Talk:Low-carbohydrate diet/Archive 2

Archive 1

Archive 2

Archive 3

Footnote 75 - Error 404 not found

One of the footnotes describing low carb as dangerous could not be found. Please correct this footnote or remove. --78.99.100.90 (talk) 23:59, 16 August 2008 (UTC)

Intro

I'd like to suggest that the intro is too short. It was originally longer but has been whittled away due to the fact that there is so little agreement about what is and is not "low carb". I'd like to reopen the discussion with the assertion that, in spite of the fact that the term is used in a lot of different ways, the article should pick a particular definition and mostly stick to it. The intro should clarify that definition while mentioning that other usages exist. Comments (else I'll take a stab at it)?

--Mcorazao (talk) 19:22, 20 February 2008 (UTC)

Tags

This article has been tagged with "Cleanup", "Refimprove", and "Weasel" since the beginning of the year (the February dates on them are inaccurate). I'd like to suggest that leaving the tags around indefinitely is not appropriate. May I suggest that we try to remove these by the beginning of March. To that end, anybody who has a concern either

• Fix it.
• Comment here with a specific request for improvement.

--Mcorazao (talk) 18:49, 20 February 2008 (UTC)

In my opinion, as long as the article lacks references, the "Refimprove" banner is appropriate and should not be removed. I agree that the other banners could be removed. My reasoning is that the "Refimprove" banner doesn't only advise editors that the article needs additional sources, but it also tells the casual reader to take the info in the article with a big grain of salt. --Phenylalanine (talk) 02:05, 4 March 2008 (UTC)

I removed the "Cleanup" and "Weasel" banners, but left the "refimprove" banner in place. --Phenylalanine (talk) 02:10, 4 March 2008 (UTC)

OK, the article now has tons of citations and references. The Refimprove citation is removed as it is no longer appropriate. If there are specific concerns please note these with local Fact citations or, if absolutely necessary, a section-specific banner. Thanks.

--Mcorazao (talk) 15:49, 13 March 2008 (UTC)

Essential Nutrients

Phenylalanine, regarding the added discussion of "essential nutrients", I appreciate the contribution but had a couple of concerns.

• First, is there truly a formal list of essential nutrients (the Wikipedia article not withstanding)? Poking around I find lists which include carbohydrates as essential nutrients (e.g. the book Nutrition Through the Life Cycle). The point is that if there is not a generally accepted list that says carbohydrates are not "essential nutrients" then this statement has no meaning.
• The other thing is simply that, as phrased, the statement kind of implies something a little misleading. That is, although it does not explicitly state this, it comes off sounding like the scientific consensus says you can be healthy without carbohydrates. I think this would need to be rephrased to remove this implication.

--Mcorazao (talk) 04:21, 15 March 2008 (UTC)

"However, carbohydrates are not essential nutrients, and the body can obtain all its energy from protein and fats."

You're right. I'll leave the statement here so that it can be rephrased. --Phenylalanine (talk) 11:29, 15 March 2008 (UTC)

References

Proteins are required to build tissue and as enzymes. They are built from amino acids, some of which can be produced internally from appropriate substrates, plus energy. Some cannot, and these are the essential amino acids (10 types, IIRC). Lipids are used in cell membranes and as signaling molecules (eg, steroids). Some of these can be built internally from appropriate substrates plus energy. Those that cannot are the essential fats (3 types IIRC). Small amounts of particular chemicals are required, often for use as co-enzymes. These are the vitamins (once thought, wrongly, to all be amines); they are vital to health and cause disease if not present in sufficient quantities. Some of these are toxic in easily achievable sufficiently large quantities (eg, B6). Finally, small amounts of some elements (typically metals) are required, mostly as active centers of some enzymes (eg, iodine in thyroxin, iron in hemoglobin). Several of these are toxic in easily achievable sufficiently large quantities (eg, iron in re hemochromatosis or frank iron poisoning).

Energy is supplied by metabolic processes, of which there are essentially two on the body. The first is built around glucose and takes place in the mitochondria present in every cell. A few amino acids can be converted (with the expenditure of energy) to glucose, and existing protein is degraded to gain access to them in starvation. The rest of the amino acids from such degraded proteins are, in essence, discarded as there is no amino acid storage mechanism. Lipids can also be metabolized, though some intermediate products, if present in sufficiently high quantities can produce acidosis, which is invariably fatal unless properly stopped. The particular sort of acidosis which can result from lipid metabolism is ketoacidosis. We cannot use more than a few simple sugars for energy (3 or 4 IIRC) and one of those only in the liver (fructose) where if processed in large quantities other liver functions are disturbed (eg, characteristic adverse changes in blood lipid profiles). We can digest only a few double sugars (sucrose (table sugar), lactose (in children but not most adults), ...) and cannot touch the rest. We can digest no triple sugars and rely on gut bacteria to do much of the work; this produces the usual gas from the complex sugars in beans. The only large chain sugar molecule we are equipped to digest and absorb is starch (which is many glucoses stuck together). Cellulose and other long sugar chains, are beyond our digestive abilities.

We cannot make glucose internally from lipids, no animal has the required enzymatic machinery. Plants can, of course. We can make our own lipids, given the necessary substrates and energy, but cannot do so with the end of using those lipids for energy. That energy (and more) was expended to build them.

So, are carbohydrates essential nutrients in the sense that amino acids are? Yes, because the energy extraction machinery our cells have can only get that energy out of two classes of substance. One is (at the core, glucose as other carbs must be converted to some substrate in that metabolic cycle), and lipids. But only carbohydrate metabolism is free of the danger of acidosis. Lipids seem to exist, in a fuel sense, as a storage mechanism since they are hydrophobic and so can be stored compactly. Storage of carbohydrate fuel is done by conversion of glucose to glycogen inside cells; it takes less space, being less able to collect water molecules. But lipid storage is more space efficient. It would seem therefore that glucos eis the preferred ordinary energy source, as lipid metabolism is more dangerous, though more convenient for long term energy stores.

Does this suggest an answer to the question of carbs being an essential nutrient? ww (talk) 08:31, 12 August 2009 (UTC)

to-dos

{{tasks |requests=Please remove [[Wikipedia:Avoid weasel words|weasel words]] from the article. |copyedit= |wikify= |merge= |split= |verify= |cleanup=Please replace refs which use About.com with more reliable sources. About.com is a [[WP:SPS|Self-Published]] unreliable source because there is no fact-checking or editorial oversight. |expand= |disambiguation= |stubs= |update= |npov= |infobox= |other= }}

• was created in this diff

-- — Preceding unsigned comment added by Phenylalanine (talk • contribs) 02:13, 4 March 2008 (UTC)

• was edited in 2012

-- — Preceding unsigned comment added by CompliantDrone (talk • contribs) 14:35, 24 May 2012 (UTC)

• reformatted, and diffs added by me in this edit. In my next edit, I will move this to the talk page archive. Jytdog (talk) 16:37, 23 September 2018 (UTC)

Other controversies

Hi, just wanted to check this line:

"One of the occasional side effects of a ketogenic diet is a noticeable smell of ammonia in the urine, perspiration, and breath. This is caused by the body's attempt to normalize blood pH by excreting excess ketone bodies, derived from the conversion of excess dietary protein".

Is the noticable smell not due to excess acetone, a breakdown product of Acetoacetic Acid? I'm pretty sure I remember reading this. It's also been described as smelling like 'paint stripper' in another wikipedia article, which contains acetone. —Preceding unsigned comment added by Randomized (talk • contribs) 19:41, 15 March 2008 (UTC)

Urea is the form in which the human body excretes nitrogenous material, largely protein components. In the context of this article, this is needed when the liver begins to destroy proteins to gain access to the few amino acids which can be converted to glucose. The rest are discarded, largely as urea. And the urine of a person in this situation does have a distinctive odor. The fruity smell of ketosis is due largly to acetone, one of the three ketone bodies produced during fat metabolism. Acetone is actually a ketone (surprise!) and has a very high vapor pressure. It is also a very small molecule and easily reaches the bloodstream and so the lungs. It is almost entirely exhaled.

Both odors may be noticed for those on severe, and especially prolonged, low carbohydrate diets. Ketosis will result and will sometimes produce sufficient ketone bodies and discarded protein. This is however, a warning sign, as sufficient ketone body production will cause ketoacidosis, which is quite dangerous. 69.126.64.233 (talk) 21:24, 27 July 2009 (UTC)

As noted elsewhere in this article, restricting only carbohydrates produces ketosis, which may prove to be very healthful once enough proper research has been done, not ketoacidosis, which is a life-threatening state possible in uncontrolled diabetes. This one error is probably responsible for most of the opposition to a low-carbohydrate diet, which is effective in countering morbidity and mortality doe to obesity, metabolic disorder, diabetes, and probably some other top-ranking diseases as well. David Spector (talk) 15:35, 20 June 2013 (UTC)

Stanford Study

Weight and Anthropometric Outcomes

Mean 12-month weight change was –4.7 kg (95% confidence interval [CI], –6.3 to –3.1 kg) for Atkins, –1.6 kg (95% CI, –2.8 to –0.4 kg) for Zone, –2.2 kg (95% CI, –3.6 to –0.8 kg) for LEARN, and –2.6 kg (95% CI, –3.8 to –1.3 kg) for Ornish and was significantly different for Atkins vs Zone (Figure 2).

Note, at the 12-month point the difference is not statistically significant except for Atkins vs Zone. i.e. one low-carb diet beat another. Rather than quote this rather complicated stats from the paper it makes sense to simply say "The 12-month weight change was significantly different for Atkins vs Zone, but not between Atkins, Ornish, and Learn." In a scientific section it's the statistical significant results that count. Look carefully at the CIs for Atkins and Learn/Ornish. There is an overlap which is why the authors point out there is significantly different for Atkins vs Zone, ( but not for the others). i.e. Atkins was not statistically significant better than the others. This is an accurate summary of the weight-loss conclusion at 12 months.

It should be noted that this is the Low-carb diet article, and thus from a Low-Carb perspective the low-carb diets did the best and worst. The summary of the Stanford Study should reflect that I guess. Macgruder (talk) 11:33, 2 May 2008 (UTC)

I take a strong objection to the previous comment. Statistical significance does not imply results are actually significant. Statistical significance also does not imply that there are significant differences. On the other hand a lack of statistical significance gives zero, I repeat zero information. There maybe a very significant difference between two things and yet statistics may show that the two alternatives do not have a statistically significant difference. This can happen because the test you are using has a low power. —Preceding unsigned comment added by 192.250.175.26 (talk) 22:41, 22 July 2009 (UTC)

This is a somewhat biased interpretation of the results. In fact it is really a strawman argument, essentially saying that all low-carb diets are exactly the same so if you get to different results for two different variants then the results for either can be applied to both.

What the study effectively implies (but certainly doesn't prove) is that following the low-carb principles very strictly may lead to greater weight loss whereas following the principles loosely is far less effective (in fact many doctors have argued that you should either be strict about low carb or not follow it at all since the "in between" can be potentially harmful).

This study does lend significant evidence that Atkins approach has merit. But obviously a larger (and longer) study is necessary to reduce the error bands sufficiently to be confident about the implications of the results.

--Mcorazao (talk) 02:24, 3 May 2008 (UTC)

Not really. Here is a direct quote from the paper:

"It could not be determined whether the benefits were attributable specifically to the low carbohydrate intake vs other aspects of the diet."

Further, I think that it does not lend 'significant evidence'. As the authors say in their analysis, there is no statistical difference in weight loss between the top three diets. Yes, they did say Atkins was 'favourable' but they qualify this in the body by saying the differences are not statistically significant for many/some of the factors and this is ultimately what counts in science.

A note about terminology : '"A statistically significant difference" simply means there is statistical evidence that there is a difference; it does not mean the difference is necessarily large, important, or significant in the common meaning of the word.' Thus I tend to be careful about using (and interpreting) the word 'significant'. A study may say the difference is (statistically) significant, but this doesn't mean it is 'there is a significant(i.e. substantial) difference' :-) So I try to avoid the word or preface it with 'statistically'. Macgruder (talk) 07:15, 3 May 2008 (UTC)

Macgruder, your logic is not consistent. First you claim the Stanford and Duke studies aren't relevant. Then you argue that we should go to only the JAMA article. Then you MAKE UP an alleged rule that one should not quote but paraphrase (which is ridiculous). You argue that I am cherry picking the results, which is wrong since I directly quoted the entire relevant part in question. You also argue that the quotes are confusing. And when I contend that we should use the news release from Stanford (which is a summation or, if you will, a paraphrase of the JAMA piece) you argue that that is not acceptable. You appear not to have an understanding of the statistical data and I haven't had a statistics course since I was an undergrad. This is why we should stick with the news release. Mcorazao appears to essentially agree with me on the interpretation of the Stanford study. It is you who does not have consensus, so please cease your reverts. And it should be noted that Stanford thinks that the Atkins diet was the most effective since they entitled their news release "STANFORD DIET STUDY TIPS SCALE IN FAVOR OF ATKINS PLAN." --Lifeguard Emeritus (talk) 17:33, 3 May 2008 (UTC)

Shouting does not make your point. "STANFORD DIET STUDY TIPS SCALE IN FAVOR OF ATKINS PLAN." This is not the Atkins article. This is the Low-carbohydrate article. If Atkins beat other low-carbohydrate diets then the result is not relevant to whether LC diets are better than other diets in this article. It is you who don't understand the term "statistically significant". Macgruder (talk) 04:53, 24 July 2008 (UTC)

I haven't checked in for a while but I'm back. The research section here was getting out of control. Most of the details that were being included belong in the main research article, not here. Regardless the section was becoming incoherent with POV on both sides being inserted to illustrate various points. I've rewritten the section to return it to what it was originally intended to be: a short NPOV summary describing the scope and breadth of research. One point I will make philosophically:

As a general rule an article should be slightly biased in favor of its topic to explain why the topic is significant and why anybody should care. To cite an often used extreme example, even an article on Adolph Hitler should focus more on describing his significance in history than trying to illustrate why he was an awful person. Regarding low-carb diets certainly it is important to bring out the controversies and the fact that there is research against the diet but this should not be the primary focus of the research section.

--Mcorazao (talk) 16:45, 17 July 2008 (UTC)

A low carb diet to restrict the sugar from a diet (carbohydrates being glucose molecutes) does not have to be "Atkins". A low carb diet for a diabetic just needs to be restricted - 20-30 carbs a day. WSNRFN (talk) 00:09, 23 September 2008 (UTC)

"and lack widespread support"

Kingrook recently removed the "and lack widespread support" clause from the introduction. Kingrook stated as his reason for the removal

since certain medical organizations are beginning to somewhat endorse the low-carb diet

There has been some movement toward limited endorsement for weight loss. However that paragraph is not discussing weight loss. This clause still applies and I believe it is important as otherwise one could mistakenly interpret this sentence to mean that low carb is a widely practiced treatment for diabetes and epilepsy that only a few doctors disagree with (which is, of course, very untrue).

I am reverting the edit but please comment if you disagree.

--Mcorazao (talk) 01:49, 24 July 2008 (UTC)

There was an anonymous edit to this same sentence. The new sentence reads

Apart from obesity, low-carbohydrate diets are often discussed as treatments for some other conditions, most notably diabetes and epilepsy. Although these treatments still remain controversial, there is new evidence for their efficacy and they are gaining support and acceptance among medical professionals.

I understand that there are strong feelings here but we need to make sure that we maintain NPOV. This revision is certainly a correct statement technically but it is introducing undue bias into the introduction (bearing in mind that the introduction needs be extra neutral). Mentioning the diabetes and epilepsy treatments at all is already pushing the envelope since these treatments are not mainstream by any stretch of the imagination. The revised text makes it sound as though today these treatments are widely accepted and that there is consensus that the research is generally interpreted as proving the effectiveness of these treatments. This is false. The time may be coming soon when these things will become true but it is misleading to imply that we are there yet.

I am reverting for now. Please do feel free to suggest other versions if you feel that something different needs to be stated but please remember that this article is not supposed to be propaganda for low-carb.

--Mcorazao (talk) 01:48, 31 July 2008 (UTC)

Early hunter-gatherer diets, mostly low-carb?

From the "beginnnigs" section:

It is well established that early humans were hunter-gatherers consuming diets high in both protein and fat and mostly low in nutritive carbohydrates (although their diets would have been high in fiber).[11][12] Indeed some isolated societies exist still today which continue to consume these types of diets. The advent of agriculture brought about the rise of civilization and the demise of the the hunter-gatherer lifestyle, and therefore, the rise of carbohydrate levels in human diets. The modern age has seen a particularly steep rise in refined carbohydrate levels in so-called Western societies.

It is definitely not well established that early hunter-gatherers ate mostly low-carb diets (see Paleolithic diet#Anthropological evidence). --Phenylalanine (talk) 03:02, 10 August 2008 (UTC)

Perhaps, however it is inconceivable that their diet contained nearly as many simple carbohydrates as the modern Western diet. With the lack of industry/processing their food was not refined and the excess complex carbohydrates (if any) would have been utilized for 'hunting' and 'gathering' rather than sitting in and office/driving. Carbohydrate (simple) intake for the average, mostly sedentary individual, in the West is far, far too high and in my opinion and is the primary cause of the obesity issue. —Preceding unsigned comment added by 66.130.189.213 (talk) 13:40, 18 January 2011 (UTC)

Well, I've gone ahead and softened this paragraph for the sake of avoiding controversy. But I believe that the old theory that most primitive humans were getting a large portion of their calories from plant sources has been largely discredited. Granted it certainly must have been the case that pockets of humans would have for some periods stumbled onto a steady supply of calorie-rich fruits and tubers that might have lasted for a while. But since the human intenstinal tract cannot digest large quantities of most primitive plants it is simply not possible that mankind as a whole could have found enough fruits and tubers to survive all of prehistory (bearing in mind that most of our modern food staples are flora and fauna that man created through domestication). So although anthropologists would all agree that human diets at various times ran the spectrum from high carb to high protein I think there are few left that would seriously argue that humans were mostly eating high carb diets for all of prehistory.

As far as the rise of agriculture (referring to your citation) I am not sure what your point is. I rephrased a little to soften a bit but I don't think even high carb advocates would argue against this. As agriculture developed humans were able to concentrate their diet on more nutritious plants (i.e. not having to just eat what they could find) and additionally were able to make the species they were growing more nutritious. I am not aware that anybody has seriously disputed this theory. The degree to which this changed the carb concentration is, of course, debated but the fact that it did begin a gradual rise in our carb (i.e. non-fiber) consumption cannot really be disputed.

--Mcorazao (talk) 04:18, 10 August 2008 (UTC)

Uh, actually any anthropologist will tell you that the rise of grains-as-food in locations is exactly correlated with a huge increase in systemic diseases. And of course the argument that these plants are "nutritous" is specious. They have lots of calories, that's all. Also, animals in general don't eat wild "vegetables", certainly not haphazardly, except in desperation. Fruit are intended (in general) to be consumed and their seeds distributed in manure. The rest of the plant is necessary for the plant's survival. Therefore plants are woody or (like grasses) rough, out of reach, or poisonous. Many plants we eat cooked today come from inedible wild plants, and many are still in part poisonous, such as the cyanide found in all the green parts of many common plants like potatoes and cherries. The bitter taste associated with e.g. arugula keeps uncivilized creatures from eating it. It is likely that many common domestic vegetables still contain subtle poisons that will be found to cause liver or pancreatic disturbances over a long reach of time, much like the pseudo-ALS associated with cycad fruit (striking 40 years after consumption).

The advent of agriculture brought about the rise of civilization and the rise of carbohydrate levels in human diets.

Are we referring to grams of carbs, or macronutrient consumption ratios (percentage of total dietary energy intake)? If the statement is referring to macronutrient consumption ratios, I believe you may cite: Cordain, Loren (2007). "Implications of Plio-Pleistocene Hominin Diets for Modern Humans (PDF)". In Ungar, Peter S. (ed.). Early Hominin Diets: The Known, the Unknown, and the Unknowable. Oxford, USA: Oxford University Press. pp. 363–83. ISBN 0195183479. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help) --Phenylalanine (talk) 17:42, 10 August 2008 (UTC)

I wasn't really attempting to be specific to either. Both, I believe, are generally true (i.e. as agriculture became more and more sophisticated people had more food to eat and they ate a higher percentage of grains and the like). Again, there was not a straight line from then to now so one should not over-generalize about all of humanity at every instance in history but, speaking about mankind in general, this can be said to be the overall trend.

Thanks for the citation.

--Mcorazao (talk) 15:36, 11 August 2008 (UTC)

In my opinion, most ancient diets must have been not only low-carbohydrate, but definitely ketogenic. Most ancient societies (prior to agriculture) probably did not have access to large quantities of carbohydrates. Humans, just like most wild animals today, ate mostly meats or fish, milk, eggs, animal fat, and vegetables having low amounts of digestible carbohydrates. Research is needed to determine if a ketogenic diet is an appropriate response to the current epidemic of obesity (metabolic disorder) throughout the world. David Spector (user/talk) 20:56, 3 May 2012 (UTC)

This article makes no reference to the studies that show man created flour more than 30,000 years ago from wild plants: http://www.pnas.org/content/107/44/18815. Additionally some genetic mutation has occurred enable the better processing of starches by humans: http://www.nature.com/ng/journal/v39/n10/abs/ng2123.html. Additionally, evidence even exists to show that Neanderthals also consumed starches: http://www.pnas.org/content/108/2/486.abstract— Preceding unsigned comment added by Crander (talk • contribs) 02:05, 17 May 2012 (UTC)

Low-carb diets and physical performance

The following paper discusses the effects of low-carb diets on physical performance and may be of use in the section: Low-carbohydrate diet#Exercise

• Phinney SD. "Ketogenic diets and physical performance". Nutr Metab (Lond). 2004 Aug 17;1(1):2. doi:10.1186/1743-7075-1-2. PMID 15507148.

--Phenylalanine (talk) 16:33, 11 August 2008 (UTC)

Another interesting reference: http://www.ajcn.org/cgi/content/full/86/2/276

--Phenylalanine (talk) 11:14, 25 October 2008 (UTC)

A systematic review

The following systematic review should be useful to editors, if they can get hold of a copy.

• PMID 18700873. Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities.

Colin°^Talk 14:07, 16 August 2008 (UTC)

This is quite a notable article. Critics of low-carb diets have often missed the point. For thirty years, now, there has been an intensive public health effort to promote low-fat diets, it became an apparent consensus that fat was bad for you. As time went on, the definition of "bad fat" was refined, but, in fact, it had never been shown that natural fats, per se, were harmful. (A combination of high carbs and high fat might be, but that's another story; part of the problem was that early studies did not look at the interaction of nutrients, but only at the effect of raising or lowering one nutrient in isolation; however, the body has different metabolic pathways for burning carbs and burning fats, and they don't operate at the same time, for the most part. Excess carbs are saved as fat; excess fat suppresses appetite, unless consumed with a lot of carbs.)

The critics will point out that differences between low-fat and low-carb diets aren't large. But if the promoted "consensus" had been true, the differences *would* have been great. Continually, the safety of low-carb diets was questioned. It was assumed that, because they are normally high-fat diets, they would be hazardous because of heart disease risk. But what these more recent studies are showing is that cardiac risk factors improve with low-carb diets, as Atkins has been claiming for thirty years; i.e., there is no scientific reason to expect the diets to be unhealthy from heart risk, more than low-fat diets, and some reason to expect them to be safer.

Gary Taubes has compiled a remarkable book, a tome, heavily referenced, on the history of the development of the cholesterol hypothesis and the push for low-fat diets. Taubes is a science writer, not a diet author, and his book, Good Calories, Bad Calories, isn't a diet book and isn't promoting a specific diet. But he does present conclusions that indict what has been the "standard wisdom" among nutritionists for decades, now. If he's right, the increased incidence of obesity, heart disease, diabetes, and even cancer, has been made worse by emphasis on low-fat diets, not better; the biochemistry behind this is actually fairly well-known; it mostly has to do with insulin and its effects. High-carb diets rely upon insulin, low-carb diets don't. Many type 2 diabetics can apparently manage without insulin on a low-carb diet, but, for many years, injectable insulin was promoted as a life-style enhancement for diabetics, allowing them to eat "normally." But that "normal" was a constant effort to keep glucose levels in a safe zone, and the long-term effects weren't good. Only recently has the American Diabetes Association even conceded that low-carb options might be useful. However, low-carb treatment for diabetes was known and commonly used for diabetics, even before medicinal insulin was available.

I've got personal issues here: I have prostate cancer, and it is a reasonable possibility that this cancer developed as it did because, twenty years ago, I greatly reduced the fat in my diet based on the standard advice (because of high total cholesterol). The result of this turns out to be nearly inevitable: higher carb content in the diet and higher sustained insulin levels. The genetic disturbances that culminate in cancer, before malignancy is established, make the cells require much larger amounts of energy, in the form of glucose, and as the cells begin to reproduce rapidly, and they need plentiful glucose and insulin for this. If glucose levels are low, and likewise insulin, it appears that cancer does not develop as rapidly. Cancer is one of the "diseases of civilization," and one of the major suspects is the high-carb diet that accompanies modern economies. Processed foods, with the refined carbs that digest rapidly, make this much worse, because low-glycemic index carbs digest more slowly, thus raising blood glucose and insulin levels to a lesser degree.--Abd (talk) 14:20, 23 September 2008 (UTC)

Can a low-Carb diet lead to a longer lifespan

One of the leading experts on ageing has strongly supported low-carb diets as a means to reduce insulin production, which has been shown to cause ageing in worms, flies and mice. There is also apparently some evidence that the same pathway causes ageing in humans. Is this something that should be included. 76.67.13.201 (talk) 07:21, 27 October 2008 (UTC)

The effect has been reliably seen in lower organisms (nematode worms, yeast, mice, rats, ...). A long term study of primates (rhesus IIRC) has recently concluded, and has shown the same effect. There is some reason to believe it happens in humans as well, but there are NO studies which establish this point experimentally. They are nearly impossible to carry out, humans being exceptionally balky and unreliable experimental subjects, especially over the decades which will be required.

More promising, likely, is research from the other end, the cellular mechanism end. Sirtuin (associated with resveratrol, it seems) may be a part of the mechanism. Or not. Still early innings here.

For most folks, losing weight (even to the point of getting skinny) will be worthwhile (if possible) for several reasons, like reduced cancer and diabetes rates, reduced vascular damage rates, etc etc. Looking good at the beach is rather less important, though that may be sufficient motivation to get off one's fundament and drop a few pounds. Would that there were a reliable diet, and not merely lots of sales blather, to do so. 69.126.64.233 (talk) 21:34, 27 July 2009 (UTC)

WTF low calorie NEQ low carbohydrate

I can go on a low calorie diet and eat ONLY carbohydrate. Why does this redirect here? --Stupified —Preceding unsigned comment added by 41.245.60.72 (talk) 09:55, 8 January 2009 (UTC)

Looks like somebody made a mistake. I changed the redirect.

--Mcorazao (talk) 05:03, 11 January 2009 (UTC)

It still redirects here. Which it really shouldnt. —Preceding unsigned comment added by 129.78.64.101 (talk) 09:35, 1 September 2009 (UTC)

No, it properly redirects to Calorie restriction, since January 11, 2009. It had been radically incorrect since 2006. Low carb diets are not generally calorie restricted, particularly if they are high in fat, they don't need to be, the fat satiates, that's part of the trick. --Abd (talk) 13:12, 1 September 2009 (UTC)

Statement "Glucose is not converted into fat"

The article contained the phrase: "No glucose is sonverted to fat and then stored in fat cells; animals, including humans, lack the necessary enzymatic machinery necessary to do this while plants generally do have the necessary machinery". This sounds rather dubious, since it would imply that a carbohydrate-only diet for a couple of days cannot lead to increase of fat content in the body. Where would all the glucose go after the glycogene storage capacity is exceeded? You pee it out? On the contrary; fatty acid synthesis tells you that fatty acids are synthesized from pyruvate, which is synthesized from glucose. I will remove this incorrect statement. Han-Kwang (t) 10:34, 2 August 2009 (UTC)

Concur with this, but I think I may have figured out what was meant. Maybe. See G M Cooper, The Cell, 1997, Amer Society of Microbiology, pg 73, Chapter 2, Biosynthesis of Cell Constituents. "Plants (but not animals) are able to synthesize glucose from fatty acids -- a process that is particularly important during the germination of seeds, when energy stored as fats must be converted to carbohydrates to support growth of the plant. In both animals and plant cells, simple sugars are polymerized and stored as polysaccharides."

The idea seems to have been that there is an asymmetry between lipid --> carbohydrates conversions and carbohydrates --> lipids conversions in animals but not in plants, and that the difference is significant in animal metabolism. Looks like some fixup is needed. ww (talk) 22:08, 2 August 2009 (UTC)

Your reference is about fat->glucose conversion, which indeed doesn't happen in animals (it's why the body breaks down protein in case of starvation). The dubious statement was for glucose->fat. I see no way how your story about the asymmetry would fit in the particular location in the article. The removed statement didn't even make a lot of sense in the argument either, by the way. Han-Kwang (t) 17:18, 3 August 2009 (UTC)

I didn't see quite how to fit it in either. Agree that it relates to the fat --> conversion direction, but there must have been some point to it, however obscured. ww (talk) 17:23, 3 August 2009 (UTC)

This page is funny, it's completely biased since it's obviously written by a pro-keto diet person. —Preceding unsigned comment added by 81.82.9.156 (talk) 18:13, 19 May 2010 (UTC)

Bias

Does anybody agree that this page reads somewhat like an advertisement for low-carb dieting? I have no real opinion on the subject as to what form of dieting is best, but it does seem to me like the "scientific research" section is, bar the final sentence, selective picking of studies. Can somebody with more knowledge than me on this matter confirm that the vast majority of studies show low-carb dieting the best option (as the section implies), or are there other studies that should be quoted to provide a more balanced view? I see the poster above is also concerned with the issue of neutrality. 202.36.179.66 (talk) 06:53, 11 June 2010 (UTC)

I agree the article seems very bias. Despite the citations, it seems to me they use too many weasel words. Perhaps it could be changed, for example, from:

"Some critics argue that low-carbohydrate diets can inherently cause weakness or fatigue," to a more direct:

"Aphroditewomenshealth.com argue that low-carbohydrate diets can inherently cause weakness or fatigue." How do we know the article was made by "some critics" anyway? Thomas_473 (talk) 19:53, 10 August 2010 (UTC)

It is very dubious indeed. The whole criticism section reads like a rebuttal for low-carb-diets. It starts with a "some critics claim X", continues with a "but Y shows that this may be incorrect", leading to "thus there is no conclusive evidence for X." and whatnot. —Preceding unsigned comment added by 129.177.143.9 (talk) 11:54, 1 February 2011 (UTC)

I agree as well. It doesn't read like a Wikipedia article, it reads like an Atkins Diet website, especially the criticism section. In every instance throughout the article where the views of consensus medicine & nutrition are imparted, they are immediately followed by a rebuttal. Very low-quality wikipedia article. RubyQ (talk) 23:16, 14 February 2013 (UTC)

I also agree. There seems to be little explanation on what is meant exactly by "low-carb". The article seems to argue that low-carb diets allow vegetable and fruit consumption, both of which are composed of mostly carbohydrate as a percentage of total calories. This is seemingly contradictory. — Preceding unsigned comment added by 50.131.193.114 (talk) 06:07, 8 November 2013 (UTC)

Misused term

In the section "Ketosis and insulin synthesis: what is normal?" of this article, the term "starvation diet" is used to refer to the class of low-carbohydrate diets. The latter is clearly a misuse of such term since you can perfectly have a low-carbohydrate eating regime which allows the patient to eat at least 2,000 Kcal per day. The latter is obviously not an starvation diet. Such a term is usually linked to very-low calorie diets. —Preceding unsigned comment added by 130.39.225.252 (talk) 15:16, 11 June 2010 (UTC)

Article

A great article [2] Doc James (talk · contribs · email) 17:52, 23 September 2010 (UTC)

Boiled carrots - higher GI than glucose?

I've removed the reference to boiled carrots having a higher GI than pure glucose. Pure glucose has a GI of 100, while boiled carrots is generally quoted to be in the 39-50 range. I found this which suggests that it may have been mistaken in the past:

"And carrots' stock goes up even further. The widely used glycemic indexing of carrots at 92 (not to mention that 131) was faulty, according to Australian researcher Dr. Jennie Brand-Miller, a leader in the field and author of "The Glucose Revolution." She told me by e-mail that a later, less publicized test put carrots' GI at 49, and very recent tests under her watch found boiled carrots to have a GI of 32 and carrot juice 43. That would give carrots a GL between 3 and 4."

http://seattletimes.nwsource.com/pacificnw/2001/0916/fitness.html

Other estimates for the GI of carrots are: 32 and 49 - http://lowcarbdiets.about.com/od/carbcounts/a/carrots.htm 41 - http://www.the-gi-diet.org/lowgifoods/ 49 - http://www.cbass.com/GlycemicIndex.htm

Does anybody dispute this change? —Preceding unsigned comment added by 111.69.242.58 (talk) 19:34, 9 October 2010 (UTC)

Pie charts

This edit added the pie charts from ketogenic diet here. There were subsequently moved to the lead image. I think this article is about low-carbohydrate diets in general use and are mostly not the kind of extreme medically-supervised diet seen in the ketogenic diet for epilepsy therapy.

I think this article should use a different set of pie charts, using the first two pies but creating new ones for other "low-carbohydrate" diets. There may be value in keeping the "classic ketogenic diet" as an example of an medical diet that is also an example of an "adequate protein very low-carb diet". Most low-carb diets are high protein. The MCT diet variant is a relatively obscure variation of the medical ketogenic diet that is unlikely to be relevant to readers of this article.

For example, we could add a pie for the proportions of the atkins diet after the induction phase. What other such diets are popular and worth creating a pie for?

Colin°^Talk 15:22, 13 January 2011 (UTC)

I've removed the pie charts. They concentrate on ketogenic diets and not low-carb diets in general, and two of them are medically-supervised diets for children with epilepsy. They aren't relevant for adults or for either weight loss or lifestyle diets. The editors of this article should devise different pie charts. Colin°^Talk 20:22, 18 March 2011 (UTC)

Weight loss

"A meta-analysis of randomized controlled trials by the Cochrane Collaboration in 2002 concluded that fat-restricted diets are no better than calorie restricted diets in achieving long term weight loss in overweight or obese people." and "published after the Cochrane review" removed. They are unrelated and seem to serve only to advertise what they mention. Jimgettman (talk) 05:09, 2 February 2011 (UTC)

References

this reads like an advocacy piece, not an encyclopedia article

the criticism section is mostly defenses (often OR) against the criticisms, there appears to be substantial cherry picking of sources, use of advocacy sites as sources, etc. This seems to be misleading about the overall scientific views about the risks of low carb diets, and about the depth and breadth of concerns among public health orgs - not just AHA, but others. I am not sure where to even begin with this. — Preceding unsigned comment added by Ricardianman (talk • contribs) 20:02, 18 March 2011 (UTC)

By finding one obvious problem, and fixing it. We will eventually meet the goal of a reasonable, balanced article. WhatamIdoing (talk) 19:12, 13 June 2011 (UTC)

Whereas I just came in (August 2011) and read it and found it was full of anti-low-carb material. Overall, I found the article gave a negatively biased impression of the diet. The "depth and breadth of concerns" was overwhelmingly represented, whereas I would vote for adding more balanced views from, say, Gary Taubes' recent research and the pre-eminent Swedish doctors who are currently bringing forth some very positive data about LC diets. (I haven't got all the Swedish sources since I've only read library copies of the Dalhqvist and Eenfeldt books, but I'm sure someone can add quotes).--Snowgrouse (talk) 19:59, 28 August 2011 (UTC)

Taubes is in some respects more controversial in his POV than the low carb diets themselves - I think that would open up a can of worms. Ricardianman (talk) 01:58, 9 January 2012 (UTC)

Ketogenesis vs the ketogenic diet

I'm sure it's no surprise to any of you that people like to dress up their ideas in science-y sounding terms and medicalizing normal, non-medical choices so that it all sounds more profound and important than it is. I ask that the editors here make a particular effort not to confuse "a diet that happens to produce ketone bodies" with "the ketogenic diet", since the later is a strict medical nutrition therapy. There are even low-quality sources trying to puff themselves up by pretending that the similarity of the names means that positive effects seen in children with severe epilepsy somehow tells you something about the benefits that adult body-builders should expect (but, somehow, they "forget" to mention the stunted growth that affects many of these kids. I guess that wouldn't make the diet sound so appealing to body builders, would it?).

Anything that results in fat metabolism (even a high-carb one) is technically "ketogenic", because ketone bodies are the normal, everyday, unavoidable result of burning fat molecules. Low-carb diets produce more of these than other diets, but it's not really some sort of magic. If we can be careful about our word choices, we might be able to reduce some of the confusion. WhatamIdoing (talk) 19:12, 13 June 2011 (UTC)

That's not the case. Fat metabolism occurs without ketosis. Free fatty acids in circulation are directly metabolized. Ketosis occurs only when blood sugar is low. The body produces ketones because some organs (the brain) cannot metabolize fat directly. Not every diet that results in metabolizing fat can be considered ketogenic.

Link to livestock interest groups

Sveriges Radio reported that a lot of studies that are favorable to these diets are sponsored by various organizations and interest groups tied to the meat, dairy and poultry industries. Dunno if anyone other news organizations have picked up on it, but here's the story (in Swedish).[3]

Peter ^Isotalo 20:44, 30 August 2011 (UTC)

I was also going to ask if this maybe should be included in the article as it seems to have some relevance I think. — Preceding unsigned comment added by 83.101.67.45 (talk) 17:25, 14 September 2011 (UTC)

In that case, shouldn't we also -- in the interest of impartiality and completeness -- include some mention of the even tighter links between carbohydrate industry money and the Swedish dietary advice establishment (including the government institution responsible for nutrition, Livsmedelsverket) that Swedish pro-LCHF debaters have dug up? Hmm, dunno if Sveriges Radio has done any stories on that... If not, why not, do you think?--CRConrad (talk) 13:47, 18 March 2012 (UTC)

"Citation needed" on Eskimos and Maasai? Not IMO.

The sentence "Arctic cultures such as the Inuit and African cultures such as the Maasai Tribesmen lead physically demanding lives and yet consume a diet almost completely devoid of carbohydrates." (in the "Excercise" section) has a "[citation needed]" tag. I don't think any citation is needed; I think it's pretty much Allgemeinbildung to know that Eskimos eat mostly fish and seals, and the Maasai mostly milk and blood from cattle. Otherwise, we'd have to put "citation needed" on pretty much every other word.--CRConrad (talk) 13:38, 18 March 2012 (UTC)

Das ist nicht Allgemeinbildung (general knowledge). I for one know absolutely nothing about traditional Maasai diets. We need citations of medical studies giving reliable data on the macronutrient composition of Maasai diets and how much vigorous activities Maasai men and women typically engage in. If such studies do not exist, then leave the Maasai out. (This and related WP pages gives good cites for the Inuit.)

Solo Owl 12:56, 27 July 2013 (UTC) — Preceding unsigned comment added by Eall Ân Ûle (talk • contribs)

I could suggest these books: Weston A. Price's "Nutrition and Physical Degeneration" about the Maasai and Stefansson's "The Fat of The Land" about the Inuit/Eskimo. Not sure about hyperlinked sources, though. 177.43.84.13 (talk) 15:33, 25 November 2013 (UTC)

Suggestion

At first glance, the Slow Carb Diet from Timothy Ferriss' '4-Hour Body' is low in refined carbs. Is it worth including on this page? That is, if any reliable sources have written anything about it. (Sincerely, a wikipedian who got sick of wikipedians) — Preceding unsigned comment added by 72.213.2.74 (talk) 17:40, 8 April 2012 (UTC)

About.com is not a reliable source

Just fact-checking a segment of this entry, I noticed there are around 15 instances of About.com as a source. About.com is a Self-Published unreliable source because there is no fact-checking or editorial oversight. Please don't cite About.com, when there are a glut of better sources! - CompliantDrone (talk) 23:23, 27 April 2012 (UTC)

Great ape relatives are definitely not vegetarian

"but suggests that humans evolved from the vegetarian diets common to other great apes to one with a greater level of meat eating.[12]"

Gorillas may be vegetarian (no doubt the source for this idea) however humans are more closely related to chimpanzees, and chimpanzees hunt in an organized fashion. "The western red colobus ranks at the top of preferred mammal prey. Other mammalian prey include, red-tailed monkeys, yellow baboons, blue duikers, bushbucks and warthogs" Common chimpanzee

Also note that the plant materials consumed by Chimpanzees are almost exclusively fruit, which is far afield from what humans usually think of as "vegetarian". 64.71.2.189 (talk) 19:58, 31 May 2012 (UTC)

Evilcyber.com is not a reliable source

Removed this link:

http://evilcyber.com/losing-weight/low-carb-keto-diet/ Disrobing Dogma – Low Carb And Ketogenic Diets In Weight Loss

Article linked to is by anonymous author.

Not a neutral POV. For example

>>The current obsession is with carbohydrates, or, more specifically, the low-carbohydrate diet. First championed into fame by the late Robert Atkins, and later perpetuated into utter idiocy by current diet commentators to the likes of Gary Taubes.

>>Ketogenic Diets – Equally As Useless, Twice As Stupid.

http://en.wiki.x.io/wiki/Wikipedia:Further_reading

— Preceding unsigned comment added by 144.142.12.1 (talk) 19:53, 12 July 2012 (UTC)

Citations

Some of the footnotes seem to contain information that belongs in the article. This does not follow with the wiki style. Footnotes are not the place to make arguments. All the arguments made in these footnotes should be included in the body.

http://en.wiki.x.io/wiki/Wikipedia:References — Preceding unsigned comment added by 144.142.12.1 (talk) 18:54, 13 July 2012 (UTC)

missing transitional authors?

DuPont's Alfred W Pennington ca 1940s appears to be a significant figure in the modern low carb saga. Robert Atkins (nutritionist) " decided to go on a restrictive diet based on the research of Dr. Alfred W. Pennington, who recommended removing all starch and sugar from meals. The article exploring the study of Pennington's work, titled "A New Concept in the Treatment of Obesity", was published in the October 1963 issue of the Journal of the American Medical Association by Edgar S. Gordon, Marshall Goldberg, and Grace J. Chosy, and advocated for the complete elimination of sugar from the diet and a marked increase in both fat and protein

In some quarters, TL Cleave's books, Diabetes, Coronary Thrombosis, and the Saccharine Disease (1966), and The Saccharine Disease (1974) may have achieved some continued popularity.

John Yudkin, Pure, White and Deadly (1972)

Likewise, Herman Taller's controversial low carb book, a best seller in 1962, Calories Don't Count(1960) could not have been missed by Atkins in 1963.--Incogm (talk) 10:53, 20 November 2012 (UTC)

Diet

Diet in the larger sense of all the choices & processes by means of which a society feeds itself, versus diet in the small sense of a slimming effort or a vehicle for selling books: I find it interesting that in all of this discussion of diet, there is absolutely no mention of any factor besides individual (or perhaps incidentally public) health. Is it not telling that the concern is squarely on consumption, & consumption's direct effects on the individual consumer, with no regard given for the effects of the type of production that a particular mode of consumption entails? All the talk of 'controversy', over insulin, ketosis, obesity. How about the sort of energy economy demanded by a particular diet, & the public policies that must be put in place in order to maintain it? If one society eats a lot of meat & another doesn't, for instance, given the fact that meat is far more energy-costly than plant foods per calorie, might those societies need to be organized differently agriculturally, economically (& everything that follows from that)?

Not one mention of anything like this in any of the 'diet' articles I've read on Wikipedia. Perhaps I shall try to amend these very poor Wikipedia articles sometime, though it is hard with my schedule, but I just had to opine about how weird it is that with all the eyes that scan over these articles, & all the people who chip in here & there to create these articles by accretion & deletion (this one since 2004), nothing like this has ever found its way into them. I suppose it says something about the priorities of our society. We are so divorced from the production of our food supply (of anything we consume in fact) that we can have entire food movements that can inveigh against the epochal introduction of agriculture itself, in pseudo-lofty terms, but with almost no understanding of what agriculture actually is. As though the emergence of agriculture, which has been intertwined with human history, myth, the structure of our social & personal thought, can be reduced to one single question: whether it has made us fatties. (And by the way, given that almost all cultures since the introduction of agriculture have been agricultural cultures, primarily subsisting on carbohydrate staple diets, yet obesity, diabetes, heart disease, & the rest have been common in very few of those cultures, only the rare ones in which calories have been cheap & overabundant, all of the good-calorie-bad-calorie camps ought to look elsewhere than in nutritionist tinkering. Absolute caloric intake is the obvious first principle of weight, body composition, & health.) RubyQ (talk) 00:15, 15 February 2013 (UTC)

Universal truth

Eat less food. We are a very bored society. RubyQ (talk) 23:29, 14 February 2013 (UTC)

No, I'm sorry, but that's not true for everybody. — Preceding unsigned comment added by 99.14.24.104 (talk) 06:33, 18 February 2013 (UTC)

Many of the sharp criticisms of low-carb diets seem to be coming from people for whom this diet is a completely new idea. Anyone who has lived with conventional dietary or other beliefs for many years will naturally find a new theory hard to swallow. Most of the controversy here derives from a reluctance to accept that which is different; such reluctance can best be countered by reading up on what a low-carb diet actually is and what it actually does in the body. There are some valid controversies here that need to be presented clearly, but it's hard to do this well when people belittle low-carb diets from a position of ignorance of the facts. Thus, condemning low-carb diets because of a supposed risk of ketoacidosis is counterproductive. A similar condemnation because their long association with Dr. Atkins is also unhelpful. The Atkins approach has been one of the more successful diets for the majority of people who have followed it, precisely because it follows a low-carb approach. When we add sufficient dietary vitamins and other supplements, exercise, and meditation to Atkins, we really have a prescription for health. Any opposition to a concept should require opponents to educate themselves first as to the claimed benefits and the rationales for those benefits. Otherwise, they're likely to fight against something advantageous that they might otherwise have actually supported if they had understood the theory and facts behind it. David Spector (talk) 16:44, 20 June 2013 (UTC)

Getting back to RubyQ's comment, I recall this quote from The Bronx Diet:

If you want to gain weight, eat more. If you want to lose weight, eat less.

(Sorry, I can't locate my copy of the book short of major archaeology in my apartment.) In any case it is not very relevant to an article on one class of diets.

Solo Owl 13:11, 27 July 2013 (UTC) — Preceding unsigned comment added by Eall Ân Ûle (talk • contribs)

Blatent POV

Doctors and nutritionists are "confused" and often "imply" things. People who criticise low carb "believe" and "perceive" things while people who are in favour "recognise" and "understand." This is the most blatantly unbalanced Wikipedia article I've ever read. Misodoctakleidist (talk) 21:58, 10 April 2013 (UTC)

It gets better. "Some variants of low-carbohydrate diets involve substantially lowered intake of dietary fiber, which can result in constipation if not supplemented." How do you solve constipation? By eliminating dietary fiber. I'm not altering the article because I noticed this long ago (blood and pain was involved—years of blood and pain). --John Moser (talk) 03:07, 10 October 2016 (UTC)

Why favor the Sweden study?

I am going to remove this paragraph from the introduction:

In Oct. 2013, after reviewing 16,000 studies, Sweden's Council on Health Technology Assessment concluded that low-carbohydrate diets are more effective as a means to reduce weight than low fat diet, over a short period of time (6 months or less). However, the agency also concluded that over a longer span (12–24 months), there are no differences in effects on weight between strict or moderate low carb diets, low fat diets, diets high in protein, Mediterranean diet or diets aiming at low glycemic index.[5] Sweden has become the first western nation to reject the low-fat diet in favor of low-carb high fat nutrition advice.[6][7]

There have been other meta studies on low carb diet as discussed in the "Studies on Health Effects" section. Without a reason to flag this particular study as the final word on health effects, it should be there. I am moving the paragraph to the Studies on Health Effects section, and removing the last sentence, which should be in the "Opinions from Major Government and Medical Organizations section. Someone else should feel free to add a Sweden section there if they like. — Preceding unsigned comment added by 124.82.48.229 (talk) 21:47, 2 February 2014 (UTC)

Proposed merge with Medical research related to low-carbohydrate diets

Topic is instrinsic to proposed this article, and should be merged here Alexbrn ^{talk|contribs|COI} 16:41, 26 August 2014 (UTC)

agree --Cornellier (talk) 19:25, 26 August 2014 (UTC)

support for merge Iztwoz (talk) 20:20, 26 August 2014 (UTC)

support combined article will be around 40k readable prose size, merger seems to be within WP:SIZE. Dl2000 (talk) 00:51, 27 August 2014 (UTC)

Disagree -- What was the rational for removing the link to the scientific studies? Primary research appears on numerous wiki pages and meta studies are not primary research. Further there is more research on the topic that should be included in the page. — Preceding unsigned comment added by CarbShark (talk • contribs) 16:27, 30 August 2014 (UTC)

See WP:MEDRS. Alexbrn ^{talk|contribs|COI} 17:29, 30 August 2014 (UTC)

Agreed; the medical research article is too short to stand on its own unless anyone's planning on expanding it. Squish7 (talk) 10:08, 28 August 2014 (UTC)

Note however that I recently substantially slimmed it down, because it was full of primary research. Alexbrn ^{talk|contribs|COI} 10:09, 28 August 2014 (UTC)

Support The recent trimming and updating looks good to me on a quick survey of the canges, & leaves the article short enough to be merged here, which is the natural thing to do. Johnbod (talk) 17:38, 24 September 2014 (UTC)

Support Unnecessary fork, fits article size requirements Abcmaxx (talk) 01:53, 20 November 2014 (UTC)

Support -- Abhijeet Safai (talk) 04:28, 28 December 2014 (UTC)

 Done This has now been done; I'll try and reconcile the content & tidy up. Alexbrn (talk) 16:17, 26 July 2015 (UTC)

@Alexbrn: Your merge was incomplete! I found out about the "medical research page" and ultimately found this talk thread, since I followed links and inspected history, starting from the following in the section Low-carbohydrate diet#1990s – present:

... It can be controversial which diets are low-carbohydrate and which are not. The 1990s and 2000s saw the publication of an increased number of clinical studies regarding the effectiveness and safety (pro and con) of low-carbohydrate diets (see low-carbohydrate diet medical research).

The link is redirected back to the top of the article; which means that the "see ..." reference now is meaningless.

Since I don't know where you put the relevant material from the medical article (if you did), I cannot fix this. Alexbrn, you are probably the one best apt to change this sentence to something sensible. When you're at it it might be an idea to check a few other of the links to the medical article (found at Special:WhatLinksHere/Medical_research_related_to_low-carbohydrate_diets); IMO, this in general is a good practise when merging articles, in order to avoid trouble of this kind. JoergenB (talk) 18:07, 14 October 2015 (UTC)

¶ I don't quite know how to smuggle this into the article: In the decade prior to the use of insulin (ca. 1922), extreme low-carb diets became quite a medical fad for diabetes treatment - even "curing" diabetes (but requiring the diabetic not to stray too far from the diet). They fell out of popularity when insulin and other medications arose to control diabetes. Very recently, however, extreme low-carb diets have staged a resurgence, not only for diabetes treatment but also for general obesity treatment. About 20 years a British doctor, Roy Taylor, noticed that patients who underwent stomach shrinkage surgery (gastric bypass, lap-band, stomach stapling, etc.) not only lost weight but also were cured of Type 2 diabetes - even though the surgery never touched the pancreas. He finally deduced this was due to the extremely restrictive post-op diet imposed, which differed slightly for each type of surgery but can be generally described as (to put it colloquially) "five handfuls of birdseed a day"; very similar to the first stage of the Starvation Diet used for diabetics in the early 1920s. He tried this extreme diet on obese diabetics - but without any surgery - and they also lost weight and their diabetes disappeared; a distinct difference between them and the surgical patients was that Taylor's patients could, after a few months, gradually ease into normal food and portions for some meals. Taylor is now making a fortune packaging his birdseed diet and selling it in the UK. Others are publishing books advocating his regimen; e.g., Michael Mosley, MD, The 8-Week Blood Sugar Diet (2015, Short Books, London, 260 pages + index). Sussmanbern (talk) 19:50, 1 November 2016 (UTC)

As i understand it the reason why diabetes recedes in many people after baratric surgery (esp gastric banding) is not well understood. There are lots of ideas about it but no consensus. If we have content about that (which is very interesting) it needs to represent the range of ideas and the uncertainty. As with anything, if there is a reliable source that discusses that, we can find a way to work it in. We need good refs to start with. Jytdog (talk) 20:14, 1 November 2016 (UTC)

¶ On the topic of bariatric surgery, I am somewhat concerned that this is a sort of amputation (of part of the stomach) which permanently impairs the patient (by disabling him from eating normal amounts at the usual times), and I feel certain that medical science could and should come up with a better treatment for obesity. One recent disturbing development is that the surgeons doing this sort of stuff are now calling their work "metabolic surgery" even though it doesn't actually effect the metabolism. Sussmanbern (talk) 05:14, 2 November 2016 (UTC)

This is not a place for general discussion of the topic; it is strictly for doing the work of building the article. Please read WP:TPG and please refrain from such discussion in the future. Thanks. Jytdog (talk) 06:21, 2 November 2016 (UTC)

MEDRS

Editors are adding[4][5][6] content to this article that falls afoul of our medical sourcing guidelines. Please don't do that. Alexbrn ^{talk|contribs|COI} 16:58, 5 October 2014 (UTC)

I added, and you deleted, content sourced from the JAMA: The Journal of the American Medical Association. Please explain how this "falls afoul" of medical sourcing guidelines. --Cornellier (talk) 19:06, 5 October 2014 (UTC)

This bit: "All Wikipedia articles should be based on reliable, published secondary sources. Primary sources should generally not be used for health related content, because the primary biomedical literature is exploratory and not reliable - any given primary source may be contradicted by another, and the Wikipedia community relies on the guidance of expert reviews, and statements of major medical and scientific bodies, to provide guidance on any given issue." Johnbod (talk) 19:08, 5 October 2014 (UTC)

Thanks for pointing that out Johnbod. I reckon a significant portion of Wikipedia is at odds with this policy! --Cornellier (talk) 21:11, 5 October 2014 (UTC)

On Glucose Availability - 'not in citation given'

In the section on Glucose Availability, there is a tag 'not in citation given' regarding the cited note that the brain can potentially operate more efficiently on ketones. In the cited paper, page 244, section "Human Cerebral Metabolism in Ketosis" does indeed seem to state that the human brain can operate more efficiently on ketoacids rather than glucose. I'm curious why this tag has been placed on this citation in the wiki article. — Preceding unsigned comment added by Jrista (talk • contribs) 18:48, 4 June 2015 (UTC)

Not sure, anyway I removed the tag. --Stefan-S ^talk 04:39, 5 August 2015 (UTC)

Sleep ketosis?

Most Westerners seldom exhaust stored glycogen supplies and rarely go into ketosis. Not even at night? The ketosis article says During the usual overnight fast, the body's metabolism naturally switches into ketosis, and will switch back to glycolysis after a carbohydrate-rich meal. --176.2.87.41 (talk) 04:48, 16 July 2015 (UTC)

No-carbohydrate diet

Should No-carbohydrate diet be redirected to this article? All of the sources there are very low quality (particularly the Effects section) and most actually discuss low-carb diets in general. KateWishing (talk) 11:06, 16 October 2015 (UTC)

• Support. @KateWishing: Yes I'll do this shortly if there is no objection. Alexbrn (talk) 13:58, 22 July 2017 (UTC)

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edits today

¶ I am very cranked that even as I was adding the references to a paragraph I just written on the Very Low Carb diets in use for diabetics just before the development of insulin, some busybody made all my work vanish. I had about five examples of publications in the decade before insulin that advocated extremely low carb regimens. And I felt this was important because these diets are now staging a comeback because of all the baby-boomers now approaching old age who are becoming diabetic. The very low carb diets appear to have been "re-invented" by entirely new experiments. Sussmanbern (talk) 19:44, 30 October 2016 (UTC)

my apologies. it is useful to include something like "sources coming" or the like in your edit note so people know you are still adding stuff. There is also an {{under construction|section}} template you can add to let people know you are working.

Please feel free to restore, but only if you have sources that comply with WP:MEDRS, that you are working from and will cite. Jytdog (talk) 20:41, 30 October 2016 (UTC)

¶ I am working with medical materials of the 1920s, so I am not at all sure what complies with WP:MEDRS, I citing to what were then medical journals. Sussmanbern (talk) 02:14, 31 October 2016 (UTC)

The present tense through me off. I will fix it. Jytdog (talk) 02:27, 31 October 2016 (UTC)

¶ You are cordially invited to wait until I am finished with my writing and editing before you try to improve upon it! Your concurrent fiddling short-circuited all my additions. Sussmanbern (talk) 02:35, 31 October 2016 (UTC)

Yours did the same to me. Fixing now. Jytdog (talk) 03:18, 31 October 2016 (UTC)

¶ I appreciate your re-editing, but was it necessary to completely omit the mention of the Rockefeller monograph produced by Allen et al, while repeating the Steiner citation for the third time? Sussmanbern (talk) 06:33, 31 October 2016 (UTC)

Content is generated from sources. I provided the source for each sentence. I left out the Allen monograph by accident; restoring it now. Jytdog (talk) 12:19, 31 October 2016 (UTC)

¶ I will accept that you are far more proficient with WP:MEDRS and so forth, but considering that the Steiner article (source 19) is a mere nine pages, is it really necessary to cite it three times in one brief paragraph in order to generate complicated superscript numbers for pin-cites??? I originally cited it only once and I bet the reader who used the link provided would have had no problem finding the passages I summarized. Sussmanbern (talk) 19:32, 1 November 2016 (UTC)

we ~could~ cite it only once, at the end of the paragraph. The problem with doing that is that editors like yourself will add content in that paragraph that is not in the source, that is in other words, policy-violating original research. Providing the citation after every sentence becomes necessary in a context where people are doing that. In the content that you added (diff), the first sentence and the last sentence were [{WP:OR]]. It wasn't clear to me exactly what source said "Thereafter the patient is taught to favor low carbohydrate foods" - this was not in the Steiner ref. Jytdog (talk) 20:54, 2 November 2016 (UTC)

Carbon footprint of typical low-carb diet

Is there any sound science on this oft-repeated claim? Many low-carb, high-fat dieters eat pretty much the opposite of ye old seventies "Diet for a Small Planet". Would be appropriate to reflect in article. Jikybebna (talk) 12:12, 16 December 2016 (UTC)

Erroneous Stellenbosch Review

The second paragraph of "Studies on health effects" is devoted to the so-called Stellenbosch Review which contains too many errors to be relied upon. A rebuttal has been published: http://www.samj.org.za/index.php/samj/article/view/11605 The errors in the review completely reverse some of its conclusions; this should be pointed out, at least by linking to this article. In addition, the review includes some diets that are not only "less extreme low carbohydrate diets" as stated in the page now, they are actually high in carbohydrates: the average is 35% for all the diets in the review and so most of the diets definitely do not match the "generally less than 20%" definition used at the top of this wiki page. This might seriously mislead readers. I suggest to use something like "moderate carbohydrate restriction" or, even better, use explicit percentages to stress that the review was mostly concerned with diets on the border of low-carb.

Note: I made an edit in this sense, but it was undone because of "conflict of interest" of the authors. Some of the authors of the review are part of the same conflict as the authors of the rebuttal, see e. g. http://www.sasomonline.co.za/images/Noakes-diet-Open-Letter-from-UCT-Faculty-of-Health-Sciences.pdf. The review is so invalid (includes studies that fail they own inclusion criteria etc.) and so little concerned with actual low-carb diets that it should perhaps be excluded from this page, or at least be given a much less prominent place and having the rebuttal pointing out the errors mentioned close to it. — Preceding unsigned comment added by Jan Mazak (talk • contribs) 16:23, 12 April 2017 (UTC)

You have misrepresented the reason I gave in my edit summary. Jytdog (talk) 16:31, 12 April 2017 (UTC)

I am sorry for misinterpreting. As far as I understand, the only other part of your reason was that the journal with rebuttal is "lower quality" which is irrelevant in this case (and a matter of opinion anyway): if there is an error, it does not matter if it was pointed out by Einstein or my aunt's dog, the error is just the same. And if Wikipedia refers to a poor quality article (the review), it is fair to at least mention an article pointing out or correcting the errors, especially since those errors revert some of the review conclusions paraphrased by this Wikipedia page.Jan Mazak (talk) 18:51, 12 April 2017 (UTC)

Lower quality is not a matter of opinion -- there are things like impact factors and a very clear hierarchy among journals. That was the first thing i noted. The second is the clear COI of the authors of the "rebuttal". The letter that you posted it makes it even more clear that the senior author on the "rebuttal" paper is conflicted with regard to low-carb diets. What the authors of the letter say is exactly in accord with mainstream advice about healthy eating btw (you should read our article on that). So no, we don't rebut a review in a high quality journal using what is basically a letter to the editor in a lower quality journal, by an author with a clear COI for the subject matter. This is all discussed in WP:MEDRS which the community guideline for sourcing content about health. Jytdog (talk) 19:04, 12 April 2017 (UTC)

I might be biased by my field of research (discrete mathematics). Impact factors there are not very relevant to journal quality (perhaps they can separate real leading journals from junk up to some extent, but not much more than that), so the perception of quality is much more a matter of the community's opinion then some objective numbers. It seems that the goal of Wikipedia is to present some consensus established view even if it was wrong or contradicted current research, or in other words, it is not the forum to change established views (so much different from mathematics, where things are just true or false). According to the report http://publications.credit-suisse.com/tasks/render/file/index.cfm?fileid=9163B920-CAEF-91FB-EE5769786A03D76E (perhaps this report is worth referring to in this wikipedia page as an interesting secondary source?), consensus among doctors and nutritionists is significantly lagging medical research in the area of high fat/low carb diets and the situation is even worse with bodies like WHO. Noakes at his trial presented strong evidence that some parts of the consensus nutritional guidelines are outdated by decades, unsubstantiated, or directly contradicting medical research. The situation is slowly changing (e.g. USDA dropping their cholesterol limits), and I believe that Wikipedia readers should be pointed out to some of that research to have a chance to understand that not everything is as clear as they are told in the nutritional guidelines, and some parts of the guidelines can actually be totally wrong. — Preceding unsigned comment added by Jan Mazak (talk • contribs) 19:55, 12 April 2017 (UTC)

@Jytdog: and @Mazak:, see this which is the reply to the reply of the above linked review. It states The complainant, Claire JulsingStrydom, referred to the importance of a meta-analysis generally and/or the Naude et al.[1] meta-analysis specifically on 12 separate occasions during her testimony. On 24 November 2015, under oath, she said of the Naude et al.[1] publication: ‘So before any media statements could be made we had to get that information and all these associations were waiting on that. It is not like the way you are saying it, it is not like everybody joined together to now make a statement against Prof. Noakes. We were all waiting for the evidence to be published.’ Another prosecution witness, Prof. H Vorster, referred to the Naude et al.[1] meta-analysis five times and quoted from it verbatim once. A third prosecution witness, Prof. A Dhansay, referenced the meta-analysis twice, using the term ‘Cochrane’ to ensure that it was afforded the appropriate esteem. Without the ‘correct conclusion’ from this meta-analysis, it is possible that the HPCSA trial against Noakes might never have happened. Therefore, the importance of the Naude et al.[1] meta-analysis extends far beyond any role purely as a neutral scientific publication.. So, of course not in as highly regarded magazine, but still the above is stated in a 'court' under oath, it is quite clear that the review was written to be used against Tim Noakes, it is therefore high risk that this report is biased, as WP:MEDBIAS states Claims of bias should always be sourced to reliable secondary sources, and are not reason to omit sources — rather the solution is to qualify sources with information of why a source may be biased, and who is calling it biased., so I think that we can easily add a statement of possible bias? --Stefan-S ^talk 15:54, 22 May 2017 (UTC)

Err, why? Some people seem unhappy - that proves nothing. Alexbrn (talk) 16:16, 22 May 2017 (UTC)

Yep this is just further down the rabbit hole of he said she said via letters-to-the-editor; this is exactly what we avoid doing. Whatever each of us is in the real world, we are editors here, and we follow the strongest sources we have. If all of this stuff that you and Jan mention, results in the review being retracted, out it will come. Otherwise it will stay until a stronger review supplants it. Stefan-S please also be aware that letters to the editor are not peer reviewed; please be careful not to violate BLP in making arguments here. Jytdog (talk) 17:37, 22 May 2017 (UTC)

@Alexbrn: because we are trying to write a good encyclopaedia based on good sources, this source does not look that good so maybe we as editors should consider picking another one? @Jytdog: Yes it is he said, she said, but with the distinction under oath. How can someone say we were waiting for the evidence to be published? That implies a strong connection between the accuser and the people responsible for the paper, with that strong connection it also implies (not prove) a high risk of bias, you should know as it is stated in WP:MEDBIAS that there is 'huge financial interests' in medicine and in this trial, and to use a paper that seams to be constructed to fight in a trial seams not so smart to me (even if it is in accordance to wikipedia rules). So I humbly suggest that we should consider if we really want to keep that source, or maybe find a better one? If you don't agree I understand. But it is my opinion. Have you read the complaint? Did you read the reply? It really makes me wonder why the author ignore so many questions raised. If you also know a bit more of the history of this trial, you really start to wonder, and I feel uncomfortable using that source. Just my opinion. --Stefan-S ^talk 13:07, 23 May 2017 (UTC)

The fact people don't like a source doesn't make it bad. On diet topics, in fact, some of the strongest sources attract a lot of dislike (from proponents of diets). Alexbrn (talk) 13:28, 23 May 2017 (UTC)

'Ketosis and insulin synthesis: what is normal?'

This used to begin

A perception developed that getting energy chiefly from dietary protein rather than carbohydrates causes liver damage and that getting energy chiefly from dietary fats rather than carbohydrates causes and other health problems.

but on [July 2017], that was removed, so that now it simply begins

This view is still held by the majority of those in the medical and nutritional science communities.

What view? I had to search back through the history of the page to find out what view was being discussed.

Well, the entire section has now been removed, with rather dubious "I don't like it" edit summaries. I'm not so sure this was a good idea. It may be necessary to bring it back with sytronger refs. Johnbod (talk) 12:30, 6 September 2017 (UTC)

Policy violations like WP:SYN have nothing to do with IDONTLIKE it; please don't misrepresent other people.

here is the whole section, as it stood back in July before the first cuts were made (version). This is all full of unsourced content, WP:SYN and the refs generally fail MEDRS where they support actual statements, and otherwise are used in SYN as well. What exactly do you see as salvageable here?

Ketosis and insulin synthesis -- what is normal?

A perception developed that getting energy chiefly from dietary protein rather than carbohydrates causes liver damage and that getting energy chiefly from dietary fats rather than carbohydrates causes heart disease and other health problems. This view is still held by the majority of those in the medical and nutritional science communities. However, it is now widely recognized that periodic ketosis is normal, and that ketosis provides a number of benefits, including neuroprotection against diverse types of cellular injury.

People critical of low-carbohydrate diets cite hypoglycemia and ketoacidosis as risk factors. While mild acidosis may be a side effect when beginning a ketogenic diet, no known health emergencies have been recorded. It should not be conflated with diabetic ketoacidosis, which can be life-threatening.

A diet very low in starches and sugars induces several adaptive responses. Low blood glucose causes the pancreas to produce glucagon, which stimulates the liver to convert stored glycogen into glucose and release it into the blood. When liver glycogen stores are exhausted, the body starts using fatty acids instead of glucose. The brain cannot use fatty acids for energy, and instead uses ketones produced from fatty acids by the liver. By using fatty acids and ketones as energy sources, supplemented by conversion of proteins to glucose (gluconeogenesis), the body can maintain normal levels of blood glucose without dietary carbohydrates.

Most advocates of low-carbohydrate diets, such as the Atkins diet, argue that the human body is adapted to function primarily in ketosis. They argue that high insulin levels can cause many health problems, most significantly fat storage and weight gain. They argue that the purported dangers of ketosis are unsubstantiated (some of the arguments against ketosis result from confusion between ketosis and ketoacidosis, which is a mostly diabetic condition unrelated to dieting or low-carbohydrate intake). They also argue that fat in the diet contributes to heart disease only in the presence of high insulin levels and that if the diet is instead adjusted to induce ketosis, fat and cholesterol in the diet are beneficial. Most low-carb diet plans discourage consumption of trans fat.

On a high-carbohydrate diet, glucose is used by cells in the body for the energy needed for their basic functions, and about two-thirds of body cells require insulin to use glucose. Excessive amounts of blood glucose are thought to be a primary cause of the complications of diabetes, when glucose reacts with body proteins (resulting in glycosolated proteins) and change their behavior. Perhaps for this reason, the amount of glucose tightly maintained in the blood is quite low. Unless a meal is very low in starches and sugars, blood glucose will rise for a period of an hour or two after a meal. When this occurs, beta cells in the pancreas release insulin to cause uptake of glucose into cells. In liver and muscle cells, more glucose is taken in than is needed and stored as glycogen (once called 'animal starch'). Diets with a high starch/sugar content, therefore, cause release of more insulin, and so more cell absorption. In diabetics, glucose levels vary in time with meals and vary a little more as a result of high-carbohydrate meals. In nondiabetics, blood-sugar levels are restored to normal levels within an hour or two, regardless of the content of a meal.

However, the ability of the body to store glycogen is finite. Once liver and muscular stores are filled to the maximum, adipose tissue (subcutaneous and visceral fat stores) becomes the site of sugar storage in the form of fat. The body's ability to store fat is almost limitless, hence the modern problem of morbid obesity.

While any diet devoid of essential fatty acids (EFAs) and essential amino acids (EAAs) will result in eventual death, a diet completely without carbohydrates can be maintained indefinitely because triglycerides (which make up fat stored in the body and dietary fat) include a (glycerol) molecule which the body can easily convert to glucose. It should be noted that the EFAs and all amino acids are structural building blocks, not inherent fuel for energy. However, a very-low-carbohydrate diet (less than 20 g per day) may negatively affect certain biomarkers and produce detrimental effects in certain types of individuals (for instance, those with kidney problems). The opposite is also true; for instance, clinical experience suggests very-low-carbohydrate diets for patients with metabolic syndrome.

References

-- Jytdog (talk) 19:07, 6 September 2017 (UTC)

Why was my revision reversed?

On Au 25, I made a revision to this page to remove CLEARLY biased language ("fad diet") and a few extremely old references that have been completely reversed by newer data. My change was instantly reversed with NO explanation whatsoever. I clearly labeled my reasons and my edits were minor and improve the article. The user who did this ("Jytdog") appears to make hundreds of edits a day, which normally would indicate to me that it's some kind of bot, but the fact that some revisions DO have comments, so that may not be the case.

Ay any rate, can anyone explain why this was reversed, and especially why no explanation was given? — Preceding unsigned comment added by Finsternis (talk • contribs) 01:26, 11 September 2017 (UTC)

You have only made one edit to this article, this one. It was reverted by someone else (not me), here, and a reason was given. Jytdog (talk) 04:09, 11 September 2017 (UTC)

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Structure

Hi all,

I'm toying with the idea of taking on the article as a project (I think a lot of information is under an unhelpful heading and would benefit from being moved). I wanted to first check if there was anyone with particularly strong opinions first? I'd normally be bold but I feel like this is an article that might have very keen watchers... Joe (talk) 12:24, 19 April 2018 (UTC)

I suppose MOS:MED might have useful guidance? Alexbrn (talk) 12:28, 19 April 2018 (UTC)

It probably does. I should be clearer about the sort of issues I'd like to tackle - for example I feel like the 'health benefits' and 'research' sections should be combined into 'health effects', and that the critisims section needs reordering from the point of view of the most common critisms (and it should give the critisms, currently it's debunking a series of strawmen). Joe (talk) 12:58, 19 April 2018 (UTC)

I had some free time and did some work - the two major parts outstanding for me are: rewrite the lead, and rewrite the controversy subsections (the controversy section itself is looking better now part of the old 'research' section has been moved there) Joe (talk) 21:48, 19 April 2018 (UTC)

Objection to reversion

User:Alexbrn, you reverted my whole edit just because you found part of it to be "unsourced". If you want to improve the article, then improve it. Don't just revert to the poor state it was in. Did you see all the changes I made? Did you read my explanation for the part I put back? Eric Kvaalen (talk) 06:24, 8 July 2018 (UTC)

Don't add unsourced and weakly-sourced text - these heavily degraded the article. If you want to make some changes which are improvements, then go ahead and do it without the toxic payload. It's kind of WP:DISRUPTIVE to dump all over the article and expect other edited to sift any good nuggets out of it. Alexbrn (talk) 07:03, 8 July 2018 (UTC)

The article was certainly better after my edit] than before. With respect to the paragraph and a half that I added back, it precedes a sentence saying "Analyses which neglect these factors are misleading ...", and all the factors referred to had been removed! If you think you can improve the article by simplifying the block I restored, or by finding references, or by removing the sentence starting with "Analyses which neglect these factors", then please do. But don't just randomly revert any edit in which you find something objectionable. What do Mcorazao and Phenylalanine think? Eric Kvaalen (talk) 14:45, 8 July 2018 (UTC)

I've restored the improvements. The following additions made the article worse, not better, and have not been restored

• Also, extreme low-carb diets cause one to burn up one's glycogen stores, giving 2 kg (4.4 lb) or more of weight loss in the first few weeks.
• A common argument in favor of high-carbohydrate diets is that most carbohydrates break down readily into glucose in the bloodstream, and therefore the body does not have to work as hard to get its energy in a high-carbohydrate diet as a low-carbohydrate diet. This argument, by itself, is incomplete. Although many dietary carbohydrates do break down into glucose, most of that glucose does not remain in the bloodstream for long. Its presence stimulates the beta cells in the pancreas to release insulin, which has the effect of causing about two-thirds of body cells to take in glucose, and causing fat cells to take in fatty acids and store them. As the blood-glucose level falls, the amount of insulin released is reduced; the entire process is completed in non-diabetics in an hour or two after eating. High-carbohydrate diets require more insulin production and release than low-carbohydrate diets, and some ...
• n addition, this claim neglects the nature of the carbohydrates ingested. Some are indigestible in humans (e.g., cellulose), some are poorly digested in humans (e.g., the amylose starch variant), and some require considerable processing to be converted to absorbable forms. In general, uncooked or unprocessed (e.g., milling, crushing, etc.) foods are harder (typically much harder) to absorb, so do not raise glucose levels as much as might be expected from the proportion of carbohydrate present. Cooking (especially moist cooking above the temperature necessary to expand starch granules) and mechanical processing both considerably raise the amount of absorbable carbohydrate and reduce the digestive effort required.

  Analyses which neglect these factors are misleading and will not result in a working diet, or at least one which works as intended. (See Catching Fire by Richard Wrangham).

Please don't add unsourced content to Wikipedia, and please use WP:MEDRS sources when editing about health.

References

--Jytdog (talk) 15:21, 8 July 2018 (UTC)

Thanks, User:Jytdog. But I don't understand why you don't like the sentence I added about using up one's glycogen. Eric Kvaalen (talk) 07:09, 11 July 2018 (UTC)

The Conversation is not ok per WP:MEDRS. Jytdog (talk) 12:50, 11 July 2018 (UTC)

The article in The Conversation says: "The true explanation for his weight loss is much simpler: an extreme low-carb diet, as favoured by Lustig and before him Atkins, completely depletes the body of carbohydrate stores over a few days. Carbohydrate is stored in the liver and in muscle in the form of glycogen, where each gram of carbohydrate is stored with about 4g of water. On average, people have about 400g of glycogen stores, so its total weight is about 2kg. A tallish biggish man like Xand is likely to have nearer 3kg in total, and all that is lost rapidly on a low-carb diet."

Do you honestly think this is unreliable? If so, then you can use the "MEDRS" rule to justify not allowing it. But if actually you do believe it, then why do you apply that rule? It's not as though you have a bounden duty to enforce Wikipedia rules. My point of view is that we should put in information that is interesting and useful, for the benefit of the reader, not stick to rules in a legalistic way. Eric Kvaalen (talk) 14:21, 13 July 2018 (UTC)

WP:V is a core policy - content needs to be backed by reliable sources. This stuff from The Conversation sounds well dodgy to boot. Alexbrn (talk) 14:29, 13 July 2018 (UTC)

I found different references now. Eric Kvaalen (talk) 14:59, 16 July 2018 (UTC)

You need to bring a MEDRS ref, that discusses this as a an effect of a low-carb diet. None of the refs do that, and so the content you added is WP:SYN Jytdog (talk) 15:12, 16 July 2018 (UTC)

"metabolic hocus pocus"

The second paragraph under Adoption is referenced by a 10-year-old edition of a textbook on nutrition. The chapter cited and the previous chapter, Chapter 9, is on google books. I couldn't find "metabolic hocus pocus" or any similar statement about any claims of a metabolic effect of low-carb diets. The advice about low carb diets in the older edition is based on what was known about 2006. The phrase may have been invented by the editor, thus violating WP:NOR, so I'm deleting the paragraph. The latest 2016 edition (14th) follows the 2015 Dietary Guidelines and might be worth using as a citation somewhere. JuanTamad (talk) 04:55, 19 August 2018 (UTC)

I think I originally included this and can assure you I don't falsify quotations. Google Books links, though convenient, aren't always reliable and often the whole text is not available. I've added a newer Google link to the next edition (the latest I have access to). It's important to have something on this to counter the fringe view "out there" that there's a magic weight loss benefit from adopting a low-carbohydrate diet - though a newer source would be great ... anybody got access to the 14th edition? Alexbrn (talk) 06:47, 19 August 2018 (UTC)

I think I found the same section in the most recent edition, on page 119 it says:

The need for carbodydrates

Glucose from carbohydrate is an important fuel for most body functions. Only two other nutrients provide energy to the body: protein and fats. Protein-rich foods are usually expensive and when used to make fuel for the body, provide no advantage over carbohydrates. Moreover, excess dietary protein has disadvantages, as Chapter 6 explains. Fats normally are not used as fuel by the brain and central nervous system -- these tissues prefer glucose, and red blood cells use glucose exclusively. Thus, glucose is a critical energy source, and whole foods that supply carbohydrates -- particularly the fiber-rich ones -- are the preferred source of glucose in the diet.

Carbohydrates also play vital roles in the functioning of body tissues. For example, sugars that dangle from protein molecules, once thought to be mere hitchhikers, are now known to dramatically alter the shape and function of certain proteins. Such a sugar-protein complex is responsible for the slipperiness of mucus, the watery lubricant that coats and protects the body's internal linings and membranes. Sugars also bind to the outsides of cell membranes, where they facilitate cell-to-cell communication and nerve and brain cell functioning. Clearly, the body needs carbohydrates for more than just energy.

If I Want to Lose Weight and Stay Healthy, Should I Avoid Carbohydrates?

Carbohydrates have been wrongly accused of being the "fattening" ingredient of foods, thereby misleading millions of weight-conscious people into eliminating nutritious carbohydrate-rich foods from their diets. In truth, people who wish to lose fat, maintain lean tissue, and stay healthy, can do no better than to attend closely to portion sizes and calorie intakes, and to design an eating plan around carbohydrate-rich fruit, legumes, vegetables, and whole grains.

Gram for gram, carbohydrates donate fewer calories than do dietary fats, and converting glucose into fat for storage is metabolically costly. Still, it is possible to consume enough calories of carbohydrate to exceed the need for energy, which reliably leads to weight gain. To lose weight, the dieter must plan to consume fewer calories from food and beverages every day.

Less flashy but same message I think. Jytdog (talk) 19:37, 19 August 2018 (UTC)

On page 367:

Are Low-Carbohydrate Diets Best? Diet promoters make much of research showing that high-protein, low-carbohydrate diets produce a little more weight loss than balanced diets over the first few months of dieting. However, in the long run, any low-calorie diet produces about the same degree of loss.2 The 2015 Dietary Guidelines committee states that diets with less than 45 percent of calories from carbohydrate or more than 35 percent of protein offer no weight-loss advantage over other calorie-controlled diets, and that they are difficult to maintain over the long term and may be less safe.3 However, for most people, cutting down on carbohydrates as added sugars and ultra-processed starch-based foods can be a nutritionally sound approach to cutting calorie intakes. Eating the normal amount of lean protein-rich foods while reducing carbohydrate and fat intakes automatically reduces calories and shifts the nutrient balance toward a higher percentage of energy from protein.4

In line with the the 2015 dietary guidelines. Three isn't evidence that low-carb weight loss is due to fewer calories or due to some metabolic effect, but there is ongoing research and at least one recent review in favor of a carbohydrate-insulin model, which suggests there may be something going on metabolically (conclusion: "Pending definitive studies, the principles of a low-glycemic load diet offer a practical alternative to the conventional focus on dietary fat and calorie restriction." So "metabolic hocus pocus" (wherever the statement comes from, it's not in Sizer and Whitney), may be jumping to a conclusion, and stating it a little 'unencyclopedically' IMO, something that may yet prove false. Parts of the article need to be updated, generally. For example, "Some evidence indicates the human brain – the largest consumer of glucose in the body – can operate more efficiently on ketone bodies.[62]" - this is accepted now, see Sizer. Just interested, not promoting. More later. JuanTamad (talk) 04:17, 20 August 2018 (UTC)

From the currently cited source: "Thus weight loss from high-protein, low carbohydrate diets probably involves water loss and reduced calorie levels, and not the metabolic hocus-pocus put forth by diet books". I don't think PMID 29971406 is a review. There is a lot of hype/faddism around ketogenic diets we need to be ultra-careful of: WP:REDFLAG. It would be good to use the newer source Jytdog mentions. Alexbrn (talk) 07:14, 20 August 2018 (UTC)

The "hocus pocus" is from the 2008 edition of the textbook and presumably directed toward the many internet hucksters/purveyors of Paleo diets and the rest (without scientific backing), but there's been a lot of research in the decade since and they have dropped that phrasing from the 2016 edition, which can be obtained for $19.99 by googling around. The title of PMID 29971406 sounds like an editorial but it is a non-systematic review in JAMA Internal Medicine, here are others on the debate about the CIM, making the point that it's more complicated than simply number of calories ("longest studies show metabolic advantages for low-glycemic index vs low fat diets" but not definitive as yet; also "dietary fat has little direct effect on insulin, providing a theoretical basis the efficacy of high-fat diets" - 29971406, p E2, - article via sci-hub). Jytdog is citing the from the same nutrition textbook, from the latest 2016 edition, as I did. I cited page 367, specifically about low-carb. The textbook is sticking with the current official guidelines (which you'd expect), but recognizing the possibility that there might be something more to low-carb diets, that it's not all necessarily hype/faddism. Look at ref 11 Harcombe, a meta-analysis from 2016. JuanTamad (talk) 02:04, 21 August 2018 (UTC)

Newbie

Hello, I am joining this page to hopefully contribute more information. This is my first wikipedia article. I feel that low carbohydrate diets are often over looked. I look forward to discussing this topic and hopefully bringing some new research and a different layout to the information that is already provided. — Preceding unsigned comment added by Yellowdragon333 (talk • contribs) 01:05, 19 September 2018 (UTC)

Query

There is a surge of interest in this page by people with few edits. User:Muca123456, User:Yellowdragon333, and User:Dlactyol are you all part of a class or something? Jytdog (talk) 06:21, 19 September 2018 (UTC)

@Jytdog Personally, I don’t know the other users. However, there have been several recent press articles and scientific papers about low carbohydrate diets, particularly related to reversing diabetes. In the UK, the deputy leader of the main opposition party revealed a few days ago how it helped him to reverse his Type 2 diabetes and lose weight: https://www.theguardian.com/politics/2018/sep/12/tom-watson-reveals-he-has-type-2-diabetes-but-has-reversed-the-disease.— Preceding unsigned comment added by Dlactyol (talk • contribs) 07:23, 19 September 2018 (UTC)

Content

Now, to return to fixing the problems with the article, could you please revert my edits? The cited source is misquoted twice. And a basic question of any reader would be ‘what is a low carbohydrate diet?’. — Preceding unsigned comment added by Dlactyol (talk • contribs) 07:23, 19 September 2018 (UTC)

The problem is there has never been an established universal definition. I have restored a source we long had here which made that very point. Please do not invoke Tom Watson: celeb testimonials are the opposite of what we are looking for as reliable sources. Alexbrn (talk) 08:59, 19 September 2018 (UTC)

See my reply in the topic ‘Definitions’. This topic was about why there has been a surge of interest in this page. If one sticks only to published papers, the surge is clearly inexplicable. However, this article could usefully add a section on the popularity of a low-carbohydrate diet in spite of official dietary recommendations to the contrary. Celebrity recommendations and personal testimonies clearly have had an influence. obhi 09:49, 20 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

If there are good sources discussing the popular "surge" in low-carb dieting, they could be useful. Anthony Warner (chef) had written about the faddism aspect quite a bit ... Alexbrn (talk) 11:26, 20 September 2018 (UTC)

I made this a new section since it changed the topic of the thread above. Jytdog (talk) 20:41, 20 September 2018 (UTC)

I am not aware of an existing source which contains an analysis of why a low carbohydrate diet has become popular. Perhaps this article could have a section on ‘Popularity’. That could cover: - the influence of celebrity endorsements, particularly on social media - a growing number of health websites favouring a low carbohydrate diet obhi 23:33, 20 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

The article should mention the award-winning ‘low carb program’, an online course which has been followed by over 370,000 people since its launch in 2015. The program was recently approved for being prescribed by the UK’s National Health Service: https://diabetestimes.co.uk/nhs-green-light-for-low-carb-programme/ . obhi 23:43, 20 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

Research, health effects and references

The standalone section on ‘Health effects’ would appear to be an invitation to add unsubstantiated claims based on press articles. Should there not be a single section on ‘Research into health effects’?

There has been quite a lot of research into the health effects of restricting dietary carbohydrate intake. This recent compilation by a team of Czech researchers has identified around 100 papers and books about this: https://www.neslazeno.cz/odborna-literatura/ . Eight of these were published in 2018.

Presumably the findings of a number of these should be picked up in this section, grouped by health issue (as now)? That would both strengthen the ‘Research into health section and help to bring the article up-to-date. obhi 23:24, 20 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

Any sources for WP:Biomedical information must be WP:MEDRS - so in general "press articles" would not be acceptable. The intended purposes of the sections are set out at MOS:MED. The Zuuren review listed at the top of that Czech page we already use; the next, PMID 29596460, is from PLOS ONE which is a journal with a less-than-stellar reputation for consistency. Nevertheless the article makes no exceptional claims and could be fairly summarized by saying that "There is no good evidence that low-carbohydrate dieting is helpful in the management of type 1 diabetes." Alexbrn (talk) 06:02, 26 September 2018 (UTC)

Structure

Could we please introduce a logical structure for this article?

Such as:

Definitions (currently 'Definitions and Classifications' but with no classifications other than a misquote from the 2015 Feinmann paper)
[Remove the 'Adoption' section, which appears to have no content about adoption. The three paragraphs currently in this section could be included more appropriately in the 'Controversy' section.]

Research into health effects (currently three separate sections 'Health effects', 'Research' and 'History', but this separation could undermine the principle of verifiability) with chronological sub-sections similar to those of the current History section, namely:
- 1797-1900
- 1900-1960
- 1960-1990
- 1990-present

Controversy (currently 'Criticism and controversies') which should begin with the up-to-date, relevant positions of major government and medical organisations. Unclear why the American Heart Association position on high protein diets appears in this article - remove? Other quoted positions are from 2003 and 2008. Are they still valid? For example, earlier this week, the Australian Health Practitioner's Regulation Agency wrote to apologise to Dr Gary Fettke, dropping all charges against him for recommending a low-carbohydrate diet to his patients. In particular, "no significant risks to public safety have been identified that require a regulatory response under the National Law. In the case of each of the three issues considered, there is no evidence of any actual harm and nor does the Board discern any particular risk to public health and safety moving forward."

obhi 13:59, 29 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

"Health effects" (settled knowledge) should be distinct from "Research" (work underway). Having a criticsm / controvery section isn't great per WP:CRITS. Some of the problems in this article stem from the content of the (very poor) Medical research related to low-carbohydrate diets, the content of which was merged here. Alexbrn (talk) 14:46, 29 September 2018 (UTC)

Increased mortality and low-carb diets

Two recent studies suggest that low-carb diets may increase mortality This seems relevant for this article and should probably be added. Or what do editors which are more familiar with the topic and the WP article think? Lucleon (talk) 21:11, 30 September 2018 (UTC)

References

The second is unpublished, and we do not add content based on conference abstracts.

The first one is useful only for the meta-analysis portion. Is obvservational data only so we will need that caveat... Jytdog (talk) 22:47, 30 September 2018 (UTC)

Recent Studies

I was wanting to add some recent studies done on low carbohydrate diets. I found a creditable study done in Beijing about low carbohydrates having a anti-tumor effects. I wanted to add, In recent studies May 5th, 2018, a ketogenic diet has been published based off of the research done in Beijing. People’s Republic of China published the research stating “The ketogenic diet is a high-fat, very-low-carbohydrate diet that triggers a fasting state by decreasing glucose and increasing ketone bodies, such as beta-hydroxybutyrate. In experimental models and clinical trials the ketogenic diet has shown anti-tumor effects, possibly by reducing energy supplies to cells, which damage the tumor microenvironment and inhibit tumor growth.” According to the research concludes that “tumors with low ketolytic enzyme expression may be unable to metabolize ketones bodies, thus predicting a better response to ketogenic diet therapy.” I am also looking for other recent research to included diabetes. — Preceding unsigned comment added by Yellowdragon333 (talk • contribs) 01:13, 3 October 2018 (UTC)

Please read and follow WP:MEDRS. Primary sources are not good in WP. Jytdog (talk) 04:32, 3 October 2018 (UTC)

Thank you for replying. I found this information done by researchers from Capital Medical University and News reporter from staff news editor at obesity, fitness & wellness week. What makes an article a secondary sources? ::This is my first edit to an article and I want to learn what I am doing wrong. — Preceding unsigned comment added by Yellowdragon333 (talk • contribs) 01:06, 10 October 2018 (UTC)

There is a bunch of guidance at your user talk page - User talk:Yellowdragon333. Please take the time to read it. Jytdog (talk) 01:30, 10 October 2018 (UTC)

Picture

I added a new photo to the article. — Preceding unsigned comment added by Yellowdragon333 (talk • contribs) 20:37, 20 November 2018 (UTC)

Controversies

I added to controversies. — Preceding unsigned comment added by Yellowdragon333 (talk • contribs) 20:41, 20 November 2018 (UTC)

You added unsourced content and content sourced to a ref that is not OK per WP:MEDRS Jytdog (talk) 20:53, 20 November 2018 (UTC)

Weight Loss

Used the same source but changed the text. — Preceding unsigned comment added by Yellowdragon333 (talk • contribs) 18:08, 4 December 2018 (UTC)

... into nonsense. WP:V is a core policy and must be adhered to. Alexbrn (talk) 18:14, 4 December 2018 (UTC)

Diabetes

Updated information on Diabetes. I felt the info saying it didn't help was dated. — Preceding unsigned comment added by Yellowdragon333 (talk • contribs) 18:38, 4 December 2018 (UTC)

What you added did not make sense. Alexbrn (talk) 18:43, 4 December 2018 (UTC)

Definitions

This page has apparently had issues since July 2017. As it stands, it is very confusing. Probably because it has no logical structure. Surely this is not so difficult to fix?

The text under ‘Definition and Classification’ says nothing about Classification and misquotes the ‘Definitions’ section of Reference 2. The text under ‘Adoption’ says more about non-adoption than anything else. The ‘Health effects’ section is somehow disconnected from ‘Research’.

The ‘Criticisms and Controversies’ section feels redundant since criticisms and controversies have been peppered throughout the preceding sections. At the same time, references to popular diets which are low-carbohydrate according to the definitions are scattered randomly around the article. This does not really help the understanding of any reader.

My ‘plain English’ version of Table 1 of Reference 2 is as follows:

“Very low-carbohydrate or ketogenic diet: 20-50g carbohydrate per day (<10% of the daily recommended 2000 kcal/day). This is the recommended early phase (“induction”) of popular diets such as Atkins Diet or Protein Power.

Low-carbohydrate diet: <130 g carbohydrate per day (<26% total energy). The American Diabetes Association recommends a minimum of 130g carbohydrates per day.

Moderate-Carbohydrate Diet: 26%–45% of total energy. The upper limit is the approximate carbohydrate intake before the obesity epidemic (43%).

High-Carbohydrate Diet: >45% of total energy. The 2010 Dietary Guidelines for Americans recommends 45%–65% carbohydrate. The average American diet is estimated to be ∼49% carbohydrate.”

Jytdog kindly reversed my edit to insert these definitions from reference 2 as being unsourced, whereas actually the last part of the first sentence is based on the misquote from reference 2 and should be either deleted or replaced by “less than 130g of carbohydrates per day”.

I would therefore respectfully ask for my edits to be reinstated. obhi 05:05, 19 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

So, I left a message at your talk page about how we edit content about health in WP. You added unsourced content and removed well-sourced content. Sources drive everything we do here. Jytdog (talk) 06:22, 19 September 2018 (UTC)

Apparently not, since you appear determined to preserve misquotes from the cited source in the article - as pointed out above. Maybe it’s time to call in a second editor to help resolve this? — Preceding unsigned comment added by Dlactyol (talk • contribs) 08:19, 19 September 2018 (UTC)

Thank you for removing the last part of the first sentence, as I had proposed.

However, now this article cites a paper from 2007 saying that there is no definition. The previously cited paper from 2015 which specifies the definitions referenced in more recent research has been removed. The 2015 paper set out a table of definitions precisely because there was a lack of clarity in any communication about a low-carbohydrate diet. I am not sure how this respects Wikipedia’s third ‘pillar’.

So that you are aware, this article is overlooking several more recent research papers on the subject, both positive and negative. It is also difficult to follow why there is a section on claimed health effects which is disconnected from a somewhat incomplete section on Research. obhi 09:40, 20 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

The 2015 paper (which has some of the same authors as the 2007 paper now cited) says in its ‘Definitions’ section “A lack of agreed on definitions for low-carbohydrate diet has been a persistent barrier to communication. We propose the definitions in Table 1 to eliminate ambiguity. Each definition is based on use in multiple publications by those authors who have performed the experimental studies [3–6].”

Not obvious why it was necessary to reverse 7 years of accumulated research. The paper is here: https://www.nutritionjrnl.com/article/S0899-9007(14)00332-3/fulltext . obhi 10:54, 20 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

"saying that there is no definition" ← not what the paper says, and not what we say: read more carefully. That people are having to "propose" a definition reinforces the point that there isn't (yet) an agreed standard. Please WP:INDENT your posts as a courtesy to other editors. Alexbrn (talk) 11:03, 20 September 2018 (UTC)

[I was hoping my replies would be indented automatically but maybe this doesn’t work on the mobile site? When I attempted to indent my earlier reply, it turned the text bold!] The article currently says “Low-carbohydrate diets are not well-defined.” citing a paper from 2007. Then it cites a definition from 2006 (which appears to contradict the reference to a minimum daily dietary carbohydrate intake of 130g later in the article) The next citation from 2016 uses the same definition of very low carbohydrate or ketogenic diets as the originally cited 2015 paper.

The definitions proposed by the 2015 paper were based on a consensus of those carrying out research in this area. Clearly, subsequent papers have referenced the same definitions. Having previously been in contact with Professor Feinmann while researching this topic, I understand that no-one has contested these definitions.

So it does not appear well-founded to say that, in 2018, “Low-carbohydrate diets are not well-defined.”

To avoid confusion, I would propose including the full definitions from the 2015 paper - especially if the title of this section is to remain “Definition and classifications”.. The 2016 paper is, of course, a useful reference to keep in the article but perhaps not for its definition? obhi 20:38, 20 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

You can't use a source that says they are not well-defined, to say that they are. WP:V is a policy. Wikipedia reflects published knowledge and that may lag what is happening now. We should also only include a summary because summarizing is what we should do. Alexbrn (talk) 20:54, 20 September 2018 (UTC)

According to that logic, there will never, ever be a definition. Meanwhile, in the real world, the scientists working on this topic (who apparently do not include you, according to your user page) have been using precisely these definitions.

You seem to be very attached to never changing this article, in spite of current research. That does not seem to have anything to do with Wikipedia policy. obhi 05:51, 26 September 2018 (UTC) — Preceding unsigned comment added by Dlactyol (talk • contribs)

It's simple - if we have a definitive source (or a source saying there is a settled definition) we can use it. As it happens, one of the very sources you refer to below,[7] from 2018, makes the point that "Clarity is needed regarding appropriate classification of a low-carbohydrate diet". This is the current situation, and we reflect it faithfully. Your attempt to personalize this discussion is not welcome. Alexbrn (talk) 06:12, 26 September 2018 (UTC)

Unfortunately, it would appear from this talk page that almost every reversal on this article has come from you. This leaves the impression that this is some kind of a personal crusade, rather than a quest for a neutral, reliable article. I would respectfully suggest it is useful to keep the article up to date and not entirely reliant on medical references from 2003-2007. As another contributor has noted, there has been a lot of research in the past 10 years. For this, contributions from those who can improve the article should be welcomed. We all have limits to the time we can dedicate to contributing to Wikipedia articles ... .

Anyhow, as far as I have seen from my wider reading of the research material on this topic, the 2015 Feinmann paper does contain the definitions which have been used by subsequent research (ie randomised controlled trials). Of course, after stating these definitions, it is also perfectly reasonable to provide any citation which explains why the definitions of the 2015 Feinmann paper are inappropriate.

In case you were unaware, there has been a lot of disinformation on this topic for purely commercial reasons (see, for example, the controversial role of the Barilla Center for Food and Nutrition since 2009). This has muddied the waters. However, that does not mean that recent randomised controlled trials (rather than the systemic review of several studies you quote) do not use the same definitions.

At least, if the Definitions section of this article cites the 2015 Feinmann paper, it should quote its definitions based on grammes of carbohydrate (and not the estimated calorific equivalents of its definitions). Then it would be clear why it had defined a low-carbohydrate diet as any diet with less than 130g of carbohydrate per day. This statistic was identified in 2015 as the dietary reference intake of the US Institute of Medicine for adults in reference 8, although the Feinmann paper attributes it to the American Diabetes Association. Looking at the corresponding table today, this statistic would appear to have been reduced to 100g per day.

Note that there are two page notes at the top of this article. The first "Not to be confused with slow carb diet." links to a Wikipedia article about a book recommending an apparent variant of a low-carbohydrate diet. The second "This article is about low-carbohydrate diets as a lifestyle choice or for weight loss. For low-carbohydrate dietary therapy for epilepsy, see Ketogenic diet." perhaps predates the incorporation of the article on medical research on health effects of low-carbohydrate diets. In any case, one of the definitions from the 2015 Feinmann paper is for the 'Very low-carbohydrate or ketogenic diet'. So perhaps the contents of that separate article could be merged here too?

Several diets can be considered to be low-carbohydrate. Apart from Atkins, there are also Paleo, Pioppi, low-glycemic index, low-glycemic load, etc. These could all be mentioned in the appropriate chronological 'Research' section.

WP:FOC. Popular nonsense diets like the Paleo have their own article, and obscure nonsense ones like the Pioppi are mentioned in their inventor's article. I would oppose merging the ketogenic diet here as it's treated distinctly in most literature. Alexbrn (talk) 15:47, 29 September 2018 (UTC)

Hi, could you clarify what you mean by "nonsense diet" and why you consider Paleo to fall into this category?

@MichaelMArmstrong97: See our Paleolithic diet article for a description of the fallacy behind that particular diet. This is not the place to discuss it. Alexbrn (talk) 17:01, 6 December 2018 (UTC)

On a further note, the Ketogenic diet has a wikipedia page dedicated to its use as a treatment for epilepsy; however, this page refers the reader back here for specifics on its use as a weight loss treatment and as a lifestyle choice. Therefore, I feel it would be appropriate to include the diet on this page despite it being classified as a very low carbohydrate diet. — Preceding unsigned comment added by MichaelMArmstrong97 (talk • contribs) 16:33, 6 December 2018 (UTC)

You are right in that low-carbohydrate diets which induce ketosis may be covered - sources used of course must be WP:MEDRS. Alexbrn (talk) 17:01, 6 December 2018 (UTC)

Ok fair enough. I would also like to ask why you felt the information I added did not warrant a place on this page. I added and amended small sections across the page, all of which you removed. Any feedback or reasoning behind this would be greatly appreciated. Thanks. — Preceding unsigned comment added by MichaelMArmstrong97 (talk • contribs) 19:44, 6 December 2018 (UTC)

Trouble accessing a citation

How do I access this citation from the U.S.?

https://books.google.co.uk/books?id=mDhMU0Sv6asC&pg=PA341#v=onepage&q&f=false

Thanks!

Rsterbal (talk) 19:08, 15 December 2018 (UTC)

I have access to it, not sure how if you are from USA. It is a scientific analysis of "popular high-protein, low-carbohydrate diets". The authors conclude "claims that weight and health are best served by eliminating or greatly reducing intakes of whole grains, vegetables, milk, fruit, and other nutritious whole foods are baseless. To omit such foods is to eliminate nutrients, fibers, and phytochemicals with proven health benefits." One of their sources is "Low-Carbohydrate Diets: Assessing the Science and Knowledge Gaps, Summary of an ILSI North America Workshop", it is online for free [8] MatthewManchester1994 (talk) 21:55, 15 December 2018 (UTC)

Position of major governmental and medical organizations

With respect to the Reversal of Deletion of Diabetes Australia Positions Statement

The changes that I made to include the Diabetes Australia position on low carbohydrate diets for diabetes should stand.

(1) The article already includes positions from the American and Australian Heart foundations. These are very similar patient advocacy groups who review and also provide tertiary sourced medical advice.

(2) This is also tertiary sourced medical advice and meets the wikipedia policy for medical advice. In Australia, Diabetes Australia sets medical advice for diabetes management. It is the co-author with the Royal Australian College of General Practitioners (RACGP) for that. That sets the trusted advice used by all doctors in Australia for diabetes management. You will note the Diabetes Australia logo on the cover. There is no higher or better authority for medical advice for T2DM in Australia. No other governmental or medical authority supercedes this advice.

(3) The specific position statement that is referred to is a comprehensive tertiary source with 24 scientific papers referred to. It was written by a committee of experts namely: The members of the Expert Advisory Working Group include: • Dr Tony Russell, MBBS PhD FRACP, Princess Alexandra Hospital, Brisbane • Dr Kirstine Bell, APD and CDE, University of Sydney • Rebecca Flavel, APD and CDE, Diabetes WA • Dale Cooke, APD, Diabetes Queensland • Caroline Clark, APD, Diabetes NSW and ACT • Jane Robinson, APD, Diabetes Victoria • Minke Hoekstra, APD, Diabetes Tasmania

These are the leading diabetes dietitians in Australia.

On that basis I do not believe the deletion reason is valid and respectfully request that my edits, which are factually valid and consistent with the section of the article they were made under & compliant with WP standards, are restored.

References

MetabolicMadness (talk) 00:05, 11 December 2018 (UTC)

We shouldn't use patient advocacy groups for biomedical content; rather WP:MEDRS should be used. If the views here are accepted knowledge, it should be easy to find such. More generally, why do we even have this section about "positions"? Alexbrn (talk) 06:44, 11 December 2018 (UTC)

In Reply: These 'Patient advocacy groups' as you label them, are for diabetes the arbiters of scientific consensus on the management of the disease. It is entirely consistent with WP:MEDRS and reflects scientific consensus for Australia. The cited reference signals the acceptance of low carbohydrate diets which changed in Australia in August 2018. This change is overdue for inclusion on Wikipedia and it would be a mistake not to reflect that before the end of the year now that it has been added and embedded in policy. Please address specifically why this is not in accordance with WP:MEDRS rather than implying that the independent review by scientists, doctors and dietitians sponsored by diabetes organisations is somehow unscientific. Are you concerned that they have a COI to not act with the best current advice for people with diabetes making this advice scientifically unsound?

To omit this particular reference reflecting the consensus in Australia by now suggesting the whole section be deleted is not warranted. The difference of opinions between countries and organisations is important for international readers of Wikipedia to understand. As stated these major organisations reflect consensus in national jurisdictions. Wikipedia is international and should represent national consensus where that is the level at which it is achieved. I note that in the area of diabetes there is no international consensus that rules dietary advice for type 2 diabetes to supercede this. MetabolicMadness (talk) 10:00, 11 December 2018 (UTC)

We proceed by the WP:PAGs. Diabetes Australia describe themselves as an advocacy organization: "Diabetes Australia is the leading diabetes advocacy organisation in Australia. We represent the interest of all people affected by diabetes by advocating and lobbying the Australian Government ...". Science is not regional. Feel free to check at WT:MED if you judge this to be WP:MEDRS. Alexbrn (talk) 10:12, 11 December 2018 (UTC)

Alexbrn, passing comment: an advocacy agency in Australia does not imply an bias per se, except perhaps against diabetes. I would expect an agency of this type, as it is understood in this context, to be a reliable source if they are endorsed by the medical community and so on. cygnis insignis 06:12, 12 December 2018 (UTC)

You still have not justified why this is not WP:MEDRS. You are the deleter and the onus is on you to show why, against the information I have posted above detailing the scientific pedigree of Australian consensus it does not meet the WP:MEDRS standard. I also agree science is not regional. In fact the position statements of (1) Diabetes UK (2) The American Diabetes Association & (3) European Association for the Study of Diabetes (EASD) all almost exactly concur with Diabetes Australia on this. Please also note that EASD is not dismissable as an advocacy organisation. As I have gone to great length to explain, these "advocacy organisations" in diabetes are the premier scientific sources for diabetes science and you dismissing there role in achieving scientific consensus because they are advocacy organisations (& therefore unreliable) shows that you are not familiar with this area. Please restore my original addition for Diabetes Australia and confirm that you will not delete when I add the updated position statements of the other three organisations. This issue is clearly one where science has moved on. It is time to reflect that in Wikipedia or it will be substantially out of date and will not reflect the current worldwide consensus view of scientists on this topic. If this is beyond you then please defer to someone with more expertise in this area. This has been a very frustrating experience for me, a new user, to update something which is clearly out of date and should be an easy change. Why do I have to go to all these lengths to make a change that is so obvious and in line with scientific standards and consensus on this topic? I have had to write about ten times the words of the original edit which was 100% factual, scientific and correct. MetabolicMadness (talk) 14:27, 11 December 2018 (UTC)

In fact if properly summarized (i.e.: doesn't help T1D; no long-term benefit for T2D; no single diet is recommended; there are safety concerns; don't use without peofessional guidance) this source is perfectly sensible - but we need to be using better sources because of our policies. I have nothing to add to my previous comments as regards policy. Alexbrn (talk) 14:35, 11 December 2018 (UTC)

Then do not delete, edit to properly summarise better or request that I do that. Isn't that how wikipedia is supposed to work? A collaborative effort to get to a better more knowledgeable outcome. Instead it seems to encourage an edit war which I have tried to avoid, however, I note that the words I used were near verbatim from the source so I do not think your criticism is warranted. You state that we should use better sources. What are those better sources particularly when this section is meant for the position statements of major medical and governmental organisations like DA, DUK, ADA and EASD which is what I posted. As such, they are a factual statement of the positions of those organisations regardless of whether they coordinate the consensus as advocacy organisations or not. MetabolicMadness (talk) 14:54, 11 December 2018 (UTC)

I note that the solution to being wrong about scientific consensus on the low carbohydrate diet for diabetes was simply to remove the section; however I note that in removing the section you have removed the position of the American Dietetic Association (ADA) on Low Carb diets. The ADA is not specifically not a patient advocate organisation. It is a major dietetic science organisation. Please restore this section and the ADA's position. I do not see how you can justify that the ADA should be deleted. Further I have thoroughly read WP:MEDRS and it makes no mention of patient advocate sources not meeting the standard. Notwithstanding the practice worldwide is for diabetes not for profits to manage scientific consensus on lifestyle and diet for diabetes which I have explained to you. Indeed the position statement that I posted which caused you to delete this whole section was a strong tertiary reference. Could you please explain the clear reasons for your behaviour referenced to relevant sections of WP:MEDRS as I have requested now numerous times. To a new user this appears to be vandalistic and unreasonable behaviour to my first very simple edit. Why? MetabolicMadness (talk) 05:17, 12 December 2018 (UTC)

Can't prove a negative. The writings of patient advocacy groups are not MEDRS. As I said, check at WT:MED if not sure. I don't think the source is "wrong" but Wp:V is a core policy and it is vital we use the best sources. The effect on diabetes and weight loss is covered earlier in the article. Alexbrn (talk) 07:21, 12 December 2018 (UTC)

Still genuinely perplexed. I've read WP:MEDRS and WT:MED and can't find any reference to patient advocacy groups as unreliable sources. There is a reference related to "Need eyes on diabetes and related articles" mentioning SPAs but this has nothing to do with the diabetes organisations. Once again I must underline that the role of diabetes not for profits in almost every country is to form scientific consensus on management with other organisations and produce THE last word on the science behind treatment and management (such as diet) often in conjunction with other medical and scientific organisations. cygnis insignis mentioned this too. If you read the wikipedia page Diabetes Australia, this role is made quite clear. A further example is the joint position statement of EASD and the American Diabetes that I foreshadowed to add just before you deleted the whole section effectively denying that. These don't just form valid tertiary references around diet and diabetes, they are the last word & gold standard. I've continually asked for specific references in WP:MEDRS and now I ask for the specific parts of WT:MED that justify the disallowance of these gold standard (for diabetes) tertiary references. At the moment the only evidence cited in the wikipedia article for low carb diets and diabetes is a single review papers (one for type 1 & one for type 2) which is of lesser weight and evidence than the position statements of these organisations. Are you saying that one single paper of evidence that a Wikipedia editor picks supercedes a group of experts in the area that review all the current evidence because it was organised by a diabetes charity who are specifically on a mission to get the best advice to people with diabetes? I am all for upholding and complying with policies on Wikipedia but in this case I fail to see any policy being applied in justification for these edits. — Preceding unsigned comment added by MetabolicMadness (talk • contribs) 00:45, 13 December 2018 (UTC)

To repeat, I cannot prove a negative. MEDRS generally guides what we should do, not what we should not do. Note iin general we prefer secondary sources. Once again, if in doubt raise a query as WT:MED. If there is more knowledge we can reflect in our Diabetes section then great - but what we have looks up-to-date and well-sourced. Alexbrn (talk) 04:10, 13 December 2018 (UTC)

It is only getting repetitious because I have asked for you to point to the section of WP:MEDRS and/or WT:MED that justify your exclusion of gold standard tertiary level scientific statements for the low carbohydrate diet and I am still none the wiser. If you are saying however that these might be acceptable if merged into the diabetes section please advise and I will propose something. MetabolicMadness (talk) 05:42, 13 December 2018 (UTC)

You obviously do not understand what I am writing: I am sorry but I cannot be more clear. Alexbrn (talk) 05:56, 13 December 2018 (UTC)

I understand what you are saying. You are saying that these are low quality/ primary sources because they come from patient advocacy groups AND that policies don't prohibit, only allow, and that these are too low quality to be allowed. Firstly my bad, on looking at the definition in WP:MEDRS these are secondary sources not tertiary as I had said before.

So let us try and resolve this by taking another tack. Here are the reasons why the information that I have tried to convey to Wikipedia readers is consistent with WP:MEDRS and should be included.

From WP:MEDRS This page in a nutshell: Ideal sources for biomedical material include literature reviews or systematic reviews in reliable, third-party, published secondary sources (such as reputable medical journals), recognised standard textbooks by experts in a field, or medical guidelines and position statements from national or international expert bodies.

Note the bold. So in a nutshell, the section you deleted has removed that information source in this topic. My edit that you originally squashed was one very relevant position statement. It should be included as should the whole section you deleted.

This answers your question above: More generally, why do we even have this section about "positions"? This section is included because it is an important part of WP:MEDRS

Then throughout WP:MEDRS Ideal sources for biomedical information include: ... position statements from national or international expert bodies.

WP:MEDDEF A secondary source in medicine summarizes one or more primary or secondary sources, usually to provide an overview of current understanding of the topic, to make recommendations, or to combine results of several studies. Examples include ... medical guidelines or position statements published by major health organizations.

WP:MEDSCI Wikipedia policies on the neutral point of view and not publishing original research demand that we present prevailing medical or scientific consensus, which can be found in recent, authoritative review articles, in statements and practice guidelines issued by major professional medical or scientific societies (for example, the European Society of Cardiology or the Infectious Disease Society of America) and widely respected governmental and quasi-governmental health authorities (for example, AHRQ, USPSTF, NICE, and WHO), in textbooks, or in some forms of monographs. Although significant-minority views are welcome in Wikipedia, such views must be presented in the context of their acceptance by experts in the field. Additionally, the views of tiny minorities need not be reported.

WP:MEDASSESS Medical guidelines or position statements by nationally or internationally recognized expert bodies also often contain assessments of underlying evidence.

WP:MEDORG Guidelines and position statements provided by major medical and scientific organizations are important on Wikipedia because they present recommendations and opinions that many caregivers rely upon (or may even be legally obliged to follow)

Now that I have proven the positive of why this information is to be included by the strong preference to include this information explicitly in WP:MEDRS now explain to you why I am frustrated by your deletions?

Could we please revert with any appropriate edits that you now feel is necessary? Thanks. MetabolicMadness (talk) 12:02, 13 December 2018 (UTC)

Major bodies are good (e.g. the WHO, CDC, or CRUK). Patient groups are not. We're not going to produce a list of "positions" of every body on every treatment because that is not encyclopedic. Anyway the point is now moot since the material on diabetes is in the diabetes section. Our job is to summarize accepted knowledge on this topic from the best sources. My question is - is anything missing? Alexbrn (talk) 12:18, 13 December 2018 (UTC)

Yes. Consistent with WP:MEDRS The following are missing with the whole section now deleted.

medical guidelines and position statements from national or international expert bodies (From Nutshell- note we no longer satisfy the nutshell with this page)

WP:MEDASSESS Medical guidelines or position statements by nationally or internationally recognized expert bodies also often contain assessments of underlying evidence. Where are the assessments of the underlying evidence as required by WP:MEDASSESS? Seems missing.

WP:MEDORG Guidelines and position statements provided by major medical and scientific organizations are important on Wikipedia because they present recommendations and opinions that many caregivers rely upon (or may even be legally obliged to follow) Seems missing

I fully understand that you hold diabetes not for profits in low esteem for their advice on the best way for patients to manage their disease; but there are positions by other organisations that should be included. — Preceding unsigned comment added by MetabolicMadness (talk • contribs) 05:36, 16 December 2018 (UTC)

Now that you're going personal and saying crass things I suspect it is time to draw this to a close. We don't do lists of "positions"; we reflect accepted knowledge in a topic. Meanwhile, we have new content: a consensus report on Type 2 Diabetes by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). This was just added to the article, summarized in-place, in just the way we are meant to. Alexbrn (talk) 07:38, 16 December 2018 (UTC)

Sorry if I offended but I don't think my comments have been personal even if I have some different opinions. I agree that EASD is a major (non-patient group) scientific body and that their consensus report is a good addition that reflects the flavour of other groups.MetabolicMadness (talk) 00:30, 18 December 2018 (UTC)

MetabolicMadness, these are or were appropriate secondary sources, attribution is likely to be relevant to their positions. However, in my estimation, there is likely to be a more productive use of your time than getting this content restored, at least, I try to keep that option in mind when I venture into these discussions. cygnis insignis 13:40, 13 December 2018 (UTC)

This is found in the linked source, not "over-egging the pudding"

"a low-carbohydrate diet was eclipsed by both the Mediterranean diet and a low-carbohydrate version of the Mediterranean diet in helping improve glycemic control, and that diet (including low-carbohydrate diets) could play a useful part in long-term diabetes management, but that "there is no single ratio of carbohydrate, proteins, and fat intake that is optimal for every person with type 2 diabetes"

This page is going to lose the neutral voice if information positive about LC diets is consistently deleted in favor of information that is unfavorable.

It should be noted in the Diabetes section of the LC diet page that LC diets are included as a dietary option for diabetes.

A low-carb high fat dieter (talk) 00:08, 17 December 2018 (UTC)

I do not have a problem with your edit apart from your comment "could play a useful part in long-term diabetes management". Because the reference actually says this:

Low-carbohydrate, low glycemic index, and high-protein diets, and the Dietary Approaches to Stop Hyper-tension (DASH) diet all improve glycemic control, but the effect of the Mediterranean eating pattern appears to be the greatest (70–72). Low-carbohydrate diets (,26% of total energy) produce substantial reductions in HbA1cat 3 month s (25.2mmol/mol, 95% CI 27.8, 22.5 mmol/mol[20.47%, 95% CI 20.71%, 20.23%]) and 6 months (4.0 mmol/mol, 95% CI 26.8,21.0 mmol/mol [20.36%, 95% CI 20.62%,20.09%]), with diminishing effects at 12 and 24 months; no benefit of moderate carbohydrate restriction (26–45%) was observed.

Diminishing effects at 12 and 24 months. This does not support your statement that a low-carb diet could be useful in long-term diabetes management. The paper is online for free so anyone can read it [9]. MatthewManchester1994 (talk) 03:31, 17 December 2018 (UTC)

@Alexbrn:, I may have got this wrong so I self-reverted, but the paper does not support results which suggest low-carbohydrate diets can contribute to long-term diabetes management. The reference cited in the above paper, found that "Carbohydrate-restricted diets, in particular those that restrict carbohydrate to <26% of total energy, produced greater reductions in HbA1c at 3 months (WMD -0.47%, 95% CI: -0.71, -0.23) and 6 months (WMD -0.36%, 95% CI: -0.62, -0.09), with no significant difference at 12 or 24 months." [10]. This is not long-term. Interestingly, the British Dietetic Association mentions this study and suggests:

Low-carbohydrate diets (i.e. defined as diets containing between 50g and 130g carbohydrate) can be effective in managing weight, improving glycaemic control and cardiovascular risk in people with Type 2 diabetes in the short term i.e. less than 12 months (Diabetes UK 2018). This is probably due to the accompanying reduction in energy (calorie) intake and subsequent weight loss (Diabetes UK 2018).

More research is needed to determine the effect of long-term adherence (over 12 months) to low carbohydrate diets (as defined above) on blood glucose control (and therefore control of diabetes), and also the effect on heart health in people with type 2 diabetes. [11]

(my bold) - I am not seeing any evidence for anything long-term here. As you have more experience in this field and have edited this article I would be interested in your opinion. MatthewManchester1994 (talk) 03:56, 17 December 2018 (UTC)

Also see Evidence-based nutrition guidelines for the prevention and management of diabetes, which is a goldmine of useful information. There is currently no evidence low-carbohydrate diets can play a useful part in long-term diabetes management. That sentence about long-term should be removed from the article. MatthewManchester1994 (talk) 04:04, 17 December 2018 (UTC)

It was over-egged. The source (which is mostly making drug recommendations) makes no recommendation for the low-carb diet. You are picking the data out of the text to arrive at different conclusions to the text itself, which is a big no-no. Pretty much all sources agree that low-carb diet can be just a.n.other way to lose weight and so it is maybe useful in the short term. That's it. What we don't want to be doing is buying into the fashionable hype "out there" that this diet has some kind of special benefit. We must also avoid clichés like "further research is needed". Alexbrn (talk) 07:03, 17 December 2018 (UTC)

I agree, A low-carb high fat dieter was getting a bit carried away with the source, it does not actually recommend the diet. He also added a line to the article "The Mediterranean and low-carbohydrate Mediterranean were found most effective in some studies" but does not list a source for that claim. Are you alright with this @CarbShark: ? MatthewManchester1994 (talk) 08:42, 17 December 2018 (UTC)

Not really - the source seems to be saying there's a load of viable options to lose weight and the consensus statement doesn't favour any of them. To the contrary, the point is made that there is no "one size fits all" diet. The one diet that is singled out is the Mediterranean one, almost as an aside. Alexbrn (talk) 08:52, 17 December 2018 (UTC)

Here is what report says:

″An individualized program of MNT should be offered to all patients.″"

Then they defined MNT

"Medical Nutrition Therapy: MNT comprises education and support to help patients adopt healthy eating patterns.″

Then, the report discusses healthy eating patterns.

This includes: Improved glycemic control from Mediterranean diets in three studies; one of which was a low-carb Mediterranean style diet that had the best results over 4 years.

It also reported good results for Mediterranean diet; low carb diet; low glycemic index and high protein diet; DASH diet, with the Mediterranean diet having the best results.

It then recommends:

″Consensus recommendation

All overweight and obese patients with diabetes should be advised of the health benefits of weight loss and encouraged to engage in a program of intensive lifestyle management, which may include food substitution.″

To distill all this into the single takeaway "The Mediterranean diet eclipsed the low carbohydrate diet" is hardly neutral.

And, no, this is not "getting carried away." This paper marks the first time the ADA has recognized LC diet as a potential therapy for diabetes.

A low-carb high fat dieter (talk) 23:39, 17 December 2018 (UTC)

And, yes the paper did recognize other diets (Mediterranean; LC Mediterranean; LGI/HP; DASH). That can be mentioned here (as I proposed) and should be mentioned on the diet pages for those diets as well. A low-carb high fat dieter (talk) 23:45, 17 December 2018 (UTC)

You are cherry-picking a tiny piece of text and misrepresenting that reference. A low-carb diet is already mentioned on the article as potential diet management for diabetes but there is no evidence for any long-term health benefits. You want to promote LCHF on Wikipedia I get that but do you not have any better sources? MatthewManchester1994 (talk) 00:19, 18 December 2018 (UTC)

I'm not promoting anything, but trying to make this page as accurate as possible.

In this case, the source is the ADA and its European equivalent, which is a pretty good source for MNT as Diabetes treatment.

And, no, this is not a tiny piece of text, it's basically the entire section on MNT, which includes LC diets and should be summarized here.

But to dismiss what they're reporting by singling out the one item comparing Mediterranean and LC, while ignoring the rest is pretty much the definition of cherry picking.

Four years is considered long term for most therapies, and there is exactly as much long term data on other MNTs as there is on LC.

If the term "long-term" is the issue then we can substitute 1, 2 and 4 years as appropriate. A low-carb high fat dieter (talk) 00:46, 18 December 2018 (UTC)

Lifestyle Management: Standards of Medical Care in Diabetes 2019

The ADA has for the first time included LC diets in their recommendations for Diabetes and weight loss. I added a well sourced entry summarizing what the ADA said and that was immediately changed to a highly biased, cherry picked misrepresentation.

Wiki is supposed to have the neutral voice, but this is becoming absurd.

The ADA is recommending LC diets for diabetes as part of their standard of care. That should be fairly and honestly included in the LC Diet page with out bias and without slanted mischaracterizations. — Preceding unsigned comment added by CarbShark (talk • contribs) 08:58, 18 December 2018 (UTC)

Misrepresenting sources is very bad. So doing things like ignoring cautions in the source and failing to summarize what it actually says goes beyond carelessness and into problematic POV-pushing. You are warned. Alexbrn (talk) 09:02, 18 December 2018 (UTC)

I'm sorry, but I'm not the one misrepresenting that source. Did you read the whole section of the ADA article? A low-carb high fat dieter (talk) 09:24, 18 December 2018 (UTC)

Obviously. Alexbrn (talk) 09:32, 18 December 2018 (UTC)

"The ADA is recommending LC diets for diabetes as part of their standard of care", no this is not the case. MatthewManchester1994 (talk) 15:26, 18 December 2018 (UTC)

This is the section of the ADA Standard of Care for Diabetes that includes the option to use LC diets as recommended treatment for T2D. Alexbrn's edit is clearly cherry picking and biased against LC diets.

But the new ADA standard of care for the first time includes LC diets as part of their recommendation for diet therapy for T2D. This is a major change for ADA and should be noted here as accurately and fairly as possible.

For people with type 2 diabetes or prediabetes, low-carbohydrate eating plans show potential to improve glycemia and lipid outcomes for up to 1 year (62–64,86–89).

Multiple randomized controlled trials including patients with type 2 diabetes have reported that a Mediterranean-style eating pattern (75,108–113), rich in polyunsaturated and monounsaturated fats, can improve both glycemic control and blood lipids.

The Mediterranean (55,56), Dietary Approaches to Stop Hypertension (DASH) (57–59), and plant-based (60,61) diets are all examples of healthful eating patterns that have shown positive results in research, but individualized meal planning should focus on personal preferences, needs, and goals. In addition, research indicates that low-carbohydrate eating plans may result in improved glycemia and have the potential to reduce antihyperglycemic medications for individuals with type 2 diabetes (62–64). As research studies on some low-carbohydrate eating plans generally indicate challenges with long-term sustainability, it is important to reassess and individualize meal plan guidance regularly for those interested in this approach. This meal plan is not recommended at this time for women who are pregnant or lactating, people with or at risk for disordered eating, or people who have renal disease, and it should be used with caution in patients taking sodium–glucose cotransporter 2 (SGLT2) inhibitors due to the potential risk of ketoacidosis (65,66).

I will edit with a somewhat longer version, with more precise language.

A low-carb high fat dieter (talk) 16:10, 18 December 2018 (UTC)

Don't - we're already saying way too much about diabetes (and it's the same info reprised three times, essentially). "Show potential to improve" does not equate to "is recommended". Alexbrn (talk) 16:15, 18 December 2018 (UTC)

If it's the case that the diabetes section is too long then this should be removed, as it's directly contradicted by the ADA Standard for care:

"There is no good evidence that low-carbohydrate dieting is helpful in the management of type 1 diabetes, and only weak evidence that carbohydrate reduction in an otherwise healthy diet is helpful in managing type 2 diabetes,[19][4] as a low-carbohydrate diet gave only slightly better control of glucose metabolism than a low-fat diet.[20][21]"

It's interesting that the low-fat diet that the ADA used to recommend is not mentioned in their new Standard of Care.

In their recommendations they spell out the criteria for MNT, and then list the diets that have shown evidence they meet those criteria. I think any medical professional would consider referring to that as a recommendation is reasonable. A low-carb high fat dieter (talk) 20:17, 18 December 2018 (UTC)

You could always ask at WT:MED, where many medical professionals would happily assess your edit. Alexbrn (talk) 20:24, 18 December 2018 (UTC)

The comment on what is recommended is this "There is no single ratio of carbohydrate, proteins, and fat intake that is optimal for every person with type 2 diabetes. Instead, there are many good options and professional guidelines usually recommend individually selected eating patterns that emphasize foods of demonstrated health benefit, that minimize foods of demonstrated harm, and that accommodate patient preference and metabolic needs, with the goal of identifying healthy dietary habits that are feasible and sustainable." A LC diet is one option but may not be as good as a mediterranean diet. Doc James (talk · contribs · email) 00:31, 19 December 2018 (UTC)

Is there such a thing as the Low Insulin Index diet?

In google searches I'm only seeing a couple talking about this in general terms, but no actual diet plan. I don't see any books or publications on an insulin index diet, and a pub med search turns up info on the Insulin Index, but no low insulin index diet.

I don't think the following belongs here: "The low-insulin-index diet, is similar, except it is based on measurements of direct insulemic responses i.e., the amount of insulin in the bloodstream to food rather than glycemic response to the amount of glucose in the bloodstream. Although such diet recommendations mostly involve lowering nutritive carbohydrates, some low-carbohydrate foods are discouraged, as well (e.g., beef)." (whoops, forgot to sign) CarbShark (talk) 21:56, 20 December 2018 (UTC)

Popular misconception

A popular misconception driving adoption of the diet for weight loss, is that by reducing carbohydrate intake dieters can in some way avoid weight gain from the calories in other macronutrients. However any weight loss resulting from a low-carbohydrate diet probably comes merely from reduced overall calorie intake.

The first time I clicked on the link the page would not display. The second time the page displayed. When I cleared browser history and clicked on the link the page would not display.

It's probably not a good idea to link to pages inside google books.

Further, it's also probably better to discuss what the diet and nutritional professionals who advocate LC diets say than popular misconceptions.

This paragraph should be removed or replaced for those reasons.— Preceding unsigned comment added by CarbShark (talk • contribs) 20:10, 13 December 2018 (UTC)

References

We reflect what RS says, duly - without editorial spin on what it's "better" to omit. That ways lies POV pushing. As to Google books - yeah it's flaky - but what can one do? Alexbrn (talk) 20:15, 13 December 2018 (UTC)

The research, including the papers cited in this article, show that when carbohydrate consumption is restricted, and fat consumption is allowed ad libitum (no limit on calories) that dieters consume fewer calories than on other diets. So how about this:

"Studies show that when carbohydrate consumption is restricted, and fat consumption is allowed ad libitum (no limit on calories), that dieters consume fewer calories than those on calorie restricted diets." With a reference to the Noakes paper cited previously. A low-carb high fat dieter (talk) 15:40, 16 December 2018 (UTC)

That doesn't, though, contradict what we're saying about a popular misconception. Also the source doesn't seem to be saying "fewer", but "not necessarily more" - which is subtly different. The Noakes review seems to be claiming these possible effects come from increased satiety. However since Noakes is a controversial figure and a sports medicine journal is a bit of an odd venue for this work, there is a WP:REDFLAG fluttering. I want to see better sourcing. Alexbrn (talk) 15:56, 16 December 2018 (UTC)

There are competing hypotheses in the field of diet and nutrition. So why are we discussing a "popular misconception"? Is it not better to accurately portray what the alternative hypothesis is?

Also the Noakes article has been part of this page for some time and accurately shows what the diet trials found. Why is it suddenly suspect? A low-carb high fat dieter (talk) 01:40, 18 December 2018 (UTC)

Also, I was referring to this Noakes article in BMJ (not a sports journal). Refer to table 2 for the info on calorie restriction: https://bjsm.bmj.com/content/51/2/133.longA low-carb high fat dieter (talk) 01:45, 18 December 2018 (UTC)

That's not The BMJ' (BMJ Group publish many journals, including this sports medicine one). Wikipedia's job is not to air hypotheses - especially fringey ones - but to reflect accepted knowledge. Alexbrn (talk) 06:57, 18 December 2018 (UTC)

Fringy? That's the neutral voice?A low-carb high fat dieter (talk) 08:33, 18 December 2018 (UTC)

This particular phrasing, even though it comes straight from the citation, is not very encyclopedic. "Probably"? That looks like unreliable speculation to me, even though it's in the book. There are other citations which say that low-carb diets have positive effects regardless of the number of calories consumed. For example, "Overall, the data show a significantly greater improvement in lipid profile as carbohydrate is reduced even if this change is not accompanied by caloric reduction" comes from https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-3-24 . This puts paid to "probably". Can we remove it now? RussNelson (talk) 13:44, 21 December 2018 (UTC)

Since evidence-based medicine is built largely on statistics, probability is pretty hard to avoid! The point about lipid profiles is not relevant - what this is saying is that there is a popular misconception that somehow low-carb diets somehow prevent you gaining weight from other macronutrients. That's a fairly unexceptional claim. The source is good. Alexbrn (talk) 13:48, 21 December 2018 (UTC)

Why are you so insistent on leaving this in the article when it is quite controversial? There is no consensus on leaving it in, yet you have reverted it multiple times. The citation does not support your claim that "probably" comes from statistics. It is more in the realm of speculation. Caloric intake is FAR more complicated than the citation says. For example, it makes no discussion of the calories that exit the body via elimination, without ever being burned as energy or stored as fat. WP:VNOTSUFF RussNelson (talk) 14:02, 21 December 2018 (UTC)

It's not controversial (apart from for those labouring under the misconception it describes, maybe). We go by high-quality, reliable sources to emsure the article is properly reflecting accepted knowledge on the topic. Alexbrn (talk) 14:08, 21 December 2018 (UTC)

There is no consensus that this paragraph should remain in the article. You think it should, and several people think it shouldn't. RussNelson (talk) 15:23, 21 December 2018 (UTC)

May I suggest ("laboring under the misconception it describes") that you are pushing a personal POV? WP:NPOV RussNelson (talk) 15:25, 21 December 2018 (UTC)

Consensus is not a vote, and bad suggestions against the grain of the WP:PAGs have no worth. We especially don't allow the fine gauge of consensus to be dirtied by meat puppetry. As to your "suggestion", see here. Alexbrn (talk) 15:30, 21 December 2018 (UTC)

As to your "refutation", I simply note that you jumped right at WP:MEAT when confronted with multiple people who think this paragraph is rubbish. You STILL have not justified your repeated reverting of removing this paragraph. It's just one tiny bit of an article, and not a very good bit. Your reversions constitute evidence that you are attempting to own this article. Stop it. RussNelson (talk) 15:50, 21 December 2018 (UTC)

Hey, Angela Stanton do you have a citation to a paper that refutes the idea that a low-carb diet probably causes weight loss because fewer calories are ingested? It seems that it's not possible to remove this text, but if we can refute it with a reliable citation, we can add that after the "probably" sentence. RussNelson (talk) 16:17, 21 December 2018 (UTC)

This paragraph is still unreliable. The claim that diet books are a "popular misconception" doesn't mention specific diet books, not even one. The claim that "probably" comes from statistics is not justified by the citation. The claim that all calories either turn into fat or energy is not supported by the citation (it doesn't discuss eliminated calories). Because of WP:VNOTSUFF, I'm removing it. Feel free to restore it after documenting why "probably" is in fact due to statistics and not merely idle speculation, and citing something which makes reference to the total measurement of calories invested versus calories stored or converted to energy or eliminated as waste. Calories in does equal calories out (if you measure humans like a test tube), but you'd never know that from the citation. RussNelson (talk) 05:55, 22 December 2018 (UTC)

It is not "unreliable". You cannot keep deleting content because you personally don't like it - and edit warring risks you getting blocked. If you want to widen consensus why not raise this at WT:MED, where this diet is already being discussed? 06:07, 22 December 2018 (UTC)

Cause of Diabetes

I suggest this:

The proportion of total carbohydrate in a diet is not linked to the risk of onset of Type 2 diabetes. However, some evidence indicates the large percentage of calories consumed as refined carbohydrates is positively correlated with increased incidence of metabolic disorders including type 2 diabetes.

CarbShark (talk) 04:45, 22 December 2018 (UTC)

References

It is not a reliable source per WP:MEDRS, and is straying too far from the topic of dieting. However, the SACN report does make the point that there is a link between sugary drinks and diabetes - maybe this is useful for context: I've added it, see what you think ... Alexbrn (talk) 04:53, 22 December 2018 (UTC)

That part is better. That source is cited elsewhere in the document. Not sure why it's suddenly not reliable.CarbShark (talk) 15:24, 22 December 2018 (UTC)

The SACN report also indicates that a high intake of white rice is linked to t2d, but higher than is common in GB.CarbShark (talk) 15:24, 22 December 2018 (UTC)

Cool - I've added white rice and a general caveat for specific foods. As for PMID 15113714 - yikes! that's primary research and we shouldn't be using that to support health claims. Alexbrn (talk) 15:46, 22 December 2018 (UTC)

Foodstuffs

Going all the way back to Banting's diet in the 19th century most major low carb diets have adopted have adopted a fairly uniform food list that includes what to eat, what to restrict and what to completely avoid. If you google "Low Carb page 4" you'll find numerous hits like this one: https://www.dietdoctor.com/se/wp-content/2014/10/no_sugar_no_starch_diet.pdf

The entire list was included in the fourth page of the handout given to patients at Dr. E Westman's obesity clinic at Duke University staring in the 1970s and the name stuck.

So my question is, wouldn't it be better (more informative) to link a source that accurately represents that list of foods?CarbShark (talk) 18:09, 23 December 2018 (UTC)

Yes. I think with one cautious eye on WP:NOTHOWTO is would be great to have some authoritative sourcing on the kinds of food found in an LC diet. What are the best sources for this? Alexbrn (talk) 18:27, 23 December 2018 (UTC)

Links in references

The link to the AKF wiki page does not support the claim made. A search for the title of the article does not provide a source that meets wiki standards, and is not linked to on the wiki page. Further, the title of the article refers to a high-protein diets. LC diets are moderate protein, and without looking at the original source, we cannot determine what level of protein they are referring to or if it applies at all to the LC diets. This link should be removed or replaced with a link to the source that meets the WIKI standards. CarbShark (talk) 19:05, 6 January 2019 (UTC)

The other reverted link correction simply linked to the source rather than the pubmed page. No sure why that was reverted. CarbShark (talk) 19:05, 6 January 2019 (UTC)

When we have a DOI it already links to the article correctly - so there's no need to have a direct link too (in fact the DOI is better since it will resolve correctly in the long term - if the journal switches publisher for example). Alexbrn (talk) 19:09, 6 January 2019 (UTC)

OK, if one form of link is better and more reliable, then we should use that. To use two different links to the same article can be misleading, and create a false sense of a consensus, when it's two links to the same source. We should decide on the best way to link to that document and use that in all references (as per Wiki style). (whoops, forgot to sign) CarbShark (talk) 03:50, 7 January 2019 (UTC)