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June 21, 2018

If you have been following keto, you’ve probably heard about the documentary The Magic Pill. Many of you reading this now might have been introduced to the ketogenic diet by watching this very documentary. The Magic Pill was initially released in May of 2017, but has recently been added to Netflix, making it more readily available to a much larger audience. The documentary follows the lives of an indigenous tribe in Australia, families of autistic children, and individuals with many heath complications in addition to obesity as they learn how to make drastic changes to their diets by adopting the ketogenic way of eating.

Before watching this film, we were a bit skeptical as the media coverage surrounding the documentary made some pretty bold claims; “The Magic Pill, claims people suffering from illnesses such as diabetes, cancer and autism can reduce their symptoms and reliance on prescription drugs by adopting the diet for just five weeks” (Daily Mail,2017) as well as “Elements of the discussion are just plain hurtful, harmful and mean,” (Daily Telegraph, 2017). We really hoped they were not making these bold medical claims because 1) That is a very slippery slope to go down and general claims like that need to be supported with peer reviewed research and 2) No one other than a healthcare provider should give medical advice and they need to know a patients ENTIRE medical history as there are pre-existing medical conditions that can play into the whole picture.

The ketogenic diet gets a lot of bad press, and most times those attacking it confuse it with Atkins or the Paleolithic diet… which it is not. The Ketogenic community doesn’t need another documentary giving this way of eating a bad reputation, especially when there is actual peer-reviewed research out there that supports all the benefits of a well formulated ketogenic diet diet (see our research references at the bottom). So needless to say, we were cringing a bit as we pressed play to start the documentary. We were pleasantly surprised to see that one of the first scenes was a disclaimer: “While we emphasize the science behind the dietary advice, the personal stories portrayed in the film are anecdotal, and we make no claims that these experiences are typical. ALWAYS consult a doctor or healthcare professional before starting any diet”.

Now on to these anecdotal accounts. There were two obese women with several medical diseases/disorders such as type II diabetes mellitus, neuropathy, and others, there was a family with a daughter with autism that also suffered frequent severe seizers, a young boy with autism who was non-verbal, a woman with cancer, and a two week trial where an indigenous tribe in Australia (with a significantly high rate of diabetes) was educated on adapting their traditional way of eating and eliminating processed foods and sugary beverages. In the time the documentary followed these people, they reported drastic changes in their health for the better, decreases in body mass (for those that were overweight), and reduction/elimination of medications. While these accounts are not unheard of in the ketogenic community, it is important to note that EVERYONE is different and responds differently to diet changes. A healthcare provider should always be consulted before implementing a diet, especially in those that are acutely ill or have pre-existing medical conditions. This goes for the ketogenic diet or any other major dietary change someone may be considering.

These anecdotal accounts, we believe, are what drew the ire from the mainstream media. While many of us love a transformational story, in a documentary that was taking on some of the most accepted scientific and medical guidelines used today, there should have been a stronger emphasis on the research and science surrounding why these people had the success they did. Explanations of the metabolic process (ketosis), how to get into ketosis, how to formulate a well-balanced ketogenic diet, and its effects on the body and common disease processes would have been very helpful. Additionally, the inclusion of supporting peer-reviewed research would have helped to combat the negative and untrue comments that were made about this documentary.

Guidelines the Documentary Gave:

In the beginning of the documentary a few guidelines were given to the viewer. While these guidelines did not say they were necessary to live a ketogenic lifestyle, it was heavily implied. Here's what they recommended:

While most will agree that these are good guidelines to follow, they are not all required to live a ketogenic lifestyle and are definitely incomplete. “Eat whole foods” is a fantastic rule to live by. Whole foods provide essential vitamins and minerals your body needs to thrive. They are also great sources of nutrition with no hidden fillers. Many times, those on the ketogenic diet will indulge in pre-made and processed products that appear “keto” but really aren’t (and over consumption can cause stalls and kick you out of ketosis).

“Choose organic” is not always within everyone’s budget and, by making that a guideline, it may discourage some people from adopting a ketogenic lifestyle due to budget restrictions. In addition, there are many small local farms that may practice organic farming but who may not have the money available to pay for the organic certification. If it’s in your budget, we recommend shopping locally for your food when possible.

“Eliminate processed foods” is another guideline we can get behind. Processed foods have filler ingredients that aren’t necessarily keto, and at the very least appear keto in SMALL amounts (amounts that really no one would be satisfied with – see our previous article on understanding the nutritional label). These processed foods often lack the micronutrients you need and take up calories that you should instead be putting towards good sources of fats and protein.

“Eliminate grains and legumes” is a no brainer for those who have been following the ketogenic diet strictly. Almost all of the foods that fit into these categories are high in carbohydrates. So if you are following a diet that restricts carbohydrates to 20g net grams a day, you would be hard pressed to hit your additional macros if you have a serving of these foods in your day. The exception would be peanuts, which many in the ketogenic community believe are okay in moderation. As with all foods, some people will respond differently than others. This is where a ketone/blood glucose meter comes in handy (LINK). You can test how foods affect you and your ketone levels so that you can make informed decisions.

“Embrace healthy fats” is one of the MOST important pieces of the ketogenic diet. Fat is fuel on keto and it’s a concept that is very different then how we have all been raised to think. Fat does not make you fat, nor does is cause heart disease. These are common misconceptions that have been around since the 1950-60s. New research has proven these misconceptions to be just that, and have further looked at the health benefits of a high-fat-low-carb diet. The documentary does go on to emphasize that not all fats are equal, and getting the proper amount of fats in from good sources is something that the documentary did cover well. Examples, such as animal fats, coconut oil, olive oil, eggs, and avocados were just a few that were suggested.

“Avoid dairy, and if you must consume it, chose full fat and organic.” Actually, dairy consumed in moderation is not harmful to most people. We say “most” as some are more sensitive and even small amounts of dairy can cause inflammation, weight-loss stalls, and lower your ketones. We also feel the same about organic dairy as we do meat and produce. If it is within your budget there are benefits, but not choosing organic will not keep you from getting and staying in ketosis or reaping the benefits of the ketogenic lifestyle.

“Chose naturally raised, pastured animals and wild sustainably caught seafood was another guideline that feels a little too restrictive.” If it is within your budget, we encourage you to buy organic and local. But, not doing so will not affect your level of ketosis or diminish the benefits you can experience from following a healthy ketogenic diet. “Eating nose to tail and fermented foods” also plays into this same idea. While there are many benefits of organ meat, bone broths, and pickled foods some cannot get over the idea of consuming them. Not having them in your diet isn’t setting you up for failure… you just need to make sure you are getting those micronutrients elsewhere.

The last guideline was intermittent fasting. While fasting can be very beneficial for some, it is not safe for all. Those with certain pre-existing medical conditions may not be able to safely fast or may need to do so under medical supervision. And while a 16/8 (fast for 16 hours and feed during an 8 hour window) is one of the more popular intermittent fasting schedules, it is worth noting there are other options and sex, age, metabolism, and pre-existing medical conditions can have an effect on what works best for you personally.

 While we don’t mind the anecdotal accounts, we wish there was more science provided in this documentary. If you are trying to educate the masses and know that what you are saying contradicts generations of advice, from not only the government but healthcare organizations, then you need to provide some substantial peer-reviewed scientific research to support your standing. And believe us, there is an abundance of this research available. Although the documentary raises the professional misconduct/negligence trial of Dr. Tim Noakes (who was cleared of all charges after a trial where he presented thousands of pages worth of research to support the ketogenic diet and his recommendations of its use), we would have loved to see more of his research presented in the film, along with other reputable scientists and doctors. Even the investigative journalist Nina Teicholz made an appearance in the movie and spoke briefly about a few of the concepts she researched more in depth in her book “The Big Fat Surprise”. Again, we would have loved to hear more from her as well as the research she cites to support her statements.

We also believe the documentary missed the opportunity to better educate the viewer on the ketogenic diet, which was very vaguely described. The ketogenic diet is a high fat, low carbohydrate, moderately-low protein diet. Portions matter and so do calories, not only to successfully lose weight, but also to maintain weight or put weight on but remain in ketosis. There was no discussion of macros (macronutrients), tracking, or even much about the metabolic process of ketosis. While the documentary does briefly touch on good fats and things to avoid, they left much to the imagination.

 Conclusion:

The Magic Pill was still a good documentary despite some of the shortcomings we point out above. If nothing else, it started the conversation and planted the “keto” seed in people’s minds. It may push viewers to look at what they are eating and they might even do some additional research on their own.  So thank you Magic Pill, you brought more attention to the ketogenic community, and will probably reach people who had never heard of the ketogenic way of eating and its many health benefits.

Research Citations:
Dashti, H. M., Mathew, T. C., Hussein, T., Asfar, S. K., Behbahani, A., Khoursheed, M. A., … Al-Zaid, N. S. (2004). Long-term effects of a ketogenic diet in obese patients. Experimental & Clinical Cardiology, 9(3), 200–205.

Sharman, Matthew J., et al. “A Ketogenic Diet Favorably Affects Serum Biomarkers for Cardiovascular Disease in Normal-Weight Men.”The Journal of Nutrition, vol. 132, no. 7, 2002, pp. 1879–1885., doi:10.1093/jn/132.7.1879.

Volek, Jeff S., and Matthew J. Sharman. “Cardiovascular and Hormonal Aspects of Very-Low-Carbohydrate Ketogenic Diets.” Obesity Research, vol. 12, no. S11, 2004,
doi:10.1038/oby.2004.276.


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