Who gave you the right to Keto Certify? An email thread.
KWe recently received an email from an angry Keto Diet consumer named Cindi who wanted to know who gave The Paleo Foundation the right to Keto Certify food products that was answered by The Paleo Foundation founder, Karen Pendergrass. The email thread begins like this:
“I’m not sure why you think you have the right to keto certify things or not, but when I see a product with cane sugar, and you have certified it, I will not believe another thing you certify. that is ridiculous. Who are you, and why do you think you can own the meaning of the word Keto?
Sincerely,
Cindi
3 years on a Keto Diet”
Not even mad at Cindi, because Cindi has a point. While the email thread began in a terse and contentious way, Cindi does ask a legitimate question to about cane sugar in our Keto Certified Standards. Further, it’s a legitimate question to ask who we are, and why we think we own the meaning of the word “Keto,” and who gave us the right to Keto Certify products. I’m glad Cindi emailed us today, because I definitely want to talk about this with concerned members of the community.
Hi Cindi,
While you’ve got this contentious thing going on with your message and are probably expecting some kind of irritated or snotty response from us, that’s not going to happen today because this is such an important discussion to have with concerned people in the community and I wish I could spend all day talking about it. Obviously you care enough to email, and to me that’s enough to respond in kind and with. Most people don’t care that much, and if there’s anything I hate it’s people that don’t have any fire which clearly you have. Also I’m like a walking cliche, because my name is Karen, and I have mad respect for the people out there trying to talk to the manager so hi, and let’s dig in.
To kick this off though, I have to tell you a bit about this organization (because context is everything).
So, we started certifying farms, ranches, and products as Paleo in January of 2010 before “Paleo” was even a blip on google radar. We were in it before it was the “cool” thing to do and like how you were in with keto before it was cool, and so were we as per usual. In fact, our Keto Certified Standards were first being developed late 2015, and the first product was Keto certified in 2016. We went through a million edits and pored over even more research before we landed on where the standards are at today. The research element there is important but let me get to that in a second.
Back to Paleo Diet back in 2010 though, it was clear early on that there were two warring camps of thought, one group that thought that there could be no such thing as a shelf-stable Paleo product, and the other that was all about 21st century shelf stable Paleo products and “paleoified” foods right. So if you zoom out a bit and look at it these two groups objectively, it’s evident there was a hard-line, yes or no, black and white dogmatic group whose ideology was that only whole foods could be Paleo, and the other group that was more practical and pragmatic and “everything is a shade of gray” in the approach saw things differently, and that even “paleofied” versions of foods had their place under the bigger “Paleo” umbrella.
Of note, the very black and white, yes or no, whole foods only approach works for some groups, but definitely not for others. And that’s where this all gets nuanced as hell.
As it turns out, both groups are ideologically right. For some, the more dogmatic, yes or no, hard-line “whole foods only” approach worked well, and adherence rate is great. In psychology these are typically referred to as “abstainors.” For the other group that see everything as a shade of gray, highly nuanced, and highly varied in their approach, having more “gray-area” foods in their diet is the best approach, and adherence is great. In psychology these are referred to as moderators. What has also been noted is that the abstainors and moderators think differently, eat differently, and if an abstainor tries to eat like a moderator, tolerability and adherence to the diet is very low, and vice versa.
These are actually incredibly important differences. One, different approaches to diet (moderator vs abstainor) are functions of personality, and important distinctions. Two, even the Randomized Control Studies (RCTs) are clear that for individuals who need a diet for medical necessity and aren’t doing it out of their own volition, tolerability is the most important factor involved. Which means, tolerability is of paramount importance no matter who you are, or what diet you’re on.
The 4 critical factors influencing tolerability according to the research are as follows:
Palatability — product variation, ideological acceptance
Availability — product offerings, location of products
Convenience- ease of identification, cultural and social acceptance
Affordability- socio-economic limitations, distribution limitations
(These are further elucidated in our Keto Certified Standards pdf, attached. This document will also give you detail into the credentials of the individuals who are involved in the development of the Keto Certified Standards)
Alright so let’s say you straight up asked us “what are the things that guide your standards here?” And I’d say tolerability, research, expert opinion, and community opinion. It’s written into our procedural policy for standards guidelines. (These are further elucidated in the Can Sugar Cane Juice be Certified Paleo pdf, attached).
Now on to the Keto Diet.
Like the Paleo Diet in the beginning, there are many groups with many ideologies. Some who take the black and white, abstainor approach which is by far the easiest and fastest, while there are others who take the “let’s read everything in existence to fully flesh this all out” because the nuance is vital to tolerability considerations. As you may have guessed since you’re getting full-on context here, I fall into the latter camp. Why? Because when you’re tasked with writing universal standards, it’s not going to be easy. No, you’re going to spend years refining and working out what’s true, what isn’t, what’s bad information, what’s dogmatic, what’s pragmatic — and you have to make considerations not just for one group but for everyone when you keto certify products. So, where does one even start?
Well, if it’s your one and only job in life to read and understand a diet, you’re going to sink deeply into the research first, and deal with the warring ideologies second. Besides, the warring sentiment will need to be fleshed out in a logical, classical argument platform anyway. So, what does the research say? For context, I’ve attached the Keto Diet Research Review where the Standards Team (I’m on the Standards team, btw, that’s why I’m answering your email) examined all 32 of the available published randomized controlled trials involving the Ketogenic Diet. It’s a great document anyway because it gives the snapshot summary of the outcomes from all of the studies dating back to the 1920’s when the diet was first developed, as well as its potential clinical utility in other disorders, as well as potential adverse effects of the keto diet (which, btw, we had to calculate for that too.)
What we found in the research (which is weighted heavily as you can imagine for standards development) is that none of the studies suggested the wholesale removal of any ingredients, but instead emphasized the approach more holistically by looking at the macronutrient content of the whole diet as opposed to singular items or ingredients. Nothing was off limits in a black-or-white, hard-line, yes or no, do not eat this ingredient or that — the classical ketogenic diet was developed simply using the context of an individuals daily intake, and used ketone bodies as diagnostic tools to determine the ketotic state. The classical ketogenic diet was developed focusing on the moderation of carbohydrate intake. Further iterations of the diet allowed for even more carbohydrate intake. In fact, you can even eat a carbohydrate-based diet and still maintain ketosis better than restricting your carbohydrate intake to less than 10%.
What’s great is that we have come a long way in the study of ketogenic diets and ketotic pathways. Which might make one wonder… exactly what has occurred in the world that has morphed the science and purpose and holistic approach of such a well-documented and well-studied diet into a narrative that suddenly suggests that the correct approach is so black-and-white, and not as practiced by those involved in developing the diet?
That’s an answer that’s is going to require a bit of psychology, and will require us to delve into a deeper understanding of the distinct differences in idealistic approaches of the abstainors vs moderators, as well as consider current ideological narratives that exist in the food blogosphere.
Black-and-white thinking patterns are excellent for quick down-and-dirty rules, and often filter out information for the purposes of expediency and simplification. It is absolutely understandable that these patterns have utility in the world. The world’s greatest leaders are those that can communicate information, and make judgments quickly. But of course there’s a catch to paring down of information and simplification, too. When the leaders aren’t encumbered by the challenges of communicating vast amounts of information offering as much nuance as possible, they run the risk of oversimplification. And in their oversimplification, there are grave inaccuracies and logical mistakes being made. The result? Others who operate in similar systems who prefer down-and-dirty simplified rules over getting into the weeds see these rules as just being rules, and not oversimplifications. If I can leave you with one thing, it’s that oversimplification, less information, and less nuance will fail at accuracy.
Personally, I am not well designed for oversimplification, arbitrary rules, or inaccurate narratives — and that’s a good thing for someone who is doing their best to keto certify products. Someone has to spend months straight examining research papers, and pulling together seemingly disparate information from other fields such as psychology. Let me give you an easier example. You know how everyone still thinks that Maltitol is not Keto? Because the standards team literally exists to research the crap out of everything, we discovered that the studies that some of the keto experts were using to base their conclusions on were totally flawed. I don’t mean kind of flawed, I mean totally flawed. We have a biostatistician on our team that does research methodology, and he completely ripped it apart.
But isn’t it interesting that the same bad information just permeates through the community? There are no checks and balances to that. Again, although this information can be spread quickly, and while that often has its utility like I said, it’s still wrong. Not sort of inaccurate, just wrong. It’s not the first time everyone was wrong before either because they didn’t pore over research. Not going to be the last time, either.
Here’s another example, too. Did you know that there are hundreds of articles published everywhere on the internet reporting that there is cross-reactivity to gluten in 19 foods that include coffee? This information is even published on doctor’s websites. For that reason, many people still take this as gospel, and we’ve had emails come from people who were outraged that we said otherwise who were also asking for our credentials because how dare we go against what [insert guru] said.
I get it. I totally get the outrage. After all, so many credible people are saying the same thing, surely their information was accurate? Surely we can assume that everyone who has reported this has looked at the research themselves and concluded the same thing, right? Wrong. If you google “19 gluten cross-reactive foods” you’ll still find that Dr. Perlmutter’s website still comes up as number one for that search listing those 19 foods. But number two on the google results page is a Paleo Foundation piece, showing the actual data sets point by point, busting the 19 gluten cross-reactive foods myth. Even the study author commented on the piece, commending us for actually looking at the data and not taking what [insert internet guru] said at face value without doing the due diligence in researching it ourselves. The fact that Dr. Perlmutter hasn’t taken it down or corrected his article just dumbfounds me. At least the other people we mentioned in the piece made updates after we published but come on. Where is respect for the truth here?
After we have a moment of silence for all of the people out there who are missing coffee in their life because of this misinformation, perhaps we can consider the implications of this kind of pervasive misinformation on an entire community. Perhaps we can consider the issue of not reading everything in existence or even simply taking a look at the actual study on a subject before we become set in our opinions. As mentioned before, the research should, and does, weigh heavily on our considerations. Nothing we’ve done was ever taken lightly, and after 10 years of seeing these things first-hand we know better than to assume that just because everyone says something that it’s right, or even well-researched by the authors.
But OK, back to your question of “Who do we think we are, who are we to own the word ‘keto’? Who gave us the right to keto certify anything?”
Man, that really is a great question. And to be honest, sometimes I really struggle with this myself. Personally, the imposter syndrome is real, and is often times debilitating, you know? While I may have a lot of information rattling around in my head, I don’t think I’ll ever be at the place in life where I can say to myself “Hey, you’re an expert!” and feel 100% confident. I think the reason for that is because there’s just so much information out there, and it’s like this thing that eats at me because I know I’m never going to know it all. I want to know it all, and I can’t. So yeah, I can surround myself with other researchers and experts in their own right, and I do take some amount of comfort knowing that they feel confident in their beliefs, but I don’t think I’ll ever get there. So here’s how I kind of pep talk myself through all of this. I think to myself, “Who is anyone to own it if they do not do their due diligence in understanding these complex topics?” You know? “Who is anyone to own if it they insist upon reducing things in such a way that nuance is lost, and there’s no meaningful way to have a real discussion around it?” And in that sense, even if it’s only that that’s getting me through, I do believe that I am doing this thing a justice and I’m meant to be here playing my part.
But you know who I think who really “owned” it like you said? The researchers who had been developing it since the early 1920s. You have to read that Ketogenic Diet RCTs Research Review paper that I sent, there are some details about the timeline for the development of the classical ketogenic diet and I think of all of the people, the credit goes to the pioneers. It’s partially why I was so interested in digging into their research and trying to understand the thought processes. It’s a shame that it had been lost for so long, only to resurface as this watered-down and at times completely insane talking piece. Like I hear some things sometimes and I’m just beside myself wondering how people have so much confidence and they’re totally making claims that have no basis in the literature at all. I wish I could be that confident, and I’m over here spending months reading textbooks and studies feeling worthless.
As for who gave us the right to keto certify? Well that’s another thing you’re right to question. I agree with you, that deserves a lot of question. Sometimes I wish that there was someone out there who could just make it easier on all of us here and just tell us what the right thing to do is, because figuring it out for the past 4 years was nothing short of a nightmare. So many chefs in the kitchen. So much to consider. Personally I had to just default to research and tolerability factors, but at the same time do this balancing act of thinking about the implications of these standards on so many people. Is it inclusive enough? Is it necessary? What about fiber? What about what this study shows is a pitfall? Which version of the ketogenic diet do we develop standards for? Do we make arbitrary rulings on specific ingredients without any evidence of that being necessary just to fall in line with popular opinion? Do we fall in to the trap of the current ideological paradigms or do we stick with the basics here? Will we lose our purpose if we do that? Will we offer unfair advantages to one product over another which may not be as good in the context of promoting ketosis if we make this decision? Is that fair? And of course, how much hate mail are we prepared to take over sticking to our principles?
I mean, the imposter syndrome is hard enough as it is. But like my mentor told me long ago, if it’s not me at the helm, who would I rather be there? Would I allow my discomfort of not knowing everything, chronically feeling like I’m not cut out for making such big decisions, to get the best of me? Should I do nothing? Keto certify nothing, just because I’m uncomfortable?
And that’s when I think to myself, imposter syndrome and all, tough and uncomfortable as it is, that I’m doing what I would want done. I’m sticking to my principles, and I have to be willing to take the hard questions and the angry emails and the discomfort of never feeling like there’s a right answer because I do have a part to play in all of this. I just have to remember why I’m here in the first place. But that’s an even longer, more personal story. And if you’ve gotten this far into reading this, you can imagine that if I got into the “why” of our existence, it’s expansive. Good times.
I know that was probably a bit more than you were expecting, but like I said this stuff is really important to me, and context is everything. Thanks for messaging us. If you ever want to more context about sugar itself though, just call next time. Too much typing 🙂
Karen Pendergrass
Paleo Foundation
Founder | Standards Team
