Are you confused about carbs? It's okay to admit it - you wouldn't be the only one.

These days it seems like in every group there's at least one person on some sort of low-carb regimen; the popular one right now is the keto, or ketogenic diet. Almost everyone you talk to who claims to be doing keto seems to have a different version of it; the lists of what they eat and what they don't eat vary.

Whatever they're eating though, the focus is on carbs. Which is where it starts to feel wrong to me. Not because it's carbs. Because it's not about food. I prefer to eat foods, not nutrients, and that's how I tend to think about what goes on my plate.

Swapping white pasta for wholegrain can have serious benefits for your gut health. Photo / Getty Images
Swapping white pasta for wholegrain can have serious benefits for your gut health. Photo / Getty Images

Have you ever said to yourself: "Right, I really feel like a nice piece of protein now, with some fat on the side"? But when we have to think about our food in terms of nutrients - and how much is allowed, and not allowed - we set ourselves up for some very wonky thinking about food. That applies to any diet, not just keto. It just happens to be the current hot trend.

When they're on keto, dieters eat very very small amounts of carbohydrate foods, and load up on fat and some protein. Keto dieters typically cut carbs to less than 50 grams a day - that's about what you'd find in a couple of apples.

The keto diet originated in the 1920s as a treatment for children with epilepsy, for which there's evidence it is effective. It's also been studied for the potential treatment of other conditions such as autism and brain cancer. The theory is that your body will use ketones from stored fat as its preferred fuel source, instead of glucose from carbs. Ketones are produced by the liver from fat when the body is starved of carbohydrates.

So what about regular people wanting to lose weight and be healthy? Do very low-carb diets like keto work? Should we all be ditching the bread, and just eating the butter?

People (at least some of the people) who are on low-carb diets will tell you they've lost weight and they feel great. Anecdotally, it seems to be a way of eating that definitely works for some people. In this respect, to me keto seems like any other diet: it'll work for some people, and some people will be able to keep it up for the rest of their lives, which is what you need to do to sustain the benefits of any diet. If that's you, good on you. If you need to lose weight for health, and this seems to suit you, this is one way to do it.

For others, this will be too restrictive and just too hard to stick to, setting aside the bad breath and possible constipation you may also experience, and the need to constantly test your pee, which sounds pretty icky and annoying.

There's not much in the way of long-term evidence to show benefit or harm from a very low-carb diet so far. It works, science says, just about as well as any other diet for weight loss. Nutritionists warn keto is likely to leave dieters short on fibre, though, which could have potential life-shortening effects; the latest research suggests we need at least 30 grams of fibre a day to lower our risk of a whole host of conditions including bowel cancer and heart disease; high-fibre eaters also live longer. Getting to 30 grams of fibre a day is potentially tricky without any grains or legumes in your life.

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While you're trying to adhere to a healthy diet, make room for treats
While you're trying to adhere to a healthy diet, make room for treats "because food is also about pleasure", writes Bezzant. Photo / Getty Images

Experts worry there's also a possible downside for the gut bacteria, which loves the food it gets from different types of fibre from a wide range of foods. Ideally, our fibre would come not just from leafy greens, but also from starchy vegetables, fruit, grains and pulses, which are mostly off the list on a keto diet.

But this is not to say all carbs are great and we're fine loading up on pasta and pies. Carbohydrates come in many, many forms, from carrots to cupcakes, and they're definitely not all created equal. A good thing about the keto diet is that it will mean ditching refined carbohydrate foods - think all the stuff made with white flour; white rice; cakes and biscuits and junk food. For all of us, avoiding these can only be good.

Thinking about my own way of eating, if I have to stick a label on it, I say it's plant-based, Mediterranean-style. I probably eat a moderate amount of carbs, in the form of grains like oats, brown rice, quinoa and barley; vegetables; fruit; lentils and chickpeas.

And sometimes, because it tastes good and food is also about pleasure, the occasional cupcake.

• Niki Bezzant is editor-at-large for Healthy Food Guide. Follow her on Facebook or Instagram @nikibezzant