The Keto Konundrum: If this diet is so great, why isn’t everyone doing it?
Undiscovered country. That’s what I’d walked into. The woods ended with me standing at the vertex of a ‘V’ formed by the treeline, opening onto a meadow shrouded by mist. Untouched, dew-topped green beneath phantasmic gray and white.
I’d been walking for some hours already, but I didn’t feel the weight of my pack. Only the cool. And the quiet.
I saw a deer feeding in the meadow, so I paused, awestruck by the scene right before me and the backdrop of rolling hills.
I had to get to the next ammo box — and soon. So I eventually started moving again. But the purely sublime sensation stuck with me for the remainder of “the evolution.” 
I’d find out only many years later that this feeling is called being present.
Keto can help you be present, fight “brain fog,” and gain improved mental health according to some studies. That “sublime sensation” I refer to above is a kind of high that I have come to relish. Those who consistently meditate come to know it well, even if it may not always arrive. The keto diet can take these sensations further through organic production of what otherwise would be illicit drugs.
To recap, people on keto often feel better emotionally and think more clearly. Sounds like a win-win. Is there really no downside?
You don’t climb hills in Florida. It’s flat after all. A giant sand bar exposed amidst the slack tide of millennia.
Hills are so foreign to Floridians that kids there can be forgiven for mistaking landfills for “Look, Mom! — mountains!” 
But the SEAL-training land navigation exercise I mentioned above was in large part about this strange phenomenon that I was now getting used to (out of pure necessity): trudging up towering domes of earth.
Getting into keto can be like climbing a hill when you’re not used to doing so. Like you’re a skinny Florida kid who’s never seen a legit hill and happens to be carrying 10 quarts of water, a dozen Powerbars, and a clunky World War II-era radio inside a Vietnam-era rucksack. 
The keto flu is a real thing, sometimes lasting three days. You feel fatigued but are just too tired to figure out why. You’re nauseous. In an ironic twist, you might be hangry at the same time. The half-keto monster is like a lycan transforming into beast mode in those Kate Beckinsale movies.
You are not to be trifled with.
Despite having to go through this gremlin phase, ghrelin is at your service. The keto diet has a complex relationship with the so-called “hunger hormone” and its twisted sister leptin, “the satiety hormone.” The science here is super interesting but also complex. So here are the main takeaways:
- Keto helps you feel satisfied even when you eat less. According to the study linked above, there is reason to believe that this is because the “I’m full” signal that the brain receives from leptin is enhanced when inflammation is reduced. Keto has been widely shown to decrease inflammation.
So, Q. E. D.
- The crazy thing is that it appears that keto elevates ghrelin levels, signaling “I’m hungry” even while you feel satisfied. 🤯 Some argue that it is the increased ghrelin that is the primary agent helping you focus on the work at hand while on keto. (The productive impulse from this hunger in the colloquial sense is what I refer to in my most popular article on Medium.)
✅ Okay, so…, high energy and focused? Check.
✅ Losing weight by feeling full sooner? Check.
✅ Not hangry anymore, ‘cause you’re past the lycan transformation? Check.
If you haven’t tried keto yet yourself, by now you’ve at least had that friend in your drum circle try to sell you on how keto solves everything. And you’ve seen a post or two telling you how many benefits of the keto diet are actually fairly well substantiated. So why are you still skeptical about keto?
The concerns people have about keto boil down to the following :
- Diet fatigue: “It’s another fad diet.”
- Yo-yo fears: Keto opponents often cite reports of keto dieters who regain all of the weight they lost once they resume a normal diet. But this is true of all diets, isn’t it? Caloric restriction is the main source of diet gains. While the leptin hack noted above in this post achieves a decrease in calories through indirect methods (resulting in what I call “keto magic”), the causal mechanism of weight reduction is the same as other successful diets. Therefore, if a person’s relationship with food does not change, she will always regain the weight.
- Brainwashing and societal inertia: A majority of adults lived through a period of intense fear of cholesterol and fat, especially the saturated kind. We generated all kinds of unhealthy solutions to “save” ourselves such as increased consumption of starchy carbs, sweet fruits, and sugary but low-fat(!) desserts. Instead of focusing on understanding the damaging effects of carbohydrate metabolism and how cardiovascular disease actually works, science delivered marvels such as trans fats, which are now more or less banned worldwide because they kill us. The medical community is made up of humans, too, mostly older ones who have sworn an oath to do not harm. This highly influential group has especially slow to accept that there are, at a minimum, reasonable arguments in favor of the keto diet.
- Lack of willpower: Some people happen to know they lack willpower, while a small few actually have it. The rest lie to themselves. Good luck climbing the keto hill again after that “break” or “cheat day.”
- “Gains, bruh!”: Dudes (and some women) want to gain muscle mass, and many fear they cannot do so on keto due to various factors such as increased satiety (lower calories), decreased performance under load due to glycogen depletion, and reduced protein uptake post-workout in the absence of carbs. While there is some evidence to support these claims, the ketogains subreddit has just as much evidence to contradict them. For what it’s worth, this author and some he knows have also had success making gains on keto. Broscience is all over the place when it comes to this topic, so beware.
- Time: Staying on the keto diet takes time. As just one example, preparing chicken or a roast is harder and takes longer than boiling some pasta.
- Expense: Meat, fats, and leafy greens cost a ton more than bread, rice, and potatoes, which are called “staples” for a reason. And if you eat organic, there is some evidence that you’ll pay an even higher markup on meat, eggs, and butter than on produce.
- That focus has a cost (and the cost is upfront focus!): Adhering to the keto diet requires commitment and focus that extends beyond the control of choice and portion size that are common to all diets. You need to closely track carbs to ensure you are under the prescribed amount. Wait, check that, you need to do a calculation of “net carbs” (total carbs minus dietary fiber). And you probably need to test your urine every day (maybe even compulsively) to ensure you are truly in ketosis. While apps like Under Armour’s MyFitnessPal can help, I’ve never witnessed someone be casually on keto for very long.
- Keto breath: Is keto breath a real thing for some people? Sure. But it’s not a real reason to not go on keto. It’s solvable. Then again, it sounds gross, so it may function as a kind of adder to whatever the real reason is (“…oh yeah, and keto breath.”).
- Fatty liver: One particularly entertaining and informative guest on the Tim Ferriss Show, Art de Vany, was emphatic that high-fat diets (specifically including keto) lead to fatty-liver disease. The comment thread in Tim’s episode notes includes several references to scientific studies, several of which challenge Mr. de Vany’s view.  If we assume for the sake of argument that the real answer is not yet known, fatty liver does sound like a pretty big risk.
- Cancer: The “Warburg effect” is the idea that sugar feeds cancer. So hypothetically cutting sugar, which the keto diet does, should help. However, Dr. Siddartha Mukherjee, author of the bestselling cancer book The Emperor of All Maladies, has found a mixed relationship between keto and this Caesar of Sickness. To be clear, the effect is not “not clear’; rather, keto really helps for some types of cancer but actually accelerates(!) tumor growth for others (e.g. leukemia).
Despite the headwinds for ketogenic evangelists listed above, it is surprising that more “average people” have not gotten onboard the keto bus. The effects on weight, body composition, and mental state/cognitive ability are real enough as referenced previously. This author has had an experience that is solidly consistent with such claims.
So if a godlike physique and mental edge are within reach, then why isn’t everyone in our society embracing this trend? In a society that so easily mortgages our individual and collective futures for short-term gain, the risk aversion and long-term thinking at play are confusing.
Maybe it’s only a matter of time before there’s olive puree in the babyfood aisle, before tiger moms (and dads) are making bulletproof coffee for their kids, and before catered lunch includes bone marrow. Maybe we’ll pump our terrorism analysts full of olive oil and our pilots full of MCTs.
Instead of The Purge, society will take one day a year to cheat on their diets. We’ll enter a societal mental fog and miss the doors of perception.
Before climbing back up the hill. Together.
All the way wet (aka the footnotes)
This post intentionally does not address how successful ketogenic diets are for treating specific medical conditions such as pediatric epilepsy and type-2 diabetes. Meanwhile, obesity is an area where the pros seem to massively outweigh the cons, so it’s crazy to this author that keto is not first-line therapy.
 “All the way wet”: Something an instructor might say to students at Basic Underwater Demolition/SEAL training.
 “Evolution”: (a) Navy speak for a meticulously planned period of training. (b) Colloquial (SEAL dialect): An event that is definitely going to suck.
 Even the sand dunes are pathetic. The below photo is sooo not Florida:
 Yes, Powerbars are disgusting. I say “are” because according to at least one forum they’re back on the market. That same forum contains priceless gems like these:
From user “Arch Stanton” (is that a real name or a joke I don’t get?):
There is not a lot of mystery about this. With all the construction around the country, there has been a demand for a strong and durable material to fill potholes. The result has been a severe shortage of Powerbars. That does not even take into account the military’s huge demand for cold weather armor plating.
Honestly, if I want to eat a handful of dirt, I just go out to my garden.
 See this link from the Indian publication livemint for more, though not all of the reasons contained herein are derived from that source. Interestingly, this author discovered that the livemint article contains a similar subheading to the title of this Medium post. Great minds :)
 I am intentionally not including those citations here, as those links won’t be helpful without the context of the comments themselves.
About the author: Sri hosts The Warrior Poet podcast, a show on the philosophy of leadership based on his experience in the SEAL Teams, at Harvard Business School, on Wall Street, and in tech. Shows every Monday. Follow him on Instagram @sri_the_warrior_poet and @sri_actually.