Last year I posted an excerpt from our Muscle and Strength Nutrition Pyramid book describing how to assess whether a ketogenic diet might be suitable for you. This is a nuanced, fully-referenced look at the claims behind keto diets and how to decide whether to try it.
While this a solid article, when you’re down the pub, it just doesn’t have the bite needed to silence stupidity. This is where today’s rant comes in, which is less about the keto diet itself and more a complaint about a few advocates making exaggerated claims about it.
Keto is trendy right now, in a way that the paleo diet was a few years ago, and many other diets before it.
The problem is that when something trends, the algorithm’s reward extreme claims. The loudest voices rise to the top, muddying the waters for all. Now, a diet that was once used almost exclusively to control epileptic seizures (the 1920s onwards), and then used by a niche crowd of bodybuilders (in the 1990s), is being touted by the media as THE cure for rising levels of obesity in the masses.
This is the sad state of the diet industry we’re in right now — everyone moving off into factions (keto, vegan, carnivore, paleo, intermittent fasting), staying in their un-fact-checked echo chambers, playing a game of he who shouts the loudest wins — like kindergarteners.
Nuance has gone out of the window. Extreme options are touted as the only solutions, and the losers are those who desperately need help but don’t know where to turn. Ultimately, this only disempowers people when they try something, find they can’t stick to it, and then lose all hope as they’ve been brainwashed into believing this is their only option.
Let me back up a moment.
Keto diets are extremely low in carbs (often defined as 50g or lower) and necessitate a very high fat intake (60% or higher). It’s no surprise that when you give someone a ruleset like this, they tend to lose weight. — You’ve just told them that they can’t eat most of their favorite foods. It is fucking crazy hard to stick to.
People say that keto is superior for fat loss. It’s not. Studies consistently show that when calorie intake is equated, fat loss is the same.
Keto diets give the illusion that they work like magic because people lose a lot of weight in the first week or two. This is mostly water and muscle glycogen (1 g of carbohydrate intake brings with it 3–4 g of water when it is stored), and gut content losses (there’s less food in the gut because carbohydrate, especially fiber intake, is lower).
The additional problem is that whenever people go off the diet, they gain a large amount of weight back and don’t realize this is mostly the water/glycogen/gut content regain. So they feel trapped.
I want to love something as much as people love to talk about their keto diet.
People have even started asking me if it cures cancer! (I’ll come back to this in a moment.)
AN ALL TOO Typical Comment Exchange
“Diets aren’t the issue, it’s the self-discipline that is usually the problem. These are people who typically have a very bad habit built into them since childhood. Everyone, if followed correctly would lose weight on keto. You can’t be in a state of ketosis and not burn fat, it has to go somewhere and it’s very, very difficult to overeat the fat burning process, especially if you are obese.”
My response:
1. Presenting someone with an overly restrictive ruleset and then telling them self discipline is the problem is like telling someone they have to drive at 100 mph down a country road and blaming them if they crash.
2. A calorie excess sustained over time will be stored as fat. Fat is the easiest to store. So yes, you can be in ketosis and still gain fat.
3. There are mild appetite blunting effects with a keto diet, but it is still perfectly possible to overeat.
(Actually, I should correct myself here: There is also an initial drop in hunger and an increase in satiety which lasts 1–4 weeks in most people and often results in a spontaneous reduction in calories and initial fat loss. But this does not mean that people can’t overeat, especially past this point.)
The commenter follows up with a seemingly reasonable reply:
“My point was, there’s no issue with the diet. Any diet will likely be an improvement over their current eating structure and habits. If an obese actually followed the keto diet, they would see a drop in weight. Is the diet the most ideal? No, is it the most healthy? Probably not. Can it be an effective way to lose weight? Obviously and definitely.
“I’d like to see an obese person eat enough fat to sustain their current size. It would likely be extremely difficult to overeat in order to store additional fat. Again the meal plan likely isn’t the problem, it’s the person and their ability and desire to stick to it.”
My response:
To say a meal plan isn’t the problem and to blame the person’s desire is just silly. The fact that it is so damn hard to stick to is the issue with the diet. Anything that can’t be sustained is not going to lead to long-term weight loss.
I disagree with you when you say that it is difficult to overeat on a keto diet. The majority of people who start a keto diet will lose fat as they’ve just had a large portion of their favorite foods banned from them, which is going to create a caloric deficit.
However, as weight is lost and diets progress, hunger will ramp up and the mind will start to get exceptionally creative with meals to try to combat it.
If someone is educated about caloric intake determining weight loss, it manifests itself in more and more elaborate food planning as they try to find less calorically dense, more satiating options, while keeping to their calorie budget. Weight is still lost in this case.
But if someone isn’t educated about caloric balance and they believe they will continue to lose fat (or can’t gain fat) if they follow the ‘no-carb rule,’ hunger is, more often than not, going to pull them to overeat the foods they are ‘allowed,’ eventually. This may bring them to caloric maintenance, or this may pull them beyond and cause them to regain weight.
The problem is that because they don’t know why their weight loss has stalled (or they are gaining it), they quit and rebound. They feel hopeless because they were told that keto was ‘the’ cure and it didn’t work for them.
Now, it’s at this point that people typically say, “But a keto diet is better than sticking to the diet that’s making them fat!”
🤦🏻♂️ Nobody is advocating the standard shitty western diet. The choice people face is not just between keto and what they are currently doing. This is a false dichotomy.
This is what I Suggest People Do
- Eat fewer processed, packaged foods. So, less sugary foods, less stuff in boxes, more fresh produce.
- Eat more vegetables and fruit — real fruit, not juices that are calorie-dense and lack the filling effect of fiber.
- Stop drinking calories. Just stop it. Water, coffee, tea, and diet sodas if you have to. And those coffees and teas should be plain, perhaps with a splash of milk. Watch out for those bottled drinks with a lot of sugar.
- Make sure you eat enough protein. This will keep you feeling fuller and help with recovery from workouts, muscle growth, and maintenance. (Aim to eat a gram of protein per pound of body weight, or for obese people, your height in cm.)
- Strength train regularly. Here’s my guide to choosing a training program.
- Understand that calorie balance is the key determinant of whether weight is gained or lost over the long term. You can’t trick the system though I really wish you could.
- Learn how to make meals that they enjoy out of their calorie and macro targets. I have a guide for that here.
Moderation is fine, and there is absolutely no need to cut out entire food groups! Education is how people will set themselves free of dietary dogma.
And back to that comment on keto curing cancer
I occasionally get asked whether keto helps cure cancer. This seems to be an increasingly common claim being made.
Such questions make me exceptionally uncomfortable. On the one hand, it’s not my place to wade in on anything medical, let alone, life-threatening like this for someone. But morally, I feel the need to say a couple of things.
Extraordinary claims require extraordinary levels of evidence.
Cancer is not one disease, it refers to over 100. I have read that there is some evidence that it may be helpful for specific types of cancer as an adjuvant therapy (in conjunction with other therapies, after that have been administered). But this is a very different thing to saying a ketogenic diet can cure cancer.
To anyone who is going through a battle with cancer, my advice is to consult with their oncologist. These specialists live this day to day, they spent 8 years of their lives working their asses off to be qualified and then killed themselves through residency and beyond because they want to help people.
If there is a dietary intervention that may help a person’s specific case, I’m sure they’ll be aware of the research and be open to telling mentioning it.
–
Although it is not very typical among recreational and competitive bodybuilders and strength athletes to do better with higher fat-to-carbohydrate ratios, here’s my guide showing you how to systematically test if it may be something for you. I also have all the pros and cons listed, with references. So if that interests you, please see that article.
Anyway, please excuse the rant. This is something close to the bone for me and I hope it was helpful. 🙏🏻
Please keep questions on topic, write clearly, concisely, and don't post diet calculations.
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Andy,
Is there any downside to building muscle on keto? Like, will I build less muscle if I am not eating enough carbs?
Most likely. But if you love it I’d understand if you wanted to make that trade-off.
Hello Andy,
You mention that one of the cons is “Constipation, due to a lowered fiber intake” so supplementing on fiber is the way to go?
Should we count dietary fiber when limiting carb intake?
I’ve read that we should keep total carbs below 30-50g but some articles mention 5-10% total intake, I recon percentages work better as a guideline?
Can any type of carbs be consumed while on the diet as long as the daily carb value stays below the defined maximum value?
Can you from time to time have a day where you eat carbs, let’s say as a “cheat day”?
Thank you!
Hi Helder, thanks for the questions.
1. Well, this depends on whether you’re actually trying to be in ketosis for some reason, or just after some simple rules by which to organize your diet.
If the former, those are just guidelines and you’ll need to actually test it, because this will differ from person to person and how you spread it out across the day. (I believe there are sticks you can pee on to do so.)
If the latter, choose whichever you find you can adhere to easiest. But if you’re rubbing up against the hard reality that you’re constipated or in pain when you go to the bathroom, eat more vegetables. Sure, you can supplement, but ask yourself this — should you really have to?
2. If the former, you’ll need to test it. If the latter, it doesn’t matter in my opinion. However, you’d be mad to not prioritize vegetables in your diet given the limited carb intake you have in my opinion.
3. Not if you wish to stay in ketosis. And I don’t recommend cheat days either. See my article: A Nutrient Timing Guide To Maximize Fat Loss and Muscle Growth for more on cheat days.
I believe the claim that keto is the “cure” comes from the fact that keto basically gets you to eat less processed foods. I’m down 52lbs since july 2019 and have about another 50ish pounds to go. I love these articles because they help keep me focused and I love seeing other people who love the science and common sense approach to this stuff. Thanks for the great articles!
… and fewer calories overall because of it.
Most welcome. Please use your name next time if/when posting. Best of luck!
Hello Andy,
I really appreciate the way you write and present your facts, that is superb!
Many at times people do choose different eating styles in the name of losing weight, not minding that individuals are not the same.
If you really want to lose weight, their should be a balance between food into and physical activities, you can’t keep taking in calories and storing them. You need to burn calories too!
Thank you, Aloysius. 🙂
Andy,
Whilst I am no body builder or strength athlete, I have been following you for some time now, and just had to say great rant!! As an exercise physiologist I appreciate the fact you use scientific evidence to support or dismiss these types of claims. It gets so tiring having to listen to these types of random claims people make. Just because something works for them doesn’t make it the solution for the world, and the people who are specialists are on top of what is happening in the scientific community and are more than willing to share the latest news to help their patients/clients. They, like you, do what they do because they care. Keep up the amazing work!!
Roslyn
Thank you, Roslyn. Back at you. I appreciate the work unsung heroes such as yourself do.
– Andy
Hey Andy,
I don’t know if you actually read or even receive responses you get to your mailing list, but I wanted to just shoot you a quick note about how much I needed to read this today. I struggle the most with overeating and emotional eating, even when I’m eating healthier foods I just…eat too much.
I did Keto for a bit, and while I felt better I didn’t see long term results for these exact reasons you talked about in your blog here. I’ve been up and down for a long time, but I’m getting there…slowly.
Really hoping I can get to a point where I can take you up on a coaching opportunity someday, but until then know that I really appreciate this mailing list for what it is.
Hi Mike,
As you can imagine, often when I open up my email after newsletter emails are sent, I get a few replies telling me to eat shit.
So, when I say a sincere thank you for taking the time to write and let me know that it’s been useful, I want you to know that I really mean it. This gives me the motivation to keep writing each day.
Just a side point – for many, we have issues where carbs make us eternally hungry. I think only fat people can understand this struggle.
Dropping carbs gave me instant control over my hunger. Even still, after 3 years on keto, any carbs send me raiding the pantry.
For me, carbs serve no benefit.
I stopped eating most carbs in 2016 and have never been healthier. Not that keto is necessarily magical in any way, but it allows me to feel satiated all the time, even when cutting.
My dad, 5’9 240 lbs, diabetic for 40 years. I had him stop eating carbs. He lost and has kept off 30 lbs with little effort. He also took his a1c from 12 to 7. He is now off 75% of his insulin injections. I’ve seen this same result with numerous people, so it’s more the norm than you may think.
I know you don’t like keto, but it’s highly effective and completely sustainable for many.
Just providing insights from the dark side. Keep up the good work.
Bob, thank you for the comment.
Just to clarify:
1. I’m not anti keto, I’m anti-bullshit and anti-people peddling bad science to tell others what to do.
2. I’m not disputing a very low carb diet as something beneficial to someone with type 2 diabetes. I just don’t discuss it as it’s medical, a special population, and my readers are 25-40 something meatheads. (It’s impossible to caveat everything and keep things readable.)
3. As for your specific case, important to not take your personal experience and extrapolate that to all (which is the mistake people make all the time). This is what research is for. See the comment from Ken.
Anyway, you’ve found what works for you. Please don’t take my writing to mean that you shouldn’t continue that. My point is, you’re more the exception rather than the norm in what you’ve found, but the media make out that this applies to all and that is just not right.
Yes, it’s certainly been touted as magic by the crazies. It’s interesting though, there are forums full of thousands and thousands who have found keto to be a life saver.
So in your population of clients, those who are probably on the healthier spectrum, you see a different side. I see people every day posting transformations and saying how they can’t believe how their lives have changed because they never could win the weight battle until they switched to a low carb approach.
As we both know, ability to control calories is what matters. Whatever works for someone to adhere to a deficit is the key.
I’m certainly not denying that people can be successful with it, but a forum full of thousands of people who are singing its virtues isn’t evidence that it works for millions. It’s an echo chamber.
Regarding your last point, we’re in agreement on that.
Hi, Andy. I worship at the altar of the one true God: nutrient-dense Paleo without BS gluten-free snacks, and with just a couple of exceptions including some whey protein and Greek yogurt…
All of which means I really don’t need anything that doesn’t make me better. And nobody ever got nutritionally better by eating gluten or lectins. Sure, you can “tolerate” plenty of food. But why bother?
One other element is hyper-palatability. Industrial foods have that in spades. Regular folks don’t have much of a chance against hundreds of billions of dollars of chemical engineering designed to trip their satiety controls.
You’ve done me honor of not only subscribing but also having the courtesy to write, replying with what has worked for you.
So first and foremost, thank you, and I must say, if you’ve found what works for you, then that’s great!
Though it would be much easier to do so, I don’t want to leave my reply like that though as it may be taken as a passive nod of approval, or worse, dismissive. I feel I owe you better than that.
Now, if you’ve read that people would be better off avoiding gluten, then I disagree with this claim.
Gluten
If someone has an allergy or find that they have an intolerance to gluten, then that’s fine. But to borrow your phrasing: if someone doesn’t clearly benefit from eliminating these foods, then why bother?
Any food avoidance, especially something like this with such wide implications on what people can and cannot eat, will complicate people’s lives immensely. To make such a general recommendation, there needs to be overwhelming evidence to support it, which there simply isn’t. People need to focus on the bigger wins.
Lectins
As for lectins, if I understand correctly, eating a large amount of some raw foods which high in lectins can cause issues. (“>…lectins can cause nutrient deficiencies, disrupt digestion, and cause severe intestinal damage when consumed in excess by an individual with dysfunctional enzymes.” — Paper here.)
^ Sounds pretty damn scary, right? But notice the words I have italicized. Importantly, many high-lectin foods are those people will not eat raw (kidney beans, soybeans, wheat, for example). This is important because once cooked, the lectin breaks down almost entirely.
So, as with most things: avoid extremes, you’ll be fine.
No real qualms with your last sentence, but I believe that people do have a chance if they are aware of it and make appropriate food choices.
Many of the better food choices I think people should make jive with a Paleo diet (more fruits and vegetables, less processed foods). Where I principally differ is the “it’s either shit or amazing” binary look at certain food and food groups, and especially the unnecessary fear-mongering of gluten, dairy, and legumes.