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AbuArz's avatar

This study did not control for dietary adherence, they relied on the testimonies from the participants. There is a chance they were not fully adhering to the protein needs for the diet, which caused muscle loss. (Protein is still necessary even in a keto diet)

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Danny James's avatar

Hey, thank you for your comments. Actually, this was a controlled feeding trial where all food was provided by researchers, not self-reported intake. Protein was adequate at 1.8g/kg body weight (19% of energy), exceeding current recommendations for preserving lean mass during weight loss. Ketosis was objectively confirmed through blood β-hydroxybutyrate measurements >0.5 mM in every participant. The muscle loss occurred despite these rigorously controlled conditions, suggesting it's an inherent effect of the ketogenic state rather than poor adherence.

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