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Originally Posted by Subby  You continue to sound as if you are busy constructing points against low carb, many assumptions and basing points on data you claim is flawed - yet you take and run with in order to "score" points. At times you verge on saying low-carb versus other are virtually equalised. Then there is a general tenor of "win or defeat" for a diet, that I do not understand, and which seems very premature given the variable indications present about these dietary options. I don't get where you are coming from, myself. |
What I'm busy doing is critiquing the study, not low carb diets in particular. Being less sophisticated, this study is a flash bang wallop get a quick showey result, and then launch a press release hailing low carb diets as the answer to diabetes. Were the authors aware of the effect of weight loss on Hba1c? Were they aware that weights would tend to equalise at around the 12 month mark? Did they follow up and quantify dropouts?
The study conclusion would be better phrased as - 6 months in those able to stay on a ketogenic diet experience greater weight loss and better glucose control than those on a low GI low calorie diet.
Yes the 5 out of 6 studies in the Cochrane looking at low-carb versus low fat diets were at high risk of bias and yes the Cochrane report could not draw a reliable conclusion. However these studies were judged to be the best available, and they showed no/little difference - I did point out that the results were unreliable. I notice that other posters were happy to accept the results of the Westman study uncritically.
When researchers publish articles which are intended for general consumption, I expect the researchers to honestly appraise and discuss the results of their study. Not only interpreting the results, but also pointing out the limitations of the study. What I don't like to see is a press release which is thinly disguised marketing, which is what this press release mostly is - as a side issue did anyone notice who the sponsors for the study were?
My personal view on low carb versus low fat diets is that theoretically there should be an advantage for a low carb approach in improving symptoms for type 2. However I am aware through reading that this may not be so. That the effect of diet may mostly be through weight loss. If this is so then clearly the best diet is the one that produces the best long term weight loss, and is the easiest to stick to. Clearly within this there is a high degree of individual variation as evidenced by the responses. The Cochrane report does list what kind of study that is needed to answer this question, and until some better evidence comes along, or someone comes up with a better interpretation of the available evidence then I don't believe I am going to change my position.
