The plot against Keto

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| By Dr. Ronald Hoffman

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The plot against Keto

I’m not susceptible to conspiracy theories, but this week’s confluence of anti-low-carb/Keto stories has me wondering. It’s a veritable torrent of orchestrated assaults!

First there was the “Keto crotch” campaign. Initially, I was going to pass up on damage control of this ludicrous story which asserts that ultra-low carb dieters acquire odiferous nether-parts.

Representative headlines included:

  • “‘Keto Crotch’—the unfortunate new side effect of the low-carb diet”—NY Post
  • “One Stinky Side Effect Of The Keto Diet Is Funky ‘Keto Crotch’ And Carbs Never Sounded And Smelled So Delicious”—BroBible
  • “’Keto crotch’: What the keto diet can do to women’s vaginal health”—Country 104 Radio
  • “Keto Could Lead to Funky Smells ‘Down There’”—First for Women
  • “Women complain about ‘keto crotch’ after switching to weight loss low-carb diet like Gwyneth Paltrow and Kim Kardashian”—UK Sun

You get the idea. Many of the stories are adorned with supposedly whimsical photos of women holding a fish over their privates or holding their noses. Body-shaming much? In the context of recent International Women’s Day, isn’t this a little reminiscent of long-discredited vaginal odor awareness campaigns to promote douche products (think Massengill, Vagisil) that destroy women’s natural microbiome with the goal of making things pristine?

But then I was alerted to something *fishy* about the media embrace of this storyline via the tweets of @johnzahorik, a self-described “n=1 nutrition explorer”. Zahorik noticed an interesting pattern in the viral dissemination of this unsubstantiated story. He sees the unmistakable fingerprints of a concerted campaign.

Within 8 days of the first release of this story, scores of media outlets—many aimed at health-conscious female audiences, but with marginal scientific bona fides—were jumping on the bandwagon. This suggests a pattern that is beyond organic, but rather, a concerted promotion leveraging influencers via press releases.

Since many sites amplify their market value via clicks—they appeal to advertisers on that basis—they love digital catnip. And, while definitive proof of “collusion” so far is lacking, it’s entirely conceivable that health writers were paid to disseminate the story. At the very least, opportunistic vegetarian nutritionists sought to raise their profiles by signing on.

So the question arises: Qui bono (Latin aphorism that means “Who benefits?”)? Women constitute a large tranche of the diet market, and Keto and low-carb diets have been taking a large bite out of the profits of Weight-Watchers, whose market value recently tanked.

Additionally, pasta makers and bread product manufacturers are feeling the pinch of grain-free nutrition messaging. Not to mention the beverage industry, which is on the verge of tobacco-style litigation.

Zahorik theorizes—admittedly without absolute “smoking gun” proof—that a big PR agency like Edelman PR has rolled out this ingenious campaign on behalf of its clients—which happen to include Barilla Pasta and Weight Watchers. Somewhere, a cabal of young savvy PR flacks is high-fiving each other for an alliterative, explosively viral roll-out.

FACT-CHECK: There are, of course, no scientific studies on whether a meat-based diet makes your booty smellier. Numerous gynecologists interviewed for this story report there’s no basis for believing that diet alters the vaginal ph, or does anything to promote or discourage the growth of vaginal flora responsible for normal genital scent. There’s evidence that some of this is under hormonal influence, as demonstrated by the fact that women’s odor varies according to the time of the month, suggesting it may act as an attractant to optimize fertility.

Notwithstanding, I did come across an unusual 2006 paper out of Czechoslovakia entitled “The Effect of Meat Consumption on Body Odor Attractiveness”. Researchers fed men diets rich in meat, then crossed them over to meat-free meals. After 14 days on each regimen, they placed cotton gauze pads under their arms and collected sweat. The odor-saturated pads were then presented to a panel of female smell-testers, who rated the samples for pleasantness, intensity, attractiveness, and masculinity.

The results were inconclusive, not reaching statistical significance, but the odors of non-meat eaters were rated as slightly pleasanter, less intense, and more attractive.

But whether this is consequential for “Keto Crotch” is unclear, since the study was done on the armpits of men!

But wait, there’s more.

Last week, readers were regaled with headlines like this: “Low-Carb Diet For Weight Loss Linked To Atrial Fibrillation” (Medical Daily).

On closer examination, this is based on a Chinese study. It’s lead author is quoted as saying:

“The long-term effect of carbohydrate restriction is still controversial, especially with regard to its influence on cardiovascular disease. Considering the potential influence on arrhythmia, our study suggests this popular weight control method should be recommended cautiously.”

But that is a ridiculous over-extrapolation, since the “low-carb” cohort in this large observational study, subject to recall bias and confounding, actually consumed, on average 44.8% of their calories as carbohydrates, which hardly constitutes a true low-carb or Keto diet.

What the complicit journalists didn’t highlight is that the supposed benefits of higher carb diets were meager—only 18% reduction in atrial fibrillation with moderate carb consumption. Oh, and the group consuming the most carbs experienced a 16% increase in their risk of atrial fib.

It’s likely that these “low-carb” Chinese subjects were simply consuming a bad diet—less high-fiber, polyphenol-rich vegetables and fruit and more meat and fat of dubious quality. Their food may have been more pro-inflammatory and bereft of key heart rate-regulating minerals like potassium and magnesium—known risk factors for cardiac arrhythmias.

This is certainly not representative of Western health-conscious low-carb dieters who studiously consume plenty of fiber and eschew junk, while accentuating healthy fats and grass-fed animal protein. Turns out the whole story is . . . a fib!

And that’s not all. A study was released last month that purports to show that a vegan meal provides more satiety and is “metabolically superior” to a meat sandwich. It all seems plausible until you read the fine print.

The meat group was served a pork sandwich chased by a sugary drink while the vegans got a veggie burger and unsweetened green tea. Talk about stacking the deck! Not surprisingly, the principal author is scientific director for the militantly vegan Physicians’ Committee for Responsible Medicine!

Finally, there’s this feeble attempt to impugn low-carb diets: “Trendy low-carb diets are fueling a rise in bloating” (Daily Mail Online). How this could be possible is inconceivable to me as a clinician who successfully deploys the low-carb diet precisely to alleviate reflux, bloating, gas, and GI urgency.

But then I see that the study is underwritten by breakfast cereal maker Kellogg’s—and, well, you get the picture!

Still think I’m being paranoid?

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