A Ketogenic Hat Trick

How many times have you heard the term “fad diet?” It seems like every year there is a new miracle way to lose weight, improve metabolic health and achieve a leaner physique. If I had $1 for every time someone mentioned the ketogenic diet and “fad diet” in the same sentence, I would be comfortably retired, living in a mansion on the beautiful island of Santorini.

Defining a Fad

According to google.com, a fad is defined as “an intense and widely shared enthusiasm for something, especially one that is short-lived and without basis in the object’s qualities; a craze.” What’s interesting are the two most critical factors in the definition: short lived and without basis. Does the ketogenic diet qualify as a fad?

Let’s take a brief trip through history:

  1. For hundreds of thousands of years, humans evolved into hunters/herders, and had to withstand long periods of fasting. During these very early millennia, carbohydrates were not widely available, and foods like fruits were consumed more “in season” vs. over extended periods of time. How did these early humans survive? Quality animal & fish proteins & fats, and in specific seasons, some seeds, nuts and berries to sustain them over long periods of fasting. Nomadic people such as the Masai (Africa), Bison (North America) and Intuit (Arctic) are well-known examples.
  2. In 440 B.C. Hippocrates famously said “Let Food be thy Medicine and thy Medicine be thy Food.” He was one of the early thought leaders who was convinced health and wellness was achieved through proper nutrition, activity & self-care (ie, massage and/or aromatic bath) vs. medication.
  3. Up until the 16th century in Russia and throughout Scandinavia, carbohydrates in the way we know them (starches) were in limited supply until the potato gained wide distribution.
  4. In 1860, William Banting famously documented his weight loss journey of 52 lbs, where he followed a dietary protocol very similar to a modern low carbohydrate diet. In fact, the “Banting Diet” is a popular low-carb diet reference in regions outside North America.
  5. In the late 19th century, dietitians and physicians were prescribing a low carbohydrate diet for both weight management and epilepsy treatment, especially in children.
  6. For well over 100 years, the ketogenic lifestyle has been used to successfully treat children with epilepsy, reducing, if not eliminating, the need for medication.
  7. In 2020, the ketogenic diet was the most popularly searched diet in the world, and in 2021, among restaurants, the ketogenic diet had the highest menu growth of any dietary plan.

So, implying the ketogenic diet is a “short lived” (back to the definition of fad) dietary lifestyle seems to be incorrect. However, we still need to assess “basis”…that is, scientific proof this dietary lifestyle works? I’ve created a reference page on my website that covers 25+ studies validating the benefits of low-carb / ketogenic dietary pathways, reinforcing just a small sample of the scientific proof behind the efficacy of this lifestyle.

But what about the most recent 2022 U.S. News ranking report where the ketogenic diet was rated toward the bottom of dietary philosophies? Doesn’t that mean it’s not healthy? No. For your reference, I covered this ranking report in quite a bit of detail in a previous blog post, which I encourage you to read below…

The Recent Hat Trick

For those not familiar with hockey, a hat trick refers to a single player scoring 3 goals in a game, and typically involves rabid fans covering the ice by tossing their own hats on the ice in honor of the players’ outstanding scoring prowess. Recently, there have been 3 sets of studies, articles and data points that show both the efficacy AND popularity of the ketogenic diet is as compelling as ever.

First, in the below article, based on 2022 Tik Tok hashtag research, the ketogenic diet had 10 billion views, almost double the next most popular dietary lifestyle. In addition, over 500K Americans search for keto diet on google.com every month.

Second, in the below linked article, recent research suggests combining the ketogenic lifestyle with drug therapy can kill pancreatic cancer cells. The hypothesis centers on the ketogenic diet starving cancer cells through the limitation of sugar, and placing additional stress on the cancer cells through the production of ketones. This combination with the correct drug therapy enhances the drug’s ability to knock out the tumor. More studies are obviously needed, but this is certainly encouraging!


Third, and for the hat trick, in an attempt to quantify the risk of a low-carbohydrate diet that is higher in saturated fat, the following study was commissioned. After having subjects consume three different carbohydrate levels, the low carbohydrate diet (~ 20% of calories…still not ketogenic) high in saturated fat improved insulin-resistant dyslipoproteinemia and lipoprotein(a), without adverse effect on LDL cholesterol. The low-carbohydrate group also showed greater improvement in lipoprotein(a), triglycerides, HDL cholesterol, large/very large TRL-P, large HDL-P, and adiponectin. So, improved metabolic health with no adverse effect on LDL cholesterol.


Bottom Line

Far from a fad, the ketogenic lifestyle has been around for at least 160 years, and has been shown in dozens of studies to improve metabolic health, reduce obesity, and reduce the symptoms around diseases like epilepsy. It requires discipline, but more importantly, the ability to question the dietary messages we’ve all received for the last 60+ years, as our current diets of high carbohydrates & sugar, highly processed foods, high poly-unsaturated fats from seed oils, and low saturated fats have been causing a global epidemic of metabolic disorders, type-2 diabetes, obesity, cardiovascular disease and a range of additional chronic diseases. Like all dietary pathways, quality matters, and following a ketogenic lifestyle with a very low carbohydrate intake, a high quality fat intake of mono-unsaturated and saturated fats, and a medium-protein intake of quality, grass-fed meat & dairy and wild caught fish, can yield lasting health and metabolic benefits. Better metabolic health, lower incidence of obesity and a reduction in the presence and severity of chronic disease? Talk about a hat trick!