10 Types of the Keto Diet

“A keto diet is any diet that gets a body into ketosis,” says Kristen Kizer, RD, who is based in Canberra, Australia.

Ketosis is a natural metabolic state in which 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.

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 of The 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 carb intake as much as the original keto diet requires cuts out many nutrient-rich foods, such as whole grains, certain vegetables, and fruits.

Who It’s Best For People who are trying the keto diet to treat epilepsy.

Unsurprisingly, this strict version of the keto diet also seems to be the toughest one to stick to.

Who It’s Best For People looking to accelerate their weight loss and tap into the other reported health benefits.

Risks to Note Kizer says there are a few groups of people who shouldn’t follow the standard version of keto (or any other version): pregnant women, people with diabetes (at least not before discussing it with a physician), and those with a history of kidney stones. She also notes that ketosis may result in bad breath, dizziness, constipation, and low energy levels (commonly called “the keto flu”) for the first few weeks.

How It Works The target keto diet involves following the keto diet as usual until 30 to 45 minutes before exercising, at which point you eat about 25 grams of carbohydrates, says Daniela Torchia, PhD, a registered dietitian based in Lakewood Ranch, Florida. The idea is that you’ll have just enough carbs to fuel your workout effectively and still be able to return to ketosis easily after you cool down. Choose carbohydrates that are easy to digest (white bread or white rice, for example) and be sure not to add calories to your daily total, simply redistributing them instead, says Torchia.

Who It’s Best For People who frequently engage in intense, muscle-building workouts, according to Torchia. We’re talking about high-intensity exercise, such as running, swimming, or playing tennis for hours on end, she says.

Risks to Note Torchia 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 carb [instake],” she says. She warns that if you have diabetes and are insulin dependent, you should not try this keto diet (or any other version of keto) before talking with a physician, as it could lead to problematically low blood sugar levels.

A high-protein keto diet may also 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,” says Spritzler. “Protein will not kick you out of ketosis if you have a lot of it, 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, she adds.

Who It’s Best For People who have a tough time sticking to the standard keto diet. “It can be helpful if someone wants to take a break and have carbs,” says Dr. Koche. That may not be easy for everyone.

Risks to Note Koche says to hold off on keto cycling until you’ve adapted to the keto diet, which means your body is used to turning to fat for fuel, before adding high-carb days, as they can slow down the possible benefits and results of being in ketosis. Kizer worries this approach may promote carb binging and notes that keto cycling can cause fluctuations in body water as well, which can lead to dizziness.

How It Works The purpose of the so-called “lazy keto” diet is to make keto easier to follow. For some people, counting calories, fat, and protein intake is too complicated. “All you track is carbs in lazy keto,” says Kizer.

You should still see results that are similar to regular keto as long as you keep your carb intake low enough and don’t go overboard in the protein department, says Kizer. “As long as carbs stay low enough, which vary by person but are usually below 50 grams a day, one will stay in ketosis,” she says. As a result, you may see the effects associated with being in that metabolic state.

Who It’s Best For People who are interested in ketosis but don’t want to be bothered with tracking calories, protein, and fat.

Risks to Note The same people who experts say should stay away from keto in general should also avoid this approach, such as pregnant women, people with diabetes who are using insulin or taking hypoglycemic medication, and people with type 1 diabetes who are at risk of ketoacidosis, says Kizer.

Lazy keto can also be dangerous if you take it to mean that you sometimes follow a keto diet and sometimes don’t. “Ketosis is all or nothing; you’re either in ketosis or you’re not,” says Kizer. “What concerns me is when people say they’re following a keto diet but not all the way or something along those lines. This could lead to weight gain and increased blood lipid values if someone just starts eating a high-fat diet and borrowing concepts from ketosis.”

Who It’s Best For People who want a flexible approach to healthy eating that is sustainable in the long term and who want more emphasis on Mediterranean elements like unprocessed foods and high nutrient density, says McDonough. If you’re a huge fan of salmon and sardines, this keto choice may be your favorite.

Risks to Note The standard Mediterranean diet (which isn’t keto thanks to its inclusion of whole grains and fruits) has many elements worth shuttling into a keto plan, so the risks are minimal, says McDonough. If you want to get truly Mediterranean, incorporate social time into your meals, rest after eating, and get regular physical activity.

How It Works The latest revamp of the keto diet is called keto 2.0, and it’s gaining traction with those who feel that the standard keto diet is too restrictive and difficult to sustain in the long run, says Penny Scholl, RD, in Avon, Massachusetts, who covers keto approaches on her blog, Remake My Plate.

One caveat: There doesn't seem to be any research that indicates this diet is effective for weight loss.

Who It’s Best For People who are looking to lose weight but have a hard time sticking to the very low carb amounts allowed in the standard keto diet, says Scholl. “The only effective diet for weight loss is one you can follow long term,” she adds. “Including more carbs may make it easier for some people to follow through on lifelong changes to what they eat.”

Risks to Note Despite the name, this diet isn’t really keto, says Scholl. With the higher carb intake, you can no longer be in ketosis, with your body using fat for energy instead of carbs. The macros with keto 2.0 align it more closely with 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 going keto and getting into ketosis, which may lead to weight gain. That said, this eating plan might be a nice bridge from higher-carb eating toward more traditional keto approaches.

How It Works The macronutrient distribution in the “dirty keto” approach is the same as in the standard keto plan, according to Melissa Nieves, RD, who is based in Puerto Rico. The big difference is that the source of these macros can come from any kind of food, including highly processed and prepackaged meals. For example, instead of getting healthy fats and low carbs from almonds, you can hit your macro amounts with BBQ pork rinds instead. “The main point of dirty keto is that since the macronutrient amounts it follows support a ketogenic state, it doesn’t matter where those macros come from,” she says.

Who It’s Best For People who need a high level of convenience and lack the time or interest for cooking and meal prep, says Nieves. It may also be the easiest route to follow for those just getting into keto, she adds, since you can stick to keto even when traveling or dealing with a busy schedule. You just need to read food package labels carefully rather than going deep into meal planning.

Nieves advises those with preexisting health conditions like diabetes and cardiovascular disease to tread with caution, but even if you don’t have those issues, be aware of the health drawbacks. In general, if you plan on going keto, consider the dirty version only when you need the convenience, not as a long-term approach, she says.

How It Works Clean keto swings in the opposite direction of the dirty keto approach, but you can still focus on convenience, says Raymore, Missouri–based Randy Evans, RD, consultant for Fresh N Lean, a meal delivery service specializing in keto foods. You also still stick to the same macronutrient distribution as standard keto. The difference is that clean keto is based on sourcing the healthiest versions of foods. You look for terms like “organic,” “grass-fed,” “pasture raised,” and “cold-pressed.” You also lean heavily toward whole plant foods, says Evans.

Who It’s Best For People who focus on food quality just as much as they do on macro tracking. Also, clean keto may involve more financial investment, since grass-fed meats and cold-pressed extra-virgin olive oil tend to be more expensive than lower-quality options, especially those packaged for convenience.

Risks to Note Focusing on the healthiest possible foods, and bringing in a fridge-load worth of plants in the process, doesn’t include many cautionary notes, according to Evans. That said, because plant foods still contain carbs, you’ll need to keep your macros in mind. If you can manage it, clean keto can be a relatively healthier way to approach the fad diet.

• While a number of variations of the ketogenic diet exist, the aim of each of them is to keep your body in a state of ketosis, which involves consuming a diet high in fats, moderate in protein, and low in carbohydrates, to fuel weight loss and reap other potential health benefits.
• If you're considering adopting a keto diet, find a version that aligns with your lifestyle and health goals.
• Always consult with a doctor or dietitian before making changes to your diet.

Additional reporting by Elizabeth Millard.