Peter Attia on keto: Why he stopped and what he thinks about the diet

From missing his favorite meals to wanting to set an example for his kids, physician and researcher Peter Attia dropped the keto diet for several reasons. He also doesn’t believe it’s universally beneficial and advises against going keto without understanding your body first.

If you’re on the fence about keto, we’ll help you make an informed decision by discussing:

• Peter Attia’s keto regimen and why he turned against it

• The effects and caveats of the ketogenic diet

• The role of genetics in the diet’s success

Why did Peter Attia stop keto?

The main reason Attia stopped keto was that he missed some of the foods he enjoyed eating the most. On a podcast, he mentioned curry stir fry — a staple meal throughout his college and med school years — that he couldn’t eat while on keto because it would kick him out of ketosis. Even if he made the dish without rice, the sheer amount of vegetables would’ve been enough to hinder the diet’s effectiveness.

For three years, Attia had to let go of various foods that he didn’t necessarily need from a health perspective but thoroughly enjoyed. We’re not talking sweets or processed carbs — Attia said he hadn't had a single banana while being on keto.

It wasn’t only about the foods he couldn’t eat but also those he had to. Attia said he’d eat a tub of sour cream every day to hit his 4,500-calorie goal. As he was working out vigorously at the time, he needed plenty of fuel to power through intense workouts.

Here’s an example of what Attia would eat in a day:

| Meal           | Foods                                                                                                                                                      |
|---------------|------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Breakfast      | “Fat shake:”<br>• 8 oz heavy whipping cream<br>• 25 g sugar-free hydrolyzed whey protein<br>• 8 oz sugar-free almond milk<br>• 2–3 frozen strawberries |
| Lunch          | • 4–5 oz of assorted cheese<br>• 2–3 oz olives<br>• 4 oz of fat salami and pepperoni                                                                     |
| Late afternoon | • 2 oz of mixed nuts<br>• Large latte                                                                                                                      |
| Dinner         | • Garden salad with plenty of olive oil and balsamic vinegar dressing<br>• 6 oz grilled salmon with butter and lemon juice

Considering how restrictive the keto diet is, Attia’s motive for stopping it doesn’t come as a surprise. Still, there was more to it than the need for a more balanced diet.

Leading by example: How Attia’s kids motivated him to move on from keto

Like many parents, Attia knows that instilling healthy habits in children requires more than preaching them. At one point, he realized that the keto diet might not be setting the best example of balanced nutrition.

Though he admitted this could be seen as an excuse, Attia shared that keto became particularly challenging with kids. His daughter would often ask him why he didn’t eat certain foods, even though they were considered healthy.

Since stopping keto, Attia found it much easier to have conversations about nutrition with his daughter. She’d see him follow a more diverse diet, which set a better example for her to follow.

Keto benefits Peter Attia achieved

Source: Victor Freitas

While Attia gave up keto for various reasons, a lack of benefits wasn’t among them. If anything, he said he responded to the diet as well as someone could and saw improvements in his mental and physical well-being across the board.

The most impactful benefits included:

• Enhanced mental clarity

• Increased resilience

• Improved biomarkers

Attia also said his performance saw a considerable spike, though it took months to achieve it. He was thrilled with the results, though he emphasizes an important point — not everyone should expect them.

💡Tip

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Attia’s stance on the effectiveness of Keto

Attia believes the ketogenic diet isn’t a cure-all for weight loss or general well-being. While he recommends it in some cases, he strongly advises familiarizing yourself with factors that might affect the diet’s effectiveness. These include:

• Inherent insulin resistance

• Pre-existing conditions

• Family history

In one article, Attia cites a study in which keto was not only ineffective but detrimental to the participant’s health. Specifically, the diet caused elevated total cholesterol and low-density lipoprotein cholesterol in some participants due to pre-existing conditions and a family history of certain diseases, such as:

• Coronary artery disease

• Hypercholesterolemia

• Prediabetes

• Hypothyroidism

Attia also recommends managing your carbohydrate reduction based on two factors:

1. Diet goals

2. Insulin resistance predisposition

While diet goals are easy to work out, many people are unaware of their insulin resistance predisposition. Insulin-related health concerns often go undetected until symptoms appear, which shows a lack of a proactive approach to their management.

Attia’s stance on keto might go against many mainstream sources, which praise the diet for its many benefits. Still, more in-depth research confirms that Attia makes a valid point about not recommending keto to everyone.

What research says about the benefits and dangers of keto

Source: Krisztina Papp

The ketogenic diet can undoubtedly be beneficial far beyond weight loss and fitness. Some of the most commonly observed health effects include:

• Reduced triglycerides

• Lower blood pressure

• Fewer seizures in those with epilepsy

You might also experience many improvements Attia saw, from improved physical fitness to increased mental clarity.

The problem is that when talking about keto, the mainstream community tends to focus on its benefits. Not enough attention is paid to the other side of the coin, making it seem like these results are guaranteed and risk-free.

In one podcast, Attia pointed out that this is a common issue with keto—when it doesn’t work for someone, they tend to feel bad and blame themselves, assuming they did it wrong.

In reality, this doesn’t have to be the case — maybe the diet isn’t working as expected due to your genetic makeup.  For example, lipid transport genes, like FAB2, can affect how your body absorbs and processes fat, leading to different responses to high-fat diets like keto.

Similarly, variations in carbohydrate metabolism genes, such as AMY1, can influence how your body digests starchy foods. People with more copies of these genes may find low-carb diets easier to tolerate. 

Besides being potentially ineffective, the keto diet might even speed up aging in some individuals. Recent research suggests keto might even accelerate the aging of organ cells by interacting with the p53 gene, potentially increasing the risk of diseases like:

• Kidney disease

• Cardiovascular disease

• Cancer

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The takeaway: Was Peter Attia right for abandoning the keto diet?

After stopping the keto diet, Attia went for a much simpler regimen by:

• Alternating between time-restricted and non-time-restricted feeding

• Incorporating considerably more healthy carbohydrates into his diet

• Focusing on avoiding junk food and other unhealthy meals

Attia felt like this method was much less challenging to follow while ensuring balanced nutrition. He still underscores the benefits of the ketogenic diet, especially in those who struggle with weight loss or diseases like type 2 diabetes.

This means that even though Attia realized keto wasn’t for him, it might still be a sensible diet for you — it all comes down to being proactive about the potential interactions that might hinder its effectiveness.

With this in mind, personalized nutrition is the key to reaping the benefits of your diet plan. Before starting keto or any other diet, though, it’s best to consult your physician and do the necessary blood tests if needed. Ideally, you’ll also take some time to understand your genetic makeup and how it drives your body’s response to keto.

Still, most genetic tests involve genotyping, which only captures a limited number of DNA variants (around 0.1% in many cases). This means many important variants that could affect your keto response might go unnoticed, resulting in an incomplete picture of the potential effects and risks.

In contrast, whole-genome sequencing offered by Nucleus Premium looks at nearly 100% of your DNA to measure your genetic predispositions and can help you decide whether keto is for you.

Make informed dietary choices with Nucleus

Nucleus is an all-in-one DNA platform offering affordable and easily accessible whole-genome sequencing with 99.9% accuracy. It leverages advanced technologies to provide over 900 screenings within a single test based only on a cheek swab.

With Nucleus Premium, you get comprehensive insights into various factors and potential diseases affecting your body’s response to the keto diet, such as:

| Factor/Disease                                                                | Example Genes Analyzed |
|-------------------------------------------------------------------------------|------------------------|
| Fat metabolism                                                                | APOB, APOC 2           |
| INS-related maturity-onset<br>diabetes of the young (MODY)<br>and hyperinsulinemia | INS                   |
| Type 2 diabetes                                                               | ABCC8, CEL, GCK

Nucleus Premium also helps assess your risk of developing diseases and conditions that might be influenced by the keto diet, such as:

• Coronary artery disease

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• Hypercholesterolemia

The platform handles the complex analyses behind the scenes and turns them into actionable, easy-to-understand insights you can use to follow the optimal diet. Thanks to Nucleus AI, you also get personalized recommendations tailored to your health profile and Nucleus also partners with SteadyMD to connect you with a board-certified genetic counselor who can help interpret your results and guide your decisions.

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For an accurate overview of your genetic predispositions, Nucleus combines your genetic data with other relevant factors that can impact your dietary regimen, such as:

• Age

• BMI

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• Blood pressure

Understand your genetic makeup effortlessly

Unlike high-ticket programs offered by Peter Attia and other experts, Nucleus lets you take charge of your health at an affordable price of $399. This makes it a good fit for anyone who wants to fully understand their body without splurging on various screenings and programs.

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Featured image source: Foodie Factor