New JAMA article discusses benefits of keto diet but warns it may be risky long term

Is there no such thing as bad press?
The prestigious medical journal JAMA published a “Patient page” on the ketogenic diet to help patients understand its potential benefits and concerns. It starts off as a non-judgmental description of what to eat and what not to eat. The authors accurately describe the potential symptoms of the “keto flu” over the first two weeks.
Although they accurately describe keto diets as having less than 5% of calories from carbohydrates, they then refer to studies suggesting low-carb diets may be linked to increased mortality. But they fail to mention that these studies defined “low carb” as containing 40% of calories from carbs, not 5%. Simple oversight, perhaps?
But here is the kicker:
Over the long term, a diet in which only 5% of total calories come from carbohydrates makes it impossible to obtain optimum amounts of antioxidant phytonutrients from fruits and vegetables.
This is news to me. Is there a defined “optimum amount” of antioxidant phytonutrients? I would love to see studies showing that people who eat whole foods and eliminate refined starches and sugars require a high level of phytonutrients. That data does not exist. But now, any patient who reads this may feel they are at grave risk of dying of a phytonutrient deficiency. If any doctors have seen this apparently common disease process, please let me know.
Last, keto diets are not by definition low-vegetable diets. We have a visual guide to help you understand the almost limitless amount of low-carb veggies full of phytonutrients that you can eat on a keto diet. Whether or not you actually need those phytonutrients is unproven and unknown. But if you want veggies for other reasons, go for it!
Thanks for reading,
Bret Scher, MD FACC
Earlier
Op-ed: Mislabelling a diet “low-carb” is dangerous
It’s time for more keto research
Nutrition research is hard. But is that an excuse to not do it well?
I also lost the cravings, bloating, cramping and having bouts of diarrhea with EVERYTHING I eat (low fat, salad, sandwich, fruit, veggies... anything! I had a colonoscopy because of it). I’ve never felt better. Is it for everyone? Probably not. Is it health to do forever? I don’t know. But... being 50lbs overweight isn’t healthy either. I’ll take my chances and enroll in a long term study.
I have been keto for over 18 months and have 5-10 cups of greens daily and don’t count them.
It is a myth that you can only have 3 spears of asparagus because it equals to 5 carbs.
People who are on the ketogenic diet, don’t spend all day eating bacon either.
Point is, we don’t snack, we don’t eat 6 times a day on so called “healthy” snacks, like granola bars etc.
This isn’t good for so many industries that thrive in keeping everyone eating all day long.
So tired of seeing these articles.
Don’t bad mouth Keto or Vegan. Let individuals move forward with confidence. My regret is that I had not gotten the challenge years earlier.
I also added Hemp based CBD 5 years ago. Have not had any airborne dis-eases at all. None. I also eat the entire plant. Very healthy. Raw offers relief from auto immune dis/eases. Requires heat to create euphoria.
Realize we are fed untruths. IMHO.
Terrie
I've been on Keto for 5 months. I've lost 65lb and never felt better.
I no longer graze. I only eat between 12 noon and 8pm.
Equally I rarely feel hungry.
That aside - I feel I eat a diet full of vegetables (spinach, kale, bok choy, broccoli, Swiss chard, and romaine lettuce), I also eat a large variety of fruit (blackberries, strawberries, raspberries and blueberries).
I think this diet (way of eating) is highly misunderstood by many.
However the success is high.
The massive reduction in the intake of sugar and processed foodstuff has to be a positive - yet never seems to be mentioned in these reports.
I never heard Keto explained as a diet where sugar and processed food are taken out of the daily diet - yet this would be my description of my way of eating.
If I refuse food when in company I always explain 'Sorry, I dont eat sugar/processed food'.
Keto is definitely for me and works for my lifestyle.
I really love when they call keto a fad diet, when the current America diet is the fad. Homo Sapiens have been eating keto for hundreds of thousands of years- not sure how that can be called a fad.
fantastic. Now just to find out if all the other claims come true: weight loss and increased energy
Here is our guide to cholesterol which you may find helpful.
https://www.dietdoctor.com/low-carb/cholesterol-basics