3 Ways to Follow a Ketogenic Diet

The ketogenic diet is designed to put the body into a metabolic state that mimics fasting—without starvation. It is a very-low-carbohydrate and high-fat diet. The body is forced to rely on fats as a source of fuel.

As the body adapts to the ketogenic diet, it becomes very efficient at burning fats. The process of breaking down fats produces acidic compounds called ketones, which brain cells can readily use as fuel. Although the ketogenic diet was initially developed as a way to reduce seizures in patients with epilepsy, modified versions of the diet have become a popular trend.

The ketogenic diet is one of the most restrictive types of diets and one of the most complicated to follow. If you are thinking about trying the ketogenic diet, please consult with a qualified nutritionist or healthcare provider. The information below is to help you understand the various ways to follow a ketogenic diet so that you can make informed decisions about your health.

Classic Ketogenic Diet

The Classic Ketogenic Diet (also called the Standard Ketogenic Diet) is considered the gold standard for all ketogenic diets. This is the diet that was developed in 1921 at the Mayo Clinic as a way to reduce seizures in patients with epilepsy. The Classic Ketogenic Diet is also the most restrictive and most complicated to follow of all ketogenic diets.

The macronutrients eaten on a Classic Ketogenic Diet are calculated in a ratio of grams of fat to grams of protein and carbohydrate combined. The ratio for the original diet was 4:1, which translates to eating 90% of calories from fat. This should only be done under medical supervision.

Nowadays, many practitioners recommend a modified version of the Classic Ketogenic Diet that is based on a less restrictive macronutrient ratio of 3:1, 2:1, or 1:1. The least restrictive of these (1:1) translates to eating about 70% of calories from fat.

To put this into perspective, a 1:1 ketogenic diet provides 70% of calories from fat, 25% of calories from protein, and 5% of calories from net carbs (net carbs means the number of total carbohydrates minus the fiber). This means that a 1950-calorie ketogenic diet with a 1:1 ratio would provide the following:

150 grams of fat
125 grams of protein
25 grams of net carbohydrates

The ratio of fat grams to protein + carbohydrate grams is typically calculated for each meal. Many people find it useful to use an app to help them calculate appropriate foods to eat. You can find a review of the best keto apps here.

Targeted Ketogenic Diet

The Targeted Ketogenic Diet is popular among athletes who do high-intensity or endurance exercise. The diet allows for increased consumption of carbohydrates before workouts. These carbohydrates are typically rapidly absorbed sugars, from sources like sports drinks or gummies. Aside from these brief bursts of carbohydrate to fuel workouts, the Classic Ketogenic Diet is followed the rest of the time. The Targeted Ketogenic Diet is explained in detail by Craig Clarke.

Modified Atkins Diet

The Atkins Diet was introduced in 1972 by the cardiologist, Dr. Robert Atkins. It involved four phases, with the first phase limiting carbohydrate intake to less than 20 grams per day. Subsequent phases of the diet introduced higher daily intakes of carbs.

The Modified Atkins Diet was developed at Johns Hopkins University as a modified version of this first phase of the Atkins diet. The goal was to mimic the ketosis achieved by the Classic Ketogenic Diet—but in a less restrictive way that would be easier to follow. The macronutrient ratio of the diet is similar to a 1:1 ketogenic diet and provides about 65% of calories from fat.

One reason the Modified Atkins Diet is easier to follow than the Classic Ketogenic Diet is that it recommends counting carbohydrates rather than calculating ratios. Children begin at 10 grams of carbohydrate per day for one month and then increase to 15 grams per day and eventually 20-30 grams per day. Adults begin at 15 grams of carbohydrate per day and increase to 20-30 grams after one month. Unlike the Classic Ketogenic Diet, the Modified Atkins Diet does not restrict protein intake.

Although the Modified Atkins Diet is best followed under medical supervision, the original

Atkins Diet is promoted to the general public as a strategy for overall health. There are also instructions on how to follow the Atkins Diet.

Healthy Foods to Include in a Ketogenic Diet

You may have noticed that we have, so far, only talked about grams of fat, protein, and carbohydrate in a ketogenic diet. There’s been no mention of exactly what foods to eat. That’s because the ketogenic diet is defined by its macronutrient content—not by its food quality or nutrient density.

That means you can follow a ketogenic diet in a healthy or unhealthy way.

Regardless of which version of the ketogenic diet you follow, consider including some of these healthy foods…

Keto-friendly foods:

Avocados. Nobody will deny that avocados are packed with nutrition. They are also high in fat and low in carbohydrates. They are a perfect staple for the ketogenic diet.
Nuts and Seeds. Nuts and seeds provide essential fatty acids as well as minerals, such as magnesium, selenium, and zinc. Nuts and seeds can provide much-needed micronutrients as part of a ketogenic diet.
Butter, Cheese, Cream, and Greek Yogurt. Organic and grass-fed dairy products provide vitamin A, vitamin D, and short-chain fatty acids. Full-fat dairy products are keto-friendly and provide little to no carbs.
Coconut oil. Coconut oil is a dietary source of medium-chain triglycerides (MCTs). These fats are more rapidly metabolized than longer-chain fatty acids and are an excellent addition to the ketogenic diet.
Rich in choline, eggs are a brain-healthy part of the ketogenic diet.
Fatty Fish. Salmon, mackerel, anchovies, and sardines are excellent sources of omega-3 fatty acids and high-quality protein.
Organic Meat. Organic beef, bison, pork, and poultry can provide protein as well as essential minerals, like iron, for a ketogenic diet.
Low-Carbohydrate Vegetables. Vegetables are essential to a healthy ketogenic diet. Green-leafy vegetables, as well as broccoli, cauliflower, zucchini, and peppers provide vitamin C, folate, and other vitamins that might otherwise be missing from a low-carbohydrate diet.

Keto Diet Takeaway

Remember—the ketogenic diet is one of the most restrictive of all diets. It can be tricky to ensure the intake of all of the essential nutrients. Please consult with a nutrition professional or other healthcare professional if you are thinking about trying the ketogenic diet.

About the Author: Sarah Cook, ND, is an instructor at the Nutrition Therapy Institute. She is also the owner of ND Pen, providing branding, copywriting, and website design services for integrative healthcare practitioners. Connect with Sarah at ndpen.com.

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