An interesting read for those who are interested in the Keto Lifestyle. This is an abridged summary of Choosing Your Keto Method: Clearing Up the Confusion authored by Mandy Pagano.
I personally use some of the tenants of Keto but am not a dyed-in-the-wool practitioner (I do after all advocate a Non-Obsessive WOE) but I do find using a WOE like this can initially help get me down to a comfortable weight to meet my wider goals, while becoming a Mindfuleater helps maintain that goal.
The Keto community has left, right and centrists camps within its wall and there is no secret that there is often controversy over exactly what having a Keto Lifestyle is.
Having taken on a Keto type diet in the beginning of my WOE has however, taught me to be more self-disciplined in learning to control cravings and better manage food choices.
Body building versus therapeutic. Traditional versus high protein. IIFYM versus clean. Dairy free/paleo keto versus a more primal style. Fasters and those opposed. Carnivore versus regular keto versus vegetarian versus vegan! And then you get into the vitriol, wherein you’ve got the “meathead” crowd yelling insults back and forth with the so-called butter chuggers. What often gets lost in the mix here is the average Joe or Jane, just looking to change their lives and reach their health goals.
The following extracts describe the three main branches of keto and will hopefully help the keto-curious figure out which style of keto will be best for them.
Let’s start by defining our terms.
What is Keto anyway?
A Ketogenic protocol is technically defined as very low carbohydrate, with a minimum macronutrient ratio of 65% or more calories from dietary fat, 35% or less calories from dietary protein, and 5% or less calories from dietary carbohydrate (yes, I’m aware this equals 105%. If one were to eat 0 carbohydrate, he or she could technically eat 35% calories from protein and still be Ketogenic). These are the parameters for keto, as laid out by researchers Phinney and Volek in their Art and Science book series.
Since most people are looking at grams rather than percentage of caloric energy, these parameters roughly translate into a gram to gram ratio that is at minimum 1:1 fat to protein. That’s means, the lowest fat to protein ratio you can regularly eat and still maintain Ketogenic macros is 1 gram fat for every 1 gram protein. No matter which approach you choose, these ratios are always the starting point for developing a Ketogenic protocol.
What is the difference between the various approaches?
When it comes to keto approaches, there can be a lot of variations. However, most fall into one of three major categories: (a) High fat, moderate protein; (b)Low-to-moderate fat, high protein, and; (c) therapeutic. The type you choose is going to depend heavily on your body and your goals.
High fat, moderate protein
This camp, which we will abbreviate as HFMP, is exactly as its moniker describes. The HFMP approach is very low carb, usually under 20 grams a day, keeps protein in a very moderate range, and is usually very high in dietary fat. Whereas the minimum fat in a Ketogenic protocol is 65%, or 1:1 in grams of fat to protein, HFMP tends to be more like 75% dietary fat, which usually works out to something over a 2:1 fat to protein ratio. In a nutshell, if you’ve cut carbs down to almost nil, and are keeping protein in a moderate range, the rest of your daily energy intake must come from somewhere, and that somewhere is dietary fat, almost but not quite by default (you could technically get the rest of your calories from alcohol, but that would probably kill you. Don’t do that). The HFMP camp is basically standard keto.
Low-to-moderate fat, high protein
The high protein approach has several variations. In my experience, I believe the moderate fat camp is probably the most numerous, but the low fat camp is definitely the most vocal. I will abbreviate this approach as MFHP, for ease of reading. This approach essentially calls for a much higher percentage of daily caloric intake coming from protein. Whereas the HFMP approach tends to recommend consuming fat at 75% calories or higher (a minimum of 2:1 fat to protein in grams), the MFHP approach calls for a lower fat and higher protein intake, generally in the ballpark of the minimum ratios for Ketogenic macros (65% fat and more like 30% + protein, which translates to roughly 1:1 fat to protein in grams).
The nuts-and-bolts of how this approach works is via the higher protein intake, usually coupled with caloric restriction. It should also be noted that protein is the most difficult macronutrient to digest and metabolize, so there is an underlying assumption that someone following this protocol will have a somewhat increased metabolism from the increased protein intake.
The therapeutic approach
The therapeutic approach to a Ketogenic protocol is exactly what it sounds like. It is an approach specifically for therapy of the medical kind. Ratios can vary from doctor to doctor, but this protocol is typically very high fat, and moderate to low-moderate protein, depending on individual needs. While it’s not completely consistent, I have seen individuals on therapeutic ketogenic protocols eating as little as 80% calories from dietary fat, and as high as over 90%. This translates to well over the minimum 2:1 fat to protein gram ratio commonly associated with HFMP. Many patients on therapeutic Ketogenic protocols are regularly eating over 4:1 fat to protein, depending on their needs.
The basic idea to this approach is that patients want to keep their blood ketones very high as part of their therapy or disease management. Epileptics and those suffering from neurological disorders and degenerative diseases are generally greatly helped by a therapeutic protocol because ketones are taken up by the brain for use as energy in a different and more efficient pathway than sugar, and do not contribute to oxidative stress and cellular damage. Those diagnosed with cancer are another good example of people who may turn to ketosis as part of disease management, in an attempt to “starve” cancer cells, which typically feed on glucose. Because keto is muscle sparing, those following a therapeutic protocol may be able to eat at fairly low protein levels without losing substantial muscle mass.
This approach, as stated above, is typically for medical use only. I wouldn’t recommend it for the average person.
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