[djsumdog]

> The entire intervention is managed by physicians and the nutritional approach is based on highly individualized carbohydrate restriction and nutritional ketosis (which I’ve written about extensively in the past and throughout this blog).

People like to hate on low-carb approach. They say things like "It causes liver problems" which don't have a basis in reality. Human beings survived for thousands of years on way fewer sugars and starches than we have today.

It's particularly bad in the US due to the availability of high fructose corn syrup, which means America products tend to contain more sugar than their overseas counterparts.

A few years ago I started going strong on a keto die, cutting out soda, pasta, bread, etc. and eating a lot more vegetables, meats, cheeses, etc. There an initial shock about two weeks in which some people can't get past, because your body has to get use to using fat as a primary fuel source instead of sugars/starches. Once I got past that though, I could cycling farther, my weight training sessions lasted longer with less fatigue, and I dropped from 72kg down to 63kg over the course of several months.

My lowest was 60kg for nearly two years! Moving back to America has been difficult. It's hard to find the same quality of ingredients and I just got burnt out on cooking my own food all the time. There is very little healthy stuff off the shelf here. In the past two years I've slowly rose back up to 67kg and it's upsetting.

I wish there were more low carb options when eating out. Salads at pubs are often loaded with croutons and fruits, there are lots of hidden carbs in salad dressing and there's just a lack of healthier options here.

The food industry pushed hard against the Adkins movement in the early 2000s. Imagine if we had kept going down the route. Would obesity have dropped significantly in the US? We'll never know. But this article goes with a lot of the current research: fat doesn't make you fat. Sugars and starch do. They have a much higher energy density and sugar is huge contributor to heart disease.

[devmunchies]

Fat + Carbs makes you fat. Cut out one and you lose weight. I'm on a plant based diet which is high carb (no highly-refined carbs) and I'm very fit.

If your body's glycogen stores are full from carbs then YES fat you consume goes straight to fat.

EDIT: and WFPB (whole food plant based) also reverses type 2 diabetes.

[dhruvkar]

I've been on keto for a > 1 year now, but feeling like I want to cut out meat products.

Any resources that you can point to, to research the physiological effects behind WFPB, and for getting started?

[devmunchies]

Rich roll podcast has a lot about WFPB diet. He’s a lawyer turned athlete so his discussions are pretty good.

I enjoy this one about the benefits of ketosis in a plant based diet with Dr Kahn: http://www.richroll.com/podcast/joel-kahn-349/

[kristallizer1]

Not OP, but https://old.reddit.com/r/vegan/wiki/veganscience#wiki_health... is a good starting point.

[Numberwang]

Thank you for being a voice of reason in all this. When this ketosis madness ends and we go back to eating plant based like our ancestors did the world will be a better place with healthier humans and no factory farms.

[djsumdog]

I think you can do either, and I should have added that to my post. Veganism isn't a health diet straight out; it's a political diet. But you can be very health (lots of plant, plant carbs and very little fat) or very unhealthy (nothing but Oreo cookies).

I agree with the poster that a high carb/low fat diet can also be pretty healthy, but you pretty much do have to do one or the other.

Both approaches are difficult, because the food supply/industry isn't really setup for it. There are a ton of unhealthy vegan meals in vegan restaurants as well, where they load up on refined sugar and not as many plants.

They keto stuff isn't madness though. It's just a different approach and it works for some people.

[ssharp]

I've done numerous stints with keto and think some of the criticisms are valid, particularly in the first phase when you're often advised to stick below 20-25 net cards a day. That's nearly impossible to do unless you are eating predominantly meat, cheese, and eggs. There isn't much balance there. If you're eating vegetables w/ every meal, you can easily jump over 20 net carbs and I find that restriction absurd. You have to do a fair amount of supplements to get the vitamins and fiber you should be eating. However, in general, it works extremely well for me in cutting weight and eating better.

I think something in the range of 30-50 net carbs per day is far more realistic to keep balance in your diet. At some point, the benefits come more from having a quality diet, full of vegetables and balanced protein, free of added sugars and grains, rather than actually being in ketosis.

[bena]

Yeah. You can eat a lot of calories of pure sugar and still not "feel" full. Whereas it's hard to overeat lettuce, you'll literally fill up before you go over your daily caloric intake.

Not that I'm advocating a lettuce only diet. But as I acquire more and more information about how we eat, what we eat, etc, I've become of the opinion that we do have way too much salt, oil, and sugar in our diets. We can even cut down our meat consumption greatly with no ill effect.

We're survivors who haven't had to survive for centuries now.

[devmunchies]

The same goes for oil which is all fat and no carb. Refined food is the real culprit, not just refined carbs.

[turc1656]

There are some healthy and natural oils, but yes the vast majority of the oils we use are cheap, processed garbage. The real issue is that our bodies aren't designed to consume, for example, vegetable oil in mass quantity because the amount of actual vegetables you would need to consume to get that same amount of the oil is simply impossible to do.

Those refined oils aren't handled in the same way the healthy, natural ones are so it contributes to the metabolic damage.

[bena]

Plain old lard contains over 100 calories per tablespoon.

It's not really a battle between processed and unprocessed. It's just simple math. Oil and sugar pack a lot of calories in a very small package.

We eat multiple times every day. We have the entire variety of food at our disposal multiple times every day. I can have a feast for every meal. Most people eat like royalty of the past. This is new. Most of us live post-scarcity. We're having a hard time adapting because our instincts and behaviors come from times of scarcity.

[turc1656]

I respectfully disagree. Calories are not created equal.

https://www.health.harvard.edu/blog/theres-no-sugar-coating-...

https://www.webmd.com/diet/news/20120626/all-calories-not-cr...

"That’s just not what the unbiased studies have shown. Looking only at calories ignores the metabolic effects of each calorie; the source of the calorie changes how you digest it and how you retrieve energy from it."

[bena]

The Harvard blog simply makes a statement without actually providing the proof.

And there's also the point that calories that "leave the body" aren't really calories consumed.

So if a portion of the raw caloric value of something gets expelled through waste because we aren't really able to process it in time, then it's not really a consumed calorie.

A large portion of the rage against Calorie In Calorie Out is really about our ability to accurately measure calories in any fashion.

We make estimates about the caloric value of a food because the means by which we can measure it is destructive. And we assume that every calorie that enters our body stays there until used as energy. Which may not be true either.

And the WebMD article specifically mentions that the low carb group was essentially stressed the whole time. And it's a study of 21 young people who lost 10% to 15% of their body weight. That's 10 - 20 pounds of an average person.

This guy lost weight eating 1800 calories of twinkies a day. https://www.huffingtonpost.com/david-katz-md/chewing-on-the-...

I think this is a much more interesting experiment as twinkies are roughly uniform. There may be some caloric variation, but none so great as to be relevant. Plus, the overs and unders should average out.

So watching the caloric content of your food is always a good idea if you're looking solely to lose weight. But instead of trying to figure out how many twinkies you can eat in a day, we should be trying to find out which foods we can eat a lot of and still maintain a caloric deficit.

[emcq]

Assuming the study is taking adults on a 2500 calorie diet down to 1600, an extra 300 calories from metabolic effects is not insignificant but the majority of variance is explained from a simple model of calories where fat calories ~ carb calories ~ protein calories.

If you want to lose weight then simply counting calories and eating less is an effective strategy.

[turc1656]

All true, except the last part. Sugars and starches do not have a higher energy density. Fats are approximately 9 calories per gram. Everything else (proteins, sugars, starches, and carbs in general) are around 4.

[magic_beans]

> I wish there were more low carb options when eating out

It's impossible. If I go out to eat, I accept that I will very likely not be eating a nourishing meal.

[virtuallynathan]

It's pretty possible -- most restaurants have steak, fish, chicken, or other meats. Bars/Grills will serve you a burger without the bun, as will fast food restaurants. Sashimi at a Sushi place, Korma with no rice/naan at an Indian place, Tom Yum Soup or other options at Thai... etc.

[aborington]

how does sugar contribute to heart disease?

[oppositelock]

It's a factor in inflammatory response, and heart disease is an inflammatory disease which creates conditions where cholesterols can then bind and cause plaques.

Here's one good talk by Dr. Robert Lustig. https://www.youtube.com/watch?v=dBnniua6-oM

Here's an overview in a pop-sci article: https://www.kqed.org/bayareabites/85169/sweet-revenge-dr-rob...

[aoeusnth1]

This video has a entertaining overview of the effects sugar has on your body: https://www.youtube.com/watch?v=f_4Q9Iv7_Ao