
3 huge new studies of 0.5MM people are casting major doubts on the keto diet - nradov
https://www.businessinsider.com/is-the-keto-diet-healthy-studies-suggest-carbs-are-linked-to-long-life-2018-9
======
ironchief
Follow the science, forget the epidemiology/poorly controlled science news.

Sustainability of improved health outcomes
([https://link.springer.com/article/10.1007%2Fs13300-018-0373-...](https://link.springer.com/article/10.1007%2Fs13300-018-0373-9))

Rapid impact on type 2 diabetes
([https://diabetes.jmir.org/2017/1/e5/](https://diabetes.jmir.org/2017/1/e5/))

Significant impact on cardiovascular risk factors
([https://cardiab.biomedcentral.com/articles/10.1186/s12933-01...](https://cardiab.biomedcentral.com/articles/10.1186/s12933-018-0698-8))

------
maxxxxx
I suspect that a lot of the successes people have with different diets are
more of a result of moving from the terrible standard US diet to better foods
than from the specific diet. When I look at what a lot of people eat every day
almost every diet, be it vegan, keto, paleo, Mediterranean or whatever will be
a huge improvement because they consume less junk food. It doesn't matter
which one they pick.

~~~
AboutTheWhisles
That's too vague. You can't just handwave and say 'better food' and 'junk
food'. For decades junk food was thought by many as food with lots of fat
instead of lots of sugar.

~~~
maxxxxx
How about "processed food" or "fresh food"?

~~~
craftyguy
Cooking is a form of processing food, so are you saying "cooked food" or "raw
food", or what, exactly?

~~~
jjoonathan
Home-cooked food that sacrifices taste for nutrition and leverages the
virtuous halo of home cooking to the hilt in order to prevent people from
acknowledging that taste was, in fact, sacrificed.

~~~
maxxxxx
I think it's a misconception that home cooked food tastes worse. I much prefer
the food we make at home and don't think we sacrifice anything.

~~~
jjoonathan
Home cooked food tastes great if you don't cut down on the sugar, salt, and
fat -- but then it's not health food. Home cooking lets you cut down on the
sugar, salt, and fat -- but then it doesn't taste great.

~~~
maxxxxx
When I cook I use much less sugar and salt than foods bought in store or at
restaurants without losing taste. Taste buds also adjust. I find a lot of the
food I buy way too salty and sweet now.

~~~
jjoonathan
You can get used to anything. Good on you for getting used to healthy food!

Don't expect to win a taste contest, though.

------
Djvacto
I definitely think that the major changes come from a switch to an
"unregulated" food consumption habit, to any sort of deliberate (and often
better-quality) diet. I gained some weight in late high school, and a lot of
weight in early college, because I basically ate whatever without thinking
much about it (and in my freshman year of college I had access to an unlimited
meal plan. I think I ate 4,000 calories a day easily). After freshman year, I
spent that summer dieting (mostly focusing on eating salads, and otherwise
eating less, and only homemade food). I got very into cooking, and just
generally ate a lot of mostly healthy, and almost always homemade food. I now
eat vegetarian/vegan and overall I think the main change comes from the fact
that my diet is consciously chosen (or comes from habits I developed while
focusing on eating healthily).

~~~
pjc50
A friend of mine lost weight through _budgeting_.

The simple act of recording all purchases of food and especially drink was
itself enough to reduce consumption - "I could buy a chocolate bar in the
vending machine, but then I'd have to note it in the accounts".

~~~
Djvacto
A solid approach :P

I've found that being deliberate about any of the aspects tends to lead to an
improvement, and oftentimes you're deliberate about all/a lot of it. A huge
shift in both health & wealth comes from switching to home-cooked meals, and
then paying attention to what you put in those will help you save money and
eat well.

------
kyledrake
The author seems to have a weird axe to grind with the keto diet. The link
that is supposed to go to the study just goes to another summary article of
the study written by her.

Low carb dieting is based on some pretty solid evidence, and it's going to
take more than this to convince me it's a bad idea to remove carbohydrate
derived glucose. It also gives me pause when the author says things like "low
carb diets cause tumors to grow". Where's the evidence?

Anecdotally, I have a friend that's no longer prediabetic because he switched
to a ketogenic diet, and numerous people have told me the diet has improved
their overall health.

~~~
jstandard
As a counterpoint, Japanese people generally eat almost the inverse of the
keto diet (high-carb, low-fat[1]) and have the longest life expectancy on the
planet.

It's just not as simple as "this diet" vs. "that diet".

[1] [https://www.huffingtonpost.com/entry/japan-healthiest-
people...](https://www.huffingtonpost.com/entry/japan-healthiest-people-in-
the-world-carbs-high-grain-diet_us_56f08cc4e4b084c6722139ca) [2]
[https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...](https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy#List_by_the_World_Health_Organization_\(2015\))

~~~
kyledrake
One interesting thing to note is that much of this comes from Okinawans in
particular, and there's a possible link to a purple sweet potato they consume
a lot of (or at least used to). You can get them at most asian grocery stores
and they're quite tasty (but not especially keto friendly).

------
jgust
> Nutrition experts say that besides their potential for harm, these popular
> diets are really hard to follow

You can probably attribute this more to the current food environment and less
so the diet. If you only have access to food that agrees with your diet, it's
pretty easy to follow. Restrictive food diets are difficult because all the
restricted food (generally the restricted foods are ones that are full of
"empty calories" or contribute to overeating) surrounds us. It's everywhere.
Restaurants. Commercials. Grocery stores. Convenient stores. The break room.
Your S.O.'s pantry. If you can manage to escape it, your diet is smooth
sailing. Good luck over eating spinach and hard boiled eggs, your stomach will
revolt.

~~~
mrhappyunhappy
You’re not kidding. For anyone who doubts this, try cutting carbs for 3 days
and you’ll realize that carbs, especially highly processed are in everything.
I wanted to go on a Keto diet but find it hard not to have something in the
morning. So now I am on a low carb diet (exceptions for sweet potatoes, rankon
etc...) and avoid any pasta products, sugar or bread. Before I started making
exceptions I was on the way to losing a lot of weight, but after introducing
some healthier carb options I am sort of at a plateau.

Eating whole veggies is hard as hell for me. I typically cook and use oil
sadly. My biggest concern is heart disease as that runs in the family. Sorry
for random rambling!

------
callesgg

        "Scientists and dietitians are starting to agree on a recipe for a long, healthy life."
    

Whenever i read/hear people say things about other peoples options in general
my BS alert goes high....

The body is one of the most complex systems we know of and people keep
claiming "Ah i am an expert i know how this works" it is pure insanity.

On top of that we are all individuals and we all work differently. I find it
likely that we wont find a single truth about the food we eat, and what food
gives best human performance.

What we will find is statistics, this food is 90% likely to be good for a
human being. Or eventually some sort of functional description that allows us
to figure out what food is "good" for what people. Probably based on genetics
or some sort of individual testing.

~~~
benaduggan
Honestly I'm hoping someday soon we will get more specific research into
associations with gene markers and diets. We already have fitness programs
oriented towards genetics, and starting to get diets oriented that way too. I
think we need a lot more research before I believe those programs, but if it
takes off like Ancestry/23andMe I think the next couple decades could see a
lot of genetic based nutrition plans.

------
nonbel
Well, the first study is the low carb = 40% of your calories from carbs study:
[https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...](https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667%2818%2930135-X/fulltext)

So, this is worthless.

~~~
tzs
How is that worthless?

~~~
toddh
40% would be considered high carb. Keto is generally considered to be under 20
grams of carbs per day.

~~~
tzs
In medical research 40% is usually considered medium carb or moderately low.

That doesn't really matter, though, because that particular study wasn't
defining the low carb group as people who are at exactly 40%. It was 40% or
lower, and included people doing much less than 40%.

The data, which looks like it ran from around 20% to over 80% seems to show
that around 50% got the best results, with the results getting worse that
farther you were from that on either side.

That's sufficient to cast doubt on all low carb diets, whether you use the
medical research definition of low carb or the definition used by Keto,
Atkins, or other very low carb diets.

Of course it is possible that the results start getting better somewhere
between 20% and zero, and maybe even get so much better that they beat that
local minimum at around 50%.

~~~
nonbel
There is zero reason to extrapolate from 20% (apparently the lowest percent
seen in the study according to the figure), to a keto diet (5-10%). You won't
even be in ketosis at 20%...

------
ricokatayama
I look to this diet from a very different perspective, because I'm no trying
to lose weight, but since I started with a low-carb approach (first Whole30
and then keto) I feel that my long term allergies, my defective intestine
problems, my stuff nose and somehow my ADHD just disappeared.

I cannot argue on the downside of this diet, but I definitely can talk about
the benefits, and I'm sold.

~~~
gremlinsinc
Wait, keto can improve allergies? How long after starting does that start? I'm
2 weeks in.

I'm 515..or I was 2 weeks ago (now I'm 500).. I started a weightloss challenge
at a Crossfit gym, where they basically make you pay $400 if you lose 25lbs in
6 weeks and go to all 18 classes (6 wks*3 classes), and follow nutrition
guidelines (my coach was okay me modifying that to keto) you get your money
back, and probably a pitch to continue crossfit, which I might fall for...I do
really like the team/people there.

I do feel a LOT better, stronger, and crossfit is getting a little easier.

So far it hasn't done anything for my adhd (inattentive).. I still can't focus
for shit. But would be nice if that would be improved. Can you elaborate on
how long that takes to manifest? My depression has improved but I think that
could be workout related endorphins.

~~~
ricokatayama
Hey pal, probably you are in the tipping point. Everytime that I restart a
cycle, I wait up to 10-15 days to start feeling the difference. Keep trying
two more weeks and tell us if it changed :)

------
leetbulb
Keto is a difficult and usually expensive diet to follow properly. I followed
it for about two years and lost around 80lbs within the first, all while under
doctor supervision. There were certain things I had to adjust within the diet
and supplement in order for my doctor to be happy with my blood work. I have
no doubt that people are following the diet incorrectly and coincidentally
causing harm, but hey, it's probably better than choking down a bunch of
exothermic fat burners every day or having an all-fruit diet.

~~~
benaduggan
What do you consider expensive? I am able to follow the keto diet on around
$200 a month, and that's with splurging on things here and there. I've never
really understood why people say it is so much more expensive.

~~~
johnkpaul
I think that it depends on how far you go after fat adaptation. Once that
happened for me, and I got comfortable with eating straight butter when in a
time crunch, things became very very cheap. Butter, sugar free bacon, eggs and
spinach are basically all I buy anymore. I have found, personally, that all of
my desire for variety was really desire for carbohydrate variety and now I'm
totally fine with whatever keto option is cheap, fast and convenient.

~~~
gremlinsinc
you really eat straight butter? I'm 2 weeks into keto, but that doesn't sound
too appetizing lol.

~~~
johnkpaul
Oh yes, but it sounded horrible to me for many many many months. Once you're
fat adapted, food is often just for energy and nothing else. It took me maybe
6 months to even consider not nasty and after a year it became a regular
occurrence.

~~~
gremlinsinc
I'd much rather eat a hamburger or chicken than butter... but I also have a
lot of native fat to contend with. A keto nutritionist told me just eat your
protein first then any veggies you can get down.. having had VSG I can only
eat maybe a 4-6oz steak or burger or chicken and maybe two pickles or stalks
of asparagus before I'm full.

When I eat candy/sugar/soda I can eat a lot throughout the day, and get a lot
of calories in from sugar... i still eat smaller meals, but the sugar did me
in. When I'm in keto, my appetite is non-existent, like ever. I'm hardly ever
hungry. I don't produce ghrellin so most hunger is mental for me anyways.

------
flossball
I wish this article wasn't flagged, as even if the info is biased crap it is
an important topic.

The only comment I have toward the discussion is to remember that the medical
field (especially in the US) has a strong religious bias to diet. There are
universities, medical schools, and hospitals built by religious groups who
have very strong opinions on what is a 'good' diet. Medicine is more craft
than science. Medical study quality and governance board decisions should
always be questioned.

------
bbg215
The majority of the people who say they are on a keto diet aren't actually in
ketosis.

