Variations on the Johns Hopkins protocol are common. The initiation can be performed using outpatient clinics rather than requiring a stay in hospital. Often there is no initial fast (fasting increases the risk of acidosis and hypoglycaemia and weight loss). Rather than increasing meal sizes over the three-day initiation, some institutions maintain meal size but alter the ketogenic ratio from 2:1 to 4:1.
In short, no. Apples even have too many carbs. Pineapples hugely spike insulin. Never consume fruit juices. The fiber is bound to the phytonutrients and the juice is cooked, removing many nutrients. You’re basically just drinking concentrated fructose + corn syrup. As an adult, I wouldn’t consume much fruit, period—except maybe ½ cup berries a day. Fructose consumption can lead to a fatty liver, insulin resistance and can spike insulin MORE THAN GLUCOSE!
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Note: Are you a vegetarian or vegan and want to go on a ketogenic diet? It’s still possible! Just keep in mind that the dietary restrictions can sometimes be a little bit intense. Make sure to plan ahead and prepare to aid your success. To help out, we’ve published articles (with 7 day meal plans included) for both the vegetarian ketogenic diet and the vegan ketogenic diet.