will not get funding. And I believe that most funding bodies feel that something like low carb diets are not a crucial way to spend their money.

I should also just point out as well - pubmed is not a publisher per se, it is an indexing website, more like a database that you can search peer-reviewed articles on. The actual publisher of that piece of work quoted here is the American Journal of CLinical Nutrition, which is a decent journal.

J

 

[Geocacher]

There are people in the world living in places where low-carb is their natural diet. The inuit people survived in a harsh climate on a diet based almost exclusively on meat and fat. Some still do and they are far healthier and live longer than their peers who have adopted a modern diet. There are several examples of cultures that base their diet on meat and fat with little variation who live active and healthy lives and they have done so for countless generations.

Give someone enough vague data and they can prove almost anything, give someone data that has been collected using an appropriate scientific method and you might get something that resembles the truth. If you can repeat it consistently and get the same results, then it may well be the truth.

This is clearly a case of assumptions based on vague data. The reliable conclusions can only really be that people die and some of them happen to be on a low carb diet at the time.

 

[AMBrennan]

The inuit people survived in a harsh climate on a diet based almost exclusively on meat and fat.[...]
Give someone enough vague data and they can prove almost anything, give someone data that has been collected using an appropriate scientific method and you might get something that resembles the truth. If you can repeat it consistently and get the same results, then it may well be the truth.

That doesn't sound very consistent, and the explanation is trivially obvious - until very recently people simply didn't live long enough to die from heart disease, diabetes and so on.

Some still do and they are far healthier and live longer than their peers who have adopted a modern diet

If that is true (it may not be true) then you are taking a group which differs in many ways from your traditional western society and arbitrarily pick one factor consistent with your preexieting ideas to explain the difference.

I'm sorry, but I really don't see why you brought this up given the rest of your post.

 

[Yorksman]

There are people in the world living in places where low-carb is their natural diet. The inuit people survived in a harsh climate on a diet based almost exclusively on meat and fat. Some still do and they are far healthier and live longer than their peers who have adopted a modern diet. There are several examples of cultures that base their diet on meat and fat with little variation who live active and healthy lives and they have done so for countless generations.

Different genetics of course. Inuit can't tolerate things like milk or alcohol. According to Fuhrman, Inuit Greenlanders, who historically have had limited access to fruits and vegetables, have the worst longevity statistics in North America. Research from the past and present shows that they die on the average about 10 years younger and have a higher rate of cancer than the overall Canadian population. (Iburg et al, Mortality among the Baffin Inuit in the mid-80s)

The top 100 places for longevity can be seen at http://www.indexmundi.com/g/r.aspx?t=100&v=30

But this excludes population groups such as those who live in the region of Abkhasia in the Caucasus where many people in their 90s are fitter and more active than we are in our 50s. Like most people in the Caucasus, they enjoy fatty meat, preferably lamb but they don't eat that much of it and habitually consume large amounts of yogurt as well as vegetables and fruits to neutralize the negative effects of animal fat. In addition they use liberal amounts of raw onion, lemon juice, pomegranate juice and sour spice known as sumag. These all work to promote digestion and break up the fat. People tend to be genetically adapted to their local food sources through a process of selective advantage over a very large number of generations and what goes for one population group does not necessarily hold for another.

I'm off for my teaspoon of cider vinegar.

 

[IanD]

How & why scientific reports are published

As a former professional consultant scientist, a further comment is necessary, with a different slant.

I've looked at a lot of reports related to this forum & written a few in my working life - most not published as they were for internal company reference, though I had 9 granted patents & helped in the writing of a few more.

In no particular order:
1. to establish the name of the author, or his supervisor;
2. to get a PhD
3. to bang a drum to establish the expertise of the author ....
4. .... preferably with a novel contribution
5. to collate and/or confirm already published research with a particular slant in view ....
6. .... even if the original reports have a different slant.
7. to promote a commercial product
8. to benefit mankind in general, & sufferers from specific health conditions

The report this thread is about is point 5:

Sid:
A new study recently out suggests that long term low carb diets are far from safe and are actually shown to increase all causes of mortality.

Report cited:
Low-carbohydrate diets tend to result in reduced intake of fibre and fruits and increased intake of protein from animal sources, cholesterol and saturated fat. In their conclusion they write: "Our meta-analysis supported long-term harm and no cardiovascular protection with low-carbohydrate diets. … Our findings underscore the imminent need for large-scale trials on the complex interactions between low-carbohydrate diets and long-term outcomes."

We have already seen that many aspects of the report are questionable, in particular the cause of death (all causes) & what constitutes low carb. I won't question it further - presumably the collaborators received their PhD, & their supervisor had a further publication to his name.

I'll stop here & post again, a specifically pertinent report.

 

[Yorksman]

Re: How & why scientific reports are published

I won't question it further - presumably the collaborators received their PhD, & their supervisor had a further publication to his name.

You don't get a PhD for collaboration, it has to be your own original piece of research that is a contribution to the overall level of knowledge of the subject or new interpretation of existing data. If you examine their credentials you will see that they all have doctorates for separate research. Atsushi Goto, if I remember correctly, got his for his hypothesis about the benefical effects of caffein on diabetes.

Hiroshi Noto 's professional affiliations are given in the standard peer review format, up front, notes 1 and 2 at the very top of the study and are:

1. Department of Diabetes and Metabolic Medicine, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan,
2 Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and
Medicine, Tokyo, Japan

and he either authored or co-authored the following peer reviewed research:

2013 Low-carbohydrate diets and all-cause mortality: a systematic review and meta-analysis of observational studies

2012 Cancer risk in diabetic patients treated with metformin: a systematic review and meta-analysis

2011 Significantly increased risk of cancer in patients with diabetes mellitus: a systematic review and meta-analysis

2011 Asymptomatic coronary heart disease in patients with type 2 diabetes with vascular complications: a cross-sectional study

2010 Autoimmune diabetes in HIV-infected patients on highly active antiretroviral therapy

2010 Substantially increased risk of cancer in patients with diabetes mellitus: a systematic review and meta-analysis of epidemiologic evidence in Japan

5. to collate and/or confirm already published research with a particular slant in view ....
6. .... even if the original reports have a different slant.

Slant? Do you mean hypothesis?

We have already seen that many aspects of the report are questionable

If there were any professional peer challenges, they'd be listed. Where are these challenges? All I have seen are some vox pops published on web forum.

 

[IanD]

How & why scientific reports are published

I hope you are all familiar with these DUK on-line publications:

Low-carbohydrate diets for people with Type 2 diabetes - March 2011

Evidence-based nutrition guidelines
for the prevention and management of diabetes - May 2011

These are hopefully:
8. to benefit mankind in general, & sufferers from specific health conditions, by 5. collating existing research.

Note the Position Statement raison d'etre:

Diabetes UK produced a position statement on low-carbohydrate diets for people with Type 2 diabetes who want to lose weight. Diabetes UK reviewed the evidence and reached the following conclusions:

Evidence exists suggesting that low-carbohydrate diets can lead to improvements in HbA1c and reductions in body weight in the short term (less than one year).
Weight loss from a low-carbohydrate diet may be due to a reduced calorie intake and not specifically as a result of the carbohydrate reduction associated with this diet.
Despite the short-term benefit there is a lack of evidence related to the long-term safety and benefit of following this diet.
.....
The guidelines daily amount (GDA) for carbohydrate is 230g for women and 300g for men
....

The evidence report gives this comment:

Low-carbohydrate diets have created some controversy, but both a recent review and meta-
analysis suggest that they are associated with significant reductions in body weight and improvements in glycaemic control [121, 135]. It has been shown that the main mode of action of low carbohydrate diets is simply a reduction in energy intake due to carbohydrate restriction [136]. Systematic reviews have reported that although these diets may be more effective than comparison diets over the short-term, there is little published evidence from studies in people without diabetes showing benefit over the longer term [44, 137]. Concern has been expressed about the potential adverse effects of these diets, especially on cardiovascular risk, but there remains no evidence of harm over the short term.

It is apparent that DUK are seeking to question the long-term safety of low carb, but in over 10 years of research & analysis of published data have failed to find any evidence. I've looked at a number of the citations.

13. Nielsen J and Joensson E (2008). Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycaemic control during 44 months follow up. Note - 44 months is not short term.

Advice to obese patients with type 2 diabetes to follow a 20% carbohydrate diet with some caloric restriction has lasting effects on bodyweight and glycemic control.
....
There is now little evidence for the claim that a fat-reduced diet for weight reduction has any particular value beyond caloric counting [10]. On the other hand, six randomised studies have shown that carbohydrate restriction with ad-libitum energy intake confers a significant benefit with regard to weight loss in obese persons [11-16]. The current study is consistent with these reports and suggests that high-starch, high-carbohydrate diets excessively stimulate appetite and disturb energy balance in patients with the metabolic syndrome and type 2 diabetes [3]. A reduction of carbohydrates normalises the balance, reduces insulin concentrations and favours utilization of stored fat as fuel as well as significantly reducing insulin resistance [3]. Considering the solid evidence for the negative effect of hyperglycemia on diabetes complications as well as cardiovascular disease the present high-carbohydrate dietary advice resulting in unnecessary hyperglycemia and insulin resistance seems difficult to support [17-19] and for diabetes patients, current dietary recommendations seem to be a major part of their problem rather than being part of the solution. Carbohydrate restriction, however, reverses or neutralises all aspects of the metabolic syndrome [20,21].

Summary: A reduced carbohydrate diet is effective in motivated patients and can be recommended for overweight patients with type 2 diabetes. There has been no sign of a negative cardiovascular effect.

That report on a 4 year & on-going study was cited in the DUK "Position Statement" with the comment:

There is evidence that low-carbohydrate diets lead to improvements in HbA1c and/or reductions in body weight, but this needs to be interpreted with caution (4, 5, 6, 7, 8). This benefit is mainly observed in short-term trials lasting six months or less. Trials lasting longer than six months reported rapid weight loss at the start (9) or in the first six months, which was then followed by a period of partial rebound and plateau (10). Despite the increases in weight and HbA1c values, these values remained lower than those at the start of the trial which could suggest that low carbohydrate diets may have lasting effects (11,12,13).

The DUK comment is a blatant rejection of the very positive Swedish study - perhaps because that study was critical of current dietary recommendations.

There's more!

 

[Daibell]

I think many of us have questioned the DUK stance on carbs over the last few years. You can trace some of it back to a report which said that low-carb diets are not proven to be safe. As I have stated before I would rather have diet that is not proven to be safe than one (the current Western one) which is proven to be unsafe i.e. too high in calories, carbs, fats etc with resulting cardio problems, diabetes and so on. DUK's stance is just very bad science. It is much safer if you have high blood sugar and normal meds aren't adequate to have reduced carbs than to severely damage your body in the longer-term thru high blood sugar.

 

[Yorksman]

I think many of us have questioned the DUK stance on carbs over the last few years. You can trace some of it back to a report which said that low-carb diets are not proven to be safe.

There are a lot of different diets that fall into the low carb category. Not all of them will be safe. DUK have the task of reducing the statistical inferences derived from the research, within the framework of the stated assumptions, parameters of the model chosen and subject to caveats and summarise it in bite sized chunks in media friendly terms.

Which low carb diet seems to be an appropriate question to me. The two I cited higher up in this thread and one on another thread may shed some light on the matter:

Johnston et al 2006, Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets
"KLC and NLC diets were equally effective in reducing body weight and insulin resistance, but the KLC diet was associated with several adverse metabolic and emotional effects. The use of ketogenic diets for weight loss is not warranted."
http://ajcn.nutrition.org/content/83/5/1055.full.pdf

Fung et al 2010, Low-carbohydrate diets and all-cause and cause-specific mortality: two cohort studies.

"A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates."

de Koning et al 2011: Low-carbohydrate diet scores and risk of type 2 diabetes in men.

"A score representing a low-carbohydrate diet high in animal protein and fat was positively associated with the risk of T2D in men. Low-carbohydrate diets should obtain protein and fat from foods other than red and processed meat."

 

[IanD]

How & why scientific reports are published

This is citation 116 in the "Evidence-based nutrition guidelines " cited above.
Influence of Fat and Carbohydrate Proportions on the Metabolic Profile in Patients With Type 2 Diabetes: A Meta-Analysis

RESEARCH DESIGN AND METHODS We searched for randomized trials that investigated the effects of two kinds of prescribed diets (a low-fat, high-carbohydrate [LFHC] diet and a high-fat, low-carbohydrate [HFLC] diet); in these studies, energy and protein intake did not differ significantly between the two dietary groups. Nineteen studies that included 306 patients met our inclusion criteria. Median diet composition of carbohydrate/fat in the LFHC and HFLC diets was 58%/24% and 40%/40%, respectively.

This show the total inadequacy of "low carb" as a diet definition.

For a 2,000 Kcal diet, 400 Kc are from protein, & 1600 divided between carb & fat. The LCHF diet therefore averages in this study & the referenced studies consumes 800 Kcals of both carb & fat - 200 g carb & about 110 g fat.

Further comment on that paper is superfluous. Low carb is 200g daily! .

I'll quote one more paper cited in the "Evidence-based nutrition guidelines" actually a study by one of the authors - Joy Worth Diabetes Specialist Dietitian, Manchester Diabetes Centr. Ref 18 in the "Position Statement." The possible harmful effects of the Atkins diet were being investigated.
Worth J, Soran H (2007). Is there a role for low carbohydrate diets in the management of type 2 diabetes? Q J Med 100; 659–663

This article will review the Atkins diet, compare it with current nutritional recommendations for type 2 DM patients, and discuss the possibility of adopting a modified version of the Atkins diet as an alternative viable dietary approach.
.....
In summary, low-CHO diets of 6–12 months duration have no adverse effect on CVD risk factors, and show no major adverse effects to preclude their use. Meaningful weight loss is achieved, but this does not appear to be sustained beyond 6 months. Long-term trials are required to assess their safety, and studies are awaited to define the role of such diets within patients with diabetes. In the study by Samaha et al., 39% had diabetes, and the mean fasting glucose level decreased more in the low-CHO group than in the low-fat group (−9 ± 19% vs. 2 ± 7%, p = 0.02) at 6 months.13 A 16-week pilot diet intervention trial also demonstrated that a low-CHO, ketogenic diet can improve glycaemic control in obese type 2 DM patients (mean BMI 42), such that diabetes medications were discontinued or reduced in 17 of the 21 participants.19 However, to date there has been no randomized controlled trial in type 2 DM patients and health care professionals remain wary of their use, particularly as standard dietary advice from Diabetes UK does not support this approach.

If you have read these my citations - & gone to the originals - it is evident that the LCHF studies have been shown to be beneficial to T2s, at least in the short term, but up to 4 years. It seems also that some of the research has been biased in seeking to find dangers with such a diet, even by organisations that should be objective.

The need for a better diet than the standard high carb recommendation is evident from the fact that these studies have been published, & that T2 is recognised as "progressive" & is currently considered of epidemic proportions, resulting in horrendous cost to the NHS.

Also there is no commercial incentive to do such research. The search for drugs & "cures" is a diversion from the recommendation of a true low carb diet. This need not be Atkins - but can include a range of foods including vegetables, nuts, dairy in addition to meat & a little fruit. Any dietary inadequacy can be compensated by taking multi-vitamin-mineral tablets.

In my case, 7 1/2 years of the DUK diet resulted in debilitating complications. After a further 5 years of LCHF I have no complications. I'm off to play tennis this evening.

 

[jddukes]

Re: How & why scientific reports are published

If there were any professional peer challenges, they'd be listed. Where are these challenges? All I have seen are some vox pops published on web forum.

We would do well to not ignore public opinion and indeed public rationality, intelligence, and experience.

Strip down medicine to its basic elements and you can usually safely conclude that if enough people report a similar finding than this could be considered the "norm." Many people here, and elsewhere have been low-carbing and doing it for years with only improvements to their health. This seems far from random noise, far from being at the tail-end of the bell-shaped curve, but actually the norm. What appears to be the abnormal observation in fact could be observing a diabetic on a high carb diet with very good control (no hypos and few hypers). That of course has to be counter-balanced by the very fact that you may get a disproportionate number of people reporting this phenomenon on here simply due to the effect of it being an internet forum (and people with a problem are more likely to end up here etc, etc).

There are plenty of intelligent, rational, experienced people here who have analysed this meta-review and found flaws - just because they are not the "peer-group" does not mean their views should be dismisses as "vox pops" and thus the unwise public opinion. Sure these people may have their biases, but to think that a scientist does not have a bias would be incredibly naive, if not more so as their bias is usually financially (funding, salary, etc) motivated. I have a PhD, post-doctoral research experience, I have published a number of first-author publications in high-impact peer-reveiewed journals and I have reviewed publications as well - things that are in my general "peer" or field but often much outside it. Yet I would not say that my opinion is right and others on here are not. You do not need a PhD or research experience to analyse piece by piece a scientific publication - in fact many scientists with PhDs I know still blindly accept any publication they see and do not dissect it to determine its quality and appropriateness to a question they are asking. I believe there are many people on this forum who can do this very well and their input on the matter is of great use.

The problem with publications is that it can be a very emotive subject - not just for us. It is emotive to us as we all know our own experiences - high or low carb, we know what has worked. Therefore it is far easier for us to come to look at a paper that supports our experience as positive, and conversely one that goes against our experience as wrong. But this happens day in day out in academic science. I can tell you for EVERY single publication I have had, there are reviewers who will say one thing is a brilliant piece of work and another reviewer will say the exact same thing is incomplete/not good/incorrect, etc. In fact, we've just had a paper I am on come back from a high-impact journal, reviewed by 2 reviewers and 1 said this is brilliant, you have shown the link between the clinical observation and the drug action, whereas the other reviewer said you certainly have not proven the link, you need to do this this and this to prove it. Peer-reviewed publications are not as puristic as many would like to think. Much of the time it comes from the own reviewer's bias (or bitterness over similar rejections of their own work) - perhaps they are working on something similar and don't want you to publish first, perhaps they do not like you, perhaps they are working on a different theory than your work suggests and don't want your work to get published as it would go against their work. The list is almost endless. Perhaps when they reviewed the work (for free, among a busy schedule), they were just in a bad (or good) mood. If you want to understand a bit what the bias of that process is like, and how difficult it is to overturn a long (not well) established theory, I encourage you to read the book "Emperor of Scent" by Chandlur Burr.

So my point - public opinion and rationale should never be dismissed or over-looked. Some of the smartest comments I have seen about various scientific topics have come from those without any scientific background. "Non-qualified" people can make very good sense.

J

 

[Yorksman]

Re: How & why scientific reports are published

If there were any professional peer challenges, they'd be listed. Where are these challenges? All I have seen are some vox pops published on web forum.

Strip down medicine to its basic elements and you can usually safely conclude that if enough people report a similar finding than this could be considered the "norm." Many people here, and elsewhere have been low-carbing and doing it for years with only improvements to their health. This seems far from random noise, far from being at the tail-end of the bell-shaped curve, but actually the norm.

You write about the public experience of low carbing. The vox pops I refer to are criticisms of peer published papers by anonymous people. They are completely different things.

I remember a time when smoking was both popular and encouraged. The GP kept a box of cigarettes on his desk and offered them to his patients. A good example of both the public and the professionals getting it wrong.

I don't hold a view one way or the other on Low Carb High Fat, Low Carb High Animal Fat, Low Carb High Vegetable Fat, Low Carb High Dairy Fat, Low Carb High Fish Fat or just Low Carb Low Fat. What I like to do is see the different views, but I'm not in a position to judge. I do agree with Sid's observation though that some people appear to want to rigidly adhere to their own chosen wisdom and perceive alternate views as injuries or slights. This forum is hardly unique. It is no different from my own field of interest, genetic anthropology, where questions people like me would raise back in 2002 are still fiercely debated in 2012.

I do not hold much hope for a resolution of this matter for in my opinion, there cannot be one. Genetically, people are different with different responses to different foods, the ability/inability to digest milk in adulthood being a good example. Take for example this genetic map of the UK based on a selection of 500,000 genes:

Some of those have the 13910 C gene which means they don't produce the enzyme lactase while most have the 13910 T gene which means they do produce the lactase enzyme. Lactase allows them to digest the carbohydrate lactose. That is just one gene and one type of carbohydrate. In time, others will be discovered. The pattern is similar for the genes which control other functions. Some of them have the MCR1 gene, some don't, the 'ginger gene'. Whilst some, for example with the Factor V Leiden mutation, are at risk of developing thrombotic conditions others the with genetic disease of haemophilia, are at risk of bleeding to death. Which populations on this map will benefit more than others from certain types of diet? Or are they all the same? I doubt it. Populations are made up of many different genetic groups and in all likelihood we have many different dietary requirements. That is how evolution works, through selective advantage and genetic diversity is beneficial in this respect.

 

[Yorksman]

If anyone is interested in the field of Nutrigenomics and Nutrigenetics, discussion starts sort of with this article:

Nutrigenomics and nutrigenetics: the emerging faces of nutrition (2005)

and starts with this warning:

"Performing population-scaled epidemiological studies in the absence of genetic knowledge may result in erroneous scientific conclusions and misinformed nutritional recommendations."

http://europepmc.org/abstract/MED/16195 ... 2/1602.pdf

 

[IanD]

Re: How & why scientific reports are published

My comments in blue.

If there were any professional peer challenges, they'd be listed. Where are these challenges? All I have seen are some vox pops published on web forum.

You write about the public experience of low carbing. The vox pops I refer to are criticisms of peer published papers by anonymous people. They are completely different things.

Should we expect professional peer challenges? When the objectives, methods & conclusions are published & reasonable, what is there to challenge? I am not vox pops which is essentially an uninformed public opinion. I am a professional scientist (B.Sc. Hull, 1961, & have worked as a professional scientist all my life. I've been diagnosed diabetic for 12 years, so I have rather more than your 4 months experience. My opinion on the various articles amounts to an expert analysis of methods & conclusions based on my own experience & the data from other papers including some citations.

If I had been invited to peer review those papers, would I have rejected them? What I am doing is questioning the validity of the conclusions drawn.

I don't hold a view one way or the other on Low Carb High Fat, Low Carb High Animal Fat, Low Carb High Vegetable Fat, Low Carb High Dairy Fat, Low Carb High Fish Fat or just Low Carb Low Fat. What I like to do is see the different views, but I'm not in a position to judge.

I AM in a position to judge. The question of T2 diabetic diet is a very serious matter - YOU don't hold a view at present, but when you've been diabetic a few years, & begun to suffer the complications you will realise you need to form a view. A view that will either result in cardio problems, failing sight, neuropathy, amputation, etc, or in excellent health that will last into old age.

I do agree with Sid's observation though that some people appear to want to rigidly adhere to their own chosen wisdom and perceive alternate views as injuries or slights.

The view maintained by the health professionals is the view maintained by Diabetes UK, which as a charity should be objective. It isn't, in the matter of T2 diet. Study those DUK reports I have cited. Look up their citations. I've quoted some relevant citations that question the DUK recommendations. These are NOT my ignorant opinion, but the opinions of experts in their field, expressed in their own papers.

These are not academic arguments - they represent the difference between good control & bad - good health & sickness. Also they point to a way for the T2 diabetic "epidemic" to be controlled at relatively low cost by well informed patients.

This forum is hardly unique. It is no different from my own field of interest, genetic anthropology, where questions people like me would raise back in 2002 are still fiercely debated in 2012.

I do not hold much hope for a resolution of this matter for in my opinion, there cannot be one. Genetically, people are different with different responses to different foods, ...

The ONLY satisfactory resolution will be for DUK to open up to an admission that their insistence on a high carb diet for all T2 diabetics & study this forum, & people like me who have suffered from following their recommendations & reversed the complications by a total change of diet. People are suffering progression of their diabetes because DUK refuse to take seriously the concept of a LCHF diet. It should at least be offered as an option for T2 control, NOT dismissed as potentially unsafe for long term use.

I am included in two long term studies - SABRE studied men in Southall & Brent for possible heart conditions & diabetes, 20 years ago & with very comprehensive checks 4 years ago. In my case, no conditions needed follow up. Ealing Hospital run a LOLIPOP study. (LOndon LIfe POPulation) with biannual checks. Again, no problem. Has anyone on this forum reported real dangers from LCHF? Now there's some research you could do.

Meanwhile, learn from people like me. CUT THE CARBS.