From 2017 until about July of 2024, I ate strict keto. Not keto-ish. Not "low carb on weekdays." Strict, tracked, in-ketosis keto, for the better part of a decade.

So when someone asks me whether keto is still worth it, I'm not answering from the sidelines.

Here's the honest version of what changed, what the research looks like now and where I've landed.

What changed for me

It wasn't some dramatic breakup, it was serious strength training.

When I started training more and preparing to compete, carbs came back into the plan more fully and that's what started shifting my thinking. While I was still low carb, I started using carbs more strategically to fuel my training and help with recovery.

If you read my carbs and training email a few weeks ago, this part will sound familiar. A meta-analysis in Sports Medicine found carbs before lifting mostly helped when sessions ran longer than 45 minutes or followed a long fast, and a second review found they made little difference for a typical fed session. Prep training is long, hard and high volume, which is exactly where carbs start to earn their place.

I'm still lower carb today, I just stopped treating keto as the rule.

Is keto still relevant?

My short answer: it's a tool, not a requirement. Two studies explain why I say that.

The first is DIETFITS, a year-long trial published in JAMA. Researchers randomly assigned 609 adults to either a healthy low-carb or a healthy low-fat diet and coached both groups for 12 months. The low-carb group lost about 13 pounds and the low-fat group about 12 and that gap wasn't statistically meaningful. The most important factor for weight loss is a consistent calorie deficit, no matter how you get those calories.

Two caveats: the low-carb group ended up getting around 30 percent of their calories from carbs, which is "lower" carb but not keto. And the participants were 18 to 50 with BMIs from 28 to 40, so this isn't a study of lean, lifting women in midlife.

Still, the takeaway holds up well. When the food quality is good, the label on the plan matters a lot less than whether you can actually live with it.

The second study hits closer to home for a lot of you. A 2024 meta-analysis in the American Journal of Clinical Nutrition pooled 41 low-carb trials with 1,379 people. In trials where people started at a normal weight (a BMI under 25), LDL cholesterol rose by about 41 mg/dL on average. In heavier groups it didn't rise at all and in the heaviest groups it dipped slightly.

That matters because leaner, active women are exactly the people most likely to see that jump. The researchers are clear that what an isolated LDL rise means in this setting still needs more study, so I'm not telling you it's dangerous (whether LDL is dangerous in metabolically healthy people is a whole other rabbit hole). I'm telling you to know your numbers if you go this route.

Who it still makes sense for

Keto has a long and legitimate medical history, especially for epilepsy, where it's used under medical supervision. It can also be a useful tool if maintaining your blood sugar in a healthy range becomes a problem. For some, breaking up with sugar and carbs have a dramatic effect on cravings, mental clarity and mood. Outside of that, if keto helps you manage your appetite, you feel strong and your labs look good, I'm not going to talk you out of it. My nutrition advice remains the same as it always has: eat whole foods (single ingredient) and avoid processed sugar. For most, that is naturally lower carb, but being in ketosis isn't necessary.

What I'd push back on is the idea that you need it. Most of the people I talk to don't have a carb problem. They have a protein and consistency problem.

What I'd focus on instead

If I were starting over today, this is the order I'd go in.

Protein first, at every meal. Lift something heavy a few times a week. Then let your carbs follow your training and how you feel, not a rule.

If you're not sure what your protein number actually is, my free calculator will give it to you in about a minute.

​Find your protein number (says for women for Google search, but works for men too!)

A quick heads-up: next Wednesday the November High Protein Kitchen plan drops. If you're on the free meal plan list, your preview lands that morning. If you're not on the list yet but would like to be, click here.

Hit reply and tell me your keto story. Still doing it, tried it and walked away, never touched it? I read every reply and I always write back.

Have a great weekend,

P.S. If "consistency over rules" is the part that stuck with you, my free 30 Day Healthy Habits Challenge is built on small daily habits instead of strict rules. Start the challenge​