All carbohydrates become sugar, sugar elevates insulin, constantly elevated insulin leads to diabetes.

I'm not sure all the causes of Type 2 diabetes but I would wager that the current epidemic of Type 2 Diabetes is caused by too much sugar.

These are anecdotes.

1. it doesn't matter what you eat, what matters are the calories; you could eat whole plants all day, but add a lot of added fat to your meals (e.g. French fries) or sugar, and there's plenty of potential for caloric excess, even from salads. And I don't know about your family, but my family living in the country side drank a lot of alcohol.

2. People have a "personal fat threshold", when that threshold is reached there's nowhere for the excess to go and people develop diabetes; this is why some people develop diabetes sooner than others. So yes, it is possible even for skinny people to get diabetes and genetics definitely play a role.

I find it baffling that even on this site people don't understand the value of anecdotal evidence (near zero), or that evidence has to come from a clinical setting with a control group and that epidemiological data must "disprove the null hypothesis".

Before trusting your own anecdotes, are you sure you isolated the variables? Have you watched them day in, day out? You know, it's a curious thing but overweight people in public don't eat much, overeating happens in private.

You should read the evidence for "energy poisoning" and then take a more critical look at your family.

Nothing but vegtables, with meat once a week is not anywhere close a balanced diet. Veggies are mostly carbohydrate, which does not help either. But as most will point out, whith that many people affected in the family it is likely a genetic predisposition.

>Vegetables all week and maybe on Sunday a roast probably fowl of some sort.

That's not a balanced diet.

I got into it when I read https://www.nature.com/articles/nrn.2017.156. The thing is that a lot of nutrition research is rather low-quality compared to the rest of science (low n in studies, small effect sizes, low study power, high chance of finding false positives, etc.), and it gets even worse once you start reading sports science papers especially nutrition for sports performance. The best conclusion I found was that a lot of these things like intermittent fasting have small but noticeable effects, meaning that if you can follow IF easily then you may as well do it (like Pascal's wager!), but there is no solid evidence that you actually should do it because the effects are uncertain and small. One pitfall of a lot of these discussions is that people point to papers that show "an effect exists", but forget to ask "how big is the effect?".

I was okay with IF for uncertain small positive brain effects, because my brain is important to me, and it's kind of free, so IF will do. But I think people overstate the effects a bit compared with what's actually known by science.

Take the study you linked to, for instance. I can quite believe that IF would increase insulin resistance based on what I've read, and it's cool that they found lower blood pressure and higher insulin resistance in pre-diabetic men. But the study has 12 people (mid-50's pre-diabetic overweight men) in it, and I don't really know what to make of that? Is this type of study particularly expensive to conduct? Should I find it convincing because I already agree with the result?

My gut reaction to the study is even simpler (not scientific, just personal): Why on Earth would anybody eat dessert for breakfast (Honey Nut Cheerios, waffles with maple syrup, etc, in Figure 1)? If you're already overweight and pre-diabetic, why is the control diet making you eat that? But they get a boiled egg, I'm guessing one?, to, you know, control cholesterol levels or something, two eggs would be crazy. They were probably trying to separate the effect of IF from the effect of eating a normal diet, as compared to the standard American diet, so didn't include a normal diet at all.

> There's a solid argument to be made that when you eat, and how often you eat, is more important than what you eat.

Yes, there is good research suggesting that fasting can offset many (most?) of the ill effects of eating poorly.

> By creating long gaps between meals, your body re-establishes what baseline level of insulin should be.

One of the nice things about Keto is that you can get many (if not most) of the benefits of fasting without needing to fast. Some research suggests that some of the benefits of fasting likely come from being in ketosis during the fast.

It's starting to look like ketones do more than deliver fat to your cells. They are also treated sort of like a hormone, which has other beneficial effects on your health.

Keto is not a balanced diet -- by definition the goal is to place your body into ketosis (by removing carbohydrates from your diet). I'm not sure what definition of "balanced" you're using, but I wouldn't call removing an entire class of macronutrients "balanced".

Note that hunter-gatherer human societies didn't just eat meat, they almost certainly ate berries and fruits (both of which contain sugars and are thus excluded from Keto diets -- though to be fair, modern fruits are quite different to their ancient counterparts). And early human societies definitely consumed grains.

Don't get me wrong, feel free to have whatever diet you prefer. But Keto is by design not an example of a balanced diet, nor is it accurate to make an appeal to nature when discussing it.

> The Western diet is highly unbalanced in favor of carbohydrates and sugar

I don't disagree with the sentiment that modern western diets are on the whole incredibly unhealthy (though large quantities of unhealthy fats are hardly blameless). But carbohydrate consumption is not limited to the Western world, nor is it a new phenomenon.

Rice has been a food staple in Asia for an incredibly long time (having been domesticated in the Neolithic Period). And bread has existed in the Middle East and Europe for even longer.

> The food pyramid we all know and love is a product of over two centuries of industrial agriculture.

And fittingly, was provided to us by the Department of Agriculture, not the Department of Health as one might expect.

Note that it is giving the advice itself that is not working, a casual perusal of statistics would show few people are actually doing it. The actual advice, if actually followed, is pretty sound though.