This is a solid overview of ketogenic diets, now being used for a variety of metabolic and other health issues, by David Ludwig, MD, PhD (@DavidLudwigMD), an accomplished physician, scientist, educator in the nutrition field.
Noting, unlike many other pieces written on this topic, David does not have financial or other ties to food or pharma industries.
People like me start reading an article by going to the conflicts of interest first (sometimes called “duality of interest” or “competing interest” – to me they are conflicts).
The author reported no funding received for this study. Author disclosures: DSL, has received royalties for books on obesity and nutrition that recommend a carbohydrate-modified, but not ketogenic, diet, and grants from the NIH and philanthropic organizations unaffiliated with the food industry for obesity related research.Ludwig DS. The Ketogenic Diet: Evidence for Optimism but High-Quality Research Needed. J Nutr [Internet]. 2019 Dec 11 [cited 2019 Dec 12]; Available from: https://academic.oup.com/jn/advance-article/doi/10.1093/jn/nxz308/5673196
I have previously posted a gallery of some impressive conflicts of interest by authors in this space, when I last updated my disclosures (I have none). These will semi-blow your mind: Updating: My Disclaimers and Disclosures (November 2018) – Examples of conflict I’ve seen recently
It’s noted in the piece and by myself in many dialogues that there are persistent misconceptions about the basics of a ketogenic diet, what it is, and its history. On a semi-regular basis, patients reach out to me privately in frustration with a medical profession that doesn’t seem to want to know them as people working to control their health destiny.
In other settings, I’ve recorded the times the medical profession didn’t want to know about something, with devastating results. (See: Slide Update: ADA’s website now includes Low-Carbohydrate Diets in Standards of Care, and looking back on the times the medical profession called people/ideas a “fad”)
For these times, I like to re-use this quote, which I discovered in the unconscious bias literature. It fits here.
…if defensive, notice it and accept the discomfort of unlearning and relearning…this requires a desire to know, motivation to become informed, willingness to correct mistakes.
I’ve always said, “If something is doing something better than me, I’d like to know about it.” This is a common attitude I find in the community of physicians that David is a part of.
More than understanding a particular diet, my hope for the profession is that it learns to unlearn and relearn better.
See what you think of the piece.
Ludwig DS. The Ketogenic Diet: Evidence for Optimism but High-Quality Research Needed. J Nutr [Internet]. 2019 Dec 11 [cited 2019 Dec 12]; Available from: https://academic.oup.com/jn/advance-article/doi/10.1093/jn/nxz308/5673196