How to Follow a Vegetarian Ketogenic Diet in a Healthy Way

Meat is a cornerstone of the ketogenic diet, but that doesn’t mean the diet is off-limits for vegetarians. As the high-fat, low-carb approach has grown in popularity, many vegetarians have wanted in on the hype and found ways to make it work for them, tweaking the typical keto diet menu and food list to fit within their meat-free lifestyles.

Given the high-fat, low-carb diet’s widespread adoption, plus the fact that it’s so restrictive — followers take in only about 20 to 30 grams (g) of carbohydrates per day — different iterations have popped up. Vegetarian keto is one riff. Others include:

• Cyclic ketogenic diet, which involves periods of carb loading (also called keto cycling)
• Targeted ketogenic diet, for which you take in a day’s worth of carbs in one meal before exercise
• High-protein ketogenic diet, with an increased percentage of calories coming from protein
• Mediterranean keto diet, which emphasizes monounsaturated fatty acids from foods like fatty fish and olive oil.

Let’s take a closer look at how to follow the diet as a vegetarian and whether it’s a good idea.

An Overview of How the Vegetarian Keto Diet Works

The keto diet puts the body into the fat-burning state of ketosis and requires followers to source 80 to 90 percent of their daily calories from fat, 5 to 15 percent from protein, and 5 to 10 percent from carbs. Most Americans get about half of their daily calories from carbs, according to a study published in October 2021 in Nutrients, so this is a major shift from the typical American diet,

It could be an especially startling shift for vegetarians, some of whom replace meat with pasta, crackers, and other carb-heavy items, says Jaime Mass, RDN, the founder of Jaime Mass Nutritionals in Fort Lauderdale, Florida. Mass refers to individuals with these eating habits as “pasta-tarians,” and she says that while transitioning to keto can be difficult for them, it may also be beneficial in helping them cut back on processed carbs and relying more on healthy plant-based foods and whole grains.

A Typical Day on the Vegetarian Keto Diet

Liz MacDowell, a certified holistic nutrition consultant behind the site Meat Free Keto, has been vegan for the past decade while following keto or other very low-carb diets. She decided to try keto with weight loss in mind. Some research suggests that the keto diet may be beneficial for that reason: A meta-analysis found that the keto diet led to greater weight loss than a low-fat diet and could be useful in fighting obesity. Additional research has also found that a ketogenic diet leads to greater weight loss and reductions in overall fat and belly fat in people with obesity compared with a low-fat diet.

Even though MacDowell has stuck with it for so long, she admits that this way of eating can be tough in social situations. “It’s not only the reaction of your family members, who will tell you eating that much fat will kill you, but going out for appetizers and drinks with friends is challenging,” she says. “You learn to work around it, but there’s a learning curve for sure.”

That learning curve involves figuring out which foods fit within the vegetarian and keto limitations. Here’s what a typical day on the diet looks like, based on recommendations from Mass and MacDowell:

• Breakfast Chia seed pudding with protein powder or protein pancakes made from eggs and protein powder
• Snack Sliced cucumber with paprika cream cheese dip or cottage cheese with sunflower seeds
• Lunch Large salad with avocado, vegetables, seeds, and nuts or an egg omelet with herbed goat cheese and pesto
• Dinner Zucchini noodles (zoodles) with pesto and tofu; sautéed vegetables with tempeh; or spinach salad with cashew-crusted tofu, grilled zucchini, cubed feta, and olive oil

The Risks and Benefits of Following the Keto Diet as a Vegetarian

Even though it’s tricky, it’s safe to say that following the keto diet as a vegetarian can be done. But is it healthy? And does it lead to weight loss?

That depends. If going keto motivates an unhealthy vegetarian to clean up their carb game, Mass says that it could be beneficial. Transitioning from a pasta-heavy diet to one that’s rich in veggies and healthy fats should help someone drop unwanted pounds, according to the Mayo Clinic. But for vegetarians who already rely on fiber-rich carbs like quinoa and oats — which are limited on the keto diet — to help them feel full, adopting low-carb keto might be overly restrictive.

The research on vegetarian keto diets is limited, but MacDowell noticed a handful of positive changes once she started following the diet. “I found that not only did I lose weight very quickly [though in a healthy amount of time], I also noticed things like joint pain was disappearing, my digestion was normalizing — little things that I didn’t at all expect,” she says.

Preliminary studies have also linked the keto diet to management of certain diseases, including type 2 diabetes. The previously mentioned study published in Nutrients, for instance, stated that, contrary to conventional beliefs, a type 2 diabetes diagnosis “can safely be reversed in many people using a very low-carbohydrate eating pattern, often while discontinuing insulin and other glucose-lowering medications.”

Still, Mass is hesitant to recommend this way of eating. “I don’t see many benefits to going keto vegetarian,” she says. The major concern is nutritional deficiencies. As MedlinePlus notes, vegetarians are already at risk of being deficient in vitamin B12, vitamin D, zinc, iron, calcium, omega-3 fatty acids, and protein. Keto then puts more restrictions in place, further increasing the likelihood of being deficient in some of these. For example, breakfast cereals, which are usually rich in vitamin B12, are not allowed on keto. On the other hand, many keto-approved cereals are not enriched with vitamins and minerals.

Protein is also a big concern. “Since the keto diet is relying on protein and fat for your calorie intake, you are cutting out many of the proteins you would be attaining — say from legumes and grains — on a regular vegetarian diet,” Mass says. “On a keto diet, this source of complete proteins is now essentially eliminated.” Protein is important to help the body build bones, muscles, and skin, according to MedlinePlus.

How to Follow a Vegetarian Keto Diet in a Healthy Way

By being aware of the nutrients you might be deficient in, you could (and should) load up on foods that are rich sources, such as tuna for vitamin B12, eggs for vitamin D, and leafy greens like kale for calcium, according to the National Institutes of Health. If you are open to it, you could try keto as a pescetarian, which means not eating meat or poultry but eating fish and seafood, which are great sources of omega-3s and protein.

The bottom line? This way of eating is tough to stick with because it combines two restrictive diets. Mass believes that the risks outweigh the benefits. But if you decide to try it, she cautions you to approach the diet carefully, ideally under the guidance of a qualified registered dietitian who can help you pick your foods strategically and ensure that you are supplementing the diet where needed. Mass also suggests reducing your carb intake gradually rather than going full-blown vegetarian keto overnight so you don’t completely shock your system.

Additional reporting by Jessica Migala.