The Cult of Keto

When the model fails, science changes the model. Keto changes the evidence.

The Cult of Low Carb

Yes, a cult. You can eat low carb, lose weight, and improve some blood work. But low carb has developed a movement, champions, villains, and apostates. I am the latter.

David Hume wrote that “a wise man, therefore, proportions his belief to the evidence.” The low-carb movement too often does the reverse. You know their model: sugar raises insulin, insulin stores fat, therefore sugar (or carbs that become glucose) makes you fat.

The model is simple (5th grade level), sounds sophisticated, easy to explain, and therefore popular.

My Adventures in Low Carb

I know because I followed it for a bit. Lost weight felt great, and when I gained weight, I could blame the 90 calories slice of bread instead of the 1800 calorie steak.

Then I did what no cult member should do. I read. Then got a formal education in nutrition when I trained for and obtained certification in Culinary Medicine. You know, those woke colleges with their education.

The low carb model doesn’t explain everything, so it is time to abandon it.

This terrifies the faithful, because when another diet succeeds, there is always an explanation for why it does not count. When epidemiology favors Mediterranean eating, epidemiology is hopelessly fake science.

When epidemiology favors low-carb, we adopt it again. Kind of like music is bad unless it is from our hymnal.

They go to lengths to justify their eating. The “lipid model” is outdated, because our low carb LDL is “large and fluffy.” Inflammation is the key, because god forbid keto makes us more vulnerable to heart attacks. Oh, and let’s abandon the red meat and cancer literature entirely.

On the internet, simplicity sells. Low-carb, calorie counting and plant-based eating dominate nutrition coaching, roughly in that order, and the easiest model is also the easiest to monetize.

Yes, low carb can sound erudite,. A gym bro can teach low-carb between sets, sell the workout, sell the meal plan and sell the supplement without once troubling the audience with uncertainty. Chiropractors love low carb because they sound like they know human physiology beyond a subluxation.

MD on Low Carb is the new hero

The internet audience awaits authority figures with degrees. If you have a MD, or Ph.D., and declare yourself keto, you now have an audience.

Look at the quality of the MD’s and you find a group of individuals far from the ivy towers, and often write things like “lies medical school taught me.” Who doesn’t like a good conspiracy from the voice of an “insider.” Even if the insider had lost their medical license.

Other Heros and Apostates

Gary Taubes is the darling of low carb. First, he is an excellent writer. But when the research went against carbohydrate-insulin claims, he kept finding ways to preserve the model. And now his writing to preserve what is, at best, science fiction.

Denise Minger became a star after critical evaluation of The China Study, through data analysis. Denise kept reading and encountered evidence to the contrary, such as Walter Kempner’s rice-and-fruit diet, that did not fit neatly into the low-carb model. She is now avoiding radical dietary “isms.”

Peter Attia evolved too and managed a softer landing in longevity medicine. He was the scientific advisor under Taub’s experiments. Apparently Peter read and agreed with the data, and Gary did not.

Have Degree - Welcome Friend

Craving authority figures in comes a new addition. Nick Norwitz. Truly impressive credentials, Oxford PhD and Harvard MD. Oddly, Dr Norwitz did not go on to residency, clinical practice or a research lab.

He is full on influencer, having stepped into a movement primed to celebrate those credentials.

Forks over Cholesterol Code

Now a group of the low carb elite have come up with a new film. The Cholesterol Code (available wherever you can buy it for a few bucks). It is remarkably similar to another move from the vegan group. Forks Over Knives.

I can imagine Dave Feldman (a low carb fanboy) and his friends saw Forks over Knives while drinking bone broth with his buddies, said, “Hey, we can do this.” And the Cholesterol Code was born.

Same format, testimonials, fighting the system, coming up with an answer. And using the fifth grade reading level appealed to a wide audience, who will feel as if they got an education. They didn’t. It was a movie, marked as a documentary. Fair note, I didn’t see the movie, I relied on my friend Simon Hill of The Proof podcast. Although oddly, I guessed the plot line with remarkable accuracy.

The danger is that their movie came after their penultimate paper was retracted. Alas, they say they retracted the paper, not the journal (yes, you resigned, you were not fired).

Make Heart Disease Healthy Again

There is always a danger to diet cults. Leave science behind, and sometimes you leave the importance of diet in health. In this case, forgetting that we had five times the number of heart deaths when we ate more butter. Keto and low carb want to return to the 1950’s.

To protect themselves from biology, they’ve identified a group: the lean mass hyper-responders. Their theory, that if you have a lean mass (not obese), and eat keto, and develop, predictably, very high LDL you will be immune from laws of biology. They wrote a paper about it, many people widely criticized it, and was retracted. Oddly, 20 percent of these chaps had accelerated atherosclerosis.

I like red meat

Lamb lover I must confess

Some of my best friends are red meat: especially lamb. But I do limit it now. When I did Atkins, keto, then Paleo, I noticed my LDL rose. My arteries seemed to gain the fat that my belly lost. Not a great trade off for someone whose family tends to have heart attacks in their 50’s. Yes, I am on a statin.

Sustainability

The second issue with low carb is sustainability. I was so tired of bacon and eggs. I remember ordering it again, and thinking “what is wrong with yogurt and granola?” Okay, I know granola is dessert, but come on. To this day, the only way I can look at an egg is if I put hot sauce on it and have beans surrounding it.

Any diet works as long as one remains permanently faithful. Falling away is a sign of weakness, because apparently keto takes away all cravings and provides complete satiation. It doesn’t.

And of course, falling off low carb means you didn’t have willpower. You were not faithful, you didn’t pray enough.

The model isn’t perfect

The problem begins when partial truth becomes total explanation. The more nutrition literature I read, the less elegant the model became. The more you read about Ancel Keys, and read his works, the more you realize he was amazing.

The more you read about Mediterranean, DASH, and MIND (a diet of DASH and Mediterranean), the more you realize that Mediterranean (or DASH) is better and sustainable. The problem is it is more of a 12th grade reading level, so hard for social media types to grasp.

Faith vs Science

The model doesn’t work. The model is dangerous. The model is unsustainable. And cave men did not eat just animals. That is your holy trinity.

Low carb is a cult, or maybe a religion. It has its faithful, it has its cult leaders, and it will explain away anything that holds up a mirror.