Dirty Keto Vs. Clean Keto: What Is The Difference?

grilled chicken meat on wooden table

In fitness and nutrition circles, the word clean has received a special connotation in recent years. No longer only a phrase used to describe a pristine, white T-shirt straight out of the wash, clean now refers to all kinds of food products and diets.

Even particular eating habits, such as the ketogenic diet, have come to be defined using the phrases clean and filthy. But what does it imply if you're following a filthy keto diet vs a clean keto diet? And what's the keto diet to begin with?

What Is the Keto Diet?

Let's start with the fundamentals. The ketogenic or keto diet is a stringent eating pattern that tries to significantly decrease the amount of carbohydrates in the diet. The traditional form of the diet is made of 90% fat, 6% protein and only 4% carbs, which compels the body to utilise fat as its major source of energy. This promotes a metabolic process called ketosis.

Ketosis is when your body breaks down both dietary and stored fat for fuel and generates ketones in the process. Ketones are a consequence of burning fat that are formed in the liver and may be tested in the blood. If you're going to be severe about the keto diet, you'll likely be testing your blood periodically to measure the amount of ketones to make sure you're in the desired zone for fat burning.

The ketogenic diet was initially created in the 1920s to help manage severe epilepsy in youngsters. It's still used to treat patients who've not had success with other approaches, and more recently, it's been proposed that the keto diet might help prevent the spread or return of some forms of cancer. It's also a highly efficient strategy to reduce weight rapidly, and consequently, some folks are choosing the ketogenic diet as a health routine.

What's Clean or Dirty Keto?

If you're following a clean diet, that means you're avoiding processed foods, but a dirty keto diet is one that doesn't concentrate as much on whole foods, but rather attempts to stick exclusively to the macronutrient ratio — that is, the ratio of fat, protein and carbohydrates – of the diet.

"Dirty keto is a variant of the typical keto diet and is frequently referred to as 'lazy keto,'" explains Matthew Black, a registered dietitian at the Ohio State University Wexner Medical Center.

"There aren't definite criteria for this variety, and it actually relies on individual desire. The primary difference with dirty keto (vs clean keto) is that users think they may have greater flexibility to eat what they want, assuming they keep a low enough carbohydrate consumption," Black notes.

This includes some "cheat days," Black says. "Some consumers of filthy keto may also accept occasional days of having higher carb items, such as refined carbs like chips, pretzels or baked goods. Additionally, filthy keto puts less of a focus on the perceived quality of meals." To others, this implies some things that are a no-go on stricter or cleaner versions of the ketogenic diet are in-bounds on the filthy version.

Examples of items that may be consumed on a filthy keto diet — routinely or just on cheat days – depending on your interpretation:

Artificial sweeteners.
Processed oils.
Processed proteins.
Low-carb snack items, such as potato or tortilla chips and cookies.
Chai and coffee beverages that incorporate coconut milk and sugar-free syrup.
Pork rinds with beef jerky.
Cheese chips.
Chocolate.
Salami with cheese.
For example, on a filthy keto plan, you may have a basic cheeseburger without the bread from any fast food establishment, Black adds. Though the food quality is poor, it complies to the macronutrient profile of the ketogenic diet.

By contrast, "clean keto is widely recognised as the original form of the ketogenic diet," Black explains. As such, this version lays a stronger emphasis on various components, including:

Nutrient density of foods.

Overall meal quality.

Where meals were sourced.

Avoidance of processed meals all together.

In line with the scenario above, someone following a clean keto programme wouldn't eat the fast food cheeseburger – even without the bread, Black adds, but rather "would take issue with the meat not coming from grass-fed animals." Instead, that individual may choose for a healthy green salad with steak tips from grass-feed cattle.

Examples of Clean Keto Versus Dirty Keto Foods to Eat Clean Keto Foods Dirty Keto Foods Baked chicken tenders with asparagus and butter Brined and fried chicken tenders (without the flour-based breading) with sugar-free BBQ sauce Homemade zucchini chips fried in grass-fed ghee Packaged keto-friendly cheese chips Coconut milk with strawberry smoothie Heavy cream and strawberry smoothie Iced tea with stevia and sparkling water Diet soda Health Benefits

For some adults, adopting a keto diet may lead to weight reduction, which may lead to health advantages for certain people. Certain study has also revealed that the keto diet may improve hormone balance in some people, with reduced acne and decrease of symptoms linked with polycystic ovarian syndrome in some women.

Studies are also continuing into whether or not a ketogenic diet might decrease the progression of cancer or lessen the chance of cancer recurrence. The concept is that many forms of cancer cells flourish while developing in a high-sugar environment, therefore by restricting the body of sugar and pushing it to transition to a fat-burning mode of energy production, that might slow down the development of cancer or perhaps reduce tumours.

There have also been some hints that the diet may be able to aid with diabetes control, although long-term evidence is still limited and many physicians and nutritionists warn diabetics to continue with care and only under the advice of a qualified dietician.

Health Risks

One 2016 research indicated that during the short term, the ketogenetic diet might produce gastrointestinal irritation. "Common side effects include constipation from lack of fibre and long-term vitamin and mineral deficiencies from avoiding carbohydrate sources, which include fruits, many non-starchy vegetables, whole grains and dairy products," says Hillary Adams, a clinical dietitian also with Providence Regional Medical Center Everett.

With both the clean and dirty forms of the keto diet, "the concentration on large levels of fat might lead to concerns with hyperlipidemia, particularly on filthy keto," Black explains. Hyperlipidemia is an elevated concentration of lipids and cholesterol in the blood, which may raise risk of heart disease.

In addition, taking out key food categories such as fruits and vegetables might set you up for certain nutritional inadequacies, says Bromley Maharg, a clinical nutritionist with Providence Regional Medical Center Everett in Washington State. So although lowering weight might enhance general health for some individuals, that's not the case for everyone, and removing nutrient-dense fruits and vegetables in favour of saturated fat may not be the best decision.

Black further states that people with liver or renal disorders should not follow a ketogenic diet because of "the function these organs play in digestion/metabolism of fat and proteins. Also, any patient who has attempted either diet more than once but did not achieve the anticipated results," should definitely forego it, he adds, since it may lead to yo-yo dieting.

In addition, Adams observes, "those taking certain drugs may face unfavourable side effects of adopting a ketogenic diet. Certain drugs for lowering blood sugar and A1c levels in patients with Type 2 diabetes might suffer acute nausea and vomiting from ingesting a diet so rich in fat." If you have diabetes or are on blood sugar regulating drugs, be careful to talk with your physician and a nutritionist before beginning a ketogenic diet.

Lastly, after your time on the tight eating regimen is done, don't be astonished if the weight that dropped off so rapidly comes back just as fast, Maharg adds. "Rapid weight loss generally happens after glucagon, a ketogenic hormone is triggered. This mobilises fat storage for energy when carbs (the body's primary source of energy) is not eaten. Despite quick weight reduction, weight gain follows when you reintroduce carbs and the body is no longer in ketosis."

Adams states that "additional study is required to identify the ultimate long-term health concerns, as well as the impact on non-epileptic people following the diet. At this moment, there is not enough information to support the utility of the ketogenic diet in other disease conditions," except than controlling intractable epilepsy. And she observes that "removal of whole food categories may sometimes lead to compulsive or disordered eating behaviours."

Costs \sMaharg writes that "following a proper ketogenic diet may be costly, since it depends on nutritional supplements to satisfy the normally high levels of animal protein and fat, which are historically more expensive than alternative proteins such as beans, nuts and seeds."

Plus, Adams writes, "the ketogenic diet is typically seen as being extremely rich in protein, not fat, which puts extra focus on increased consumption rates of meat, chicken and fish," all of which may be pricey sources of calories. And it may not even have the intended benefits. "Consuming too much protein may hinder someone from establishing a ketogenic state. Prepackaged ketogenic items may be easy and less time consuming, but quite pricey in this niche market."

Black thinks that a filthy keto would be cheaper than a clean one "as it allows for packaged meals. Clean keto requires real meals, nothing processed and more costly protein sources, which is a fair philosophy, but will likely raise your shopping expense."

Which One Is Better?

So, is one version healthier than another? "In short, no," Maharg adds. "In order to establish a state of ketosis, carbohydrate consumption needs to be low, as does protein intake. The advised diet advises a ratio of 3 to 4 grammes of fat for every 1 gramme of carbohydrate and protein combined. High levels of saturated fats are generally necessary to attain this aim." But, having a large quantity of saturated fats is associated to the development of cardiovascular disease.

Both diets follow similar prescriptions for the ratio of fat, carbohydrates and protein, and for some individuals, the low-carb lifestyle may lead them to lose weight. "If a person can endure being on either (clean or filthy keto) diet long enough, weight reduction might be the reward, which can lead to gains in general health ranging from lowering of blood pressure and reducing insulin resistance," Black explains.

However, since it's so restricted, any variant of the diet is typically difficult to keep long term. "The Achilles heel with both variants of the ketogenic diet is sustainability," Black explains. Because there's more wiggle space on the filthy form of keto, it may be somewhat simpler to sustain for a longer duration.

"While clean keto has better criteria, it still asks for large doses of lipids, such as coconut oil, which are much too high in saturated fat than advised and may raise LDL cholesterol," Black notes. Keto advocates claim these oils will not cause issues with cholesterol, due to MCT oil content in coconut oil. But the average dieter will not always completely follow clean keto guidelines or know how to correctly implement them, he warns.

The Takeaway

Ketogenetic diets, whether they're clean or dirty, can lead to rapid weight loss, but maintaining that reduction long term can be really challenging. "In general, any diet that requires users to make such drastic changes and all but eliminate the foods they enjoy, will typically offer limited long-term success," Black says.

For this reason, "I do not offer either to patients, unless there is a clinical requirement, such as epilepsy," Black explains. "Otherwise, I think this diet to be simply a temporary answer to a persistent issue. These diets appeal consumers because they allow them to eat highly sumptuous and satiating meals," he argues. That's because fatty meals may help you feel filled longer.

But the lack of diversity gets old soon. "In time, the ordinary user becomes bored of these diets and eventually ends up coming back to the core cause of obesity," Black explains. These root causes include:

Overconsumption of calories, particularly from processed carbs.

Lack of portion control.

Poor awareness of human nutrition, which may be aggravated by adopting fad diets.

Similarly, Maharg and Adams claim they also "cannot safely prescribe a ketogenic diet outside the epileptic group. Instead, we stress incorporation of a diversity within each of the five food groups: dairy, fruits, grains, protein, and vegetables," and they advocate visiting with a trained dietitian to discover the best eating plan for your lifestyle and individual health requirements.

Dirty Keto Vs. Clean Keto: What Is The Difference?