https://www.youtube.com/watch?v=G4_HLyxQly8

Actually a keto-"friendly" video, I think the guy's a neurosurgeon, somewhere in that field anyways. Uses a modified ketogenic diet with patients. About 22 minutes in, there's discussion about it being a myth that a keto diet needs to put you into ketosis to be effective. I think that's a good point, but at the same time--yeesh. So why call it keto? If you don't think it's important, why give it the headline?

At any rate, ketosis not being important is just a contention--certainly non-ketogenic diets can be therapeutic, but anecdotally and clinically there are a lot of people out there who for instance only get seizure relief when their diet is a higher fat ratio ketogenic diet and their ketones are high. That still doesn't mean that the ketones are responsible for the therapeutic effect, I do better when I increase the fat ratio of my diet to a certain point, better mood, better energy, better workouts. But I haven't isolated ketosis as a cause, any of the things I do to increase ketosis might have some other effect.

I think there's a place for a looser approach--even if it were less effective, greater adherence might make for more benefits in a given population. I'm not up for making the toolbox smaller and turning people like me who need a slightly different approach away.