Caveats to the Ketogenic Diet


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If you listen to the proponents of the ketogenic diet, everybody should be increasing their consumption of animal products, particularly red meat and animal fat, while restricting the intake of processed carbohydrates such as sugar. There is no question that the scientific literature supports the effectiveness of ketogenic diet in rapid weight loss and in the improvement of indicators of the metabolic syndrome. Similarly, it makes total sense to greatly reduce the excessive intake of processed carbohydrates that are part of the typical North American diet. Given the worldwide epidemic of obesity, metabolic syndrome, and the failure of most therapies to reverse this epidemic, the ketogenic diet seems like the perfect solution to this problem.

However, there are a few things you should consider before jumping on the bandwagon of this trend:

  1. There is an overwhelming evidence for the health benefits of largely plant-based diets (including the Mediterranean and traditional Asian diets). The latest microbiome research provides the explanation on why diets high in fiber are optimal for the health of your gut, your gut microbes, and for the prevention of cardiovascular disease, cancer, and even neurodegenerative diseases such as Alzheimer’s disease. These diets contain a small amount of lean meat, in particular coming from poultry and fish.
  2. There is overwhelming evidence from preclinical studies (1-4) that high-fat intake causes changes in the gut microbial composition and function, resulting in an increased leakiness of the gut and low grade inflammation of the gut and other organs, including the brain.
  3. Would every obese person in the world switch to a ketogenic diet, it would dramatically increase the population of cows. Why should we worry about such a development? The production of meat compared to plant-based food to generate the same amount of calories requires 15 times more water, and the global contribution of green house gases from animal agriculture already exceeds that from transportation. An increase in animal agriculture would not only lead to even greater production of greenhouse gases, but also to a further increase of water consumption at a time of growing global water shortages.

Take-Home Messages:

  1. The full ketogenic diet is probably the best and fastest way to loose weight, and to bring your metabolism under control if you suffer from metabolic syndrome and type II diabetes.
  2. However, the ketogenic diet is not our human default diet, and an increase in animal agriculture has detrimental longterm effect for the health of the planet.
  3. Staying away from refined carbohydrates and sugar, eating lots of fiber containing plants (not in the form of juices), moderate amounts of plant oils and fats (as contained in olive oil, avocados and nuts), and eating a lot of berries (in particular blue ones) is the best thing you can do for your own health, and for the health of the planet!


  1. Moreira AP et al. Influence of a high-fat diet on gut microbiota, intestinal permeability and metabolic endotoxaemia. Br J Nutr. 2012 Sep;108(5):801-9. doi:10.1017/S0007114512001213. Epub 2012 Apr 16. Review. PubMed PMID: 22717075.
  2. Cani PD, Everard A. Talking microbes: When gut bacteria interact with diet and host organs. Mol Nutr Food Res. 2016 Jan;60(1):58-66. doi:10.1002/mnfr.201500406. Epub 2015 Aug 26. Review. PubMed PMID: 26178924; PubMed Central PMCID: PMC5014210.
  3. Guillemot-Legris O et al. High-fat diet feeding differentially affects the development of inflammation in the central nervous system. J Neuroinflammation. 2016 Aug 26;13(1):206. doi:10.1186/s12974-016-0666-8. PubMed PMID: 27566530; PubMed Central PMCID: PMC5002131.
  4. Cani PD. Gut microbiota – at the intersection of everything? Nat Rev Gastroenterol Hepatol. 2017 Jun;14(6):321-322. doi:10.1038/nrgastro.2017.54. Epub 2017 Apr 26. PubMed PMID: 28442782.