Low Carb Zucchini Pizza Boats

Hype About Keto Diets? Say It Ain’t So!

Please don’t tell the keto cult. They’ll be all over us with compelling anecdotes. But it seems that we may be nearing the peak of ketogenic diet hype. Writing in JAMA Internal Medicine this week, Shivam Joshi,  Robert Ostfeld, and Michelle McMacken tell us:

Although the ketogenic diet has garnered much attention for the dietary treatment of chronic diseases such as obesity and type 2 diabetes, the evidence supporting its use is currently limited and the diet’s potential risks are real. Physicians and patients should continue to judiciously appraise the benefits and risks of the ketogenic diet in accordance with the evidence, not the hype.

Impressive in the Short Term

In the short term, a ketogenic diet can be quite impressive for weight loss. People have less hunger, eat less, and lose more weight. However, the long-term results are not nearly so impressive. Meta analysis of data from studies that lasted more than a year shows a difference of less than a kilo versus lower fat diets. This is a case where statistical significance is clinically insignificant.

Likewise, we’ve seen sensational results in short-term studies of ketogenic diets in type 2 diabetes. But if you look at longer-term studies, the results are bland. Once again, a meta-analysis shows no difference in glycemic control.

Risks to Consider

Joshi et al point out that long-term risks merit your consideration. People report fatigue with keto diets that may be more annoying than anything. But other issues, including nutritional deficiencies, are possible.

However the most significant issue, they say, may come from limiting whole grains, fruits, and legumes in a person’s diet over the long term. Whole grains offer benefits for reducing the risk of cardiovascular disease, cancer, and mortality. Fruits and legumes are also quite beneficial.

It might be a good thing that keto diets are tough to maintain for the long term. Banishing beneficial foods from your diet is not something to do lightly, based solely on short-term benefits.

Click here for the viewpoint by Joshi et al and here for more on keto hype.

Low Carb Zucchini Pizza Boats, photograph © LuckyNessa / flickr

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July 17, 2019

6 Responses to “Hype About Keto Diets? Say It Ain’t So!”

  1. July 17, 2019 at 7:45 am, Michael said:

    Ted at least you avoided calling dairy a food group. 😉

  2. July 17, 2019 at 8:09 am, Ted said:

    Too busy with the swarm that wants to fight the keto fight.

  3. July 17, 2019 at 9:23 am, Anthony Pearson said:

    I don’t think this opinion piece in JAMA adds much. The authors are clearly tied to plant-based organizations and/or food conglomerates that favor food-like substances.
    The concept that everyone should up their whole-grain intake is not proven but I do think it’s wise if you are eating lots of non whole-grain foods to substitute whole-grain.
    And the quote that “the diet’s potential risks are real” is meaningless.
    Indeed, “Physicians and patients should continue to judiciously appraise the benefits and risks of the ketogenic diet in accordance with the evidence, not the hype” as they should do for vegan diets, statin drugs and all things in life.

  4. July 17, 2019 at 9:40 am, Traci Malone said:

    Thank you for sharing this.
    “the evidence supporting its use is currently limited and the diet’s potential risks are real. Physicians and patients should continue to judiciously appraise the benefits and risks of the ketogenic diet in accordance with the evidence, not the hype.”

    I find it incredibly problematic that health care providers are recommending the Keto Diet with such little evidence of efficacy and some very clear risks. People would not be given open heart surgery by a procedure with little evidence of efficacy and some actual evidence of harm. Or, doctor wouldn’t prescribe a medication that hasn’t been given approval. So, why is it OK to prescribe this fad diet as if it’s a proven winner without any possible downsides?

  5. July 17, 2019 at 6:36 pm, ravi kamepalli said:

    it’s really not about which kind of diet it’s about personalization of a nutritional lifestyle and collecting data and guiding oneself that makes a better process… for me, LCHF worked with reducing my insulin, High crp, and LPa increased my HDL. yes also increased my total cholesterol and LDL particles. I am 50lbs lighter and feel great with nutritional ketosis approach from 2015 till 2019. see the below link and the video in interested. https://conta.cc/2NWDCdf
    Dr.kamepalli

  6. July 19, 2019 at 10:58 am, Aubri said:

    There are several 12-month RCTs on the benefits if a low-carb diet. Please just look into the evidence for yourself and then make assertions. And to the comment about doctors never prescribing surgeries and drugs that are not beneficial. Please look into this as well because this happens often. All I’m asking is for you to look for yourself- not trust what you think you know based on what you’ve been told. In this day and age when there are SO many conflicts of interest and lobbying and entanglement between govt. agencies and food corporations, we HAVE to find the answers for ourselves.