I think I could eat the whole thing, but then nothing else for 48 hours

This is a great comment, really excellent.

One point - the vast majority of the current evidence is from a population centered around a carbohydrate dominated metabolic context - which can be another confounding variable

https://scholar.google.com/

Wrong url?

Same! When you find great people hold onto them!

Cardiometabolic function isn’t the same as metabolic syndrome. Cardiometabolic function would be like a spectrum or perhaps a map. Metabolic syndrome would be the section of spectrum(say red in the rainbow) or area on the map (like a swamp) that designates the “danger zone.”

Here the term “optimal” is used and that’s around 7 percent as having optimal cardiometabolic function. That doesn’t instantly mean 93 percent are impaired. The other classes are **intermediate, which is half of people, ** and lastly poor which was ~44 percent.

I’m afraid your anchored on “metabolic syndrome” when I am referring to impaired metabolism, since that is driven by hyperinsulinemia - and thus demonstrates a epidemic of elevated insulin in the population at large which is driven by persistently elevated blood glucose… which is exactly the environment cancer needs to thrive… And not optimal does mean a degree of impairment by definition.

Thanks for those links, they do demonstrate cancer has a very interesting metabolic plasticity, but they do not definitively show fatty acid ATP synthesis, your Shilpa review even indicates FAO is down regulated in a variety of known cancer types… However, I hope when you read my references you just missed the section in the above paper, which addresses your rebuttal:

https://doi.org/10.1007/s10863-025-10059-w - Questionable Assumption 5: Fatty acid oxidation can provide sufficient ATP production through OxPhos in cancer cells

Regardless if Fatty Acids have some role to play, can we agree that glucose is very much the favored fuel? So even if we disagree on metabolic mitochondrial dysfunction as the basis of cancer, can we agree there is no benefit to feeding EXTRA glucose into a cancer patient?

After everything runs through the Krebs cycle and electron transport chain, you end up with roughly 106 ATP. Which is a huge amount compared with glucose(1 glucose is about 30 ATP.)

Yes, this is addressed in the Seyfried paper above, the problem is in dysfunctional mitochondria glucose pathways while less efficient are massively upgraded… i.e. why the PET scan works.

Weight gain is typically merely about CICO, barring rare genetic disorders. With an unimpaired metabolism, if you eat excess calories you will gain weight. No hormonal imbalance necessary. This is basic energy expenditure(Calories Out) to calories consumed(Calories In, thus CICO.)

CICO is technically accurate, but really describes what happened after the fact, not why it happened. Plus humans are not closed systems, have many inputs and outputs not accounted for in human level CICO, nutrition labels can be off by as much as 20% for calories. Humans are NOT bom calorimeters, we don’t burn our inputs to heat water (how calories are measured). Please have a look at the carbohydrate-insulin model of obesity https://lemmy.world/post/33254443 - Basically We are hormonal machines, elevated insulin drives obesity.

Actual metabolic syndrome afflicts 30-40 percent of Americans. Not anywhere near 96 percent.

I’m sorry, I misremembered the number, its actually 93% with impaired metabolic health - https://hackertalks.com/post/7340607 - https://doi.org/10.1016/j.jacc.2022.04.046 - I’m using impaired metabolic health and not metabolic syndrome, because the key problem is hyperinsulinemia not necessarily the cluster of clinical signs used for metabolic syndrome that can take years to manifest. Impaired metabolism indicates elevated insulin.

Some people are just fat and diet and exercise will absolutely work metabolically to control their weight. Some people lack of willpower.

They are fat because of the hyperinsulinemia, without the elevated insulin they wouldn’t be fat (See the carbohydrate-insulin model of obesity above).

Gastric bypass again proves that with caloric reduction their metabolism, in most cases, is fully capable of sustaining weight loss.

50% bypass patients regain the weight in 2ish years https://doi.org/10.1007/s11695-007-9265-1 , because just restricting calories didn’t teach those people how to eat, and how to fix their insulin. If your only eating junk food, a gastric bypass by itself can’t fix your insulin (which is the core problem of obesity)

Cancer metabolism is also flexible. It does not exclusively depend on glucose and is not “starved” by removing carbs. Fats and amino acids are fair game for many cancers.

Glucose, glutamate. By the cancer as mitochondrial dysfunction model - https://hackertalks.com/post/13010967 - https://doi.org/10.1007/s10863-025-10059-w TLDR here is the energy consumption and fermentation of cancer cells and show that only glucose and glutamine can produce ATP in cancer cells. we see that cancer cells are NOT flexible and can not metabolize fat.

Gluconeogenesis alone creates sufficient glucose to feed cancer.

100% Correct, but no need to feed cancer with exogenous glucose that is not nutritionally essential. You can’t STARVE cancer by removing carbs from food, but you can stop helping it accelerate.

4x is quite an exaggeration…

3.42x, but writing 4x is just easier. https://doi.org/10.1007/s00592-017-0966-1

I turned my hyper fixation into lemmy communities! You can too!

!carnivore@discuss.online - There are fives of us, fives!

!ketogenic@discuss.online - Dozens!

This makes sense at many levels -

Weight gain is a symptom of impaired metabolism, of which 96% of western adults have some degree of impairment. Most metabolism issues are driven by excessive carbohydrate load, which drives elevated blood glucose, which drives elevated insulin, which drives hormonal imbalances (i.e. weight gain).

Cancer cannot metabolize fat. Adults with impaired metabolism, with excessive carbohydrate intake, with elevated glucose levels are filling their blood stream with the very fuel cancer cells need to thrive and out compete their bodies immune system.

T2D is another 4x risk factor for cancer (i believe for the some logic as above)

If you haven’t tried one yet, you might want to consider a elimination diet protocol for a few weeks. If your RA is exacerbated by some food compound it would reveal itself, and you could then plan your meals avoiding that.

I’ve seen lots of consistent anecdotes, and myself, diminishing joint pain and inflammation on a strict elimination diet.

Yeah the literature coming out on the metabolic brain connection, and improving metabolism resolving psychiatric disorders can’t be ignored.

Given we are in a metabolic health crisis that is only trending up, it’d reasonable to speculate it has had a impact on larger mental health trends since the metabolic health collapse started.

I.e. 96% of western adults have impaired metabolic health.

This makes sense at many levels -

Weight gain is a symptom of impaired metabolism, of which 96% of western adults have some degree of impairment. Most metabolism issues are driven by excessive carbohydrate load, which drives elevated blood glucose, which drives elevated insulin, which drives hormonal imbalances (i.e. weight gain).

Cancer cannot metabolize fat. Adults with impaired metabolism, with excessive carbohydrate intake, with elevated glucose levels are filling their blood stream with the very fuel cancer cells need to thrive and out compete their bodies immune system.

T2D is another 4x risk factor for cancer (i believe for the some logic as above)

I have to agree with you, i’m on a special diet, so I only drink black coffee - and if I get an americano from starbucks its so immensely bitter it’s almost undrinkable - I think it only makes sense if they are balancing it against the super-sweetness of their sugar/fructose loaded drinks as default.

they are intertwined in business, you can’t pay one without the other.

Dementia and Alzheimer’s appear to be highly associated with metabolic dysfunction. I’m willing to wager if you put a cgm (continuous glucose monitor) on your mom you would see she has poor glycemic control right now.

Good news is there are ways to improve brain health: reduce carbs in the diet, use a CGM and play the game of keep the line flat. If those aren’t options you can give your mom exogenous ketones / MCT to take 2-4 times a day in a effort to get energy into the brain.

Why: most people have impaired metabolic health, and have persistently elevated insulin, unfortunately over time this leads to the blood brain barrier rejecting some of the insulin, and the brain slowly over time literally starves of energy. Ketones are the brains default energy source, but their production is suppressed by insulin… introducing ketone (or MCT which gets quickly converted into ketones) will provide energy directly to the brain, for a short while, but early studies indicate they help.

Now that they emphasize metabolism in describing the problem… will they tell people about the low cost way to fix their metabolism and hormonal disregulation? This article certainly didn’t

I have to avoid many of the most common food crops specifically because of inflammation. Wheat, soy, and nuts.

How do you measure your inflammation? periodic blood draw lab tests? What diet did you end up with for the lowest inflammation?

Yeah, so I took a quick read of it… It’s even better, it’s not plant based vs omnivore… it’s actually Whole food (plant or animal) plus exercise vs standard processed diet and no exercise.

Direct link to the paper: https://doi.org/10.1016/j.numecd.2026.104631

Due to the limited number of RCTs with a pure diet only intervention, we decided to include studies with mixed interventions, for example, PBDPs paired with exercise prescriptions.

mixed variables - so its not just PBDP’s its PBDP’s plus exercise.

Studies were excluded if they were…an inappropriate control was used not an omnivorous diet

That was a interesting exclusion - So a non-plant based non-omnivorous diet, a zero-carb carnivore RCT? I wonder why that exclusion specifically

in PBDP (Plant Based Dietary Pattern) they include : Vegan, lacto-ovo-vegetarian, and “wholefood, plant-based” – which includes meats and seafoods.

… So this study is saying a whole food (plant or animal) eating pattern PLUS exercise shows lower inflammation markers then a standard processed food eating pattern & no-exercise… I mean, sure, yeah… no big shock there.

Significant differences between groups at baseline; median CRP was 10 mg/l lower in those on vegan diet than those on the reference diet.

Wait? What? How can a RCT have significantly different CRP levels at baseline? That means it wasn’t a RCT… Because if there was a vegan group before the trail, then they couldn’t get randomized into different interventions… Yet this paper says its a meta-analysis of RCTs…

Indeed. May also means May Not.

Bonus: Anything compared to the standard western diet (heavily processed, lots of carbs) - does better. The base line is so low any intervention actually appears beneficial.

So is the PBDP better then eating fast food and gunk every day? Sure. Is it optimal compared to other potential eating patterns - May… be?

One problem lots of papers have is confusing a inflammatory response with anti-inflammatory. i.e. a hormetic effect of consuming a inflammatory compound that elicits a anti-inflammatory response… it’s still inflammatory, and the net effect is anti-inflammatory in the context of a healthy person with a large “inflammation budget”, but someone sick who is battling systemic inflammation already wouldn’t see any benefit since their body is already on red alert, and the inflammatory compound would just inflame them more.