"The other side of our town is quite affluent, and one observation I've made is the presence of several high-end nursing homes. Additionally, there are a few adult daycare centers. It's intriguing to see the number of adults utilizing these facilities throughout the day. This likely reflects the impact of cognitive decline, as discussed, which can lead to child-like behaviors and necessitate daytime care."
Excellent big picture heads up for the people! Some crucial complimentary information, that explains the origin of this backwards "healthcare" system, is in the chapter Trilogy of Lies: Part 3 (pgs. 145-147) from the book The Medical Mafia by Guylaine Lanctot MD.
When thousands of people improve every measure of health with low-carb diets, your refutation cannot be "well you're not actually healthy, and I'm a doctor, so I would know". People see this as gaslighting and arguing from authority, which has minimal rhetorical value. I want you to be right, and I think you're right 90% of the time, but I want you to show me *why* you're right 100% of the time. You agree that the very idea of authority within the realm of nutrition has been decimated by decades of bad info from the medical establishment, so why should people trust you at your word? Being an "expert" is meaningless to the uninitiated. You have such a powerful message but I think you underestimate how convincing it is to people working with different sets of data. The low-carb crowd doesn't have any issues with those who benefit from a vegan diet, but the vegan crowd becomes emotional when someone reports that their NAFLD, CKD, cholesterol, diabetes, obesity, depression, etc. significantly improved with low carb. In this day and age, the anecdote of "I don't know how it works, but me and untold thousands of people lost weight and became healthy" is significantly more convincing than "trust me, I'm a doctor."
Short term people can improve with any diet based on increased attention and the Hawthorne effect. Long term all that paleo keto carnivore stuff leads to poor health. This is well known. Trying to argue otherwise is like saying 2 + 2 = 5.
@@PeterRogersMD When you say paleo/keto/etc. long-term leads to poor health, are you citing a study that evaluated long-term outcomes, or are you taking physiological principles in a vacuum and generalizing them? I am seeing that you are in the habit of doing the latter, and I think this is where you run into the most problems when it comes to convincing non-laymen. For example, you claim that a high protein diet will create a phosphate sink in the kidneys to maintain pH, thereby lowering bone density. And I agree that this is true in principal, but it's really not obvious outside of a vacuum. For starters, meat contains phosphate, so carnivores aren't eating pure amino acids. Beyond the capability of meat to provide a consistent supply of phosphate, bone density is likely more heavily influenced by weight-bearing activities than whether or not you eat 50g/day of protein versus 150g/day or more. Thus, what is certainly true for sedentary females of osteoporosis-prone age is not necessarily true for all humans at all times. And this is the crux of the problem. There's so much nuance to the discussions you're trying to have--discussions that I *want* to have--but I don't think these ideas generalize to the purported scale. As a matter of routine, so much of what we thought was obvious in medicine has been proven to be far more complicated. For the longest time, we thought high protein was bad for the kidneys. This is because patients with renal impairment worsen when they consume excess protein, so this supposition was not without evidence. Physicians wanted to err on the side of caution, and this is admirable. But now we have new data. Every nephrologist and internist I've spoken with regarding high protein tells me, in no uncertain terms, that unless you have one kidney or you're a CKD patient, there's no evidence that high protein (south of comically high intake, e.g. 500+ g/day) is actually harmful to the kidneys. Could it be, for some people, at some point in their lives? Absolutely. You wouldn't want to consume 250g of protein the day after an episode of AKI, and if you did, it might cause irreparable damage. Is it a guarantee? No. A third point, because why not. Regarding keto for type 2 diabetes, if the diabetes is sufficiently severe, it should be obvious to any competent clinician that eliminating carbohydrates entirely will not lead to improvement (and can actually cause much harm). Serum free fatty acids are already through the roof, and the issue isn't merely one of insulin receptor sensitivity downregulated by chronically elevated glucose. The extant problems are numerous. You propose restricting dietary fat to increase insulin receptor sensitivity, and I think there's a time and place for this. For someone who is pre-diabetic, and their condition is obviously caused by excess dietary carbohydrates, restriction of carbohydrates is a sensible solution employed by innumerably many, and with great success. I don't see where the problem is. Neither prescription is one-size-fits-all, and I don't see that as a critical limitation for either carb-restriction or fat-restriction. You always want to use the best tool for the job.
"The other side of our town is quite affluent, and one observation I've made is the presence of several high-end nursing homes. Additionally, there are a few adult daycare centers. It's intriguing to see the number of adults utilizing these facilities throughout the day. This likely reflects the impact of cognitive decline, as discussed, which can lead to child-like behaviors and necessitate daytime care."
Excellent big picture heads up for the people! Some crucial complimentary information, that explains the origin of this backwards "healthcare" system, is in the chapter Trilogy of Lies: Part 3 (pgs. 145-147) from the book The Medical Mafia by Guylaine Lanctot MD.
When thousands of people improve every measure of health with low-carb diets, your refutation cannot be "well you're not actually healthy, and I'm a doctor, so I would know". People see this as gaslighting and arguing from authority, which has minimal rhetorical value. I want you to be right, and I think you're right 90% of the time, but I want you to show me *why* you're right 100% of the time. You agree that the very idea of authority within the realm of nutrition has been decimated by decades of bad info from the medical establishment, so why should people trust you at your word? Being an "expert" is meaningless to the uninitiated. You have such a powerful message but I think you underestimate how convincing it is to people working with different sets of data. The low-carb crowd doesn't have any issues with those who benefit from a vegan diet, but the vegan crowd becomes emotional when someone reports that their NAFLD, CKD, cholesterol, diabetes, obesity, depression, etc. significantly improved with low carb. In this day and age, the anecdote of "I don't know how it works, but me and untold thousands of people lost weight and became healthy" is significantly more convincing than "trust me, I'm a doctor."
Short term people can improve with any diet based on increased attention and the Hawthorne effect. Long term all that paleo keto carnivore stuff leads to poor health. This is well known. Trying to argue otherwise is like saying 2 + 2 = 5.
@@PeterRogersMD To clarify, you attribute the empirically verifiable benefits of a meat only diet to the Hawthorne effect?
@@PeterRogersMD When you say paleo/keto/etc. long-term leads to poor health, are you citing a study that evaluated long-term outcomes, or are you taking physiological principles in a vacuum and generalizing them?
I am seeing that you are in the habit of doing the latter, and I think this is where you run into the most problems when it comes to convincing non-laymen. For example, you claim that a high protein diet will create a phosphate sink in the kidneys to maintain pH, thereby lowering bone density. And I agree that this is true in principal, but it's really not obvious outside of a vacuum. For starters, meat contains phosphate, so carnivores aren't eating pure amino acids. Beyond the capability of meat to provide a consistent supply of phosphate, bone density is likely more heavily influenced by weight-bearing activities than whether or not you eat 50g/day of protein versus 150g/day or more. Thus, what is certainly true for sedentary females of osteoporosis-prone age is not necessarily true for all humans at all times. And this is the crux of the problem. There's so much nuance to the discussions you're trying to have--discussions that I *want* to have--but I don't think these ideas generalize to the purported scale.
As a matter of routine, so much of what we thought was obvious in medicine has been proven to be far more complicated. For the longest time, we thought high protein was bad for the kidneys. This is because patients with renal impairment worsen when they consume excess protein, so this supposition was not without evidence. Physicians wanted to err on the side of caution, and this is admirable. But now we have new data. Every nephrologist and internist I've spoken with regarding high protein tells me, in no uncertain terms, that unless you have one kidney or you're a CKD patient, there's no evidence that high protein (south of comically high intake, e.g. 500+ g/day) is actually harmful to the kidneys. Could it be, for some people, at some point in their lives? Absolutely. You wouldn't want to consume 250g of protein the day after an episode of AKI, and if you did, it might cause irreparable damage. Is it a guarantee? No.
A third point, because why not. Regarding keto for type 2 diabetes, if the diabetes is sufficiently severe, it should be obvious to any competent clinician that eliminating carbohydrates entirely will not lead to improvement (and can actually cause much harm). Serum free fatty acids are already through the roof, and the issue isn't merely one of insulin receptor sensitivity downregulated by chronically elevated glucose. The extant problems are numerous. You propose restricting dietary fat to increase insulin receptor sensitivity, and I think there's a time and place for this. For someone who is pre-diabetic, and their condition is obviously caused by excess dietary carbohydrates, restriction of carbohydrates is a sensible solution employed by innumerably many, and with great success. I don't see where the problem is. Neither prescription is one-size-fits-all, and I don't see that as a critical limitation for either carb-restriction or fat-restriction. You always want to use the best tool for the job.