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(Lest low-carb advocates think that I am anti-low-carb, I’d like to reiterate that both the research and my clinical experience suggest that low-carb diets can be incredibly effective therapeutic tools for certain conditions.

In these circles low-carb diets have become dogma (i.e.

a principle or set of principles laid down by an authority as incontrovertibly true).

I recall an 84 year-old woman who came to see me complaining of dementia and early-onset Alzheimer’s.

She was losing her memory and cognitive abilities at an alarming rate.

Yet as impressive as very low-carb (VLC) and ketogenic diets can be in certain situations, that does not mean that these diets may not have some undesirable side effects over the long term—some of which we’re only beginning to understand.

For example, as I discussed with Jeff Leach from the American Gut project in a recent podcast, some preliminary research suggests that long-term ketogenic/VLC diets may cause adverse changes to the gut microbiota.

If you talk to practicing clinicians who work with patients on a daily basis, or spend any amount of time in internet forums or the comments sections of nutrition blogs, you’ll find numerous reports from people who either experienced no benefit from or were even harmed by following a low-carb diet.

What blows my mind is that the “low-carb zealots” seem completely incapable of accepting these reports at face value.

What’s more, contrary to popular claims, studies have shown that it’s unlikely the Inuit spent much time—if any—in nutritional ketosis.

Their high protein intake would have prevented ketosis from occurring.

After just two weeks on a ketogenic diet, this progression not only halted, it reversed: her memory returned, her mind was sharper, and she was far less confused and disoriented.