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[quote=Anonymous]https://www.vox.com/science-and-health/2018/2/21/16965122/keto-diet-reset

[i]This might sound great, but what’s often lost in all the boosterism is that this is still just a hypothesis. And most studies of ketogenic and other very low-carb diets suggest they don’t actually outperform other kinds of diets in the long run when it comes to weight loss.

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[i]When you look at head-to-head studies comparing low-carb diets to other kinds of diets, weight loss on a very low-carb diet can be a little more dramatic in the short term, but by the one-year mark, all diets perform equally miserably.

This seminal randomized trial, published in JAMA in 2007, involved 300 women and measured their weight loss on the Atkins diet compared to the Zone, Learn, and Ornish diets. The researchers found that while women on Atkins shed a few more pounds, the weight loss on low-carb diets was “likely to be at least as large as for any other dietary pattern” and “the magnitude of weight loss [on Atkins] was modest, with a mean 12-month weight loss of only 4.7 kg.” In other words, Atkins wasn’t meaningfully better than the other diets.
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Other big studies comparing popular diets of different macronutrient compositions, like the one I mentioned above, consistently suggest that the very low-carb approach isn’t a sustainable solution for weight loss. A review of the research on weight loss for different types of diets, published in the Lancet in 2015, found that people on low-carb diets lost 1 kilogram of additional weight after one year compared to people on low-fat diets — again, a marginal difference.

Still, in the short term, low-carb diets like keto can sometimes help people lose more weight because they cause rapid water loss, which gives people the impression they’ve lost fat. “This happens because low-carbohydrate diets deplete stored glycogen, and glycogen binds large amounts of water,” explained obesity researcher Stephan Guyenet.

[i]Another reason very low-carb diets seem to help with weight loss initially is that there’s some evidence they’re effective for appetite control, “so most people actually eat fewer calories than they would on most other diets,” said Guyenet, adding: “The evidence supporting this isn’t great right now, but that seems to be where it’s going.”

But again, these benefits seem to disappear in the long run, probably because very low-carb diets — like many other fad diets — are hard to stick to. In our food environment, it’s extremely difficult to avoid eating foods like bread, cookies, or pasta for months on end. As Guyenet wrote on his blog:

The more extreme a diet, the harder it is to adhere to, and the ketogenic diet is extreme. “But wait”, you say, “I’ve been on the ketogenic diet for five years and it’s easy!” That may be true, but randomized controlled trials don’t lie. The average person can’t even stick with the diet for six months, as judged by urinary ketone levels. The minority of people who find it easy, get good results, and stick with it are the ones who write about it on the Internet.
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