With the growing popularity of keto and its health benefits, some vegetarians have considered giving it a try. But can keto and vegetarianism be combined in a way that is well balanced and sustainable? Are there any risks involved? This article will explore these questions and make recommendations for creating a healthy keto vegetarian lifestyle.
Reasons for Following a Vegetarian Diet
People choose vegetarian diets for a number of reasons. Children raised in vegetarian households typically grow up to be vegetarian adults. For those who adopt vegetarian diets on their own, reasons fall into one of three categories or a combination of them:
- Ethical: Concern for animal welfare, including killing animals for food and/or confining them in feed lots or cages
- Environmental: Concern about land and other resources needed to raise livestock
- Health-related: Belief that eating meat or other animal products is harmful to health and that a meat-free diet may protect against cancer and other diseases
Studies suggest that ethical vegetarians may be more committed to a meat-free lifestyle and remain vegetarian longer than those who do so for health reasons ( 1).
Of course, it isn't surprising that vegetarians who don't believe in killing animals for food would be less likely to resume eating meat than those who do so solely because they believe it's healthier.
However, many people adopt a vegetarian lifestyle for more than just a single reason.
The author of a 2014 review on vegetarianism concluded:
“An increasing number of people do not want animals to suffer nor do they want climate change; they want to avoid preventable diseases and to secure a livable future for generations to come” ( 2).
What Are the Different Types of Vegetarian Diets?
Vegetarians consume no meat, poultry, or fish but some may eat certain other animal products, depending on their beliefs:
- Lacto-Ovo Vegetarians consume dairy products (lacto) and eggs (ovo). This is by far the most common type of vegetarianism.
- Lacto Vegetarians consume dairy products but no eggs.
- Ovo Vegetarians consume eggs but no dairy products.
- Vegans don't consume dairy, eggs, or animal products of any kind, although some eat honey. In addition, they don't wear clothing made from animals, such as leather or suede. They may also avoid using any items containing animal byproducts, such as household cleaners, shampoos, moisturizers, etc.
Although the term isn't universally accepted by vegetarians, there is also a category of eating that is considered “semi-vegetarian”:
- Pescatarians consume seafood but no meat or poultry.
- Flexitarians follow a primarily plant-based diet but eat meat and other animal products occasionally.
Can A Keto Vegetarian Diet Be Well-Balanced and Sustainable?
In recent years, keto diets have become well known for helping people lose weight, decrease blood sugar and insulin levels, and improve other aspects of health. As a result, the question of whether a vegetarian diet and keto diet can be combined has been raised.
Most keto diets are fairly high in animal products, including meat. In fact, most people who follow a keto lifestyle eat at least one serving of meat, fish, or poultry most days.
However, it's possible to create a healthy vegetarian keto diet. Anecdotally, there are hundreds of stories of people successfully combining these two ways of eating. And although there aren't any published studies that have explored this, recently, researchers from India discussed how a keto vegetarian diet can be accomplished (3).
Many Indians are vegetarian for cultural or religious reasons, whereas others do eat meat. In their article, the authors first discuss the benefits of ketogenic diets for those struggling with diabetes, obesity, and other disorders characterized by insulin resistance. They then provide examples of keto-friendly Indian cuisine for both vegetarians and meat eaters.
On the other hand, 100% vegan and keto diets don't work very well together. Humans require complete protein that contains all nine essential amino acids (an “essential” nutrient can't be made by the body and must instead be obtained via diet). Although animal protein provides all the essential amino acids, plants only contain some of them. For instance, legumes and seeds are high in lysine but very low in methionine, whereas grains are high in methionine but lack lysine.
Because vegans exclude all animal products, they must rely on a combination of grains, legumes, and seeds to get all of the essential amino acids their bodies need. This combination is too high in carbs to achieve and maintain ketosis. Therefore, you can either choose to eat a keto vegetarian diet as described above or eat a lower-carb but non-keto vegan diet.
The “Eco-Atkins” diet is the best known low-carb entirely plant-based diet. Although it contains fewer carbs than most vegan plans, it can't be considered ketogenic because it includes grains and fruits and provides considerably more than 60 grams of net carb per day.
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In a 2009 study, 44 overweight adults with high cholesterol consumed either an Eco-Atkins diet or a high-carb lacto-ovo vegetarian diet for 4 weeks. At the end of the study, the Eco-Atkins group experienced greater improvements in LDL cholesterol, total cholesterol/HDL ratio, and other heart health markers than the high-carb vegetarian group, despite similar weight loss within the two groups ( 4).
Keto Vegetarian Protein Sources
Protein is arguably the most important macronutrient since, unlike carbs and most fatty acids, our bodies can't make the essential amino acids. Therefore, we need to eat enough protein to ensure we have enough of all amino acids in order to support muscle growth and maintenance, metabolic rate, hormone synthesis, and other important functions.
After calculating your own protein needs, check to make sure you're consuming enough by including these keto-friendly sources on a daily basis:
- Greek yogurt: 18-20 grams protein and 4-6 grams carb per 170 grams (6 ounces)
- Cottage cheese: 20 grams protein and 6 grams carb per 170 grams (6 ounces)
- Cheese: 7 grams protein and 1-2 grams carb per 28 grams (1 ounce)
- Egg: 14 grams protein and 1 gram carb per 2 large eggs
- Peanut Butter: 8 grams protein and 4.5 grams net carb per 2 Tablespoons (32 grams)
- Almond Butter: 7 grams protein and 5.5 grams net carb per 2 Tablespoons (32 grams)
- Pumpkin Seeds: 7 grams protein and 4 grams net carb per 28 grams (1 ounce)
- Protein Powder (whey, casein, egg, pea): variable protein and carbs -- check label
You'll also get about 1-3 grams of protein from each serving of vegetables, although like other plant foods, they don't contain all of the essential amino acids found in animal products.
Other Nutrients of Concern on a Keto Vegetarian Diet
Omega-3 Fatty Acids
Omega-3 and omega-6 fatty acids are considered essential fats because they must be obtained from the diet. Although obtaining enough omega-6 fats as a vegetarian is easy because it's found in large amounts in many foods, getting an optimal amount of omega-3 can be more challenging.
The long-chain omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have strong anti-inflammatory properties that may help protect heart health, improve insulin sensitivity, and reduce risk of depression ( 5).
These fats are mainly found in fatty fish, although DHA and small amounts of EPA also occur naturally in algae. However, another type of omega-3 fat called alpha-linoleic acid is found in several plant foods, especially seeds. Although your body can convert ALA to EPA and DHA, the conversion process unfortunately isn't very effective ( 6).
Because of this, researchers recommend that vegetarians consume a minimum of 2.2 grams of ALA daily, which is twice the AI (Adequate Intake) established by the Institute of Medicine ( 7). In fact, many experts believe that omega-3 fatty acid intake should be further increased in order to improve the omega-6/omega-3 ratio of modern diets.
Best Keto Vegetarian Sources of Omega-3 Fatty Acids:
- Algae supplements: EPA and DHA in variable amounts – check the label
- Chia seeds: 2.5 grams of ALA per 14 grams (1 Tablespoon)
- Hemp seeds: 2 grams of ALA per 20 grams (1 Tablespoon)
- Flaxseed, ground: 1.6 grams of ALA per 7 grams (1 Tablespoon)
Iron is vital for the production of hemoglobin, a protein found in red blood cells that helps transport oxygen from your lungs to cells throughout your body; and myoglobin, which provides oxygen to your muscles.
There are two forms of iron: heme (found in meat) and nonheme. Heme iron is better absorbed than nonheme iron. However, eating foods rich in vitamin C can improve iron's absorption. Dark leafy greens are high in both iron and vitamin C.
Vegetarian diets have been linked to lower iron stores in adults, which can lead to anemia. On the other hand, elevated iron stores are a sign of inflammation and may increase disease risk ( 8). Although a healthy body is able to regulate iron storage, it's recommended that people without hemochromatosis (a disorder marked by elevated iron levels) consume adequate but not excessive amounts of this mineral.
The Recommended Daily Intake (RDI) for iron is 18 mg per day for reproductive-age women and 8 mg per day for men and women who are over 51 and/or postmenopausal.
Best Keto Vegetarian Sources of Iron:
- Pumpkin seeds: 4.2 mg per 28 grams (1 ounce)
- Sesame seeds: 4.1 mg per 28 grams (1 ounce)
- Coconut milk: 3.3 mg per 100 grams (3.5 ounces)
- Olives: 3.3 mg per 100 grams (3.5 ounces)
- Dark chocolate: 3.3 mg per 28 grams (1 ounce)
- Cooked spinach: 3.6 mg per 100 grams (3.5 ounces)
- Hearts of palm, canned: 3.1 mg per 100 grams (3.5 ounces)
- Cooked white mushrooms: 2.7 mg per 100 grams (3.5 ounces)
- Chia seeds: 2.2 mg per 28 grams (1 ounce)
Zinc is a mineral involved in energy metabolism, immune function, and wound healing. Research has shown that vegetarian adults tend to have lower zinc intake and blood concentrations than those who include meat in their diets ( 9). In fact, the foods richest in zinc are beef and seafood.
The RDI is 15 mg per day for adults and children over 4 years of age. Zinc occurs in very small amounts in most non-meat foods, but there are also some relatively good sources. With a little planning, zinc needs can be met on a keto vegetarian diet.
Best Keto Vegetarian Sources (per 100 grams/3.5 ounces):
- Dark chocolate: 9.6 mg
- Pumpkin seeds: 7.8 mg
- Sesame seeds: 7.8 mg
- Egg yolks: 5.3 mg
- Peanuts: 3.3 mg
- Flaxseeds: 5 mg
- Spinach: 0.5 mg
Calcium is known for its role in bone health, but it's also needed for blood clotting, muscle contraction, and nerve function. The RDI is 1000 mg per day for most adults.
Lacto-ovo vegetarians who include dairy in their diets regularly shouldn't have trouble meeting their calcium needs while eating keto. However, if you avoid dairy, make sure to consume high-calcium keto foods listed below.
Best Keto Vegetarian Sources of Calcium
- Almond milk (calcium fortified): 300-450 mg per 225 grams (8 ounces)
- Sesame seeds: 273 mg per 28 grams (1 ounce)
- Greens (spinach, kale, etc.), cooked: 135 mg per 100 grams (3.5 ounces)
- Broccoli rabe, cooked: 120 mg per 100 grams (3.5 ounces)
- Almonds: 74 mg per 28 grams (1 ounce)
Vitamin D occurs naturally in moderate to large amounts only in fatty fish, although many dairy products and alternatives like almond milk are fortified with it. If you consume no dairy or vitamin-D-fortified products, you'll likely need to supplement with vitamin D (D3 is best) and/or expose your skin to the sun in order to prevent deficiency.
Sample Keto Vegetarian Meal Options
Like any other keto meals, meatless keto meals can be as simple or complex as you like. It's important to always include a good protein source, however, to ensure your needs are met.
The keto vegetarian meal options below provide high-quality protein, in addition to being well balanced, easy to prepare, and delicious.
Keto Vegetarian Breakfast Ideas
Keto Vegetarian Lunch and Dinner Ideas
Keto Vegetarian Snack Ideas
Although you're unlikely to need snacks if you follow a keto diet, here are a few simple, tasty vegetarian options:
Hundreds More Vegetarian Keto Recipes
There are hundreds more vegetarian keto recipes here and many vegan keto recipes here. You can find all savory vegetarian keto recipes by using the filtering tool in Recipes and select "vegetarian" and "savory".
Also, be sure to check out the free 2-week keto vegetarian meal plan with recipes and complete nutritional analysis for each day.
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