His answer to "what do we know so far?" is that "the most impressive research" was an experiment with no control, conducted by a start-up, which then published the results on their company blog. OK, next.
Your characterization of the experiment is so wrong it's almost hard to know where to start. This is an interventional clinical trial with a large group of participants (hundreds) with a control receiving standard of care run by IU Health with ongoing measurements over years (which is incredibly impressive). You can see the clinical trial registration here: https://clinicaltrials.gov/ct2/show/NCT02519309
And some of the (ongoing) peer-reviewed publications here:
Athinarayanan SJ, Adams RN, Hallberg SJ, et al. Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-year Non-randomized Clinical Trial. Frontiers in Endocrinology. 2019; 10:348. doi: 10.3389/fendo.2019.00348
Hallberg SJ, McKenzie AL, Williams P, et al. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at One Year: An Open Label, Non-Randomized, Controlled Study. Diabetes Therapy. 2018; 9(2): 583-612. doi: 10.1007/s13300-018-0373-9
McKenzie AL, Hallberg SJ, Creighton BC, et al. A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes. JMIR Diabetes. 2017; 2(1):e5.
Bhanpuri NH, Hallberg SJ, Williams PT, McKenzie AL, Ballard KD, Campbell WW, McCarter JP, Phinney SD, Volek JS. Cardiovascular Disease Risk Factor Responses to a Type 2 Diabetes Care Model Including Nutritional Ketosis at One Year: An Open Label, Non-Randomized, Controlled Study. Cardiovasc Diabetol. 2018; 17:56. doi:10.1186/s12933-018-0698-8
Vilar-Gomez E, Athinarayanan SJ, Adams RN, et al Post hoc analyses of surrogate markers of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis in patients with type 2 diabetes in a digitally supported continuous care intervention: an open-label, non-randomised controlled study BMJ Open 2019;9:e023597. doi: 10.1136/bmjopen-2018-023597
Siegmann MJ, Athinarayanan SJ, Hallberg SJ, et al. Improvement in Patient-Reported Sleep in Type 2 Diabetes and Prediabetes Participants Receiving a Continuous Care Intervention with Nutritional Ketosis. Sleep Medicine. 2019; 55: 92 - 99. doi: 10.1016/j.sleep.2018.12.014
I am sorry that you are downvoted and getting negative responses, you are exactly right.
Beside the implementation problems (non-randomized etc.) and the backer problem (result is self-serving) the study is literally just "we give patients and intricate personal treatment with daily expert interventions" vs "go on live your life". You explain this away with the Hawthorne effect alone.
Really reminds me of the sugar propaganda some decades ago. They used the exact same combination you see embodied in this thread: Anecdata, Appeal to Authority, Appeal to Emotion, Ad Hominem.
> Beside the implementation problems (non-randomized etc.) and the backer problem (result is self-serving) the study is literally just "we give patients and intricate personal treatment with daily expert interventions" vs "go on live your life". You explain this away with the Hawthorne effect alone.
I am sorry to say that just as atdt was making things up, you are as well. The control group did not just get told "go on live your life" - they received "Usual Care" (Standard of Care) for T2D. There's a whole section in the first paper linked about it:
"The participants recruited for usual care (UC) received care from their primary care physician or endocrinologist and were counseled by a registered dietician as part of a diabetes education program. These participants received the American Diabetes Association (ADA) recommendations on nutrition, lifestyle and diabetes management. No modification of their care was made for the study and routine biomarkers (weight, glucose and ketones) were not collected from these participants. This group was used as a reference control to study the effect of disease progression over 2 years in a cohort of participants prospectively recruited from the same geography and healthcare system."
Athinarayanan SJ, Adams RN, Hallberg SJ, et al. Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-year Non-randomized Clinical Trial. Frontiers in Endocrinology. 2019; 10:348. doi: 10.3389/fendo.2019.00348
For anyone who's actually interested in the science or methodology of the research, the peer-reviewed work has been linked (and I believe is all open access, if not, it's on sci-hub), and it is written in a pretty accessible manner IMO. The PI, Sarah Hallberg, has quite a few presentations online, including some that delve deeper into some of the details and the pros/cons of their study design (the biggest pro IMO is that they were able to use a biomarker (blood BHB) to track adherence). This of course, is just a single study - there are lots more studies and papers (I've read thousands on the topic area over the past few years). Human nutrition and metabolic health is a minefield, for a variety of reasons and people should be skeptical, but that's also no excuse for adding to the misinformation pile.
