It’s tough to find keto criticism in a world of trend-driven search engine optimization, so I was positively delighted to find James Fell’s article “Keto Is the Dumbfuck Diet Du Jour, But That Won’t Last.” Turns out he’s been featured in The Washington Post, The Guardian, Chicago Tribune, and Men’s Health, and has committed a decade to diet myth-busting after watching his mother struggle with her weight all his life. I gave him a call after reading his poem “Much Ado About Stuffing.”
We discussed why people lose weight and have health benefits on the diet. “It’s because of the low-rule complexity,” he said. In his article “Why Your Diet is Doomed to Fail,” he mentions a 2010 study that highlighted how people are most likely to stick to diets that have fewer rules… Which brings us back to carb cutting.
"They cut out a massive food group,” Fell said. “Carbs are likely problematic for them -- pastries and donuts and pizza and what not -- and that creates a de facto restriction of calories. It's not miraculous.”
We then discussed how dietary restriction can become somewhat of a religious ideology.
"There are people who follow keto who aren’t crazy,” Fell said. “But some of them think that it is a miracle cure to everything, that it violates all sorts of proven science.”
He likened ardent keto followers to extremely religious people's tendency to look beyond politicians' moral shortcomings: As long as they get them closer to the overall results they're looking for, they're willing to look past even glaringly negative characteristics.
Basically, the proven science is in the pudding. A highly cited low-carb study from The New England Journal of Medicine concludes with the statement, “The low-carbohydrate diet produced a greater weight loss (absolute difference, approximately 4 percent) than did the conventional diet for the first six months, but the differences were not significant at one year.” The study mentions health benefits from the low carb diet, of course, but that it’s largely unsustainable.
And it’s not an easy diet to stick to, even in the short term. Fell pointed me to a series of articles he’d written after talking to scientists about low-carb diets. As a former track runner myself, I wasn’t surprised to hear him say that carb depletion is terrible for athletes, nor did it come as a shock to hear that fat isn’t necessarily going to make you feel “fuller for longer.”
You could hear a decade’s worth of frustration in Fell’s voice. “People hold it up like it’s some kind of Bible. ... We've got Dr. Oz, and tons of doctors that don’t know what they’re talking about … but have that beloved M.D.”
He went on to talk about how physicians often support keto/paleo, or even write books about the diets. Fell’s wife is a physician. “Nutrition education is practically non-existent in medical school,” he said. “You can fail every nutrition exam you get in med school and still be a doctor."
This means, when it comes to diet information, many medical professionals are largely in control of the sources they choose to rely on, making it easy to ignore the reality of keto.