Two studies how to refute?

(May-Britt Scheffer) #1

So I’ve found these ‘studies’ About high carbohydrate diets being beneficial for diabetes. It is so sad, and makes me angry, and I don’t believe one whit they say. But I am just wondering how to refute these studies, as there is no information in this short summery about what they have done and how they have measured it etc. Does anyone know?

(Carl Keller) #2

The best way to refute suspicious studies is to respond with more credible studies. How about their N=27 + N=13 vs this N=350:

(Bob M) #3

I can’t see the actual study for the first one. Or the second one. For me, that means there’s no way to see what they actually did (eg, what is “low carbohydrate”?). However, if you eat a very high carb diet, you’re mainly removing fat. This means you should get a benefit. This is why the “potato” diet works.

The problem is that once you introduce any fat, your results plummet. As evidenced by the study of high carb versus not as high carb.

(May-Britt Scheffer) #4

No that what confused me as well, there is no study just a summary. But I thought maybe I was looking at it wrong.
But the benefit would be because the fat and carbs are seperated and only one of the two is eaten. (that’s what you meant right?) A potato diet actually works? Whoa ok…
Well tnx for your respons!

(Bob M) #5

It does work. Here’s an incredibly complex analysis of why:

Peter is a brilliant super-genius in my opinion, but his posts are very technical.

So, (very) high carb will work. I ate very high carb, very low fat for years. However, I had depression, mood swings, was always hungry, etc. And you add in any fat (typically, the bad fats of seed oils, if you eat out at all), and it goes downhill rather quickly.

(Robert C) #6

You probably don’t want to refute these (waste of time).
The first one is from 1981 and the second one is from 1976.
An absolute waste of time to read past those dates once you have clicked into them.
They’ll likely never be removed as they support the authors “publish” counts and are essentially simply a historical record at this point.

(Karim Wassef) #7

Eating high fiber is essentially eating high fat because the fiber fermentation converts it into butyric acid, a short chain fatty acid.

So they were comparing high fat to high fat and got the same results… surprise!

(Bacon is a many-splendoured thing) #8

The standard criticisms of nutritional studies, even radomized controlled trials, are the low number of subjects, the small observed effect, and the level of what is considered statistically significant. The first one applies in the two studies you posted, but the other two are impossible to assess from the abstracts. Other common problems are definitional; i.e., what counts as high- or low-carb or -fat. I have seen a few studies of “low-carb” diets in which they defined “low-carb” as over 200 g/day. Finally, another problem is that in the case of a true low-carb diet the participants are often not kept on it long enough for fat-adaptation to occur.

The reasons for most of these problems lie in how expensive and difficult it is to do proper nutritional research. To get truly useful results would require locking up thousands of people in metabolic wards and tightly controlling their food intake—finding that many people who can give up that much time and tolerate that much boredom is impossible, quite apart from finding the funding!

But some things are known. Firstly, both high-carb, very low-fat and low-carb, high-fat diets are known to reverse Type II diabetes. But the key to the former seems to be an extremely low fat content to the diet, for reasons Peter explains in the blog post @ctviggen linked to above. Walther Kempner had notable success with his rice diet, for example. (It was a very difficult diet to adhere to, but it worked for many people.) On the other hand, as Peter points out, the key seems to be an undamaged liver, and once the liver is sufficiently damaged, low-carb, high-fat/keto is the way to go.

That aside, however, I suspect that if we were to look at the full texts of those two studies, we would find that, firstly, the observed effect, while statistically significant, is probably not clinically significant. The absolute size of the effect makes a difference as well as the relative size. By this, I mean that losing 0.5 kg on one diet and 1.0 kg on another is a large relative effect, but neither result is all that wonderful; alternatively if you lose 15.0 kg on one diet and 15.5 on another, there is not much to choose between them, however statistically significant the difference. These are not the best possible examples, but you get my drift. The problem with most nutritional research is that the observed differences are usually very small, and on top of that, the definition of statistical significance is generally much looser than would be tolerated in a field such as physics. Hope this helps.

(Todd Allen) #9

Here’s a link to the first paper full text:
http://sci-hub.tw/https://doi.org/10.1016/S0140-6736(81)90112-4

The low carb diet was 40% carbs supplied by white bread, crackers, boiled potatoes, bananas, fruit flavored yogurt, and orange juice.

(May-Britt Scheffer) #10

Whoa, interesting!!

(May-Britt Scheffer) #11

Yes thanks!! It really does!

(Karim Wassef) #12

Wow… that’s just trash science then.

(May-Britt Scheffer) #13

oh tnx! Interesting that they still got to lower their insulin with those kinds of foods! But apparently it is all about the low fat aspect of it! Tnx for finding the whole text!

(Todd Allen) #14

The low carb diet was 40% high glycemic carbs vs a diet 60% carbs with the carbs mostly coming from beans and dried peas. Mean insulin was about the same on both diets although the beans and peas gave a little lower blood sugar but still not what we would consider good.

(Bunny) #15

High carbohydrate diet?

What do they mean by that? (it is not a simple carbohydrate like high octane junk food)

Eating veggies (beans and legumes provide large amounts of fiber and resistant starch) is a far cry from eating free sugars?

Nothing to refute because you can’t refute it?

The only way to refute it, is when your eating processed junk food (free sugars) along with it?

#16

Don’t misidentify the studies. They don’t just say high carbohydrate. I could eat sugar all day long and be high carbohydrate. But it wouldn’t match the foods they are using as part of their high carbohydrate diet.

Just like the “low carb” label in many studies doesn’t even come close to “keto”.

#17

A comment on the Nina’s post about the keto effects on t2 diabetes:

"Great results but it is not cured. Symtoms are gone but return when diet stops . So great but cure is misleading"

Im speechless.

Under glycolysis its about same ammount of muscle as fat lost, during ketosis theres no need for such duel catabolism. Thats why people with crazy gains can go back to skinny snacks in short time after stopping gym.

(Full Metal KETO AF) #18

In simple words “High carbohydrate diets are unsustainable (because we die)”. :cowboy_hat_face:

#19

Yes. I would say “treat” rather than “cure”. When under treatment, symptoms being gone is meaningless. While taking a medication for any condition, the symptoms would be gone. But they reappear as soon as someone stops taking the medications.

My T2 diabetes is being treated well with keto, as I haven’t used insulin since 2016, metformin since last 2017, and take no other medications for my T2 diabetes. My A1c has consistently been in the lower 5 range. I couldn’t be diagnosed by looking at my fasting blood sugar or an A1c, but I would bet the OGTT (Oral Glucose Tolerance Test) would still indicate I have T2 diabetes.

A recent article claimed that A1c failed to detect 73% of the cases that the OGTT detected.

(Hyperbole- best thing in the universe!) #20

The thing that bothers me about saying “cure” is misleading and keto is only a “treatment” is that it implies that SAD is a healthy way to eat for people that don’t have diabetes.

Also, the term diabetes is used when a patient displays certain signs such as high blood sugar. If the signs and symptoms aren’t there, they are not diagnosable as having diabetes. If they return to the diet that caused the disease they will get it again. This is true of any disease you cure. Second exposure to the pathogenic agent will cause the disease again, unless your body has become immune. It may be true to say the person remains insulin resistant, but not that they have diabetes.

Just to be clear, I’m not arguing with you. I just think this whole “it’s not a cure” is disingenuous coming from the people who have stated that there is no cure for so long. I wish they could just be happy to be wrong when it means good things for their patients.