Rethinking Diabetes – interview with Gary Taubes
theguardian.com
theguardian.com
> perhaps because of his serious and scientific background – he has a physics degree from Harvard and studied aerospace engineering at Stanford [...]
Which, for the thing he's doing now, is not a serious background! Knowledge isn't transferrable and there are plenty examples of people who transfer fields with unwarranted confidence and make totally bogus claims (see the Nobel disease [1]). I wish we would stop claiming the opposite, because especially in a field like nutritional sciences you can find some "evidence" for any theory (see eg. the Chemical Hunger drama [2]).
[1] https://en.wikipedia.org/wiki/Nobel_disease
[2] https://www.lesswrong.com/posts/NRrbJJWnaSorrqvtZ/on-not-get...
All things being equal, I would probably trust the judgement of someone that went deep in the hard sciences and engineering, and then educated themselves on the literature of some soft science specialty on the side, than the average person whose entire education was in the much less rigorous and more shallow soft sciences. I have seen far too much sloppy and motivated reasoning in the soft sciences to trust anything that comes from people that exclusively live in that world. I am sure there are proper scientists in those fields doing good work, but that isn’t the average.
I don’t know anything about this particular case, but it is much easier for someone with mastery of the hard sciences to become fluent in the soft sciences out of interest than vice versa. It may not be fair but I have seen so many real world examples of this, where hard science/engineering experts became recognized experts in softer science fields entirely out of interest, but never in the reverse, that it is difficult to ignore.
Over time I've mentally recategorized entire parts of medical science into what I would say is non-science, or at least, a very different approach to science. In particular, nutrition, and many other areas, take extremely limited amounts of data and extrapolate it, making conclusions that far exceed what the data actually supports. And the folks publishing it got really good at convincing the larger press/medical world that they knew what they were talking about, which has led to all sorts of trends.
I would love to see more translation of quantitative physics into the medical sciences, but it's truly a challenging problem, especially because we (for good reasons) don't run the sorts of trials that would provide truly convincing evidence for causal mechanims related to disease, or whatever area of biology you care about.
I'm not sure that's justified, at all. The domains are harder to experiment in - so the standards are more fitting for their domain. That doesn't make them better or worse, just different.
> All things being equal, I would probably trust the judgement of someone that went deep in the hard sciences and engineering, and then educated themselves on the literature of some soft science specialty on the side, than the average person whose entire education was in the much less rigorous and more shallow soft sciences.
You are, IMO, too dismissive in your language about entire professions. "Shallow, soft sciences".
I get where you're coming from - I'm more of a CS/Math/Physics person myself. But I think "our" side of hard sciences is far more dismissive than it should be - leading to implicitly trusting people who wave the right "hard science" credentials around instead of people working on the field for many years.
Not taking sides here, but I want to point out that there is a distinction between rigor in reasoning and diligence in testing (given feasibility constraints). The true answer need not be in the space of hypotheses that's feasible to test [1]. It's crucial that scientists appreciate that; sloppy reasoning tends to make strong conclusions from weak tests because there's a desire (bias) to emphatically drive outcomes even from weak conclusions.
Titles don't help. An "environmental engineer" might not have sufficient knowledge about zoology or bridges to support whatever they are talking about, but a layperson might not realize that.
How can you tell whether I am as trustworthy as a guy on the bus on matters of software engineering? I am a high school dropout. Likewise, I'm no medical doctor, but knowledge is a spectrum, and I believe I know more than the average Joe on matters of nutrition because it is something that fascinates me and I've read and researched a lot about.
Given that I've read and heard about Taubes for 15 years, it is simplistic to say the least that he doesn't know anything because he's got a physics background.
tl;dr: the Gell-Mann effect only makes sense in a vacuum and if you really want to believe that having a degree automatically makes you an expert with worthwhile ideas.
I’m also underqualified for my position and am wary of credentialism. But if I’m looking at a topic I don’t know well — e.g. seismic building codes- I have to start somewhere.
Software engineering is thankfully a field that is particularly accessible to people without formal training. Demand is high, functional skills can be proven on the spot, and employers are (usually) not in a position where their hiring decisions have potential legal consequences.
If you have a real scientific background and real engineering background you are way more likely to do a proper job.
It frustrates me that people think nutritional "science" is a serious scientific field. And that the "nutritional scientist" is somehow better equipped - they have barely done any real science a single day in their life.
While a scientific or engineering background might demonstrate capability to understand another scientific field, that doesn’t replace the near decade of education people in that field have.
I would absolutely trust a physicist (who has done actual empirical lab work) who has deeply studied a problem in the nutrition space over someone conventionally trained in nutrition.
You may be stunned to see how little numerical sense so many in the medical field have. And as someone who grows medicinal plants and follows that literature closely, I read tons of papers in that space. It is full of experimental design flaws and dubious correlations.
I have worked on a medical device that went through clinical trials.
A dedicated physicist who self-taught medicine would allow hoofs to be zebras, not horses, some % of the time.
Doctors need practice in the hospital and do an excruciating amount of rounds surrounded by senior experts.
Nutritionists? No.
Given a nutritionist who has studied the books and gotten a degree and a physicist who has studied the books and hasn't gotten the degree I would be hard pressed to choose the nutritionist
Cause from where I'm sitting, nutritional scientists do plenty of real science - studying a very complex problem that poses a lot of challenges to experiments, and still coming up with a lot of great results that teach us tons about nutrition.
Most people that criticize the field do so because they read a bunch of articles. Or because they're in the world of hard sciences, and are simply arrogant enough to think they know better than everyone else, even in fields they've never studied.
If you can't, or won't, it is not a scientific field.
Unfortunately, like most fields it’s the junk you read about because rigor is slow/difficult/expensive and therefore less common than BS. Just look at say fusion research and all it’s seriously flawed experiments.
Sure, human biology is (hundreds of) orders of magnitude more complicated than say going to the moon.
But at this point in 2024 we “know” a lot more about physics than we do about nutrition.
And maybe that’s because physicists, when faced with contradictory data, keep digging until they figure out the basics once and for all.
The problem is that the public doesn't want to hear it, so the media keeps running articles that make it simple like "nobody knows anything". Which is just plain false.
About the only things I see as generally accepted are to eat a varied diet (whatever that means), keep total consumed caloric content near the amount expended, eat at least the RDA of micronutrients, and drink enough water to avoid overt dehydration.
But generally - yes, afaik there's mostly a consensus that total caloric intake is the driver of amount of adiposity, that maintaining a 10%-20% body fat percentage (for men) is optimal for long term health, that most diets are close from a health and fat-loss perspective - meaning, amount of adiposity is the main driver of long-term bad health, especially as compared to individual ingredients. There are some things that are known to be specifically problematic, e.g. trans-fats, at any amounts. And there are healthier and less healthy foods, some of which we know - but total caloric intake is the only driver of body composition, and a bigger driver of body health.
Most of this is basic - probably because, as I said, I'm not a nutrition scientist myself so only understand the basics myself.
That said, a large part of the population doesn't even understand these basics either, preferring to constantly talk about and argue about specific diets, keto vs. vegan vs. whatever. And science mostly has that question covered, as far as we can tell right now.
For a more in-depth take on this from someone who actually is an expert, I recommend videos by Mike Israetel:
https://www.youtube.com/watch?v=7FM9VAH_EXw&list=PLyqKj7LwU2...
There is a long list of things that cannot be synthesized by people and must be consumed. (Elements like Potassium as well as specific nutrients like Vitamin C and Thiamine being well known.) There’s a longer list of things than can be synthesized but should largely be consumed ex:
Linoleic acid (LA), an omega-6 fatty acid, and α-linolenic acid (ALA), an omega-3 fatty acid, are considered essential fatty acids because they cannot be synthesized by humans.
The long-chain omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), can be synthesized from ALA, but due to low conversion efficiency, it is recommended to consume foods rich in EPA and DHA.
There’s also a lot of basic facts that get complicated when you dig into them. For example calories produced by burning foods isn’t 1:1 with the calories available to people. Cellulose for example burns but is effectively indigestible. One way to investigate this is to have some eat something and then burn their poop, followed by many studies that do so for various reasons.
There’s also a lot of nutrition science that straddles the line with medicine. Thus there exists many specialized diets for various conditions etc.
I also tend to think there’s real nutritional science but it’s being drowned out by all the snake oil.
It reminds me of the studies they've done in Canada and the US about how natives (American Indians) die a lot of the time in the ER because they're immediately written off as alcoholics or drug-addicts, and so their complaints are evaluated through the lens of "this person just wants opiates."
This is underscored by frequently cited articles, like: "The Unreasonable Effectiveness of Mathematics in the Natural Sciences", in which math is treated as separate, but intimately related, to natural philosophy.
I think you can do math without science, but you can't do science without math.
No one has any idea which diet (if any) is best, or the connection between insulin and obesity, or if fats are good or not, etc. All hunches. Carbs have been falling out of favor for a while now but obesity getting worse.
Anecdotally, my wife went onto a low-carb diet 18 months ago. She likes low carb food, and isn't a huge fan of bread, potatoes etc anyway, so it was easy. She's not total though, still eats a rusk at breakfast, and has a (home made) pizza once a week. She also started exercising a lot more, and found a sustainable rhythm for that. She's lost 50 lbs. (Around 25kg).
Interestingly, her blood sugar levels have not dropped significantly, but they did drop a bit.
I sporadically do low-carb, and always lose weight doing so. I like bread, potato's, rice though so my diet is much less obsessive. My results are more fluctuating but slowly trending down. I'm in no rush, but eould like to drop around 15 lbs this year. I lose about 1lb per week if I'm "fairly strict" - exercise levels don't change (I exercise a reasonable amount.)
Incidentally, I've found that just slowly reducing quantity has helped as well. Eating from small bowls and plates has helped me.
None of this is data. And I still "cheat" (I'll happily eat normal in social situations, and often on weekends etc) but I seem to have found a pattern I can maintain long term. It's a "diet" in the sense there's good and bad, but its also "lifestyle" in the sense that I try to be "moderate" with the bad.
So his claims really dont seem to fall short in my own experience and the experience of people I know.
Part of the problem is that all the tables of carbs assume you are only eating the one thing (which is how they make the tables), but the actual affect on blood sugar spikes is the sum of what you ate. For example, eating a boiled potato by itself will spike a Type 2 steeply, but eating it with lots of butter will not.
I prefer to understand my health issues by reading a wide variety of information from people who specialize in them, not just read one guy's opinion.
YMMV of course, but at no point eating the approved ADA diet and pushing insulin was my A1c ever below 6.5. Since eating low carb and no insulin, my A1c has never been above 5.4
Going full on no-carb and taking long walks daily got a friend out of pre-diabetes type 2. No sugar, no fresh potatoes (cooking and putting them into the fridge for 24 hours is fine), no rice, no fruits, and much more got them off metformin and normalized their blood sugar enough for them to be able to eat cake and sweets again without fearing to get diabetes.
It's not trivial, I will certainly admit, but it is eminently doable with the right mindset and a reasonable plan. The hard part is that sugar and carb-laden foods are positively ubiquitous in the western diet, due to the fact that carbs are cheap to grow, process, ship, and store. Fat and protein are expensive and harder to find depending on where you live. But I look at it like this: by going out of my way to find and cook metabolically-optimal food for myself, I am investing in my future health in a way that will be _much_ cheaper than the cost of getting my foot removed in a few decades.
If I could give any advice at all to someone considering a keto diet, it would be this: do some research, start with some kind of plan, and be forgiving of yourself. It will take some time to figure out which keto-friendly foods you have available to you, and which ones you will actually enjoy eating. If you fall off the wagon and murder a bag of chips in a moment of weakness, know that the whole effort isn't down the drain. You just try to do better tomorrow.
What's that meant to achieve?
It seems to be a very easy win in improving one's diet. Apparently heating it back up doesn't undo the starch conversion.
I'm a big fan of Dr. Patrick and she's been promoting the notion that the gut is foundational in one's immune system and feeding the critters there food that they want will serve one well.
My go to internet advisors:
Dr. Rhonda Patrick
Dr. Peter Attia
Dr. Brad Stanfield
Andrew Huberman
I'd replace him with the Barbell Medicine folks. Check out their recent podcast episode on the common cold for what I mean about Huberman.
And of course he's not perfect, but there's still a boatload of worthy information coming from his podcasts. He's disappointed me multiple times, but again, there's worthy nuggets of knowledge gathered there.
He's obviously a talented scientist and he's always careful to qualify his claims, but he still ends up with an audience that takes away conclusions that ignore the qualifications.
He knows this because this is the only way to keep pumping out content because what we know actually works is the same old boring stuff no one wants to pay attention to.
Compare this to folks like the Barbell Medicine guys, run by MDs who have a sworn duty to do no harm, and their advice. Watch enough of their episodes and you'll often be able to predict what they'll say because they're relying on what we know works, whether from programming of strength training or medical advice. (Their recent episode on the Common Cold is a particularly useful episode to contrast with Huberman.)
What does waiting a day accomplish?
The overall effect is modest though, the whole thing doesn’t turn into resistant starch. It makes it better, but I don’t think it would make a big portion of potatoes suddenly safe for a diabetic.
Extremely useful. I'm not a T2 diabetic, but did have a slightly elevated A1C at my last physical. I asked my doctor for a prescription for a CGM, she gave me one, and it has been a huge help in learning both how food effects my blood sugar, as well as how blood sugar effects my mood.
I think everybody regardless of their current health should have one of these things. Blood sugar is a fantastic look into sorts of aspects of your health.
Yes, though depending on what your diagnosis is, you may be able to get a monitor which allows you to track your blood sugar in near-realtime. The technology has advanced a lot in the last 20 years.
perhaps occasional bouts of keto can be therapeutic?
Popular brands of it in the US are Freestyle Libre and Dexcom.
Their final cost to you will vary hugely by your insurance provider. Some with little to no cost, and others several dollars per day.
If you like data and are analytical by nature, and since you’re on HN that’s fairly likely, I’d highly recommend using them for a little while if you can afford it. They’re great for newly diagnosed people to understand in near real time without repeated finger pricking. But those are no terrible either and much better than not managing and monitoring! Slightly annoying at first but it is something that most people can get used to fairly easily.
You're not measuring HbA1C in real-time; you're measuring the blood sugar in real-time.
HbA1C is a lagging indicator, used because it's a convenient and non-invasive diagnostic and a summary statistic. It's not the way you measure the short-term or medium-term effectiveness of interventions.
I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Would be interesting to see if there is research showing that CGM area under the curve is a better (or worse) predictor of clinical outcomes than A1C.
Both metrics have their own use. Continuous glucose monitoring is better for measuring the short-term impact of interventions, but it's also more invasive (albeit less so than it used to be) and more expensive. HbA1C is still measured for diabetic patients who have continuous glucose monitoring.
One downside of A1C is that the baseline values actually vary, and it's known to be either downward biased or a particularly lagging indicator for certain groups that are predisposed to Type 2 diabetes (e.g. South Asians and people of African descent).
My dad ended up with Type2, I mentioned the no sugar thing. He said it sounded too hard and he had done Atkins before. He read all the recommended books and tried all the recommended diets, even went vegan for a while. After about 6 years he found some doctor that put him on an extreme elimination diet as part of a medical study, basically nothing but protein shakes (with some added nutrients). He didn’t eat solid food for months. Then had to slowly add real food back over several months after that. It ended up working for him, but it seemed far more difficult and unmaintainable than what I suggested to him 6 years earlier.
My mom also ran into it. She called me, did what I mentioned and was good to go a few months later. Of course that doesn’t mean she could go back to eating how she did before, but still has some treats and things she enjoys. She found some balance once out of the danger zone.
My dad’s experience made me pretty cynical of the industry around type 2 diabetes. They have no incentive to cure a person, when they can keep them sick and have a lifelong customer buying all that medication. The diet may have been extreme, but for me, I’d rather be extreme for a few months than have it drag on for years like my dad. And actually, I didn’t feel like I was being that extreme. I ate until I was full (giant plates full of vegetables), I felt great, and didn’t feel deprived. Every Saturday I’d cook myself a big ribeye with a sweet potato; it was great. It was only other people saying it was extreme or too hard that got to me. I started questioning myself. My doctor told me I was doing awesome and not to listen to them.
Best of luck on your next A1C check. Hopefully the road you’re on work for you. If things aren’t working, I’d question the motivations of those providing the information, or the systems which educated them. A doctor telling someone with type 2 diabetes to eat white flour and sugar doesn’t sound like a doctor who understands what type 2 diabetes is.
You can test fructosamine which I believe is a 2 week avg. or you could do finger pokes or even a CGM if you got the ability. [1]
I personally enjoyed The diabetes code by Jason Fung. He’s a nephrologist in Canada. Good luck in your diabetes journey! Luckily you seem interested which is such a distinction.
https://thefast800.com/programme/
as well as a book:
https://oceanofpdf.com/authors/michael-mosley/pdf-epub-the-8...
Not overweight and type 2 is rare.
You might not be overweight, but you might still have a high body fat percentage. Increasing the amount of muscle you have while getting leaner should help all aspects of your health.
I'd recommend checking out the Barbell Medicine podcast episodes on diabetes, cholesterol, strength training, and their recent 3-part series on endurance training.
Should potatoes be in this list? I understood the potato diet to be very effective at causing weight loss (thought to be due to high potassium content of potatoes)? Can something consistently cause weight loss and cause a major insulin response (which I think causes calories to be stored as fat…)?
The “potato diet” will only lead to weight loss if you’re eating fewer calories than you’re expending, same as anything else. You could eat nothing but bacon grease and you’d lose weight if you were eating below maintenance.
The effect of food on blood glucose if a matter of how easily it is converted to glucose. Starches like those in potatoes, flour, rice etc are basically converted nearly as easily as straight sugar.
I've "beaten diabetes" (i.e. I tested as not being diabetic) twice now by losing weight (via calorie counting) and getting fit, but found it too hard to maintain that lifestyle. I've made dietary changes but they had less/no effect. Keto was fine, but my wife didn't get on with it and making two meals every time we ate was too onerous.
I stopped measuring my blood sugar a few months after getting diagnosed because it was kinda pointless. I haven't had a single symptom. If I didn't visit the doctor every 3 months or so I'd never know I was diabetic (and I was probably diabetic for 10+ years before getting diagnosed). I take Metformin regularly mostly for the anti-aging side effect. The endless diarrhoea from Metformin is something I got used to, though I had to suspend taking it while travelling because the combination of Metformin shits and travel shits was too much.
It all feels like a non-thing to be honest. I know people lose limbs to D2, and go blind, and stuff, but it's hard to take that personally and know that as a definite risk that mean I need to make drastic and difficult lifestyle changes. I keep getting checked and told there's no sign of any damage, but my blood sugar is too high. For 12 years now. I know this sounds a bit anti-vax, but it feels like the science is wrong here. I do not want to go down an anti-science rabbit hole and end up in a conspiracy theory world of my own. So I just keep doing the thing they tell me as best I can. But when/if someone finds out that we've been thinking about D2 all wrong, I will not be the faintest bit surprised.
edit: and another thing: I've never had consistent advice from doctors around this. Some GPs say I need to come in every month to get checked up. Others says I only need once a year. Some examine my feet and eyes. Others don't. Some think I'm on too high a dose of Metformin. Others say it's fine. Some are really strong on the diet thing, others not so much. Almost every aspect of this disease seems to be subject to personal opinions about treatment.
There's no question that there us good medical science, but equally there is a lot of junk-science and so in this age of "hearing everyone's opinion", it can be hard to separate fact from opinion.
I think we can agree on some stuff. Smoking is bad for you, exercise is good, and so on. Keeping your weight down, more accurately keeping % body fat down, and so on.
Making small, incremental, sustainable changes to lifestyle that trend you in good directions, are definitely the best.
GPs are (with respect) not a terribly good source. They tend to see sick people all day, and gather lots of superficial anecdotes. Which is not to ignore them, but to understand their POV. But it's worth taking their opinions on board as an hypothesis.
The ambiguity seems to point to "we don't understand this very well yet, but this is what we think you need to do", which would be fine if that's what anyone said. But it's presented as "we know exactly what's going on here, and this is what you need to do", and then different people give contradictory advice with exactly the same level of confidence.
Anyway, keto is great. I wasn’t terribly overweight and lost 19lbs in 9 weeks with it with a cheat day included. It’s great because it’s a very simple set of very few rules. It’s easy to adhere to because it removes moment decision making around whether or not you “should” or “deserve” to have X food. It’s nearly impossible for you to eat enough calories to maintain your current weight on keto when you’re already overweight. Therefore a deficit is nearly guaranteed therefore weightless is guaranteed. On top of all that you do get better at burning fat and don’t get as hungry.
The counterpoint is the tough piece - how do you come off that diet and reenter the real world where people eat carbs. How can you get pizza with friends, etc. I understand their are some who view keto as a lifestyle, good for them but most people aren’t going to do that.
Beyond the simple reality of calories are calories, none of this other stuff around fat vs protein vs carbs is really very hard to understand. Simple carbs are rocket fuel, they provide a lot of energy over a very short period of time. If you’re not going to use it, once the sugar saturates your blood, the excess will be taken out and stored. Then you’ll get hungry again. Fats are slower burning, so it’s harder for you to saturate your blood quickly.
This is an over simplification obviously but this is just not so hard to understand that it needs to be an endless debate over or be positioned as controversial in order to sell books.
1. Losing weight can and often will fix your diabetes. 2. Be conscious of the method you choose for weight loss, when you obtain your goal weight - what will you do long term?
Modern foods are horrifically fiber deficient, as in it's removed and fed back to animals. One of the key things you said around this is...
>once the sugar saturates your blood,
This is the glycemic index. Our modern diet is filled with foods that are pretty much instantly available to the bloodstream. If like me you have a continuous blood sugar monitor you can see this in effect. Drink a soda and minutes later your sugar levels go up. Eat simple carbs and 15-20 minutes and it starts climbing. Move to more complex carbohydrates and items high in fiber that take a long time to break down and the ramp is slower and less steep.
The problem for just about everyone is how do we get away from our simple carbohydrate based lifestyles.
And yes, transitioning off of a keto diet may lead to the reversal of the positive gains (insulin sensitivity, body composition, average blood sugar level measured using red blood cell oxidation or A1C).
And agreed, controversy gains attention which may lead to book sales.
I am aware of carbs though. Specifically though the difference between "sugar" carbs and "starch" carbs. I try and minimise sugar carbs (I haven't eliminated them) and I do starch carbs "in moderation". With cheat days for both. I'll happily enjoy a good desert when eating out. I'll have a pizza now and then. I love re-fried potato. I only very occasionally drink soda. I don't take sugar in coffee.
Each change has been introduced slowly. I stopped taking sugar in coffee. It took about a month to adjust. Now its just how it is. I reduced bread (oh man, I love good bread..) Over time I've come to enjoy a bit less, a bit less often.
My weight is trending down. I'd like to lose 15 lbs, but I'm happy if it takes all year to do it.
Here's a study funded by Taubes himself (!) That disproves his earlier claims: https://examine.com/articles/low-fat-vs-low-carb-for-weight-...
[1]: https://thescienceofnutrition.wordpress.com/2014/04/05/good-...
The fact that either he or this article does not seem to distinguish between the two types in this regard is a basic category error.
The low carb "managing" of T1d before the 1920s was basically a permanent hyperglycemia which you could last months, maybe years. Once your honeymoon period ends you die a spectacularly brutal death -- your blood turns to acid and you starve in insatiable hunger. None of this is "manageable" through diet, since your body has a baseline rate of gluconeogenesis entirely independent of diet.
Type 1 and Type 2 sharing the "diabetes" name has to be up there on "most frustrating lexical errors" ever.
Another example, for Taubes, of how early researchers were mistaken, concerns the differences between type 1 and type 2 diabetes, which are so different they almost shouldn’t share a name. Type 1 diabetes is an autoimmune disease in which the body’s immune system attacks and destroys the cells in the pancreas that produce insulin, the hormone which regulates the level of glucose in our blood; people living with type 1 need insulin injections or an insulin pump, to survive. Like type 2, type 1 can cause complications such as heart, kidney or eye disease, and nerve damage.
Type 2 diabetes accounts for about 90% of cases, and is a metabolic disorder in which the body either can’t make or can’t use insulin (AKA insulin resistance) to metabolise glucose, leading to persistently high levels in the blood. Ultimately, people living with type 2 diabetes may need insulin and other diabetes medications, too, but for a lot of people, diet and lifestyle modifications can defer that need.
It's not "carb abstinence", but "carb restriction". Carbohydrates should be greatly reduced and if you must eat them, eat complex carbs with a lot of fiber instead of sugars. But they should be reduced as much as possible.
As an alternative to his book, I suggest looking at the research on plant based diets fat toxity. https://nutritionfacts.org/topics/diabetes/
30% of people get insufficient sleep, which directly leads to increased insulin resistance the following day, along with increased appetite and craving for sugary and fattier foods, and a decrease in willpower.
Diabetes needs to be treated as a whole person health, diet is absolutely key, but so is sleep and particularly as we age, as slow-wave sleep decreases naturally with age (this is what we're working on).
For those with slow caffeine metabolism, it’s killing your sleep, it’s making you anxious and eventually it’s going to cut your life short.
If you’re a slow metabolizer of caffeine, your sleep quality is suffering. Cut out caffeine for two weeks - see how deeper your sleep becomes.
“ Slow caffeine metabolisers are:
Associated with a higher risk of heart disease [19]
Associated with a higher risk of hypertension [20]
Associated with impaired fasting glucose [21]
May not have the protective effects against some cancers that it appears to for “fast metabolisers” [22,23]
A recent umbrella review of 218 meta-analyses concluded that coffee presented statistical harm only in pregnancy and possible fracture risk for women. [4]”
https://www.thesustainabletrainingmethod.com/tstm-blog/2021/...
Yes, Insulin is the "last line of defense" for Diabetes 2, but at least here in Germany dietary change (e.g. Keto or at least less carbs) is an essential part of treatment. And so are other medications (e.g. Metformin). Insulin is given if there's no other option, cause well, not giving insulin if your blood sugar is really bad leads to very bad outcomes, but if there is any other option doctors will take it first.
Indians typically follow either a rice based diet in southern regions or wheat based diet in northen regions. Doctors down south recommend eating limited or no rice and switching to wheat based roti, whereas northen doctors recommend switching to rice. I suspect this is to reduce overall consumption, in anecdotal experiences it works better than just asking people to limit their preferred grain. People eat less of unfamiliar foods.
This is kind of like how calorie restrictions will fix your issues, how you achieve that restriction is the hard and very human problem that people endlessly debate about.
So the only lesson to take away is that this is a solvable problem, and ultimately you gotta cut calories (and exercise). But how is important; so keep trying till you find something that works for you.
But based on what I am reading in the interview, and the other comments on this post, am I chasing a fool's errand?
My personal experience says that any diet works as long as you are disciplined, and although in my social circles (work and family), it is hard to be sugar free, it is still possible (along with vegetarianism) as compared to low carb. However, I do not see any advocates for that here, are there?
Btw I am planning for a modified version of something called LMK diet, LMK is not a doctor and is probably at the extreme edges of selling veganism, and I am definitely not going that far, but going as close as I can. Mentioning it just in case someone wants to counter or support it.
If you define "work" as losing weight, then sure any diet can indeed "work" if you're able to stick to it. But personally that wouldn't be my sole criteria, especially if I had had a cardiac event.
I have never heard of LMK. I couldn't find any actual description of what that means except for a graphic at the bottom at lmkhealth.com, which needs clarification. Why are you wanting to follow LMK and not any of the usual WFPB doctors (Greger, Essylstyn, Campbell, McDougall, Ornish, Barnard, Fuhrman, etc.)?
[1] https://thescienceofnutrition.wordpress.com/2014/04/05/good-...
No reason. I was ready for a change to vegetarian lifestyle anyways and a friend independently added me to whatsapp group run by him. He follows all the names you mention anyways so it is all the same to me. And I am familiar with all of these names since I followed them for a while but then got confused by the alternatives. He has a few youtube videos which repeat what he says on whatsapp just that whatsapp morphs into local support groups on completing first 2 months. Not yet there.
Although he is a vegan killjoy, reason to prefer him would be indianized recipes.
What does he mean when his logo says "1% Fruits & Berries" and "1% Vegetables"?
> Eat a minimum of 1% of your body weight in fruits (must include berries) and a minimum of 1% of your body weight in vegetables (half in green leafy vegetables) daily.
But there is lot of nuance and adjustments available by juicing but that's the high level pitch
Juicing isn't recommended much any more now that we understand the importance of fiber and fiber-bound nutrients. As long as it's greens and not fruits, and only offsets a part of the cruciferous veggie intake, it could still be a healthful part of a WFPB diet. I have heard some of the nutrition intervention type retreats do that, as their guests may need the extra boost.
BTW when I was googling a few days back, I found this ... from 2 years back, and is the first few posts from his whatsapp group: https://groups.google.com/g/1982batch/c/vdjlMpTe84w
If you enjoy a sweet treat on special occasions or social gatherings, just enjoy it. Being good 90% of the time allows you to indulge 10% of the time.
A sufficiently good diet combined with regular strength and endurance training will be the most powerful levers at your disposal to drastically improve your health and quality of life.
I'd check out the Barbell Medicine podcast for more reliable information.
I've successfully lost 80 pounds in the past year after 10 years of yoyo dieting with low carb and counting calories. I did not become a healthy weight until I was counting calories on a HIGH CARB and HIGH PROTEIN diet and doing a significant amount of exercise 6 days a week. Meaning, 1 gram of protein per pound of lean body mass, 1 gram of fat per 1/3rd of your weight in pounds and as many carbs that fit in your calorie budget and at least 30 grams of fiber.
Note, I'm not giving advice to people with diabetes but the reason there are so many people with metabolic disease in this country is not carbs. It's lack of exercise (and walking) and processed high calorie food. Those french fries you are avoiding, the reason they have so many calories is not because of carbs, it's because of fat.
If you want to lose weight and you plan to also exercise, going low carb will hamstring you. The difference between running in the morning fasted and running after eating a single banana is the difference between feeling like you are being tortured and being able bounce around like a bunny.
I was literally lying in bed all day with 0 mental energy on my diet because I went low carb. I failed my diet 3 times over 10 years because I believed the low carb bullshit. Go look around at how many people successfully lose weight, they all believe the same low carb stupidity.
I'm running 30 miles a week and lifting 6 days a week, if I went low carb I would be tired in bed all day. If you don't have diabetes or some other metabolic disease, don't go low carb.
So basically all im saying is you gotta listen to your body and adjust accordingly. Keto/low carb does not work for everyone but it definitely is very effective for some
Also I think lots of cheap beer has something to do with the fatness of many laborors
A low carb diet may still contain enough carbs to inhibit the ketone generation mechanism. Was your ketogenesis active at the time? My experience of exercising under ketogenesis was OK.
This seems really wrong for the vast majority of people.
Is your average person really bottlenecked by their blood glucose levels and not say, cardiovascular health or lung capacity?
I think most people get winded in a hard run way before their muscles are low on energy and they are feeling sluggish, no?
From personal experience, when i was untrained, i could feel if i was fasted or not. Additionally if i did not eat some form of carbs 40 minutes into my workouts i would crash and burn but if i had a small gel pck i could go for another hour. I dont know the mechanism for how to glucose would even be absorbed that quickly but i did feel a noticeable boost in energy as soon as i consumed the gel.
I think there is some connection between the digestive system and the brain that signals that you can use more glucose immediately after consuming food.
If I can summarise, from memory, it tricks the brain into thinking more fuel is being added so it's okay to release more of the stored fuel it was holding back.
> Routinely rinsing a carbohydrate-containing solution around the oral cavity for between 5-10 s has been shown to improve high intensity endurance performance lasting 30-70 min.
> The magnitude of the performance benefit is similar to that of carbohydrate ingestion, although athletes who are prone to gastro-intestinal (GI) distress during high intensity exercise may want to consider rinsing because of the reduced risk of GI discomfort.
> These effects appear to be specific to carbohydrate and independent of taste or sweetness.
[1] https://www.gssiweb.org/sports-science-exchange/article/sse-...
It wasn't 100% predictable -- sometimes I felt fine fasting (and ran fine).
Good job, theguardian.
Another example, for Taubes, of how early researchers were mistaken, concerns
the differences between type 1 and type 2 diabetes, which are so different they
almost shouldn’t share a name.>Taubes has published five books on sugar, fat and carbohydrate, including his latest, Rethinking Diabetes, in which he posits that low-carb diets have been under-used as a way to manage blood glucose in type 1 and type 2 diabetes, in favour of drug-heavy treatment regimes which, he suspects, may do more harm than good.
So, it conflates and then says "we shouldn't conflate".
It's not good enough. I currently live with a type-1 teenager who is not at all happy about her condition and my family simply does not need cross talk that can be selectively quoted back at us over the dinner table. This sort of wording and "questioning" is harmful and dangerous. Before my daughter was diagnosed she got scary thin, we were seriously frightened by the process and I have no doubt that without insulin she would have died before her 10th birthday.
Taking insulin or not taking insulin is a life and death issue for us, this sort of article is not the right place for a debate of this sort - that debate should happen in the scientific community. This isn't a popularity contest.
You have a problem with a daughter who doesn't reason well. That is too bad but it should not be other people's problem. It is also not a problem with the Guardian article or with Taube's writing.
It also not "conflating" in any meaningful sense of the word.