Hi everyone, personalised nutrition companies are out here warning the public about glucose spikes from blueberries.

Yes, blueberries.

So I’ve written an 8-part series to debunk every glucose-related piece of nonsense you can imagine. I start by comparing meal-related glucose rises in NGT to the prolonged hyperglycaemia in type 2 diabetes with some sophisticated drawings.

drguess.substack.com/p/what-is-type…

This new paper came out.

I read it for about 4 mins and decided watching Summer House season 5 again was a better use of my time. Firstly, a key pillar of this paper is that there is a strong association between circulating erythritol and major adverse cardiovascular events (MACE).

The @conversationUK asked me to write a piece on the lack of evidence behind “personalised nutrition”.

They did not tell me that the companies I was critiquing would get a right to reply with some unquestioned marketing guff. This kind of bothsidesism is an enormous barrier to supporting the public in understanding science.

Luckily I have a twitter account (ha ha) and I try use it as a medium for making my field - nutrition science - more transparent.

My good friend (and PI of some legitimately excellent RCTs) Dr Sarah Berry has written a thread on personalised nutrition.

I think there is some stuff in there that needs clarifying.🧵

https://twitter.com/saraheeberry/status/1550577122443497474

"Promising" findings from PN studies.

Let's look at these EU programmes (Food4me and PREVENTOMICS).....

Our carbohydrate dosing study is out as a preprint!

medrxiv.org/cgi/content/sh…

I think this paper is going to cause some... discussion so I wanted to do a thread to hopefully help prevent over-interpretation of the data our study generated. Design:

Crossover study: n=12.

We tested 5 different "doses" of carbohydrate (10,15,20,25,30%kcal) for 7 days in people with type 2 diabetes.

The menus aimed to keep weight constant.

Protein was kept at 15%kcal

The new highly competent SACN review on low-carb diets & T2D is out.

They came to the same conclusion as every other review (20+).

A thread on why we need to stop doing these reviews in the expectation they will tell us something new.

They won't. These are the limitations noted by the reviewers.

They have been noted multiple times previously.

Reviewing the data in the same way again and again is not going to change this.

A paper came out last week with some new data on a ketogenic dietary intervention in prediabetes by @Virta. So it’s time for another tweetorial! First of all (as mentioned in previous tweetorials) any new approaches to T2D prevention should be celebrated. Right now, pretty much one diet has been tested. Giving people at risk of T2D choice is A GREAT THING.

There's a new meta-analysis out in @bmj_latest on low-carb diets on remission of #type2diabetes.

Here are my thoughts in a LONG thread. 🤓 The short version:

1) this adds nothing new 😕
2) long term RCTs on this are so flawed/heterogeneous we can't compare them meaningfully 😴
3) please stop doing meta-analyses on low-carb and glycaemia (with one exception h/t to @DylanMacKayPhD)

High protein and low glycaemic diet to prevent type 2 diabetes.

A tweetorial. The PREVIEW study primary results came out last month.

This was a large international trial looking at the effect of diet on the prevention of T2D (an endpoint OMG!!)

It didn't get much traction which is weird, so I wanted to review.

If any healthcare professional is interested in learning about nutrition, be wary of the words "lifestyle medicine" in any conference or course (1) There's a 45% chance it's a conference held by vegans who've already decided 100% plant based is the best.

There's a 45% chance it's a conference held by the low-carb crowd who've already decided carbs are the worst.

There's a 10% chance it might be legit (2)

Sad to see the usual angry responses to the announcement that the NHS is rolling out the "DiRECT"-style plan to help people with T2D achieve remission. (1) To have the NHS get behind a charity-funded research programme which has pretty solid evidence (clinical and physiological) behind it is fantastic. It's a great option in addition to bariatric surgery. The more evidence and options we have, the better. (2)