Finally, official RCTs on Ketogenic diets.

The standard Kiwi or American diet is bad for you. I suggest you read the entire article, and take note of the risks. In particular, if you are on medications, monitor them. Pull out your blood sugar strips and prick your finger. Be prepared to go off medications. Discuss your diet with your doctor.

Byt stable weight in the healthy range, particularly for northern people, probably requires something like this.

From the Journal of the American Medical Association.

This summer, 25 overweight and obese adults participating in a tightly controlled feeding study will take up full-time residence for 3 months at a wooded lakefront center in Ashland, Massachusetts. However, before checking in at Framingham State University’s Warren Conference Center and Inn, they will have to lose 15% of their body weight on a calorie-restricted diet with home-delivered meals.

Those who pass this hurdle will be invited to the inn, where they’ll be randomly assigned to 1 of 3 equal-calorie diets: a low-fat, high-carbohydrate diet that’s either high or low in added sugar or a very low-carbohydrate, high-fat ketogenic diet that causes the body to switch from burning carbohydrates to burning fat.

The group will be the first of 5 that will participate in the trial over 3 years. Changes in body fat mass and energy expenditure will be assessed to determine if any of the diets have a unique effect on metabolism, while controlling calorie intake, in people who have already lost weight.

“It’s hard to lose weight, but it’s much harder to maintain that weight loss because of well-described physiological adaptations,” said coprincipal investigator David S. Ludwig, MD, PhD, a professor of pediatrics and nutrition at Harvard Medical School and Harvard T.H. Chan School of Public Health. After most diet-induced weight loss, “hunger goes up and metabolic rate goes down, and tendency to restore fat increases.”

But there are hints that the ketogenic diet may be different. A meta-analysis of 13 randomized controlled trials suggested that people on ketogenic diets tend to lose more weight and keep more of it off than people on low-fat diets. People placed on these diets often report decreased hunger, according to Amy Miskimon Goss, PhD, RD, an assistant professor at the University of Alabama at Birmingham (UAB) Nutrition Obesity Research Center. The appetite-suppressing powers of the diet aren’t fully understood but could have to do with the satiating properties of fat and protein, changes in appetite-regulating hormones on a low-carb diet, a direct hunger-reducing role of ketone bodies—the body’s main fuel source on the diet—or other factors.

Additionally, the ketogenic diet may not affect metabolism the same way other diets do. In a previous study, Ludwig found that metabolism slowed by more than 400 kcal/d on a low-fat diet while there was no significant decline in metabolic rate on a very low-carb diet.

In a Ketogenic diet, your carbohydrates are under 50 g a day (1 oz). In a strit keto diet, they are below 30g. There are tools to help you do this, and books that can help. But you really need to self monitor, and have some pretty frank discussions about your medications. And be prepared to cut things down slowly while monitoring.

And a lot of current diets suggested in the press and books are quite keto: for one reason. It works. It is how we both lost weight (paleo diets are functionally keto).