By Dr. Mercola
Some 45 million Americans make a pledge every year to improve the way they eat.1 While you may be among those who desire to change your eating habits for the better, how do you decide which type of diet is best for your body and lifestyle? In an effort to help you choose, the U.S. News & World Report2 annually releases its evaluation of what some consider to be the top 40 best diets. For the first time this year, the ketogenic diet3 was featured on that list.
The good news is this low-carb, high-fat diet, which I recommend for most people who would like to optimize their health, is being recognized among other popular programs such as the Mediterranean diet and DASH diet, which tied for first place. Some consider the bad news to be the fact the ketogenic diet tied for last place, alongside the relatively unknown Dukan diet. Keto was outpaced by other well-known low-carb diets such as the Paleo (32nd) and Atkins (36th).
While it's wonderful mainstream media is drawing attention to the ketogenic diet, it is also clear the diet, as I have promoted it for the past several years, is, as of yet, still somewhat misunderstood. Given the attachment most people have to processed food, starchy carbohydrates and sugar, it's no wonder a diet focused on attaining nutritional ketosis would receive a lower ranking. Once you reach nutritional ketosis your body is able to burn fat as its primary fuel.
To get there, you eat minimal carbohydrates, moderate amounts of protein and high quantities of healthy fats. Sadly, this approach was considered by some of the judges to be drastic, restrictive and unsustainable. I suppose it all depends on your perspective, your goals and any health issues you are attempting to resolve.
While it would have been nice had the ketogenic diet achieved a higher ranking, the fact it made the list at all is quite an accomplishment. To me, the real news is not its ranking as No. 40 out of 40 diets, but rather, that it made the list at all, and for the first time. Regardless of what the so-called experts say, this dietary approach is changing lives for the better and continues to be an important tool you can use to take control of your health.
Panel Assessing Top 40 Eating Programs Reflects Bias Against Alternative Health Practitioners
While the annual top diets report from U.S. News & World Report is well-intentioned, the notion the assessment was generated by an "expert panel"4 billed as the country's top practitioners in nutrition, diet and weight loss is absurd. Taking a closer look at the background of the 25 "experts" reveals an abundance of dietitians, but not a single naturopath or osteopath.
This is not surprising since registered dietary nutritionists and their trade group, the Academy of Nutrition and Dietetics, function as a closed guild. One of their primary goals has been to exclude and marginalize competing voices.
In 2012, the North Carolina Board of Dietetics/Nutrition, a state chapter of the Academy of Nutrition and Dietetics, threatened legal action against a blogger for writing about the Paleo diet without being a registered dietitian.5 They have also worked to gain legal control over the term "nutritionist" as a path to limit competition and suppress the views of anyone who has not been indoctrinated in their conventional views on health.
This fight has raged at the state level for years, and if the Academy of Nutrition and Dietetics gets its way, other health experts such as your chiropractor, naturopath, personal trainer, myself and numerous others would not be allowed to share nutritional advice.6 Given the tremendous bias toward conventional approaches, anyone hoping for a science-based and nuanced view of the low-carb, high-fat diet was sorely disappointed by the panel's analysis of the ketogenic diet.
So-Called 'Health Experts' Criticize the Ketogenic Approach
With some matters of health and wellness, it often seems you may be better off doing the opposite of what conventional medicine suggests. As such, the 2018 Best Diets report may mark another occasion when taking the advice of so-called experts may not be in your best interest. Although the panel conceded the ketogenic diet is excellent for short-term weight loss, they heavily discounted it for a number of myths and misconceptions that have already been debunked. Below are a few examples of this misguided advice:7
• A ketogenic diet will likely be a struggle for you if you “love morning toast, whole-wheat pasta, pizza and sugary desserts” — items I suggest you avoid regardless of the type of diet you follow. The exception is once you’ve achieved ketosis, as then you’ll want to cycle in higher amounts of carbs once or twice a week, ideally on strength training days. This feast-and-famine cycling will help you optimize the health benefits of the ketogenic diet.
• The need to eat more meat, including grass fed selections, and fresh vegetables will cost you more than processed or fast foods, but, “You can select less-expensive, leaner cuts of meat and fatten them up with some oil.” This is terrible advice. A better approach would be to simply moderate your protein intake and stick with high-quality grass fed or pastured meat products.
• Canola oil was listed among the healthy fats even though it is manufactured from genetically engineered rapeseed plants and is processed through several chemical baths before being bleached. Avoid this toxic oil at all costs.
• Take note that palm oil, also suggested as a healthy oil, is only beneficial in its unrefined form, whereas refined palm oil is toxic. Flax and olive oil, which were also noted, are healthy choices only when used cold.
• One expert said, “This diet is fundamentally at odds with everything we know about long-term health.” Another expert suggested that any weight loss comes at the expense of “giving up fruits, whole grains and starchy and nonstarchy vegetables … [which] … is the opposite of what we want for diabetes and heart disease prevention.”
The truth is that most of the conventional diet advice this panel espouses is at the root of the global obesity epidemic, and responsible for the surge in chronic disease we’ve seen during the past few decades.
Even though the panel suggested keto-friendly eating is too difficult and restrictive for the average dieter, with preparation and education anyone can successfully implement the ketogenic diet. Thankfully, many tools exist to help you get started, including my ultimate Ketogenic Diet beginners guide and "Fat for Fuel Ketogenic Cookbook." In addition, my Healthy Recipes website is loaded with delicious dishes. All of these tools will help ensure your success.
Benefits of Cyclical Nutritional Ketosis
While the "expert panel" ranking the Top 40 diets may disagree, with a few exceptions, I believe the ketogenic diet is healthy for most people, whether or not you are dealing with chronic disease. It will help you achieve optimal health by transitioning from burning carbohydrates for energy to burning fat as your primary fuel. You can learn more about this approach to boosting your mitochondrial function in my book "Fat for Fuel."
One of the most common side effects of being a sugar-burner is you typically end up with insulin and leptin resistance, which is at the root of most chronic disease. To further boost your results, you may want to pair the ketogenic diet with intermittent fasting. Intermittent fasting is an effective strategy to shift your body from burning sugar to burning fat for energy. Some of the well-known benefits of a cyclical ketogenic diet are as follows:
While your body can use both sugar and fat as fuel sources, fat is preferred because it is a cleaner-burning, healthier fuel. Fat releases far fewer reactive oxygen species and secondary free radicals, thereby decreasing your risk of developing chronic inflammation throughout your body.
Constant hunger can cause you to consume more calories than your body can burn, which may lead to weight gain. By reducing carbohydrate consumption, the ketogenic diet can help suppress hunger symptoms. In one study, participants who were given a low-carb diet experienced reduced appetites, helping them more readily lose weight.8
Increased muscle mass
Ketones spare the oxidation and breakdown of leucine, which is a branched-chain amino acid used for building body mass. As a result, higher levels of leucine are left in your blood, ultimately improving muscle mass.
Lower risk of cancer
Unlike mitochondria that have the flexibility to burn either glucose or fat for energy, cancer cells thrive primarily on glucose. When you adopt a ketogenic diet and your body enters a state of nutritional ketosis, cancer cells are robbed of their primary source of fuel, eventually starving to death.
Reduced insulin levels
When your body burns glucose for fuel, it causes your blood sugar levels to rise, resulting in higher insulin levels. Over time, a constant spike in insulin levels may cause insulin resistance, consequentially increasing your risk of developing Type 2 diabetes. With a cyclical ketogenic diet, your body uses healthy fats for fuel instead of sugar, and fats do not negatively affect your blood sugar.
If you're trying to lose weight, a ketogenic diet is one of the best ways to do it, because it helps access your body fat so it can be shed. In one study, obese test subjects were given either a low-carb ketogenic diet or a low-fat diet. After 24 weeks, researchers noted the low-carb group lost more weight (9.4 kilograms) compared to the low-fat group (4.8 kilograms).9 In addition, HDL cholesterol was higher and triglycerides were lower in the low-carb group.
Getting Started With Ketogenic Meal Planning
As you will see below, the ketogenic diet is close to what could be considered an ideal way of eating for most people. In fact, I believe a cyclical ketogenic diet can be very beneficial for the vast majority of people, either alone or in combination with intermittent fasting and/or longer multiday water fasts.
The primary difference between someone struggling with a chronic disease such as cancer or epilepsy and people who have not yet been diagnosed with a chronic disease comes down to how strictly you must follow the diet and how long you have to maintain it.
As a general rule, if you are insulin-resistant, I recommend intermittent fasting along with a ketogenic-type diet for as long as it takes to resolve your insulin resistance. At that point, you can increase your number of meals. Regardless of whether you're intermittently fasting or not, the following food guidelines can be beneficial for you — especially if you're trying to shed unwanted weight. Start by:
- Avoiding processed foods, grains, refined sugar and processed fructose in excess of 15 grams per day
- Eating whole foods, ideally organic, and minimizing or completely eliminating processed foods
- Replacing grain carbohydrates with large amounts of organic vegetables, higher amounts of healthy fats and low-to-moderate amounts of high-quality protein
- Consuming 75 to 85 percent of your total diet in high-quality, healthy fats — saturated and monounsaturated fats from animal and tropical oil sources — including the following:
Animal-based omega-3 fat such as krill oil, and small fatty fish like anchovies and sardines
Butter made from raw grass fed organic milk
Cacao butter (raw)
Coconuts and coconut oil
Dairy (raw, grass fed)
Ghee, also known as clarified butter
Lard and tallow
Meat (grass fed, organic)
Nuts (raw), such as macadamia and pecans
Olives and olive oil (use cold)
Organic pastured egg yolks
Seeds like black sesame, cumin, hemp and pumpkin
Unheated organic nut oils
Wild Alaskan salmon
The Importance of Moderating Your Protein Intake
Most Americans eat far more protein than needed for optimal health. On average, your body requires about one-half gram of protein per pound of lean body mass, which translates to about 40 to 70 grams of protein a day for most people. If you aggressively exercise, are a competitive athlete or are pregnant, you may need up to 25 percent more protein than the average person.
The rationale behind limiting your protein is a significant consideration. When you consume excessive protein, it activates your mTOR (mammalian target of rapamycin) pathway, which can help you gain large muscle, but may also increase your risk of cancer. Furthermore, research suggests the mTOR gene is a significant regulator of aging,10 and suppressing this gene appears to be linked to longer life.
To determine whether you're getting too much protein, first calculate your lean body mass by subtracting your body fat percentage from 100. For example, if you have 20 percent body fat, you have 80 percent lean body mass. If you weigh 150 pounds, your lean mass would then be 120 pounds (150 X 0.8), and your protein requirement would be about 60 grams (120 X 0.5).
To calculate the amount of your daily protein from all sources, you might want to look at the USDA National Nutrient Database on each food to find out how much protein it contains. A 3- to 4-ounce serving of protein is about the size of a standard deck of playing cards.
Final Thoughts About the Top 40 and the Ketogenic Approach
Once again, the big news about this year's Top 40 Best Diets relates to the ketogenic diet being recognized for inclusion on the list. Considering there are literally hundreds of special diets and many fad diets, being noted among the Top 40 is a step in the right direction.
While certain characteristics can be universally ascribed to healthy eating — eliminating processed foods and sugar, for example — every diet will need to be adapted to your unique needs. In that sense, the "best" diet is one you can successfully adopt and sustain over time.
Despite its No. 40 ranking this year, based on my experience and the validation of numerous reputable health experts, I anticipate the ketogenic diet will continue to attract attention for years to come. There is no doubt in my mind that caring for your mitochondria and using fat as your primary fuel — two tenets of the ketogenic diet — will not only help you take control of your health, but also enable you to prevent and treat chronic illness and disease.