People like to hate on low-carb approach. They say things like "It causes liver problems" which don't have a basis in reality. Human beings survived for thousands of years on way fewer sugars and starches than we have today.

It's particularly bad in the US due to the availability of high fructose corn syrup, which means America products tend to contain more sugar than their overseas counterparts.

A few years ago I started going strong on a keto die, cutting out soda, pasta, bread, etc. and eating a lot more vegetables, meats, cheeses, etc. There an initial shock about two weeks in which some people can't get past, because your body has to get use to using fat as a primary fuel source instead of sugars/starches. Once I got past that though, I could cycling farther, my weight training sessions lasted longer with less fatigue, and I dropped from 72kg down to 63kg over the course of several months.

My lowest was 60kg for nearly two years! Moving back to America has been difficult. It's hard to find the same quality of ingredients and I just got burnt out on cooking my own food all the time. There is very little healthy stuff off the shelf here. In the past two years I've slowly rose back up to 67kg and it's upsetting.

I wish there were more low carb options when eating out. Salads at pubs are often loaded with croutons and fruits, there are lots of hidden carbs in salad dressing and there's just a lack of healthier options here.

The food industry pushed hard against the Adkins movement in the early 2000s. Imagine if we had kept going down the route. Would obesity have dropped significantly in the US? We'll never know. But this article goes with a lot of the current research: fat doesn't make you fat. Sugars and starch do. They have a much higher energy density and sugar is huge contributor to heart disease.

That's really the key to what is fixing the diabetes. And it's just a brief mention in the article. Nothing else about the nutritional aspects. This was extremely light on actual, real information.

That being said, I'm also not sure why this stuff is still considered news. Many people, myself included, have been saying for some years now that low-carb is the way to go. I'm glad this stuff is getting press, but I'm just surprised that people seem to be acting like this hasn't already been known for quite a while.

The real problem is that people can easily fix this themselves, but they either 1) don't know this information or 2) don't have the willpower. It's more of #2 though, because people generally know when they are eating garbage. There might be some foods that surprise people as having extremely high glycemic responses, but most of the time they know what they should be avoiding. The problem, I think, is that they don't quite know exactly how horrible what they are consuming really is for their metabolic processes. The one that seems to surprise people is potatoes. They know french fries are bad, but think it's because they are deep fried. When I tell them that a regular baked potato or red potatoes have glycemic index values of around 85-89 and that potato chips are around 50-55 they are stunned. I don't know why, but they are. If you are consuming the same mass of food for comparative purposes, the potato chips are loaded with fats where the regular potatoes are not so that makes sense to me that it would be lower. This tells me there is a serious lack of education on this topic and it is quite literally costing people their lives.

Also, I'm skeptical of the claim that obesity does not cause T2D. Is this backed up by good studies?

I can't help but notice their average BMI was 40. That's in the "extremely obese" category - pretty sure we're out of the "massively muscled" category (exception - monsters like Ronnie Coleman, but let's be honest here, his blood serum reading come back "minotaur" and the muscle is probably doing damage). I'd always assumed that for the majority of the population going from an obese BMI to a normal/overweight one largely does the trick.

Meaning the symptoms get better and in some cases diabetes disappears.

Remission is the state of absence of disease activity in patients with a chronic illness, with the possibility of return of disease activity.

I'm relatively sure that if patients quit their new lifestyle, they get to back to diabetes symptoms faster than those who didn't develop diabetes. It's also possible that they just delay the progress and after 5-10 years changes of nutrition is not enough anymore. Even then the results would be huge improvement.

The only link with some facts was this paper: https://asset.jmir.pub/assets/a2c0047f60bd77156d22029b8bdd5c...

His channel: https://www.youtube.com/channel/UC3w193M5tYPJqF0Hi-7U-2g

One video: "Can Diabetes be reversed?" https://www.youtube.com/watch?v=NdpnAkYlWwo

Keto Diets (and intermittent fasting) have been shown to help "reverse" type-2 diabetes, since it moves people out of the medical criteria for the disease. But if the original lifestyle returned that individual may become classified as a type-2 diabetic again.

So, pro-tip from me: find a doctor who answers "yes" to the question and work with them, if you have T2D and want to reverse it.

(ignoring the "at scale" part of the OP question... for various reasons)

For context, I'm a T2 diabetic, whose diabetes has "progressed" to the point that I take insulin. I'd recently had to adjust my dose to 100U / day (I only use a once a day, long-acting insulin at the moment).

Then a buddy of mine mentioned a book on fasting[1] and said that some diabetics had had great results from fasting. I ordered the book, but haven't read it yet. But I did start a sort of psuedo-fasting routine of my own design. Basically, I allow myself a normal sized meal, and then for the next 48 hours I an aggregate total of maybe 1000 calories. A typical meal during that time is a thin soup made of chicken broth, jalapeno peppers, banana peppers, cherry peppers, cactus and onion, with some spices thrown in for flavor. Note that jalapeno peppers, banana peppers, and cherry peppers, and cactus share a common trait: extremely low calorie content, and low carbohydrate content.

Anyway, after doing this for about 2 weeks, I can already see a pronounced difference (for the better) in my blood sugar numbers. And that's even after lowering my insulin dose a bit.

I don't know that the protocol I'm using is anything close to what the experts recommend or not. But it definitely seems to be having a positive impact. I'm really looking forward to seeing how this works out long-term. Especially once I can start lifting weights again (I hurt my arm a few weeks ago doing some bench presses and haven't been able to lift for a while). Resistance training has been shown to help with insulin resistance, so I'm hoping the combination of regular lifting and this dietary approach will yield some good results.

[1]: https://www.amazon.com/Complete-Guide-Fasting-Intermittent-A...

I'm also somewhat skeptical of the evidence that the ketogenic diet can cure diabetes (or cancer / autism etc). I haven't looked into it in depth, so may be wrong, but all I've seen in the way of evidence are 1) anecdotal cases 2) hypotheses about a supposed biological mechanism (haven't seen any good studies validating this mechanism) and 3) appeals to evolution, i.e. "People ate low carb for most of human history etc", again with no rigorous science (that I've seen) to support this, just logical sounding claims

You'd need large randomized controlled trials to really test 1) whether it works, 2) whether it's safe and 3) whether the benefit is attributable to a low carb diet or to people just being on a diet in general. Unfortunately those are expensive so will probably never be done because no one requires them (like FDA for drugs)

Proponents of keto diet also cite the entrenched corporate financial interests that led the low-fat wave based on shoddy science. The same dynamic is at play with low carb. I asked a very well funded company marketing keto diet products about their clinical research efforts, and they said they don't have a clinical research arm -- all the clinical studies fall under the marketing department

I'm not saying it's pseudoscience, but based on the limited data I've seen I don't think we can rule that out

[0] https://www.google.com/amp/s/www.citylab.com/amp/article/560...

I'm frankly SHOCKED by the amount of people I encounter on a daily basis -- even my own damn significant other -- who have no idea what a carbohydrate even is. I love my SO to death, but I was appalled he had no idea grains and potatoes were carbs, and he is very well educated and works in tech.

If someone like my SO can't understand what a carb is, how do you expect your average American to get it?

Nutrition education in this country is so disappointing.

Having T1D and a CGM I can say the normal potatoes are much easier to control compared to the french fries. The fat is really a huge problem if you dose your own insulin. It is guaranteed if I eat french fries that I don't need that much insulin right now, but the fatty food will raise my glucose levels in the next five hours. If I eat the fries for dinner, I can guarantee to be in the upper high levels at night when I sleep.

This is of course fixed with a closed loop system, but that doesn't help the T2Ds out there that much.

https://gearjunkie.com/bike-team-race-food

I think there's at least a 75% chance that the whole cure is essentially contained in that sentence.

I've been keeping a bit of an eye on this area for a while, and watching the studies fling back and forth and such. My current pet theory that I think explains a lot of observations is "Carbohydrate-restriction diets (such as Atkins) work well on obesity caused by insulin resistance and metabolic syndrome, and may even be able to reverse the underlying causes, but may be ineffective for other causes." Basically, if you damaged your pancreas to some degree (or convinced them to stop working, or whatever; "damaged" them in terms of end result not necessarily "harm to the pancreas"), carb restriction may work well for you, but if that's not the core problem, it may not work for you at all. This may explain the variance in studies, if there is an unaccounted for variance in the populations being studied and how affected by metabolic syndrome they are, and why for some people low-carb diets work great and for others they fail completely.

I've also noticed as I've been getting into some intermittent fasting and such that when I'm doing it, I seem to be more able to consume a higher degree of ("good") carbs without it going straight to my waistline, as if I'm actually repairing or healing some things that I broke in my teens. (Where I considered a Coke and a king-sized package of Skittles a good after-school snack; it wasn't bad for you, there was no fat in it!)

(Perhaps slightly less controversially, what if the term "obesity" is actually like the term "schizophrenia"? We know the term "schizophrenia" is a catch-all term for what is almost certainly multiple distinct disorders that we currently lack the technology or know-how to distinguish. What if "obesity" is actually several distinct problems, with several distinct cures? In some sense, we already know this is true, because for instance thyroid malfunctions can cause issues with weight. But what if what's "left over" after those other cases is still three or four distinct things we're currently lumping together, and that we lack the tech or know-how to distinguish? It wouldn't really be that shocking.)

But note I label this "pet theory" for a reason. I'm not claiming to have Truth here, just a pet theory.

I do know at least one person who has Type 2 Diabetes with a regular BMI, but even the article points out the average BMI was 40 - I really hope that's not the average population's BMI. I guess you could argue chicken & egg (diabetes causes obesity... maybe?), but in this case the egg is rather fat.

Look for neal barnards books, including a cook book.

I don't have any studies for you though.