If you’re already trying a ketogenic diet or interested in starting one, you might be wondering which version is for you. That depends on a few factors, including your goals, activity level, and health history.
Here, dive into six of the most popular types of the ketogenic diet. Kizer says to keep in mind that while there are many studies involving ketosis. These diet variations have yet to be investigated.
1. A strict ketogenic diet is used to treat epilepsy
How it works
When people say they are on the strict version of keto. They are probably referring to the one that has been shown to help treat epilepsy. “Tight ketosis was traditionally for those who used ketosis as part of treatment for [people with epilepsy] who did not respond to medication,” says Kizer.
This version of the diet allows the least amount of carbohydrates (therefore, it is the strictest). According to the Practical Neurology study, 90 percent of daily calories come from fat, 6 percent from protein, and only 4 percent from carbohydrates.
Who is better for people trying the ketogenic diet to treat epilepsy
Risks to watch out for
The most common side effects among children who followed the diet were constipation, weight loss, and growth problems or anorexia, according to the Practical Neurology study. Growth problems among children can be the result of limited protein intake, says Spritzler.
There is also a risk of developing hypercalciuria kidney stones, and low blood sugar levels. Although most of the research has been done on children, adults can experience the same problems. Although the levels should drop once you stop the diet and start eating normally again.
2. The standard ketogenic diet is the most common version
How it works
This is the most common approach to the ketogenic diet and involves getting 75 percent of your calories from fat, 20 percent from protein, and 5 percent from carbohydrates. That means limiting your carbohydrate intake to about 20 to 30 grams (g) of carbohydrates per day, Shapiro says. It is important to note that while this is the keto diet that most people follow. It is not the original or therapeutic version of keto that a Canadian Family Physician article showed 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 carbohydrates.
Who is better for people looking to accelerate their weight loss and take advantage of the other reported health benefits
Risks to be aware of Kizer says there are some groups that shouldn’t follow the standard version of keto (or any other version either): pregnant women, people with diabetes (at least not before discussing it with a doctor), and those with a history of kidney stones She notes that ketosis can result in bad breath, dizziness, constipation, and low energy levels (commonly called the “keto flu”) for the first few weeks.
The most concerning drastic weight changes, whether ketogenic or not, can increase mortality risk, Kizer says. The weighted cycle, also called a yo-yo diet, can put particular pressure on the heart.
3. Targeted ketogenic is for athletes looking to improve their performance
How it works You will follow the ketogenic diet as usual until 30 to 45 minutes before exercise; then it’s time to eat about 25 g of carbs, says Daniela Torchia, Ph.D., a registered dietitian based in Loma Linda, California. The idea is that you will have enough carbohydrates to fuel your workout and you can still easily return to ketosis after you cool down. Choose carbohydrates that are easy to digest (for example, white bread or white rice) and make sure you don’t add calories to your daily total – just redistribute it, says Dr. Torchia.
A study published in 2019 in the Journal of Sports Medicine found that 28 days of a ketogenic diet helped increase some athletic endurance. But the researchers added that the benefits of the diet were mostly seen in short-duration, vigorous-intensity exercise and that the results were inconsistent, so it may not be the preferred approach for all athletes.
Who is it best for? This approach is intended for people who frequently do intense workouts to build muscle, according to Torchia. We are talking about high-intensity exercises, like running, swimming, or playing tennis for hours on end, says Torchia. Going to the gym at a moderate pace a few times a week is probably not enough.
Risks to watch out for Torchia says don’t try targeted keto until you’ve been on a standard keto diet for a month or two. “This idea is called ‘adaptive keto,’ and once your body is used to using fat for fuel, it can more easily come and go with moderate carbohydrates,” he says. She cautions against trying this (or any version of keto) before speaking with a doctor if you have diabetes and are insulin-dependent, as it could lead to too-low blood sugar.
4. A high-protein ketogenic diet may be best for bodybuilders
How it works This version of keto requires increasing your protein intake a bit. Protein should make up about 30 percent of calories, with the other 65 percent coming from fat and 5 percent from carbohydrates, Spritzler says. Try to get your protein from both animals (meat, fish, and dairy) and plants (nuts and seeds), Spritzler suggests.
Who is it best for? This is intended for those who need protein to help protect muscle mass, such as bodybuilders and older people who need to prevent muscle breakdown, says Spritzler. It is also a good option for those who show signs of protein deficiency. Those signs include muscle loss or hair thinning, according to the subcommittee of the 10th edition of the federally recommended dietary allowances.
Risks to watch out for:
People with kidney problems should be careful not to increase their protein intake too much. People with kidney disease can experience waste build-up in the blood if they have too much protein.
High-protein keto may not be right for you if you are on the diet for therapeutic reasons. “The reason protein is limited [in keto] is because the goal of keto therapy is to treat epilepsy and have high levels of ketones,” says Spritzler. “Protein won’t get you out of ketosis if you have a lot of it, but it will definitely lower the number of ketones in your blood.” Since a little more protein shouldn’t affect your body’s ability to stay in ketosis, this version of the diet offers the same weight loss benefits as standard keto, says Spritzler.
5. A cyclical ketogenic diet (or “ketogenic cycling”) may help you stick with the diet
How it works In cyclical keto, also called the keto cycle, you will go in and out of keto; Typically, you will stay on the diet for five days, followed by a day or two with more carbohydrates. “The whole point of the keto cycle is to make it easier for someone to follow it,” says Kizer. Every five or six days they can consume the carbohydrates that they have been completely restricting. There is no set protocol for what your carb days should be like. But Kizer cautions against overdoing it because that will make it harder for your body to get back into ketosis.
What is best for this is intended for those who have a hard time sticking to the ketogenic diet. “It can be helpful if someone wants to take a break and eat carbohydrates,” says Dr. Koche. That may not be easy for everyone.
Kizer is concerned that this approach may promote carbohydrate binges. You may have heard of the keto cycle recommended for athletes. Who use the extra carbs to boost their workouts or competitions. For example, that 2019 study in The Journal of Sports Medicine indicated some endurance benefits. But the results are mixed, and a study published in April 2018 in The Journal of Sports Medicine and Physical Fitness has shown that the ketogenic diet makes it difficult to exercise performance.
Risks to be aware of Koche says to wait until you’ve adjusted to the ketogenic diet, which means your body is used to turning fat into fuel, before adding these high-carb days as it can slow down the potential benefits. and results from being in ketosis. Kizer notes that the ketogenic cycle can cause fluctuations in body water, which can lead to dizziness. “It can also be hard on the heart for those with some heart conditions,” she adds.
6. The lazy ketogenic diet might be the easier version
How it works The purpose of the so-called “lazy keto” diet is to make the keto diet easier to follow. Counting your calorie, fat, and protein intake – For some people, that’s too tricky. “All you track is the carbs on the lazy ketogenic diet,” says Kizer.
You should still see similar results to the regular ketogenic diet, as long as you keep your carb intake low enough and don’t overdo it in the protein department, Kizer says. “As long as your carbs are kept low enough, which will vary from person to person, but is generally less than 50g a day, you will stay in ketosis,” says Kizer. As a result, you will be able to see the effects associated with being in the metabolic state.
Risks to be aware of The same people who experts say should stay away from the ketogenic diet, in general, should also avoid this approach, such as pregnant women, people with diabetes who use insulin or take hypoglycemic medications, and people with Type 1 diabetes who are at risk for ketoacidosis, says Kizer.
Lazy keto can also be dangerous if you interpret it to mean that sometimes you are on a keto diet and sometimes not. “Ketosis is all or nothing, or you’re in ketosis or you’re not,” says Kizer. “What worries me is when people say they are on a ketogenic diet but not quite or anything like that. This could lead to weight gain and increased blood lipid values if someone just starts eating. a high-fat diet and borrows concepts from ketosis. ” For example, a small preliminary study published in the February 2019 issue of Nutrients suggested that those taking a “cheat day” on keto could be damaging their blood vessels.
7. Keto 2.0 is a standard low-fat type of diet
How it works The latest revamp to the ketogenic diet is Keto 2.0, which is gaining traction for those who feel that the standard ketogenic diet is too restrictive and difficult to stick with long-term, says Penny Scholl, RD, in Avon, Massachusetts, who covers ketogenic approaches on his blog, Remake My Plate.
With Keto 2.0, the amount of fat goes down, while carbs and protein go up, with the idea that you will be able to eat a wider variety of carbohydrates, such as fruits, vegetables, beans, and whole grains. The breakdown here is 50 percent fat, 30 percent protein, and 20 percent carbohydrates. “In general, this diet allows for more variety compared to the traditional ketogenic diet,” says Scholl.
One caveat is that there doesn’t seem to be any research yet to indicate this is effective for weight loss.
Who is it Best For “Including more carbohydrates can make it easier for some people to stick with life-long changes in what they eat.”
Risks to be aware of Despite the name, this isn’t really keto, says Scholl. With a higher carbohydrate intake, you will no longer be in ketosis, and your body will use fat for energy instead of carbohydrates. Keto 2.0 macros bring you closer to a moderately low-carb diet, such as the maintenance phase of the Atkins diet, according to Scholl. So the risk is that you’re not actually doing keto and getting into ketosis, which can lead to weight gain, but with that said, this could be a nice bridge from a high-carb diet to more traditional keto approaches.
A final word on choosing the right type of keto diet for you
It’s a good idea to meet with your doctor or a registered dietitian every time you change your diet, whether you’re on keto or another eating plan. And above all, Torchia says to listen to your body and evaluate your energy level and how you feel about the diet. “You will be your best teacher,” she says.
As a primary care physician, I am asked at least twice a week what I think about the ketogenic diet – does it really work? The short answer is yes, it works for some. The long answer is more complicated. Keep in mind that if you have any medical problems, especially chronic kidney disease, diabetes, high cholesterol, or heart disease, you should first discuss important dietary changes with your primary care physician.
What is the ketogenic diet?
Simply put, the ketogenic diet is a way of teaching your body to use fat for energy instead of glucose or sugar. The diet focuses on limiting carbohydrates or foods high in flour and sugar and increasing fat and protein intake.
Why the ketogenic diet can work
First, we have to think about why we eat. Our cells need glucose to function. When you’re hungry, your brain signals that your cells need energy. The easiest form of energy for your body to convert is glucose. So if you eat carbs as a result of that hunger signal, your cells get the sugar they are requesting. But if you don’t give your body easy access to glucose, you will have to work harder to get your energy. It finds fat in the liver and uses stored fats for energy. This results in weight loss.
What you need to know about the ketogenic diet
It is important to take into account fats. Some ketogenic diet websites and recipes will tell you to eat as much fat and protein as you want and to avoid all carbohydrates. This is very hard on your kidneys and bad for your cholesterol. My keto diet recommendation is to focus on protein and good fats like avocado, olive oil, and walnuts. And don’t give yourself a pass to eat an unlimited supply of bacon.
Second, don’t avoid all carbohydrates. You should avoid starchy carbohydrates and highly refined carbohydrates, but keep your veggies.
Starchy carbohydrates include bread, pasta, potatoes, tortillas, and rice. If you eat things from these groups, choose the brown version instead of the white one. Refined carbohydrates are foods like sugary drinks and cookies. Many highly processed or refined carbohydrates will have high fructose corn syrup as an ingredient; be sure to avoid them.
Possible problems with the ketogenic diet
Several patients have come for routine visits with significant weight loss on the ketogenic diet, but high LDL cholesterol (the bad kind) and worsening kidney function. Like any other way of eating, any excess can cause problems. Too much protein and insufficient carbohydrates can be too difficult for the kidneys to filter and process and can lead to poor kidney function.
However, the two main causes of chronic kidney disease are hypertension and diabetes. The ketogenic diet can help control diabetes and hypertension by promoting low carbohydrates and sugars. This means that you need medical guidance if you already have kidney disease and will need specific modifications to closely monitor your kidney function.
There is also concern that the long-term ketogenic diet could lead to bone demineralization and osteoporosis. This is still under investigation. The key point is to talk to your doctor and monitor your calcium and vitamin D levels. Supplement these, especially if you are at increased risk for osteoporosis.
What about fasting?
Another concept of the ketogenic diet is “intermittent fasting.” Fasting helps access your body’s fat for energy to promote weight loss. Again, you need to be careful about this and be sure to speak with your primary care physician.
Fasting doesn’t have to be a complicated algorithm or days of eating only bone broth. It can be as simple as having an early dinner around 5:30 p.m. and waiting until 6:00 a.m. for breakfast. This allows your body to “fast” and tap into fat stores for energy rather than eating something else to provide simple sugar for energy.
Ultimately, remember that the key to a healthy lifestyle is not another fad diet, it is a way of life.