Dr. Norman Swan - media doctor - an attempt to debunk the popular ketogenic diet benefits mythology

#1

It is time for a reality check in this keto biased echo chamber.

Here is what the evidence says. And in case you don’t listen to the short, radio report, I’ll summarise it below.

Dr. Swan speaks with a nephrologist in New York who has authored a scientific paper based on a meta-analysis published in 2013.

The keto diet makes you feel like crap.

You need carbohydrates if you want to exercise.

You will lose friends from your bad breath.

Weight loss on the ketogenic diet is from an energy deficit. Just like any other diet. So any low calorie diet will work for weight loss.

The ketogenic diet only has, at best, short term effects on type 2 diabetes, whereas type 2 diabetes is a long term progressive disease.

Kidney stones are a risk on a ketogenic diet.

The ketogenic diet raises LDL. LDL is a bio marker of heat disease.

The Inuit have a genetic mutation and a higher rate of heart disease than the general population.

Ketones in the metabolism will lead to an acidic body state that is risky when faced with infection?

Constipation due to low fibre.

Ketogenic dieters are a mob of anti-science pitch fork waving zealots. (Smiley face)… a bit of levity at the end of the report.

People who promote the ketogenic diet have a political motivation and tend to be the types who go against the established norms without understanding the science.

This is a report from one of our main trusted medical media resources in Australia.

The most surprising point in the report is that Dr. Swan has gone keto, occasionally. This lifted my personal opinion of him. But the story is not about him, it’s about the currently popular ketogenic diet and getting down to some facts.

It’s all here

https://www.ketogenicforums.com/t/australians-canadians-dr-norman-swan-media-doctor-lowering-cholesterol/57327?u=frankobear

Keto diet discussed for type 2 diabetes on ABC Health (Australia)
Can we please stop repeating the “You have to eat at a deficit to lose weight on KETO” lie?
Oily sleek- urine
(Full Metal KETO AF) #2

Okay let’s pick this apart piece by piece.

Pretty much everyone here on the forum past a week or two reports feeling better. I felt an huge increase in “better” on day 5. I still feel as good as I did in my mid thirty’s eating non keto as I do at 60 now on a ketogenic diet.

Absolutely false! Plenty of fitness and weight lifting threads here, people love lifting weighs in a fasted high state of ketosis. Look up Shawn Baker on YouTube and tell me that the record holder for 500m rowing competition continually breaking his own record and a hardcore Carnivore needs carbs to exercise. Ridiculous!

Absolutely, if you don’t brush your teeth. Excessive ketone wasting is an early phase of adapting to a keto diet. While we’re on the subject I wonder why he didn’t bring up Keto Crotch? Must have slipped his carb addled mind.

I’m not going to bother here, It’s been addressed on the thread I started that you linked already and I will believe Dr. Fung, Dr. Lustig, and even a down to earth practicing MD like Dr. Berry over a media doctor any day. Watch those at least one.

You can argue that with Dr. Fung, his clinics have cured 30,000 + patients. Or any number of people here who have diabetes in total remission and are non diabetic now. The temporary examples are the guys who go back to their old ways expecting things to be okay. It was the old ways that gave them diabetes, not keto fixing it per say. Just starting to live a permanent keto or very low carb lifestyle is what keeps you healthy and diabetes free.

Kidney stones are a risk on any diet, even the vegan diet. (I’m really starting to feel the vegan agenda vibe as I type) :smirk: They come from not drinking enough water and keeping your kidneys from accumulating salts. Some of the worse come from oxalate rich vegetables like spinach and chard, also from cocoa. Or from excessive build up of urea in the kidneys. I am renal patient for the last 12 years, 10 on dialysis and 2 now with a transplant. I understand and was schooled on taking care of the new healthy kidney. Almost everyone has some small kidney stones that started forming during some chronic low hydration times. They tend to dissolve on a ketogenic diet. All my nephrology team knows and highly approves of what keto has done for me in the last year. Two of them told me that they wished many of their patients would take it to heart.

I’ll admit a great amount of zeal and pitchfork waving goes on when people get keto goin’ on…Absofreakinloutly!
And rightly so. The part that says we’re anti-science, I gotta ask if you’ve ever read anything here or watched a video or read an article if this was the best you could dig up. What a waste of the last twenty minutes. :unamused:

Yeah, yeah, blah blah cholesterol baaad!:roll_eyes: Need to read Franko.

I’m not going to discuss Inuit genetic mutations. Am I living on seal blubber and eating 6000 kcal a of fat per day to survive?

Keto 101…Ketosis anc Ketoacidosis are two different things. There’s virtually no danger of ketoacidoisis unless you’re T1 of a lactating mother fasting in ketosis.

No no no! Fiber is more likely to cause a log jam. High fibre is only essential when you eat a lot of processed foods that have had the fiber removed. People don’t get constipated on keto unless they under consume salt

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Sorry Franko, wrong again, I think he meant Vegans.

You just can’t really trust most of the stuff on mass media can you? I mean who paid for the commercials and Dr. Anonymous Nephrologist’s study? You gotta dig deeper Franco.

:cowboy_hat_face:

(Michael - When reality fails to meet expectations, the problem is not reality.) #4

He also missed keto toe jam and keto navel fluff. Oh, and keto ear wax. And keto boogers.

#5

@PaulL . It is linked to a 2019 report in JAMA. I just found the link to the paper in the forum in a topic by Todd Allen @brownfat.

But this media report is recent mainstream medical reporting in Australia. It just took a month for Dr. Swan’s research team to report on it. Obviously they are not subscribed to this forum.

It does have a link to @David_Stilley thread via the calorie deficit discussion. But it covers more than that.

(Full Metal KETO AF) #6

When I hit the link it went to a thread from 2018, :neutral_face: sorry. I still think if the best takeaway was in the summary it’s opposite world thinking. Plenty of idiots still waving the low LDL flag out there even though it has been disproven and they quit ragging on about saturated fat over time so we wouldn’t notice their change in position. At least that’s how it is in America. :cowboy_hat_face:

#7

Dr. Norman Swan anecdotally mentioned the keto diet will make people feel like crap at the start.

We (here) know about the ‘keto flu’. We (here) know about Dr. Phinney advising about ketogenic dieresis and the need to supplement salt especially at the embarkation point into a ketogenic diet. Knowing about the salt helps some people avoid feeling unwell.

But the fact remains, right there at the start, a person can “feel like crap” as Dr. Swan puts it.

#8

Dr. Peter Attia still had LDL concerns and has a pretty good point of view to be considered in his podcast when he invited Dave Feldman to chat.

I think it is too early to state unequivocally that LDL cholesterol concerns in relation to potential cardiac disease have been debunked.

#9

Dig, dig, dig.

The national radio broadcaster in Australia, Radio National, is outwardly commercial free. It’s tax payer funded. That’s who Dr. Swan works for.

There is some excellent funding research done on the authors in @brownfat, Todd Allen’s thread. The second author to be precise. As the first author claimed no conflicts of interest.

#10

After digging some more. Into the authors of the paper. Author number one, who was interviewed is not bias squeaky clean. He is currently writing a book on the adverse health effects of a carnivorous diet.

https://www.forksoverknives.com/contributors/shivam-joshi-md/#gs.22rqek

@DeeCS did some awesome research into the other two authors and uncovered they are associated strongly with plant-based diet organisations in their consulting work. Not sure if they are actually vegans or vegetarians themselves.

I was thinking “something ain’t right” as I listened to the interview. And by bringing it to the forums I think we uncovered it?

Am I off track in suspecting a vegan/vegetarian biased agenda?

Has Dr. Swan been duped like I was (for 14 minutes)?

Thanks for being patient with me @David_Stilley and @amwassil. Apologies on dragging you through this process.

(Bacon is a many-splendoured thing) #11

Folks, I am not averse to leaving this as an independent thread, but if there is still sentiment for merging it, please let me know (and a link to the thread to merge to would be helpful.) If you do have an opinion, perhaps sending me a PM would be best, so as not to clutter up the thread? Cheers.

(Bob M) #12

Unless you are a lipophobe, I think LDL has been fairly well debunked. Even many risk calculators online no longer have LDL.

It’s up to each person to decide what he or she is comfortable with, however.

(Bunny) #13

Wow look at the comments by different physicians linked to that article? If a physicians interpersonal relations with patients does not become political then people die for lack of education and knowledge about real world experience with patients and not dependent on some research done on lab mice and rats that reaches inconclusive results and making public health decisions based lab animals? Say what?

11 Comments for this article:

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July 16, 2019

Diabetes and Metabolic Syndrome can be reversed on Keto:

Stephen Riggs, MD | MercyOne Waterloo, IA

I have been in the practice of internal medicine for over 30 years. In all that time I never took anyone off their insulin or rarely reduced their medications unless they had gastric bypass surgery or something as drastic. After implementing the ketogenic diet for the past year I daily am seeing patients come off insulin and reverse their diabetes, correct their hypertension, feel great, reduce inflammation and chronic pain, improve cognitive scores, correct their dyslipidemia, and improve athletic performance. As with most other physicians my nutritional education was poor and I considered it irrelevant. Today, the low carb approach is by far the biggest tool in my toolbox. So I read with disappointment the Viewpoint by Joshi et.al., replaying the old yarn about the “dangers” of the ketogenic diet and lack of evidence. Actually, though not yet mainstream the ketogenic diet has been extensively studied since its development at Mayo in 1921. Over 30 head to head trials confirm that keto is the king of weight loss diets and that nutritional ketosis (not to be confused with DKA) is a natural physiological condition that not only helps fuel the brain, heart, muscle and gut but current research is exploding with evidence that ketones are also signaling molecules that turn on many biologically beneficial pathways that reduce inflammation, lower seizure activity, promote glycogen sparing, increase athletic performance and especially lower insulin resistance and can even reduce or eliminate the need for diabetes medications. There are currently over 30 clinical trials ongoing looking at the ketogenic diet and cancer therapy for its profound metabolic effects. There have been far more studies on the ketogenic diet than either vegetarian, DASH, or the Mediterranean diet. In the words of Duke University researcher Eric Westman "If Keto were a drug it would already have FDA approval."There is no drug that can do what the low carb diet can. There are many medical interventions that we clinicians in the trenches do based solely on what we are told in the literature based on p-values and confidence intervals based on massive population studies; we take it on faith and clinical practice guidelines. Not so with keto. The evidence is so remarkable and patients get better literally right before our eyes. I have had patients that I diagnosed with diabetes over 15 years ago and gradually ramped up their medications including & 100 units of insulin and within 2-3 months most are off insulin and their other meds as well. What drug can do that? In the words of Elliot Joslin (founder of Harvard’s Joslin Diabetes Center) before the advent of insulin, the evidence for the low carbohydrate treatment of diabetes is so obvious that “no clinical trials are needed.” My experience with hundreds of real patients – patients I have diagnosed and treated for 15, 20 or even 30 years just watching them get sicker and fatter and within months seeing their health rebound and diabetes resolve is hard to ignore. I only hope the medical establishment will catch up to what is being rapidly discovered here “in the trenches.” But don’t take my word for it. For those interested in the massive amount of evidence for the ketogenic diet I would encourage the Ketogenic Nutrition Course by the ANA (American Nutrition Association) for starters. My own conclusion after doing a deep dive on this over the past year is that this will be standard of care in 10 years. In 30 years, we will look back on the decision to take fat out of our diet as the biggest public health mistake we ever made.

The old yarn is indeed on its last thread?

(Bunny) #14

And still a lower rate of CVD and CHD than all of America and possibly the world combined?

The Extrapolation Band Wagon is a funny game humans play with each other for political reasons?

Make things appear as to what they are not by making up little white lies?

That is rare unless you are genetically inclined and the cure, drink a little lemon juice…problem solved!

I can drink Apple Cider Vinegar which is much more powerful to power my mitochondria than carbohydrates especially to exercise!

Not true, it (higher acidic state) actually goes down and back to normal the longer you remain on a higher fat diet and moderate carb, moderate protein diet?

That’s due to too previously eating too much fiber and not enough bile from not eating enough fat!