A lot of people ask me if a ketogenic diet is good for your gut. Well, it depends. Everyone’s gut microbiome is unique, and low-carb foods can vary a lot in terms of healthfulness.

Those with damaged gut ecosystems may benefit from removing inflammatory foods and eating a low-carb diet to starve bad bacteria. But it’s not the best plan for all people, since good bacteria like carbs too. And while some folks thrive on fermentable fiber, others find the lower the fiber, the better their digestive health. I’ll share the science on this—but first, the story of my gut. Riveting, I know.

My gut problems started young. I likely inherited a compromised gut microbiome from my mother, and was exposed to inflammatory foods like soy and grains early on. As a result, my adolescence and early adulthood included countless cases of strep throat and antibiotics for acne. Since few people talked about food sensitivities at the time, I mostly ignored my diet.

In my 20s, I made a dramatic dietary change: I became a vegan. It didn’t work for me. After plummeting to a skeletal 135 pounds and being diagnosed with ulcerative colitis, I even considered a bowel resection (a procedure to cut out a piece of my intestines). I wondered what future first dates would say when they noticed my colostomy bag.

If you’ve read The Paleo Solution, you know the rest: In a moment of clarity (desperation), I realized an inflammatory diet was setting my gut on fire. To get better, I cut out the inflammatory foods—grains, sugar, legumes, and dairy—that infiltrate the modern diet. I ate like the cavemen used to, except this time with utensils. For decades now I’ve stuck to a low-carb diet, and my gut is super happy. This article will explain why.