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1. Let's try a different approach. A thought experiment. Bear with me (please), I'm going to ask for your predictions.
You are hypothesizing that what happens over 2 weeks predicts long-term effects. I (we) doubt it.
So imagine the 6-month version of this precise study. https://twitter.com/KevinH_PhD/status/1352442805000548354
You are hypothesizing that what happens over 2 weeks predicts long-term effects. I (we) doubt it.
So imagine the 6-month version of this precise study. https://twitter.com/KevinH_PhD/status/1352442805000548354
2. That solves the 2-week/too-short problem and @davidludwigmd's (I think very) valid point.
So six months instead of 2 weeks.
Subjects are ob/insulin resistant.
A feeding trial: subjects eat only what's given; they determine how much.
LCHF/Keto vs. LF/Vegan
So six months instead of 2 weeks.
Subjects are ob/insulin resistant.
A feeding trial: subjects eat only what's given; they determine how much.
LCHF/Keto vs. LF/Vegan
3. What do you, @KevinH_PhD predict would happen? (But everyone can play.)
Again, your paper/tweets imply no meaningful change in ad-lib intake from 2 wks to 6 months.
Is that correct?
And no meaningful change in rate of fat loss?
Correct?
For either diet?
Again, your paper/tweets imply no meaningful change in ad-lib intake from 2 wks to 6 months.
Is that correct?
And no meaningful change in rate of fat loss?
Correct?
For either diet?
4. My predictions (foolishly?):
A. LCHF/K group loses significant weight/fat without hunger.
Why? Because LCHF/k is a weight-loss diet and prescribed typically ad lib. And it minimizes insulin.
A. LCHF/K group loses significant weight/fat without hunger.
Why? Because LCHF/k is a weight-loss diet and prescribed typically ad lib. And it minimizes insulin.
4B. Some LCHF/K dieters decrease consumption compared to baseline, some don't.
Why? Because the effect of lowering insulin and mobilizing/oxidizing the previously stored fat --i.e., getting leanner -- can manifest as either an increase in intake AND/OR decrease in expenditure.
Why? Because the effect of lowering insulin and mobilizing/oxidizing the previously stored fat --i.e., getting leanner -- can manifest as either an increase in intake AND/OR decrease in expenditure.
4C. Per pound of fat lost, the LCHF/K dieters consume considerably more calories than do the LF/V dieters.
Why? Because I expect little to no metabolic compensation when carbs are restricted, rather than kcals. Subjects aren't starving; their bodies don't respond as if starved.
Why? Because I expect little to no metabolic compensation when carbs are restricted, rather than kcals. Subjects aren't starving; their bodies don't respond as if starved.
4D. LF/V dieters lose significant fat (more, say, than half a dozen pounds) only by further restricting calories consumed.
Why? 1. LF/V is not a weight-loss diet unless calories are consciously restricted. (I'm assuming they were unconciously restricted in your 2 wk study.)
Why? 1. LF/V is not a weight-loss diet unless calories are consciously restricted. (I'm assuming they were unconciously restricted in your 2 wk study.)
4D. Why? 2. The Keys starvation study.
Subjects fed 1600 kcal/day of 17% fat diet.
Average weight loss: 1 lb/wk for 12 weeks and then 1/4 lb for next 12.
But they were, well, starving.
If eating ad lib->more kcals/d->less weight loss. https://www.nytimes.com/2015/08/30/opinion/diet-advice-that-ignores-hunger.html
Subjects fed 1600 kcal/day of 17% fat diet.
Average weight loss: 1 lb/wk for 12 weeks and then 1/4 lb for next 12.
But they were, well, starving.
If eating ad lib->more kcals/d->less weight loss. https://www.nytimes.com/2015/08/30/opinion/diet-advice-that-ignores-hunger.html
4E. Hunger will be an issue for LF/V dieters who do try to lose fat/weight.
Why? They will have to calorie restrict to do so and (per the Keys study) they will experience both hunger and metabolic compensation.
Why? They will have to calorie restrict to do so and (per the Keys study) they will experience both hunger and metabolic compensation.
5. My caveat: since 10% fat vegan diets are new to human populations/experience, I'm less comfortable with my predictions for those diets than LCHF/K. As I say in TCfK, I can imagine they starve the body of fat, not calories. The long-term response would be interesting to see.
6. What would you, @KevinH_PhD predict?
But anyone can play. Please provide predictions and explanations.
If you don't believe two week response (i.e., present study) predicts 6 month response (our thought experiment), please say why.
But anyone can play. Please provide predictions and explanations.
If you don't believe two week response (i.e., present study) predicts 6 month response (our thought experiment), please say why.
7. What I would like to know, @KevinH_PhD , is your level of confidence that the 2 week results and the 6 months results would be effectively identical?
That's the key issue, of course: if what happens at > 2 weeks is significantly different, why discuss a 2 wk trial?
That's the key issue, of course: if what happens at > 2 weeks is significantly different, why discuss a 2 wk trial?
8. Isn't this how science should work?
When a study is criticized, design/do one that addresses the criticisms.
A 6-month trial tests the hypothesis that what happens over two weeks tells us what happens over months, maybe even years or decades.
When a study is criticized, design/do one that addresses the criticisms.
A 6-month trial tests the hypothesis that what happens over two weeks tells us what happens over months, maybe even years or decades.
Perhaps worth discussing with your friendly NIH funding agents?
This trial could be done for 1/50th-1/100th of the DAILY medical costs of ob and db in this country.
This trial could be done for 1/50th-1/100th of the DAILY medical costs of ob and db in this country.
