Aside from creamy vs. crunchy peanut butter, nothing boils the blood on facebook, twitter, instagram, snapchat or (insert the next social app here) like discussing the ketogenic diet.
To date, I have lost 7 friends (the real life kind), 1 colleague, and 139 hours over these debates.
The fervor, both for and against, any particular diet has always been a mystery to me as it seems quite silly and that instead of entrenching yourself in a singular view about one’s diet, perhaps one could instead try and see the key messages and truths other diets hold.
This holds especially true for the ketogenic diet. The recent resurgence in ketogenic and low carb diets has caused us to rethink this paradigm and revisit these ideas, and it turns out that the Keto-Craze has taught us a few things.
Here are three things you can learn from ketogenic dieters:
1. Ketogenic diets can be effective
For decades, it was nutrition lore that dietary fat was bad and that low-fat diets were the best way to eat for leanness. However, over the past almost thirty years, nutritional science has come a long way and it is very clear what works and what doesn’t work for weight loss and fat loss.
Hint: Ketogenic diets can work for weight loss and fat loss… but maybe not in the way most people are told they work.
Let me tell it to you straight, no matter how you slice the pie, if you want to lose weight you have to find a way to sustain a calorie deficit. This can be achieved in an infinite combination of diets and exercise modalities and activity levels, but at the very bottom, you must sustain a calorie deficit.
In the 1990s and through the 2000s there were several large, randomized controlled trials that looked at the efficacy of low-fat diets and low-carb diets on a wide range of populations: from perimenopausal women, to people with type 2 diabetes, and a representative sample from our population1,2,3.
These studies often lasted for an entire year and had fairly large sample sizes, thereby giving us enough confidence to draw some conclusions. Each of these studies came to the exact same conclusion - you can very effectively lose weight on a low-carb diet. Calorie balance and overall adherence are the main predictive factors of diet-induced weight loss.
There have also been several tightly controlled, metabolic ward studies where they restrict people to hospitals and give them ketogenic diets4. In all of these studies they have shown that when controlled for calories, low-carb diets can be effective tools for weight loss similar to low-fat diets.
It is abundantly clear from decades of research that low carb diets can be effective tools for weight loss when used appropriately.
2. You probably need more veggies
If you have a hope or a prayer of pulling off a ketogenic diet and staying in a calorie deficit you better start loading up on your vegetables. Anecdotally, people who consume high-fat, low-carb, and moderate protein diets are usually consuming more vegetables and other high-volume, low energy dense foods compared to most people.
Consuming more vegetables is a very good habit to get into. Why? Well let me put it this way, of all the things we argue about in nutrition science, vegetable intake is the one thing we call agree about.
In virtually every single study to date, vegetable intake is associated with a lower risk of whatever disease you are looking at (e.g. cancer, heart disease, stroke, zombification, etc.) and death5,6,7,8.
If you don’t want to get sick and die, for the love of the gods (the old and the new – GoT Reference), eat more vegetables please. Seriously, making a salad every once in a while won’t kill you. It also makes you look like an adult, if you are into that kind of thing.
I mean seriously, what is a simpler dietary change for lowering your risk of dying early from a preventable disease than adding in some veggies? There isn’t one. You can literally grab some bell peppers and carrots at the store and chop them up and eat them for snacks and lower your risk of dying. Ketogenic dieters have that one in the bag.
3. Dietary therapies offer hope for some medical conditions
Medicine is hard. Like REALLY hard. There is a reason doctors at the top of their respective fields spend anywhere from 7-15 years AFTER college before they are considered trained. Even then, they call their work practicing.
Why do they call it that? Because you never know everything about medicine and you are always learning and getting better. This holds especially true for dietary therapies for certain medical treatments.
Ketogenic diets may offer some substantial benefit for neurological disorders due to the unique metabolism of the brain. Epilepsy in children is often resistant to standard medical therapy (e.g. anticonvulsant drugs); However, a robust body of science has shown that ketogenic diets can substantially improve epilepsy in children9, 10.
This phenomena was originally observed in the 1930’s and it has been shown to be a very viable nutritional intervention for the last 8 years11.
Other diets offer hope for several other medical conditions. For example, gluten-free diets offer almost complete reversal and prevention of symptoms in people with celiac. Additionally, the previously fatal genetic condition phenylketonuria can be managed quite well with a phenylalanine (one of the dietary amino acids) restrictive diet12.
The Wrap Up
Look, ketogenic diets are not the messiah of nutrition or the second coming of Krishna or a magical weight loss tool.
That doesn’t mean that we can’t learn something from them, because we can.
They have shown us that low-carb diets can be REALLY effective weight loss tools, that you can and should eat more veggies, and that for some medical conditions nutritional based therapies are very viable interventions.
Instead of keto bashing, how about you learn something from them and improve your own nutrition and understanding about the world?
- Comparison of the Atkins, Ornish, Weight Watchers, and Zone Diets for Weight Loss and Heart Disease Risk Reduction. A Randomized Trial
Comparison of the Atkins, Zone, Ornish, and LEARN Diets for Change in Weight and Related Risk Factors Among Overweight Premenopausal Women
The A TO Z Weight Loss Study: A Randomized Trial
- Comparative Study of the Effects of a 1-Year Dietary Intervention of a Low-Carbohydrate Diet Versus a Low-Fat Diet on Weight and Glycemic Control in Type 2 Diabetes.
- Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity
- Fruit and Vegetable Intake and Overall Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)
- Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study
- Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study
- Fruit and Vegetable Intake in Relation to Risk of Ischemic Stroke
- Low Glycemic Index Treatment in Patients with Drug-Resistant Epilepsy.
- Efficacy of a Ketogenic Diet in Resistant Myoclono-astatic Epilepsy: A French Multicenter Retrospective Study.
- Epilepsy in Children: With Particular Reference to the Ketogenic Diet.
- Treating Phenylketonuria by a Phenylalanine-free Diet.