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The ketogenic diet (in earlier iterations known as the Atkins diet and the Low Carb High Fat diet) has been vilified for decades by members of the nutrition establishment, because it is pretty much telling people to do the exact opposite of what the establishment is telling them to do. While official diet guidelines recommend cutting down on fat intake, the ketogenic diet instead recommends cutting down on carbohydrate intake. Since cutting down on one of the sources of energy virtually requires increasing intake of the other, the two diets are completely incompatible.
The reason proponents of a low fat diet are so against the ketogenic diet is because they believe that fat, and in particular saturated fat, causes heart disease. But this belief has become increasingly hard to maintain over the last couple of decades. In spite of the fact that populations around the world have been dutifully following advice from nutritionists to cut down on fat intake, they've actually gotten fatter and more diabetic. The prevalence of metabolic syndrome (a combination of central obesity, type 2 diabetes, and high blood pressure) has exploded since governments started recommending that people cut down on fat. And metabolic syndrome is one of the leading risk factors for heart disease.
This suggests that the nutrition establishment has got everything terribly wrong.
It suggests that it's a high intake of carbohydrates that is responsible for the current poor metabolic health of western populations, rather than a high fat/saturated fat intake. Of course, the data suggesting this is all observational, and observational data can show correlation, but they cannot prove causation.
So, let's look at what the randomized controlled trials of the ketogenic diet have to say on the matter. A
systematic review and meta-analysis was published in Nutrients in July 2020 that gathered together all the trials of a ketogenic diet. The review was funded by the South Korean government.
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