Talk:Ketogenic diet: Difference between revisions
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:::::With the key changed, of course. [[User:Fvasconcellos|Fvasconcellos]]<small> ([[User talk:Fvasconcellos|t]]·[[Special:Contributions/Fvasconcellos|c]])</small> 15:55, 17 January 2010 (UTC) |
:::::With the key changed, of course. [[User:Fvasconcellos|Fvasconcellos]]<small> ([[User talk:Fvasconcellos|t]]·[[Special:Contributions/Fvasconcellos|c]])</small> 15:55, 17 January 2010 (UTC) |
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::::::Ah. Are you proposing a change to the shading + key change. That's fine. [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 16:00, 17 January 2010 (UTC) |
::::::Ah. Are you proposing a change to the shading + key change. That's fine. [[User:Colin|Colin]]°[[User talk:Colin|<sup>Talk</sup>]] 16:00, 17 January 2010 (UTC) |
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:::::::Yes, there'd be shading + key saying "carbohydrates, protein, dietary fat, MCT oil". [[User:Fvasconcellos|Fvasconcellos]]<small> ([[User talk:Fvasconcellos|t]]·[[Special:Contributions/Fvasconcellos|c]])</small> 16:06, 17 January 2010 (UTC) |
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== Effects on lifespan? == |
== Effects on lifespan? == |
Revision as of 16:06, 17 January 2010
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Calories vs food energy.
A recent edit replaced most instances of "calorie" with "food energy" or "energy" with the comment "this isn't unit-dependent, don't be using names of units as substitute for quantity being measured, and those critters are hard to hold down to get a "number" count". Of the changes, some are neutral, some are grammatically wrong and most are non-idiomatic. Nobody talks about "energy-free drinks". "low-calorie" is the idiomatic term for food; "low-energy" is the idiomatic term for lightbulbs. Wikipedia is written for the general reader, not the pedant.
I've looked at my journal sources, which one would expect to use acceptable terminology. The neurologist papers use calories everywhere. One set of papers by a US dietitian uses calorie everywhere. Another set of papers, by a UK dietitian uses "energy" fairly consistently in one paper (but never "food energy" and once "dietary energy") but is completely mixed in another paper.
The other change was the addition of kJ as a unit. I'm not aware that any country uses kJ as their unit of food energy. It appears as an additional unit on food labels in the EU, but nobody reads it. My dietitian papers all use calories ("kcal" when they are being precise). Only one paper out of over 200 offers kJ as an alternative to kcal. I wonder if there are any readers who benefit from this additional unit, which clutters the sentences. Thoughts? Colin°Talk 17:30, 15 January 2010 (UTC)
- I didn't find the changes useful; people understand calories. SandyGeorgia (Talk) 18:04, 15 January 2010 (UTC)
- I just looked in my kitchen cupboard; all of my packets of rice, dried pasta, flour etc are labelled with both kJ and kcal. None are labelled "food energy". The articles that I have checked on PubMed uses "calories". Most people understand "calories" in this context."Food energy" is not idiomatic. I suggest the changes be reverted—the expert reviewer did not criticise the use of the term. Graham Colm Talk 18:16, 15 January 2010 (UTC)
- I agree - "calorie" is an accessible term to the lay reader, while "food energy" and "energy" is simply confusing. Considering that the sources use the word "calorie" as well, we should stick with that. If the sources switch to a different terminology, we can revisit the issue then. Awadewit (talk) 19:38, 16 January 2010 (UTC)
Globalize
There really are people who measure their caloric intake in the modern SI units, kilojoules, rather than archaic—and thousand-fold ambiguous, plus numerous variants in precise definitions at each size level, compounding the problem—non-SI metric units not coherent (in the metrology-jargon sense) with any system of units. That's part of the reason why this article already included some conversions to kilojoules, before I added more. See any European nutrition label, for example. Consider common usage in Australia. This diet isn't unit-dependent. And in any case, using the name of a unit of measure as a substitute for the quantity being measured is in general bad form. Doing so does not "exemplif[y] our very best work". Wikipedia:Featured article criteria.
Another aspect of the globalization is that there are a whole lot of people who aren't going to understand why the units are written out as "calories", yet they use the symbol "kcal" with "k" for the "kilo-" prefix. That might be common in various geographical locations, or among specialized jargon within certain journals, but it is not by any stretch of the imagination a universal practice. I never see "kcal" used in any general audience publications in the United States, for example.
Consider also usage elsewhere on Wikipedia such as in Template:Nutritional value which only accepts energy in kilojoules as a parameter, and which, unlike common practice in U.S. nutrition labels, does not use "calories" not as a unit of measurement but rather as a substitute for the quantity being measured. Its output field identifies the quantity as "Energy", given in both kilojoules and calories in the infobox. There may be other usages in other templates in Category:Food infobox templates, but from what I've seen lately on Wikipedia, I would be surprised any of them seeing significant use would use "calories" as a field name, when what is meant is "energy". Gene Nygaard (talk) 18:50, 15 January 2010 (UTC)
- See, e.g., this paper dealing with guidelines for New Zealand found on a .au (Australia) website, "Food and Nutrition Guidelines for Healthy Adults: A Background Paper" http://www.broadmeadows.grassroots.org.au/library/community_resources/items/2004/01/71818-upload-00001.pdf
- It uses kJ (and kJ/g, etc.) standing alone much of the time; in Table 3 there are conversions to kcal, but the text is always "kilojoules" or "kJ" (calorie is never spelled out, near as I can tell).
- The other thing is constant is that the quantity being measured is always "energy", not "kilojoules" and not of course "kilocalories" (as I said, calories are never spelled out in this paper). Gene Nygaard (talk) 19:17, 15 January 2010 (UTC)
- Example 2: then, of course, we have SportsDieticians Australia talking specifically about ketogenic diets, saying things like:
- "Low carbohydrate diets achieve weight loss because they are low in kilojoules, not because carbohydrate is fattening" and "therefore reducing the number of kilojoules you eat" and "will help you keep a lid on your kilojoule intake". This does use units of measure to mean the quantity being measured, the same problem this Wikipedia article has, just with different units.
- Nary a "calorie" to be seen on that page, however. Gene Nygaard (talk) 19:50, 15 January 2010 (UTC)
I have restored the kJ measurements. Australia/New Zealand do seem to be trying to use those as an official measurement. However, Googling their websites (health, Weight Watchers, etc) show that every day people use the term "calories" just as we do. In Europe, both measurements appear on food labels but nobody in the UK talks about kilojoules when discussing diet. Yes we know that pedantically it is "energy" but nobody talks like that. I've removed the Globalize tag unless someone can show that some English speaking counties no longer understand the idiom "calories" wrt food energy intake. Colin°Talk 19:57, 15 January 2010 (UTC) I've made a few other tweaks which leave calorie/calories only for idiomatic (i.e., "energy") usage and use "unit of energy" or "kcal" in other cases.
- Well! What can I say? You've managed to leave me dumbfounded. But I'll try to work my way through it.
- Let's see if I've got this right. You are now convinced that you have everything in this article fixed so that "kcal" always means "calories", and so that "calories" never means calories but always means "energy"? Wow! That's profound.
- And—the mind-boggling part—you think that now fixes everything? So much so, that this brilliant move on your part means that the issue is resolved, so you can unilaterally decide the discussion has to be over and on your own whim remove the link to this discussion from the article page? Before you even get a response from anybody about your strange solutions?
- I guess the good news is that now, if we do them in the right order, it will only take two simple search-and-replace operations to get the article so that it actually says what we intend it to say.
- Note that the globalization issues do not have anything to do with "English-speaking countries" per se. But I'm probably at least partly at fault there, by not more clearly distinguishing the globalization issues from the bad-writing and clarity-of-expression issues. Usage in the rest of the world, in whatever language, is also relevant. Nutrition labels throughout the EU use kilojoules, as to those in other places such as Norway and Japan; about the only place where they are rarely found is the United States.
- You claim nobody in the British public ever uses the kilojoules which do appear on all their nutrition labels. Not real sure I believe that. But be that as it may, there is a more important factor about usage which you seem to be unaware of. Nobody in the U.S. general public ever uses "kcal" for calories, even though some researchers do use that symbol in some publications. And, unlike the situation in the UK, "kcal" never appears on any of our U.S. nutrition labels.
- In other words, an unexplained jump from "calories" to "kcal" can indeed cause confusion. But you've come up with a really bizarre solution to that: let's just never use "calories" as a unit of measure, even though that's what a lot of people are familiar with, especially in the UK and the U.S.
- I can come up with only one possibility that could possibly explain some of your recent actions. Are you laboring (sure, you'd probably be labouring, but unlike the Americans reading "kcal", you aren't going to have any difficulty understanding what I meant) under a misapprehension that the units really are and always have been "kilocalories", and that it is only through laziness in general usage that this has come to be abbreviated and shortened up to "calories"? If so, you are flat-out wrong. Furthermore, calling them "kilocalories" is actually what is new, a development that has taken place in my lifetime, and it remains a minority usage.
- In fact, the large calories, the ones based on the kilogram rather than the gram, are the older definition of calories. The small calories, or gram-calories, came along later. And all of that, of course, happened before people figured out the advantages of using "coherent" (a metrology jargon term, meaning each derived unit in the system is a unitary combination of base units) systems of units, such as the SI and its joules for energy (1 J = 1 N·m = 1 kg·m²/s² in terms of the base units in this coherent--because of those "ones"--system). You are likely too young to remember when physicists and chemists actually used gram-calories. Those units are pretty much obsolete now—they survive only in the strange notion that there is still a need to distinguish the only calories still in use, the large calories used in a nutrition context, by using the inaccurate symbol "kcal" for them. We can only get away with that because there never was any significant use of the prefix "kilo-" for the large calories used for nutrition, so we can use the symbol for 1000 small calories to mean 1 large calorie. So when we are talking about nutrition, "calories" and "kilocalories" and "cal" and "kcal" and even the grotesque "Cal" and even more strange "kCal" all mean the same thing—none of them ever differs from any of the others by a factor of 1000, despite the appearance of the prefix kilo- or its symbol k in the usage of some writers and its absence in the usage of others (and my spell-checker flags kilocalories and kcal, too). Maybe not exactly the same thing; seems there are some questions as to the precise definition, whether the International Steam table calories (4.1868 kJ) or the thermochemical calories (4.184 kJ) or one of the other variants should be used in this context, but it really doesn't matter because none of our measurements are precise enough to distinguish between any of those definitions. Gene Nygaard (talk) 06:53, 16 January 2010 (UTC)
- The units on UK nutrition labels are kcal and kJ. Look at File:Nutrition-label.jpg for what I typically see on a packet. I reviewed all my papers on the KD (well over 200) which are written by dietitians and neurologists from over the world but with a tendency (both author and publication) towards the US. When precise energy units are required (e.g. 1500 kcal) then "kcal" is the form used and "kJ" is often given as an alternative. As noted above, papers by neurologists and dietitians use the term "calories" for the energy component of food just as the general reader does. These are papers are published in some of our most prestigious journals, which have high editorial standards. If they are happy with this usage of the word calorie then so am I. Wrt British usage of "kilojoule", try Googling a newspaper such as The Guardian. The term just isn't used. Colin°Talk 11:00, 16 January 2010 (UTC)
- Here's some typical American usage, from Seattle:
- The Regulation to Require Nutrition Labeling in King County Chain Restaurants
- (Chapter 5.10 of the King County Board of Health Code)
- Chain restaurants are required to provide total amounts of the following for each standard menu item (acceptable abbreviations):
▶ Calories (cal) ▶ Grams of saturated fat (sat fat) ▶ Grams of carbohydrate (carb) ▶ Milligrams of sodium (sodium)
- <end of quote>Note that "cal" is used many times throughout this guidebook to help the restaurants comply with the law, never "kcal", which are not an acceptable abbreviation under this law.
- But what about the real main problem here? Why do you insist on pretending that this diet is somehow unit-dependent? Local journals don't make the deliberate efforts to globalize their usage, as we do here. This diet does not only work if the units you use measure energy are calories, not if you use joules. The usage is particularly strange in this article as it stands now, given that you have so carefully eradicated any use of "calories" as a unit of measure. Gene Nygaard (talk) 14:59, 16 January 2010 (UTC)
- Gene Nygaard, I'm unaware if you have ever had an article on the mainpage, or realize what a stressful time it can be. Lowering the sarcasm in your responses, and raising the AGF collaborative factor, would be appreciated and would help reduce the TLDR factor. SandyGeorgia (Talk) 15:25, 16 January 2010 (UTC)
- I'm not trying to "pretend that this diet is unit-dependent". You know very well that the use of "calorie" has entered the language in a way that no longer ties it to one measurement system or another. Even our Calorie article documents this usage. Wikipedia is replete with articles that are full of calories. Calorie restriction, Very low calorie diet, Dieting, Obesity, Diet and obesity. Go change all of them to talk about "low energy diets" and see how far you get. Wrt "kcal", I'm following the practice of our best sources, written by dietitians, including those published in the US -- a country you claim doesn't understand the term.
- I strongly suggest that we just agree to disagree on this point. I had no intention of wasting today reading about the history of units or the laws of some US county. I'll have more important things to worry about tomorrow. If you continue to feel strongly about Wikipedia's abuse of these terms then I suggest you debate this and establish consensus in a bigger venue elsewhere, not in an article with a handful of watchers on an obscure diet eight hours before it hits the main page. Colin°Talk 16:00, 16 January 2010 (UTC)
- Unlike the situation with the units of the International System of Units and of the few other units acceptable for use with it, where the CGPM has prescribed uniform, consistent symbols for use throughout the world, these calories are just like old software, legacy applications no longer supported and updated. There are no generally accepted standards for the use of them. THUS, if we are going to use a symbol (kcal) which is prima facie (on its face) incongruous with the generally used spelled-out name of that unit (calories), and one that is also different from the symbol many readers are familiar with, then some explanation is in order. And it would cost little to make this article more readable by putting in an explanation. Gene Nygaard (talk) 16:17, 16 January 2010 (UTC)
- The note (which is now in the Notes section along with usage of the term "fasting", etc) is a reasonable compromise. Let's move on. Colin°Talk 17:24, 16 January 2010 (UTC)
- Unlike the situation with the units of the International System of Units and of the few other units acceptable for use with it, where the CGPM has prescribed uniform, consistent symbols for use throughout the world, these calories are just like old software, legacy applications no longer supported and updated. There are no generally accepted standards for the use of them. THUS, if we are going to use a symbol (kcal) which is prima facie (on its face) incongruous with the generally used spelled-out name of that unit (calories), and one that is also different from the symbol many readers are familiar with, then some explanation is in order. And it would cost little to make this article more readable by putting in an explanation. Gene Nygaard (talk) 16:17, 16 January 2010 (UTC)
- I strongly suggest that we just agree to disagree on this point. I had no intention of wasting today reading about the history of units or the laws of some US county. I'll have more important things to worry about tomorrow. If you continue to feel strongly about Wikipedia's abuse of these terms then I suggest you debate this and establish consensus in a bigger venue elsewhere, not in an article with a handful of watchers on an obscure diet eight hours before it hits the main page. Colin°Talk 16:00, 16 January 2010 (UTC)
This issue is not about "globalisation" at all. It's about one editor who does not like the fact that one useful word—used a few times in the article—was once an esoteric scientific term but is now well-established in everyday language. Calories, in this context is used on both sides of the equator and both sides of the Atlantic, even in Russia. Gene Nygaard, I am struggling to assume good faith here. It appears to me that you are not even trying to achieve a consensus, but are trying to win. There is no support for the changes you suggest. And yes, Colin is right, why choose on this article all of a sudden? There are many others. That ridiculous tag should be removed forthwith. Graham Colm Talk 16:33, 16 January 2010 (UTC)
- I agree, and have removed the tag. I tried to fix the note, but may have bungled it. SandyGeorgia (Talk) 16:37, 16 January 2010 (UTC)
- Thanks for formatting the note for me. And suggestions on improving the wording would be welcome. Gene Nygaard (talk) 17:49, 16 January 2010 (UTC)
- Well, GrahamColm, if you had taken the time to address the issues here, rather than attacking me, that would help too. Gene Nygaard (talk) 17:31, 16 January 2010 (UTC)
Gene, if you continue to tag this article, over a trivial issue, this close to Main page day, I shall be requesting Administrator intervention on your editing abilities. Is that clear? Colin°Talk 17:24, 16 January 2010 (UTC)
- What do you mean, trying to accuse me of some wrongdoing. You were the one who removed a properly added tag, in an incomplete discussion, a removal hidden away in an edit that didn't even mention that you were doing so. I put it back, saying I was doing so.
- Seems to me that we have some ownership problems here, too. Gene Nygaard (talk) 17:35, 16 January 2010 (UTC)
- I'm guessing that you are too close to the issue here, Colin, and can't see the forest for the trees. You've been at this long enough to understand full well that there are a whole lot of sources that use the word "calories" when spelling out the units, and use the symbol "kcal" when abbreviating it. Including, of course, "our best sources, written by dietitians, including those published in the US". Nobody needs to explain that to you. That doesn't mean that the average Wikipedia reader is going to understand this incongruous usage without explanation. Gene Nygaard (talk) 17:44, 16 January 2010 (UTC)
- I removed it in the edit that fixed the globalisation issue (lack of kJ as an alternative to kcal). In good faith, I assumed this was the only globalisation issue. It seems there is no pleasing you. The globalisation tag is a bullying tactic to win your argument. You appear to have no concept of good faith discussion and the idea that people may genuinely disagree with your position. Rather than insulting me with claims of ownership why don't you please go gain Wiki consensus to ban the use of "calories" for food energy and ban the use of "kcal" for units of energy. Start with a bigger article or a Wikiproject talk page. If you have Wikipedia's interest at heart (rather than a selfish desire to win this argument) then argue your case somewhere there is less heat and more eyes. Colin°Talk 17:55, 16 January 2010 (UTC)
- Choosing to use one of the units of measure as a synonym for the quantity being measured, rather than choosing to use the other unit of measure for the same purpose, is part and parcel of the very same globalization problem.
- I'll bet that if this article were instead written in the style of my Example 2 from Australia above, and it consistently used the word "kilojoules" when energy was meant as that Australian article did, you and some of the others backing your position here would be first in line whining about the need to globalise the usage here. Maybe we should just try that for a while, to see what happens. Wouldn't be hard to replace every appearance of "calories" with "kilojoules".
- This is the article being held out as an example of the best we can do now. It is the part of Wikipedia most in need of fixing right now; bad usage elsewhere isn't an excuse. This article is quite reasonably, and should be, held to a higher standard.Gene Nygaard (talk) 02:13, 17 January 2010 (UTC)
Sandy asked me to comment on this. Looking over the discussion here, and particular this edit - I don't have a problem with giving the kcals and providing a parenthetical alternate measurement in kilojoules; however, relacing all instances of calorie with "food energy" ends up with clunky writing. Case and point from that edit I cited: The diet provides just enough protein for body growth and repair, and sufficient calories to maintain the correct weight for age and height. -> The diet provides just enough protein for body growth and repair, and sufficient food energys to maintain the correct weight for age and height. The former sounds natural, the latter does not. Raul654 (talk) 18:05, 16 January 2010 (UTC)
- Additionally, this is a misuse of the {{globalize}} template. The issue at hand is an issue of WP:ENGVAR, not WP:NPOV. It's not like some countries have a different perspective on the how much energy is being represented here: they just have different units. Whether we say "calorie" or "Calorie" or "kcal" or "kJ" is exactly as unimportant as whether we use British or American spelling. I'd as soon fuss over whether Colin tells me his height in centimeters or inches.
- The globalization tag is meant for situations in which different perspectives exist -- as in, "Those bally Orangemen might think that, but a true Green would never agree!" or "American and Japanese bankers aren't the only people in the world that have an opinion on Japan's financial situation." WhatamIdoing (talk) 20:09, 16 January 2010 (UTC)
- Colin has admitted that a globalization issue existed. Maybe you need to go look at the article's history page, and get out your dictionary.
- Find the edit summary "for the benefit of our Antipodean friends"
- Read the actual discussion in this thread
- Try to figure out what that edit summary meant.
- Gene Nygaard (talk) 01:20, 17 January 2010 (UTC)
- Colin has admitted that a globalization issue existed. Maybe you need to go look at the article's history page, and get out your dictionary.
- No, you've misunderstood -- and if Colin actually thinks that the choice of units is an issue of systemic bias (which I sincerely doubt: I think he was using your chosen handle as a shortcut), then he's simply wrong.
- The first thing I'd like you to understand is that "this isn't how we use that particular template" does not mean "please remove kJ units from this article." Personally I support the inclusion of such a conversion in all relevant articles. {{Globalize}} exists to tag articles that have inappropriate geographic restrictions -- like only representing what's been published in one country about the diet (assuming that there were actually different views in different countries). An article can't be considered either complete or neutrally written if it excludes major viewpoints.
- However, whether you use kJ or kcal or both is an issue of style, not content. Converting it to kJ doesn't indicate that Australians believe something different about the role of nutritional energy in this diet; it's the same thing, just "spelled" differently. {{Globalize}} is not meant to identify differences in style -- even if this or that style is less accessible to readers in this or that country.
- Wikipedia has a settled system for this specific issue, BTW. You'll find the ENGVAR-style overall information here, and a requirement that kcal be used as the primary unit here. The use of kJ is neither required nor even mentioned.
- And, I add, I didn't make these rules, and I can't change them. If you want to continue this discussion, then I suggest going to WT:MOSNUM and telling them that you think their long-standing preference for kcal is stupid. Talking to me, or to anyone here, isn't going to change a single character at MOSNUM. WhatamIdoing (talk) 02:59, 17 January 2010 (UTC)
- The guidelines at WP:MOSNUM are not prescriptive, so they admit some exceptions, if there's a good reason. However, in this article, I can't see any problem: each mention of kcal (the unit) is followed by a conversion to kJ. Just about any reader will be familiar with one or the other of those in this context, particularly as you've taken the time to make a note distinguishing between the use of calorie and kcal in this article. It works for me and meets the guidance at WP:MOSNUM#Units of measurement:
- When used in a nutrition related article, use the kilocalorie as the primary unit.
- Where English-speaking countries use different units for the same measurement, follow the "primary" unit with a conversion in parentheses.
- What more could anyone want? --RexxS (talk) 03:31, 17 January 2010 (UTC)
- The guidelines at WP:MOSNUM are not prescriptive, so they admit some exceptions, if there's a good reason. However, in this article, I can't see any problem: each mention of kcal (the unit) is followed by a conversion to kJ. Just about any reader will be familiar with one or the other of those in this context, particularly as you've taken the time to make a note distinguishing between the use of calorie and kcal in this article. It works for me and meets the guidance at WP:MOSNUM#Units of measurement:
- User:WhatamIdoing, I've dealt with a number of national-varieties-of-English issues. This is not one of them. There is little or nothing to do with national varieties of English in this article.
- And sure, I probably could have added a {{copyedit}} tag and probably a whole bunch more of the various specialized maintence tags as well. But what would have been the point of doing so? If I had put a bunch of them there, would that have fostered a better discussion? I doubt it.
- Back to ENGVAR. Let's just assume that the first major contributor to this article had indeed uniformly and consistently used "kilojoules" to mean food energy, as some people do, something I have already shown to be the case up above. Then, would you be here arguing that in accordance with our national-varieties-of-English rules, the practices of the first major contributor need to be restored? I doubt very much that you would.
- But since I really can't speak for what you might do, let's just make it clear that I most certainly would not be doing so. It isn't a national-varieties-of-English issue. I'd be opposing that argument vigorously; I'd still be insisting that this needs to be presented in a neutral point of view, by using the word "energy" when we mean "energy", rather than using the name of one of the two units in widespread use to measure that energy as a synonym for that energy. Gene Nygaard (talk) 11:39, 17 January 2010 (UTC)
Thirds of halves or wholes
"The diet is effective in half of the patients who try it, and very effective in a third."
Does this mean that the diet is ineffective in one-half or one-sixth? Are we looking at ineffective + effective + very effective being measured separately (17% + 50% + 33% = 100%), or are the "very effective" third part of the "mediumly effective" half?
If the numbers run 17% + 50% + 33% = 100% (ineffective through very), then the second clause should be re-phrased as "...very effective in another third". If the numbers instead run 50% + (17%+33%) = 100%, then the first clause should be re-phrased as "The diet is either effective or very effective in half...". WhatamIdoing (talk) 19:57, 16 January 2010 (UTC)
- It is the second case. Half the patients find it ineffective (reduces seizure frequency by less than 50%). Later we put it another way: "The ketogenic diet reduces seizure frequency by more than 50% in half of the patients who try it and by more than 90% in a third of patients." I was hoping that "effective" without any qualifiers (such as "moderately effective") would be assumed to include the "very effective" set of patients. For that reason "effective or very effective" reads oddly to me. I agree that it is good to be clear on this: something my sources don't always manage. Perhaps there's another way of phrasing it that is clear but simple? Do other people find the existing text ambiguous? Thoughts? Colin°Talk 20:44, 16 January 2010 (UTC)
- Maybe just reverse it so it's clear the first is included in the second?
- "The diet is very effective in a third of the patients who try it, and effective in half."
- or:
- "The diet reduces seizures considerably in a third of the patients who try it, but reduces them to some degree in half of all patients."
- or something like that. SandyGeorgia (Talk) 21:00, 16 January 2010 (UTC)
- The data would line up with the inelegant phrase, wouldn't it? Here are some other options:
- ""The diet is ineffective in half of the patients who try it, helpful to one-sixth, and very effective for the remaining third."
- "The diet is effective in half of the patients who try it. Although half of patients receive no benefit, it is very effective in a third."
- "The diet is effective in half of the patients who try it."
- WhatamIdoing (talk) 20:56, 16 January 2010 (UTC)
- I guess I misunderstand then; I thought Colin was saying the opposite. SandyGeorgia (Talk) 21:00, 16 January 2010 (UTC)
- The data would line up with the inelegant phrase, wouldn't it? Here are some other options:
- I'm not sure I'm following the "misunderstanding" Sandy mentions. The half (50%) who find it reduces their seizure frequency by less than 50% may disagree that it was "no benefit" or that it wasn't reduced "to some degree". It is just that the 50% reduction is a typical benchmark for anticonvulsants being regarded as "effective". Colin°Talk 21:36, 16 January 2010 (UTC)
- Here's some examples from the sources: "the ketogenic diet reduced seizures by >90% in a third of the patients and by >50% in half" and "approximately half of children having at least a 50% reduction in seizures after 6 months. Approximately one third will attain a 90% reduction in their seizures." Colin°Talk 21:54, 16 January 2010 (UTC)
- Two thoughts. First, how about just mentioning one (either the half or the third) and not mentioning the other? It is the lead, after all, and it doesn't need to mention every statistic. Second (and here I am to some extent contradicting the first point, but never mind), how about briefly saying what "effective" means rather than "effective", a word that is vague to the average reader? In short, I propose replacing the sentence with "The diet reduces seizures by at least 90% in a third of the patients who try it." By the way, congratulations (or should it be, commiserations?) on making the main page; I'll be watching, but will not be on-Wiki as much as I'd like. Eubulides (talk) 22:12, 16 January 2010 (UTC)
- That would work for me. I like the simplicity and the focus on the major outcome (i.e., it may not work for you, but if it does, it really works). If wanted, it could be extended to say "...and reduces seizures to a lesser extent in some other people." WhatamIdoing (talk) 02:16, 17 January 2010 (UTC)
- Two thoughts. First, how about just mentioning one (either the half or the third) and not mentioning the other? It is the lead, after all, and it doesn't need to mention every statistic. Second (and here I am to some extent contradicting the first point, but never mind), how about briefly saying what "effective" means rather than "effective", a word that is vague to the average reader? In short, I propose replacing the sentence with "The diet reduces seizures by at least 90% in a third of the patients who try it." By the way, congratulations (or should it be, commiserations?) on making the main page; I'll be watching, but will not be on-Wiki as much as I'd like. Eubulides (talk) 22:12, 16 January 2010 (UTC)
Medium Chain Triglycerides in the graph
The graph, http://en.wikipedia.org/wiki/File:Ketogenic_diets_pie.svg, seems to imply that all dietary fats are long chain, except for the medium-chain triglycerides included in that variant of the diet. However, I believe there should be appreciable amounts of short and medium chain fats in all of the diets. For instance, cream is cited as a major component of the standard ketogenic diet, and milk fat contains about 8% medium-chain fatty acids and about 3% short-chain fatty acids. [1] Perhaps the graph should be clarified in some way. Bluethegrappler (talk) 03:16, 17 January 2010 (UTC)
- Thanks. I'm a bit busy this morning but I'll give a fuller response this afternoon, with a suggested change to the chart. Colin°Talk 10:04, 17 January 2010 (UTC)
- From what I've been able to tell, vegetable oils tend to contain very little short or medium chain fatty acids. The exceptions are coconut oil and perhaps to some extent palm oil. The classic diet doesn't factor the MCT portion of dietary fat as part of its calculations. The fat does typically come from dairy but doesn't have to. Therefore it would probably be quite hard to get a figure for the portion of MCT in the classic diet. In addition, this chart shows percentage of calorific contribution to the diet, not the proportion by weight. The charts would look quite different if based on weight as fat has over twice the kcal/g of carbs. To complicate things MCT has 8.3 kcal/g compared to 9.0 for LCT.
- I think the best thing to do would be to modify the key. Replace "Fact LCT" with "Dietary fat (mostly LCT)" and replace "Fat MCT" with "MCT oil". That should make it more honest even if we can't (without conducting some original research) make the charts more detailed. Colin°Talk 15:30, 17 January 2010 (UTC)
- Hmm, will work on this. Perhaps instead of making MCT a different color, we should make it the same color as "LCT" and shade it, to imply that MCT is a subset of dietary fat. Fvasconcellos (t·c) 15:40, 17 January 2010 (UTC)
- The problem is that the dietary fat portions in our charts do contain some MCT also. We don't know how much but probably enough to be visible. So really the MCT portion should be bigger and appear in the other charts too. Which is why being specific that it is MCT oil rather than MCT fatty acids we remove the problem. Colin°Talk 15:52, 17 January 2010 (UTC)
- How's this? Fvasconcellos (t·c) 15:54, 17 January 2010 (UTC)
- With the key changed, of course. Fvasconcellos (t·c) 15:55, 17 January 2010 (UTC)
- Ah. Are you proposing a change to the shading + key change. That's fine. Colin°Talk 16:00, 17 January 2010 (UTC)
- Yes, there'd be shading + key saying "carbohydrates, protein, dietary fat, MCT oil". Fvasconcellos (t·c) 16:06, 17 January 2010 (UTC)
- Ah. Are you proposing a change to the shading + key change. That's fine. Colin°Talk 16:00, 17 January 2010 (UTC)
- With the key changed, of course. Fvasconcellos (t·c) 15:55, 17 January 2010 (UTC)
- How's this? Fvasconcellos (t·c) 15:54, 17 January 2010 (UTC)
- The problem is that the dietary fat portions in our charts do contain some MCT also. We don't know how much but probably enough to be visible. So really the MCT portion should be bigger and appear in the other charts too. Which is why being specific that it is MCT oil rather than MCT fatty acids we remove the problem. Colin°Talk 15:52, 17 January 2010 (UTC)
- Hmm, will work on this. Perhaps instead of making MCT a different color, we should make it the same color as "LCT" and shade it, to imply that MCT is a subset of dietary fat. Fvasconcellos (t·c) 15:40, 17 January 2010 (UTC)
Effects on lifespan?
It's intriguing that caloric restriction and anticonvulsants both increase lifespan in model organisms and both have some effects in common with the ketogenic diet. I didn't see any clear indications in the literature in a superficial search, but I wonder if a deeper look would turn up something. Were lifespan effects (or telomere shortening) discussed during development of the article? Wnt (talk) 04:52, 17 January 2010 (UTC)
- Thanks. I'm a bit busy this morning but I'll look at my sources on this in the afternoon. Calorie restriction is mentioned in some sources. There's very little data on lifespan issues wrt the ketogenic diet as very few people have been on it for a long period of time (decades say), but there might be some data on mice and the KD. Colin°Talk 10:04, 17 January 2010 (UTC)
- I haven't found anything regarding lifespan or telomere shortening wrt the ketogenic diet. In fact, PMID 3104076 (which is fruit fly research admittedly) might indicate such a diet may not be the best choice for a long life. The ketogenic diet, deficient in most fruits, vegetables and pulses, is not recommended by the major heart and diabetes organisations as a long-term option for weight control. Over the long-term, a standard low-calorie diet has the same efficacy as these low-carb diets but allows plenty healthy foodstuffs that we know help avoid the diseases of ageing.
- The ketogenic diet is calorie controlled. Although the calories are initially set slightly below the RDA, this is due to fat taking less energy to metabolise. The children are monitored to make sure they maintain a healthy weight and growth pattern and the diet adjusted accordingly. Although overweight children may initially aim for a reduction in their weight, being underweight is not the aim. I'm aware some folk use calorie restriction to be permanently underweight and hungry in the hope this extends their life as it does with lab rats. Colin°Talk 15:49, 17 January 2010 (UTC)
Citation needed task in the "Other applications" section
This edit added a citation needed tag. The tagged sentence is supported by the reference cited at the end of the next sentence. The source is free online so you can check yourself if you doubt the facts. I would prefer not to have to repeat the number at the end of every sentence. This article is fully cited but the number may appear after several sentences or even the end of the paragraph. I have asked Lofnazareth to reconsider the tag. Colin°Talk 15:20, 17 January 2010 (UTC)
- I see the citation has now been repeated. Oh well. If it is contentious then best to play safe. Colin°Talk 15:22, 17 January 2010 (UTC)
- Yep. Fvasconcellos (t·c) 15:35, 17 January 2010 (UTC)