Can an extreme low carb diet be used as medicine? • Hacker News Board

Re: Can an extreme low carb diet be used as medicine?

#131

Post by PudgePacket » Wed, Jul 15, 2020, 2:15 PM UTC

tlow wrote: post #98

PudgePacket wrote: post #82

Earlier quoted context omitted.

Yes yes calorie in calorie out blah blah. Most people can't maintain a caloric deficit for an extended duration. Countless studies have shown that. The point is people who are overweight tend to lose weight when eating ad libitum on a ketogenic diet, whereas people on a standard diet generally gain weight (see western populations).

>Most people can't maintain a caloric deficit 1. Do you have an evidence or is this just an assumption based upon your perceived "feeling"? 2. Why?

1. People on western diets. This isn't some hidden mystery.. it's in plain view. Plenty of studies done, or just ask _any_ doctor that sees patients, or any of your friends/family who have tried diets. Or search pubmed for diet adherence.

2. Because their base metabolic rate reduces over time to match their new reduced caloric intake.

Re: Can an extreme low carb diet be used as medicine?

#132

Post by playing_colours » Wed, Jul 15, 2020, 2:20 PM UTC

There is The Autoimmune Protocol diet (AIP), a stricter version of Paleo, and there is keto diet. They both seem to help with autoimmune deceases and inflammations.

Did anyone try them, and can share their experience? Do they both have comparable effects in a long term?

Re: Can an extreme low carb diet be used as medicine?

#133

Post by shlant » Wed, Jul 15, 2020, 2:29 PM UTC

amanaplanacanal wrote: post #126

shlant wrote: post #88

Earlier quoted context omitted.

exactly. The diet is one big Appeal to Nature fallacy

Possibly. On the other hand, it does makes sense to feed animals a diet to which they are evolutionarily adapted. Visit a zoo sometime and ask what each animal eats. They are all feed something intended to be nutritionally similar to their natural diet. Because that’s what works.

I tend to agree that, in many cases, more "natural" is more "healthy" but my main caveats would be:

1. "natural" does not automatically mean better. Depends on the context and many other factors.

2. Determining what is "natural" is also contextual based on what timeline you are talking about and what geographic location. To say "paleolithic ways of eating are healthier" is meaningless unless you think that we a. know exactly what they ate back then and b. every human had access to the same foods regardless of where they lives on the planet

Re: Can an extreme low carb diet be used as medicine?

#134

Post by shlant » Wed, Jul 15, 2020, 2:36 PM UTC

amanaplanacanal wrote: post #129

shlant wrote: post #79

Earlier quoted context omitted.

here's some information to start with: https://link.springer.com/chapter/10.1007/978-1-4020-9699-0_... Here is a simplified overview: https://steemitimages.com/DQmYgdPbWvCt78oycPdEKNffevjh7UnCsq...

“Nonhuman” primates, it says. It’s pretty clear that humans haven’t eaten a primarily fruit based diet in a very long time. It’s likely that moving away from that diet predated changes that made us human.

you could certainly make the argument that most humans haven't a primarily fruit based diet for a while (although evolutionarily it really hasn't been that long) but that doesn't change the fact they are our closest ancestors and the way our bodies are built STILL very much mirror those of primates which means they, in many ways, still work as theirs did. It's not like we have evolved entirely different digestive systems or something. Essentially everything is the same (which again makes sense as evolution is a VERY slow process)

Re: Can an extreme low carb diet be used as medicine?

#135

Post by bigtex » Wed, Jul 15, 2020, 2:36 PM UTC

So my daughter had epilepsy soon after birth and was hospitalized for 20 days @ 1 month old. By the time we left they had her on 4 different drugs, but the seizures continued. At 4 months old she went to the local children's keto clinic. The seizure frequency slowly tappered off until a month or so later she was seizure free! That lasted for a few months until an ear infection brought the sickness back and then revealed the true cause of the seizure, a brain abnormality.

That was when my eyes were truly opened to how much diet can effect the body.

Re: Can an extreme low carb diet be used as medicine?

#136

Post by ubercow13 » Wed, Jul 15, 2020, 2:42 PM UTC

shlant wrote: post #119

amanaplanacanal wrote: post #111

Earlier quoted context omitted.

The advice doesn’t work. If it worked, why do we still have an obesity epidemic? Are there still people who haven’t heard this message?

> If it worked, why do we still have an obesity epidemic not everyone follows the advice? It takes a LOT of effort and discipline? Food is a powerful vice and coping mechanism. Addiction of any kind is not an easy thing to overcome especially when that addiction is so normalized. > Are there still people who haven’t heard this message? I think in most first-world countries no, but there is a massive difference betwee…

>It takes a LOT of effort and discipline

That's the whole point, low-carb takes less effort and discipline for the same result

Re: Can an extreme low carb diet be used as medicine?

#137

Post by shlant » Wed, Jul 15, 2020, 2:46 PM UTC

PudgePacket wrote: post #112

shlant wrote: post #64

Earlier quoted context omitted.

additional downsides include kidney stones[1,2,3,4], bone mineral loss[5] and a long list of other complications (including death): https://www.thepaleomom.com/adverse-reactions-to-ketogenic-d... 1. https://pubmed.ncbi.nlm.nih.gov/11095028/ 2. https://pubmed.ncbi.nlm.nih.gov/10893623/ 3. https://journals.sagepub.com/doi/pdf/10.1177/088307380730192... 4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852806/ 5. https:/…

Firstly those studies are all in children.. Study 1 doesn't actually show increases in kidney stones. Study 2 has N of 4... Study 3 looks reasonable, though they did note "use of oral potassium citrate significantly decreased the prevalence of stones" which is good news! Study 4 has N of 25 & no info about what they actually ate other than macronutrient ratio.

> Firstly those studies are all in children

Your point? the OP ended his sentence with "especially in children" so I thought I'd share that which was relevant to children. If you are looking for information on adults, here are some possible clues:

https://www.nature.com/articles/pr19971830

It makes sense considering the increase in uric acid, but might only be a problem in children and those susceptible to kidney stones (although when it presents in children, that is some pretty important information in terms of holistic, long-term diet considerations). Still definitely worth mentioning and I'm sure we will get more information as more studies are done on adults (most are on children due to it being used as an epilepsy treatment)

Re: Can an extreme low carb diet be used as medicine?

#138

Post by el_oni » Wed, Jul 15, 2020, 2:49 PM UTC

49para wrote: post #89

jonfw wrote: post #69

Earlier quoted context omitted.

You've also got to look at how doctors are being incentivized. Medicine funnels more money into the medical system- and kickbacks or 'rewards' programs from pharmaceutical companies are common. Outside of that- people like their doctors to do things. Everybody knows that they could use a better diet and more exercise- a doctor who says that and nothing else may not make people feel like they're getting their money's…

Dr's are also incredibly uninformed about Keto, Carnivore, low carb in general. The response I've received from my Dr friends regarding nutritional intervention vs drugs, is that "diets don't work". They have no clue as to recent research being done. Changes to medical "best" practice are generational and take a long time.

I wouldn't say that they are uninformed, just that they are informed by the literature. And unfortunately the literature surrounding diet is awash with special interest groups, small sample sizes and dodgy statistics. While clinical trials involving pharmaceuticals are often more rigorous. It's near impossible to do randomised double blind controls for diet, and energy levels and feeling great aren't as easy to measure empirically

Re: Can an extreme low carb diet be used as medicine?

#139

Post by shlant » Wed, Jul 15, 2020, 2:53 PM UTC

ubercow13 wrote: post #136

shlant wrote: post #119

Earlier quoted context omitted.

> If it worked, why do we still have an obesity epidemic not everyone follows the advice? It takes a LOT of effort and discipline? Food is a powerful vice and coping mechanism. Addiction of any kind is not an easy thing to overcome especially when that addiction is so normalized. > Are there still people who haven’t heard this message? I think in most first-world countries no, but there is a massive difference betwee…

>It takes a LOT of effort and discipline That's the whole point, low-carb takes less effort and discipline for the same result

> low-carb takes less effort and discipline

"less effort and discipline" than what? depends on the comparison

Also, I'm sure a lot of people who have had trouble staying on the diet would disagree. Regardless of the specific regime, if a diet is restrictive (especially of things people are used to consuming) it can require a lot of discipline.

Re: Can an extreme low carb diet be used as medicine?

#140

Post by AnonC » Wed, Jul 15, 2020, 2:56 PM UTC

49para wrote: post #89

jonfw wrote: post #69

Earlier quoted context omitted.

You've also got to look at how doctors are being incentivized. Medicine funnels more money into the medical system- and kickbacks or 'rewards' programs from pharmaceutical companies are common. Outside of that- people like their doctors to do things. Everybody knows that they could use a better diet and more exercise- a doctor who says that and nothing else may not make people feel like they're getting their money's…

Dr's are also incredibly uninformed about Keto, Carnivore, low carb in general. The response I've received from my Dr friends regarding nutritional intervention vs drugs, is that "diets don't work". They have no clue as to recent research being done. Changes to medical "best" practice are generational and take a long time.

Of course “diets” don’t work. People consider diets as something you get on for some results or changes and then abandon them or give up later. So what actually works is making it a lifestyle change, which isn’t easy either, but is at least honest in what it means to people when they hear the word. Lifestyle changes are hard. Diets are what people usually see celebrities doing before an awards ceremony.