However, no significant improvement in HbA1c levels was observed, and an increase in total cholesterol and LDL-C was noted [41].

Here is what Wang et al actually said

Reductions were observed in the triglyceride (mean differences: −0.20 mmol/L; 95% CI: −0.29, −0.11; I2: 72.2%), blood glucose (mean differences: −0.18 mmol/L; 95% CI: −0.33, −0.02; I2: 76.4%), blood insulin (mean differences: −8.32 pmol/L; 95% CI: −14.52, −2.12; I2: 81.5%), diastolic blood pressure (mean differences: −1.41 mmHg; 95% CI: −2.57, −0.26; I2: 49.1%), weight (mean differences: −2.59 kg; 95% CI: −3.90, −1.28; I2: 87.4%), and body mass index (mean differences: −1.59 kg/m2; 95% CI: −2.32, −0.86; I2: 84.5%) concentrations after implementing ketogenic diets.

but they focus on hba1c because they can neg it? only 7 of the studies in the meta-analysis covered hba1c, so it was underpowered, AND it doesn't account for these studies didn't focus on metabolically unwell people... so maybe their hba1c didn't need to improve....

Plus Wang isn't the newest meta-analysis on keto, but Pi et al in 2025 shows a improvement in hba1c, so I guess they stuck with the older reference... for some reason.

Further clinical studies have also shown significant increases in LDL-C and ApoB levels in the context of a ketogenic diet

Back to evidence based, is that a BAD thing? Different metabolic contexts are important. The doctors they are following here could have provided them data to add to this commentary.

The traditional Inuit diet is often cited in this context, as it consisted largely of raw animal foods and was associated with generally good health outcomes, partly due to its fatty acid profile and micronutrient content [47,48,49]. However, these findings are only of limited relevance to modern populations, particularly given differences in lifestyle, food availability, and physical activity.

Kinda missing the forest for the trees, yes, there are modern problems, and people are tying to get back to a known good state by changing modern diets and lifestyle!

Available studies lack clinical endpoints, and prospective longitudinal data are missing.

Wishing for observational epidemiology just shows how poor science literacy is, even in paper authors. Epidemiology is hypothesis generating and cannot inform on cause and effect.

Given its nutrient profile, potential deficiencies may increase long-term health risks. This need for caution is supported by a long-term follow-up study reporting a potential U-shaped association between carbohydrate intake and mortality

Which deficiencies, i thought we were being evidence based? Their reference is erroneously implying there is such a thing as an essential carbohydrate, based on... wait for it, epidemiology with absurdly small absolute risk (hazard ratio 1.2 - no absolute risk provided!!!!!!) . Surely if carbohydrates are essential we would have more data on it?

Overall, it should be noted that there is an assumed link between meat consumption and an increased risk of developing diabetes, cancer, obesity, hypertension, inflammation and atherosclerosis. However, it is difficult to transfer this to CD`s due to a lack of data

Finally! A honest statement. Assumed link (not proven)... let's just examine of of their assumptions. Diabetes is a condition of carbohydrate intolerance, carnivore is zero-carb... mechanistically how does it make sense for a no carbohydrate diet to cause carbohydrate intolerance? the others I leave as exercises to you, the reader.

Phelan et al. demonstrated that the CD had the lowest score in a comparison of seven trending diets using Healthy Eating Index (HEI) scores. This was due to the elimination of plant-based foods and the high content of saturated fatty acids and sodium.

And scores here are demonstrated to lead to bad health outcomes based on evidence? Or was it a score made up using observational assumptions?

In addition to fibre, micronutrients such as potassium, calcium, and vitamin D were also classified as potentially deficient

potentially is such a weasel word, it also means potentially sufficient.

Goedeke et al. determined that thiamine, magnesium, calcium, vitamin C, iron, folate, iodine, and fibre are potentially critical in the carnivore diet. Including liver and iodised salt in hypothetical diet plans for women was necessary to ensure adequate iron and iodine intake

Determined? So opinion based on RDAs? and look at the weasel word again... potential, means they didn't base it on real human studies. Show me a case study of a carnivore with scurvy, please. Let's resolve this potential fraud!

O’Hearn’s hypothesis proposes different micronutrient requirements for a CD due to reduced carbohydrate metabolism, microbiome modulation, and increased meat intake

Oh my heart be still, they included a differing viewpoint finally. The first in this entire screed

In summary, despite the high bioavailability of animal-based foods, a CD appears to be associated with micronutrient deficiencies, contradicting content creators’ claims that such a diet predominantly meets nutritional requirements. Additionally, the advantages of the CD as an elimination diet do not outweigh the risk of nutritional deficiencies. Less risky elimination diets (e.g. the low-FODMAP diet) should therefore be preferred.

AND YET, DESPITE THE DIFFERING VIEWPOINT THEY JUST INCLUDED... "associated with deficiencies" as demonstrated in what population? They only provided opinion pieces speculating on RDAs, not examining patients for clinical outcomes. What risk? What is the magnitude of the risk? How long before the risk realizes? i.e. If I skip one meal am I at risk for these deficiencies? Is it a week, a month, a year? How would these manifest? They should use SPECULATED deficiencies, because they have not been demonstrated in this population... remember their earlier statement that there were not many studies here? Suddenly they can speak with authority on the effects of this diet?

Muller et al. conducted a social media analysis examining the posting behaviour of two carnivore content creators from 2020 to 2023 in terms of their rhetoric. The analysis revealed a proliferation of conspiracy theories and right-wing ideologies in the content creators’ content. They viewed and ideologised meat consumption as a means of achieving “ultimate white masculinity.”

Oh we have moved from dietary slander, to political assassination, good good....

note the potential for less ideologically driven content creators to provide a shallow entry point into the community, and through their networks, these content creators could facilitate a path into more radical, racist-oriented scenes

Carnivore is a slippy slope into racism...

Monteiro et al., described carnism as an ideology and found a connection between meat consumption and carnistic beliefs. These beliefs justify the killing of animals for food and counteract cognitive dissonance

WTF is this, their study said most of the content was about health, which means OUTCOME BASED... and now suddenly its a cult?

Cognitive dissonance can be triggered by the “meat paradox,” which expresses a dilemma between meat consumption and empathy for animals

It's not a paradox, if you want to live something has to die. Plant, animal, fungus... you consume substrates from other living things. It's part of the being alive subscription service.

Monteiro et al. examined, carnistic defence, which legitimises the consumption of animals and trivialises their suffering. They also analysed carnistic dominance, which justifies killing animals for food based on hierarchical superiority, also known as speciesism. Both concepts are linked to socio-political attitudes, such as right-wing authoritarianism and social dominance orientation. Carnist dominance has also been associated with symbolic racism and sexism

Farming, giving animals a high quality of life, and eating them - is the standard human condition... it's not some new evil phenomena but here they are inferring morality in a study of social media posts (17 users 2 weeks)

What a wild pivot this paper has been. So now not eating any carbohydrates is racist AND sexist.

The present analysis revealed tendencies toward conspiracy-related narratives, ideological elements, and politically relevant statements that may support the justification of the promoted dietary practices.

Well, let me put on my tin foil hat after reading this PEACH of a paper... crypto-adventists are disguising their biases as science and trying to bully people into giving up meat for reasons that are not based on clinically meaningful evidence.

I'm going to stop there it just keeps going on and on, the discussion section is 80% of this paper, the "research" is tiny and meaningless, and it's clearly just a soap box to get a academic publication to preach their biases at everyone.

Take away - If you eat meat your a racist and a sexist.... or these authors are full of shit. Take your pick.