This thread is an example of how we do a disservice to the community by defining a “keto” diet based on carb count instead of based on the state of ketosis. Keto isnt a WOE, it’s a physiological state.
My sister is a vegetarian. She probably averages about 75-100g of carbs. Her blood ketones are typically 0.6-0.8 mmol.
My mother aims for a macro of 50% fat, 35% protein, 15% carb. Her ketones are 0-0.6, depending on wine consumption.
My dad can maintain ketones levels of 0.6-1.2 via IF.
I am the most metabolically deranged member of my immediate family. I can eat anything I want so long as I fast two days before and after, my ketones will stay above 2.
I would classify my family as being on a keto diet, even though all of us consume more than 20g of carbs. So if keto is a result rather than a diet, what’s not working? I can think of 3 problems:
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Poor food quality. A keto diet tends to emphasize macros. A paleo diet emphasizes food quality. This is better than a diet heavy in processed meats, fat bombs with artificial sweeteners, factory dairy, and other low quality “keto” foods. A paleo diet can easily be ketogenic when defined as maintaining a state of ketosis.
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Nutrient deficiencies or subpar gut biome. Could be vitamin, mineral, or fiber as a result of insufficient vegetable intake. What’s optimal is very individualized.
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Problem with ketosis. Could be caused from poor utilization of dietary fuel sources. Inadequate de novo glucose synthesis or insufficient mobilization of fatty acids.
Many LC healthcare practitioners (like Dr Perlmutter,
Dr Mercola, Dr Wahls) advocate a well formulated diet that is essentially a Paleo diet that results in a state of ketosis at least some or all of the time.