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  #1   ^
Old Tue, Nov-24-20, 03:43
Demi's Avatar
Demi Demi is offline
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Default Should Americans Get Half Their Calories From Carbs? Two Camps Battle It Out

Should Americans Get Half Their Calories From Carbs? Two Camps Battle It Out

As the U.S. government revises its dietary recommendations, opposing groups are fighting over thA food fight over carbohydrates is shaping up for control of Americans’ plates.


https://www.wsj.com/articles/should...out-11606150740

Quote:
Years after low-carb eating gained attention with the Atkins diet, the low-carb movement is trying to gain wider mainstream acceptance and a nod of government endorsement. The latest battleground is the U.S. government’s dietary guidelines, which are being revised for the first time in five years.

Low-carb advocates believe the current guidelines—which recommend Americans get about half their calories from carbohydrates—are partly to blame for America’s high rates of obesity and Type 2 diabetes. Lining up against them are supporters of plant-based diets, among others, who argue that low-carb diets often include too much saturated fat from meat and dairy products and neglect important sources of nutrients like fruit, certain vegetables and whole grains.

During heated public hearings over the past 18 months, low-carb advocates pushed to include a low-carb diet option in the new dietary guidelines, which the government is expected to finalize in December. A federal advisory committee rejected that idea, saying evidence supporting that approach wasn’t conclusive. Now low-carb advocates have regrouped and are pushing the government to include a disclaimer with the final guidelines saying they are “only for healthy Americans”—marking them irrelevant for the majority of the country who are overweight or have diabetes or prediabetes.

For many such people, low-carb advocates say it’s unhealthy to follow the current guidelines and better to follow a low-carb approach. “About half of the country has either diabetes or prediabetes, 40% are obese, and if you include overweight Americans it’s about 70%,” says Mark Cucuzzella, director of an advocacy group called the Low-Carb Action Network and a professor and director of low-carb nutrition at the West Virginia University Center for Diabetes and Metabolic Health. “The people that are well, they really don’t need the government’s advice.”

The U.S. Department of Agriculture and the Department of Health and Human Services are currently reviewing recommendations from advisory committees on everything from carbohydrate levels to sugar intake to alcohol limits. The guidelines, which get updated every five years, have a broad impact. They help determine school lunch programs, shape state and local health promotion efforts, and influence what food companies make.

Seven percent of Americans report eating a low-carb diet this year, up from 5% in 2018, according to a survey conducted by the International Food Information Council, a nonprofit science communications and consumer research organization.

Low-carb advocates argue that the approach should be more widespread—and were vocal enough at hearings over the new dietary guidelines to get the federal advisory committee to review their case.

“This came out big at the first meeting that the public spoke,” says Carol Boushey, a registered dietitian and associate research professor in the epidemiology program at the University of Hawaii Cancer Center who chaired the dietary patterns subcommittee.

One of the leaders in the low-carb lobby is the Low-Carb Action Network, which describes itself as a coalition of doctors, academics, advocates and consumers of low-carb diets. They say they have more than 550 members, about 230 of whom are medical professionals, and that they don’t take money from industry. The group believes a low carb diet should be defined as one where carbohydrates make up 25% or less of daily calories.

They argue that reducing carbohydrates can help prevent and even reverse Type 2 diabetes, help people lose weight, and reduce the risk of heart disease. Carbohydrates raise the level of glucose in a person’s blood; the body produces insulin to reduce and regulate glucose levels. Low-carb advocates cite research suggesting that when blood sugar spikes too high too often, the resulting increases in insulin levels can make the body resistant to insulin and contribute to Type 2 diabetes and obesity. They also say carbohydrates increase the risk of heart disease by raising blood levels of triglycerides and small LDL particles, and high sugar intake increases blood pressure.

There is some research on their side. An American Diabetes Association panel published a report last year that found sufficient evidence that a low and very low carbohydrate diet can be helpful in lowering blood sugar levels and even lowering medication use. The benefits were more pronounced for the very low carbohydrate diets. The ADA review defined low carbohydrate diets as having less than 45% of calories from carbs and a very low carbohydrate diet as less than 26%.

Ronald M. Krauss, a professor of pediatrics and medicine at the University of California, San Francisco, says there is a growing body of evidence supporting low-carb diets to improve insulin resistance and cholesterol levels, which reduce the risk of heart disease and diabetes.

Dr. Krauss is on the scientific advisory board of Virta Health, a company that provides very low-carbohydrate diet counseling for people with diabetes and has published data showing that prolonged treatment with a very low-carbohydrate diet reduces insulin resistance and a number of cardiovascular risk factors in Type 2 diabetes patients.

Low-carb diets are often higher in fat than higher-carb diets because people often eat more meat when they cut carbs. But the research on the cholesterol impact is mixed. William Yancy, a general internist and obesity medicine specialist at Duke University, says studies have shown that on average low-carbohydrate diets increase the levels of good HDL cholesterol and reduce triglyceride levels compared with low fat diets. Furthermore, levels of bad LDL cholesterol do not on average significantly increase in people losing weight on a low-carbohydrate diet.

“In head-to-head trials, low fat diets might be more effective for lowering LDL cholesterol but there are other advantages of low carb diets,” which are generally higher in fat, says Dr. Yancy, who has been studying low carb diets for nearly 20 years. “What happens is people aren’t as hungry if they eat a low carbohydrate eating pattern so they end up self-restricting spontaneously.”

Opponents of a low-carb approach say it’s important to distinguish between different types of carbohydrates. While highly processed carbs like white bread, sugar-laden packaged foods and sodas spike blood sugar quickly, other foods that contain carbohydrates like fruits, certain vegetables, whole grains and beans also contain fiber, which helps glucose release more steadily into the bloodstream. Those foods also contain beneficial nutrients and are low in cholesterol and unhealthy fats, like saturated and trans fats.

“We think Americans already consume too few carbohydrates in the form of helpful carbohydrates,” says Susan Levin, director of nutrition education for the Physicians Committee for Responsible Medicine, an advocacy group that supports plant-based diets.

Shivam Joshi, a primary care and lifestyle medicine physician at NYU Langone Health and Bellevue Hospital in Manhattan, sees patients at Bellevue’s Plant-based Lifestyle Medicine Program. Started about two years ago, the program aims to help patients with chronic diseases get healthier with lifestyle changes, primarily following a plant-based diet consisting largely of whole, unprocessed plant foods.

“The demonization of healthy carbs is because of our inability to separate unhealthy carbs from healthy carbs,” says Dr. Joshi, who cites foods like whole grains and oats, quinoa, and bananas as healthy carbs. “People are now afraid to eat bananas because they think it will cause diabetes but a banana is very different from banana bread.”

Some experts also say it’s difficult to tell whether the health benefits noted in low-carb research come from reducing carbohydrates or simply from reducing calories—people often consume fewer calories when they eat fewer carbs.

Alice H. Lichtenstein, director of the Cardiovascular Nutrition Laboratory and professor of nutrition at the Friedman School of Nutrition Science and Policy at Tufts University, says there’s no evidence that low-carb diets reduce the risk of heart disease and diabetes more than other types of weight-loss diets.

Dr. Lichtenstein was vice-chair of the 2015 dietary guidelines advisory committee that issued recommendations to the government five years ago. “We have two long-term studies that indicate the level of carbs alone has little effect in terms of weight loss or cardiometabolic risk factors,” she says.

This year’s dietary patterns subcommittee also found it difficult to draw conclusions. Jamy Ard, a member of the dietary patterns subcommittee and a professor in the department of epidemiology and prevention at Wake Forest School of Medicine, said the biggest challenge the subcommittee had was isolating the health impact of low-carb diets when they’re not being used for weight loss or cutting calories.

The low-carb camp is undaunted, firing off a letter earlier this month criticizing the subcommittee’s failure to endorse a low-carb diet option to the U.S. secretaries of agriculture and health and human services, where recommendations for the final guidelines are under review. Advocates requested that the final guidelines should “include a prominent statement that its recommendations are ‘Only for Healthy Americans’ so that those with diet-related chronic diseases will know that these Guidelines are not appropriate for them.”

A USDA spokesperson says the dietary guidelines are “intended to be generalizable to the American population at large” and that it’s “beyond the scope of the dietary guidelines to be tailored to specific groups or treat specific diseases.” But organizations often build on the guidelines to tailor advice to particular needs and conditions, the spokesperson noted: “The dietary guidelines serve as one piece of America’s larger nutrition guidance landscape.”e healthiness of carbohydrates

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  #2   ^
Old Tue, Nov-24-20, 08:27
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GRB5111 GRB5111 is offline
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Thanks for this, Demi. It's a very balanced article accurately outlining the dietary camps attempting to update the DGA. Journalism like this is a breath of fresh air. Unfortunately, all previous versions of the DGA assumed a healthy individual was eating to the recommendations. We know that's far from true even though the DGA "keepers" won't admit it. Also, I'd prefer to see low carb described as not having a meat emphasis. There are many who do well with a low carb vegetarian approach. If these camps could step away from their preoccupation with the "crusades," they might even find they can agree on much. It's not a zero-sum game.
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  #3   ^
Old Wed, Nov-25-20, 16:30
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Calianna Calianna is offline
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Quote:
Opponents of a low-carb approach say it’s important to distinguish between different types of carbohydrates. While highly processed carbs like white bread, sugar-laden packaged foods and sodas spike blood sugar quickly, other foods that contain carbohydrates like fruits, certain vegetables, whole grains and beans also contain fiber, which helps glucose release more steadily into the bloodstream. Those foods also contain beneficial nutrients and are low in cholesterol and unhealthy fats, like saturated and trans fats.




I fell for this many years ago, and about all I can conclude from my experience with eating lots of healthy carbs like whole grains, fruit, and starchy vegetables is that the tiny bit of fiber in them makes so little difference in the rate at which glucose is absorbed and enters the bloodstream that you might as well be eating donuts and cake.
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  #4   ^
Old Wed, Nov-25-20, 17:49
Sniggle Sniggle is offline
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Seems to me that the 'solution' is to acknowledge that the one-size-fits-all approach to diet does not work. Low carb, high carb, high protein, vegetarian....they all can work for different people. The government should step away from trying to endorse any specific dietary guideline, and just present different dietary paths to healthy eating, and let the individual determine what works best for them. After all, it was the government that pushed the carb-heavy approach that adversely impacted a large segment of the population.

For me, low carb works because I do not do well with calorie deficits. But I do not care what other folks want to do, as long as it works for them. I do advocate for low carb to friends and acquaintances that are looking to get control of their weight, but I don't go beyond that.

'Wise' government is not wise.
Government should be more about helping the citizenry to get good information and less about being our mother and father.
One size does not fit all.
Everyone is different, see above.
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  #5   ^
Old Thu, Nov-26-20, 19:23
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sheryl2020 sheryl2020 is offline
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Great post Demi! I am a fan of the Low Carb Action Network. I do hope, that as time goes on, low carb is taken more seriously. A lot of people think low carb is only keto, when it actually can go up to 100-150 grams carbs a day. Dr. Eric Westman’s End Your Carb Confusion talks about this and will be published next month. Colette Heimowitz’s The Atkins 100 Solution will also be published next month. Low carb rules!
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  #6   ^
Old Thu, Nov-26-20, 21:43
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Kristine Kristine is offline
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Quote:
Originally Posted by Calianna
I fell for this many years ago, and about all I can conclude from my experience with eating lots of healthy carbs like whole grains, fruit, and starchy vegetables is that the tiny bit of fiber in them makes so little difference in the rate at which glucose is absorbed and enters the bloodstream that you might as well be eating donuts and cake.
Hear, hear. There are countless clinicians that we see around the 'net - MDs, dieticians, etc - who have "seen the light" because they actually started tracking their BG while eating their Healthy Carbs(tm). It's a rude awakening. Glucometer don't lie.

Some will argue that it's not the same because those donuts and cakes are far less nutritious - fine, but that's not a good reason to sugar-bomb yourself with oatmeal and corn if you can get roughly the same nutrition from foods that don't spike sugars, contain anti-nutrients, make you hungrier, etc.
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  #7   ^
Old Fri, Nov-27-20, 08:23
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Ms Arielle Ms Arielle is offline
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Dr Atkins was very clear to make wise food choices, picking nutrient dense foods. Not to be confused with calorie dense, of course.

And eat a wide variety. I now eat far more types of veg and fruits. Jicama, dragon fruit, leeks, arugula , dandelion and so many more added to the menu.

Nutrients are key.

(Today our local scout troop will unload 900 Christmas trees and I KNOW someone will bring donuts. Grrrrrr)
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  #8   ^
Old Fri, Nov-27-20, 09:38
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Calianna Calianna is offline
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Quote:
Originally Posted by Kristine
Hear, hear. There are countless clinicians that we see around the 'net - MDs, dieticians, etc - who have "seen the light" because they actually started tracking their BG while eating their Healthy Carbs(tm). It's a rude awakening. Glucometer don't lie.

Some will argue that it's not the same because those donuts and cakes are far less nutritious - fine, but that's not a good reason to sugar-bomb yourself with oatmeal and corn if you can get roughly the same nutrition from foods that don't spike sugars, contain anti-nutrients, make you hungrier, etc.

I never used a glucose meter, but I could certainly tell by how I felt that the "healthy" carbs weren't helping matters.



The thing is when I first switched from the truly bad for you carbs (donuts, cake, cookies, chips, etc) to the "healthy carbs", I noticed some improvement in how I felt, since there are some nutrients in those which I was certainly missing in the junky carbs. That provided enough improvement that it led me to believe I was on the right track, at least at first.


It took a while to realize that although they weren't as bad as the junky carbs, they certainly were no holy grail to feeling good, and truly almost as bad as the junky carbs.
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  #9   ^
Old Fri, Nov-27-20, 11:00
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teaser teaser is offline
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I think I could make a better argument for 70 than 50 percent carbs. 70 percent is more like some traditional diet where metabolic outcomes weren't so bad--the pre-fast food Asian and South American etc. diets. 50 percent carbs is easy to do on pizza and doritos.
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  #10   ^
Old Tue, Dec-15-20, 13:02
Demi's Avatar
Demi Demi is offline
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Quote:
Should you give up carbs? Here’s why starchy foods aren’t the enemy

In the US, campaigners are calling on the government to reduce the recommended carbohydrate intake — but plenty of experts aren’t convinced


Are carbohydrates the dieter’s worst enemy — delicious, but a surefire way to gain weight? Or are they the opposite: high in nutrients and fibre, and part of any balanced regimen?

On the other side of the Atlantic, this debate is being played out in high-profile style. The US Department of Agriculture and the Department of Health and Human Services are reviewing nutritional guidelines. Updated every five years, they advise on everything from carbohydrate intake to safe alcohol levels.

Some campaigners, who blame calories from carbs for causing epidemics of obesity and type 2 diabetes, want the government to slash its recommended daily intakes. Where America leads, Britain usually follows.

In the US and Britain it is recommended that people get half their calories from eating carbohydrates

The US recommends that people get half their calories from eating carbohydrates. So does Britain. However, in heated public hearings over the past 18 months, American low-carb advocates have pushed for guidelines to advise halving their recommended daily carbohydrate intake for millions of overweight people, to 25 per cent or less (about the same as the Atkins diet). In Britain, an official panel of leading dietary experts has put new draft guidelines on low-carb diets out for consultation, with the results due next year. Which way will we go in the war on carbs?

The case for cutting carbs

Low-carb regimen backers claim that carbohydrates not only can cause weight gain, but also pose a particular diabetes risk because eating them can cause glucose levels in the blood to spike, with the body responding by rushing to produce insulin to regulate the blood sugar. Supporters argue that when these sharp insulin rises happen too often, the body becomes physically resistant to insulin and this can lead to type 2 diabetes.

They claim that by radically cutting carbs from their food, dieters can achieve such a significant and lasting change in their metabolisms and weight that their bodies’ insulin-regulation systems revive and the diabetes is reversed.

A report by investigators at the American Diabetes Association last year said they had found sufficient evidence to suggest that very low (less than 26 per cent) carbohydrate diets can be helpful in lowering diabetics’ blood-sugar levels and also their use of medication.

Removing carbs seems to be a simple way to remove calories from your diet, which is why it may help you to lose weight


Short-term gain, long-term pain?

A US federal advisory committee that has explored the low-carb claims has indicated this year that there is no conclusive evidence to support a radical reduction in national carb consumption. Furthermore, in March the UK’s Scientific Advisory Committee on Nutrition (SACN) produced its own draft conclusions, finding that low-carb diets show no long-term health advantages over higher-carb regimens.

The report, which was commissioned by Public Health England, examined the best clinical-trial evidence on differing diets’ benefits for people with type 2 diabetes. For weight-loss it concluded that, after a year, there was no meaningful difference between low-carb diets and normal-carb diets.

The independent committee also found that, for lowering blood-glucose levels, low-carb diets might have better short-term results — but that there was no evidence to show they were any better than normal-carb diets over the period of a year or more.

Present UK dietary advice is the same for diabetics and non-diabetics: about 50 per cent of dietary energy should be from starchy carbs (such as potatoes, bread and rice), preferably high-fibre or wholegrain.

Consultation on the SACN draft report ended in April and a spokesman for Public Health England says the final report is due to be published “next year – but there are no specific timings”.

The calorie equation

Roy Taylor, professor of medicine and metabolism at the University of Newcastle, was the world’s first researcher to demonstrate that diabetes is reversible through weight loss, in 2011.

He did this by showing that type 2 diabetes is not caused by excessive glucose spikes caused by carbohydrates, but by overweight people’s bodies storing excess fat in the liver and pancreas. This overload causes insulin production to shut down. If that fat is lost by dieting, insulin production recommences.

To reduce patients’ weight, Taylor worked with Glasgow University to create a crash-course liquid diet. After crash-dieting, patients need to maintain their healthy weight. But that doesn’t necessitate any particular level of carb intake, he says.

“It is not the composition of your diet that matters, it’s the total amount of calories,” he says. “Moderation is the key, however you do it — be it intermittent fasting, moderately low carbs, or low fat.”

Certainly he says there should be no biscuits, crisps or similar snacks. That’s all about cutting calories not carbs, though. If you eat healthy carbohydrates instead, in the form of fruit or veg, that’s fine, Taylor adds.

A Mediterranean diet is typically about 40 per cent carbs

Quality of carb counts . . .

Helen Bond, a registered dietitian and spokeswoman for the British Dietetic Association, says that removing carbs seems to be a simple way to remove calories from your diet and may help you to slim.

“But not all carbs are created equally,” she says. “It’s important only to reduce free sugars, as found in soft drinks and sweet snacks, for the sake of our waistlines.”

NHS guidelines say we should consume no more than 30g of free sugars a day (seven sugar cubes). That’s easily exceeded: a 12oz can of Coca-Cola contains 39g of sugar.

Healthy diets can happily contain significant levels of carbs, Bond adds. “When you look at a regime such as the Mediterranean diet, it’s about 40 per cent carbs. These are what our body and major organs, including our brain, use as a main fuel.

“People forget that fibre is carbohydrate. The fibre in starchy carbs is especially good at helping to keep our digestive system healthy. Gut health, in the form of your microbiome, is important for general health. Fibre acts as a fertiliser for friendly microbes.”

Some forms of fibre (such as oat beta glucan) can also help to reduce cholesterol levels, Bond says. And fibre from wholegrains is linked to a reduced risk of developing type 2 diabetes, as well as heart disease.

. . . so does portion size

The key, Bond stresses, is not to overload on carbs, but to stick with healthy serving sizes: a tennis ball-sized serving (about 150g) of cooked pasta, rice, noodles, couscous or other grains; one handful or five level tablespoons (30g) of wholegrain breakfast cereal; one potato the size of a computer mouse (180g); and one to two slices of wholegrain bread.

Such sentiments are echoed by Natasha Marsland, the senior clinical adviser at Diabetes UK. “While a low-carbohydrate diet can help some people with type 2 diabetes, it’s not the only option,” she says. “The Diabetes UK-funded DiRECT trial [being led by Professor Taylor] has shown that a low-calorie diet, alongside support from a healthcare professional, can help put people with type 2 diabetes into remission following weight loss.”

The key, it seems, lies not in condemning food groups, but in sensible, healthy eating. As Taylor puts it: “People who shout about low carbs or low fat just distract from the real cause of the problems — the fact that we are being fed calorie-packed processed food that is not good for us.”



https://www.thetimes.co.uk/edition/...enemy-m7v5nxptl
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  #11   ^
Old Wed, Dec-16-20, 07:40
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WereBear WereBear is offline
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I must say, I have noticed that the low carb advocates, doctors, journalists, what have you, all seem to practice what they preach. And they look good: not in any unhealthy way, either.

I have never understood the hysteria over eliminating "good carbs" from the diet because of their obsession with low fat, fiber, and vitamins that turn out to have very different absorption rates in different people.

And while I am, at best, nearly Carnivore when I'm eating right (I've been dinged by stress and holidays,) all my nutrient numbers are great when I do.
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  #12   ^
Old Fri, Dec-18-20, 11:00
Calianna's Avatar
Calianna Calianna is offline
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Quote:
The US recommends that people get half their calories from eating carbohydrates. So does Britain. However, in heated public hearings over the past 18 months, American low-carb advocates have pushed for guidelines to advise halving their recommended daily carbohydrate intake for millions of overweight people, to 25 per cent or less (about the same as the Atkins diet). In Britain, an official panel of leading dietary experts has put new draft guidelines on low-carb diets out for consultation, with the results due next year. Which way will we go in the war on carbs?




Wait - what? The official US RDA of carbs is a whopping 300 grams, which is actually closer to 65% of a "typical" 2,000 calorie diet. So to claim it's only 50% is already misleading, because 250 g would be 50%.


But ok, let's go with the fantasy that the US is only pushing 250 g of carbs. If we cut that in half, that's still 125 g carbs, which is in the range of what the ADA insists that everyone NEEDS to keep their brains functioning - and is still far too much for many diabetics to handle.... and they obviously don't know what Atkins levels of carbs are, because aside from the rare individual who can eventually climb up the carb ladder to 125 g/day without gaining weight, that's not Atkins levels.


Quote:
The report, which was commissioned by Public Health England, examined the best clinical-trial evidence on differing diets’ benefits for people with type 2 diabetes. For weight-loss it concluded that, after a year, there was no meaningful difference between low-carb diets and normal-carb diets.




When you're comparing a lower but still high carb diet with an even higher carb diet (which is not exactly what I'd call the best clinical-trial evidence), you'll always come to the conclusion that there's no meaningful difference.





What would really help them is to cut carb consumption to closer to 10% or less of calorie intake, which on a 2,000 would still be as much as 50 grams - still too high for a lot of us to expect to lose weight, and for many, still too high to expect to maintain weight loss.



But hey, at least if you can get it down to 125 or 150 g/day, people who are still in a normal weight range, and have normal blood sugar/insulin levels, that would probably keep them from gaining weight. Too bad that wasn't the point of the article at all.
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  #13   ^
Old Fri, Dec-18-20, 15:18
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GRB5111 GRB5111 is offline
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Yes, it's all in how you tell the story. One can come to some amazing conclusions when numbers are bent, distorted, or overlooked when telling the story.
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