[jonny_storm]

The real question is whether or not ketogenic diet is good for you. Unfortunately, the literature simply cannot supply a clear answer either way.

Joe Rogen just did a great show with two scientists discussing the evidence for and against carnivore vs. ketogenic vs. low carb. vs. high carb: https://youtu.be/u93oh9kC-rU. In summary, we're a long way off from matching an individual's biomarkers to an optimal diet, but caloric restriction seems to provide the bulk of the benefits for any given diet.

[gnulinux]

I'm sorry I want to make myself clear that I'm a lay person so I'm not trying to be skeptical. But is this correct? This conflicts with my understanding. E.g. I have a family history of heart diseases (although mine and my sister's hearts are healthy so far) so proponents of high-carb diet would claim fat would increase the likelihood of heart disease by clogging my arteries. But low-carb people would claim fat would have no affect on my arteries, and the only factor would be my genetic markers making heart diseases more likely. I would guess that if this debate was settled, wouldn't it be easy to just say keto is bad since it increases the likelihood of heart diseases. But I really cannot find evidence supporting this. Quite the contrary, plant based low carb diet seems to decrease these diseases. What's going on here?

Even if you were to personalize my diet based on my full history and genetics, it doesn't seem possible you could do that, since we don't have evidence even for that.

[jonny_storm]

On the contrary, I think you're being precisely the right amount of skeptical.

I'm no expert, either. I've read some of the relevant literature when able, and I've experimented extensively with food and supplements. I also collect anecdotal evidence for the success and failure of different dietary regimes. I think it's especially instructive when your own chosen regime fails for other people. Caution is always warranted.

If you ask a toxicologist whether or not something can kill you, the reply will come swiftly: "How much?" Given the number of people that die each year from water toxicity, we clearly lack intuition regarding the answer. When it comes to fat (saturated fat, in particular), there clearly must be some upper limit before pathologies arise, but the question actually being debated is, "How little saturated fat should we consume?" Similar questions have been posed about cortisol and inflammation, two "obviously bad" things that, as it happens, we cannot do without.

From this standpoint, such debates are largely ideological, as contradictory evidence, discovered in earnest, for opposing viewpoints implies both must be wrong in some fundamental way. Scientists generally recognize this; enthusiasts and journalists, less so. This in no way means proponents are wrong about their observations. Rather, it means their conclusions--that is, the model through which they view their results--are somehow incomplete. This is where new science can shed the most light.

All of this is a long-winded way of saying I have no idea how to reconcile even the data I have seen because there's so much data I haven't read or don't understand. Besides, even experts are weary to give medical advice. And just because my blood work on a ketogenic diet looks fine, that doesn't mean your family history won't affect your own results on the same diet.

If you don't trust your physician to keep up on the latest nutritional science (Why would they?), you can at least work with them to monitor lipid panels while experimenting with your diet. Regular blood work every couple years can also alert you to drastic changes you might not otherwise be aware of. Just be sure to request complete copies of the data for your own records. Otherwise, you may only receive a list of notable results.

Best of luck to you.

[DoreenMichele]

As best I can tell, the comment is accurate and asserts three things:

1. It depends a lot on individual factors.

2. What we know is limited.

3. Caloric restriction seems helpful, regardless of what you actually eat.

I haven't really looked at keto. What I can tell you is that different fats have different chemical composition and this impacts how the body reacts to them, especially if you have specific problems.

I have no plans to ever get all that knowledgeable about keto. I don't think it actually makes sense and I suspect its positive reputation is probably rooted in benefits from confounding factors that haven't been identified, such as inadvertently eliminating allergens for some people. If you stop eating things that are actively making you low grade sick, you will feel better, possibly dramatically so, and it almost doesn't matter what you actually are eating, so long as it is less harmful than what you were consuming.

[jonny_storm]

"...inadvertently eliminating allergens..."

Whatever your view on ketosis, I strongly agree that food allergies may be causing more grief than we know. In particular, I suspect most people with GERD are consuming food they're allergic to. It's tragic.