Paleo players recently celebrated research which found this diet (which includes fruits, vegetables, lean meats, fish, eggs, nuts and seeds and avoids grains, legumes and dairy products) the most healthy.
There is much excitement about the potential for specialist diets to answer many diverse problems from obesity and type 2 diabetes (now believed to be the two biggest costs to the NHS) and also mental health. There is fascinating evidence emerging that the keto diet, for example, may help treat serious mental health disorders. A new clinical trial by James Cook University in Australia is investigating how this diet can affect conditions such as bipolar disorder.
Fab or fad?
But can these diets ever be truly accessible, convenient, and affordable options for mainstream consumers?
Yes, according to Andy Welch, a ketogenic food pioneer who founded SRSLY Low Carb. This UK-based brand has since made its name online becoming the leading provider of low carb bread before extending its reach into rolls, pizza, wraps and condiments.
The keto diet has been the most searched-for diet on Google for the last four years, Welch told FoodNavigator’s recent Positive Nutrition Summit.
“We conducted also survey of 1,000 people in the UK which found that keto and low carb diets equal the same amount of followers at the moment for vegan, vegetarian and paleo,” he told the audience. “For me that was amazing and goes to show the popularity it's now seeing.”
So convincing are the links with weight loss, the NHS has introduced a low carb programme for people with, among other things, overweight or obesity, prediabetes, type 2 diabetes and high cholesterol. It also has a growing number of around 60 ketogenic dietitians working across a number of hospitals, revealed Welch.
The ketone diet works by restricting carbohydrate intake to provoke the body into producing ketones – an alternative fuel for the body that are made when glucose is in short supply.
Keto is often called a diet, but it's actually a metabolic state of ketosis, explained Amy Moring, the co-founder of Hunter & Gather, an ancestrally inspired real food and supplements brand whose products are free from refined sugar, seed oils or grains. She’s also a supporter of keto, paleo, and low carb lifestyles for health.
When in ketosis, the body burns stored fats for energy, instead of carbohydrates. A person following the keto diet, therefore, is hoping to burn unwanted fat, as opposed to carbohydrates, by pushing the body to rely on fat, not carbs, for energy. “You can come in and out of ketosis,” explained Moring. “The main reason I support it is because if you can get into ketosis in the first place you are less likely to be insulin resistant, obese, or have type 2 diabetes. These are major factors that are impacting the health of our nation now.”
The carnivore diet (which typically only includes animal-based nutrition), paleo diet, keto diet and intermitted fasting or the one meal a day (OMAD) diet, are closely linked in that they can all bring about a state of ketosis.
But there are challenges. For example, we don’t yet know the long-term health implications of adopting what are technically restrictive diets, argued Alvaro Cuesta, the CEO of Foodinthebox, Spain’s leader in the meal kit industry. He’s also CEO of the hyper-personalized nutrition platform Youniq Health.
The fact keto and low carb options “keep glucose under control has an incredible impact” he said. “The only issue with keto is that there are not enough long-term studies.” Kidney stones, for example, are a noted potential side effect of the ketogenic diet.
The long-term effects are going to be hard to measure thanks to trends such as ‘dirty keto’ – which is, for example, ordering a greasy burger and throwing away the bun.
Amanda Blanco, brand manager at Funky Fat Foods, which makes low carb keto chocolates, said the long-term impacts of specialist diets “will be difficult to research mostly because with keto, veganism and paleo, there are people who do it in a clean way and there are those who do in a dirty way. So how can you see that impact in the long run when it’s a grey area?”
The rise of ‘dirty keto’ may also dilute the health benefits of this way of eating and associated longevity, warned Moring.
Accessibility and convenience are other challenges. According to Moring, the role of brands is to be a gateway for mainstream consumers to enjoy the associated benefits of these specialist diets. "In an ideal world there wouldn't be packaged products for keto,” she said. “This comes probably as a shock from a brand that sells packaged products for keto… where packaged products come into it is that there will be people who cannot go from point A to Z in one jump.”
Most of us can’t, for example, balance giving up the traditional western diet, not eating white bread, cooking from scratch, all whilst going to work and bringing up kids. “By having brands that are educating and bringing easy swaps, our condiments might be the first point of something thinking ‘I can take that step and educate myself about what keto means' and it starts them on a journey. That's the role of brands.
“For example, we have expanded our range and reach for people who just want healthy options. A person doesn't necessarily have to be keto unless they have a medical reason to do so, but you can flex from keto to paleo to carnivore to just eating healthier. That's how brands can keep themselves from straying too niche and alienating new people trying a product.”
Welch agreed. "We did 100,000 orders in our first year without advertising and we have an 85% repeat purchase rate. 80% of our customers buy for weight loss and 50% buy to manage their diabetes. 90% of those customers do not strictly follow the diets we've discussed today. The reason our customers come back is for convenience. Our pizza bases have more protein in them than in a steak. There are no swaps: You can swap your bread for bread; you can swap your pizza for pizza; swap your pasta for pasta. That's how to attract customers for life.”
Too much dough?
The big challenge in the short term is the cost of ingredients to make commercial products, however. Welch’s particular bugbear, for example, are ‘hidden sugars’ in foods. "Highly processed carbs hit your stomach and turn to sugar straight away,” he said. “A standard loaf of bread could have 6% sugar but 50% carbohydrates. All of those carbs will turn into sugar when it hits your stomach.”
But removing them is more expensive, he admitted. “A good quality premium bread is £4, ours is £3.50. If we could make this understanding of the benefits of lower carbs then we could make this type of bread more ubiquitous and if bigger companies nab the idea, it would make it great for everybody.”