The Plant-Based Ketogenic Diet
A lot of diets come and go, but for the most part, we live by the idea that if there aren’t vegetables at the heart of one, it can’t be that great. Which is why we find Pittsburgh-based functional medicine practitioner Will Cole, IFMCP, DC’s plant-based approach to a high-fat, ketogenic diet so compelling.
The gist is to eat a variety of vegetables and lean on healthy fats instead of carbs for energy. It’s a strategy Cole has found works well for most of his patients. It’s also a lot less restrictive than the standard ketogenic approach. In Cole’s practical food book, Ketotarian, there’s significantly more space devoted to all the things you could eat than the things you shouldn’t. And the message is really: Don’t sweat the small stuff, but once you get the ball rolling, you’ll actually…enjoy it.
For more from Cole, listen to us geek out with him on his episode of The goop Podcast, or read his guides to testing gut health and understanding the autoimmune spectrum.
Our bodies have two options for fuel: sugar or fat. Burning sugar for energy is like kindling on a fire: It burns quickly and brightly, but it’s short-lived. You have to keep coming back for more, which a lot of people experience as hunger and anger’s grumpy spawn, hangriness. Even healthy, clean eaters can be stuck on this blood sugar roller coaster: A breakfast of oatmeal with fruit, for example, is ultimately broken down into sugar to fuel your body. A ketogenic diet provides fat instead of sugar as the primary source of energy, which burns slower and lasts longer; it’s metabolic firewood instead of kindling.
A ketogenic diet is generally a high-fat, moderate-protein, low-carb diet. Protein, fat, and carbohydrates are all macronutrients. There are several different ways people can do a ketogenic diet:
Standard Keto: This is the version of the ketogenic diet most people do today. This lifestyle variation of the diet typically consists of getting your calories from 75 percent healthy fats, 20 percent protein, and 5 percent carbohydrates.
High-Protein Keto: This variation of a ketogenic diet doesn’t moderate protein, allowing for more protein during the day. (The Carnivore Diet would be considered this sort of ketogenic approach.)
Cyclic Keto: This way of going keto typically consists of eating a normal ketogenic diet for four to five days a week and increasing carbs the other two to three days a week.
Targeted Keto: Similar to cyclic keto, targeted keto increases carbohydrates around increased activity like a workout.
Restricted Keto: This is different than all the lifestyle versions of keto. By lowering carb and protein intake even more, restricted keto is used to help manage conditions like epilepsy and other seizure disorders as well as forms of cancer that derive their fuel from sugar.
Ketotarian is my plant-based keto approach. Whether you’re making your own meal or eating out, these are the basic guidelines to follow:
- Eat real food.
- Keep your carbs low.
- Keep your healthy fats high.
- If you eat a nonstarchy vegetable, add some healthy fats.
- If you eat a healthy fat, add some nonstarchy vegetables.
- Eat when you are hungry.
- Eat until you are satiated.
Just because something is “low-carb” and “high-fat” or “keto” doesn’t mean you should be eating it. The conventional keto diet often focuses too heavily on dairy, meat, and artificial sweeteners, all in the name of being low-carb and high-fat. This can sometimes work for people to lose weight and gain energy in the short term but has potential long-term health impacts that concern me. Our gut microbiome needs a variety of plant foods for rich bacterial diversity to thrive. With conventional keto, people may focus too much on saturated fats, and I often see inflammation levels spike on labs for people with gut problems and gene mutations (such as the APOE4 allele). Plus, some people have difficulty digesting a lot of dairy and meat.
A ketogenic diet puts your metabolism in nutritional ketosis, a fat-burning state that eschews the volatility of swinging between high and low blood sugar and has the effect of curbing most cravings. There is so much exciting research emerging on ketosis and the main ketone your liver produces, beta hydroxybutyrate (BHB). When you get your body to produce ketones—which is what follows naturally when your body burns through all available carbs—they can also pass through the blood-brain barrier, providing your brain with clean, efficient energy.
Our brains are made up of 60 percent fat and require a lot of energy production to work optimally. From both an evolutionary and a biological perspective, the most sustainable form of energy for your brain and body is healthy fats—not sugar. The ketone BHB has been shown to preserve brain energy levels, protect against neuron death, and lower brain inflammation. Ketones are also thought to be epigenetic modulators, which means they could beneficially regulate gene expression related to metabolism and longevity. Most of my patients are somewhere on the autoimmune-inflammation spectrum, so one of my favorite lifestyle applications of ketones is that BHB is a strong anti-inflammatory.
Ketotarian is meant to be a healthy lifestyle for anyone looking to explore the health benefits of ketosis. I suggest going plant-based keto for at least eight weeks to give your body time to shift from sugar-burning to fat-burning.
After sixty days, reassess where you are and how you feel. If you like where you are, you don’t need to change anything. You’re eating some of the most nutrient-dense foods on the planet. But does everyone need to stay in nutritional ketosis permanently? Absolutely not. You’ll find your groove. You’ll experiment with plant-based keto meals; maybe test out other ketogenic tools, like intermittent fasting; and find your personal carb tolerance. After those two months, I typically suggest spending varying times out of ketosis by increasing your healthy carbs and paying close attention to how you feel.
What makes ketotarianism so sustainable is that it is centered around balance and finding what works for you. Have fun with it. Everyone’s different; many people who are prone to insulin or weight-loss resistance, insatiable cravings, or neurological problems thrive staying in longer-term nutritional ketosis. Others do great with moderating their carbs seasonally or even throughout the week, eating plant-based keto around four to five days a week and increasing their carbs the other two to three days. Some people do just fine with more carbs from real food but love to go back into ketosis when they want a reset.
Since vegetables contain varying amounts of carbs, many well-intentioned people who go keto end up limiting or avoiding vegetables long-term. Let me explain why this fear of vegetables is unwarranted:
Total carbohydrates are all carbs found in your food. Net carbohydrates, on the other hand, are total carbohydrates minus the fiber and sugar alcohols that your body does not digest. Carbs from real foods, like vegetables and avocados, contain both insoluble and soluble fiber. Insoluble fiber in particular (such as cellulose and lignin) can’t be absorbed by the body, so it has no effect on blood sugar and will not take you out of ketosis. Soluble fiber is useful, too. It’s fermented by microbes in your gut microbiome, where it is transformed into beneficial short-chain fatty acids (SCFAs): acetate, propionate, and butyrate. The concern in the mainstream ketogenic world is that soluble fiber can increase blood sugar levels, thereby negatively impacting ketosis. However, studies have shown that soluble fiber can actually lower blood sugar levels.
The SCFA propionate is used by the body for intestinal gluconeogenesis (IGN), making glucose in the intestines. Through the IGN pathway, SCFAs actually bring about a net decrease in blood sugar. So unlike liver gluconeogenesis, which can throw someone out of ketosis by raising insulin and blood sugar levels, IGN seems to help balance blood sugar levels. Fiber also helps your brain know when your stomach is full, which helps curb overeating.
The Ketotarian plan focuses on nutrient-dense, real foods, like vegetables, nuts, and seeds, which all contain carbs that are buffered and harnessed by whole-food fiber. When you are eating nonstarchy vegetables, avocados, olives, healthy oils, low-fructose fruits, nuts, and seeds on the Ketotarian plan, count your net carbs, not total carbs. Shoot for fifty-five grams or less of net carbs a day from these foods. In the beginning, food logging can help you become more conscious of how your food is fueling you and track what helps you feel the best.
If you eat processed, boxed foods—even the supposedly healthy ones—or any foods other than a whole food, count total carbohydrates.
One way to keep total versus net carbs simple is to not count carbs from nonstarchy green vegetables and avocado at all, because they are so low in carbs and so high in fiber. Count only fruit and starchy vegetables, like sweet potatoes, in your total carb count.
Also know that as you nourish your body with plant-based keto foods and your body becomes more metabolically flexible, you can get away from tracking carbs. You will intuitively know what works for your body and what doesn’t.
We all have a different tolerance to carbs, fruit sugar included. Some people can tolerate several handfuls of fruit a day and still get all the benefits of ketosis, while others who are more carb-sensitive will have to limit their fruit intake as their body becomes fat-adapted. In general, for the first eight weeks of becoming a fat-burner, I suggested limiting fruit to a maximum of two handfuls a day and focusing on low-fructose fruits, such as berries and grapefruit.
There are three ways to measure your body’s ketone levels:
- Blood: the current gold standard. Similar to a blood sugar meter, it’s a simple home test.
- Breath: exciting new technology that involves breathing into a meter. I prefer this one.
- Urine: This is fine as you are starting out but not as accurate long-term.
If you are going plant-based keto just to try it, I don’t think most people need to test ketones once they get the hang of it and become fat-adapted. I want the Ketotarian plan to be an effortless, simple way of living—you can rely on natural clues that indicate your body is in ketosis:
- You don’t get hangry anymore.
- You have increased mental clarity and focus.
- You have more sustained energy throughout the day.
- You can go a few hours without wanting to eat or can skip meals easily (which is why intermittent fasting can be easy once you’re fat-adapted).
That said, people who use the ketogenic diet to manage health conditions may need to test ketones long-term, but that would be something to discuss with your doctor.
Plant-Based Keto: Is It Sustainable?
You know that vegetables are good for you. But most vegetables are high-carb and the ketogenic diet demands that you cut carbohydrates. So, which is it? A ton of colorful fruits and vegetables or a low-carb, high-fat ketogenic diet?
Maybe it’s both. You can get all the health benefits of keto without giving up nutrient-dense vegetables.
But is it healthy or sustainable for the long-term to favor a plant-based ketogenic diet? Can a ton of coconut oil and leafy greens make up for the lack of animal products?
Let’s dig into what a plant-based keto diet could look like, and what your options are if you want to give this version of the keto diet a try.
What is a Plant-Based Ketogenic Diet?
The term “plant-based diet” is relatively new, and can refer to a number of different diets that favor vegetables, fruits, and even grains.
Depending on who you talk to, plant-based can mean anything from 100% vegan to simply eating more veggies than animal products.
The ketogenic diet can also be broken down into several distinct ways of eating.
You can follow a standard keto diet, cyclical keto diet, high-protein keto diet, targeted keto diet, and more. The one thing that all forms of the keto diet have in common is low-carb intake.
That means that you reduce your glucose (carb) intake to the point where your body has to turn to an alternative source of fuel for energy — ketones.
So where do these two diets meet in the middle to form a plant-based keto diet? Any diet that relies heavily on plant-based foods and keeps carb intake low enough to where you’re in ketosis is a plant-based keto diet.
However, some people claim that “plant-based keto” refers to a vegetarian or even vegan keto diet. Let’s explore some different definitions of what plant-based means.
Different Types of Plant-Based Diets
Here are some of the most common plant-based diets:
The vegan diet is 100% plant-based. Vegans don’t allow for any animal products, including honey — because it comes from bees.
The vegetarian diet avoids all meat products. It’s almost entirely plant-based, with the exception of dairy and eggs.
The pescatarian diet is a spin-off of the vegetarian diet where plant foods are at the forefront, but in addition to dairy and eggs, seafood is also allowed.
The lacto-vegetarian diet is another spin-off of the standard vegetarian diet where you can eat dairy, but not eggs.
The ovo-vegetarian diet is the opposite of the lacto-vegetarian diet, where you can eggs, but not dairy.
The flexitarian diet is a newcomer to the plant-based diet trend. People who consider themselves flexitarian eat mostly plant-based but allow meat and other animal products in moderation.
People have different reasons for choosing a plant-based diet. Some choose to avoid animal products for religious purposes, while others do it for moral reasons.
Still others believe that a plant-based diet is best for their health, and some choose to avoid meat for environmental reasons. Many people prefer plant-based for a combination of the above points.
Whatever your reasons, the plant-based trend is on the rise.
A 2018 Nielson report revealed that 39% of Americans are actively trying to eat more plant-based. This data also correlated with an increase in produce and vegan grocery sales.
Can You Be Plant-Based and Keto?
As you can see, there are a number of different diets that you can label “plant-based.” But which type is best if you also want the benefits of ketosis?
There are a few things to keep in mind if you want to:
- Get into ketosis
- Eat more plants and few animal products
Here are a couple of points to keep in mind if you’re looking to marry the keto diet with a more plant-based approach.
1: To get into ketosis, you must cut carbs
The main point to remember if you want to get into ketosis is that you have to restrict carbohydrates. Too many carbs and your body won’t switch into a metabolic state where its producing ketones from stored fat.
Most people stay under about 50 grams of carbs per day to achieve ketosis. But you can calculate your unique macronutrient ratios here.
Staying low-carb means that you won’t be able to rely on many vegetarian and vegan proteins like grains and legumes. They’re just too high carb. Which brings us to the next point.
2: It has to be sustainable
Both the ketogenic diet and vegan and vegetarian diets are highly restrictive. The keto diet banishes anything super high-carb, including grains and legumes.
And more plant-based diets get rid of animal proteins from meat and fish to even dairy and eggs.
If you combine the two, you’re left with some coconut oil, olive oil, and low-carb veggies. Not really a sustainable life plan.
More flexible plant-based diets like vegetarian, pescatarian, and flexitarian are the best choices if you want to try plant-based keto because this leaves room for a variety of protein sources.
Which brings us to the protein problem.
3: You need adequate protein
Protein plays a significant role in several aspects of your health including; immunity, growth and development, the health of your heart, and physical energy.
Animal products are complete proteins, meaning they contain all the essential amino acids you need for optimal health. Amino acids are labeled “essential,” when your body can’t make them and you need to get them from your diet.
A plant-based keto diet with no animal protein could mean that you’re not getting adequate protein or a full spectrum of amino acids in your diet.
A better approach would be to up your veggie intake, while still getting plenty of high-quality animal protein from things like meat, bone broth, eggs, and full-fat dairy.
6 Steps To Adopting a Plant-Based Keto Diet
1: Choose Your Path
As mentioned above, there are several different types of plant-based diets to choose from. Similarly, there are several different types of keto diets to consider.
Before embarking on your plant-based keto journey, choose the version of the diet that you believe will be most sustainable for you.
Be gentle and realistic with yourself — figure out which foods you can easily go without and which ones will set you up for success.
No matter which way you go, increasing the number of ketones your body produces while eating more plant-based foods will most likely make you feel pretty great.
2: Keep Carbs Low
As with any keto diet, keeping carbs low is the most important factor to getting into ketosis.
Since you have to avoid meat on a vegetarian or vegan diet, you will have to plan accordingly if you go this route. Remember: no rice or beans on a keto diet.
If your current plant-based diet relies heavily on fruit, grains, and starchy carbs you’ll have to do a bit of an overhaul.
Make sure you know what your carb intake should be and if you’re unsure you can check out this Keto Calculator to find your ideal macronutrient ratio.
3: Eat Lots Of Low-Carb Veggies
When it comes to low-carb veggies on plant-based keto, the more, the merrier. You’ll be limiting starchy vegetables like potatoes, carrots, winter squash, and other root vegetables, so you’ll want to focus on low-carb options like:
- Brussels sprouts
For a more comprehensive list, check out this Low-Carb Veggies Guide.
Try to have at least one serving of these low-carb veggies at each meal, and replace higher carb veggies with leafy greens and cruciferous options whenever possible.
4: Stay On Top Of Your Protein
This is the trickiest macronutrient to manage on a plant-based keto diet. When you’re getting enough animal protein from meat, seafood, eggs, and dairy, you don’t need to worry about it.
But even non-keto plant-based diets can get low in protein.
Depending on which type of plant-based diet you choose, this could mean relying more on eggs and dairy for your protein intake, or a combination of plant-based proteins to get you into your optimal protein intake range.
It’s highly likely you’ll need to supplement with a vegetarian or vegan protein powder if you choose to ditch animal products altogether.
Again, if you’re unsure what your optimal protein intake should be, use this Keto Calculator to determine your protein needs.
5: Consume A Variety Of Fats
Consuming a variety of fat sources is essential no matter which type of keto diet you’re following.
With plant-based keto, you’ll be avoiding animal fats, but luckily you still have an abundance of options in the fat arena.
Always choose healthy fats like coconut oil and olive oil over processed vegetable oils like canola and safflower oils.
You also want to make sure you’re getting enough omega-3 and omega-9 fatty acids from healthy oils, and not over-doing it with omega-6 fatty acids found in many vegetable oils.
Some great plant-based fat options include:
Nuts and seeds:
- Macadamia nuts
- Brazil Nuts
- Walnuts (omega-3)
- Chia seeds (omega-3)
- Flax seeds (omega-3)
- Hemp seeds
- Pumpkin seeds
- Olive oil (omega-9)
- Coconut oil
- Avocado oil (omega-9)
- MCT Oil (medium chain triglycerides)
- Macadamia oil
- Flax oil (omega-3)
- Avocado (omega-9)
- Coconut butter
- Coconut milk
6: Plan Ahead
Regardless of the diet you’re following, planning is essential if you want to prepare for the unexpected. This is especially true when you’re starting a new diet with multiple restrictions.
To avoid going hungry, meal prep on Sunday so you’ll have prepared food all week. Make sure to have plenty of vegan or whey protein powder and almond milk on hand.
If you’re planning a trip, then make sure you have lots of plant-based keto snacks handy in case you aren’t in an ideal place to find a meal. Look into local plant-based restaurants and make sure they have low-carb options.
There are plenty of ways to prepare. And after a while, eating a more plant-based keto diet will become second nature.
Best Sources of Protein on a Plant-Based Keto Diet
Your body needs the nine essential amino acids to function properly. One of the most significant ways in which these protein building blocks affect your health is through muscle growth and synthesis, but they have many other functions in your body as well.
Protein is also essential for immunity, body weight, growth and development, and heart health.
Since plant-based diets either cut or eliminate animal protein, you’ll want to make sure you have plenty of other protein sources on hand. Here are just a few:
- Nuts and seeds
If you are not doing vegan then:
Tips For Supporting a Plant-Based Keto Diet
Take Exogenous Ketones
Taking exogenous ketones can be a great way to increase the number of ketones in your blood, which can help increase energy and performance.
Exogenous means “from the outside,” so exogenous ketones are a way for you to get ketones without having to get into dietary ketosis.
On a plant-based diet, you might have to go higher carb at times, which can kick you out of ketosis. Taking exogenous ketones is a great way to help you get back into ketosis and avoid some of the symptoms that come along with this transition.
Eat More (High-Quality) Fat
Dietary fat is essential to your health for many reasons. Fat is responsible for protecting your nervous system, and helping your body communicate with different areas through neuronal signaling. Your brain consists of nearly 60% fat and has a large impact on your brain’s ability to perform.
Fat is also essential for the production of many hormones and creates a protective layer around your organs. You also need dietary fat for the absorption of many nutrients, including vitamins A, D, E, and K.
Also, make sure you’re getting the right balance of omega-3 fatty acids to omega-6 fatty acids.
Omega-6 fats are abundant in nature, and most people consume more than enough. Omega-3s, however, can be a little more challenging to find. The ideal ratio of these two fatty acids is 1:1; however, in the U.S. most people are getting closer to 20:1 (omega-6:omega-3).
Frankly, getting a 1:1 ratio of these fats would be incredibly difficult, but the closer you get, the better off you’ll be. Omega-6 fats aren’t inherently bad, but a high ratio of omega-6 to omega-3 is correlated with many chronic diseases like heart disease, cancer, and autoimmunity.
Track Your Macros
Tracking your macros is crucial to getting into (and staying in) ketosis. It may take a few weeks or even a couple months to determine what your ideal ratio of carbs to fats to protein is.
Macro tracking is especially important for plant-based keto because you’ll inherently be eating more carbs.
You also want to make sure you’re getting adequate calories. Due to the limitations on a vegetarian or vegan keto diet, you may end up undereating. And that can be just as bad for your health and your goals as over-eating.
Track your calories and add some more healthy fats if you’re coming in under your goal.
Avoid nutrient deficiencies
As important as it is to get adequate calories, you also want to make sure you’re getting sufficient nutrients. Eat an array of different types of foods. Vary your low-carb veggies, choices of nuts and seeds, and vegan protein options.
If you find yourself in a food rut, take to the internet and look for some keto-friendly, plant-based recipes. You’ll likely find keto recipes where you can replace the protein with more veg.
Talk to your doctor
Before starting any diet, it’s always a good idea to talk to your doctor. There are many benefits to the ketogenic diet, as well as plant-based eating. However, everyone’s body is different and depending on the current status of your health, some diets can actually make matters worse.
The Takeaway: A Plant-Based Keto Diet Is Highly Restrictive
The plant-based keto diet is do-able, but it may be quite a bit to manage depending on how strict you decide to go.
Trying to be vegan while following keto may present some real challenges, including unsustainable weight loss, eating under calories, and nutrient deficiencies.
Protein is essential for your health, and the limitations of protein sources on a plant-based keto diet may leave you at risk for deficiency.
If you want to try out this way of eating, make sure you’re on top of your protein intake and that you include plenty of healthy fats. If you can, include eggs and dairy or small amounts of animal meat and/or seafood.