Was the ketogenic diet the biggest fad of last year? I think it was. In the past 12 months, it has seen a roughly 100% increase in popularity according to data from Google trends.
People are excited by it because it can help with weight loss. I discussed all of this in this video below.
In the video, I talk about the core three elements of any health fad. They are:
I will discuss each below in context of keto.
Pseudoscience is bad science. It’s attempting to use science but in a way that does not represent it properly. It is lazy and often a product of commercial interests. Most bodybuilding supplements on the market advertise with pseudoscience. Science becomes the marketing tool, not an educational tool. In a capitalistic world, this is the result.
Now, pseudoscience manifests in two ways. First, claims are made about a product, diet, or other fad. Secondly, these claims are taken out of context, and this is what ultimately defines pseudoscience in my opinion.
There are two claims specifically that I came across (although there are many others) in the world of keto that elevated it to fad status in my view. The first was concerning epilepsy; people kept citing the idea that the ketogenic diet was a “great” and “effective” treatment for “intractable” epilepsy. Having been highly involved in the raw food community in the past, I have learned to detect when people are taking things out of context. They’ll often take medical studies and use them to fuel confirmation bias.
Keto vs. Epilepsy
The effectiveness of the ketogenic diet in curing intractable epilepsy isn’t 100%; it doesn’t have to be that high to be effective. From the studies I’ve seen, the cure rate is around 1/3 or less (which is definitely “great”). When researchers report their findings, they’ll report it in a few ways, based on the results of the study. If it was found that say 1/3 of patients saw a complete elimination of their seizures, they’ll report it. But if it was only 1 patient out of 20 patients that saw a 100% reduction, they’ll report differently. In that study, perhaps 80% of patients saw a greater than 50% reduction in seizures. That will be reported. It gets complicated and it’s hard for the layman to understand this stuff; it’s hard for me too, as I’m not a doctor, but as a former medical and research student who has spent years reading research in my spare time for fun, I know how to interpret research better than most people discussing health.
So below, I will just summarize a few studies I will search for right now on PubMed, just so you can see what the reality is regarding keto and epilepsy.
- In this study, 22 patients with highly refractory epilepsy failed to see even a modest response to the ketogenic diet (KD). Now the interest in keto for treating epilepsy came from studies that found a response when nothing else worked. In this group, on average (the median number actually), the children had been treated 7 times previously ineffectively. They were hard to treat. 6 out of the 22 patients continued the diet because there was a partial response, but it wasn’t very good. Now this doesn’t mean keto sucks, it’s just that these children were hard to treat.
- In this study on the other hand, after three months of KD, over 2/3 of patients (n = 33; n is the number of patients in the trial) saw a greater than 50% reduction in seizures. In addition, those patients saw an improvement in the electrical activity of their brain (via electroencephalogram, EEG).
- In this study, patients with Lennox-Gastaut syndrome (a severe epileptic disorder that results in mental retardation and involves multiple seizure types) were treated with the KD. After 18 months, three out of 20 patients (15%) were seizure free. 25% of them saw greater than 50% reduction in seizure activity.
- In this study, a modified atkins diet (10 g carbs/day) was found to reduce seizure frequency in 10/25 patients in just three months. After 6 months, 8/25 saw a greater than 50% reduction in seizures.
Treating epilepsy is hard. And although these studies do show much promise for keto in preventing brain degeneration, it’s in context of a disorder that involves abnormal electrical activity of the brain. Certainly, ketones may be neuroprotective, but maybe not for everyone. For people with normal brains, ketogenic diets may not be ideal. I certainly felt very “slow” on keto when I tried it, but I only lasted two weeks in each of the two times I attempted it. I felt terrible and my workouts weren’t great so I decided to never do it again. But I think if I persisted perhaps I could have adapted and experienced a benefit.
The point I’d like to make is expressed more eloquently here on epilepsy.com.
It should not be difficult to distinguish an intelligent child with benign focal seizures or childhood absence epilepsy from a child with Kozhevnikov-Rasmussen, Lennox-Gastaut, Down, or Sturge-Weber syndrome or a child with severe post-traumatic cerebral damage, brain anoxia, or catastrophic progressive myoclonic epilepsy. Describing all these children as simply having epilepsy just because they have seizures offers no more benefit than a diagnosis of febrile illness irrespective of cause, which may be a mild viral illness, a life-threatening acute bacterial meningitis, or a malignancy. Inappropriate generalizations with regard to terminology, diagnosis, and treatment are the single most important factor of mismanagement in epilepsies.
What they’re essentially saying there is: be specific. That’s the job of a practitioner, someone who gets paid to treat illnesses in Western medicine. But the layman who participates in a health fad is not specific. And I write about this stuff because I know that you don’t have to be a practitioner to develop a basic understanding of these things. You just have to study it a little bit and you’ll feel less confused. And why not? If you’re passionate about health why not spent a few hours a week reading studies and trying to educate yourself? It’s fun, but it can be daunting. But like any task, if you take baby steps and show up to the process, you will become successful eventually. That’s what I need to tell myself right now as I attempt to sow up my favorite jeans which have crotch holes in them from continually putting on my shoes without sitting down, which stretches the crotch area too much. Doing squats and deadlifts doesn’t help this cause either.
“Babies are in Ketosis”
I already discussed this in a previous post, so read that for the studies. Basically, I saw a few times people cite this idea that babies are in ketosis. I did some research and found that yes indeed, babies are in a mild state of ketosis. But so WHAT? What does this imply for ADULTS who are in ketosis? This is the epitomy of faddish behavior and confirmation bias in health, because people used that idea to support being on a ketogenic diet.
Now let’s apply some common sense here. You’re an adult. You are not an infant. An infant is a developing human that mostly sleeps, is very fat, has little muscle mass, a small brain, and little need for glucose utilization. As it grows, it naturally starts to use glucose more. More glucose receptors (GLUTs) are translocated to the tissues, like muscle tissue, so that it can start to use glucose for energy. Glucose is fast. Fat is slow. This makes intuitive sense to me and I was able to quickly confirm it with studies. This is intuitive sense that lacks in those who get too excited about a fad.
One unfortunate side effect of long term keto is growth retardation. Children with epilepsy treated long term with keto are shorter than normal, and it’s the majority of them—not 50%, but the majority of children in these studies (see the post for details). Maybe the body’s natural developing preference for glucose helps the child grow normally. I wonder what a human adult raised on a completely ketogenic diet would turn out to be like. Who knows…
One positive implication for this growth retardation is that ketogenic diets could help treat cancer. But again, for a healthy human adult, the fact that keto causes growth retardation and slows down the electrical activity of the brain in children with hard-to-treat cases of epilepsy means that it will slow you down. This is consistent with everyone’s experience. You become slow. I’m not interested in that, especially as an impatient Aries.
2. Attachment to Beliefs
The second core element of a fad is attachment to the pseudoscientific beliefs. I get it. You’ve spent energy trying to understand something. You have developed a relationship with it. But if you can’t change that opinion in light of new findings, you are not practicing science. You are a layman still; a lazy one at best.
What I see among these people is defensiveness. Vegans are really good at this, since they think they’re standing up for a noble cause when they’re in fact just deluded, because you can harvest an animal (aka, kill it) without it ever having to suffer.
Attachment is human nature. We have to transcend these parts of us to be scientific about things. Scientists aren’t really that good at this even. Most scientists get attached to their beliefs too. When you consider committing suicide on a regular basis to get a Ph.D, eat shitty ramen noodles in plastic containers with BPA because you’re poor, and work your ass off defending your thesis, it’s kinda difficult to let go of your opinions.
Being a scientist should really be a spiritual path, that involves traits like acceptance, letting go, compassion, and peace. But that’s not what the average human believes in. But I have faith in you! If you regularly practice these things in your life already, you will be even better equipped than a real scientist at understanding health. That being said, I do have to say that a real scientist who has these traits is a noble person, and there are three in particular who have really influenced my own ability to think critically. But sometimes I wish I was like Dave Asprey and just said whatever I needed to say to sell fads. Just kidding, I don’t wish that upon myself.
Anyway, below is an example of attachment and defensiveness, featuring the biggest moron perpetuating health fads today: “Dr.” Axe.
I wrote this comment under one of Dr. Axe’s YouTube videos, titled “What is the Ketogenic Diet.” In the video he says, emphatically: “It is THE diet that works when NOTHING else does.” I think when people are trying to lose weight and are repeatedly failing, the last thing they should do is go on ANOTHER diet. That’s why I don’t particularly like his approach here.
I share a counterpoint; I say that the ketogenic diet doesn’t work in everyone. I wrote this comment before I found the exact studies; the number I cited (60%) was too high, and I wasn’t being very specific when I said “works” (see, unlike other people who discuss health, I like to call myself out and admit my faults and I have to say this because it’s a superficial world we live in and I’m just too real and authentic to be like that so I have to sell this point to you).
Dr. Axe replies to defend his beliefs. That’s what he has to do. His brand is all about getting you excited about everything and framing things positively. But it’s not the medical reality of the situation. But it’s what laymen like to hear. It’s what drives consumers to buy products. Unfortunately, I have to do that from time to time to sell things, which I will start to do soon with my book (sign up for my newsletter to learn about that; it’s coming out later this month), but I like to study the reality for my own fulfillment.
You can tell when someone is attached and defensive when they fail to acknowledge a single point you bring up. These kinds of people aren’t worth your time. You see that again in the comment from “T M.”
There has to be a market for the fad to exist. A lot of products may have exciting bold claims made about them based on pseudoscience, but without the attachment to the ideas, sales can’t be driven to the product. See, attachment to pseudoscience creates what’s called in the business world brand loyalty. If you are loyal to the brand, you are a good customer! Good job!
It would be interesting if people one day woke up to realize that everything they believed in about health came from headlines and internet research, which was designed to create some kind of brand loyalty to drive sales. Of course, there are good sources of information about health on the internet. But blogging now is much more commercial than it was 7 years ago, when you saw more unfiltered opinions like mine circulating. Unfortunately I can’t keep my mouth shut!
The real knowledge is still in books. It’s not on your iPhone (Gary Vaynerchuk is wrong about this one). You can’t find much useful information about health from an internet search. You can find some basics, but you will be very very confused. To stop being confused about health, you have to understand your environment (capitalism), create a filter for all the messages you hear, educate yourself as much as you can, but most importantly, connect to nature. When you think about health operating from a perspective informed by nature, you will understand what to eat, how to move, and navigate through the confusing world of health information.
As far as the future of the ketogenic diet, I would love to see how people fare on it after 5+ years. I’ve heard people say they develop weird anxiety after a few years on it, and this makes sense to me. It just seems that when we eliminate something like carbs, one of the only three macronutrients, we are due for imbalance somewhere, considering that we have evolved on carbohydrates and our anatomy is designed to detect and absorb them. Who knows, maybe if an entire generation is raised on a ketogenic diet, we will evolve into a new species of humans, like Herbert George Wells predicted in his classic novel The Time Machine.
I hope you learned something from this post about how fads work. If this post helps you stop being confused about health, feel free to donate $1/month on my Patreon. I may reward you soon there with some book summaries (once I get to 25 patrons). But no pressure! Patreon is just something I’m trying out for the time being. I will continue to share my views on health and attempt to share the truth no matter what!