Which comes first, high insulin or obesity?
Conventional view:
weight →
insulin (ins resistance)
New study:
insulin →
weight
Raises new possibilities for obesity treatment
Consistent with Carb-Insulin Model of Obesity
h/t @bschermdhttps://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777423 …
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Replying to @davidludwigmd @bschermd
I'm confused. How is this consistent with the CIM? This is about fasting insulin. CIM is about the post prandial insulin surge following CHO meals, causing the internal starvation state that drives further intake - is it not?
5 replies 2 retweets 41 likes -
Am I missing something here or is this association *only* in people who had gotten bariatric surgery? If so, that should dramatically change the conclusions we can draw.pic.twitter.com/NtelyHPa9K
3 replies 0 retweets 14 likes -
Replying to @TamarHaspel @JohnSpeakman4 and
Am I missing something here or is everyone jumping on these results w/out having considered the quality of a) the review & b) the data therein? How do we know we don’t have GIGO (no, not CICO)? A quick check: n=90 for main finding, Obs studies = Low/very low certainty likely
2 replies 0 retweets 5 likes -
Replying to @dnunan79 @TamarHaspel and
Looks like the review used a fairly loose risk of bias rating system and even then found that a majority of the included research was high risk in at least one areapic.twitter.com/yIszy36PbB
2 replies 0 retweets 2 likes -
Replying to @GidMK @TamarHaspel and
Yeah downs and black is one (not much used) tool to assess RoB is obs studies. I need to read fully to se how RoB is incorporated into conclusions, but other important issues like consistency, precision, information size, directness etc need to be considered.
1 reply 0 retweets 1 like
Yeh, given it's mostly obs research it's problematic in my opinion that there's no assessment for pretty basic stuff like rating selection bias in the paper
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