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Comment by sph | Hacker News Reader

People that believe scientists and qualified medical doctors, operating on current research, are quacks because their research deviates on 50-year old advice, simply have no idea how science works and evolves. Please point me to anti-vax and homeopathic panels going over actual peer-approved studies.

Those videos I linked contain dozens of research papers and data for you to cross-reference, but given your snarky one-line dismissal with no further elaboration, I don't think there's any intelligent discussion to be had here.

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I've had to do some research into various health issues this year and I've been shocked by how poor some of the original papers are.

Tiny studies of very limited demographics, studies with questionable premises (like this one), in vitro being generalised to in vivo, conclusions that say "This effect could go either way" turned into "Don't ever..." advice, and so on.

This isn't anti-vax nonsense on YouTube. These are medical papers in mainstream medical journals which define medical policy.

Of course "poor" does not mean "worthless" so there's often still some signal in the noise.

But "you should lower your cholesterol" is a perfect example of bad research leading to bad messaging.

The science actually says you should manage LDL, HDL, triglycerides, and blood sugar and keep all of them in their healthy ranges.

Some doctors will tell you that, but many won't - because many don't even know.

I've been in the Keto community for years, until I realized that the whole community is full of quacks, indeed.

There's no intelligent discussion to be had because the Keto “science” has been proven wrong repeatedly. At this point, I don't think it's worthy of respect, actually. And don't get me wrong, I don't want censorship or anything of the kind. People believing that crap will eventually realize that it hurts them, whereas a small minority will double down.

The problem with the Keto “science”, and its arguments, is that the goal posts are moved, much like anything non-falsifiable, and the studies that are supposedly in their favor are cherry-picked, or misinterpreted. Whereas, they dismiss studies or reviews that prove them wrong, even if high quality (e.g., RCT, pre-registered), based on non-scientific grounds (e.g., not long enough, use of the wrong proxy markers, etc.). What's ironic is that we do have year-long, high-quality studies on nutrition. Diabetes and cardiovascular disease are understood fairly well, but they rarely attack those. They are also full of double standards, crying “conflict of interest” from the “sugar and oil industry”, while not observing the conflict of interest in their backyard, including the conflict of interest from those peddling the nonsense.

And all the nonsense they spew on cholesterol is accompanied by a conspiracy theory involving Ancel Keys and his limited selection of countries to study. They conveniently ignore the facts that a selection had to be made post-world-war, as few countries had data available, and those studies are pretty good, actually, and his findings were replicated. Keto and conspiracy theories go hand in hand.

When I made the comparison with anti-vaxxing or homeopathy, it's quite a literal comparison. They have conferences and are “science”-based too.

yeah unfalsifiable beliefs are always starting at an outcome and trying to prove that

as opposed to starting at a hypothesis and accepting any result, and any future hypothesis and result modifies everything, the only question asked is whether it can be reproduced and how the reproduction went

unfalsifiable beliefs have no capability of doing that, or, as you say, the goal posts keep moving. its just a flawed place to start from

faith based belief systems are taking advantage of people that lack the mental faculties to understand that others aren't relying on beliefs, they're relying on reproducibility and acceptance of any outcome

There can be no good studies on keto since it has only recently resurged.

Also big pharma and big food won't be sponsoring it any time soon.

You can find many examples of people who cured what their doctors told them "uncurable illness" by following keto or carnivore diets.

You can find 105 pages of testemonials how keto/carnivore helped people:

https://carnivore.diet/category/success-stories/

Yes, but this is the best example of how the plural of anecdote is not data.

"But it's only anecdotal". Then one learns that most of nutrition research is nothing more than that. No one is doing double-blind randomised nutritional studies for any significant amount of time. Who's got money, time and patience to take thousands of people, lock them in a room and control everything they eat for 2 years? And how would you do double-blind food testing?

Of course the entire field is dubious, and then there's the commercial interests.

This is to say, actual success stories are probably the best we've got. In my experience, carnivore is excellent, albeit very restrictive for many.

There are quacks in particle physics as well. That does not mean the field is hopelessly broken, a scam, or a pseudo-science, as you originally claimed.

And it's not a conspiracy theory to question the fact that since we introduced low-fat dieting, obesity has gone from being a circus attraction to common place. "We're eating too much" does not explain it either, and you just need to have read a couple papers after 1995 to see this is exactly where mainstream science is going. Calling it a conspiracy theory is not scientific rebuttal.

Again, there is no discussion to be had where there's dogma, and painting everything with the same brush, and certainly not on a forum comment.

> to question the fact that since we introduced low-fat dieting, obesity has gone from being a circus attraction to common place

I don't really know about keto, but the problem as widely understood with obesity is calories, not just calories from fat. And the easiest way to onboard calories without realising is to snack on sugary food and drinks.

Also, your point relies on the idea that the population is doing low-fat dieting. They may not be in the first place.

The only sensible diet I know of is the No S diet[0], which is so simple (and free) that it fits into the hover title of its web page.

[0] https://www.nosdiet.com

I have banged on why calories doesn't explain the full picture probably a dozen times on this site, and I'm not sure I want to go into that any more.

Yes, "thermodynamics". But we are not a simple furnace (which is by the way the very thing used to calculate the calories in food. A furnace). We are a complex machine with thousands of chemical pathways, feedback loops, some more efficient than others. You do not eat pure energy, you eat organic matter that is chemically turned into multiple forms of energy.

Nothing has been a better ally to the obesity epidemic than CICO (calories in, calories out)

> Nothing has been a better ally to the obesity epidemic than CICO (calories in, calories out)

I doubt that's true. The availability of Mars Bars and magic food diets (Fat is bad! No, now carbs are bad!) are more likely culprits. People don't fail to lose weight if they count calories. People fail to stick to their diets if they count calories, because it's a joyless activity; biology divorced from psychology.

The Mars Bar is available and says "can be part of a healthy diet" BECAUSE of the calorie bullshit. People see "it's only 250 calories" and "it's less fat than cheese" and happily chomp on them, while demonising red meat or saturated fat.

I genuinely don't see a logic chain of reasoning from you. 250 calories is massive. If someone were worried about calories they wouldn't be eating something that's over 10% of their daily allowance.

The "it's less fat than cheese" isn't a calorie thing. You seem to be mixing things up.

I used to think it was as simple as calories in/out, until I learned that certain fibers (and their calories) and totally non absorbable by the body, so their calorie content doesn't matter...among other things that don't follow the in/out rule.

The often forgotten assumption of the "calories out minus calories in is all we need to look at" is that the metabolic rate is independant of the kind of food we ingest.

There is also food => inflammation change => body water gain/loss.

> There are quacks in particle physics as well.

Not nearly as many, unless you consider "unpublished people posting videos on youtube" to be "in particle physics." There is a meaningful difference between scientific communities that are centered in universities and wellness communities that are happy to include every influencer with enough followers on tiktok.

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