Against Low-Carb Diets

[brimstoneSalad]

Interestingly, the mechanisms behind fasting and epilepsy were so obvious Hippocrates wrote about it (or one of his school) in ancient Greece.

It was also obvious to them bloodletting sometimes alleviated the symptoms (hypertension...), so they killed countless patients with that.

Bloodletting is a valid treatment for some diseases like hemochromatosis, AND it's a functional treatment for many conditions that put people at acute risk from high blood pressure when you don't have blood pressure medications (e.g. in ancient times). The trouble was its overapplication, and modern application in lieu of safer medications.

However, how many people do you think keto as treatment for epilepsy has killed?

A medical treatment dating back to ancient times is not a good argument in its favor. It may even be an argument against it, since there is a bias towards maintaining the tradition.

It depends on the treatment; it may mean there are better treatments available (seen as less natural etc.), but it also means that it probably works at least somewhat.
In the case of keto diets, consensus is to use them as a last resort when medications are not working, so that's irrelevant. They are not preferred and are not the first line of treatment.

Consensus on the point is overwhelming.

It doesn't appear to be. ScienceBasedMedicine, one of the most reputable sources about issues of alternative medicine, is against it.

Keto diets for epilepsy aren't altmed, so sciencebasedmedicine's opinion on it isn't relevant to that supposed expertise. Keto dietary treatments are consensus, and the article you linked to (if you read it) even mentions that in the headline:

Does the ketogenic diet work for epilepsy or other neurological disorders? While the consensus is that it probably does, the evidence is surprisingly thin.

They also agree it seems to have a benefit, but like everybody else would like to see a large study:

There seems to be a benefit in terms of reduction in seizure frequency for some patients, but we still need better quality studies to confirm this.

The Cochrane review says the same thing. But interestingly you have, in your infinite wisdom, gone beyond this level of skepticism to pronounce more certain condemnation than any professional is.

The rest of the article is about migraines, for which there's not good evidence. Yeah obviously it's nonsense for a whole host of conditions. The only one it seems to work for is epilepsy, and also only in children not in adults. And again it's a last resort treatment for those cases that are resistant to medication, medicine is first.

And there are objective metrics to assess seizures.

And ketogenic diet doesn't appear to affect them. This double-blind study found no statistically significant difference in EEG-detectable seizures between children who are fed a keto diet and children who are fed a diet relatively high in glucose, and only marginally statistically significant (p=0.07) difference in subjectively-reported seizures.

Wow Teo, you're so good at picking cherries I'm impressed. Let's ignore consensus and systematic reviews, and ALSO the well known trouble trials have when something only works well for a small percentage of people as in this case.

Perception of frequency of seizures is also not something that's likely to be influenced by placebo

What do you mean they aren't? This study found that up to 7% of epileptic patients who receive placebo claim to be seizure-free.

[/quote]

I didn't say placebo won't reduce seizures in some cases, I said perception of frequency is unlikely to be influenced, which means we're seeing an effect.
Yes, placebo has a moderate real effect for things linked to cognitive function from seizures to depression. Not as as strong as interventions, and it has a stronger effect on other things (like taste and more subjective symptoms -- pretty food is almost universally said to taste better than ugly food), but it has an effect that you wouldn't see in things like cancer at all.

Interestingly, different placebos also have different potency even without clinically real mechanisms. The question of which placebos are most effective, most affordable, and have the fewest side effects is an important one. Beyond that, though, keto appears to have real clinical effects though - double that of placebo is a big deal, particularly when placebo is already so good. If placebo works in 1% if cases and you double that, that's not as meaningful or significant.

Also...

it becomes far too obvious to fuck up by accident.

McArthur Wheeler probably thought that way when deciding not to do a properly controlled and blinded experiment (or even just trying with water instead of just with lemon juice) to determine whether lemon juice makes one invisible to the cameras.

He decided that based on a misunderstanding of THEORY and a poorly reasoned conclusion from that based on mechanism, not based on experimentation that wasn't blinded. If he had done any experiment whatsoever he likely would have found it didn't make him invisible unless he was insane. E.g. point a camera at himself and turn the view finder toward him to see himself and whether he was invisible or not after applying the lemon juice.

Also, if multiple people had done unblinded experiments like that it would be inconceivable that they would still believe that lemon juice rendered people invisible to cameras.

That you do not understand the difference here between professional consensus with some actual evidence (even though not of ideal quality) and Wheeler using lemon juice to make himself invisible is in itself pretty unbelievable.

[teo123]

However, how many people do you think keto as treatment for epilepsy has killed?

I don't know. Maybe it did kill a few people with the kidney problems it causes. It's certainly less harmful than bloodletting.
My point is that the bias towards maintaining the tradition is so strong in medicine that bloodletting lasted for more than two thousand years, even though it was counter-productive in most cases (it was used to treat anaemia), and in those few cases it did work it merely alleviated the symptoms. Yet, physicians somehow convinced themselves it was a magical cure.

consensus is to use them as a last resort when medications are not working

When medications aren't working? So, that means, it works, but it works differently than all the medications. Doesn't that sound a bit like ascribing magical properties to it?

Keto diets for epilepsy aren't altmed

Mainstream medicine is (or at least should be) science-based medicine. And ketogenic diets helping against epilepsy is scientifically implausible. Not as implausible as homeopathy working, but still implausible.

They also agree it seems to have a benefit

Well, the author needs to maintain some neutrality, or else his views won't get published. Not only do they go against the tradition, they also go against what the coconut industry wants us to believe.

The only one it seems to work for is epilepsy, and also only in children not in adults

And doesn't that sound like an ad-hoc hypothesis? I mean, there are studies showing it doesn't work, and, instead of admitting that maybe it doesn't, they make an excuse that studies that show it doesn't work tend to be done in adults, rather than in children.

Wow Teo, you're so good at picking cherries I'm impressed.

How is that cherry-picking? That's, as far as I am aware of, the only double-blind controlled study done on the matter.

The question of which placebos are most effective, most affordable, and have the fewest side effects is an important one.

Giving people false hope is immoral even if consequences may be positive.

Beyond that, though, keto appears to have real clinical effects though - double that of placebo is a big deal, particularly when placebo is already so good.

Except that, in most studies with keto-diet, it's not just the placebo effect at play, it's also the lack of blinding at play.

He decided that based on a misunderstanding of THEORY and a poorly reasoned conclusion from that

Well, that played a role, but the poorly designed experiment is what gave him confidence.
When I think about it this way, maybe what played a role in me getting weird results while doing the experiments for the computer science paper, which will probably get published in Osječki Matematički List, was not so much my poor understanding of the theory (after all, nobody can be certain they know all the relevant details), but me having poorly designed the experiment. After doing some more research (after submitting the paper) I know the reason I got the result that MergeSort is faster than QuickSort when the array is randomly shuffled (obviously against the consensus in computer science) is because I implemented QuickSort vastly suboptimally in both C and my programming language. Methodologically correct would be to use some well-known implementation of both QuickSort and MergeSort in the C program. This way I influenced the result way more than I should have. Though that's not really a problem with blinding, a problem with blinding would be if I got the results I expected, but I got the results I couldn't explain. Until recently, I thought getting results contrary to your expectations was a sign you've done the experiment well, now I am not so sure about that.

E.g. point a camera at himself and turn the view finder toward him to see himself and whether he was invisible or not after applying the lemon juice.

But I think that's almost exactly what he did. He pointed a polaroid camera at himself and captured himself, and, for some reason, his face wasn't visible on the picture that polaroid camera printed out. Of course, had he tried that after rubbing his face in water rather than lemon juice, he would almost certainly get the same result, because camera was either broken or not operated properly.

Also, if multiple people had done unblinded experiments like that it would be inconceivable that they would still believe that lemon juice rendered people invisible to cameras.

Why? Chances are, quite a few old unused polaroid cameras are broken without people who own them knowing that. And not everybody knows how to use a polaroid camera. I am not sure either.

[Peppesq]

if you love carbs that much keto is going to be far from easy! and from my understanding (from what my dad's RD told him) you should avoid saturated fats if you have high cholesterol, and keto seems even harder to do if you cant rely on animal fats and dairy.

also i dont think people respond differently to carbs from a weight loss point. If she eats 1800 kCal a day from far or carbs it wont matter other than from compliance and adherence to her diet. keto wont make more weight loss unless it allows you to eat less calories in a day.

I know a friend who lost 60 pounds from keto though. He wrapped most of his meals in bacon and used cooking oils for every meal lol. Just meat, oils, cheese, and green veggies basically is all he could eat.

sorry i dont have much help and I know convincing a partner of something is tough, but I wish you luck if you do decide to try keto!