I just read an article that ranked diets, and Keto diets rank last! I was recently asked to try this diet.. but then this study came out...

"they ranked the diets poorly on long-term weight loss success, ease of use and overall impact on health"

"the experts were especially concerned about extremely high fat content -- about 70% of daily calorie intake -- as well as unusually low carbohydrate levels: only 15 to 20 net carbs a day. The 2015-20 dietary guidelines for Americans suggest that 45% to 65% of daily calories come from carbs but less than 10% from saturated fat."

"The keto diet is just not sustainable over the long term. It doesn't teach you how to acquire healthy eating habits. It's good for a quick fix, but most people I know can hardly give up pasta and bread, let alone beans and fruit."

Thoughts? I was about to try this diet.

I've known some people who had great success with keto. Others like me would struggle with it. Just like switching to vegetarianism - ie. giving up meat doesn't mean you switch to mac and cheese all the time. You have to select your foods carefully and pick the wisest choices among that which fits into the plan.

I tend to like things with carbs in them so I would be in constant turmoil thinking about all the things I could not have.

On the other hand a friend went Keto a year ago and absolutely loves it. However she admits she is not a sweets eater (candy, sweetened drinks and baked goods) and doesn't really like fruit all that much. She got used to giving up popcorn, pasta and bread products. I wouldn't say she eats fatty things - cheese would be about the most fatty thing she would incorporate into her meals. Many of the things she makes sound quite good to us so I would not say it's an imbalanced eating plan.

Some people give things a bad rap for fats but there is a difference between healthy natural fats like eggs, avocados, salmon, lard and yes, even bacon to an extent vs the kind of fats in processed foods.

To some fat is not the enemy - sugar / carbs are. Each person's body treats foods differently. Any eating plan basically comes down to portion control, choosing healthy foods from a food list and getting regular exercise.

Why not give it a try for a while and see how you feel? My only advice would be to eat natural foods and avoid processed foods as much as possible - that's where I think you get into trouble. Good luck.

In my experience, you can do keto without all the fat consumption, especially if you are doing keto to lose weight. Many people that I know that have done keto have actually seen improvement in many of their health concerns prior to starting, such as lowering blood pressure, lowering cholesterol, and decreased swelling in legs. To do this diet correctly for weight loss you need to eat plenty of protein and veggies. The idea in keto is to limit carbs because when eaten in excess, the carbs/sugar you eat turn into fat in the body. Yes, a high-fat diet does have some negative health aspects as well, especially saturated fats, which is why when I did it I focussed on meat and veggies, those will keep you full longer and can get you the calories you need for energy for the day.

"The keto diet is just not sustainable over the long term. It doesn't teach you how to acquire healthy eating habits. It's good for a quick fix, but most people I know can hardly give up pasta and bread, let alone beans and fruit." To elaborate on this: I do think it helps people acquire healthy eating habits, as a result of this diet I learned to eat more veggies with each meal, its second nature to me now. And most diets are not for the long term. I watched an interview on youtube that was very interesting on this topic. They stated that they don't think that one diet fits a person for their whole life, a person may need different diets at different parts of their life. I found this very interesting. You can look it up: if you search "Joe Rogan #994: and "Joe Rogan #996" Both are very interesting regarding the keto diet.

the experts were especially concerned about extremely high fat content

I read that article, too. However, "experts" is not a qualification. Being "concerned" is not a scientific measurement. I didn't accept their rating because I'm not convinced by 'expert opinions' without research to back it up.

I am not following keto, and I think that long-term keto would be hard to stay on.

There are studies showing that low carb is beneficial and has good results. As my doctor says (Optifast), there are essential proteins, essential fats, but no essential carbs. Although it'd be awfully hard to stay in ketosis (usually under 20g carb a day), staying under 100 is not that hard--and 50, for dieting, isn't that hard either.

A true ketogenic diet requires lots of fat consumption, because an excess of protein can actually be insulinogenic, which will 'bump you out of ketosis', to use the colloquial phrasing. If you're not eating carbs (typically under 20-50g/day) and you're not eating lots of protein (accepted ranges typically vary between 1.3-2.2g/kg of bodyweight, or 0.6-1g protein/lb if you prefer imperial), the only maconutrient left is fat. Well, ok, I guess there's alcohol too, but that's not exactly a great substitute.

The article you're referring to was ranking diets according to a number of different factors - including compliance, long term usage, convenience, and adaptability, as well as the more mundane 'health markers'. One of the reasons a keto diet, that's specifically designed to keep you in ketosis, is that it's HIGHLY restrictive, and for the vast majority of people, not a realistic long term option. Low carb diets (<100g/day) are often what keto folks move into, once they've met their goals. Which, while still restrictive, are generally easily maintained with a few tweaks.

However, there's some intriguing research being compiled that suggests that low carb caloric deficits are actually less effective for fat loss than low fat diets, but at the end of the day it's all a wash. The best diet is the one that you'll stick with! Some people prefer low carb meal plans because they feel more full and are less likely to get hunger cravings. Other prefer low fat diets because the carb allowance is more effective for them to work harder during training and therefore burn more kcal. Personally, I think that everyone needs to test it out for themselves, and go from there!

If it were me, I'd aim for at least 1g of protein per lb of bodyweight, a minimum of 0.3g of fat per lb of bodyweight, and then toggle between filling the rest of your caloric allowance between carbs and fats, until you find the mix that works best for you. EG. ~1,800kcal TDEE, 160lb woman = |160g protein (640kcal), 50g fat (450kcal), 175g carb (700kcal)| OR |160g protein (640kcal), g 85fat (765kcal), 100g carb (400kcal)| ......OR, somewhere in between (yes, I know those kcal don't add up exactly the same, but I like round numbers)

Aaaanywho, that's just my 2c!

I don't believe it. I have plenty of other articles that say your article is faulty.

I've done a combo of low carb (paleo) and very low carb (keto). I'm down 90 lbs. My blood pressure is perfect. My cholesterol ratio is perfect. My triglycerides are very low. Energy is great. I follow dietdoctor.com and idmprogram.com and there is a ton of evidence that shows that keto not only works, it's the ideal diet for the human body. It prevents and reverses type 2 diabetes, fatty liver, and insulin resistance which all go hand in hand with being overweight. Carbs are the reason we're fat. Intuitively, we all know this. Grandma was telling us 40 years ago to lay off the bread if we didn't want to get fat. We feed farm animals grains to fatten them up. We've been lied to since the 1960's about how fat is bad and carbs are good and so a lot of times when you read a study maligning paleo or keto, it's because someone is using bias confirmation (a closed mind) and cherry picks data to make the diet look unhealthy or as though it doesn't work. I encourage you to check out dietdoctor.com, idmprogram.com or marksdailyapple.com and see the hundreds of success stories on there from people who succeeded using low carb or very low carb approaches.

This is actually being hotly debated right now in the keto community. Some of the leading experts believe that protein is being maligned unfairly, and they have their patients eat protein to satiety. It's an interesting debate.

Oh cool, if you have a moment could you point me in that direction? I'm always happy to read more about nutrition, and I'd love to see more targeted studies on it. I dunno if protein being insulinogenic is really debateable (some of them are at least, eg. whey, though I know others are less so - like casein, red meat, raw eggs, etc) but it'd be great for more data on how - if at all - it affects ketogenesis and fat loss!

I've been seeing it in a few places in the paleo/keto community. Most recently, this video came out this week on DietDoctor.com. Not sure if you'll be able to view much of it without signing up, but DietDoctor.com is an amazing resource for people interested in Keto and the first month is free- you could always sign up and binge watch and then cancel haha. https://www.dietdoctor.com/fear-protein-new-fear-fat

I was listening to an interview with another well known keto doc (whose name escapes me right now) who made a similar argument. If I run across that podcast again I'll post the link for you.

I'm seeing the argument more and more. I'd say right now it's about 80/20 with the majority still saying protein needs to be limited due to the insulin response it creates, but the other side is saying that it's not true.

Thanks! I wish they'd source the specific studies they're pulling from. I suspect though, that my understanding and your understanding are actually pretty similar; mostly because the 'acceptable' ranges that I'm familiar with for protein intake during a ketogenic diet are still more than most people manage to eat without trying. So the concern about over-consumption is overstated simply because most people can't stomach more than that anyway!

EG. 1,800kcal TDEE for a 160lb woman, the upper end is 160g of protein (which is the equivalent of 1c chopped chicken breast, 3 eggs, 4oz of roast beef, and a tin of tuna - EVERY DAY). Even if she's eating at a 300kcal deficit, with under 50g of carbs a day, the remainder is ~45-55g of fat after what's in the proteins (which looks like 2Tbsp of butter, 1/2c of chopped avocado, and 1/4c of almonds), which is not an outrageous amount by any means. If this same woman ate at the lower protein range, say 1.4g/kg, that's only 100g of protein a day (take out the tin of tuna and eggs), but she'd then need to eat another 27g of fat (plus 15g from removing eggs), or an extra 2Tbsp of olive oil (plus 3Tbsp of unsweetened shredded coconut instead of eggs).

Not 'lots of fat' by any means in either of those scenarios; but if she ate at maintenance, while it's only an extra 300kcal (~33g) of fat, that's an extra 2Tbsp of peanut butter and 1/4c of sunflower seeds (in addition to butter, olive oil, coconut, almonds, AND avocado). At that point, it's starting to look like closer to 'lots of fat' to me - still not crazy numbers, but higher than I'd eat in a day without thinking about it.

I suspect you're right, I have trouble actually eating enough protein, especially since I do intermittent fasting also. A lot of times I only eat meat at dinner, fast for breakfast, and have a coffee with heavy cream for lunch. I'm trying for around 125g of protein a day. That's a lot of chicken. I don't have any problem getting enough fat because I love both heavy cream and butter.

PS- I found the podcast, it was Dr. Ted Naiman who says we need more protein than most keto docs recommend. This is the link to the podcast:
https://ketogeek.com/blogs/news/epis...-dr-ted-naiman
It's at about 40 minutes in where he starts to address protein. One of the most telling comments at 45:00, where he says he tells his patients just to eat steak and eggs until they're full. Keep listening until at least 50:00. He explains why he thinks protein restriction is not helpful.
Be warned, the guy interviewing him is a little annoying. But Dr. Naiman's info is great.

I currently have many patients doing Keto and seeing much success

These strips work perfectly. I've been doing low carb/keto on and off for twenty years and have used a variety of different brands of strips. Some of those brands didn't give proper readings (e.g not registering that I'm in ketosis when I know for a fact that I am). I've been using these strips for a week now without a problem and they are giving me accurate readings. I will definitely purchase again!