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The rising popularity of the ketogenic or keto diet appears to be largely due to the apparent benefits of weight loss and reduced risk of Type 2 diabetes ( , April 26). However, the science and physiology behind the keto diet are more complex than they appear. People should ask basic, relevant questions before starting on a keto diet. Weight loss may arise from loss of water, muscle or fat. What kind of weight loss does a keto diet give rise to in the short and long term? Is the weight loss healthy? While the keto diet may lower blood sugar and appear to reduce or reverse the risk of Type 2 diabetes, does it really improve glucose intolerance and insulin resistance? Most people merely look at the enticing benefits of a keto diet but do not pay enough attention to the possible risks of the diet on the kidney, heart, liver, bones, metabolism, and macro- and micro-nutrient deficiencies. For example, low-carbohydrate diets may lead to deficiencies in fibre, vitamins, minerals, and phytochemicals. Consuming saturated fats increases the risks of high cholesterol and cardiovascular diseases. Reports and reviews from major global institutions like the University of Chicago and Harvard Medical School have warned about the serious side effects of the keto diet.   The safety of any diet should ultimately be the primary concern. The diet of people who live in the “blue zones” of the world is noteworthy. Blue zones are areas of the world where people live exceptionally long lives. They are generally free from major chronic diseases, and diet is a significant contributing factor. People in blue zones mostly follow a plant-based, whole-food diet consisting of vegetables, beans, nuts, whole grains, sweet potato and fruits, with minimal animal protein. A safer, healthier and more sustainable alternative to the keto diet is available. Choose the safe path to good health.