1
4
submitted 22 hours ago* (last edited 21 hours ago) by jet@hackertalks.com to c/ketogenic@discuss.online

A combination of ketogenic diet and voluntary exercise ameliorates anxiety and depression-like behaviors in Balb/c mice

abstractThe positive effects of both ketogenic diet (KD) and regular voluntary exercise on anxiety and depression behavior have been recently reported in rodent animals, but the effects of pairing a KD with exercise on depression and anxiety are unknown. In this study, we aimed to investigate the effects of combination of KD and regular voluntary exercise on anxiety and depression-like behavior in Balb/c mice. We've demostrated that anxiety and depression levels decreased in KD-exercised (KD-Ex) mice. β-hydroxybutyrate (BHB) levels increased while glucose, insulin levels and LDL/HDL ratio decreased in KD-Ex mice. There was a negative correlation between BHB and the time spent in the closed arms of elevated plus maze (EPM) or the time spent in periphery walls of open field test (OFT) and the immobility time in forced swim test (FST) which all of them are indicators of low depression and anxiety levels. There was a positive correlation between LDL/HDL ratio and the time spent in the closed arms of EPM or the immobility time in FST. The immobility time in FST was positively correlated with insulin while the mobility time in FST was negatively correlated with glucose. In conclusion, these results suggest that decline in anxiety and depression-like behaviors resulted from KD with regular voluntary exercise may be associated with increased BHB levels and decreased LDL/HDL ratio and insulin or glucose levels. Further research is necessary for our understanding of the mechanisms by which pairing a KD with voluntary exercise influences brain and behavior.

Fasting or the short-term consumption of a ketogenic diet protects against antipsychotic-induced hyperglycaemia in mice

abstractAntipsychotic (AP) medications, such as olanzapine (OLZ), are used in the treatment of schizophrenia and a growing number of 'off-label' conditions. A single dose of OLZ causes robust increases in blood glucose within minutes of treatment. The purpose of the current study was to investigate whether interventions that increase circulating ketone bodies (fasting, β-hydroxybutyrate (βHB), ketone esters or a ketogenic diet (KD)) would be sufficient to protect against the acute metabolic side effects of OLZ. We demonstrate that fasting or the short-term consumption of a KD protects against OLZ-induced hyperglycaemia, independent of alterations in whole-body insulin action, and in parallel with a blunted rise in serum glucagon. Interestingly, the effects of fasting and KDs were not recapitulated by acutely increasing circulating concentrations of ketone bodies through treatment with βHB or oral ketone esters, approaches which increase ketone bodies to physiological or supra-physiological levels, respectively. Collectively, our findings demonstrate that fasting and the short-term consumption of a KD can protect against acute AP-induced perturbations in glucose homeostasis, whereas manipulations which acutely increase circulating ketone bodies do not elicit the same beneficial effects. KEY POINTS: Antipsychotic medications cause rapid and robust increases in blood glucose. Co-treatment approaches to offset these harmful metabolic side effects have not been identified. We demonstrate that fasting or the consumption of a short-term ketogenic diet, but not treatment with β-hydroxybutyrate or oral ketone esters, protects against acute antipsychotic-induced hyperglycaemia. The protective effects of fasting and ketogenic diets were paralleled by reductions in serum glucagon, but not improvements in whole-body insulin action.


Complete remission of depression and anxiety using a ketogenic diet: case series

abstractBackground: There is little data that describe the use of ketogenic metabolic therapy to achieve full remission of major depression and generalized anxiety disorder in clinical practice. We present a retrospective case series of three adults with major depression and generalized anxiety disorder with complex comorbidity, treated with personalized ketogenic metabolic therapy, who achieved complete remission of major depression and generalized anxiety disorder and improvements in flourishing, self-compassion, and metabolic health.

Methods: Three adults, ages 32–36, with major depression, generalized anxiety, other anxiety disorders, and comorbid psychiatric conditions were treated for 12–16 weeks with personalized whole food animal-based ketogenic metabolic therapy (1.5:1 ratio) in a specialized metabolic psychiatry practice. Interventions included twice-weekly visits with an experienced ketogenic registered dietitian; daily photo journaling and capillary blood BHB/glucose/GKI monitoring; virtual groups; family/friends support; nature walks and talks several times per week, and community building. Successful adoption of the ketogenic diet was defined as the achievement and maintenance of capillary BHB ≥ 0.8 mmol/L and GKI < 6. Remission was assessed by GAD-7 and PHQ-9, and quality of life was assessed subjectively and with validated scales for flourishing and self-compassion. Metabolic health was assessed by laboratories/biometric measures.

Results: Two patients achieved remission of major depression (PHQ-9 ≤ 4) and generalized anxiety (GAD-7 ≤ 4) within 7 weeks of therapeutic nutritional ketosis; one required 12 weeks. Anxiety responded and remitted more quickly than major depression. Flourishing and self-compassion increased steadily. Patients lost 10.9 to 14.8% of their initial body weight within 12 weeks and improved metabolically; one achieved optimal metabolic health.

Conclusion: Complete remission of major depression and generalized anxiety disorder occurred within 7–12 weeks of therapeutic nutritional ketosis during treatment with a personalized animal-based ketogenic diet (ratio 1.5:1) in adults with complex comorbid depression and anxiety engaged in a specialized metabolic psychiatry program.

Ketogenic metabolic therapy in the remission of chronic major depressive disorder: a retrospective case study

abstractBackground: There is limited evidence describing the use of ketogenic metabolic therapy (KMT), also known as a ketogenic diet (KD), to achieve full remission of treatment-resistant major depressive disorder (MDD) in real-world clinical settings. This case study examines a 47-year-old woman with lifelong treatment-resistant MDD who achieved complete remission of depressive symptoms and improved functioning through a ketogenic diet.

Methods: The patient engaged in KMT with a 1.5:1 macronutrient ratio under the supervision of a treatment team consisting of a medical professional, psychotherapist, and ketogenic-informed nutrition professional through an online program that provided both individual and group support. Interventions included dietary modifications, micronutrient supplementation, and participation in a group coaching program. Outcomes were assessed using validated tools for symptom severity, including PHQ-9 for depression and GAD-7 for anxiety, at baseline, 2 months, and 4 months post-intervention. Qualitative data on patient experiences and functional improvements were also collected.

Results: The patient achieved remission of MDD within 8 weeks of initiating KMT, with PHQ-9 scores decreasing from 25 (severe depression) at baseline to 0 at 2- and 4-month assessments. GAD-7 scores decreased from 3 (minimal anxiety) to 0 over the same period. Qualitative findings revealed significant improvements in emotional regulation, energy levels, and cognitive function.

Conclusion: This case study demonstrates the potential of KMT as a non-pharmacological intervention for achieving full remission in treatment-resistant MDD. These findings suggest further research to evaluate feasibility, efficacy, and broader applicability in diverse clinical settings.

The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients

abstractBackground and hypothesis: The robust evidence base supporting the therapeutic benefit of ketogenic diets in epilepsy and other neurological conditions suggests this same metabolic approach may also benefit psychiatric conditions.

Study design: In this retrospective analysis of clinical care, 31 adults with severe, persistent mental illness (major depressive disorder, bipolar disorder, and schizoaffective disorder) whose symptoms were poorly controlled despite intensive psychiatric management were admitted to a psychiatric hospital and placed on a ketogenic diet restricted to a maximum of 20 grams of carbohydrate per day as an adjunct to conventional inpatient care. The duration of the intervention ranged from 6 to 248 days.

Study results: Three patients were unable to adhere to the diet for >14 days and were excluded from the final analysis. Among included participants, means and standard deviations (SDs) improved for the Hamilton Depression Rating Scale scores from 25.4 (6.3) to 7.7 (4.2), P < 0.001 and the Montgomery-Åsberg Depression Rating Scale from 29.6 (7.8) to 10.1 (6.5), P < 0.001. Among the 10 patients with schizoaffective illness, mean (SD) of the Positive and Negative Syndrome Scale (PANSS) scores improved from 91.4 (15.3) to 49.3 (6.9), P < 0.001. Significant improvements were also observed in metabolic health measures including weight, blood pressure, blood glucose, and triglycerides.

Conclusions: The administration of a ketogenic diet in this semi-controlled setting to patients with treatment-refractory mental illness was feasible, well-tolerated, and associated with significant and substantial improvements in depression and psychosis symptoms and multiple markers of metabolic health.


Is this proof keto will fix your problem? No. Is this suggestive that a free, no-downside, self-administered eating pattern is worth a try? Yes.

About 1/2 times per week there is a post on lemmy roughly asking "How do I fix anxiety or depression at home/without a doctor/without meds"

I highly encourage people to look at the emerging research coming from metabolic mind https://www.metabolicmind.org/resources/science/research/ specifically investigating metabolic health with brain health.

2
6

Aim: Mobile health (mHealth) applications have been reported to be effective in improving glycaemic control and cardiometabolic health, but mainly as part of shorter-term intervention studies. The aim of this study is to examine the effect of the ongoing Defeat Diabetes mHealth low-carbohydrate diet (LCD) intervention on clinical markers and cardiometabolic risk after 6 months of intervention.

Methods: Data were collected via primary care physicians as part of routine T2D monitoring. These included HbA1c (primary outcome), blood pressure, blood lipids, and markers of kidney and liver function. Anthropometrics, as well as changes in the prescription of diabetes, hypertension, and dyslipidaemia medication, were also recorded. Calculated variables, total cholesterol to HDL-c, triglyceride to HDL-c, and waist to height ratios, were analysed to examine changes in cardiometabolic risk profile. Three-day food records were used to assess dietary intake and intervention adherence. Univariate regression models examined changes from baseline to 6 months.

Results: Ninety-four participants remained in the study out of the ninety-nine at baseline (mean age 59 ± 11 years, 55 females). After 6 months of intervention, there were significant reductions in HbA1c by −1.0% (95% CI: −1.3 to −0.6), as well as in the liver enzymes ALT (−9.3 U/L 95% CI −16.3 to −2.4) and GGT (−18.8 U/L 95% CI: −31.4 to −6.3) across the cohort. In addition, there was a significant reduction in cardiometabolic risk, as measured by the calculated variables and a decrease in waist circumference (−4.6 cm 95% CI: −8.9 to −0.2).

Conclusions: People with T2D receiving LCD education and resources through the Defeat Diabetes mHealth app (version 3.3.8) improved their glycaemic control after 6 months of intervention. Cardiometabolic risk profile and liver function also showed significant improvement. These findings indicate that the use of an LCD digital app is a valuable adjunct in the management of T2D.

Full Paper - https://doi.org/10.3390/nu17060937

For context, here is their published protocol for telehealth: https://doi.org/10.3390/nu15092153

3
4
submitted 2 days ago* (last edited 2 days ago) by jet@hackertalks.com to c/ketogenic@discuss.online

Dr Peter Brukner OAM, world-renowned sports physician and founder of Defeat Diabetes and SugarByHalf, shares how a low-carb, healthy-fat diet transformed his own health, reversing type 2 diabetes and shedding excess weight.

Dr. Brukner dives into:

  • The growing evidence for low-carb diets in managing chronic diseases
  • Why our dietary guidelines need to change
  • The role of sunlight and vitamin D in health
  • The challenges doctors face implementing nutritional changes in clinical practice
  • How reducing sugar could radically improve public health

Whether you’re managing diabetes, looking to lose weight, or simply curious about the link between nutrition and health, this conversation is packed with practical insights.

summerizer

Summary

The podcast episode features Professor Peter Brookner, a former renowned sports doctor with extensive experience in elite sports teams, who transitioned to focus on nutrition and diabetes, particularly through low-carb, high-fat dietary approaches. Initially skeptical, Brookner shares his personal journey from being pre-diabetic and overweight to reversing his metabolic issues by adopting a low-carb, healthy fat diet. He explains how this lifestyle change led to significant health improvements, including weight loss, better energy, and reversal of fatty liver. Brookner became an advocate for low-carb nutrition, co-founding the Defeat Diabetes program aimed at helping Australians manage and reverse type 2 diabetes through dietary changes. The program includes educational resources, meal plans, and support, and has shown promising results in clinical studies involving general practitioners and patients.

Throughout the conversation, Brookner criticizes conventional dietary guidelines, particularly the longstanding low-fat, high-carb recommendations, which he argues have contributed to the rising prevalence of obesity and type 2 diabetes. He highlights the powerful influence of the food and pharmaceutical industries in maintaining the status quo and discusses the cultural and institutional resistance within the medical profession towards low-carb approaches. Brookner also touches on the broader impact of diet on chronic diseases, including mental health and neurological conditions, and advocates for a more natural, whole-food-based lifestyle, including sensible sun exposure for vitamin D.

He expresses cautious optimism about emerging shifts in dietary recommendations globally, referencing movements like the US “Maha” movement and ongoing research challenging current paradigms. Brookner discusses the carnivore diet as a more extreme, but potentially effective, low-carb option especially for autoimmune conditions, while emphasizing the importance of open-mindedness in nutrition science. His overall message is that type 2 diabetes is a disease of carbohydrate intolerance and that dietary carbohydrate restriction offers a straightforward and effective way to manage and even remit the disease. The episode closes with discussion of the challenges in changing public and professional understanding but expresses hope and determination to continue spreading awareness.

Highlights

  • 🥓 Professor Peter Brookner’s personal transformation reversing pre-diabetes through a low-carb, high-fat diet.
  • 📚 The influence of politics and industry on dietary guidelines, challenging the low-fat orthodoxy.
  • 💪 Defeat Diabetes program’s success in helping thousands manage and reverse type 2 diabetes.
  • 🍳 The carnivore diet as a potential therapeutic approach for autoimmune and metabolic conditions.
  • 🧠 Emerging evidence linking diet to mental health and neurological diseases.
  • ☀️ Advocating natural lifestyle factors such as sun exposure for overall health.
  • 💉 Critique of conventional diabetes management and over-reliance on medications like insulin.

Key Insights

  • 🔬 Personal Experimentation as Catalyst for Change: Brookner’s journey highlights the power of self-experimentation (n=1) in challenging entrenched medical assumptions. His transition from sports medicine to diabetes nutrition underscores the importance of personal experience alongside scientific evidence in driving innovation. This also illustrates how professionals can remain blind to their own health risks until confronted with data and new paradigms.

  • 🥩 Low-Carb, High-Fat Diets Address Root Cause of Type 2 Diabetes: Brookner asserts that type 2 diabetes is fundamentally a disease of carbohydrate intolerance. The standard high-carb, low-fat diet exacerbates the problem by promoting hyperglycemia and insulin resistance. His experience and clinical data from the Defeat Diabetes program reinforce that carbohydrate restriction normalizes blood sugar and insulin levels, enabling remission rather than mere symptom management.

  • 🏥 Resistance Within Medical and Nutrition Professions: Despite accumulating evidence, many healthcare professionals remain wedded to outdated low-fat dietary dogma. This resistance is partly due to rigid medical education systems emphasizing rote learning, institutional inertia, and fear of challenging industry-supported orthodoxies. Such systemic barriers slow progress and deny patients effective care.

  • 💰 Food and Pharmaceutical Industry Influence: The enduring low-fat paradigm is heavily influenced by commercial interests. The food industry’s use of hidden sugars and processed carbohydrates drives addiction and chronic disease, while pharmaceutical companies profit from ongoing disease management rather than prevention or reversal. This creates a conflict of interest that hinders public health advances and skews research priorities.

  • 🧠 Diet’s Impact Beyond Diabetes—Mental and Neurological Health: Emerging research links dietary patterns to mental illnesses (bipolar disorder, depression, anxiety) and neurodegenerative diseases (Parkinson’s, Alzheimer’s, epilepsy). Brookner’s anecdotal and wider clinical observations suggest that dietary interventions, especially ketogenic and low-carb diets, can significantly improve these conditions, opening new frontiers for integrative medicine.

  • 🌞 Holistic Health Requires Natural Lifestyle Practices: Beyond diet, Brookner emphasizes the underestimated benefits of natural sunlight for vitamin D synthesis and nitric oxide production, which influence overall health and disease prevention. Modern lifestyle trends of sun avoidance and excessive use of processed foods disrupt these natural processes, contributing to widespread deficiencies and chronic illness.

  • ⚖️ Quality of Life Over Longevity Alone: Brookner distinguishes between lifespan and healthspan, advocating for lifestyle changes that maximize not just years lived but the quality of those years. His own improved health in his 70s, compared to earlier decades, illustrates that dietary and lifestyle changes can reverse damage and enhance vitality well into older age.

  • 🥚 Reevaluating Nutritional Dogmas—Saturated Fat and Cholesterol: The episode challenges the long-held belief that saturated fat and dietary cholesterol cause heart disease, citing evidence that these fears are unfounded. Foods like butter, eggs, meat, and fish provide vital nutrients and have been unfairly demonized, leading to misguided public health policies and worsening metabolic health.

  • 🔄 Dietary Flexibility and Individualization—Carnivore and Beyond: While endorsing low-carb diets broadly, Brookner acknowledges that stricter regimens like the carnivore diet can be beneficial, especially for autoimmune conditions. This highlights the need for personalized nutrition approaches and openness to diverse dietary models rather than one-size-fits-all prescriptions.

  • 📈 Encouraging Results from Clinical Studies and Real-World Programs: The Defeat Diabetes program’s success in clinical trials involving general practitioners and patients demonstrates that structured, evidence-based low-carb interventions can be effectively integrated into mainstream healthcare. This model shows promise for scalable public health strategies addressing the diabetes epidemic.

  • 🚫 The Challenge of Changing Public and Professional Mindsets: Despite robust evidence and success stories, Brookner underscores the uphill battle against skepticism, misinformation, and commercial interests entrenched in dietary guidelines and healthcare practices. Progress requires persistent advocacy, education, and shifts in policy to prioritize prevention and cure over symptom management.

  • 🌍 Global Relevance and Hope for Future Policy Change: While focused on Australia, Brookner connects local efforts to international movements such as the US Maha movement and the reassessment of saturated fat guidelines. These shifts signal potential for broader transformation in nutrition science and public health policy worldwide, though progress is slow and contested.

  • 💡 Empowerment Through Education and Accessible Resources: Providing practical tools like meal plans, cooking demos, and supportive communities empowers individuals to take control of their health. The Defeat Diabetes subscription model reflects an affordable, scalable solution to widespread metabolic disease, emphasizing prevention and remission through informed lifestyle choices.

  • 💉 Reducing Reliance on Medications and Insulin: The conversation cautions against the common medical approach of escalating drug therapy for diabetes without addressing dietary causes. Significant reductions or elimination of insulin use are possible with carbohydrate restriction, mitigating side effects and improving patient quality of life.

  • 🧩 Interconnectedness of Chronic Diseases and Lifestyle Factors: The discussion reveals how obesity, diabetes, cardiovascular disease, mental health disorders, and neurological illnesses share common roots in diet and lifestyle. Addressing these factors holistically offers a more effective path to reducing the burden of chronic disease than fragmented medical interventions.

  • 🙌 Importance of Humility and Willingness to Change: Brookner’s narrative stresses that healthcare professionals must be willing to admit past errors and update their practices based on emerging evidence. This intellectual humility is crucial for advancing patient care and public health.

Conclusion

Professor Peter Brookner’s insights provide a compelling critique of conventional dietary wisdom and medical approaches to type 2 diabetes and chronic disease. His personal and professional journey underscores the transformative potential of low-carb, high-fat nutrition, combined with natural lifestyle practices, to reverse metabolic dysfunction and improve overall health. Despite systemic resistance, industry influence, and entrenched beliefs, Brookner’s work with the Defeat Diabetes program and advocacy efforts offer hope and practical pathways for individuals and healthcare systems confronting the global diabetes epidemic. The episode encourages open-mindedness, evidence-based practice, and persistent education to reshape nutritional health paradigms for better outcomes worldwide.

4
4

Dr Jonathan Martin presents data from his practice, showing substantial weight loss and improved liver function tests in patients who adopted a low-carbohydrate, high-healthy-fat diet.

Being told I had FLD was the reason I started reading about metabolic health. I'm glad to say that my liver function markers are normal now.

Summary
Title: Dr. Jonathan Martin - 'Slimming Down Your Liver: The Truth About Fatty Liver Disease'

  • Fatty liver disease, or non-alcoholic fatty liver disease (NAFLD), is a significant health issue affecting approximately 22% of Australians, with about 1,700 deaths annually from related complications like NASH, cirrhosis, and liver cancer.
  • NAFLD can progress to non-alcoholic steatohepatitis (NASH), which leads to progressive liver damage, fibrosis, cirrhosis, and liver failure.
  • Key risk factors for NAFLD include being overweight or obese, having high blood pressure, high triglycerides, low HDL cholesterol, diabetes, insulin resistance, and a high waist circumference.
  • Diagnosis of NAFLD involves identifying risk factors, abnormal liver function tests (such as elevated GGT and ALT), ultrasound findings like coarse echo texture, and high shear wave elastography indicating liver stiffness and fibrosis.
  • NASH increases the risk of progressive liver damage, liver failure, primary liver cancer, and cardiovascular diseases like heart attack, arrhythmia, and stroke.
  • Current guidelines for managing NASH include weight loss through a low-calorie, low-fat diet, blood sugar control, moderate alcohol consumption, coffee intake, weight loss drugs, vitamin E, obesity surgery, and statins, though statins do not reduce triglycerides.
  • Dr. Jonathan Martin emphasizes the importance of a low-carbohydrate, high-healthy-fat diet in managing and potentially reversing NAFLD and NASH by addressing insulin resistance, the root cause of the metabolic issue.
  • A study showed that a ketogenic diet improved diabetic control, reduced medication needs, and improved liver markers in diabetic patients, highlighting the benefits of low-carbohydrate diets.
  • In Dr. Martin's practice, 50 patients with NAFLD underwent a low-carb, ketogenic diet intervention, resulting in an average weight loss of 8.5 kg (8.6% of body weight), with significant improvements in liver function tests and a reduction in waist circumference.
  • A notable case involved a 65-year-old woman with severe liver fibrosis (F4) who, despite continuing moderate alcohol consumption, lost 15.6 kg and saw her fibrosis score improve from F4 to F0 after adhering to a ketogenic diet.
  • Dr. Martin advocates for a tailored, one-on-one approach to managing NAFLD and NASH, emphasizing the effectiveness of a high-healthy-fat, low-carbohydrate diet in reversing liver damage and improving overall health.

5
6
First time making Kefir (discuss.online)

I tried fermenting Kefir yesterday. Put some store-bought freeze dried Kefir powder and put them in a 1L tetrapak carton of pasteurized milk, and then I left it for ~24h. Ambient temperature is currently around 28-30'c.

When I opened the milk carton today the Kefir was almost entirely solid and I was unable to pour it out of the carton. I managed eventually to move it to the bottle by scraping it out of the carton, where it now rests.

I've put about 200 ml of milk in a small glass jar and because I was unable to find any grains, added 2 tbsp of the kefir to the glass jar. I wonder if this will let me continue fermenting without using another packet of freeze dried Kefir?

If anyone has any advice about how I should go about doing this I'd really appreciate it.

6
3

Purpose of review - Quality or quantity of food has been at the heart of the diet debate for decades and will seemingly continue for many to come unless tightly controlled studies are conducted. To our knowledge, there has never been an overfeeding study comparing the effects of multiple diets.

Recent findings - This study reports a case study of an individual who ate 5800 Calories per day of 3 different diets for 21 days at a time. The 3 different diets were low-carb, low-fat, and very-low-fat vegan. The weight gain over 21 days was 1.3 kg for low-carb, 7.1 kg for low-fat, and 4.7 kg for very-low-fat vegan.

Summary - In this n-of-1 study, consuming 5800 Calories/day of 3 different diets for 21 days did not lead to the same amount of weight gain. Further research should be conducted on how the human body gains weight with an emphasis on how different foods affect physiology. If these findings are replicated, there would be many ramifications for obesity treatment and healthcare guidelines.

Full Text: https://doi.org/10.1097/MED.0000000000000668

Ben Bikman brought up this study, and made a nice summary slide for it

7
7

Dr. Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. He is currently a professor of pathophysiology and a biomedical scientist at Brigham Young University in Utah.

Dr. Bikman's professional focus as a scientist and professor is to better understand chronic modern-day diseases, with a special emphasis on the origins and consequences of obesity and diabetes, with an increasing scrutiny of the pathogenicity of insulin and insulin resistance. He frequently publishes his research in peer-reviewed journals and presents at international science meetings.

Dr. Bikman has long been an advocate of a ketogenic diet in light of the considerable evidence supporting its use as a therapy for reversing insulin resistance. His website InsulinIQ.com promotes dietary clarity, healing, and freedom through evidence-based science about insulin resistance. Employing cell-autonomous to whole-body systems, Dr. Bikman's recent efforts have focused on exploring the intimate associations between the metabolic and immune systems.

Low Carb Down Under

summerizer

Summary

The talk explores the intricate biology of fat cells (adipocytes) and their critical role in obesity and insulin resistance, emphasizing that understanding fat cell behavior is essential to addressing metabolic disease rather than focusing solely on total fat mass. The speaker, an insulin resistance scientist, explains that fat mass can increase through hypertrophy (fat cells grow larger) or hyperplasia (new fat cells are created). Hypertrophic fat cells become dysfunctional—they reach a physical size limit, become hypoxic due to poor oxygen supply, and turn pro-inflammatory, contributing to insulin resistance and systemic metabolic disease. This dysfunction is central to the "common soil" hypothesis, which suggests insulin resistance is the root cause of many chronic diseases.

The concept of the "personal fat threshold" is introduced, which is an individual’s capacity to expand fat cells or create new ones before insulin resistance develops. This threshold varies genetically and ethnically, explaining why some populations develop insulin resistance at lower fat levels than others. For example, South Asians tend to have fewer but larger fat cells compared to Caucasians, making them more prone to insulin resistance despite similar fat mass.

The talk further discusses the hormonal regulation of fat cells, primarily focusing on insulin’s pivotal role in fat cell growth and metabolism. Insulin promotes fat storage by increasing glucose and lipid uptake into fat cells and inhibiting lipolysis (fat breakdown). Without insulin, fat cells cannot grow, even if energy (calories) is abundant, highlighting the endocrine theory of obesity beyond simple calorie balance. Conversely, lowering insulin levels increases fat breakdown and energy expenditure, sometimes leading to weight loss even under conditions of high calorie availability.

The speaker critiques many diet studies for conflating calorie restriction with insulin reduction, making it difficult to distinguish between the caloric and endocrine theories of obesity. They call for hypercaloric studies that vary only macronutrient composition to better understand the differential effects on fat cell growth and insulin sensitivity.

Finally, the talk addresses specific populations and conditions: the metabolic impact of menopause (declining estrogen leads to reduced fat turnover and more visceral fat accumulation), ethnic differences in fat cell number and size, and how insulin resistance and inflammation are intertwined. The speaker also touches on type 1 diabetes management, criticizing the conventional advice to consume high carbohydrates while injecting insulin, which exacerbates insulin resistance and causes metabolic instability.

Highlights

  • 🔬 Fat cell hypertrophy leads to hypoxia, inflammation, and insulin resistance.
  • ⚖️ Personal fat threshold explains individual and ethnic differences in insulin resistance risk.
  • 🧬 Insulin is essential for fat cell growth; without it, fat cells do not enlarge even with excess calories.
  • 🔥 Lowering insulin increases fat breakdown and metabolic rate, causing fat loss even with high energy intake.
  • 🍽️ Most diet studies confound calorie and insulin effects, making it hard to isolate the role of insulin in obesity.
  • 🌍 Ethnic groups differ in fat cell size and number, influencing susceptibility to metabolic disease.
  • ♀️ Menopause causes loss of estrogen’s protective effect on fat metabolism, increasing visceral fat and metabolic risk.

Key Insights

  • 🧪 Fat Cell Hypertrophy and Disease Mechanisms: Enlarged fat cells reach a physical size limit, causing hypoxia due to insufficient capillary proximity. This leads to pro-inflammatory cytokine release, worsening systemic insulin resistance and contributing to chronic diseases. The fat cell is not merely a passive storage depot but an active participant in metabolic health. Understanding this cellular pathology shifts focus from weight alone to fat cell health.

  • 🎯 Personal Fat Threshold and Genetic/Ethnic Variation: Each individual has a personal fat threshold determined by their ability to create new fat cells (hyperplasia). Once this threshold is surpassed, hypertrophy and insulin resistance ensue. Ethnic differences, such as the smaller, more numerous fat cells in Caucasians versus fewer, larger fat cells in South Asians, explain why some populations develop diabetes and metabolic disease at lower BMI. This insight demands personalized approaches to obesity and metabolic disease risk.

  • 💉 Endocrine Control of Fat Cell Growth via Insulin: Insulin is the critical hormonal signal required for fat cell expansion, regulating both nutrient uptake (glucose and lipids) and preventing fat breakdown. Fat cells surrounded by abundant energy but lacking insulin do not grow, debunking purely caloric theories of obesity. This highlights insulin’s dual role in energy storage and resistance development, reinforcing the endocrine theory of obesity.

  • 🔥 Metabolic Effects of Insulin Suppression: Lowering insulin enhances lipolysis and increases metabolic rate, resulting in fat loss despite continued calorie availability. This phenomenon is seen in type 1 diabetes before insulin therapy and explains the metabolic advantage of low insulin states. It also suggests that insulin-lowering interventions could be more effective for weight loss and metabolic health than calorie restriction alone.

  • 📉 Limitations of Calorie-Restricted Diet Studies: Most dietary intervention studies unintentionally reduce insulin by lowering calories, especially carbohydrates, confounding interpretations between caloric restriction and insulin effects on weight loss. The speaker argues that to properly test diet effects, hypercaloric feeding studies varying only macronutrient ratios are needed, as demonstrated in a unique case study showing greater fat gain on high-carb versus low-carb hypercaloric diets.

  • ♀️ Estrogen’s Role in Fat Metabolism and Menopause Effects: Estrogen promotes higher fat turnover and subcutaneous fat storage, protecting women metabolically despite higher fat mass. Menopause reduces estrogen, slowing fat turnover and increasing visceral fat accumulation, similar to male fat distribution patterns, which increases metabolic risk. Additionally, fat cell number declines with age, further exacerbating fat cell hypertrophy and insulin resistance if diet and metabolism are not adjusted.

  • 🔄 Interplay of Inflammation and Insulin Resistance: Inflammatory signals directly impair insulin signaling in fat and muscle cells, creating a vicious cycle where hypertrophic fat cells release pro-inflammatory cytokines, worsening insulin resistance. This crosstalk between immune activation and metabolic regulation is fundamental to chronic disease progression and highlights the need for anti-inflammatory strategies alongside metabolic interventions.

Additional Notes

  • The speaker critiques current medical advice for type 1 diabetes patients encouraging high carbohydrate intake with insulin injections, which can worsen metabolic control and increase insulin resistance. A low carbohydrate approach may improve glycemic stability but is underutilized due to entrenched guidelines and commercial interests.
  • Hormonal regulation is emphasized as the primary determinant of fat cell behavior, with insulin being the key hormone for fat storage and growth; energy availability alone is insufficient.
  • The talk underscores that fat cell size and function, not just total fat mass, are major determinants of metabolic health, shifting the paradigm toward cellular and molecular understanding of obesity.
  • The endocrine theory of obesity, focusing on insulin’s regulatory role, is presented as a more explanatory framework than the traditional caloric balance model.

This comprehensive exploration reveals that tackling obesity and insulin resistance requires a nuanced understanding of fat cell biology, hormonal regulation—especially insulin—and the personal, genetic, and environmental factors influencing fat cell growth and function.

8
2

(T2D → Carbs)

Type 2 Diabetes (T2D) is a condition defined as persistently elevated blood sugar.

Which food elevates blood sugar? Carbohydrates (almost exclusively). Any type of carbohydrate gets converted into blood glucose in short order. This means sugar and whole grains basically have the same blood glucose impact gram for gram.

Most T2Ds still produce insulin in their pancreas, in fact they are likely producing the most insulin over their lifespan while T2D. T2D is not a condition of insufficient insulin, but excessive glucose. Some people will develop double diabetes where the T2D is joined by T1D, so they wouldn't be producing any insulin as a T2D.

**I have not seen any case in the literature where someone who isn't eating a high carbohydrate diet develops type 2 diabetes. **Please correct me if you are aware of such a case study.

Around lemmy I see the constant news cycle of X,Y,Z will increase or decrease T2D risk. Every one of these news articles is just driving hype and doesn't mention the necessity for carbohydrates in the development of type 2 diabetes. Every single "article" Ive come across is providing a sensational simplification of a epidemiological study.

Epidemiology is not science, its the start of science, but it cannot establish causation. At best it can suggest associations which then should be followed by interventional studies with falsifiable hypothesis. With epidemiology you can tease out any association you want Paper - Grilling the data: application of specification curve analysis to red meat and all-cause mortality with basically advanced forms of p-hacking.

Epidemiology shouldn't be in the news, it shouldn't be reported on as lifestyle or dietary advice, it should always come with a huge disclaimer about the assumptions of the study models.

The significant problems with epidemiology in nutrition

  • Food Frequency Surveys administered every 1-4 years
  • Model assumes variables are independent
  • "Control" models make assumptions about RV independence
  • Significant healthy user bias
  • Weak hazard ratios
  • Only reporting in relative risk and not absolute risk
  • Tends to use older population so they can see hard endpoints in the data (old people die more often)

TLDR

  1. You can't get type 2 diabetes if you don't eat carbohydrates
  2. Epidemiology isn't science
9
2
submitted 2 weeks ago* (last edited 2 weeks ago) by jet@hackertalks.com to c/ketogenic@discuss.online

Ketogenic: The Science of Therapeutic Carbohydrate Restriction in Human Health presents the most up-to-date and evidence-based science and research available in the field of TCR, with the purpose of training medical and allied healthcare professionals on the effective therapeutic use of low-carbohydrate and ketogenic nutrition in clinical practice. This book explores the appropriate, safe, and effective use of TCR to improve patient outcomes in a broad range of chronic metabolic conditions and aims to promote health.

Focused on lifestyle management, health support and the treatment of diseases rooted in poor nutrition, this book explores the role of food and lifestyle modification as medicine and is a valuable resource for nutritionists, dietitians and medical professionals who provide diet-related counselling, as well as those researching or studying related areas.

  • Presents new best-practice guidelines for using TCR to treat, improve or reverse nutrition-related metabolic conditions and diseases that were previously thought to have a chronic, irreversible progression
  • Provides an overview of the most recent evidence outlining the biochemistry and physiology pertaining to human nutrition and health
  • Offers evolutionary and historical context to human nutrition
  • Contains clinical practice guidelines for the implementation of TCR from medical practitioners who prescribe TCR in their practices, allowing readers to understand real-life concerns in the field
  • Features case studies that provide practical examples of how to assess, monitor and intervene with patients that practitioners encounter in their practices
  • Explains the physiology and biochemistry of the normal and pathophysiological state for each condition and links these to the application of TCR

https://doi.org/10.1016/C2019-0-03604-7 Full Book is available on the normal book sharing websites.

Chapter 1 - Understanding human diet, disease, and insulin resistance: scientific and evolutionary perspectives

Nutritional authorities promote high-carbohydrate, low-fat diets to combat modern diseases such as obesity, type 2 diabetes and heart disease. However, the science behind this ideology is flawed. Virtually everything the public knows about diet can be challenged. The foods that cause harm are the very food groups the public believes are healthy: carbohydrates and polyunsaturated vegetable oils. Conversely, human physiology, from brain size to gastrointestinal morphology appears to support a carnivorous design. While low amounts of certain carbohydrates are tolerable, chronic consumption of processed carbohydrates promotes non-communicable diseases (NCDs). Indigenous cultures adopting modern agriculture develop diseases practically absent beforehand. Processed foods have been linked to systemic inflammation, mitochondrial dysfunction, and more. Their mechanism is insulin resistance, which is crucially involved in most NCDs. The chronic disease pandemic only worsens despite the billions of dollars invested to treat them. A new perspective is needed.

Chapter 2 - Nutritional aspectsWith evidence pointing to the efficacy of therapeutic carbohydrate restriction (TCR), official protocols for implementation into clinical practice are required. During the metabolic transition from a high-carbohydrate to a TCR diet, clinical considerations and patient guidance are required. Aside from the formulation and prescription of TCR, clinicians must be familiar with the precautions, assessment, and monitoring of clinical outcomes associated with this intervention. Nutritional ketosis is a physiological ketosis of the fed state with specific biochemical and nutritional aspects that must be taken into account in TCR. Understanding this metabolic state, as well as the biochemistry and physiology of ketone metabolism, is critical. When prescribing TCR, the clinician must also understand the context of nutrient requirements, as well as the differences between animal and plant nutrition. This chapter discusses the most important nutritional aspects to consider and comprehend when prescribing TCR.

Chapter 3 - EndocrineEndocrine dysregulation is the hallmark of modern chronic disease, with insulin resistance (IR) playing a central role. Research surrounding treatments to such disorders are complicated due to complex hormonal regulation of homoeostasis, with the liver playing a central role. Yet recognising the common pathology provides a more universally applicable approach to treatment: the target and regulation of insulin. Therapeutic carbohydrate restriction (TCR) has efficacy in regulating insulin, often without the need for, or with the deprescription of, pharmacotherapeutics. The most evidence for TCR focuses on its induced remission of metabolic syndrome (MetS), IR, and type 2 diabetes (T2D). Emerging research also supports its use for type 1 diabetes (T1D), polycystic ovarian syndrome (PCOS) and regulation of the thyroid and the hypothalamic-pituitary-adrenal-axis. Overall, TCR is promising in the treatment of endocrine disorders, often surpassing many medications prescribed to treat them.

Chapter 4 - Cardiovascular disease and its association with insulin resistance and cholesterolAs the main nutrient delivery system, the cardiovascular system is intimately tied to metabolic health. Insulin resistance (IR) is implicated in atherosclerosis through numerous pathophysiologies, causing a variety of problems from stroke and renal failure to congestive heart failure (CHF) and myocardial infarction (MI). The traditional atherosclerosis model, the diet (lipid) heart hypothesis, wrongly demonises LDL, a biologically essential, multifunctional transport molecule, which is more likely atheroprotective than atherogenic. The resultant prescription of cholesterol-lowering medications (statins and PCSK9 inhibitors) arguably worsen heart health and IR. Evidence is presented for the role of therapeutic carbohydrate restriction (TCR), despite its high fat and cholesterol content, in reducing IR and improving overall cardiometabolic risk (lipids and blood pressure).

Chapter 5 - NeurologyThe brain is a metabolically demanding organ and thus sensitive to nutrient availability. It is not ordinarily conceived to be predisposed to metabolic syndromes, though research postulates insulin resistance and chronic hyperglycaemia may be behind most neurological disorders, redefining them from a metabolic perspective. High-carbohydrate diets also have an important psychological impact. The brain has been evolutionarily programmed to treat carbohydrates as a reward, activating dopaminergic cascades due to their historical scarcity. This neurobiology has disadvantages in an age of carbohydrate abundance. While the brain is perceived as a glucose-dependent organ, ketone bodies are an alternative and possibly superior fuel, allowing patients with Alzheimer’s disease (AD), dementia, and mood disorders to improve their glucose hypometabolic states and associated symptoms. Ketogenic diets (KDs) are an accepted standard of treatment for refractory epilepsies and alleviate neuroinflammation in other neuropathologies. Research on the KD in the treatment of these disorders is in its infancy, yet has demonstrable restorative potential begging further investigation.

Chapter 6 - CancerSince the discovery of DNA, the metabolic theory of cancer has been sidelined for genetic research. Yet cancer continues to rise. New research recaptures mitochondria as the driver, while upregulation of oncogenes and tumour suppressor mutations are recognised as downstream of the damage to oxidative phosphorylation (OxPhos). Despite the prevalence of the somatic (genetic) mutation theory, there are numerous inconsistencies. In contrast, it appears that all cancers are characterised by dysfunctional mitochondria. Cancer pre-1960 was a rare disease, all of which has changed as diets have. Press-pulse therapy and ketogenic diets (KD) have proven effective therapies, due to cancers’ selective metabolism of glucose and glutamine (Warburg effect), in combination with the non-fermentability of ketones. Some dietary aspects are individualised to the patient and cancer, but follow this general protocol. Fasting induces additional selective stress to cancers. With cancer genetic research stagnating and metabolic approaches showing promise, this perspective offers a new path forward.

Chapter 7 - Musculoskeletal and immunological considerationsMusculoskeletal conditions are primarily thought to be age-related and unavoidable. While age is a factor for musculoskeletal functional decline, an association with age should be considered alongside lifestyle factors. Inflammation accompanies musculoskeletal conditions, and should be targeted when considering interventions for these conditions. Diet is a key modulator of inflammation. The Western diet is known to contribute to inflammation and can negatively affect the microbiome, both of which are implicated in autoimmune disease. Therapeutic carbohydrate restriction (TCR), on the other hand, shows promise for improving inflammation and the microbiome, as well as rheumatic and autoimmune conditions. As it relates to age-associated declines, a well-formulated TCR protocol naturally is animal nutrient-centric, meaning it supplies sufficient protein, minerals, and fat-soluble vitamins to prevent or delay chronic conditions and bone and joint issues, supplemented with exercise (which itself demonstrates similar preventative effects). TCR, in addition to metabolic improvement, has well-documented effects of improvement in age associated physiology, such as visceral adiposity, decline of cognition, bone mass, density, and muscle mass, and increased risk for chronic disease associated mortality. In this chapter the role of TCR as a promising supportive treatment for many rheumatic and autoimmune conditions, as well as age-related conditions is discussed.

Chapter 8 - Gastrointestinal health and therapeutic carbohydrate restrictionHuman health is tied to the microbiome, and dysbiosis begets disease. Many gastrointestinal (GI) conditions cause unnecessary proliferation of normal gut microbiota, leading to dysbiosis, painful symptoms and hunger signal dysregulation. Dysbiosis causes damage to tight junctions and provides an entryway for pathogens to systemic circulation, which leads to a variety of conditions, including allergies, intolerances and even autoimmune reactions. Other disorders exist in the liver, pancreas, hepatic portal system and gallbladder, all of which follow from poor dietary choices. Therapeutic carbohydrate restriction or the ketogenic diet (KD) is, by nature, closely related to diets with evidence of efficacy for various GI conditions (namely, specific carbohydrate diet and low-FODMAP diets). Unsurprisingly then, evidence is emerging regarding a similar efficacy. The KD is animal-based and as such excludes many plant-based gut irritants. Some troubleshooting and individualisation may be required, but an adapted KD has long-term clinical potential to alleviate many GI conditions and deserves more clinical application.

Chapter 9 - Exercise and sports performanceThe role of fat adaptation and carbohydrate restriction for athletes is an emerging and controversial area. Many athletes voice concern over glycogen depletion with carbohydrate-restricted diets. Though, with mounting metabolic concerns of chronic excessive carbohydrate consumption manifesting in athletes, alternative ergogenic protocols need be devised to sustain health and performance in athletes. Much research on the metabolic effects of ketogenic diets (KDs) and low carbohydrate, high fat (LCHF) diets and related supplementation in athletes is ongoing. Most literature concentrates on high-carbohydrate male athletes and cannot apply to ketogenic or female athletes without considering metabolic differences. The research that has surfaced on KDs maligns it with performance impairment due to trial brevity. Other studies accounting for the extensive period of metabolic reprogramming generally show performance maintenance or improvement. Athletic nutrition and performance are individualised and troubleshooting may be needed. Case studies have emerged of KDs showing benefit in some athletes, emphasising the need for clinical trials.

Chapter 10 - Therapeutic fastingFasting is a voluntary, controlled period of abstinence from food that is important to human evolution and has medical, spiritual, and cultural significance in most areas of the world. However, in Westernised countries, incidence and duration of fasting has decreased due to dietary emphasis on snacking. This shift has profound health effects due to the continual suppression of fasting-state gluconeogenesis, nutritional ketosis, and protein conservation, often resetting the cycle before blood glucose and insulin falls. Patients may voice concerns over malnutrition or nutrient depletion, though evidence underscores the physiological differences between fasting (benefits) and starvation (complications). Contraindications and cautions are few but require consideration. Fasting is an effective regimen as it minimises time and financial expenditure, in addition to having health benefits and enhancing longevity.

Chapter 11 - Psychological, behavioural, and ethical considerationsA dietary intervention is only effective in the long term if it is sustainable. Sustainable health improvements require persistent changes in thoughts and behaviour, as well as control over eating. There are techniques healthcare practitioners can employ to guide patients towards behaviour change, while encouraging them to take responsibility for their own health and achieve lasting improvements. Therapeutic carbohydrate restriction (TCR), gives patients a physiological advantage by controlling hunger (despite reduced caloric intake and weight loss); offering a sustainable alternative to conventional hypocaloric weight loss interventions, which usually result in hunger and rebound weight gains. Evidence indicates that ultra-processed food (UPF) may also play a role in cravings and eating control, promoting addictive eating behaviours that thwart health and weight loss efforts. TCR eliminates UPF and thus, as an adjunct to other behavioural and psychological interventions, may offer a treatment modality to address addictive eating. While TCR is a relatively novel nutritional evidence-based modality that challenges current dietary guidelines, healthcare practitioners have an ethical responsibility to fulfil the Hippocratic values that underlie western medical ethics, to first do no harm. In the light of evidence indicating the harmful effects of conventional high-carbohydrate diets on metabolic health, TCR public health advocacy is one of the most crucial ethical duties of healthcare professionals in modern times.

10
1
submitted 2 weeks ago* (last edited 2 weeks ago) by jet@hackertalks.com to c/ketogenic@discuss.online

Comprehensive Resources

Primary Research

Epidemiology

Reviews

Models

11
3
submitted 3 weeks ago by xep@fedia.io to c/ketogenic@discuss.online

Nina Teicholz is a New York Times bestselling investigative science journalist who has played a pivotal role in challenging the conventional wisdom on dietary fat. Her groundbreaking work, 'The Big Fat Surprise', which The Economist named as the #1 science book of 2014, has led to a profound rethinking on whether we have been wrong to think that fat, including saturated fat, causes disease.

Nina continues to explore the political, institutional, and industry forces that prevent better thinking on issues related to nutrition and science. She has been published in the New York Times, the New Yorker, the British Medical Journal, Gourmet, the Los Angeles Times and many other outlets.

  • Nina Teicholz's Background: Teicholz is an investigative journalist and author of "The Big Fat Surprise," which challenges conventional wisdom about dietary fats, particularly saturated fats. She is also a founder of the Nutrition Coalition, advocating for evidence-based nutrition policies.
  • Historical Context of Dietary Fat Guidelines: The belief that saturated fats and dietary cholesterol cause heart disease originated from Ancel Keys' diet-heart hypothesis in the 1950s. This hypothesis gained traction despite limited evidence and became widely accepted, influencing dietary guidelines for decades.
  • Scientific Evidence: Recent systematic reviews and meta-analyses of clinical trials have found no support for the diet-heart hypothesis. The data do not show that saturated fats cause heart disease, leading to a shift in scientific understanding.
  • Influence of Industry and Politics: The vegetable oil industry, pharmaceutical interests, and political agendas have resisted changes to dietary guidelines. These groups have a vested interest in maintaining the status quo, making it difficult to implement new scientific findings.
  • Health Impacts of Vegetable Oils: Vegetable oils, originally used for industrial purposes, were marketed as healthy alternatives to saturated fats. However, they are highly unstable and prone to oxidation, which can lead to inflammation and other health issues, including cancer.
  • Clinical Trials and Outcomes: Large clinical trials from the 1960s and 1970s, which were initially interpreted to support the diet-heart hypothesis, have been re-examined and found to be flawed. Many of these studies did not show the expected benefits of replacing saturated fats with vegetable oils.
  • Nutrition Guidelines and Policy: The U.S. dietary guidelines have not included crucial evidence from large clinical trials. The process of creating these guidelines is influenced by various interests, leading to recommendations that may not be fully supported by science.
  • Vegan and Plant-Based Diets: The evidence for the health benefits of vegan and plant-based diets is limited and often based on weak forms of evidence, such as population studies and observational data. Clinical trials supporting these diets are scarce and often flawed.
  • Blue Zones and Long-Lived Populations: The Blue Zones, often cited as examples of long-lived populations with plant-based diets, are not unique. Other long-lived populations have diverse diets, and the specific contributions of diet to longevity in these regions are not well understood.
  • Personal Health and Diet: Teicholz emphasizes the importance of individual health and dietary choices. She follows a low-carb diet, which has improved her health, but acknowledges that perfection is not necessary. She advocates for a balanced approach that prioritizes nutrient-dense foods.
  • Future of Nutrition Science: There is hope for a paradigm shift in nutrition science, with growing research supporting low-carb and high-fat diets. However, political and financial interests continue to pose challenges to widespread acceptance and implementation of these findings.
12
3
submitted 4 weeks ago by xep@fedia.io to c/ketogenic@discuss.online

The video is an interview with Sally K. Norton, an expert on oxalates and their impact on health. Norton discusses the basics of oxalates, their sources, and the potential health issues they can cause, including kidney stones, arthritis, and mitochondrial damage. She highlights high-oxalate foods like spinach, nuts, and sweet potatoes, and explains that a low-oxalate diet can help alleviate symptoms. Norton also addresses common misconceptions, such as the belief that certain bacteria can heal the gut and eliminate oxalate issues.

13
1

After 12 weeks, anthropometric and body composition measurements revealed a significant reduction of body weight (− 9.43 kg), BMI (− 3.35), FBM (8.29 kg) and VAT. There was a significant, slightly decrease of LBM. A significant decrease in glucose and insulin blood levels were observed, together with a significant improvement of HOMA-IR. A significant decrease of triglycerides, total cholesterol and LDL were observed along with a rise in HDL levels. The LH/FSH ratio, LH total and free testosterone, and DHEAS blood levels were also significantly reduced. Estradiol, progesterone and SHBG increased. The Ferriman Gallwey Score was slightly, although not significantly, reduced.

Our results suggest that a KD may be considered as a valuable non pharmacological treatment for PCOS. Longer treatment periods should be tested to verify the effect of a KD on the dermatological aspects of PCOS.

Full Paper: https://doi.org/10.1186/s12967-020-02277-0

14
1

Is everything you’ve heard about carbs, seed oils, and diabetes wrong? Dr. Westman and Bart Kay dig into the real science.

summerizer

Summary

In this extensive and candid conversation between Dr. Eric Westman and Bart K, a former health science professor turned influential keto and carnivore diet advocate, the discussion primarily focuses on the flaws in nutritional epidemiology, the misinformation surrounding low-carb and ketogenic diets, and the challenges of implementing evidence-based nutritional advice in modern medicine. Bart K shares his journey from academia, where his radical views on carbohydrate requirements and fiber were met with resistance, to becoming an online influencer educating the public about metabolic health and nutritional myths. He underscores the fundamental flaws in nutritional epidemiology studies, particularly their reliance on self-reported dietary data and inappropriate statistical adjustments, which often lead to misleading conclusions about diet and health.

The dialogue also tackles the prevailing misconceptions about low-carb diets, such as the unfounded fear that high fat intake causes heart disease or cancer. Both speakers emphasize that type 2 diabetes is fundamentally about chronically elevated blood glucose, not simply insulin resistance or deficiency, and criticize the medical system’s reliance on pharmaceutical interventions over dietary solutions. The conversation highlights the challenges physicians face in promoting nutrition due to systemic constraints, commercial interests, and professional risks.

Bart K expresses optimism about grassroots changes driven by informed individuals and emerging research, including the growing acceptance of ketogenic therapies in cardiology and the rise of carnivore diet proponents. However, he acknowledges the difficulty of conducting long-term, rigorous clinical trials on diets due to ethical and practical constraints. The discussion concludes with a call for critical thinking, individual experimentation, and skepticism of authority in nutrition science, encouraging people to explore low-carb or carnivore diets gradually while monitoring their own health outcomes.

Highlights

  • 🥩 Bart K advocates for a 100% carnivore diet as the species-appropriate human diet.
  • 📉 Nutritional epidemiology is deeply flawed due to reliance on self-reported data and improper statistical adjustments.
  • 🔬 Association does not imply causation; many diet-health claims are based on misleading correlations.
  • 💊 The medical system favors drug interventions over dietary changes due to financial incentives.
  • 🍽️ Type 2 diabetes is fundamentally about elevated blood glucose, not just insulin resistance.
  • 📊 True scientific causality in nutrition is hard to establish due to ethical and practical research constraints.
  • 🌱 Emerging research and grassroots movements are fostering new perspectives on keto, carnivore, and metabolic health.

Key Insights

  • 🔍 Flaws in Nutritional Epidemiology: In-depth Analysis
    Bart K explains that nutritional epidemiology studies are inherently unreliable because they rely on infrequent, self-reported dietary surveys that are inaccurate by nature. These studies often use complex statistical techniques like multivariate regression that violate key assumptions such as independence of variables, leading to invalid conclusions. For example, adjusting for age while studying long-term diet-related disease incidence creates collinearity, making the data mathematically invalid. This calls into question much of the dietary advice based on such studies, including the demonization of saturated fat and meat consumption.

  • 🧪 Association Does Not Equal Causation: Critical Thinking Needed
    Both experts stress that a high correlation between a dietary factor and disease does not prove that one causes the other. They illustrate this with humorous examples (ice cream sales and sunburn incidence) to highlight how such data can be misleading. This misunderstanding fuels pseudoscientific claims in nutrition and public health. The takeaway is that consumers and practitioners must critically evaluate scientific claims and not accept correlations as proof.

  • 🍏 Misconceptions About Low-Carb and Keto Diets
    The conversation debunks common fears that low-carb or ketogenic diets cause heart disease or cancer. Bart K and Dr. Westman emphasize that these diets often reduce hunger and promote steady weight loss, making them sustainable and effective. They also argue that insulin resistance is not the root cause of type 2 diabetes but rather a protective response to chronic hyperglycemia caused by excessive carbohydrate intake. Thus, reducing carbs is a logical and effective intervention.

  • 💊 Pharmaceutical Industry vs. Nutrition: Systemic Challenges
    There is a critical view of the medical establishment’s preference for drug treatments over dietary interventions, largely driven by financial incentives. Drugs like insulin or SGLT2 inhibitors are prescribed widely for diabetes and heart failure, despite the potential for dietary approaches to achieve similar or better results without adverse side effects. This systemic bias inhibits the adoption of nutritional therapies even when evidence supports their efficacy.

  • 📈 The Role of Ketones and Emerging Research in Cardiovascular Health
    Interestingly, new research in cardiology is exploring ketones as a therapeutic agent for heart failure, often via drugs that induce ketosis (e.g., SGLT2 inhibitors). This paradoxically introduces ketones into mainstream medicine, though through pharmaceutical routes rather than diet. This development might pave the way for broader acceptance of ketogenic diets in clinical practice, but the financial motivations behind drug promotion remain a barrier.

  • 🥩 Carnivore Diet as the Ultimate Species-Specific Diet
    Bart K strongly advocates the carnivore diet, claiming it to be the natural, optimal diet for humans based on anthropological evidence such as nitrogen isotope analysis of ancient human remains showing high animal product consumption pre-agriculture. Despite skepticism and lack of long-term randomized controlled trials (RCTs), he asserts that the carnivore diet has solid scientific and clinical foundations and is gaining traction, evidenced by new educational courses and patient interest.

  • 🧬 Challenges in Conducting Long-Term Nutrition Trials
    Both speakers agree that high-quality, long-term RCTs to definitively prove causality in nutrition are nearly impossible due to ethical, practical, and financial constraints. Human subjects cannot be locked in controlled environments for decades, and dietary adherence is difficult to monitor objectively over long periods. Consequently, much of nutrition science remains observational or mechanistic, and individuals must rely on personal experimentation and biomarker monitoring.

  • 🧠 The Need for Critical Thinking and Personal Experimentation
    Ultimately, the dialogue encourages moving beyond blind trust in authorities, government guidelines, or even academic consensus. Instead, individuals should engage in personal experimentation, using modern tools like continuous glucose monitors, artery ultrasounds, and lipid profiles to assess their health responses to different diets. This pragmatic approach empowers people to find what works best for their unique biology and circumstances.

  • 🛑 Critique of Medical Education and Practice on Nutrition
    Bart K criticizes medical training for lacking robust nutrition education, leaving physicians ill-equipped to counsel patients on diet. Physicians are often “trained monkey grinders,” bound by professional norms and punitive licensing boards to avoid deviating from established dogma. This institutional inertia suppresses innovation and honest dialogue about effective dietary therapies, forcing patients to seek alternative sources of information.

  • 🌿 Grassroots Movements and New Generations of Doctors
    Despite systemic obstacles, there is optimism about change driven by younger physicians and researchers independently exploring ketogenic and carnivore diets. The growing grassroots interest, online education, and patient-driven demand are gradually challenging the status quo. This bottom-up momentum may eventually influence mainstream medicine and public health policy.

Conclusion

This conversation offers a profound critique of the current state of nutritional science and medicine, revealing the deep flaws in epidemiological research, the misinformation surrounding diet and chronic disease, and the systemic barriers to adopting effective dietary therapies like low-carb and carnivore diets. Bart K and Dr. Westman advocate for a return to rigorous scientific principles, critical thinking, and personal experimentation, while highlighting the growing momentum of grassroots movements and emerging research validating metabolic health interventions. Their message is clear: individuals should be empowered to explore dietary approaches grounded in evolutionary biology and clinical outcomes rather than flawed statistics and commercial interests.

Low Carb High Fat - Ketogenic

63 readers
4 users here now

A casual community to talk about LCHF/Ketogenic lifestyles, issues, benefits, difficulties, recipes, foods.

The more science focused sister community is !metabolic_health@discuss.online

Rules

  1. Be nice
  2. Stay on topic
  3. Don’t farm rage
  4. Be respectful of other diets, choices, lifestyles!!!
  5. No Blanket down voting - If you only come to this community to downvote its the wrong community for you

founded 1 month ago
MODERATORS