Although there has been little research, I can't help but wonder whether a true longterm keto diet is essentially genocide for your gut microbiome - and that in itself has huge implications for mental health, brain health (including degenerative conditions, normal hormone function, chronic inflammation, gut disorders etc.

We know for sure that microbe accessible carbohydrates are key for nourishing the few strains of bacteria in our gut that produce short chain fatty acids that are vital for our overall health and wellbeing - and those carbs are entirely derived from plant based sources.

In my mind, if we had evolved to eat keto, we would have, but we didn't.