The multicomponent nature of the intervention makes attribution of effects to the low-fat diet problematic. Unfortunately, no comparable studies of very-low-carbohydrate diets have been conducted, but smaller trials and observational studies suggest promise. Long-term clinical studies in humans are still necessary to validate the anecdotal claims of keto’s health benefits. Yet critics say those initially popular plans have struggled to keep the public's interest as dieters have succeeded in losing some weight, only to fail to keep it off over the long term.
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