Is Keto just a Band-Aid?

I hear it's super painful to take off

The perfect movie does not exi-

I recently wrote about how Keto has Clearly Failed for Obesity.

In short:

1. Keto isn’t necessary to reverse obesity (people do it w/ potato/rice diets)

2. Keto isn’t sufficient to reverse obesity (plenty of people don’t lose much on keto)

3. There are plenty of ways to do keto (low/high-protein, low/high-PUFA, animal/plant foods..)

4. Most of them don’t seem to work for more than about 30% of those who try

5. Some variants work better for some people than others

6. I’ve previously gained 100lbs on strict, therapeutic keto (yes I measured ketones)

That last one hits pretty close to home. It’s just hard to believe something after it failed so hard for you, personally.

BUT

I am still doing keto (well, not this month cause I’m doing the rice diet, but in general) and am actually more ketarded than ever with typically 90% fat kcals.

So I thought it’d be just fair to write an article explaining why keto is still a pretty viable option with my updated model of metabolic dysfunction and obesity. If you do it right, that is.

Why do people think Keto is just a band-aid?

I think my own story with keto is a pretty good example. Initially when starting keto, I effortlessly lost about 100lbs and reached the thinnest I’d ever been as an adult. I didn’t “do” anything, I used no willpower, I cheated plenty of times, I ate to satiety all the time.

It was a miracle!

Until it wasn’t. Circumstances changed, I moved back to the U.S. The version of keto I did necessarily changed completely.

It went from low-protein to very-high-protein, because beef is so plentiful and affordable in the U.S. and all the American ketards/carnivores were eating lots of beef.

I was also eating way more cheese. In Asia, where I started keto and lost most of those 100lbs, cheese is rare, imported, and expensive. You have to go to a specialty store and pay out the nose for a bit of decent cheese. In the U.S., you can buy a 3lbs block of cheese for $9.99 at Costco. And I did.

Was my Asian keto diet lower in PUFA than my U.S. keto diet?

It’s hard to say, but probably. Back in the U.S. I ate lots of bacon. At least one pack per week, usually on Saturdays/Sundays for brunch. When I ate out at restaurants, I’d get a salad with extra dressing. The dressing: soybean oil.

On the other hand, that’s also what I ordered in Asia a lot, and their sauces are probably also pure seed oil. And I cheated quite a bit back then, even with fried chicken from time to time.

My impression is that palm oil is a traditional cooking oil there, and sunflower is also common. So maybe I was “eating seed oils” but only getting the 9% linoleic acid (palm oil, similar to olive oil) or a high-oleic/low-linoleic version of sunflower oil with around 20% linoleic acid.

Overall, it’s hard to say. One of the pernicious things about seed oils is that they’re hidden in everything, even things you wouldn’t suspect to contain oil at all.

Once back in the U.S., I started gaining weight. And gained. And gained.

And I keto’d harder: not deeper in ketosis (which would’ve involved removing protein), but instead going more “clean” and higher in protein. I moved toward carnivore, not toward ketosis or low-PUFA or low-protein.

And I gained more.

I started working out (which I mostly hadn’t in Asia, when losing).

And I gained more.

Within 2 years, I was back up to 280lbs.

Massive, unstoppable regain: Band-Aid

If this is your experience with keto, it’s not hard to understand why you’d think it’s a band-aid. It worked in the short term, but it failed in the long-term. It might even have made you worse off, depending.

I only continued because of the therapeutic benefit on my Non-24 circadian rhythm disorder.

If you don’t experience a therapeutic benefit like that, why wouldn’t you throw keto out as “failed” and declare it a band-aid?

And while I think that “keto” as in “a diet that induces at least some degree of ketosis much of the time” is neither sufficient nor necessary for reversing obesity, I continue to believe it is a pretty viable path.

Are Band-Aids even bad?

I think Band-Aids are pretty good. In a broader sense, a tourniquet is “just a band-aid” but it can save your life by stopping you from bleeding to death, allowing you to make it to a hospital.

Of course a Band-Aid won’t fix your broken bone, and a tourniquet won’t fix organ damage. I assume the implication in the “keto is a band-aid!” cry is that ketoers aren’t addressing the actual issues, just papering over the symptoms.

But is that accurate?

I would say: not necessarily, but in practice, often, yes.

Keto can fix the root issues, if done carefully

A quick recap of what I believe the root issues are:

1. Excess consumption of linoleic acid over time

2. Leading to excess linoleic acid in adipose tissue (4-8 year time span)

3. Leading to dysfunction of mitochondria and other cell functions

   1. Conditionally upon 3) + your genetics: inability to switch efficiently between glucose and fat as fuels (=> “don’t swamp”)

   2. Conditionally upon 3) + your genetics: inability to switch efficiently between amino acids and other substrates as fuel (=> protein restriction)

And how do you counter this condition?

1. Aggressively reduce linoleic acid intake forever (ideally, to <2% of total kcals)

2. This will lead to your adipose tissue containing less linoleic acid (again, 4-8 year time span probably)

3. While you’re still somewhat metabolically dysfunctional (4-8 years is a long time):

   1. Experiment to see if swamping carbs + fat causes you issues. If so, avoid it until metabolically fixed.

   2. Same for protein. If you have high glucose and don’t lose fat eating normal or high protein, try lowering protein.

As you can see, this path neither requires nor forbids ketogenic diets. The only thing that’s off the table for sure is high-PUFA foods.

If you decide to do the swamping thing, one route is very amenable to keto: high fat/low carb/low protein. Of course, there’s also high carb/low fat/low protein, which is pretty much the opposite of keto. I call it “carbo” even though there’s probably no physiological state of “carbosis” like there is with ketosis.

Keto gives you lots of rope to PUFA yourself

There are many high-PUFA ketogenic foods. Linoleic acid is a fatty acid, aka a fat. And yes, if you do what I call “Standard American Keto” it will probably be very high protein (steaks) and very high linoleic acid (bacon, nuts, salad dressings, sauces).

It is therefore fair to say that a ketogenic diet, by its high-fat nature, gives you a lot more rope to hang yourself.

If the real bad guy is a certain type of fat (linoleic acid), the higher the fat content of your diet, the more you can accidentally incorporate that type of fat.

In this sense, a high-carb, low-fat diet is relatively fool-proof. You won’t accidentally eat lots of PUFA if you don’t eat much fat to begin with.

But keto can also make this very easy

You can certainly do keto “wrong” in our sense, but you can also do it very right.

Ruminant fat is typically extremely low in PUFA, with <3% measured even for regular, grain-fed supermarket beef & dairy.

A high-fat diet can make it very easy to lower your protein percentage. Many staple starches like wheat, rice, and potatoes are 7-10% protein. This means that even if you eat just the starch, and zero meat on top of it, you won’t get to the level of protein restriction you can do on ex150. You can get lower if you incorporate fruit, which has pretty much zero protein, or sugar/honey.

But if you don’t want to do the starch/fruit diet, and still eat some meat (be it for enjoyment or for health reasons), a keto diet is a pretty good way. If you generally tolerate fat well, especially dairy fat, this is a great option.

Just stick to ruminants like cows when it comes to animal foods: beef & dairy. You can also experiment with cocoa or coconut fats, though I view these more as specialty applications, not staples.

In summary: You can do keto or non-keto and make your long-term PUFA situation worse, it's completely orthogonal. Sticking to low-fat will make it easier to stay away from accidental PUFA exposure.

But if you’re doing this level of dietary restriction, you’ll probably know which fats/foods to stick to anyway.

But keto is stressful!

No, it’s not. Anyone who’s telling you otherwise better give you objective markers to test for.

The “keto is stressful!” claim usually comes from Peaters, who take Peat’s writing as inherited truths. It doesn’t seem to matter that none of their markers actually seem to conform to their theories.

Here’s what they predict for long term keto:

• It will ruin your sex hormones (e.g. testosterone)

• It will ruin your thyroid (“hypothyroidism”)

  • It will therefore lower your metabolic rate

  • It will therefore lower your body temperature

• It will make you glucose intolerant

• It will raise cortisol

• It will force stressful gluconeogenesis, because you’re not eating the carbs your body needs

I know lots of ketards, I’m a 9 year pretty extreme ketard myself. I just ate a 90% fat diet for 2 years straight. I’ve been around the low-carb community for 2 decades.

None of these markers are true for me, or any of the long-term ketoers I know.

• My metabolic rate is normal by RMR, and normal or high by DLW.

• My temperature upon waking is usually over 98°F, and I sometimes hit 99°F after eating.

• All my thyroid markers are normal (T3, T4) or insane (TSH)

• My testosterone is usually over 1,000

• My serum cortisol is normal. My 4 spot saliva cortisol test throughout the day is normal.

• Regarding gluconeogenesis, turns out that happens to almost the same degree even when you eat carbs. Amber O’Hearn writes about the keto/stress claim here.

• I pass an Oral Glucose Tolerance Test even in deep ketosis, i.e. without “carbing up” for 3 days, like you’re supposed to. After carbing up for about a week, I just passed it again, with my glucose 2h post-prandially even lower (as expected). So much for glucose intolerance.

Some people fail hard on keto/carnivore

Now it’s obvious that some people get in real trouble doing keto or carnivore. And it’s easy to say “they were doing it wrong.” Of course, you CAN do it wrong. There are many types of keto, and most of them consider the other ways wrong.

I outlined what I currently believe to be the “correct” way above: low-PUFA, low/moderate protein for some.

Another dimension is that the people who fail on carnivore tend to eat a lot of liver, whereas almost none of the long-timers do.

Of course it could also be that some people, for genetic or similar reasons, are simply not able to thrive on keto even if they “do it right.”

I’d say the jury is still out on what that distribution looks like.

Should you do keto?

Luckily, it’s pretty easy. You can do keto if you like it, but you don’t have to. So just pick whichever you like better!

Does the idea of a heavy cream diet with dark chocolate make your mouth water?

Or do you live & thrive on potatoes and rice and cassava, love fruit, and couldn’t imagine ever giving them up?

That’s probably a pretty good signal.

Maybe you could retrain yourself and change your food preferences over time. But why bother? It’s easy enough to do keto right: stick to ruminants, avoid seeds/nuts/sauces/dressings, consider lower protein.

It’s also easy enough to do carbo right: don’t use seed oils for cooking, don’t use your fat budget on high-PUFA foods like nuts & seeds.

So just do what sounds better to you. If you’re curious, you can give the other option a go. I’m normally a huge ketard, but I’m currently doing a rice diet that is about 92% carbs.

And it’s just fine so far. I seem to easily tolerate it, although I must admit I prefer ex150 flavor & convenience wise.

No need to have tribal warfare over this one.

(Brief update on the rice diet: I went up a few pounds even from my protein refeed weight, but have been stable there since. Also, it’s day 9 and my Non-24 has not come back. Crazy talk! Feels a bit like predicting the election at 10pm to declare victory, but last time I ate carbs, I had shifted by 7 hours on day 9.)