SarahB wrote: The low carb starvation of the microbiome along with a low amount of fiber makes the situation worse.
Your whole post is very interesting but I am going to respond to just this element, your comment regarding the microbiome.
Safeguarding a healthy microbiome is a challenge in a traditional paleo-ketogenic diet, but the microbiome does not need to be starved in low carb ketogenic diet as long as it includes a large quantity and wide variety of vegetables . This also creates a high fiber intake. I checked this out with a microbiologist after hearing him say in a webinar that a high fat diet is bad for the microbiome. My understanding is that a healthy microbiome is crucial for overall good health, so I was upset. In my message to him, I told him that as a carier of the ApoE4 allele, I am eating a plant based ketogenic diet to support my brain health, but hoped I did not have to choose between my brain and my microbiome. My lunch salad that day had 18 different botanicals.
His response, was that he had never heard of someone eating a lot of vegetables while being on a ketogenic diet. He said that his comment about the high fat diet being damaging to the microbiome was based on the assumption that it was a meat based diet since his experience with keto has been with people who severely limit vegetable intake and thereby do in fact starve their microbiomes.