BMJ 24-5-21 article Diabetes remission and low carb definitions

[TinaD]

Interesting paper recommending better definition of terms such as "remission" and "low carb". Some acknowledgment of benefits of low carb but long term research into health outcomes requied.

Low and very low carbohydrate diets for diabetes remission

Dietary interventions that restrict carbohydrate intake for the management of diabetes are of particular interest to researchers, healthcare providers, and patients. Based on evidence of moderate to low certainty from 23 randomized trials (n=1357), evidence synthesis suggests that patients who...

www.bmj.com

 

[trophywench]

Want to make that link clickable?

 

[TinaD]

Low and very low carbohydrate diets for diabetes remission

Dietary interventions that restrict carbohydrate intake for the management of diabetes are of particular interest to researchers, healthcare providers, and patients. Based on evidence of moderate to low certainty from 23 randomized trials (n=1357), evidence synthesis suggests that patients who...

www.bmj.com

Thanks Martin - I have no idea how to make it clickable. Much easier for people than copying and pasting.

 

[trophywench]

Ta Martin! @TinaD - do you use a phone or a laptop to access the internet - I know exactly how to make a clickable link on a Windows puter with a keyboard and can simply explain how - but not on a different device.

 

[TinaD]

Ta Martin! @TinaD - do you use a phone or a laptop to access the internet - I know exactly how to make a clickable link on a Windows puter with a keyboard and can simply explain how - but not on a different device.

Desk top running Windows 7 (having donated my loathsome Windows 10 laptop to Rotary for local kids for school work) My tame IT man having died I am dreading buying a new tower which will, inevitably, be running 10.

 

[DaveB]

The usual hint that a low-carb diet may possibly cause long-term harm but no mention that high carb diets DO cause proven harm thru obesity and therefore the paper is biased and not giving a balanced view of risks. There is the question of saturated fats which we all know have long been demonised but I gather the research for this had 'fixed' results from the data so is suspect.

 

[trophywench]

Desk top running Windows 7 (having donated my loathsome Windows 10 laptop to Rotary for local kids for school work) My tame IT man having died I am dreading buying a new tower which will, inevitably, be running 10.

W7 and W10 it's the same method as it happens.

Open webpage you wish to create the clickable link for - on the here W10 laptop I am on right now, above the top row that says

Forum What's new Media Learning Zone (etc) (each of them clickable links) there is another line with the actual forum address -

h ttps://forum.diabetes.org.uk/boards etc

Take your cursor up to that line with the address and click on it, which highlights all that text bright blue. Now hold down the lefthand keyboard 'Control' button and tap on the 'C' then let go of the control button so both hands no off the Keyboard.

Then go to wherever you want to paste it to, and put your cursor exactly where you want it to appear, hold down your lefthand Control button again and tap your keyboard V this time.

https://forum.diabetes.org.uk/boards/threads/bmj-24-5-21-article-diabetes-remission-and-low-carb-definitions.93553/#post-1073100

When the webpage address appears in full but in just normal black writing on a white background. Now hit the 'Post reply' button.

 

[trophywench]

And Ooh look! The clickable link now appears in blue writing! as if by magic.

There are indeed other ways - but hey! it's easy and it works reliably for stuff that is only needed for a load of other PWD and not intended for legal docs or commercial use.

 

[pm133]

The usual hint that a low-carb diet may possibly cause long-term harm but no mention that high carb diets DO cause proven harm thru obesity and therefore the paper is biased and not giving a balanced view of risks. There is the question of saturated fats which we all know have long been demonised but I gather the research for this had 'fixed' results from the data so is suspect.

High-carb diets cause obesity?

I always thought it was over-eating and I'm struggling to find a reputable source claiming it to be anything other than that.

 

[Leadinglights]

High-carb diets cause obesity?

I always thought it was over-eating and I'm struggling to find a reputable source claiming it to be anything other than that.

I believe some of the TED talks on diabetes cover some of the 'new ' thinking on diabetes, causes and management.
But as with all these things you have to make your own mind up about what you hear.
I have a book The Diabetes Code by Dr Jason Fung which has some interesting 'theories' and explanation.

 

[Deleted member 21371]

Longterm observational studies with a mean follow-up of 25 years suggest a U-shaped relation with both higher and lower extremes of carbohydrate intake, showing an increased mortality risk, although confounding cannot be excluded.

I can't see any other comment in that article on carbohydrate intake?

 

[everydayupsanddowns]

Thanks Martin - I have no idea how to make it clickable. Much easier for people than copying and pasting.

It was only that the web address was joined joined to the text before it due to a missing space, so that the system didn’t spot it correctly 🙂

 

[Deleted member 21371]

High-carb diets cause obesity?

I always thought it was over-eating and I'm struggling to find a reputable source claiming it to be anything other than that.

This is another one of those "research" studies,
"Based on evidence of moderate to low certainty from 23 randomized trials (n=1357), evidence synthesis suggests that patients who adhere to low or very low carbohydrate diets for six months might achieve diabetes remission without adverse consequences"

Doesn't that translate as "we're not sure but we made up some evidence that may suggest......." ? (my highlights)

 

[everydayupsanddowns]

This is another one of those "research" studies,
"Based on evidence of moderate to low certainty from 23 randomized trials (n=1357), evidence synthesis suggests that patients who adhere to low or very low carbohydrate diets for six months might achieve diabetes remission without adverse consequences"

Doesn't that translate as "we're not sure but we made up some evidence that may suggest......." ? (my highlights)

The way I read it is more... Everyone uses different definitions for all this stuff, so it’s hard to compare apples to hatstands, but some people do well on low carb (whatever that means for them) while others are worried about that because of fats, though evidence about that is questioned by others... So it works, and doesn’t seem to do any harm in the short term, but we haven’t (m)any long terms studies really.

Oh... and either end of the spectrum, either loads of carbs, or hardly any carbs probably aren’t a great idea. 🙂

 

[pm133]

This is another one of those "research" studies,
"Based on evidence of moderate to low certainty from 23 randomized trials (n=1357), evidence synthesis suggests that patients who adhere to low or very low carbohydrate diets for six months might achieve diabetes remission without adverse consequences"

Doesn't that translate as "we're not sure but we made up some evidence that may suggest......." ? (my highlights)

I don't know what "evidence synthesis" means but I don't agree with your conclusion about them making up evidence. That's a pretty cynical view.

They appear to be saying that evidence exists but they've classified it as moderate to low certainty in terms of whether it represents a real effect.

The words "suggest" and "might" is also important in there.

Overall, that's them being non-committal about that specific piece of evidence but listing it anyway. In fact I can go further and say that they are saying that the result they are talking about is not conclusive.

 

[TinaD]

The way I read it is more... Everyone uses different definitions for all this stuff, so it’s hard to compare apples to hatstands, but some people do well on low carb (whatever that means for them) while others are worried about that because of fats, though evidence about that is questioned by others... So it works, and doesn’t seem to do any harm in the short term, but we haven’t (m)any long terms studies really.

Oh... and either end of the spectrum, either loads of carbs, or hardly any carbs probably aren’t a great idea. 🙂

To me the major importance was the recognition that definitions either need to be standardised or if a standard term is not used then the author should spell out very clearly what he means by "low carb" etc. So those reading the papers (and hopefully the abstracts) would know if they had apples or hatstands.

 

[Deleted member 21371]

I don't know what "evidence synthesis" means but I don't agree with your conclusion about them making up evidence. That's a pretty cynical view.

They appear to be saying that evidence exists but they've classified it as moderate to low certainty in terms of whether it represents a real effect.

The words "suggest" and "might" is also important in there.

Overall, that's them being non-committal about that specific piece of evidence but listing it anyway. In fact I can go further and say that they are saying that the result they are talking about is not conclusive.

Well, sysnthesis is the artificial execution of chemical reactions to obtain one or several products.
It is literally making something up out of different parts.

Or in writing, synthesis refers to combining multiple sources and ideas. Using information from several sources to create new ideas based on your analysis of what you have read.
The evidence has been made from reading, and combining different evidence from other studies.
Again, it's literally been made up from different parts.

And the evidence they did read was of low to moderate certainty in the original studies. Certainly no where near certain.

However, my point was, once again it's yet another meta-analysis, which actually states it's own validity is built on questionable data, and published in the BMJ, rather than any meaningful research.

 

[Deleted member 21371]

To me the major importance was the recognition that definitions either need to be standardised or if a standard term is not used then the author should spell out very clearly what he means by "low carb" etc. So those reading the papers (and hopefully the abstracts) would know if they had apples or hatstands.

I agree entirely.
I was really just looking at how that could have been said, rather than by funding a study which drew no real conclusion, and even started out by saying it was of dubious quality because no definition existed.
The could have spent the money coming up with a meaningful definition instead.

 

[DaveB]

High-carb diets cause obesity?

I always thought it was over-eating and I'm struggling to find a reputable source claiming it to be anything other than that.

Hi, yes over-eating also causes obesity. Carbs are turned to glucose in the stomach and are either used for 'immediate' energy needs or stored as fat. If I eat more carbs than I currently do, not only will my BS increase but so will my weight.

 

[Deleted member 21371]

Hi, yes over-eating also causes obesity. Carbs are turned to glucose in the stomach and are either used for 'immediate' energy needs or stored as fat. If I eat more carbs than I currently do, not only will my BS increase but so will my weight.

That always puzzled me.
I always wondered, if the theory is, only carbs make you fat, carbs are turned to glucose, and stored as fat, why don't I waste away entirely if I eat less carbs, as my body will have to use the fat stored in my body to make glucose.
If I ate no carbs at all, say a completely meat only diet, would my body eventually become fat free?
And if I ate more meat then I needed to, I wouldn't put any fat back on?

No one ever explained the answers, or indeed, did answer that?