Vegetarian Diet and Keto
Can These Two Work Together?

Vegetarian Diet and Keto - Can These Two Work Together?ShareFollow us 139.9k

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:

  1. Ethical: Concern for animal welfare, including killing animals for food and/or confining them in feed lots or cages
  2. Environmental: Concern about land and other resources needed to raise livestock
  3. 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.

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

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

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

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

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.

Additional Resources

Take Home Message

Whether to eat meat and other animal products is a personal choice that should be respected by those with differing views.

Although combining keto and vegetarian principles into one diet can be challenging, it is definitely doable.

The most important factors to keep in mind are getting enough high-quality protein and micronutrients on a daily basis. It's also beneficial to keep your diet as varied as possible since food choices are somewhat limited.

Over time, you'll establish a keto vegetarian way of eating that is uniquely suited to your food preferences, health goals, and lifestyle.

Do you like this post? Share it with your friends! 

By Franziska Spritzler, RD, CDE
Registered dietitian, certified diabetes educator and creator of LowCarbDietitian.com

Franziska Spritzler, a registered dietitian and certified diabetes educator, is a strong proponent of carbohydrate restriction for people struggling with diabetes, insulin resistance, obesity, and PCOS.

She follows a very-low-carbohydrate, ketogenic diet for blood sugar control and has experienced many improvements in her health as a result of making this change.

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Comments (18)

I don't know how anyone can eat less than 50 grams of carbs on a vegan diet. It's not possible unless you are willing to make poor dietary choices or get deficient in nutrients. I've been vegan for over 10 years purely for ethical reasons. I've tried keto and followed a vegan keto diet for 7-8 months. I tracked everything, worked with a nutritionist and I'm also following one those keto vegan facebook groups. Still I was deficient in amino acids and several other nutrients. I don't eat legumes (IBS) and soy especially because breast and prostate cancer run in my family. So I made a choice... I still eat low carb but not at a ketogenic level and it works! You don't have to be keto to get the benefits.

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It is possible, but pricey. I'm talking about superfood powders and sprouted raw protein powders.

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Thank you Char! I did try them and I wish I could do that... but I wasn't a fan. I didn't want to let a diet rule my life completely. But I'm still low carb and I'm happy with that.

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Extremely informational! Great writer, thank you for the info.

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Thank you for posting this article, and for all the helpful, informative links.  I appreciate learning about different approaches, and having the information available to make the choices that work best for our family's health.  

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I just wanna say that I've been ketovegan since Feb and that it's possible to do it. As for soy having hormone-disrupting effects, organic eggs, dairy, meat, and chicken are full of hormones too. Grass-fed cows and free-range chickens are female animals, which means they nautrally produce their own hormones. Phyto-estrogens are weaker compared to animal estrogens. I do not need estrogens that are as potent as mine because I am already creating my own estrogen.

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As I mentioned in the comment below, it is great if you can make it work and find a way to get all the nutrients you need. But I beg to differ when it comes to soy. Soy is not a healthy choice for the ketogenic diet. Not all phytoestrogens are equal.
From Is Flaxseed Healthy? Safety Concerns, Benefits & Recommendations: In contrast to flaxseed's apparently protective effects on breast cancer, study results regarding soy and breast cancer risk have been mixed. Unlike the lignans in flaxseed, flavones and other phytoestrogens found in soy seem to either stimulate or suppress cancer growth, depending on dosage and other factors (www.ncbi.nlm.nih.gov/pmc/articles/PMC4129534/).
Also, this article is not about the vegan vs anti-vegan argument. It simply looks at the combination of vegan and keto, which for most (not all) people is not sustainable due to the very few choices. But since you mentioned this, the consumption of conventional meat - not organic meat - is linked to hormone disruption (www.ncbi.nlm.nih.gov/pubmed/28625952).

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I guess it's "the dosage and other factors" that is the fine print, like how stressed are the subjects, what else are they eating eating etc. If soy is really bad then there shouldn't be centenarians in Loma Linda and Okinawa. I'd listen to Dan Buettner, not to people out there who say the Japanese eat minimal soy.
There is something wrong with nearly all (if not all)foods. We all just choose our own toxins. I personally prefer to eat foods with much less POPs, i.e., foods that didn't use to be bigger filters than me when they were still alive.

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It's absolutely fine to do what you feel is best for you. But let's not go down the path of discrediting every piece of research that doesn't support your dietary choices.

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Soy is bad for you for so many reasons... especially tofu and soy milk. I ditched them years ago. There are healthier vegan options.

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Soy is bad if it's GM and if you are allergic to it. I am not crazy about soy, but I am Asian and have no problem with it, probably because I also eat raw food. Some people do react to it. I used to be afraid of soy but it turns out I am fine with it. I don't consume it everyday to begin with.

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It doesn't matter whether it's GM or not because that has nothing to do with its endocrine disrupting effects. You are Asian so you should know there is more to this. Most Asians have no problem with rice and can eat plenty of it. They can't metabolise alcohol and they can't metabolise dairy. Does that mean that what applies to them applies to everyone? "Probably because I eat raw food".... This is not science. Just saying.

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It is absolutely possible to follow a vegan keto diet. In just one Facebook group there are 14,000 members doing just that.
The amino acids are a question mark that we are very well aware and have devised solutions to ensure that we ingest sufficient amounts of all of them, including lysine and methionine. It does require a very close tab on food tracking. Soy and hempseeds are both complete proteins, but many of us also include a pea protein isolate in our diets, whether it's through a protein powder, a meat analog such as Beyond Meat burgers and crumbles, or a non-dairy milk made from pea protein, like Ripple.
It can be done. Many are doing it, and we're thriving.

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Thank you for your insights. Although it is difficult and I would personally avoid this dietary approach, it is great if you can make it work and find a way to get all the nutrients you need. I agree that there are some good protein sources such as hemp seeds or pea protein isolate, however, soy is best avoided. Apart from some fermented soy products, most soy products are heavily processed and have hormone disrupting effects.

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Erika, I wholeheartedly agree! Maybe we will even avoid the complications of a ling-term meat-heavy keto diet.

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The ketogenic diet is not meat-heavy. It is moderate in protein and high in fats.

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I stand corrected. Standard keto is animal-heavy. Someone died on a long-term keto diet. It bewilders me how he became selenium-deficient when animal foods are rich in selenium. He died of cardiomyopathy. The study is on PubMed.

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Char, I'm afraid you are missing the point. You say "Someone died on a long-term keto diet" - I say "Someone died on a long-term vegan diet". Now that's just an example of how meaningless these comments are. There is plenty of evidence contradicting what you are saying (especially the link to CHD). Of course, we can spend hours discussing the studies but I won't do that because this is not the place to discuss the vegan vs non-vegan question and I won't hijack this article by doing so.

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