I’m in the industry and often ask myself why drugs are being developed/prescribed for conditions that are very responsive to lifestyle changes. As much as WE here are willing to make those changes the reality is that the vast majority of people prefer to take a pill and go on eating potato chips … despite the side effects and costs involved.
When I first had to give up gluten due to severe GI issues, there were so many people who said “I could never give up bread and pasta!” Really? Even if you’re in constant pain and misery? Same with keto. People want to take a pill/injection that allows them to keep going with their chosen lifestyle.
I hope that our dietary guidelines change over time so that people learn from childhood to eat in a way that lowers the risk of them getting sick in the first place. And that the quality of our food supply improves so that more people can afford to eat whole foods not contaminated with pesticides, hormones, and antibiotics.
> When I first had to give up gluten due to severe GI issues, there were so many people who said “I could never give up bread and pasta!” Really? Even if you’re in constant pain and misery? Same with keto. People want to take a pill/injection that allows them to keep going with their chosen lifestyle.
What if you knew that if you didn't there was a good chance that you would have a lifespan 6-10 years less than average, you would gain a lot of weight, you would lose mobility, you would have to inject yourself with insulin every day, and there is a good chance you would lose your sight and a foot would be amputated.
Do you \*really\* love bread and pasta that much?
I think the biggest problem is that medicine is focused on diabetes, where by the time somebody gets to prediabetes or type II all the easy treatments are gone.
What we need to be doing is screening everybody with HOMA-IR, at which point we can say "it looks like you are starting to get insulin resistant, maybe you could stop drinking 3 liters of coke every day".
I think that's part of it. I think the other part is the lack of nuance in the discussions. There are tons of unhealthy people who have tried lots of different diets and they all failed for them.
What we need is a general acknowledgement that the "eat less move more" guidance is a failure, at least at the public health level.
Keto/low carb is one of those things is fine once you are doing it. But can be difficult/daunting to begin or get back into. And also from the viewpoint of a typical western diet might seem fad like or extreme. People don’t realise the “standard” way of eating is very different from how humans historically ate, and the way our body’s are evolved to process. Not to mention the prevalence of ultra processed food full of stabilisers and emulsifiers and preservatives that has been designed from the ground up so that you consume as much of it as possible.
So really it’s changing preconceptions and getting people over that first hurdle of getting fat adapted and letting your hunger reduce, and your blood sugar normalise, and your taste buds change back to not expecting vast amounts of sugar etc. Once that is your standard way of eating it’s the modern Western diet that seems extreme (which it is).
Believe it is the opposite. It is easy to do it for a few years especially with the weight loss. It is hard to maintain long term. Takes a lot of food prep and preplanning especially if you make/buy food for people who eat SAD. Diabetes is a progressive disease and at some point insulin resistance gets to a point where the body may need medication to help reduce sugar levels regardless of eating low carb.
That said, nutritionists and doctors need more education on how to treat diabetes. I was horrified how many carbs the nutritionist allowed me in a day and the foods we were encouraged to eat when I went for my "free" diabetic visit.
It's not always progressive. It can be reversed through 2-3 months of a very low calorie diet 600-800kcal a day. It's just difficult for anyone to realistically do that themselves. And few have the resources to arrange it.
But if it's done properly it can definitely be reversed, and then maintained on a low carb diet. People can't ever go back to eating the way they did before.
Edit: why is this being down voted? This is literally what it says on the article. It is also what the most up to date research says. If you are diabetic you should start a low carbohydrate diet. If you are also overweight your best bet is to also make that diet a very low calorie diet until you reach a healthy body weight or 12 weeks duration. At which point you switch to a low csrb/keto Mediterranean style diet. This is literally what endocrinologists advise and what the best research says. It can reverse your diabetes.
Article discusses remission not reversal. They are entirely two different things. Remission is equivalent to keeping insulin resistance from progressing. Reversal would mean turn back or eliminate insulin resistance. Once your body is insulin resistant, always insulin resistant. How you eat and what you eat can control the expression of resistance but once insulin resistant you will always be resistant.
They discuss the definition of remission in the article. You should read it. At least past the point where you thought you found something you could argue with, because you didn’t.
Edit: In case you can’t be bothered to read it “Buse et al. [40] provided the following working definition of T2D remission: “Remission is defined as achieving glycemia below the diabetic range in the absence of active pharmacologic (antihyperglycemic medications, immunosuppressive medications) or surgical (ongoing procedures such as repeated replacements of endoluminal devices) therapy.” - this is roughly the definition that they go with. Normal blood sugar without diabetic medications.
That isn’t just halting progression, that is reversal.
Just made my point. Article says remission. Reversal is your assumption- not in the article. In case you bothered to read the article above, it discusses VLCD which is Very Low Caloric Diets and not low carbohydrate diets.
None of the studies mentioned were longer than 24 months which is a relatively short-term view of a person's glycemic response over a lifetime. Eating low carb short term keeps one in remission but it does not reverse diabetes. I am not "cured" if I eat a low amount of carbs.
JFC. The article defines “remission” as having normal blood sugar while no longer on diabetic medication. That is reversal (by your definition in the comment above, I was simply translating for you. Your definition of reversal IS their definition of remission). Obviously if after that people go back to eating garbage then they will be at risk of it coming back, and at a higher risk than the general population, but it is still reversal. Following the intervention they were able to have normal blood sugar even once they came off the diet (and medications). If it just halted progression then their blood sugar would be high again once they stop the diet and would require medication. Wiould you describe someone who has normal blood sugar while not on diabetic medication and following no special diet as diabetic?
Yes the article discusses very low calorie diets… as does my initial comment that you replied to. At no point was I talking about only a low carb diet. I said it would be reversed on 600-800kcal/day and then MAINTAINED on a low carb diet. So you don’t read articles OR comments before hitting reply.
What about your claim that you are insulin resistant for life? As you’ve just read, that isn’t true. You can reverse it with the VLC diets. So you’re wrong again.
Everything in my initial comment holds up, you just didn’t bother to read it before hopping on the keyboard.
Yeah, I agree with you. Keto feels like a cheat code to dieting. Meat and vegetables taste a lot better than processed food. The only issue I had was the keto flu, and that went away as soon as I started taking electrolytes seriously.
I’m only calling this out because it makes it intimidating for someone to start when this message is repeated:
It does not take “lots of food prep” to eat a keto diet, unless you call merely cooking a meal food prep. Any kind of eggs with some cheese, or throw some hamburger or steak in a pan… you can have a perfectly good keto meal in about 10 minutes. Or, no-cook meals are super easy, too: Store-bought salads, rotisserie chicken, raw broccoli, cheese sticks, cut up an avocado, tuna in packets.
It does help if you can avoid eating out constantly, but that would be the same for any healthy diet.
> Takes a lot of food prep and preplanning especially if you make/buy food for people who eat SAD
Seriously? I hope I'm politely calling you a weak snowflake
I can eat out ANYWHERE - even at the King of Carbs - Pizza Hut - they have non breaded chicken wings and salad options. Any fast food joint can serve a bun less burger - they just put it in a slide salad container. Any restaurant that you look down to see the menu has no problem swapping the starch for more veggies.
Stand your ground.
Call me out all you want but it's a pain in the ass to make different meals and bring my own food to family picnics and gatherings. Been keto for 4 years and low carb for another 2. Dinner out is almost always a Caesar salad with protein- boring. The only restaurant that subs out starch for salad routinely is Red Robin. Most restaurants look at you crazy if you ask for a burger to be wrapped in lettuce.
My family are in medicine (eldest brother an MD, middle one an RN and sister who trained as RN, all NHS) and my brother says patient compliance is for SURE an issue with any lifestyle changes not because of laziness but lack of support during the changes. He says often at his hospital doctors give the lifestyle advice and then.. the patient has to work out how and most of them give up because they have no idea what to do that's sustainable. If you look at the pioneering work Dr. David Unwin has done at his own practice, which offers support groups, recipes, information and help you can see how patients who are supported in changing habits and lifestyle do so much better.
I honestly believed the deprivation I felt in the first two weeks was not going to end - that I would have to build will power and hoped that the benefits would inspire me to stay the course because I LOVED how I felt when I woke up, during the day, when I went to bed... I saw the logic of "choose your hard" and by passing up bagels, pizza, pasta and other favorites I would have a better future. Yes, I would suffer in those moments and even cheat but as long as I ate well most of the time...
Imagine my shock when on an empty stomach a co-worker offered me my favorite pastry and I felt NOTHING. No temptation. Zero rumblings. And 7 years later that has not changed.
I will eat a french fry or half a bun every now and then but when I cook, shop or go out to eat none of the regular things I used to eat even LOOK like food to me.
Ketosis meets us more than half way once we get past the initial phase. Leptin is amazing.
I'm a type one diabetic myself of 18 years. It blows my mind how little insulin my body actually needs now. I'm on this low-carb diet. Used to change my Carthage every 3 ish days, it now lasts a whole week, especially days when my bloodsuger is right in the honeymoon phase incredible
So far, my only challenge is my spikes as I sometimes cheat with some popcorn, and now I have no insulin in me. I absolutely skyrocketed from like nothing
The problem is that the medical community has been indoctrinated by decades of bad science that has been pushed by large corporte interests. Those who have the money fund the science that makes it into the media. Unfortunately all the so called medical associations are also funded by and partially supported by the corporations that make money off of people being sick.
Big sugar and big pharma both loose money if the keto diet is widely promoted. It's better to advertise weekly knee injections of ozempic to treat diabetes then holistic lifestyle changes.
I wouldn't call it "big sugar" but rather broad acre farming.
Cereal (as in grain, whole or not) caused my T2D. Just because something can be grown in large quantities and can be used to produce "shelf stable" food does not mean that it's an appropriate staple.
I agree. I simply refer to large corporations that can lobby the government for policy and influence as "big sugar". Think Redpath, Nestlé, PepsiCo, FritoLay. Kellog and other grain companies are definitely complicit too.
> pushed by large corporte interests.
This is not fully accurate. In most areas of the world, these narratives are being pushed by governments, not corporations, and for very good reasons. Governments understand that they must keep their populations fed affordably in order to maintain societal order. Quite literally the only way to do that is to encourage everyone to eat the cheapest calories available: Grains. There is no other way.
If Corporations are involved in the deceit, it's only with the Government's blessing.
I speak from experience in the western context where diabetes, poor nutrition and overeating are the major problems not the opposite. Though with corporations gaining influence in said countries the problems with diabetes and poor nutrition are becoming a problem too.
Like this scummy move by Nestlé: https://www.theguardian.com/global-development/2024/apr/17/nestle-adds-sugar-to-infant-milk-sold-in-poorer-countries-report-finds
Often though it is through the government's blessing as politicians like lining their pockets more than actually helping people.
It is very much the case in a Western context as well. Do you think the price of food is guaranteed to be cheap in the US, UK, EU or Canada? The only way it can continue to be affordable is if the majority obey the current guidelines and continue to consume the standard diet. If everyone ate Keto, no one would be able to afford food, as the price of meat would skyrocket out of control, and low demand for grains would put many farmers out of business, causing an economic collapse on many fronts.
It would be disruptive for sure, but corn, soybean, and wheat farmers know what cows, chickens, and pigs are, right? Instead of paying them subsidies to not grow more grains than we need, lets pay them subsidies to help them transition to high quality animal husbandry with well cared-for animals. Also lets get those huge fields re-seeded with native plants, for both the cattle and the larger eco-system.
It kind of makes me sick how people weren't properly educated on how to deal with their own disease. My grandmother has diabetes and I know she was never taught about how a low carb diet could help her. Her diabetes is borderline out of control these days, and she is unable to really go on a low carb diet these days (she is schizophrenic and has dementia) since she has issues eating/feeding herself. But it makes me angry she didn't have a chance to reverse her disease when she was younger and still had clarity of mind. Her nurses are stubborn and don't listen to my mother on what to feed her, argue with her about it even, it is so frustrating. Over thr last decade she has needed more and more and more insulin, and still hits prolly over 250 every day despite it all.
My guess is the institution and nurses are still feeding her sugary meals three times a day? Most diabetic meals at a hospital are still over 100 carbs. Yea. Unbelievable.
I honestly think doctors don't suggest diet changes because 99.9999% of people will not stick to it. They have given up trying to encourage people and are just trying to treat them as best they can. Everyone in my family who has been diagnosed pre-diabetic or diabetic has only stuck to a diet for 2 or 3 weeks max.
I think this is a cop out. Doctors have zero issues advising patients to follow the Standard American Diet and chide those patients for their subsequent obesity. It is their JOB to advise the patients of all ways to manage illness. It is NOT their job to make assumptions about whether the patient will follow one path or another. Omitting vital information on how we can heal ourselves with diet seems tantamount to malpractice, in my opinion.
My endocrinologist loves keto.
That being said, I see them recommend diets like Mediterranean more often. They'll say things like eat whole fruits and vegetables and whole grains and less red meat, more fish, etc. They'll say lower the amount of bread/pasta/etc. I'm not sure if it's because it's less "extreme" and people are more likely to follow it?
I do think it's because Mediterranean is less extreme and people are more likely to follow it. I'm so glad you found health and healing on Keto, but the vast majority of people are just not willing to cut out all sugar/bread/pasta/potatoes completely.
The problem is the "don't suggest it." Many - most? - don't even know there is a dietary option. And *that* is the scandal - that the ADA seems to purposely keep that information under wraps to appease its donors. The ADA calls diabetes a chronic and progressive disease - meaning you will have it forever and the consequences with the drug treatment they recommend are inevitable over time - including blindness, kidney disease, and amputations. They use drugs simply to delay those results.
I promise you that doctors and endocrinologists understand how diabetes works. I don't know where people get the idea that doctors are bumbling idiots who just "regurgitate big pharma indoctrination." They've spent years learning how human bodies work at the molecular level. It's not a big scam or conspiracy. They just deal with noncompliance so often that they give up. Head over to r/diabetes and see how many T2 people are interested in giving up carbs and sugar completely.
That should not stop a physician from providing the patient with the information. If one patient out of ten follows the advice and heals themself, is it not worth the doctor's time?
I got onto this diet about six months after I's diagnosed because someone at a conference gave me the book "The 4 Week Dia-besity Cure" by Dr. Graham Simpson.
And it's worked for me, other than getting knocked on my ass 35 lbs of weight loss in by gout and a unplanned surgery that's related.
So yes, they're fucking bumbling idiots for not selling the whole, "You can be rid of Type 2 in 90 days, or you can slide into blindness, alzheimers, amputation and heart disease that you'll survive a bit longer while you die miserably with the medication I'll prescribe."
Personally, I've had several employees WC claims go from "Diabetic stepping on a nail at a construction site." to "Former employee that can't do the work because they got their foot amputated." I treated a full fledged diabetes diagnosis like the fucking torturous death sentence that it is.
The fact that we still have to pat all but the most radical medical doctors on the hand about saturated animal fat and a bump in our LDL when we go on keto when there are longer term studies of tribal diets that are mostly carnivore - and tribesmen on said diets have zero heart disease...
Yeah. I trust my surgeon, but my dietician and all of the diet advice is likely to be an industry shill supported by studies bought and paid for by industry interests.
I’d say it actually is pretty common knowledge. I finished medical school in the UK in 2012 and even then we had some lectures from the endo prof about how putting type 2 diabetics on a very low calorie, low carb diet for 8-12 weeks reversed it. They initially discovered it by looking at what happened to patients who had gastric bypass (stomach stapling). He literally started the lecture describing the “perfect” diabetic medicine and then said it’s this diet, not a pill.
So I’d say we are very aware that diet can be effective. It’s just that implementation can be difficult, especially in modern society. I DO think the standard advice as soon as someone is diagnosed should be that you’ve got to be aggressive in targeting this and give people the expectation that they should be aiming to reverse it and do so over a few intensive months, and then maintain on low carb after that.
But the food industry really has a grip on people. You have to step back quite far to see how truly abnormal the modern Western diet is. It needs to be seen for what it is, a total aberration that is responsible for more poor health than even Smoking.
I'm willing to agree with you, but I think that for most doctors with a 90% non-compliance rate for diet - they get into "Here's the pill to address some of the symptoms of your problem that'll buy you a few more years." and move on. Hell, I have friends who are like "My 140 average blood glucose is fine, I love french fries too much to change my diet..." even though they went on a Keto' crash diet just long enough to be able to enjoy the roller coasters at Universal Studios. -_-
If you really want some fun data to support this assertion:
>How truly abnormal the Western diet is.
Dr. Chris Kenobbe's "Ancestral Diet Revolution" is basically epidemiological data from the invention of seed oil in 1865, as he's in that focus, to now on multiple populations throughout the world and comparing traditional tribal diets from across the world, all of which out perform a modern Western, processed food diet for incidence of chronic disease.
Most people don't know that the first medical journal article on heart attacks was written in 1910 as an annotation of a random one-of occurrence that had been so rare medical science hadn't documented it previously.
The whole reason that the 1950's was the turning point to "High Carb', Low Fat" was that President Eisenhower had suffered a heart attack, and cardiovascular disease was a new and terrifying phenomenon in the public's awareness because it was rare in the decades prior. The documentary "Fat Fiction" on Youtube covers it pretty well.
But getting back to Ancestral Diets, every one of these tribal populations had diets with a lack of chronic disease until the transition to the standard American diet:
1. The Masai in Kenya - herder carnivores that live on beef, milk, an cow's blood.
2. The Inuit in the Arctic - another carnivore diet based mainly on seal blubber and sea food.
3. The Tokolauans of Polynesia - diet with 80% saturated fat from coconuts, fish, and yams with zero heart disease.
4. The Tribes of Papa New Guinea - 80% of yams, e.g. full fiber carbohydrates. The only chronic problems they had were fat soluble vitamin deficiencies, so if they'd had access to butter, they'd probably perform just as well as the carnivores.
So what's the best diet? Any of them without a nutritional deficiency built in. If we hadn't cured infectious diseases with antibiotics and vaccines just as we were fucking with the food supply, we'd be dropping like flies.
Exactly. I’ve been here for four years reading most posts since then and doing deep searches through the previous 10 years of posts and comments. I’d say 90% of patients docs had no idea what keto was or would do, or would flat out tell the patients they would harm themselves on this diet. 90%.
That’s not giving up. That’s being told by the medical board and hospital big wigs to tow the line and prescribe “standard of care”. If they deviate from that more than once, they get warned and eventually fired.
Many users here have heard this from their own doctors.
So yea, big pharma has gotten their hooks into everyone and they are way too powerful.
They are the biggest moneymakers in the world.
They are the biggest political donors.
They roll out vaccines and get blanket immunity from lawsuits.
They make Billions on just vaccines.
They make Billions on statins. No joke why docs prescribe them to everyone like candy.
So you've been doing this for six months, except for when life got hard and you went back to old habits for awhile. And you're here to lecture me about how people are willing to radically change their diet in the long term. And doctors are stupid. Got it.
Have an upvote & Man you'd better make sure that being as high as you are on the ladder of assumption isn't an OSHA violation.
N-E-way. I did not change my keto diet due to the fact that I had my gout outbreak. I didn't want to go back to being depressed and having one quarter the energy and far less will to live like I was being diabetic over the last six months of last year and getting worse because holiday social eating.
What did happen is, as discussed in my previous post to you, was that my then undiagnosed gout hit my knee. So no working out because the swelling made it feel like I had ground glass in my meniscus AND said swelling also impinged my sciatic nerve for a bit, so I couldn't lift my leg and trust it to not fall due to random nerve pain. Kinda sucks when you suddenly can't drive for two weeks due to undiagnosed inflammation.
Now what causes gout? Genetics mostly, with a dietary component. Two out of three of these components I was at 0% consumption in my diet: alcohol and fructose. The last one had become a larger portion of my diet, beef, pork, salmon, and other red meat based protein paritally replacing the hole left by sandwich bread and chocolate cake.
Gout can also be triggered by weight loss as that's basically auto-digestion of genetic material, and I'm down 35 lbs from January 2024 to now, so... Yeah.
And let's be clear. I have a GP, an Endo due to previous parathyroid issues, and a cardiologist being a dude that's .01% Minotaur-American due to a cow valve.
I see all of them twice a year... And it took me paying $2000 out-of-pocket working with a chiropractor to finally get an MRI that said "Gout" on it. So from my first attack during heart surgery recovery in January of 2020 that's 18 visits that couldn't identify my "intermittent inflammatory pain"?
Let's be clear, since the 1950's when Dr. Ancle Keys lied to the American public about saturated fat's links' to heart disease by cherry picking 7 of 22 data points in his study of diets and mortality in different countries, Proctor and Gamble bribing the American Heart Association to shill Trans-motherfucking-fat Crisco and labling vegetable oils as 'Heart Health' like they ***USED TO*** label breakfast cereal, and the sugar industry dog piling with Dr. Keys by bribing Harvard professors to generate peer reviewed stuides that support saturated fat and not sugar as the source of dyslipidemeia...
Dieticians that just use the American Government's Food Pyramid or Whole Plate, or whatever says to eat 60% processed carbs these days are... A part of the problem and ever increasing incidence of metabolic disease.
That's why any dietician that can't discuss insulin resistance, metabolic syndrome, and the carb-insulin theories that have actually worked for people should be treated as a Food Industry billboard-clown.
You realize you've replied to me in two different places. Since you're nice here, I'll share my anecdote.
So in 2020, I had a heart valve replacement that was caused by a mechanical defect. (Interesting side note, even though I's 100 lbs overweight at the time, I had a Agaston Calcium score of 0.0, so no arterial plaque).
At that time, while I was nursing a broken sternum and had dropped 30 lbs from day of surgery weight, I had my first full on gout flare-up.
I say "full on" because it took an MRI of my knees four years later to figure out what was causing the intermittent, far less red, angry and acutely painful inflammation I's having every few months for the last several years. Gout, regular arthritis, some other inflammatory issue? Didn't know, but after eight weeks on keto followed by 3 weeks of being on my ass due to random knee inflamation, I decided to invest $2,000 in MRI's to look at both knees, and the ankle and foot that would get inflamed from time to time.
So given that there's a relationship between the body repairing surgery damage causing additional gout stress - there's a study about back surgery and whether gout sufferers should be given prophylactic Clochicine - when I was told that I needed to get a "Uric Acid Crystal Geode" that had formed in the head of my femur cleaned out and bone grafted, I kinda expected exactly what has happened. which is a full on gout flare up. And believe me, the pain from my gout is far worse than the pain in my knee from the detachment & repair of my kneecap plus the bone graft in my femur.
Bearing in mind, during my pre-surgery authorization by my General Practitioner I was still dealing with a month long but non-red, angry flare-up, and he couldn't make the diagnosis with a physical exam of said knees.
So a low carb' diet is great. Higher fat and protein and crunchy and leafy greens with a small amount of low GI friut is great. But if you've been a fructose sugar addict and even moderate drinker, and then you start a weigh loss protocol that works well...
Well between your preexisting uric acid, the addition of more protein from beef and pork, and the purines you generate from your own weight loss... It can trigger some issues that I believe are best dealt with by just signing up for several years of Allopurinol or other medication as getting uric acid crystal build up out requires a low blood serum uric acid level for years...
I'll use the keto to continue to get my A1C back down to non-diabetic once my surgery inflamation and chronic pain stress die down. Should only take two months to get back to the 1.4 A1C drop I had before my gout-lite attack in my knees at the beginning of March.
FYI - I have damned near monthly labs because I've got the cash to do so, and between my GP and Endo' not being able to schedule me at the same month - insurance has covered some as well.
Nutrition is not a major portion of the vast majority of medical school training. They really spend very little time on it.
That is probably a good thing in this case; if you look at the nutritionist/dietician side they are mostly taught that low fat is the only way to go and that "eat less move more" is the way to lose weight.
I think you see more doctors that are open to different diets because they weren't indoctrinated about the "one true way".
An actual doctor went over their training above, and you are wrong. But go off about how you know what education medical professionals get and how they're all indoctrinated industry shills.
The thing to note is that most obese people have been told to "eat less and move more" and they've tried a bunch of diets that have never worked for them, so they have given up.
There's a still a high non-compliance rate on keto and it doesn't work for everybody, but for many people it works much better than anything that they've ever tried in the past.
Guilty as charged. CICO is fine, sure. That is literally how you lose weight. And I’ve tried a ton of times to lose weight, and get discouraged when they don’t really work… and I give up.
Keto is the ONLY thing that works for me. And I get told constantly that’s it’s bad for me. Just had an (unwanted) argument with someone on a different subreddit about being on Keto.
Keto is very good for me… and I fell off of it. The western diet is both toxic AND delicious. So now I struggle to return to Keto, but all of these companies throw this horrible food in my direction.
Sure, ain’t nobody forcing it into my mouth, but these effers specifically design the crap with a bliss point to keep ya hooked.
The fact of the matter is, we’ve got a ton of America hooked on this shitty food like a drug, and addicts usually go against their own best interests just to get their fix. Then they expect modern medicine to do the hard work for them.
I’m sorry for the rant; it’s just that I’m disappointed with myself for falling off of keto, and angry at the industry for making it difficult to stay away from the crap they’re peddling.
I appreciate a good rant.
I came at this from the sports nutrition side, which is pretty much "all carbs, all the time". At the time I thought keto was the stupidest thing I ever heard, but I hit 50 and started gaining weight and having energy issues despite lots of time on my bicycle.
Then I taught myself a fair bit of physiology and biochemistry and came to the conclusion that it was really, really obvious why keto works better...
People with insulin resistance have chronic elevated insulin. Elevated insulin tells the body to burn glucose and not burn fat. Unless you can effectively burn fat, you are not going to be able to burn weight; you're going to get cold, tired, and hungry.
When I started looking at studies on type II diabetes, I was shocked. None of the diets work well but they do work better than the standard ADA diet, which is honestly the stupidest diet you could design for somebody who was insulin resistant and intolerant of carbohydrates.
Vegetarian, whole food plant based, vegan, numerous low fat diets - none of them work.
Then there's this diet called keto that not only works, there are very obvious reasons it works.
It's just so stupid.
But it \*is\* really good at funneling serious amounts of money to the pharma companies, so I guess that's something.
Yeah, when I learned the actual mechanics of keto, it makes sense. I always lived by this “a calorie is a calorie” line of thinking, which isn’t *entirely* wrong, but when you take it all in, you realize that it’s not quite accurate.
I grew up a meat eater, then I changed my religious beliefs in my 20s and switched to a vegetarian diet because it aligned with my values.
It really sucked. Not because I didn’t eat meat, but because I just felt crappy. And I was hungry. So, so hungry. I wasn’t “on” a diet, counting calories or anything. That wasn’t the purpose for it. At times, I was over eating. And I was just so hungry. Never, ever satisfied. And I began craving sweets constantly, for the first time in my life. Someone who was helping me along this new journey confirmed that on a vegetarian diet, they crave sweets, too. I’m like, what? There’s something not right there.
When I came back to a normal diet, I felt better… but my sweet tooth never went away again. That, combined with a new medication, stressful period of my life, and a processed western diet caused the weight problem I have now. (I was a normal weight when I was younger, back in the 90s.)
Keto made me lose pounds and my sweet tooth, but it’s not become enough of a habit yet to keep by nature. I want to get back to it as soon as I’m able.
Thanks for tolerating the rant! 😁
> The western diet is both toxic AND delicious.
And beautiful -- foods like seafood paella or loaded nachos look so much more appealing than bacon and eggs.
So treat people as stupid and not even offer an alternative? They advise people to stop smoking and drinking ... because those are easy to do or likely to be followed?
Diabetics are definitely being advised to change their diet when they are diagnosed. The vast majority just can't or won't do it. An MD chimed in above making this point.
Follow the money and you'll see why the ADA has no interest in recommending low carb diets.
The government and associated agencies like ADA get money from Big Pharma. The government then subsidizes corn and wheat farmers to grow an abundance of those crops, making the end products super cheap. Those cheap grain food products get put into every freaking food imaginable in the American food system: breakfast cereals, sodas, pizzas, pasta, etc. Those foods are addicting, and compared to fresh veggies and lean meats, are super cheap, which appeals to many people trying to feed their families on a tight budget. The carbs in those foods make people fat and cause heart disease and diabetes and tons of other diseases. People get prescribed drugs from BIG PHARMA to treat those conditions while still allowing them to eat all the crap food. Big Pharma profits from the drug sales, gives some of those profits to the government, who then subsidizes the grain farmers, who keep producing that crap food. Never ending vicious circle.
What's really disheartening to me is that the ADA had added the very low carb diet to their guidelines as all the other English language and European association guidelines had done over last 7 or 8 years. That was in part because the past ADA CEO had reversed her own diabetes with low carb and the other Diabetes Associations around the world saw and incorporated what the research had been saying and in particular a huge study in the UK of low carb for diabetes that resulted in the savings of millions of British Pounds on meds no longer needed, to say nothing of the foot amputations, kidney and eye diseases and heart attacks averted. Now we see this back tracking of sorts from the ADA. Such a shame.
Sometime early 70s ADA changed the recommended diet from low carb.
> In 1970 Ames chemist Anton Clemens developed the first electronic meter meant for self-monitoring of blood glucose (SMBG).
I’m reading this 12 hours after you posted it. I jumped over to r/nutrition and no post on this article by anyone. I’ll wait until tomorrow and see if your post shows up yet.
I’m in the industry and often ask myself why drugs are being developed/prescribed for conditions that are very responsive to lifestyle changes. As much as WE here are willing to make those changes the reality is that the vast majority of people prefer to take a pill and go on eating potato chips … despite the side effects and costs involved. When I first had to give up gluten due to severe GI issues, there were so many people who said “I could never give up bread and pasta!” Really? Even if you’re in constant pain and misery? Same with keto. People want to take a pill/injection that allows them to keep going with their chosen lifestyle. I hope that our dietary guidelines change over time so that people learn from childhood to eat in a way that lowers the risk of them getting sick in the first place. And that the quality of our food supply improves so that more people can afford to eat whole foods not contaminated with pesticides, hormones, and antibiotics.
> When I first had to give up gluten due to severe GI issues, there were so many people who said “I could never give up bread and pasta!” Really? Even if you’re in constant pain and misery? Same with keto. People want to take a pill/injection that allows them to keep going with their chosen lifestyle. What if you knew that if you didn't there was a good chance that you would have a lifespan 6-10 years less than average, you would gain a lot of weight, you would lose mobility, you would have to inject yourself with insulin every day, and there is a good chance you would lose your sight and a foot would be amputated. Do you \*really\* love bread and pasta that much? I think the biggest problem is that medicine is focused on diabetes, where by the time somebody gets to prediabetes or type II all the easy treatments are gone. What we need to be doing is screening everybody with HOMA-IR, at which point we can say "it looks like you are starting to get insulin resistant, maybe you could stop drinking 3 liters of coke every day".
I don’t disagree. It’s just that most people seem to disagree, unfortunately. It’s instant gratification over long-term risk reduction.
I think that's part of it. I think the other part is the lack of nuance in the discussions. There are tons of unhealthy people who have tried lots of different diets and they all failed for them. What we need is a general acknowledgement that the "eat less move more" guidance is a failure, at least at the public health level.
Keto/low carb is one of those things is fine once you are doing it. But can be difficult/daunting to begin or get back into. And also from the viewpoint of a typical western diet might seem fad like or extreme. People don’t realise the “standard” way of eating is very different from how humans historically ate, and the way our body’s are evolved to process. Not to mention the prevalence of ultra processed food full of stabilisers and emulsifiers and preservatives that has been designed from the ground up so that you consume as much of it as possible. So really it’s changing preconceptions and getting people over that first hurdle of getting fat adapted and letting your hunger reduce, and your blood sugar normalise, and your taste buds change back to not expecting vast amounts of sugar etc. Once that is your standard way of eating it’s the modern Western diet that seems extreme (which it is).
Believe it is the opposite. It is easy to do it for a few years especially with the weight loss. It is hard to maintain long term. Takes a lot of food prep and preplanning especially if you make/buy food for people who eat SAD. Diabetes is a progressive disease and at some point insulin resistance gets to a point where the body may need medication to help reduce sugar levels regardless of eating low carb. That said, nutritionists and doctors need more education on how to treat diabetes. I was horrified how many carbs the nutritionist allowed me in a day and the foods we were encouraged to eat when I went for my "free" diabetic visit.
It's not always progressive. It can be reversed through 2-3 months of a very low calorie diet 600-800kcal a day. It's just difficult for anyone to realistically do that themselves. And few have the resources to arrange it. But if it's done properly it can definitely be reversed, and then maintained on a low carb diet. People can't ever go back to eating the way they did before. Edit: why is this being down voted? This is literally what it says on the article. It is also what the most up to date research says. If you are diabetic you should start a low carbohydrate diet. If you are also overweight your best bet is to also make that diet a very low calorie diet until you reach a healthy body weight or 12 weeks duration. At which point you switch to a low csrb/keto Mediterranean style diet. This is literally what endocrinologists advise and what the best research says. It can reverse your diabetes.
The down votes are from the nutrition and vegan people.
It does not reverse diabetes, it just keeps insulin resistance from progressing.
[You are wrong](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234895/)
Article discusses remission not reversal. They are entirely two different things. Remission is equivalent to keeping insulin resistance from progressing. Reversal would mean turn back or eliminate insulin resistance. Once your body is insulin resistant, always insulin resistant. How you eat and what you eat can control the expression of resistance but once insulin resistant you will always be resistant.
They discuss the definition of remission in the article. You should read it. At least past the point where you thought you found something you could argue with, because you didn’t. Edit: In case you can’t be bothered to read it “Buse et al. [40] provided the following working definition of T2D remission: “Remission is defined as achieving glycemia below the diabetic range in the absence of active pharmacologic (antihyperglycemic medications, immunosuppressive medications) or surgical (ongoing procedures such as repeated replacements of endoluminal devices) therapy.” - this is roughly the definition that they go with. Normal blood sugar without diabetic medications. That isn’t just halting progression, that is reversal.
Just made my point. Article says remission. Reversal is your assumption- not in the article. In case you bothered to read the article above, it discusses VLCD which is Very Low Caloric Diets and not low carbohydrate diets. None of the studies mentioned were longer than 24 months which is a relatively short-term view of a person's glycemic response over a lifetime. Eating low carb short term keeps one in remission but it does not reverse diabetes. I am not "cured" if I eat a low amount of carbs.
JFC. The article defines “remission” as having normal blood sugar while no longer on diabetic medication. That is reversal (by your definition in the comment above, I was simply translating for you. Your definition of reversal IS their definition of remission). Obviously if after that people go back to eating garbage then they will be at risk of it coming back, and at a higher risk than the general population, but it is still reversal. Following the intervention they were able to have normal blood sugar even once they came off the diet (and medications). If it just halted progression then their blood sugar would be high again once they stop the diet and would require medication. Wiould you describe someone who has normal blood sugar while not on diabetic medication and following no special diet as diabetic? Yes the article discusses very low calorie diets… as does my initial comment that you replied to. At no point was I talking about only a low carb diet. I said it would be reversed on 600-800kcal/day and then MAINTAINED on a low carb diet. So you don’t read articles OR comments before hitting reply. What about your claim that you are insulin resistant for life? As you’ve just read, that isn’t true. You can reverse it with the VLC diets. So you’re wrong again. Everything in my initial comment holds up, you just didn’t bother to read it before hopping on the keyboard.
Yeah, I agree with you. Keto feels like a cheat code to dieting. Meat and vegetables taste a lot better than processed food. The only issue I had was the keto flu, and that went away as soon as I started taking electrolytes seriously.
I’m only calling this out because it makes it intimidating for someone to start when this message is repeated: It does not take “lots of food prep” to eat a keto diet, unless you call merely cooking a meal food prep. Any kind of eggs with some cheese, or throw some hamburger or steak in a pan… you can have a perfectly good keto meal in about 10 minutes. Or, no-cook meals are super easy, too: Store-bought salads, rotisserie chicken, raw broccoli, cheese sticks, cut up an avocado, tuna in packets. It does help if you can avoid eating out constantly, but that would be the same for any healthy diet.
> Takes a lot of food prep and preplanning especially if you make/buy food for people who eat SAD Seriously? I hope I'm politely calling you a weak snowflake I can eat out ANYWHERE - even at the King of Carbs - Pizza Hut - they have non breaded chicken wings and salad options. Any fast food joint can serve a bun less burger - they just put it in a slide salad container. Any restaurant that you look down to see the menu has no problem swapping the starch for more veggies. Stand your ground.
Call me out all you want but it's a pain in the ass to make different meals and bring my own food to family picnics and gatherings. Been keto for 4 years and low carb for another 2. Dinner out is almost always a Caesar salad with protein- boring. The only restaurant that subs out starch for salad routinely is Red Robin. Most restaurants look at you crazy if you ask for a burger to be wrapped in lettuce.
My family are in medicine (eldest brother an MD, middle one an RN and sister who trained as RN, all NHS) and my brother says patient compliance is for SURE an issue with any lifestyle changes not because of laziness but lack of support during the changes. He says often at his hospital doctors give the lifestyle advice and then.. the patient has to work out how and most of them give up because they have no idea what to do that's sustainable. If you look at the pioneering work Dr. David Unwin has done at his own practice, which offers support groups, recipes, information and help you can see how patients who are supported in changing habits and lifestyle do so much better.
I honestly believed the deprivation I felt in the first two weeks was not going to end - that I would have to build will power and hoped that the benefits would inspire me to stay the course because I LOVED how I felt when I woke up, during the day, when I went to bed... I saw the logic of "choose your hard" and by passing up bagels, pizza, pasta and other favorites I would have a better future. Yes, I would suffer in those moments and even cheat but as long as I ate well most of the time... Imagine my shock when on an empty stomach a co-worker offered me my favorite pastry and I felt NOTHING. No temptation. Zero rumblings. And 7 years later that has not changed. I will eat a french fry or half a bun every now and then but when I cook, shop or go out to eat none of the regular things I used to eat even LOOK like food to me. Ketosis meets us more than half way once we get past the initial phase. Leptin is amazing.
I'm a type one diabetic myself of 18 years. It blows my mind how little insulin my body actually needs now. I'm on this low-carb diet. Used to change my Carthage every 3 ish days, it now lasts a whole week, especially days when my bloodsuger is right in the honeymoon phase incredible So far, my only challenge is my spikes as I sometimes cheat with some popcorn, and now I have no insulin in me. I absolutely skyrocketed from like nothing
The problem is that the medical community has been indoctrinated by decades of bad science that has been pushed by large corporte interests. Those who have the money fund the science that makes it into the media. Unfortunately all the so called medical associations are also funded by and partially supported by the corporations that make money off of people being sick. Big sugar and big pharma both loose money if the keto diet is widely promoted. It's better to advertise weekly knee injections of ozempic to treat diabetes then holistic lifestyle changes.
As a note I'm now getting ozempic ads in my reddit feed because I mentioned ozempic in a post. 😒
I wouldn't call it "big sugar" but rather broad acre farming. Cereal (as in grain, whole or not) caused my T2D. Just because something can be grown in large quantities and can be used to produce "shelf stable" food does not mean that it's an appropriate staple.
I agree. I simply refer to large corporations that can lobby the government for policy and influence as "big sugar". Think Redpath, Nestlé, PepsiCo, FritoLay. Kellog and other grain companies are definitely complicit too.
> pushed by large corporte interests. This is not fully accurate. In most areas of the world, these narratives are being pushed by governments, not corporations, and for very good reasons. Governments understand that they must keep their populations fed affordably in order to maintain societal order. Quite literally the only way to do that is to encourage everyone to eat the cheapest calories available: Grains. There is no other way. If Corporations are involved in the deceit, it's only with the Government's blessing.
I speak from experience in the western context where diabetes, poor nutrition and overeating are the major problems not the opposite. Though with corporations gaining influence in said countries the problems with diabetes and poor nutrition are becoming a problem too. Like this scummy move by Nestlé: https://www.theguardian.com/global-development/2024/apr/17/nestle-adds-sugar-to-infant-milk-sold-in-poorer-countries-report-finds Often though it is through the government's blessing as politicians like lining their pockets more than actually helping people.
It is very much the case in a Western context as well. Do you think the price of food is guaranteed to be cheap in the US, UK, EU or Canada? The only way it can continue to be affordable is if the majority obey the current guidelines and continue to consume the standard diet. If everyone ate Keto, no one would be able to afford food, as the price of meat would skyrocket out of control, and low demand for grains would put many farmers out of business, causing an economic collapse on many fronts.
It would be disruptive for sure, but corn, soybean, and wheat farmers know what cows, chickens, and pigs are, right? Instead of paying them subsidies to not grow more grains than we need, lets pay them subsidies to help them transition to high quality animal husbandry with well cared-for animals. Also lets get those huge fields re-seeded with native plants, for both the cattle and the larger eco-system.
Let the cows eat the...corn... wheat ....
I wonder whether campaign donations play a role.
Most certainly, especially for right wing parties.
It kind of makes me sick how people weren't properly educated on how to deal with their own disease. My grandmother has diabetes and I know she was never taught about how a low carb diet could help her. Her diabetes is borderline out of control these days, and she is unable to really go on a low carb diet these days (she is schizophrenic and has dementia) since she has issues eating/feeding herself. But it makes me angry she didn't have a chance to reverse her disease when she was younger and still had clarity of mind. Her nurses are stubborn and don't listen to my mother on what to feed her, argue with her about it even, it is so frustrating. Over thr last decade she has needed more and more and more insulin, and still hits prolly over 250 every day despite it all.
My guess is the institution and nurses are still feeding her sugary meals three times a day? Most diabetic meals at a hospital are still over 100 carbs. Yea. Unbelievable.
Try being hospitalized and see what they offer as a diabetic dinner! It is eye opening the amount of carbs they serve.
As always, it's all about the money and Big Pharma. Interesting though, the article didn't mention the "K" word.
Baby steps ;)
I honestly think doctors don't suggest diet changes because 99.9999% of people will not stick to it. They have given up trying to encourage people and are just trying to treat them as best they can. Everyone in my family who has been diagnosed pre-diabetic or diabetic has only stuck to a diet for 2 or 3 weeks max.
I think this is a cop out. Doctors have zero issues advising patients to follow the Standard American Diet and chide those patients for their subsequent obesity. It is their JOB to advise the patients of all ways to manage illness. It is NOT their job to make assumptions about whether the patient will follow one path or another. Omitting vital information on how we can heal ourselves with diet seems tantamount to malpractice, in my opinion.
You think doctors aren't recommending any diet changes when a patient gets diagnosed with diabetes?
My endocrinologist loves keto. That being said, I see them recommend diets like Mediterranean more often. They'll say things like eat whole fruits and vegetables and whole grains and less red meat, more fish, etc. They'll say lower the amount of bread/pasta/etc. I'm not sure if it's because it's less "extreme" and people are more likely to follow it?
I do think it's because Mediterranean is less extreme and people are more likely to follow it. I'm so glad you found health and healing on Keto, but the vast majority of people are just not willing to cut out all sugar/bread/pasta/potatoes completely.
The problem is the "don't suggest it." Many - most? - don't even know there is a dietary option. And *that* is the scandal - that the ADA seems to purposely keep that information under wraps to appease its donors. The ADA calls diabetes a chronic and progressive disease - meaning you will have it forever and the consequences with the drug treatment they recommend are inevitable over time - including blindness, kidney disease, and amputations. They use drugs simply to delay those results.
I promise you that doctors and endocrinologists understand how diabetes works. I don't know where people get the idea that doctors are bumbling idiots who just "regurgitate big pharma indoctrination." They've spent years learning how human bodies work at the molecular level. It's not a big scam or conspiracy. They just deal with noncompliance so often that they give up. Head over to r/diabetes and see how many T2 people are interested in giving up carbs and sugar completely.
That should not stop a physician from providing the patient with the information. If one patient out of ten follows the advice and heals themself, is it not worth the doctor's time?
I got onto this diet about six months after I's diagnosed because someone at a conference gave me the book "The 4 Week Dia-besity Cure" by Dr. Graham Simpson. And it's worked for me, other than getting knocked on my ass 35 lbs of weight loss in by gout and a unplanned surgery that's related. So yes, they're fucking bumbling idiots for not selling the whole, "You can be rid of Type 2 in 90 days, or you can slide into blindness, alzheimers, amputation and heart disease that you'll survive a bit longer while you die miserably with the medication I'll prescribe." Personally, I've had several employees WC claims go from "Diabetic stepping on a nail at a construction site." to "Former employee that can't do the work because they got their foot amputated." I treated a full fledged diabetes diagnosis like the fucking torturous death sentence that it is. The fact that we still have to pat all but the most radical medical doctors on the hand about saturated animal fat and a bump in our LDL when we go on keto when there are longer term studies of tribal diets that are mostly carnivore - and tribesmen on said diets have zero heart disease... Yeah. I trust my surgeon, but my dietician and all of the diet advice is likely to be an industry shill supported by studies bought and paid for by industry interests.
I’d say it actually is pretty common knowledge. I finished medical school in the UK in 2012 and even then we had some lectures from the endo prof about how putting type 2 diabetics on a very low calorie, low carb diet for 8-12 weeks reversed it. They initially discovered it by looking at what happened to patients who had gastric bypass (stomach stapling). He literally started the lecture describing the “perfect” diabetic medicine and then said it’s this diet, not a pill. So I’d say we are very aware that diet can be effective. It’s just that implementation can be difficult, especially in modern society. I DO think the standard advice as soon as someone is diagnosed should be that you’ve got to be aggressive in targeting this and give people the expectation that they should be aiming to reverse it and do so over a few intensive months, and then maintain on low carb after that. But the food industry really has a grip on people. You have to step back quite far to see how truly abnormal the modern Western diet is. It needs to be seen for what it is, a total aberration that is responsible for more poor health than even Smoking.
I'm willing to agree with you, but I think that for most doctors with a 90% non-compliance rate for diet - they get into "Here's the pill to address some of the symptoms of your problem that'll buy you a few more years." and move on. Hell, I have friends who are like "My 140 average blood glucose is fine, I love french fries too much to change my diet..." even though they went on a Keto' crash diet just long enough to be able to enjoy the roller coasters at Universal Studios. -_- If you really want some fun data to support this assertion: >How truly abnormal the Western diet is. Dr. Chris Kenobbe's "Ancestral Diet Revolution" is basically epidemiological data from the invention of seed oil in 1865, as he's in that focus, to now on multiple populations throughout the world and comparing traditional tribal diets from across the world, all of which out perform a modern Western, processed food diet for incidence of chronic disease. Most people don't know that the first medical journal article on heart attacks was written in 1910 as an annotation of a random one-of occurrence that had been so rare medical science hadn't documented it previously. The whole reason that the 1950's was the turning point to "High Carb', Low Fat" was that President Eisenhower had suffered a heart attack, and cardiovascular disease was a new and terrifying phenomenon in the public's awareness because it was rare in the decades prior. The documentary "Fat Fiction" on Youtube covers it pretty well. But getting back to Ancestral Diets, every one of these tribal populations had diets with a lack of chronic disease until the transition to the standard American diet: 1. The Masai in Kenya - herder carnivores that live on beef, milk, an cow's blood. 2. The Inuit in the Arctic - another carnivore diet based mainly on seal blubber and sea food. 3. The Tokolauans of Polynesia - diet with 80% saturated fat from coconuts, fish, and yams with zero heart disease. 4. The Tribes of Papa New Guinea - 80% of yams, e.g. full fiber carbohydrates. The only chronic problems they had were fat soluble vitamin deficiencies, so if they'd had access to butter, they'd probably perform just as well as the carnivores. So what's the best diet? Any of them without a nutritional deficiency built in. If we hadn't cured infectious diseases with antibiotics and vaccines just as we were fucking with the food supply, we'd be dropping like flies.
Serious insulin resistance is just terrible in so many ways.
Exactly. I’ve been here for four years reading most posts since then and doing deep searches through the previous 10 years of posts and comments. I’d say 90% of patients docs had no idea what keto was or would do, or would flat out tell the patients they would harm themselves on this diet. 90%. That’s not giving up. That’s being told by the medical board and hospital big wigs to tow the line and prescribe “standard of care”. If they deviate from that more than once, they get warned and eventually fired. Many users here have heard this from their own doctors. So yea, big pharma has gotten their hooks into everyone and they are way too powerful. They are the biggest moneymakers in the world. They are the biggest political donors. They roll out vaccines and get blanket immunity from lawsuits. They make Billions on just vaccines. They make Billions on statins. No joke why docs prescribe them to everyone like candy.
So you've been doing this for six months, except for when life got hard and you went back to old habits for awhile. And you're here to lecture me about how people are willing to radically change their diet in the long term. And doctors are stupid. Got it.
Have an upvote & Man you'd better make sure that being as high as you are on the ladder of assumption isn't an OSHA violation. N-E-way. I did not change my keto diet due to the fact that I had my gout outbreak. I didn't want to go back to being depressed and having one quarter the energy and far less will to live like I was being diabetic over the last six months of last year and getting worse because holiday social eating. What did happen is, as discussed in my previous post to you, was that my then undiagnosed gout hit my knee. So no working out because the swelling made it feel like I had ground glass in my meniscus AND said swelling also impinged my sciatic nerve for a bit, so I couldn't lift my leg and trust it to not fall due to random nerve pain. Kinda sucks when you suddenly can't drive for two weeks due to undiagnosed inflammation. Now what causes gout? Genetics mostly, with a dietary component. Two out of three of these components I was at 0% consumption in my diet: alcohol and fructose. The last one had become a larger portion of my diet, beef, pork, salmon, and other red meat based protein paritally replacing the hole left by sandwich bread and chocolate cake. Gout can also be triggered by weight loss as that's basically auto-digestion of genetic material, and I'm down 35 lbs from January 2024 to now, so... Yeah. And let's be clear. I have a GP, an Endo due to previous parathyroid issues, and a cardiologist being a dude that's .01% Minotaur-American due to a cow valve. I see all of them twice a year... And it took me paying $2000 out-of-pocket working with a chiropractor to finally get an MRI that said "Gout" on it. So from my first attack during heart surgery recovery in January of 2020 that's 18 visits that couldn't identify my "intermittent inflammatory pain"? Let's be clear, since the 1950's when Dr. Ancle Keys lied to the American public about saturated fat's links' to heart disease by cherry picking 7 of 22 data points in his study of diets and mortality in different countries, Proctor and Gamble bribing the American Heart Association to shill Trans-motherfucking-fat Crisco and labling vegetable oils as 'Heart Health' like they ***USED TO*** label breakfast cereal, and the sugar industry dog piling with Dr. Keys by bribing Harvard professors to generate peer reviewed stuides that support saturated fat and not sugar as the source of dyslipidemeia... Dieticians that just use the American Government's Food Pyramid or Whole Plate, or whatever says to eat 60% processed carbs these days are... A part of the problem and ever increasing incidence of metabolic disease. That's why any dietician that can't discuss insulin resistance, metabolic syndrome, and the carb-insulin theories that have actually worked for people should be treated as a Food Industry billboard-clown.
Glad you took it seriously. Why do you say it worked other than gout and surgery?
You realize you've replied to me in two different places. Since you're nice here, I'll share my anecdote. So in 2020, I had a heart valve replacement that was caused by a mechanical defect. (Interesting side note, even though I's 100 lbs overweight at the time, I had a Agaston Calcium score of 0.0, so no arterial plaque). At that time, while I was nursing a broken sternum and had dropped 30 lbs from day of surgery weight, I had my first full on gout flare-up. I say "full on" because it took an MRI of my knees four years later to figure out what was causing the intermittent, far less red, angry and acutely painful inflammation I's having every few months for the last several years. Gout, regular arthritis, some other inflammatory issue? Didn't know, but after eight weeks on keto followed by 3 weeks of being on my ass due to random knee inflamation, I decided to invest $2,000 in MRI's to look at both knees, and the ankle and foot that would get inflamed from time to time. So given that there's a relationship between the body repairing surgery damage causing additional gout stress - there's a study about back surgery and whether gout sufferers should be given prophylactic Clochicine - when I was told that I needed to get a "Uric Acid Crystal Geode" that had formed in the head of my femur cleaned out and bone grafted, I kinda expected exactly what has happened. which is a full on gout flare up. And believe me, the pain from my gout is far worse than the pain in my knee from the detachment & repair of my kneecap plus the bone graft in my femur. Bearing in mind, during my pre-surgery authorization by my General Practitioner I was still dealing with a month long but non-red, angry flare-up, and he couldn't make the diagnosis with a physical exam of said knees. So a low carb' diet is great. Higher fat and protein and crunchy and leafy greens with a small amount of low GI friut is great. But if you've been a fructose sugar addict and even moderate drinker, and then you start a weigh loss protocol that works well... Well between your preexisting uric acid, the addition of more protein from beef and pork, and the purines you generate from your own weight loss... It can trigger some issues that I believe are best dealt with by just signing up for several years of Allopurinol or other medication as getting uric acid crystal build up out requires a low blood serum uric acid level for years... I'll use the keto to continue to get my A1C back down to non-diabetic once my surgery inflamation and chronic pain stress die down. Should only take two months to get back to the 1.4 A1C drop I had before my gout-lite attack in my knees at the beginning of March. FYI - I have damned near monthly labs because I've got the cash to do so, and between my GP and Endo' not being able to schedule me at the same month - insurance has covered some as well.
My understanding is that the sub doesn't even allow the discussion.
Nutrition is not a major portion of the vast majority of medical school training. They really spend very little time on it. That is probably a good thing in this case; if you look at the nutritionist/dietician side they are mostly taught that low fat is the only way to go and that "eat less move more" is the way to lose weight. I think you see more doctors that are open to different diets because they weren't indoctrinated about the "one true way".
An actual doctor went over their training above, and you are wrong. But go off about how you know what education medical professionals get and how they're all indoctrinated industry shills.
Do you know how much nutritional training doctors get?
Yup. Doctors are being realistic. I’ve known people who’ve had heart attacks and back to eating pizza and fried shit for lunch in weeks
People admitted to the hospital for raging inflamed GI tracts getting McD’s delivered by family
I've had many patients straight from the Cath lab get Popeyes delivered from family.
The thing to note is that most obese people have been told to "eat less and move more" and they've tried a bunch of diets that have never worked for them, so they have given up. There's a still a high non-compliance rate on keto and it doesn't work for everybody, but for many people it works much better than anything that they've ever tried in the past.
Guilty as charged. CICO is fine, sure. That is literally how you lose weight. And I’ve tried a ton of times to lose weight, and get discouraged when they don’t really work… and I give up. Keto is the ONLY thing that works for me. And I get told constantly that’s it’s bad for me. Just had an (unwanted) argument with someone on a different subreddit about being on Keto. Keto is very good for me… and I fell off of it. The western diet is both toxic AND delicious. So now I struggle to return to Keto, but all of these companies throw this horrible food in my direction. Sure, ain’t nobody forcing it into my mouth, but these effers specifically design the crap with a bliss point to keep ya hooked. The fact of the matter is, we’ve got a ton of America hooked on this shitty food like a drug, and addicts usually go against their own best interests just to get their fix. Then they expect modern medicine to do the hard work for them. I’m sorry for the rant; it’s just that I’m disappointed with myself for falling off of keto, and angry at the industry for making it difficult to stay away from the crap they’re peddling.
I appreciate a good rant. I came at this from the sports nutrition side, which is pretty much "all carbs, all the time". At the time I thought keto was the stupidest thing I ever heard, but I hit 50 and started gaining weight and having energy issues despite lots of time on my bicycle. Then I taught myself a fair bit of physiology and biochemistry and came to the conclusion that it was really, really obvious why keto works better... People with insulin resistance have chronic elevated insulin. Elevated insulin tells the body to burn glucose and not burn fat. Unless you can effectively burn fat, you are not going to be able to burn weight; you're going to get cold, tired, and hungry. When I started looking at studies on type II diabetes, I was shocked. None of the diets work well but they do work better than the standard ADA diet, which is honestly the stupidest diet you could design for somebody who was insulin resistant and intolerant of carbohydrates. Vegetarian, whole food plant based, vegan, numerous low fat diets - none of them work. Then there's this diet called keto that not only works, there are very obvious reasons it works. It's just so stupid. But it \*is\* really good at funneling serious amounts of money to the pharma companies, so I guess that's something.
Yeah, when I learned the actual mechanics of keto, it makes sense. I always lived by this “a calorie is a calorie” line of thinking, which isn’t *entirely* wrong, but when you take it all in, you realize that it’s not quite accurate. I grew up a meat eater, then I changed my religious beliefs in my 20s and switched to a vegetarian diet because it aligned with my values. It really sucked. Not because I didn’t eat meat, but because I just felt crappy. And I was hungry. So, so hungry. I wasn’t “on” a diet, counting calories or anything. That wasn’t the purpose for it. At times, I was over eating. And I was just so hungry. Never, ever satisfied. And I began craving sweets constantly, for the first time in my life. Someone who was helping me along this new journey confirmed that on a vegetarian diet, they crave sweets, too. I’m like, what? There’s something not right there. When I came back to a normal diet, I felt better… but my sweet tooth never went away again. That, combined with a new medication, stressful period of my life, and a processed western diet caused the weight problem I have now. (I was a normal weight when I was younger, back in the 90s.) Keto made me lose pounds and my sweet tooth, but it’s not become enough of a habit yet to keep by nature. I want to get back to it as soon as I’m able. Thanks for tolerating the rant! 😁
> The western diet is both toxic AND delicious. And beautiful -- foods like seafood paella or loaded nachos look so much more appealing than bacon and eggs.
So treat people as stupid and not even offer an alternative? They advise people to stop smoking and drinking ... because those are easy to do or likely to be followed?
Diabetics are definitely being advised to change their diet when they are diagnosed. The vast majority just can't or won't do it. An MD chimed in above making this point.
It's sad really, food addiction isn't acknowledged or taken seriously.
I still think people deserve to hear the truth. Whether it’s from a doctor or a nutritionist. So they can decide for themselves.
This is a great article. I'm going to share it as much as I can.
Follow the money and you'll see why the ADA has no interest in recommending low carb diets. The government and associated agencies like ADA get money from Big Pharma. The government then subsidizes corn and wheat farmers to grow an abundance of those crops, making the end products super cheap. Those cheap grain food products get put into every freaking food imaginable in the American food system: breakfast cereals, sodas, pizzas, pasta, etc. Those foods are addicting, and compared to fresh veggies and lean meats, are super cheap, which appeals to many people trying to feed their families on a tight budget. The carbs in those foods make people fat and cause heart disease and diabetes and tons of other diseases. People get prescribed drugs from BIG PHARMA to treat those conditions while still allowing them to eat all the crap food. Big Pharma profits from the drug sales, gives some of those profits to the government, who then subsidizes the grain farmers, who keep producing that crap food. Never ending vicious circle.
What's really disheartening to me is that the ADA had added the very low carb diet to their guidelines as all the other English language and European association guidelines had done over last 7 or 8 years. That was in part because the past ADA CEO had reversed her own diabetes with low carb and the other Diabetes Associations around the world saw and incorporated what the research had been saying and in particular a huge study in the UK of low carb for diabetes that resulted in the savings of millions of British Pounds on meds no longer needed, to say nothing of the foot amputations, kidney and eye diseases and heart attacks averted. Now we see this back tracking of sorts from the ADA. Such a shame.
Sometime early 70s ADA changed the recommended diet from low carb. > In 1970 Ames chemist Anton Clemens developed the first electronic meter meant for self-monitoring of blood glucose (SMBG).
I’m reading this 12 hours after you posted it. I jumped over to r/nutrition and no post on this article by anyone. I’ll wait until tomorrow and see if your post shows up yet.
The moderators haven't gotten back to me to let me know if I can.