10 ms·

Ketones have been shown to reduce oxidative stress and inflammation in the brain. We've known for a hundred years that it can be effective at treating epilepsy,

by improv 2y ago

Ketones have been shown to reduce oxidative stress and inflammation in the brain. We've known for a hundred years that it can be effective at treating epilepsy, and increasing evidence is mounting that it can be helpful for Alzheimer's, mental illness, and many other diseases. It's weird that there is such a stigma surrounding keto.

toolz 2y ago
I thinks it's more just stigma around all diets and keto just gets lumped into the category.
loveiswork 2y ago
I used to work in a home for special needs children around 2007, there was a child there who was on a 'keto diet', by order of clinicians, to help prevent seizures. This was well before it entered the zeitgeist as a fad diet. I think the supplement/fitness influencer machine is so aggressive and fraught with misinformation that anything that falls in its crosshair is just squeezed to death.
markstos 2y ago
Science doesn't support keto as an optimal diet for most cases, which I wouldn't call a weird stigma. The book How Not To Die is a good primer on nutrition, major diseases and longevity, and includes references to all the scientific studies references. Meat and dairy have causal or correlations with a lot of terminal diseases, which is bad news for the keto diet. Whole-food plant-based diets fare best in most scientific trials, which is fairly incompatible with keto. Research into optimal diets for longevity also found whole-food, mostly plant-based was what folks that live the longest eat. WFPB has also been used successfully in to address Alzheimer's and diabetes.
- jjtheblunt 2y ago
  What is meant by “whole” when used in “whole food”?
  - riehwvfbk 2y ago
    Leaving the whole contents of your wallet at the grocery store rather than partial.
    - markstos 2y ago
      Ah yes, the "beans and rice are more expensive than beef" argument.
      - riehwvfbk 2y ago
        It's a joke. It went whoosh.
      - abduhl 2y ago
        Are beans and rice more "whole" than beef? Is beef not a "whole food"?
        rmast 2y ago
        Beans and brown rice would be… unless you’re eating the whole cow. But actually, it’s surprising how many things like preservatives get added to things like ground beef.
        abduhl 2y ago
        Sorry but this is a ludicrous statement. Beans and brown rice are more "whole" than beef unless you're eating the whole cow? You're not eating the whole bean plant or rice plant. Even looking at brown rice or beans off the plant, with brown rice you are still removing the husk and with beans you are removing the pod.
        rmast 2y ago
        That part was humor, sorry you missed it. I’ll elaborate. If it’s unprocessed beef it could be considered a whole food — but often people don’t bother checking the ingredients for the meat they buy and just assume that it doesn’t have things added. That said, there is research that points to eating too much beef and other red meats potentially being bad for health.
- abathur 2y ago
  I'm not sure it's intrinsically bad news for the diet (but I won't dispute that it's a challenge for how it's usually followed). I haven't met one, but I've at least heard that there are vegans following ketosis-inducing diets.
  - markstos 2y ago
    I've been at meals where common ground is attempted... you end up with things like cauliflower mashed potatoes. Yes, there's technically some overlap, but people on low-fat WFPB diets often have good short and long term results so there's not an incentive to keto-ize it. For example, I just ran 4 marathons in 5 weeks in my late 40s eating mostly WFPB. That's good-enough health for me.
  - throwawaycities 2y ago
    I’ve personally done both vegetarian and vegan keto diets (a couple months each). From my normal keto diet it basically meant I stopped eating eggs/bacon and meat. Vegetarian was easier than vegan because I could still eat eggs. Ketosis definitely can be achieved with “whole food diets” and “whole food plant based diets”
- slibhb 2y ago
  > Meat and dairy have causal or correlations with a lot of terminal diseases How do studies show causation? I imagine almost all the evidence here is observational. In general, due to that limitation, I don't think we can really draw conclusions about what foods are good/bad. With an intervention like a keto diet, at least we could potentially get some experimental data.
  - tech_ken 2y ago
    Not familiar with the specific studies being discussed, but there are techniques available to infer causal relationships from observational data (generally referred to as “causal inference/statistics”). The specific method depends heavily on the question you’re trying to answer, but the general idea is to identify sources of variation in your population that are unrelated to the variables under study, and then to exploit that variable to create a situation where you’ve got a “proxy” control and treatment group. A classic example is discontinuity regression, but other methods exist.
    - spacephysics 2y ago
      As I understand, you’d need to know all the confounding factors to account for variations? What about multi-variate problems? For instance many studies used red meat intake in the form of burgers from fast food as “red meat” full stop, and concluded that causes cancer. Not really paying attention to the seed oils or mountains of other ingredients in a SAD which are banned in other places yet allowed here. Not including the problems with pesticide use. I really don’t trust meta analysis or statistical gymnastics to draw causal conclusions from nutrition studies given the wide array of factors that we really can’t account for. Genetics of the individual, environmental history (high protein with someone who has a history of kidney disease is bad vs an average person for example) I’m more concerned over pesticides, preservatives, and even storage containers produced in the last 75 years to cause cancer and other issues than a source of food that we’ve and many others have lived off for some thousands of years. Plants and meat included. Unfortunately there’s a mistrust in many of these institutions, but I think for good reason. They need to get their act together (see sugar industry’s collusion with scientist that asserted saturated fats cause heart disease). Not to mention the enormous p-hacking and reproducibility crisis.
- toolz 2y ago
  The author of that book seems to exaggerate quite heavily, often stating that there's only one proven diet that reverses heart disease, which I find completely overstating the evidence. I do think he's onto something, but he completely oversells how confident science is on plant based dieting. Here's an interesting overview on the subject https://www.youtube.com/watch?v=Ypilw1KCq9Y https://www.youtube.com/watch?v=Ypilw1KCq9Y it would seem to me that Dr. Greger is simply wrong on this subject as the mediterranean diet would also appear to meet his criteria of "proven" diets and he claims only plant diets have been "proven"
  - markstos 2y ago
    The Mediterranean is a similar diet-- also emphasizes whole foods and mostly plants with less animal products. It's gets mentioned alongside WFPB as being good for longevity.
    - throwawaycities 2y ago
      Most “keto friendly foods” are part of the Mediterranean diet, the main difference is really a matter of cutting out foods that spike insulin and managing the marcos for ketosis. So the emphasis is on fats from the Mediterranean diets like fish, olive oils, meat, and nuts. It’s not like green vegetables (and other low glycemic vegetables) from the Mediterranean diet aren’t permitted.
      - rmast 2y ago
        There’s also research showing fruits (the whole thing with the fiber, not juice) can be eaten without causing an insulin spike — as in, X grams of natural sugar eaten in the form of an apple is not the same as getting those X grams as refined sugar such as a can of soda.
        throwawaycities 2y ago
        Yes it’s possible to eat small amounts of certain fruits (not sure about apples specifically) and not be thrown out of ketosis. When in ketosis I tend to avoid fruit, sometimes I’ll have a small amount of blueberries in a smoothie balanced out with fats from coconut milk, almond butter and chia seeds, plus some fiber (spinach). But I even avoid high-glycemic vegetables, like carrots, when in ketosis. Generally in calculating their carb/sugar intake people will reduce carbs/sugars by fiber, it’s not exactly scientific but probably works for the most part. I don’t even bother calculating carbs for stuff like spinach, kale, or Broccoli.
- verticalscaler 2y ago
  The folks that live the longest in your studies were all born at the beginning of the tumultuous 20th century rather than some optimal fishbowl experiment. If, for example, one of them was visiting a market in NYC around 1924 it is unlikely that bananas were on offer. Much has changed in what we eat and how it is produced and an infinity other confounding factors. Science does not put forth an "optimal diet" to begin with. It is unlikely there exists such a thing but rather diets carry various tradeoffs for differing populations.
- fl0ki 2y ago
  I would really appreciate if people would stop referencing this book as evidence for anything. If it was written as a literature review paper and subjected to peer review, it would have been torn to shreds, not published and endorsed by a scientific journal. (Even by the infamous standards of an industry neck-deep in replication crisis) https://www.healthline.com/nutrition/how-not-to-die-review https://www.healthline.com/nutrition/how-not-to-die-review https://thehealthsciencesacademy.org/book-reviews/how-not-to-die/ https://thehealthsciencesacademy.org/book-reviews/how-not-to... Meanwhile, what do actually peer-reviewed studies say: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881926/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881926/ https://www.adelaide.edu.au/newsroom/news/list/2022/02/22/meat-eating-extends-human-life-expectancy-worldwide https://www.adelaide.edu.au/newsroom/news/list/2022/02/22/me... There seem to be people out there who managed to make plant-based diets work for them, but it took more than reading a single book, and it takes a lot of maintenance and monitoring to sustain. That gets more and more difficult in advanced age, as nutritional needs naturally change, including changes to the the absorption, metabolism, and even transport of the raw nutrients we do eat. Even steelmanning the cardiovascular case: The population base rates of depression, anxiety, and obesity are far greater than cardiovascular disease. It is ignorant at best and irresponsible at worst to encourage people to optimize for reducing their already slim chances of cardiovascular issues while increasing their already high chances of several other issues. Even that doesn't hold, of course, because obesity also increases the risk of cardiovascular issues anyway. I'm going to stop short of accusing plant-based diets of being a scam or a conspiracy, but I do believe they are somewhere in the space of bad science and poor reasoning, even in the most well-trodden easily-avoidable ones like the base rate fallacy.
  - rmast 2y ago
    That adelaide article claims that meat was a staple pre-agriculture, but doesn’t do much to back it up. Studies of feces appear to indicate plant consumption was high. There’s also one I came across on Neanderthal diet 50k years ago that suggests they ate more plant stuff than previously thought. https://www.researchgate.net/publication/329486931_Dietary_fiber_From_early_hunter-gatherers_to_the_1990s https://www.researchgate.net/publication/329486931_Dietary_f... https://link.springer.com/chapter/10.1007/978-1-4684-2481-2_8 https://link.springer.com/chapter/10.1007/978-1-4684-2481-2_... This one says meat was an important component, but that fiber (only from plants) consumption was much higher than it is now. https://socialsci.libretexts.org/Bookshelves/Anthropology/Biological_Anthropology/EXPLORATIONS%3A__An_Open_Invitation_to_Biological__Anthropology_1e/16%3A_Contemporary_Topics%3A_Human_Biology_and_Health/16.01%3A_Osteology https://socialsci.libretexts.org/Bookshelves/Anthropology/Bi...
- Attummm 2y ago
  It must be noted that science is not a single entity, and with nutrition, different sciences will have opposing views. For example, the ketogenic diet has been used in medicinal contexts for more than a century. Longevity research is heavily focused on insulin, making ketogenic diets of interest even when used cyclically.
  - rmast 2y ago
    Specifically, keto was aimed at helping manage epilepsy.
- stcredzero 2y ago
  Science doesn't support keto as an optimal diet for most cases, which I wouldn't call a weird stigma. In fairness, the spike in cholesterol is a legit piece of data to be concerned about. But then again, there's other data that supports the idea that the higher cholesterol is an adaptation which doesn't increase the risk of heart disease. Something as complex as the human metabolism is going to require a higher degree of nuance. (Also works this way for climate.)
- newzisforsukas 2y ago
  > The book How Not To Die is a good primer on nutrition, major diseases and longevity, and includes references to all the scientific studies references I read this book. You might want to check some of those references.
  - markstos 2y ago
    Any you'd like to refute?
    - deleted 2y ago
      [deleted]
- dham 2y ago
  It's not meat and dairy; it's meat and dairy...with carbs. It's why societies that only ate saturated fat we're fine until they started eating carbs. Then they started dying off and getting diabetes. Steak and eggs are not bad for you. Steak, eggs, toast and pancakes will kill you.
  - newzisforsukas 2y ago
    Anyone stating a truth like this around nutrition is over confident, if not completely disingenuous. No one has a complete picture of this. https://scholar.google.com/scholar?cites=7789746717773890744&as_sdt=5,33&sciodt=0,33&hl=en https://scholar.google.com/scholar?cites=7789746717773890744...
  - hombre_fatal 2y ago
    > It's why societies that only ate saturated fat we're fine until they started eating carbs. Define "fine"? Calcified atheromas are even found in Inuit mummies. If you're trying to eat a diet that's not atherogenic, you'd drop eggs and especially red meat, and you'd include carbs like beans and broccoli.
    - cykros 2y ago
      I don't think I've ever met someone doing a keto diet that didn't eat an obscene amount of broccoli and other brassicas. But yes, beans generally don't make the cut.
- riku_iki 2y ago
  > The book How Not To Die did that book receive any kind of proofreading itself?.. Many pop-science authors manipulate studies results to push narrative.
- chlodwig 2y ago
  There are an infinite number of lousy and p-hacked studies showing that every single possible diet is both good and bad before. What are the one to three highest quality, most convincing studies showing that eating unprocessed ruminant meat (ie, beef and lamb) is bad for your health?
riehwvfbk 2y ago
The stigma just might be backlash against the holier-than-thou attitude of keto proponents. It's stuff you put into your mouth. Important, yes, but it's not a religion or the meaning of life. This seems to be lost on the keto adherents.
- mwigdahl 2y ago
  I think part of it comes from the fact that you can't do "partial keto" -- you're either in ketosis or not, it's hard for folks to achieve (particularly when new to the diet) and the dietary modifications required are nontrivial. So it is not at all uncommon for folks to fail to get the benefits of the ketogenic diet because they aren't compliant with the diet. They then conclude the diet doesn't work, and get into conflict with other folks who are compliant and do see benefits from the diet. The rhetoric gets pretty heated, and I think that contributes to the general feeling of "religious war" that surrounds the topic.
  - riehwvfbk 2y ago
    I don't know, I'd say this is true for all diets. Many of us have had that friend who's lost a bunch of weight or got into good shape and that's all they'll talk about from now on. Usually that person also starts picking on other people who don't join their compulsion. I think it's a strategy to mask a lack of accomplishments other than the weight loss.
    - mwigdahl 2y ago
      It's definitely a factor for all diets, true. But as I understand it there's a (close to) binary cutover between "you're in ketosis" and "you're not in ketosis", rather than a gradient. If you're 90% compliant with a normal diet you might still get the benefits, just at a slightly lower level. If you're 90% noncompliant with a ketogenic diet, you get 0% of the benefits because you don't trigger ketosis.
astura 2y ago
The ketogenic diet was invented as a treatment for epilepsy in the 1920s, before we had effective anticonvulsants. It works to control seizures, but nowadays most people will be able to control their seizures with anticonvulsants which is generally more tolerable than ketogenic diet. So it's not used as much as an epilepsy treatment in modern times, but it is still used for some hard to treat cases of epilepsy. 100 years later it emerged as a fad diet among non-epileptics that is promoted as a cure-all for everything. It's adherents have a near-religous devotion to it. That's where the "stigma" comes from - not its medical use.
- fl0ki 2y ago
  This doesn't point in the direction you are suggesting. Imagine we had a pill that prevented lung cancer risk from smoking cigarettes. Would we say that preferring fresh air over cigarette smoke is "a fad, promoted as a cure-all for everything, its adherents have a near-religious devotion to it" just because we could now eliminate one of the many severe consequences of smoking? When we know something has several adverse effects, it's not a "fad" or "near-religious devotion" to want to avoid it, even if some of those adverse effects can be mitigated with medications. That's even putting aside the likelihood of other consequences from those medications, especially when many are combined, as they often end up being.
  - astura 2y ago
    ^--- See what I mean? Dude just compared eating rice (a staple food staple food for 3.5 billion people) with cigarette smoking. I rest my case.
    - fl0ki 2y ago
      I was replying to a comment about epilepsy, not rice. Not everyone who eats carbs will suffer epilepsy just like not everyone who smokes will get lung cancer. A medication mitigating that effect doesn't invalidate concerns around the trigger.
    - ImPostingOnHN 2y ago
asveikau 2y ago
> It's weird that there is such a stigma surrounding keto. I'm always curious about health topics, having lost a lot of weight in 2017-2018 almost by accident and getting curious about how all that works. (For me it was: stress reduction, smaller portions, daily walking) So at one point I got a YouTube recommendation that turned out to be keto-aligned, but was phrased as just scientific material about metabolism. As I followed that rabbit hole a bit, I had to stop when it got rather cult-like. They made a lot of claims that all ailments are caused by gluten, carbs, and lack of vitamins. Keto was the solution for literally every problem. Some of the same people promote stuff saying that psychiatry is 110% quackery and that if you take antipsychotics you should stop. Once you adopt a mindset that modern medicine is failing everybody all the time and that there's a silver bullet solution to everything else, the door is open to other such conspiracies. My own weight loss story involved daily pasta intake. Conspiracy theories about gluten and carbs are just that. I'm sure that not everybody who's into keto is that culty, but man the ones I saw are scary.
- polishdude20 2y ago
  I feel like if you go down any nutritional / medical rabbit hole deep enough, you'll find videos making outrageous claims. And that's not because one topic or another is true or false or bullshit but it's because that's how people are able to make money. By making these false amazing claims, more people watch and give views. Outrageous claims are made because they are the optimal solution to the problem : making money.
incomingpain 2y ago
>It's weird that there is such a stigma surrounding keto. Consider an average grocery store and restaurants. Now make all the aisles which are not remotely keto friendly empty. What amount of of the grocery store is now empty? Pretty significant right? What percentage of society suddenly is unemployed? It's likely depression level unemployment. Most of these workers are unemployable elsewhere. So we have MadMax society incoming. Also what happens to society in a scenario where everyone stops eating carbs? There's literally nowhere near enough farmed animals to ever satisfy that demand.
- iamthirsty 2y ago
  So, your theory is Keto is being suppressed to avoid a modern-day societal collapse? That's a pretty serious intellectual leap.
  - incomingpain 2y ago
    >So, your theory is Keto is being suppressed to avoid a modern-day societal collapse? That would be putting words in my mouth, but I guess ill be getting my downvotes none the less. I'm quite negative already for sharing my opinion. Im not accusing you because I dont know, if you wouldnt mind sharing why you would downvote my post. >That's a pretty serious intellectual leap. The point I was replying to was the weird stigma against keto. Stigma being a suppression. I was never alleging the US government is censoring speech on keto diet or really any diet.
    - iamthirsty 2y ago
      > Stigma being a suppression. Actually, IMO, the stigma comes from the over-commercialization, lack of reliable [mass] information, and "silver bullet" preaching in regards to Keto. It's not targeted, specific suppression, it's the "buy my course about Keto to solve all life's ailments!" that gets annoying and pushes people away. Note: personally not a Keto fan or critic — just don't quite care, because of reasons listed above.
    - deleted 2y ago
      [deleted]
brodouevencode 2y ago
Alzheimer's is colloquially known as Type 3 Diabetes in some circles. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/ Edit: I'll accept that "colloquially" might not be the exact proper word.
keybored 2y ago
> It's weird that there is such a stigma surrounding keto. It upsets both orthodox/80’s health advice and environmentalists (pretty liberal towards animal products).
alex_lav 2y ago
There is (rightly) stigma around anything that invites fanaticism. Real value discussion gets drowned out by fanatic hyperbole.
paxys 2y ago
What stigma is there surrounding keto? It just became a new fad diet in the last decade, like a hundred others. If anything there is now a stigma against advocating for a reasonable portion of healthy carbs as part of a balanced diet.
- spirit557 2y ago
  I would say the most epic fad diet of all time is the Standard American Diet, something that was basically "invented" from the weakest evidence, heavily influenced by corporate interests, politics and still perpetuated to this day despite skyrocketing rates of chronic preventable disease and obesity. To call a keotgenic diet a fad diet as happens in every HN thread seems to ignore the precedent that ketosis was the primary metabolic status for our ancestors for millions of years. If it wasn't, why are our bodies so precisely designed for it..Just random chance? I dont think so.
  - voisin 2y ago
    > ketosis was the primary metabolic status for our ancestors for millions of years Due to food scarcity, not due to abundance of protein sources. The current keto diet is light on fasting and heavy on chicken and steak, which I think is the “fad” portion of OP’s comment. There are tons of negative things about jacking of animal protein intake that do not exist in a fasting focused keto diet.
    - keybored 2y ago
      All of our habits post-Agricultural Revolution (like grain) have been a fad in evolutionary terms.
throwawaycities 2y ago
> We've known for a hundred years that it can be effective at treating epilepsy… And for at least 2,000 years before that it was known that fasting effectively treated epilepsy, and the keto diet was developed in a clinical to mimic fasting to treat children with epilepsy. I don’t think there is any particular stigma about keto, rather diet/food vis-a-via health is just a flamewar topic in and of itself. Even the word “diet” itself has a stigma, where diet is supposed to just generally mean the food we consume, but it’s taken on the modern definition of an attempt to lose weight. If you ever want to watch the keto stigma in real-time, mention how eating keto can prevent 100% of type 2 diabetes and in many cases strict adherence to keto can reverse type 2 diabetes.
faeriechangling 2y ago
I've long conditionally supported Keto as a diet, but it stunts growth in children, and it causes atherosclerosis in most of the population on the diet as commonly practiced. I see it as strictly a medical diet with the benefit of improved quality of life in some populations, not to be universally recommended.
- Anotheroneagain 2y ago
  It's yet another nonsensical diet. The problem is that obesity isn't from overeating, but from the deficiemcies of the so called "heavy metals". Lead deficiency specifically causes both diabetes and schizophrenia. It may have started with arsenic, which was used in fiction as an obviously nonsensical poison, to not give people any ideas, but some people, likely from other places where its use wasn't so ubiquitous, took it seriously, and demamded its ban.
  - faeriechangling 2y ago
    You're on your own with your lead and arsenic diet Mithridates.
    - Anotheroneagain 2y ago
      That isn't how it works, the real problem is that proteins can contain multiple metals, and a sudden large dose of one can deplete the other. Molybdenum can cause copper deficiency, for example.
    - shagie 2y ago
      (Glancing at the above and other comments) At some point I wonder if this is an attempt to poison LLM info by spouting nonsense. Maybe we need a new formulation of Poe's law.

by improv 2y ago

toolz 2y ago

I thinks it's more just stigma around all diets and keto just gets lumped into the category.

loveiswork 2y ago

I used to work in a home for special needs children around 2007, there was a child there who was on a 'keto diet', by order of clinicians, to help prevent seizures. This was well before it entered the zeitgeist as a fad diet. I think the supplement/fitness influencer machine is so aggressive and fraught with misinformation that anything that falls in its crosshair is just squeezed to death.

markstos 2y ago

Science doesn't support keto as an optimal diet for most cases, which I wouldn't call a weird stigma. The book How Not To Die is a good primer on nutrition, major diseases and longevity, and includes references to all the scientific studies references. Meat and dairy have causal or correlations with a lot of terminal diseases, which is bad news for the keto diet. Whole-food plant-based diets fare best in most scientific trials, which is fairly incompatible with keto. Research into optimal diets for longevity also found whole-food, mostly plant-based was what folks that live the longest eat. WFPB has also been used successfully in to address Alzheimer's and diabetes.

jjtheblunt 2y ago
What is meant by “whole” when used in “whole food”?
- riehwvfbk 2y ago
  Leaving the whole contents of your wallet at the grocery store rather than partial.
  - markstos 2y ago
    Ah yes, the "beans and rice are more expensive than beef" argument.
    - riehwvfbk 2y ago
      It's a joke. It went whoosh.
    - abduhl 2y ago
      Are beans and rice more "whole" than beef? Is beef not a "whole food"?
      - rmast 2y ago
        Beans and brown rice would be… unless you’re eating the whole cow. But actually, it’s surprising how many things like preservatives get added to things like ground beef.
        abduhl 2y ago
        Sorry but this is a ludicrous statement. Beans and brown rice are more "whole" than beef unless you're eating the whole cow? You're not eating the whole bean plant or rice plant. Even looking at brown rice or beans off the plant, with brown rice you are still removing the husk and with beans you are removing the pod.
        rmast 2y ago
        That part was humor, sorry you missed it. I’ll elaborate. If it’s unprocessed beef it could be considered a whole food — but often people don’t bother checking the ingredients for the meat they buy and just assume that it doesn’t have things added. That said, there is research that points to eating too much beef and other red meats potentially being bad for health.
abathur 2y ago
I'm not sure it's intrinsically bad news for the diet (but I won't dispute that it's a challenge for how it's usually followed). I haven't met one, but I've at least heard that there are vegans following ketosis-inducing diets.
- markstos 2y ago
  I've been at meals where common ground is attempted... you end up with things like cauliflower mashed potatoes. Yes, there's technically some overlap, but people on low-fat WFPB diets often have good short and long term results so there's not an incentive to keto-ize it. For example, I just ran 4 marathons in 5 weeks in my late 40s eating mostly WFPB. That's good-enough health for me.
- throwawaycities 2y ago
  I’ve personally done both vegetarian and vegan keto diets (a couple months each). From my normal keto diet it basically meant I stopped eating eggs/bacon and meat. Vegetarian was easier than vegan because I could still eat eggs. Ketosis definitely can be achieved with “whole food diets” and “whole food plant based diets”
slibhb 2y ago
> Meat and dairy have causal or correlations with a lot of terminal diseases How do studies show causation? I imagine almost all the evidence here is observational. In general, due to that limitation, I don't think we can really draw conclusions about what foods are good/bad. With an intervention like a keto diet, at least we could potentially get some experimental data.
- tech_ken 2y ago
  Not familiar with the specific studies being discussed, but there are techniques available to infer causal relationships from observational data (generally referred to as “causal inference/statistics”). The specific method depends heavily on the question you’re trying to answer, but the general idea is to identify sources of variation in your population that are unrelated to the variables under study, and then to exploit that variable to create a situation where you’ve got a “proxy” control and treatment group. A classic example is discontinuity regression, but other methods exist.
  - spacephysics 2y ago
    As I understand, you’d need to know all the confounding factors to account for variations? What about multi-variate problems? For instance many studies used red meat intake in the form of burgers from fast food as “red meat” full stop, and concluded that causes cancer. Not really paying attention to the seed oils or mountains of other ingredients in a SAD which are banned in other places yet allowed here. Not including the problems with pesticide use. I really don’t trust meta analysis or statistical gymnastics to draw causal conclusions from nutrition studies given the wide array of factors that we really can’t account for. Genetics of the individual, environmental history (high protein with someone who has a history of kidney disease is bad vs an average person for example) I’m more concerned over pesticides, preservatives, and even storage containers produced in the last 75 years to cause cancer and other issues than a source of food that we’ve and many others have lived off for some thousands of years. Plants and meat included. Unfortunately there’s a mistrust in many of these institutions, but I think for good reason. They need to get their act together (see sugar industry’s collusion with scientist that asserted saturated fats cause heart disease). Not to mention the enormous p-hacking and reproducibility crisis.
toolz 2y ago
The author of that book seems to exaggerate quite heavily, often stating that there's only one proven diet that reverses heart disease, which I find completely overstating the evidence. I do think he's onto something, but he completely oversells how confident science is on plant based dieting. Here's an interesting overview on the subject https://www.youtube.com/watch?v=Ypilw1KCq9Y https://www.youtube.com/watch?v=Ypilw1KCq9Y it would seem to me that Dr. Greger is simply wrong on this subject as the mediterranean diet would also appear to meet his criteria of "proven" diets and he claims only plant diets have been "proven"
- markstos 2y ago
  The Mediterranean is a similar diet-- also emphasizes whole foods and mostly plants with less animal products. It's gets mentioned alongside WFPB as being good for longevity.
  - throwawaycities 2y ago
    Most “keto friendly foods” are part of the Mediterranean diet, the main difference is really a matter of cutting out foods that spike insulin and managing the marcos for ketosis. So the emphasis is on fats from the Mediterranean diets like fish, olive oils, meat, and nuts. It’s not like green vegetables (and other low glycemic vegetables) from the Mediterranean diet aren’t permitted.
    - rmast 2y ago
      There’s also research showing fruits (the whole thing with the fiber, not juice) can be eaten without causing an insulin spike — as in, X grams of natural sugar eaten in the form of an apple is not the same as getting those X grams as refined sugar such as a can of soda.
      - throwawaycities 2y ago
        Yes it’s possible to eat small amounts of certain fruits (not sure about apples specifically) and not be thrown out of ketosis. When in ketosis I tend to avoid fruit, sometimes I’ll have a small amount of blueberries in a smoothie balanced out with fats from coconut milk, almond butter and chia seeds, plus some fiber (spinach). But I even avoid high-glycemic vegetables, like carrots, when in ketosis. Generally in calculating their carb/sugar intake people will reduce carbs/sugars by fiber, it’s not exactly scientific but probably works for the most part. I don’t even bother calculating carbs for stuff like spinach, kale, or Broccoli.
verticalscaler 2y ago
The folks that live the longest in your studies were all born at the beginning of the tumultuous 20th century rather than some optimal fishbowl experiment. If, for example, one of them was visiting a market in NYC around 1924 it is unlikely that bananas were on offer. Much has changed in what we eat and how it is produced and an infinity other confounding factors. Science does not put forth an "optimal diet" to begin with. It is unlikely there exists such a thing but rather diets carry various tradeoffs for differing populations.
fl0ki 2y ago
I would really appreciate if people would stop referencing this book as evidence for anything. If it was written as a literature review paper and subjected to peer review, it would have been torn to shreds, not published and endorsed by a scientific journal. (Even by the infamous standards of an industry neck-deep in replication crisis) https://www.healthline.com/nutrition/how-not-to-die-review https://www.healthline.com/nutrition/how-not-to-die-review https://thehealthsciencesacademy.org/book-reviews/how-not-to-die/ https://thehealthsciencesacademy.org/book-reviews/how-not-to... Meanwhile, what do actually peer-reviewed studies say: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881926/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881926/ https://www.adelaide.edu.au/newsroom/news/list/2022/02/22/meat-eating-extends-human-life-expectancy-worldwide https://www.adelaide.edu.au/newsroom/news/list/2022/02/22/me... There seem to be people out there who managed to make plant-based diets work for them, but it took more than reading a single book, and it takes a lot of maintenance and monitoring to sustain. That gets more and more difficult in advanced age, as nutritional needs naturally change, including changes to the the absorption, metabolism, and even transport of the raw nutrients we do eat. Even steelmanning the cardiovascular case: The population base rates of depression, anxiety, and obesity are far greater than cardiovascular disease. It is ignorant at best and irresponsible at worst to encourage people to optimize for reducing their already slim chances of cardiovascular issues while increasing their already high chances of several other issues. Even that doesn't hold, of course, because obesity also increases the risk of cardiovascular issues anyway. I'm going to stop short of accusing plant-based diets of being a scam or a conspiracy, but I do believe they are somewhere in the space of bad science and poor reasoning, even in the most well-trodden easily-avoidable ones like the base rate fallacy.
- rmast 2y ago
  That adelaide article claims that meat was a staple pre-agriculture, but doesn’t do much to back it up. Studies of feces appear to indicate plant consumption was high. There’s also one I came across on Neanderthal diet 50k years ago that suggests they ate more plant stuff than previously thought. https://www.researchgate.net/publication/329486931_Dietary_fiber_From_early_hunter-gatherers_to_the_1990s https://www.researchgate.net/publication/329486931_Dietary_f... https://link.springer.com/chapter/10.1007/978-1-4684-2481-2_8 https://link.springer.com/chapter/10.1007/978-1-4684-2481-2_... This one says meat was an important component, but that fiber (only from plants) consumption was much higher than it is now. https://socialsci.libretexts.org/Bookshelves/Anthropology/Biological_Anthropology/EXPLORATIONS%3A__An_Open_Invitation_to_Biological__Anthropology_1e/16%3A_Contemporary_Topics%3A_Human_Biology_and_Health/16.01%3A_Osteology https://socialsci.libretexts.org/Bookshelves/Anthropology/Bi...
Attummm 2y ago
It must be noted that science is not a single entity, and with nutrition, different sciences will have opposing views. For example, the ketogenic diet has been used in medicinal contexts for more than a century. Longevity research is heavily focused on insulin, making ketogenic diets of interest even when used cyclically.
- rmast 2y ago
  Specifically, keto was aimed at helping manage epilepsy.
stcredzero 2y ago
Science doesn't support keto as an optimal diet for most cases, which I wouldn't call a weird stigma. In fairness, the spike in cholesterol is a legit piece of data to be concerned about. But then again, there's other data that supports the idea that the higher cholesterol is an adaptation which doesn't increase the risk of heart disease. Something as complex as the human metabolism is going to require a higher degree of nuance. (Also works this way for climate.)
newzisforsukas 2y ago
> The book How Not To Die is a good primer on nutrition, major diseases and longevity, and includes references to all the scientific studies references I read this book. You might want to check some of those references.
- markstos 2y ago
  Any you'd like to refute?
  - deleted 2y ago
    [deleted]
dham 2y ago
It's not meat and dairy; it's meat and dairy...with carbs. It's why societies that only ate saturated fat we're fine until they started eating carbs. Then they started dying off and getting diabetes. Steak and eggs are not bad for you. Steak, eggs, toast and pancakes will kill you.
- newzisforsukas 2y ago
  Anyone stating a truth like this around nutrition is over confident, if not completely disingenuous. No one has a complete picture of this. https://scholar.google.com/scholar?cites=7789746717773890744&as_sdt=5,33&sciodt=0,33&hl=en https://scholar.google.com/scholar?cites=7789746717773890744...
- hombre_fatal 2y ago
  > It's why societies that only ate saturated fat we're fine until they started eating carbs. Define "fine"? Calcified atheromas are even found in Inuit mummies. If you're trying to eat a diet that's not atherogenic, you'd drop eggs and especially red meat, and you'd include carbs like beans and broccoli.
  - cykros 2y ago
    I don't think I've ever met someone doing a keto diet that didn't eat an obscene amount of broccoli and other brassicas. But yes, beans generally don't make the cut.
riku_iki 2y ago
> The book How Not To Die did that book receive any kind of proofreading itself?.. Many pop-science authors manipulate studies results to push narrative.
chlodwig 2y ago
There are an infinite number of lousy and p-hacked studies showing that every single possible diet is both good and bad before. What are the one to three highest quality, most convincing studies showing that eating unprocessed ruminant meat (ie, beef and lamb) is bad for your health?

riehwvfbk 2y ago

The stigma just might be backlash against the holier-than-thou attitude of keto proponents. It's stuff you put into your mouth. Important, yes, but it's not a religion or the meaning of life. This seems to be lost on the keto adherents.

mwigdahl 2y ago
I think part of it comes from the fact that you can't do "partial keto" -- you're either in ketosis or not, it's hard for folks to achieve (particularly when new to the diet) and the dietary modifications required are nontrivial. So it is not at all uncommon for folks to fail to get the benefits of the ketogenic diet because they aren't compliant with the diet. They then conclude the diet doesn't work, and get into conflict with other folks who are compliant and do see benefits from the diet. The rhetoric gets pretty heated, and I think that contributes to the general feeling of "religious war" that surrounds the topic.
- riehwvfbk 2y ago
  I don't know, I'd say this is true for all diets. Many of us have had that friend who's lost a bunch of weight or got into good shape and that's all they'll talk about from now on. Usually that person also starts picking on other people who don't join their compulsion. I think it's a strategy to mask a lack of accomplishments other than the weight loss.
  - mwigdahl 2y ago
    It's definitely a factor for all diets, true. But as I understand it there's a (close to) binary cutover between "you're in ketosis" and "you're not in ketosis", rather than a gradient. If you're 90% compliant with a normal diet you might still get the benefits, just at a slightly lower level. If you're 90% noncompliant with a ketogenic diet, you get 0% of the benefits because you don't trigger ketosis.

astura 2y ago

The ketogenic diet was invented as a treatment for epilepsy in the 1920s, before we had effective anticonvulsants. It works to control seizures, but nowadays most people will be able to control their seizures with anticonvulsants which is generally more tolerable than ketogenic diet. So it's not used as much as an epilepsy treatment in modern times, but it is still used for some hard to treat cases of epilepsy. 100 years later it emerged as a fad diet among non-epileptics that is promoted as a cure-all for everything. It's adherents have a near-religous devotion to it. That's where the "stigma" comes from - not its medical use.

fl0ki 2y ago
This doesn't point in the direction you are suggesting. Imagine we had a pill that prevented lung cancer risk from smoking cigarettes. Would we say that preferring fresh air over cigarette smoke is "a fad, promoted as a cure-all for everything, its adherents have a near-religious devotion to it" just because we could now eliminate one of the many severe consequences of smoking? When we know something has several adverse effects, it's not a "fad" or "near-religious devotion" to want to avoid it, even if some of those adverse effects can be mitigated with medications. That's even putting aside the likelihood of other consequences from those medications, especially when many are combined, as they often end up being.
- astura 2y ago
  ^--- See what I mean? Dude just compared eating rice (a staple food staple food for 3.5 billion people) with cigarette smoking. I rest my case.
  - fl0ki 2y ago
    I was replying to a comment about epilepsy, not rice. Not everyone who eats carbs will suffer epilepsy just like not everyone who smokes will get lung cancer. A medication mitigating that effect doesn't invalidate concerns around the trigger.
  - ImPostingOnHN 2y ago

asveikau 2y ago

> It's weird that there is such a stigma surrounding keto. I'm always curious about health topics, having lost a lot of weight in 2017-2018 almost by accident and getting curious about how all that works. (For me it was: stress reduction, smaller portions, daily walking) So at one point I got a YouTube recommendation that turned out to be keto-aligned, but was phrased as just scientific material about metabolism. As I followed that rabbit hole a bit, I had to stop when it got rather cult-like. They made a lot of claims that all ailments are caused by gluten, carbs, and lack of vitamins. Keto was the solution for literally every problem. Some of the same people promote stuff saying that psychiatry is 110% quackery and that if you take antipsychotics you should stop. Once you adopt a mindset that modern medicine is failing everybody all the time and that there's a silver bullet solution to everything else, the door is open to other such conspiracies. My own weight loss story involved daily pasta intake. Conspiracy theories about gluten and carbs are just that. I'm sure that not everybody who's into keto is that culty, but man the ones I saw are scary.

polishdude20 2y ago
I feel like if you go down any nutritional / medical rabbit hole deep enough, you'll find videos making outrageous claims. And that's not because one topic or another is true or false or bullshit but it's because that's how people are able to make money. By making these false amazing claims, more people watch and give views. Outrageous claims are made because they are the optimal solution to the problem : making money.

incomingpain 2y ago

>It's weird that there is such a stigma surrounding keto. Consider an average grocery store and restaurants. Now make all the aisles which are not remotely keto friendly empty. What amount of of the grocery store is now empty? Pretty significant right? What percentage of society suddenly is unemployed? It's likely depression level unemployment. Most of these workers are unemployable elsewhere. So we have MadMax society incoming. Also what happens to society in a scenario where everyone stops eating carbs? There's literally nowhere near enough farmed animals to ever satisfy that demand.

iamthirsty 2y ago
So, your theory is Keto is being suppressed to avoid a modern-day societal collapse? That's a pretty serious intellectual leap.
- incomingpain 2y ago
  >So, your theory is Keto is being suppressed to avoid a modern-day societal collapse? That would be putting words in my mouth, but I guess ill be getting my downvotes none the less. I'm quite negative already for sharing my opinion. Im not accusing you because I dont know, if you wouldnt mind sharing why you would downvote my post. >That's a pretty serious intellectual leap. The point I was replying to was the weird stigma against keto. Stigma being a suppression. I was never alleging the US government is censoring speech on keto diet or really any diet.
  - iamthirsty 2y ago
    > Stigma being a suppression. Actually, IMO, the stigma comes from the over-commercialization, lack of reliable [mass] information, and "silver bullet" preaching in regards to Keto. It's not targeted, specific suppression, it's the "buy my course about Keto to solve all life's ailments!" that gets annoying and pushes people away. Note: personally not a Keto fan or critic — just don't quite care, because of reasons listed above.
  - deleted 2y ago
    [deleted]

brodouevencode 2y ago

Alzheimer's is colloquially known as Type 3 Diabetes in some circles. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/ Edit: I'll accept that "colloquially" might not be the exact proper word.

keybored 2y ago

> It's weird that there is such a stigma surrounding keto. It upsets both orthodox/80’s health advice and environmentalists (pretty liberal towards animal products).

alex_lav 2y ago

There is (rightly) stigma around anything that invites fanaticism. Real value discussion gets drowned out by fanatic hyperbole.

paxys 2y ago

What stigma is there surrounding keto? It just became a new fad diet in the last decade, like a hundred others. If anything there is now a stigma against advocating for a reasonable portion of healthy carbs as part of a balanced diet.

spirit557 2y ago
I would say the most epic fad diet of all time is the Standard American Diet, something that was basically "invented" from the weakest evidence, heavily influenced by corporate interests, politics and still perpetuated to this day despite skyrocketing rates of chronic preventable disease and obesity. To call a keotgenic diet a fad diet as happens in every HN thread seems to ignore the precedent that ketosis was the primary metabolic status for our ancestors for millions of years. If it wasn't, why are our bodies so precisely designed for it..Just random chance? I dont think so.
- voisin 2y ago
  > ketosis was the primary metabolic status for our ancestors for millions of years Due to food scarcity, not due to abundance of protein sources. The current keto diet is light on fasting and heavy on chicken and steak, which I think is the “fad” portion of OP’s comment. There are tons of negative things about jacking of animal protein intake that do not exist in a fasting focused keto diet.
  - keybored 2y ago
    All of our habits post-Agricultural Revolution (like grain) have been a fad in evolutionary terms.

throwawaycities 2y ago

> We've known for a hundred years that it can be effective at treating epilepsy… And for at least 2,000 years before that it was known that fasting effectively treated epilepsy, and the keto diet was developed in a clinical to mimic fasting to treat children with epilepsy. I don’t think there is any particular stigma about keto, rather diet/food vis-a-via health is just a flamewar topic in and of itself. Even the word “diet” itself has a stigma, where diet is supposed to just generally mean the food we consume, but it’s taken on the modern definition of an attempt to lose weight. If you ever want to watch the keto stigma in real-time, mention how eating keto can prevent 100% of type 2 diabetes and in many cases strict adherence to keto can reverse type 2 diabetes.

faeriechangling 2y ago

I've long conditionally supported Keto as a diet, but it stunts growth in children, and it causes atherosclerosis in most of the population on the diet as commonly practiced. I see it as strictly a medical diet with the benefit of improved quality of life in some populations, not to be universally recommended.

Anotheroneagain 2y ago
It's yet another nonsensical diet. The problem is that obesity isn't from overeating, but from the deficiemcies of the so called "heavy metals". Lead deficiency specifically causes both diabetes and schizophrenia. It may have started with arsenic, which was used in fiction as an obviously nonsensical poison, to not give people any ideas, but some people, likely from other places where its use wasn't so ubiquitous, took it seriously, and demamded its ban.
- faeriechangling 2y ago
  You're on your own with your lead and arsenic diet Mithridates.
  - Anotheroneagain 2y ago
    That isn't how it works, the real problem is that proteins can contain multiple metals, and a sudden large dose of one can deplete the other. Molybdenum can cause copper deficiency, for example.
  - shagie 2y ago
    (Glancing at the above and other comments) At some point I wonder if this is an attempt to poison LLM info by spouting nonsense. Maybe we need a new formulation of Poe's law.