[consteval]

To me, this just doesn't add up. For virtually all of human history, the human diet is mostly carbohydrates. If anything, we eat less carbs than we used to - instead, we now eat more saturated fats and protein, due to ready access to farm meats.

Prehistoric humans however (that is, before the agricultural revolution) consumed most of their carbs through fruits, nuts, and vegetables. It's estimated their diet probably consisted of around 100 grams of fiber a day, as opposed to the typical 2 grams people eat today. Fiber slowly the blood glucose elevation by quite a lot.

I don't think simply cutting out carbs is the answer or even sustainable. I think it makes much more sense to gravitate towards a diet of more whole food, which contain more fiber and thus don't raise blood glucose as severely. Carbs are important, and we've been eating them forever.

[nradov]

You're not adding correctly. Carbs aren't important. They are not an essential nutrient. People can live indefinitely without them.

For virtually all of human history, the human diet was whatever people could get their hands on. That meant as much meat as they could hunt or raise plus whatever else. Most regular people barely stayed ahead of starvation and they couldn't afford to be picky. Insulin resistance only becomes a problem when consuming excessive amounts of carbs over a long period, which only even became widely possible after 1913 due to the Haber-Bosch process making farming more productive.

Your baseless claim that cutting out carbs isn't the answer or even sustainable is directly contradicted by clinical research. Many patients have literally put type-2 diabetes into remission through nutritional ketosis. That diet isn't recommended for everyone, just patients who already have insulin resistance (with appropriate medical supervision). Regardless of what you "think", that is the reality. After the patient's metabolism has been somewhat repaired it may be possible to reintroduce limited carb intake without triggering a relapse. Fiber is certainly helpful in this, and no one is seriously suggesting to eliminate fiber.

[consteval]

> That meant as much meat as they could hunt or raise plus whatever else

The human diet has been a very, very small minority meat. Because meat is hard to get.

And prehistoric game meat is also not the same as farm meat. Beef and pork contain high amount of saturated fat, but game antelope would contain much less and would have unsaturated fat. Meat of that time is really closer to avocado than meat of our time.

> Regardless of what you "think", that is the reality

I'm glad to see everyone is being civil.

But if we come back down to Earth, you'll realize diabetes is reversed 95% of time when Ozempic is used.

Do those people eat carbs? Yes, they do. Is 95% a higher success rate than whatever pathetic adherence rate a miserable existence like ketosis has? Yes, it is.

If for 99.9999% of all of human history our diets consisted of almost exclusively carbohydrates, I don't think we're following the right path here.

Just because ketosis reversed diabetes DOES NOT mean it address the root cause. It could be purely incidental. And it's also a piss-poor treatment. Because it sucks, and nobody wants to do it, so they try it and then lose a foot or two.

We should stick to real medications, such as insulin and Ozempic. The granola-brained can continue their keto.

[_yb2s]

> And prehistoric game meat is also not the same as farm meat. Beef and pork contain high amount of saturated fat, but game antelope would contain much less and would have unsaturated fat. Meat of that time is really closer to avocado than meat of our time.

Wild meats have very different ratios of fats that farmed meats, but mostly in the opposite direction you are saying. Because (especially non-ruminant) animals take most of their fat from their diet, rather than synthesizing it directly, farmed meat closely mirrors the ratios of fats fed to them via diet- and using seed oils in animal feed makes them have much more omega-6 polyunsaturated fat, and much less saturated, monounsaturated, and omega-3 fats.

Overall a high omega-6 intake is a huge problem as it alters our cellular lipids in a way that impairs a lot of systems, as is eating muscle meat only which has weird amino acid ratios compared to our needs. Weird amino acid ratios in diets have different usually undesirable drug like effects. Both are major issues for anyone trying to do a 'high meat' diet in modern times. As with vegans, if you deeply understand this stuff and have the time and money you can probably make it work.

> whatever pathetic adherence rate a miserable existence like ketosis has

Ketosis seems pretty effective for some people and not for others. I did it for many years and felt amazing- it was in no way "miserable" but eventually got into competitive sports where my performance just wasn't as good with a restricted diet. If I were diabetic, there is no way I'd rather be insulin dependent than do a ketogenic diet, assuming it actually worked that way for me. I know several people that permanently solved major mental health issues that didn't respond to other treatments by staying on ketogenic diets.

For many people, I do thing higher carb diets actually are better for diabetics, because low carb induces extra insulin resistance and raises blood sugar levels. The most effective diets I have seen in peer reviewed research for diabetes treatment seem to be something like "high carb paleo" diets with lots of starchy root vegetables. However, if it makes it easier to lose weight and eat less for someone, ketogenic diets will help.

Moroeover- and this is little known I think- ketosis and low carb are really totally independent things. Ketosis occurs anytime there are excessive acetyl groups in the TCA cycle, which happens under various conditions unrelated to carb intake.

Most people on low carb diets never get into ketosis unless they also severely restrict protein, because we make a ton of glucose from protein (via gluconeogenesis). People eating mostly lean wild animals are unlikely to ever reach ketosis- you'd have to be eating mostly things like seal blubber.

However, many people on high carb diets, especially things like raw vegan diets or diets with lots of resistant starch, e.g. from potatoes and rice are in ketosis, because resistant starch gets ultimately metabolized as ketones. The so called "keto diet" is probably not actually a ketogenic diet but "raw veganism" and the "potato diet" probably often are ketogenic diets.

I don't really have a high vs low carb bias or preference but think it is fascinating how adaptable metabolism is (and it is what I research professionally).

[CRConrad]

> For virtually all of human history, the human diet is mostly carbohydrates.

Which is rather a short time in our evolution, compared to virtually all of human pre-history. During which the human diet was most likely not mainly carbohydrates.

[consteval]

Human pre-history was also mainly carbohydrates. The idea that humans lived off of primarily meat is fantasy - we eat more meat now than we ever have. Prehistorically, humans ate primarily gathered foods - nuts, fruits, and vegetation. I believe it's something like the average prehistoric human ate 100 grams of fiber a day. As opposed to the US ~ 2 grams of fiber a day, caused by our diets high in meats, saturated fats, and ultra-processed foods.