Sarah Halberg at 39:05; most brilliant comment and significant insight from her. She talks about continuum of food/nutrition. However, utilizing processed food and sugar compromises metabolic health. Choices are then limited and low carb becomes the primary option.
Excellent panel, great moderation . I was formerly obese or yo-yo dieting for 40+ years, (ages 6-46) now in weight maintenance for 6+ years (70 pounds lost). I need multiple tools: calorie restriction and Low Carb diets and intermittent fasting to maintain. I stopped just short of surgery. I NEED to have choices as options at my doctor, so I appreciate Dr. Hallberg's point of needing choices. I've found sustainability with combining 3 methods. Thank you Swiss Re, Fiona Godlee, and Dr. Hallberg.and for the panel members' rational discussion. Bravo!
From reading "Diabetes Unpacked", it seems that people's metabolism 'avoids' getting type 2 diabetes by storing the excess glucose as fat, but some people are more successful than others at this. So some may get diabetes without putting on much weight whereas others put on weight until such a point that the body can no longer store the excess glucose and only then develop diabetes. So it seems obvious that it isn't being 'fat' per se that is the risk factor in type 2 diabetes, it's individual response to excess blood glucose. The bottom line is that type 2 diabetes is an intolerance of carbohydrates - and, as they are saying, limiting that is often the best way of preventing or reversing it.
The elephant in the room is that we have been eating animals and plants 4 million years and it is only in the last 50 that we have seen an exponential rise in metabolic diseases. What happened? The USDA guidelines happened.
Interesting that there didn't seem to be too much of a controversy on this controversial subject. Note the question (and response) to the public at 13:10-13:50 "How many people in the audience would consider themselves to be, currently, on a reduced carbohydrate increased fat diet?... Is there anyone in the audience who would consider themselves to be on a high carbohydrate reduced fat diet?"
@33:56 Sarah is incorrect. BHB increases when free fatty acids are converted into usable energy. There are multiple studies showing increases in ketones in all caloric restricted diets (whether low fat, low carb or Mediterranean) which is to be expected, if you're losing weight from fat you're increasing ketones. (fasting, very low carb or low carb high fat increases levels significantly more)
What do you mean by "losing weight from fat"? The only way to lose weight is by eating less calories than you burn (caloric deficit). We should be specific when we say "weight" though because almost no one is trying to lose muscle. So weight really just means bodyfat
I assume Sarah is right, that is, Mike is wrong. BHB does not run on mass action, that is, simply how much free fatty acid is out there but on hormonal state, particularly insulin and the whole metabolic milieu. As I say, what I always assumed but I would like to see the evidence. I will look myself.
@Richard Feinman Isnt the production of BHB by the liver a direct result of the cycle in the mitochondria when processing fat. That is, certain by products build up and are re-purposed? This doesnt happen if the mitochondria are burning available glucose. And fat is not available to the mitochondria if Insulin is high.
39:36 its said that maasai have high saturated fat and free of heart disease/healthy. I think that was an incredibly inaccurate and misguided claim to make for someone whos supposed to be highly educated when infact the maasai had "atherosclerosis which equaled that of old U.S. men", but their incredibly active lifestyles and fitness caused their vessels to expand in diametre offsetting the prevelence of heart disease, and since they mostly died around the ages of 50 its not a surprise they were free of heart disease. But given that accumulation of atherosclerosis its quite clearly evident the effect the high fat diet was having on their bodies. academic.oup.com/aje/article-abstract/95/1/26/167903
Funny enough its said from the same women quoted saying "theres more than one way to skin a cat"... Umm like i get its a figure of speech but wow, waita opt for the most sadistic figure of speech possible :O
My issues with the talk 1. Visceral fat is considered as a whole and sole contributor to increasing blood sugar levels. Or at least it is being potrayed as one by the guests. That is not true. We still do not know root of diabetes. 2. There is no evidence of cellular repair anywhere in literature. So rather than saying diabetes reversal blood sugar management seems better word. 3. The first speaker says adherence is important and also claim nutrition is very individualised. And still proposes common cliche solutions like low carb TO ALL OF THEM. 4. She also says adherence is amazing and it is not an issue. In all the literature, it never is a problem for mostly initial year when accompanied with counselling. However, eventually people fail in 5 years approx. 5. What about rebound. My conclusion : Everyone wants to propose theories and solutions too fast. No one actually is focusing at real problem. Till then, individualistic approach with proper counselling is the only solution. Eventually a line of approach can be formed, but low carb is not a solution nor a bariatric surgery. They may have 'proven' themselves to be efficient in balancing blood sugar levels, however story doesn't and shouldn't end here. We need better line of treatment that can lead to 'cure' of obesity epidemic. Temporary treatment is not a solution, most of the times it is just pulling an arrow back which will eventually bounce back with greater intensity. At this stage, the way people are being treated and trained with complete avoidance to how severe the rebound can be, any person who is deciding to start a diet just to lose few kgs, is at a risk of getting fat in long term.
Akshay Alawani On your point 4. Have you heard of Dr Bernstein, who wrote "The diabetes solution"? He's been on LCHF since the 70s, long before it was even called by such a name. He's now 85, I haven't heard that he died yet. I think you could call that long-term. Please note that he's a T1 diabetic and has not suffered the usual problems that end up appearing in all T1 diabetics sooner or later.
Akshay, you are wrong. If T2DM people eat less than 50g carbohydrate per day blood sugars, blood insulin is lowered. Humans can easily live with zero carbohydrates. Compliance is a different problem. The prevalence of carb/fat hyper pleasure full foods is a big reason why you suggest a rebound. I liken this to an alcoholic who has chosen to not have a drop and then gets back to drinking. It is usually a heck uv a rebound. Clearly sugar causes death.
Anyone doing ... Well not just anyone, but many how take this seriously and do not live a hedonistic life goal, tends to stick in LCHF or protein centric diets in that manner and if incorporated with intermittent fasting, falls in love with it. I myself, like many before, was a pathological sugar craving addict. I love now my life without sugar and carbs. All who try and get it, know they won't backlash. At least after becoming insuline sensitive. This enables one to gain fat when ever needed. Who needs long term trials when we have n=1 and internet or fasting as tools to shape our life. Just do it. Ok just try it, or don't do anything different and hope that the environment changes. Sorry for not being so nice this time. No offence intended to any living soul.
Hi Johnny. Roy Taylor talks more easily than his colleague Michael Lean. I saw Taylor write that folks were adamantly opposed to his ideas that they could "reverse" or put T2 into remission. So it was very hard to get results published; (I think he said they just could not get their work published in the US). Remember that for journals, peer-reviewed=peer pressure. Taylor did comment that one of his comments came up to him; in 2016 I think; and said that he now conceded Taylor was right, and he was wrong. So even now, many will feel their are heretics; perhaps for such as Lean, it is better not to be too heretical; (we are talking about a priestly circle here ..); so better to keep the head down and not publicly concede any recognition of low-carb.
Once your mind is made up it's difficult to reverse course. Most of us would do well to take some time out from opining and see what new info might get in.
Sarah, you were gold. You saved so many people from type2. R.I.P.
Sarah Halberg at 39:05; most brilliant comment and significant insight from her. She talks about continuum of food/nutrition. However, utilizing processed food and sugar compromises metabolic health. Choices are then limited and low carb becomes the primary option.
Excellent panel, great moderation . I was formerly obese or yo-yo dieting for 40+ years, (ages 6-46) now in weight maintenance for 6+ years (70 pounds lost). I need multiple tools: calorie restriction and Low Carb diets and intermittent fasting to maintain. I stopped just short of surgery. I NEED to have choices as options at my doctor, so I appreciate Dr. Hallberg's point of needing choices. I've found sustainability with combining 3 methods.
Thank you Swiss Re, Fiona Godlee, and Dr. Hallberg.and for the panel members' rational discussion. Bravo!
What a start studded audience asking the questions!
From reading "Diabetes Unpacked", it seems that people's metabolism 'avoids' getting type 2 diabetes by storing the excess glucose as fat, but some people are more successful than others at this. So some may get diabetes without putting on much weight whereas others put on weight until such a point that the body can no longer store the excess glucose and only then develop diabetes. So it seems obvious that it isn't being 'fat' per se that is the risk factor in type 2 diabetes, it's individual response to excess blood glucose. The bottom line is that type 2 diabetes is an intolerance of carbohydrates - and, as they are saying, limiting that is often the best way of preventing or reversing it.
The elephant in the room is that we have been eating animals and plants 4 million years and it is only in the last 50 that we have seen an exponential rise in metabolic diseases. What happened? The USDA guidelines happened.
I agree with regard to animals. We have been eating some plants but the evidence shows that 70-80% of our food came from animal sources...
As if people actually consult the USDA recommendations before deciding what’s for lunch.
ROY knows what he is talking about
Terrific! Too bad it was too short
Interesting that there didn't seem to be too much of a controversy on this controversial subject.
Note the question (and response) to the public at 13:10-13:50 "How many people in the audience would consider themselves to be, currently, on a reduced carbohydrate increased fat diet?... Is there anyone in the audience who would consider themselves to be on a high carbohydrate reduced fat diet?"
The fourth choice is intermittent feasting followed by fasting. ..
Cf Dr Jason Fung.
Graham Edwards
no
@33:56 Sarah is incorrect. BHB increases when free fatty acids are converted into usable energy. There are multiple studies showing increases in ketones in all caloric restricted diets (whether low fat, low carb or Mediterranean) which is to be expected, if you're losing weight from fat you're increasing ketones. (fasting, very low carb or low carb high fat increases levels significantly more)
What do you mean by "losing weight from fat"?
The only way to lose weight is by eating less calories than you burn (caloric deficit).
We should be specific when we say "weight" though because almost no one is trying to lose muscle. So weight really just means bodyfat
I assume Sarah is right, that is, Mike is wrong. BHB does not run on mass action, that is, simply how much free fatty acid is out there but on hormonal state, particularly insulin and the whole metabolic milieu. As I say, what I always assumed but I would like to see the evidence. I will look myself.
@Richard Feinman Isnt the production of BHB by the liver a direct result of the cycle in the mitochondria when processing fat. That is, certain by products build up and are re-purposed? This doesnt happen if the mitochondria are burning available glucose. And fat is not available to the mitochondria if Insulin is high.
Drop people in the wild and log the ones that survive and are healthy and see what they eat....well it won't be tons of carbs.
39:36 its said that maasai have high saturated fat and free of heart disease/healthy. I think that was an incredibly inaccurate and misguided claim to make for someone whos supposed to be highly educated when infact the maasai had "atherosclerosis which equaled that of old U.S. men", but their incredibly active lifestyles and fitness caused their vessels to expand in diametre offsetting the prevelence of heart disease, and since they mostly died around the ages of 50 its not a surprise they were free of heart disease. But given that accumulation of atherosclerosis its quite clearly evident the effect the high fat diet was having on their bodies. academic.oup.com/aje/article-abstract/95/1/26/167903
Funny enough its said from the same women quoted saying "theres more than one way to skin a cat"... Umm like i get its a figure of speech but wow, waita opt for the most sadistic figure of speech possible :O
very stressfull, speeded, frantic setting and a dragon of moderator ... Sadly shorted time for these people to argue important things ...
walter kempner treated all metabolic syndrom with table sugar and white rice with 100% succsess
My issues with the talk
1. Visceral fat is considered as a whole and sole contributor to increasing blood sugar levels. Or at least it is being potrayed as one by the guests. That is not true. We still do not know root of diabetes.
2. There is no evidence of cellular repair anywhere in literature. So rather than saying diabetes reversal blood sugar management seems better word.
3. The first speaker says adherence is important and also claim nutrition is very individualised. And still proposes common cliche solutions like low carb TO ALL OF THEM.
4. She also says adherence is amazing and it is not an issue. In all the literature, it never is a problem for mostly initial year when accompanied with counselling. However, eventually people fail in 5 years approx.
5. What about rebound.
My conclusion :
Everyone wants to propose theories and solutions too fast. No one actually is focusing at real problem.
Till then, individualistic approach with proper counselling is the only solution.
Eventually a line of approach can be formed, but low carb is not a solution nor a bariatric surgery. They may have 'proven' themselves to be efficient in balancing blood sugar levels, however story doesn't and shouldn't end here. We need better line of treatment that can lead to 'cure' of obesity epidemic. Temporary treatment is not a solution, most of the times it is just pulling an arrow back which will eventually bounce back with greater intensity.
At this stage, the way people are being treated and trained with complete avoidance to how severe the rebound can be, any person who is deciding to start a diet just to lose few kgs, is at a risk of getting fat in long term.
Akshay Alawani On your point 4. Have you heard of Dr Bernstein, who wrote "The diabetes solution"? He's been on LCHF since the 70s, long before it was even called by such a name. He's now 85, I haven't heard that he died yet. I think you could call that long-term. Please note that he's a T1 diabetic and has not suffered the usual problems that end up appearing in all T1 diabetics sooner or later.
Akshay, you are wrong.
If T2DM people eat less than 50g carbohydrate per day blood sugars, blood insulin is lowered.
Humans can easily live with zero carbohydrates.
Compliance is a different problem. The prevalence of carb/fat hyper pleasure full foods is a big reason why you suggest a rebound.
I liken this to an alcoholic who has chosen to not have a drop and then gets back to drinking. It is usually a heck uv a rebound.
Clearly sugar causes death.
Anyone doing ... Well not just anyone, but many how take this seriously and do not live a hedonistic life goal, tends to stick in LCHF or protein centric diets in that manner and if incorporated with intermittent fasting, falls in love with it. I myself, like many before, was a pathological sugar craving addict. I love now my life without sugar and carbs. All who try and get it, know they won't backlash. At least after becoming insuline sensitive. This enables one to gain fat when ever needed. Who needs long term trials when we have n=1 and internet or fasting as tools to shape our life. Just do it. Ok just try it, or don't do anything different and hope that the environment changes. Sorry for not being so nice this time. No offence intended to any living soul.
I hear closed minded physicians, and not willing to even enertian low carb diets.
Hi Johnny. Roy Taylor talks more easily than his colleague Michael Lean. I saw Taylor write that folks were adamantly opposed to his ideas that they could "reverse" or put T2 into remission. So it was very hard to get results published; (I think he said they just could not get their work published in the US). Remember that for journals, peer-reviewed=peer pressure. Taylor did comment that one of his comments came up to him; in 2016 I think; and said that he now conceded Taylor was right, and he was wrong. So even now, many will feel their are heretics; perhaps for such as Lean, it is better not to be too heretical; (we are talking about a priestly circle here ..); so better to keep the head down and not publicly concede any recognition of low-carb.
Once your mind is made up it's difficult to reverse course. Most of us would do well to take some time out from opining and see what new info might get in.