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Anecdotal Evidence Butts Heads With Science on Matters of Diet

Published on April 10, 2024

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Have you noticed how the nutritional world is changing all around you? Latest news on television: the drop in sugar consumption placed manufacturers at a tipping point of collapse. News a few weeks earlier: grocery stores are redesigning their stores and the products they carry because the middle aisles are not used by shoppers (that is where they usually keep cereals, grains, sugars, and canned or boxed processed foods, cooking oils). McDonald’s announced not too many months ago that they are dropping high fructose corn syrup from their buns and several other fast food chains advertise wholesome fresh foods without sugar. Restaurants are popping up where glutinous grains are not served.

The interesting commonality about all of this is that these are all anecdotal evidences that the scientific world refuses to notice. What will it take scientists to become curious? A change in funding sources for research perhaps?

No one is suggesting that anecdotal evidence is science. It is not. Anecdotal evidence is defined as follows:

“Anecdotal evidence is evidence from anecdotes, i.e., evidence collected in a casual or informal manner and relying heavily or entirely on personal testimony. … Thus, even when accurate, anecdotal evidence is not necessarily representative of a typical experience.” (Wikipedia)

By definition, scientific “evidence” doesn’t exist. So, we must use the scientific method’s definition:

“A systematic approach to solving a problem by discovering knowledge, investigating a phenomenon, verifying and integrating previous knowledge. It follows a series of steps that evaluates the veracity or the feasibility of a prediction through research and experimentation from where the information obtained will be used as a basis in making conclusions.

The fundamental steps of scientific method are:

(1) Identifying the problem to solve

(2) Formulating a tentative answer or hypothesis

(3) Testing the hypothesis

(4) Gathering and analyzing data

(5) Making conclusions” (from the biology online dictionary)”

Looking at it this way, the only way scientific examination can yield any results that can be interpreted in usefulness (or lack thereof) and officially applied to a population is by experimenting in a controlled environment, testing every possible outcome, and finding what does or does not work, and most importantly: find out why and/or how.

The Evidence for Diet: Anecdotal or Scientific?

One of the most studied databases for scientific research is the Women’s Health Initiative (WHI), which is an ongoing study of over 80 years. As you can see at this link, the data has been collected three ways: self-administered forms, interviews, and clinical measurements, such as a general physical exam. You can see here the data collection methods. There is absolutely no scientific method whatsoever in this study. The only difference between this study and a survey posted anywhere on the internet about what people eat, is who does the asking, the data collection, and where the funding comes from.

Another famous dataset that researchers constantly analyze is the National Health and Nutrition Examination Survey, the NHANES dataset. This too is based on surveys and questionnaires. The questionnaires for 2015 are found here. There is no scientific method applied in them whatsoever.

However, both the WHI and the NHANES have been treated as the gold standard for scientific evaluation to the degree of making health and nutrition regulation for the US over the past nearly 60+ years. The nutrition guideline (even the latest one created in 2015), the heart-health movement, high cholesterol treatment with the statin ideology, the low fat hypothesis by Ancel Keys, and several other nutritional and medical decisions, including reduced salt intake requirement for hypertension, originally called the Rice Diet founded by Walter Kemper, had all been made based on datasets like these. Note that these datasets are all just anecdotal evidence. They twisted our imagination into believing that they are science because of the funding source (often National Institutes of Health, the NIH), the scope, and the length of the data collection.

While there is no science in data collection, so much of our lives have been changed (often destroyed) by the regulations made based on the often-faulty statistical analysis of these datasets that it is scary. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) tells us that 2 out of 3 (67%) Americans are overweight or obese and 1 in 3 (33%) are obese. In 2014 (the latest statistics available), over 9% of the population had diabetes. In 2015, a JAMA report suggested that over 50% of the US population was either pre-diabetic or had diabetes by 2012. This is scary indeed!

Although the cause of these very sad changes are highly debated and controversial, it is important to note a very strong point: the start of the deteriorating health of the US population coincides with the nutrition and health regulations brought about as a result of these two and several other similar databases. Note that thee databases are collections of anecdotal evidence that masquerade as scientific evidence—they are not. There has never been any shred of scientific evidence that a high carbohydrate diet is healthier than a low carbohydrate diet, yet current nutritional guidelines suggest that there is such evidence. There isn’t any. There are many research papers published based on the assumption that these guidelines are correct, in which the researchers tried to prove that they are correct. However, in science, one cannot prove something correct. The role of science is to try to disprove by replication and finding mistakes and if all attempts at disproving fail, perhaps the findings stand. There is not a single research paper published according to these guidelines based on the above noted datasets.

The Diet Underground

While scientists argue and face-off in debates of trying to make each other look bad, there is a different movement taking place that is apparently unnoticed by scientists: it is an underground grassroots movement of people changing their dietary habits and shaking obesity, insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease, hypertension, and all kinds of other health conditions. And they are doing it all by self-initiated dietary changes—not with the help of nutritional experts or doctors and definitely not with any medicines. It is because of this underground movement that grocery stores are now reevaluating the products they carry, why McDonald’s and other fast food chains dropped HFCS, and why people are stopping the consumption of vegetable oils and cook with animal fats instead.

Anecdotal evidence is piling up in favor of the health benefits of the “modern human” who no longer eats grains or sugar and who cooks with animal fats.

Social Media and the Rise of Anecdotal Evidence

I counted the number of weight loss groups on Facebook. There are over 500. At least five of these groups have over 20,000 members, so that is over 100,000 people. Ketogenic groups are much larger; many have over 70,000 members and one had almost 400,000 members. There are more ketogenic groups on Facebook than weight loss groups—I could never reach the end of the list after five minutes of scrolling so I gave up. I estimate the number of people in ketogenic groups to be over one million. Although the Atkins Diet is the original ketogenic diet, since few people realize that, there are about 100 Atkins Diet groups, with one boasting nearly 400,000 members and several over 10,000 so I estimate about 500,000 people on the Atkins Diet just on Facebook. Similarly, there are about 300 low carbs high fat (LCHF) groups of Facebook with several groups over 10 thousand in membership, one close to 40,000 so I estimate approximately 100,000 members in the LCHF groups.

If you visit any of these groups, you will find amazing success stories of weight loss, reversal of type 2 diabetes, pre-diabetes, insulin resistance, non-alcoholic fatty liver disease, allergies, arthritis, asthma, etc. In total, I just noted ~2 million people (granted some people may be in many groups but as a rough estimate) as anecdotal evidence (just on Facebook alone) who have proven (to themselves and to scientists who wish to listen) everything that flies in the face of nutrition and medicine guidelines currently enforced and practiced. Since scientists dismiss the movement as a fad, few scientists like me participate in observation, let alone practicing this “fad” to see if it really is better than the official guidelines-driven nutrition and healthcare.

As a scientist myself, I do participate actively in some of these Facebook groups, and even have several of my own, in which members practice these so called “fads” and indeed are shedding weight, healing from migraines, diabetes, insulin resistance, hypertension, etc. A scientist may now say that “but these are only placebo effects.” That is very hard to envision since these people also stop all their medicines, all of which came through clinical trials tested for efficacy against placebo. Increating to weight 400 lbs over the years on the officially supported nutritional guidelines in spite of all efforts to get rid of the weight, and then losing it all in a year by a nutritional change and becoming healthier at the same time, speaks volumes!! And I see this happen over and over again!

I often hear that “oh but this is just short term.” I have yet to have any scientist define what “short term” versus “long term” means in their experimental mode but someone who has been on a changed nutritional diet for over two years (me) is definitely not short term. There are many people who have been following these new nutritional paradigms for over 10, 15, and some 20 years. Is that really short term?

The Winners

The ultimate decision is not in the hands of the scientists, the nutritional experts, or the healthcare providers. The judgment of what people will do is in the hands of the people. It seems, just by sheer numbers and success stories, that science is losing out big time. Instead of opening their minds and evaluating why and how these nutritional changes work, most scientists stay closed off in their dogmatic corners. There are a few scientists who try to publish their findings of the benefits of the “fad” nutrition but they seldom get published because the publishers are members of the dogmatic team. In reality though, none of that matters. What matters is information exchange and the changing markets as a result of pressure by the majority who want out from under the dogma umbrella. One way or another the new and healthy will win. Whether you join or are left behind is only up to you.

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This article was published originally on June 5, 2017.

The Insulin Resistance Time Bomb

by Angela A Stanton, PhD

Published on September 12, 2017

8656 views

I seldom watch television but for some reason nearly every time I do, the same commercial pops up. It goes something like this: a couple of women are sitting on a bench, chatting, when a guy walks up to them and asks if they have T2D (the answer is “yes”) and then he asks if they know that T2D can cause heart disease. The women act very surprised since they didn’t know. Why did they not know? And how come the pharmaceutical companies know that people don’t know? This commercial always makes me pause because it is so clear that we do not know what is happening to us.

We all know the scary statistics: the CDC admits that 9.3% of US adults are diagnosed with type 2 diabetes (T2D) as of 2010. The key word here is diagnosed. That is because more people are not diagnosed but have T2D than those who are diagnosed. It is estimated that over 30% of the population has T2D only they don’t know they have it. So one must ask a few questions:

Why do so many Americans have T2D?
Why don’t so many Americans know that they have T2D?
What causes T2D?
How does T2D start, why, and when?
Can T2D be prevented?
Can T2D be reversed or at least put to remission?

So let me be the one who tries to explain. The topic is not easy to explain so I am breaking it up into several parts, each at a different level of depth. In part 1 of this series, I will begin by discussing what nutrients are and how they connect to T2D. This will help explain why so many Americans do not know they have T2D and why they remain undiagnosed.

What Are You Eating?

If you look at what is sold in grocery stores today, you will find that over 80% of the stores are filled with commercially prepared foods: cereals, breads, canned foods, frozen pre-cooked foods, juices, soft drinks, candy, dried fruits, health bars, potato or veggie chips, crackers, popcorn, cooking oils, sugar, flour, prepared lunch meals, etc. Fresh dairy, meat, seafood, poultry, and fresh produce represent 10%, and toiletries, kitchen supplies, healthcare products, supplements, and sometimes cosmetics and greeting cards are the remaining 10%. The prices seem to be inversely related to the percentage these occupy in the store. Food-like products that are commercially processed are the cheapest, while fresh produce, dairy, and fresh meat are often prohibitively expensive. Thus, as budget allows, we end up buying a bunch of prepared foods; not only are they cheaper, they are also more convenient. In today’s busy world, who doesn’t want precooked foods that only require re-heating? What a time saver! Indeed, not a health-saver though. The money we save on food will end up in the pockets of medical institutions and pharmaceuticals for healthcare later, because most commercially prepared foods will make us sick.

Unfortunately, the cheapest and most readily available foods contribute most to type 2 diabetes. This takes a little explanation, so I am breaking foods down into the basic nutrient groups; macronutrients. There are three macronutrients: carbohydrates, protein, and fats. Because so many people don’t know what food falls into what macronutrient category, let me help you; some of the foods really aren’t obvious where they belong.

Protein

In our minds, protein refers to meat or fish though a small amount of protein is found in most every food item; even lettuce, only too small to matter. More protein is found in whole foods like unprocessed meats and fish than in processed foods like sausages or hot dogs. Protein is essential, meaning we must eat protein to survive. Proteins are made up of amino acids that form some of the most important macronutrient elements in our body. Protein is not just important for body building but it is essential for our brain and body to function and to survive.

There are a number of amino acids that are nonessential—meaning the body can create them–and others are essential–meaning we must eat them because our body cannot create them. All nonessential amino acids convert only to glucose, some essential amino acids convert to ketones only and some essential amino acids convert to either glucose or ketones based on dietary need. Over 50% of the amino acids convert to glucose. Glucose is in the family of carbohydrates, another macronutrient.

Carbohydrates

The largest nutrient group in most Americans’ life is carbohydrates. Carbohydrates are nonessential nutrients, meaning we can live perfectly healthy lives without a bite of carbohydrates. There is nothing in carbohydrates our body cannot make or we cannot eat in protein. Carbohydrates include the following foods (short list here): candy, sugar of all types (including honey), fruits, vegetables, legumes, nuts, seeds, grains, all foods sweetened with sugar like cookies, pastries, juices, and all natural vegetables, fruits, nuts, legumes, seeds, and alcohol. Carbohydrates are made from starches, glucose, fructose, lactose, and galactose. For example, most fruits contain glucose and fructose, most vegetables have glucose or some have starches (potatoes and carrots contains a lot of starch), milk has lactose, nuts are mostly glucose, and grains are glucose and starches. Although fiber is categorized as a carbohydrate, fiber is not used by the human body; it simply gets eliminated, so I exclude it from this category.

The key factor to know is that all carbohydrates convert to glucose (or to fructose and that partly converts to glucose). The speed with which they convert to glucose makes some difference but ultimately they all become glucose. Starches convert to glucose in our mouths before we swallow them even if they are not sweet (this includes whole wheat bread as well). Since protein is essential and over 50% of protein converts to glucose, carbohydrates become nonessential since we can make glucose without them. Carbohydrates play the biggest role in T2D because they provide excess glucose we don’t need. Although there is genetic predisposition to T2D as well, even those who are genetically so predisposed can prevent T2D by avoiding carbohydrates.

Fats

The third macronutrient group is fats. Fats represent the only nutrient that do not, under normal circumstances, convert to glucose. Fat remains fat. Fat is an essential nutrient in our body made of fatty acids, all of which are essential: omega 3 and omega 6.

From the three macronutrients, carbohydrates is the only one that poses a problem for insulin management and lack of proper insulin management leads to T2D.

How Do We Get T2D?

While most people think that T2D is the start of the problem, in reality it is the outcome, and thus, the end of the problem. There are many ways one can look at the progression to T2D. Most medical professionals (and the general population at large) think that people with T2D are obese. This is far from the truth and this causes the biggest problem in diagnosis. I think the confusion comes from the lack of understanding the progression toward T2D.

T2D starts when a person is thin and knows/cares very little about what she eats. The cause for T2D is too much insulin in response to excess glucose, that cannot be delivered to the liver. Though this sounds simple, it is complex enough to get many confused even in the field of medicine. We must ask a few questions:

Where does excess glucose come from?
Where does excess insulin come from?
Why is insulin not able to pick glucose up from the blood and deliver it to the liver?

Understanding the Liver and Insulin

Insulin is a signaling hormone for many functions, including packaging glucose into the liver for storage. Thus insulin is a storage hormone. Without insulin, people cannot gain weight—a typical problem for type 1 diabetics (T1D) who lack insulin production. T1Ds need to use insulin injections in order to survive, and gain and maintain healthy weight.
Since insulin is a storage hormone, it automatically implies that it stores whatever food we were not able to immediately burn. This is healthy. Think of hibernating bears; they fatten up all summer and then in the winter hibernation they live off of the accumulated energy stored as fat. The key to their health is that they don’t eat during hibernation–meaning all year long. In contrast, humans continue to eat and store excess energy all year long.
Once the storage cabinet of our body has reached its comfortable limit (the liver is our storage cabinet), insulin cannot pack more glucose into it. The liver refuses insulin’s attempts. This is called insulin resistance.
Prediabetes and insulin resistance are the same phenomenon at different stages. Prediabetes usually occurs in people who already have insulin resistance.
During insulin resistance, the excess glucose and the excess insulin circulate in the blood causing damage. They damage arteries by causing inflammation¹ increasing blood pressure as a result, and can cause nerve damage (in the brain as well as in the body). Diabetic neuropathy starts at the stage of insulin resistance for many people and not at a later stage when T2D developed, which is how it is always portrayed.
Insulin resistance is compartmentalized—meaning one may have insulin resistance in one organ (such as the liver) but not in another. This makes insulin resistance very hard to diagnose with conventional tests. The most typical test is the hemoglobin A1c (HbA1c), which measures the average amount of glucose the person had in his blood for a period of two to three months.
Alzheimer’s disease is the insulin resistance (or type 3 diabetes) of the brain but not the body. Hence, the first sign of Alzheimer’s disease is the disease itself and not insulin resistance. This further shows the difficulty of diagnosing insulin resistance.
During the start of insulin resistance, as more and more insulin is released to carry the glucose into the liver that cannot handle any more, the liver becomes ill with non-alcoholic fatty live disease. It makes the liver bigger, inflamed, and less able to do its job, which is the detoxification of the blood.

Since we feel none of this as pain or illness, nearly 100% of the people with insulin resistance have no idea that they have insulin resistance! As insulin resistance continues over decades being undetected, the body slowly degrades in its ability to fight back. Finally, when it is time, T2D arrives. By the time T2D is diagnosed, most people (not all) are overweight, because of the preceding years of insulin resistance that went unnoticed.

Manifestations of Insulin Resistance

Insulin resistance is not felt by anyone (the pain in the legs may be diagnosed as something else) and so its diagnosis is usually accidental and often inaccurate^2,3. The tools used to check for insulin resistance, in the US and elsewhere, require one to be obese or pregnant with gestational diabetes risk. This presents a major problem since obesity tends to develop only after years of insulin resistance. An individual may have insulin resistance at age 11 and not know about it until at age 35, when she suddenly develops neuropathy with hurting feet, or gets shaky and dizzy if the food is five minutes late on her table. The achy feet are often misdiagnosed as a pinched nerve, Plantar fasciitis, or fibromyalgia. If you are ravenously hungry before breakfast and must eat every 3 hours, chances are pretty high you are have insulin resistance, even if you are paper thin, exercise a lot, even at the level of an athlete, and have no aches and pains.

There are two ways insulin resistance can be manifested and there is a bit of confusion in categorizing them so here I cap them under one roof: insulin resistance. The most common is simply being hungry very often with correspondingly high blood sugar—one can use a blood sugar measuring kit (finger poke) to test. This type of insulin resistance is hyperinsulinemia, which only lets itself be known by frequent hunger when the blood sugar levels are still high. The body’s ideal blood sugar level is <100 mg/gL and a healthy individual will not feel hungry while the blood sugar level is at or above 100 mg/dL. A typical hyperinsulinemic person feels hunger pangs at blood sugar of over 110 mg/dL. Normal blood sugar is defined as 70 – 140 mg/dL.

The hardest to treat insulin resistance is reactive hypoglycemia. Its manifestation is feeling shaky, dizzy, cold sweaty, feeling nauseous, whose blood sugar drops below the pre-meal starting blood sugar very shortly after eating. A typical hypoglycemic may start eating with pre-meal blood sugar of 90 mg/dL, an hour after finishing the meal may end up with 70 mg/dl, and an hour and a half later she may drop to 60 mg/dL. The level of glucose in the blood is closely regulated for its healthy minimum. Below 70 mg/dL, the body is in trouble so consider it a major warning. Below 60 mg/dL call the paramedics immediately. Below 50 mg/dL you may be dead—so don’t wait!

Can Insulin Resistance Be Prevented?

Yes it can. Since insulin resistance is too much insulin in response to high dietary glucose (glucose spikes insulin), if you stop eating those foods that give instant glucose access (see the glycemic index of foods), or more glucose than your body needs in general, you can reverse insulin resistance. Examples of foods to avoid include: all sweets with any shape or color, sugar, raw or otherwise, honey, etc., all foods sweetened with sweeteners of any kind (including sugar substitutes and naturals since they may also cause health problems, including obesity and T2D⁴), all juices whether they are sweetened or not, all smoothies and shakes whether they are sweetened or not, all tropical fruits and 90% of other fruits, all vegetables grown below the ground (like potatoes and carrots), peanuts, cereals, pseudo cereals (like quinoa), rice, corn, starches used in place of flour, all breads and pastas of all grain types, including whole grain or whole seed, oats, in general all grains, fermented alcohols, and legumes.

For some people dairy is also insulinogenic but not for all so I am not including dairy on the list. Stop eating all of the high glucose spiking foods listed above and increase animal fats, meats, eggs, and dark green leafy veggies in your diet, and you will be able to prevent insulin resistance.

So what can you eat when you cut out all these great tasting “foods” from your diet? Once you understand that these are really not foods but conveniences, you can see the replacements: increase green leafy vegetables in your diet; eat only those fruits we associate with vegetables: zucchini, bell peppers, squashes, tomatoes, cucumbers, and alike or low carbohydrate veggies like broccoli and cauliflower. Consume only raspberries, blackberries, and strawberries as your fruits with an occasional small orange or if must a very small serving of cantaloupe. Avoid all other fruit. Increase healthy dairy with full fat in your diet, use animal fats for cooking since vegetable oils are unhealthy and can be harmful. More details on the types on fats in part 2 of this series. Animal fats are butter, ghee, pork lard (buy pure pork lard and the not hydrogenated types available in grocery stores), beef tallow, bacon drippings (save it in a ceramic container–no refrigeration needed), poultry fat is super too.

Can Insulin Resistance be Reversed?

One of my migraine group members in the keto mild for migraine group had reactive hypoglycemia–that is the insulin resistance that is harder to treat. I asked her to switch to the zero carbs diet for a short time, after which she wrote the following:

“So looking back Aug 31st was my last low blood sugar [reactive hypoglycemia] day, yay! I followed Angela Stanton’s advice and did the zero carbs program for 6 days; I have reintroduced carbs back now, up to almost my norm for the ketogenic diet and still no low blood sugar!! I’m ecstatic! I have the bruised fingertips as proof of all the poking (I was actually eye spying my toes as an alternative ☺️) for me the increase in protein was the key. I realized I was not eating enough before. So for those of you struggling with reactive hypoglycemia this is the answer.” –LM 9/6/2017

As you can see, she reversed her reactive hypoglycemia by cutting all carbohydrates out of her diet for 6 days, and ate only protein and fat. Why does the zero carbs diet work? This and the rest of the information about nutrition and T2D are going to be discussed in the second part of the series on diabetes. So stay tuned and look for part 2!

Sources:

Dandona P, Chaudhuri A, Ghanim H, Mohanty P. Proinflammatory Effects of Glucose and Anti-Inflammatory Effect of Insulin: Relevance to Cardiovascular Disease. American Journal of Cardiology.99(4):15-26.
Kraft J, R;. Diabetes Epidemic &You. revision 1 ed. North America & International: Trafford; 2011.
Crofts C, Schofield G, Zinn C, Wheldon M, Kraft J. Identifying hyperinsulinaemia in the absence of impaired glucose tolerance: An examination of the Kraft database. Diabetes Research and Clinical Practice.118:50-57.
Shearer J, Swithers SE. Artificial sweeteners and metabolic dysregulation: Lessons learned from agriculture and the laboratory. Reviews in Endocrine and Metabolic Disorders 2016; 17(2): 179-86.