Dear Mark: Abandoning the Keto “Fad,” Ketone Study Calories, and Low-Lactose Fat

For today’s edition of Dear Mark, I’m answering three questions from readers. First, does the renewed vigor assailing the keto diet have me worried about my business? Should I start going vegan to cover all my bases? Second, did the “ketones for overtraining” study from last week control for calories? And third, how can a person eat enough fat if they’re avoiding lactose?

Let’s go:

Interested to see if Mark’s focus on keto will continue now that the trend factor is wearing off. That VICE piece, flawed though it may be, is part of a much larger media pushback against keto. What are the business implications of aligning yourself with a so-called “fad diet”?

I’ve built a pretty good business by aligning myself and my writing and my products with “fad diets.”

I generally use several factors to determine where to align myself and target my work:

  1. Personal experimentation. What am I trying? What kind of diet, exercise, and lifestyle modifications am I experimenting with? The quality of my work suffers if I’m not fully engaged on a personal level. I’m not a technical writer. I need to live my subject matter for it to come alive on the page.
  2. Personal needs. What works for me? What gets me going? What am I interested in, drawn toward on an intuitive level? What am I missing? Even my best products were designed with my own selfish desires in mind. I made Adaptogenic Calm because I needed a way to recover from excessive endurance training, and it turned out that tons of other athletes needed it, too. I made Primal Mayo because I was sick of whipping up a batch of homemade mayo every time I wanted tuna salad without all the soybean oil. I went keto because the research fascinated me. It turns out that the things I vibe with tend to resonate with others, too. Humans are often quite similar to each other. Not all of them, but there are enough that are.
  3. Your needs. What does my audience want? What do they need? What kinds of questions are they asking me? What feedback am I getting from them? How are they responding to what I’m putting out?
  4. New information. I’m always ready to pivot when new information is made available or when new research arises. Sometimes a reader will point something out and it will change the trajectory of my thinking and writing. I try not to wed myself to my ideas, to the things I want to be true, even though that’s a human foible that’s unavoidable. I always try to approach a subject in as intellectually honest a manner as I can. To me, new developments, even if they appear to contradict a stance I hold, breathe new life into my work. For example, I’m definitely biased toward lower-carb approaches for most people. They just clearly work better for the bulk of the people who encounter my work and who struggle with their health and weight in modern industrialized countries. Most people don’t perform enough physical activity to warrant perpetual “high-carb” diets, and most people find weight loss is easier and hunger lower on lower-carb, higher protein/fat diets. But at the same time, there’s room for higher-carb intakes, or even moderate-carb intakes. And can people eat high-carb and be healthy? Have populations lived well on high-carb diets? Absolutely.

Keto still satisfies these factors. Now, I’m always looking toward the horizon; I think my ancestors were probably explorers of some sort. It’s in my blood. So I probably will write about something else—next week, next month, and years from now. But my overall “thrust” will still be low-carb/Primal/keto because, well, the stuff just works.

What I wonder after reading this is: Would there have been a significant inter-group difference had calories been controlled for? Ketone esters obviously have some caloric value that the control group did not receive. How much of the benefit is merely having a better caloric intake to support this intense training protocol?

Good question—this is in regards to the study discussed last week. They actually did control for calories. The experimental group got the ketone ester drink. The control group got an isocaloric medium-chain triglyceride-based drink. Both groups consumed the same amount of calories.

Having tracked through to Michael Eades’ blog on cholesterol—how do you increase fat when you are lactose intolerant? A problem for myself and my adult children. I hadn’t realized that high fat was the actual content rather than the percentage!

Oh, man, there are so many ways to increase fat while lactose intolerant.

My favorite way is to focus on whole food sources of fat, rather than isolated fat sources:

  • Fatty animal foods: a ribeye, a beef shank, some ground beef. A lamb shank, some lamb chops. Bacon, eggs, sausage.
  • Fatty plants: olives, coconut, nuts (favoring higher MUFA nuts like macadamias), dark chocolate. Salads, which aren’t “fatty” without the dressing and meat but I’m counting as “whole foods” because that’s the effect of eating them.
  • Whole avocados: great source of potassium, fiber (if you want that), and polyphenols.

Foods like my Primal Mayo or avocado oil dressings, while technically “isolated” or “refined,” allow and promote the consumption of nutrient-dense whole foods like tuna (tuna salad), eggs (deviled eggs, egg salad), cruciferous veggies (slaws), and steaks (try searing a steak covered in mayo). And even our mayo isn’t nutritionally bereft—it contains choline, folate, and all the other good stuff found in eggs. And our dressings are full of spices and herbs that confer health effects through their phytonutrients.

Also, don’t think you have to focus on “increasing fat.” That’s the mindset that leads to things like chugging olive oil and eating a bowlful of sour cream. High level athletes who need calories at any cost can get away with and even benefit from that, but for most people it makes more sense to focus on reducing excess carbohydrates and eating whole-food sources of fat as they appear naturally.

Also, the lactose intolerant can still have dairy. Try hard cheeses, Greek yogurt, and yogurt and kefir that’s clearly marked “low” or “no lactose.” Butter is fine in all but the most severe cases, and cream is not far off from butter. Ghee is another good cooking fat that should be near zero in lactose.

Anyone else have good “lactose-free” fat sources? Anyone else worried about “keto as a fad”?

Thanks for reading, everyone. Take care!

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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22 thoughts on “Dear Mark: Abandoning the Keto “Fad,” Ketone Study Calories, and Low-Lactose Fat”

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  1. If you are used to deep frying in vegetable oils, switch to lard or tallow. Yum! McDonalds used beef in their french fries for years which is why people liked them so well.

  2. Thank you so much for getting back to Dear Mark! It’s my absolute favourite of your posts!

    Great questions and feedback, and love how you address your alignment with the ’keto fad diet’

    For a future Dear Mark just wondering if there are any supplements I could take to help my body cope with the overall stress of smoke and poor air quality. I’m in Australia and it’s taking its toll, any suggestions would be great. I’m out of the acute region of the fire and safe thankfully, but both the psychological stress and physical wear is adding up.

    Cheers Pete

    1. Hi Pete, Sulforaphane found in broccoli sprouts (you can grow your own) has been shown in some studies to increase secretion of certain air pollutants and decrease inflammation caused by those pollutants. Hope that helps!

    2. The classic solution for pollution is seaweeds and algaes. Sun chlorella is probably the best known. Watch out for Spirulina, it has some great attributes but the burps can be foul. Chlorella is much more neutral.

      You can also help your liver to function better by eating liver, taking choline (fi it makes a difference when you take some), and using a sauna when the opportunity arises.

  3. Hi Mark, “The Definitive Guide to Blood Sugar” appears to have gone missing.

  4. Mark
    Many of your food products have avocado. I , like others with latex allergy, can not eat avocado. Have you considered expanding your product line to offer avocado-free versions?
    Thanks for your blog

    1. I’d love some suggestions too! My three kids are all latex intolerant as well.

      Love this round up Mark thanks.

  5. Thank you Mark! Your willingness to pivot, selfishly make your life easier and to be an N=1 are reasons you have been a guide on my journey to healthy longevity. That and the MAYO is life changing.

    Tuna with PK Mayo and PK Ginger and sesame dressing is on the menu for lunch.

    You and your amazing team are AWESOME!!!

  6. It boggles me that with the huge body of research into keto dieting for decades that it is still being referred to as a “fad diet.” I am troubled by the huge glut of branded “keto” products hitting the market (as well as the masses of not-so-discerning consumers embracing them) that are, as I like to call it, KINO (keto in name only.)

    Mark’s approach with the huge amounts of veggies and high quality fats and proteins is the most nutrient dense, delicious, and healthy approach to keto I’ve seen yet! And, as evidenced by him, myself, and scores of people here, it is sustainable as a very healthful lifestyle.

    Thanks for the continued information and inspiration Mark!

    1. We definitely saw Peak Keto in 2019, with all those products. Once they started hitting the discount bin / stores en masse I knew it was on its way out of the mainstream fad.

  7. I wouldn’t consider keto a fad diet per se. Medically, it’s been around for a hundred years and also happens to be the best weight loss diet out there. It has been labeled a “fad” by so-called experts who, themselves, don’t have the willpower or desire to eat a healthful diet, and who consider sweets and grain products essential food groups.

    That said, people who don’t need to lose weight and/or don’t have any health concerns would likely do just as well on the less restrictive Primal (Paleo) way of eating. Keto isn’t always necessary. It becomes a fad when people who don’t really need it think it’s the only way to maintain optimal health.

  8. If you’re lactose intolerant, try using products made with A2 milk, perhaps? A2 milk is becoming easier to buy at supermarkets. French butter is a good choice for A2 butter as well.

    1. Be careful with French butter. The coop in Santa Monica has French butter with a European-looking yellow paper wrapper. If you read the ingredients, it actually has a small percentage of cream and the rest is trans fat (shortening)! I alerted the management over two years ago but they still carry it.

      Also, I asked Trader Joe’s head office if their French butter in the blue and yellow wrapper is from A2 cows and they said no.

    2. A2 vs A1 has nothing to do with lactose intolerance. Lactose is the milk sugar, all milk has it. A2 and A1 contain different types of casein (milk protein), which can cause inflammation (more for some people than others), and A2 can help people who have sensitivity to A1 casein.

  9. I’ve hesitated about doing Keto, based on my doctor stating I don’t process fats well, and should therefore be on a low-fat diet. This is apparently why I didn’t do well on a Paleo diet – I gained weight. I need to loose 40 pounds. Is it still possible to go on the Keto Diet, given my “fat processing issue”?

    1. Yes, take ox bile with meals as you slowly increase your fats. Your body will eventually start making more lipase to break down the fats itself. It’s the low-fat intake, for years, that’s made it so you can’t digest fats well anymore. Low-fat diet is not the answer, it’s the problem.

  10. I’m interested in the fact that keto works really well for some very specific issues–MS, epilepsy, and short term weight loss, among others. I remain unconvinced that it’s good for everyone, indefinely, and for me personally the “diet-like” construct of constantly counting and monitoring just doesn’t work. Bores the heck out of me, and I tend to drift off, as I’ve done for every diet UNTIL Primal Blueprint. That’s why I’ve loved Paleo/Primal all these years, and why I glaze over with too much keto this and that. I dug The Primal Blueprint and The Primal Connection back out for inspiration this month!

    1. Hi Kate! I, too, have not got the mindset for this counting and monitoring nonsense! The keto folks that talk incessantly about their “macros” turn me right off.
      However, I LOVE the approach of limiting your diet to fresh meats and aboveground vegetables. Even if you don’t care one iota about “keto” anything, it is relatively obvious that this is the most nutrient-dense diet you can have (i.e., most vitamins, minerals, polywhatsits, etc. per calorie). It is simple and straightforward, and, though it took me a while to adapt, with plenty of periods of backsliding in the past, it works very well for me. I think a general meat & aboveground veg diet, with occasional forays into more standard primal diet, with some starchy veg and fruit, is much more like what our bodies are made to handle.

  11. I’m guessing that I”m somewhat sensitive to casein. I seem to react much less to things like goat butter. It might be an A1/A2 thing. So if casein is the problem and the person knows that then, it’s a straight up milk allergy and they shouldn’t even bother with low lactose.

    But, for naturally high fat foods…

    I like to make coconut pudding. Made just like rice pudding, except you use shredded coconut and coconut milk, then flavor as you like. I made it first as a sub for oatmeal. Works very well.

    There are a few tips and tricks, like if you toast the shredded coconut a tiny bit first, the flavor is better. And watch out for scorching. There’s no easy way to make it, you just have to keep stirring. Let it simmer longer than you think you need to, the coconut bits need time to cook through and soften.

    It doesn’t even need a recipe, with a moment’s experimentation you’ll get the hang of it.

  12. Lactose in cheese: Just look at the nutritional breakdown listed on the label. 0 grams (careful, not the % value) of carbohydrates means there is less than 0.5 grams of lactose. Basically, lactose free.

  13. I am confused by the comment on “low-lactose fat”… Huh? Where is the high-lactose fat?? Are they perhaps talking about butter? (It’s the only fat I can think of with ANY lactose at all, though it does not have much…) You can always try using coconut oil on anything you used butter on. It is delicious on vegetables, and better for cooking than butter.