What Are the Different Types of the Ketogenic Diet, and Which Is Right for You?
As the high-fat, low-carb diet has grown in popularity, several versions have emerged, and each one offers a unique set of benefits and risks.
By Moira Lawler
Medically Reviewed by Kelly Kennedy, RD
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Some ketogenic (or “keto”) diet devotees stay true to the diet 100 percent of the time, while others have found they need a little more carbohydrates or protein. That’s inspired some to tweak the low-carb, high-fat diet to meet their needs. As a result, several spins on the keto diet have emerged.
Kristen Kizer, RD, a registered clinical dietitian at Houston Methodist Hospital in Houston, says that all of these diets have one thing in common. “A keto diet to me would be any diet that gets a body into ketosis,” she says.
Ketosis occurs when the body turns to fat as its main source of energy instead of carbohydrates, says Amy Shapiro, RD, the New York City–based founder of Real Nutrition. Keeping the body in ketosis for extended periods of time may lead to weight loss, according to a study published inExperimental & Critical Cardiology. Ketosis is a natural metabolic state in which the body burns fat rather than carbs.
RELATED:The Top Foods to Eat and Avoid on the Ketogenic Diet
That’s what motivates most people to go keto. “It’s popular because in most cases it can produce very easy and effective weight loss — that’s the primary reason why people start it,” says Los Angeles–based Franziska Spritzler, RD, the founder of Low Carb Dietitian. There are some other researched benefits beyond weight loss, including possibly acting as a mood stabilizer in those with bipolar disorder (per a )and lessening epileptic seizures (according to a study published in May 2019 inEpilepsy & Behavior).
But not everyone’s a fan. “For most people, going keto means jumping on the diet of the moment bandwagon,” says Jackie Newgent, RDN, a culinary nutritionist in New York City and the author ofThe All-Natural Diabetes Cookbook. “For most, it’s a fad diet that will offer temporary results.” That runs counter to Newgent’s usual advice to find an eating plan you can follow for a lifetime. She also worries that reducing carbs as much as the original keto diet calls for will cut out nutrient-rich foods, like whole grains, certain veggies, and fruits.
If you’re already trying a keto diet or are interested in starting one, you may be wondering which version is for you. That depends on a few factors, including your goals, activity level, and health history.
RELATED:What Are the Risks and Benefits of the Keto Diet?
Here, dive into four of the most popular types of the ketogenic diet. Kizer says to keep in mind that while there are many studies involving ketosis, these variations of the diet have not yet been researched.
What Does the Standard Keto Diet Involve?
How It WorksThis is the most common approach to keto and involves sourcing 75 percent of calories from fat, 20 percent from protein, and 5 percent from carbs. That means limiting carb intake to about 20 to 30 grams (g) of carbs per day, Shapiro says. It’s important to note that while this is the keto diet that most people follow, it’s not the original, or therapeutic, version of keto that an article inCanadian Family Physician shows can help children with epilepsy. That diet consists of slightly different percentages: 80 percent of calories from fat, 15 percent from protein, and 5 percent from carbs.
It’s Best for People Who ... are looking to accelerate their weight loss and tap into the other reported health benefits.
Risks to NoteKizer says there are a few groups who should not follow the standard version of keto (or any other version either): pregnant women, people with diabetes (at least not before discussing it with a physician), and those with a history of kidney stones. She notes that ketosis may result in bad breath, dizziness, constipation, and low energy levels (commonly called the “keto flu”) for the first few weeks. More concerning, drastic weight changes, from keto or otherwise, can increase your risk of mortality, says Kizer. Weight cycling, also called yo-yo dieting, may put particular strain on the heart, suggests a study published in February 2015 inObesity Reviews.
RELATED:Does the Ketogenic Diet Work for Type 2 Diabetes?
What Is a Targeted Keto Diet?
How It WorksYou’ll follow the keto diet as usual until 30 to 45 minutes before exercise — then it’s time to eat about 25 g of carbs, says Daniela Torchia, PhD, a registered dietitian based in Loma Linda, California. The idea is that you’ll have just enough carbs to fuel your workout and still be able to return to ketosis easily after you cool down. Choose carbs that are easy to digest (for instance, white bread or white rice) and be sure not to add calories to your daily total — simply redistribute them, Dr. Torchia says.
It’s Best for People Who ... frequently engage in intense, muscle-building workouts, according to Torchia. We’re talking high-intensity exercise like running, swimming, or playing tennis for hours on end, Torchia says. Hitting the gym at a moderate pace a couple of times a week likely won’t cut it.
Risks to NoteTorchia says not to try targeted keto until you’ve been following a standard keto diet for a month or two. “This idea is called ‘keto adaptive,’ and once your body is used to using fat as fuel, it can go back and forth more readily with moderate carbs,” she says. She warns not to try this (or any version of keto) before talking with a physician if you have diabetes and are insulin dependent, as it could lead to a too-low blood sugar level.
What Goes Into Doing a High-Protein Keto Diet?
How It WorksThis version of keto calls for upping the protein intake just a bit. Protein should make up about 30 percent of calories, with the other 65 percent coming from fat and 5 percent from carbs, Spritzler says. Aim to source your protein from both animals (meat, fish, and dairy) and plants (nuts and seeds), Spritzler suggests.
It’s Best for People Who ... need protein to help protect muscle mass, like bodybuilders and older people who need to prevent muscle breakdown, Spritzler says. It’s also a good option for those who show signs of a protein deficiency. Those signs include a loss of muscle or thinning hair, according to the subcommittee on the 10th edition of the federal recommended dietary allowances.
Risks to NoteThose with kidney issues need to be careful not to increase their protein intake too much, says Lisa Koche, MD, a Tampa, Florida–based senior medical adviser for Kegenix, a company that creates keto meal replacements and other keto-friendly products. People with kidney disease may experience waste buildup in the blood if they have too much protein, according to the National Kidney Foundation. High-protein keto may not be right for you if you’re following the diet for therapeutic reasons. “The reason protein is limited at all [in keto] is because the goal in therapeutic keto is to treat epilepsy and to have high ketone levels,” Spritzler says. “Protein will not kick you out of ketosis if you have a lot, but it will definitely lower the amount of ketones in your blood.” Since slightly more protein shouldn’t affect your body’s ability to stay in ketosis, this version of the diet delivers the same weight loss benefits as standard keto, Spritzler says.
RELATED:10 Popular Low-Carb Diets, and Their Pros and Cons
What Does a Cyclical Keto Diet (or ‘Keto Cycling’) Mean?
How It WorksOn cyclical keto, also called keto cycling, you’ll cycle in and out of keto — usually on the diet for five days, followed by one or two days with more carbs. “The point of keto cycling is to make it easier for someone to follow,” Kizer says. “Every five to six days they can have the carbohydrates they’ve been entirely restricting.” There’s no set protocol of what your carb days should look like, but Kizer warns not to go overboard because that will make it more difficult for the body to return to ketosis.
It’s Best for People Who ... have a tough time sticking to keto. “It can be helpful if someone wants to take a break and have carbs,” says Koche. That may not be easy for everyone. Kizer worries this approach may promote carb binging. You may have heard keto cycling recommended for athletes, who use the extra carbohydrates to fuel their workouts or competitions. But no existing published science backs this up, though studies, including an April 2019 study published inThe Journal of Sports Medicine and Physical Fitness, have shown that the keto diet does hinder exercise performance.
Risks to NoteKoche says to hold off until you’ve adapted to keto, which means your body is used to turning to fat for fuel, before adding these high-carb days, as it can slow down the possible benefits and results of being in ketosis. Kizer notes that keto cycling can cause fluctuations in body water, which can lead to dizziness. “It can also be hard on the heart for those with some cardiac conditions,” she adds.
A Final Word on How to Pick the Right Type of Keto Diet for You
It’s a good idea to meet with your doctor or a registered dietitian any time you switch up your diet — whether you’re on keto or another eating plan. And above all, Torchia says to listen to your body and assess your energy level and how you’re feeling on the diet. “You will be your best teacher,” she says.
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