By Yoon Hang Kim, MD, MPH, FAAMA | www.directintegrativecare.com

Health Secretary Robert F. Kennedy Jr. made headlines when he told USA TODAY that he eats nothing but meat and fermented foods. He dropped 20 pounds in 20 days, slashed his visceral fat by 40% in a month, and says his mental clarity has never been better. He wisely added that this approach "may not be for everyone."

Here's what's getting lost in the conversation: the benefits Secretary Kennedy is experiencing almost certainly come from ketosis—not from meat specifically. And ketosis? There are many roads to get there. Carnivore is just one of them, and frankly, it's the most restrictive and potentially problematic path for most people.

Ketosis Is the Destination, Not Carnivore

When you cut carbohydrates drastically, your body shifts from burning glucose to burning fat for fuel. This metabolic state—ketosis—brings real benefits for many people: reduced inflammation, improved insulin sensitivity, mental clarity, and often significant weight loss. The research on therapeutic ketosis is substantial and growing.

But here's what I tell my patients: you don't need to eat only meat to get into ketosis. Not even close. In my practice, I use several different approaches depending on the patient's situation, preferences, and what we're trying to accomplish:

Fasting. Intermittent fasting or extended fasts reliably induce ketosis without changing what you eat at all—just when you eat. For some patients, this is the simplest entry point.

The Duke Keto Diet. This is a well-researched, medically supervised ketogenic approach that's far more flexible than strict carnivore. You get the metabolic benefits without eliminating entire food groups unnecessarily.

Modified Paleo with no added carbs. This gives you the ancestral, whole-foods framework while keeping carbohydrates low enough to maintain ketosis. You can still eat vegetables, nuts, and a wider variety of foods.

Green juicing with low-carb vegetables. For patients who want plant nutrients and phytocompounds while staying in ketosis, strategic green juicing with vegetables like celery, cucumber, spinach, and kale can work beautifully.

Each of these has its place. The question isn't "should I go carnivore?" The question is "what's the right ketosis pathway for my body, my goals, and my life?"

Where Carnivore Actually Shines: A Diagnostic Tool

Now, I'm not saying carnivore has no place in medicine. In my practice, I actually use it—but not as a long-term diet. I use it as a diagnostic tool for SIBO, small intestinal bacterial overgrowth.

Here's how it works: SIBO comes in different forms. Some patients have hydrogen-dominant or methane-dominant overgrowth. Others have hydrogen sulfide-producing bacteria. These different types respond to different treatments, and knowing which type you're dealing with changes everything about how you approach it.

A strict carnivore diet eliminates the fermentable carbohydrates that feed most gut bacteria. When a patient goes carnivore for a short period, their symptom response—or lack of response—tells me a lot about what's happening in their gut. If symptoms improve dramatically, we're likely dealing with hydrogen or methane SIBO. If symptoms persist or even worsen, hydrogen sulfide-producing bacteria (which thrive on protein and sulfur) may be the culprit. This information guides treatment in ways that standard breath testing sometimes misses.

That's a specific, time-limited, medically supervised use. It's very different from adopting carnivore as a permanent lifestyle.

Why Long-Term Carnivore Gives Me Pause

If ketosis is the goal and there are gentler ways to get there, why take the most extreme route? Here's what concerns me about indefinite carnivore eating:

We have zero long-term outcome data. Surveys show favorable TG/HDL ratios but median LDL around 172 mg/dL. Some people become "lean mass hyper-responders" with LDL over 300. What does this mean for cardiovascular events over 20 or 30 years? Nobody knows. The studies simply haven't been done.

Documented nutrient gaps. A December 2024 analysis found carnivore diets consistently fall short on thiamin, magnesium, calcium, vitamin C, folate, iodine, and potassium—while delivering 15 to 20 times the recommended sodium. These deficiencies affect bones, blood pressure, thyroid function, and energy. And yes, scurvy still happens. I've seen the case reports.

Gut microbiome shifts. Without fiber, butyrate-producing beneficial bacteria decline while bile-tolerant, potentially inflammatory species increase. The long-term implications for colon health and systemic inflammation remain unclear.

Why accept these risks and unknowns when you can achieve ketosis through approaches that don't require eliminating all plant foods?

A Note on Fermented Foods

Secretary Kennedy includes fermented foods, which is smart. They provide beneficial microbes that support gut diversity. But they don't replace fiber. They don't provide polyphenols. They don't fill in all the nutritional gaps that come with eliminating plants entirely. Think of fermented foods as helpful, not sufficient.

The Bottom Line

Secretary Kennedy is experiencing real benefits. I don't doubt that. But he's likely benefiting from ketosis, not from meat per se. And for most people, there are better ways to get there—ways that don't carry the nutritional risks and unknowns of strict carnivore eating.

In my practice, carnivore has a role—as a short-term diagnostic tool for SIBO, used under supervision with clear clinical goals. As a lifelong eating pattern for the general population? The evidence isn't there, and the risks are real.

If you're intrigued by what ketosis might do for you, talk to a physician who understands metabolic health. Find the pathway that fits your body, your goals, and your life. You have options. Meat-only isn't the only door.

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Yoon Hang Kim, MD, MPH, FAAMA is a board-certified preventive medicine physician who specializes in integrative and functional medicine. He trained under Dr. Andrew Weil at the University of Arizona and has built integrative oncology programs at Miami Cancer Institute and the University of Kansas Medical Center. Dr. Kim sees patients through Direct Integrative Care (directintegrativecare.com) in Iowa, Illinois, Missouri, Georgia, Florida, and Texas.