In Shai et al's study, the adherence was about 3/4 in the Atkins group over two years (compared to over 90% in the low-fat group, which once again wasn't a low-fat group at all, since they were eating 30% of calories from fat). So, I don't know how you defend Atkins in terms of adherence in the face of this. As to results: Once again the weight loss was only different by 3lbs. Pathetically small. And blood pressure scores (sys and dia) were better on LF than on LC. What are you hoping to prove??
Can you stick to the facts please? Your opinion, while welcome, detracts from your analysis of the facts. For example, you object to some ratios as not being low fat enough. It's low enough for the researchers, if not for you. You did the same with A-TO-Z since the start with "they didn't actually comply". The facts please. Otherwise it gets tedious to point out all your hyperbole and exaggeration.
It has nothing to do with my opinion. The Ornish and McDougall diets (actual, low-fat diets) are 10% fat. These 30% fat diets are, at best, "moderate" (a person eating 2000 calories, at 30% fat would be eating 66 grams/day, which the USDA calls the top mark of "moderate"). So these are not actually low-fat diets. Also, a lack of compliance is in fact relevant, and you agreed until it turned out of your favor with the Shai study. 75% adherence vs. 90% and suddenly it doesn't matter?
In fact, if I recall correctly, since the A-TO-Z study didn't actually test the diets in question at all, you said its main merit might be in showing us which diet was easiest to adhere to. You then asked why Atkins is so much easier to adhere to. Well, it turns out that it isn't, in the long run. Shai et al disproves that, during a timespan that the A-TO-Z researchers themselves would agree is better than their study.
That's true. The results of all those studies have nothing to do with your opinion, nor mine as it were. Saying they didn't test what you wanted serves no purpose other than to point out that the facts don't agree with your opinion. That's why it's important to stick to the facts, and avoid hyperbole and exaggeration.
Again, who is talking about testing what I want?? It is either a low-fat diet (which means at the very most 20% of calories from fat, and Ornish, McDougall, etc might debate even that) or it isn't. These studies did not test a low-fat diet. My citation of Ornish's 3-YEAR study, which actually was low-fat, and had dramatic results for weight loss and heart disease has received no comment from you for some reason. And yet you say you accept wherever evidence leads....
Do which studies replicate which results? The results are different depending on timeframes, actual content of the "low-fat" group, adherence, etc. But which results were you hoping to replicate?
It's a convenient excuse to ignore contradicting evidence. This way you can continue to rely on the evidence that agrees with your opinion. I can just as easily ignore the Angiology FMD study with the same excuse: They did not actually test the Atkins diet. However, even if I accept that study's results, I'm still left with the fact that it did not replicate the results of the bulk of other low carb studies.
This is a complete red herring! I am making the point that very few, if any of your references actually tested a low fat diet as a SIDE POINT. It is not even near the basis of my argument. I directly addressed those studies, and even if you do consider the diets they tested to be low-fat, the studies still favor my point. The fact that they could have done even better if they'd actually done a low-fat diet is just a side point.
I have addressed this "bulk", and showed where the differences lie (timeframe, composition of opposing diets, etc). This is not the "silly sidetrack" I was referring to (and I apologize for using that term at all). The side argument that threatens to bury my relevant responses is the one about whether they were "really low-fat" or not. They weren't, and the results would have been better if they had been, but that is not central to my argument, and has no effect on my other points.
Observational studies are not inherently bad. They are inherently unreliable though. And when you combine all potential flaws I cited in the same study, it's really hard to produce reliable results. Maybe we can rely on its results anyway. Maybe it's all the other studies that are badly designed. But I doubt it.
"Ten additional individuals elected a different dietary regimen consisting of a "high-protein" (high protein group/HPG) diet, which they believed would "improve" their overall health."
Translation:
Too small sample size (10 subjects on "high-protein" diet)
Flawed study design (self-selected subjects, not randomized)
The study I commented on that was antepenultimate in the list of 16, had 13 subjects. Is it also invalid because of sample size? Will you then change your number to 15, when you make the general statements?
As to people choosing their own diet, that doesn't change the effect of that diet on the arteries, which were directly investigated. This is a study of what occurs each time these patients ate their high-fat meals, which can be seen directly.
The Angiology FMD study contains all three flaws that can prevent results from being replicated in otherwise properly designed studies. I only cited three potential flaws. If we know of those, how many more flaws does this study really contain?
Too small sample size can create a statistical bias. For example, if 4 of 10 subjects' results are significantly different than the other 6, their results can skew the average thereby reversing the results of a comparison.
Self-selection creates its own bias. In fact we call it self-selection bias. If we allow all subjects to choose what they prefer, they will perform better by virtue of have more practice than other randomly selected subjects.
I understand what's wrong with a small sample size, Jack, I'm just asking if you're going to apply that across the board and withdraw support from those studies in your (16) which had comparably tiny sample sizes.
This would only be a problem if their performance was what was in question. The artery in question did not "choose" a high-fat diet. ITS performance was being tested. And it would have performed the same way if a doctor had force-fed them the high-fat meal.
Self-selection of the intervention, researchers did not design nor administer the intervention. This means the study is basically an observational study. Sure, they gave out food questionnaires, and that's exactly what they do in observational studies. Sure, they collected blood samples at the end, as is done in observational studies. But what they did not do is design and administer the intervention, also exactly like an observational study.
Observational studies yield a great deal of useful information, so I don't know why that's such a bad thing. But, beyond that, they did know what the people ate, and they directly measured the effect on the arteries. To say there's something wrong with that, because the doctor's hadn't pre-selected the meals is like saying that studying the effects of malaria in a person's body is invalid because we didn't personally infect them.
From the abstract of the Angiology study, I don't see where it says the researchers administered the diets to the subjects, nor were present when the subjects ate. If they did, they would've printed it proudly because that's a critical design parameter. So I'm left with the conclusion that they simply gave out food questionnaires and collected the answers.
I never contested that they gave out food questionnaires and collected the answers... No offense, but maybe you should re-read my post. That was never a point I contested.
I may change my mind, but I doubt it. The Angiology only administered the intervention to the low fat group.
"The 16 people (treatment group/TG) studied modified their dietary intake as instructed."
The other study of 13 subjects also gave instructions, but to all subjects, not just a fraction. 16 or 13, it's about the same quality. But comparing a group of 16 with intervention to a group of 10 without intervention is not proper study design.
It's the size of the study that you questioned. That's it. You are only now combining it with the (completely unrelated complaint) of the self-selected diet. These are two separate objections. My point is that, to avoid bias, if you believe that a small number of subjects invalidates a study, then you must apply that across the board, and reject a few of your 16.
On the subject of self-selected diets: as long as the data collected is accurate, what difference does it make?
I think we have a serious difference in the quality of evidence that we consider valid to support your arguments. If you believe that self-selection bias is irrelevant, then by all means. However you must realized that your credibility will suffer, in my eyes, if not yours.
Honestly, I think we'll just go round and round at this point. As I've said, there are serious problems with short-term studies of Atkins (since ketosis is a survival mechanism with some short-term survival benefits), and the only long-term study (Shai, et al) showed lots of problems and unimpressive weight loss and compliance. Also the natural pathways toward disease on a high-fat diet are well documented, and none of your studies refutes this.
Also, just in my own defense, if you look back I never said that self-selection bias wasn't relevant in general. I said it wasn't relevant when they are reporting what they eat, and their arteries are being directly examined. That is a very fair statement, since we use the same assumptions in many animal studies, when examining particular organs directly.
In any case, it's been very engaging and interesting discussing this with you. I wish you the best.
I cited _potential_ flaws. The Angiology contains all three I cited. I didn't say that's why it didn't replicate the results of the bulk of low carb studies. But it's a good indication.
And do you really intend to bury yet another good set of objections in these silly side arguments? I just showed that only one of the studies you've cited was long enough to show long-term effect (the A-TO-Z, Dansinger, and Shai researchers agree with me on this point). Those short-term studies show bad effects on depression, anxiety, and cognitive speed. They show, at most, 4lbs more weight loss, even over a year's time, than the standard USDA diet plan. And each meal hurts FMD.
Then, finally there is a two-year study, and it shows that blood pressure was better on the "low-fat" diet than on Atkins, and the difference in weight loss was 3lbs again. The Ornish study, on the other hand, had the subjects on an actual low-fat diet, and they did head-and-shoulders better than anything Atkins did in any of your cited studies. Better in terms of weight loss (sustained, by the way), and in terms of coronary risk factors. Where is the evidence leading you??
Also, please stick to the relevant point. In this case, it's FMD and conventional risk factors, and replicating results. Do these low carb studies replicate results on conventional factors?
I just showed that, in the Shai study (the only one of all the ones you've ever referenced that was longer than a year) blood pressure was better on the "low"-fat diet, vs. the low carb one. That's a "conventional factor", no?
Do they replicate results on conventional risk factors or not? If not, which result, which study? You cited blood pressure for one study. Is it the only study, only result? If yes, why? Was that study badly designed, did it have too small sample size, did they make inaccurate measurements? Do the other studies contradict this one?
As I've been saying since the very beginning, the studies of Atkins are never long-term enough to show the overall effect. The Shai study was the longest I've ever seen (all the others were a year or less), and it showed that blood pressure was better on a moderate fat, higher carb diet. The other studies are simply at two short a timeframe, which distorts the results, since the initial shock of ketosis has survival advantages, but was never meant to be long-term.
Once again, I never claimed that FMD was unrelated to conventional risk factors. The only straws are the ones your strawmen are made of, since you are attacking a position I never espoused. I said the *long-term* (not 8 weeks; but over the *years*) effect on the arteries of consistently eating meals which slow FMD and damage the arteries would be deletrious. Can you not see how completely different that position is from what your study addressed?
Compare Dansiger and A-TO-Z studies. Adherence was much higher with A-TO-Z than Dansiger's. When adherence is higher with Atkins, we get more weight loss. But when adherence is higher with ZONE and Ornish, we get less weight loss.
Dr Atkins called it "benign dietary ketosis". It's doubtful that restricting carbohydrates then going into ketosis would lead to ketoacidosis when we still secrete all the insulin needed to regulate normal ketogenesis. But if you know of a study that shows that risk you mentioned, I'd be happy to take a look at it.
That's true. Total cholesterol goes down when you avoid animal products. That's because HDL goes down, and LDL particles become smaller. If I'm not mistaken, those are both risk factors for heart disease.
i got fat on that program. 30 pounds in 10 weeks. That was after a starving period. Now i am doing it again and i am getting fatter again. Whats going on?
I presume you are Dr McDougall himself? When you say "kings queens", are you referring to a period before the 20th century? If that is so, it's important to note they also ate lots of sugar and wheat flour which was not as ubiquitous as it is today, nor was it as cheap as it is today. Thanks to subsidies and official guidelines, Americans eat more sugar and wheat flour today that they ever did. Probably more so than those kings and queens.
You advise to eat mostly vegetables, yes? Do you not also advise to cut refined sugar and wheat flour too? If that's the case, then we could also conclude that the benefit you attribute to eating mostly vegetables can also be attributed to the reduction of that refined sugars and wheat flour.
I presume you know about changing multiple variables. By advising to eat mostly vegetables, and to reduce refined sugar and flour, you are advising to change two variables.
One last point, Dr McDougall. At 23:25, you show a slide that lists "Less Sugar" as a factor for reduced risk of type-2 diabetes. I presume this slide is a good representation of the diet you advise? But then, at 26:22 you cite a study by Brunzell with a slide that says "Sugar Makes Diabetes Better".
Forgive me if I'm little confused but why would you give advice that contradicts a scientific study? Do you know something we don't?
The slide at 23:25 is from one study. The study by Brunzell is separate, and has confirmed by studies that Neal Barnard and others have done. Simply put, the first study (with "less sugar" listed among the suggestions) was wrong on that one point.
If we believe the studies that found meat to be the culprit, shouldn't we also believe those same studies that also found sugar was the culprit? If we use that 85% sugar study to refute just the part of the other studies about sugar, shouldn't we do studies on all the other items listed to find out what's really going on?
For example, there is one study that looked exclusively at an all-meat diet. It found zero detrimental effect to health.
That's the point, those studies have been done. Meat and dairy cause heart disease, cancer, osteoporosis, and numerous other problems (including diabetes, if they are high-fat products).
Or for example, the tissue damage from hyperglycemia, shouldn't this tissue damage also occur even when blood sugar rises to hyperglycemia level for just the two hours postprandial? What I mean is that even if eating mostly sugar makes insulin work better, wouldn't all that glucose still cause tissue damage as it does when it's chronically elevated?
Or glycation (AGEs), whouldn't there be more glycation from eating more sugar?
If insulin is working correctly, sugars are processed in the cells, and they don't cause glycation-related damage.
As to clinical trials proving the connection between meat and disease, I refer you to Dr. McDougall's website, where he cites several. However, the pathways are clearly documented in the literature (between, for example, high amounts of sulfur-containing amino acids and osteoporosis; and between high fat diets and intramyocellular lipids, which cause diabetes).
I'm not sure what research has been done on the increase in glycation due to a high-carb diet. However, the Okinawa Program and the China Study (both very long-term studies) both showed that the longest-living, healthiest people (namely: Okinawans and rural Chinese) live on an almost all-starch diet..
On McDougall's website, click the "Medical Info" tab, then "Common Health Problems", then there is a drop down. Choose "atherosclerosis", and there are some references.
The China Study did 2 mortality surveys, and 2 diet surveys. The diet surveys were done years after the mortality surveys. How can effect come before cause?
The *study* of an effect can easily come long after the *study* of a cause. That is not the same thing as the effect itself coming after the cause. And clinical trials like the Adventist Health Study have at least shown that the increase in amount of animal products correlates with higher BMI and higher risk of type-2 diabetes. But, I am not a physician, and I don't have access to much more than what I've shared with you.
In the China Study, the presumed cause is food, the effect is diseases. They did food surveys _after_ the health surveys. They measured food _after_ diseases. People can change their diet in 15 years.
The AHS is not a clinical trial. Two kinds of studies: Observational (ex. look at population), interventional (ex. a clinical trial). The AHS study is an observational study.
I'm not a physician either. I'm just like you, I'm looking for answers.
Well, in the search for answers, wouldn't such strong correlations be indicative of the more plausible reality? Couldn't we infer from all of the observational studies that people have less coronary (and other) diseases when they exclude animal products? And what about studies like Neal Barnard's. He had a control group and a participating group. The group that followed his diet lost weight and cured their diabetes. Isn't that a clinical trial?
Yes, exactly. We can infer cause and effect with observational studies. But we can't prove anything. I don't know which Neal Barnard's study you're referring to. But if he fed people his diet, compared it to a control group, then looked at the results, then yes that's a clinical trial. There's another clinical trial called the A-TO-Z study. They compared 4 diets, Atkins, Ornish, ZONE, LEARN (conventional diet). Atkins did best.
Then Barnard's study was certainly a clinical trial, and you can find the results in the YouTube video "Breaking the Food Seduction", where Barnard lectures on the topic, and then references his work and the work of others.
In the A-to-Z study, what were the parameters of success? After all, I know that a ketogenic diet can lower many risk factors, but as McDougall mentions in this video, so can chemotherapy.
That's true. Atkins lowers risk factors, just like chemotherapy. But Dr McDougall's diet lowers the same risk factors as well. If Dr McDougall is right, then anything that lowers the same risk factors should be just like chemotherapy, including Dr McDougall's own diet.
The point he's making is that we shouldn't conclude a diet is better based on it's effect on those risk factors. If the Atkins diet really makes people sick (as that link I've posted actually goes on to show), then saying it helps you lower risk factors doesn't change the fact that it does so by making you sick.
That's exactly what Dr McDougall says. He says the Atkins diet makes us sick. But he doesn't explain how Atkins makes us sick. Instead, he compares it to chemotherapy, and says Atkins lowers the same risk factors as chemotherapy. I'm just saying Dr McDougall's diet also lowers the same risk factors. I'm confused about that. That's why I want to know how Atkins makes us sick, if it really does make us sick as Dr McDougall says.
Now I know Dr McDougall says low carb diets (Atkins) make us sick. But if that's true, then why did the Ornish diet (almost exactly like Dr McDougall's diet) do worse than the Atkins diet in the A-TO-Z study? If Atkins is supposed to make us sick, then the A-TO-Z study should have told us about it.
It's interesting. The lead researcher of the A-TO-Z study is a vegetarian, Chris Gardner.
For McDougall's remarks on the A-to-Z study, please see h t t p:/ /drmcdougall. com/misc/2 007nl/mar/defend .htm (remove gaps). Scroll down to the subheading "Atkins is better than Ornish, Stanford study says".
I read Dr McDougall's comments. I agree. For any diet to be effective, we have to stick to it. Chris Gardner says the same thing. Dr McDougall says the Atkins diet is much easier to stick to. I agree. But then the LEARN diet is much easier to stick to than Atkins because the LEARN diet is just like the conventional diet: People don't have to work very hard to keep doing what they're already doing. Yet the LEARN diet did the worst of all 4 diets.
You missed the point. Atkins-style diets caused constipation and decalcification, as well as coronary problems. And for the weight loss, you cannot use the ATOZ study, since the ones on the Ornish-style diet *didn't follow an Ornish diet*! If they had, their %CFF would have been 10, not 29.
If the Atkins diet really causes coronary problems, then the A-TO-Z study should have told us about it because it measured it. Risk factors for heart disease were better with Atkins than the other diets. As for constipation, that's easy to fix and a much smaller problem than the alternatives: Obesity, diabetes, heart disease, Alzheimer's, cancer, etc.
Reversal of atherosclerosis has been demonstrated by angiograms and PET scans after following the Ornish Diet for 12 months and longer.11 The only study of patients on the Atkins Diet has shown a worsening of blood flow at one year from all that saturated fat and cholesterol with an overall cumulative progression of artery disease (atherosclerosis) of 39.7%.12
I got it. That study didn't test the Atkins diet, but a "high protein diet". Atkins is not high protein, but low carb high fat. The A-TO-Z study gives us a breakdown of all four diets. All diets were between 19% and 22% protein.
I don't know what that high protein diet is, but I know it's not Atkins. Though many people believe Atkins is high protein so that would make a good argument for Dr McDougall. But not good enough to convince me.
But I've seen analyses of the Atkins diet (see atkinsdietalert(.)org) that show that the Atkins Induction phase is 33% kcal from protein. It is always referred to as a "high-protein" diet (by the American Heart Association, the American Dietetic Association, and by the American Kidney Fund, etc). The warnings against "high-protein" diets are referring to Atkins-style diets.
That's probably true. But the induction period is just two weeks. So all those people who refer to the Atkins diet as high protein really refer to the induction period. In my opinion, two weeks isn't long enough to warrant all those dire warnings. And as the A-TO-Z study shows, protein ratio for the Atkins diet is not really 33%, but 22%.
I don't refer to the Atkins diet as high protein because I actually have the book so I would know about something like that.
Well, it doesn't matter what they had in mind when it doesn't reflect the actual thing. But if what they had in mind reflects what most people have in mind, then that matters too.
That's an interesting point. In fact, we could say that's one flaw of the Atkins diet: it's too easily misrepresented by most people. But how we perceive the Atkins diet doesn't change the fact that it did better against 3 other diets in a clinical trial.
You missed my point completely. The study about the effects of a "high-protein" diet on coronary health were specifically about Atkins-style diets. The labelling is irrelevant.
I agree, labeling is irrelevant when we have the real numbers instead. The study you referred used a 33% protein diet. The A-TO-Z study tested the genuine Atkins diet, and protein ratio is 22%. That's a significant difference. Seems to me the study you referred is misrepresenting the Atkins diet. I don't know of any commercial diet that says to eat 33% protein. Seems to me the study went out of its way to test an extreme version of the Atkins diet.
If Atkins asks them to hold to a >30% protein diet for any amount of time, then it falls under the purvue of that study.
Asians eat pork and lard *now*, since they can afford it. The Okinawans *love* pork, but the studies in the '80s showed that it was less than a percent of their yearly intake. It was a special occasion thing. They thrived because of sweet potatoes and rice.
I'm happy for you that you like it and that's it's easy for you. But the A-TO-Z study says it's harder than Atkins and not as effective for weight loss for most people.
Whole grains is tricky. We can't digest grains without processing, so it's not really whole grains, but refined grains. Without processing, we can't absorb the starch and protein contained in the husks. And whole wheat bread raises blood sugar just as much as white bread.
And, in any case, I've looked more closely at the study in the JAMA, and you have this quite wrong. Only one person quit the Ornish diet because they didn't enjoy it (and one person quit Atkins for the same reason). 6 quit Ornish because of Scheduling difficulties, and 10 quit for other reasons. 1 quit Arkins for Scheduling reasons, and 8 for other reasons. However, no one quit Ornish because of "health", while 3 quit Atkins for that reason
Also, the carbohydrate intake accounted for 34% of calories in the Atkins group by the 12-month point. Is that in accord with the Atkins prescription? By my calculations 50g/d would have only been ~10% of daily intake. That means that the Atkins group wasn't compliant either.
And, finally, while the Atkins group had the highest weight loss, the paper says that the weight loss was modest anyway. 4.7kg or ~10lbs. Many critics of Atkins have shown that 60% of weightloss can be attributed to water weight and glycogen depletion. So, this is truly unimpressive. Also, in the conclusion of the paper, the researchers make it clear that the weightloss stats were starting to converge, and that, in the longer term, the difference may have disappeared
Here's an idea. The A-TO-Z study says the Ornish diet is hard to stick to. Seems to me if Dr Ornish wanted his diet to do better, he should find a way to make it easier to stick to. Every study done shows that the single most important factor for success is that we stick with the diet. As far as I can tell, Dr Robert Atkins figured that out long ago.
You said people should have done better with Ornish. People are not machines. They don't just do what you tell them. Their bodies don't just take anything you throw at it. They'll do better if it's easier. They'll do worse if it's harder. The Atkins diet seems to be easier. The Ornish diet seems to be harder.
You gotta wonder why. Maybe it's got something to do with compatibility. Maybe the Atkins diet is more compatible with humans. That makes sense to me.
They should have stuck to the diet. The Atkins diet is easier to stick to, because you can still go right through the drive-thru and get your burgers etc. Fatty foods are tasteful to us, because they provide us with excess fat on our bodies for when the famine comes. That was useful in our past. It isn't useful now. We need to go back to the things that keep us trim and long-lived, and push aside our taste for "energy to save for later".
They should've, but they didn't. We're back to square one: Why is it harder to stick to the Ornish diet?
That's true, the Atkins diet is easier for all the reasons you said. But then, if the Atkins diet really provides us with excess fat on our bodies, then why did the people on the Atkins diet lose more weight? Seems to me if Atkins makes us lose more weight, then that's the thing we need to go back to, the thing that keeps us trim as you say.
It is a culture shock for Americans. An Asian would have no difficulty at all. Except in areas that have been more Westernized of late, the normal diet was right inside of Ornish's and McDougall's parameters. This was mostly because the people were too poor to afford the richer foods of an Atkins-style diet, but that poverty saved them from obesity and disease.
Atkins diets do not lead to long-term weight loss: NEJM 348(2003):2082.
There's no diet that lead to long term weight loss. Once you quit a diet, you lose its effects. Nothing new here.
Eating an Atkins diet isn't that expensive. If you're a smart shopper, you can do it for no more money that you pay now. Meat isn't that expensive when you choose cheap cuts. Since the Atkins diet is high fat, you can choose fatter meats which are cheaper. Vegetables are the same price for the Atkins diet as they are for the Ornish diet.
And you missed my point on the poverty issue. I'm saying that Asians have been historically trim and diabetes-free on a very high-starch diet, with little to no animal products. To this day, the healthiest, longest-lived people (and least likely to have heart disease or cancer) are people on starch-based diets with very little, if any animal products (e.g. Okinawans, rural Chinese, rural Peruvians, etc). Their poverty led them to that diet, but that is incidental.
One thing I know about Asians, their diet staples besides rice is pork and lard. They don't even eat that much rice. A small bowl with the meal perhaps, no more.
Maybe it's true they live longer due to the lack of meat. But I don't believe it. I think it's the lack of refined carbs like sugar and flour. There's research that support that idea too. Cynthia Kenyon, C. elegans, glucose. The worms lived much longer when they ate less glucose.
I'm not debating the fact that we need to get away from all the processed foods, and extra sugar. Nor is McDougall. Nor are Bernard or Ornish. They all suggest getting away from all the processed, refined foods and sugars. But that says nothing against the *whole* grains and starches.
Even Dr Neal Barnard says Americans eat too much sugar in the youtube lecture you referred me to. When those Asians start getting fatter after McD came around, we can't blame meat. There's very little meat in a trio but there's tons of sugar though. The soft drink, the bun, the fries, the patty filler. All refined carbs. No wonder they grow just as fat as we do.
Again, poverty is incidental. The poverty of Asians and South Americans led them to the right diet: a starch-based one, with some fruits and vegetables, and very little (if any) animal products.
Oh, and on the point of long-term weight-loss, you are not supposed to "quit a diet". A diet is supposed to become a lifestyle. And, if that were the case with Atkins, then why do they all regain their weight in the long-term?
I know you're not supposed to quit the diet. But the study subjects are under no obligation to stick to the diet once the study is over. They only did the study because they got paid. That's how those studies work. So they quit after the study ends. And that's why they regain the weight. It's not like the diet stops working. It works, but like you said, it's gotta become a lifestyle. That's true for all diets.
I can't speak for how expensive Ornish's diet is, but when I eat like a McDougaller, I spend about $4 per day on food. Not too bad, in my opinion. And it isn't hard to stay on at all. You just have to make an adjustment in your thinking, where starch is the center of your diet, with fruits and vegetables around it, and no animal products or oils. It's very easy after that, and there are hundreds of testimonials on McDougall's diet that show it's worked for them.
That's true. The Atkins group was non-compliant. In fact, all groups were non-compliant. But the Atkins group did better anyway. You said if the Ornish group were more compliant, they'd have done better. We can say the same about the Atkins group too.
The Atkins group did *barely* better in terms of weight loss (which can be explained through ketosis, and the loss of water weight and glycogen), and they did worse in LDL scores, actually. But, because they did better in the HDLs and triglycerides, the LDL scores were deemed irrelevant.
That's true. We can explain the Atkins weight loss with ketosis and water weight. This means that the other groups lost less weight because of the same reasons. They did not do ketosis very well, and they retained more water.
But ketosis is something that only occurs in nature under two conditions: starvation and extreme sickness. Why should we induce a sick-state in order to lose weight, when we can do so on a diet that doesn't require simulating sickness? Especially when we also have to become constipated and run the risks associated with ketoacidosis *(i.e. kidney failure and osteoporosis) over the long-term?
Ketoacidosis does not occur with carbohydrate restriction. Au contraire, it occurs with carbohydrate poisoning, i.e. diabetes type 1. In fact, that's a cause of death for diabetics type 1. I call it carbohydrate poisoning because diabetics type 1 can't secrete insulin, therefore any carbohydrate causes blood glucose to rise to toxic levels, and stay at those levels.
Your argument lends support to the idea that many are confused about ketosis and ketoacidosis.
I hope you enjoyed your weekend. I'm sorry I was unavailable to respond to you during that time.
You are wrong about the ketogenic diet not being a cause of ketoacidosis. "Clinical Aspects of the Ketogenic Diet" DOI: 10.1111/j.1528-1167.2007.00914. They used a ketogenic diet (couple with fasting, which has some of the same effects) to treat epilepsy. Almost all their patients got ketoacidosis, and they had to be very careful to avoid kideny stones (many still got them).
The term they used is "mild acidosis" in the side effects section. This is not a side effect, this is the primary effect. Ketoacidosis is not merely caused by large concentration of ketones in the blood, but also contributed by large concentration of glucose in the blood. The same study pointed out that blood glucose drops significantly.
Mild acidosis was reported in 6% of subjects. In other words, 94% of subjects did not develop mild acidodsis.
Glucose does drop significantly. Indeed, another side effect was hypoglycemia. And you misread: acidosis was seen in "most patients", and the body of the study talks about the pains they went to to try and avoid this. The 6% number was of those who developed nephrolithiasis.
The ketoacidosis that diabetics type 1 suffer from is due to the lack of insulin, which otherwise regulates fat metabolism. Without insulin, ketogenesis runs wild. When we simply cut carbs on the Atkins diet, we still secrete insulin which regulates ketogenesis normally, therefore the risk of developing ketoacidosis is nil.
As for the 3 in the Atkins group that quit because of health, it's doubtful that it was due to the Atkins diet itself. The Atkins group, those who stuck to the end, did better than the other groups in all things measured, including health markers.
I know that the A-TO-Z didn't test the McDougall diet. But you argued that Atkins-style diets were all alike. Surely you will allow me to argue that Ornish-style diets are all alike. But if you know of a significant difference between the Ornish diet and the McDougall diet that can make a significant difference in the results, then by all means.
Almost all diets rely on caloric restriction for weight loss, except Ornish and Atkins, both say eat as much as you want except where restricted: Atkins = carbs. Ornish = fat. All diets were effective but Atkins was best. Why?
The answer may be that the single most significant factor for weight loss is carbohydrates. When we start with high carb and cut calories, we end up cutting mostly carbs, but not as much as Atkins. That's what the piecharts say anyway.
But the Atkins group was barely having less carbohydrate than the Zone group. As a percentage of calories, there was very little difference, since the Atkins group was non-compliant to the point of having almost as much carb as the Zone group. How can this be the relevant factor, when the Zone diet did the worst?
Also, what do you say to the conclusion of the paper, which shows that things were levelling off, and that there wasn't enough time to see the long-term effect?
32% of 1500 kcals is 480 kcals, or 120g of carbs. That's right around what's called the ketogenic threshold where we start burning lots of fat. The other diets were 46%-52% carbs, or 690-780 kcals, or 170g-195g carbs. A difference of 50g-75g carbs per day. Apparently, that's enough to make people lose twice the weight on average.
You said weight loss was modest, you said Atkins group ate too much carbs. There's your explanation.
That is begging the question. You assume that eating less carbs would have led to greater weight loss, but that cannot be shown from this study, and so is based entirely on bias. I could equally say that, had the Ornish group actually been compliant, they would have lost more weight as well.
I assume nothing. I simply look at the results and draw my own conclusions. As for being biased, if you could say that had the Ornish group actually been compliant, they would have lost more weight, then you should also say had the Atkins group been compliant, they'd have lost more weight as well. And as far as I can tell, that's what I've been saying all along. So we can hardly accuse me of being biased.
I agree with the conclusions regarding convergence. This can be explained by the diets' convergence: They all tended to return to the same ratios. 120g carbs per day is still too high for weight loss. This is reflected by the slight upward curve for the Atkins group at the end. All of this confirms the idea that the single most significant factor for weight loss is carbohydrates.
It does not confirm the carb theory at all. Once again, that is begging the question (a logical fallacy). It could just as easily confirm that, once you get past the water weight and glycogen loss, the weight loss on an Atkins diet is simply unimpressive, or even non-existent. A longer-term study was needed, by the authors' own admission.
We could argue that the other groups, who ate the least fat, show that fat is the single most significant factor for weight loss. But we would be wrong because the Atkins group, who ate the most fat, lost more weight anyway.
Barely more weight. And, by the way, the study also didn't measure what *kinds* of weight were being lost. I read another reference that showed that Atkins dieters often lose a great deal of their lean mass as well. Weight loss is not, in and of itself, a great goal.
Water is considered lean mass. Since the Atkins group lost more water weight, that explains it.
Actually, they lost twice the weight. If 10lbs is "barely", then 5lbs is "almost none".
Ketosis occurs when we restrict carbohydrates below a certain point. This point varies by individual but runs around 100g per day. Perhaps you are referring to ketoacidosis? The two are not the same. Though many are confused about that.
I am reading that study you referred me to. I see red flags already in the methods section. First, they did not actually provide the diet books. Instead, they provided the official diets' cookbooks. They standardized things like exercise across all diets. In other words, they did not actually test the diets, but some variation they thought would suffice to represent the diets. The A-TO-Z study tested the genuine diets, not merely the associated cookbooks.
The ATOZ did not test the "genuine diets", since almost no one adhered to the actual diet guidelines. And your idea that you can range the efficacy of a diet over the compliance would be great if you were measuring LEVEL of compliance, rather than the NUMBER OF PEOPLE who were compliant. Number of people who were compliant is not an independent variable that can be related directly to amount of pounds lost. Level of compliance on an individual's part could be.
The A-TO-Z tested the genuine diets by virtue of having given and read the actual diet books. The Dansinger study however gave only the associated cookbooks.
The Dansinger did not test the genuine diets either since no one adhered to the actual diet guidelines either. Since this is true for both studies, we are left with measuring adherence from the data we know of. % of study finishers is indeed a relevant study parameter, as it affects the quality of results.
And I never said the percentage of those who finished the study wasn't relevant. I just showed that your attempt to correlate NUMBER of compliant people (rather than LEVEL of compliance) with the efficacy of a particular diet in terms of (altogether miniscule) weightloss was a non-sequitor.
Also, adherence was much lower at 58% vs 80%, and starting group size was smaller at 140 vs 311. All of this combined makes the A-TO-Z study's results much more reliable.
That's true. Dehydration is a common charge against the Atkins diet. But the Atkins diet, when one reads the book, finds that it advises to drink lots of water. It's ironic. The book advises to drink lots of water, and we blame loss of water weight for the bulk of weight loss on the Atkins diet. It seems to me the complaints don't fit the facts. But maybe it's a question of blaming the wrong diet? If they didn't read the book, they didn't really follow the diet.
As the epilepsy study you referred noted, dehydration is a short term effect. This is confirmed by water loss in the induction phase of the Atkins diet. This water loss does not continue past this early phase as water balance is maintained normally afterward, and as most of that lost water was bound to glygocen, which is now depleted back down to baseline level, and only replenished by the liver and the small daily amount of carbohydrate allowed by the Atkins diet.
The liver does not have an endless supply of glycogen, and gluconeogenesis at high levels is taxing to the liver. And dehydration was a problem *throughout* the diet in the study I referenced. Read the body of it, and they mention it numerous times. Dehydration is a serious problem that the American Dietetic Association mentions among its several reasons to be wary of the Atkins diet.
Like I said, the health of Dr Robert Atkins is a matter of public records. Anybody can read the truth by searching "Dr Robert Atkins death certificate".
Even after his death, Dr Atkins is frequently maligned by the press and his opponents of old. It seems unfair to attack the man, when one can attack the arguments instead. It seems more unfair since many of the attacks come from otherwise respectable sources like Dr Dean Ornish for example.
In Shai et al's study, the adherence was about 3/4 in the Atkins group over two years (compared to over 90% in the low-fat group, which once again wasn't a low-fat group at all, since they were eating 30% of calories from fat). So, I don't know how you defend Atkins in terms of adherence in the face of this. As to results: Once again the weight loss was only different by 3lbs. Pathetically small. And blood pressure scores (sys and dia) were better on LF than on LC. What are you hoping to prove??
Mentat1231 1 week ago
@Mentat1231
Can you stick to the facts please? Your opinion, while welcome, detracts from your analysis of the facts. For example, you object to some ratios as not being low fat enough. It's low enough for the researchers, if not for you. You did the same with A-TO-Z since the start with "they didn't actually comply". The facts please. Otherwise it gets tedious to point out all your hyperbole and exaggeration.
JackFook 1 week ago
@JackFook
It has nothing to do with my opinion. The Ornish and McDougall diets (actual, low-fat diets) are 10% fat. These 30% fat diets are, at best, "moderate" (a person eating 2000 calories, at 30% fat would be eating 66 grams/day, which the USDA calls the top mark of "moderate"). So these are not actually low-fat diets. Also, a lack of compliance is in fact relevant, and you agreed until it turned out of your favor with the Shai study. 75% adherence vs. 90% and suddenly it doesn't matter?
Mentat1231 6 days ago
@JackFook
In fact, if I recall correctly, since the A-TO-Z study didn't actually test the diets in question at all, you said its main merit might be in showing us which diet was easiest to adhere to. You then asked why Atkins is so much easier to adhere to. Well, it turns out that it isn't, in the long run. Shai et al disproves that, during a timespan that the A-TO-Z researchers themselves would agree is better than their study.
Mentat1231 6 days ago
@Mentat1231
That's true. The results of all those studies have nothing to do with your opinion, nor mine as it were. Saying they didn't test what you wanted serves no purpose other than to point out that the facts don't agree with your opinion. That's why it's important to stick to the facts, and avoid hyperbole and exaggeration.
JackFook 6 days ago in playlist Favorite videos
@JackFook
Again, who is talking about testing what I want?? It is either a low-fat diet (which means at the very most 20% of calories from fat, and Ornish, McDougall, etc might debate even that) or it isn't. These studies did not test a low-fat diet. My citation of Ornish's 3-YEAR study, which actually was low-fat, and had dramatic results for weight loss and heart disease has received no comment from you for some reason. And yet you say you accept wherever evidence leads....
Mentat1231 6 days ago
@Mentat1231
And you keep avoiding the question. Do the studies replicate the results on conventional risk factors, yes or no?
JackFook 6 days ago in playlist Favorite videos
@JackFook
Do which studies replicate which results? The results are different depending on timeframes, actual content of the "low-fat" group, adherence, etc. But which results were you hoping to replicate?
Mentat1231 6 days ago
@Mentat1231
"These studies did not test a low fat diet".
It's a convenient excuse to ignore contradicting evidence. This way you can continue to rely on the evidence that agrees with your opinion. I can just as easily ignore the Angiology FMD study with the same excuse: They did not actually test the Atkins diet. However, even if I accept that study's results, I'm still left with the fact that it did not replicate the results of the bulk of other low carb studies.
JackFook 6 days ago in playlist Favorite videos
@JackFook
This is a complete red herring! I am making the point that very few, if any of your references actually tested a low fat diet as a SIDE POINT. It is not even near the basis of my argument. I directly addressed those studies, and even if you do consider the diets they tested to be low-fat, the studies still favor my point. The fact that they could have done even better if they'd actually done a low-fat diet is just a side point.
Mentat1231 6 days ago
@Mentat1231
It's a fair question to ask if one study replicates the results of the bulk of similar studies. I don't find it silly, even if you do.
JackFook 6 days ago in playlist Favorite videos
@JackFook
I have addressed this "bulk", and showed where the differences lie (timeframe, composition of opposing diets, etc). This is not the "silly sidetrack" I was referring to (and I apologize for using that term at all). The side argument that threatens to bury my relevant responses is the one about whether they were "really low-fat" or not. They weren't, and the results would have been better if they had been, but that is not central to my argument, and has no effect on my other points.
Mentat1231 6 days ago
@Mentat1231
Did the Angiology study's results replicate the low carb studies' results regarding conventional risk factors?
JackFook 6 days ago
@JackFook
Observational studies are not inherently bad. They are inherently unreliable though. And when you combine all potential flaws I cited in the same study, it's really hard to produce reliable results. Maybe we can rely on its results anyway. Maybe it's all the other studies that are badly designed. But I doubt it.
JackFook 6 days ago
@Mentat1231
The short answer: No.
Angiology. 2000 Oct;51(10):817-26
"Ten additional individuals elected a different dietary regimen consisting of a "high-protein" (high protein group/HPG) diet, which they believed would "improve" their overall health."
Translation:
Too small sample size (10 subjects on "high-protein" diet)
Flawed study design (self-selected subjects, not randomized)
JackFook 6 days ago
@Mentat1231
And inaccurate measurements (subjects selected own diet, i.e. intervention was not designed by scientists)
JackFook 6 days ago
@JackFook
The study I commented on that was antepenultimate in the list of 16, had 13 subjects. Is it also invalid because of sample size? Will you then change your number to 15, when you make the general statements?
As to people choosing their own diet, that doesn't change the effect of that diet on the arteries, which were directly investigated. This is a study of what occurs each time these patients ate their high-fat meals, which can be seen directly.
Mentat1231 6 days ago
@Mentat1231
The Angiology FMD study contains all three flaws that can prevent results from being replicated in otherwise properly designed studies. I only cited three potential flaws. If we know of those, how many more flaws does this study really contain?
JackFook 6 days ago
@Mentat1231
Too small sample size can create a statistical bias. For example, if 4 of 10 subjects' results are significantly different than the other 6, their results can skew the average thereby reversing the results of a comparison.
Self-selection creates its own bias. In fact we call it self-selection bias. If we allow all subjects to choose what they prefer, they will perform better by virtue of have more practice than other randomly selected subjects.
JackFook 6 days ago
@JackFook
I understand what's wrong with a small sample size, Jack, I'm just asking if you're going to apply that across the board and withdraw support from those studies in your (16) which had comparably tiny sample sizes.
This would only be a problem if their performance was what was in question. The artery in question did not "choose" a high-fat diet. ITS performance was being tested. And it would have performed the same way if a doctor had force-fed them the high-fat meal.
Mentat1231 6 days ago
@Mentat1231
Self-selection of the intervention, researchers did not design nor administer the intervention. This means the study is basically an observational study. Sure, they gave out food questionnaires, and that's exactly what they do in observational studies. Sure, they collected blood samples at the end, as is done in observational studies. But what they did not do is design and administer the intervention, also exactly like an observational study.
JackFook 6 days ago
@JackFook
Observational studies yield a great deal of useful information, so I don't know why that's such a bad thing. But, beyond that, they did know what the people ate, and they directly measured the effect on the arteries. To say there's something wrong with that, because the doctor's hadn't pre-selected the meals is like saying that studying the effects of malaria in a person's body is invalid because we didn't personally infect them.
Mentat1231 6 days ago
@Mentat1231
From the abstract of the Angiology study, I don't see where it says the researchers administered the diets to the subjects, nor were present when the subjects ate. If they did, they would've printed it proudly because that's a critical design parameter. So I'm left with the conclusion that they simply gave out food questionnaires and collected the answers.
JackFook 6 days ago
@JackFook
I never contested that they gave out food questionnaires and collected the answers... No offense, but maybe you should re-read my post. That was never a point I contested.
Mentat1231 6 days ago
@Mentat1231
I may change my mind, but I doubt it. The Angiology only administered the intervention to the low fat group.
"The 16 people (treatment group/TG) studied modified their dietary intake as instructed."
The other study of 13 subjects also gave instructions, but to all subjects, not just a fraction. 16 or 13, it's about the same quality. But comparing a group of 16 with intervention to a group of 10 without intervention is not proper study design.
JackFook 6 days ago
@JackFook
It's the size of the study that you questioned. That's it. You are only now combining it with the (completely unrelated complaint) of the self-selected diet. These are two separate objections. My point is that, to avoid bias, if you believe that a small number of subjects invalidates a study, then you must apply that across the board, and reject a few of your 16.
On the subject of self-selected diets: as long as the data collected is accurate, what difference does it make?
Mentat1231 6 days ago
@Mentat1231
I think we have a serious difference in the quality of evidence that we consider valid to support your arguments. If you believe that self-selection bias is irrelevant, then by all means. However you must realized that your credibility will suffer, in my eyes, if not yours.
JackFook 6 days ago in playlist Favorite videos
@JackFook
I hope you had a good weekend :-)
Honestly, I think we'll just go round and round at this point. As I've said, there are serious problems with short-term studies of Atkins (since ketosis is a survival mechanism with some short-term survival benefits), and the only long-term study (Shai, et al) showed lots of problems and unimpressive weight loss and compliance. Also the natural pathways toward disease on a high-fat diet are well documented, and none of your studies refutes this.
Mentat1231 4 days ago
@JackFook
Also, just in my own defense, if you look back I never said that self-selection bias wasn't relevant in general. I said it wasn't relevant when they are reporting what they eat, and their arteries are being directly examined. That is a very fair statement, since we use the same assumptions in many animal studies, when examining particular organs directly.
In any case, it's been very engaging and interesting discussing this with you. I wish you the best.
Mentat1231 4 days ago
@Mentat1231
I had fun debating with you. I wish you the best as well.
JackFook 3 days ago in playlist Favorite videos
@Mentat1231
I cited _potential_ flaws. The Angiology contains all three I cited. I didn't say that's why it didn't replicate the results of the bulk of low carb studies. But it's a good indication.
JackFook 6 days ago
@JackFook
And do you really intend to bury yet another good set of objections in these silly side arguments? I just showed that only one of the studies you've cited was long enough to show long-term effect (the A-TO-Z, Dansinger, and Shai researchers agree with me on this point). Those short-term studies show bad effects on depression, anxiety, and cognitive speed. They show, at most, 4lbs more weight loss, even over a year's time, than the standard USDA diet plan. And each meal hurts FMD.
Mentat1231 6 days ago
@JackFook
Then, finally there is a two-year study, and it shows that blood pressure was better on the "low-fat" diet than on Atkins, and the difference in weight loss was 3lbs again. The Ornish study, on the other hand, had the subjects on an actual low-fat diet, and they did head-and-shoulders better than anything Atkins did in any of your cited studies. Better in terms of weight loss (sustained, by the way), and in terms of coronary risk factors. Where is the evidence leading you??
Mentat1231 6 days ago
@Mentat1231
Also, please stick to the relevant point. In this case, it's FMD and conventional risk factors, and replicating results. Do these low carb studies replicate results on conventional factors?
JackFook 1 week ago in playlist Favorite videos
@JackFook
I just showed that, in the Shai study (the only one of all the ones you've ever referenced that was longer than a year) blood pressure was better on the "low"-fat diet, vs. the low carb one. That's a "conventional factor", no?
Mentat1231 6 days ago
@Mentat1231
Do they replicate results on conventional risk factors or not? If not, which result, which study? You cited blood pressure for one study. Is it the only study, only result? If yes, why? Was that study badly designed, did it have too small sample size, did they make inaccurate measurements? Do the other studies contradict this one?
JackFook 6 days ago in playlist Favorite videos
@JackFook
As I've been saying since the very beginning, the studies of Atkins are never long-term enough to show the overall effect. The Shai study was the longest I've ever seen (all the others were a year or less), and it showed that blood pressure was better on a moderate fat, higher carb diet. The other studies are simply at two short a timeframe, which distorts the results, since the initial shock of ketosis has survival advantages, but was never meant to be long-term.
Mentat1231 6 days ago
This has been flagged as spam show
Jack,
Once again, I never claimed that FMD was unrelated to conventional risk factors. The only straws are the ones your strawmen are made of, since you are attacking a position I never espoused. I said the *long-term* (not 8 weeks; but over the *years*) effect on the arteries of consistently eating meals which slow FMD and damage the arteries would be deletrious. Can you not see how completely different that position is from what your study addressed?
Mentat1231 1 week ago
@Mentat1231
Compare Dansiger and A-TO-Z studies. Adherence was much higher with A-TO-Z than Dansiger's. When adherence is higher with Atkins, we get more weight loss. But when adherence is higher with ZONE and Ornish, we get less weight loss.
Dansiger vs A-TO-Z adherence and weight loss.
Atkins: 53% = 2.1kg vs 88% = 4.7kg
ZONE: 65% = 3.2kg vs 77% = 1.6kg
Ornish: 50% = 3.3kg vs 78% = 2.2kg
Isn't that cool?
JackFook 1 week ago in playlist Favorite videos
@Mentat1231
Dr Atkins called it "benign dietary ketosis". It's doubtful that restricting carbohydrates then going into ketosis would lead to ketoacidosis when we still secrete all the insulin needed to regulate normal ketogenesis. But if you know of a study that shows that risk you mentioned, I'd be happy to take a look at it.
JackFook 1 week ago
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Mentat1231 2 weeks ago
@Mentat1231
That's true. Total cholesterol goes down when you avoid animal products. That's because HDL goes down, and LDL particles become smaller. If I'm not mistaken, those are both risk factors for heart disease.
JackFook 1 week ago
i am gaining a pound a day on this diet, wtf?
Mongodelight 3 weeks ago in playlist Favorite videos
tree ripened mangos (without any acid) is more appeiling then raw grains^^ because we re frugivores.
Mongodelight 3 weeks ago
starches are the best replacement for fruit obviously.
Mongodelight 3 weeks ago
bullshit...We re not starchivores,we re frugivores like all the other primates
Mongodelight 3 weeks ago
i got fat on that program. 30 pounds in 10 weeks. That was after a starving period. Now i am doing it again and i am getting fatter again. Whats going on?
Mongodelight 3 weeks ago
@Mongodelight Out of curiosity, can you list out what you have been eating during an average day?
sabby123456789 2 weeks ago
That is true but meat was a condiment maybe eaten on Sundays and holidays - not like kings queens and americans.
drmcdougallmd 3 months ago 3
@drmcdougallmd
I presume you are Dr McDougall himself? When you say "kings queens", are you referring to a period before the 20th century? If that is so, it's important to note they also ate lots of sugar and wheat flour which was not as ubiquitous as it is today, nor was it as cheap as it is today. Thanks to subsidies and official guidelines, Americans eat more sugar and wheat flour today that they ever did. Probably more so than those kings and queens.
JackFook 2 weeks ago
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JackFook 2 weeks ago
@drmcdougallmd
You advise to eat mostly vegetables, yes? Do you not also advise to cut refined sugar and wheat flour too? If that's the case, then we could also conclude that the benefit you attribute to eating mostly vegetables can also be attributed to the reduction of that refined sugars and wheat flour.
I presume you know about changing multiple variables. By advising to eat mostly vegetables, and to reduce refined sugar and flour, you are advising to change two variables.
JackFook 2 weeks ago 2
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JackFook 2 weeks ago
@drmcdougallmd
One last point, Dr McDougall. At 23:25, you show a slide that lists "Less Sugar" as a factor for reduced risk of type-2 diabetes. I presume this slide is a good representation of the diet you advise? But then, at 26:22 you cite a study by Brunzell with a slide that says "Sugar Makes Diabetes Better".
Forgive me if I'm little confused but why would you give advice that contradicts a scientific study? Do you know something we don't?
JackFook 2 weeks ago 2
@JackFook
The slide at 23:25 is from one study. The study by Brunzell is separate, and has confirmed by studies that Neal Barnard and others have done. Simply put, the first study (with "less sugar" listed among the suggestions) was wrong on that one point.
Mentat1231 2 weeks ago
@Mentat1231
If we believe the studies that found meat to be the culprit, shouldn't we also believe those same studies that also found sugar was the culprit? If we use that 85% sugar study to refute just the part of the other studies about sugar, shouldn't we do studies on all the other items listed to find out what's really going on?
For example, there is one study that looked exclusively at an all-meat diet. It found zero detrimental effect to health.
JackFook 2 weeks ago
@JackFook
That's the point, those studies have been done. Meat and dairy cause heart disease, cancer, osteoporosis, and numerous other problems (including diabetes, if they are high-fat products).
Mentat1231 2 weeks ago
@Mentat1231
I am aware of those studies. They are observational. This means they can't show actual cause and effect, but only an association.
JackFook 2 weeks ago
@Mentat1231
Before we prove meat causes disease, we have to do clinical trials. I know one clinical trial that found zero detrimental effect on health in humans.
JackFook 2 weeks ago
@Mentat1231
Or for example, the tissue damage from hyperglycemia, shouldn't this tissue damage also occur even when blood sugar rises to hyperglycemia level for just the two hours postprandial? What I mean is that even if eating mostly sugar makes insulin work better, wouldn't all that glucose still cause tissue damage as it does when it's chronically elevated?
Or glycation (AGEs), whouldn't there be more glycation from eating more sugar?
JackFook 2 weeks ago
@JackFook
If insulin is working correctly, sugars are processed in the cells, and they don't cause glycation-related damage.
As to clinical trials proving the connection between meat and disease, I refer you to Dr. McDougall's website, where he cites several. However, the pathways are clearly documented in the literature (between, for example, high amounts of sulfur-containing amino acids and osteoporosis; and between high fat diets and intramyocellular lipids, which cause diabetes).
Mentat1231 2 weeks ago
@Mentat1231
Glycation occurs inside cells too. I can't find any study that shows meat _causes_ disease on Dr McDougall's website.
JackFook 2 weeks ago
@JackFook
I'm not sure what research has been done on the increase in glycation due to a high-carb diet. However, the Okinawa Program and the China Study (both very long-term studies) both showed that the longest-living, healthiest people (namely: Okinawans and rural Chinese) live on an almost all-starch diet..
On McDougall's website, click the "Medical Info" tab, then "Common Health Problems", then there is a drop down. Choose "atherosclerosis", and there are some references.
Mentat1231 2 weeks ago
@Mentat1231
None of the references you pointed me to are clinical trials with meat and disease.
The China Study can only show association, but not cause and effect.
JackFook 2 weeks ago
@Mentat1231
The China Study is not a clinical trial.
JackFook 2 weeks ago
@Mentat1231
The China Study did 2 mortality surveys, and 2 diet surveys. The diet surveys were done years after the mortality surveys. How can effect come before cause?
JackFook 2 weeks ago
@JackFook
The *study* of an effect can easily come long after the *study* of a cause. That is not the same thing as the effect itself coming after the cause. And clinical trials like the Adventist Health Study have at least shown that the increase in amount of animal products correlates with higher BMI and higher risk of type-2 diabetes. But, I am not a physician, and I don't have access to much more than what I've shared with you.
Mentat1231 2 weeks ago
@Mentat1231
In the China Study, the presumed cause is food, the effect is diseases. They did food surveys _after_ the health surveys. They measured food _after_ diseases. People can change their diet in 15 years.
The AHS is not a clinical trial. Two kinds of studies: Observational (ex. look at population), interventional (ex. a clinical trial). The AHS study is an observational study.
I'm not a physician either. I'm just like you, I'm looking for answers.
JackFook 2 weeks ago in playlist Favorite videos
@JackFook
Well, in the search for answers, wouldn't such strong correlations be indicative of the more plausible reality? Couldn't we infer from all of the observational studies that people have less coronary (and other) diseases when they exclude animal products? And what about studies like Neal Barnard's. He had a control group and a participating group. The group that followed his diet lost weight and cured their diabetes. Isn't that a clinical trial?
Mentat1231 2 weeks ago
@Mentat1231
Yes, exactly. We can infer cause and effect with observational studies. But we can't prove anything. I don't know which Neal Barnard's study you're referring to. But if he fed people his diet, compared it to a control group, then looked at the results, then yes that's a clinical trial. There's another clinical trial called the A-TO-Z study. They compared 4 diets, Atkins, Ornish, ZONE, LEARN (conventional diet). Atkins did best.
JackFook 2 weeks ago
@JackFook
Then Barnard's study was certainly a clinical trial, and you can find the results in the YouTube video "Breaking the Food Seduction", where Barnard lectures on the topic, and then references his work and the work of others.
In the A-to-Z study, what were the parameters of success? After all, I know that a ketogenic diet can lower many risk factors, but as McDougall mentions in this video, so can chemotherapy.
Mentat1231 2 weeks ago
@Mentat1231
That's true. Atkins lowers risk factors, just like chemotherapy. But Dr McDougall's diet lowers the same risk factors as well. If Dr McDougall is right, then anything that lowers the same risk factors should be just like chemotherapy, including Dr McDougall's own diet.
JackFook 2 weeks ago
@JackFook
The point he's making is that we shouldn't conclude a diet is better based on it's effect on those risk factors. If the Atkins diet really makes people sick (as that link I've posted actually goes on to show), then saying it helps you lower risk factors doesn't change the fact that it does so by making you sick.
Mentat1231 2 weeks ago
@Mentat1231
That's exactly what Dr McDougall says. He says the Atkins diet makes us sick. But he doesn't explain how Atkins makes us sick. Instead, he compares it to chemotherapy, and says Atkins lowers the same risk factors as chemotherapy. I'm just saying Dr McDougall's diet also lowers the same risk factors. I'm confused about that. That's why I want to know how Atkins makes us sick, if it really does make us sick as Dr McDougall says.
JackFook 2 weeks ago
@Mentat1231
Now I know Dr McDougall says low carb diets (Atkins) make us sick. But if that's true, then why did the Ornish diet (almost exactly like Dr McDougall's diet) do worse than the Atkins diet in the A-TO-Z study? If Atkins is supposed to make us sick, then the A-TO-Z study should have told us about it.
It's interesting. The lead researcher of the A-TO-Z study is a vegetarian, Chris Gardner.
JackFook 2 weeks ago
For McDougall's remarks on the A-to-Z study, please see h t t p:/ /drmcdougall. com/misc/2 007nl/mar/defend .htm (remove gaps). Scroll down to the subheading "Atkins is better than Ornish, Stanford study says".
Mentat1231 2 weeks ago
@Mentat1231
I read Dr McDougall's comments. I agree. For any diet to be effective, we have to stick to it. Chris Gardner says the same thing. Dr McDougall says the Atkins diet is much easier to stick to. I agree. But then the LEARN diet is much easier to stick to than Atkins because the LEARN diet is just like the conventional diet: People don't have to work very hard to keep doing what they're already doing. Yet the LEARN diet did the worst of all 4 diets.
JackFook 2 weeks ago
@JackFook
You missed the point. Atkins-style diets caused constipation and decalcification, as well as coronary problems. And for the weight loss, you cannot use the ATOZ study, since the ones on the Ornish-style diet *didn't follow an Ornish diet*! If they had, their %CFF would have been 10, not 29.
Mentat1231 2 weeks ago
@Mentat1231
If the Atkins diet really causes coronary problems, then the A-TO-Z study should have told us about it because it measured it. Risk factors for heart disease were better with Atkins than the other diets. As for constipation, that's easy to fix and a much smaller problem than the alternatives: Obesity, diabetes, heart disease, Alzheimer's, cancer, etc.
JackFook 2 weeks ago
@JackFook
From the page I posted:
Reversal of atherosclerosis has been demonstrated by angiograms and PET scans after following the Ornish Diet for 12 months and longer.11 The only study of patients on the Atkins Diet has shown a worsening of blood flow at one year from all that saturated fat and cholesterol with an overall cumulative progression of artery disease (atherosclerosis) of 39.7%.12
He cites his sources, I'll copy and paste them...
Mentat1231 2 weeks ago
@Mentat1231
I got it. That study didn't test the Atkins diet, but a "high protein diet". Atkins is not high protein, but low carb high fat. The A-TO-Z study gives us a breakdown of all four diets. All diets were between 19% and 22% protein.
I don't know what that high protein diet is, but I know it's not Atkins. Though many people believe Atkins is high protein so that would make a good argument for Dr McDougall. But not good enough to convince me.
JackFook 2 weeks ago
@JackFook
But I've seen analyses of the Atkins diet (see atkinsdietalert(.)org) that show that the Atkins Induction phase is 33% kcal from protein. It is always referred to as a "high-protein" diet (by the American Heart Association, the American Dietetic Association, and by the American Kidney Fund, etc). The warnings against "high-protein" diets are referring to Atkins-style diets.
Mentat1231 2 weeks ago
@Mentat1231
That's probably true. But the induction period is just two weeks. So all those people who refer to the Atkins diet as high protein really refer to the induction period. In my opinion, two weeks isn't long enough to warrant all those dire warnings. And as the A-TO-Z study shows, protein ratio for the Atkins diet is not really 33%, but 22%.
I don't refer to the Atkins diet as high protein because I actually have the book so I would know about something like that.
JackFook 2 weeks ago
@JackFook
The fact remains, when the *study* referred to "high-protein diets", and their effect on coronary health, they had Atkins and South Beach in mind.
Mentat1231 2 weeks ago
@Mentat1231
Well, it doesn't matter what they had in mind when it doesn't reflect the actual thing. But if what they had in mind reflects what most people have in mind, then that matters too.
That's an interesting point. In fact, we could say that's one flaw of the Atkins diet: it's too easily misrepresented by most people. But how we perceive the Atkins diet doesn't change the fact that it did better against 3 other diets in a clinical trial.
JackFook 2 weeks ago
@JackFook
You missed my point completely. The study about the effects of a "high-protein" diet on coronary health were specifically about Atkins-style diets. The labelling is irrelevant.
Mentat1231 2 weeks ago
@Mentat1231
I agree, labeling is irrelevant when we have the real numbers instead. The study you referred used a 33% protein diet. The A-TO-Z study tested the genuine Atkins diet, and protein ratio is 22%. That's a significant difference. Seems to me the study you referred is misrepresenting the Atkins diet. I don't know of any commercial diet that says to eat 33% protein. Seems to me the study went out of its way to test an extreme version of the Atkins diet.
JackFook 2 weeks ago
@JackFook
If Atkins asks them to hold to a >30% protein diet for any amount of time, then it falls under the purvue of that study.
Asians eat pork and lard *now*, since they can afford it. The Okinawans *love* pork, but the studies in the '80s showed that it was less than a percent of their yearly intake. It was a special occasion thing. They thrived because of sweet potatoes and rice.
Mentat1231 2 weeks ago
@Mentat1231
Atkins is 22% protein.
I'm happy for you that you like it and that's it's easy for you. But the A-TO-Z study says it's harder than Atkins and not as effective for weight loss for most people.
Whole grains is tricky. We can't digest grains without processing, so it's not really whole grains, but refined grains. Without processing, we can't absorb the starch and protein contained in the husks. And whole wheat bread raises blood sugar just as much as white bread.
JackFook 2 weeks ago in playlist Favorite videos
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Mentat1231 2 weeks ago
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Mentat1231 2 weeks ago
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Mentat1231 2 weeks ago
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@JackFook
ATOZ didn't cover McDougall.
And, in any case, I've looked more closely at the study in the JAMA, and you have this quite wrong. Only one person quit the Ornish diet because they didn't enjoy it (and one person quit Atkins for the same reason). 6 quit Ornish because of Scheduling difficulties, and 10 quit for other reasons. 1 quit Arkins for Scheduling reasons, and 8 for other reasons. However, no one quit Ornish because of "health", while 3 quit Atkins for that reason
Mentat1231 2 weeks ago
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@JackFook
Also, the carbohydrate intake accounted for 34% of calories in the Atkins group by the 12-month point. Is that in accord with the Atkins prescription? By my calculations 50g/d would have only been ~10% of daily intake. That means that the Atkins group wasn't compliant either.
Mentat1231 2 weeks ago
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@JackFook
And, finally, while the Atkins group had the highest weight loss, the paper says that the weight loss was modest anyway. 4.7kg or ~10lbs. Many critics of Atkins have shown that 60% of weightloss can be attributed to water weight and glycogen depletion. So, this is truly unimpressive. Also, in the conclusion of the paper, the researchers make it clear that the weightloss stats were starting to converge, and that, in the longer term, the difference may have disappeared
Mentat1231 2 weeks ago
@Mentat1231
Here's an idea. The A-TO-Z study says the Ornish diet is hard to stick to. Seems to me if Dr Ornish wanted his diet to do better, he should find a way to make it easier to stick to. Every study done shows that the single most important factor for success is that we stick with the diet. As far as I can tell, Dr Robert Atkins figured that out long ago.
JackFook 2 weeks ago
@Mentat1231
You said people should have done better with Ornish. People are not machines. They don't just do what you tell them. Their bodies don't just take anything you throw at it. They'll do better if it's easier. They'll do worse if it's harder. The Atkins diet seems to be easier. The Ornish diet seems to be harder.
You gotta wonder why. Maybe it's got something to do with compatibility. Maybe the Atkins diet is more compatible with humans. That makes sense to me.
JackFook 2 weeks ago
@JackFook
They should have stuck to the diet. The Atkins diet is easier to stick to, because you can still go right through the drive-thru and get your burgers etc. Fatty foods are tasteful to us, because they provide us with excess fat on our bodies for when the famine comes. That was useful in our past. It isn't useful now. We need to go back to the things that keep us trim and long-lived, and push aside our taste for "energy to save for later".
Mentat1231 2 weeks ago
@Mentat1231
They should've, but they didn't. We're back to square one: Why is it harder to stick to the Ornish diet?
That's true, the Atkins diet is easier for all the reasons you said. But then, if the Atkins diet really provides us with excess fat on our bodies, then why did the people on the Atkins diet lose more weight? Seems to me if Atkins makes us lose more weight, then that's the thing we need to go back to, the thing that keeps us trim as you say.
JackFook 2 weeks ago
@JackFook
It is a culture shock for Americans. An Asian would have no difficulty at all. Except in areas that have been more Westernized of late, the normal diet was right inside of Ornish's and McDougall's parameters. This was mostly because the people were too poor to afford the richer foods of an Atkins-style diet, but that poverty saved them from obesity and disease.
Atkins diets do not lead to long-term weight loss: NEJM 348(2003):2082.
228 AoIM 140(2004):778.
Mentat1231 2 weeks ago
@Mentat1231
There's no diet that lead to long term weight loss. Once you quit a diet, you lose its effects. Nothing new here.
Eating an Atkins diet isn't that expensive. If you're a smart shopper, you can do it for no more money that you pay now. Meat isn't that expensive when you choose cheap cuts. Since the Atkins diet is high fat, you can choose fatter meats which are cheaper. Vegetables are the same price for the Atkins diet as they are for the Ornish diet.
JackFook 2 weeks ago
@JackFook
And you missed my point on the poverty issue. I'm saying that Asians have been historically trim and diabetes-free on a very high-starch diet, with little to no animal products. To this day, the healthiest, longest-lived people (and least likely to have heart disease or cancer) are people on starch-based diets with very little, if any animal products (e.g. Okinawans, rural Chinese, rural Peruvians, etc). Their poverty led them to that diet, but that is incidental.
Mentat1231 2 weeks ago
@Mentat1231
One thing I know about Asians, their diet staples besides rice is pork and lard. They don't even eat that much rice. A small bowl with the meal perhaps, no more.
Maybe it's true they live longer due to the lack of meat. But I don't believe it. I think it's the lack of refined carbs like sugar and flour. There's research that support that idea too. Cynthia Kenyon, C. elegans, glucose. The worms lived much longer when they ate less glucose.
JackFook 2 weeks ago
@JackFook
I'm not debating the fact that we need to get away from all the processed foods, and extra sugar. Nor is McDougall. Nor are Bernard or Ornish. They all suggest getting away from all the processed, refined foods and sugars. But that says nothing against the *whole* grains and starches.
Mentat1231 2 weeks ago
@Mentat1231
Even Dr Neal Barnard says Americans eat too much sugar in the youtube lecture you referred me to. When those Asians start getting fatter after McD came around, we can't blame meat. There's very little meat in a trio but there's tons of sugar though. The soft drink, the bun, the fries, the patty filler. All refined carbs. No wonder they grow just as fat as we do.
JackFook 2 weeks ago
@Mentat1231
The cheapest foods in America are sugar and grains. Poverty won't save us here.
JackFook 2 weeks ago
@JackFook
Again, poverty is incidental. The poverty of Asians and South Americans led them to the right diet: a starch-based one, with some fruits and vegetables, and very little (if any) animal products.
Oh, and on the point of long-term weight-loss, you are not supposed to "quit a diet". A diet is supposed to become a lifestyle. And, if that were the case with Atkins, then why do they all regain their weight in the long-term?
Mentat1231 2 weeks ago
@Mentat1231
I know you're not supposed to quit the diet. But the study subjects are under no obligation to stick to the diet once the study is over. They only did the study because they got paid. That's how those studies work. So they quit after the study ends. And that's why they regain the weight. It's not like the diet stops working. It works, but like you said, it's gotta become a lifestyle. That's true for all diets.
JackFook 2 weeks ago
@JackFook
I can't speak for how expensive Ornish's diet is, but when I eat like a McDougaller, I spend about $4 per day on food. Not too bad, in my opinion. And it isn't hard to stay on at all. You just have to make an adjustment in your thinking, where starch is the center of your diet, with fruits and vegetables around it, and no animal products or oils. It's very easy after that, and there are hundreds of testimonials on McDougall's diet that show it's worked for them.
Mentat1231 2 weeks ago
@Mentat1231
That's true. The Atkins group was non-compliant. In fact, all groups were non-compliant. But the Atkins group did better anyway. You said if the Ornish group were more compliant, they'd have done better. We can say the same about the Atkins group too.
JackFook 1 week ago
@JackFook
The Atkins group did *barely* better in terms of weight loss (which can be explained through ketosis, and the loss of water weight and glycogen), and they did worse in LDL scores, actually. But, because they did better in the HDLs and triglycerides, the LDL scores were deemed irrelevant.
Mentat1231 1 week ago
@Mentat1231
That's true. We can explain the Atkins weight loss with ketosis and water weight. This means that the other groups lost less weight because of the same reasons. They did not do ketosis very well, and they retained more water.
JackFook 1 week ago in playlist Favorite videos
@JackFook
But ketosis is something that only occurs in nature under two conditions: starvation and extreme sickness. Why should we induce a sick-state in order to lose weight, when we can do so on a diet that doesn't require simulating sickness? Especially when we also have to become constipated and run the risks associated with ketoacidosis *(i.e. kidney failure and osteoporosis) over the long-term?
Mentat1231 1 week ago
@Mentat1231
Ketoacidosis does not occur with carbohydrate restriction. Au contraire, it occurs with carbohydrate poisoning, i.e. diabetes type 1. In fact, that's a cause of death for diabetics type 1. I call it carbohydrate poisoning because diabetics type 1 can't secrete insulin, therefore any carbohydrate causes blood glucose to rise to toxic levels, and stay at those levels.
Your argument lends support to the idea that many are confused about ketosis and ketoacidosis.
JackFook 1 week ago
@JackFook
I hope you enjoyed your weekend. I'm sorry I was unavailable to respond to you during that time.
You are wrong about the ketogenic diet not being a cause of ketoacidosis. "Clinical Aspects of the Ketogenic Diet" DOI: 10.1111/j.1528-1167.2007.00914. They used a ketogenic diet (couple with fasting, which has some of the same effects) to treat epilepsy. Almost all their patients got ketoacidosis, and they had to be very careful to avoid kideny stones (many still got them).
Mentat1231 1 week ago
@Mentat1231
The term they used is "mild acidosis" in the side effects section. This is not a side effect, this is the primary effect. Ketoacidosis is not merely caused by large concentration of ketones in the blood, but also contributed by large concentration of glucose in the blood. The same study pointed out that blood glucose drops significantly.
Mild acidosis was reported in 6% of subjects. In other words, 94% of subjects did not develop mild acidodsis.
JackFook 1 week ago
@JackFook
Glucose does drop significantly. Indeed, another side effect was hypoglycemia. And you misread: acidosis was seen in "most patients", and the body of the study talks about the pains they went to to try and avoid this. The 6% number was of those who developed nephrolithiasis.
Mentat1231 1 week ago
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JackFook 1 week ago
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@Mentat1231
The ketoacidosis that diabetics type 1 suffer from is due to the lack of insulin, which otherwise regulates fat metabolism. Without insulin, ketogenesis runs wild. When we simply cut carbs on the Atkins diet, we still secrete insulin which regulates ketogenesis normally, therefore the risk of developing ketoacidosis is nil.
JackFook 1 week ago
@Mentat1231
As for the 3 in the Atkins group that quit because of health, it's doubtful that it was due to the Atkins diet itself. The Atkins group, those who stuck to the end, did better than the other groups in all things measured, including health markers.
JackFook 1 week ago
@Mentat1231
I know that the A-TO-Z didn't test the McDougall diet. But you argued that Atkins-style diets were all alike. Surely you will allow me to argue that Ornish-style diets are all alike. But if you know of a significant difference between the Ornish diet and the McDougall diet that can make a significant difference in the results, then by all means.
JackFook 1 week ago
@Mentat1231
Almost all diets rely on caloric restriction for weight loss, except Ornish and Atkins, both say eat as much as you want except where restricted: Atkins = carbs. Ornish = fat. All diets were effective but Atkins was best. Why?
The answer may be that the single most significant factor for weight loss is carbohydrates. When we start with high carb and cut calories, we end up cutting mostly carbs, but not as much as Atkins. That's what the piecharts say anyway.
JackFook 1 week ago
@JackFook
But the Atkins group was barely having less carbohydrate than the Zone group. As a percentage of calories, there was very little difference, since the Atkins group was non-compliant to the point of having almost as much carb as the Zone group. How can this be the relevant factor, when the Zone diet did the worst?
Also, what do you say to the conclusion of the paper, which shows that things were levelling off, and that there wasn't enough time to see the long-term effect?
Mentat1231 1 week ago
@Mentat1231
All groups ate same total calories.
32% of 1500 kcals is 480 kcals, or 120g of carbs. That's right around what's called the ketogenic threshold where we start burning lots of fat. The other diets were 46%-52% carbs, or 690-780 kcals, or 170g-195g carbs. A difference of 50g-75g carbs per day. Apparently, that's enough to make people lose twice the weight on average.
You said weight loss was modest, you said Atkins group ate too much carbs. There's your explanation.
JackFook 1 week ago in playlist Favorite videos
@JackFook
That is begging the question. You assume that eating less carbs would have led to greater weight loss, but that cannot be shown from this study, and so is based entirely on bias. I could equally say that, had the Ornish group actually been compliant, they would have lost more weight as well.
Mentat1231 1 week ago
@Mentat1231
I assume nothing. I simply look at the results and draw my own conclusions. As for being biased, if you could say that had the Ornish group actually been compliant, they would have lost more weight, then you should also say had the Atkins group been compliant, they'd have lost more weight as well. And as far as I can tell, that's what I've been saying all along. So we can hardly accuse me of being biased.
JackFook 1 week ago
@JackFook
I only mention bias because you keep interpreting the results to fit the anti-carb theory, whereas that is not in evidence here.
Mentat1231 1 week ago
@Mentat1231
I agree with the conclusions regarding convergence. This can be explained by the diets' convergence: They all tended to return to the same ratios. 120g carbs per day is still too high for weight loss. This is reflected by the slight upward curve for the Atkins group at the end. All of this confirms the idea that the single most significant factor for weight loss is carbohydrates.
JackFook 1 week ago in playlist Favorite videos
@JackFook
It does not confirm the carb theory at all. Once again, that is begging the question (a logical fallacy). It could just as easily confirm that, once you get past the water weight and glycogen loss, the weight loss on an Atkins diet is simply unimpressive, or even non-existent. A longer-term study was needed, by the authors' own admission.
Mentat1231 1 week ago
@Mentat1231
We could argue that the other groups, who ate the least fat, show that fat is the single most significant factor for weight loss. But we would be wrong because the Atkins group, who ate the most fat, lost more weight anyway.
JackFook 1 week ago in playlist Favorite videos
@JackFook
Barely more weight. And, by the way, the study also didn't measure what *kinds* of weight were being lost. I read another reference that showed that Atkins dieters often lose a great deal of their lean mass as well. Weight loss is not, in and of itself, a great goal.
Mentat1231 1 week ago
@Mentat1231
Water is considered lean mass. Since the Atkins group lost more water weight, that explains it.
Actually, they lost twice the weight. If 10lbs is "barely", then 5lbs is "almost none".
Ketosis occurs when we restrict carbohydrates below a certain point. This point varies by individual but runs around 100g per day. Perhaps you are referring to ketoacidosis? The two are not the same. Though many are confused about that.
JackFook 1 week ago
@JackFook
Dehydration is a common charge against the Atkins diet.
10lbs and 5lbs are both rather insignificant over a 12-month period. I certainly wouldn't be proud of it.
I meant ketosis, though ketoacidosis is a common risk once one is in ketosis for any length of time.
Mentat1231 1 week ago
@Mentat1231
I am reading that study you referred me to. I see red flags already in the methods section. First, they did not actually provide the diet books. Instead, they provided the official diets' cookbooks. They standardized things like exercise across all diets. In other words, they did not actually test the diets, but some variation they thought would suffice to represent the diets. The A-TO-Z study tested the genuine diets, not merely the associated cookbooks.
JackFook 1 week ago
@JackFook
The ATOZ did not test the "genuine diets", since almost no one adhered to the actual diet guidelines. And your idea that you can range the efficacy of a diet over the compliance would be great if you were measuring LEVEL of compliance, rather than the NUMBER OF PEOPLE who were compliant. Number of people who were compliant is not an independent variable that can be related directly to amount of pounds lost. Level of compliance on an individual's part could be.
Mentat1231 1 week ago
@Mentat1231
The A-TO-Z tested the genuine diets by virtue of having given and read the actual diet books. The Dansinger study however gave only the associated cookbooks.
The Dansinger did not test the genuine diets either since no one adhered to the actual diet guidelines either. Since this is true for both studies, we are left with measuring adherence from the data we know of. % of study finishers is indeed a relevant study parameter, as it affects the quality of results.
JackFook 1 week ago
@JackFook
And I never said the percentage of those who finished the study wasn't relevant. I just showed that your attempt to correlate NUMBER of compliant people (rather than LEVEL of compliance) with the efficacy of a particular diet in terms of (altogether miniscule) weightloss was a non-sequitor.
Mentat1231 1 week ago
@Mentat1231
Also, adherence was much lower at 58% vs 80%, and starting group size was smaller at 140 vs 311. All of this combined makes the A-TO-Z study's results much more reliable.
JackFook 1 week ago
@Mentat1231
That's true. Dehydration is a common charge against the Atkins diet. But the Atkins diet, when one reads the book, finds that it advises to drink lots of water. It's ironic. The book advises to drink lots of water, and we blame loss of water weight for the bulk of weight loss on the Atkins diet. It seems to me the complaints don't fit the facts. But maybe it's a question of blaming the wrong diet? If they didn't read the book, they didn't really follow the diet.
JackFook 1 week ago
@JackFook
He tells them to drink a lot of water, and YET they suffer dehydration. You're not helping your case here.
Mentat1231 1 week ago
@Mentat1231
As the epilepsy study you referred noted, dehydration is a short term effect. This is confirmed by water loss in the induction phase of the Atkins diet. This water loss does not continue past this early phase as water balance is maintained normally afterward, and as most of that lost water was bound to glygocen, which is now depleted back down to baseline level, and only replenished by the liver and the small daily amount of carbohydrate allowed by the Atkins diet.
JackFook 1 week ago
@JackFook
The liver does not have an endless supply of glycogen, and gluconeogenesis at high levels is taxing to the liver. And dehydration was a problem *throughout* the diet in the study I referenced. Read the body of it, and they mention it numerous times. Dehydration is a serious problem that the American Dietetic Association mentions among its several reasons to be wary of the Atkins diet.
Mentat1231 1 week ago
@Mentat1231
Like I said, the health of Dr Robert Atkins is a matter of public records. Anybody can read the truth by searching "Dr Robert Atkins death certificate".
Even after his death, Dr Atkins is frequently maligned by the press and his opponents of old. It seems unfair to attack the man, when one can attack the arguments instead. It seems more unfair since many of the attacks come from otherwise respectable sources like Dr Dean Ornish for example.
JackFook 1 week ago
@Mentat1231
I don't know of any long term stud