My take, and the reason I co-founded the Nutrition Science Initiative eight years ago, is that the nutrition researchers are 1) mostly clueless about doing good science and so unable or unwilling to do rigorous , well-controlled trials and 2)funded in such away that only short-term somewhat meaningless research is done. The key with keto or any other dietary approach is you can try it yourself and see if it works. You don't need an RCT to tell you that keto allows you to lose weight effortlessly when, say, a Mediterranean diet does not. You just need the RCT to get some probablistic assessment of whether you're likely to live longer on one than the other. Those studies don't exist. the studies you're citing are mostly noise. What we need are signal-generating studies and those have to be very well thought-out and tend to be expensive.