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Rethinking Diabetes – interview with Gary Taubes

135 点作者 prmph超过 1 年前

17 条评论

n2d4超过 1 年前
Good article, but there&#x27;s one thing that really bothers me:<p>&gt; <i>perhaps because of his serious and scientific background – he has a physics degree from Harvard and studied aerospace engineering at Stanford [...]</i><p>Which, for the thing he&#x27;s doing now, is not a serious background! Knowledge isn&#x27;t transferrable and there are plenty examples of people who transfer fields with unwarranted confidence and make totally bogus claims (see the Nobel disease [1]). I wish we would stop claiming the opposite, because especially in a field like nutritional sciences you can find some &quot;evidence&quot; for any theory (see eg. the Chemical Hunger drama [2]).<p>[1] <a href="https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Nobel_disease" rel="nofollow">https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Nobel_disease</a><p>[2] <a href="https:&#x2F;&#x2F;www.lesswrong.com&#x2F;posts&#x2F;NRrbJJWnaSorrqvtZ&#x2F;on-not-getting-contaminated-by-the-wrong-obesity-ideas" rel="nofollow">https:&#x2F;&#x2F;www.lesswrong.com&#x2F;posts&#x2F;NRrbJJWnaSorrqvtZ&#x2F;on-not-get...</a>
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coldcode超过 1 年前
As a newly diagnosed Type 2, but not overweight, I take metformin and have a carefully altered my diet to slow down my digestion and have few easily digestible carbs (i.e. such as the whites, flour, sugar, potatoes and rice). But it takes 3 months to see if my A1C goes down (a measure of the past 3 months of blood sugar), so I won&#x27;t know for a couple more months. Going keto to me seems like using a shotgun to kill a fly on your foot, it is too hard to keep up with, and causes other issues, while simply understanding how carbs affect your blood sugar is much easier to do.<p>Part of the problem is that all the tables of carbs assume you are only eating the one thing (which is how they make the tables), but the actual affect on blood sugar spikes is the sum of what you ate. For example, eating a boiled potato by itself will spike a Type 2 steeply, but eating it with lots of butter will not.<p>I prefer to understand my health issues by reading a wide variety of information from people who specialize in them, not just read one guy&#x27;s opinion.
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kshahkshah超过 1 年前
Is this basically a book review?<p>Anyway, keto is great. I wasn’t terribly overweight and lost 19lbs in 9 weeks with it with a cheat day included. It’s great because it’s a very simple set of very few rules. It’s easy to adhere to because it removes moment decision making around whether or not you “should” or “deserve” to have X food. It’s nearly impossible for you to eat enough calories to maintain your current weight on keto when you’re already overweight. Therefore a deficit is nearly guaranteed therefore weightless is guaranteed. On top of all that you do get better at burning fat and don’t get as hungry.<p>The counterpoint is the tough piece - how do you come off that diet and reenter the real world where people eat carbs. How can you get pizza with friends, etc. I understand their are some who view keto as a lifestyle, good for them but most people aren’t going to do that.<p>Beyond the simple reality of calories are calories, none of this other stuff around fat vs protein vs carbs is really very hard to understand. Simple carbs are rocket fuel, they provide a lot of energy over a very short period of time. If you’re not going to use it, once the sugar saturates your blood, the excess will be taken out and stored. Then you’ll get hungry again. Fats are slower burning, so it’s harder for you to saturate your blood quickly.<p>This is an over simplification obviously but this is just not so hard to understand that it needs to be an endless debate over or be positioned as controversial in order to sell books.<p>1. Losing weight can and often will fix your diabetes. 2. Be conscious of the method you choose for weight loss, when you obtain your goal weight - what will you do long term?
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adaszko超过 1 年前
Here&#x27;s [1] how well the references check out for Taube&#x27;s previous book. Is there any reason I should believe his newer books are any better?<p>Here&#x27;s a study funded by Taubes himself (!) That disproves his earlier claims: <a href="https:&#x2F;&#x2F;examine.com&#x2F;articles&#x2F;low-fat-vs-low-carb-for-weight-loss&#x2F;" rel="nofollow">https:&#x2F;&#x2F;examine.com&#x2F;articles&#x2F;low-fat-vs-low-carb-for-weight-...</a><p>[1]: <a href="https:&#x2F;&#x2F;thescienceofnutrition.wordpress.com&#x2F;2014&#x2F;04&#x2F;05&#x2F;good-calories-bad-calories-a-critical-review-chapter-1-the-eisenhower-paradox&#x2F;" rel="nofollow">https:&#x2F;&#x2F;thescienceofnutrition.wordpress.com&#x2F;2014&#x2F;04&#x2F;05&#x2F;good-...</a>
mlsu超过 1 年前
I&#x27;m confused. De-loading carbs for fat makes sense for overall wellness and health (since healthy things tend to be fatty and&#x2F;or low carb), but it is not possible to &quot;manage&quot; T1 without insulin treatment.<p>The fact that either he or this article does not seem to distinguish between the two types in this regard is a basic category error.<p>The low carb &quot;managing&quot; of T1d before the 1920s was basically a permanent hyperglycemia which you could last months, maybe years. Once your honeymoon period ends you die a spectacularly brutal death -- your blood turns to acid and you starve in insatiable hunger. None of this is &quot;manageable&quot; through diet, since your body has a baseline rate of gluconeogenesis entirely independent of diet.<p>Type 1 and Type 2 sharing the &quot;diabetes&quot; name has to be up there on &quot;most frustrating lexical errors&quot; ever.
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sombragris超过 1 年前
Type 2 here. The article text sounds strange to me, maybe because I live elsewhere than the US&#x2F;UK. From Day 1 of my diagnosis (in 2009) I was prescribed a low-carb diet alongside with medication and, eventually, insulin. I was never told I could just manage my blood sugar with insulin and medication without a low-carb diet. So this guy comes across to me as preaching to the choir.
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drjasonharrison超过 1 年前
Taub, a science writer, has a theory and book to sell. His theory that drugs instead of diet leads to later problems is pretty well established. I don&#x27;t know if he also discusses how insulin resistance in type 2 diabetes starts, or how the ability of the pancreas to make insulin in adulthood can be damaged by fat soluble poisons leaking into and out of fat cells.<p>As an alternative to his book, I suggest looking at the research on plant based diets fat toxity. <a href="https:&#x2F;&#x2F;nutritionfacts.org&#x2F;topics&#x2F;diabetes&#x2F;" rel="nofollow">https:&#x2F;&#x2F;nutritionfacts.org&#x2F;topics&#x2F;diabetes&#x2F;</a>
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pedalpete超过 1 年前
The next phase of diabetes treatment just may be sleep.<p>30% of people get insufficient sleep, which directly leads to increased insulin resistance the following day, along with increased appetite and craving for sugary and fattier foods, and a decrease in willpower.<p>Diabetes needs to be treated as a whole person health, diet is absolutely key, but so is sleep and particularly as we age, as slow-wave sleep decreases naturally with age (this is what we&#x27;re working on).<p><a href="https:&#x2F;&#x2F;www.cdc.gov&#x2F;sleep&#x2F;index.html" rel="nofollow">https:&#x2F;&#x2F;www.cdc.gov&#x2F;sleep&#x2F;index.html</a>
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sgift超过 1 年前
I&#x27;m surprised a bit that this seems to be contentious&#x2F;not already part of normal treatment in the US? Or is the article wrong?<p>Yes, Insulin is the &quot;last line of defense&quot; for Diabetes 2, but at least here in Germany dietary change (e.g. Keto or at least less carbs) is an essential part of treatment. And so are other medications (e.g. Metformin). Insulin is given if there&#x27;s no other option, cause well, not giving insulin if your blood sugar is really bad leads to very bad outcomes, but if there is any other option doctors will take it first.
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kamikaz1k超过 1 年前
It’s pretty amazing how many different ways people approach this problem. The article scared me a little when there were anecdotes about people just using an insulin pump to keep levels in check…do people understand what insulin does? Diabetes Type 2 is an awful name and needs to be rebranded. Type 1 is fixed by insulin, Type 2 is slowed down(?) by insulin, they’re not the same thing.<p>This is kind of like how calorie restrictions will fix your issues, how you achieve that restriction is the hard and very human problem that people endlessly debate about.<p>So the only lesson to take away is that this is a solvable problem, and ultimately you gotta cut calories (and exercise). But how is important; so keep trying till you find something that works for you.
kshacker超过 1 年前
So I have been at risk of diabetes for 8 years ... started tracking actively since I had a cardiac incident. My first 2 years of cardiac recovery were whole food vegetarian with zero added sugar and they were awesome. But then the discipline slipped and it has been one thing after the other with degrading health (mostly A1c, still not diabetic, and weight gained 30 pounds in the past 6 years). Went back to Whole Foods plant based diet since January 1st and have cut down sugar significantly. This time I am prepared by having a fridge stocked with fruits and other alternatives when I get tempted to eat.<p>But based on what I am reading in the interview, and the other comments on this post, am I chasing a fool&#x27;s errand?<p>My personal experience says that any diet works as long as you are disciplined, and although in my social circles (work and family), it is hard to be sugar free, it is still possible (along with vegetarianism) as compared to low carb. However, I do not see any advocates for that here, are there?<p>Btw I am planning for a modified version of something called LMK diet, LMK is not a doctor and is probably at the extreme edges of selling veganism, and I am definitely not going that far, but going as close as I can. Mentioning it just in case someone wants to counter or support it.
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brigadier132超过 1 年前
&gt; For Taubes, dietary fat wasn’t a problem at all. Instead, the real danger was carbohydrate, he asserted, sparking a backlash, and fuelling the ongoing conversation about what constitutes a “healthy diet”<p>I&#x27;ve successfully lost 80 pounds in the past year after 10 years of yoyo dieting with low carb and counting calories. I did not become a healthy weight until I was counting calories on a <i>HIGH CARB</i> and <i>HIGH PROTEIN</i> diet and doing a significant amount of exercise 6 days a week. Meaning, 1 gram of protein per pound of lean body mass, 1 gram of fat per 1&#x2F;3rd of your weight in pounds and as many carbs that fit in your calorie budget and at least 30 grams of fiber.<p>Note, I&#x27;m not giving advice to people with diabetes but the reason there are so many people with metabolic disease in this country is not carbs. It&#x27;s lack of exercise (and walking) and processed high calorie food. Those french fries you are avoiding, the reason they have so many calories is not because of carbs, it&#x27;s because of fat.<p>If you want to lose weight and you plan to also exercise, going low carb will hamstring you. The difference between running in the morning fasted and running after eating a single banana is the difference between feeling like you are being tortured and being able bounce around like a bunny.<p>I was literally lying in bed all day with 0 mental energy on my diet because I went low carb. I failed my diet 3 times over 10 years because I believed the low carb bullshit. Go look around at how many people successfully lose weight, they all believe the same low carb stupidity.<p>I&#x27;m running 30 miles a week and lifting 6 days a week, if I went low carb I would be tired in bed all day. If you don&#x27;t have diabetes or some other metabolic disease, don&#x27;t go low carb.
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verisimi超过 1 年前
There are possible causes that simply cannot be considered on account of the level of investment that big pharma has sunk into that sort of treatment. No investigations are undertaken whereas such a cause should be a consideration. IMO.
dvektor超过 1 年前
Who else read this as: Rethinking databases - ?
stevebmark超过 1 年前
Skip Taubes!
sgt101超过 1 年前
Great to see him (and this article) conflating Type 1 with Type 2. The kind of conflation that could kill someone.<p>Good job, theguardian.
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rafaelero超过 1 年前
Putting together a lot of different foods inside the category of &quot;carbohydrates&quot; is stupid, and telling people to restrict it is even more stupid.