To the Editor A recent Viewpoint by Joshi and colleagues1 argued that the enthusiasm for ketogenic diets outpaces the evidence. If so, then endorsement of any nutritional approach outpaces the evidence. Several eating patterns have received support from experts or in guidelines over the past half century, but there are limitations to the evidence precluding any single pattern to be considered above the rest. In this climate, and considering the increasing prevalence of obesity, it is critical to objectively support all of the approaches that have evidence for net benefit.