Ketogenic Diet vs. Other Diets: Which Is Best?

ketogenic diet

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The ketogenic diet —also called the keto diet—has become a popular choice among people who want to lose weight, improve their level of fitness or overall health. To follow the diet, you consume foods that are very high in fat and very low in carbohydrates to get your body into a state of ketosis. Ketosis occurs when your body burns fat, rather than glucose, for fuel.

While the eating program has a history of use in medical settings, there is inconsistent evidence supporting its use for long-term weight loss or overall wellness. If you are considering a keto diet, evaluate how it compares to commercial programs like Atkins and see how it fares against other low carb diets.

The 2019 U.S. News and World Report Best Diets ranks the keto diet number #38 in Best Diets Overall and gives it an overall score of 2.1/5.

USDA Recommendations

There are several areas where the ketogenic diet differs from nutritional guidelines provided by the USDA.

Macronutrient Balance

The macronutrient balance of a ketogenic diet varies substantially from the recommendations provided by the USDA.

On a ketogenic diet, it is recommended that you consume about 75 percent or more of your calories from fat. According to 2015-2020 Dietary Guidelines, adult men and women are advised to consume only 20 percent to 35 percent of calories from fat with an emphasis on healthy fat.

Some versions of the ketogenic diet advise that you choose healthy fats such as plant-based oils, nuts, and seeds. But other versions of the keto diet allow for a high intake of saturated fats from sources such as fatty cuts of beef and full-fat dairy products. USDA guidelines recommend that you limit your intake of saturated fat to less than 10 percent of your total caloric intake.

Regarding other macronutrients, the USDA guidelines advise that adults consume 45 percent to 65 percent of calories from carbohydrates. On a ketogenic diet, you consume about 5 percent of calories from carbohydrates.

Your protein intake on a ketogenic diet may align with USDA guidelines. On most versions of the keto diet, you are likely to consume about 20 percent of your calories from protein. USDA guidelines suggest that you should consume 10 percent to 35 percent of calories from protein.

Additionally, the USDA also provides a recommendation for dietary fiber (approximately 23–33 grams per day). Those on a ketogenic diet would have a difficult time reaching this goal since fiber is a carbohydrate.

Food Groups

USDA guidelines suggest that we consume fruits, vegetables, dairy, grains, and protein. While no food is specifically off-limits on a ketogenic diet, many people who go on the diet may find that some food groups need to be extremely limited or eliminated completely to reach and maintain ketosis.

For example, those following a ketogenic diet are likely to consume very little fruit and very few grains as these are primary sources of carbohydrates. In addition, you may not consume many vegetables on the ketogenic diet because many varieties also provide fiber, a form of carbohydrate.

Calories

Calorie counting is not required on a ketogenic diet. There is no specific calorie target on most versions of the program. However, since this diet is high in fat, it is possible that you will consume more calories on a keto eating plan because fat contains more than twice as many calories per gram as carbohydrate and protein.

However, proponents of the keto eating plan suggest that when you follow the program, you end up eating less overall because fatty foods are more satisfying than foods high in carbohydrate.

If your goal is to reach or maintain a healthy weight, you should consume the right number of calories each day—whether you follow a ketogenic eating plan or any other. You can increase your total number of recommended calories by increasing your activity level.

Similar Diets

There are very few diets that follow the exact macronutrient breakdown of the ketogenic diet. But there are other low-carb eating plans that are similar.

Keto Diet

  • General Nutrition: Depending on the variation of the keto diet you choose, you will consume most of your calories from fat (75 percent to 90 percent), limited calories from protein (5 percent to 20 percent) and about five percent of calories from carbohydrate . This makes it hard to reach your daily intake of certain nutrients such as fiber, and other vitamins and minerals that you would get from consuming fruits and vegetables which are limited to the plan.
  • Cost/Accessibility: This is not a commercial diet so there is no subscription fee or required foods to purchase. However, many of the keto diets recommend eating foods that are more expensive such as grass-fed beef and specialty oils like avocado oil or MCT oil.
  • Weight Loss: While some studies have shown significant weight loss on a ketogenic diet, other studies have found that this eating style is no better than low-fat or other low-carb diets for long-term weight loss results. In addition, no-calorie targets are provided on a keto diet. Therefore, it is possible to consume more calories on this eating plan and gain weight as a result.
  • Sustainability: The ketogenic diet is often criticized as being hard to maintain for the long-term. Because the eating program is substantially different from a typical American diet, some consumers have a hard time maintaining the program when eating out or socializing.

Atkins

The Atkins diet has gone through changes since it was developed in the 1960s. The current version of the eating plan is advertised as being keto-friendly.

  • General Nutrition: On the Atkins diet, 55 percent to 70 percent of your calories come from fat. You'll also consume more protein on the Atkins plan (20 percent to 30 percent) and also more carbohydrate (5 percent to 15 percent of your total calories) Therefore, the Atkins diet provides a more balanced nutritional approach. You are also more likely to get your recommended intake of fiber (whole grains are encouraged) and important vitamins and minerals as fruits and vegetables are encouraged during most phases of the eating plan.
  • Cost/Accessibility: You can follow the Atkins diet by reading any of the Atkins books or by signing up for the program online and getting foods and services delivered for a monthly fee. While the subscription plan is likely to be more expensive, following the program based on one of the Atkins books is likely to be less expensive. Most of the foods recommended on the plan are easily found in most grocery stores.
  • Weight Loss: The Atkins program has been studied with mixed results in terms of weight loss. Although since the program has changed through the years, results from older studies may not be relevant. However, the current program is more likely to produce weight loss over the long-term as it suggests proper portions for various foods and also includes an activity program to burn calories and improve health.
  • Sustainability: The Atkins diet is probably easier to sustain for most people, simply because it provides a more balanced approach to eating. While many consumers may not want to subscribe to the commercial program for an extended period, the Atkins books make it easy to follow the maintenance plan for a longer period of time.

Other Low-Carb Diets

There are many diets that fall into the low-carb category. Some consumers simply cut carbs for weight loss or improved health.

  • General Nutrition: There is no specific guideline for carbohydrate intake on a low-carb diet, but in general, you might consume 30 percent of your calories or less on a low-carb eating plan . This provides substantially more carbohydrate than a ketogenic diet. In addition, many low-carb diets are high in protein. As a result, you consume fewer calories from fat. On these eating plans, quality carbohydrates are often emphasized, meaning that you choose whole grains, fruits, and vegetables rather than processed foods that are high in sugar. As a result, you are more likely to meet nutritional goals on a low-carb diet than you are on a keto diet.
  • Cost/Accessibility: There is no single low-carb diet, but many commercial diets follow a low-carb eating style (such as the South Beach Diet and others). While you might choose to join one of those subscription programs for a fee, there is no cost involved in simply cutting carbs from your meals. Additionally, since low-carb eating has become more popular, many traditionally high-carb foods are now manufactured and sold in low-carb versions. This eating style is more accessible and is likely to be less expensive than a keto diet.
  • Weight Loss: Many different low-carb eating plans have been studied with mixed results in terms of weight loss. In some studies, low carb diets have been compared to low-fat diets or to low-glycemic diets. While there have been various study results, researchers often conclude that the diets most likely to produce weight loss are the diets that consumers can stick to for the long-term.
  • Sustainability: A low-carb diet is likely to be more sustainable than a very low-carb, high fat diet such as the ketogenic diet. A low-carb diet provides a more balanced approach to eating and allows for a wider variety of foods overall.

Dukan Diet

Similar to Atkins and the ketogenic diet, the Dukan Diet has its roots in the medical community. The eating program was developed by a physician in the 1970s. It is a low-carbohydrate, high-protein approach to weight loss.

  • General Nutrition: There are four phases of the Dukan Diet: Attack, Cruise, Consolidation, and Stabilization. The first two phases are designed for weight loss and the last two are designed for weight maintenance. On some phases of the Dukan Diet, 79 percent to 90 percent of calories come from protein. The diet is very low in fat and allows for moderately-low carbohydrate intake. It may be hard to consume enough calories and stay within the recommended macronutrient balance on this plan.
  • Cost/Accessibility: There are books you can buy to follow this eating plan. There are also some free online resources. However, if you prefer coaching services, you can purchase a plan for $29.95 per month. Meals and snacks are also available for purchase although they are not required to stay on the eating program. Many foods that you find at your local market are allowed on the program, making it cost-effective and accessible for most.
  • Weight Loss: The Dukan Diet is likely to be effective for weight loss, especially in the short-term. The very low caloric intake will help most consumers lose weight on the plan. However, clinical trials to support the diet's effectiveness are lacking and diet's that are very low in calories are known to backfire. In addition, the diet may be hard to maintain, making it less effective for long-term weight loss or weight maintenance.
  • Sustainability: Those who choose to buy coaching services are more likely to stick to this program, although some support groups and other resources (such as recipes) are available online. Others may find it hard to stick to because of the high protein and very low fat intake.
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Article Sources

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Additional Reading

  • Astrup, A., Larsen, T. M., & Harper, A. (2004). Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss? The Lancet, 364(9437), 897–899. doi:10.1016/s0140-6736(04)16986-9


  • Brinkworth, G. D., Noakes, M., Buckley, J. D., Keogh, J. B., & Clifton, P. M. (2009). Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo. The American Journal of Clinical Nutrition, 90(1), 23–32. doi:10.3945/ajcn.2008.27326

  • Brouns F. (2018). Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable?. European journal of nutrition57(4), 1301–1312. doi:10.1007/s00394-018-1636-y

  • Cappello, G., Franceschelli, A., Cappello, A., & De Luca, P. (2012). Ketogenic enteral nutrition as a treatment for obesity: short term and long term results from 19,000 patients. Nutrition & metabolism9(1), 96. doi:10.1186/1743-7075-9-96

  • Dashti HM, Mathew TC, Hussein T, et al. Long-term effects of a ketogenic diet in obese patients. Exp Clin Cardiol. 2004;9(3):200-5. PMID:19641727

  • Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348(21):2082-90. doi: 10.1056/NEJMoa022207

  • Iacovides, S., & Meiring, R. M. (2018). The effect of a ketogenic diet versus a high-carbohydrate, low-fat diet on sleep, cognition, thyroid function, and cardiovascular health independent of weight loss: study protocol for a randomized controlled trial. Trials19(1), 62. doi:10.1186/s13063-018-2462-5NLM

  • Kosinski, C., & Jornayvaz, F. R. (2017). Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies. Nutrients9(5), 517. doi:10.3390/nu9050517

  • Paoli A. (2014). Ketogenic diet for obesity: friend or foe?. International journal of environmental research and public health11(2), 2092–2107. doi:10.3390/ijerph110202092

  • Ting, R., Dugré, N., Allan, G. M., & Lindblad, A. J. (2018). Ketogenic diet for weight loss. Canadian family physician Medecin de famille canadien64(12), 906. PMID: 30541806

  • Urbain, P., Strom, L., Morawski, L., Wehrle, A., Deibert, P., & Bertz, H. (2017). Impact of a 6-week non-energy-restricted ketogenic diet on physical fitness, body composition and biochemical parameters in healthy adults. Nutrition & Metabolism, 14(1). doi:10.1186/s12986-017-0175-5