December 7, 2016

9 Ketogenic Diet Myths






Let me burst your bubble right here at the beginning. This list is for people who are already following a ketogenic diet or are considering beginning one specifically for the purpose of losing body fat. If you’re looking for a nice, solid debunking of other myths about this way of eating (e.g., “All that saturated fat will clog your arteries,” “All that protein is bad for the kidneys,” “You need carbs for energy,” “I learned in medical school four hundred years ago that ketosis is fatal,” and other such nonsense), here are two excellent debunkings: one from Authority Nutrition, and one from my dear friend Ellen Davis, creator of Ketogenic Diet Resource, which is the single best one-stop-shop, gateway entry I'm aware of for all things ketogenic-diet related. (And I'm not just saying that because Ellen's a friend. I'm saying it because it's true. The reason we became friends is because I came across her site a few years ago, and ... well, the rest is history.)



Why do these ideas need to be called out for the myths that they are?

Well, now that I’m participating more in social media related to low-carb and keto, I’m noticing—and I could be wrong, but I don’t think this is only my imagination—that there are a few falsehoods that have become quite pervasive in our community. So pervasive, in fact, that they persist despite being flat-out incorrect. And because they persist, we continue to see post after post after post on Facebook, Instagram, Twitter, and wherever else, from people at their wit's end because they aren’t losing fat, are gaining fat, or have not had every single longstanding malady resolve immediately upon ditching bread and loading up a cup of coffee with butter and coconut oil, or drowning everything in cheese, as others may have promised them would happen.  

If these individuals are lucky, they stumble upon a group where logic, sanity, science, long-term experience, and the attainment of actual results rule (rather than chasing ketones for the sake of high ketones). If they’re not lucky, they fall head-first into groups where the same-old not-helpful advice is parroted ad nauseum.


With this in mind, here is my own personal list of the top 9 biggest falsehoods regarding ketogenic diets for fat loss, along with "alternate versions," intended to help us see things from a different perspective. There are probably many more out there; these are just the ones that came to me first. If you have some favorites that I've missed here, share them in the comments so we can all collectively cringe! 



1.  I can eat unlimited fat and lose body fat.

2.  It’s not possible to gain body fat while in ketosis.

(Alternate version of numbers 1 and 2: insulin is the only thing that matters when it comes to the gain or loss of body fat, so as long as insulin levels are low, I will not and can not gain fat, regardless of anything and everything else going on in my life and my body.)

3.  I must be in ketosis in order to lose body fat. It is the only way.

(Alternate version of number 3: every single person on the planet who has ever lost body fat has done so via a ketogenic diet.)

4.  There is a direct relationship between ketone levels and fat loss: the higher my ketones, the more fat I will lose, and the more quickly I will lose it. Higher ketones mean more fat loss, because higher ketones cause greater fat loss. Fat loss is the result of high ketones.

(I don’t have an alternate version of this to illustrate how wrong it is. Frankly, it doesn’t need one. It’s just wrong. *Think, think, think…*  I guess I can give the example of an uncontrolled type 1 diabetic: they’re not losing fat because their ketones are [pathologically] high; their ketones are [pathologically] high because they’re hemorrhaging fatty acids out of their adipose tissue. High ketones are the result, not the cause, of breaking down large amounts of fat.)

5.  I must eat at least 70% of my calories from fat, or I’m not eating at “ketogenic ratios.”

6.  Going by macronutrient ratios (percentages of total calories from fat, protein, and carbohydrates, rather than absolute grams) is the best way to formulate a ketogenic diet for fat loss.

(Alternate version of numbers 5 and 6: ketogenic diets are defined by the macronutrient ratios. In other words, a diet consisting of 10,000 calories with 80% of total energy coming from fat, 12% from protein and just a teeny, tiny 8% from carbohydrate will be ketogenic simply because fat is 80% and carbs are a paltry 8%, even though 8% of 10,000 calories is 800 calories, or 200 grams of carbohydrate. Anyone out there think you can achieve nutritional ketosis eating 200 grams of carbohydrate? [Assuming you are not mainlining MCT oil and are not a T1 diabetic.]  There: “ratio” myth officially debunked. And no, I don't think anyone trying to lose body fat -- or for pretty much any other reason [except perhaps being an Olympic-caliber swimmer] is eating 10,000 calories a day. I'm just trying to illustrate the point is all.)

7.  If my blood ketone level is not above 1.0 mmol/L, I am not in ketosis, it is not high enough, or I am “doing it wrong.”

(Alternate version: Jeff Volek, PhD, RD, and Stephen Phinney, MD, PhD, are wrong when they say nutritional ketosis begins at blood β-OHB levels around 0.5 mmol/L. Dr. Phinney, who has been doing low carb research almost as long as Amy Berger has been alive, doesn’t know what he’s talking about, so you should listen to the “bros” in your Facebook group instead. Also: looking back at the debunking of number 4: WHO CARES WHAT YOUR KETONE LEVELS ARE?!  Since higher ketones do not cause greater fat loss, stop chasing ketones. Let me say that again: Since higher ketones do not cause greater fat loss, stop chasing ketones. For the specific goal of fat loss, it is more important to be fat-adapted and generally using fat for fuel than to be “in ketosis” at all times. Does this mean it’s never a good idea to aim for high ketones and take specific measures to produce them [e.g. fasting, exogenous ketones, MCT oil]? No, of course not. There are #contexts in which it very well could be appropriate to deliberately modulate specific factors in order to generate higher ketones. What contexts? Maybe cancer treatment, traumatic brain injury, Alzheimer’s disease, or other neurological issues. My point is, these #contexts are NOT FAT LOSS.)

8.  Carrots, red/orange/yellow bell peppers, beets, and other “sweet-ish” vegetables are outright prohibited on a ketogenic diet.

(Alternate version of number 8: it is not physiologically possible to consume one carrot, or half a red pepper and remain in ketosis. If I want to lose fat on a ketogenic diet, I can never, ever have a salad with shredded carrots or julienned pepper. If someone tries to serve me carrots at Christmas dinner, I will disown them because they don’t understand my diet, they are trying to poison me with their carby garbage, and I will never, ever attend another holiday at their house again, because if they’re gonna serve carrots, they might as well just tie me up and force-feed me white bread slathered with grape jam.) I’m not the biggest fan of the Whole30® program, but I agree with the creators when they called this “the carrot train to crazytown.” (More on this in the upcoming mega-epic keto rant I warned you about last time.)

9.  A ketogenic diet is pure magic, and it will fix all aspects of my life and my health. If I hate my job, keto will make me happy. If I no longer love (or even like) my spouse or significant other, keto will magically repair my relationship. If I'm drowning under heaps of financial debt, keto will help me win the lottery. People don’t like me because I’m an *sshole; keto will turn me into a kind, compassionate person.* Keto is good for everything in life – Every. Single. Thing. – and if my life is not perfect after “going keto,” then I’m doing it wrong.

*I actually think this is not all that far-fetched, IF someone’s *sshole-ness stems from anger and irritability resulting mostly from hypoglycemia. In cases where mood swings and general un-likability stem from wacky hormones and the brain going crazy on sugar (or lack thereof), then I can totally see keto making someone less of a d*ck. (Keto does have mood stabilizing effects, and it’s even been known to help bipolar!)

(Alternate version of number 9: any diet, whether ketogenic or not, is the secret to happiness. For a good debunking, see this post on Vitamin J. [Warning: it’s one of my longest ever, so save it for some night when you have trouble sleeping.])


I realize that my alternate versions of these ideas are a bit extreme. Normally I actually kinda hate when people make arguments using extreme examples that typically don’t occur in the real world, but I think this approach can be helpful sometimes—like now. I only used the extremes to point out how laughable—and misguided—some of this stuff is. We tend to be blinded by our own biases and beliefs, and when this stuff starts stinking of religious zealotry and closed-mindedness, well, I refuse to participate. I don’t think low-carb and ketogenic diets are the only way people can lose weight and be healthy. And I think sometimes we do get a little too enamored with our own principles. And sometimes we just need a little reality check.


For another good reality check regarding some potential falsehoods we allow ourselves to believe about low-carb and keto diets, here’s another post from Authority Nutrition. (What can I say? Kris Gunnars and the people who write for him do great work.)



More rants coming soon!  ;-)






Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

27 comments:

  1. Interesting opinion. #1 & #2 are valid, but that's about where it ends unfortunately.

    The ketogenic diet is a well researched, well evidenced diet. It works. Yes, there are ratios, and they work! I have never seen any guidance from those that know that has said eat as much as you like. In fact there are keto calculators that specifically tell you your caloric range. If you eat 10,000 CAL per day, then well, you deserve what is coming to you. Yes there are foods that should be avoided. Even those that you think are healthy but hide relatively high amounts of sugars like bananas and your precious carrots.

    Show me the science that says this doesn't work. The science that shows the well researched diet doesn't work.

    How much weight have you lost? Until you can show me your results surpass those of my "Facebook group bros " that have all lost very real weight (200lbs + in as little as 1 or 2 years) then thanks, but i think i will stick with what their science is showing proving.

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    1. If it works for you, then KEEP DOING IT! :) I have absolutely no problem with that, and in fact, I have said that before more than once on my blog. Indeed, if it's working for ya, then keep on truckin'. Ain't got nothin' bad to say about that.

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    2. Love it when people totally miss the point of a well written post. She never says a keto diet doesn't work. The point is all these are myths about the keto diet. Ketosis is obtained through lack of carbs not a special ratio. The special ratio is for medical ketosis not nutritional keto for fat loss.

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    3. Anonymous,

      As you may have noticed from the replies to your comment, you clearly did not get the point of Amy's article. And your challenge to her about how much weight she has lost? Why does that matter? What if the number isn't that big because she didn't have that much to lose? I think if you took Amy at her largest weight and took away 200 pounds, there would be no more Amy...so what number are you looking for, and what would it mean to you? If it was ten pounds, is that somehow less deserving of your respect that twenty? Because context matters friend, and if she only wanted/needed to lose ten, then losing twenty doesn't make sense.

      You've inspired an idea though: what if blogs had a quiz you had to pass before you are allowed to comment. Something to prove that you have read the article. I could be multiple choice, and include questions such as, "What is the main point of this article? a) Keto is bad b) Some people (but not all) have some misunderstandings about ketogenic diets c) Keto doesn't work for anyone d) Amy hates keto" If you pick the wrong answer, you don't get to comment because guess what? With rights come responsibilities. Yes, you have the right to free speech, but at the same time, this is AMY's blog and you probably have a responsibility to actually read and understand her post before you go spouting off about things that really weren't there in the article you are commenting on.

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    4. Listen, Anonymous Jackass, you miss the point of the article. Read it again, then again and you will see that Amy supports the Ketogenic lifestyle, but wants people to not fall for all the falsehoods out there.

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  2. Thanks for writing this! My favourite carrots are the little baby ones, not the gross ones in little bags but the fresh ones that I get at my local farmer's market. So crunchy! In fact I think that I'll have a couple right now with some pepper-jack. Seventy-five pounds down!

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  3. There should be some sort of medal for those who publish on the internet. Putting up with people who do not, or don't want to except what the actual article is about. I see this over and over while I browse on different subjects (and it appears on ALL subjects). Why is it that people need to post negative comments all the time. Is that a power thing ?
    Everything on the net is an opinion (even from eminent authorities)some I like some I don't .Pick the people on your team , stay away from those who aren't.
    Good luck to those on there weight loss travels.
    Stuart

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    1. Thank you, Stuart. All I can say is thank you. You have redeemed my mood after I was feeling slightly bummed by the anonymous comment above. (Isn't it funny how most negative or rude comments are left anonymously? Like, jeez, you can't even be bothered to pick out a fake name to use when you insult me? If you think that little of me, why even read my blog?) ;-)

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    2. Amy as I read the Anon post I was thinking exactly the same - Oh yet another keyboard warrior LOL!!
      Love all your posts (suits my British sense of humour) keep them coming and dont let the KW get you down!

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    3. Point of information - some of us who used to post as ourselves can no longer do so as Google has borked the name/URL bit, but can still post anonymously. They want us ALL on their database.

      the person formerly known as chris c

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  4. I'm a retired Air Force vet going to school to try and become a RD. I enjoy the rants.

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    1. Thanks for your service! (Don't know how long you've been reading my blog, so in case you haven't come across this yet, I'm a USAF vet, too!) Good luck with the RD program. We need more low carb & keto-savvy RDs for sure. I don't envy you having to learn all about those healthy whole grains, though. ;-) But at least the dietetics program will give you a great steeping in the biochemistry and physiology. That's key.

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    2. Thank you for your service! And for your continued efforts as an RD!

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  5. Love it! 1/2, 8, and 9 are the worst offenders, as far as I'm concerned! They produce the most cringing when I hear them...

    Also, I LOL'D quite a bit reading the anony post. They just need to stick around and read more of your work! :)

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  6. Yes, #6 so hard!! Keep doing the good work, Amy. Love your blog and everything you share here. Brilliant mind.

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  7. I ate a ketogenic diet for the last twelve years AND I GOT TWELVE YEARS OLDER!!! This shouldn't have happened. Proof that ketogenic diets don't work!!!!1111

    Thabks for pointing me to Wooo's blog BTW, I'd read her numerous comments on numerous other blogs but never gotten round to checking out the source. I'm reading her end to end, which is taking a long time but well worth it

    the person formerly known as chris c

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  8. oh great, another post knocking down ketogenic dieters rather than ficussing time and energy towards the real issue: sugar and simple carbs. with all the attacks on low carb diets and all the idiotic vegan propaganda out there I will never understand why people like you choose to constantly harp on people who get the ketogenic diet slightly wrong or have a different opinion from you instead of focusing your energy on something useful. thanks for taking the easy route, again.

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    1. Really? REALLY?! *This* is the comment you leave? You're kidding, right? Obviously you have not been reading my blog for very long or you would know that I am a big fan of ketogenic diets, when they are applied appropriately for someone's given health situation and goals. If you aren't too disgusted by my very existence, please give this podcast a listen. It will set you quite straight as to my feelings on the wonderful benefits of ketogenic diets. Thanks for stopping by. http://www.reversediabetescoach.com/episode-32-how-ketogenic-diets-work-for-many-conditions-and-intermittent-fasting/

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  9. In re this and your following post, two words - Metabolic Flexibility. J Stanton (gnolls.org) has some good stuff on this.

    So I ate some Christmas pud and it threw me out of ketosis? So what, I go straight back in. This is what never happened while eating my high carb low fat diet - I was permanently locked in to metabolising glucose and not fat. True for most but not all of the population I suspect.

    chris c

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    1. YES!! I know about J. Stanton and I'm a big fan. His AHS presentation on metabolic flexibility is KILLER. Love it!

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  10. I still ROFL at some of his one liners

    birdseed and diesel fuel are NOT food groups

    if you can put it in a truck and the truck starts it is NOT FOOD

    chris c

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  11. Hi
    I have been eating LCHF since September 2016, and went Keto in December. About mid December started Intermittent Fasting. I have Metabolic Syndrome and pre diabetes, age 68. Anyway I found your blog through Dietdoctor, and learned a lot today. It was very helpful to hear that my health journey will be easier if I cut down on the fat, and not be so uptight about unprocessed carbs.
    Thank you! love the rants!

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  12. Love the rant, and treasure it. I've done Atkins many times in my life and recently switched to Keto--already sick of all the wrangling over it all. (Someone just jumped on me for suggesting frozen berries for a sweet craving. Have me drawn and quartered already!) I appreciate the myths because I've been on sugar free, not low carb necessarily just controlled, diets and lost weight. But I had to cut back to 25-28% fat to start losing, never counted carbs at that time. Eating 70%fat just seems wrong to me but I've been laid up with a broken ankle, cannot afford to gain weight, so got drastic with the Atkins then found Keto. Anyway I appreciate and value what I find to be well balanced opinions and advice here. Some one has to be a voice of reason!

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  13. Thanks for putting some of the myths straight or at least pointing out that they are myths. Sometimes I do get the feeling that parts of what is preached on ketodiet blogs (also DietDoctor.com) is sometimes more a conviction then proven fact or an attempt not to confuse people and by that confusing them even more.

    I lost 20 kg in 11 weeks (thank you, thank you:-), but that was due to the fact that apart from eating LCHF (which made me feel great! best ever! Keto is the bomb!), everytime I stopped losing weight (like for a day, maybe two:-) I started fasting for a few days.
    But in the back in my head I felt a little quilty because I was disproving the basics teaching of LCHF, namely eat as much as you feel like as long as it is LCHF and you are hungry.
    But isn't that what makes it religion< I mean, if you feel guilty if you don't follow the rules?
    Anyways, isn't it best just to keep experimenting and find what is best for oneself using all the information people that have years and years of experience with this and seen thousands of people trying this under their guidance put out there.
    And your great blog Amy B. (loved the article one the protein, and looking forward to the article on protein and longevity)

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    1. Thanks for reading. :)
      The post on protein & longevity will probably be a while. Lots of other stuff I want to get to first, and honestly, I have a bunch more to learn about it anyway.

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  14. Amy:

    You ROCK! I'm a little late to the "party," though. I just now, tonight, finally got around to researching on the internet this "keto" bullshit diet craze because a site that I like to visit for recipes (I'm TRYING to learn how to cook) kept posting "keto" this and "keto" that recipes. Like, uh, WTF?

    So, after very little time and a little effort, I learned that the miraculous/magical/sensational "keto" diet ... [yawning] ... is ... [wait for it] ... just ANOTHER bullshit fad.

    THANK YOU for trying to help combat the ignorance and outright brainwashing that is so much a part of our world with regards to human physiology, diet and health.

    I have a hard time believing there are so MANY gullible, tin foil hat-wearing, koolaid-drinking dolts out there.

    There are actually people who think it's a good thing to drink their own urine!

    Sigh.

    The human race: is there any hope?

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    1. I'm glad you found me, too. :)
      I feel like a lone voice screaming into the void about some of this stuff.
      But: as for keto being a "bullshit fad" -- no, no no ... the ketogenic diet is most definitely NOT a BS fad. It is an extremely effective medical/dietary therapy that is quite literally lifesaving for some people. The "BS fad" you are seeing is that people have bastardized this amazing therapeutic nutritional approach and completely twisted it into something it doesn't need to be, and it's leading people to do all sorts of nutty things that are at best, useless, and at worst, actively harmful. This is why I actually prefer the term "low carb," but if I were to use that, I would probably have zero people finding my blog anymore or watching my YouTube videos.

      I understand what you're saying -- and yes, I pride myself on being a source of sanity, reason, and simplicity among all the craziness and noise. But don't let the zealots and whackjobs out there (and there are A LOT of them out there) turn you off to something that *is* actually very helpful and wonderful -- when done correctly. :)

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