I appreciate your openness to low-carbohydrate diets as a valuable tool for wt loss. As for their benefit being *limited* to wt loss, how do you reconcile that with improvements in metabolic health that precede wt loss--and that even preclude wt loss? https://insight.jci.org/articles/view/128308 …
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Replying to @ahhite
As far as I'm aware current best evidence supports a short-term benefit but no long-term difference for low-carb diets. Unsure if a 3-6 month improvement is enough to recommend a specific dietary pattern over anotherhttps://www.ncbi.nlm.nih.gov/m/pubmed/29522789/ …
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Replying to @GidMK
Not asking about "short-term benefits." The question is "Can metabolic improvements be separated from weight loss?" The Volek team showed that they can be, although there are other studies that demonstrate similar effects with carbohydrate restriction. How do you explain this?
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Replying to @ahhite
Well, it certainly doesn't in long-term RCTs. The fact that a single small study that fed its subjects demonstrated these benefits is less convincing to me than the many studies that have not found any such improvement
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Replying to @GidMK
First of all the meta-analysis that you pointed to defines CHO restriction as less than 45% of kcals. Let's be realistic about this. Clinicians who use therapeutic carb restriction don't 1) use % kcals or 2) use a level of carb intake that high.
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Second, I'm talking about a mechanism (efficacy). Why do we see metabolic improvements with carb restriction before wt loss occurs? (PS. This also happens with bari surg). What you are pointing to is effectiveness or how carb restriction is implemented in an RCT.
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If the intervention is too weak to demonstrate a significant difference, that doesn't mean that a different intervention--maybe focused on & supporting carb restriction rather than wt loss--wouldn't have more efficacy. But if we revert to "it's just the wt loss" in all cases,
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which clearly isn't the case, then we can't learn more about what might be more efficacious. And if we don't learn about that, we won't be able to learn more about what *could* be more effective. Again: How do you explain metabolic improvement prior to/in absence of wt. loss?
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Replying to @ahhite
Honestly? No idea. I don't know nearly enough to argue about mechanisms
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Replying to @GidMK
LOL That's a starting point anyway. Then you really don't have enough information to say low-carb diets are unlikely to be better than similarly low calorie high carb diets. Because that *likelihood* does exist. Calories need not be restricted, even inadvertently, for benefit.
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And yet, after more than a decade of research, hundreds of studies, this mechanistic difference that is so very clearly demonstrated has yet to show benefits in real-world studies 
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