More isn’t necessarily better. Alsos surprising: fruits, veggies and legumes only showed a benefit up to a certain point. Still, as one doctor said aout the trial:
“The effects are modest effects, in the neighborhood of a 20% reduction in relative risk. So if the annual [absolute] risk of mortality is 1%, it would be reduced to 0.8%. At the individual level, it is tiny. And nowhere near what you find for smoking and lung cancer — about 200 times smaller in fact,” said Mente.
http://www.cardiobrief.org/2017/08/29/huge-diet-study-questions-conventional-wisdom-about-carbs-and-fats/
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Wouldn’t it be crazy if the diet our grandparents ate turns out to be good for you? Downsized, of course, since we lead a more sedentary lifestyle. Interesting research.
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I don’t think, however, the diet they say is optimal necessary corresponds to any one that our grandparents ate on a collective global level – or at least not my grandparents. I mean, my grandparents lived in India and I would be shocked if I ate more carbs than they did. I’ve seen how much rice and poori they pile on their plates for a small portion of fish! I’d be shocked if they ate better back when food was scarcer.
And my other grandparents, who lived in Poland, ate a ton of things like blintzes and bagels and pierogies, which are very carb heavy.
I’m pretty skeptical about the fruits and veggies finding – as that’s something we’ve definitely been eating in bulk since we were not even Homo sapiens almost everywhere around the world. My guess is that the results are confounded by the legumes and that globally, people who are eating more legumes, for instance, may have less access to high protein animals foods as a result of poverty and that may be confounding the data. They probably tried to control for that, but still.
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Oops, should have said my grandparents. 1 piece of protein and two veggies on the plate. In the US, that diet was lambasted in the 70s - 90’s as being terrible for you because it had fat in the protein.
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I think that would exceed the daily veggie and fruit quotient though, by their estimate?If you have two veggies per meal and a few fruits you’re already in the six serving realm, which is higher than they claim provides any benefit.
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As a caveat, this interesting study is not a causal but but a retrospective one.
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To be fair, there will probably not be anyone with enough interest and money to actually fund a large prospective food study. This is a bit sad for everyone that would benefit, except of course the media, who seems to make a living publicizing small study results as click-bait.
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I think it was prospective, just based on self-reports…OR the adverse outcomes were prospective and the food reports were retrospective.
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Nice study.
I think I’ll just keep eating LCHF, heavy on the veggies. Non processed as much as possible. Love the phytonutrients in whole foods.
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Interestingly, Medpage headlines on the low fat/ high carb consequences:
“Defying expectations, PURE found that high carbohydrate intake was associated with a significant increase in the risk of death, while both total fat and saturated and unsaturated fats were associated with a decreased risk of death. However, fat consumption was not associated with cardiovascular disease or cardiovascular mortality, though saturated fat had an inverse association with stroke.”
Pretty ironic in the light of the dietary recommendations of the 1970s-2000s. Of course, we had all started to recognize that in the last 10 years.
There is danger, of course, in taking the results of such studies as absolute truth – that’s what happened the last time around 
A healthy amount of doubt and cynicism a la @Thomas is, I think, wise
To be fair, the amount of carbs they are finding is optimal – 50-55% of calories from carbs – is nowhere near what could be considered "low-carb"
A person eating a 2,000 calorie diet would be eating about 250 g of carbs a day using that metric.
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I happened across those (thanks to my mother-in-law) this morning, and managed to find them on The Lancet on a library website and turn them into PDF’s so I could read them.
I haven’t had time to read them completely myself, and the hubbub that seems to be happening on FB/Twitter from what I noticed is relating just to the abstract that’s available, which seems silly.
EDIT: I pulled the links, as the legality of my publishing them was questionable.
Want more info? Feel free to PM me. Unless you want to have me arrested. Then don’t. 
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Thank you for pointing that out. I think this is an absolutely critical point, and unfortunately not at all clear from the reporting that is being done. Because of all the discussions and push to eat Bernstein or ketogenic in the diabetic community, “low-carb” seems to have an ever diminishing definition. It is eye-opening to realize that “low-carb” in this instance means 250 g carb a day.
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Because of all the discussions and push to eat Bernstein or ketogenic in the diabetic community, “low-carb” seems to have an ever diminishing definition.
I agree. I think keto diets can be really helpful for people, but I see it as a a physiological hack. Even Inuits aren’t ketogenic! Even cultures that eat almost all animal products make a point to eat the sugar-rich portions of meat, like the liver, and are still eating more carbs than Bernstein typically recommends.
That’s not to say going low-carb might not be the healthiest option for some people with a busted pancreas, but I can’t imagine broad population-based studies would ever show strong benefits to this type of ultra-low-carbing.
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All things in moderation. Is it wise to completely starve our bodies of all carbohydrates? Probably not… is it wise to take a long hard look at how humankind has bastardized carbohydrates across the board and led us to the situation we’re currently in??? Likely so…
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To be clear, there are many among us for whom it works.
We don’t do low-carb because we feel that this is not something we want to inflict on a kid – but the Bernstein premise of low quantities of carbs resulting in small errors with insulin is hard to disagree with.
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But… you don’t do that, do you? So I don’t understand the proposition that it works ? I agree with Bernstein in some regards, but haven’t lost sight of the reality that 99% of the md in the world strongly disagree… I’m not quite ready to decide that he knows something that nobody else does
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Eating low-carb isn’t starving the body of all carbohydrates. I don’t know anyone, diabetes or not, who is eating zero carbohydrates. I think that would be very hard to do given that even lettuce, eggs, and cheese have some carbohydrates in them.
I eat low-carb, and I think restricting carbohydrates is far healthier than eating carbohydrates and having blood sugar swing from high to low every day. Not everyone has to do that, but for some of us it’s the easiest way to achieve tight control. I take what I like from Bernstein and leave the rest. I do the same with Gary Scheiner, John Walsh, Stephen Ponder, Adam Brown, and others. All of these individuals are people who have lived with Type 1 diabetes themselves for decades, so I appreciate them sharing their knowledge. In the end, the only person who knows what works best for each individual is the individual living with and experimenting with their own diabetes.
Also, it should be noted that Dr. Bernstein is not the only MD who advocates a low-carb diet. There are dozens of them out there. Dr. Bernstein is the only one who specifically deals with Type 1 diabetes, though.
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@britt_j also follows a pretty strong low-carb diet, as does @walkingthedragon88.
We are not low carb by any means, although in our local community people think we are :-). But I see the logic in the argument, as well as the success of many.
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the Bernstein premise of low quantities of carbs resulting in small errors with insulin is hard to disagree with.
I disagree with it.
Here’s why: At some point, carb reduction results in much higher sensitivity to carbs for many people and likely higher insulin resistance for at least some. For those people, they may find themselves using almost the same amount of insulin for much fewer carbs. So you still have the same big doses.
Also, any time you DO have carbs (which for most people, will be eventually) you have no idea how to bolus for them.