Over 40% of US Adults have Insulin Resistance
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I agree, I have my own "do not eat" list I keep when I'm in and trying to maintain a deficit.
GI is meaningless. GI is the carb source measured in isolation, that means without fiber, protein, or fat. You can turn a "fast carb" into a "slow carb" just by having a mixed meal.
Fat is also calorically dense, moreso than refined carbs
Eating fewer refined carbohydrates (which tend to be calorically dense, and nutritionally lacking, and have a high glycemic impact and load) seems smart place to start and smart all around.
How about eating better? Does that have a role?
That would be a good thing to start with
Her numbers are for the U.S. Not the world. Eobla deaths, malaria deaths, AIDS deaths, are a drop in the bucket when put against world populations. But not in the context of their communities.
It's likely not "a handful of people" either.The estimates presented for undiagnosed populations were based on an NHANES survey and considered the results of fasting glucose or A1C tests - one result of one test. Anyone who has ever been pregnant and taken the gestational diabetes test knows that if you show up as positive on the first test, they bring you back in for a longer test before diagnosing you as having gestational diabetes.
Claiming that those population estimates are accurate based on one set of test results is flawed, not to mention that there are limitations to the tests themselves and factors that can impact the results. Those factors, particularly lifestyle factors, would not be accounted for in a survey, as most patients would not know to report those factors as possibly skewing their test results.
I just wanted to bump this post. A lot of the numbers in the OP are estimates. And just because you have prediabetes, doesn't mean you are full blow insulin resistant. I would also like point out, of that 30-35% estimated to have prediabets, about only 15% to 30% actually develop diabetes II.
http://www.diabetes.org/diabetes-basics/statistics/cdc-infographic.html
There are a handful of people who have insulin resistance and it's real, but it's not 40% of our population has full blown insulin resistance. Those that are prediabetic can get their A1C back to normal with just weight loss, many of which don't even have to be concerned about carbs.
OP, i am sorry it took so long for you to discover your health issues, but your situation does not apply to the majority of the population. I understand your frustration, over the past 4 years, my wife has been in and out of 7+ different hospitals and dealt with a ton of specialist to include: Cardiologist, Endocrinologist, Gastroenterologist, OBGYN's and Electrophysiologist for her medical conditions. She is borderline PCOS and Postural Orthostatic Tachycardia Syndrome, so she has to be gluten free and low carb. Having said that, I do believe the majority of people can benefit from lowering their carbs, but that is merely for the fact that most people get too little protein in their diet.
More likely, it's not "the majority of the population".
Well, I guess if you consider a handful to be a huge part of the population -- well over 80 million adults -- then I guess those semantics could apply.
Why can't people on this site just discuss issues with a little intellectual honesty?
I think this site can have intellectual conversations. In fact, that is why I am participating. But in a population of billions in this world, 80 million is a small number.
Looking at this link: http://www.diabetes.org/diabetes-basics/statistics/cdc-infographic.html 29 million have diabetes (1 out of 11 people) and 86 milllion have prediabetes, of which 15-30% will develop diabetes (which translates to 25 million will ever have type II diabetes). So again, in a population of billions, that is a drop in the bucket.
Do I think it needs to be addressed, absolutely. Do i understand that people should be aware, absolutely. Do I think people may need to take alternate approach, absolutely, but I don't think people should diagnose themselves in that potential 40% based on the extrapolated statistics.
It's a bit alarming how fast obesity rates have rise IN THE U.S. in MY LIFETIME, and how fast the related illnesses rose as well. I recently read that the expected lifespan of Americans is actually decreasing.
What's the answer? Eat less, move more?
Well, define "better"
If IR is a factor, then better would be "low glycemic" right?
But it also has a lower glycemic index - so, hitting your micro and macro targets with low glycemic foods would be more likely to eliminate refined carbs.
However, my suggestion to people would be to look at the GI and the micros and macros rather than the "refined carbs"
Yeah. I'd argue that a person experiencing IR should allow exercise to balance out their issue and just eat less. If they find that they are hungrier after eating certain foods, to eliminate those foods for the time being.
Heh. I was sending my personal trainer my diary for a time. She said "It looks like you have a sweet tooth." I was like "Not at all. My failing is potato chips." The thing is that they RARELY show up in my diary. For good reason
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Well, I guess if you consider a handful to be a huge part of the population -- well over 80 million adults -- then I guess those semantics could apply.
Why can't people on this site just discuss issues with a little intellectual honesty?
:huh: I imagine for the same reason you are willfully ignoring the points made above about the flaws in the methodology for collecting the data that the estimates, and your entire argument, are based upon.
Here is how the NHANES survey data is collected:The National Health and Nutrition Examination Survey (NHANES) is one of a series of health-related programs conducted by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS). A unique feature of this survey is the collection of health examination data for a nationally representative sample of the resident, civilian noninstitutionalized U.S. population. The survey consists of questionnaires administered in the home, followed by a standardized health examination in specially equipped mobile examination centers (MECs).
So the estimates you are claiming are accurate are based on self-reported data surveys and ONE physical exam. Any doctor will tell you that a positive result on ONE test at ONE point in time is not enough to make an accurate diagnosis or even indicative that a larger problem exists in that one individual, let alone an entire population.
So you're claiming that the American Diabetes Association is wrong?
Hey, you're free to do so. I don't know if the numbers are perfect, but I feel pretty safe in the conclusion that it's a BIG problem, whether it's 43.3% or 33% of US adults. And that is also reflected in the obscene amount of US adults that are overweight/obese -- 69%. But, maybe the CDC is wrong on that too.
Now, if you think there is a fundamental flaw where it should really be 4% or something of that magnitude, please explain. But, as with other posters on this site, you seem more interested in obscuring important information with peripheral details.
No, I am claiming the ADA extrapolated a conclusion from the data that is not supported by the data itself after closer examination of the methodologies of data collection. That's not a peripheral detail in scientific circles, it's actually one the biggest determining factors of the validity of a study.
You also might want to take a gander at the data concerning the sample populations used in the studies. For example, here's the data for OVERSAMPLING (yes, oversampling) for the 2011-2014 NHANES:Predesignated: 87 subdomains† of sex-age groups for non-Hispanic black persons, non-Hispanic non-black Asian persons, and Hispanic persons, and income-sex-age groups for other persons
Oversampled: Hispanic persons, non-Hispanic black persons, non-Hispanic non-black Asian persons, low-income non-Hispanic non-black non-Asian white and other persons (at or below 130% of federal poverty level), and adults aged 80 and over
And here's the information about the entire sample size, again NHANES 2011-2014:Number of selected persons . . . . . . 27,631
Number of interviewed persons. . . . . 20,491
Number of examined persons. . . . . 19,644
I'm sorry, but if you can look at that information and not understand why lab results from one point in time and from the specified populations cannot be extrapolated and applied to the general population of the US, then the conversation is going to have to end here, because I'm not going to continue to attempt to have a learned discussion with someone who is going to ignore facts to support their confirmation bias.0 -
I actually have insulin resistance, and that's why I started on MFP, to reduce it. I gotta say, a lot of doctors don't recognize it. I've been to many doctors in the past and they never even thought of it. I found out last year because my fertility doctor recognized some of the signs - I have acanthosis nigricans on the back of my neck, armpits and thighs, which is an unusual dark skin. I also have a fat roll overlapping my belly button, which she told me was because my body was storing my fat instead of using it - she said it accumulates in that area.
I DID have a lot of success with a lower carb diet (60 or 70 carbs a day), but I found it was almost impossible to keep up. So now I just try to do the best I can on a lower calorie deficit. Hopefully I'll be able to get some of my sensitivity back.
If it helps, some of the things I've done specifically to help with insulin sensitivity is (1) lifting heavy (some studies show this being as one of the best forms of exercise to increase insulin sensitivity -- also helps maintain as much LBM in a deficit) and (2) IFing (I opt for 5:2 plan and found it to be a great way to get my weekly deficit -- so much easier for me than traditional daily deficit -- and you get the added benefit of increased insulin sensitivity which was my main goal for trying it).
I've thought about if, how did you do it? What were your calories for the 5 days? The 2 days? If you don't mind sharing
Sure. The idea behind 5:2 is pretty easy. 2 non-consecutive days you eat 500 calories (or 25% of your TDEE if your TDEE is over 2000). You can space those out however you want. Some divide into two small meals. I prefer holding them all to dinner -- it's easier for me and it also means I have a full 24 hour fast (as I haven't eaten since dinner the night before). They suggest focusing on protein in particular for satiety, but it's not required. The other 5 days you eat at your TDEE.
I've found that often I don't eat as much as my TDEE on the other 5 days -- I'm just not hungry as much. I think the IFing has trained me to truly recognize hunger and TDEE days can feel quite indulgent.
Thx, did you notice better weight loss during? Were you painfully starving during the 24 hrs.0 -
Is there a group or page you recommend to go for sharing, support and information that doesn't have all the arguing? I know this is my problem, even though my doctors say everything is in "high normal range", yet suggested both bariactric surgery and take up running as solutions (I can barely walk). I can't afford to go back yet again for more blood tests. I know how I feel. I need to figure out what I'm doing right and wrong, numbers wise so I can meet targets. Any help would be great.0
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Not knowing the details of someone's medical record/history and not being a doctor are both valid and excellent reasons for not attempting to advise them.
Telling people with insulin resistance, thyroid disorder, PCOS, etc. to simply keep cutting calories not a healthy solution AT ALL. And can be downright dangerous for some.
but that's why it's up to them to go to their doctor and rule those things out first?
very few people on these forums are doctors or able to give people blood tests simply by reading their post. for the majority of people (as implied in your own OP) calories in and calories are all that matters. it's also pretty much assumed that people who are asking for advice have been to the doctor.
you cant very well expect the people who are asked for their advice and opinion to know intimate details of an OP's health :laugh:
I don't think most people do visit the doctor. If they did, they wouldn't ask a lot of the questions they do.
Or that a lot of doctors simply aren't that well versed in such issues. I went to 4 different doctors over 10+ years before I got the proper diagnosis -- and I was the poster child for the most common thyroid disease. Yet, 4 docs (and 2 endos) missed it or didn't do the proper tests. It was discussing my issues on boards like these where I found a good deal of similarly situated people that shared their stories/information which ultimately led me down the same path.
I've seen similar stories from other posters on MFP for PCOS, thyroid, insulin resistance, etc. Going to the doctor is a great starting point, but depending on the doctor, it's not the ending point for many.
Getting accurate information is important, regardless of whether it's coming directly from a doctor or not. Whether the person ends up diagnosed or not with any given disorder/disease will be a matter for him/her and the doctor. But more information also leads to specialists and other opinions.
Word. But people be wary of your doctor and advocate for yourself. My doctor told me I was healthy. I Googled the lab results and according to national current guidelines my fasting blood sugar was in the high end of pre-diabetes and I had low Thyroid levels. After seeing two other doctors I had to finally go to a specific bariatric weight loss doctor (I wasn't even planning on any sort of surgery, still not) to get someone to listen to my concerns. Confirmed I was pre-diabetic, low thyroid, and added on some insulin resistance to me. 3 months of trying to lose weight with diet and exercise alone to no avail and this doctor tells me to add 200 more calories to my diet and change up my macros. It's been about a year and I've been losing weight slowly and steadily, but more importantly, physically I feel so much better. I don't blame the other doctors. I work in medical educational and most aren't trained in any of this as a standard of practice.
TL:DR I got diagnosed with insulin resistance. Changing my food changed my quality of life. It's important to consult doctors if you can. But it's more important to be your own health care advocate.0 -
I actually have insulin resistance, and that's why I started on MFP, to reduce it. I gotta say, a lot of doctors don't recognize it. I've been to many doctors in the past and they never even thought of it. I found out last year because my fertility doctor recognized some of the signs - I have acanthosis nigricans on the back of my neck, armpits and thighs, which is an unusual dark skin. I also have a fat roll overlapping my belly button, which she told me was because my body was storing my fat instead of using it - she said it accumulates in that area.
I DID have a lot of success with a lower carb diet (60 or 70 carbs a day), but I found it was almost impossible to keep up. So now I just try to do the best I can on a lower calorie deficit. Hopefully I'll be able to get some of my sensitivity back.
If it helps, some of the things I've done specifically to help with insulin sensitivity is (1) lifting heavy (some studies show this being as one of the best forms of exercise to increase insulin sensitivity -- also helps maintain as much LBM in a deficit) and (2) IFing (I opt for 5:2 plan and found it to be a great way to get my weekly deficit -- so much easier for me than traditional daily deficit -- and you get the added benefit of increased insulin sensitivity which was my main goal for trying it).
I've thought about if, how did you do it? What were your calories for the 5 days? The 2 days? If you don't mind sharing
Sure. The idea behind 5:2 is pretty easy. 2 non-consecutive days you eat 500 calories (or 25% of your TDEE if your TDEE is over 2000). You can space those out however you want. Some divide into two small meals. I prefer holding them all to dinner -- it's easier for me and it also means I have a full 24 hour fast (as I haven't eaten since dinner the night before). They suggest focusing on protein in particular for satiety, but it's not required. The other 5 days you eat at your TDEE.
I've found that often I don't eat as much as my TDEE on the other 5 days -- I'm just not hungry as much. I think the IFing has trained me to truly recognize hunger and TDEE days can feel quite indulgent.
Thx, did you notice better weight loss during? Were you painfully starving during the 24 hrs.
For me, it helped me break a 6 week plateau. But, that also could have been just coincidental timing. Hard to tell. I do know that when I implemented it, I haven't hit any other plateaus since. I think there is validity behind the resetting of hormonal levels/markers with calorie/carb cycling, so that would make sense to me.
For me, the hunger was actually shockingly manageable. I put off trying it for a long time because I thought it was going to be really, really hard. I was shocked by how not hard it was. If I eat a good sized dinner the night before with a good dose of protein (talking 40g+) -- which is common for me -- I find that I'm not all that hungry until mid/late afternoon around 3-4 pm. From 4-6 pm, I feel it, but I find that if I drink water/tea and keep busy, it's not all the noticeable. But if I'm doing something very mellow like watching TV during that time, I do notice it more. Sometimes I don't eat until 8 pm because I'm busy, but I consider my fast ending time to be 6 pm.0 -
Number of selected persons . . . . . . 27,631
Number of interviewed persons. . . . . 20,491
Number of examined persons. . . . . 19,644
I'm sorry, but if you can look at that information and not understand why lab results from one point in time and from the specified populations cannot be extrapolated and applied to the general population of the US, then the conversation is going to have to end here, because I'm not going to continue to attempt to have a learned discussion with someone who is going to ignore facts to support their confirmation bias.
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If you think it's all hooey, by all means feel free to dismiss it. 20K seems like a very large sample size to me and although some populations are oversampled, there is still quite a considerable breadth of populations. A lot of the peer reviewed studies are focused on a few hundred people at best. Here there is 20K. But, if it doesn't meet with your standards, by all means dismiss it. I'll stick with the American Diabetes Association on this one.0 -
So, I've gotten flak on some threads about making weight loss all about diseases/metabolic disorders. I definitely don't think it's all about them, but I think they play a HUGE role in the difficulty many of us have with losing and maintaining weight. I know I thought I was going crazy doing everything "right" and still getting dismal results -- then I discovered that I had certain issues, including insulin resistance (and I was only about 30 lbs overweight). I know when I found out how common some issues were (insulin resistance, thyroid, PCOS, etc.), I was SHOCKED. I said, Why aren't more people talking about this?!!!
Lulz, I like it when people don't realize that things like insulin resistance, thyroid, pcos are simply symptoms of a greater problem. The problem? Overweight. See, believe it or not, and this is quite amazing.... but being overweight causes medical issues. I know, revolutionary thought there.
People probably aren't talking about this because they know better that to confuse a symptom with a malady.0 -
So, I've gotten flak on some threads about making weight loss all about diseases/metabolic disorders. I definitely don't think it's all about them, but I think they play a HUGE role in the difficulty many of us have with losing and maintaining weight. I know I thought I was going crazy doing everything "right" and still getting dismal results -- then I discovered that I had certain issues, including insulin resistance (and I was only about 30 lbs overweight). I know when I found out how common some issues were (insulin resistance, thyroid, PCOS, etc.), I was SHOCKED. I said, Why aren't more people talking about this?!!!
Lulz, I like it when people don't realize that things like insulin resistance, thyroid, pcos are simply symptoms of a greater problem. The problem? Overweight. See, believe it or not, and this is quite amazing.... but being overweight causes medical issues. I know, revolutionary thought there.
People probably aren't talking about this because they know better that to confuse a symptom with a malady.
I'd think the point is sort of apparent. There are certain steps you might take to optimize your weight loss if you suffer from one of these conditions and certain other actions you might want to avoid because they can have unintended consequences if you suffer from one of these conditions.
Also, last I checked, hypothyroidism isn't caused by being overweight; it's more caused by having an eff'd up thyroid gland. The same goes for PCOS. There's more going on there than just symptoms of carrying excess body fat around. If you're going to make a snarky post, at least have a clue what you're talking about.0 -
remember, though... our first instinct is to blame the dieter when the diet fails. i see it here every single day... we get multiple posts by people who are frustrated because they're not losing weight. the knee-jerk answers are always "you're not measuring correctly" or "you're overestimating what you eat" or "you're not exercising enough." for some, yes that's the answer. but even when the person says "here's my diary, here's my exercise schedule, why is this not working", people are quick to give the easy, canned answer.
i don't know about you, but i find it incredibly insulting and demoralizing when i say "here's what i'm doing, i'm doing what everyone says is "right", why is this not working?" and i get an answer that equates to " oh it's easy, just eat less and move more. it was easy for me so therefore you're just making excuses and don't really want this badly enough." there are only a few, scattered souls who have the knowledge, the patience, and the compassion to step up and say "ok... let's try some other tactics. have you seen a doctor and discussed these specific topics?"
IRT the daily threads of the "I am not losing threads", a majority of the time, people are't logging daily, they aren't using food scales, they are over estimating calories burned or have only been doing it for a week. This is the general thing I have seen over the past several years. Once that is estimated, its the rare occasion someone actually comes back with an additional post saying they tried all of that and it didn't work. Or in some cases, after 4 pages of debating, they come back saying they have a medical conditions and our answers (or at least mine does) will change.
Addressing accuracy and consistency is the first key (especially for more lean individuals). After that, if a person does come back and has the same results, then you modify it more (changing macronutrients or even possibly cutting out a specific food group). But again, of the thousands of people who I have personally worked with, I can count on one hand that amount of people who have come back with a plan to be adjusted and approach elimination diets or a different dieting style. In fact, that is how my wife found out she had a gluten intolerance.
I would think it would be wrong of our community, to jump to the extreme first (going low carb, cutting XX foods out, etc..) without understand what the person has tried or their medical history. I will say though, there are people on this board that jump to conclusions without knowing facts and will blame dieters, and it is clearly wrong but it's the internet... so having high expectations that everyone will get all the information should be low. :laugh:0 -
I'd think the point is sort of apparent.
I'll make it easy. Eat less, move more. Fewer excuses. Impediments are only impediments if you want them to be. 0 -
I'd think the point is sort of apparent.
I'll make it easy. Eat less, move more. Fewer excuses. Impediments are only impediments if you want them to be.
So to clarify, people who suffer from hypothyroidism should not take their prescribed synthetic thyroid hormones given to them by their doctors. Rather, they should eat less and move more, and this is sure to cure their defective thyroid gland. Because their defective gland is simply a symptom, not an ailment. Am I understanding your opinion on the subject correctly?
And I don't disagree with eat less and move more - but you're talking out your rear when it comes to some of these medical conditions.0 -
remember, though... our first instinct is to blame the dieter when the diet fails. i see it here every single day... we get multiple posts by people who are frustrated because they're not losing weight. the knee-jerk answers are always "you're not measuring correctly" or "you're overestimating what you eat" or "you're not exercising enough." for some, yes that's the answer. but even when the person says "here's my diary, here's my exercise schedule, why is this not working", people are quick to give the easy, canned answer.
i don't know about you, but i find it incredibly insulting and demoralizing when i say "here's what i'm doing, i'm doing what everyone says is "right", why is this not working?" and i get an answer that equates to " oh it's easy, just eat less and move more. it was easy for me so therefore you're just making excuses and don't really want this badly enough." there are only a few, scattered souls who have the knowledge, the patience, and the compassion to step up and say "ok... let's try some other tactics. have you seen a doctor and discussed these specific topics?"
IRT the daily threads of the "I am not losing threads", a majority of the time, people are't logging daily, they aren't using food scales, they are over estimating calories burned or have only been doing it for a week. This is the general thing I have seen over the past several years. Once that is estimated, its the rare occasion someone actually comes back with an additional post saying they tried all of that and it didn't work. Or in some cases, after 4 pages of debating, they come back saying they have a medical conditions and our answers (or at least mine does) will change.
Addressing accuracy and consistency is the first key (especially for more lean individuals). After that, if a person does come back and has the same results, then you modify it more (changing macronutrients or even possibly cutting out a specific food group). But again, of the thousands of people who I have personally worked with, I can count on one hand that amount of people who have come back with a plan to be adjusted and approach elimination diets or a different dieting style. In fact, that is how my wife found out she had a gluten intolerance.
I would think it would be wrong of our community, to jump to the extreme first (going low carb, cutting XX foods out, etc..) without understand what the person has tried or their medical history. I will say though, there are people on this board that jump to conclusions without knowing facts and will blame dieters, and it is clearly wrong but it's the internet... so having high expectations that everyone will get all the information should be low. :laugh:
Brilliant summary!
However, I'll beat the moderation drum a little more softly when it comes to "trigger foods" and "addiction"0 -
remember, though... our first instinct is to blame the dieter when the diet fails. i see it here every single day... we get multiple posts by people who are frustrated because they're not losing weight. the knee-jerk answers are always "you're not measuring correctly" or "you're overestimating what you eat" or "you're not exercising enough." for some, yes that's the answer. but even when the person says "here's my diary, here's my exercise schedule, why is this not working", people are quick to give the easy, canned answer.
i don't know about you, but i find it incredibly insulting and demoralizing when i say "here's what i'm doing, i'm doing what everyone says is "right", why is this not working?" and i get an answer that equates to " oh it's easy, just eat less and move more. it was easy for me so therefore you're just making excuses and don't really want this badly enough." there are only a few, scattered souls who have the knowledge, the patience, and the compassion to step up and say "ok... let's try some other tactics. have you seen a doctor and discussed these specific topics?"
IRT the daily threads of the "I am not losing threads", a majority of the time, people are't logging daily, they aren't using food scales, they are over estimating calories burned or have only been doing it for a week. This is the general thing I have seen over the past several years. Once that is estimated, its the rare occasion someone actually comes back with an additional post saying they tried all of that and it didn't work. Or in some cases, after 4 pages of debating, they come back saying they have a medical conditions and our answers (or at least mine does) will change.
Addressing accuracy and consistency is the first key (especially for more lean individuals). After that, if a person does come back and has the same results, then you modify it more (changing macronutrients or even possibly cutting out a specific food group). But again, of the thousands of people who I have personally worked with, I can count on one hand that amount of people who have come back with a plan to be adjusted and approach elimination diets or a different dieting style. In fact, that is how my wife found out she had a gluten intolerance.
I would think it would be wrong of our community, to jump to the extreme first (going low carb, cutting XX foods out, etc..) without understand what the person has tried or their medical history. I will say though, there are people on this board that jump to conclusions without knowing facts and will blame dieters, and it is clearly wrong but it's the internet... so having high expectations that everyone will get all the information should be low. :laugh:
As someone who has both type 1 diabetes and type 2 diabetes (type 1 makes it really hard to lose weight), and Hashimoto's disease (type 1 diabetes and Hashimoto's are auto-immune diseases, not symptoms of being overweight), I have an incredibly difficult time losing weight. It's taken me years to even figure out how to lose weight. At all! So now I'm slowly losing weight, which is the only way I can do so successfully. Sometimes I end up in a plateau for a couple months or longer. Many people can just lose weight quickly and safely, and that is great! But I get annoyed when I do the right things unsuccessfully, so I reach out for help and get called a liar instead. It doesn't help.0 -
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remember, though... our first instinct is to blame the dieter when the diet fails. i see it here every single day... we get multiple posts by people who are frustrated because they're not losing weight. the knee-jerk answers are always "you're not measuring correctly" or "you're overestimating what you eat" or "you're not exercising enough." for some, yes that's the answer. but even when the person says "here's my diary, here's my exercise schedule, why is this not working", people are quick to give the easy, canned answer.
i don't know about you, but i find it incredibly insulting and demoralizing when i say "here's what i'm doing, i'm doing what everyone says is "right", why is this not working?" and i get an answer that equates to " oh it's easy, just eat less and move more. it was easy for me so therefore you're just making excuses and don't really want this badly enough." there are only a few, scattered souls who have the knowledge, the patience, and the compassion to step up and say "ok... let's try some other tactics. have you seen a doctor and discussed these specific topics?"
IRT the daily threads of the "I am not losing threads", a majority of the time, people are't logging daily, they aren't using food scales, they are over estimating calories burned or have only been doing it for a week. This is the general thing I have seen over the past several years. Once that is estimated, its the rare occasion someone actually comes back with an additional post saying they tried all of that and it didn't work. Or in some cases, after 4 pages of debating, they come back saying they have a medical conditions and our answers (or at least mine does) will change.
Addressing accuracy and consistency is the first key (especially for more lean individuals). After that, if a person does come back and has the same results, then you modify it more (changing macronutrients or even possibly cutting out a specific food group). But again, of the thousands of people who I have personally worked with, I can count on one hand that amount of people who have come back with a plan to be adjusted and approach elimination diets or a different dieting style. In fact, that is how my wife found out she had a gluten intolerance.
I would think it would be wrong of our community, to jump to the extreme first (going low carb, cutting XX foods out, etc..) without understand what the person has tried or their medical history. I will say though, there are people on this board that jump to conclusions without knowing facts and will blame dieters, and it is clearly wrong but it's the internet... so having high expectations that everyone will get all the information should be low. :laugh:
As someone who has both type 1 diabetes and type 2 diabetes (type 1 makes it really hard to lose weight), and Hashimoto's disease (type 1 diabetes and Hashimoto's are auto-immune diseases, not symptoms of being overweight), I have an incredibly difficult time losing weight. It's taken me years to even figure out how to lose weight. At all! So now I'm slowly losing weight, which is the only way I can do so successfully. Sometimes I end up in a plateau for a couple months or longer. Many people can just lose weight quickly and safely, and that is great! But I get annoyed when I do the right things unsuccessfully, so I reach out for help and get called a liar instead. It doesn't help.
The thing is that, if you reach out for help, you've got to mention all that. Because it's relevant to the question.
And if you mention all that, everybody's going to slowly back away because our inexpert advice could land you in the hospital. You should have a team of specialists to direct your questions to.0 -
Advice for insulin resistance and losing weight from the National Institutes of Health:
"Eating, Diet, and Nutrition
Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weight-loss solutions. People may need to get help from a dietitian or join a weight-loss program for support.
In general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan.
The DASH (Dietary Approaches to Stop Hypertension) eating plan, developed by the NIH, has been shown to be effective in decreasing insulin resistance when combined with weight loss and physical activity. More information on DASH is available at www.nhlbi.nih.gov/health/health-topics/topics/dash."
AND
"The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week."
ALSO
"Approaches to Preventing Diabetes
The DPP tested three approaches to preventing diabetes:
Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.
Taking the diabetes medication metformin. Those who took metformin also received information about physical activity and diet.
Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medication in it.
People in the lifestyle change group showed the best outcomes. However people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years.
Lifestyle change was even more effective in those ages 60 and older. People in this group reduced their risk by 71 percent.
People in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under NIH clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dppleaving site icon."
http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/0 -
Ah, yes, DASH. Mocked as a "fad" diet on here.Advice for insulin resistance and losing weight from the National Institutes of Health:
"Eating, Diet, and Nutrition
Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weight-loss solutions. People may need to get help from a dietitian or join a weight-loss program for support.
In general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan.
The DASH (Dietary Approaches to Stop Hypertension) eating plan, developed by the NIH, has been shown to be effective in decreasing insulin resistance when combined with weight loss and physical activity. More information on DASH is available at www.nhlbi.nih.gov/health/health-topics/topics/dash."
AND
"The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week."
ALSO
"Approaches to Preventing Diabetes
The DPP tested three approaches to preventing diabetes:
Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.
Taking the diabetes medication metformin. Those who took metformin also received information about physical activity and diet.
Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medication in it.
People in the lifestyle change group showed the best outcomes. However people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years.
Lifestyle change was even more effective in those ages 60 and older. People in this group reduced their risk by 71 percent.
People in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under NIH clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dppleaving site icon."
http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/0 -
Ah, yes, DASH. Mocked as a "fad" diet on here.Advice for insulin resistance and losing weight from the National Institutes of Health:
"Eating, Diet, and Nutrition
Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weight-loss solutions. People may need to get help from a dietitian or join a weight-loss program for support.
In general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan.
The DASH (Dietary Approaches to Stop Hypertension) eating plan, developed by the NIH, has been shown to be effective in decreasing insulin resistance when combined with weight loss and physical activity. More information on DASH is available at www.nhlbi.nih.gov/health/health-topics/topics/dash."
AND
"The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week."
ALSO
"Approaches to Preventing Diabetes
The DPP tested three approaches to preventing diabetes:
Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.
Taking the diabetes medication metformin. Those who took metformin also received information about physical activity and diet.
Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medication in it.
People in the lifestyle change group showed the best outcomes. However people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years.
Lifestyle change was even more effective in those ages 60 and older. People in this group reduced their risk by 71 percent.
People in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under NIH clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dppleaving site icon."
http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/
Because if you don't have a problem with hypertension, you don't need to address it.0 -
Have you read about it?
Ah, yes, DASH. Mocked as a "fad" diet on here.Advice for insulin resistance and losing weight from the National Institutes of Health:
"Eating, Diet, and Nutrition
Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weight-loss solutions. People may need to get help from a dietitian or join a weight-loss program for support.
In general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan.
The DASH (Dietary Approaches to Stop Hypertension) eating plan, developed by the NIH, has been shown to be effective in decreasing insulin resistance when combined with weight loss and physical activity. More information on DASH is available at www.nhlbi.nih.gov/health/health-topics/topics/dash."
AND
"The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week."
ALSO
"Approaches to Preventing Diabetes
The DPP tested three approaches to preventing diabetes:
Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.
Taking the diabetes medication metformin. Those who took metformin also received information about physical activity and diet.
Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medication in it.
People in the lifestyle change group showed the best outcomes. However people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years.
Lifestyle change was even more effective in those ages 60 and older. People in this group reduced their risk by 71 percent.
People in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under NIH clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dppleaving site icon."
http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/
Because if you don't have a problem with hypertension, you don't need to address it.0 -
Ignoring the 5 pages of "low carb yay!" and "low carb nay!"
I am 40 years old, I have been on a diet my whole life. And really, I've always eaten textbook healthy. Fruit, whole grains, low fat, healthy protein. I was a competitive swimmer most of my life. But those pounds, they just kept going up.
I started to have issues. My eyesight was blurry in the morning. I developed psoriasis on my feet. I was sore and tired for hours after working out. I could sleep for 5 hours in the middle of the day.
I went to the doctor to check my feet and eyes. Nobody mentioned diabetes. My parents died when I was very young, so I don't really know about their medical conditions, there was nobody to tell them to me.
I chalked it all up to 40-itis. Then my Type 1 boss tested me for fun. And the numbers were in stroke territory so he made me go to the doctor.
Got sent to diabetic education, and I've lost 40ish pounds since May. I'm actually eating MORE now than I did before. I have to. I've dropped from an 11.2 to a 6.4, which is top of the pre-diabetic range.
The point I'm going to take from this post is that if what you are doing isn't working, maybe it's time to try something else. And maybe time to make your doctor work for his money. I can honestly say that diabetes was the best thing that ever happened to me.
Exactly right. There are many cases here where Calories in vs Calories out doesn't mean crap until you address the medical issues going on in your body. Fat is a symptom of more than just over eating. People who've never dealt with this you're very lucky. But when you are doing everything "right" and nothing is working, we have to keep asking questions. I think the OP's point is simply be aware this stuff is out there. Get checked, change your macros. Do what it takes until you find the answer.
No one is saying that oh I have a medical condition, so it's OK that I'm fat. We are all here to loose weight. To share information. To learn, and ultimately to loose the weight.
bingo! we have a winner! :flowerforyou:0 -
So, I've gotten flak on some threads about making weight loss all about diseases/metabolic disorders. I definitely don't think it's all about them, but I think they play a HUGE role in the difficulty many of us have with losing and maintaining weight. I know I thought I was going crazy doing everything "right" and still getting dismal results -- then I discovered that I had certain issues, including insulin resistance (and I was only about 30 lbs overweight). I know when I found out how common some issues were (insulin resistance, thyroid, PCOS, etc.), I was SHOCKED. I said, Why aren't more people talking about this?!!!
Lulz, I like it when people don't realize that things like insulin resistance, thyroid, pcos are simply symptoms of a greater problem. The problem? Overweight. See, believe it or not, and this is quite amazing.... but being overweight causes medical issues. I know, revolutionary thought there.
People probably aren't talking about this because they know better that to confuse a symptom with a malady.
So are you telling me I have been Obese since I was born? I was born with my heart condition and have had PCOS since I hit puberty (but didn't know it) and got Thyroid Cancer in my thirties but according to you if I wasn't overweight none of this would have happened. You might want to educate yourself. PCOS is not caused from being over weight it is a hormonal imbalance that generally starts at puberty or early twenties and can make you gain weight and make it harder to lose weight.In many cases it is hereditary. Also many people with Hypothyroidism start out skinny and because of the problem put on weight fairly quickly before they can confirm what is wrong. Get some education before you start spouting off BS.0 -
Have you read about it?
Ah, yes, DASH. Mocked as a "fad" diet on here.Advice for insulin resistance and losing weight from the National Institutes of Health:
"Eating, Diet, and Nutrition
Adopting healthy eating habits can help people lose a modest amount of weight and reverse insulin resistance. Experts encourage people to slowly adopt healthy eating habits that they can maintain, rather than trying extreme weight-loss solutions. People may need to get help from a dietitian or join a weight-loss program for support.
In general, people should lose weight by choosing healthy foods, controlling portions, eating less fat, and increasing physical activity. People are better able to lose weight and keep it off when they learn how to adapt their favorite foods to a healthy eating plan.
The DASH (Dietary Approaches to Stop Hypertension) eating plan, developed by the NIH, has been shown to be effective in decreasing insulin resistance when combined with weight loss and physical activity. More information on DASH is available at www.nhlbi.nih.gov/health/health-topics/topics/dash."
AND
"The DPP and other large studies proved that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity—for example, walking 30 minutes a day, 5 days a week."
ALSO
"Approaches to Preventing Diabetes
The DPP tested three approaches to preventing diabetes:
Making lifestyle changes. People in the lifestyle change group exercised, usually by walking 5 days a week for about 30 minutes a day, and lowered their intake of fat and calories.
Taking the diabetes medication metformin. Those who took metformin also received information about physical activity and diet.
Receiving education about diabetes. The third group only received information about physical activity and diet and took a placebo—a pill without medication in it.
People in the lifestyle change group showed the best outcomes. However people who took metformin also benefited. The results showed that by losing an average of 15 pounds in the first year of the study, people in the lifestyle change group reduced their risk of developing type 2 diabetes by 58 percent over 3 years.
Lifestyle change was even more effective in those ages 60 and older. People in this group reduced their risk by 71 percent.
People in the metformin group also benefited, reducing their risk by 31 percent. More information about the DPP, funded under NIH clinical trial number NCT00004992, is available at www.bsc.gwu.edu/dppleaving site icon."
http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/
Because if you don't have a problem with hypertension, you don't need to address it.
http://www.nap.edu/catalog.php?record_id=183110 -
I feel like I am the exact opposite. I have difficulty losing weight because I consistently need to eat at maintenance to combat hypoglycemic episodes. I'm a TYPE 1 diabetic and am insulin sensitive.
Unfortunately, my father was diagnosed as a type 2 diabetic a few weeks ago. He only got himself checked out once I forced him to call my CDE when he had two random BG readings in diabetic ranges after complaining about jittery-ness and blurry vision. I don't think he had elevated levels for a long time, so I am hoping that catching it early and getting his BG under control might prevent some diabetes-related complications.0 -
So, I've gotten flak on some threads about making weight loss all about diseases/metabolic disorders. I definitely don't think it's all about them, but I think they play a HUGE role in the difficulty many of us have with losing and maintaining weight. I know I thought I was going crazy doing everything "right" and still getting dismal results -- then I discovered that I had certain issues, including insulin resistance (and I was only about 30 lbs overweight). I know when I found out how common some issues were (insulin resistance, thyroid, PCOS, etc.), I was SHOCKED. I said, Why aren't more people talking about this?!!!
Lulz, I like it when people don't realize that things like insulin resistance, thyroid, pcos are simply symptoms of a greater problem. The problem? Overweight. See, believe it or not, and this is quite amazing.... but being overweight causes medical issues. I know, revolutionary thought there.
People probably aren't talking about this because they know better that to confuse a symptom with a malady.
Ugh, thyroid is not a symptom of being overweight. Neither is PCOS. They're both genetic. Though both can contribute to weight gain. Insulin resistance goes both ways.0 -
The estimates presented for undiagnosed populations were based on an NHANES survey and considered the results of fasting glucose or A1C tests - one result of one test. Anyone who has ever been pregnant and taken the gestational diabetes test knows that if you show up as positive on the first test, they bring you back in for a longer test before diagnosing you as having gestational diabetes.
Claiming that those population estimates are accurate based on one set of test results is flawed, not to mention that there are limitations to the tests themselves and factors that can impact the results. Those factors, particularly lifestyle factors, would not be accounted for in a survey, as most patients would not know to report those factors as possibly skewing their test results.
I just wanted to bump this post. A lot of the numbers in the OP are estimates. And just because you have prediabetes, doesn't mean you are full blow insulin resistant. I would also like point out, of that 30-35% estimated to have prediabets, about only 15% to 30% actually develop diabetes II.
http://www.diabetes.org/diabetes-basics/statistics/cdc-infographic.html
There are a handful of people who have insulin resistance and it's real, but it's not 40% of our population has full blown insulin resistance. Those that are prediabetic can get their A1C back to normal with just weight loss, many of which don't even have to be concerned about carbs.
OP, i am sorry it took so long for you to discover your health issues, but your situation does not apply to the majority of the population. I understand your frustration, over the past 4 years, my wife has been in and out of 7+ different hospitals and dealt with a ton of specialist to include: Cardiologist, Endocrinologist, Gastroenterologist, OBGYN's and Electrophysiologist for her medical conditions. She is borderline PCOS and Postural Orthostatic Tachycardia Syndrome, so she has to be gluten free and low carb. Having said that, I do believe the majority of people can benefit from lowering their carbs, but that is merely for the fact that most people get too little protein in their diet.
What do you consider to have "full blown insulin resistance". Just because people can reverse it doesn't mean they don't have it while they have it. My understanding is that you have "full blow insulin resistance" based on your blood tests. 5.7-6.4 for A1C is at prediabetic levels and over that is diabetes. That's what the numbers are based on. How is that not "full blown insulin resistance"?
In the context of this discussion, I would equate insulin resistance with the inability to process carbohydrates. But anecdotal information from several people in this thread, a calorie deficit, weight loss and exercise allowed a person to get their A1C into the normal range.
No one is debating that insulin resistance can't be reversed for some people with diet and exercise alone, though many find that they need to restrict carbs to do that (some don't). But that doesn't negate the fact of whether they have insulin resistance or not, or negate others' symptoms being more severe and requiring more than just diet and exercise to reverse. And, even some with proper diet and exercise, can't reverse it.
So, what's your point?
Ditto! Thank you for saying this. I was able to reverse my diabetes with weight loss and moderate changes to my diet and just lowering my sugar a bit. I feel fortunate that this worked for me cause I know it doesn't work for others. What I have learned from my experience is that the human body is really hard to generalize on, what works for one person doesn't work for others.0 -
So to clarify, people who suffer from hypothyroidism should not take their prescribed synthetic thyroid hormones given to them by their doctors. Rather, they should eat less and move more, and this is sure to cure their defective thyroid gland. Because their defective gland is simply a symptom, not an ailment. Am I understanding your opinion on the subject correctly?
Not people, just you. Please do so and report back.
Then you can tell us all how being ridiculous worked out for you.
Eat less, move more, quitcher*****in'.0 -
remember, though... our first instinct is to blame the dieter when the diet fails. i see it here every single day... we get multiple posts by people who are frustrated because they're not losing weight. the knee-jerk answers are always "you're not measuring correctly" or "you're overestimating what you eat" or "you're not exercising enough." for some, yes that's the answer. but even when the person says "here's my diary, here's my exercise schedule, why is this not working", people are quick to give the easy, canned answer.
i don't know about you, but i find it incredibly insulting and demoralizing when i say "here's what i'm doing, i'm doing what everyone says is "right", why is this not working?" and i get an answer that equates to " oh it's easy, just eat less and move more. it was easy for me so therefore you're just making excuses and don't really want this badly enough." there are only a few, scattered souls who have the knowledge, the patience, and the compassion to step up and say "ok... let's try some other tactics. have you seen a doctor and discussed these specific topics?"
IRT the daily threads of the "I am not losing threads", a majority of the time, people are't logging daily, they aren't using food scales, they are over estimating calories burned or have only been doing it for a week. This is the general thing I have seen over the past several years. Once that is estimated, its the rare occasion someone actually comes back with an additional post saying they tried all of that and it didn't work. Or in some cases, after 4 pages of debating, they come back saying they have a medical conditions and our answers (or at least mine does) will change.
Addressing accuracy and consistency is the first key (especially for more lean individuals). After that, if a person does come back and has the same results, then you modify it more (changing macronutrients or even possibly cutting out a specific food group). But again, of the thousands of people who I have personally worked with, I can count on one hand that amount of people who have come back with a plan to be adjusted and approach elimination diets or a different dieting style. In fact, that is how my wife found out she had a gluten intolerance.
I would think it would be wrong of our community, to jump to the extreme first (going low carb, cutting XX foods out, etc..) without understand what the person has tried or their medical history. I will say though, there are people on this board that jump to conclusions without knowing facts and will blame dieters, and it is clearly wrong but it's the internet... so having high expectations that everyone will get all the information should be low. :laugh:
As someone who has both type 1 diabetes and type 2 diabetes (type 1 makes it really hard to lose weight), and Hashimoto's disease (type 1 diabetes and Hashimoto's are auto-immune diseases, not symptoms of being overweight), I have an incredibly difficult time losing weight. It's taken me years to even figure out how to lose weight. At all! So now I'm slowly losing weight, which is the only way I can do so successfully. Sometimes I end up in a plateau for a couple months or longer. Many people can just lose weight quickly and safely, and that is great! But I get annoyed when I do the right things unsuccessfully, so I reach out for help and get called a liar instead. It doesn't help.
The thing is that, if you reach out for help, you've got to mention all that. Because it's relevant to the question.
And if you mention all that, everybody's going to slowly back away because our inexpert advice could land you in the hospital. You should have a team of specialists to direct your questions to.
but sometimes, we're not reaching out to get medical diagnoses... we're looking for others who have also travelled the same road we're on, who have run into the same roadblocks and sludgy progress. we want people to bounce things off, asking "how did you deal with this?" or "hey i read this, i thought you'd be interested."
we come looking for the community and the support. and sometimes, others might be able to identify what questions we should be asking our doctors and what kinds of tests to specifically ask for. because doctors are just as guilty of dismissing patients who are overweight as the rest of us are.0 -
So to clarify, people who suffer from hypothyroidism should not take their prescribed synthetic thyroid hormones given to them by their doctors. Rather, they should eat less and move more, and this is sure to cure their defective thyroid gland. Because their defective gland is simply a symptom, not an ailment. Am I understanding your opinion on the subject correctly?
Not people, just you. Please do so and report back.
Then you can tell us all how being ridiculous worked out for you.
Eat less, move more, quitcher*****in'.
So now it's me that's making excuses? It's fine to say you don't know what you're talking about or misspoke, but shifting it to me as just "*****in" is pretty comical. I don't have any of those conditions nor am I particularly struggling to make progress. I do at least have a clue about what's a symptom and what's an ailment though. You keep thinking genetic defects are caused by people being fat though - no chicken and egg problem going on there at all.0 -
Number of selected persons . . . . . . 27,631
Number of interviewed persons. . . . . 20,491
Number of examined persons. . . . . 19,644
I'm sorry, but if you can look at that information and not understand why lab results from one point in time and from the specified populations cannot be extrapolated and applied to the general population of the US, then the conversation is going to have to end here, because I'm not going to continue to attempt to have a learned discussion with someone who is going to ignore facts to support their confirmation bias.
If you think it's all hooey, by all means feel free to dismiss it. 20K seems like a very large sample size to me and although some populations are oversampled, there is still quite a considerable breadth of populations. A lot of the peer reviewed studies are focused on a few hundred people at best. Here there is 20K. But, if it doesn't meet with your standards, by all means dismiss it. I'll stick with the American Diabetes Association on this one.
Did you take a good look at the populations who were oversampled? Let's do it, just for fun:Hispanic persons, non-Hispanic black persons, non-Hispanic non-black Asian persons, low-income non-Hispanic non-black non-Asian white and other persons (at or below 130% of federal poverty level), and adults aged 80 and over
Now, there are three minority groups listed. Here is a list of potential issues when sampling from minority groups, not all-inclusive by any means and not saying that these automatically apply to all people who identify as a minority group, but things any good researcher would consider:
- Limited financial resources
- Limited access to medical care
- Limited access to food/nutrition
- Limited access to education
- Understanding of English language/English not primary language spoken in home
We also have low income persons, for whom the following would also apply and need to be considered:
- Limited financial resources
- Limited access to medical care
- Limited access to food/nutrition
- Limited access to education
And finally, we have our final group, adults age 80 or over:
- Limited financial resources/fixed income
- Limited access to medical care
- Limited access to food/nutrition
- Limited access to education (particularly women and minorities given social constructs during their lifetime)
- Increased likelihood of medical issues due to age regardless of the above
Now, given that those groups were oversampled, and human studies are notorious for not having accurate representation of the population regardless of oversampling because the fact is, people who are financially secure or educated generally aren't going to be enticed to give up their time to participate in a study for a measly stipend or free medical exam, the sample size of 20,000 is not as significant as it would first appear. Especially when you consider that according to the 2012 census, there were over 313 million people in the US. An n=20,000 is a mere 0.00006% of the population.
And that concludes my final attempt to encourage critical thinking and analysis of the data presented. I'm excusing myself from the conversation now, as I see no need to continue to try to elevate the discussion.0
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