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Qualitative Evaluation of Lived Experience with Keto: Methodology and Findings



This article is overall quite well done for what it is. It is interesting to note that the qualitative findings came as a component of a RCT for which the quantitative data will be published elsewhere. Had both sets of results been published together a mixed methods report would have resulted, but likely would not have been able to go into the depth for either methodology to answer the questions adequately. The authors note that they specifically used an inductive method to identify themes, and sought to be as unbiased as possible in theme identification.

A few notes:

The specific philosophical perspective was not stated. As such it is hard to compare the methodology to the perspective if we don’t know what it is. We can infer from the words “lived experience” that phenomenology was used. Participants completed surveys and also participated in a focus group.

Did the research questions mesh with the methodology? I believe so- they wanted to evaluate the broad themes of experience with keto, and to provide snapshots of individual experiences. Surveys with open-ended questions and a focus group seem like a good route to go. It is interesting, however, because the study in its entirety was only 3 weeks long...Participants were not obese and didn’t have diabetes. Did the methodology/research design for the RCT really give participants enough time to get into ketosis before they really knew what they were talking about their “lived experience??”

I did not see a statement about the researcher philosophical or cultural background. Further, at least 1 of your colleagues noted that the lead author owns a Keto business for which he charges money for KETO MAstery...this is a conflict that was not disclosed. The authors do talk about remaining as unbiased as possible with respect to their results. Also, with respect to bias, searching for participants using social media is certainly not an unbiased method...

I do feel the participants voices are adequately represented through pages of thematic discussion and direct quotes. By having survey results and focus groups, the authors had both written and oral findings to analyze. This provides a broader perspective. I’m just not sure they can really answer the question about the lived experience of keto...with a 3 week study. Also, as with any study when all data are not presented, and we have to trust that they are presenting all the data, not just that which they want to present, what aren’t we hearing about? Not all responses related to the stated themes. What remained?


For the synthesis...I would say YES to the key question related to this article. For what it is, it is a relatively well constructed qualitative article.

Startling stat: there are so many available for obesity and keto- think about comorbidities, prevalence, financial implications, etc Go to Healthy People 2020, CDC, or another article to find a good stat.

Strengths and Weaknesses- USE INSTRUCTORS

Strengths: Methodology matched research questions, analysis was appropriate, etc

Weaknesses: Bias and conflict of interest were not addressed well enough, outcome measures, etc

Main Conclusion- this is the part that you need to emphasize...make it bold/big/attention grabbing! Here it is:

There is insufficient evidence in this collection of literature (cite; cite; cite) to recommend low carb over low fat for weight loss. If labs are well monitored, and shared decision making with risks/benefits are reviewed, it may be an appropriate choice for an obese client. Be sure to discuss the need for more info.

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