A new documentary featuring celebrity chef Pete Evans and the ketogenic diet for chronic diseases has recently been slammed by Dr Tony Bartone, President of the Australian Medical Association.

You can read an article on this here.

ASLM President, Dr Sam Manger, shares a few words in response to the story below.

“What a spicy conversation this is…pun intended.

To be annoyingly diplomatic, I can see where both Pete Evans and Dr Tony Bartone of the AMA are coming from.

Firstly, let’s be careful about media headlines and magic diets. Unless of course you want polarised, reductionist views which can be so common today, especially in the social media world. For a more universal approach and to paraphrase the author Michael Pollan, the human body is designed to process a wide variety of whole foods, not too much, and mostly plants.

If you examine Pollan’s timeless wisdom a little closer, you will see that he has just three recommendations:

1. ‘eat food’ (meaning whole food),
2. ‘not too much’, and
3. ‘mostly plants’.

Sadly, our food industry and society fails us miserably on all three counts, encouraging us to eat sugar and highly processed food-like substances, to eat much more than we need generally, and to also eat more meat and animal products than are good for us or the planet. This is where we need to start – promoting healthy eating – not specific diets.

Does the documentary promote healthy eating? To the extent that it helps people get off sugar and highly refined foods – yes. And to the extent that it promotes eating healthy fats – yes. But to the extent that it promotes going all-out on fats (swapping one excess for another if you like), or promotes the ketogenic diet as a one stop cure-all for everybody, then no.

There’s a lot of benefit to be had from reducing calorie intake for most people, and recently, good scientific evidence for very low calorie diets (VCLDs) in treating obesity and reversing early stage type 2 diabetes. Similarly, healthy fats are crucial, but they should mostly come from food sources (think walnuts and olives) not jars and bottles, and are not needed in excess, which I’m concerned people might think from watching the documentary. Which brings me to my second point.

We have some major problems in healthcare, including a dangerous storm of lifestyle-related chronic diseases, a reliance on medication to manage these (for example, around 50 per cent of those aged over 65 years are on five or more medications), and the good, caring and hard-working folk of the health system simply overwhelmed by this demand.

People want to come off medications, want to self-manage and improve their conditions, and want to stay healthy – this is to be applauded and needs to be encouraged. So I can well understand Pete’s passion in this area. But he also has a responsibility to be careful what he is saying, or more likely, what people ‘think he is saying’ by what is presented in the documentary.

Stories of cure from a diet are inspiring, but can also be misleading, may not be the right thing for everyone and can’t replace professional guidance. So let’s’ be wary of ‘magic pills’. This is where I agree with what the AMA is saying. Suggesting a ketogenic diet as a cure-all for conditions like autism or cancer is just not responsible.

Don’t get me wrong, we’re not knocking all that passion for the cause. I think most doctors and allied health practitioners share exactly the same passion. We are acutely aware of these problems and working hard for solutions, but we are also the ones who see the mistakes, the misunderstandings and the misinformation play out on people’s health.

We want to see more evidence-based lifestyle interventions in clinical practice and in the community, to get people off medication when it is effective and safe to do so, and to ensure all practitioners get training in Lifestyle Medicine. Fortunately, where we all agree, is that if there is to be a magic pill for all our ills, the closest things are quality nutrition, movement, sleep, mind states, meaningful connection and so on. Not to mention looking after our environment properly so that it in turn can look after us.

So whilst a ketogenic approach has some evidence for a few specific conditions under health professional supervision, it is one very small part of a much larger approach.”